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My father-in-law admits he's depressed but refuses treatment

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The question

My father-in-law suffers from depression. He admits this but he hates what he calls the "medical model", including psychologists, and refuses to see a professional. Is there any way to help him with his depression?

The answer

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Although as a society we are gradually improving in our awareness and understanding of psychological health conditions, unfortunately a considerable amount of stigma continues. Stunning, given that the statistics indicate that one out of four Canadians (or more) will at some point in their lifetime struggle from a diagnosable depression or anxiety disorder.

Individuals from certain demographic groups – including older adults, men, and those from certain cultural backgrounds – tend to have even more difficulty than the average person in both admitting to and seeking assistance for mental health issues.

Often this comes from a combination of not fully understanding what psychological health difficulties mean or entail; feelings of shame or embarrassment; feeling that one is "weak" for having emotional difficulties; and hopelessness that their difficulties are not getting better.

Your father-in-law admitting that he he has depression is a positive step. His statements of "hating" the "medical model" may be grounded in a lack of understanding of what treatments look like, and a lack of hope that treatment could be helpful.

I wonder what he means by "the medical model". Certainly the traditional medical model view of mental health issues (i.e., that a biochemical imbalance unilaterally leads to illness) is not supported by the research.

The evidence is very clear: that, like most physical health conditions, psychological difficulties such as depression are the result of a complex interplay of a number of factors: Genetics/family history, early childhood experiences, stressful life events, personality factors, our ways of thinking, and the behaviours and actions we engage in all play an important role in whether or not any one of us develops depression.

Start by speaking to your father-in-law and indicating you are worried about him. Acknowledge that you understand he has strong feelings about the medical model, but that you understand there may be other effective treatments out there that may help him that maybe he could think about exploring.

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Try to understand what exactly he is resistant to. Is he worried about taking medications and becoming "addicted" or having side effects? Has he tried treatments before that were ineffective? Is he nervous about sharing private issues with someone? If you can better understand his apprehension, you may get useful information that can help you know how to better support him.

You may also find it helpful to read more about ways to support a family member with depression. You can find useful links to a number of free, evidence-based individual and family resources for depression on my website at www.drjotisamra.com, under "Individual/Family Resources".

Send psychologist Joti Samra your questions at psychologist@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Read more Q&As from Dr. Samra.

Click here to see Q&As from all of our health experts.

The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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