When I was invited to write about mental health for this blog, I struggled to find a topic. I was suggested: just think about why you find mental health research particularly interesting. As an undergraduate Neuroscience student, my answer would be expected to be relatively ‘scientific’ — maybe there is a specific mechanism that attracted me to it, maybe I recognize the toll mental health has taken on our youth today etc. The truth is: most researchers will have a personal reason that drew them to their field.
My personal reason? I grew up in contact with close friends and close relatives struggling with depression or other mental health disorders. Moreover, I grew up in Italy and Brazil — countries where the stigma is still heavily felt.
A study has shown that, in a cohort of 1000 Italians, 75% believed that those suffering from depression should avoid talking about their problems, and most seemed to look down on pharmacological treatments as addictive. In Brazil, access to psychiatric treatment is still insufficient despite its world-leading rates of depression and anxiety.
I am currently involved in a research project regarding Major Depressive Disorder. If you are reading this blog, chances are you know, or know of someone in your family, amongst your friends, in your group of extended acquaintances, that struggles with it. It seems that it is very common. According to the WHO, over 300 million sufferers worldwide.
I will tell you the story of someone I know, a close relative.
She has been suffering from depression for years. The first diagnosis only came during her late teenage years, following a tormented youth filled with teenage anxiety and angst. During a certain period of crisis that seemed to be endless, she uttered the words to our close-knit family: ‘I think I have depression’. It wasn’t completely unexpected — it can happen to anyone, right?
My first thoughts?
This could not happen so close to me, not to her. It had to be a mistake.
We had grown up so close, we share our lives, we share genes. Despite our same genetic background, I could not understand what she was going through. How could this be?
I consider myself outspoken in many social causes and movements, and the fight towards the breakdown of stigma around mental illness is no exception. However, when you find yourself or a loved one under the critical magnifying lens of society, it becomes difficult to accept.
Internalized scrutiny can get to you.
Today, I regret my first reaction. My first reaction was to say that she was wrong.
She visited psychiatrists and I hoped they would say that was not her diagnosis. After all, no one wishes to receive such a diagnosis. However, in context of suffering and desperation, diagnostics can be freeing. It provides you with an explanation, a possible cause for what seemed to occur out of the blue.
It provides a patient with hope of finding help.
Now I know I was young and, frankly, ignorant. All of this unraveled when I was only sixteen. I could barely understand my own feelings, let alone explain them rationally. I had never experienced open conversations about mental health. Although I had heard of it, I could not entirely grasp what was taking place and what was to follow.
When it came, my first thought was that they would follow a treatment plan and it would pass.
The process of actually finding the combination of pharmacological and psychological treatment was long and strenuous. Eventually she did feel better, but as anyone in this situation knows, the road to recovery is not a straight line. Some days are better than others, some months are better than others, some therapists and antidepressants will work better than others.
Unfortunately, statistics are not favourable. Following a first depressive episode, the probability of having a second one skyrockets. So, it can become a life-long illness.
This story is mainly about the millions of sufferers — but also involves me and you, if you, like me, are close to someone suffering from depression. The so-called support network around each patient. We each play a role in these personal stories.
Depression is heterogeneous and affects many areas of life leading to a range of symptoms that may change from individual to individual. Symptoms include loss or gain of appetite, weight gain or weight loss, cognitive problems, sleep disturbances of hypersomnia or insomnia, memory deficits, suicidal thoughts, feelings of hopelessness and excessive guilt, negative rumination. Therefore, my personal experience will not apply specifically to someone else’s interpersonal relationship with a sufferer of depression.
Although the overall grief, sadness, lack of motivation and pleasure are core traits of this disorder, each individual will cope with them in different ways. Some more openly, wanting to talk about it. Others, simply wishing to be distracted from the situation. In any case, this shows that many approaches can be taken to provide at least a sliver of help to those around you.
Why is this important? Research has shown that having a strong social support base is essential to learn how to cope. This places part of the responsibility on us, those who play the supporting role. What can we do?
Help them manage stress. We have seen in a previous InSPIre the Mind blog how stress plays an important role in depression. Doctors often tell their patients about stress management, and it seems like the solution for everything.
First of all, one can help a close friend manage their stress by helping their nutrition: eating together, providing a nutritional diet, cooking together. The importance of nutrients such as omega-3 fatty acids in a depressive patient’s diet has been explained previously in another of our blog.
Another easy tip is to possibly go with them for a walk or even on a run, if possible. Physical activity has repeatedly been shown to be effective in the treatment of depression. Moreover, sunlight exposure also seems to have beneficial effects and so it could definitely be helpful to get out in the sun for some exercise.
You can even help them with chores. For depressed individuals, it becomes difficult to get out of bed at times, and chores become insurmountable obstacles. This shows that you are there for them and a support.
Most importantly: understand them. Seek to understand what they are going through and try to put yourself in their shoes. Giving them a call, checking in on them once in a while, having a get together: this can help them feel loved and may also influence their decision to seek help.
Research has shown that putting your feelings and thoughts into words, also known as ‘mentalizing’, can help you cope and work through them.
In my experience, understanding can include reassuring them that they have done nothing wrong or embarrassing at a social gathering. That they were invited for a reason and people were happy to see them. It has included helping them take a bath. Trying to distract them from their thoughts and trying to drag them out of bed. Making them laugh at their own obsessive thoughts and negative feelings.
It includes understanding that if they show distance to you, it does not necessarily have to do with anything you have done. The relationship may feel one-sided at times, but try to stay close.
Asking them to help you understand is not only helpful to you to gain insight into their situation, but it also helps them get their thoughts out.
Finally, what NOT to do.
An easy ‘manual’, I have found the ‘What Not To Say’ campaign by Sarah-Louise Bingley, designer and art director, consisting of a series of prints presenting unhelpful phrases that are usually suggested to sufferers of depression.
These include: “You can’t be sad all the time”, “Lighten up” or the most common “Snap out of it!”. We often hear in mainstream media “Happiness is a choice” but, unfortunately, it is not.
And sadness is not a choice either.
All in all, there is no exact advice you should follow. This is what I have learnt from my experience. Each relationship will follow a different dynamic. Depression and antidepressant treatment affect each individual in a unique way and this will determine the suitable course of action for who is close. The important thing is to stay close. Read about it. Understand.
This is the reason why I do what I do today. This is the reason why I have written this blog.
I felt limited in the way I could help, but in this way I have been able to combine my passion for neuroscience and activism with my love for my own support network, into one. I aim to continue to contribute to the treatment of this illness.
Below you can find a poem from the button poetry project by Neil Hilborn. This is a written transcript from a spoken word poem, and I do not claim to have any rights over it. I believe this can summarize how it can be difficult to accept that other people may be going through the same struggles as you.
Button Poetry Neil Hilborn — “You can’t be depressed”
“Aaron Rodgers, probably the best Quarterback to ever play the game, Has those bags under his eyes that tell me he’s been eating a lot of cold Mac ’n’ Cheese in bed with the lights off. Aaron Rodgers looks how I really feel when I say ‘I’m doing great.’ Aaron Rodgers makes $22 million a year, And yet he still looks like his dog bit him after calling him a selfish person. Aaron looks like he last slept in 2011, maybe, And he’s playing like he’s thinking about how he needs to wash his sheets. He’s playing like, how he hasn’t washed his sheets in 5 or 6 months. He’s playing like he’d was his […] sheets if he could stop […] crying for one […] minute, But maybe I’m reading too much into this. I find myself saying out loud, ‘How is he depressed? He makes so much money and his life is perfect.’ That sounds like the last time someone said to me ‘How are you sad when you have your dream job?’ Or, ‘you get paid to do your art, and you’re in perfect health, and you’re engaged to someone who loves you, You don’t have any reason to be depressed.’ But there doesn’t have to be a reason. The brain is clay but the mold is persistent. The brain is a shape, and you can only see the shadows. The brain remains a brain no matter how much cash you stack around it.”
Header image Source: Natalia Mikhaleva’s ‘Mental Health Support’ Project