With one in five Australians experiencing mental health issues at some point in their lives, its almost inevitable that you will know one. But if someone close to you is depressed, how will you know and what will you do? The conversation surrounding mental health involves friends, families, fathers and sons, mothers and daughters turning to each other to discuss this complex issue. Learn how to talk to someone who is depressed and how to intervene with these expert tips.
By Annie Gurton, Psychological Therapist and Counsellor
There are several classic signs which indicate when a person is experiencing depression. One is when they say that they wake feeling tired, even after a long nights sleep. This is because the brain is so overwhelmed with thoughts that it is unable to properly process and ‘cleanse’ during sleep. Another classic sign is a change in behaviour. Where the person was previously cheerful and able to cope, they become irritable, withdrawn, appear unable to concentrate or enjoy life anymore, and often start to self-medicate with the use of alcohol or distracting activities.
If you ask them if anything is wrong they are likely to attempt to brush you off, although the more self-aware might say that they don’t feel themselves these days, and reach out for help. They may say they feel tired all the time (see above), or have more tangible physical symptoms like feeling sick and run down with headaches and muscle pains, or a churning gut and a loss or gain of appetite with corresponding change of weight. They may say that they feel overwhelmed and unable to cope, frustrated or guilty, that their previous sense of self-worth has evaporated and now they lack confidence, or find decision-making strangely hard. Or they are just plain miserable, sad and blue.
Their self-talk may take an unusually negative turn, with phrases like, ‘People will be better off without me’, or ‘I’m a failure’, or ‘I’m useless’, or ‘Life’s not worth living’, or, ‘Nothing good ever happens to me’. Their world becomes characterised by everything being about them, the negativity is permanent, and it affects everything in their lives.
HOW TO RESPOND
When people are depressed, sympathy doesn’t help. Neither does the tough-love approach, saying things like ‘Get a grip’, ‘You’ve got nothing to complain about’ or ‘Pull yourself together’. If the person could change, they would.
The best strategy is to offer empathy, and try and put your self in their shoes. Try and establish what it is in their lives that has happened or is happening now that is causing the depression, for depression does not come without any cause. There is always a reason. Sometimes it is a normal human response to some life crisis or change, such as unemployment, loss or a partner, or growing sense of loss of purpose and meaning in life. In that case it will either pass, when new purpose and meaning is found.
Sometimes it is because one or more of their basic human needs are not being met, such as the need for privacy, or the need for community, or the need for respect. There around around eight basic emotional needs, which are as necessary for good mental health as air, water and food are for our existence. Without these emotional needs being met we do not die, but we do experience emotional distressed in the form of anxiety or depression.
So often the first step with a depressed person is to determine which of their emotional needs are not being met and then see which of their innate resources can be utilised to help them back to emotional balance. Together with the needs these are called our Human Givens.
HOW TO INTERVENE
One difficulty with depressed people is that sometimes there is a growing tendency to find the condition comfortable and familiar, and to not want to change. If someone has been depressed since childhood (and many children whose parents are overly controlling can often have borderline depression), or even for several years, then it becomes a pattern which can be very difficult to shift.
We are pattern-matching animals – its the way our brains function, and we are perpetually looking for patterns in the world around us. We can become literally addicted to negative feelings and thoughts, and repeat the same unhelpful mental loops and social behaviours once they become established. An addiction to depression is quite common. We see it in traumatised people too – their responses and reflexes automatically revert to the traumatised or depressed state.
If someone is just mildly depressed, or there is good cause for their depression such as the breakup of a relationship, death of a family member or loss of work, distraction and occupation are frequently the best strategies. There are good reasons why early mental hospitals had gardening and farming activities attached. Ensure that the person is getting a good diet with plenty of B vitamins and iron, and plenty of exercise. A walk a day is the barest minimum – ideally, they should be doing some yoga, swimming and cycling as well as walking. Two or three exercise sessions a day is not excessive, and if they can be persuaded to do this, the brain chemicals generated will help hugely. Talk to them about The Depression as though it is a character (Winston Churchill has his Black Dog) and mentally separate the sufferer from the depression. Ask them what the depression makes them do, and how it serves them. This separation from the person and the illness can be very powerful.
If someone is seriously ill, cannot or will not get out of bed or has suicidal thoughts, or is self-harming (and alcohol abuse and eating disorders are categorised as self-harming), the best route is to involve a professional therapist. You can see a psychologist or psychiatrist with a referral from your GP, or you can see a psychological therapist or counsellor with just a phone call. No referral is necessary to see many very experienced counsellors and therapists.
Remember: the opposite of depression is not happiness, it is vitality, and everyone deserves to live a vital life.