Helping Depressed

Bob and Katie's lives seemed to be going along fine.  The bills were getting paid, the kids were healthy and had made some good friends, and Katie no longer wished she lived back in Florida instead of Hayden.  Things were pretty good.  There was just no reason at all to explain Bob's unexpected slide into depression.

After a couple of months, Katie finally convinced him in to see a therapist, and the diagnosis was confirmed.  A psychiatrist prescribed an antidepressant, and Bob usually felt a little better after a counseling session.  Some days were good, but others put Bob into such a dark mood it was hard for him to get out of bed in the morning, much less function at work.  He knew his mood affected Katie and the kids, and he hated that.  Sometimes he wished he lived alone so he could fight through this thing and not be such a burden to his family.

Cloud of Depression

What Is Depression?

Life circumstances can throw any of us into a depressed place, for a time.  Events like divorce, job loss, or death of a loved one can trigger a period of despair or anguish that is easy to comprehend.  Recovery from this kind of depression is highly responsive to brief counseling and the balm of time.  For some people however, depression seems to come without any obvious cause.  The tendency to feel depressed can run in families, apparently a 'mood disorder' that may have a genetic basis.  Endogenous depression seems to have a mind of its own, coming in waves, lifting, returning again, and feeling so painful and oppressive that suicidal thoughts may occur.

When you stand by and watch someone you love at the mercy of depression, you  hurt, too.  It's agonizing to want to help, yet feel basically powerless.  Your own hopes go up and down with each good day and bad.  You want to trust the doctor or therapist, but curse them when they seem unable to make things better and progress seems nil. 

Best Supporting Role

The best way to help is somewhat dependent upon you, your relationship, and what your loved one needs from you.  Assuming s/he is receiving counseling, talk with the therapist about your role and how best to be helpful.  If not, here are some basic guidelines for helping with depression however, such as the following:

    1) Depressed people find it difficult to relate to others.  They usually signal this by less eye contact, speaking more slowly and softly, and avoiding interactions when they can.  When we "intrude" by engaging the person in real-life responsibilities or conversations, we may provoke an anger or hostile response (it's no wonder that families with a depressed adult is often accompanied by an increase in marital arguing). 

    Because of the negative reaction, it's tempting to steer clear of the depressed person after a few of these encounters.  Don't.  Life goes on, and there are decisions that need to be made, parent-teacher conferences that need to be attended, and household responsibilities ("put your dirty laundry in the hamper, Bob") that need to be adhered to.  Everyday topics and issues need to remain part of your interaction, in the interest of everyone's health.  But excessive probing, chatty exchanges, unnecessary parties or functions to attend…these can be minimized if your loved one is not up for it.  There's no reason to push for a discussion of Britney's latest escapade or the sale of the Steamboat Ski Area, when he/she is a million miles away.  Find the balance.

    2) Depression can affect the children, too.  In the early stages, you may find yourself minimizing or excusing-away the irritability or emotional remoteness to your child.  But kids are aware, and if the problem continues this kind of avoidance is not healthy.  Depending on the ages of the children, you can have a Family Meeting (all of you) to explain what depression is, or just talk with your child(ren) about it privately with whatever detail fits the age.  Think of it this way: if daddy had diabetes, and required insulin injections twice a day, it would be silly not to explain it to the kids.  Same with chronic depression.

    3) The depressed person feels, by definition, hope-less (at times).  This means you have great importance to him/her, as a source of security, faith, and hope.  Being depressed means you've lost the way, and without a ray of optimism or reassurance that it will get better this pessimistic slide continues.  You can provide that encouragement and hope, by remaining positive and realistic.  It's not the same as being a pollyanna or always-up optimist.  That kind of cheeriness is hard to stomach, and transparent to all.

    Your realism should recognize that depression does relent with time, that therapy and medications do work, and that this is not a terminal condition.  All of those statements are based in research studies, by the way.  Allow him or her to cry, despair, and grieve when that has its grip.  But when the tears have been shed and the anguish has passed, you can provide the realistic reassurance that things will get better in time, that s/he is doing all the right things to get there (if compliant with treatment), and that your love remains as strong as ever.  You are a life raft of hope.

    4) Don't over-adapt to the depression.  When your loved one sinks into the gloom, you don't have to alter your lifestyle to become a nurse.  If you like to hike every weekend or go ski-touring in the winter, keep it up!  If you volunteer at the Tread of Pioneers or want to audition for the next Emerald City Opera performance, do it!  Your self-denial is likely to become an additional burden to your depressed loved one.  More importantly, if you stop enjoying things just to be supportive or a good caregiver, you may well end up resentful and angry over time. 

Helper Do’s & Don’ts

Depression does not follow strict rules.  Symptoms shown by one person may be absent in another.  Alcohol abuse?  Sleep problem?  Over- (or under-) eating?  While these are common signs of depression, they may not be problems for your loved one.  With that in mind, consider these Do’s and Don’ts for helping someone cope with depression.

  • DON’T  exclude the depressed person from important family discussions or decision-making.  This will encourage feelings of inadequacy or isolation, and cheat the person of opportunities to feel valued and included.
  • DO  discuss the depression and coping openly, when appropriate.  Learn what you can about depression from reading, your therapist, and other sources.  Be candid with your loved one about what you know.  Treat it with the same openness you’d give to other problems like a leaky roof or arthritis.
  • DON’T  do too much for the depressed person.  While depression often saps energy and motivation, jumping in with “No, I’ll do that” too often sends a message of incapability. 
  • DO  identify faulty ways of coping with the depression, and express your concern.  If the person is drowning his feelings in alcohol, don’t look the other way.  If dodging work is jeopardizing her job security, expose the problem.  If eating is becoming a weight or health problem, talk about it.  Make it known that these are complicating the problem, not fixing it.  But DON’T chip away at bad habits or traits that just bug you.  Fixing the bad table manners or snoring is best left alone for another time.
  • DON’T  make important decisions during the depressive illness, if possible.  Getting married or divorced, buying or selling a house, changing jobs, moving to Montana -- these are often dealt with much better when emotions are less of a problem.
  • DO  listen.  It’s a skill most of us don’t do very well.  Practice it.  Knowing someone really listens and understands is a huge help.

In summary, recognize that your loved one is going through a very difficult illness, and that it is appropriate for you to show concern and want to help.  But don’t remake your own life around their angst.  You can be a comfort when the despair is overwhelming and he or she needs someone to hold on to.  But you can also be a source of strength and hope, by showing your positiveness and affirmation of life, a beacon that depression can and will pass in time. 

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