how do we get a depressed person help who doesn't want it?

[msnick]

My 24 year old step-daughter seems to be getting more and more depressed and won’t seek help on her own.  As background, her mother was in and out of her life from the time she was 5 until her mother died when she was 12.  She had difficulty in her teenage years and found solace in food.  We took her to family counseling (she has a brother 2 years younger, a sister 4 years younger-who have adjusted) and she attended individual counseling but she refused to open up and talk in the sessions.  She left home at 19, and returned with a baby three years ago.  Over the past few months, she has gained a lot of weight… she was always heavy, but recently has put on enough weight to go up 4 sizes, weighing over 250 pounds, at 5’2”.  She sleeps all weekend if she could, and when she is around the rest of the family (including her daughter) she sits as everyone else engages in the activities.  She is a closet eater, never eating in front of us, and hiding all kinds of food in every crevice of her bedroom.  We have made doctor appointments for her, which she doesn’t go to.  We have been positive in encouraging her to do it on her own, but she doesn’t.  What can we do? It’s obvious she is very sad and needs some help?  Can we force her by taking her to a community hospital for evaluation?  What would you advise?  

[Jaquta]

Could you physically attend the appointment with your step-daughter?  Sometimes people just need a little moral support (and a lot of encouragement).

I would think it would depend on how bad the situation as to whether it warranted being forced into being assessed (and treated if necessary).

We had a similar situation at home where we felt one family member was depressed.  Our family doctor said there was nothing they could do unless the family member sought treatment them-self.  They also suggested leaving to precipitate a crisis, in which case help would be needed (and hopefully sought).

I think that if you feel the person is significantly depressed then it would be appropriate to seek intervention.

I was sectioned under the Mental Health Act for severe depression and although I was severely traumatized by the hospital admission I think early intervention has the potential to make a difference.  I don't think I would have pursued treatment otherwise.  At that point I had withdrawn.  I refused to take medication and to talk to anyone (psychologist, psychiatrist, etc).

It sounds like something is definitely going on with your step-daughter.

It seems that your step-daughter may not have felt safe in the therapy, or with the therapist.  Or the therapy may not have been intense enough.

J

[Roger Gould, M.D.]

the law doesn't help you because unless she is of immediate danger to herself or others, you can not force an evaluation. The best method is persistent, honest and direct talk to her about her situation, highlighting that  treatment is absolutely necessary for her health and the health of her children, and the family that is supportive but also being put out by her behavior. Because she is a step daughter you may be too solicitous and careful about direct talk..but now is the time to do it.  There is a roundabout way that might also help.  My website, shrinkyourself.com, has a self help program for obesity that is psychological  and might open her up enough to get treatment.