Revealing Your Depression Didn’t Go Well

Someone close to you has depression. Here’s how be an ally.

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Imagine you’re swimming in the ocean with some friends, out beyond the waves, when something goes wrong — you get a cramp, swallow too much water, feel dizzy — and you panic. Fortunately, your friends see you. They hear you say, I’m drowning.

They swim close and reply, That’s awful. They ask a few questions, thank you for sharing, and offer a few troubles of their own. With great sympathy, they tell you they’re sorry, and swim away.

All depression metaphors and allegories are imperfect, but those with depression may know this feeling of abandonment from those they’d least expect it. If you’re a friend or family member to someone struggling with thIS disease, you may think this particular allegory makes you out to be a villain — you’re not.

What happens when conversations about depression don’t go as expected? Does the disconnect lie in the reactions or the expectations? How does someone struggling with depression find the clarity to examine either, let alone both? What do we do when revealing an illness makes us feel worse?

How do we close the gap that suddenly appeared between us and our loved ones?

The allegory continues: Somehow you stay afloat and swim to shore, asking yourself: Did they not understand me? Not believe me? Not know what to do? It’s not the first time you’ve had to ask these questions.

I’m “expert” only in my own depression, three decades and counting. I, like everyone who has ever written about depression — a complex illness with many variations — risk being reductive or painting with too broad a brush. Here, I’m only talking about depression as I know it. (For simplicity, I’ll use “friends” to also mean family, partners and coworkers.)

Thirty years was a long time to wait to talk about something so essential to who I am, and it didn’t go well. I didn’t anticipate what would follow: the opening of voids capable of swallowing relationships whole, leaving me exposed in ways I hadn’t been. Those precious moments of knowing who I am were fleeting, words that swiftly rearranged themselves back into something all too familiar: Who am I?

What do I mean by “swim away?” To be informed about someone’s depression but never ask about it; to discuss anything but that. Letting mentions of depression pass without acknowledgment threatens the trust placed in you by someone vulnerable.

A couple of years have passed since I began talking about my depression. To my surprise, those conversations proved to be one-sided — with me doing all the talking — or one-offs — never mentioned again. Over time, my hurt and resentment (sometimes outrage and embarrassment) subsided, and I was able to better understand the reactions of those I told, reassess the expectations I had of them, and resolve some of the incongruities between the two.

Instead of narrating my story — each grievance and regret — I’ve turned it into something I hope helps others, especially those in potentially supporting roles. The following are some barriers that may arise, and some guidance for all involved.

Six communication barriers between people with depression and loved ones

And how to overcome them

1. When depression is unrecognizable…

Most of us have learned how to spot someone who’s drowning. Often described as being not like what you’d imagine, drowning victims typically don’t splash with flailing arms, screaming, Help! Help! Somebody save me! Unless we know what to look for, we could watch a person quietly sinking and look away, thinking nothing of it. Drowning may not be dramatic for onlookers.

In many cases, depression is no different. If someone close to you is suffering from depression, would you be able to spot it?

You may observe some combination of crying; lethargy; erratic or unstable behavior; frequent sick days away from the office; or even attempts at self-harm. Or you may observe none of these, especially if your depressed friend is high-functioning or hiding his emotions. More likely, you don’t know what to look for.

This makes the role of friends and family especially difficult, but other signs of depression are harder to conceal: sudden changes in behavior; absences from social gatherings; noticeable weight change; and visible exhaustion or irritability are but a few.

Sometimes depression doesn’t look like anything, and perhaps all you have to go on is a suspicion or hunch.

What to do: Learn the symptoms; an internet search will yield more than you need. Beyond expert opinions, consider non-expert, first-person accounts too. If what you read and observe seem connected, they probably are. If you inquire, try not to automatically use the word ‘depression,’ — let your friend define it.

If you do this much, you’ll have done more than most.

2. When someone doesn’t know what to do…

If you did accurately identify someone as drowning — in water — you’d jump into the pool, river, or ocean, or at least call for help. You’d find a lifeguard. You’d do something.

If you’ve correctly observed — or were told directly — your friend is depressed, would you do something?

There are reasonable explanations for why you may not. If you’re aware she sees a therapist, you might assume she’s in good hands and doesn’t need anything from you. Inquiring may seem meddlesome or too personal; you may think she will share what he wants to share when she’s ready to share it.

What to do: Recognize that your friend may have a serious disease or disorder, not a rash. Consider responding as if he were diagnosed with cancer. Ask him what he wants to tell you, knowing that it may change over time, and how much privacy or space he wants. Because there is a fine line between caring and suffocating, ask how often he wants you to initiate conversations about it. Don’t expect him to volunteer all of this; depression is frequently attached to shame, and reasons for hiding it often exceed those for revealing it.

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3. When someone doesn’t know what to do…

As a largely invisible illness, it’s understandable for those privy to another’s depression to have doubts. It’s hard to imagine doubting a friend’s cancer diagnosis — there will be procedures and treatments, and test results to confirm it. Unfortunately, public skepticism and stigmatization about mental health disorders is widespread. Without X-rays and blood tests that “prove” a disease, people suffering from depression often feel compelled to convince others of its existence.

Doubt inhibits a person’s ability to listen. Few want to hear about a friend’s colon, but when it’s being devoured by cancer, most are willing to set their discomfort aside. Doubt can dull or trivialize the severity of the illness.

What to do: Listen. Or better yet, hear. If your friend sounds vague and repetitive and listening to her feels tedious, there’s a reason for that. She may be stuck, returning to similar-sounding issues time after time. Try to manage your expectations: she won’t likely progress along a straight line, as you may be accustomed to in your own life. She may travel in loops, which even she may not be able to perceive. Your observations matter. Present them as only that — observations — not as remedies.

Getting involved is not a commitment to fix or heal someone.

Fears of being “dragged into” something messy are legitimate and fair. If you have them, ask yourself, What, if not this, are friends for?

4. When depression is confused with sadness…

No one says they “sometimes have cancer,” but most people, you included, feel sad from time to time. Perhaps your sadness goes away on its own, or you can pull yourself out of a funk through sheer will and determination. Perhaps you think your friend should be able to do the same. After all, she’s a military vet, a surgeon, teacher, or stockbroker; she can handle difficult situations, right? She’ll snap out of it eventually.

Often, sadness is depression’s sideshow — a tangible side-effect, a veneer for something much more vast, heavier, and with greater staying power. If, by comparison, you’re able to distinguish between mild and severe constipation, you know it to be the difference between discomfort and complete shutdown of your digestive system. Now move that sensation to your heart and mind.

What to do: Accept that depression has nothing to do with strength or weakness. It’s lurking beyond one’s will and determination. It can’t be cried out or entertained away. Sadness typically isn’t fatal; depression can be and too often is, even among the mighty. Like with any disease, depression demands courage — a lot of it — within the first minutes of your friend’s day.

5. When isolated depression is confused with chronic depression…

Let’s say you were legitimately depressed when your brother died. Months or even years passed, but the anguish remained. It not only hurt but inhibited your ability to interact socially, function at your job, or perform even menial tasks. Maybe you received treatment for a while — maybe it helped, maybe it didn’t — but eventually you moved on, and the constant dread of facing another day without your brother faded. If only your friend could pinpoint the source of his depression and tackle it head-on, he could battle through it.

Undoubtedly, chronic depression can result from a specific trauma — death of loved ones, severe accidents, or abuse — but is often detached from any specific event or circumstance. Medical opinions point to imbalanced brain chemistry as a major factor, but what causes these imbalances isn’t certain.

These chemicals serve as messengers that enable our brains to communicate effectively with our bodies. According to an article published by Harvard Medical School, genetics, stress, temperament, and other factors can contribute to chemical imbalances, or even physically alter nerve pathways in the brain.

Serotonin is one such messenger that regulates mood, social behavior, sleep and other functions. But because approximately 95 percent of serotonin is found in our digestive tracts, not our brains, researchers have identified gut health as a possible contributor to depression.

For the sufferer, onsets of depression can be as random and uncontrollable as the weather. It can arrive during sleep, or midway through a workday, to turn one’s world upside-down. A storm sweeps in from nowhere and stalls directly overhead.

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Chronically depressed people know that this too shall pass, but when it does, little relief follows. Instead, there is an immediate and lingering dread of its return. While a “depressive episode” is a term that, at the very least, has a beginning and end, chronic depression doesn’t allow for much relief between episodes. Depression is the cyclic trading of one form of dread for another.

What to do: If you haven’t experienced chronic depression, try not to correlate it with isolated depression, or rush to help identify root causes. It’s not a whodunnit or game of Clue.

Chronically depressed people may experience a major breakthrough when they identify a trigger for their despair; such discoveries are useful, and sometimes strangely comforting. But chronic depression returns again and again, often finding new culprits. Whether your friend rides emotional roller coasters or Merry-Go-Rounds, you don’t need to get on; just be there each time they come around.

6. When you want your “old friend” to return…

Imagine Kim. She’s is your friend for good reason. She’s funny and tells great stories; social gatherings just aren’t the same without her. Or, she’s loyal, patient, and trustworthy, and was there for you during your own difficult times. Maybe Kim is your unflappable coworker who steadies the office during upheavals. But after she stopped coming to parties, or took a back seat during workplace dust-ups, you learned about her depression.

For weeks and months, you listened and provided Kim whatever support you could, but her situation didn’t improve. You regularly texted to see how she was feeling, but over time, wanting the old Kim to return, slipped in some YouTube clips that the two of you used to laugh about, or some other distraction. You had to go to a birthday party alone because Kim wasn’t feeling up to it, and then she forgets your birthday entirely. Kim’s disinterest in a recent problem in your life made you resentful.

Depression often assigns its host to survival mode. Depression can be a matter of life and death, but even when it isn’t, it may feel that way. When trying to survive anything — a divorce, unemployment, a car accident — what a person cherishes most may suddenly seem distant in the current moment. Fight or flight, whichever way our nature directs us, whittles us down to absolute essentials. Your birthday wasn’t the only one Kim forgot.

What to do: Acknowledge that depression may alter a person forever. Expectations that they put aside or hurry along each successive crisis will likely have the opposite effect. A major milestone for people with chronic depression is accepting that it’s long-lasting or permanent. Being accepted by friends and family is an important milestone, one that won’t be reached so long as loved ones are waiting for their old friend to return. Hoping for “normal” is non-acceptance.

It’s worth restating that this story is based solely on my experiences; they’re shared by many, but certainly not all. There is no designated path forward for people suffering from depression, nor for you — their friends and family. But paths can be discovered together. While isolation can contribute to depression, depression almost always contributes to isolation. Revealing one’s depression is intended to bring you closer, but when the opposite happens, you’re needed to help fill the void.

What we — the depressed people in your life — need from you is more than hearing, “Okay, got it.”

We need allies. Here’s how to be one:

1. Listen and learn: There’s much more to depression than you may realize.

2. Ask: What are the rules of engagement? Where are the boundaries?

3. Acknowledge and Accept: Don’t make someone with depression convince you of it, even if you have doubts.

4. Stand side-by-side: You don’t need to be there every step of the way, but whichever path a depressed person is on is the one they’re on — join them there. Don’t lead, don’t dawdle. Stand side-by-side. Let that person choose which way to go.

5. Learn their language: If your friend refers to her “mental state,” do the same. If she calls it “depression,” don’t diminish it by calling it her “mental state;” call it “depression.”

6. Don’t look for normal: We are all changing all of the time. Those with depression simply change differently, more abruptly, and often unpredictably.

Depression is a disease that doesn’t always have cures or timelines. It’s about management. These are ways that you can help.

Recent fellow at Creative Nonfiction; housing, mental health, culture. vrabelman@downstream.city

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