Much of This is Spot On… but… Advice From the Other Side

Friends of the depressed and mentally ill, take heed. I saw this article from the NY Times posted on Twitter and it’s so very spot on, and trust me, I know.  I turned to a whole cadre of supposed friends when things turned dark.  Friends who claimed to be there no matter what, demand your attention for their drama, but who turned and ran, taunting me with “you’re crazy” when I needed them most.  Then there was another cadre of friends who listened, offered advice, still listened when I insisted they were sick of my crap, and moved heaven and earth to find me when I attempted suicide.  There is a right and wrong way to deal with a loved one in mental pain.

The number one thing that people who have not walked a mile in my shoes need to realize is that those who attempt suicide, whether they succeed or not, don’t do it from selfishness.  They don’t do it to get back at you.  They do it because they are in so much pain and they just know they are such a burden to those who love them that suicide is the only reasonable action.  Our diseased brains tell us that and that belief is so strong that we can’t see any other way.

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So read on and I’ll share more below.  Oh, and the items that are bolded are not original from the article.  I bolded them to highlight the points being made.

Reports of Kate Spade’s suicide and struggle with depression have transformed her from symbol of polished prep to a blunt reminder that suffering affects all types.

Her death has inspired hundreds to tweet some version of the same message: Mental illness is nothing to be ashamed of.

But deep in the comment threads, some also debated a more uncomfortable question: What do you do when a friend is depressed for such a long time that you’ve started to feel that that nothing you can do will make a difference, and your empathy reserves are tapped out? There are no easy answers. But here are some tips from experts:

Don’t underestimate the power of showing up.

You may not feel that your presence is wanted. But just being by the side of someone who is depressed, and reminding her that she is special to you, is important to ensuring that she does not feel alone, said Dr. Norman Rosenthal, a clinical professor of psychiatry at Georgetown University School of Medicine.

If she acknowledges she’s depressed, that’s a good sign, said Dr. Rosenthal. He recalled the story of a patient who stopped feeling suicidal after telling people he was close to how he was feeling.

“When you shine the light on the shame, it gets better,” Dr. Rosenthal said.

Don’t try to cheer him up or offer advice.

Your brother has an enviable job and two lovely children. He’s still ridiculously handsome even though he hasn’t gone to the gym for six months. It’s tempting to want to remind him of all these good things.

Not only is that unlikely to boost his mood, it could backfire by reinforcing his sense that you just don’t get it, said Megan Devine, a psychotherapist and the author of “It’s O.K. That You’re Not O.K.”

Your job as a support person is not to cheer people up. It’s to acknowledge that it sucks right now, and their pain exists,” she said.

Instead of upbeat rebuttals about why it’s not so bad, she recommended trying something like, “It sounds like life is really overwhelming for you right now.”

If you want to say something positive, focus on highlighting what he means to you, Dr. Rosenthal advised. And though offering suggestions for how to improve his life will be tempting, simply listening is better.

It’s O.K. to ask if she is having suicidal thoughts

Lots of people struggle with depression without ever considering suicide. But depression is often a factor.

Although you may worry that asking, “Are you thinking about killing yourself?” will insult someone you’re trying to help — or worse, encourage her to go in that direction — experts say the opposite is true.

“It’s important to know you can’t trigger suicidal thinking just by asking about it,” said Allen Doederlein, the executive vice president of external affairs at the Depression and Bipolar Support Alliance.

If the answer is yes, it’s crucial that you calmly ask when and how; it’s much easier to help prevent a friend from hurting herself if you know the specifics.

Take any mention of death seriously.

Even when a person with depression casually mentions death or suicide, it’s important to ask follow-up questions. If the answers don’t leave you feeling confident that a depressed person is safe, experts advised involving a professional as soon as possible. If this person is seeing a psychiatrist or therapist, get him or her on the phone.

If that’s not an option, have the person you’re worried about call a suicide prevention line, such as a 1-800-273-TALK, or take her to the hospital emergency room; say aloud that this is what one does when a loved one’s life is in danger.

In some cases, calling 911 may be the best option. If you do, ask for a crisis intervention team, Mr. Doederlein urged.

But remember that interactions with law enforcement can vary wildly, depending on race and socio-economic background. In cases where you’re concerned that calling police could put a person in danger, try to come up with an alternate plan in advance.
Make getting to that first appointment as easy as possible

You alone cannot fix this problem, no matter how patient and loving you are. A severely depressed friend needs professional assistance from a psychologist, psychiatrist, social worker or another medical professional.

Yeah, you know. You’ve told your boyfriend this, but it’s been months — or maybe even years — and he still has not set anything up.

“You can’t control someone else’s recovery,” said Kimberly Williams, president and chief executive of the Mental Health Association of New York City. But you can try to make getting to that first appointment as easy as possible.

That might mean sitting next to your friend as he calls to make the appointment, finding counseling that he can afford, or even going with him that first time, if you’re comfortable with it.

What if you’re not sure whether you should start with a therapist or a psychiatrist, or whether you’ve found the perfect person? Ask around for recommendations, and know that one practitioner may ultimately lead to another.

But don’t overthink it. The key initially is just getting a professional involved so you are not the only person managing this situation. (That said, if that first appointment seems really unhelpful, trust your instincts and find someone else.)

Take care of yourself and set boundaries.

When the thoughtful and kind people we’ve loved for years are depressed, they may also become uncharacteristically mean and self-centered. It’s exhausting, painful and hard to know how to respond when they pick fights or send nasty texts.

“You don’t have to attend every argument you are invited to,” Ms. Devine said.

Still, just because someone is depressed is not a reason to let their abusive behavior slide. Set clear boundaries with straightforward language such as, “It sounds like you’re in a lot of pain right now. But you can’t call me names.”

Similarly you may find that your friend’s demands on your time are starting to sabotage other relationships or your job. You’re not going to be able to help if you’re not in a good place yourself.

It’s O.K. not to be available 24-7, but try to be explicit about when you can and cannot help. One way to do this, Ms. Devine advised, is to say: “I know you’ve been really struggling a lot, and I really want to be here for you. There are times that I physically can’t do that.”

Then come up with a contingency plan and kindly push her to stick with it. Coming up with a consistent schedule for when you’ll see each other every week can be helpful to you both.
Remember, people do recover from depression.

It can be hard when you’re in the middle of the storm with a depressed friend to remember that there was a time before, and hopefully an after, this miserable state. But it’s essential to remind yourself — and the person you’re trying to help — that people do emerge from depression. Because they do.

I have seen it. Every single one of the experts quoted here has seen it, too. But it will take patience and time.

I know that I was utterly exhausting to my friends and family.  Those who turned away only reinforced my feelings that no one cared.  I knew what I had, what my blessings were.  I also knew that I was a huge burden to them and they would be much better off without me, and that I didn’t deserve them.  Telling a depressed person to “just think happy thoughts” or “just snap out of it” is as ridiculous as telling a person with cancer to think happy thoughts to fight their cancer, or telling a person with heart disease to just snap out of it and they’ll be well.  Telling a person with anxiety “oh come on, how bad could it be” or “what’s the worst that could happen?” is also ridiculous.  That person, the anxious one, has already thought about the worst that could happen and then gone beyond that.  Don’t do it.  It makes you look tone deaf and uncaring.

Piling on the “Oh my God, how selfish can she be to commit suicide” crowd only makes people with depression clam up and put on that smiley face.  It isn’t selfishness.  It’s selflessness.  I know my thoughts were to fix every wrong I perceived I did to those I loved by taking their biggest problem out of the equation – me.  I knew beyond a doubt that they would be happier and less stressed with out my existence.

Three years later I’m in a much different state of mind.  I suffer from depression and I have for a very long time.  It will never go away.  I can’t think good thoughts and make everything happy again.  My brain, an organ in my body, is sick.  I treat it with medications and therapy.  It’s no different than any other sick person…

THE ONLY DIFFERENCE IS THAT A PERSON WITH CANCER, HEART DISEASE OR DIABETES ISN’T MADE TO FEEL ASHAMED TO HAVE THAT ILLNESS.  THE MENTALLY ILL PERSON MOST DEFINITELY IS.

Those of faith, please don’t shame the mentally ill person by telling them more prayer will help, that if their faith was stronger they wouldn’t be depressed or that it’s just nihilistic nonsense.  I can’t speak for all, but I have a strong faith.  I spent days, months, years begging God to help me.   Your judgment of their faith is NOT helpful.

One last note:

Perpetuating the myth that the mentally ill are, as a group, a danger to other people and should be feared still happens.  No, a depressed person isn’t a danger to others, but they are to themselves.  An anxious person isn’t a danger to anyone.  Bipolar, schizophrenia, etc. are the same.

The people who we call “crazy” and “mentally ill” that are an obvious danger to others, the sociopath, the psychopath, aren’t mentally ill.  They suffer from personality disorders, and my therapist said there is a difference (she has a bit more education that I do on the subject, so I’ll take her at her word!).  They, unfortunately, drag the rest of us into their lump and all those who are mentally ill are shunned, feared and mistreated.

So please, let’s not just sweep this subject back under the rug until another celebrity ends their own life.  I guaranty you that you know someone struggling with mental illness.  Be there for them.  Help them get help.

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Because they aren’t “fine”…yet.

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