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Depressed Messages from a Struggling Soldier

Dear Dr. Ryan,
A year ago, my youngest sister’s husband was discharged from the Army for medical issues pertaining to depression. He has been diagnosed manic depressive which he receives medication for. Occasionally, he sees a therapist and he often uses heavy drinking as a method of coping. Recently, he started instant messaging me and my wife (his sister-in-law) every few days. He tells of his hurt and struggles with depression and also that he uses overtime at work in order to avoid being home with his wife and two young daughters. Today, we found out that he has been messaging my other sister too and he has told her that intends to eventually kill himself and he wants her to tell the family that it isn’t their fault. We are confused and worried. How should we respond to these confessionals?
-Depressed Messages from a Struggling Soldier

Dear Depressed Messages,
Through my time at the VA hospital, I have worked with many depressed soldiers and many concerned families worried about what they should do. It is a difficult situation to be in and one that doesn’t have an easy answer. I commend you for reaching out for direction and I want you to know that your brother-in-law has many resources available to him, as do you as his family.

If he has been reaching out to you on a regular basis, it likely shows his trust in you and your willingness to be there when he sends a message. I do want to encourage you for your availability and support for him. The important thing to recognize however, is that while you can be an emotional support at times, you can’t be his therapist.

It is often difficult to know how to find the balance of support for someone that is struggling, but given the seriousness of his messages about suicidality, he needs a higher level of support that you and your wife likely can’t offer. It is possible that he is using your support as a way to build up to therapy, however it’s just as possible that he is using your electronic support as a crutch so he doesn’t have to fully engage in therapy. If I were in your shoes, I would continue to provide a level of support that you feel comfortable with, while also giving him strong encouragement that he needs to fully commit to the therapeutic process.

It will be important to know about the therapeutic resources available to your brother-in-law. He is able to receive a range of individual and group therapy services as well as psychotropic medication from any VA facility. Since you mentioned that he is receiving medications, he has likely already found a facility close to him.

Both Unipolar Depression (feels down, depressed) and Bipolar Disorder (feels both up and down; also known as manic depression) are responsive to treatment. Although Bipolar Disorder can present a wide range of challenging symptoms, specific evidence-based psychotropic medications and therapies have been developed. While it is possible that he may experience symptoms of Bipolar Disorder throughout his life, the therapeutic resources available to him in the VA or in the community can help him in being the husband and father that he wants to be. Lastly, know that if suicidal ideation worsens for him the veteran’s crisis line is always available, as is his local emergency room.
-Dr. Ryan

This was originally posted on DearHoopers.com

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