Living with someone who’s depressed can be one of the most frustrating experiences there is. We want to help the sufferer, but we don’t know how; often it seems that whatever we do only makes things worse. Sometimes we get angry at the depressed person, but feel guilty afterward. Depressed people have an intense need for love and acceptance, but they usually can’t reciprocate, so they seem needy and ungrateful. Their tone of desperation or self-sacrifice may turn people off. The hopelessness and defeatism are very frustrating for loved ones.
The depressed person often has little energy left over to think about others, so may appear overly self-absorbed, often with a host of minor physical complaints. Their problems don’t respond to good advice or common sense, so people give up on them. Then they may feel guilty about their self-absorption, and try too hard to compensate, or relentlessly seek reassurance or forgiveness.
Anger seems to accompany depressed people like a dark cloud overhead. Sometimes they feel it themselves; they may feel that life isn’t fair, they may feel bitterly that they’ve been deprived of something they deserve. Or they make others around them angry with their self-pity and pouting. Family members are usually afraid to express their anger out of fear of hurting the victim.
Clearly, people like this can be very difficult to live with. Something that can be of immense help to a friend or loved one is to get an accurate diagnosis. It’s much easier to put up with difficult behavior from someone we love if we understand that he or she is in the grip of a major illness and not provoking us deliberately. Depression is an illness; it can develop very gradually or very quickly; it can come in response to life events or as a result of changes in body chemistry; it can strike anyone regardless of age or sex, wealth or poverty; but it is an illness, not a choice.
It’s important to remember that depression is not an emotion, but a defense against emotions. The depressed person is keeping a lot of feeling bottled up inside. He generally expects that no one will understand him. It helps lift the depression to express the feelings, although those feelings may be unpleasant for loved ones and family members to hear. He may be angry at us for no good reason that we can see or he may be consumed by guilt over seemingly trivial incidents. He may be very fearful or very self-centered. On the other hand, he may be telling us important truths about our relationship, perhaps ways we have taken advantage of his depression. Of course it’s difficult to hear these things, but it is important that the depressed person learn that honest emotions don’t drive people away.
The depressed person needs understanding, patience, and acceptance from those close to him. As friends or relatives, we may feel uncomfortable around the sufferer; we want to tell them to snap out of it, we want to give them good advice, we want to tell them how we handled similar situations. This just reinforces the depressive’s feeling of inadequacy. We need to listen to our friend with care and concern. The self-help group I used to lead put together a fine list of how their loved ones can help:
1. Try to be considerate, thoughtful, and empathic. If your spouse had a broken leg, you would expect that their abilities and energy would be restricted, that they would be in pain at times, and that they couldn’t heal themselves more quickly just because you want them to. Think about depression the same way.
2. Don’t be provocative. Every relationship has the little hot buttons that can start a fight at any time. Dirty socks on the floor, the remote control misplaced, the car low on gas. You know what your partner’s buttons are. Don’t push them while he/she is in a depressed state.
3. Small acts of kindness are appreciated, and do help, even if the recipient doesn’t reciprocate. When I retreat to bed, my wife makes a point of breaking in to kiss me good night. Even though I often don’t act very glad to see her, I would feel worse, lonely and unloved, without her attention.
4. Easing your partner’s burden in small ways can help a great deal. Offer to do the shopping, empty the garbage, do the laundry, take the kids out for pizza. It communicates more than words the feeling that you understand how difficult these mundane chores can seem at times.
5. “Advance directives” can be a contract loved ones arrange while the sufferer is not depressed, describing what to do when depression sets in. It can be in stages: stage 1, leave me alone; stage 2, be kind, patient, and attentive; stage 3, insist I call my therapist; stage 4, take me to the hospital. One patient loses her ability to see color when depression sets in. From experience, she has learned to tell husband right away when this happens, because she won’t let him know when it gets worse.
6. Take the trouble to educate yourself. Learn all you can about depression. Be willing to talk to your friend’s therapist. It’s amazing how seeing it in print or hearing it from an authority can change your perspective. Even if you believe you understand that depression is a disease, that the patient doesn’t choose to be depressed, and so forth, you need all the education you can get. These are facts we don’t want to believe. Learning the facts helps you help your friend, and also shows that you care enough to take some trouble.