to help a loved one with depression


Back from the Brink Too: Helping Your Loved One Overcome Depression
When preparing Back from the Brink Too we interviewed over 350 depression caregivers to understand their greatest frustrations, lessons learnt, and a list of resources they have found helpful. The book was recently awarded SANE’s 2009 Book of the Year.

Step 1: Build Knowledge

“I would like them to know that you can’t snap out of depression anymore than you can snap out of diabetes.”

Clinical depression is an illness. Hopefully this book has given you a good overview of depression, its causes and its treatments. The resources section lists literature and websites to deepen that knowledge.

Step 2:
Open Communication Channels

“It is very destructive to try and minimise my feelings. Please don’t cut me off or attack me. Try to understand how frustrated I am.”

If you suspect a loved one might be suffering from depression, raise it with them at a time they can speak freely. Be gentle. Assure them every thing they discuss with you will be confidential. Trust is paramount. If you find it difficult discussing it directly, you might consider writing them a letter.

It is also important to understand that everyone’s experience with depression is unique –ask exactly what you your loved one’s symptoms are.

CheckmarkDo Say:

  • I love you.
  • I care about you.
  • You are not alone.
  • I’m not going to leave you.
  • I’m sorry you’re having to go through this.
  • Can you tell me what depression is like for you?
  • How can I help you?

CrossDon’t Say:

  • What’s the problem?
  • Just realise how lucky you are.
  • Snap out of it.
  • You don’t look depressed.
  • What do you have to be depressed about?
  • You need to do this.

Step 3:
Help Them Find the Right Professionals

“When I’m in the Black Hole, it doesn’t seem remotely possible that I will get well again.”

Their GP is a great place to start. If they don’t have faith in their GP, beyondblue has a list of GPs around Australia who have a special interest in mental health. Ask them if they would like you to go with them.

Cognitive ability may be affected by depression and having a third party there to ask questions and remember responses can be very helpful. Remember it is the nature of depression for the sufferer to think there is no hope but they may be willing to see a doctor if you accompany them.

The GP should be in the best position to decide if they need to be referred to a psychiatrist and/or a therapist. It is important they leave the GP with a clear plan for the next week and another appointment to review progress.
Todd Zemek, a psychologist and psychotherapist, has written an excellent ebook called Shopping for a Therapist which is available free from his website – www.toddzemek.com.

The website www.goodtherapy.com.au is a great source of therapists. It lists Australian members and allows you to read about their approach and philosophy before actually contacting them.

If the person with depression doesn’t feel confident in the ability, values or approach of their doctor or therapist, encourage and help them to find another one.

Step 4:
Finding the Right Help for You

“Advise them to remember to look after themselves, otherwise their physical and mental health will decline as well.”

As a loved one of someone with depression, you carry a considerable burden. It is important to be able to communicate with people who understand. In the resources section there are contact details for the Association of Relatives and Friends of the Mentally Ill (ARAFM).  This organisation is a good place to start. DepressioNet has a useful section for family and friends and anonymous online forums where you can communicate with others in a similar situation. Beyondblue, the Black Dog Institute and SANE each offer fact sheets and books.

Try to help build a network of support for your loved one so it doesn’t all fall on your shoulders. This could incorporate family, friends, peers, mentors and mental health professionals.

There is a very good book called When someone you love is depressed by Laura Rosen and Xavier Amador.
Be kind to yourself so that you can be kind to your loved one.

Step 5:
Providing the Best Support

“Let those family and friends know that it isn’t them when we want to shut out the world…. and most of all, hugs are really important. A touch on the shoulder or arm is reassuring.”

Kindness and caring is everything.

“Ask me how you can help – don’t tell me.”

Every person’s experience with depression is unique. Ask if there is anything specifically you can do. If they can’t name anything consider some practical things like bringing around a meal once a week, cleaning their bathroom, washing their clothes etc. If they don’t have good professional mental health advisers, offer to help find them. See previous section.

“Sometimes I need help just to get out of bed.”

“Congratulate me when I do things that help me because shit, it’s hard.”

Recognise the importance of small steps. Ultimately recovery is the accumulation of many small steps.

“There is a real need to stress that depression makes you do and say things you don’t mean.”

Try not to take it personally. Depression is not the person. Their behaviour while they are depressed does not reflect their true self.

“They don’t have to have all the solutions. One friend said to me: ’I can’t do anything, so I’ll just hold you tight while you cry’. That was incredibly affirming and the most helpful thing anyone has done”.

Step 6:
Preparing for a Crisis

Crisis line phone numbers are in the resources section. Make sure you have these and your doctor/therapist listed somewhere accessible.

Warning signs of suicidal thinking:

  • Feelings of hopelessness and helplessness.
  • Extreme withdrawal from loved ones.
  • Talking increasingly about death.
  • More risk taking and self destructive behaviour.
  • Giving away possessions.
  • Increased usage of drugs and/or alcohol.
  • Identification with someone who has committed suicide.

What to do:

  • Ask if they are thinking of suicide.
  • Ask if they have they decided exactly how they plan to do it.
  • Do they have what is required to carry out the plan? The more specific the plan and availability of resources, the greater the urgency.
  • Do not agree to keep it a secret.
  • Make keeping them safe your first priority.
  • Help them make an immediate appointment with a doctor, psychologist or therapist. If these are unavailable, take them to the nearest emergency room at a hospital.
  • Ask them to promise to reach out to you or another loved one if they feel this way in the future.

Of course, crises other than suicide/self harm threats, such as panic attacks, can also occur. Assure your loved one you won’t leave them. Consult a support group to find out exactly what to do.

Step 7: Staying Well Yourself

“Don’t become so involved with my problems that you also become depressed.”

When the flight attendants on planes are doing their safety demonstration and they discuss the oxygen masks dropping down, they always advise parents to put on their mask first, before placing a mask on a child. The logic is simple – a parent can’t help their child if they are unconscious. You must place a high priority on your own health. The same lifestyle recommendations for people with depression in chapter? apply to their carers. Make sure you make time for exercise, taking breaks, relaxation, hobbies and fun. You can’t sustain help if you don’t feel good about yourself.