Reflections: February 2008

This is a collection of helpful articles written for those of you out there who know someone with depression, but who may not be sure of what to say or do to help that person. It is most tempting, when you find out someone is depressed, to attempt to fix the "problem." or just sometimes it's hard to think of the right things to say.

Is Someone you Love Depressed?
http://www.hbcprotocols.com/someoneyoulove.html

The pain of seeing a loved one in the depths of clinical depression can be almost as torturous as being depressed oneself. Needless to say, our understanding of the illness and how we relate to the person is paramount to their recovery. Here are some important ways in which you can help their healing process.

1) If a friend or family member's activity and outlook on life starts to descend and stays down not just a few days, but for weeks, depression may be the cause. The first way you can be of support is to help the person to recognize that there is a problem. This is especially crucial, since many people fail to realize that they are depressed. Begin by encouraging your friend to share his or her feelings with you. Contrary to myth, talking about depression makes things better, not worse. Once it becomes clear that something is amiss, you can suggest that he or she seek professional help. (This is critical since only one third of people with mood disorders ever receive treatment.)

You can be of further support by accompanying your friend to his initial doctor's or therapist's appointment and subsequently monitoring his or her medication. In addition, explain that seeking help for depression does not imply a lack of emotional strength or moral character. On the contrary, it takes both courage and wisdom to know when one is in need of assistance.

2) Educate yourself about the illness, whether it is depression, manic depression, anxiety, etc. Learn about symptoms of the illness and how to tell when they are improving. Your feedback to the psychiatrist or therapist about how your friend is faring will help him or her to assess if a particular treatment is working.

3) Provide emotional support. Remember, what a person suffering from depression needs most is compassion and understanding. Exhortations to "snap out of it" or "pull yourself up by your own bootstraps" are counterproductive. The best communication is simply to ask, "How can I be of support?" or "How can I help?"

4) Provide physical support. Often this means participating with your friend in low-stress activities-taking walks, watching movies, going out to eat-that will provide an uplifting focus. In other instances you can ease the depressed person's burden by helping with the daily routines-running errands, doing shopping, taking the kids out for pizza, cooking, vacuuming the carpet, etc.

5) Encourage your friend to make a list of daily self-care activities, and them put them into practice.

6) Monitor possible suicidal gestures or threats. Statements such as "I wish I were dead," "The world would be better off without me," or "I want out" must be taken seriously. The belief that people who talk about suicide are only doing it for the attention is just plain wrong. If the person you care about is suicidal, make sure that his or her primary care doctor is informed. Don't be afraid to talk with the person about his or her suicidal feelings. Meanwhile, hold on to the possibility that your loved one will get better, even if he or she does not believe it.

7) Don't try to talk the depressed person out of their feelings, even if they are irrational. Suppose the depressive says, "My life is a failure," "Life is not worth living," or "All is hopeless." Telling him he is wrong or arguing with him will only add to his demoralized state. Instead, you might want to say, "I'm sorry that you are feeling so bad. What might we do right now to help you feel better?"

8) Maintain a healthy detachment. You may become frustrated when your well-meaning advice and emotional reassurance are met with resistance. Do not take your loved one's pessimism personally-it is a symptom of the illness. When the light you shine is sucked into the black hole of depression, you may become angry or disgusted. Direct your frustration at the illness, not the person. People who suffer from depression complain that their families' resentment over their condition often leads to neglect or outright hostility.

9) If prayer is something that he/she believes in than encourage them to do so. Prayer goes directly to a person's unconscious where it will not meet the negative thinking so commonly found in depression.

10) Establish communication with other people in the person's support network-e.g., family members, friends, physicians, therapists, social workers, clergy, etc. By talking to other caregivers, you will obtain additional information and perspective about the depressed person. If possible, arrange for all of the caregivers to meet together in one room for a brainstorming/support session. In this way, you will be working as part of a team-and not in isolation.

11) Take good care of yourself and your needs. It is easy to get immersed in your friend's care and lose your own sense of self. You may also experience "contagious depression"-i.e., taking on the other person's depressive symptoms-or you may get your own issues triggered. Here are some ideas on how to "inoculate" yourself so that you can stay centered enough to truly help:

- Take good care of your body. Make sure that you are getting adequate food and rest.

- Find a safe place to process your feelings. In the role of being a caregiver, you may feel powerless, helpless, worried and scared (when you hear talk of suicide), or resentful and frustrated (at your inability to heal the pain). Or, you may fear being pushed over the precipice into your own depression. Process your frustrations and fears with a trained therapist or a friend; you will be less likely to dump your negative mood (anger, fear or sadness) on the person who is suffering. Remember, it is okay to have negative thoughts as long as you don't act on them.

- Maintain your routine as much as possible. Although you may need to adjust your work schedule or other routines to accommodate helping a depressed person, keep your life as regular as possible. Don't become so involved that you lose touch with friends and social support.

- Learn to set limits, especially when you are feeling overwhelmed by the depressed person's pain and tales of woe. To avoid burning out or experiencing hostility towards the depressed person, encourage him or her to seek professional help. Your role is that of a friend or family member, not a therapist or a medical doctor.

- Take breaks. When you start to feel emotionally or physically drained, ask other friends and support people to relieve you. Then do things to nurture yourself.

- Continue to pursue activities that bring you pleasure. Having fun will replenish you so that you can keep on giving.

- Give yourself credit for all that you are doing-and realize that you cannot do everything. No matter how much you love another person, you cannot take responsibility for his or her life. Try to distinguish between what you can control (your own responses) and what you cannot (the course of the illness). To this end, you may wish to meditate on AA's "Serenity Prayer."

- Attend support group meetings for families who are dealing with mental illness. See the bottom of the page for organizations can provide you with times and locations of such groups:

12) Finally, encourage the person you are caring for to create a support system of other caring people, or help him or her to do so. It takes a whole village to see someone through a dark night of the soul. You cannot transform the illness of depression by yourself, but you can be an integral part of the healing process

If You Know Someone Who's Depressed
http://www.healthyplace.com/communities/depression/living/ifyouknow.htm

Main Problems for Friends and Family

Let me start by saying that I, for one, appreciate your wishing to understand someone else's depression. I commend you for taking an interest in a very difficult subject and for wishing to help. In an indirect way, you're a victim of depression too because this illness impinges on everyone around the people who have it.
Pardon my bluntness, but there are a few things you really need to know, before you get too far into this subject.

You cannot cure someone else's clinical depression. It is not just sadness which can be waved off with a few kind words. It goes far deeper than that. If you are going into this with the heroic notion that you can somehow "fix" it for your friend, spouse or relative, then you need to disavow it immediately. Operating on this assumption will only frustrate you and does no one any good.
There are ups and downs in depression recovery. It is neither swift, nor steady. Your friend or relative is going to go on the decline, now and then. Don't think it's because you are failing them or they are not trying hard enough. The "roller-coaster" effect is just a part and parcel of depression.
Please don't tell a depression patient that "you understand." Unless you, yourself, have experienced clinical depression, you don't. And your friend, spouse or relative knows it. It's not a bad thing; since understanding depression means having it. I'd rather that no one, anywhere, understood it. The point here is to be honest with your friend or relative and don't profess things that aren't so. Sincerity will help him or her a great deal; it will engender trust, which every depression patient has a problem with, at one time or another.
No one wants to make your life miserable by being depressed. Try not to view someone else's depression as your own affliction. Rather, be grateful that you don't have clinical depression and try to realize what the other person is going through. Don't take the things your friend, spouse or relative says/does, personally. They aren't meant that way.
Recovery from depression is not just a matter of taking anti-depressant medication and going to therapy. Both the depression and recovery from it can totally change a person's life. Treatment involves a lot of fundamental changes in a person. At times, you'll wonder if it's the same person you've known for so long. Believe me, it is--the depression probably hid the "real person" from your view, up to the point that he or she was diagnosed and began treatment.
At times, it may seem that the person is actually pushing you away. This is very likely true. Most depression patients believe that they unduly affect those around them and will do anything to prevent that from happening. Thus, they isolate themselves from others. This kind of self-sabotage is actually a symptom of the illness itself. Don't let it overcome your relationship. Try to understand that this is often involuntary and irrational, and act accordingly

The 23 Best Things to Say to Someone Who is Depressed
http://www.hbcprotocols.com/23best.html
Additional Contributions Are From From Individuals at the PASS Support Boards, and are used with permission

1. "I love you!"

2. "I care"

3. "You're not alone in this"

4. "I'm not going to leave/abandon you"

5. "Do you want a hug?"

6. "I love you (if you mean it)."

7. "It will pass, we can ride it out together."

8. "When all this is over, I'll still be here (if you mean it) and so will you."

9. "Don't say anything, just hold my hand and listen while I cry."

10. "All I want to do know is give you a hug and a shoulder to cry on.."

11. "Hey, you're not crazy!"

12. "May the strength of the past reflect in your future."

13. "God does not play dice with the universe." --A. Einstein

14. "A miracle is simply a do-it-yourself project." --S. Leek

15. "We are not primarily on earth to see through one another, but to see one another through"

16. "If the human brain were simple enough to understand, we'd be too simple to understand it." --a codeveloper of Prozac, quoted from "Listening to Prozac"

17. "You have so many extraordinary gifts; how can you expect to live an ordinary life?" --from the movie "Little Women" (Marmee to Jo)

18. "I understand your pain and I empathize."

19. "I'm sorry you're in so much pain. I am not going to leave you. I am going to take care of myself so you don't need to worry that your pain might hurt me."

20. "I listen to you talk about it, and I can't imagine what it's like for you. I just can't imagine how hard it must be."

21. "I can't really fully understand what you are feeling, but I can offer my compassion."

22. "You are important to me."

23. "If you need a friend..... (and mean it)"

Additional Contributions by Individuals

24. I know I'd much rather here someone say " I may not be able to really understand all of this, but I'm trying to, and I care..." rather than pretend to understand or not even bother to appreciate the real issues...

The 99 Worst Things to Say to Someone Who is Depressed
http://www.hbcprotocols.com/99things.html
Additional Contributions Are From From Individuals at the PASS Support Boards, and are used with permission

Some people trivialize depression (often unintentionally) by dropping a platitude on a depressed person as if that is the one thing they needed to hear or sometimes well meaning intentions can come off the wrong way. While some of these thoughts have been helpful to some people (for example, some find that praying is very helpful), the context in which they are often said takes away any intended benefit to the hearer and could even make them feel worse.

0. "What's your problem?"

1. "Will you stop that constant whining? What makes you think that anyone cares?"

2. "Have you gotten tired yet of all this me-me-me stuff?"

3. "You just need to give yourself a kick in the rear."

4. "But it's all in your mind."

5. "I thought you were stronger than that."

6. "No one ever said life was fair."

7. "As you get stronger you won't have to wallow in it as much."

8. "Pull yourself up by your bootstraps."

9. "Do you feel better now?" (Usually said following a five minute conversation in which the speaker has asked me "what's wrong?" and "would you like to talk about it?" with the best of intentions, but absolutely no understanding of depression as anything but an irrational sadness.)

10. "Why don't you just grow up?"

11. "Stop feeling sorry for yourself."

12. "There are a lot of people worse off than you."

13. "You have it so good, why aren't you happy?"

14. "It's a beautiful day!"

15. "You have so many things to be thankful for, why are you depressed?"

16. "What do you have to be depressed about."

17. "Happiness is a choice."

18. "You think you've got problems..."

19. "Well at least it's not that bad."

20. "Maybe you should take vitamins for your stress."

21. "There is always somebody worse off than you are."

22. "Lighten up!"

23. "You should get off all those pills."

24. "You are what you think."

25. "Cheer up!"

26. "You're always feeling sorry for yourself."

27. "Why can't you just be normal?"

28. "Things aren't *that* bad, are they?"

29. "Have you been praying/reading the Bible?"

30. "You need to get out more."

31. "We have to get together some time." [Yeah, right!]

32. "Get a grip!"

33. "Most folks are about as happy as they make up their minds to be."

34. "Take a hot bath. That's what I always do when I'm upset."

35. "Well, everyone gets depressed sometimes!"

36. "Get a job!"

37. "Smile and the world smiles with you, cry and you cry alone."

38. "You don't look depressed!"

39. "You're so selfish!"

40. "You never think of anyone but yourself."

41. "You're just looking for attention."

42. "Have you got PMS?"

43. "You'll be a better person because of it!"

44. "Everybody has a bad day now and then."

45. "You should buy nicer clothes to wear."

46. "You catch more flies with honey than with vinegar."

47. "Why don't you smile more?"

48. "A person your age should be having the time of your life."

49. "The only one you're hurting is yourself."

50. "You can do anything you want if you just set your mind to it."

51. "This is a place of business, not a hospital." (after confiding to supervisor about my depression)

52. "Depression is a symptom of your sin against God."

53. "You brought it on yourself"

54. "You can make the choice for depression and its effects, or against depression, it's all in your hands."

55. "Get off your rear and do something." -or- "Just do it!"

56. "Why should I care?"

57. "Snap out of it, will you?"

58. "You want to feel this way."

59. "You have no reason to feel this way."

60. "Its your own fault."

61. "That which does not kill us makes us stronger."

62. "You're always worried about *your* problems."

63. "Your problems aren't that big."

64. "What are you worried about? You should be fine."

65. "Just don't think about it."

66. "Go Away."

67. "You don't have the ability to do it."

68. "Just wait a few weeks, it'll be over soon."

69. "Go out and have some fun!"

70. "You're making me depressed as well..."

71. "I just want to help you."

72. "The world out there is not that bad..."

73. "Just try a little harder!"

74. "Believe me, I know how you feel. I was depressed once for several days."

75. "You need a boy/girl-friend."

76. "You need a hobby."

77. "Just pull yourself together"

78. "You'd feel better if you went to church"

79. "I think your depression is a way of punishing us." - My mother
80. "Sh_t or get off the pot."

81. "So, you're depressed. Aren't you always?"

82. "What you need is some real tragedy in your life to give you perspective."

83. "You're a writer, aren't you? Just think of all the good material you're getting out of this."

84. This one is best executed with an evangelical-style handshake, i.e., one of my hands is imprisoned by two belonging to a beefy person who thinks he has a lot more charisma than I do: "Our thoughts and prayers are with you." This has actually happened to me. Bitten-back response: "Who are 'our'? And don't do me any favors, schmuck."

85. "Have you tried chamomile tea?"

86. "So, you're depressed. Aren't you always?"

87. "You will be ok, just hang in there, it will pass." "This too shall pass." --Ann Landers

88. "Oh, perk up!"

89. "Try not being so depressed."

90. "Quit whining. Go out and help people and you won't have time to brood..."

91. "Go out and get some fresh air... that always makes me feel better."

92. "You have to take up your bed and carry on."

93. "Why don't you give up going to these quacks (i.e., doctors) and throw out those pills, then you'll feel better."

94. "Well, we all have our cross to bear."

95. "You should join band or chorus or something. That way you won't be thinking about yourself so much."

96. "You change your mind."

97. "You're useless."

98. "Nobody is responsible for your depression."

99. "You don't like feeling that way? So, change it."

Additional Contributions from Individuals

100. "Is this your way of telling me you're depressed?" (My own mother after sharing this list with her)

101. "You can't let stressors bother you" - as if stress is the only thing contributing to my depression

102. Or ex-bf's from tuesday night - "c'mon, we ALL could use a pill or two...."

103. Turn that frown upside down (first time i ever wanted to backhand my mother)

104. Life is as only as hard as we make it

105. Life really isnt all that bad

106. If i listened to such depressing music i would be depressed too (my aunt commenting on my rock music)

107. The worst thing anyone could say (in my opinion) is "Right, are you done sobbing? I need to get laid." Closely followed by "Could you come off the Prozac because I just don't see the point in ******* you if you're gonna be like that".

108. If you just were a stronger person....

Additional Resources for Friends and Family Members

National Alliance for the Mentally Ill
1 (800) 950-NAMI
http://www.nami.org/

Depression and Bipolar Support Alliance
http://www.dbsalliance.org/

Depression and Related Affective Disorder Association
http://www.drada.org/

Child and Adolescent Bipolar Foundation
http://www.bpkids.org/

Families for Depression Awareness
http://www.familyaware.org/

DBSA Educational Materials
Free online brochures with information on a number of mood disorder-related topics. Note: Some come in PDF format and require Adobe Acrobat Reader
http://www.dbsalliance.org/bookstore/brochures.html

Healthy Minds (American Psychiatric Association) Psychiatric Disorder and Topic Information
http://healthyminds.org/disorderandtopicinfo.cfm

Wednesday, February 20, 2008

My Childhood Hero

Wednesday, February 13, 2008

If You Know Someone with Depression or a Mood Disorder

Tuesday, February 5, 2008

Pop Culture and Christianity