By Louise from her own experience with depression
Written for Internet Mental Health
- Encourage the person to seek medical aid, especially
that of a psychiatrist. This specialist has the type of expert knowledge
that is needed to treat depression. Most importantly psychiatrists know
the types of medication that may be needed and the doses that may prove
adequate. For antidepressants to work, the dose must be at a therapeutic
level. General practitioners, however well-intentioned, often give doses
that are too low. Even low doses of antidepressants have negative side-effects.
To endure these side-effects without receiving any real benefit can be
a particularly painful experience. It makes the person lose confidence
in the medication that may be the only source of hope of being healed.
If it is possible, attend the appointments with the psychiatrist. Knowing
details of the disease and of the course of treatment can be very helpful.
The depressed person can greatly benefit from having a friend who knows
how the disease is likely to progress.
- Know details of the medication that the depressed
person is receiving. This allows encouragement to be given. Antidepressants
take from four to six weeks to have a strongly beneficial effect. The
first three weeks of taking these drugs can be filled with ghastly side
effects. The depressed person needs constant encouragement to persevere.
At first the depression remains severe. To this is added a whole range
of side effects: headache, dry mouth, muscular weakness, stomach pain,
drowsiness. If one is anxious or affected by panic and fear, these early
weeks of treatment can be very distressing. Constantly this person needs
to hear: “trust! It will be all right. Don't give up!”
- Be ready for a whole range of moods. Depression can
make each day a nightmare of variation. It may be that in the morning
all is bleak and dark. A person may be so panic-stricken that even being
alone for a few minutes seems to be impossible. This mood may last for
hours. In such times be quietly and faithfully present. The depressed
person does not want to manifest this behavior. No one wants to
be afraid, anxious, panic-stricken. But it happens to the person. What
gives strength is simple presence.
- During the dark and fear-filled times that a person
is enduring, do not give advice on how to cope. Yes, the person should
“smarten up, appreciate all life's blessings, pull up bootstraps and get
on with life.” No one wants to do that more than the depressed person.
But it is not possible at the moment.
- When the depressed person expresses fears about the
future, give assurance that change will come. It seems to be impossible
for the ill person. Keep emphasizing that it will be so.
- The depressed person may express suicidal thoughts.
These should be taken very seriously. There are degrees of this type of
thinking. If the depressed person finds life unbearable and “wants to
die”, encouragement should be given with emphasis that life may change
and become better. If the depressed person appears to be searching for
actual means of committing suicide, the doctor should be informed. Here
a test of loyalty may occur. The depressed person may feel betrayed by
the friend who reveals the suicidal intentions to the doctor and lash
out in anger. At this point there may be a great temptation to give up
on the depressed person and leave. There would certainly be ample justification
if one were to do that. But if the friend departs, the depressed person
becomes more desperate than ever. Bear the anger, seeing its source as
the disease, not the person.
- Even when medication is given, a depressed person
may express wishes to die for weeks. Listening to such talk can be very
wearying. Have a few answers that you always give. For example, “your
life is precious.” “You have work still to do here on earth.” “God has
a plan for you.” “If you are here, you have some purpose to fulfill.”
- A depressed person often rushes to person after person
for help. This depressed individual tends to focus only on the terrible
suffering that is being experienced. People soon grow weary of this type
of conversation. Soon rejection after rejection occurs. The depressed
person desperately needs someone to care, someone to hold onto. Most people
cannot fulfill this role. If you are a casual friend to whom a depressed
person is clinging, be merciful. Listen gently. Give a little of your
time. Perhaps not much will be asked of you. You may not be phoned. You
may not need to visit. But be gentle and understanding for the short time
that is asked of you. Nothing hurts a depressed person so deeply as the
sight of people avoiding encounters and fleeing away.
- If you are a close friend, let the depressed person
cling for a time. It will not last. Above all be there when others reject
the depressed person, as they will. Such rejections may bring many tears.
They certainly add to the depression. Be one who accepts. Depressed people
need to have their worth confirmed.
- A depressed person is often overwhelmed by irrational
fears. Doing activities alone seems impossible. Staying alone, even more
so. The person is fully aware that such fears are totally irrational.
Adults feels shame and horror at their inability to do things that children
easily do. Embarrassment at being afraid joined with true inability to
be free from fear brings intense suffering. Be gently understanding of
someone in this state. Do not comment upon it. The person knows how irrational
the behavior is. Just understand that the fear is real and be merciful.
- A depressed may find it very hard to live alone.
If possible, stay with the person. If this is not possible, perhaps contact
several friends and see if each could take one evening.
- As treatment proceeds, the depressed person will
improve. It is important to know that recovery is very slow. Casual friends
will expect a complete recovery. They will breathe a sigh of relief and
have no further tolerance of any signs of depression. But depression likes
to cling. A person can feel almost normal in the evening only to find
the next morning that all is bleak once more. The depressed person needs
to receive understanding of these mood swings with constant assurance
- One feature of depression is an inability to make
even the simplest decisions. When a depressed person does make some choice,
the one not chosen immediately seems to be the correct one. For the normal
person for whom decision-making is easy, such indecision causes contempt
and scorn. Depressed persons need help in making decisions, which still
must be their responsibility. The agony and suffering that accompanies
such decisions is very real. Patience and tolerance prove most helpful.
- The depressed person often feels quite worthless.
All life seems to be a failure. Give constant assurance of the person's
past activities and future productivity.
- If you have friends who have also suffered depression,
be willing to let them speak to the depressed person. Often someone can
get through the darkest days because there is a network of those who have
walked the same path.
- Share in activities with the depressed person. Often
this individual finds it terrifying to be at home alone. Be ready to do
what seems to soothe anxiety and bring some peace. Invite the depressed
person also to share in your own activities in order that your patterns
of activity are preserved.
- Above all, patience, patience, patience. Depression
is a disease. It is marked by a chemical imbalance in the brain. No one
ever wants to be depressed. No one can simply throw off a moderate or
severe depression. It would be nice if someone could. “Being there” is
the most important thing, being there patiently with gentle understanding.
Depression brings an agony within in which death seems to be a blessed
relief from anxiety, fear, and loneliness. It takes a great friend to
stay with someone in this state, to stay without lecturing, without condemnation,
without exasperation, without fleeing.
- Why would one choose to help a depressed person?
The answer is hard to give but love is certainly a factor, loving concern
for a fellow human being who has been struck by a terrible disease. We
human beings are frail; we seem best when we help each other.
The sub-title of this article is: “A Portrait of Ellen.” I have suffered
a severe depression and am only now starting to feel the positive effects
of antidepressants. My greatest blessing during my illness has been a
friend called Ellen. All the points I have made above are simply descriptions
of her behavior to me. Without her I would not have survived this ghastly
illness. She listened and listened to my desires for death without losing
patience. She guarded me carefully so that I would not do myself harm.
She affirmed my worth when I completely doubted it. She helped me bear
the worst side-effects of the antidepressants. She did not expect me to
be cured in a short time. She constantly gives me hope that all will not
be as bleak as it sometimes seems. She shows genuine happiness when I
seem to have improved. She has taught me what courage, fidelity, and true
Christian charity are. She has shown how generous and noble a human being
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