Who, Me? I'm Not Depressed

It's important to understand that depressed people don't always realize they're depressed. They may be oblivious to the impact that their depression has on others, including you.

Be prepared for the depressed individual to be in denial. Many depressives are, at first anyway. Accepting that you are "disordered" is painful. Accepting that something is wrong is not easy. The person may try to shrug it off, or explain away his symptoms. I'm fine — I've just felt a little tired lately. The baby keeps me up all night. They may even concoct a false, minor medical problem: I think my allergies must be making me a little sluggish.

Depression can also creep up slowly, so the depressed person might feel normal initially, but they cannot see that over time their mood has changed significantly. The mood change also becomes part of their Identity so they are afraid to admit something Is wrong (because it might mean something is wrong with them) and also afraid to get treatment (because who will I be without the depression?) You can see the dilemma and why It is hard to help people move out of denial.

Depressives typically know how to fool people, but they don't know to get their own needs met. Their psychological defense mechanisms may be so well-developed that they've become experts at fooling people, and perhaps themselves. Depressed people are often out of touch with their own emotions and feelings. They usually won't communicate the depth of their pain and fear. They may fear you will reject them, and there will only be more negative consequences if they admit they have a problem.

The following strategies will help you map out a plan for broaching the topic of depression and moving forward toward an appropriate solution.

  1. Cite clear examples of behavior that suggests depression. For example:

    • I've noticed that you've been having a hard time getting out of bed every morning for the past month or so…
    • While you have had some difficult things happen in your life, you are crying significantly more the past few weeks than in the past…
    • The way you feel about yourself and others has changed recently. I notice you are quick to put yourself down and more frustrated with other people. Tell me more about that…

  2. You may need to orchestrate a gentle intervention. You can structure your conversation in such a way that you lead up to the topic of depression gradually, gently. It may not even be necessary to mention the word depression, per se. You can frame your observations in the context of the person's demeanor, their apparent sluggishness, and the fact that they seem blue and "just not with it." For example:

    • Lately, you seem to be having difficulty concentrating…
    • You don't seem to feel very enthusiastic about your job [our relationship] anymore…
    • You haven't been doing the things you love to do recently…
    • I notice you have had trouble eating and sleeping…

  3. Pay special attention to your communication style, including non-verbal behavior and gestures. For example, pointing your finger or using an accusatory tone is intimidating, and won't encourage cooperation or convey empathy. You're more likely to achieve a positive outcome if the person views you as receptive and empathetic, rather than a scolding parent. In other words, maintain eye contact, speak in a moderate or soft tone and demonstrate that you care.

If the person is willing to admit they're depressed, you can remind them that depression is an illness, just like any physical illness. This can help them recognize that the depression is making them feel bad rather than feeling like their Identity is flawed because of these thoughts and feelings. They may be more open to treatment if they are able to externalize depression as the problem, rather than feeling like they are the problem.

People who are depressed respond very well to a loving, supportive person. They are hyper-sensitive to shame, since they already feel so bad about themselves. If you sense that a loved one needs professional help, it may be helpful to schedule the therapy session and even go to the first session with them. This is a way of acknowledging your support, reminding them that you care and that they are not alone, and ultimately helping them get the help they really need.

Do you suspect that someone you care about is depressed? This checklist can help you recognize the warning signs of depression.

 

©2009 Maria Lloyd, LMFT MFC38399. All worldwide rights reserved.
Maria Lloyd is a Licensed Marriage and Family Therapist located in the Silicon Valley area— San Jose / Santa Clara County, California. Maria provides individual counseling for women for: depression and stress management, post-partum depression, anxiety and panic disorders, bipolar disorder, interpersonal relationship issues, self and identity issues, co-dependency, anger management, and managing grief and loss.