My daughter has a friend, who for the sake of anonymity we'll call... um... Suzi. Sure, that works.
Suzi has suffered from some form of depression since I've known her as a junior in high school. I don't know if this has ever been treated by a doctor or otherwise diagnosed by some form of professional. Judging by what I have seen of her personality, I would guess bi-polar, but I am certainly no expert. To date, Suzi has had two failed attempted suicides, but no visit to a psyche ward, and as far as I know, no medication.
Last night, Suzi came to visit my daughter. Suzi's mother isn't speaking to her because she doesn't approve of some of Suzi's lifestyle choices. Also, she told my daughter that she had found a way to numb the constant sadness: Percocet. She'd had a bottle of 36 pills and had five left. After a week.
My daughter, having had to live with me and my struggles the past couple of years, asked some questions.
"Maybe you should go see a psychiatrist?"
"No! They'll lock me up in a white room, with a white gown, and feed me white food."
"No, it's not like that. I went to visit my mom in the psyche ward, it's not like that."
"Well I have friends who've been there, it's like that, I'm NOT talking to a psychiatrist."
So she tried another route:
"Maybe you should come in and talk to my mom. She knows how you're feeling, she can probably help."
"No, I don't need to talk to your mom. I don't need help. I've figured out how to help myself. I'm fine."
So she came to talk to me.
"Mom, how can I help her? She doesn't want my help and she doesn't listen."
I'm not a therapist, but the way I see it is either: A - we report them for illegal use of a prescription drug, they get put in jail or I pull some strings and have them put in a psyche ward for detox. They don't want to be there, they don't think they need to be there. They smile and nod and do what they have to do to get out, and then go back to their life, one friend less, and still make the same choices.
B - We love her, we continue to try to point out where professional help would be effective, we try to be there without being taken advantage of. And in a rose-colored world, they'd see the light, realize they need help, then WANT the help, and then get it.
B doesn't happen often.
In 28 Days, Sandra Bullock's character didn't want to be in rehab. Thought it was stupid, that she had her life under control, and that the rules for everyday normal people didn't apply to her. And then things happened to her in rehab that caused her to have a change of heart, have some serious introspection, and take a good honest look at the world and people around her. By the time she got out of rehab, she *wanted* the help.
therapy, advice, meds, whatever, they are all available, but they aren't half as effective as they could be if the person being subjected to them either doesn't want them, or doesn't believe they'll help.
A psychiatrist can get the med combination 100% perfect, and it won't do a damn thing if the person is convinced their life sucks, nothing ever goes their way, it's not going to work out, so why bother trying. If it's not worth trying, they're not even going to see the great things around them even when their mood does lift.
A psychiatrist can get the med combination partly right and a person who wants help will notice a difference immediately (Or if not capable, their family will notice) and communicate back and forth with the doc about what's working and what's not.
Depression changes thought processes, so part of being on meds is working to change those negative trains of thought into positive ones. Or if that's not possible, then learn to recognize the rhetoric and de-rail it with something else. If a person isn't willing to examine their thought process, the meds can't do a whole lot to help them, either. Meds can do a little, but meds cannot and will not do the actual thinking for you.
People who WANT help, will find it. People who don't want help but need it, then have it thrown at them, won't be grateful for it. While it might keep them safe and out of jail, they won't truly get better until they want to. That's just how it is.
All that being said, you don't magically heal and get better from depression. you know that, right? But the helps, the coping skills, the meds, the advice, the small things friends can do, all of that helps and matters. All of that helps dealing with the illness *easier*