How can I help my girlfriend (we're fortyish) who is suffering from severe clinical depression and has other issues?

I fully sympathize with your feelings for the woman, and even with your desire to be a “white knight”. And I’m not mocking that feeling or intent, in case there’s any doubt. However, aside from her depression (and since you used the term “clinical depression”, I’m going to assume that this is a diagnosis from a qualified mental health professional, and not a snap decision by you or others with no access to her medical records and physical, in-person exam, etc.) she has other severe psychological issues evident from your description.

It’s very likely that you have complementary issues, such as the desire to be her savior, for example. The difference, of course, is that her issues are more or less destructive to others as well as to herself, and yours – if they exist – are likely only to be destructive to you, in that there’s only so much of yourself that you can give before you exhaust yourself. So again, making a supposition that “what if” you have psychological needs to rescue that mirror her need for rescue, not just saying “you have issues” your potential for self-destruction by giving-until-you’ve-given-all is necessarily self-limiting: you can’t give more than you have. Her potential for destruction, however, is potentially unlimited. She has the power to engage others in her misery, and the only limit to that potential is the attenuation of her appeal as her sphere of influence grows.

Not to put too fine a point on it, what you’ve described is a black hole of human despair. She will – apparently, from your description – suck into her orbit all of the people she can who (she claims) have harmed her and continue to harm her: parents, doctors, surgeons, and now you. If I trust your description of things, then I doubt that you are in any way culpable for her condition.

Looking at this from a wholly uninterested orbit and completely objectively, as if I didn’t care about her misery and yours at all, it would be a simple matter to say “you need to get away from her and cut all contact; she’s trying to get you to drown with her”. But … I get how you feel. So what I will say, with the best will in the world, is that you need to find a way to help her from a distance, if that is even possible. (I suspect, for example, that you only know about the parental abuse because it’s what she has told you. The parents may be no more monstrous than you or her former surgeon. That is to say, imperfect and trying to do the right thing.)

She sounds highly manipulative and toxic, but I get that you recognize the humanity within and want to help her. That speaks highly of you. But consider this: How would you feel about helping her if you were not in love with her? Can you dissociate at least temporarily to help yourself to ask and answer that question as objectively as possible? For example, and by way of comparison, how do you treat homeless and hungry people that you pass on the street, especially if you can see that they have obvious mental or psychological issues? Aside from your internal feelings for her-as-she-was (perhaps), what makes her different?

I do wish you well. She’s obviously in a bad place, but so are you.

I’m osrry you’re experiencing this situation and really can’t add anything to what @CWOTUS above has said, except, as he mentions trying to distance yourself some as you will end up going down with her broken ship as well.
I am a realist and while caring and compassion are great qualities they can easily morph into codependent masochism. If she has been suffering from these same issues for over 20 years, well, the odds of some miraculous shift is highly unlikely. I think it best you keep working on yourself and find a women that is not going to require you to be her savior and oxygen tank forever after.

I read what you wrote and thought to myself “how can @Yellowdog love this person who sounds clingy, morose, depressed and depressing to be around?” It sounds like not a fun time, and not a fun relationship. I am wondering if you have low self esteem, @Yellowdog, choosing a girlfriend like that, or some other issue like codependency?

It’s always easier for a higher functioning person to go down in a toxic situation than it is for the lower functioning person to rise above their issues.

http://www.fluther.com/186910/she-says-she-needs-me-but-it-seems-to-be-as/

Your question from two months ago. Many responses should be revisited.

I also wonder if this is the girlfriend you are referring to in this question, @Yellowdog:

http://www.fluther.com/188709/bluntly-speaking-how-do-you-shut-up-someone-who-rambles/

This woman seems to be a drain on you now so how much worse would it be if you were living together? Do you get on well with her sister? It might be worth discussing things with her though that might make your girlfriend suspicious that you are ‘ganging up’ on her.

I would examine what your feelings are for her. You say you were in love with her twenty years ago and then you say you fell in love with her when she contacted you again. This suggests to me that your feelings have not been constant over this period. I do not doubt your sincerity in wanting to help but I feel you can best do this if you keep a certain distance from her. If you don’t you could drown together.

Your question is “How can I help…”

And the plain fact of the matter is that she needs professional help. If you can somehow persuade her to actively participate in thereapy, that’s about the extent of what you can do. This is above your pay grade (and mine as well).

I assume that as part of your ministerial training you took some courses on counseling/therapy and which situations clearly call for referral to a mental health professional. This is one of them.

And you’ve also learned that it is counter productive for you to assume that role because of your emotional involvement.

Do you realistically see any hope for change if she does not get professional help? I mean, honestly, do you forsee any hope of change without the input of a trained 3rd party looking at the situation objectively? How exactly do you picture that happening, absent her participation in the therapeutic process?

If she persists in her current state, it’s only a matter of time before her sister can’t tolerate her living there either. And then you’re back to where you started trying to prevent her from homelessness (which bankrupted you last time around).

She needs professional help. Period. I don’t care what excuses she gives you. You might be the only one who has a chance of getting her to seek the help she needs. The question is how much effort are you willing to put into that.

I’m going to recommend a book which you might find a little odd since it was first published in 1964. But it contains the beginnings of what is now known as Cognitive Behavioral Thrrapy.

It’s called “Games People Play” by Eric Berne.

She’s not aware of it but the game she’s playing is called “YES, BUT”. Everytime someone offers a helpful suggestion to her, she counters with an objection of why that won’t work for her.

I’m sure you’re not the first to suggest therapy. But she has her excuse ready.

I’m sure there are numerous examples more once you think about it. In his book he describes numerous others which keep people locked in maladaptive ways of dealing in relationships.

At some point, you need to make a decision as to whether you are going to continue to “play” her self-destructive game where she is constantly demanding and manipulative toward you or whether you will set some healthy boundaries (such as: if she wants to continue having you as a presence in her life, she needs to get her ass into therapy on a regular basis).

She needs to face up to her issues keeping her in this dysfunction that is her current life and you are not the person who can do that because it’s impossible for you to look at it with the objectivity necessary.

For your own sake, please read the book so that if you decide to take no real decisive action, at least you’ll have your eyes wide open as to what YOUR participation in her self-sabotaging game is doing to both her and to yourself.

But, I honestly don’t think that there is anything you can do to help her other than getting her into therapy. Everything else is just cosmetic, like rearranging the deck chairs on the Titanic, which IMHO is just a gigantic waste of effort. She needs help from a competent therapist (not you.). I know that may be difficult to hear. But it’s the unvarnished truth.