Dealing with a Depressed Friend...

Hi C.,

Having been clinically depressed (it was a long time ago, but I remember it well), I will speak from my own experience.

First, therapy is good so long as the therapist is good. Does your friend feel like she is making *any* progress? Ask her how that's going. If she doesn't feel like things are progressing, there may be a few underlying issues: the therapist isn't a good fit/there's a lack of a trust relationship there (I had one of these); the therapy IS good, but she's in the middle of working through something very hard and is grieving; she needs to find some kind of naturopathic alternative to anti-depressant medication and should consult a well-regarded Naturopathic Doctor.

Exercise/getting out is important. Eating well is important too. Junk food calls loud when I am depressed, but then I feel sluggish and more depressed.

Changing one's daily habits can also help. Maybe turning off the tv at night and turning to an uplifting book helped me at times. The news and other shows can show us the worst of what our world has to offer; something uplifting can show us the light within ourselves, and nurture us.

Is she challenged by a lack of resources, and is there an area in her life where some of those resources could be met? That's a big one.

She will also need to ask the therapist about developing cognitive, self-soothing techniques which she can use on her own. When you mention that she feels better only briefly after therapy, I wonder if she hasn't developed those skills for dealing with the hard feelings about herself/her life. Studying child development (esp. social/emotional) it's been clearly stated that children who don't have loving, caring parents who are able to help the child by containing their feelings (the adult does this, reflecting back to the child that the feelings can be mangaged)-- this can lead to those kids becoming adults who have challenges with resilience and processing their negative emotions; they also have difficulty appreciating the good times.

I would encourage one other thing: do not view what you are doing as 'handling' her. Help her to help herself, but do not take on more than you can reasonably deal with. When I was at my lowest, two very good friends said something very hard to me "you need to go talk to someone". The first time, I didn't take that friend's advice. She practiced some very healthy boundaries, listened empathetically, reflected things back to me, and gave me a couple of concrete solutions. However, from that point, she would just sort of turn things back to me: "well, you know what you need to do when you are ready" and change the subject. It made me realize that while she loved me, I wasn't welcome to just dump on her. When my second friend said it a few years later (it was a long, low time) I listened and received great support from her and the therapist I was working with.

I did take medication for about 5 years, and the counseling really helped more than the meds did. The meds kept me able to function and go to work but didn't 'fix' any of the underlying problems. It was the commitment to working on myself which helped immensely. I also got to a point that I was able to identify triggers and figure out how to deal with them. Some music was a trigger to sad feelings, so I got rid of that stuff-- just got it out of the house. When I got blue, I would force myself to make a list of 10 blessings in my life (people, good situations, the lovely neighborhood I lived in-- whatever made me smile to think about) and mentally NOT LET MYSELF 'go there'. I began to think of it in nearly combative terms: I was going to fight for my control of my life and not let the past actions of others determine my *today*. I would not relinquish my power to enjoy my life, even one moment of it, to those who could care less about me. I think this fight inside me, this strength, is what has pulled me through some even more difficult moments.

It's easy, when we are depressed, to roll in it a bit. To feel terrible for ourselves, about ourselves. This is part of depression being a mental illness. I also know, on the other side of things, that it's terrible to be around that depressed person when *nothing I can do seems to make them feel better*. And here's the thing: **we have to want to feel better for ourselves**. Some of us have to fight, very very very hard, for it. There will be days when we feel that the only thing we've got going for us is the ability to get out of bed and go to work and parent our kids. Your friend will need to get to a point where she will want to keep on trying because she values herself. Maybe she's not there yet? Counseling is the best investment a person with a hard upbringing can have, yet is often very difficult to come by because we've had so many negative messages about ourselves that we feel we aren't worth it.

Your friend may have a lot of anger and hard feelings to work through before it's over. Maybe some baby steps will help. A self-defense class to combat feelings of powerlessness and victimization. A kickboxing class. Finding a safe place to throw eggs. Purging our homes of trigger items. Redefining our boundaries with the people that made us feel terrible to begin with. (Being in continued relationships with our abusers is very difficult; we have to redefine those relationships so that we aren't further damaged and take back our own power, which is always unwelcome conflict and can feel scary.)

Healing from what you describe is going to take some time. Be prepared for your friend to have a long journey. It may take five, ten years or more. If this is an intimate partner, I also suggest couples counseling. You will need support, too, in staying healthy with her while she deals with this.

Sorry this is so long, but I hope there's something in here that you can walk away with. Ultimately, the only person who could fix me was me. It's hard to envision at the beginning of the process how happy, healed and healthy and whole one can become as they do the work, but the only way to do it is to just do it.

She needs counseling or some sort of professional help. I don't mean this in a harsh way......... it is HER responsibility to help herself.... not your responsibility to help her. And I say this fully understanding the myriad of ins-and-outs of mental illness / abusive childhood / PTSD.

If the music drags her back down.... don't listen to music. there are TONS of medication or diet modifications that DON'T have side effects that she could take, she just has to keep trying to find the right mix.

She is not helping herself. She feels powerless. Or she is controlling the things she CAN control, which is causing her to stay within her depression. Sometimes it's EASIER to take the control on ourselves... the blame on ourselves.

I worked through "when Panic Attacks" by David Burns. It's a book that provides Cognitive Behavioral Therapy techniques. He has another book specifically for Depression - "The Feeling Good Handbook". If you want to be her friend, buy her this book. Point her to a meditation class (and go with her.... meditation is good for everyone) - meditation is a great tool for learning how to live beside your thoughts without acting on them. It's called "Mindfulness" and it was honestly one of the best things I've ever learned in my life.

You can't drag someone to the surface. Recovery / survival doesn't work like that. Dead weight is heavier. Dead weight wins. So if you are trying to drag her to the surface so she doesn't drown, the ONLY thing that will happen is YOU get sucked down with her. There REALLY isn't any alternative until SHE wants to get help. I know depression is tricky. I know demons are fierce.

It's interesting that you say "I'm trying to keep my wits and not just abandon her because that's not what she needs is another person to walk out and leave her."..... see, she's running a loop insider her life. She's reinforcing that she's not good enough by ACTING poorly and running people away. It's a self-fulfilling prophecy. She reinforces that she's no good because people abandon her.... but then she acts in a way that isn't healthy.... so the good people can't stay. She doesn't even know she's doing it, though.

The fix for this ISN'T to make it so that people always stay. the fix is to help her be self-sufficient enough and independent enough that she can take it when they leave. You can't control what other people do. You can only control what YOU do in response.

My favorite analogy about *survival* is something a therapist said to me when I was in 8th grade. She said "when someone comes in and trashes your bedroom..... are you going to sit there in the ruins and cry about how you got dealt a bad hand and someone ruined your bedroom? Or are you going to clean up the debris and make it liveable? Because in only ONE of those reactions do you then have a livable bedroom". It's always stuck with me.

People do shitty things. People treat other people in horrible, unspeakable ways. But you HAVE to pull from way down deep inside and get over it. Otherwise, they have won.

Tell your friend not to let them win. Tell her you'll be there for her, but only if she helps herself. Set boundaries and guidelines for when and how long you are available.

I have not dealt with depression personally, but sadness due to relation to things that remind you of a hard time. You are her friend. It is clear you are a good one. Now to be a proactive one....throw that stinkin music out. I would have a sit down with her, and this will inspire tears, but you are use to this. Take anything that gets her all riled up, have her explain why, what memory, but not in dept (you don't want to take her back, you just want to understand) and then you can both throw it away. You can reassure her that she is important, and this does not define you. And throw it away, this is letting go.
I would help her redecorate her space with all of the things that make her happy, all the things she feels she is (positively)

I would try getting her involved in yoga. Very good for stretching the legs, and not too harsh and straining as she has experienced damage.

Her depression spawns from not just the things that remind her of her past, but also her limitations. Help her to see that it may take time, but it hasn't taken everything.

In your support however, do not forget who you are. You are a good friend. And there comes a point when someones mood brings even you down. So though you may want to be there, when she fights the choice to have a 'good day' she has to know that once you have reassured her you love her, you will have to go. It is not good for you to be down as well. and it does not and will not help her.

Good luck.

What about starting up exercising together? If she can't tolerate medication, exercise may help to boost her mood. It gives her a positive goal and the exercise process itself will help her feel a lot better. Maybe train for a charity run together? Even getting out for walks can be good.

You don't handle her at all, this is her problem, though I understand what you mean. All you can do is be there as a friend. Don't get so caught up in her mental health that yours suffers, then you're no help to her. Been there.

Do encourage her to press the doctor to find a medication that suits her as best as one can, none are perfect. Therapy alone is often ineffective long term for some people as depression is often due to a chemical imbalance, which has to be brought under control. Yes, many medications have bothersome side effects, but in the long run feeling better outweighs depression and the annoying side effects, I speak from experience on this as well. Uncontrolled depression can lead to serious consequences so urge her to speak to her doctor about medication, even one she's already tried at a lower dose. Side effects are a necessary evil sometimes.

And suggest she speak to her doctor about joining a group therapy, her doctor can put her in touch with one, it opened my eyes when I did. I went only once, the other people there made me realize my life was not as bad as I perceived it so it was good for me to go. Most people continue with the group and it's beneficial to them to have people they know understand and can relate, and gives them an outlet to air their feelings.