“When you have depression, simply existing is a full time job.”
While it is uncertain who said this, the individual most likely had personal experience with depression. Major depressive disorder is a mental health disorder that plagues an estimated 16.2 million adults in the United States. Most of us have suffered from depression, or, if not, have a family member or know a friend who has. Here are some ways to offer support to family and friends who experience depression.
The first step to helping loved ones with depression is being able to identify its symptoms. Depression is more than just sadness. It includes a loss of interest or pleasure in doing things previously enjoyed. Often, it is accompanied by an increase or decrease in weight and/or sleep. Irritability or mood reactivity may be prominent. Loved ones may move slower than usual or be fidgety and restless. Fatigue or loss of energy can be debilitating. A depressed individual may feel an excessive amount of guilt and worthlessness that can escalate into thoughts of death or even suicide. Because depression may cause difficulties in concentration, decision-making and motivation, depressed loved ones are especially challenged when it comes to communicate their needs.
People with depression may not recognize their symptoms. Helping them identify the depression and then encouraging them to get proper treatment is extremely important. Some people may not recognize their symptoms or be in denial. Sadly, some feel shameful about depression. Hearing they have non-judgmental support can be liberating. Depression usually progressively worsens without treatment. Assisting loved ones with finding a doctor and making appointments may make all the difference in ensuring they get the help they desperately need.
Once loved ones begin treatment, encouraging them to stick with the treatment is also important. When starting medications, it can take several weeks before patients experience any relief from symptoms. Sometimes, medications do not work for patients, or they experience unwanted side effects. It can take time to find the medication that best fits the patient. Patients often become hopeless during the “waiting period.” Gently reiterate to your loved one that this depression episode is temporary. Being willing to simply listen, without offering advice, can be very meaningful. Knowing that their self worth is at an extreme low, sharing memories of their past accomplishments, their positive characteristics, and the ways in which they have enriched the lives of others can help keep despondency at bay.
When neither psychotherapy nor medications provide help, there are alternative methods for treatment resistant patients, such as electro-convulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). While 70-80% of patients respond well to ECT, it is invasive, causes a seizure and cognitive impairment, requires the patient to have general anesthesia and requires the patient to stop employment or daily commitments. In contrast, rTMS is non-invasive, has no cognitive side effects, does not require anesthesia and patients may continue their daily routines without interruption. ECT patients will need assistance to and from every treatment. rTMS patients will be able to go to treatment alone, but will most likely appreciate support and companionship when treatment begins.
For those suffering with depression, the guilt and shame they feel about their mental health can be daunting obstacles. Stigma and prejudices can cause some to keep their depression hidden and stop them from seeking the help they desperately need. Willingness to help can make a world of difference for those whose world, due to depression, is crumbling beneath their feet.