18 October 2011

"How Do I Help Someone Who Is Depressed?"

In the last week as my family and friends have become aware of the true nature of my depression, one of the most frequently asked questions has been, "How can I help?"  This is a difficult question to answer, because each relationship has its own dynamics.  A family member can be freer to say something to you that perhaps a coworker may not, for instance.  And, of course, everyone has their own perceptions of what depression even is.  For the purpose of this post, I will begin with the assumption that you care enough about someone with depression that you want to help and that you are not in the "Depression is a scam/They're not really depressed/They need to man up and get over it" state of mind.

Create a Comfortable Environment
Don't leave your loved one/mob boss alone in a chair.
Depression insulates a person, nudging us to withdraw from our family and friends.  We become self-conscious about even being depressed, which only exacerbates things.  If you know, or even suspect, that someone you know is depressed, one of the single most important things you can do for them is reassure them that they can talk about it with you, and that you're there for them.  It's okay if you don't know what that involves--chances are, neither do they.  Just knowing that you're on their side and that you're informed about their condition can be helpful.

You Are Not a Therapist!
Also, try not to look so bored.
Do not attempt to treat your loved one!  No matter how many times you've watched The Sopranos, you're not qualified to recreate a therapy session.  If you want to read up on depression and become better informed, that's terrific.  But do not make the mistake of trying to pass on what you've read.  I don't care who wrote what book.  It is not helpful to hear someone you know is not actually trained in psychiatry lecture you with the words of a professional.  Let the depressed person hear those concepts and ideas from the pros directly.  Think about how you feel when someone who hasn't done your job tries to tell you how to do it because they've heard something about your line of work on TV.  You just want them to shut up and quit trying to make themselves experts about your world, right?  Same thing here.

You may have genuinely constructive ideas about how the person might address specific issues that are bothering him or her, and you should feel free to share those.  For instance, if I had said to someone that one of the things upsetting me was that it was too expensive to go to movies, they might have said, "On Tuesdays, you can go for only $5.25 all day long."  What would not be helpful, however, would be for you to try to persuade me that not being able to afford going to movies is not a good enough reason to be depressed.  Which brings me to point #3...

Depressed People Can Give Stupid Reasons for Being Depressed
"What the f---?  You're not makin' any f---in' sense!" "I know."
Even we know how absurd it sounds sometimes when we talk about the little things that have overwhelmed us.  Just yesterday, I was talking with my brother and I told him that one of the things that has been bugging me this past year has been that I began to feel guilty for having a good day.  Now, three out of every five days for me are generally miserable with Crohn's, but I got to the point where I felt like I wasn't entitled to those two days that might not suck.  Like somehow it meant I was a fraud, that I wasn't really sick.  That guilt escalated to the point where I didn't even want to have good days.  My brother couldn't understand this; he couldn't even understand how it had made sense to me.  All I could say was that I knew how absurd it sounded, but that he had to just take my word for it that I had felt that way and that it seemed real enough to me.

Don't Let Depression Dominate
Use good judgment about when to put a pool cue in the hands of a depressed person.
I recently wrote about how frustrating it is to be greeted with, "How you doin'?" because it reduces the person being addressed to a condition to be monitored.  This is as true of depression as it is of any chronic illness.  You don't have to talk about depression at all, unless either the person with depression brings it up or if you get the sense that maybe they want to--this gets into the realm of specific relationship dynamics and it's up to you to navigate those nuances.  Even when depression becomes the most powerful part of our lives, there's still more to us than that.  It's nice when some other part of ourselves is engaged.  If we used to talk about movies, then talk to us about movies.  Steve Earle shared this terrific anecdote about Johnny Cash when the Man in Black passed away in 2004:
Johnny was one of the few people who wrote me when I was locked up - he sent me a very encouraging letter saying how everybody was pulling for me, that he and June were praying for me and that he would see me when I got out. I saw him again when I helped put together the band for his song on the Dead Man Walking soundtrack. When I got to the studio, nobody was there but John and the engineer. I walk in and there's this old-fashioned picnic basket sitting in the middle of the pool table - you know, gingham tablecloth, the whole bit. John's got his hand in that picnic basket, and he looks up and says: "Steve, would you like a piece of tenderloin on a biscuit that June made this morning?" I was really hungry, so I said: "Yeah." And he said: "I knew you would."
We could've talked about our shared demons (I'd been clean probably a year and a half) but he knew that sometimes it's better to leave some things private and just talk about tenderloin and biscuits.