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.

 

 

 

 

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

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

Nope.

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. 

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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.

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.

Can America end gun violence?

Can this country do what it takes to reduce gun violence?  Let's talk about the issues involved.

We'll start with President Obama's proposals.  The President's plan includes four points:

1. Closing background check loopholes to keep guns out of dangerous hands
2. Banning military-style assault weapons and high-capacity magazines, and taking other common-sense steps to reduce gun violence
3. Making schools safer and
4. Increasing access to mental health services.

I like this.  There's some good stuff here.

Closing background check loopholes wouldn't have affected Newtown, granted.  But it might stop suicides and domestic shootings.  And making straw purchases a felony might stop some of the street sales of guns in inner cities. 

I have mixed feelings about banning assault weapons, but I can get behind banning high-capacity magazines that let someone rip off 150 shots in five minutes.  That would definitely help in mass shooting scenarios, like the one in Arizona where the shooting was stopped when the shooter had to stop to change clips.  Some people think that stopping gun violence is a gun control issue.

I also have mixed feelings about "making schools safer."  There is some evidence that school resource officers (SROs), who are supposed to make schools safer, are criminalizing childish behavior and teaching kids to distrust police. But others say this isn't true.  The ACLU has put forth a paper to guide SROs that encourages thinking about "the role of SROs within the context of the educational mission of schools."  Some people believe that gun violence can be addressed as a school safety issue.

Increased access to mental health care is great because mentally ill people have been stigmatized and marginalized forever.  They need care.  Some people think that gun violence is a mental health issue.

But, even if we had the courage to enact them, these ideas alone are not enough to stop America's gun violence.  That's because America's gun violence isn't just found in mass shootings. 

CDC data indicates that there were 11,078 firearm homicides in 2010. That's an average of 30 deaths per day -- 30 people killed by guns per day. That's a Newtown every single day.

There were also 19,392 firearm suicides in 2010. Hopefully, steps will be taken as I proposed in an earlier post that might help bring this number down. 

Our biggest problem is not mass shootings.  I would posit that our biggest problem is the objectivizing and marginalizing of our fellow citizens, which causes daily violence.  Some Americans nourish a hatred for people who are not like them, and some feel as if they're in competition with everybody else.

 

Oryx Cohen, in a blog post, claims that we are all responsible for the mass shootings. He says, "[W]e are all responsible for creating healthier communities so these types of tragedies do not occur. We all have more power than we realize." He suggests some common-sense steps we could all take to avoid marginalizing people who are different from the norm. It's worth your time to read.

My friend, Heather, commented on a previous post,

"When you live in a country that has so many people vehemently against providing basic health care for everyone, it leaves you wondering just how much a human life is worth to these people? When you have people say that those without insurance and cannot afford care should just die? Is it any wonder that we have so many people killed with guns."

Heather just might be on to something here.

A CNN article reminds us that mass shootings are only a small fraction of America's gun crime. Its authors agree with Heather that many shootings are caused by societal ills, saying

"Through a complex mix of violence, institutional arrangements and exploitation, black Americans were pressured into ghettos, which are the hotbeds of contemporary gun violence. Their inability to escape their conditions is not a choice but rather the byproduct of continued structural discrimination. Slowing the tide of inner-city deaths through gun control is therefore a modern-day civil rights issue." (italics and bold type mine)

Randolph Roth, author of American Homicide, who researched homicide rates over a four-century period in America and western Europe, makes the following observations:

"[H]omicide rates among adults are not determined by proximate causes, like poverty, drugs, unemployment, alcohol, race, or ethnicity. Instead, factors that seem on the face of it to be impossibly remote—like the feelings that people have toward their government, the degree to which they identify with members of their own communities, and the opportunities they have to earn respect without resorting to violence—determine homicide rates." (italics mine)

"The killers were already predisposed to violence. They were already prepared to view people as enemies or rivals or prey."

"The predisposition to violence is not rooted in objective social conditions. . . . The predisposition to violence is rooted in feelings and beliefs." (bold type mine)

Jamilah King relates, in an excellent article at ColorLines.com, that people in Chicago are examining gun violence from multiple angles. A group called CeaseFire sees the root of the violence as untreated trauma and views it as a public health problem.

But David Brotherton, a criminologist at John Jay College, says that "Gangs are caused by people responding to massive levels of marginalization." (italics mine)  He thinks that CeaseFire is limited because that group can't "create jobs, they can’t make society shift real resources to the poorest areas.” This view sees violence as a political challenge rather than a public health one.

An op-ed in Yes! Magazine states that "U.S. society tends to deal with violence by treating it as an individual occurrence—focusing on the “perpetrator” and how he is different from us." The writer describes gun violence as a cultural issue.

So we have multiple perspectives on the gun violence that threatens Americans every single day:

• It's a gun control issue.
• It's a school safety challenge.
• It's a mental health issue.
• It's a civil rights issue.
• It's an issue of feelings and beliefs.
• It's a public health problem.
• It's a political challenge.
• It's a cultural issue.

The causes of gun violence are far more complex than what the president's plan addresses.  In addition to his plan, we need to make changes that allow people to feel valued.  We must make changes that allow people to believe they can achieve the American Dream. 

This means that we have to make our schools vibrant and attractive centers of learning, not for-profit operations.  We have to encourage our most talented and brightest people to be teachers, in part by paying them great salaries.  We have to make college affordable so people can learn to think critically and to advance beyond their class of origin.  We have to stop sending drug users to prison and get them help. We have to learn to really live by the Golden Rule, not just give it lip service. 

American Christians have to read the red letters in the Gospels and really love one another.  This means willingness to assist our fellow citizens who are in need, not to punish and penalize them.  It means that we are all created equal.  It means we must end the greed, selfishness, resentment, and inequality bred by our system of unfettered capitalism. 

Fixing this problem of American violence also requires leadership, compassion, and courage from the people we elect.  Unfortunately, there hasn't been much in the behavior of Republican politicians to make us think we can expect leadership, compassion, or courage from them.  They couldn't even pass an amendment that closes loopholes in background checks.  Let us pray that this obstructionism ceases.

Since 1971 I've been voting, reading, writing, educating people, trying to be more loving and peace-giving, contacting my state and federal legislators by phone and email to advocate for compassionate legislation, and attending small and huge demonstrations to call attention to issues.  I don't know what else to do.

We all, including you, must continue to take action to restore the American Dream and live by the Golden Rule.  This is the only way to end the carnage in America.

Can we rise to this challenge?

Scapegoating the crazy folk

I've been looking at the President's plan to reduce gun violence.  There's some good stuff there, but I have lately wondered if there is too much emphasis on mental health.  As if mentally ill people are the only ones shooting people. 

The President's plan, in the section on background checks, says some alarming things.  It contains a whole section on mental health care, and it discusses mentally ill people in the section about background checks.  The plan uses the euphemism, "dangerous people," to refer to mentally ill people.  So now, along with being called nutjobs, maniacs, lunatics, and monsters, we are "dangerous people." 

The NRA's LaPierre calls for a "national database of the mentally ill."  I guess we get put on his list, whether we are "dangerous" or not, just because we happen to be sick. 

But that's not right.  The majority of gun violence isn't attributable to mental illness, so don't blame crazy people for it.  There's no word for that except "scapegoating."

In an interview, Pamela Hyde, JD, administrator of the federal Substance Abuse and Mental Health Services Administration warns that we must

"disconnect the discussion about mental health from the discussion about violence. While there is no question that some people with mental health problems perpetrate violent acts, so do lots and lots and lots of people who don’t have mental health problems."

The Huffington Post gives us the sad information that, as of February 1, U.S. Gun Deaths Since Sandy Hook Top 1,280.    The article discusses many accidental shootings, and talks about "silly arguments" becoming "final arguments," but it doesn't mention any crazy people doing the shooting.

My friend, Heather, commented on a previous post,

"When you live in a country that has so many people vehemently against providing basic health care for everyone, it leaves you wondering just how much a human life is worth to these people? When you have people say that those without insurance and cannot afford care should just die? Is it any wonder that we have so many people killed with guns."

Heather just might be on to something here. 

Randolph Roth, author of American Homicide, researched homicide rates in America and western Europe for a four-century period. Discussing his book, he reveals that

"[F]actors that seem on the face of it to be impossibly remote—like the feelings that people have toward their government, the degree to which they identify with members of their own communities, and the opportunities they have to earn respect without resorting to violence—determine homicide rates."

Homicide rates aren't correlated with poverty, drugs, alcohol, unemployment, or race, according to Roth. Rather, it's the predisposition to "view people as enemies or rivals or prey" that determines whether people "are emotionally prepared to be violent at the slightest provocation or whether they refrain from violence even if they are brutalized or humiliated."

In Roth's discussion of his research, he never even mentions mental illness as a factor in high homicide rates.

A CNN article reminds us that mass shootings are only a small fraction of America's gun crime. Its authors agree with Heather that many shootings are caused by societal ills, saying

"Through a complex mix of violence, institutional arrangements and exploitation, black Americans were pressured into ghettos, which are the hotbeds of contemporary gun violence. Their inability to escape their conditions is not a choice but rather the byproduct of continued structural discrimination. Slowing the tide of inner-city deaths through gun control is therefore a modern-day civil rights issue."

Got that?  A civil rights issue, not a mental health issue.

Mass shootings are certainly heart-breaking and shocking.  And it's good that people understand how hard it is to get mental health care.  But an article published shortly after the Newtown shootings cautions against focusing on mental health care as the cure for gun violence:

"Such discussion, say psychiatrists and mental-health experts, may be beneficial if it actually leads to increased care and treatment, as well as better funding of treatment programs. But it also runs the risk of further stigmatizing mental illness or reducing civil liberties of the mentally ill, if people start to associate mental illness with violence."

Whether you want to call it stigmatizing or scapegoating, it's clear that blaming mentally ill people for gun violence is no way to stop the problem.

Bad. Very bad.

Today's in-box contained a letter titled "Message to Our Nation’s Health Care Providers" from the US Department of Health and Human Services.

Its release today suggests that it is part of the President's new gun policy proposals.

The letter says, in part,

[T]he Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule does not prevent your ability to disclose necessary information about a patient to law enforcement, family members of the patient, or other persons, when you believe the patient presents a serious danger to himself or other people.
 

It goes on to say that

The HIPAA Privacy Rule. . . . allows the provider, consistent with applicable law and standards of ethical conduct, to alert those persons whom the provider believes are reasonably able to prevent or lessen the threat.
 

This is bad.

You can take a look at the letter and see what you think.  When I read it,  I see confusion.

The letter bounces around a lot, telling providers that the HIPAA Privacy Rule doesn't prevent them from betraying their clients' confidentiality, talking about their "professional ethical standards," "the laws applicable to their profession in the states where they practice," and ending with "providers play an important role in protecting the safety of their patients and the broader community."

This letter/policy will have two effects.

1.  Clients will not trust their providers.  A client's relationship with her/his therapist must be based upon trust. 

Some clients or potential clients will have thoughts of suicide, thoughts of murder, thoughts of murder-suicide, or other forbidden thoughts.  It is important that they be able to verbalize these thoughts.  Verbalizing, processing, and understanding these thoughts is important.  Perhaps verbalization would prevent a client from acting on these thoughts.

But if clients with these thoughts value their possession of guns, if they hunt, if they shoot skeet, if they like to shoot targets on a range, if they are survivalists, or if they just don't want to be on a list, they will either stop seeing their counselors, hide their thoughts from their counselors, or refrain from seeking therapy altogether. 

If they do seek therapy and their provider tells the authorities that they are dangerous, how, then, do they continue therapy with that provider?  How, then, do they trust any counselor again?  They are done with therapy.  Maybe forever. 

This is bad.

2.  Providers will be confused.  How do you tell your client or patient that everything s/he says is confidential except suicidal or homicidal thoughts?  Oh, but only if s/he's serious.  What?  What if the entire reason the client is there is because s/he is suicidal?  Or having murderous thoughts?  How does one decide if someone who verbalizes such thoughts is likely to act on them?  Is that even possible?

Ah, but then there is another shooting.  It is revealed that the deceased shooter sought therapy.  The deceased victim's family sues the therapist.  It is a sensational trial.  The therapist's notes are subpoenaed. and they show that the shooter discussed his thoughts about killing another person.  The therapist is ordered to pay damages, and a career is ruined.

After this happens once or twice, providers will learn.  They will understand that they must report anyone who discusses any thoughts of violence or risk their careers and livelihoods.  No more professional discretion, just report it all.

This is bad.

Both of these situations will prevent people who need treatment from seeking it.  These situations will further stigmatize those who seek treatment for a "mental" condition.  They will further shame anyone who has taken psychotropic medications.  They will remove confidentiality from the therapist's toolbox.  And they may not even prevent gun violence at all.

I commend the President and Vice President on assembling a variety of recommendations to end gun violence.  But this letter to providers is a mistake.

I stand by my original proposal¹, that people should be added to the no-gun list only if they are admitted to a mental health facility as a danger to self or others.  Any less-strict criteria will only lead to more gun violence, not less. 

And this is bad.


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¹ Put me on the crazy list, Crazy list part 2

 

Crazy List part 2

An anonymous commenter wrote the following thoughts about a previous post:

I guess I'm wondering if we would have . . . a decrease in those willing to seek treatment for the fear of losing the privlage. I do have a permit to cary a weapon and if I thought I would lose that permit by going to the hospital for help, I'm not so sure that I would go. I have been a hunter since I was 12 and value my permit as much as my drivers licens. I'm wondering how many people would try to push through it instead of getting help if losing there permit was seen as being a punishment for being mentaly ill?

I realized when I wrote the original post that a decrease in seeking treatment could be an unintended outcome, but I decided not to address it.  My thinking was that I can only put so many concepts in a single post before my reader gives up on the post.

But now that this person has asked the question, let's talk about it!

Please note that people who are involuntarily admitted to a mental health facility, because they are a danger to themselves or to others, are already prohibited from possessing, using, manufacturing, controlling, selling or transfering firearms under PA law.  These people would already be labelled as "mental defectives" (!) under federal law, and prohibited from purchasing firearms when a background check is performed.  Thus my proposal would have no effect in this situation.  The change I propose would only affect those who admit themselves voluntarily. 

That being said, I would like to address two things from the comment.

First, the commenter says, "if I thought I would lose that permit by going to the hospital for help, I'm not so sure that I would go."  It's really not likely that you would need admission to a hospital for help with depression.  There are many other treatments for depression besides a hospital stay.  You could get help from a psychologist, psychiatrist, an outpatient program, or even your primary care physician.  You could be treated via talk therapy or medication.  According to WebMD,  over 90% of depression is treated on an out-patient basis.

Second, I'd like to discuss the commenter's assertion that her/his carry permit was just as important as her/his driver's license.  I tried to picture how that would feel:  What if  admitting myself to the hospital for suicidality would result in losing my driver's license? 

Please bear with me now as I try to respond to this honestly.

My gut response was that, of course, I would still admit myself.  After all, if I didn't get into a safe environment, there would be no more driving anyway.  Or sleeping, or eating, or anything.  Because I would end up dead if I didn't get into the hospital.

After some more honest consideration, however, I wondered if I wouldn't try to "push through it instead of getting help," as the commenter suggested.

Because here's the thing.  If I admitted myself to the hospital, I would do so under the assumption that it would stop me from killing myself. And that I would eventually be released.  It would be very important for me to have my driver's license when I left the hospital, especially because I live in a rural area where driving is a necessity. 

So maybe I would not admit myself if I thought I'd be released and then not have my driver's license.

But, dear commenter, I'm afraid I have to reject the idea that guns are as important as drivers' licenses for many Americans, and guns would not be a consideration when seeking voluntary admission to a hospital for suicidality.  Most depressed people would not worry about losing their guns, because they simply don't have any.

I formed this opinion from statistics in the following articles:

There are more women than men in the United States.  Women suffer from depression at roughly twice the rate of men.  So I think it's safe to say that more than two thirds of depressed people in the US are women.

Another study finds that 45% of men own guns, whereas only 10% of women own guns.  So it looks like only a small percentage of depressed people own guns.

And remember that per WebMD, only about 10% of depression cases require hospitalization.

It appears that the loss of firearm privileges would affect only about 2% of depressed people.*  And I would expect that an even smaller percentage would be as passionate as the commenter about potential loss of their Second Amendment rights if they were considering admission to the hospital for suicidality.

So, in answer to the anonymous commenter, I do not think that my proposal to add voluntarily admitted people to the no-gun database would much decrease the likelihood of seeking treatment for depression.

      
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* I tried to come up with a formula to represent what percentage of the population would actually be affected by my proposal, but I'm a word person, not a numbers person.  This is how I did it.  Feel free to correct me!

women - 66% of depression cases  x  10% hospitalization  x  10% own guns
men - 33% of depression cases   x  10% hospitalization   x   45% own guns

so

for women  -  .66 x  .10  x  .10   =   .0066   = my proposal affects .007 of depressed women or 0.7%
for men  -  .33  x  .10  x  .45  =  .01485   =  my proposal affects .015 of depressed men or 1.5%

add depressed women and men  -  0.7%  +  1.5%   =  2.2%