People with depression (or any mental illness for that matter) need to be heard. Whilst a variety of symptoms are collectively shared, people are individuals. How they experience depression is individual. Blanket advice will not, therefore, help everyone. At least not in the most severe cases. This is the most important thought to keep in mind as I carry on below…
Basically my point is that advice, whilst often well meaning, is not always helpful. It can be detrimental to the point of being dangerous.
Yes, we all know that exercise, eating well, getting out, socialising, getting adequate sleep and a routine is often helpful. As is trying to maintain hobbies. Yada yada yada.
However, some people CANNOT manage these things. That’s not to be negative and say “oh well, there’s no way out if you don’t do it”. It’s the reality for some types/severity of symptoms/depression at that point in time. Hence my blanket advice comment being N/A at times.
It is also hard to know what to say in times of crisis. I know from being on both sides of the fence how, when in crisis, the well intentioned professional response feels and when being that professional how difficult it is to help.
On these occasions, the following stuff can be helpful:
Using myself as an example… before my last 2 episodes of illness, I had a postnatal depression lasting around 2 years. I was able to force myself to do those things suggested. I didn’t enjoy anything. I was numb. The anxiety was so debilitating too. I tried numerous medications. Had therapy. Mixing with people felt horrible and weird; socially awkward, even with friends. However I was able to physically move and punch thorough even though it was utterly ghastly. Eventually I came out the other side. I was convinced it was because I did it all ‘correctly’, working hard. Shamefully, at that time I would’ve said to anyone else suffering that if they did the same as I had done then eventually that would be the reason they’d get better too but then….
I had a mixed episode (posted here) followed by this last depression that I haven’t written about properly before now….
This depression was very very different. I couldn’t do the most basic daily living tasks. It was like my mind and body were separate. My mind knew what I ‘should‘ do but my body was my enemy. I had psychomotor retardation. No appetite (which is common anyway) and literally unable to move to prepare food to force it. I had ‘leaden paralysis’. This basically felt like I had kilos of weights hanging off all my limbs. Any movement was incredibly difficult, to the point of finding it extremely hard to even go to the loo. I lost nearly 3 stone in as many months. I was CONSTANTLY exhausted, sleeping most of the time. No matter how much sleep was had it was never enough. Sat under my blankey in the same spot for months, just managing the school run (which initially I couldn’t). Washing myself regularly was seriously neglected.
Ordinarily, I’m bright and cheerful, I love cooking and eating, being active, socialising, doing all those nice helpful bits of ‘advice’ given. I meal plan, shop, socialise, work, do activities with my children, pursue my own interests. Shower daily and wear make up. I’m active. Always busy.
To add weight to my point, in my professional role in mental health, I have looked after people in deep depression who have been virtually unable to move too. Needing to be spoon fed. Not being able to respond to conversation, some catatonic, not able to basically do anything much.
There is no way that the aforementioned advice will help that at all. Fact. It will only serve to make people feel worse about the things they want to be able to do but can’t and therefore lose hope.
And we all know where loss of hope can lead….
What should we do then to help people in these cases?
From experience, listening is the one of the most powerful things – actual active listening and validation. You don’t need to have advice or even words. Watch. Visit that person. They may not be able to talk much (or at all) but they will remember your presence. This is all very important.
Take over care if necessary and temporarily remove responsibility. Make sure they eat by providing and supervising food. Always seek professional advice. Advocate. Medication will most likely be the kick start to even the most basic step to ‘recovery’.
Eventually the depression will start to shift. Only then can the work to recovery begin.
So, to summarise, everyone is individual. If you’re going to give advice, first stop, evaluate, think. Is this advice appropriate right now? What is the most important basic need to address first? Risk assess. What can YOU do to help? Who do you need to be involved in their care? Practically and emotionally.
We all have a responsibility to ensure advice, support and treatment is appropriately timed for the person, led by the person (if possible) and is respectful. Compassion and empathy is everything.
Above all don’t patronise. That person is the expert by experience.
Some other reassuring words such as these can be really helpful to some: