Anya, sadly, that is the state of the NHS in the UK at the moment - it is seriously underfunded for what it has to do, and mental illness (often, by the way, called 'mental health' services...also, in this forum you will see 'MH' which means, 'mental illness')(English paradox!), is particularly underfunded against the demand in the population alas.
Because of this, there really is very little 'help' other than, as I say, anti-depressants (ADs) and some limited psychotherapy which usually takes a long time to get (ie, there's a long queue - the British love queuing, which is just as well when it comes to the NHS).
A key lesson for anyone trying to access MH services in the NHS is, alas, to 'shout loudly and continually'.....in a way, what help there is goes to those who make the most noise about it! If you are 'good and patient' then you are all too often fobbed off because, sadly, there are not enough psychiatric nurses and doctors in the system to treat everyone 'properly'.
I agree with you that it could well be that your boyfriend is frightened of what will/might happen to him if he does go to the doctor, and I think it's an excellent idea for you to see the GP and find out what that is likely to be, so that hopefully you can reassure him. I do think, though, that the GP will want him on some ADs first....
I'm glad your boyfriend can work, as 'keeping busy' is essential. It really will do him no good to be at home and brood. Other key 'self-help' 'healing' for depression, as well as work, are the following:
- getting out into the fresh air. Go for walks, get out into the countryside, do gardening if you've got access to a garden.
- exercise. Exercise will release endorphins in the brain - these are our natural 'feel good' hormones which will help lift his spirits (see below). Exercise can be as simple as long walks (ie, combined with fresh air as above!), or jogging, or working out in a gym (most councils have gyms though you may have to join) or swimming (public swimming pools are 'pay as you go', but you need to find the sessions that are not for 'children', though often there are a couple of lanes kept aside for exercise swimming)
- counting your blessings. Depressed people always see the 'worst' in their lives, and fail to take account of all that is good. There is ALWAYS a lot lot lot of GOOD in the lives of anyone who isn't, to push it to extremes, in a Nazi death camp!!!! Even a simple exercise like 'Shut your eyes. Think about what it feels like not to be able to see. Count 30 seconds. Then open them again.....and think how WONDERFUL it is to see'..... it can take self-discipline to count blessings, but it needs to be done, little by little, day by day. Some people with depression keep a 'blessings diary' in which every morning/evening they write down all the 'nice' things that happened - and that includes things we take for granted about our rich safe western life, eg, eating food, not being bombed, etc etc etc. Don't take our precious life for granted....others would give all they (don't) have to share it with us!
- animals. Animals are always therapeutic, and help to 'soothe' us. They have simple needs and wants, and take visible pleasure in life (cats purring, dogs running around excitedly). If you have access to a dog, eg, a neighbour, take it for a walk, or maybe phone an animal sanctuary nearby and ask if you can help out, or dog walk or some such. Dogs don't 'demand' anything of us, they just like our company and want to go for long vigourous walks (so you get exercise as well, and in the fresh air!)
- kindness to others. Helping other people is empowering. It makes you realise that even though you are depressed, you have the power to make someone else 'better' in some way. It makes you feel 'good' to help others, and restores 'faith in humanity'. It takes you 'out of yourself' and gives you something else to think about, other than your own woes. It also adds to the 'count your blessings' factor, if you help someone who is worse off than you.
I hear what you say about your boyfriend saying that the part of his brain that feels 'joy' is 'dead', and whilst this is, so far as I know, not something that 'shows up' on an MRI scan (!), yet it is, of course, exactly what a depressed person feels, that NOTHING can 'seem good' at all - the world is black and bad, and they cannot take off their 'black-tinted glasses' to the wonderful world that is 'really' there from which they feel excluded.
His depression cannot 'lift' overnight, as in be suddenly 'cured', but little by little it can be worn away. The ADs will help, as in stop him sinking even further, they provide a kind of chemical 'platform' for the beleaguered mind, so it does not just flounder in despair, they give the mind what should be a 'purchase' (eg, hold/fulcrum) so that it can start to climb, slowly, back upwards towards the light of good life.
There is also, too, of course, two other 'informal' sources of therapy - one is one forums (and if you search the internet there are a good few number of forums for those afflicted by MH - though perhaps you should check them first to see they are not just full of people who are SO 'down' they will drag your boyfriend further down)(and BEWARE of 'pro-suicide' sites!!!).
But there is also simply 'talking to you' and 'writing things down' for himself. If he can 'get a handle' on just WHY he is so depressed, and start to see the patterns in his life, the threads of the web that bind him, he may see ways of pushing back, or breaking them, to free his mind.
The human mind should not be 'set' to depression permanently - we should be as capable of 'elation' as 'despair', but when you are depressed you lose the ability to think you can EVER be 'not-depressed'. Depression is like a cancer of the mind, it 'takes us over' and in a way the first thing to fight is the 'depressed about being depressed' state of mind, the state of mind that makes us feel there is 'no point' in trying to 'feel better' because it's impoosible. Depression WANTS us to feel it's incurable .....
From what (little) I understand, depression can be caused by two things (broadly speaking):
- a chemical imbalance in the brain. This is a 'faulty setting' that is caused by brain chemicals, just as any 'illness' is caused, ie, it is not (possibly!) within our control. (Just as, say, epilepsy is not in our control). BUT it can, one must hope, be controlled, or at least managed, by, say, anti-depressants, which simply serve the function of compensating for the biochemical imbalance in the brain
- 'bad things' happening to us in our lives. These 'bad things' could be anything and everything, and of course could go way, way back into childhood (eg, a traumatic event), or things still going on, etc etc.,. Then it is a question of using both ADs, and psychotherapy, to 'tease out' just what is behind the depression, what is the 'bad stuff' that has haunted us and continues to haunt. By exposing the cause, you can start to tackle it. Problems don't just 'go away' on their own - they tend to fester unless they are exposed, identified and understood, and, hopefully, we come to 'peace' with them.
Or, of course, there can be a combination of the two - a chemical imbalance might create what could be called a 'predispostion' to depression, which could then be triggered/exacerbated by a 'bad life event' etc etc.
One thing is for sure (in my mantra personally!), we are not 'designed by nature' to be depressed - like I say, we are designed to hold the balance, and adapt to our circumstances, and find the strength, courage and determination to triumph over them. We are designed to be 'happy'.
