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Posts from the ‘Depression Trough The Looking Glass’ Category

Being In The Room Part 1

Being In The Room: Part 1

I’m posting this as an update. I realize this is a long post but read and learn. My friend, George, is on new medication and is doing great. It isn’t a perfect fix, but it really works for him. I’m also posting this as a 1 of 2. I’ll be adding to this blog.

Today I discovered something about my kitty, Princess Penelope. She needs me to hang around while she eats. The reason for this is that when ‘Roo and Bob ( my other cats) were alive, I supervised the eating process so that they did not “mooch” off of each others food. I guess she got to like the secure feeling my “anti-mooch” presence provided her.

After Bob died, I took to placing Princess’s food down and letting her eat. I’d go about my business and I thought everything was fine. It wasn’t.

This morning when I fed her I stayed in the room and sat at the table. She’d eat and then come over to see me and then return to her eating. Just like a two-year old!! I thought about this and realized that in her time of adjustment by being in the room while she eats is part of her process of building a new life without Bob. For 15 months I was in, and out, of her daily life. I’d better remain present now: She still needs me to be in the room.

Lately I’ve been thinking about being in the room for those who need us. It isn’t always easy, and sometimes it can be frightening to watch someone you know and love suffer either physically or emotionally. So, how often do we remain in the room for those that need us? How often are there enough people in the room? Rarely.. Sometimes people run from friends and family because they don’t know what to do or are just scared. They run from perceived rejection which can be very real. People turn from the room because of the anger and resistance that are present there. In all honesty, who needs any of that anger, rejection and resistance-to-help stuff? However the person in the room needs you.

Yesterday I had a talk with my mother and she asked me about someone who I am presently “in the room” with. I’ll call him George. Her comment to me was that George is really suffering. Yes, he is and I hurt for him. Both my mother and I have known those who have suffered in life and it is hard not to hurt when you see this type of emotional pain in others. Seeing this type of pain isn’t a highlight of life, but it is what life is made of and I have chosen to not run from it.

George is suffering from depression and despite the fact that there is a treatment team in place for him, he feels very much alone within his life. He feels many things: some are rational and others not so rational. Depression is a blood-sucking alien that distorts every aspect of life. For some there is no escape from the daily ravages that depression can cause. George is one of those people who, despite medication, is not helped as much as he’d like to be helped.

Here is something I found to be very valuable in my process of remaining in the room with George: https://www.youtube.com/watch?v=NOAgplgTxfc&index=6&list=PL4C47FE7B6D5BFE1A (Full Lecture) This is a great lecture and explains depression well. It is well worth your time to listen and learn.

Staying in the room is challenging, heart wrenching, and at times frustrating. It takes work on my part to remain supportive and present. I remain a friend to George because I am committed to our friendship. True friendship entails being there for the fun, the good, the bad, and the hard stuff. True friendship seems to be a dying art.

We each know someone who needs us. If your circle does not include such a soul, look deeper into your circle and you will find your own George, or Georgina. If you say that you have looked and there is no person with needs then ask yourself WHY? I promise you there ARE people who need you this way in your life.

What George teaches me is to show compassion when it is hard to do so. He teaches me to remember that there is hope. I learn each time with him, to search within myself for understanding. He teaches me that I can’t fix it, but that I can listen. He has taught me to be a better therapist. Knowing George has enabled me to look at the way I deal with my own struggles in a more honest manner.

What I hope George is learning is that I will not leave the room. What I hope George is learning is optimism in his daily life. He might never be completely rid of the depression, but it can be far better than it is now.

We all know a George. This is someone who struggles with something that causes you to question what you can do for them. Sometimes the feeling is that you don’t know what to do so you do nothing. You feel embarrassed, or clueless, and feel as if you can’t relate to this person. You might not want to admit that you are truly ignorant about what to do with someone facing a particular challenge in life. But, don’t walk away!!! There are many ways of dealing with those in need. There are things you can do to learn how to remain in the room.

Getting into the room may not be easy. You might find resistance at first. That is because there is going to be disbelief and shock and skepticism inside. At first you may not be welcomed with open arms. Keep your heart in the right place and things will happen.

Here are some things to start with and to keep in mind when entering the room. It isn’t a complete list: it is meant to get you to think of what you can do if someone needs you.

If you don’t know what to say at first, be loving and kind and tell them that you aren’t certain of what to say. Tell them that you will listen a great deal. The fact that you care enough to be there is a grand beginning. Once you have started to earn their trust as someone who will remain in the room with them, offer to help. Ask them what they need.

One woman I know sat for hours and did some needlework while her friend sat, slept, and then wanted to eat. Just being there opened a door so that her friend could learn that there was someone who cared.

People with depression suffer from low energy. Don’t challenge them physically. Let them set the pace. While you can see the benefit of getting out and walking, the thought of putting one foot in front of the other might be too much of a task for them.. Reassure them that it can get better. Don’t expect them to move towards anything rapidly. At this point in time, my friend, George, manages to walk for five minutes on the treadmill. That is all he can do and it is enough for him.

Try quiet things. Keep it low energy. Sit and talk. You might try giving them a back rub (if they are comfortable with you doing so) to help stimulate the body. Music and other quiet, soothing activities can also help. You might discover other things that are easy and low energy. Don’t try to over-stimulate someone; let them set the pace. Think about doing things that take little concentration. People who suffer from depression have brains that are often offline.

Make sure they eat. Meals are great. Lack of energy and lack of ability to keep nutritional things on the table is an issue for many with depression. When your brain and body aren’t working efficiently, the ability to make good choices becomes difficult. Easy, fast and low energy consumption is how many people with depression function. Grocery shopping takes time and energy. Everything takes energy! Thinking takes energy, so a depressed person might try to avoid activities that entail complex thought processes. Cooking and cleaning are two such activities.

Commit to being there. You might get hurt. You might get told to “get lost”. You might wonder why you bother with this person. You might want to leave: don’t leave. The more you listen and learn, the more you will know what to say to your friend when they feel as if there isn’t hope. Don’t promise them things you can’t deliver. Deliver what you say you will do and be consistent about it. If you are honest with them, they’ll be honest in return.

Your friend may be really embarrassed. This isn’t easy for either of you to deal with. Your friend may be feeling embarrassed with the situation. Your friend might not be totally honest about what he, or she, truly needs. They may feel as if they are not deserving of your time. Your friend might think that the only way they are going to get through the ordeal is to go it alone. Let them know that they aren’t alone by showing them that you are with them.

Depression sucks the life out of its victims. The depressed person may attempt to drive you away by creative means. THAT is the DEPRESSION talking. Realizing that you are actually having a dialogue with an illness will make hanging in there easier to deal with. You might not be thanked at first but hang in there as eventually the tide will turn.

You may see how important it is for your “George/Georgina” to get professional help. They may understand the need for help as well, but might be too worn down to help themselves. Offer to help them get the help, but make certain that they are still in charge of the situation. They might need reassurance, they might be scared, and they might not be able to understand how bad it really is. Point things out gently and don’t push. If you are kind and gentle you will have an easier time being successful.

Switched off brains.

Imagine that you have a laundry pile that needs doing. You walk by hurriedly because you are running out the door and can’t get it into the machine. When you return home, you go put the laundry in the machine and simply get the wash done. That is what normally happens. Now in the mind of someone who is really depressed, this is what happens: they see the pile of wash, walk by and think, oh I must do that wash and I will do the wash later. The next day they still see the wash and think the same thing. This goes on for some time until a crisis, or something else, triggers the wash having to be done. In simple terms, the brain is switched off. One of the plusses regarding medication is that it can switch the brain back on.

I am just scratching the surface here but my goal here is to get you to think of remaining in the room.

Briefly, I want to talk about suicide and medication use. Suicide happens because there aren’t enough resources to bring to the situation. Most people want to live and move on. Most people, even when they do have feelings of suicide, don’t want to act on them. This does not mean that a person won’t act, but rather that they are driven to act because they feel that the resources have run out. I’ve known family friends who did act. They are now beyond my voice. For them I wish that there might have been a way to help. I wonder what went wrong. What could have been done to bring the needed help to each of them?

The most dangerous time during depression is when a person has the energy to act on the impulse to suicide. It takes energy to kill yourself. A person with a lack of energy can only think about a plan, but once their energy rises, they can carry the plan out. You might want to know what your friend is thinking as far as a plan and be prepared to “suicide proof” the house. Make a protection plan in your mind. Don’t be afraid to ask directly “how suicidal are you right now?” I’ve asked this at times and been told what I needed to know. George says that my asking lets him know I’m in the room.

Medication is a tricky thing. It isn’t the answer for everyone but for those that it works for, it can be truly helpful. Medication is a process of hit-and-miss and it takes some time to get it working well. A good psychiatrist will work with you to find a good drug, or combination of drugs. The best results for treatment, combine medication and talk therapy. But, don’t expect the problem to disappear in one to six weeks!!!! Be gentle with yourself and work with your mental health professionals for the best possible outcome. Think of those involved as part of a treatment team. Help your friend to understand this and to be gentle and realize that it will take some time to see results.

Penelope is now sleeping here on her blue table by the window. She seems content to sleep and enjoy life. I smile at her lovingly, because she is acting better and feels my love for her. Okay, I assume she thinks all of this. Meanwhile, George continues to learn about his depression and how he can strengthen himself. Life does go on and each day that I am in the room with him is a day that is good. Now if it would only rain chocolate. AHA there’s a thought.

Being In The Room 2/2

A few of my readers have contacted me off-blog with questions. This second post is meant to address those questions and focus on the area of support and maintaining a positive outlook when you are in the room with a person that is stuck in the tube of depression. This is long, but worth it. (In my humble opinion.)

One of the issues with depression is that there are many who distance themselves and few who are courageous enough to enter into a support role. This can be a really dark, lonely place to be in with someone. Depending on the variety of depression that is being dealt with, there can be many dynamics occurring.

Here are some suggestions. 

Be a friend. You can’t fix it or make it better. You CAN urge them to take steps to get help. Know that this is easier said than done.

Above all else, you are a friend first. Your love and caring for this person is far more important than anything else and they need to know that: no exceptions. However this doesn’t mean that you fail to set boundaries with them.

There are several reasons this is hard to do: a) The depressive brain is not thinking logically. b) The person with depression might behave in an aggressive manner that shuts you out because they are fighting to protect their dignity, their space, their denial, or their uncertainty about what they are witnessing within themselves. And this is just a fraction of what might be going on in their head!

YOU have to decide if you care enough to push through the facade. Sometimes you act out of love and you find that it is more than you bargained for. Once you are in that room, leaving can do a great deal of damage, so hang in and learn how to be a good friend.

Recognize that the depression will most likely speak louder than your family member, or friend.

Remember the laundry pile? You are dealing with somebody who has switched off logic. While their brain might tell them on some level that something is not right, they may not be in a position to make the connection.

Something called “psychomotor retardation” is occurring in their body. This means that physically and mentally processes slow down. They can’t think at a normal rate. Movement may also be impaired.

They may, or may not, know what they really need. You will have to ask questions. Ask slowly: Don’t ask them several things at once. Their ability to process answers may be impaired due to psychomotor retardation.

At first they may not have the energy to think about the answers, but as you persist, over time they will open up. They might not believe that you are taking a genuine interest in them and might push you away: Stand firm. You are doing a great thing, but remember their brain is processing inaccurate information. Reassure them that they are worth your time and that you really are there because you care about them.

Once you break through and establish some trust in this area things will change. You’ll know this because they might call you and tell you they are having a bad day or that they need a walking companion. It could be anything. They might admit to some of the chores that they really struggle with. Offer to help out and follow through.

Sitting in the room.

You are now with them, they know you care and they are willing to accept your support. How do you keep yourself healthy?

Reward yourself!! Dig into your movie stash and watch a favorite film. Read a book or article. Pursue your hobby. Do anything that lifts your spirits under normal circumstances.

There are times when you might need to talk and let it out. Make certain that your talking partner understands your need to process your own feelings. Just as you can’t fix the depression for your friend, you don’t need someone to fix your feelings about being a support person.

I’ve mentioned setting boundaries. Often people think that setting boundaries is about saying NO. It is also about saying YES and compromising. It is about knowing and understanding when you can say I need to finish x y z. There are times when hearing the urgency in their voice will signal a decision that it needs to be heard right then.

You can’t force anyone to do anything.

As much as you might want to force a promise out of this person, you can’t. They’ll promise you only if it is their choice to do so. If you expect them to commit when they aren’t willing it will cause both of you to have stress. It will strain the relationship and you will burn out.

Now that the above paragraph has been stated firmly I’ll explain further what you can do. I’ll explain what you need to know in order to keep your head together.

Professionally, I want to keep people safe. If I have a client who has the energy to both create a plan and carry it out, that client is going to need to be in a safe place. That might mean a hospital. I set very firm boundaries with my clients.

George is my friend. George and I have a deal. George has promised me that he’ll talk to me before he would carry out a dangerous plan. The problem with the type of depression George has is that his mood swings are sudden. George knows that if he were to complete suicide it would hurt me and others.

I’ve had to come to terms with the fact that you can’t stop someone if they are really hell-bent on doing it. That is also part of the depression dynamic. It really is a no win situation. The thing is that by knowing and accepting what could happen I am less stressed about it. That doesn’t mean I’ve stopped caring, but it does mean that I’ve come to a peace about how I deal with the threat of suicide. I can listen and try to understand.

I’ve known multiple people who have committed suicide. I’ve shed tears and yelled and screamed and I wish every one of them were still here. I’ve also realized that for each of them they felt there was no other option. This has caused me to listen to people seriously and to respect the power of depression in their lives. This is why I have the policy that I do towards my clients.

Take what your family member or friend says seriously. When they can’t move and do much is one thing, but when they can move and carry out a plan, that is a time for action on your end.

Support Teams

You shouldn’t support alone. The ideal would be to urge your friend or family member to seek professional help. Build a treatment team. If at all possible find someone local. Find a professional that works with depression. Ask around because depression is common and someone you know might be aware of that professional person who helped them. Some are better than others. If medication is an option know that there are some psychiatrists that are better than others. Here are some tips you might not find on other sites:

• Anyone who won’t take the time to do a proper intake and evaluation is out. I once saw a psychiatrist spend two hours on an intake with a man. Because of the time he took, the doctor was able to look at this man and his depression from a completely new angle. It made a great deal of difference. It might take several visits to really understand the issues. This is also true in terms of locating a good therapist.

• Does your friend or family member want you involved in the treatment process? Sometimes you, or others, must be contacted if the need arises. I’ve had family members contact me to report urgent psychiatric situations. When depression and suicide are involved I can only ask for this to be in place, and we talk about it before it is put in place. This is a relationship and can be negotiated. So, as a therapist I have signed release forms before I speak to someone of my clients choice.

• Does this professional work in a holistic manner or are they only focused on their particular slice of the therapy pie? If the therapist or psychiatrist takes a more holistic view be prepared to support this. They’ll most likely start with the diet and exercise. People with depression don’t eat well and often they don’t have the ability to exercise because of low energy. The list goes on but these are two basics. When the time is right both eating and exercise should be addressed. You, as part of the team, may have an influence here. Most folks like a good meal. The exercise is a wee bit trickier. That will take time. George is into food because it is one thing he can enjoy.

• Getting a gym membership might not be an option. How can you exercise? At first it might be that walking or running around the house is all you can do. Then as things pick up, walking or running in front of the house or building, up to a walk around the block!! Keep it simple and low energy. George lives near a foot bridge so we walk and feed the duckies. This activity works on multiple levels. Get creative. Walk a neighbors dog for them because doggies should be walked. Find something that is easy for the depressed person to do. They might have insight into this as they become stronger in dealing with the depression.

I haven’t mentioned it all.

I’ve only scratched the surface here. This is meant to get you thinking. I hope it does do just that. Get in that room and stay there and become a person that says yes to being a true loved- one, or friend in a time of need. You will be thankful that you did this for them and when they finally pop out the other side of the tube, it will be a grand celebration for the both of you.