Clinical depression

Clinical depression is something that affects over 17 million Americans. If you are the partner, parent, child or friend of someone who is undergoing a depressive episode, the pain of seeing a loved one in the depths of clinical depression can be almost as torturous as being depressed oneself. Your understanding of the illness and how you relate to the patient can either support or deter his or her ability to get well. Here are some important ways in which you can help the healing process.

1. If a loved one's activity and outlook on life starts to descend and stays down not just a few days, but for weeks, depression may be the cause. The first way you can be of support is to help the person to recognize that there is a problem. This is especially crucial, since many people fail to realize that they are depressed. Begin by encouraging your friend to share his or her feelings with you. Contrary to myth, talking about depression makes things better, not worse. Once it becomes clear that something is amiss, you can suggest that he or she seek professional help. You can be of further support by accompanying your friend to his initial doctor's or therapist's appointment and subsequently monitoring his or her medication. In addition, explain that seeking help for depression does not imply a lack of emotional strength or moral character. On the contrary, it takes both courage and wisdom to know when one is in need of assistance.
2. Educate yourself about the illness, whether it is depression, manic depression, anxiety, etc. Learn about symptoms of the illness and how to tell when they are improving. Your feedback to the psychiatrist or therapist about how your friend is faring will help him or her to assess if a particular treatment is working.
3. Provide emotional support. Remember, what a person suffering from depression needs most is compassion and understanding. Exhortations to "snap out of it" or "pull yourself up by your own bootstraps" are counterproductive. The best communication is simply to ask, "How can I be of support?" or "How can I help?"
4. Provide physical support. Often this means participating with your friend in low-stress activities-taking walks, watching movies, going out to eat-that will provide an uplifting focus. In other instances you can ease the depressed person's burden by helping with the daily routines-running errands, doing shopping, taking the kids out for pizza, cooking, vacuuming the carpet, etc.
5. Encourage your loved one to make a list of daily self-care activities, and them put them into practice.
6. Monitor possible suicidal gestures or threats. Statements such as "I wish I were dead," "The world would be better off without me," or "I want out" must be taken seriously. The belief that people who talk about suicide are only doing it for the attention is just plain wrong. If the person you care about is suicidal, make sure that his or her primary care doctor is informed. Don't be afraid to talk with the person about his or her suicidal feelings. Meanwhile, hold on to the possibility that your loved one will get better, even if he or she does not believe it.
7. Don't try to talk the depressed person out of his feelings, even if they are irrational. Suppose the depressive says, "My life is a failure," "Life is not worth living," or "All is hopeless." Telling him he is wrong or arguing with him will only add to his demoralized state. Instead, you might want to say, "I'm sorry that you are feeling so bad. What might we do right now to help you feel better?"
8. Maintain a healthy detachment. You may become frustrated when your well-meaning advice and emotional reassurance are met with resistance. Do not take your loved one's pessimism personally-it is a symptom of the illness. Direct your frustration at the illness, not the person. People who suffer from depression complain that their families' resentment over their condition often leads to neglect or outright hostility.
9. If prayer is something you believe in, then pray for your friend's healing. Turn his or her welfare over to the care of a Higher Power.
10. Establish communication with other people in the person's support network-e.g., family members, friends, physicians, therapists, social workers, clergy, etc. By talking to other caregivers, you will obtain additional information and perspective about the depressed person.
11. Finally, encourage the person you are caring for to create a support system of other caring people, or help him or her to do so. It takes a whole village to see someone through a dark night of the soul. You cannot transform the illness of depression by yourself, but you can be an integral part of the healing process.
12. Offer hope. Remind the individual that depression is treatable and that he or she will likely get better. If your loved one is undergoing treatment, gently remind him or her that it takes time for treatment to work.
13. Give positive reinforcement. Depressed people often feel worthless, and they dwell on their faults and shortcomings. Remind your loved one of his or her strengths and competencies and how much he or she means to you.
14. Keep your sense of humor. You're likely to feel frustrated and even angry at times. That's OK, but try not to vent in front of the person who's depressed and don't take your anger out on him or her. Use humor when possible to diffuse tension and to lighten the atmosphere, but don't make jokes at your loved one's expense.
15. Encourage healthy behavior and activities. Invite your loved one to join you in doing activities or visiting family or mutual friends. But don't push and don't expect too much too soon. Also gently remind the individual of the importance of exercise and a healthy diet.
16. Take good care of yourself and your needs. It is easy to get immersed in your friend's care and lose your own sense of self. You may also experience "contagious depression"-i.e., taking on the other person's depressive symptoms-or you may get your own issues triggered.

Here are some ideas on how to "inoculate" yourself so that you can stay centered enough to truly help:

• Take good care of your body. Make sure that you are getting adequate food and rest.
• Find a safe place to process your feelings.
• Maintain your routine as much as possible. Although you may need to adjust your work schedule or other routines to accommodate helping a depressed person, keep your life as regular as possible. Don't become so involved that you lose touch with friends and social support.
• Learn to set limits, especially when you are feeling overwhelmed by the depressed person's pain and tales of woe. To avoid burning out or experiencing hostility towards the depressed person, encourage him or her to seek professional help. Your role is that of a friend or family member, not a therapist or a medical doctor.
• Take breaks. When you start to feel emotionally or physically drained, ask other friends and support people to relieve you. Then do things to nurture yourself.
• Continue to pursue activities that bring you pleasure. Having fun will replenish you so that you can keep on giving.
• Give yourself credit for all that you are doing-and realize that you cannot do everything. No matter how much you love another person, you cannot take responsibility for his or her life. Try to distinguish between what you can control (your own responses) and what you cannot (the course of the illness).
• Living with someone who's depressed isn't easy. The situation can become even more difficult if you have others to care for. Remind yourself that you're only one person and you can do only so much. Requesting help from others or taking time for you isn't a sign of weakness. If you're stressed out, tired or develop health problems, you'll be less able to help your loved one. Keep telling yourself that there's light at the end of the tunnel. With proper treatment, most people experiencing depression do recover. Better days may be on the horizon.