You’re in love with this wonderful person–a man who
truly gets you, or a woman who makes you laugh every day. There’s a
kind of connection you feel in your solar plexus and you know this is someone
you want to stay with, be loyal to, and love with your whole heart.
Your relationship grows and deepens. But after
a while, something seems not quite right with your beloved. Maybe he
snapped at a waiter over nothing, which he’s never done before. Or maybe
she has started to doubt that you love her, which makes no sense because you’re
more in love with her than ever.
Below are 23 things your loved one wishes you
understood about depression and how it’s affecting them.
1.
They’re suffering from a brain imbalance, not a character disorder
Research has shown that in some depressed people an
important part of the brain (called the hippocampus) is 9-13% smaller than in
people who do not suffer from depression. And the more bouts of depression the
person has suffered, the smaller it is. To complicate things a little more,
research also shows that a heavy load of stress over a long period of time can
shrink this area of the brain. So, depression can start from intense
emotional strain and become biological over time.
2.
Their motivation is impaired
The brain chemicals (called neurotransmitters)
responsible for that the feeling we call “motivation” are dopamine and
norepinephrine. If you’re lucky enough to have ample amounts of them surging
through your brain, you get up every morning feeling ready to tackle your tasks
and responsibilities for the day. But many who are suffering from depression
have low levels, leaving them devoid of even enough motivation to get out of
bed. Telling these folks they just need to start exercising or find a job is like
telling someone with the flu they just need to stop throwing up. It’s not
something they can instantly control.
3.
The worse the depression, the less they care…about anything
Motivation isn’t the only casualty that depressed
people experience. As the brain becomes increasingly depressed, the person
often experiences apathy—a lack of interest in life’s activities and
relationships. Barrie Davenport gave the best description of it in her blog
post on Live Bold and Bloom: “It’s white noise. Dead air. You feel like a
chunk of flavorless tofu. Not happy. Not sad. Not angry. And certainly not
passionate.” It is one of
the most heartbreaking aspects of depression,
because it creates so much interpersonal upset: loved ones fret more and more
about the person’s wellbeing, but the person cares less and less about their
fretting.
4.
They often feel “broken”
You may even hear them use this term about
themselves. There is a sad finality to this word, so it’s important to disagree
with this judgement. People with depression are not broken any more than people
with diabetes or cancer are broken. It is a condition, an illness—something to
address and manage. It might be a life-long challenge, but it does not mean the
person is condemned to life-long pain.
5.
They don’t want to be a burden
Depression is not a ploy for attention. The last
thing people with depression want is to inconvenience people they care about.
They already feel bad about themselves; becoming a burden only deepens that.
And yet, they need help. They need people to show up for them. So the trick is
to convey your unwavering love and support for them, regardless of what it’s
doing to your life. Not easy, but crucial.
6.
Their illness may show itself as deep sadness
Most people equate depression with sadness. In fact,
most people will loosely describe anyone who is bereaved and crying a
lot as “being depressed.” If the person suffered through abuse,
abandonment, or a significant loss as a child, it may have imprinted their
sadness deep into their minds, which they basically relive every day. Without
these experiences being processed in adulthood, they stay stuck in their
childhood grief, manifesting as depression.
7.
Or it may show itself as anger
In my work with combat veterans, I found that many
depressed soldiers experienced their depression as anger or even rage and not
as much as sadness…at least not initially. (I also often found that when they
felt safe enough to dig into it further, underneath that anger was profound,
almost unbearable, grief and sadness from all the layers of loss they witnessed
and experienced.) Uncharacteristic anger is another way depression can show
itself–a sign that can be easily missed.
8.
Or it may show itself as anxiety
Research is showing more and more genetic and neurobiologic
overlaps between depression and anxiety. This would explain why 90% of people
with an anxiety disorder have many of the symptoms of depression and why 85% of
people with depression also experience anxiety. Is this because the experience
of depression makes us worried that we’ll lose our jobs or our families? Is it
because anxiety disorders are so difficult to deal with that we get worn down
emotionally and start to feel hopeless? Hard to tell. But increasingly, we’re
understanding that there are many complex issues at play.
9.
They may be extremely sensitive to criticism
One of the least recognized symptoms of depression
(specifically “atypical depression”) is an extreme sensitivity to criticism.
What might have been meant as nothing more than an opinion, e.g., “Blue is a
better color for you,” is perceived as a criticism that the person is wearing
green. This is not a personality trait; once the depression is treated, this
hypersensitivity resolves.
10.
It may have started with a specific incident
As I mentioned earlier, painful things that happen
to us early in life can leave imprints on our brains that affect us our whole
lives. The more powerful the experience, the more difficult it is for a child
to understand and integrate it fully and therefore the bigger the impact it’s
likely to have. But events in adulthood can be just as devastating, especially
if it causes upheaval of one’s identity. Divorce is hard for almost everyone,
but it’s hardest on those who feel that the meaning of their roles and lives
have been altered because of it. A mastectomy is always painful and scary, but
it can become a source of deep depression if it threatens the woman’s identity.
11.
Or it may be cumulative from many incidents
Research shows that there can be a cumulative effect
from a long string of “minor” events. For instance, being verbally criticized
or ridiculed over many years almost always wears down the person’s sense of
self-worth, which can become a depressive episode. Multiple job losses can
create a new (but inaccurate) negative narrative that the person comes to
believe, deepening into a depressive episode if it’s not robustly
challenged.
12.
Or it may be chemical and not from any incident at all
Genetics play a role in pretty much everything, and
those who have a long familial history of depression are more vulnerable to
depressive episodes than those with no family history. If the person was
exposed to those family members directly while growing up, they may have also
unwittingly learned negative patterns of thinking that contribute to
depression.
13.
Their sleep patterns are usually way off
Some will sleep every minute they can, even to the
point of sleeping through important events (like getting up in time for work!)
And others have a terrible time sleeping, even when they’re exhausted. A change
in sleep pattern is one of the classic signs of depression.
14.
Their eating patterns are usually way off, too
Like sleep, a change in their usual pattern of
eating is almost a given. Again, some will eat compulsively trying to feel
better and others have no energy or motivation to eat at all. It shows up as
significant weight loss or weight gain.
15.
They may also have a lot of body pain
Sometimes people present in the doctor’s office with
body pain that ends up having no medical cause. Headaches, back pain and
stomach pain are the most frequently reported kinds of body pain associated
with depression, and are frequently misdiagnosed. Most of these improve
as the depression is treated and abates.
16.
They feel profoundly alone
Our culture values productivity and strength, so
being crippled with exhaustion and paralyzing emotion (sad, mad, or scared)
puts the depressed person at risk of being ridiculed, criticized, or in some
other way degraded, all of which creates a sense of being “different” and
somehow “less.” Often, the depressed person thinks the “solution” is to use all
their energy to hide what’s happening from their co-workers, friends, even
loved ones, which only intensifies their sense of alienation.
17.
They may frequently think about death or suicide
Alienation—that feeling of being utterly alone in
the world with no one to talk to or lean on—is one of life’s most painful experiences.
For some, it is unbearable and leads to thoughts of suicide as a way to end the
pain. People who are severely depressed think about suicide far more often than
anyone would imagine, and certainly more often than they let on. In fact,
research shows that most people who die by suicide have been “rehearsing” it in
their minds for quite some time. So it’s essential that you take this
condition seriously and help your beloved get some kind of intervention.
18.
Exercise helps about 30% of those who suffer from depression
Motion improves emotion. It helps reduce
anxiety, it helps dissipate anger, and it helps ease depression. Even a
10-minute walk (in an environment that feels nurturing, not stressful) can
mobilize the body’s fluids and the brain’s blood flow in positive ways.
Research has shown over and over again that there is a segment of the
population who can completely erase their depressive symptoms through exercise,
and that the more exercise these folks do, the better they feel. It’s not true,
or even possible, for all of us (for instance those who are wheelchair bound or
chronically ill with another disease), and it is no small task to start when
you’re seriously depressed. But it has completely changed the lives
of many.
19.
Psychotherapy helps about 30% of those who suffer from depression
People who have suffered neglect, abuse, trauma,
great loss, combat, or assault often need someone knowledgeable and grounded
with whom to talk through their difficult experiences. Even without those major
events, some people experience a significant improvement in their symptoms
through psychotherapy. Those of us trained in providing psychotherapy have
studied and practiced this art extensively under expert supervision. There is a
long list of helpful techniques a therapist can employ that helps ease
depression, but there is an equally long list of things not to do, and only
someone trained will be adequately skilled to provide safe care.
20.
Medication helps about 30% of those who suffer from depression
I suffered a terrible bout of depression in my 30s
that no amount of psychotherapy could fully treat. When I finally accepted my
doctor’s urging to try an antidepressant, the effect was nothing short of
miraculous: within 3 weeks, I had a kind of mental resilience I had never known
before. The best way to describe it is that it gave me a new kind of mental
shock absorbers. Instead of every pebble in life’s road feeling like a boulder,
I glided over them with grace. Sometimes, medication is exactly what the person
needs.
21.
It may take several weeks before an antidepressant starts to work
Don’t expect your beloved to “snap out of it” once
he or she is on medication. When prescribed, let’s say, fluoxetine (also
known as Prozac), the capsule is not filled with serotonin. It’s a
medication that rebuilds the serotonin receptors (among other things). That
rebuilding process takes time; how much time is different for each person. For
some, they start to feel better in a week or two. But lots of people take longer—up
to 6 weeks—before they feel the effects. So be patient.
22.
Friends and family who stick by them are treasured beyond words
Because of the alienation those with depression so
often feel, the friends and family who stick with them and weather their storm
of depression become their most trusted and appreciated allies. That kind of
loyalty can be life-saving.
Depression is at nearly pandemic levels world-wide,
so don’t hesitate to let others know these important points about depression.
The more we know and understand, the stronger we all are.
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