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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

#191

Post by mirimir »

anonfunction wrote: post #182
megaman22 wrote: post #165

Earlier quoted context omitted.

See, this is exactly what I am talking about. It's evaluating a set of contingencies. Like, the general staffs of armies make war plans that they will never execute, unless the particular parameters fall in place, all the time. To do otherwise would be irresponsible.

I think what is missing is what set of circumstances would trigger you to execute your plans. If it’s “world wide epidemic which causes extreme pain and suffering with less than 5% chance of survival” that is one thing. However if you are planning your suicide in case you lose your job or your significant other cheats on you then that would be concerning and reason to seek help.

There's no need to imagine such an epidemic. We're all going to die. And sometimes that involves extended periods of pain and suffering, with no chance of survival. In civilized places, voluntary euthanasia is available. Elsewhere, one needs to plan ahead.

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

#192

Post by narag »

Jtsummers wrote: post #83
Magmatic wrote: post #72

Earlier quoted context omitted.

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.…

Excuse me if I stray out a little (I wholeheartedly agree with your comment) and ask you how is that your bed needs making. Are these things uncommon over there?

https://en.wikipedia.org/wiki/Duvet

I hate making my bed so I can't be happier now :)

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

#193

Post by chillwaves »

tomjakubowski wrote: post #156
Jtsummers wrote: post #83

Earlier quoted context omitted.

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.…

Your comment rings so true for me. I have had nearly the same experience with depression, talk therapy, and ritualistic self-care. > (I still suck at cleaning the shower often enough, and I never make my bed) I stopped using the top/flat sheet, which means "making the bed" is as simple as fluffing the pillows and shaking your duvet/comforter/quilt out over the bed. The flat sheet is responsible for probably 95% of th…

Keep in mind the flat sheet provides a barrier to protect your comforter from your gross body. Sheets are easier to wash than a comforter.

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

#194

Post by [deleted] »

astura wrote: post #81
RobertDeNiro wrote: post #26

Earlier quoted context omitted.

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…

[deleted]

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

#195

Post by 0xcde4c3db »

> A severely depressed friend needs professional assistance from a psychologist, psychiatrist, social worker or another medical professional.

This is an example of a troubling pattern often seen when talking about "depression". Depressed mood can be a symptom of numerous medical conditions. That means you need to write down all observed symptoms and see a doctor to diagnose or rule out those conditions. It's a bad idea to jump straight to psychology or psychiatry just because your most distressing symptoms are psychological. It's an especially bad idea to get committed to a psychiatric hospital with an undiagnosed chronic condition that psychiatrists don't specialize in treating.

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

#196

Post by mhink »

DoreenMichele wrote: post #175
questionsuch wrote: post #3

As much as I know all of these things, the attitude my loved one has has killed the love out of me. Constant negativity, agitation, it's just tiring. I just can't seem to not take it personal, and to have a mindset that it is the disease and not the person. I can't figure out how to start loving the person again.

If there are no children or other complications, I would not hesitate to leave. The relationship could be part of why the depression persists, and I don't mean that in a "it's your fault" kind of way. Some people just mix like oil and water. It is possible to leave in a nice way. My divorce followed telling him "I'm tired of hurting you. I'm tired of being hurt. I think we both really gave it our best. If we could do…

Thank you so much. I’m gonna need this way of explaining things very soon, it’s been eating me up inside.

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

#197

Post by whitepoplar »

A couple things that helped me when I was severely depressed and suicidal:

1) I can kill myself, at any time, if I want to. I'm in control and nobody can take that away. Paradoxically, understanding that made me feel better, because if I know I can do it at any time, why do it now? May as well wait a little while.

2) Make a checklist of essential tasks and get into a habit of doing those things no matter what. Some examples: shower, brush teeth, floss, use mouthwash, clip nails, walk 10k steps, do dishes, make bed etc. Check them off. It doesn't matter what's on the list, but it is important to check off 100% of the items each day. Put every small task you can think of on this list and you'll feel good when you check each of them off.

3) Take a good multivitamin + vitamin D

4) Eat healthier. Fresh steamed spinach and wild salmon always made me feel a little better for whatever reason.

5) Get out of the house! Walk! This is really important.

6) Go to the gym. Aim for at least a couple minutes of sprints per day (I like the rowing machine for this). Sprints are holy time in that suicidal thoughts will completely disappear, if only for those few minutes.

7) Walk through a dangerous part of town. Nothing gets rid of depressive thoughts faster than rising blood pressure and a fast heartbeat.

8) Get rid of as much decision-making as possible in your life. Turn decisions into mechanical rules. e.g. don't think "do i want to brush my teeth today?" You need to brush your teeth in order to cross it off your list.

9) Sleep will naturally improve on its own, over time, if you exercise, move around, and eat healthier, so don't worry if you currently have trouble sleeping.

10) This book is pretty good, but only read after you've eaten healthy, gone outside, and exercised: https://www.amazon.com/Guide-Good-Life-Ancient-Stoic/dp/0195...

What didn't work for me was: thinking about all the people i'd hurt, calling a hotline, any decision-making that wasn't mechanical and required reasoning, insight, or motivation.

If you're suicidal right now, start by putting some shoes on, going outside, and sprinting until you can't breathe anymore. Do this 3 times.

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

#198

Post by mirimir »

Someone1234 wrote: post #31
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…

If you're in the US, you may also wish to think twice before calling the cops on a loved one, particularly if they're only a danger to themselves (and not you or others). Police in the US rarely receive training[0] in dealing with suicidal individuals, and are instead trained to escalate the situation and or use violence for a resolution[1]. There are numerous examples of the police turning up on a suicide call and k…

Just saw on The Intercept:

> Police Broke Into Chelsea Manning’s Home with Guns Drawn — in a "Wellness Check"

She wasn't home. But the surveillance video is frightening. At least, it wasn't a SWAT team. But damn.

https://theintercept.com/2018/06/05/chelsea-manning-video-tw...

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

#199

Post by cup-of-tea »

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.

Sure but they make people feel good about themselves when they post them. Much like "liking" a Facebook post as a form of activism.

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

#200

Post by mendelsd »

ridgeguy wrote: post #138
mendelsd wrote: post #90

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 mor…

Yes. There is a subset of patients with depression who have either of two different genetic polymorphisms for methyeneltetrahydrofolate reductase. This may be causally linked to their depression. [1] Supplementing diet with a modified form of folate appears to diminish depression in patients with these particular polymorphisms. My understanding is that this is still a matter of controversy. [1] https://www.ncbi.nlm.n…

A few interesting things to note on this topic:

1) Prevalence of MTHFR gene variants you refer to is very high, e.g. 10%/50% for homo/heterozygous C677T SNP [1] (with frequencies varying substantially between ethnic groups).

2) Effects tend to be stronger with two copies of a variant (homozygous), but a single copy (heterozygous) may still be a concern, e.g. for C677T: "Individuals with the 677TT genotype, have approximately 30% the MTHFR enzyme activity of those with the 677CC genotype, whereas heterozygotes 677CT have around 65% of enzymatic activity" [2]

3) It seems odd to me that pharmacological dosages of folate are getting prescribed (I mean, it's a nutrient so why take it in doses that exceed the nutritional range?):

"The most active form of folate has recently been approved in the United States as a prescription medical food for depressed patients with folate deficiency. Doses are usually 7.5 to 15 mg/d". [3]

"Another concern is that folate doses > 800 μg/d can result in high levels of unmetabolized serum folic acid, reducing the amount of brain l-methylfolate and leading to decreased monoamines, an outcome that potentially increases the risk of or exacerbates depression." [3]

Folate RDA is 400-800 μg/d depending on pregnancy status [4]

[1] https://www.ncbi.nlm.nih.gov/pubmed/28847029

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3078648/#R6

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

[4] https://www.mayoclinic.org/drugs-supplements-folate/art-2036...

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