What do you need or want from your loved one?

@marlenec I would say that what you are doing right now is most helpful to your son. You are showing him that you care for and about him. This caring attitude is more important (in my view) than most anything else. You don’t have to do anything else other than be « present » for him as you are already doing. Asking him to take a walk with you and your dog did get him moving and that’s a very good thing. Sometimes with depression and anxiety it’s just so difficult to move. Moving the body is a kind of reset to the nervous system. I found that my brother and I (like you and your son) had similar responses to one another with antidepressants. We are now both taking duloxetine (Cymbalta) and it’s working for both us.

When I have felt very depressed I didn’t like or want unsolicited advice. To me that wasn’t caring. It was an attempt to fix the problem from someone who didn’t understand how I felt and didn’t want to know how I felt.

I think when you remind your son that he has had so called good times and bad times is helpful. He hasn’t always felt this way.

Perhaps not today but someday your son will look back and will know and appreciate how much you care about and love him. If there is a depression support group in your community or online he may appreciate listening to others even if he chooses not to talk. Is your son seeing a mental health therapist?

Thank you. He has a therapist - finally recommenced therapy after a hiatus while securing new insurance after our move. I also have a therapist whom I see weekly because I struggle with how upset I get at seeing him upset but I also struggle to not show it since I think that will make him feel worse. He keeps saying he’s sorry and I keep telling him that he has nothing to be sorry for since this isn’t his fault. He drummed up the energy just now to go into work but I could see he was still fragile. He has a lengthy history - was in residential for a month six years ago followed by an IOP. In essence he’s done all the “right” things to address his illness but his illness still makes him feel so worthless. He’s unemployed because he cannot seem to get a job he wants; he’s in grad school trying to get another degree but I know he feels as if nothing he does is ever going to work out for him and all this affects how he feels as a dad. I am considering going to a NAMI support group for care givers. I was my late husband’s primary care giver for five years during his (lost) battle with lung cancer and it’s hard to keep having to assume this role.

The kind of help I need from my loved ones varies, and there are no hard and fast rules, it is not set in stone.
Sometimes I need space, meaning no interaction with others. However, that space has to be given for a limited time otherwise I fall too deep. Unfortunately, I can't give a number of hours that's suitable.
Sometimes (A LOT OF THE TIME), I need help with chores and errands. On this one, I need to be asked because sometimes it helps that I was somewhat involved in the activities, so I don't feel more useless as a person. Other times, I don't have the strength and those activities just make it worse.
Also, loved ones asking what I need, and listening to the answer(s) is crucial. Some of the things they may want to do for me to help can do more harm than good, so I value it when I am asked. You must help a person on their terms, not on the terms of the person giving the help.
Being reminded that I am loved and valued also helps. As does being reminded of the good that I have accomplished. Those reminders can help with the feeling of being useless as a person.
Basically, what I need from loved ones is "We love and cherish you. We are here for you, please show us how to take care of you. We will try to catch you or cushion your fall, whichever way you fall".
Sorry that this is not a very precise response.

Thank you for such a candid response. Your comments are very helpful to me.

Having given it a bit more thought: there's more. Everyone has one thing or a few things that sort of soothe them. If you can get that or have it done, it helps. When I am soothed, I am less anxious, and that lessens the weight of the depression. It will be different things for different people. For me it is: my bed having been made in a certain way, a long soak in the tub (this one only works a handful of times), cotton clothing (if possible, freshly washed and ironed), dim lights, and open windows. Eating breakfast late at night also helps me.
If you could find what those things are for your son, you could do them for him. You don't have to do everything at once or do something each day, but on particularly difficult days or perhaps at random, you can do some of those things.
Please ensure you are also receiving some care as the caregiver, because you are very important, and needed, and valued.

Please go to the support group. Gather whatever support you can, and use it.
May I also suggest that you do something for yourself at least once a week. It doesn't have to be something big, it can be as simple as taking yourself for coffee and just having some you time for half an hour or going to brunch or to see a movie.
Sending you love, warmth, light, and hugs.

I think the hardest thing for him - and for me to see him feeling - is his absence of hope that things will ever be better and his absence of any sense of success or accomplishment. I know - and at some level he knows as well - that these are the demons speaking. And frankly there are many times he’s tried something and failed. What do you do to regenerate hope?

He might want to look into getting Spravato treatments. It’s the only thing that really helped me in decades. It helped me have hope and feel more motivated. It only costs me $20 per treatment. I’ve also found that mindfulness meditation helps. I recommend that for you also. Insight Timer is a free meditation app that I like.