Given the frequency that doctors diagnosis individuals with depression, chances are you know and / or love someone who has struggles with it. And while you can’t change your loved one’s diagnosis, it can be helpful to understand some things they experience. Depression can be extremely isolating and often misunderstood as someone who is extremely pessimistic or overly sensitive.
Here are ten things (listed in no order of importance) to consider if your loved one has depression:
1. There are multiple types of depression. The DSM 5 is the manual and guide which licensed professionals use to diagnose depression. It is important to understand which type of depression your loved one has because not all types are the same.
2. Depression is a serious diagnosis, so it is important that one is being treated by a licensed specialist. Many people are surprised to learn that people advertise they are competent in treating depression, but are not actually licensed to practice in the mental health field and do not have the educational background to support their advertisement. For example, just because someone calls themselves a “coach” doesn’t mean that they are licensed to treat people with depression. Each state has a licensing board which sets standards of practice and anyone can verify a professional license.
3. Sometimes medication is warranted. If your loved one has psychotic features (i.e., hallucinations, delusions) then it is usually necessary for a psychiatrist to treat this particular symptom with medication. It is anxiety provoking for anyone to hear voices or see things which are not actually there. Sometimes people are aware that they are experiencing these symptoms and they know it is not normal, so they are reluctant to share this with anyone. Other times, people are not aware they are talking to someone who is not present.
4. Age matters. Depression can express itself differently depending on someone’s age. For example, a young child may become more withdrawn; whereas, an adult may abuse alcohol. And for parents be mindful that when your adolescent who used to be on the honor roll brings a report card with failing grades it might be a sign of depression and not teenage rebellion. Also, according to the Mayo Clinic, malnutrition is a serious problem for seniors and it can be a sign of depression.
5. A dual diagnosis isn’t rare. It is not usual for a person to struggle with both depression and alcohol/ drug abuse or dependence. And it can be difficult to tease apart which came first because one often contributes to the other. For example, someone gets a ticket for drunk driving and now they can’t drive to work and this leads to financial stress. In order to cope with this they turn to alcohol. It is important for someone to obtain treatment for both.
6. Self- worth is at an all- time low. Someone with depression isn’t just down or having a bad day. They feel like a film envelops their being, and they are aware this isn’t attractive. They often know their behavior is off- putting and they aren’t gaining any friends either. For these reasons depression can be very isolating and a lonely experience. They feel guilty for letting down their friends and family and aren’t sure how to get out of it.
7. Depression creates a huge blind spot. Depression is the lens through which someone with depressions views life and this means that they walk through life with blinders on. And while you may want to give them a list of all the things that are fine in their life but because they have fuzzy vision they can’t clearly see their life from your perspective. This is what leads to intense frustration on your part as well as theirs.
8. Suicide is something people with depression think about and consider. If you speak with your loved one about suicide, they may try to protect you and deny that they think about suicide or have even come up with a plan. And they may even believe that you would be better off without them because they see themselves as a burden. According to the National Institute of Mental Health, over 40k people each year die as a result of suicide. However, the institute is very clear that suicide is preventable. Their link provides suggestions and guidelines for helping someone who is suicidal. It is important to seek professional help. This is not the time to try to manage this on your own. This same NIH link provides a hotline number to seek help and/ or bring your loved one to the nearest emergency room.
9. Non- compliance happens. There is a still a significant stigma with seeking professional mental health services, and it is not unusual for someone to stop treatment. Speaking about your personal issues and sharing fears is not for the faint of heart. Confronting the past isn’t usually something one looks forward to and talking about certain issues can stir up emotional pain which in turn creates more anxiety. So in order to cope your loved one may try avoidance, as in skipping appointments or not talking during the sessions. Also, the therapeutic relationship can be complex. Even the most skilled professional may struggle with developing rapport. Prematurely ending treatment is viewed as the path to less pain.
10. Fear becomes the nucleus. When one is depressed, fear tends to underlie all that they do. I’ve spoken with many widows who came from various educational, financial, religious backgrounds and the causes of their partner’s death varied as well. It was clear in speaking with those who sought mental health treatment for depression that they were living in constant fear. The depressed are often afraid they won’t ever experience joy or happiness. They may tell you that they “fake being happy” to maintain work and /or other relationships, but deep down they’re afraid it will be discovered what they truly feel. They are afraid of losing relationships because they can’t seem to pull themselves out of the depression, and they are afraid of telling the truth because of the risk of rejection.
Approaching the very subject of depression without judgment will open the door to more meaningful conversations with your loved one. If they feel that you are blaming them for their circumstances, chances are they will shut down. Depression is treatable and compassion is an important part of providing emotional support.
Kristin Meekhof is a licensed master's level social worker, writer, speaker and co- author of the book, "A Widow's Guide to Healing" with cover blurbs from her friend Deepak Chopra, MD, FACP and Maria Shriver. Kristin is a panelist at this upcoming Harvard Medical School conference. Kristin can be reached via her website and is a contributor to the wellness platform Jiyo, created by Deepak Chopra and Poonacha Machaiah.
Senior Health, Mayo Clinic - http://www.mayoclinic.org/healthy-lifestyle/caregivers/in-depth/senior-health/art-20044699
Depression Treatment, DSM, Mayo Clinic-
Suicide Prevention - National Institute of Health