The Truth about Depression BBC Full Documentary 2013
Self-harm – difficult times for you and your family
Depressive illness is debilitating and exhausting for the sufferer. It also has a very powerful effect on carers and loved ones. It is difficult to go on caring and being positive in the face of continuing negativity and inertia from the person who is ill – no matter how much you love them.
It is terribly important to recognise that carers and loved ones need care too. It is vitally important that the carer cares for themselves – it is not selfish, it is essential. You cannot help if you too become ill. You need strategies to cope. If you are the person who is ill, you very much need strategies. Treatments – talking or drugs – do not work instantly. It may take 2-3 weeks before treatment starts to make an impact. You need to be able to cope day to day. Different strategies will work better at different times. Some of the suggestions that follow will help you; others may not and may even irritate you. Find what works for you and keep using it. Regular exercise may be enjoyable and helpful for some, for others it would a miserable trial. You need your own special recipe.
Motivating yourself is very difficult when you are depressed. Feeling pleasure often has to be relearned – it cannot happen to order. Experiment and try to be patient with yourself. When very depressed, coping with the day ahead is a very big challenge – tackle it in stages. Perhaps you need to plan ahead just until coffee time or lunchtime. The day ahead may seem very long if you see it as one big stretch of time. Try and have a mixture of things that may really have to be done interspersed with something that could possibly give you some pleasure. Pace yourself and praise yourself. Recognise that coping with the day, is a big achievement in itself when you are very low.
Dealing with someone with depression
My sister’s become a real recluse. She’s dropped out of her career, seems awfully depressed, doesn’t look after herself, and has become isolated from her friends. We help out with money when we can, but she gets resentful if we ‘interfere’. Should we leave her alone?
It sounds as though she needs help. We have all got the right to do what we want with our lives, and there is nothing to stop her leaving her chosen job or career, but this sounds more serious. If someone drops out of their chosen path and takes up some alternative lifestyle, the decision has to be accepted. However, if they are unhappy and seem ill, it is different. Is this an alcohol- or drug-related problem? If you think so, you maystart with some support and advice from your local advisory centre. These problems will affect the whole family. This does sound more like a depressive illness and may be quite severe, so first of all, keep in touch. Don’t give up on your sister, but make sure that you keep up a friendly contact. Putting too much pressure on her may be counterproductive, and people may understandably become resentful of direct advice. Occasional lunches out, and visit to the shops together; or perhaps doing things that you used to enjoy doing together when you were younger, may be a good start. Too much pressure, on the other hand may make her resentful and she may retreat into her shell.
When she realises that you accept that she is feeling low, try to look at it together with her. Understand that people with depression feel that things can never ever improve whatever anyone says or does. Quite often, no matter how fixed the ideas someone has, there is usually a small part of them that will accept that something is wrong, and they will want to do something to get better.
Maybe try leaving some leaflets about depression and mental health around (or a copy of this book). You may be able to get her to accept a visit to the doctor with you, to explain your concerns. She might use one of the phonelines for people with mental health problems. If she won’t consider medication from the doctor, she could try St John’s wort as a starter, which is an effective herbal antidepressant. At least she will then be starting to address the problem.
A family member gets very depressed. We all love her but we don’t know how to help, she seems so low sometimes. How can we help her?
It’s really important that you help her to get started with treatment. Start out by saying that you’re worried, and get her to attend the doctor’s. Suggest she has a ‘checkup’. Perhaps have a word with her doctor. Go along with her for her first visit, if you can. It’s a big help when families do this because then we know who’s giving support, and we often get a better picture of how extensivethe difficulties are. The doctor can never disclose the contents of a consultation with a third party, however worried and helpfully concerned you are but, if you are in the room during the consultation, you can have a three-way discussion and you will then be reassured that everything has been addressed. When she starts on treatment, it will be helpful if you can encourage her to stay with the treatment until it really starts to work. Keep an eye on her medications to reassure you that she is taking them. Progress may take several weeks. If she is not getting better, or you are worried, encourage her to say so to her doctor. Different treatments may be needed if no improvement occurs. A change in her medication or a further opinion may be helpful. About 1 person in 8 or 10 may drop out from their initial antidepressant treatment owing to side-effects, and a similar proportion will need referral to a psychiatrist about their depression.
The commonest side-effect of the SSRIs is probably initial nausea and indigestion feelings. These pass off with time, so tell her to be patient, unless they are really awful, in which case her doctor’s needs to know. As a family member you are well placed to offer vital support. This can need lots of patience, understanding and affection. Don’t give up! Talk to her and listen carefully. Realise that she may be full of low and negative thoughts, which she cannot get into perspective. These thought cycles can almost seem to be catching. Depressed people can radiate gloom in an infectious way. This can be quite exhausting to the listener. Don’t be annoyed by her repeating the same worries, but do gently help her get things into perspective. If she starts to make remarks about harming herself, pay attention. Try not to panic or overreact, but do make sure her doctor knows. See that you take her along for some gentle exercise, so that she doesn’t get stuck in a rut. Make sure she does not miss out on social events – the company of other people is good treatment. If she doesn’t want to go out, ask another time, and keep asking – tactfully but persistently – until she says yes. Do not push her too hard, do not pester her, but do not give up either.
Try to get her to take some part – just a little – in her own interests: hobbies, sports, religion or pastimes. Do not expect toomuch at first, as this may make her feel guilty for disappointing you. Allow her her own space, but make sure you are closely in touch. Don’t get exasperated; if she doesn’t seem to be responding to your support, back off a little and try again later. Recognise, and reassure her, that she will get better, even if she doesn’t seem to believe you now. Recovery from depression takes a number of months with treatment, and can be quite gradual, so doesn’t become frustrated. Signs of improvement include better sleep, less early waking, less sad thoughts, and a resumption of pleasure and enjoyment in normal activities. Hope is always important. Look after yourself too; caring for a depressed person can be very draining.
