What I’m struggling with is how to talk about things that I think are a result of his depression but are affecting him, or us, and need to be dealt with. On the ‘mostly affecting him’ side are things like not going to the dentist or eye doctor. On the ‘affecting us’ side are things like a very low sex drive and fatigue that affects our plans or his responding to texts/calls.
How do you have conversations with someone about things they aren’t doing/need to do without making them feel like crap…when the reason they aren’t doing them is because they already feel like crap? — Apprehensive Girlfriend
First of all, what does “planning to back to therapy soon” really mean? I get that out-of-pocket therapy is cost-prohibitive for a lot of people and that insurance is often a whole mess of red tape, but what steps is your boyfriend actively taking to deal with these roadblocks? When you say that even “shopping around” for a therapist is difficult, it sounds like the hunt for a therapist hasn’t even really begun, never mind making an appointment. And when your boyfriend hasn’t made appointments for other medical needs he has – dental and vision care – there seems to be a theme here, right? And, yes, this theme of self-neglect could be a symptom of his depression, as could his fatigue and his very low sex drive, which are affecting your relationship, which is all the more reason for him to address the underlying issue – his depression – as soon as possible.
So, how do you address these issues with your boyfriend without making him feel like crap? Maybe you don’t prioritize avoidance. Instead of avoiding “making him feel like crap,” accept that he already feels like crap and you aren’t the one making him feel that way. His mental health is making him feel that way, and you want the mental health addressed and treated so that he feels better and your relationship improves. So, while his dental health is important and your sex life matters, neither will really improve much until the mental health issue is addressed, and that should be your focus.
Your boyfriend needs therapy now; he would likely benefit from a consultation with a psychiatrist to discuss treatment options – like medication, for example – as well. These things cannot be put off. If “shopping around” for a therapist is difficult, help him. If costs are a barrier, research all the options within your boyfriend’s insurance, but also sliding scale therapy, low-cost online therapy, community resources, and local universities that may offer low-cost therapy sessions with graduate students studying psychology.
Let your boyfriend know that the symptoms of his depression are affecting you and your relationship and need to be addressed pronto. Will this make him feel likeo crap? Maybe. But doesn’t not addressing all of this feel pretty crappy, too (for you and for him)? Eventually, if you both let these issues continue, you’re going to feel resentful and want to leave. That would feel pretty crappy, too (for both of you). If you need a script to get the conversation started, try something like this:
“I love you and am very happy that you’re my boyfriend, but I’m concerned that your untreated depression is a threat not just to your mental health but also to our happiness together, and I want to help you find the treatment that you need. This need feels urgent to me and something we should prioritize above everything else because it affects so much in your life and in our relationship.”
Once he actually has a therapist, you can share some concerns you have – like his sex drive and his medical needs – that he might bring to his therapist. I think bringing these issues to his attention now, when he has nowhere to go/no one to help him address the underlying cause, would backfire, which I suspect is your fear when you say you’re afraid of making him feel like crap. Because, yeah, it’s a super crappy feeling when you know there’s a problem but you don’t have the tools to address or fix the problem. And when someone you love points out more problems that need fixing – which you probably already know about anyway but are too depressed to deal with – without offering any solutions or tools, it feels even worse. So focus on helping your boyfriend find solutions and tools right now, in the way of professional mental health attention. Once those supports are in place, it will be much easier to bring up issues he can address with a therapist, like how he needs a dental cleaning and you need to get laid more often.