When a loved one is suffering from depression

Facing the challenging reality of battling a psychological issue can be quite daunting. Mental suffering penetrates through all domains of life: changes relationships at the workplace, at home, and most of all – changes a person’s relationship with themselves. Unfortunately, the change is usually for the worst. A creeping feeling of worthlessness, self-hate, constant negative dialogue in the head, the list goes on. As hard it is to be a person dealing with mental illness, it is just as challenging to live in the same household with one. There are a lot of changes that occur and the most reported family issues are: decreased social life activities, marital difficulties, anxiety, insomnia. Moreover, a study from 2010 discovered a direct correlation between family burden and patients’ adherence to treatments. Also, family psychoeducational interventions have been found to be effective tools in regards to improving patient’s compliance to treatment.

If someone in your family is suffering from depression, you most definitely have already felt the struggle. This text will try and help you navigate this complex matter and suggest strategies that could help improve your loved one’s situation, as well as your own.

Depression has a great impact on personality. Often people become more irritable, distant and overall avoiding. They may act hostile and quickly diminish any enthusiasm in family members to be helpful and caring. From a psychoanalytic perspective, a depressed person is described as someone who has “pulled back” their “cathexis” (Bezetzung;  the process of allocation of mental or emotional energy to a person, object, or idea) from the outside world into themselves. In real life, it could translate into distancing and seeming lack of interest or care in the outside world. Figuratively speaking, the person needs a lot of mental energy to cope with depression and normal interaction with family and friends is “over capacity”. Please note, this is not literal speech, it is not a conscious decision, but rather an emergency coping mechanism of the psyche to help gather all resources and direct them to the inside, rather than outside. People would feel awful for ignoring their spouse, for example, but have no mental capacity to communicate their troubles.

A family is a living system. One member suffers, the whole system suffers. People do feel the suffering of their loved ones as if they were their own. The closer people are, the harder it is sometimes to distinguish between one’s own feelings and those of the person standing in front. This is why, when situations and emotions at home escalate, it is important to be mentally prepared.

Seek professional help

In case you feel your spouse or family member shows signs of depression, do your best to encourage them to see a health professional. Whether it’s your family doctor, or a psychotherapist, they would provide you with a professional assessment of the current situation. Depression is a condition that can and should  be treated in a timely manner, just like any other physical or psychological condition. If this step has not yet been taken, you should make an appointment with a doctor as soon as possible to plan how to proceed.

Learn about depression

A quite very basic tip: of course it is enormously helpful to know as much as possible about the illness of depression, the effects and the therapy possibilities, etc. This not only creates understanding for the partner, but also will give you more knowledge, thus more realistic expectations on the process of coping, types of treatment and overall good practices to implement together. Please see below the main signs of depression:

  • Depressed mood by self-report or observation made by others
  • Loss of interest or pleasure
  • Fatigue/loss of energy
  • Worthlessness/excessive or inappropriate guilt
  • Recurrent thoughts of death, suicidal thoughts or actual suicide attempts
  • Diminished ability to think/concentrate or indecisiveness
  • Psychomotor agitation or retardation
  • Insomnia/hypersomnia
  • Significant appetite and/or weight loss
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Build a strong supportive environment

Home and family support will play a major role in recovery from depression. Every effort you put into the home environment will probably have a greater effect than you expect. It is true you can’t “fix” your partner, but you can most definitely help.

Depression is found to have direct correlations with food, sleep, level of activity. On the other hand, it diminishes motivation. Often depressed people find themselves immobile, apathetic and overeating. That is why a spouse or partner is a position to be of great help. Firstly, try to create a stress free atmosphere. Talk to your partner about their needs. Maybe introducing more routine into life: eat at the same time, take meds, go for walks, etc. at the same time, so that your partner feels more in control and not overwhelmed by day to day life. Encourage them to make plans for the near future: go to the movies next week, go out to dinner, so on. Depressed people would often avoid almost any social situations and interactions, or any activity whatsoever. It is good to be there to encourage at least a minimum amount of activity and planning the future.

If possible, prepare your food at home, encourage them to take part in cooking. It’s good for two reasons. First, the obvious one: eating healthy food is extremely important and a powerful factor in recovery. Second, the mere process of cooking needs a good amount of involvement. Also, planning, shopping, preparing the food every day, thus taking control and responsibility, also putting in effort in one’s health. Perhaps your partner will not be willing to help every day, but do encourage them to take part. We can’t mention food without mentioning movement. Be there to initiate walks, runs, hikes, yoga or whatever physical activity you like. In moderate depression episodes, exercise can be as powerful as antidepressants in regards to positive effects, while in severe depression it is a powerful accompanying treatment. What people eat is important, but sometimes what they drink becomes the problem. Watch out for change in alcohol consumption habits: if the usual glass of wine has suddenly turned into the usual bottle, make sure to take notice. Same applies for drug use, prescription medication, etc.

Take care of yourself

Being the support system itself, family members, children, spouses, friends will need mental strength and agility. It is not shameful to need time for oneself, it is not shameful to need a break or someone to talk to. Not only is it not shameful, it is necessary. A depressive episode may last for months and it is a great challenge for all. Having someone to talk to is very important. Maybe a friend, or a specialist, or a support group?

People often decrease their social interactions in accordance to their depressed spouse. If it’s possible, try and take part in life, as it is important for your own mental health. Your partner may be unable and unwilling to meet with people, uninterested in seeing movies or going dancing, and it is absolutely normal because they are depressed and all that activity is too much. You, on the other hand, have a responsibility to yourself as well. Take some “time off” being a caregiver and enjoy whatever activities you like, this is not betrayal. Think of it as emotional fuel recharging.

Reaching out to friends

It is research-confirmed that people who receive support from their family members have better recovery prospects. Another interesting fact is that support from friends can be an even stronger predictor of successful recovery. One way to think about it is that, in some sense, support from family is to be expected. While support from outside of the immediate family group may be perceived with even greater value. There are also instances of family conflict, bad communication and unhealthy atmosphere at home. In those cases, receiving support from outside that circle can be absolutely crucial for recovery. However, people are often unwilling to share their troubles with friends as they don’t want to be a burden. You could ask your partner about their relationship with their friends over the course of depression. Do they still communicate regularly or they have been avoiding contact. If they are in touch, has your partner shared any of their depression-related problems with friends? Encouraging your spouse to seek out a friend and maybe open up about their condition, or simply spend some time together can be a good idea.

What NOT to do

If the partner of a depressed patient has the mindset that depression is just being sad or lazy, they might do more harm than good. The type of tone to avoid would be: “Can’t you just cheer up?”, “It’s all in your head”, “Why are you so lazy?”, “You know some people have it much worse than you?”, etc. This brings us back to point two: learn about depression and be empathetic. Give your partner space to be depressed and go through their emotions. Ask them how they feel, rather than why; asking how you can be of help, rather than telling them what to do to fix it. Ask about their sleep, appetite, energy levels, try to notice things they might be unable to notice in themselves.

Being witness to a loved one suffering can be very challenging and overwhelming. It is difficult to keep the balance between being empathetic and wanting to help and feeling helpless at the same time. It is important to note that patience, peaceful environment and emotional stability will be your key partners in the battle with depression in your family. Try to learn more about depression and don’t hesitate to contact a professional.

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