June 5th, 2015

Doffing hat

"How Can I Help?"

I considered for a moment whether I would write this in first or third person. I wanted to write in first person, since it claims ownership of the things I'm feeling and saying. I'm trying to get better at actually expressing myself rather than holding it all in for lack of a safe place and context to do so. However, I assume that I'm not the only person in your life who is struggling with depression. I don't remember the exact figure, but I think it was something in the range of 40% of people suffer from depression some time in their life, so it's safe to say you know more than one depressed person. I switched to third person, so that you might apply this to others in this struggle. Each person is different. Each struggle is unique. If this doesn't fit the person you know, then ask them. They may not know how to tell you how you can help, but asking is not a bad thing. Just don't pressure them on it (we'll explore this more in a bit).

"How can I help?"

It can be difficult to support someone dealing with depression. A lot of the time, there doesn't seem to be anything you can do and the things you do try seem to make things worse somehow. First thing you should know is that it is generally not your fault. Depression skews the input of the world in ways that are usually negative. It's something that the person will probably already be aware of, but can't stop from happening. Second, you cannot cure them. No medications, no actions or words or miracle things (insert ill-researched Buzzfeed list here) on the part of any other person will ever, ever fix them. The only person who can cure the depression is the person dealing with the depression. Trust me, that's a really sucky thought, but it has to come from them. However, there are things you can to do make that journey, which may be life-long, a little easier for them:

1. Do not pity them. The last thing they want is pity or to be patronized. They want your respect and your love, but not your pity. Pity is a natural human response, so don't feel guilty for it, but counter it with respect. This person is a warrior, bogged down in a war that's slogging on for what seems like forever, against an enemy that no one else can see.

2. Comfort them. They live in a world that is growing evermore dim and grey. Things that were once the joy of their lives are now a symbol of regret for lost connections and pain. Anything to bring back that connection or to sooth that pain will be greatly appreciated. See #1 for nuances.

3. Do not press for answers. Part of the whole depression thing is a search for answers. If you push someone trying to find answers to suddenly come up with answers, it will hurt them and drive them away. Have patience. Be someone safe they can present what they find to as they find it. Otherwise, you may find them closing up and being reluctant to share anything they find.

4. Be there. Sometimes you don't actually need to do anything at all. Just show up. Stick around until they're ready.

5. Don't stop inviting them. They may decline every single invitation you give them, but I guarantee they appreciate being invited. They're not declining because they don't like you. They're most likely declining because they aren't sure they'll be able to get out of bed that day. Just keep them coming and maybe they'll accept one or two down the road. See #3 for more information.

6. Do not expect specific emotions. They may not even remember what a particular emotion feels like. They may not remember how to move the muscles in their face to signal that particular emotion. That may turn into anger at not being able to feel the way you want them to feel. Trust me, they don't feel the way THEY want to feel and are super frustrated about it. Just relax and have patience. See #3 again.

7. Be "normal" for them. Isolation is a huge problem with depression. Nothing isolates faster than feeling like everyone looks at them as the "depressed person". They want to feel normal. They want to feel connected. You may have noticed that I used the words "for them" rather than "to them" or "around them". That was on purpose. In times when things are really messed up in the mind and heart, having a safe harbor and an anchor in the world can make all the difference. Be that sense of normalcy for them until they're able to generate it for themselves.

8. Pray for them. If you're religious, pray for them. You don't necessarily have to tell them all the time that you are praying for them (see #1 and #7), but definitely do so. If you're not religious, then just keep them in your thoughts. Isolation can make a depressed person feel like they are being erased from the world and forgotten. Pretty simple way to help is just to remember them. Like I said earlier, don't rub it in their face, but give them a reason to believe they still exist.

9. Answer the call. So, this one's a little weird for me and I wasn't sure how I was going to phrase this as it is not something I personally struggle with, but here we go. We're going to talk about suicide now. It's the thing that most people are super afraid of and it's the one we're most likely not prepared to handle. There's been a lot of media attention about it now and it's easy to think that everyone who is depressed is potentially suicidal. Medications or lack of medications or lack of counseling or being told that there's a chance of suicide while taking medications can lead to ideation about suicide or death. If left unchallenged or unmonitored, those ideations can build to critical mass. Telling someone to not think about suicide is probably the worst way to handle that. The brain is weird and if you keep telling it not to do or think about something, that will be the very thing it thinks about. I believe it has to do with the way our brains process negatives (don'ts and do not's, ironic considering this list). Anyway, there are suicide prevention hotlines specifically because of how bad this can be, but that tends to be the last resort. Anyone with depression (and just anyone in general, to be frank) needs to be in counseling of some sort. It's expensive, true, but it's cheaper than the alternative. Ultimately, there needs to be many several layers of safety nets for a depressed person before they have to call one of those hotlines. Calling one of those lines is pretty much admitting that there's very little left that they can control. And while the hotline staff are usually very well trained and mean very well, sometimes there are too many calls and the hold time is longer than their ability to keep it together or it was an off day for one of the staff. Who knows? My knowledge on how those hotlines are set up is pretty much entirely hearsay, so I might be completely off base. Whatever the case, being a person that they call first before calling that hotline could be just the right amount of support to prevent any lapses that may or may not exist. But, it's only as effective as much as you are able to answer the call. Though, you have your own life to live and your life should not necessarily be solely focused on them (depending on your relationship, of course). That's why it's important to have as many people as possible. It can be difficult to build a support structure while depressed, so maybe you can help them build it (with their permission and also while not invading their lives, see #1 and #7). But above all else, don't think of them as a ticking time bomb. They're human. They're going to stumble, often. See #4.

10. Recognize that trying for them looks different than it might for you. Depression is not something anyone else can see (see #1). You see the effects (when they aren't carefully hiding it), but you do not see the damage inside. You wouldn't tell a person whose hand has been blasted off to pick up something using both hands. Telling someone who has had their energy sapped by the leech that is depression will not respond well to being told that they just need to do stuff that requires energy. Even if it's absolutely true, which it totally is, you'll come off as a drill sergeant and it will hurt them. It will hurt the relationship between you and them (see #3). Small steps may be the most they can do at that time. Be glad for their victories, however small, and be patient and forgiving of their failures, of which there will be many.

So, it's getting late and I'm going to wrap up here. Again, each person deals with depression differently and will identify with these needs in varying ways or not at all. The key thing you should take from this is that a person with depression wants to feel like a human being (a feeling that has most likely been denied them for a long time). If you want to help them, just love them and treat them as a human being. So go out there and hug your nearest depressed person (if that's something they're comfortable with and you have that kind of relationship). Or just say hi and let them know they exist. Small things.