My Family Member’s Depression Isn’t Getting Better. How Can I Help?

The most useful thing you can do is help them get a proper reassessment. When two antidepressants have not worked, there are specific treatments built for that situation, and many people never hear about them.

Build the medication history

This one task changes appointments more than anything else you can do. Write down:

• Every antidepressant they have taken
• The highest dose they reached
• How long they stayed on it
• Why it stopped

Most people cannot recall this under pressure. A written list often reveals that fewer medications got a real trial than anyone assumed.

Ask the provider three direct questions

• Have they had two full antidepressant trials at a proper dose?
• Has anything else been ruled out, like thyroid problems, sleep apnea, bipolar disorder, or ADHD?
• Are they a candidate for TMS or Spravato?

Asking specifically about treatment-resistant depression tends to move a conversation further than asking whether there is anything else to try.

Go with them if they will let you

You will remember details they will not, especially the timeline. Ask their permission first, and let them lead the appointment.

What helps day to day

• Be specific. Offer to drive to one appointment or make one phone call, instead of offering to help generally.
• Keep inviting them. Expect no, keep asking anyway.
• Handle friction points. Pharmacy runs, insurance calls, and paperwork are common places treatment quietly stalls.
• Notice small changes out loud. Sleep and energy often improve before mood does.

What to avoid

Anything that implies effort is the missing ingredient. Depression that resists two medications is a clinical problem, and suggesting they try harder adds guilt to something already heavy.

Also avoid pushing a specific treatment you read about. Bring the question to their provider instead.

Look after yourself too

Supporting someone through this is genuinely draining, and burning out helps no one. Your own support, whether a therapist, a group, or a friend who knows, is part of the plan.

When it is urgent

If they talk about ending their life, describe a plan, or start giving away possessions, treat it as urgent. Call or text 988. Call 911 if they are in immediate danger.

Take direct statements seriously even when they sound calm.

Common questions

How can I actually help?

Build the medication history, offer to attend an appointment, and ask directly about TMS and Spravato.

What should I avoid saying?

Anything that frames improvement as willpower.

Can I attend their appointment?

Yes, with their permission.

What if they refuse more help?

Stay specific and keep the door open. One call, one ride.

When is it an emergency?

Any talk of ending their life, a plan, or giving away possessions. Call or text 988.

References

• Rush AJ, Trivedi MH, Wisniewski SR, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163(11):1905-1917. PubMed

Medically reviewed by Nefretiri Abat, J.D., PMHNP-BC, board-certified Psychiatric-Mental Health Nurse Practitioner.