How DO I support someone dealing with depression?
How do you support someone who’s dealing with depression?
Why can’t I make them happy? All great questions.
First of all, you can not make other people happy, that is all their responsibility. You can however give loving support. Depression looks and feels different for everyone. There is no one-size-fits-all as support or in treatment. Recovery is a process with or without medical, professional help and or medication. It takes time.
The most important part of giving support is to be patient and compassionate. Avoid comments like ‘can’t you just be happy?’ ‘how long are you going to be this way?’ Judging and criticism are not supportive for folks dealing with depression and can send them deeper into shame and despair. No one wants to feel depressed. Like who wants to feel sad, hopeless and helpless? No one!
Love is needed, necessary but not enough.
Love is a big part of being supportive but not the total solution in recovery. I know as I speak from experience with depression and PTSD. All the love in the world could not take away those emotions. It was a journey of time and self-discovery, self-compassion to find the way from the black silent pit to the light of happiness and life. I say love is not enough because even though I knew I was deeply loved by my partner and family, I continued to battle with the sadness of depression. It was a combination of therapy, mediation and emotional work that pulled me out. Love was like arms of courage wrapped around me in the recovery. Love was what kept me going even in the darkness, five minutes at a time. You can’t fix them but you can encourage them to seek professional therapy. If they refuse get support for yourself if needed. It is a slow, well worth journey.
There are many more resources available and more and more people are talking about mental health, depression and suicide. From the article ‘5 ways to Help Someone Battle Depression and Anxiety’ Psychology Today:
The impact of having a loved one struggling with depression or anxiety can be profound and, in fact, is often itself a reason that many people seek therapy. Unfortunately, there is no single behavior that is effective at helping all people who are struggling with depression and anxiety.
Allowing someone to just talk about what is going on, listening and asking them what they need as support? You can’t fix them and at times it can feel frustrating and never-ending. Talk about a safety plan, a list of folks they can call day or night if they are feeling suicidal. Links to the crisis line and crisis clinic in your area or online. Removing the stigma of mental health and depression is something that continues to be a problem for those struggling. Men and women, anyone can suffer from depression at some point in their lifetime. And it is okay to acknowledge that supporting may be too much for you emotionally and encouraging other professional supports. Not everyone knows how to effectively communicate during a mental health crisis. It can be exhausting.
What does tend to help are things like empathic behavior, validating communication, supportive listening, collaborative problem-solving, and patience.
What about suicide?
Suicide is never an option but a finality leaving others with a lifetime of questions and unimaginable emotional pain. Be watchful of signs, less interest in daily activities, avoiding family and friends, talking about killing themselves or ending their suffering, wanting to fall asleep and feel nothing. You see that is how I felt at the brink, simply falling asleep and feeling nothing. No pain, no sadness, no anxiety, no feelings of worthlessness, no pain from years of bullying, nothing. Often people walk around with a suicide note in their pocket for weeks before they actually make that final decision.
Any indication that someone is seriously thinking about hurting or killing themselves needs to be taken seriously. Signs that someone is suicidal can range from the obvious (such as purchasing a gun or writing a suicide note) to the very subtle (such as no longer talking about the future or taking care of themselves). If you believe that someone is feeling suicidal, you should encourage them to reach out to their treatment provider or the National Suicide Hotline (1-800-273-8255) as soon as possible. If you think that someone is on the verge of engaging in suicidal behavior, you should call 911 or accompany them to the nearest emergency room.
Speaking from a personal experience supporting someone dealing with depression it can be mentally and physically exhausting. Never give up on them, never give up on you. You may need support as a supporter. Makes sense? Yes, you may also need therapy and that is okay. There is nothing we can do to ‘make’ someone better or ‘make’ them want to live. Watching someone struggle with depression with one foot in life and the other in wanting to die. You never know when someone will move that foot from wanting to die to want to live.
No matter how frustrating it is, keep asking. You never know when you’re going to get through to someone, or when they will be ready to accept your help.
It is okay to set limits/boundaries.
Remember being supportive does not mean you lose yourself in the help, setting boundaries and having your own self-care strategies can help you help them. I remember after spending hours listening and encouraging I needed to get outside for a walk, enjoy the sun and feel the breeze as a reminder I am alive and needed to recharge after trying to support a friend dealing with depression. Self-care strategies look and feel different and were helpful so that I could go back and be supportive. From the Canadian Mental Health Association and care for the caregiver
SET HEALTHY LIMITS
It’s easy to feel like you have to be there for a loved one all the time or find yourself spending more time caregiving than you’d like. Limits are a healthy part of any relationship—even more so when you are juggling a lot of different priorities. Think about your own needs, then work with everyone around you to find a solution. You could set limits around behaviours, the time that you will focus on caregiving, expectations around the home, or whatever makes sense in your situation. Part of setting limits is letting go of the idea that you can control someone else’s symptoms or behaviours. You may have influence, but in the end, your own actions are the only things you have control over.
Depression and chronic pain is double whammy.
I can remember after my shotgun training accident to my right shoulder. The shoulder kept falling out of the arm socket at random times during the day and night. The pain was so intense I screamed at night and during the day. People got upset because it disturbed their work. Slowly and I mean slowly depression began to sink in, the sense of uncertainty ‘when is this going to be over. Eventually, surgery was able to fix part of the problem in stabilizing the shoulder. Too much stabilization resulted in a frozen shoulder. Months and months of physiotherapy, another surgery and slowly life returned to a new normal. It took a toll on my mental health. At the time I did not realize I was suffering from chronic pain which brought on and exacerbated depression.
Is There a Cycle?
Pain provokes an emotional response in everyone. If you have pain, you may also have anxiety, irritability, and agitation. These are normal feelings when you’re hurting. Usually, as pain subsides, so does the stressful response. But with chronic pain, you may feel constantly tense and stressed. Over time, the stress can result in different emotional problems associated with depression. Some of the problems individuals with both chronic pain and depression have include:
From the article Chronic Pain and Depression: Finding Ways to Cope:
Chronic pain is a term used to describe pain that lasts beyond the typical time it takes for an illness or injury to heal. Sometimes chronic pain is also described as pain that lasts longer than three months. Research suggests that anywhere from 30 to 50% of people with chronic pain also struggle with depression or anxiety.1
Sometimes it can be difficult to assess whether chronic pain has led to depression, or vice versa. People with chronic pain are three times more likely to develop symptoms of depression or anxiety, and people with depression are three times as likely to develop chronic pain.2
A couple of years ago I had to deal with another frozen shoulder, this time the left side from an unknown injury. No idea why it suddenly became stiff and limited mobility. The treatment was painful, twice daily exercises every day for a year and there were times I cried because I could not undress, waiting for my partner to arrive home after work to help. Such a helpless feeling weighs on our mental health. None of us is immune from suffering from depression and pain chronic pain really sends our emotions in a tailspin.
Managing the pain and our emotions is an important part of the journey in recovery. Treatment is important in addressing both health concerns at the same time with good supports. My treatment options included physiotherapy, medical doctor, medication, pain management, chiropractor for the frozen shoulder, regular therapy sessions and my own physical and emotional self-care.
Assembling a Treatment Team
Patients benefit the most when chronic pain and depression are treated together and utilize a team of people. This team of experts may include:
- Physician. A physician can provide a thorough examination and evaluation, give a diagnosis, and, if necessary, prescribe both pain and psychiatric medications.
- Pain specialist. A pain specialist can educate the patient about the relationship between chronic pain and depression and help design a treatment plan.
- A Therapist. Regular sessions with a therapist trained in cognitive behavioural therapy, or other forms of psychotherapy, can help address anxious or negative thinking patterns and teach coping skills that reduce symptoms of both pain and depression. They can also work with patients’ families to help them better understand chronic pain and depression.
- A Physical Therapist. A physical therapist can help improve mobility, reduce pain, and increase low mood by introducing helpful exercises and muscle relaxation techniques.
Other professionals such as nutritionists, acupuncturists, and occupational therapists can provide specialist knowledge to help curb chronic pain and depression.
Treatment Options
Many treatment options can provide relief and healing to chronic pain and depression. Some of these include:
- Talk therapy – Also known as psychotherapy, talk therapy can help an individual change pattern in thinking, learn coping skills for symptoms, and help prevent future depressive symptoms.
- Stress-reduction skills – These skills can include exercise, muscle relaxation, meditation, positive thinking, etc. Therapists, pain specialists, physical therapists and others can provide recommendations to fit the needs and interests of the patient.
- Medication – Standard analgesics and antidepressant medications may be prescribed to help combat symptoms. For extreme pain, opioids may be prescribed, but talk to your doctor about the risks and any history of substance use first.
- Peer support – Many people find that support groups for chronic pain, mental illness, or both can provide both emotional support and psycho-education. If there isn’t an in-person group in your area, consider looking online for support.
- Inpatient or outpatient pain programs – More intensive programs can provide immediate and long-term support when depression and/or chronic pain is severe. These programs typically provide onsite medical support, individual and group therapy, and psycho-education for reducing stress and pain.
Supporting family, friends co-workers who are dealing with depression and or chronic pain is a wonderful gift. No matter what happens just try to be a good listener, patient, kind, encouraging and loving.
The hope is to be positive in your support, give them hope, keep the conversation going, educate yourself about mental health, possible treatments, and on the resources available, be willing to just listen without criticism or judgments, seek out and encourage therapy if needed for yourself, do not be afraid to cal 911.