I have a very dear friend who suffers from depression. He is 19, and I often fear he will end his life. He is very smart but also very stubborn. He has gotten in trouble with the law, which finally led him to see a therapist, but he does not put any effort into it. He says the doctor hates him and is a bad doctor. He is not talkative and has trouble expressing himself, so it is difficult to communicate with him. He wants to get better, but he believes it's hopeless. He trusts very few people. He has given me permission to choose a doctor for him. How do I know what doctor will be good for him? How do I convince him that he needs to take his medications? Are there any books he or I should read? I'm only 18, and I'm trying to do what's best for him.

S.

What a difficult situation for you to be in. I commend your concern about your friend, and while I can't make specific recommendations without evaluating him personally, I'll mention some possibilities you (or he) might consider.

Before I do that, however, I want to emphasize that the ultimate responsibility for your friend's recovery lies with HIM... not with you, and not even really with his doctor or therapist. Even the best therapist in the world can't help someone who won't participate in the process. And while there are certainly some bad or incompetent therapists or doctors out there, it's also common for people who are reluctant to look at or change things about themselves and their lives to continue that pattern by blaming their helpers (and others) for their lack of progress. People who are forced into therapy by the courts, employers, family members, etc., also frequently refuse to truly engage in the process, and thus don't get much out of it.

There's also a tendency for people who feel bad about themselves to project that onto those around them -- again, including helping professionals -- and perceive them as feeling and acting negatively toward them even if that's untrue. And some people who had abusive or controlling parents especially have trouble relating to therapists or doctors, or other people they perceive as having authority over them.

That said, if you still want to find a new therapist for your friend, you have several choices. You can get some possible names from your own therapist or physician, or from the psychology department of a nearby university or college. You can encourage your friend to talk with his current therapist about his dissatisfaction with therapy (which is a good idea in any case), and have the current therapist make a referral if the problems can't be worked out.

There IS hope in resolving even severe depression... but again, the individual must truly engage in the therapy to get any response. If your friend continues to refuse to participate in therapy or take prescribed medication, and you continue to worry about him, please consider consulting with a therapist yourself, if you haven't already, for support in managing your fears about him. Good luck.