She’s not willing to seek help from a therapist (she thinks that divulging her feelings won’t help her) and she believes that exercising (and ultimately feeling better about her self image) is the surefire way to improve herself and our relationship. Should I play a role in keeping her accountable? If so, how?
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Sure! Make an exercise plan and work out with her. The help with self-image part she mentioned is basically irrelevant, but exercise does usually help quite a bit with depression.