October 27, 2013

What not to say to a depressed person

If you are dealing with a depressed person, you might be pretty frustrated and irritated. 

At least that's how I felt when my mother was depressed.  I was so frustrated that I wanted to just shake some sense into her.  That was before I knew Major Depression myself.

Please realize that the depressed person's brain is not functioning properly.  Let that be your fallback thought when you get frustrated, "He's not trying to frustrate me on purpose, his brain isn't working right."

Here are some things that you should probably not say.  These comments will not help your friend or family member.  In fact, they may make him feel worse.

"What are you depressed about?”

There may be a situation that is depressing him, and maybe he doesn’t really want to talk about it. 
Or he may not be able to come up with a reason, and then you have made him feel stupid on top of his depression.  Sometimes brain chemistry changes without a clear reason.
Just don't ask this. 

“You have so much to live for!   Why would you be depressed ?”

The person likely knows if he has good things in his life. 

If you remind him of this, you'll make him feel guilty for being depressed because he "should" be happy.  it will just add guilt to his depression.  
Just don't ask this, either.


“Just don’t think about it.”

People say this when the depressed person is obsessing about something. The person cannot just not think about it.  It’s like if someone says, “Don’t think of a kitchen sink;” then all you can think of is a kitchen sink. 
Instead, help the person find something else to put his mind on.  Maybe you can help him place his thoughts on the present, the sights, sounds and sensations affecting him right now; that can be helpful.

“Don’t say that.  You don’t mean that.”

Yes, he does mean that.  Don’t tell him he doesn’t. 

Maybe you could just say, "I'm sorry to hear that."

“I know how you feel.”

No, I assure you, you do not. 
Even if you have suffered from depression, everyone experiences it differently.

“C'mon!  Just cheer up!”

He can't.  He would if he could. This is like telling a diabetic, “C'mon!  Just change your blood sugar!”  

“Don’t cry.”

He doesn’t want to cry and he would stop if he could.  Tears can be cleansing.  
Just offer to get him some tissues. 

"Don't feel that way!"

They're his emotions; allow him to own them.  In his mind, his thoughts are perfectly reasonable. 
You might say, "I don't agree with that," or "I wish you didn't feel that way."

"I'm worried about you."

Worry doesn't help anyone.  And it makes it sound like he's responsible for your feelings.  He is not.  You are.
Just tell him you care about him.

"You just need to (take this vitamin, eat this fruit, do this exercise, go to this doctor, read this book, think this way, blah, blah, blah.)"

If he is seeing a doctor, let the doctor do her job.  If not, encourage him to go to his primary care provider.  Offer to go with him if he wants you to, but don't insist on it.

"You're just doing this to get attention."

If you say this, you are telling him that what he is feeling is unimportant and frivolous.
Especially if the person sounds like he wants to kill himself, take him seriously.  Call your local crisis services. 

The most important thing is that he knows you are there for him.  

If you are uncomfortable with the depressed person's behavior, please educate yourself on major depression.  There are lots of agencies and web sites you can learn from.  You could start with National Alliance on Mental Illness or the Depression and Bipolar Support Alliance.

October 22, 2013

What I talk about when I talk about "depression."

"Depressed." That just means "sad," or "down," or "feeling low," maybe "moody," or "unhappy."  Right?


In my book, "depressed" means "self-loathing," "paralyzed," "angry," "crying for no reason," "not interested in anything," "unable to function."  Oh, and "suicidal."  Which goes along with "in the hospital." 

I also call depression "the black pit."

When I'm just starting down the slippery slope into that black pit, I can act for a while.  Before I go someplace I tell myself, "Okay, time to put on the happy face."  And I smile and act like everything is okay.  But as soon as I leave, my face drops and I'm right back the way I was.  Or maybe worse, because playing the "happy" role is exhausting.  So I start limiting my interaction with other people.

After a while, the happy face cracks.   I can no longer put it on at all.  Then I just stay home.  It's a huge effort just to get to a doctor appointment.  If I have to go out, I just look down at the ground, pretending to be invisible.

The people I love -- my husband, my daughter, my friends, my co-workers, my family -- I feel . . . I know . . . that I'm a burden to them.  They would be better off without me.  They just won't admit it.

And I am such a disappointment to myself.  I was so smart.  I could have done so much more.  I should still do so much more.  But I can't.  I can barely take care of myself.

I get paralyzed.  I will sit or stand in one spot for half an hour.  Or more.  Like a statue.  With no thought process going on.  Sometimes I try to do something.  I want to take a shower, but I can't do it.  I want to go to work, but I can't do it.  I want to exercise, but I can't do it.  I mean PHYSICALLY I cannot do it.  Really.  Wish I could explain it.

I am angry.  At any big or little thing.  I get ferocious:  so angry that I cry and shake.  It is free-floating anger, ready to erupt at any time.  I feel sorry for the people who have to live or work with me.

I am not interested in eating.  Not even chocolate.  I'm not interested in word puzzles.  I have a stack of terrific books to read, but nothing appeals to me.  There's nothing on TV that I want to watch.  Not even politics.  Dear God, you know I'm sick when I'm not interested in chocolate or politics. 

I cry.  I sob.  For long periods of time.  I am distraught.  And the worst part is that I don't know why.  Even the beautiful things that I normally find joy in -- a blue sky, an adorable dog, a fuzzy caterpillar, God's amazing creation, sunshine (especially sunshine) -- just make me cry.  Why?  Something is screwed up inside my brain, I guess. 

I am in so much emotional pain that I cannot stand it.  So I scream when nobody is around.  No words, just screams.  Somehow it feels like if I scream loud and long enough, the emotional pain will go away.  But it doesn't work. 

Once, when I was in the hospital, I screamed while I was in the shower, thinking the running water would drown out my screams.  But everybody heard me.  After that, I was just the crazy screaming lady.  It's sad when your fellow mental patients look at you like you're the crazy one.

I am in so much pain that I want to die.  I think it's my only way out of the pain.  But it's not a passing thought, like, "I might as well kill myself."

Suicide is my old friend.  It comforts me.  I have been thinking seriously about it for a very long time.  I have read countless books about it.  It is my daily companion, even when I'm well.  I have several well-thought-out plans of how I can kill myself.  I know how to get past the fear of the pain of death itself.  Suicide is my plan B.

I often think that I'm going to die by suicide eventually anyway so I might as well just get it over with. 

But I have promised someone that I won't kill myself.  And I don't break my promises, especially to this person.  So now I am trapped.  There is no way out.  I am down in the black pit, death and pain are churning all around me, dragging me down and down, and there is  No. Way. Out.

Sometimes I have to go to the hospital to keep from killing myself.  And then my insurance company gets to decide if I am sick enough to be admitted to the hospital.  Not my doctor, not my family, not the professional evaluator at the hospital, MY F*CKING INSURANCE COMPANY.  Talk about a death panel.

Now I've been through this drill many times before.  And I have finally learned that I can get better.  I desperately try to hang on to that thought, to keep from being swept further down into the churning black pit.

My doctor will add in a new medicine (already has, actually), and after a few weeks it may help (already hasn't, actually).  So now we'll try a different combination of medicine and give that a few weeks to work.  Patience is one of the unwanted lessons of depression.  But eventually, agonizingly slowly, I will start to feel better.  At least I hope so.

Do you think I'm crazy for writing this, insane for feeling this way?  Frankly, my dear, I don't give a damn.  I only write for those whose minds are open enough to learn.  If you're not one of those people, then you can go straight to hell.  I'll be waiting for you here, because depression truly is hell.

Thanks for reading. 

P.S.  Please . . . 
  • Do not give me advice.
  • Do not tell me you know how I feel.
  • Do not tell me why I'm depressed.
  • Do not ask me why I'm depressed.  If I knew that, I could work on fixing the problem.
  • And do not worry about me. For God's sake, don't worry about me. The last thing I need is people thinking worst-case scenarios about me and flinging those kind of bad vibes about me into the universe.

October 06, 2013

There but for the grace of God . . .

If you have always lived comfortably, I want to help you understand why people with mental illnesses need so much help. 

These people's brains don't work right.  They need our help to have a place to live, to have food to eat, to feed and clothe their children.  They need our help to get medical care to help their brains function correctly.

I am amazingly lucky.  I don't know how I landed in this place, but I'm so glad I did.  Yes, I have suffered from Major Depression since I was a teen.  But I had all the right supports:

  • My husband takes his marriage vows very seriously.  In sickness and in health, this wonderful man has stood by me. 
  • I had a home to return to when I got out of the hospital.
  • I had a daughter to live for.
  • My parents both had experiences with depression.  They were  kind and compassionate.
  • My in-laws were also kind and compassionate. 
  • My co-workers were mostly nice. 
  • I have seen the same psychiatrist for over 25 years. 
  • I had jobs with healthcare insurance, plus short- and long-term disability insurance. 
  • My job and benefits were still there for me when I came back from sick leaves, thanks to the Family and Medical Leave Act, signed into law by Bill Clinton.

When you are in the throes of a mental illness, your brain is not functioning correctly.  Now, consider the misery some people have to go through at the same time  that they can't think straight:

  • Her spouse decides he can't tolerate her lack of motivation/fatigue/crying/sleeping all the time.  He leaves and she has no income.  She has to move to a homeless shelter, where her belongings become infested with bed bugs.
  • His parents kick him out of the house because he is acting weird.  Now he is sick and homeless; he couch surfs until his friends cannot cope with his illness anymore.
  • She has to be admitted to the hospital.  She has no family supports, so OCY takes her children.
  • He takes medicine that helps his brain work correctly, but it has awful side effects -- it makes him drool.  He feels better but no one wants to hire him.
  • He is misdiagnosed.  Instead of helping his brain work right, medicine makes him worse.  He becomes lost in a maze of case managers, agencies, therapists, psychiatrists, disability hearings, and hospitalizations.
  • He is denied Social Security Disability Income.  He appeals, but they tell him it could take up to a year to get a decision.  A year!  In the meantime, he is homeless because he has no income.
  • He has been in and out of psychiatric treatment for years.  Every time he gets sick, he sees a different psychiatrist.  There is no continuity of care; no one knows what treatments have worked or not worked in the past.  Doctors don't trust his own story of his previous medical care.

These examples are all based on people I have met in my various hospitalizations and outpatient experiences.  Please try to imagine living with illness plus these various sad circumstances.  Try to imagine being homeless or losing your children while your brain can't correctly interpret reality.

Sure, they're part of Mitt Romney's 47%, but they are not freeloaders.  They are very sick and they cannot work because of their illnesses.  Or they try to work but can't keep a job because of their illnesses.  Or nobody wants to hire them because of their illnesses.

And there, but for the grace of God, go I.