I am Kailash Mittal, a 38 year old police officer. My wife Maitri attempted suicide about 15 days back. This is her 3rd suicide attempt in the last 2 years. She has been diagnosed with depression. She feels that she will never get better. She is taking medicines for the same purpose but is not very compliant. I am ready to take leave from my job and be with her; however, I do not know how I can help her. Please advise.
Non-compliance with medications is a major problem for relatives of psychiatric patients. The reasons for non-compliance may include discomfort resulting from side-effects, the expense of treatment, decisions based on a personal value judgment, religious and cultural beliefs about taking treatment, maladaptive personality traits or coping styles and a presence of a symptom of the illness itself. Maitri appears to have the reasons of severe depression in which the willingness to take the medication and improve is not there, the hopelessness that she will ever improve, a feeling of helplessness and a judgment that medications are not helpful for her. It has been found that compliance with treatment is there in acute states and in the initial phase of the illness, but for chronic illnesses and in prolonged treatments, the patient may often lose faith. Compliance is most likely when there is a satisfactory relationship with the care-giver, in this case, you. Enthusiasm and spending more time with her will also increase her compliance. She will be more likely to take medicines if she is reassured that the medications will lead to an improvement; that the illness is severe but treatment will help. It will help at the present time, when she is in the hospital and symptoms are obvious. However, she has to recognize that the amelioration of symptoms does not mean that the depression is over and she may need to continue medication for some time after she is better. Encourage ancillary aids along with antidepressant medications. She needs to hear that there is hope that things will get better with time and effort. Encourage her to get help. Listen and talk openly about the depression. Let her tell you how she feels. Accept her feelings and be willing to talk about them. Compliment and encourage her. If you have good things to say, this is the time to say them. Do not criticize or judge her. She is already feeling bad herself. Do not add to those feelings. Smile, hold hands and hug a lot. Affection can go right to the heart and give real comfort. Do not be easily pushed away. She may lash out at you. Stick to her, no matter what happens. Encourage her to go out. Take her to good restaurants or movies. There is a lot of emphasis on recognizing depression in modern times. Depression can last days, weeks, months, or a lifetime if untreated. Some have a brief depression, recover, and the problem never returns. Others have bouts of depression throughout their lives. And some may never recover from mild depression. It is usually a recurring disease. After one episode, there is a 50% likelihood of having another within 5 years. The sooner it is treated, the better. Left untreated, a few bothersome symptoms can turn into a disabling condition. This can damage her marriage, family relationships and friendships, job performance, and health. It can shut her from the love and support of friends and family. Most threatening is the danger of suicide. Prompt treatment and continuing support can mean the difference between life and death. As depression lifts, the old self will start to reappear. The world will seem as before. She will begin to make judgments as in earlier times. Work will seem appealing and absorbing again. Activities of fun will seem attractive. The purpose will start to instill each day. Life will have meaning once more. There may be pockets of depression but they will gradually go away. Remember, progress is like a roller coaster. You are up one moment and down the next moment. However, you will learn how to live through the tough times, which will decrease, with proper help. There will be times, though when she will relapse again, and you may feel that it is the same thing again and again, but do not give up.