What I would like to share with you, and in turn, hear you share your thoughts about, is chronic unhappiness. Is there ever an end to depression and its shadow? Is there a way to “get over it’? My goal is to be able to live beyond depression and to actually grow from it. Sure, I hate those books where people claim to be grateful to their depression… but I hate it mainly because I resent their ability to feel that way! What do you think?

There’s no way to “get over” problems you have no control of in the first place and, no matter what form it comes in (shitty in-law, brain tumor, Hurricane Earl, etc). Chronic unhappiness is high on that “uncontrollable” list.

So now you have to ask yourself what it means to “get over” an uncontrollable problem. Usually, it means you’ve asked yourself to do the impossible and thus given yourself a chronic headache to top off your chronic unhappiness.

Know your exact strain of chronic unhappiness so you can figure out what you can and can’t do with each one. Depression is unique in being a thought-distorting illness: it’s more than a poor outlook or a bad mood caused by bad luck or a rough divorce (or both at once). It’s a bad mood that goes on and on, even when you win the lottery or hit your 50th anniversary.

As an illness, it hits you with a variety of complicated, brain-related symptoms, like messed-up sleep, appetite, focus, energy, social urges, and sexual reflexes, and that’s not counting the storms of anger and/or anxiety. It’s a bad mood on steroids.

Having an unhappy life, on the other hand, can make you depressed, but not necessarily. Some people with happy lives can get very depressed, and some people with grumpy personalities aren’t depressed, although other people may wish they were. In each case, figure out, through trial and error, what you can and can’t do. Each strain is unique.

To “get over” your “getting over,” try cognitive therapy. It protects you from negative thinking by attacking the plausible, idiot assumptions you make without thinking, the most dangerous of which is that you should be able to get over chronic unhappiness.

Once you’ve done what you can do with your particular flavor, whatever that is, give up and chill out. It’s time to go on with work and relationships, however much your chronic unhappiness hurts or slows you down. The better you do that, the more you’ll grow.

No, no one should be grateful to aging, loss, and chronic pain—I think we’d all be happier with fewer “growth opportunities”—but there’s no choice. This is the life we’ve been given, so take pride in what you do with it, with or without depression (or a brain tumor).

STATEMENT:
“I don’t know why these blues won’t leave me alone. Maybe I inherited them as part of a gene-package deal from my creative, reach-out-and-connect-with-people ancestors. In any case, I’ve done what I can to manage them and I haven’t let them make me lazy or isolated or self-absorbed, and that’s a major accomplishment (which I’d be happy to do without).”

My younger brother is four years younger than me—that makes him 26, but you’d never know it because he acts like a freaking toddler. He’s not mentally impaired, he’s responsibility impaired. He dropped out of college to “find himself,” and he’s still searching, sometimes getting crappy jobs but mostly going on “adventures” and landing our parents with the bill (and sometimes the bail). I love him, but the older we get, the more I worry, because our parents won’t be around forever and I can’t be the one to clean up his messes—I’m not rich and I have my own kids to care for. Is there anyway to get him to take life a little more seriously?

Sorry for the obvious response, but the real question is, are you serious?

I’m sure your brother would say he’s serious about experiencing joy and living in the moment and that you ruin your chance of present happiness by worrying too much about things that aren’t going to happen. In other words, he’s not going to change.

Even thinking about trying to reform him will backfire and trigger conflict. You’ll give your brother a worried look, he’ll return that with a look of tolerant condescension, and your parents will accuse you of undermining his confidence. This will all leave you stewing about good deeds, their punishment, and his bullshit.

Forget about your responsible feelings and figure out what a good sibling should do to help one not-so-good. Your parents have shown you that rescuing him does no good, so rejoice. Since they’ve proven there’s not much you or anyone can do that will actually help him, there’s nothing much that you have to do, period.

When he makes a mess, help him help only when you think it will do good and it’s not someone else’s job; that won’t be often and it won’t drain you dry. The rest of the time, give him your best wishes, condolences, and directions on what he can do if he can get it together.

Don’t expect to feel comfortable, at least not at first. Your guilty, responsible feelings will be stirred up, but if you don’t keep those feelings hidden, other people will stir the pot. If experience and logic tell you that you’re not responsible, believe them and act accordingly, regardless of how you feel or what the rest of the family has to say.

Announce, don’t communicate. Let him know what you think is best without paying much attention to his response. Yes, it would feel better if you could get him to agree, but your need for agreement opens a door you want to keep closed.

He’ll keep his carpe diem attitude, and all you have to do is keep your end of the bargain, on your terms. He can go find himself, and you can find some peace.

STATEMENT:
Here’s a statement to keep you from trying to change him or win him over. “As much as I want to protect my brother and parents from his irresponsibility, I know I can’t. He will wind up in horrible messes. I will not stop loving him, caring for him, or doing for him if there’s a real chance to help. Most times, it will hurt to watch him suffer, but I will not turn away.”

I decided recently to listen to my friends and family and see a psychiatrist about my depression, but I don’t know whether I’ve made the wrong decision, or whether I’ve just chosen the wrong doctor. Basically, I decided to get help because I feel helpless, but my doctor wants me to do a lot of the work myself and doesn’t really help that much. It’s not just he wants me to ask myself a lot of questions (and answer them—if I had the answers, would I really be paying him?—but also deal with my insurance company and read up on the medication he suggests (he tells me about them, sure, but he says I owe it to myself to read up on them on my own, and that doesn’t make sense to me since he’s a doctor, knows everything about the pills, and he could just tell me himself). My goal is to figure out whether therapy is worth it, or whether I’m just getting help from the wrong source.

I hate to sound like your psychiatrist, but ask yourself what you have a right to expect from treatment, given what you know about its limits and your resources for paying for it.

If you want, you can spin things positively by saying that you’ve heard about good new treatments that can really help and that you’ve got great insurance that you pay a ton of money for. Of course, you’d probably be full of shit.

You don’t need to do months of research to know that no treatment has yet been acclaimed as a cure for mental illness or any other life- or personality-related problem.

Plus nothing you’ve read (or probably haven’t bothered to read) about the effectiveness of any current treatment implies that it works 100 percent of the time or that the treatment, if medical, is safe from possible side effects.

In addition, every method of “screening” for depression that you’ve heard about involves a questionnaire, right, rather than a blood test or scanning machine, which means that the burden for enduring, measuring and tracking the results of a trial of treatment falls, inevitably, on you the patient. And those are unfortunate facts of life whether you’re rich or poor, smart or stupid, board certified or not.

That’s the next problem: you’re not rich. And while you bristle at having to deal with insurance limits, you can’t afford insurance that would give you unlimited mental health treatment because it doesn’t exist. All insurance puts a limit of some kind on the amount of treatment you get and, unless you know what that limit is, you’ll use up your resources too quickly and have no idea about what, if anything, entitles you to more.

In addition, insurance limits your doctor’s fees and the amount of time s/he can afford to spend on a visit, so don’t fall for the professional who is ultra-amiable until your money runs out. Instead, look for someone who gives you what you most need in as little time as possible. In other words, beware smiles and frills because they may drain your limited resources.

Depressed people like yourself also tend to get negative and helpless ideas, which make them act negatively and passively, which makes them yet more depressed. That’s why mental health clinicians will push you to challenge your negative assumptions, learn more positive ways of thinking about your problems, and put the breaks on the depressive cycle.

It’s a cognitive kind of psychotherapy and is very helpful, although it’s often unpleasant in the beginning because you need to clamp down on your natural instincts. It’s a mental workout to make your non-depressive muscles stronger. No pain, no gain.

So yes, therapy of all kinds can be worth it, but you’ll be the one doing much of the work, not because someone else is slacking, but because mental illness sucks and both treatment and the resources to pay for it require careful management—by you.

Now you just have to decide what’s harder—doing the work or doing nothing. It might not be what you want to hear, but there’s no psychiatrist out there with a better offer.

STATEMENT:
Here’s a statement to keep you positive about a negative treatment process. “It’s hard having an incurable illness and knowing that the treatments are iffy, take a long time, and can easily use up my insurance before helping me, but I owe it to myself to give every reasonable treatment a try and become and good resource manager because that’s what I have to do.”

I’ve been in therapy for five years, and while I like my therapist a lot, I’m moving soon (my girlfriend got into grad school on the west coast), so I’m ending my treatment with her. She asked me recently though whether I was going to continue my treatment in my new town or whether I thought I’d taken it far enough, and I realized I honestly don’t know. She had some suggestions in terms of determining when and why to end therapy, but to be honest, they didn’t really help. I’ve been in therapy long enough that I don’t really remember how I coped beforehand, and while I feel much less tormented than I did when I began therapy, I’m not sure if my state of mind will crumble once I’m no longer getting help. How do you think one can determine when therapy has run its course, or whether there’s more to be done?

There’s a simple way to figure out how much talking psychotherapy you need: imagine paying full fee for it.

Before you crunch the numbers, ask yourself why you started therapy in the first place. Forget self-improvement, introspection, or generally pondering your bellybutton. Figure out what’s so bad about the way you feel and/or handle your life that you need to continue to spend lots of time and money on changing it.

Having failed to solve your problems over the past 5 years, you should wonder whether you can realistically expect a cure in the next year (no way) or whether you need maintenance treatment to keep you from slipping backwards (which is what you’ve been wondering all along).

At the same time, go back to the original question and ask yourself how much you can afford to spend on treatment each year and whether you should hold a few sessions in reserve for use in emergencies.

Unless you’re rich, don’t waste time worrying about how stopping treatment will make you feel. Instead, try stopping and see what happens. Even if you miss your therapist’s support, lose confidence, and re-experience your nervous stammer, suck it up, give it time, and the earth will continue to turn.

Next, think of therapy as a course that’s supposed to give you a specific marketable skill in exchange for your hard-earned debt. Don’t think like a college kid; you’re not there to party, please your parents, or become cool. If the first few sessions don’t deliver what you need, drop the class.

If you do have ample insurance coverage for therapy, don’t let it make you forget basic resource management skills. For one thing, many insurance policies are stiffening the limits on outpatient psychotherapies and are about to force you to do the above.

For another, being an active manager protects you from unnecessary dependence and time-wasting. Give your therapy specific goals, then examine how close to those goals you’ve come.

If therapy is more about discussion, then save the insurance hassle and start a search for a fun hairdresser. You can get your hour of talk and never have a bad hair day.

STATEMENT:
Here’s a statement that keeps you focused on making the best of limited resources instead of going for all-you-can-eat and then feeling deprived and abandoned. “I like psychotherapy and feel it’s been good for me, but it’s time, before it eats up more time and/or money, to think hard about how badly I need it, how well it’s working, how much is necessary, and how much I can afford to pay for it. The more I answer these questions for myself, the less likely I am to depend on experts to tell me what I need.”

I recently started going to a doctor for my depression. She thinks I should take pills, I’ve seen lots of articles about how antidepressants don’t work and the main reason they’re prescribed is because of the huge investment that big pharmaceutical companies have made in producing and marketing them. It makes sense to me that there are better natural, holistic solutions that get played down by the medical establishment because they can’t make money for anyone and threaten the profits made by those companies. My goal is to find treatments that work best, not the treatments that server the corporate interests.

The problem with most criticism of current drug treatments is its hopefulness; it implies that there are good, effective, cheap and low-side-effect treatments for depression (that are being suppressed). If only principal clause of that statement were true.

Sure, a magic bullet, holistic or otherwise, would be great (there are lots of other unsolved and incurable problems I can work on, so I’m not worried by the hit my business will take).

The truth is, however, that current treatments are time-consuming, weak, often costly, sometimes risky, and not guaranteed to work

Please resist the temptation to change the subject to tell me why current treatments are costly and often ineffective. You’re entitled to be angry about that sad fact, as about any other of the tragic, unfair and irritating facts of life, like tailgaters, the fact they cancelled “Firefly,” and almost anything having to do with hospitals and health insurance.

As much as I agree with you, I don’t want to hear it; you’ve got a job to do, and anger is a distracting escape from facing what you need to deal with if you’re going to manage treatment decisions for depressive illness. Instead of getting mad at your hand, play the cards you’re dealt.

Your treatment choices for depression aren’t that complicated…once you accept the fact that there’s no way to tell in advance which treatments are going to work or what side effects you’ll encounter. If you’re not in a hurry (i.e., if your depression isn’t about to push you out a window or immediately end your relationship with wife and family), you begin with non-medical treatments, like cognitive behavioral therapy, exercise, and diet and life-style changes.

If the symptoms are severe or longstanding or coming back after previous bouts, then you also experiment with antidepressant medications. This isn’t because Pfizer decrees it so, but because non-medical treatments are unlikely to perform miracles and an antidepressant medication improves your chance of recovery, even though it also has possible side effects.

If you want to try holistic remedies first, by all means, go ahead, but approach those treatments with the same care you would conventional ones; do your research to see what the data show in terms of results and what the side effects might be. Most data are inconclusive, but if you believe the treatment is working, then take that placebo to the bank.

Either way, you know the major principle of risk management: the more desperate your condition, the greater risk (pain, side-effects, cost, etc.) you should be prepared to bear in your effort to manage it. Draw on your own experience of your symptoms, their severity, and their impact on your life, as well as what the experts tell you about them, to decide how desperate you are.

It’s not a big pharma conspiracy against your health; your options just aren’t that great, and you have to figure out which one will work out, if not perfectly, then best.

STATEMENT:
Include your doubts about medication in a statement that focuses on management, not resentment or silly hopes for hidden cures stashed away in a cave with Sasquatch. “If I ever decide to use medication, it will be because I’m desperate and other methods haven’t worked. At that point, I’ll try to figure out their benefits and risks by looking at scientific, controlled studies, not emotional statements based on single cases or uncontrolled, badly selected patient populations. I will consult specialists and authorities to explain why they place faith in particular data or don’t like someone else’s data; but I will then make up my own mind, shutting out my emotional response to charisma or sincerity or a desire to include everyone’s opinion. When it comes to decisions about my health, I deserve a good, objective risk manager—me.”

I know the tranquilizer I take is addictive and interferes with my memory, but it’s the only thing that works when I get really anxious, and the other drugs I’ve been given for anxiety made me sick and didn’t work. I’m anxious because I’m stressed by some unusual recent events, which I’m sure I’ll get over in time, and then I won’t need to take medication. So my goal is to get the medication that works for me and avoid the stuff I know is going to make me sick.

It’s wonderful to get relief from severe anxiety, which is a terribly painful and frightening sensation. So I hate to make you more anxious by telling you that, unfortunately, there’s no good, safe medication that provides rapid relief.

The medications that provide rapid relief pose high risks of addiction and impair memory and balance, and the medications that are safer don’t provide rapid relief. That’s not very reassuring, but if you don’t cowboy up and face that fact, you’re in for trouble.

Remember, anxiety isn’t the worst thing that can happen. Much worse is what anxiety can make you do, like avoiding whatever stirs it up, medicating with alcohol, and making it your goal to feel less anxious. Given these dangers, your real goal is to do what you can to reduce anxiety while not letting it change what matters to you.

Don’t stop trying alternatives to addictive drugs because previous trials failed—that’s anxiety whispering its lies. It tries to tell you that everything that caused you pain in the past should be avoided now and in the future.

If you find yourself listening to that shit, you desperately need some cognitive therapy to help you straighten out your thinking. You can get it from books or a therapist or hanging out with anxious people who have learned how to manage their fears. There isn’t an actual Anxiety Anonymous, but there are groups like it.

If you stay with your current plan, you’ll not only lead a restrictive life, but you’ll tend to choose immediate relief over long-term advantages, whether it’s in treatment, jobs, or relationships. At that point, your anxiety is managing you, and that’s a real cause for worry.

STATEMENT:
Here’s a statement to keep you strong. “I need to develop new methods for dealing with anxiety because, as much as I wish it weren’t true, anxiety will always come back, eventually, and the tranquilizers that give me great relief in the short run will cause problems if I take them for too long. There are lots of non-medical techniques I should learn; and, if they aren’t sufficient, there are lots of non-addictive medications I should try that have a very low risk of causing serious harm. I need the courage to do what makes most sense to me, not what my anxiety would prefer.

My husband worries a lot about my drinking and depression but, to my mind, I don’t think my drinking is a problem and I don’t think I’d be depressed if I wasn’t worried that he’d leave me. For the sake of our marriage, I’ve agreed to stop drinking for a while and go to AA, but I really feel that my drinking wasn’t causing me any problems and that I’m doing this to make him happy, which makes me feel weak and angry. I want to get him to accept me the way I am before I can’t take it anymore.

You’re in a tough spot, because partnership really can’t work without acceptance, and acceptance is not something you can control. The more you force acceptance, the harder it is to achieve. Accept that, buddy.

If you try too hard to get his acceptance, you’ll hide whatever you think he won’t accept, which means putting your drinking in the closet and going to the mall instead of AA meetings.

On his end, if he tries too hard to make the relationship work, he’ll pretend you’re not really drinking or that you’re going to change, which also means no real acceptance.

The sad fact of life is that you are never going to change who you really are, which, at the very least, is a girl who enjoys drinking, and he’s going to have to take it or leave it. On the other hand, if you present the issue positively and he considers it realistically, maybe acceptance will occur, now that you’re not forcing it.

That’s why your goal shouldn’t be to win acceptance from your love; it’s to find out if your love can be accepting. He doesn’t need to like your drinking, but you need to know whether he can accept that it’s part of your package and accept the whole deal.

Instead of getting him to accept you the way you are, begin by accepting yourself. Forget how much you like to drink and ask yourself, on the basis of your own experience and what you’ve read, whether drinking gets in the way of anything you hold dear, like your health or making a living or being a good woman and a good friend. If in doubt, stop drinking for a while and see if there’s any difference.

Once you know your own mind, lay things on the line with your husband in a positive way. Of course, if you’ve come to agree that you’re a lush, let him know that you want to stop drinking because you believe you need to, and not to please him.

Otherwise, state your differences positively while letting him know how much you’d like him to accept you, if he can. If he can’t, then that’s a sad reality you both have to accept on your own.

STATEMENT:
Prepare a statement of your own views that is not overly reactive to his. “I respect your concern for my drinking and regret that it worries you. I’ve looked hard at how much it affects my health, work, and friendships. In the end, I don’t see it as causing me problems and, as much as I love you, it won’t help our relationship to appease unfounded fears. I hope you’ll accept my decision. Meanwhile, I think we should drop the topic of my drinking and, hopefully, move on to other things.”

My daughter is severely bipolar and lives with us so my wife and I can try to make sure she takes her meds and doesn’t hurt herself. We aren’t always successful—she’s practically an adult now and hates when we parent her—so she stopped taking her meds because she thought she didn’t need them anymore. Now she’s extremely manic, maybe using hard drugs, and extremely irritable. We’re absolutely helpless and there’s nothing we can do because she won’t talk to us. Our goal is to get her to listen to us, stop drugging, and get back on her meds.

Mental illness makes all families helpless; after all, it’s hard to have a dialogue with someone whose brain is diseased, irritable, inattentive and unresponsive. You’d have better luck reasoning with a rabid wolverine.

If you believe that your only power derives from your ability to have a heart-to-heart talk with her, then you are, indeed, helpless. The good news is, you’re wrong. After all, you can help wild horses improve their self-control without first teaching them English. Thus, you, too, can become a bipolar whisperer.

As parents and landlords, you control a number of powerful incentives, like access to money, car, refrigerator, shelter, and, oh yeah, money. That doesn’t mean you can control her or her illness, but it does mean you can create some pretty strong reasons for her to do the good things she needs to do.

Set rehabilitation goals for your daughter that you believe are truly essential, which will probably include sobriety, doing enough household chores in order to live independently, controlling violent behavior, and stopping sudden impulses from affecting her safety or treatment. Add or subtract from these core goals, based on your own experience and other parents’ war stories.

Once you know your priorities, announce them and back them up with rules and incentives for following them. I said announce, not converse. If you’re too worried about her anger or hurt or lack of understanding, you’ll be ineffective.

Don’t pick a fight, but don’t hold back on saying what you think with friendliness, conviction, and optimism. Tone of voice is as important as content. Don’t end sentences with a rising, Valley Girl inflection that asks for approval. Use the same calm, assertive energy praised by Cesar Millan.

Yes, there’s a risk that she’ll do something dangerous or force you to ask her to leave, but a bipolar-veteran parent knows how to manage crises without appearing to panic. It’s a risk you need to take, and be prepared for, because the alternative is way worse than facing an angry four-legged beast.

STATEMENT:
You need a statement that says, “This is what we believe, here are the rules that are required for self-control and independence and this, very simply, is what will happen if you don’t follow them. There are no punishments and we do not believe you are being stubborn or childish; but we will withhold privileges and, if necessary, ask you to live elsewhere for a while if we think it’s necessary, either because your behavior makes it impossible for us to live with you, endangers your safety, or blocks you from making progress.”

My biggest frustration on a daily basis is having someone ask me a question and then either get angry in response to the answer or the fact that a decision has already been made and then ignore the answer they asked for. My wife will ask “do you mind if I do/go/be “x,” and if I answer “yes I mind” then she’s angry and usually proceeds with what she’d already scheduled anyway. Just today my sister asked if the coffee I was holding was warm enough. I said yes, and she then proceeded to take the cup from my hand and run to the microwave with it. OK, so maybe her intentions were good…but why the hell did she ask me, when my answer didn’t matter? Because this seems to happen to me ALL the time, by MANY different people, I’m getting to the point that I don’t even want to be around other people. Should I just shut up and quit even answering questions, or start answering with what I know they want to hear? Giving honest answers is clearly NOT working for me. Can you shed some light on what I’m doing wrong here? And more importantly, what do I do about it?

Nobody likes to feel ignored—at least by people we like and particularly by the ones we love—but some people are particularly sensitive to it.

They feel it as a kind of peace-destroying personal injury that injects them with a festering dislike of their fellow human beings. This leads to a desire to learn wilderness skills or get a solo gig on a space station.

You’re the kind of person whom being ignored gets to, and if I asked you to change, you couldn’t help but ignore my request, even if you tried not to.

Unfortunately, as you’ve noticed, people ignore one another all the time because that’s the way they are. They ask your opinion when what they really want is your OK, they ask how you’re doing when they really want nothing more than to avoid enmity, and they don’t actually care if you drive safe.

Some people who ignore you are, nevertheless, nice and reasonably respectful when they aren’t tired, distracted or irritable. If you’re lucky, and that’s whom you’ve got in your family, then you don’t want to fight over an irritation you can’t possibly change. Even if you’re rich and powerful or order a third-world wife, your family will always, eventually, tend to treat you like chopped liver.

Trying to eliminate the irritation of being ignored usually makes things worse, as I’m sure you’ve noticed. Make a fuss, and they’ll consider you a temperamental grump or autocrat. You’ll get more irritated and feel less respected, they’ll see it as your problem, and everything will get worse.

So don’t make it your goal, like the late, great Rodney Dangerfield, to get respect. The only way to avoid feeling disrespect is to become mean, insanely rich, and/or live in total quarantine from the human race.

Instead, make it your goal to do and be a person you can respect. If you’re not getting respect when you feel it’s deserved, do your best to, you guessed it, ignore it.

STATEMENT:
Here’s a statement for motivating yourself to eat the shit of feeling ignored and proclaim its tastiness when necessary. “I’ll never like being ignored, but I know when it’s an unavoidable part of a worthwhile relationship, so I’m proud of the way I tolerate it when I have to.”

I’m a pretty miserable person sometimes because I get mired in regret. For example, my biggest hang-up to this day is the “traditional” college experience (good friends, staying up all night studying or watching movies with members of the opposite sex, getting top-/transformative academic experiences). I graduated college three years ago and still wonder why things hadn’t gone, well, my way. Whining and pining over past/imaginary circumstances keeps me focused on my own perceived setbacks and flaws instead of moving forward. How do I stop sighing and lamenting, and start valuing and appreciating what I do have? Also, how can I identify what I really want to do in life? Should I learn to be content with doing something, anything, rather than searching for that something? I’m sure I must possess some innate fear of something, as implicit in this message.

Some people tend to ruminate about the contenders they could have been, just as some dogs tend to chase their tails. If your goal is to be happy—which is never a good goal in the first place—stop now, because, like those determined dogs, your tail will always remain out of reach.

Unfortunately, like many people, you’re not the happy type. Of course I don’t mean that you can’t be happy—bring a chocolate cake out after dinner, and everybody’s ecstatic—but anyone who obsesses as much about the difference between what was and what might have been is always going to have a shitload of unhappiness on his plate, which will cause more rumination about what a bad state of mind that is, in infinite regression.

Begin then by accepting the fact that, as a person, you’re a happiness-impaired ruminator. Unlike most shrinks, I don’t want you to ask yourself why you’re a ruminator, not just because I don’t care, but because I don’t think it’s good for you. Figuring out why will ignite yet more rumination and delay the day when you decide you just have to ignore yourself.

Now that you know you ruminate excessively, try to block off the ruminative chatter in your head and prevent it from influencing your actions. In other words, instead of sitting and thinking and fretting, keep doing.

If that seems easier said than done, therapy is an option. Good therapy will help you ignore your ruminations, focus on the here-and-now of your life, and keep moving (or they’ll gain on you). On the other hand, bad therapy will help you ruminate about why you ruminate and keep you so firmly ensconced in your navel you’ll forget what daylight looks like.

Yes, it can be helpful to identify the shortcomings or weaknesses that prevented you from being a college all-star, but the point in knowing your shortcomings is to do the best with them. If college was a bust, then fuck it, and thank goodness you don’t have to stay in college; there’s a world out there where your strengths may serve you well.

So, once you accept that you over-think/under-enjoy, stop over-analyzing your past and start focusing on making a living and creating a social life. It’s not easy, and you might not end up happy, but at least you’ll stop spinning in circles and start moving in a straight line.

STATEMENT:
Meanwhile, here’s a positive way of thinking of college that will protect you from ruminative “might-have-beens.” “I’ve always had ideals and dreams about the college guy I wish I could have been, and the tough side of those perfect superhero dreams is feeling how often and in how many ways I fell short. I did my best and, despite having had no great social or academic triumphs, I learned enough to get my money’s worth and was a decent guy (to whatever dweebs wanted to be my friend). I believe life can get better if I find my niche; meanwhile, I’m proud of what I did with what I had.”

I’ve been depressed for some time and could use some treatment, but my insurance has a big deductible, so I’ll be paying everything out of my pocket, which isn’t deep. My goal is to get treated for the least amount of money.

I’ll assume from your tone that depression isn’t making you suicidal or putting you at immediate danger of losing your job and/or family because, if it is, you need to forget about the cost of treatment and value the cost of your survival.

If depression is putting your life/work/family in danger, get a psychiatric evaluation, in an emergency room if necessary. Do not pass go, do not collect $200 (no matter how much you need it).

If that isn’t the case, there’s lots you can do to reduce the amount of money you spend on treatment…if you’re willing to spend some time, do some research, and use your common sense.

While the above question is quite short, the answer is anything but; looking for a treatment on any budget is a serious, involved process, so we have an involved, serious answer. Behold, our five step process that will help you with your depression without hurting your wallet.

Step one is telling your primary care physician (during a brief visit or even email) that A, you’re feeling low, B, you don’t have any physical symptoms (no fever, no weight loss), and C, you’d like to get some tests to rule out a physical cause of depression, like thyroid disease.

Tests will reveal if you’re feeling low because your glands, not your brain, are problematic.

Assuming your glands are good and your brain isn’t, step two is considering the options other than antidepressant medication, which, because it’s medication, always has a higher risk than non-medical therapies.

I’m guessing that medication is probably the last thing on your mind. It’s important to think about it upfront, however, because sometimes depression doesn’t wait for psychotherapy to work before causing severe pain and/or damage to your life, and medication always increases the odds for a better and faster (and sometimes cheaper) recovery.

Step two then, (postponing the issue of possible pills), is considering psychotherapies, including the how-do-you-really-feel-about-that kind. Many people assume this is the only kind since it gets lots of airtime on TV, where it uncovers exciting and unexpected changes of heart and inspires tears and plot reversals.

Despite what TV tells you, however, not everyone with depression needs psychotherapy. Psychotherapies are better at helping you manage depression than cure it, so it’s not surprising that many people with depression have had a number of psychotherapies.

Before considering a feelings-focused therapy, ask yourself and the people who know you whether there’s an issue you need to talk about. Remember, sharing your feelings with a professional is most effective if you haven’t done it before or your confidantes are unsupportive bozos and bartenders.

So, while the bad news is that psychotherapy is not a cure, the good news is that you don’t have to pay for it unless you think there’s a kind that’s worth trying. Either way, you save!

Your job is to figure out whether you (still) need one or more of them. If you want to save money, do your homework. It’s that, or pay a professional to do it for you.

If you decide that a feelings-focused psychotherapy is necessary, you may get a bargain at a state-subsidized community mental health center or a psychotherapy teaching institution. Don’t assume you should see a therapist every week, because you may get just as much bang for your buck by making the meetings less frequent.

You haven’t completed step two, however, until you consider other psychotherapies, particularly cognitive behavioral therapy or “CBT”, which is a good option if your negative thinking (caused by depression or being human) is making you more depressed.

Read books on the negative thinking caused by depression and anxiety (like The Feeling Good Handbook by David Burns) and decide whether you need to do thought exercises to stop your negative feelings from becoming negative beliefs or actions. If you find it useful, look for a therapist who “does CBT” or “DBT”, a form of CBT that focuses on thoughts of self-worthlessness and the desire to injure oneself.

Please note: we’re not recommending all kinds of self-help. In fact, if you see a self-help book about “healing the inner hurt,” run the other way as if it were on fire. If Dr. Phil recommends a book, we forbid it.

Step three is taking a break from the books and tuning up your diet and lifestyle. Exercise is a powerful antidepressant (the way you feel afterwards, not during, anyway). Vitamins and omega three fatty acids help, and, despite what most people think, drinking and drugs don’t, so learn to abstain.

Finally, read up on antidepressants while ignoring the eye-witness accounts of horrors and miracles. Consider the risks (fairly low, despite what Scientology says) and possible benefits (positive, but delayed and very iffy). Then, if you decide that the risks of staying depressed are worse than the medication risks you’ve read about, ask your primary care physician for an “antidepressant medication trial.”

Remember, you’re conducting a trial, not taking a cure. Note, quantify and record your symptoms and possible side effects over the next few weeks. (There are programs on Google that can help you do this). You’re the one who decides whether the new medication is doing more good than harm.

If a couple medication trials haven’t worked, the very last possible step, number five, is to get a referral to a psychiatrist and give him/her a list of the medications you’ve tried, the doses, how long you took them, and the good and bad things you noticed. You can find a psychiatrist on the cheap at the same clinics we sent the feelings-focused types to.

Follow these steps, and you’re on the road to dealing with/managing your depression. It’s not a cure or an easy answer, but it’s a start, and hopefully this is all the information you need to start on a good path to treatment without paying a pretty penny.

STATEMENT:
Here’s a statement of purpose that will counteract depressive helplessness and pessimism. “I don’t know why I’ve been feeling depressed and I may never know, but I know how to find any causes that are worth finding and to try the cheapest treatments first. I expect to run into a lot of dumb ideas about depression because many people want to believe they have the answer and an easy way to control it. Whether or not I can control it, I know that, by doing the research myself and using professional help whenever I think it’s necessary, I can do a good job of taking care of myself.”

My parents have decided to retire, sell the big house I grew up in and move into a smaller condo closer to my sister and me. The move makes sense—my sister and I are adults with our own families—but it’s brought up a sort of taboo issue for my parents, which is my mother’s attachment to stuff. She’s not a hoarder, but if my dad wasn’t around to put his foot down, I sometimes worry it could be, because my mother has trouble throwing anything away. She says that moving all the time as a child has given her a different appreciation of objects, and that it’s better to regret having too much stuff than to miss something you threw away and can’t get back. Problem is, there’s no room for this stuff in the new condo, they won’t have the budget for storage, and my sister and I aren’t able to put all of her old work files, souvenir spoons, and elementary school textbooks (seriously) in our basements. What I’m afraid will happen is that my father, who has always taken responsibility for managing their money, will try to get my mother to agree that they can’t afford to move and store her stuff when they move, she’ll keep complaining, and he’ll get nasty. How can we get my mother to learn to let go?

I know you and your father want to make your mother happy and have harmony, but it looks like she’s not eager to adapt a sparse, Zen lifestyle.

The problem is, trying to make someone happy when it’s just not possible usually causes more unhappiness. False hope is dangerous, no good deed goes unpunished, and stuff happens (sometimes in great quantities).

There’s no way you can spare your mother the pang of parting from her horde. Trying to do so, while well intentioned, makes your father assume responsibility for her pain and its relief. In reality, life imposes the problem, not your father or any other member of your family, and it’s your mother’s job to deal with it, because no one else can.

Ask yourself (and your father) why he takes responsibility for a problem that isn’t really his. By managing the budget, carrying out spending decisions, and insisting on making your mother happy, he assumes total responsibility, infantilizes her, and garners himself a shitload of blame.

Tell him to accept that, while he might have failed as family manager/mom’s #1 cheerleader, he can succeed in not being responsible for any unhappiness caused by the stuff-alanche.

Seriously, you can tell him he’s done a wonderful job managing the household and your mother’s angst, but there are limits to what he can do, and that he’ll do better if he presents the situation to your mother and invites her to come up with a better solution.

In other words, instead of your father telling your mother it all has to go and your mother saying she can’t bear to part with any of it until the whole dispute becomes a clusterfuck, your father should instead do some math.

After he prices storage, figures out their fixed income budget, and sees that the two don’t mix, he can present that evidence to mom, explain how he can’t make it work, and give her the chance to find a solution.

At that point, the future of mom’s stuff collection is nobody’s fault. Hopefully, she’ll find an option that works for her, but in the meantime, you, your father, and your sister have avoided a stuff-load of aggravation.

STATEMENT:
Here’s a positive statement your dad could make to protect the family from blame while requiring his wife to share responsibility for a painful but necessary decision. “I’m glad we’ve been able to retain our family memorabilia until now, but I’ve looked at the cost of moving and storage, given that our new condo has no basement, and it doesn’t fit our budget. Please review the numbers and see if you can come up with a better answer and we’ll talk about it. One way or the other, it looks like we’re facing a painful compromise.”

I don’t know why my 10-year-old kid is so selfish and materialistic, because her mother and I aren’t. I can’t take her past a toy store without her having a tantrum if I don’t get her what she wants, and by tantrum, I mean she just keeps yelling and crying, even after I’ve dragged her out of the store and put her in the car. It’s not like we deprive her, either, because we do buy her toys occasionally for no reason, but she’s furious when she can’t get them on demand, which is all the time. She sees a shrink because she throws tantrums in school whenever the teacher wants her to stop doing what she’s doing and start something else. I’m afraid she’s spoiled and I don’t know how to undo the harm.

If the main cause of tantrums and other bad behavior in children was poor moral values like selfishness and materialism, then we’d know how to correct it by teaching better values, as forcefully and loudly as necessary.

All we’d need to rectify bad behavior is a Sunday school nun with a metal ruler.

You’ve got evidence, however, that whatever triggers your daughter’s tantrums is not simply a matter of her being spoiled, because she also has tantrums in school over the non-materialistic issue of being asked to stop what she’s doing and transition from one activity to another, sans toys of any kind.

What you’ve got here isn’t a bad set of values, but a problem in her nervous system that you don’t know how to correct. It’s understandable that you’d focus on the toys instead; you’d rather blame her and yourselves rather than face something you can’t control.

Once you face the sad fact that you’re helpless (but good) parents, you’re free to consider ways to help an unavoidably irritable kid improve her self-control.

At first, of course, try behavioral tricks you learn from teachers and therapists, because they’re less risky than medications. You learn to give her more “structure,” which means keeping her busy, providing her with clear rules, and imposing immediate time-outs when she starts to tantrum. It also means avoiding toy stores.

Therapy seldom helps if it focuses on your faults, but can be very helpful if it teaches you new child management techniques, and protects you from feeling responsible for your child’s (bad) behavior.

If non-medical treatment isn’t enough, and you think her behavior is seriously interfering with her schoolwork, friendship, and self-esteem, find out whether medications are safe enough to be worth a try.

As I’ve said many times, meds are never a cure, they sometimes don’t work, and they can often come with less-than-desirable side-effects. They’re worth a try, however, if you think the risk of her behavior is worse than the risk of the medication.

You and your daughter are in this together, and you have a lot of options for ways to manage and cope. One day, she might have a peaceful relationship with the toy store, but in the meantime, do your research, stay calm, and avoid women in habits.

STATEMENT:
Prepare a way to announce your new policy that conveys acceptance and hope. “I know that seeing new toys gives you very strong feelings that make it hard to walk away without them. We’ll help you by staying away from toy stores until you’re old enough and strong enough to manage those feelings. If you get those feelings anyway, we’ll try to find you a quiet place where you can be alone until you no longer want to scream or hit people. You’re not the only kid who’s had this problem, and we’ll get through it until you grow out of it.”

I hate life. What is the most reliable and painless way to commit suicide?

You hate life, and I hate the kind of dangerous, self-lacerating whining that makes a painful life seem meaningless, when it isn’t.

Hating life is an understandable feeling, whether the problem is a hateful life or your own, reflexive intolerance of life’s general hatefulness. There’s no doubt that life is sometimes hateful, some people’s lives are more hateful than most, and some good people are more sensitive to its hatefulness.

There’s more than enough hate to go around, and you can’t help how you feel.

Any time you let hateful feelings shape your goals, however, you’ll make life more hateful (after a brief burst of genuine satisfaction) and destroy what’s left of your self-esteem.

Yes, taking your hate out on yourself may give you the satisfaction of protesting life’s unfairness and heaping guilt and contempt on your so-called friends. What it also does, if you think about it or survive to see what happens next, is define your life as a reaction to your hurts and the people you value least. It both fuels and destroys, hateful little fucker that it is.

What you really want (and what your survivors will try to do) is to remember the times you did better things and followed your own values. It’s not as exhilarating as being a nihilist, but exhilaration is, by its nature, short-lived. You shouldn’t be.

During its short run, hate is a lot more attractive and satisfying than reminding yourself about what you stand for and thinking about values and consequences. That’s why you need to work on building a philosophy and preparing for hate before it arrives, instead of boarding the hate train and then finding the will to get off.

You can do that by going to the right church or temple (one that doesn’t waste too much time on holy this or ecstatic that), hanging out or reading about people who’ve made the same journey, or getting the right kind of therapy. DBT (dialectic behavioral therapy), which borrows heavily from Jewish, Christian, Buddhist and 12-step ideas about living with anger, can be particularly helpful.

Therapy or no, you can find ways to keep your hate (and my hate for your hate) under control.

STATEMENT:
Here’s a statement for taking pride in good hate management. “I know what it’s like to hate life, but I won’t let myself forget what I value about life and my own ability to make it better. I can’t escape hate; but I will make myself strong enough to protect myself from its destructiveness and use its energy for my own goals.”

I feel like it’s finally time to confront a serious problem I’ve had for years; when I drive, I become filled with rage. My mother was the same way, and it was scary. She was never violent and neither am I, but the amount of anger I feel can’t be healthy, and I don’t want my daughter to do the same thing. I want to feel less furious.

I hope you’re not expecting therapy, a pill, or some Tibetan meditative experience to take away your anger, because it probably won’t.

Whatever causes anger—mommy’s genes, bullying by your older brother, or one rotation too many around a Boston-style rotary—it’s usually yours for life by the time you’re old enough to write me a letter.

Sure, psychotherapy may help, but my rule of therapy thumb is, if it hasn’t helped in a few months, move on. Therapy just isn’t that powerful (not even in my Harvard hands), and sticking with it when you’ve got anger to control delays your acceptance of the red-hazed reality you need to start managing.

What I’m really advocating isn’t to give up on therapy, but to give up on the idea that it will make you feel better by taking your anger away. Instead, use therapy (like DBT, see above) to help you manage anger.

I know you’ve probably seen kung fu monks master their anger by thinking pacifist thoughts while smashing bricks, and maybe you think channeling your rage into big muscles and loud thuds will improve your control while intimidating your tormentors into not cutting you off you in the first place.

Wrong, young grasshopper. The only reason martial monks don’t get sued for everything they own by everyone they lay a finger on is that they’re monks and own nothing. For the rest of us, the slightest adult physical altercation, combined with martial training, is as bad as a car-crash without insurance or witnesses: an endless goldmine for lawyers (and shrinks) at your expense.

So now that you’ve abandoned all hope of ever getting rid of your anger, you’re ready to improve your ability to manage it. Instead of tailgating those who dare offend your road-warrior sensibilities, learn to shut up and back off until you have a chance to think and decide whether a battle is worth fighting (almost never) and, if so, how to do it most effectively (by never appearing angry).

Feeling angry is unhealthy because it raises your blood pressure, but expressing it is even more unhealthy because it causes you endless misery that raises your blood pressure higher for longer.

You can’t control the former, but you can learn to get a handle on the latter (even if you can’t break a brick with your fist).

STATEMENT:
Here’s a statement for taking pride in frustrated rage. “I hate the way other drivers ignore the road rules, put my life in danger, and never get punished. Teaching them a lesson would make them think twice about driving like assholes. My goal in driving, however, is to get from one place to another as safely as possible, without being endangered or diverted by people whom I least respect. I’m proud of my ability to eat my anger and never, ever fight.”

My psychiatrist thinks I should increase my medication, but it already makes me sleepy and has caused me to gain 10 lbs. If anything, I’d really feel better getting off it entirely, because I hate being dependent on it. For the time being, I know I need it, because I’ve barely recovered from my last depression, but even thinking about increasing the dose makes me feel depressed. I’ve seen this doctor throughout my entire illness and she’s been very good with me up to this point, but now that I don’t agree with her I don’t know what to do. I don’t want to have to take more medication.

It’s much easier to have an agreeable disagreement if you’re not pushing someone with your emotions; after all, lawyers use evidence, not tantrums, to win a case.

Still, it’s hard not to push with your emotions when the issue is personal and scary. Unfortunately, you don’t have a choice.

If you don’t put your emotions, you’ll sound (even to yourself) like a kid who hates needles. Your doctor will then feel like you need protection against your fears and impulses, and so will become even more insistent and condescending (and afraid of a liability lawsuit when your fear turns to anger).

That attitude will make you feel more like a helpless kid who isn’t being heard, and long story short, it’s a vicious circle we’re all familiar with, and it requires you to shift approaches, not give in.

Besides, if you’re pushing someone with your emotions, you’ve got to wonder whether you’ve conned yourself into doing what you want, rather than what’s best for you.

Switch your language (and maybe your way of thinking), list risks and benefits, and prepare a list of the questions you need answered to make a good decision. Put your feelings aside, put facts first.

No one likes medication, but it’s your job to know enough about the possible course of your long-term, incurable mental illness to judge whether the beneficial promise of a given medication outweighs its costs and sluggish, chubby side effects.

Becoming educated about your illness and its treatment is the only way to avoid being a medical victim who feels helplessly reliant on a doctor’s judgment.

If you want to have a discussion with your doctor that doesn’t sound like you’re trying to escape the ouch of your camp shots, learn what your odds are for relapsing and whether resuming meds at the beginning of a relapse can be counted on to stop your symptoms before they damage your life and/or your brain. Also, find out what the chances are that a higher dose will make a positive difference in the short or long run.

Don’t forget to ask what evidence the doctor is drawing on for his answers. Then you’re prepared to announce your verdict as a responsible adult.

STATEMENT:
Here’s a formula for a worst case, high risk disagreement. It alludes to your fears but sticks with a managerial point of view. “I know that rejecting your recommendation carries a 10 percent higher chance of relapse, that there’s no guarantee that we can stop a relapse once it’s started, and that relapse can cause a little brain damage. But I’ve weighed these odds against the risk and side-effects of the medication and my own conviction that I’m less vulnerable to relapse now and I’ve chosen to keep the dose where it is and wean off in the not-too-distant future.”

Admittedly, I’m a neurotic, depressive guy—I’m a New Yorker, I’m normal here—but when I had a shitstorm a year ago when my girlfriend left me and my job changed/became horrible, I started going to a therapist. It was helpful to rant and get some perspective, but now I really think I’ve come through the other side of the situation and don’t need therapy anymore. My therapist, on the other hand, thinks I still have a lot of work to do, because we never really talked about my relationship with my father (not great) or why I had trouble with my ex-girlfriend. Thing is, I don’t really think my dad has anything to do with anything, and I know what my problem is with my ex-: I chose badly. How do I convince my therapist I’m ready to leave and that there’s nowhere deeper to dig?

There are always therapists out there who, when it comes to accepting the fact that people are the way they are and treatment is a limited tool, need more therapy than their patients do.

What your therapist may have trouble facing—more so than you—is that your treatment has produced all the change and relief that it’s going to, despite the fact that you still have pain and other problems.

Many therapists can’t accept imperfect results. They feel they’ve failed if they can’t help you and, so as long as you’re suffering, they’ll look for a deeper level of change.

If they could bring themselves to accept you the way you are and let go, they could also become more creative about teaching you methods for minimizing the harm your behavior can cause. Obviously, this is not the case here.

So prepare for your decision by gathering data about whether or not it’s really time to stop. See your therapist less often, or take a designated break, and see what happens.

If you slip back into that shitstorm feeling, your goal is to figure out what the treatment was doing to help you, whether you can get that help for free from any other source and, if not, how often you need to see your therapist to sustain the benefit.

If, after running that test, you decide to stop treatment but don’t want to get drawn into a fight with your therapist in which you sound like you’re trying to avoid your homework and your therapist sounds like a concerned adult, there are 2 options.

You can lie, and tell your therapist you’re feeling better and last night you had a dream about a happy bird flying high above the clouds and missing its nest down below but confidently soaring towards the mountains in the distance where your dad and ex-girlfriends were waiting to give you a hug.

Or.

You can be straightforward and truthful, telling your therapist exactly what you told me, backed by the results of your experiments with withdrawal, and stick to it.

After all, you’re an adult who can make your own decisions, and your therapist will have to accept your decision. And if s/he can’t seem to cope, s/he’s the one who needs time on the couch.

STATEMENT:
“I know I’ve still got problems but I think I’ve got what I’m going to get from this treatment and I’m managing things well enough. I wish I were less grouchy but I don’t think that’s going to happen and, meanwhile, it’s not doing me any harm. I’ll always look for new ideas about how to manage my problems but, for now, I don’t think I need more psychotherapy.”

I don’t want to break up with my girlfriend, but I know that I can’t really be with her, either. We can’t live in the same city, for one thing, because I have a grown child, grandkids, and a business I rely on and can’t move. She and I first met in college, but drifted apart, then married other people. We have great chemistry and I’m really happy that I found her again and could recapture part of what we once had; we talk every day, visit monthly, and I get along with her kids and family. The problem is that we can never live in the same place, and I know how much she wants a live-in partner, and I’m sure that, as she realizes our relationship can’t go forward, she’ll drift away. My goal is to keep our relationship from falling apart for the second time in my life, but I don’t know how to do it.

You’ve got a girlfriend you’ve known for decades whom you still love, accept and want to see. If that isn’t success, I don’t know what is. Seriously.

Yes, for various reasons beyond your control, you can’t live in the same city, and there’s always a chance that she’ll find someone who can and he’ll steal your true-love away. There’s also a chance Megan Fox will call you up and ask you out, but I wouldn’t plan your life around it.

If you’re thinking that way—that she gets swept away by a local guy—and the true-love guy doesn’t get the girl in the end, you might, like most people, think that love has failed.

Or you might be lucky, and be too old and smart and experienced to believe that kind of bullshit.

You pre-owned, second-life lovers know that your liaisons and partnerships have their own, special, inescapable risks. If you become disabled, or your finances fail, your dependence on first-life families and businesses may force you and your partner apart. Life is tough; but that isn’t the pain of failed love.

Of course, you can’t stop her from getting discouraged by your inability to up stakes and move to her city; and if this arrangement isn’t enough for her, that’s too bad. Refuse, however, to let fear or lack of commitment define your own views.

As you see it, it’s not a lack of love that keeps you apart, but a mature, surviving love that brings you together in spite of certain inescapable realities. And if she sees it differently, that’s her problem, not yours.

Be proud that you’re making the most of what life has given you: a love restored, under conditions that also force you to maintain separate lives. You’re not looking to get married, settled down, and have kids—been there, done that. If you’re truly looking for someone to understand you and your circumstances and where you’ve come from, you’re looking for each other.

STATEMENT:
Prepare a statement to define your own views and, hopefully, influence hers. “This relationship isn’t the cozy, share-everything love we would have preferred, but it’s survived a long time, it’s better now than ever, and it’s something we can treasure. If we can’t spend as much time together as we’d like, it won’t be because our love has failed.”

I love my boyfriend, but when he gets down on himself, he’s impossible. We’ve been together 20 years and I moved out on him 5 years ago, bur we’re still together. He’s funny, he’s a good English teacher, and his students love him, but he sees himself as a failed writer and drunk who can’t love anyone, particularly when he gets into a certain mean, low mood, and when he’s like that, I can’t get through to him, which is why I moved out. That’s when he binges. For the first 15 years, I thought my love could put the lie to his self-criticism and I felt terrible about moving out, because I knew he would take it as confirming his feelings of failure. My goal is to get him to see that he’s really a nice guy.

Some nice people are permanently self-critical, and there’s nothing loving partners or empathic shrinks can do to change it. It’s as basic to who they are as their hair color or shoe size, only much more annoying.

It may be their parents or their DNA, but who cares, because it is what it is, and trying to change it creates precisely the sense of failure that the tortured person believes belongs to him, so he can then see himself as a failed patient and lover. It’s a (not-racist) tar baby, so don’t touch it. Lay low yourself.

All you can do is let him know your own view and refuse to be drawn into his self-destructive side, and that’s basically what you’ve done. By living separately, you avoid sharing life with the drunk and the self-flagellator, but you’re available to spend time with his better side.

He can’t keep the demons out of his life; but you’ve created a boundary that shuts them out of yours. That’s real, grown-up love and it’s a major achievement. Of course, you might wonder if he’d get a kick out of religious rituals of group self-flagellation (fundamentalist Muslims have some good ones, and certain Catholic groups may not be far behind). Maybe he’d feel better and drink less, at least until he drank again, and then, not so much.

You might wonder if sobriety would help him feel better, but remember, feeling bad is his way of feeling good. Certainly, sobriety would eliminate the depressive impact of alcohol, but, on the other hand, it would also deprive him of the self-punishment of being humiliated and hung over, so he might feel worse if he felt better. You can’t win.

You’re actually providing him with good therapy by doing what you’re doing. You’re showing love and respect while accepting that he’s also a nasty, demeaning drunk who needs to be managed.

It’s an achievement to share real happiness with someone who often steeps himself in misery, and it’s not easy. If you want to make the best of your love, you’re going at it the best way possible, which is to say, from a necessary distance.

STATEMENT:
Prepare a statement to honor what you’ve accomplished. “I can’t help the fact that my boyfriend has terrible moods and binges. It hasn’t stopped me from respecting the nice guy and caring teacher and even the high standards by which he measures himself. I’m sorry we can’t live together, but I’m happy to have shut out the bad and held on to the good and perhaps one day he’ll learn how to do the same.”