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What to Do When a Loved One Is Severely Depressed

nytimes.com

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Re: What to Do When a Loved One Is Severely Depressed

#81

Post by astura »

RobertDeNiro wrote: post #26
spdustin wrote: post #9

I feel like this should be left here: Everybody you meet has a secret smile, and a secret pain. If your secret pain feels like a weight you can no longer carry, please talk to someone. Anyone. Lay down your burdens, and give your shoulders a rest. If you're in the US, there's the National Suicide Prevention Hotline: 1-800-273-8255 LGBT folks in the US might also consider The Trevor Project Lifeline: 1-866-488-7386 I…

Suicide hotlines are pretty ineffective as far as suicide prevention goes.

You're getting downvoted, but I am not sure that's really fair.

I've been thinking this topic today. I happened to lose a (young) family member to suicide a couple days ago and, shit, that bothers me immensely.

Every time the subject of suicide comes up the first thing that is said is "call the hotline," however, in the last couple days, I have been questioning if suicide hotlines are evidence based. I have zero idea if the topic even has been studied, or even if it could be studied. I wonder if our resources can and should be better allocated. I wonder if people are calling suicide helplines instead of calling their doctor.

Or even people are saying it just because it makes them feel good. Because preventing suicide is actually hard and telling someone to call a phone number is easy.

I'm just pondering right now, I have no answers.

Personal story: I called a suicide hotline once and it was extremely unhelpful. It was the opposite of helpful, it actually made things worse.

Re: What to Do When a Loved One Is Severely Depressed

#82

Post by metamet »

Someone close to me once shared this as the best representation of how depression feels to them.

It was really helpful in helping me understand in a way that I hadn't been able to before.

* http://hyperboleandahalf.blogspot.com/2011/10/adventures-in-...

* http://hyperboleandahalf.blogspot.com/2013/05/depression-par...

Re: What to Do When a Loved One Is Severely Depressed

#83

Post by Jtsummers »

Magmatic wrote: post #72
AnIdiotOnTheNet wrote: post #64

Earlier quoted context omitted.

I, for one, can count the number of times that talking to someone has helped my depression on 0 hands. That includes professionals. I don't know how other people who've suffered depression most of their lives feel, but I can't stand this advice. It reeks of being the lowest effort possible by someone who has no understanding whatsoever of what they're talking about and prefers to just parrot something that sounds goo…

I think the best talk I had from a therapist in the early aughts went, "In general, the only things we know that help with depression are: exercise, some sunlight, a little social interaction, and self-care; bathing, brushing your teeth, etc. Medicine can help some but results are inconsistent, talk therapy is rarely helpful." He spent two years just keeping me accountable on the little day to day things and while it…

I survived my deepest depression by showering and shaving every day. Then forcing myself to get dressed and go be with other people, even sitting in a coffee shop and feeling miserable, hiding it behind a smile and a book.

Being home, alone, unshaven, unclean, in an unkept house made me feel worse because of all the things I saw that needed to be done, and the isolation allowing me to think about that and only that.

A bit of tidying made my space feel better (less cramped) and a bit of tidying each day reduced the sense of burden compared to seeing the whole place as one big mess. Same for the self-care and other aspects.

Every undone thing is an extra stressor because it's an extra thing that you know needs to be done, but in a depressed state you do not feel able to do or that there is sufficient time to do (it seems overwhelming, even when in reality it's a small chore).

Being somewhat social (even as an introvert), being physically active and getting my sunlight, and maintaining a decently tidy home (I still suck at cleaning the shower often enough, and I never make my bed), have made an immense difference.

There's also the benefit of routine and ritual. That's part of what the showering and shaving did. I'm lying in bed and I haven't shaved yet, I need to shave, let's get up and shave. I have to do this, once it's done it's done and I can move on. Now I'm out of bed and I can maybe do something else or not, but the ritual helped force me out of bed and gave me even the chance to have a healthy day.

Re: What to Do When a Loved One Is Severely Depressed

#85

Post by ajkjk »

gowld wrote: post #46
ajkjk wrote: post #42

Earlier quoted context omitted.

Why should he want to? When I was very depressed I would have hated nothing more than being made to watch 8 hours of something meaningless to me. What helps (I would think) with depression would be things like "fitting in", "feeling valid", "feeling purpose", "not feeling shame", ""not having social anxiety", "sleeping well", "being fit", "having a healthy community", "having fulfilling hobbies", "having a healthy fr…

You listed a pile of goals, not tools. Understanding how depression works can be a tool.

I'm not saying that a depressed person wouldn't want to understand how depression works, just that they don't necessarily want to, and it's wrong to be annoyed that they don't.

Re: What to Do When a Loved One Is Severely Depressed

#86

Post by emptybits »

danschumann wrote: post #60

One thing that helped me was seeing depressed thoughts as transient entities, not belonging to me, but just passing through my mind once and a while. It's like a weird dream. If you have a weird dream, you don't think, "oh I'm weird", you think, "that was a weird dream". It's the same with depressed thoughts: if you see them as "oh that's a depressing thought", rather than, "I'm depressing", then it's easier for thos…

FWIW, this is a common paradigm taught by instructors of meditation. That is, thoughts in general are transient and not something to necessarily identify as "me" nor to assign undue importance. Notice thoughts come and go and return to the breath.

I am not qualified to suggest that meditation is beneficial specifically for depression, but I think there is sufficient evidence to advise the practice in general.

Re: What to Do When a Loved One Is Severely Depressed

#87

Post by astura »

viburnum wrote: post #74

Good stuff, but I've learned the hard way that most therapists have no idea what they're doing. If someone is not feeling better after 6-8 sessions, they need to get a new therapist. It's all too easy to get into a codependent relationship with a therapist that only enables the depression or anxiety to persist.

I had a therapist that once suggested taking herbs for an non-treatable medical issue and another time antibiotics for a cold.

I can't believe I actually paid money to see her.

Re: What to Do When a Loved One Is Severely Depressed

#88

Post by tylersmith »

astine wrote: post #57
mywittyname wrote: post #53

Earlier quoted context omitted.

I suspect this is a driver of the increased suicide rate. People are afraid to tell others because they don't want to deal with the police/authorities, so they don't get the help they need. My sister attempted suicide as a teenager and the police that responded spent hours ransacking our home and further tormenting my family for no good reason. Then to think of her being locked up in the hospital (I wasn't able to se…

As a person who lives in the US, this isn't something that I would generally think of if I were considering whether to tell someone that I was planning suicide. Reading your account however, maybe it's something I should be worried about.

Telling anybody associated with the government that you're thinking about suicide instantly triggers a type of panic. I think it's very similar to the situation with drug overdoses, where calling for help can often get you into additional trouble. It's very likely, IMO, that there are people who have suicidal ideation but won't talk about it because they don't want to get committed, or worse. Then they don't get any help or advice and feel even more alone and do something that may have been preventable if they'd not been too scared about the consequences of openly talking about it.

Re: What to Do When a Loved One Is Severely Depressed

#89

Post by koube »

AnIdiotOnTheNet wrote: post #64
spdustin wrote: post #9

I feel like this should be left here: Everybody you meet has a secret smile, and a secret pain. If your secret pain feels like a weight you can no longer carry, please talk to someone. Anyone. Lay down your burdens, and give your shoulders a rest. If you're in the US, there's the National Suicide Prevention Hotline: 1-800-273-8255 LGBT folks in the US might also consider The Trevor Project Lifeline: 1-866-488-7386 I…

I, for one, can count the number of times that talking to someone has helped my depression on 0 hands. That includes professionals. I don't know how other people who've suffered depression most of their lives feel, but I can't stand this advice. It reeks of being the lowest effort possible by someone who has no understanding whatsoever of what they're talking about and prefers to just parrot something that sounds goo…

I was always a bit skeptical that just posting a phone number helps people, although it must have helped some people at least.

But besides that, what is there to do? Is depression even something that can be helped with?

Re: What to Do When a Loved One Is Severely Depressed

#90

Post by mendelsd »

Ensure they are getting adequate folate, noting that normal blood levels may not indicate functional sufficiency [1][2]:

"Folate deficiencies may lead to an increased risk of depression and poorer antidepressant treatment outcomes..."

"...deficiencies may be caused by improper absorption and utilization, often due to genetic polymorphisms."

"Supplementation with the active form of folate, (methylfolate), which is more readily absorbed, may be effective in the prevention and treatment of both depression and dementia."

"...(methylfolate) indicated efficacy as adjunctive therapy or monotherapy in reducing depressive symptoms in patients with normal and low folate levels..."

[1] https://www.ncbi.nlm.nih.gov/pubmed/19909688

[2] https://www.ncbi.nlm.nih.gov/pubmed/17900207

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