Have a Loved One Who is Struggling With Depression? Here Are The 5 Ways to Best Support Them.

September is Suicide Awareness Month.

September is a designated time for us to share stories, resources, and awareness. Over 40,000 people a year in the U.S. die from suicide. That is a horrifically high number. I don’t know how many others suffer from depression and anxiety and grief as a result of those losses, but it seems like it must be astronomical.

Here are a few things I’ve learned that I think are worth passing on this September.

1. Be Nice. This may sound overly simplistic, but it couldn’t be more important and a lot of times it couldn’t be more difficult. For me, a red flag that I’m sinking into a depressive state is my irritability. I snap at people and I say rude things – things I don’t even mean. As a result, I piss off people around me and I end up feeling horrible – sinking me even further into the hole sliding into. It’s strange because I don’t even notice I’ve sunk that low until I find myself repeatedly acting like an asshole. Instead of yelling back every time or screaming, “WHAT THE HELL IS WRONG WITH YOU?” like you probably want to, a gently phrased, “Are you feeling okay? You don’t usually snap at me so much.” could go a long way. So could a touch on the arm or a neck massage. Emotions are strange – and depression lies and makes you forget that you were ever capable of feeling well – so you just might help your loved one realize that what they are feeling and how they are acting isn’t typical for them.

2. Take something off of their plate. A common symptom of depression is extreme exhaustion. Offering help with even the simplest of tasks (washing dishes, picking up something from the store, making a freezer meal) can help your loved one feel like they can handle life a little better. Forget the phrase, “Let me know if I can do anything.” Instead, ask if there is anything you can help with at a specific date and time, or offer up 1 or 2 options of specific help that you know you could provide.

3. Ask them if they have self-harming thoughts. Not everyone who has self-harming thoughts, or even suicidal thoughts, is at that moment actually contemplating suicide. However, it does give a huge heads up that professional help is needed. Most people don’t offer up to others that they are having self-harming thoughts and most loved ones don’t think to ask. Even though it can make us uncomfortable – THIS IS THE QUESTION WE NEED TO ASK. If they are having those kinds of thoughts – tell them they NEED to make an appointment. With ANYONE.  Depression lies and tells us that everyone probably has these thoughts even though this is not the case. A general practitioner is a great place to start if your loved one isn’t already seeing someone. Tell them to use you as an excuse for making the appointment. You aren’t expected to help them figure this out on your own – but you can refer them to a professional who can.

4. Share your own struggles. You might not have experience with anxiety or depression or other mental health troubles, but if you have battled – let them know. Sharing your own experiences lets them know that it’s okay to not feel okay. It opens up the opportunity for your loved one to speak about struggles that are often hidden inside because they of the stigma that surrounds those topics. It will help them feel not so alone. Be mindful not to tell them what will work for them – because what each person needs is different.

5. Take care of yourself. If the person you are supporting is very close to your inner circle, you need to be mindful of compassion fatigue. Compassion fatigue is when the physical and emotional toll it takes to support a loved one starts to affect your own health. It’s important to be supportive, but you cannot do that well without taking care of yourself. Do not feel guilty about taking care of yourself. I don’t know who made up the phrase, “You can’t pour from an empty cup.” but it’s dead on. Remember that you are not responsible for fixing your loved one’s depression all by yourself.

If you have been affected by the suicide of a loved one, know that it is not your fault. We can only do what we can do, and as much as we would like to think we can control the actions of those around us, the reality is we cannot do more than offer the support we are capable of offering.

If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HELLO to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.

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Think Suicide is Selfish? Here’s Why You’ve Got it Wrong.

This has been a pretty fucking horrible week. On Wednesday, a suicide hit way too close to home and it’s been awful.  No, it wasn’t Chris Cornell, it was someone much closer to my inner circle, but both events on the same day evoked an overwhelming amount of emotional commentary – both on social media and in person.

Unfortunately, when suicides occur there are some people who blame the victim. There are many who lash out in anger at the one who caused others pain by taking their own life. It’s understandable to be angry about a loss, but when anger is directed at the person who took their own life it shows a significant lack of understanding of how depression works.

I don’t know what was going through our friend’s mind because I was not in it. I just know how depression manifests and how destructive thoughts can flit through the brain and how depression is able to justify them.

Here are some answers to things like:

1. Don’t they love their family? Don’t they understand what impact this will have on them? OF COURSE THEY DO. They know it well. They hate the thought and they’re sick about it. The fucked up part is that their brain is telling them that not being here is the better option to that horrific outcome – that living without them is helping their family live a better life than living with them. DEPRESSION LIES and it says things like, “You’re a burden” and “You’re dragging those around you down” and “You’re making everything worse.” I don’t know if you’ve ever tried to not believe your brain, but it’s pretty much impossible to not listen to what your own mind is telling you.

2. How could they do this? How could they leave their loved ones forever? Depressives feel like they are already gone inside, so they don’t see leaving as leaving because they’re already gone. They might not look that way, they might not act that way, but they feel that way. And they’ve been feeling that way for quite a long time at this point. DEPRESSION LIES and tells them they are gone for good, even though therapies and medications can often bring them back. Depression is a convincing liar. It is a seasoned actor that masquerades as truth. It’s a macabre magician’s act that makes someone think they’re already gone even when they are standing right there.

3. Why weren’t they more grateful? They should have been more thankful for what they had. As irony would have it, practicing gratitude makes severe depression worse, not better. This is contrary to popular belief because for people without mental illness, their emotional state depends on REASONS. So, focusing on all the good you have around you helps your mood. But, depression doesn’t give a shit about reasons. It doesn’t give a shit if you are poor or rich, weak or strong, ugly or beautiful. It doesn’t need ungratefulness. It doesn’t need back stories or traumatic experience to exist. Depression is like a parasitic worm swimming around in your brain but you never once visited the tropics. And that’s the kicker – when there is no “why” depressives often feel guilty. After all, they have everything to be grateful for, right? Nothing to complain about. Because of this, their feelings of hopelessness and worthlessness increase. They don’t feel worthy of your love, their friend’s love, their kid’s love. How could they be, when they don’t even feel worthy of their own depression? They know how good they have it and yet they still find themselves in a state of intense internal turmoil and emotional distress. DEPRESSION LIES and the more grateful the person is, the more monstrous depression makes them feel. No one in a remotely normal state of mind can understand how this is possible, so if you fall in that camp, consider yourself privileged.

4. Every problem can be fixed, how didn’t they see that? Whoever wrote the whole “suicide is a permanent solution to a temporary problem” bullshit clearly never suffered from depression. You don’t need REASONS to be depressed. Neurochemicals don’t tend to care about your problems or your social life. Most depressives are not sad about a particular event. They might not even feel SAD. They often feel things like hopeless, or worthless, or nothingness. They often feel empty for absolutely no reason at all, other than their own chemical imbalance. When the problem is your own self, you don’t have a “temporary problem”. You just have YOU. DEPRESSION LIES and tells you that you cannot be fixed.

DEPRESSION LIES. It’s a horrible asshole bitch that breaks people – it breaks good people, strong people, loving people, grateful people. It does not discriminate. It’s an equal opportunity fucker.

Dark Days

I come with the hardest form of artillery. One is two and the other is four and they have small, smooth feet and cute tiny noses. They have the loudest of voices and the most beautiful of spirits. They bring giggles and hugs and peanut butter crackers.

When I can juggle it all, I bring my strongest ammunition, but even when I do I know we cannot beat the beast that we encounter. Sometimes though we can soothe it. Temper it. Entertain it.

At the very least, we can be there with it.

I know which wars I’m likely to win and which ones I’m not. Since I refuse to surrender, all I can do is show up to every battle and keep on fighting and take any gains I can get. Any small moments of victory.

I know I can’t win them all.

I can tell it is a good day by her gaze. She looks alert, she looks at me, she follows the conversation with her eyes. She smiles – more with the crinkles around her eyes than with the movement of her mouth, but still. On those days, I talk. I talk and I talk and I try to think of interesting or clever things to say. If I’m lucky I get a chuckle, a nod, a smile.

A win.

On bad days, her eyes are glazed. She is not able to be fully present. It’s hard to describe but easy to observe. She doesn’t have the energy for much in the way of eye contact, conversation, or responsiveness.

“Bad day?” I ask.

I am not really asking, I just want her to know that I see it.

“Bad day.” She confirms. She shuts her eyes and squeezes them tight for several seconds before opening them slowly as she exhales and shakes her head, as in disbelief at the shit she’s dealing with.

I’m glad she can tell me. She doesn’t need to explain.

I do not need her to justify her pain to me. Or her reaction to her pain. I just need her to know I’m there.

In many ways, I get it.

Life is hard. It is sometimes too much.

On those days, I’m quiet. I massage her arms. They are frail and bird-like and her skin is softer than any other skin I’ve touched. It is smooth and supple and if it is a little bit dry, a small bit of lotion revives it immediately. I rub her back, her shoulders, her neck. I brush her hair. I hold up her insulated mug of ice water to her lips so she can drink it through the bendy straw. When she gulps it down I think of the 34 ounce jugs she used to keep on her counter, refilling them throughout the day to ensure her hydration. I wonder now how many ounces she consumes when I’m not there to hold the jug to her lips.

Every once in a while I bring in a single serving of pink moscato and hold it to her mouth after she’s had her water. She gulps down as fast as her weak lips and her weak throat and her weak stomach will allow.

Parts of her body are weak – too weak to move a whole lot – her arms, her legs. But other parts are hearty and strong. Her heart, her lungs.

Her depression.

She hates her weakness and she hates her strength.

When I leave her, I give the others the update.

“She’s having a bad day.” I say.

“Why?”

“What?”

“Did something happen?”

At first, I’m confused. I thought I already explained when I said “she’s having a bad day.” It takes me a minute, but then I realize.

Some people only have bad days for reasons. Because of things that happen externally. And certainly she has some external reason, but for the most part it’s her insides that are broken.

People who aren’t broken on the inside don’t understand that bad days are just a given for depressives. Some days are just harder than others for no reason at all.

“I wish I were dead.” She can articulate this on the good days. Because sometimes that is what a good day looks like for a depressive.

And her “good days” aren’t really good days. They’re not full twenty-four hour periods. They are more like flashes of light in her darkness. Brief cracklings of lightning that illuminate a pitch black sky for a quarter of a second at a time. Sometimes maybe a half-second.

All I am is a spark. A brief bit of lightening. Powerful, yet fleeting. There and gone, in an instant.

 

Insides

There was no horrific event, no jarring trauma.  But one day during her teenage years she woke up and discovered she was a totally different her.  The new her was no longer full of light, or love. She no longer housed any cheer or warmth or joy. For a while, she thought her old self had been replaced and she had been filled with hate and gloom and darkness but eventually she realized that her old self had just disappeared and now she was actually just full of nothing.  Her insides were empty.  She was a void occupying the skin that the old her used to live in.

emptyinsides.jpg

No one knew she wasn’t in there anymore.  For a long time, she couldn’t believe nobody noticed.  After all, almost all of her volume, her substance, was gone.  She was hollow in the places where she used to be solid.  I suppose she can’t blame them for not noticing. After all, people typically only notice each other’s outlines.  Our innards beneath the surface are pretty well hidden.

She certainly noticed, even if no one else did.  It’s pretty worrisome when your insides have disappeared.  She kept patting herself, pressing gently to see if there was some resistance underneath.  Some sign that herself had miraculously returned.  But every time she pressed, her fingers just sank in.  There was nothing of substance that pushed back. She was an empty shell.  Every once in a while, she worried about someone poking her too hard, or tripping and tumbling onto something sharp, either of which could have ruptured her completely.  

For the most part, though, she stopped caring if she ruptured completely since she knew there was nothing inside to save anyway.  She wasn’t even in there.  She was gone.

Sometimes she thought of just gashing her skin to bits, allowing any minuscule flecks of herself that were left inside to escape.  Maybe there’d be a bit of release in that feeling, or if not release at least a reduction of strain.  It was exhausting to stand up straight and walk and talk and give the general impression that she was still a whole person, when she didn’t even have any bones or muscles or thoughts or feelings.

Somehow, she existed like this for twenty years.

Every single day, for twenty years in a row, she thought about ending it all.  And she used the word “all” lightly, because she knew she was nothing more than a sack of skin.  It would mean nothing to this world to lose the nothing that she was.

Sometimes the Horrible Thought was a fleeting one that came after a thought about what to eat for dinner or before a thought about what was on her calendar the next day. Sometimes the thought was lengthier, and she contemplated the Horrible Thought as she sat in the garage with the car on, but the door still open.

Once she became a mother she knew she couldn’t be a good one with no insides.  A good mama needs working parts.  Or at least needs parts.  Vacuous sacks of skin cannot raise children. Even though she hadn’t ever given up on finding the internal her that used to exist, she now searched for it harder than ever.  She was able to locate a small fraction of herself through yoga and running and diet changes, but that still left mostly emptiness inside where her old self used to be.

Sometimes she felt confused and frustrated about this.  To herself she asked, Why am I so empty?  Where the hell did the rest of me go?  Why can’t I find me? Am I gone forever?  Mostly though, she figured that her confusion and frustrations weren’t really valid. She figured, I’m just being dramatic. I’m sure everyone feels like this, they just don’t admit it.  I just need to suck it up.

Finally.  Begrudgingly.  She told a doctor how she felt. She didn’t think it would help, but she knew she owed it to her children to at least give it a shot. She initially resisted filling herself up with the meds that she had been prescribed.  She wanted to fill herself up with her, after all, She belonged inside her skin, not some pharmaceutically manufactured impostor.

Truth be told, she was a bit afraid of taking the meds. She was afraid they’d turn her into more of a zombie than she already was, afraid they’d make her feel dizzy or sick. That’s what she told the doctor, anyway.  Way deep down, she was afraid that they wouldn’t work. That maybe everything really was fine and she just really did just need to suck it up.  She was also afraid that they would work, but then someday stop working.  She’d read somewhere that meds for depression can lose their effect after taking them for a while. Then what would she do?  After all of these years of lacking a substantive center, the thought of finding her core and then having it go missing again was almost too much to contemplate dealing with.

In the end, she decided that she had already been missing for quite a long time, so even if she only found herself for a short amount of time, it would be wise to take what she could get. She started filling herself up with her meds.

The other day she leaned over the kitchen counter to reach something and she noticed that the counter didn’t threaten to push through her skin and out the other side.  She felt something inside her push back.  She leaned back and then slowly leaned forward again, paying attention to the way the counter felt as she applied more pressure.  She felt it again. Resistance.  

She thought about it and realized that she hadn’t had the Horrible Thought in a long time. Long enough ago that she couldn’t remember when.

She thinks, after all this time, she might be back inside her old skin again.  

Depression Lies

There is no coming out of it.
There is no getting over it.
There is just IT.

It ebbs and it flows and it morphs.
It hides.
It does not ever disappear.

It teases, at times.
It seems long gone.
But, it is never really is.

It always returns.
With a vengeance.
With a downward pull.

It distorts.
It deceives.
It consumes.

It tells you that it is all for naught.
That you will never be enough.
That you’re better off not here.

If you’re in a good place, you’ll recognize the tone.
You’ll recognize the facade.
You’ll recognize the weakness in the argument.

So you counter the exchange with self-talk.
With meditation. Deep breaths.
With exercise and proper nutrition.

You will look like you’ve got it all under control.
And sometimes you do.  But sometimes you don’t.
Sometimes you are out quietly out of control.

Sometimes, you are low.
Sometimes you are sinking deeper.
Sometimes, you’re just tired.  Oh, so very tired.

It tells you it’s easier to let go, that there is no use fighting back.
It tells you things will never be good.
Even if things are already so much better than good.

Depression lies.
Assuredly.
Convincingly.

Sometimes we need to etch this in our skin
To make us remember, to make sure we get the message,
when we can’t hear anything but the deceit.