[desotodeson]

For the last few months my brother has been really depressed, and it's gotten to the point that he regularly says things like "I just want to die"; "I just want it all to end"; "What's the point of it all if we all die in the end anyways." Then I talk to him about it and he always says that he wouldn't actually kill himself, but it frustrates him because he wants to die and the only reason he doesn't do it is because he wouldn't want to hurt other people (mainly me and my family). He says he doesn't have a plan, but that he has thought about ways he would do it. Last night he said he ran a knife over his wrists, but didn't break the skin.

He's been going to a number of psychiatrists and therapists, and he is on medication but I don't think it's doing any good at this point (in fact, doesn't some medication make you more suicidal?). He's just recently graduated from college and is working as a server, but can't find a 40 hour work week job and has stopped applying for jobs because he's so depressed.

The main reason for his depression is a recent breakup with his boyfriend of two years. He's been in this situation before - where a boyfriend broke up with him and he was severely depressed for a long time - but it didn't get to the point where he wanted to kill himself.

When he isn't at work all he does is lay in bed unless I get him up, and when he does get up all he wants to do is lie around and watch TV. He does sometimes go out with friends, but he isn't that great of friends with these people and he always says that he hates going out with people because he hates who he is, and that he'd rather stay at home in bed.

I just want to know - should I go so far as to admit him into a hospital? My uncle is a therapist and he said when it gets to the point of where he doesn't go to work for days or doesn't eat for days then I should really worry and take him to the emergency room. But I'm really worried now. He says he wouldn't actually go through with killing himself, but I'm constantly worried that at some point he's going to break and actually do it.

[Wondergirl]

If you're in the U.S. (not sure about other countries), you can't admit him into a hospital or a psychiatrist hospital. He has rights and can say no. Your brother must go to the doctor who is prescribing for him and discuss the medications and what their purposes are. Also discussed should be a plan to get him out of his depression and use CBT or other kinds of therapy. That probably means the psychiatrist will refer him to a counselor or social worker whom your brother can meet with once or twice a week. This will give him someone emotionally unbiased and knowledgeable about mental health to be accountable to.

If your brother is willing, accompany him to be supportive and to take notes.