Sunday, 1 September 2013

23 Ways to Deal with Depression
(If You Don't Have It)

It's not easy to live with/work with/be friends with/love/raise/whatever someone who has Depression. I would go so far as to say it's a bitch. That's right... Depression is a bitch! It's tough on you - but it's even harder for those of us who suffer from it. Trust me.

Many a time Drew (from Twisted Stitches blog) and I have raged against the people in our lives who "Just. Don't. Get. It." Yes, it would be nice if our parents, lovers, friends, bosses, coworkers, teachers, whatever understood Depression and why it makes us moody, unpredictable bitches sometimes. It would save us a whole lot of apologies, for sure. But, thinking on it, I don't know that I would wish that upon the "normal" people in my life. You don't understand Depression? Good. I hope you never have to.

Unfortunately, we do.

So to make everyone's lives a little easier, Twisted Stitches and Wondra's World have collaborated to create this handy list of 23 Ways to Deal with Depression (If You Don't Have It):

1. Know the difference between "I am depressed because something bad happened" and "I have Depression."
It seems obvious but it's really not. I can't count the number of times that someone has tried to relate to me by saying "Oh, I had Depression once when my mom died" or some other inane thing. You did not have Depression. You were depressed. There is a difference. You were depressed because something bad happened but, when good things started happening again, you were happy. People with Depression always have Depression, even when things go right. It may seem like all our wildest dreams are coming true - and we still feel like we're dying inside.

2. Don't ask them why they feel the way they feel. 
On the list of Things You Should Never Say to a Depression Sufferer, "What's wrong with you?" is pretty damned high. Hint: if we knew what was wrong with us, we'd be a lot closer to tackling our Depression once and for all. And, as one disgruntled Depression sufferer once said, "We don't fucking ask you why you're so fucking happy, do we?!"

3. You don't have to say "I don't understand."
Really, that should read: NEVER say "I don't understand." What a frustrating thing to say! If you missed it before, we know that you don't understand us or the way we feel. We kind of wish you did but are also glad you don't. For you to understand how we feel, you would have to suffer from Depression. We don't want that. We don't want anyone (ourselves included) to suffer from Depression. Unfortunately, we can't help that. But you... you can stop saying insensitive things. Please do.

4. Don't assume that they are "healed" because they seem happy.
One, we can seem happy and still be thinking about killing ourselves. Often the happier we seem, the harder we're trying not to let you see how much pain we're in. But, hey, sometimes we are genuinely happy. It happens. But it doesn't mean that our mental illness has gone away. It is still there, lurking, waiting for its chance to come back - and you know what? Even at our happiest, we're absolutely terrified of that happening.

5. Know that they might be thinking about hurting themselves. They may even do it.
Self-harm is a reality for people who suffer from Depression. Not everyone does it and not everyone does it the same way - you might not even notice it if he or she does. Maybe your daughter wears long sleeves a lot because she doesn't want you to know she cuts herself. It happens. Maybe your best friend stays in an abusive relationship because she thinks she deserves it. Maybe your sister drinks herself to sleep every night because night's are the hardest part of the day to make it through. Maybe the girl who sits next to you at work never wears skirts because she's pressed a burning cigarette to the flesh of her legs one too many times. It happens.

Self-harm takes many forms and happens for many different reasons. Sometimes we do it to punish ourselves because we hate ourselves that much. Sometimes we do it because we feel like we just can't keep the rage bottled up inside any longer and we have to let it out. Sometimes we do it just because it hurts less than the pain burning away in our chest.The only advice I can give you is this: don't judge him/her because, trust me, they're doing enough of that themselves.

6. Know that they think about killing themselves. A lot. 
It's impossible for anyone who has never suffered from Depression to understand how fucking hard it is for us to get out of bed (Why should I get out of bed? What's the point? Today is going to be just like yesterday. And the day before that. And the day before that. Nothing ever changes. I've been in this rut my whole life. What is the point of my life? Tomorrow I'll be old. The day after I'll be dead. My whole was a waste.), brush our teeth and shower (Why bother? No one is attracted to me. No one even notices me. No one will ever love me. Who could? I don't.), get dressed and walk out the front door (I hate these clothes. I hate myself. I'm too fat/skinny/ugly/whatever. People are going to look at me. People are going to judge me. I'm going to do something wrong, I just know it.), etc. And that's on a good day. All the worst thoughts you've ever had, every day. That's a lot of shit to deal with on a daily basis. But what's the alternative? Oh, yeah... Death. And sometimes that seems a helluva lot easier.

7. Do not hide sharp objects and/or pills from someone you love if they have Depression.
If someone that you love has Depression and are thinking about killing themselves, don't alienate them by removing the laces from their shoes in case they try to hang themselves. Trust me, if they have reached that point, if they have thought of nothing else for however many days on end, if death seems the only option they have left, they will do it. There's nothing you can do but give them a reason to want to live.

8. Don't assume that a suicide attempt is a "cry for help."
I won't deny that some people use a suicide attempt as a cry for help. There are a lot of people out there and it takes all kinds to keep this ole earth spinning. But, if someone you love is showing signs of Depression - especially if they've been seeing a therapist or have been taking an anti-depressant, or their behavior has become erratic - think twice before accusing them of downing a bottle of painkillers for the attention.   For starters, attention might be the last thing they wanted. They might be lying in a hospital bed, wishing the floor would split open and the world would eat them alive. They might just be wondering how long it will be before they can get home and try it again. A suicide attempt isn't a cry for attention on their part, its a second chance on yours.

9. Understand that not all pain is physical. 
And sometimes the wounds you can't see hurt the most. 

You can't imagine how much it hurts sometimes, just being. Just breathing. Have you ever thought about how much it takes just to draw a single breath into your body and release it? Gods but it's hard. And holding a smile on your face while other people are around? Exhausting. But none of that compares to the black hole of despair swirling in your chest, stabbing at you with doubts, insecurities, fears, hatred, anger, disappointment, disillusionment, self-loathing, etc. etc. etc. Stabbing you over and over and over again until you feel like you're a piece of Swiss cheese, with so many holes that your soul is seeping right out of your body. That kind of pain. Pain we bear too often in silence because we don't want to hurt the people around us by sharing it.

10. Learn that "I'm tired" doesn't mean "I need sleep."
Remember that black hole I told you about? People with Depression spend all day clinging to the edge of that black hole, desperately trying to claw their way back out - and that's on top of shopping, working, walking the dog, cooking dinner, balancing the checkbook, helping the kids with their homework, etc. "I'm tired" often means "I am so weary of this battle that I just want to let go and let the damned black hole take whatever is left of my life."

11. Do not - (repeat after me) - DO NOT tell someone with Depression that it's "all in their head."
We know that. We're not stupid, we're sick. Mental illness. That means that our minds are sick. Yes, we know that it's all in our heads. We know that somehow, we have done something terribly wrong and fucked ourselves up. (That's not necessarily true, of course, but that's how it feels to us.) Do not insult us by suggesting that if we could just recognize that's it's all in our heads, we would be okay because that is simply not true.

12. Never assume that "I can't" means "I won't." 
This is one I get a lot at work. Apparently my bosses are so ignorant of mental illness (or, more likely, have never had to suffer one themselves) that when I say "I just can't do that" they assume I mean "I'm too lazy to do that and don't want to." Dammit, people, open your fucking eyes! Better yet, look into mine. Do you see the fear behind them? The fear that I might come across a situation I simply cannot deal with and, when confronted with it, will break and lose myself completely and irrevocably? The fear that someone might say the wrong thing, because they just don't know better, and I'll start crying and won't be able to stop? Again. Something that might seem easy to you could be like climbing Mount Kilimanjaro for us. Let me put it this way: if my disability was physical, and I was in a wheelchair, would you laugh off my "I can't"? No. Think about that.

13. Never tell them that their response isn't logical. 
We're not stupid. We know that curling into a ball on the floor and crying for hours on end is not a normal reaction to accidentally dumping half a bag of dog food. You don't have to tell us. At least not until we're out of that black place and we've picked ourselves (and the dog food) off the floor. And, for the love of the gods and all that is sacred, try to be tactful about it if you must say it.

14. Learn their triggers.
Maybe your girlfriend/boyfriend/husband/wife/daughter/son doesn't know what his/her triggers are yet. I've been "recovering" from Depression for going on two years (my whole life, it seems) and I couldn't tell you what my triggers are. But my husband could probably tell you a few - because he sees things that I can't. If you have someone in your life who suffers from Depressioin, try to learn what their triggers are and, if they can't avoid them entirely, try to help them find ways of coping with them.

15. Don't assume, because you know what their triggers are, that you know what's best for them, even if they don't.
You could be the best meaning mother/father/husband/wife/whatever in the whole world but, when it comes to what would make us "better," you might not know shit. Accept it. Let me guess... You just know that if your daughter drops her job at the coffee shop and gets a desk job, if she swaps her bohemian lifestyle for that of Betty Homemaker, if she would just find the right man, everything would be okay and her Depression would go away. False. Her Depression may never go away, no matter how hard you, she, or anyone else tries. Constantly pushing her into something that is not right for her will make her worse, not better.

16. Just in case you didn't get that: DO. NOT. TRY. TO. "FIX THEM."
 Don't get me wrong, it's amazing that you care enough about the Depression sufferer in your life to want to make them happy - but you can't force it. You can't make them get help. You can't make them take anti-depressants. You can't make them "all better." Do what you can do: support them. Love them. Keep on caring. Don't push them away, or further into their black space, by trying to fix them.

17. If something makes them smile, do it again. If doing something makes them geniuniely happy, even for a moment, keep encouraging them to do it. 
My (second) therapist gave me the best advice anyone could: figure out what makes you happy and do more of it. Great advice - but hard as hell to accomplish when you feel like nothing will ever make you happy again. Help the Depression sufferer in your life with this one, remind them of the things that used to make them happy; maybe they'll make them happy again.

18. Don't assume that they're "all better now" because they're happy today.
We have good days and we have bad days. We have up days and we have down days. Some days we are actually happy! Sadly that doesn't mean that it's all over now, we're healed, we beat Depression, hooray! If only. It means that for one day (or ten or twenty) we managed to claw back enough of our lives to hold the Depression at bay. Best case scenario. You know what else it could be? It could be that we've gotten damned good at pretending. That's what learning to manage Depression is, you know, learning to smile when you're not happy because one day, some day, it might feel real.

19. Don't ask "How are you?" if you don't care.
People who suffer from Depression have spent a lot of time evaluating their mental well being. If you ask us how we are today, we'll actually think about how we are feeling today. (Don't take it personally, we get that a lot from our shrinks.) If you ask me how I am today, I'm likely to respond with a number: 5 means I'm doing pretty good, 4 means I'm functional, 3 means I'm teetering on the edge, 2 means I'm just waiting for that straw that will finally break me and send me back to that bad place and 1... Well, chances are you won't see me on a 1 day and, if you do, you won't need to ask how I am. Notice how 6-10 didn't make it on that list? That's because I don't see them often enough to make it worth mentioning. Depression suffers pretty much kiss our 10 days goodbye. I don't know if your son/daughter/husband/wife uses a scale or if they just say "fine." Beware of "fine."

20. Don't assume that "I'm fine" means "I'm fine." 
Because it probably doesn't. It's more likely to mean "I'm doing a very good job of pretending to be a functioning adult. Please don't look too closely or you'll see what a lie I am." Don't be afraid of asking someone with Depression if they're really fine - as long as you can cope with the answer.

21. Never say, "It'll be okay." 
Firstly, they're not going to believe you. Secondly, it's condescending. Thirdly, we've all seen enough medical dramas to know that line is almost never true. The only advice I could give to a friend recently, when she asked me if it was "going to be okay," was this: "No, honey, it's not. It's going to get a whole lot worse before it gets any better. But, if you're strong enough to make it to that later, it gets easier." That's the best I can offer. If you have to say something, stick with that. Maybe it's not going to be okay. But it's going to get easier, a little bit every day.

22. Ask if there is anything you can do.
This is not trying to "fix them." (Again... never, ever try to "fix them!") This is being as supportive as you can possibly be. Ask what you can do to make them smile. Ask if there's anything you can do to make it easier. Ask if they need a shoulder to cry on. Maybe they give you a straight answer, maybe they shake their head and do their best not to cry. But they are never going to forget that you offered.

23. Be there.
Just that. Just be there. Sit next to him/her, hold his/her hand. Give him/her a hug. Write him/her a note to say you're thinking about them. Just let them know that, no matter how it feels now, someone is there who genuinely gives a damn about them. Just be there.

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