How to: help someone with depression — part 2
Anger. Helplessness. Confusion. Sadness. Self-hate. Defeat.
When I asked my friend what she struggles with most when it comes to understanding the depression that her partner suffers from, what came back wasn’t so much only a list of things she didn’t understand, but a list of the visceral emotions it evokes in her too. Those that I’ve just written above.
If you’ve ever supported — or are currently supporting — someone through mental illness, you may identify with some or all of these emotions. There will probably be others too that make up the unique impact that living a life touched by mental illness has on you. It’s different — but always so gut-wrenchingly hard — for all of us.
I set out to write these blog posts to help my friend, which is why I asked her what she struggles with most; I wanted this blog post to address the specific and direct challenges she finds herself coming up against. What I wasn’t prepared for was to feel so overwhelmed with sadness in the face of the reality that came back at me. So much so that at first I was left with no words of my own to offer back in return; all I could do was sit there with tears in my eyes as the feeling of a life tainted by depression, as I’m now so familiar with, came rushing at me in an oh so very palpable way. It felt heavy, like a lump in the throat. A feeling like that sucks the light out of everything. I couldn’t help but feel so very sad for my friend. But then also for my friends, my family, the girlfriends I’ve abandoned in the middle of it all. My friend’s sadness and frustration was the most honestly described and raw reflection of what my own loved ones go through. It was heartbreaking.
But that’s exactly why I’ve committed myself to trying to offer some words of advice to help people help their loved ones who are struggling with depression. I honestly believe that the impact on the sufferer’s life and the lives of those that were there by their side through it all is so huge — it blasts such a great big gaping hole through your core — that it’s almost impossible to imagine or understand unless you’ve been there yourself. I know that for me, my family and friends, every year brings with it the chance that “Jacs might get ill again” and everything will come grinding to a halt. That is just a fact of depression — the inertia, the way the cogs just. stop. turning — but I do believe that the role of your nearest and dearest is a crucial one. You might not be able to fix it — in fact, I’ll unequivocally state that you can’t fix it alone — but your efforts are needed. You efforts are valued.
How to: help someone with depression
- Be their constant. Depression feels scary. It feels scary because stretched before you is more of the same. There is no appreciation of the possibility that things might change because there is no hope. And an eternally hopeless future is pretty shitty because I believe that motivation thrives on hope. Because you’re scared — but equally indifferent because that’s the only way to survive such a hopeless future — everything feels shaken up. A day of no plans, no fluctuations, can still feel all over the place just because it’s hard to even get to the end of the day just sitting with the self-loathing and despair that you feel. The thought that this is forever can send your mind spinning. When things feel all over the place, the one thing that can keep us slightly positive, slightly grounded, is to know that there is someone by our side. And that they aren’t going anywhere. Let them know that. You don’t have to be perfect; your mood can and will be affected because, my god, is it hard on you too. But as long as you have the person who you want to help’s best intentions at heart, and you’re there to hold their hand or give them a hug when they need it, that is more powerful than you might know.
- Go easy on yourself. Consistency is so very important but if you don’t take your own needs into account then you’ll burn out before you even have the chance to be by their side for as long as they need you. Those who are caring for someone else’s mental health have to look out for their own too. As humans, we aren’t built to have a negative tape playing on loop in our heads. When that kicks in, the track that says “you should be able to fix this” or “she would be better if only could do xyz” or “I should be able to be more patient”, then consider countering it with some of these compassionate B-sides:
- You are trying your best — and on the days when you can’t give it your all because you’re exhausted, that’s ok
- It is ok to get angry sometimes
- It is ok to resent the situation that both of you are facing — anyone would
- It is ok to need to take some time out or away from the situation
- It is ok to feel defeated, hopeless, fed up — we are humans, not machines
There’s plenty more where those came from. To find them, just think about what you would tell a friend who was being too hard on themselves. We dish this advice out all the time yet we seem to think that we aren’t worthy of the same compassionate treatment, particularly in emotionally demanding circumstances such as dealing with mental illness.
3. Help them structure their day. An extremely common effect of depression is to stop planning your days — out the window goes all structure and any opportunity to complete tasks that give you the sense of pleasure and mastery that you need to keep your mood higher rather than lower. The reason for this is two-fold.
As humans, planning forms part of our executive functions. There is a small walnut-sized part of the brain that controls our ability to plan and make decisions called the lateral frontal pole that sits within the frontal cortex. When depressed, your frontal cortex functioning is significantly impaired or even “switched off” as other parts of the brain take over. With it goes your ability to plan. That’s the first reason; a completely biological, neurological one. The second is more of an emotional reason. When depressed, you just really don’t want to do anything for all sorts of reasons. Low motivation. Total lethargy. Social anxiety. Fear of stepping out your own front door to leave your house. Feelings of worthlessness. Deriving no joy from things you once enjoyed. Having given up. I could go on. So the chances that any depressed person is going to have a diary full of all the things that could conceivably help them get better on a day-to-day basis is so very slim.
My therapist is a big believer in planning your week being a good way to get you feeling like you once did. Being honest, at times it has yanked me out of depression within a couple of weeks, while at other times it has done very little. Probably because I wasn’t ready for it. Still, just as mentally healthy people really need a daily or weekly plan of some sort, so too do depressed people.
The key is to pitch it at the right level — it shouldn’t be too easy. I got into the habit of just scheduling one walk a day and I would drive somewhere far away where I knew I wouldn’t bump into someone I knew and I would walk deserted paths through fields and woodland, where it was rare to see another human being. This did nothing for me — though the exercise was good. Nor should the schedule be full to the brim, so much so that it makes the person feel sick with anxiety. Remember, they’ve probably been doing nothing.
I find that a couple of activities a day (one in the morning and one in the afternoon/evening), of varied types, is a good starting point. It’s a good idea to sit down together on a Sunday night and complete this together. It might sound like it could come across as patronising, but perhaps you could plan your week with them too. Plus mental illness makes you do all sorts of things that are awkward, hard and seemingly ridiculous. It’s something to get used to.
4. Break things down into steps with them. When I’ve been depressed I slip into thinking “I should just be able to go to the gym” or “I should be able to meet up with my friends”. It’s part of the illness — that relentless being hard on yourself — but it’s also part of my personality. I tend to think I should be capable of most things. When you’ve barely moved from the sofa for a week, or haven’t socialised in months because the social anxiety is crippling, the thought of going from zero to sort-of-hero (if you allow yourself a pat on the back for achieving anything at all) just seems like an insurmountable challenge. But I read some really useful advice somewhere once. If your goal is to go to the gym, you might break it down as follows:
- Day one: get trainers out and put them on. Just to get used to the idea.
- Day two: visit the gym (maybe with a friend/partner). Even just do the journey.
- Day three: step inside the gym. Aim to do 10 minutes, but if you can’t just take a look around then go home
- Day four: aim to do more time in the gym than you did the day before
And so on and so forth until you are hitting up the gym like nobody’s business. Same for going out with friends: make a list of people you feel comfortable to hang out with. Message one or two of them. First meet at your house or somewhere you feel comfortable. Next time perhaps go to a local pub, or invite a couple more friends along to your house with them. You can help your loved one do this (again, it’s hard to do on your own due to the lack of decision-making and planning skills). All it has to be is progress on the day before. Because that’s what recovery from mental health is; every day an improvement on the last. It doesn’t matter how big or small. Help them take little steps until they’re taking great big bounding ones. And celebrate the small wins together. Sometimes just getting out of bed is something to celebrate.
4. Listen. You don’t need the answers when it comes to mental health. Mainly because no one really has them — it is still one of the most unknown areas of our health and one that we are still trying to figure out. It’s crazy to think that doctors still don’t understand what causes depression. Add on top of that there’s the fact that it is a highly politicised and commercialised issue which complicates things; the drug companies have made a ton of dosh from convincing us all that it’s all down to chemical imbalances in the brain that can be corrected with SSRIs (selective serotonin re-uptake inhibitors). Traditional psychiatrists will say the same thing — that it’s just a natural lack of serotonin in people that leads to depression. In other words, your brain is just a bit fucked and there’s not much you can do to change it (I don’t personally subscribe to this belief).
So yes, answers aren’t required. But listening is. Depression is about the thoughts that go on in your head, for the most part. Such things are always better out than in, not least because sometimes saying them out loud makes you realise that that thing isn’t actually true at all. Also getting another’s perspective on things can have the same effect. Maybe you can even laugh together at the ridiculousness of it all. My therapist always says laughing at mental health is one of the best attacks on it. But honestly, you could sit there in silence, taking it all in and nodding, and that would do them the world of good. I can’t even remember most of what goes through my head when I’m depressed but I know that I sure as hell didn’t share any of it. I wish I had because, if nothing else, it would help the people who love me to understand what the hell makes it all so hard.
5. Love them. And tell them.
I have to end this list here. If I’m being honest, I now realise I don’t feel in any position to be instructing anyone on how to help someone with depression. I’ve not done it to the degree I’m describing here. I’ve seen my parents, sister and friends try to do it but always come up against a brick wall because I, or perhaps I should say my depression, just seem to be so damn stubborn. I believe the points I have highlighted above are some of the things that could help someone when they’re depressed. But if you’re looking for change, I’m not sure they’ll bring it. Dragging yourself out of depression just takes a fuck-load of hard work from the person that finds themselves in that pit. Therapy and/or medication can be extremely effective and I would urge anyone to turn to these if they are struggling — and for you to encourage them to do so. Else there’s just a long wait in store and who knows if time alone will heal.
Your role, as the person caring for the other, is vital. I am not saying it isn’t. And going through all the darkness and pain that they’re going to have to get through to get themselves better is one million times easier with you by their side. So never think you are not important, because you are. But know that your role is to support, not to fix. That you can’t mend them, that you can’t take away this thing that seems to have stolen who they once were, isn’t a failing on your part. For you to be there for them shows such immense strength. I honestly think that of everything I’ve mentioned, being there constantly and loving them is the biggest thing you could ever do for your partner, sister, parent, friend. Love is more powerful than I think most of us realise, particularly in these circumstances.
So my biggest advice is: tell them you love them, you’re not going anywhere, you’ll do whatever they need to help them, and you’ll still be here when they come out the other side — because they will.
If you’re currently supporting a loved one through depression and want to chat, my DMs are always open @JacsGud
— — —
Like what you read? I send out a Monday newsletter, Zero F*cks, about caring less about the things that don’t matter, with lots of content on mental health. For a short piece written by me and links to my week’s inspiration in everything from music to articles to tweets, sign up here. Let’s give zero fucks together.
