The suicide of beloved comic actor Robin Williams has again brought the topic of depression to the forefront. I cannot imagine what it feels like to have the weight of such unendurable despair that is so intense you cannot bear even staying in this world. But I know all too well what it is like to live with family members who have depression. One of my parents, a sibling, my husband, and one of my children have also suffered from this black cloud, in varying degrees, and for varying lengths of time. I have spent much of my life living with people I love with all my heart who often have trouble feeling happy or optimistic. This is in itself is very, very painful.
Depression runs in families, and seems to be especially common among Ashkenazi Jews. Maybe our difficult history somehow let it seep into our psychological DNA. Depressive episodes don’t necessarily have causes. While traumatic events can trigger depression, in many cases it is part of a person’s psychological make-up, and I was at first baffled when years ago, my daughter, who had everything going for her, including friends and success in school, suddenly descended into a black cloud, seemingly “for no reason.”
Too often I have seen “that look” on a loved one’s face: the grimly set mouth, eyes slightly hooded, shoulders slumped, the entire demeanor broadcasting the message to stay away, that she cannot cope now. I had to learn that my daughter’s or sister’s or father’s or husband’s depression was not my fault, that I didn’t do anything wrong as a child, sibling, spouse or parent to “cause” it. I have also had to learn coping skills to deal with it. Here are some of the most important lessons I have learned about living with someone who has depression.
1. Offer your love and support emphatically and consistently, especially when your loved ones are in their least lovable states. A depressed person has trouble believing in herself, no matter how much she has going for her. Hearing someone say, “I love you” and “I believe in you,” and knowing that they mean it emphatically, is hugely important. Your expressions of love will register, even if they cannot be returned at that time.
2. Get help to deal with your own stress. You need to still try to live your life to its fullest, and you have to balance all your other obligations in addition to being a caretaker of sorts for a depressed person. Confide in wise and close friends. Support groups or short-term therapy could be a good idea.
3. You cannot “convince” someone not to be depressed. Nor can you “cheerlead” her out of an episode. Accept the reality that these episodes will repeat from time to time, but that they will pass. Offer that same reassurance to your beloved family member that you know it will pass, like a wave.
4. It is not okay for someone with serious depression to refuse treatment or stay in denial. If that is the case, she has no right to expect ongoing unconditional support. The behavior and moods of a person with depression affect everyone around them, and it is their responsibility to acknowledge the problem and agree to a plan of action. It is helpful to reassure the person that there is nothing to feel guilty about if they need to take medications to stabilize moods. Just like a diabetic needs insulin, someone with significant depression will need medication on a short-term or perhaps long-term basis, as well as therapy. I have been fortunate that most of the relatives I have dealt with have recognized the need to be proactive and been willing to get help.
5. Take care of yourself and do not let the wave of depression engulf you. Just like when you are in an airplane and advised that if traveling with children, you need to put on your own oxygen mask first before putting it on your child, you need to do things that lift you up, provide you with satisfaction and joy. In fact, it is extremely important for your loved one to see that you are making self-care a priority, especially in cases where a relative, consciously or not, uses their depression as a tool to exert power over you.
6. People predisposed to depression are predisposed to it in their own individual ways. When life’s accumulated stressors or traumas line up in a certain way, the result can be anxiety, depression or even schizophrenia. Our genetic make-up is God-given, and because our make-up is so unique, it is not easy to find the right therapeutic modality right off the bat. For some people, a combination of medication and cognitive-behavioral therapy works well; for others, dialectical-based therapy (DBT), psychodynamic therapy, or mindfulness based stress reduction work better. This is only a short list of treatments that can help. Start with a good therapist who will be willing to offer referrals to other practitioners if he or she cannot help get results.
7. Take it one day at a time. Don’t allow worrying thoughts to pile on, imagining “what if” scenarios that have bad endings. A friend of mine gave me a little laminated card with this bit of wisdom: “Worrying does not empty tomorrow of its troubles; it empties today of its strengths.” Stay strong by pushing long-term worries away.
8. Pray. This is an opportunity to grow closer to God and to ask Him to help you. I have told God very directly, “I cannot do this without You. I need Your help.” And I have found comfort and solutions in this. One year ago, right before Rosh Hashanah, I began to pray like I never prayed before for my daughter to heal from persistent depression. And for the first time, I replied to an advertisement from an organization in Jerusalem to have someone pray for my child at the Kotel for 40 days. While I believe in prayer, I had considered these annual pray-for-something-or-someone at the Kotel pitches to mostly be about fundraising. But last year, when things looked very dark, I figured I had nothing to lose and possibly much to gain. I wrote to the organization about my very wonderful child and all her talents and potential. I sent a picture of her. I also had everyone else in our immediate family also say the special prayer that was being said for her during those 40 days. At first things got worse, but after two weeks we had a wonderful breakthrough, finding a new and different treatment that has worked better than anything else has over the course of many years. I believe that heartfelt prayer does work, and that the Almighty is the ultimate Healer.
Depression is an illness that can be pernicious and debilitating, and it takes a toll on those near and dear. But there is always hope for a better tomorrow, and with effort, teamwork, faith and patience, you and your loved one will survive those occasional black clouds and see the sun shining through again.
If you are struggling with depression or suicidal thoughts, please seek help.
You can call: Relief, a mental health referral agency (718) 431-9501.
Suicide Hotline (718) 389-9608
Or Ohel Family: 800-603-OHEL
Pearl Goldman is a pseudonym.