So you’re in a relationship with someone who is suffering from depression. Maybe it is your spouse, a lover, a child, a parent, or a friend. What do you need to know in order to survive, and maybe help them survive as well?
For those of you who have read my blog, I admit I tend to romanticize depression at times – we have to cling to whatever we can. Depression is not a good thing, certainly, but maybe it is not strictly a bad thing either. Life is a struggle. Didn’t Nietzsche once say “That which does not kill us makes us stronger”? Catchy phrase, isn’t it? The trouble is, with depression any drastic swing has the potential to do just that, kill you. Unfortunately, depression is rarely a one time event. It runs in cycles, often in combination with bouts of mania; you can even experience both at the same time. But surviving each episode can make you stronger, if you can find a way to draw something positive from each experience.
If this sounds like a tall order for those suffering from this affliction, that is because it is. In some regards, it is an even taller order for those in a relationship with someone who is depressed. So what can you do?
Often your greatest concern will be suicide. You can see it written in their face – the lack of will to go on. Sadly, if they are committed to this end there is little you can do. I think the goal in this regard should be to focus on lessening the chances rather than trying to prevent it. You can’t tell them not to do it. You can’t tie them up 24/7. It is the spur of the moment you must fear. In their darkest hour they will be looking for the quick out. There will be no elaborate plans, they can’t make them; it takes too much effort. Obviously the simplest form of prevention is to keep potential methods out of easy access (you know what I mean – guns, ropes, medications, etc.). Bear in mind that wanting to end your life is not the same thing as doing it. Most depressed people think about suicide. Having said this, it is just as likely that since they have no will or energy to do other things they probably don’t have the will to kill themselves either. At least this is what you must hope for.
There are many different kinds and different degrees of depression. They can be tough to diagnose or classify. Some are of the short term variety, such as post partum, situational, or stress related. With luck these will pass and things will eventually return to normal. Some are longer term. They can affect a person for most of their life, and almost always follow a pattern, a cycle. They can range from SAD (seasonal adjustment disorder) to continuing deficient levels of serotonin to full blown bi polar disorder. The latter are the ones that will be focused on here.
The key word, believe it or not, is cycle. Your best hope of surviving the stress of knowing someone with longstanding depression is to understand their cycles. You may not be able to influence them, but you can be prepared, and this in itself may put less stress on them, and likewise yourself. If things seem bad, you must accept that they can always get worse. When things seem like they can’t get any worse, you must hope they will eventually get better. You don’t get to request the genetic makeup of your children; you don’t always get to choose who you fall in love with or care about. It will never be a picnic.
The hardest lesson to learn: don’t push. You may not be able to handle the recoil.
Your first instinct is to try and convince them to get help – medication, see a psychiatrist, or get some councilling. While this is often a necessary step, you must realize that many depressed people feel there is something wrong not only with them but with the world in general. They know something is drastically wrong; their mind just has a hard time focusing on exactly what it is. They feel extensively, but their turmoil is internal. With such a cluttered mind it is difficult for them to cope with people. Because of this, their flight or fight instincts are heightened. Confrontation is the last thing they want. Whatever you suggest will be met by an immediate no. Until they accept that their depression is not a mental or character flaw but only a chemical or perspective one they will feel averse to getting help.
As difficult as it might be for you, you must give them their space. Don’t try and pretend things are normal, they are anything but. The struggle for you is trying to help them realize their affliction is not so different from others, an imbalance or deficiency rather than a weakness. It sounds so simple, doesn’t it. Except that their minds are not functioning properly. This is where we return to their cycles. When they are in their darkest hour is not the time to convince them of anything. You must tough this out just as they must. But if you are aware of their cycles you can pick a time when they are more receptive, functioning more closely to the norm. Then you can get your foot in the door.
As an example, it is usually not a difficult thing to convince a person with diabetes that they need insulin. Why should it be any different with depression? Your body needs serotonin, end of story. If you can’t produce enough of it you need to get it somewhere else. Taking insulin does not cure diabetes, and taking SSRIs (selective serotonin reuptake inhibiters) will not cure depression. But they can help moderate the symptoms. (Note: SSRIs increase extracellular levels of the neurotransmitter serotonin by inhibiting its reuptake into the presynaptic cell, increasing the level of serotonin available to bind to the postsynaptic receptor. Quoted from Wikipedia.)
Of course this is where it gets tricky. There are numerous methods and medications to treat depression. Unfortunately it can be a real trial for those suffering and those around them to wade through – antidepressants, mood stabilizers, SSRIs, to SAD lamps, ionizers, or melatonin. Some medications help some people; some make things worse. Some can even increase the risk of suicide. And, of course, with depression there are almost always other mitigating circumstances. Those who suffer from depression can often exhibit other traits, such as sleep disorders, obsession, compulsion, and addiction. Needless to say, these can complicate matters.
In some cases, those suffering depression find their own ways to cope, they do eventually get help, and they do start medication. Often they are the best people to diagnose their own conditions, for they are keenly aware of the symptoms, but they must always be reminded to work in concert with a doctor. And so, you too must become familiar with their cycles and symptoms. You must learn as much about their affliction as you can. After all, you also have to cope.
Finding a way to cope is your battle. They are battling their demons; you must confront yours. Above all, remember it has nothing to do with you. Their irritability, their rage, their anxiety, their stress, their sense of isolation, their darkness has little to do with you personally. It can be brought on by any number of conditions – just accept that you are one of the handiest conditions. You are the closest to them and so everything you do is amplified. They are not the only ones who will need help; you will too. Don’t keep it bottled up, don’t keep it hidden; talk to someone if you need. Just remember there are parameters. If they haven’t come out of the closet, so to speak, you better be careful about who you tell. There can be no overlap. The last thing they need is for Aunt Betty to gush over them. They will hate you for this. It’s unfair, I know, but your parameters are going to be so much more stringent than theirs. If they cross the line your life will be hell, but if you cross the line they will be dead or gone. Tread carefully.
Otherwise, try keeping your own life as normal as possible. Do what you would normally do. You can’t spend your life babysitting. If you need to get out and socialize do, just don’t always try and drag them along. It doesn’t hurt to ask, but remember don’t push. Chances are they won’t mind, unless resentment is a big factor. They will probably appreciate the space.
I suppose an article like this should come with a suitable disclaimer, so here goes. I am not a doctor or psychologist. I am not an expert, by any means. I am merely a person giving my perspective on an affliction that has accompanied me for over forty years. I make no bones about letting everyone know about my depression. It explains why I can be such a prick at times or antisocial. The people who matter will accept this, even if they don’t fully understand it. As much as I long for it at times, no one stands alone.
