When a Loved One is Depressed – A Survivor’s Guide Part I

There may be nothing more difficult in your life than having a very close friend or family member with depression.   You may chose to be supportive and not abandon them … or give up, if things get to be too tough or if you are not prepared or experienced. Most of the time that depressed person more likely will abandon you, sometimes its just in a mental way and sometimes physically.  With time and experience, you as the person giving support, will learn to cope more or less and to survive these depressed episodes.  I hope that throughout these years that I have been successful overall and have helped my friend have some joy in their life.

Most of you reading this page have had little or no experience in how to deal and cope with depression in other people that may be very close to you. Perhaps these series of blog entries may help give you a little bit of direction, understanding of what is happening and maybe even some hope.  This is a long topic and therefore divided into 6 different posts.

According to the National Insitute of Health (NIH) – read this link for the symptoms — Each year about 6.7% of U.S adults experience major depressive disorder. Women are 70 % more likely than men to experience depression during their lifetime (some of this increased rate for women is due to all of the hormonal changes from adolescence, postpartum to menopause).

Due to the stigma attached to mental illness, this is the one disease that the person afflicted usually tends to want to hide it from others or even be in complete denial. Not only does this make it very difficult for the supportive person or spouse to be able to provide them with help and proper medical attention, but they likely may fight you over the fact that the problem even exists at all. Were the person a minor under 18 years of age, you would have much more control over their care. But an adult has legal rights which can block you from doing a lot of things to help them such as being involved with the selection of a good doctor, getting them properly diagnosed and treated, or in the worst case scenario — even being involved at all in their medical care and office visits.

Depression is not an isolated problem like cancer, diabetes or some other disease. It affects everyone who comes in contact with this person. It has the danger of drawing you in and also making you yourself depressed.  This is the first of a multiple part documentary summary by someone who has been involved in this for 26+ years trying to give support to a close family member and best friend and is currently right now trying once again to survive this latest round.

Hopefully you will never have to experience this either as the depressed person or as the one giving the support. Being on either side of this line is traumatic.  It is a disease without a cure and at best has inadequate treatment. However, if you do find yourself involved, perhaps some of these ideas might help you to survive the pain and sadness that you will inevitably have to go through should you decide to stay on and help.  In the end, it is worth all your pain and sadness it because you love that other person and know that being together with some pain is okay because you also get to see them during the times that they are out of their depressive episodes and have periods of some normalcy in their life.  Those times which are sometimes just moments or can last for a few months or even years, make it all worthwhile.

Depression is a medical problem. You who are offering the support are not the cause. Do not let it or them make you feel bad or guilty. Depression is the result of a chemical imbalance or physical irregularity in the brain.  If the initial depressive “episode” is long enough and serious enough, it could have cause permanent damage to parts of their brain.  In this case, the doctors will insist the person stay on antidepressants for the rest of their life …. for better or worse.  This too may do further harm unless the meds are carefully monitored, adjusted, and even changed.

Most medicines including sleeping pills begin to lose their effectiveness during their first year or two of use.  If the doctor is just one of those pill-pushers, and the patient only visits their shrink to get their meds renewed, they can both be fooling each other in order to quickly end the office visit. The patient is happy because they walk away with months of prescription renewals to meds which they believe are keeping them stable.  The shrink gets his 10-minute in and out visit, easily billed to insurance … and believes that the patient actually told them the truth  … that they are fine, happy, and everything is great.  The shrink is also very happy to hear this because they just were told that they have been doing a great job.  Which is likely far from the truth. This is where you as a third party and  day-to-day observer of this erratic behavior would find it important to be involved in this process. Otherwise these office visits and the meds being prescribed are just a complete waste of time and may even be harmful.

For many people, depression has a very strong genetic link to it. If one person in the family has it, then it is likely that other blood relatives may have it also. It is not the fault of the person affected.  Nor should you the caregiver be blamed as being the cause.

Most psychiatrists do not really understand it, do not take the time to sit the patient down on their couch – if they even have a couch anymore- to try to determine the cause. The fact is that most psychiatrists are just pill-pushers who are using a best-guess approach (accent on “GUESS”) when they make their 10-minute diagnosis and their follow-up office visits. Most  are not trained in the art of talking to and understanding their patient. You are just a component of their chargeable hours of that day. The more people they can fit in, the more $ they earn. Most of the meds they prescribe are just drugs that will temporarily numb the mind and the pain to help the person get through the day, but do not cure anything. Because in most cases, the cure does not exist. Psychiatrists will be in denial about this last statement. But trust me, after 26 years experience, they are no closer to finding the cause or the cure than was Freud. Over time, those prescriptions that they prescribe become much less effective  … probably never worked at all.

Depression most of the time follows the pattern of a sine curve (or ocean wave). It has its up periods when your “friend” seems to be okay. This period can last for weeks, usually for months. If you are lucky, this up period might even last for a few years. But inevitably, the slide back into what I call the black hole of depression is inevitable. It is not a question of if it will occur, just when.  It is at this point that your job to shower that person with love is critical. We don’t have many other options available. If you happen to have a cooperative shrink involved, who will take your phone calls and listen to your feedback, perhaps they can offer some intervention or at least be a third party to talk to.

Many of the modern shrinks won’t listen to you the supportive friend or spouse because they like to hide behind their “HIPAA” rules (rules of secrecy about disclosure of health info. concerning their patient) which are just their means to keep you out of the loop of participation. Those that hide behind HIPAA do so because they have very limited training in anything other than being pill-dispensers. They have little confidence in what they are doing is the right approach and don’t want to have anyone else close by that has some degree objectivity, overseeing their mistakes and second-guessing what might be a better approach.  Most shrinks don’t even want to spend the time to listen to their patient. If your friend or spouse has one of these types of psychiatrists, find another one. It is imperative that you be actively involved in their medical care.

When this slide back into the ‘black hole” occurs, be prepared to be blamed as the cause and the entire reason that their depressed life is being destroyed.  So you have to listen, smile, give them hugs, lots of love, and continual support. Those are the only tools that you have. But just keep in mind that this is a medical condition, not something that family therapy can cure. It is also not something that the shrink will likely cure.  This is the period when you say a lot of prayers and hopefully have a group of friends, family and your Church supporting you  …. and try to hold on as best as you can because eventually the ebb and flow of this disease will begin to shift and that person will climb back out and become more like their old selves … for a while. Give thanks for these periods and enjoy them as well as you can. Hold on to the positive memories because the cycle will inevitably begin to repeat all over again.

Do not blame yourself either way. The depressive episodes will happen independently to what you are doing. You can just hope to lessen their pain. Do not allow your depressed spouse to pull you back into that dark hole with them, because then there may be no one left to help them. You have to stay strong. Try and keep living your life as best as you can under these difficult circumstances. Try and keep a positive attitude toward life and towards them.

This is too sad of a topic and getting too long to continue right now. So this ends Part I.  There will be at least 5 more Parts to this.

Even this fish picture below is empty of any colorful fish, just some purple tube coral …. in a vacant sea.