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How to Help a Loved One: Depression, Alcoholism, Addiction ...

by Scott Haltzman, M.D.

help_couple_upset.jpg One of my favorite cartoons is something I found almost 20 years ago in a New Yorker magazine. In the first panel, a boy drowning in a lake yells, “Lassie! Get help!!” In the second panel, Lassie is lying on a psychiatrist’s couch, pouring out the contents of her heart.

When you suspect a friend or family member is having a hard time, you may also feel like shouting, “Get help!” But will that person be as obedient as Lassie? If he had broken a leg, he'd probably welcome your help. But for an emotional problem? There’s a good chance your suggestion will at best be brushed aside and at worst make your friend never want to talk to you again.

In fact, many people are so anxious about recommending emotional help for their friends and family members that they sometimes put it off until it’s too late. But your involvement can save a life! Here are some common problems and ways to deal with them.

When speaking to someone about depression, alcoholism, addiction or similar problems

Because your loved one may not see she has a problem, you might have to point it out. Gulp! Who wants to be the one to tell her best friend she may be mentally unstable? Like it or not, the responsibility to at least speak up may lie on your shoulders.

There are no hard and fast rules for helping a loved one. In the following sections, I'll talk about how to address specific kinds of mental health issues, but here are some general dos and don’ts.

DO point out your observations. (“I’ve noticed you’ve been acting differently lately.”)
accuse or point fingers. (“You’re not the person I married anymore!”)

DO turn to other people in your life for support when you prepare to talk to your loved one.
gather people for a Jerry Springer style intervention. It may further alienate your friend or family member. (See the box to the right for more on this.)

DO see the discussion as an opportunity to work together to help your friend.
see the interaction as a confrontation.

DO let your friend know how important he is to you and how much his well-being means to you.
give ultimatums, like, “If you don’t go for help, I’m out of here!” (If you do fear for your well-being because of your loved one’s behavior, you may have to leave. But simply threatening this action rarely makes people change.)


Often, depression is associated with social withdrawal and negative thinking. When people are depressed, they can feel helpless and sometimes believe they’re to blame for their suffering.


Avoid trying hard to brighten the mood by joking around. Also, tough love, such as, “Pull yourself up by the bootstraps,” doesn’t work so well.

Your best bet is to remind your friend you have faith in her and believe there is a brighter future. Because depression robs people of momentum, it may be up to you to schedule an appointment with a therapist. And that’s perfectly all right.

(Sometimes associated with schizophrenia, bipolar disorder and depression)

Psychosis is a condition in which someone loses touch with reality. It’s generally associated with schizophrenia but often seen in bipolar disorder or depression. Sometimes a person’s beliefs can become so distorted that he believes he’s being poisoned or spied on. In these cases, it’s often fruitless to try to talk the person into seeing reality your way.

If your loved one is already on medications, see if he’s taking them as prescribed, and coordinate follow-up care with the psychiatrist. If he’s not already in treatment, forget negotiating. It’s time to call the doctor. Even if he says he’ll never forgive you for calling, it’s still important to get help. In time, you’ll be forgiven.

Including alcoholism, drug addiction, gambling addiction and pornography addiction

help_scared_teenager.jpgOne of the main features of substance abuse is the tendency to blame others for your problems or to deny that a problem exists.

It’s a waste of time to debate someone who doesn’t want to confront her problem. It’s better to present your evidence directly: “Kris, I think your drinking is getting in the way of work.” If your friend is open to talking, you can start a dialogue. If, instead, she defends or denies, reinforce that you’re available to talk later and walk away.

If the substance abuser’s activities are dangerous to you or others in your home, you may need to ask or force—by police if necessary—your family member to leave until she gets treatment. Remember that there are good treatment options for substance abuse problems, including Alcoholic Anonymous, Narcotics Anonymous and medications. There are also support organizations for you, such as Al-Anon and Alateen.

Including smoking, overeating, neglecting hygiene and living in an abusive relationship

People don’t have to have an addiction to need psychological help. Those who smoke, overeat, or neglect their hygiene or safety have problems everyone else can see. And odds are, they know they have the problem. I ask all my patients who smoke whether they realize it’s dangerous, and so far every one has said yes. Obese people know they’re obese. Nail biters know they have no nails. Domestic-violence victims know they’re living in danger.

So if all these folks know that there’s a problem, why don’t they just stop? Because they can’t. Call it addiction, call it self-punishment, call it bad habits, call it lack of self-esteem. The problem is, you don’t know what to call it because it’s a professional’s job to figure it out. And that’s where your friend or family member should be looking for answers. (By “professional,” I mean nutritionist, doctor, therapist or physical trainer.)

Because your friend can recognize the problem, approach him in a collaborative way, by saying, “I know you’ve been having a hard time managing your ______. Is there any way I can help you get it under control?”


If behavioral changes are necessary, consider the fact that, in a supportive effort, you might also have to start an exercise regime or quit smoking. Pitch in and make solving the problem teamwork.

Part of caring about loved ones is knowing when they’re having trouble, and part of being an important component in their lives is sometimes stepping forward and help them see when they need help. If you act lovingly and respectfully, you can make your relationship grow even stronger.

Board-certified psychiatrist
SCOTT HALTZMAN, M.D., wrote The Secrets of Happily Married Women and The Secrets of Happily Married Men. He's also medical director of NRI Community Services , a behavioral-health organization in Woonsocket, R.I.

Last updated and/or approved: April 2010. Original article appeared in July/August 2008 former print magazine. This article is not meant as individual advice. Please see our disclaimer.


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written by Ana Almanza , May 03, 2010

My boyfriend stresses me out like Major Crazyness.I dont know if thats why i have depression.
report abuse
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