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; the depressive brain is not thinking logically.
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, and 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, and 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 wished 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, that is one thing, but when they can move and carry out a plan, that is a time for action on your end.
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 client’s 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 neighbor’s 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.