Recently, a friend has been seeking help for long-standing depression but has reached a point where he feels the treatments are not working and he is feeling hopeless.
I am wondering if those of you who have experienced serious clinical depression and recovered from it have any words of encouragement or advice for someone else in that position? What thoughts or actions helped you when you were at your lowest points? What would you say to someone who has begun counseling and medication but yet feels they are not helping enough?
I’ve made no secret of my battles with depression, so I’ll tell you what I know. Feeling like things aren’t working or the whole situation’s hopeless is perfectly normal. Come on! Feeling that things are hopeless is a textbook symptom of depression.
You didn’t say how long your friend has been being treated for depression, but medications do take a few weeks to take effect and therapy, too, takes time. I’m afraid there’s no instant miracle cure for it and there are times when it’s just a matter of slogging through. That said, please promise your friend from me that it does get better. Tell him for me that I know it takes time and it can be incredibly frustrating, but it does get better.
As for what helps, you’d be surprised how much good a hug or a kind word can do. Talking to someone who understands or is at least willing to listen, who you trust enough to know they won’t condemn you or run away makes things easier to bear. I’m good friends with a man who also suffers from severe depression. We’ve been there for each other through any number of crises. During one awful winter when I’d been out of work for 6 months and his wife had had a stroke 3 weeks after they moved 600 miles away, we had what I’ve referred to as a “Mutual Non-Assured Destruction Treaty” which basically amounted to “I won’t commit suicide if you don’t.” Even though he was 600 miles away, the comfort and understanding he gave me got me through. Being there for someone isn’t an easy job, and it can leave you feeling frustrated and helpless yourself, but it makes a difference. My e-mail address is in my profile. You or your friend are free to e-mail me if you need to. I’ve poured my troubles out on enough people, I figure it’s only right to let people dump theirs on me, so to speak. There’s also Cecil’s Place, an on-line support group for people battling this.
Tell your friend not to give up yet. When I was hospitalized with depression for the third time in one year, I met a fellow sufferer who wanted to know why God didn’t do miracles any more. I pointed out that even after the burning bush and the parting of the Red Sea, there was still 40 years of slogging through the desert. I wish there was a miracle cure for depression; as far as I know, there isn’t one. There is however, good therapy and good friends. It does get better, even when you can’t see it because all your world is dullness and pain. Meanwhile, here’s a hug to both of you and a shoulder to cry on.
Oh yes, I nearly forgot the most important thing to tell your friend: “You’re not alone. There are people out there who’ve been through this and are willing to help. I’m one of them.”
Take care, both of you,
CJ
Identifying the causes of my depression, coming up with a plan to fix those causes, and implementing that plan.
Counseling and medication alone are worthless if you’re not willing or able to change the underlying causes of depression.
lavenderviolet, you are great for wanting to help your friend. Encouraging words for someone who is depressed would be the same as you would use for providing encouragement for anyone else. Tell your friend to stick to his treatment plan and that eventually he will feel better, given time. But don’t be under the illusion that the encouragement itself will help your friend come out of his depression. It’s not the kind of illness that someone can think away (unless perhaps if it’s a very mild case).
When your friend feels his recovery isn’t coming along fast enough, tell him to remember how long it took him to get this screwed up.
But seriously, a lot of people expect a pill or a few sessions with a therapist to magically change their lives. That’s only a first step.
Hello. I have suffered from severe depression all my life (I remember being as depressed as I have ever been at the pre-school age).
It is vital to know that this is an illness that screws up your thinking, your perception. As your friend comes to deal with this longer (if it is a long-term thing, and not just situational), he will be able to recognize The Beast and be able to, hopefully, separate it somewhat from who he is as a person.
This is not a matter of personal weakness or lack of ethics. And it’s certainly NOT a matter of will. It’s really, really important to have a therapist that you connect with, who you know cares for you and your recovery, and is skilled in dealing with depression. If he’s like me, there will be times when he just wants to crawl into bed and the last thing he wants to do is go to therapy. Go anyway. (I gave myself a reward for going to therapy at one point. I love Hostess Cherry Pies sooooo much. Immediately after leaving a session, I would stop at the nearest Texaco and buy one.)
Self care matters. Treating yourself with gentleness matters.
If I had direct advice for you as his friend, it would be to make sure you let him know that you feel hopeful and confident that he will recover. That you still see in him all the things that brought you together as friends in the first place. Definitely let him know that he is not alone, not in the literal sense, and not in the world at large. There are many people who have this, who deal with it on a daily basis, and who still have the things in life that matter.
If his meds aren’t working, he must must must share this with his physician. There are many out there. It does suck that it can take a good amount of time to find the right med at the right dose. But, trust me, he will know when he’s found the right one.
And if right now he just has to do the basics - get up, go to work, go to therapy, take his meds, try to eat right, get eight hours of sleep - that’s okay and normal. Gentleness, gentleness.
Oh, and I forgot.
I take an Omega-3 and B-Complex supplement every day. That makes a big difference, too.
Just my opinions, but your friend might benefit from getting good exercise on a daily basis, eating right, and perhaps tinkering with the medications or finding a different therapist. Prayer may help as well.
Working through my depression took years and many different efforts. I had two particular lows, one at age 14 and one at 25. Both times I went into therapy, and neither one did much (if any) good. Instead, at 14 I became bulimic, and at 25 just got fat! One does survive, as best we can.
When I finally found the therapist who really helped me, the transformation took place after about 7 sessions. We’d really connected and he said something one day that blew my mind and my life has been different ever since. That’s not to say I was “cured”, but I did start to live differently. Which led to more authentic choices, self-acceptance, new opportunities, embracing my passions (which was a huge healing experience), and making peace with my limitations. This took place over 5 years.
I’ve had some mild lows since then and tried to work with other therapists (we’d moved) but none of them even came close to being able to help. I think finding the right therapist is huge, and that most of them are not a good fit.
My favorite self-help book is If You Meet the Buddha on the Road, Kill Him, by Sheldon Kopp. Perhaps your friend would enjoy it?
Regular aerobic exercise is very helpful for depression and studies have shown that. A few forms of meditation including mindfulness and tong-len (tong-len is just a way to use the theories of logotheray) should help too as they refame how you look at yourself and situation.
Omega-3s or flaxseed can help too. I personally take 1.5g of trimethylglycine and 125mg of DL-phenylalanine daily (I try to take the lowest dose I can get away with in case they have side effects but i’ve never heard of side effects of trimethylglycine and the side effects of DL-phenylalanine supposedly don’t occur until you get into multiple gram a day dosages) and they have done alot for my depression.
I am so sorry, but I think I will be of no help at all given that I believe myself to be rather unique, medication-wise.
I’m rather young, yes, so my deppression went unnoticed for several years (!) because people thought I was having a particular kind of “teenage mood swing”. Oh, the hormones! My depression kept getting worse with each year, for the course of 4 years. High School years. The “best years of my life”, or so I was tried to brain wash.
The 4th year was the worst of all. I stopped liking everything. I stopped enjoying music and films (my only comfort). I couldn’t sleep. I cried. I kept thinking about death periodically, though not about killing myself, specifically. I felt I was ready to join the cast of Dawn of the Dead except that they were very active zombies. I felt anxious most of the time. I sweated for no reason. My grades dropped. I felt stupid because I no longer understood things in the speedy way I used to. I felt like crap.
Then, as my brother was treated for OCD and his rather shyzophrenic tendencies, which pretty much messed up a good portion of my life due to events I’d rather left untold here, the psychiatrist pointed out that his suicide threats were a crock, that I was the one in real danger. So, he’s the guy who identified my depression. I felt insulted, but when it was pointed out to me a second time, I sought advice from the holy realm of the internet and was blessed with its wisdom. “Yay, I’m depressed!” doesn’t sound very well, but I was happy to learn that none of it had been my fault.
I went on Prozac and, in about a month’s time, I was back to normal. 20 mg a day. That was it. Only real side-effect, was an on-and-off mania for a week, which I got a kick out off. A real boost of self-confidence. 
So, in this regard, neurologically, I became the perfect patient.
My advice, as it was the turning point for me, is to show your friend the information that is available (all kinds, not just the “take this fun test and see how you score on your serotonin level! Huh-Ho!”) and let her know it isn’t her fault. That’s the thing with us depressed folk. We place the blame on ourselves too often in many different forms.
However, all the advice in the world won’t help him. It’s what comes from within that will. Some of us are luckier than others, though.
How depressing.
I have depression and have not had good experiences with medication. They arn’t the perfect bullseye solution for everyone.
In the last year or so it really seems like my life has come back- I don’t cry for no reason, I don’t feel hopeless, I actually am starting to look forward to the rest of my life. I’m not sure why or how I got better, and I’m still not 100%. I feel like all the bones in my body were broken and put back together again, and now I get a new life- a bit more fragile- but I am grateful every day for it.
The hardest thing to do is to want to get better. This is an increadable act- you are putting your trust back in the world and denying everything you’ve believed in for so long. Depression is seductive. It invites you to plumb it’s depths- to see how far you can go. It is way more interesting and exciting than running around trying to fix things. And the weight of everything you have to do to get better feels so heavy that you feel like it’s not worth shouldering. But at some point you have to decide your curiousity is sated. You have to choose to rejoin the world. You have to commit yourself to it again. I’m pretty sure nobody and nothing can make this happen any sooner than it does. It’s like a fever breaking.
Depression is also something that I don’t think you can just be rid of like that. It’s a part of you like everything else. I personally think it’s glib to think we can turn it off and that is that. A big moment for me was when I realized that depression was something I could live with. It’s a harder life, but it doesn’t have to be dehabilitating. With a little self-knowledge you can prepare for it, head it off, and learn how it trys to trick you and cut through your defenses. I know I will always be faced with these waves of sadness caused by nothing but some bad luck, but I also know they don’t mean anything, and I don’t have to let them knock me down. It’s not a matter of willpower, it’s a matter of faith.
Writing in my livejournal really helped me. It let me see all my problems as this great romantic artisitic affair, not just plain hopelessness. I found myself thinking of how I’d write up my worst moments, instead of giving in to them. The Internet aspect gave me a sense of purpose- I liked the idea that someone somewhere might read it.
And of course friends helped, even as I pushed them away. Just being invited out- even if I never accepted- helped.
It’s the hardest thing I’ve ever done. I feel like I’ve climbed mountains. It took a lot of very low lows, a lot of hard self-reflection, and more faith and trust than I though was possible. But it can be done.
Getting and and doing things (especially if it involves some exercise) are very important when dealing with depression for me. A friend could help greatly by both suggesting things to do and also by trying hard to go with anything your depressed friend suggests. If I find some event to go to, I am much more likely to go to it if a friend is also going. If it was me allone, I often fall in the trap of thinking its not worth the hassel even when I know going out will do me good (which it invariably does). If I have a friend going as well, then I won’t miss the event through appathy because that would dissapoint my friend.
With my depression, the worst is when there’s nothing to do. Being bored and idle leaves my mind open to hopeless thinking. On the bad days, I try to stay busy. Read a book, work on a puzzle, bake cookies, clean the house… anything that will keep my mind away from those thoughts.
It doesn’t always work, but it can help. The thing is, people are different and deal with depression in different ways. For example, writing in a journal (livejournal, same idea) helped even sven, but I learned that writing about my feelings just made me focus on them more. It was an excuse for me to wallow in my sadness.
The trick is to try all sorts of things, and at the end of each day, see how much you were able to forget about the dark thoughts. And not to give up on the treatments, whether it’s therapy, medication, or whatever. It’s not like strep throat - getting past depression is a long fight. But it can be done.
Changing his diet made a dramatic difference in my husband’s depression. Sugar really exacerbates it — he can still have it now in small doses, but if he eats as much as the average person, after a few days he starts getting moody.
That sounds more like diabetes than depression. According to friends who are diabetics (ones who are Type I and ones who are Type II), one of the surer indications that their blood sugar’s out of whack is that they get cranky. I’ve also seen that effect first hand.
CJ
I’ve had great success with exercise. Long walks & bike rides help.
Do it daily.
No quick cure here. Everyone responds differently to depression. It’s good that some people find relief with exercise and nutritional supplements. If your friend is willing to try medication, I would recommend it at the lowest therapeutic dose as prescribed by a psychiatrist (not just an internist or family doctor). Anyone who has been in the dark hole will attest to the fact that it can be debilitating and cause suicidal ideation. What helped me is to remember that things DO change. Life is not static. Keeping a journal, maintaining a daily routine of activity and rest, meditation, good nutrition, therapy - it’s all good. For me, it was medication.
I continue to take it, and on days I really hate the side effects. But it allows me to work and function socially. Best of luck to you and your friend.
Some books that I found helpful:
Self-Coaching: How to Heal Anxiety and Depression – Dr. Joseph J. Luciani, Ph.D. - I really liked this book, especially when the author said to not give anxiety and depression too much respect.
The Power of Self-Coaching – Dr. Joseph J. Luciani, Ph.D.
From Panic to Power - Lucinda Bassett
The Feeling Good Handbook – Dr. David D. Burns, M.D. - this is an excellent resource for working on your thinking habits at home, between therapy sessions.
Anxiety and Phobia Workbook – Edmund J. Bourne
Coping with Anxiety: Ten Simple Ways to Relieve Anxiety, Fear, and Worry -
Edmund J. Bourne, Lorna Garano
Power over Panic - Bronwyn Fox
Hope and Help for Your Nerves - Dr. Claire Weeks
Most of these authors also have websites that you can visit:
www.stresscenter.com - Lucinda’s site
www.panicattacks.com.au - Bronwyn’s site
www.self-coaching.net - Dr. Luciani’s site
Dr. Luciani’s site also has a message board where you can ask Dr. Joe Luciani himself any question you can think of relating to anxiety and depression.
www.greatday.com/motivate - This site has a new motivator each day (except Sunday) – they are very brief articles on how to move forward, stay positive, and look after yourself.
Most of these resources address anxiety and depression, rather than just depression, but the two seem to go hand-in-hand more often than not.
Yes, exercise could be one of the best decisions a depressed person can take. It is believed that some kinds of depression come from an imbalance that occurs because of a disrupting, or abnormal, sleep cycle. In a very broad manner, when you sleep, your body does a lot of maintenance. It releases hormones in quantities it usually doesn’t deliver when awake. The same goes with other chemicals. If you don’t get enough of this, you’re not ready to wake up and face the day. When your sleep deteriotes -which it can in many ways, such as an increased REM cycle- it could eventually lead to a chemical imbalance in your body. Thus, your brain depresses.
Exercising can improve your health in several ways. While I find acupuncture to be nothing special, its main point, that all parts of our body are related to one another, holds. So, while seemingly stimulating your body instead of your brain, you’re actually telling your brain to take care of its body. It will raise endorphins and release testosterone, regulate the heart and take care of muscle tissue. It will need nutrients and will let you know of all these things. Most importantly, it will tell you to rest. Your brain will try to balance things out.
While this “trying” thing might not be what depressed folk want to hear, and it may not be the ultimate cure, it’s worth it.
That’s my theory, anyway. But the fact is, keep busy. Do stuff. You don’t have to like it (because, frankly, what do you like doing recently?), but it doesn’t have to be an obligation. So, in this case: Just do it.
I am so sorry for that last sentence, by the way.
I guess I’m kind of weird when it comes to therapy because once I realized that I was depressed, the first thing I wanted was to get therapy, and my parents were the ones who were trying to keep me from going. I love going to therapy; it gives me a chance to talk through my problems with someone else who’s objective. But your friend needs the therapist that’s right for him. If he doesn’t feel comfortable talking with his therapist or doesn’t like the methods being used he should switch therapists. It may take awhile to get into the issues that are causing his depression and working through them is not a fun experience, but the most important thing is for him to go every week.
The best thing you can do for him is just keep being his friend. Depression can turn you into an awful person, and you wind up turning away the people who are trying to help you. Just keep doing the things with him that you usually do.