Helping Someone with Depression

Help Others

I’ve been focusing my posts on my own experience with depression because I believe it’s important for others to know what we are and are not thinking when we are very depressed. But, it’s also important to educate others in how to respond to a loved one in the midst of a major depressive episode.

So, what should you do? Let me answer that question with another question. How would you respond to someone who just had major surgery? “But that’s different,” you might say. And I would come back at you with, “not really.” When someone has surgery, they are tired and exhausted, sometimes need help doing routine tasks, feel lonely because they are not able to be with coworkers and friends, can feel sluggish, and just not want to do much of anything.

Those are all things someone in a depressive episode experiences. Remember, it is a disease, a real illness. It needs to be treated as one.

So, now I’ll ask a different question. How could you respond to someone with depression? I’m guessing you might have come up with some of the following as possibilities.

Call, email or text the person and just say “Hi!” You might have to leave a message because they are probably isolating (I was a QUEEN of isolating!) but leave the message anyhow…and point out that they need to reach out and you are there for them. It can be hard when the person with depression doesn’t respond, but don’t let that stop you from doing the same thing the next time.

If you are a coworker, bring them lunch or dinner if they are missing work because of their depression. Even if you aren’t a coworker, do it anyway. You would likely do this for the person that had surgery, why not your friend with depression? When I missed three months of work due to my depression, I do not recall one person doing this for me. I did have a meal with a couple of friends, but that was at my initiation.

Give a day and time that you will come over and help clean. If you end up doing most of the work, do it anyway. It is not uncommon for the person with depression to not pick up after themselves. We aren’t being lazy…we really just do not have the energy. We may have used all we had just getting out of bed. Throughout my years of depression, I have struggled to maintain an orderly place. This has kept me from having people over and being more social. Since I’ve had a case worker helping with this, it has motivated me to do more things on a regular basis. If someone had asked if they could come over and help, I would have thanked them and turned down their invitation. Don’t ask…just do it.

Send a card or stop by with flowers. Everyone likes cards and flowers. They are a simple reminder that you are thinking about the other person. Imagine being out of work with an illness for three months and NOT getting a card or flowers. It’s a pretty lonely feeling.

Maybe you have wanted to do some of the above for a friend or family member with depression but hesitated because you just didn’t know what to discuss while with the person. Here are a few guidelines.

First and foremost, if you’ve never been as depressed as the other person, convey your lack of fully understanding what the person feels. Nothing minimizes a person’s experience like hearing, “I know how you feel” or “things can’t be that bad.” Admit to what you don’t know. It will go a long way.

If you want to make a suggestion, or offer advice based on something you read about depression, make sure you preface your comment with that bit of information. If you suggest exercise, offer to go for a walk with the person.

Avoid trying to give advice of what worked for you when you were feeling ‘down.’ A couple of memorial pieces of advice I’ve received in the past included, “just get up and go to work and you’ll feel better” and “if you would clean your apartment you would feel better.” If I had felt well enough, I would have gone to work or already cleaned my apartment. I was beyond the point where these would have helped me.

Just meet the person where they are in their depression and you’ll be fine.

I nearly forgot to mention probably the biggest suggestion: HUGS!

Give hugs as often as possible.

Hugs

I hope this will help you to feel more comfortable reaching out to your friend or family member the next time they are experiencing a major episode of depression. It’s already a lonely ‘place’ to be but with your love and understanding, it just might bring healing faster.

I’ve also mentioned a few Do’s and Don’ts in my previous Mental Health Awareness post. If you haven’t read that already, I encourage you to head over now.

…and along came 1999

May is Mental Health Awareness Month. Throughout the month I will share my own experience with depression. This is the continuation of the journey which would eventually lead me to qualifying for Social Security Disability benefits because of my depression.


Medication and therapy go a long way in helping make the days more tolerable; but figuring out and accepting who you really are as a person helps a great deal as well. The first half of 1997 was filled with questions surrounding my sexual orientation. While I had had questions prior, I had suppressed them each time because I just didn’t have a name for what I was feeling. Thanks to Ellen DeGeneres and her sitcom, that changed. Shortly following the “Puppy Episode” where she came out publicly, I, too, came out.

The euphoria I felt after my first kiss with a woman is indescribable. I literally saw fireworks! Despite my attempts to make myself feel bad like I thought I was supposed to feel, I only felt all the more normal. I felt I was doing what everyone else was doing…loving who they were supposed to love.

Phoenix 1997

Phoenix 1997

This relationship did a great deal to settle my depression for a time. Denise and I would have typical relationship ups and downs throughout that first year and a half. Going into the second half of year two, I really began to struggle again. I began missing work or going in late. What was most troubling, though, was my struggle to contain my anger outbursts at home.

I write this with much shame and humility…I was physically abusive to Denise on a couple of occasions. After the first incident, my therapist wisely had me begin seeing a psychiatrist to better monitor my medications. It was clear by my behavior that I needed more intensive intervention than my physician could provide. I only wish it had come sooner. If you are in therapy AND on medication, you really should be getting your medication through a psychiatrist. Your family doctor can only do so much for you.

Immediately following the second incident, we mutually agreed that we could not live together. Even though we would have separate places to live (I moved off of the property) we still saw each other daily. We were still very much in love; we just couldn’t live together at that time.

Denise and I separated in May 1999.

On 9-9-99, I had taken the morning off for two appointments including one with my therapist at 11 am. As I was on my way home from therapy to have lunch my cell phone rang. It was a coworker of Denise’s. He told me she was in the hospital and I needed to get there as soon as I could. Before I could get there, though, I received another phone call by my supervisor. He informed me; unwisely (because I was in my car driving) that Denise had died. That phone call would be played over and over in my head in the years to come. It took only one minute for the life that I knew to come to a screeching halt.

(I’ll write more specifically about that day at a later time.)

I lived in a fog for the next few weeks. I missed at least a full week of work. Even when I was at work, though, I couldn’t concentrate to get much done other than the day to day tasks. My depression had been confounded by the grief I had been thrown into suddenly. Imagine trying to get through the day while stuck in mud over your head. That was me. Doing ANYTHING was a challenge. Everything felt so heavy.

Almost a month to the date, I recall a thought I had at work. “I think I can finally focus and concentrate enough to do more than just day to day things.” The thought was accompanied with a feeling of optimism and hope. I was nowhere near over my grief of losing Denise and her family, but I felt I wasn’t going to be ‘stuck’ forever.

The joke was on me, though. That evening on my way home, I got a phone call from my mother letting me know that my grandmother had died. Seriously?! I felt I couldn’t get a break at that point!

I muddled through October the best I could. I was still missing some work and not getting bigger projects completed. One afternoon I got an email from my supervisor with a list of projects I needed to complete and specific deadlines in which to complete them. That email filled me with despair. Did he not see that I was barely making it?! Was he purposely trying to push me over the edge?!

I had been considering it already, but I KNEW now I had to take time off from work or I would definitely end up in the hospital. It didn’t matter that I was out of sick leave and wouldn’t be paid for that time. The only thing that mattered in that moment was my sanity.

I asked for and was granted FMLA (Family Medical Leave Act) leave for the month of November with no pay. I was so ashamed of having to do this that it took me over a week to tell my mother about my leave. She responded with, “Are you sure you can afford it?” I quickly snapped back, “If I don’t, I’ll end up in the hospital.”

The month away from work was definitely beneficial for me.  I was able to simply focus on me.  After a lot of reflection on November 30, I wrote in my journal:

It is just amazing how LOW a person can get. I don’t think many people understand that. They haven’t felt it or even seen it. I wish there were some way to educate people about how I have truly felt these past three months.

To be so lifeless…so hopeless…so empty. Words can barely describe it. When you reach that point the last thing you want to hear are things like:

  • Get over it.
  • It’ll be okay.
  • I’m sorry, what can I do?
  • You need to just get up and go to work and you will feel better.

The next day brought some much needed optimism:

I can’t wait til the day I can look back at this journal and be amazed at how I survived.  I know that day will come!  I know it will!

And that day would come!  It took a while, but it did come!

 

“Use memories.  Don’t let memories use you.” –  Deepak Chopra

Depression Becomes More Visible: 1996

May is Mental Health Awareness Month. Throughout the month I will share my own experience with depression. This is the continuation of the journey which would eventually lead me to qualifying for Social Security Disability benefits because of my depression.


After my ‘mini’ breakdown and not showing up at the junior high, I was able to finish my practicum and completed my Master of Education in August 1995. It was a few tense months before I landed and started my first full-time job at a community college in January 1996.

This was NOT an ideal position for anyone, much less a 25 year old fresh out of graduate school. I reported to three different supervisors for a grant-funded position with no clearly defined duties. It was a recipe for disaster from the beginning regardless of my struggle with depression.

Early on I was very resistant to accepting criticism/feedback. I wrote one night that “more than once, I have gotten defensive and/or just ignored what was said to me.” I knew I needed to get back into therapy, but because I had previously been diagnosed with depression, I had a pre-existing condition and had to wait the required six months. (Thank you Affordable Care Act for changing that for others!)

By the time I was able to return to therapy, the stress had built to such a level that I began to have inappropriate angry outbursts whenever I was critiqued by one specific supervisor. After one of these explosions in mid-July I wrote in my journal, “I know that it was PMS and that it had only been getting worse each moth as I had more and more work.” (In hind sight, this is a sign that full-time jobs were not for me. It only took me 13 more years to finally accept that as fact. J)

In regards to the same ‘episode’ I wrote, “She made it appear as if I had chosen to act that way. I was not in total control. But, she doesn’t understand that.” I knew I didn’t have a handle on the situation, but I just was processing what needed to be done to better the situation.

Much time in therapy was spent exploring my anger. I was encouraged to read, “When Anger Hurts: Quieting the Storm Within,” by Matthew McKay. I was given handouts about the different types of anger and suggested ways to work through it without it coming out of me like lava when a volcano erupts. We did guided imagery to help me get more in control of my emotions. We did EMDR (Eye Movement Desensitization and Reprocessing) which is often used for treating post-traumatic stress disorder.

None of this was helping. I just couldn’t get a grasp. In December, I was very discouraged and wrote, “I become upset at the lack of control I have over my feelings.”

Not only was I being easily agitated and having inappropriate/unprofessional outbursts, my physical appearance was also taking a toll. My release for anxiety and stress was most often to pick on my face. A simple, small pimple would easily fall victim to my fingers and repeated scrapings. Before long, my face would be covered with large, very noticeable scars.

1996     1996

These were taken the summer of 1996, only six to eight months into my first job. It would take a few major episodes, and many years of doing this before I recognized it as a pattern. But, the pictures don’t lie. Friends and family thought I just had a problem with acne and would give me advice and tips to clear my face. None of us realized at the time that it wasn’t an acne problem, but rather a more serious problem with depression and anxiety. Let’s call it what it really was: self-harm.

When someone talks about self-harm, we often first think of someone that cuts one’s self. According to NAMI, National Alliance on Mental Illness:

Self-harm includes cutting, picking, scratching, burning…to reduce, express or cope with overwhelming, painful emotions…[persons] living with depression may self-harm if they do not have healthier alternatives in place to cope with or relieve negative feelings.

 Self-harm can also be used as a kind of “self-medication” for treating depression—not unlike drinking, using substances or overeating. Some individuals report that self-harm can be experienced as a “runners high” when “feel good” endorphins are released in the brain in response to the physical injury.

By and large, picking was my form of self-harm behavior. I had one instance of intentionally burning myself; and then just a few years ago, I was scratching my hand with a box cutter. Picking at my face was mostly an unconscious act. The burning and the scratching with a box cutter were deliberate attempts to relieve the pain of the depression.

Even with that pattern of self-harming behavior, I was not prescribed a separate medication for anxiety. I suppose since many of the antidepressants I had been prescribed are sometimes used for long-term treatment of anxiety as well this is why my psychiatrists took so long to consider adding another medication.

Things in that position never really improved to where I was happy with the job. I eventually asked for an accommodation based on my depression to be moved into another position for which I was qualified. I began my academic advising career and worked directly with students just as I had wanted all along. For the most part, this was a much better position and I was generally happy…until my world came crashing down in 1999.

In my next post I’ll share one of the worst days of my life and the impact it had on my depression.

rune

This is the tattoo I got to cover the scar where I burned myself with a fork.

It is a compilation of four runes from “The Healing Runes” by Ralph H. Blum and Susan Loughan.  In short, the runes are a way to bring focus in a chaotic world.

The different runes are: Courage (the arrow going up), and starting at the bottom going up Surrender, Prayer, and Serenity.

 

 

So it begins: 1995

May is Mental Health Awareness Month. Throughout the month I will share my own experience with depression. This is the beginning of the journey which would eventually lead me to qualifying for Social Security Disability benefits because of my depression.


Prior to the spring semester of 1995, I had been able to manage any symptoms I had of depression. They had not interfered with my daily activities to the point that it was really noticeable. That all changed the semester I was working to complete my practicum, or internship, in school counseling.

I kept a journal throughout the process, but did not really take notice of what I was experiencing until it became very apparent that I needed more help than just talk therapy. Even as I reached that point, I was in denial and resistant to taking medication. My writing makes it clear that I had preconceived ideas of people that were on antidepressants. I was definitely impacted by the stigma that existed then, and still exists to this day.

Below are excerpts from my journal. My words from then do a much better job of explaining what I was experiencing than my words today could.


February 22:

Damn this PMS! Why the hell has it been hitting me so hard?!

March 20:

(One of my tasks for my practicum was to co-lead two junior high school support groups. I was finding this very stressful and tried unsuccessfully to lessen my role in those groups.)

I really don’t think I can finish my practicum this semester. I am so freaking burned out that I can’t do anything other than lay around and watch TV. When I think of things I have to do – I just feel overwhelmed and out of my league. I am at a point now, though, that I could very easily stay home all day & not worry about getting too far behind in my practicum.

April 4:

What the hell is my problem?! I am going through such mood swings. I could cry if you asked me to, or I could break into a rage in a moment’s notice. Today I told Jan how good it might feel to put my hand through a glass door or window. Tonight I beat on the pillow again. I told someone today that I am barely making it day by day. I can hardly see two days ahead. I almost believe that someone is taking days away from me. I am considering “oversleeping” tomorrow & only show up for one group.

April 5:

I blew it this time! I didn’t go to Edison [Jr. High] this morning & I didn’t call until 9:45.

When I didn’t get up for 1st period, I thought how easy that was and I would just miss 2nd, too. I didn’t even stop to consider the consequences. I just didn’t think!

It is so scary to think that I have finally reached this point. I had to really work to stay in bed this morning, too. Robbin [friend] had called me and so I was up. I just didn’t care. I’ve been saying for a while how I could do this very easily. Well, I finally did it. Now look what has happened. I didn’t even get out of bed until 1 pm.

Dr. Miazga [graduate school advisor] didn’t tell me anything I didn’t already know. But just hearing it made it even scarier for me. I really have lost it. I saw it coming, but I couldn’t & didn’t do anything about it. I let it slip too far this time.

Carrie [therapist] suggested that I see a doctor to get an antidepressant. Just the thought of that makes me feel “weak.” I know that I have been through a lot, but I would think I could handle it. Obviously, though, I proved today that I couldn’t.

For the most part I don’t consider myself a depressed person, but I guess I really am. Just thinking over things I have told some others and seeing my activity pattern, I can see where I could be mildly depressed.

April 6:

As I laid here trying to get to sleep, I thought of my inner child. When I imagine her, she is lying down with her face covered in the ground. She is hardly moving. She appears to be so low that it will take a lot to make her happy again.

That is such a scary vision. I don’t think I have ever seen her that low. Just as I never saw myself as low as I did yesterday. I have some heavy duty work to do that this point. I pray that the good Lord will be there by my side to help me through this difficult time. I know he will be, but I pray that I will remember that.

I just reread all of this journal. Scary stuff. Reading it makes it all the more serious. This didn’t happen overnight, and it won’t be back to “normal” overnight either. I’ve got to get that little girl inside to smile again, though.

April 11:

I went to see Dr. Forlano today. It is official; I have been prescribed Zoloft, an antidepressant. It is really a strange feeling. All growing up, we only took medicine if we were “dying.” I can just imagine telling Mother that I am on Zoloft. She would probably say, “You don’t need that. Things can’t be that bad.”

It was kind of a sobering moment when I actually took the pills in my hand at the office. It was sort of like it was another burden. I look at them in my hand & wonder how something so small will work for me. I almost feel like everyone will know. I know that that’s not true, but I sort of feel that way.


I am so glad that I did not know what struggles were to come. But, I am also glad that I took that step to begin medication along with talk therapy. The combination of the two would keep me alive in my future episodes.

In my next post I’ll take you into 1996 and the more obvious outward symptoms of my depression.

 

“Never deprive someone of hope; it might be all they have.”

H. Jackson Brown, Jr.