Dear Beth

Helping a depressed family member

How to determine whether psychotherapy for depression is working. How family members can help a depressed person to resolve conflicts and gain self-confidence. 

Dear Beth,
My sister has been seeing a psychotherapist for two years for depression. At first she seemed better, but for months now she has been complaining to me that nothing seems to be happening and she does not know what to do. I said to get another therapist, or at least get another opinion, but she said her therapist told her that if she switches therapists she will not be able to work through the transference and the therapy will not work. Is this true? Also, her doctor prescribed medication for depression and our mother has been telling her to take it, but she is afraid that it will stop her psychotherapy from working and that her therapist will be angry. My mother says so dump him. This situation is really getting me down. What can I do?

Beth answers: It is true that if someone switches therapists whenever the difficult issues and stuck places come up the therapy will not work. However, getting a second opinion from a psychotherapist who is skilled in working with transference will not hurt the process, and might help your sister to decide whether she is on the right track. Regarding medication, it has been my experience that appropriate medication does not interfere with psychotherapy and often helps it.

I get the impression that your sister is used to having other people very involved in her personal decisions and is afraid to make decisions for herself. As different people have different points of view, this situation would be confusing and would perpetuate her stuckness and depression. When the family tries to decide what your sister should do, this re-enforces her tendency to wait for others to resolve her conflicts instead of getting down to the business of doing it herself.

You too are in a very powerless and anxiety-producing situation when you feel responsible for resolving your sister's conflicts, which only she has the power to do. You will reduce your stress level as well as help your sister's self-confidence if you can trust that she is the best person to sort it out. When we are testing our wings we may have a few spills--but it's the only way to fly.

For further information, see
Does depression run in your family?
Online counselling for depression
Seeing a psychiatrist for depression