How do you deal with someone who's depressed?

In My Humble Opinion
21

Militant anti-psychiatric activist checking in, somewhat quietly.

For the most part, what they said. When your personal world implodes, it is hard to know how to keep going, and although you appreciate the supportiveness of friends, you tend to think that it isnt’ enough, that it won’t fix anything, so you don’t cheer up. And so on.

Now, a brief word about professionals of the psychiatric sort, and their profession, and the institutions thereof.

A couple months ago I finished scanning and doing OCR on the policies and procedures of the various psychiatric facilities that do ECT (electroshock) in NY. The sections describing involuntary treatment, and who is to do what in the circumstance where the patient declines treatment that has been ordered, are often scary in their detached mechanical-ness.

Before I go any farther, I should note and celebrate the caring professionals who go into the mental health profession in order to help us and perhaps even reform the system. Having done so, I should also note that they don’t tend to last long. They burn out. It’s an ugly practice, an ugly institutional world, and an ugly reality for caring professionals to get inducted into. Mostly it does not exist for the benefit of the depressed (or schizophrenic, or bipolar, or just plain disturbing) people who land there. It exists as a means of coping with them, for the benefit of those who are disturbed by them.

I would counsel: be wary of exerting strong pressure, especially of imposing involuntary anything, in your attempts to do right by your depressed friend. The modern snake pits have clever snakes with Sesame Street friendly neighborhood snake faces and pseudo-scientific explanations pertaining to neurons and neurotransmitters and dopamine and serotonin, but for the most part the chemistry they dispense and impose is not good for human brains and other living tissue, it isn’t anywhere near as narrowly tailored to fit the symptoms as they’d have you believe (mostly their pills just interfere with neurotransmitter activity in an across-the-board buckshot kind of way), and their statements about “depression” being a physical illness of the brain is still (despite years of research) an unproven hypothesis with poorly defined variables.

More info, more opinionated writings: http://members.aol.com/ahunter3

22

Not technically a depressive. More of a recurrent mood disorder combined with excessively strong chemical-producing cells in my brain… the sort of stuff that gets lumped into “depressive” but I think my life’s probably easier than some.
Be ready to commit a lot of resources to this guy if you offer help, but don’t overcommit. Borders are important, at least they have been with me: offer me help and I latch on immediately, even though the force required to pull me out of the mire is too much for one person. So make allies, other friends of his who you can work with (somebody shoot me for thinking the word “synergise…” I swear my anatomy teacher taught it to me!) to help him.
What anyone who’s depressed can use is a success, an achievement of some kind. He’s lost his job? Give him a hand redrafting his CV, help him clip ads in the paper, let him use the net at your place to search online. Lost love? Not so easy, but keep him company, plan things to do with him, make him feel less alone. There’s always something you can do to make him feel a bit better about himself and life, and being a wonderful and caring person tops the list. DON’T get sucked into talking about how insoluble his problems are, and DON’T try to mother him either. The more diffuse his support network is, the less likely he is to become dependant as he doesn’t get used to any one person helping him…
Speaking as the little tiny voice behind Loupdebois when he’s depressed, my heart goes out to you, I’ve seen people drive themselves half-crazy and run themselves ragged trying to help a depressive. One thing you can certainly do to make the world a better place: don’t disappear just because he seems to be doing better. I once got into the pattern of thinking that I only had friends when I was falling apart, and that they took off once I felt better…
These are mostly things I wish my friends had done to protect themselves against ME, I hope I haven’t been to repetitive of things others have said (I skimmed, already determined to say my two cents’)

23

Yeah, Mom, take care of yourself, for sure. You can help, you can care, and you can support. You are a pretty kind soul, and just being around you is probably therapeutic. But keep your own needs met, and don’t let yourself be overburdened by someone else’s psychiatric need. It is subtle, and it is almost inevitable, if you are living with, or very close to a person with a long term depression that it will use up your emotional resources.

So, here are some good practical things to say to a depressed person. All of them require that you have already built enough of a relationship that you can ask them without sounding judgmental, or demanding.

“If it wasn’t bad, what would it be like?”

“Can you think of anything that you can do today to make it more like that?”

“Don’t you think you really deserve help getting out of this?” “Even if you can do it alone, why should you do it alone?”

“Who do you think you could trust, to help you?”

“Wouldn’t a trained therapist have some experience with how to feel differently about yourself?”

Help them make plans in a practical manner. Not by making the plans, but asking who, when, and where about anything that is in any way vague about who, when or where. Tomorrow is about the latest you can actually start getting better, and today is a lot better.

Depressed people need schedules. Time management is a very common deficit for depressed people. Don’t try to impose one, but encourage him to write one down. It really helps. For really seriously ill people, hourly schedules are the best first step. Daily ones are enough for most people. Weekly means “someday.” Someday is a bad day to start anything.

“Sick people wear their pajamas all day. When you get well, you get up, and get dressed, every day. As soon as you can, you find a place outside of your home, and go there, pretty regularly, if not every day. After a while, the people in those places will expect you to show up. They will come to depend on you. The will need what you have, and what you are, if you let them get to know you. But for them to do that, you need to be there. Get up, suit up, show up. That’s how it starts. It isn’t what you do for someone else, it’s what you do for yourself.”

Tris

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