Caring for someone with depression: Netdoctor Article

After a lot of research online, I've come across a great article directed at Supporters or Carers of those suffering from depression. Let me be absolutely clear - I did not write the following article and I am nothing like clever enough with blogging to have worked out how to embed the article!

The link is at the bottom for those wishing to view the article on the netdoctor website and comment there. There are also links to other related articles if you would like to read more.

I hope it is of help to you. I think the most important point for me was the reminder to look after myself first. It's really easy to fill your time with everything else in life rather than make time for yourself. I have certainly forgotten that in recent weeks and, in hindsight, I think it's beginning to show in my mood. Unfortunately I can't quite manage to jet off to Paris for the weekend, nor can I squeeze in a relaxing spa day, but I can certainly get out the house for a coffee/walk in the drizzle/jump in the bath with my headphones in!

Take care of yourselves folks.

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"Depression can touch all of us

Depression is a surprisingly common disorder. Something like one in every five adults will suffer from it during their lifetime. Two million new cases are diagnosed every year in the UK.

The condition affects all age groups, though women are twice as likely to experience it as men.

There is also evidence that depression has become more common in recent years largely due to the increasing levels of stress that we are all confronted with on a daily basis.

Many factors contribute to the onset of true clinical depression. But whatever the cause, it all boils down to this: at some stage and to some extent, you, personally, are probably going to need to care for someone close to you with depression, even if you are lucky enough never to suffer from it yourself.

Caring is a vital role
It is far from easy to care for a depressed person. The results and rewards in the long term are usually wonderful, but in the initial stages it is often an uphill and thankless task.

Your role as a carer requires immense patience and perseverance, but ultimately it could prove essential to a person's recovery and could even save someone's life.

However sympathetic and up-to-date the doctors and nurses may be, they simply cannot be there 24 hours a day to observe every small alteration in someone's behaviour or mood. But this is where you, as the carer, can help.

Barriers
Depression is different from most medical conditions in that sufferers with depression rarely seek or welcome support.

Typical of the disorder is a conviction of guilt and worthlessness, poor self-esteem and apathy.

Together with emotional numbness, self-imposed isolation and pervasive gloominess, the depressed person's state of mind is very hard to get through to; you may find it hard to get your offers of help and support accepted.

Moreover, depression, regrettably, remains stigmatised by society.

It seems perfectly acceptable to be off work and incapacitated by a broken leg, but not with depression.

But if the carer has a good understanding of the symptoms of classical depression and knows how best to deal with them when nobody else wants to know, many of the barriers which depression erects in the face of assistance can be overcome.

Recognising depression
Depression comes in different forms.

Sometimes it is a reaction to some sudden and unexpected life event (acute depression), but it can also come on gradually for no obvious reason.

In both types certain symptoms are evident. Low, despairing moods and tearfulness are common.

There is a general loss of interest in work, hobbies and pastimes. Emotions are blunted and life doesn't seem worth living. Their concentration may be poor and their memory unreliable. Anxiety and restlessness are common.

In severe cases there may be delusions, hallucinations and suicidal thoughts or impulses.

Physically, waking up in the night or early in the morning is typical.

There may be a loss of appetite and weight, constant tiredness, hypochondriasis and reduced libido.

In bipolar depression, otherwise known as manic depression, the depressive symptoms alternate with mania – where high moods, excitement and elation give sufferers excess energy, rapid speech, less need for sleep and wild, racing thoughts and impulses.

In postnatal depression, which affects up to 15 per cent of women up to two years after childbirth, strong feelings of isolation, inadequacy, exhaustion and alienation from their baby are common.

What not to say
Well-meant comments like 'you can't be sad, you've everything to live for' and crass ones such as 'pull yourself together' and 'snap out of it' are totally unhelpful.

A depressed person does not have the ability to 'snap out of it'.
Nobody chooses to be depressed or gains anything from the symptoms, and if they only could just 'snap out of it' they certainly would. Sensitivity and patience are paramount.

Offering support
Start by talking to the depressed person about their problems and feelings. Approach it sympathetically and listen carefully even if what they tell you is patently not true or painfully misguided.

Try not to offer bland, groundless reassurance or spur-of-the-moment advice, and encourage them to talk to their GP. Accept the way they see the world at present – you won't be able to change their mood through logical argument, much as you may want to.

Reassure them however that medical treatment is very effective and that there really is light at the end of the tunnel. Once you've talked, keep in regular touch, be available and see if there is any practical help you can provide right now.

Accompany them to the doctor's appointment if it helps, but don't be tempted to take over completely – a person with depression is going to need to make decisions for themselves again as soon as possible.

Monitoring progress
Remember that it is going to take just as long for the patient to get well again as it may have taken to become gradually depressed. So keep an eye on them frequently and assess progress.
If you're worried they've taken a turn for the worse, call their doctor.

You may also be in a good position to make further appointments, collect and deliver prescriptions, dish out the correct number of tablets, observe any side-effects and reinforce any on-going psychotherapy.

While medical treatment is best left to the doctors, there is no reason why a carer cannot introduce the patient to complementary therapies if appropriate.

St John's wort is one of the best researched herbal remedies, with some reasonable evidence supporting its use in depression. Yet current NICE guidelines do not recommend its use because of these on-going concerns about appropriate doses, duration of effect, variation in preparations and potential for serious drug interactions.

Pet therapy, reflexology and aromatherapy for example are all great ways to relax, as well as being gentle and safe.

Threats of self-harm or suicide
Some 3000 suicides a year occur in England and Wales as a result of depression, so never take suicidal gestures or thoughts lightly.

Many attempts at deliberate self-harm are simply a cry for help but they often signify serious depression and need to be referred for urgent professional help.

If the person concerned suggests that they have ever contemplated 'ending it', or spoken of how they might do it, you cannot take on this responsibility alone. You need to obtain immediate help.

Emergency and crisis
Life can be full of unexpected hard knocks for everyone; for a depressed person, it doesn't always take much to push them right over the edge.

In an emergency situation, call their GP, the Samaritans (08457 90 90 90) or take them to the nearest casualty department.

Sometimes a psychiatric nurse or doctor can even visit them at home, especially if they are already receiving treatment from a hospital team.

Some hospitals have Crisis Management Centres on constant standby just for these sorts of situations.

Your needs

Caring for someone with depression can be rewarding but it is also arduous and taxing. A devoted carer can easily get sucked into the situation, to the extent that their own health and welfare begins to suffer.

So, step back and delegate some of the support to others. If you don't look after yourself you'll soon become unable to look after your 'patient', so getting exhausted helps nobody.

Ensure adequate sleep, rest and exercise and refer to professionals whenever and wherever appropriate.

Other sources of help
There are many sources of help and support for depressed people and those who care for them, with some of the most notable being the Samaritans, MIND and Cruse Bereavement Care.

Carers, in combination with these charities, doctors and nurses, can combine to make an essential contribution to helping a depressed person overcome their disorder and feel well again."

Read the whole article here

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Life is a Rollercoaster

There's the old cliché that life is a rollercoaster. And although it sounds like something that should be on some motivational poster, it is never truer than when you have depression in your life.

One of the things I am finding particularly hard is adapting to the ups and downs. Although in general my Sufferer is doing far better than he was, there is still the feeling of taking steps forward and then back. Of course, that's entirely natural. Depression doesn't go away overnight. If anyone tries to tell you otherwise, they're reading far too many motivational posters!

My problem is trying not to take the blips, bumps and backwards steps personally. I don't handle them too well so far. Nor do I seem to be able to maintain any sense of perspective. It's as if we've dropped off the edge of a cliff rather than having encountered a familiar little bump on the road.

Perhaps my problem is that I am an optimist - or at least I try to be. I am always looking for hope to cling to. When things are going well, or at least improving, I have hope. I pin all my hopes on this being the beginning of the next big step in the right direction.

I know I shouldn't. How do I stop this? Will it just take time? Practice? Should I be more pessimistic so that I can always be pleasantly surprised?

I'll figure something out!

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Dog-fighting

Arguments happen. No matter whether you live with a Sufferer of depression or not. They are inevitable and, in fact, often a sign of a healthy relationship apparently.

However, I find myself running round in circles sometimes. Arguments that I know aren't going anywhere but won't come to an end. They follow a pattern. I can sense the descent into a downwards spiral but I can't do anything to change it.

I try logic, reasoning, shouting! Nothing works. I tell my Sufferer what's happening. He takes offence and the argument takes a turn in another direction. It's self-perpetuating.

And the worst of it is knowing that it will swallow up all available time and energy - like a black hole - and it will just spit me out at the end. Spent. As if I had nothing better to do.

Today, I worked out why this keeps happening. I'm not arguing with my partner. I'm arguing with a black dog that lives with us. No matter what I say, he can't hear me. The black dog has taken over. He is powerless to push the black dog away. He can't hear me. And, when backed into a corner, a dog's only response is to attack. And so it does.

We have talked about this and can't find a solution to avoid it happening again and again. All we can come up with is my Sufferer needs to try to find a way through the dog. Not easy when the black dog's presence is all-encompassing. Alternatively, he may, perhaps, try to put his trust in me when I tell him I can see what's happening.

If it were the other way round, I really don't know if I could do that.

I'm sure we're not alone in this predicament. I do wonder if anyone has found a way to overcome this facet of depression though.

Feel free to share your advice.

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10 Things that might just help with Depression

 

Here are some of the things you can encourage your Sufferer to try, in order to keep on top of depression. Some of them we've mentioned before but here they are, all in one place.

In no particular order!

1. Routine - To avoid feeling as though one day is just a continuation of the day before's drudgery, it's good to establish *some* sort of a routine. I realise that's easier said than done some times! But it makes sense that a bit of routine will give shape to the days and weeks so at least they don't blend into each other. I'm going to try to do this with my sufferer as we have virtually no routine from day-to-day or week-to-week!
2. Goal-setting - Start small but start nonetheless. Depression leaves the sufferer feeling incapable so each day that trickles by with nothing accomplished only makes it worse. Setting a goal - even if it is something as basic as loading the dishwasher every day - begins to fight that sense of uselessness. And, as each goal is achieved, their coplexity can be increased to slowly bring your Sufferer back up to speed.
3. Exercise - Healthy body, healthy mind. Very true. But better than just that, the chemicals released in the brain when we exercise - endorphons - are nature's natural highs. They make us feel better by flooding our brains with loveliness. Exercise can also tie in very well with forming part of a routine and with your sufferer's goal-setting.
4. Food, glorious food - avoiding lots of fat, sugar and caffeine can help. Also, eating bananas promote feel-good chemical production. There has been research that suggests that a low-carbohydrate diet is not helpful for depression and rather eating a good amount of carbohydrate by way of rice and pasta (not so much from potato) is beneficial.
5. Sleep - Get enough of it but don't get too much. That goes for both you and your Sufferer. Napping during the day isn't usually helpful. If you can get your routine in place, sleeping should form a part of that. If your Sufferer struggles to sleep, try to avoid watching TV/using a laptop in bed. Keep the bedroom as your sanctuary for sleeping only. (Well, and for baby-making practice - that counts towards exercise!)
6. Responsibilities - Make sure your Sufferer has some. My Sufferer has been struggling with work but is beginning to take on responsibilities at home, over and above those I refuse to ever adopt myself! [Bins are a boy job!] Tie these in with your routine and goals.
7. Negativity - Trying not to let it take over is hard enough. What your Sufferer needs to try to do though is focus on their negative thoughts in order to rationalise them and then, eventually, find a different way of looking at them the next time they crop up. Mindfulness courses might help - my Sufferer has undertaken one recently but only time will tell if it's going to help him to think differently!
8. Medication - There are many different anti-depressants available now which can help to avoid the very lowest of lows. They tend to keep the Sufferer on an even keel. There are other supplements thought to help such as Omega-3 and folic acid which you could talk to your doctor/pharmacist about.
9. Try something new - anything goes really! This is a tricky one though. Although there's a lot to be said for the feeling of satisfaction we derive from trying something new - excitement, satisfaction - for a sufferer of depression, the perceived risks associated with it and their generally negative outlook can make this impossible. If they can be persuaded though, there are rewards to be had.
10. Fun - It sounds glib to suggest you tell your Sufferer to try to have fun. Depression's main aim can often seem to be to strip the joy and fun out of the Sufferer's life, leaving it devoid of pleasure and happiness. Try really hard not to let it. I've noticed that we're having more fun lately - just silly stuff like dancing around the kitchen with the kids or laughing at silly pictures on the internet. It all helps release a few more blobs of happy chemicals in the brain. And we ALL need as much of that as we can get!

I'm going to start implementing some more of these suggestions tomorrow - starting with drawing up some kind of schedule/routine with my Sufferer. I'm hopeful this will provide the framework for a lot of the other elements to slot in to. Here goes!
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The Rain

To My Very Own Sufferer

I hope you know that I'll hold your umbrella.

It may be a shower, a downpour or even a monsoon.

But I will still love you.

My arm will get tired sometimes and that will make me grumpy.

I won't blame you. 

Sometimes I might get too tired and I'll drop the umbrella.

We'll both get wet.

I'm sorry. 

We'll never make the rain go away.

So we'll sit on our bench.

And I will still love you. 

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GUEST POST: "I can’t be bothered" by My Sufferer

My Sufferer has taken the time to write a guest post for us. It's important, as a Supporter, to have as much understanding as possible of depression in order to fight it with a united front. I hope you gain something from reading the following:

"I can't be bothered" 

This simple phrase, mostly spoken internally and not out loud – convenient excuses work so much better, is something that is/was (hopefully not will be) repeating over and over like a broken record in my head. From the mundane to the exciting, from miserable to (usually) pleasurable, no activity is safe from the inhibiting nature of this refrain. 

It is incredibly tough to deal with, and even harder to explain to others, how, without any forewarning, trigger or indication, the world can almost be closed off to a sufferer of depression as they sit mired in the fog of their own negativity.

One of the difficulties of being a depressed person is dealing with an accusation of avoidance of doing things no one ‘wants’ to do i.e. chores, work, etc. What others don't see is the avoidance of activities that the sufferer also does ‘want’ to do – hobbies etc. The picture that can then be built up of the depressed person is one of laziness and selfishness – accusations that serve to reinforce one’s own sense of low worth.

These accusations are things I have dealt with, and still deal with from some quarters. Depression is used as such a wide ranging term it is difficult to separate fact from fiction and something that my partner, until recently, didn't really understand. Growing up, and for much of her adult life my partner has always been a ‘pull yourself together’, ‘just get on with it’ type of person. To a true sufferer of depression (not someone who is just a bit down) this is akin to learning to breathe underwater.

I am thankful to my partner for undertaking this 31 Days of Writing as it is leading to a deeper understanding of the issues I face, and giving us the opportunity to turn from fighting each other over ultimately trivial matters to fighting my depression together.

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Mirror, Mirror...

Today was one of those days when I just couldn't get anything done. Not that I could be bothered to even try. I've been fighting off a lurgy for over a week now and it seemed to finally take me down today.

What was interesting was that my sufferer seemed to suffer some reflected lack of motivation - as if my sloth-like response to this virus was contagious. Don't misunderstand - he didn't suddenly tumble back down the hill into some pit of darkness. He just couldn't seem to get started on almost anything.

I used my usual nudging techniques to point him in the right direction but to no avail.

When we talked about it at lunchtime, he pointed out that he finds it a real struggle when I'm out of action. I don't micro-manage his time to ensure he gets things done - far from it. I try very hard to leave him to his own devices. For some reason, though, he can't kick-start his day if he knows I'm not up to much.

Is this the essence of co-dependence? It seems like something other than that. But I'm not sure exactly what! Is it just an excuse for having a lazy day too? Can it be overcome? How?!

Reflecting on the day that's drawing to a close, my sufferer has actually been pretty busy. EVen if he doesn't realise it. He has cared for our young boys, made lunches, cooked dinner, read stories, written a guest post for me (without being asked!), tidied a mountain of toys away, bathed the  boys and done the bedtime routine. Not bad at all really.

Maybe it's more about feeling unproductive than actually being unproductive. Damn those pesky feelings! ;)

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