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Wednesday, September 05, 2012
To Those of You Coping With Depression - From a Loved One's Perspective
In response to a blog post by a colleague with depression:
I read a post today by a well-known business consultant in which he asked his readers to indulge his occasional mention of his bouts of depression and not to try to "help" him with advice when he does it. Essentially his point was that mentioning that he's having symptoms of depression is part of his coping mechanism. He does it so that, if people detect a less than cheery attitude in his work for the day, they might understand and cut him a little slack.
As someone who is relentlessly cheery, I can't say I understand chronic depression from personal experience. I went through a brief bout of it after my son died in 2006. The doc gave me some medication for it, but I quit taking it after two weeks. It didn't help me. The particular medication took away the sadness alright, but it also took away my motivation to get up in the morning and get back to work. Another medication might have worked better for me, but I was able to bounce back without it. Work, for me, was my medicine for depression. That said, what works for me in no way works for everyone, or for even anything more than a small minority of people suffering from recurring or chronic depression. Everyone's depression is different. It comes from different places. It responds to different sorts of treatments.
I have a couple of loved ones like you with depressive disorders. Both are up around 9.5 on the Richter scale for Bipolar Disorder if there was such a thing. They experience periods of high energy on the one hand. One gets massive anxiety attacks and an overpowering urge to clean everything in sight. The other becomes king of the world and begins planning its conquest. Next day they may be curled up in a fetal position planning how to commit suicide.
Medications can keep folk with bipolar alive, but as people with depressive disorders soon realize, it may take a couple of years to get your meds right and that's only if you've got a good psychiatrist working with you. It's understandably frustrating for you who have bipolar, because your loved ones so often do exactly the wrong thing in trying to help. We tell you to pull yourself up by the bootstraps when you have no bootstraps. We ask you, "Did you take your meds?" and that really makes you mad. We hover over you like you're a bomb fixing to go off and you hate that. We give you advice when you can't bear to hear it. We pitch remedies at you like a snake-oil salesman. Worse still we run away when you need us the most to be there.
Please understand that we love you and are only trying to help. It's not an excuse, it's just how it is. We know you are in pain. We instinctively want to help. The problem is that your depression and the emotional pain you experience is unique to you. What's happening is that your brain is experiencing random emotions due to the misfiring of neuro-chemicals in your brain. You are then betrayed by the very mental mechanisms that make intelligent thought possible.
Usually there is a precursor to emotions. You see something. It is either processed by the upper brain, or if it is a familiar thing, it goes straight to the lower brain. Either way, an emotion is created to match that experience you just had. You laugh if it was funny, cry if it was sad or jump back if it was scary.
What happens to you when you're depressed, anxious or manic is that you experience the emotion first. The brain goes, "Wait a minute, why am I feeling that?" Then, like a good brain it goes looking around for the precursor that made you feel that way, just in case you need to do something about it like fight or run away or give it a cookie to make it stop crying. If it can't find a reason for the emotion you are feeling, it will make one up in order to make sense of the world, because that's what brains do. The brain is a storyteller. It tells stories so we can make sense of what's happening around us and react appropriately.
Unfortunately, sometimes your mind writes fiction. Sometimes you feel an emotion, that has no story behind it and so your mind comes up with one to go with how you feel. Your brain basically lies to you. Things that make perfect sense to you in this story make absolutely no sense to people around you. And that's where the disconnect occurs.
And you're absolutely right. No one understands what you think and feel because no one shares the story your brain has created to explain why you are depressed. Of course, you may have a perfectly good reason to be depressed. Who doesn't have things to feel bad about in their lives? Unfortunately, your mind is working backward from the powerful chemically induced emotion to the event it's seized on as the cause of that emotion and incorrectly makes it worse than it would be otherwise. A car breakdown goes from being a minor frustration to a full blown, world-shattering tragedy.
Those who love you want to understand. Because we love you our natural inclination is to want to help. For years, I've worked from home in order to watch over my loved ones with bipolar. I know they are under terrible stress with the disease. Between them we've had multiple serious suicide attempts and at least 5 hospitalizations in the past 5 years related to their disorder..
And I admit it. Sometimes I make it worse. I have to be careful to give you guys room to find your own ways of coping. I find that if I'm too "helpful" or try to "talk you out of it", all I succeed in doing most times is making it worse. Sometimes all I can do is bring you a cup of hot tea or an ice cream bar and listen while you talk. Sometimes I take you out to a movie or a restaurant just to get out of the house for a bit.
But, like you, I had to learn what works and what doesn't for coping with depression. In some ways it's harder for us to know what to do since we can't get inside your head to learn what story is currently rattling around in there in response to your latest depression. We're just guessing most of the time. You've learned that if you do tell people what you're thinking, they just want to argue with you and you really can't deal with that, because if you lose the story in your head, then there's no reason for you to feel the way you do and suddenly the world would not make sense and who can handle that. So you don't tell us what you're thinking. You may share how you're feeling with us, but where problem-solving is concerned, that's backwards. It's effect to cause reasoning and results in the cause being manipulated by your every helpful brain to match the emotion you are feeling for no real reason other than that some chemical is squirting into your bloodstream that shouldn't be at this time.
Having knowledge about what causes depression helps me a bit, but it doesn't give me an instant understanding of what I can do to help. Every person's depression is different. Every person has a different coping mechanism. I have 28 graduate level college hours in rehabilitation counseling psychology and it still took me years to figure out how to be helpful after the onset of my loved ones' illnesses and I still get it wrong about half the time.
The best thing we can do is listen hard and try to find out what you need for us to do and what you don't want us to do. One big lesson I have learned was that it can be just as important to NOT do certain things as it is to do something to help sometimes.
So on behalf of all those who love someone with a depressive disorder let me offer you people with depressive disorders our collective sympathies as people who love you. Let me ask your indulgence of our ham-fisted efforts to "help out". You see, we not only have to figure out what you need when you're depressed, but we also have to figure out what we CAN do to help so we don't feel completely useless when you're obviously in pain. It's important for us to feel like we're helping in some way, if it's only to bring you coffee and hold your hand.
You see, we have our own stories to write in our heads so the world will make sense to us.
That awful power, the public opinion of a nation, is created in America by a horde of ignorant, self-complacent simpletons who failed at ditching and shoe-making and fetched up in journalism on their way to the poorhouse. -Mark Twain