Some Basic Don'ts

I know, I'm supposed to balance the Dont's with the Dos.  But, a) Don'ts with depression are easier, and more universal, and b) relax, next week's edition is on the Dos.  I've got to maintain a little mystery, right?  Keep you coming back for more?  Or something.

Again, I really cannot speak for all persons with depression.  This is more about me and all the people I've known with the condition than the world at large.  But pronouns are tricky and not always as varied as I might desire.

I am going to do five of these, since that's a nice, round number.

5.  Do not take it personally if I don't seem terribly present.

As I've talked about in this note, depressives are taught early--and later internalize--that our tendency to be "sad" means we are self-involved.  This often creates a defense mechanism which turns us into people who automatically de-prioritize ourselves.  As such, when we are at all, even just a little bit able to be, chances are we're going to be the best person in your life for listening, empathizing, and trying to support you.

If you notice we've stopped really paying attention, say, we're nodding our heads but not responding the way we normally might, chances are a few things are happening.  Depression robs people of the ability to concentrate.  It might be taking us all our energy just to focus.  It's also possible that we don't have the energy to care at that time.  This is NOT personal.  It's not even close to personal.

We have stopped caring about OURSELVES.  We have stopped caring about everything that previously made us happy.  In my case, when I get to this point, if I COULD care about anything, it would be what's going on with my friends and family.  But I'm so far beyond that, it's generally all I can manage just to be physically listening/hearing.

You don't have to stop talking.  Just be compassionate if the response you usually get is unavailable.  And don't get mad because we can't be the person you need right at that moment.  At least in my case, I'm trying as hard as my little heart can manage.  Also, getting mad isn't going to get you what you need or want.  In my case, it's going to mean I withdraw emotionally from you long term, because I have learned you have no ability to consider my emotions, and because the last thing I have the ability to do at that moment is say, "Hey, I need you to realize I'm having a hard time right now and that doesn't mean I don't care about you."

4.  Do not let us disappear.

This is a hard one.  Especially if the depressive you know and are trying to be there for is an introvert.  Because that person NEEDS time alone to even have a chance of functioning in the rest of her life.

If the person is an extrovert, don't mess around: make sure that person is going out with you, even if you have to provide rides, or set up hanging out at her house with some friends.  This latter is a good way to handle an introvert if you cannot get her to come out: take food to her place.  It allows her the safety of her surroundings, and means that she's eating.  Depression can cause emotional over-eating, but it can also cause a complete lack of interest in food, ESPECIALLY if it has to be made.

I am someone who's really awesomesauce at making myself eat when depressed and last night I had a bowl of cereal and an apple for dinner because I couldn't rustle up the mental energy to actually figure out a meal plan and enact it.

A sub-tip to number four is, if you get to her house and basic things, such as taking out the trash, laundry, etc., need to be done, help.  DO NOT do it for her.  Unless you physically cannot drag her out of bed--in which case, call someone stronger than you, put her in your car, and take her to the nearest hospital--have her participate in some way.  It can be small.  You can have her sit down and sort the laundry.  Or walk with you to the curb with the trash cans.  Anything.  But force her to take part in her own life.  I am not saying this is easy.  She might be a total crab-ass at you.  Or say terrible things.  Or cry hysterically.

Get her some water or Gatorade, and make her participate in her own life anyway.

At the VERY least, call or text and check in with her.  Suicide happens, in my experience, when people reach a crucial clusterfuck nebula of two points: the sense that things are hopeless, cannot get better, and things will always be this terrible and painful, and that the world, even the people in it who love us, is better off without us, and things will be easier for everyone that way.

This is possibly the most important point of this post: nobody can stop another person from committing suicide.  At the end of the day, it is the person who takes that step's choice.  That said, letting a person know you care day in and day out, even if it's just by saying "hi, thinking of you," can go a long way toward slowing or even halting the cycle of "nobody needs me" thoughts.

If you can--and being the friend to someone suffering from depression is grueling, so if this means too much mental and emotional energy on your part, just don't--occasionally find a reason WHY you care about that person to mention.  It doesn't have to be epic.

A friend recently told me she needs me to hang on because she learns things from me.  That's an A++ reason.  Any reason that's real will help.  It won't FIX anything, but it will help.

3.  Do not expect miracles from medication and therapy.

Speaking of fixing...

In some people, these steps do cause miracles.  And if that happens to someone you love, be thankful, because miracles are rare and precious.  But if what you get out of that person is instead two days out of the week that are better than they were before?  Or the ability to communicate frustration where she could not before?  Take that and run.  And be proud when those moments happen.  Let the person KNOW you are proud, not only for the progress, but for being willing to get help, to try different things, when, frankly, it's one of the hardest things.

On Thursday, I went to my prescribing doc.  He really wishes I would go to the hospital, because I have hit the space where I genuinely have no capacity to believe life will get better than it is right now, and I have no interest in continuing on in this space.  Or, as I said to my therapist when she asked me if I planned on doing another triathalon, "The thought of being alive long enough to do that is depressing."

I won't go to the hospital because I cannot afford it, either financially or time-wise, and because all it would mean is a bigger mess when I come out the other side.  Additionally, I have a bunny who just got an ear infection, and I'm the only person who can take care of her the way she needs.  My bunnies are actually my last line of defense.  I remind myself regularly that nobody is going to take an almost nine year old and almost seven year old bunny and really pay attention to them and love them if I'm not around.

So, instead, my doc doubled my dosage.  If this doesn't work, the next step is putting me on a THIRD anti-depressant, co-currently.  Being honest, I sincerely doubt any of this will even take the edge off.  Changing meds hasn't worked the last two times we've done it.  I don't think it will now.  I don't think going to therapy is doing anything, because I've reached the point where there's nothing more to say: something I straight up told my therapist this week.  And that's the disease.  It tells me, in no unclear manner, that nothing I do will help, that things will always be like this.

And I believe it, because I have no other choice.  But I go to therapy and doctors because I know its the right thing to do.  If you know a depressive who constantly goes and does the work, at her worst, she's not doing it because she believes it will change anything.  She's doing it because she's supposed to.  Hug her and tell her she's doing a great job and you're proud of her for keeping it up, even when it seems hopeless.   Because, trust me: it does.

2.  Do not let us go silent.

This is another hard one.  For me, talking, really talking, when I'm like this, is a chore.  I'm tired of hearing my own voice in my head.  I don't have anything new to say.  I don't want to pretend to be happy.  Silence is my best option.

Which is why, once a week or so, it's important that someone find a way to get me to talk, even if I am saying the exact same thing.  Things haven't gotten better for me in two years.  They're unlikely to anytime in the foreseeable future.  I'm not going to have a lot that's new and interesting to say.

Ask leading questions and listen anyway.

It's like this: I may be tired of hearing my voice in my head, but that's not going to shut it up.  And a lot of the poisonous shit it says?  Is just plain better getting released.  When someone overdoses, we pump her stomach, because "better out than in."  Depression is the experience of constantly overdosing on hopelessness without any affirmative action on one's own part.  Someone's gotta go in and make us bring it all up every once in a while, because just like the drugs, if not as immediately, it will kill us.

1.  Do not, do not, do NOT, EVER, say the words "things could be worse," or "just cheer up," or any variation thereof.

I actually get that for some people this helps.  Those people are not chemical depressives.

Have you ever broken a limb, or had a bad flu, or cut yourself deep enough to need stitches?  Out of curiosity, did thinking positive thoughts about getting better hasten your healing process?  Because, if it did, you might have either mutant or angelic powers, and you should consider a career in televangelism, or something.

I can think all the positive thoughts I want.  Realistic ones, even.  Ones like, "I write well and research like a boss and have a really interesting professional and academic background: someone has to hire me sooner or later."  Or, "Lots of people meet life partners much later in life, things are just taking their time."  I can repeat them in front of the mirror every morning.  I can use them as a meditation, whatever.  My BRAIN does not believe them.  Because my brain does not function correctly.  Much like a broken arm, the essential function of my brain is in a state of disrepair and works on a basis of limited functionality.  The difference is, fixing a broken arm is a decently exact science at this time.  Fixing my brain?  Not so much.

As far as the "things could be worse" approach, let me quote something I saw on tumblr, the font of all true wisdom.  (That is a lie.)

"In breaking news, the person in the worst situation on planet earth was finally found and THAT person is allowed to be sad.  No sads for anyone else, though, ever."

Like I said, I realize that for non-clinical depressives, this sometimes helps.  I've met people who find it useful to think about the fact that they could, say, not have a home, or be going hungry, or be physically ill.  And I envy the crap out of those people.  Man, if I could make myself better by thinking about all the things that could be worse?  I'd be the world's happiest chickadee.

For a moment, though, let's take it for granted that I don't actually want to be so miserable all the time that I would rather be dead.  And from there, let's take the logical step that if it were that easy for me to feel better, I'd have already fixed the problem.  I talk in this note about how, not only is using this approach unhelpful, it's DANGEROUS.  It tends to cause a guilty reaction, which will not only make me stop talking--see point number two, this is NOT a good thing, it doesn't mean I feel better, it means I've been made to feel like my pain does not matter--but will stay with me, and very possibly trigger a cycle of even worse feelings of worthlessness than are usually an issue.

A sub-suggestion here is, "things will get better"?  Also not helpful.  I cannot convince myself of this.  You telling me it?  Feels dismissive, even if it is not intended to be.  And again, it makes me feel foolish for not being able to make my brain believe it, makes me feel like I should stop talking, like I should go away.  Away away.

So what DO you say to a person who's depressed?  *grins slyly*  Come back next week, mes amis.