N is actually doing better than he has in a long time. We've tried a new strategy that seems to be working. The stress of the semester continued to become a heavier and heavier burden. We saw depression emerge at a completely different and dangerous level. At the point that he started having suicidal thoughts, we knew it was time to intervene. After consulting with his new doctor, we decided to try medication. All this time, N has persisted without it.
The amazing thing is that by the second day after starting the meds, he was already benefiting. We use a scale to discuss depression in our home. A "1" means you're doing well. A "3" means you are feeling blue. A "5" includes feeling blue with having occasional suicidal thoughts. A "7" means constant suicidal thoughts and ideas of how to follow through are forming. A "9" is the point where plans are in place and they are actively working toward them. As we contemplated needing to get N additional help he was up in the 5s and sometimes as high as 7s. Since going on the medication, he's had all 1s. In fact one day he commented that maybe he needs a new scale because he is doing even better than the scale allows. I'm amazed that it has made this much difference.
He is on a med that addresses both anxiety and depression. I suspect that N has lived with daily anxiety for so long that he (and we) didn't realize how much it affected him. The meds usually take two or three weeks to really help with the depression, but they address the anxiety much more quickly. That quick response suggests that the anxiety has continued to be a major contributor to his struggles. I'd hoped that a reduction of anxiety would also help with anorexic issues, but those haven't completely gone away. His weight is in a much better place, but he continues to look in the mirror and dislike what he sees. The good news is that he is doing a great job of holding his weight instead of giving into those thoughts.