I have been struggling with depression for the last 9 years. Sure, it’s been a topsy-turvy ride with some years being far worse than others, but the words ‘clinical depression’ will apply to each and every one of those nine. I have attempted suicide twice, failing miserably both times. Some would argue that I never really tried at all – that it was all just a cry of attention. Hell yeah it was a cry of attention. Depression is one big sob – both literally and figuratively.
No one beyond my immediate family and extremely close friends knows I was diagnosed with depression or that I was seeing a psychiatrist (which is a scandalous thing to do if you’re in a conservative society like Pakistan’s) or that I was on anti-depressants, anti-anxiety, sleeping pills, and muscle relaxants for a year. This is what I have learned is necessary from my harrowing experience.
1. Depression is not a choice, it is never a choice – and to tell a depressed person that it is, is the stupidest thing you could do.
The most common reaction I have received when I have told someone I have depression is for him or her to tell me that I should try and be happier, to try and look on the bright side of things.
That is utter bullshit. I didn’t wake up one morning with the thought that I am now depressed. And I won’t wake up with the opposite either. Depression is most often the result of two things, usually in combination: a poor social situation and imbalanced brain chemistry. I am no psychiatrist or psychologist so I will not go into the details here. You can actively change both your social circumstances (by changing the people you surround yourself with, making certain lifestyle changes, etc.) and your brain chemistry (e.g. through the use of anti-depressants). However, neither of those may be enough to alleviate depression. I have done both – and failed.
Depression strikes the rich and poor, the fat and thin, the old and young, the Western and Eastern. It is the most indiscriminate illness and yet we still do not treat it as an illness (at least not as much as it should be).
When you tell someone who is depressed that they simply shouldn’t be, you’re not giving constructive feedback – you’re making things worse. By placing the responsibility of the illness on the patient, you’re shifting blame of the problem to the patient. Given how strongly guilt features in depressive minds, the added burden is only pushing them deeper into their own self-hatred.
2. Emotional support needs to be patient and unwavering.
That isn’t to stay that you coddle and indulge the depressive – that’s the other side of the spectrum which is as ineffective – but rather that you provide emotional support with the most uncommon thing I have noticed in the loved ones of a depressive – patience. You have to be patient with the person because depression, as horrible and unending as it seems, does – almost always – have an expiration date. Emotional support needs to be unwavering.
Unfortunately, if the support isn’t constant, the depressed mind will fixate on the instances where you failed to adequately provide support rather than the many times you did.
Elizabeth Wurtzel has described depression as ‘if you loved me, you would’ – and she couldn’t be more right. For a depressed person, logic and rationale won’t feature prominently and it is a waste of time to show them that constantly (only very structured and consistent therapy can change a way of thinking, emotional support from a loved one serves a very different, but equally important, purpose). The support you provide has to be of your own accord because someone who is depressed will never ask you to help them. They will hint, they will imply, but they will never ask. It’s hard to always know when they need the most help but small gestures at random times are always a positive – and these can be as simple as a hug, a spontaneous treat to coffee or dinner, or even saying ‘I value your existence’.
This lets the depressed person know that you value them (even if they don’t respond in kind or seem immediately different) and they are very grateful for it, although they may not show it – which is why patience is so important: helping a loved one through depression may not always be rewarding, but you could be staving off a suicide attempt with that hug or a expression of love, so why not go for it?
3. Get them help – and don’t take no for an answer.
Ultimately, all the emotional help, patience, and understanding will not get rid of the depression. It will help, it will make the pain less, it may even erode the severity of the illness, but without professional help – as is the case with any medical ailment – depression will linger and it will fester.
Unfortunately, most depressives will either tell you that they don’t need help, that they can’t be helped, or that they got/get help but it didn’t/doesn’t work. The problem here is that depressives often believe that they cannot be saved. The simple truth is different: they can. If they have previously received consistent help or are currently in therapy and/or on medication and have not improved or are not improving, it is possible that the therapist and/or medication do not suit them.
So what can you, as a loved one, do? Take them to another psychiatrist or psychologist. If they say no, persist (patiently; see no 2). Offer to go along for the first few appointments, or be forceful (but kind) in your words. Too often someone has told me to get help but when I said no, they left it at that. Depressed people don’t necessarily mean no when they say it. They’re looking for a sign to show how deeply you care, and persistence is a sign of both patience and love (again, see no 2).
Depression is one of the worst things that can afflict anyone. To see it happen to someone you care about can be nearly as bad. But these 3 things – 3 pointers I wish someone had told my family and friends – may be more helpful than you could ever imagine: it can be life saving. I may have failed at my suicide attempts – your loved may not share the same fate if you don’t reach out to them properly.