The other way to look at this is that his friends are keeping him alive with the least restrictive involvement of external, sometimes even more counterproductive, organizations, agencies, systems etc. These people have decided that this works for them whatever the reasons. We can’t know all the variables. I would love to have friends with this caliber of commitment.
Agreed, it’s difficult to really understand the situation without knowing all the variables, and as a result, I end up imprinting some of my own experiences to fill in the gaps. It’s hard to know whether their intervention is keeping him alive, where without it, he’d have hurt or killed himself, or if it’s enabling him not to take action. For those who don’t understand it, certain types of intervention seem reasonable, because they would be for most people, but they have different effects on people with depression.
Consider this analogy. I don’t rarely drink alcohol, and when I do, it’s usually just one or two drinks in a social setting, never to get drunk as anything beyond the slightest buzz gets progressively more unpleasant. But even still, most people aren’t alcoholics. If I’m in a social setting and not planning on drinking and someone continues to insist I have a drink or two (happens often when I do go to social gatherings), I just take it as it’s intended, a little light social pressure to loosen up and join in the fun. If, however, I were a recovering alcoholic, or otherwise had trouble with addictions, that sort of well meaning prod could cause a major relapse and a downward spiral.
By the same notion, I have certain routines I maintain, and they’re intended to keep me from sinking down, and I can stick to them as long as I can keep my head above water. Sometimes people encourage me to just not bother on one day, and maybe for most people, that’s not a big deal, but I know for me, if that’s the case, maybe I’ll be okay, but it carries a very real risk. Or, worse, when I already am down, some people may try to help me out by dragging me out to some sort of social gathering, and as an introvert, that sort of thing just stresses me out and makes it worse, where I’d benefit much more with the direct interaction with a loved one. Maybe that would work for someone who is an extrovert, I’m unsure.
I guess my point is, it’s difficult to really know how to best help someone with depression. My concern with the example in the OP, though, is that this person has been medicated and is still unemployed after several years. Presumably the psychiatrist has made adjustments to the medication in that time, but after a certain point we have to realize that what we’re doing to support someone like that just isn’t working. I can understand six months or a even a year, but six years is definitely a point where something different needs to be tried. I’m obviously not in a place to say which course of action is the best one, but if I were among those helping him, I’d be engaging with the others to see what further action needs to be taken.
What would that action be? It could be something simple like just engaging him in some kind of simple part-time work to get re-acclimated to working to help rebuild confidence and all, or it could be as serious as getting more professionals involved. For me, I know the former was more of what I needed, and just getting some consulting work and getting me doing that in a supporting environment rather than on my own, went a long way whereas the latter would have probably utterly crushed me, but seeing the person in my life I’m dealing with now, having tried the former several times and it not working and knowing he’s responded well in the past to the latter, if only for a time, he probably needs more of it.
Or maybe not. My aunt is on SSDI for major depression. She’s had depression for fifty years at this point in time. She’s had medication adjusted, goes to therapy every week, has been in supported employment when she is healthy enough - but nothing sticks long term. Sometimes, her husband simply has to make sure she eats.
After fifty years, every sort of action has been tried. Some things cannot be fixed.
Blaster, are you aware that depression can be an intractable condition? There are people who can’t be “cured” even with the best medical and therapeutic interventions. Just like any other mental or physical illness.
Perhaps if left to his own devices, the guy in the OP would require long-term hospitalization. But with the support that he does have he’s able to maintain some functionality. And maybe this is the best functionality that he can ever hope for, at this point in time. We simply don’t know. So it seems like the safest course would be to withold judgement until more information becomes available, rather than coming up with a recommendation based on your personal experience.
Yes, I am aware, as I’ve mentioned, I have moderate depression, it runs in my family, and I know others who are severe. I even said I’m not in a place to say what the best course of action is, but based on the information in the OP, I don’t think it’s unreasonable that he can recover. We know that the person mentioned in the OP was holding down a job until his depression got him, that means he was functional at one point. Now, it’s entirely possible that since then something made it irreversibly worse and he’s functioning the best he’s ever able. All I’m doing is relating some of my personal experience and suggesting that maybe trying a few new things might help.
But frankly, again based on my own experience, if the guy was able to hold a job and is still able to go out and do things he enjoys, particularly things like going to conferences, I’m disinclined to think he’s at a place where it’s unrecoverable and the way he is now is the best he’ll ever get. When it’s severe it typically means not even being able to muster the motivation to do activities one enjoys, sometimes even not being able to get out of bed or feed oneself. That is, I think there’s hope for him to recover, it’s going to be arduous, particularly since he’s been out of work for so long. I want the OP to have hope, just that it might require something different than what’s being done now. And, obviously, only those who actually know him are in a place to say. Then again, if everyone is content with that situation, that’s their choice too.
Another just freshly diagnosed clinically depressed here.
Before I got sick from that shit, I always imagined depressed person to be suicidal, wanted to cut their wrists, talking some emo bullshit or at least being strongly self-pity-ish. But in my case, I was really more in some half catatonic state. I got fucking nausea just to think to do anything, including getting out of the bed. I starred at the wall or ceiling most of the day and when I turned computer on I just stared through the screen pretending I’m really interested in something. Basically, I was pretty much limited to primal living functions. And almost nobody noticed that there is something fucking wrong with me. Thanks to some light benzos, I recovered ability to be functional again now and then, although on account of being slow and lethargic.
I am on SSRI (Lexipro/Cipralex) now for 3 weeks and it seems to work, although it is slow medicine. It should took another 6 weeks or so be fully functional again and at least 6 months to be sure it would not recede.
As for OP original question how to understand depressed being. From neurochemical point, this is standard nerve disease (had have some googling, when felt better). In some (most?) cases Serotonin (main nevrotransmiter) is lacking / misfiring (so dopamin and other neuro chemicals can’t do their job properly). I have all the symptoms of misfiring Serotonin, so SSRI looks like right choice for my treatment. Depression is just one of the symptoms (thought most debilitating), since Seratonin is 90% in guts and only 10% in brains. Other symptoms are general gut problems into extremes (diarrhea - constipation, no appetite - wolf appetite, extreme nausea - no nausea at all even on windy road), short term memory loss (as someone mentioned in this post, you go to work on something, then you feel it is pointless, and then you are surprised when you stumble on your half done work). Sleeping problems (no feeling when to sleep or when to wake up). And total deconcentration and lifelessness.
Basically, everything you do, takes enormous effort. Not because you do not want to (I still have some great creative ideas to be realized), but because everything from brains that goes to my body is 403 or 404-ed. Or hanging on an old ADSL line. And then backfires back to brain for additional damage.
I spent whole day for this post. I hope it helped someone.
If it helps some people here understand that the subject is a disease that “chose us” rather than laziness/weakness/self-pity/moral failing that we have chosen, it was well worth the effort.
I’ll say it to you as well: I wish you the best.
My favorite days are the ones where primal living functions are too much effort. When you realize that you wet your pants sometime in the last hour - or two. That you haven’t eaten anything since yesterday.
People say getting out of bed to shower is too much work. They are trying to explain it without mentioning the grosser end of that isn’t that you haven’t showered for two days.