Supporting family member with severe depression?

[Hollybobs]

Hello everyone :). I'm Hollybobs and I work in an ICU currently. I'm pretty new to this forum and this may be the wrong part of the forum to post in? I'm sorry if so. I was hoping for advice from anyone with any personal or professional experience/knowledge of supporting a family member with severe clinical depression.

A brief bit of background..."Rosebobs" has a long standing history of depression and can experience troughs like the one she is currently in for years at a time. Her anti-depressants are not working, there is no difference after a year of increasing the dose. She also suffers from anxiety and struggles to leave the house. She is a very private individual and dislikes speaking about her feelings.

I'm aware of ways to help someone with mild-moderate depression e.g. exercise, CBT, counselling, diet changes but these are not possible/working at this point for the reasons mentioned above. Any ideas or guidance or insight appreciated.

Hollybobs.

[Hollybobs]

Hi Verene, more food for thought, thank you.

Ah I didn't know that I could do that. I haven't also partly because of certain things about the PCP which I can't mention due to TOS but is good to know I can if needed. We also think there may be other, more specialised support coming with who I can liaise, with permission, but we are waiting to see if that occurs and when and how that will work. We don't know at the moment. it's beneficial for me to have a plan B if there is a crisis, I hadn't thought that far ahead and it is not a bad idea so I can be calm and make good decisions.

I have really good support, I'm very lucky. For example, I have had lots of time to post here and consider the replies, i get time on my own etc. There is one other person whom I am able to bring in to help and they are on board with anything needed but i'm responsible for decision making. I'd reached the point where i was just internally repeating "I don't know what to do, I'm out of my depth, I don't even know how to start". I didn't know who to ask or where to look.

I think counselling for me is a bit overdue and worth pursuing as I have overly needed the kindness of strangers on these boards with these posts about me, me, me and my feelings. I hope i will be able to post and help others in the future. It has been very therapeutic but that is neither fair to any of you nor sustainable. I can feel the lack of emotional control as I write, it isn't like me to for example to have not strictly adhered to the TOS and this needs addressing. Thanks Verene for the reminder.

[canigraduate]

Viva has the most experience of us in dealing with this situation from the patient side.

In my own case, I often need someone non-judgmental to just listen and tell me I will be OK, without trying to "fix" me, because that makes me feel "broken."

Suggest things that you know Rosie enjoys and do them with her, as long as she feels up to it. A lot of the time, it is the perceived loneliness that can be the most hurtful. Let her know that you, and her other friends and family, are there and love her. If she is the kind of person that likes gifts, give her little things to brighten her day. If she likes words, send her a card every now and again to let her know you care.

Little gestures of love and support often mean the most and build a relationship of trust. At some point she will reach out for help. You want her to feel like you are someone she can trust when the time comes. The hard part for you will be waiting for that moment.

[Cola89]

Having my own struggles with depression and having a husband who suffers from depression and refuses treatment, my advice is to be supportive but not enabling. Establish boundaries for your own health and well being. Support healthiness in your loved one. Other than that, it's a tough thing to deal with but I wish you the best.

[honeyforasalteyfish]

I will. I am glad you managed to overcome your depression and I'm sorry that you went through it. Thank you for sharing your experience. I will remember that.

No problem. I am not a medical expert, or a psychiatrist. But I remember what finally worked for me.

I have a big soft spot for any one who gets sick wether physically or mental since I have suffered from both.

Much of it is my own fault I felt broken beyond repair. A hopeless case, that was until I finally took control myself.

I decided I would do something about my situation even though I didn't believe there was anything to be done.

I developed a what have I got to lose mentality, and finally pushed myself to get out there and give it my best shot. At overcoming both my situation, and my depression.

Fot me it was a nasty cycle become depressed do nothing about it, and sink further into depression.

That is why I suggest constructive, ideally with little stress activities that the person enjoys. It gave me a sense of meaning and purpose to me that made me if not happy more satisfied with myself. That of course lead me to down the road to happiness later on.

I am happy since things progressed albeit bumpy good enough to give me hope for myself. Don't get me wrong I am not happy all the time, but I can feel joy and contentment in the things I am doing with my life even if I am not quite where I want to be.

The only thing you can do when you are in a hole is try to climb out of it, that's why I throw myself into work and school as much as possible

[Hollybobs]

Viva has the most experience of us in dealing with this situation from the patient side.

In my own case, I often need someone non-judgmental to just listen and tell me I will be OK, without trying to "fix" me, because that makes me feel "broken."

Suggest things that you know Rosie enjoys and do them with her, as long as she feels up to it. A lot of the time, it is the perceived loneliness that can be the most hurtful. Let her know that you, and her other friends and family, are there and love her. If she is the kind of person that likes gifts, give her little things to brighten her day. If she likes words, send her a card every now and again to let her know you care.

Little gestures of love and support often mean the most and build a relationship of trust. At some point she will reach out for help. You want her to feel like you are someone she can trust when the time comes. The hard part for you will be waiting for that moment.

That makes perfect sense. I can do those things. I can stop trying to fix. I can be thoughtful in little ways and patient. "At some point she will reach out for help. You want her feel like someone she can trust when the time comes"- that is exactly what I want! It won't be so hard now I have more of a plan and understanding.

[Hollybobs]

Having my own struggles with depression and having a husband who suffers from depression and refuses treatment, my advice is to be supportive but not enabling. Establish boundaries for your own health and well being. Support healthiness in your loved one. Other than that, it's a tough thing to deal with but I wish you the best.

Thanks Cola for your thoughts. It is a difficult balance! I'm getting a bit more of a clue how to do this I think. I wish you and Mr Cola the best also, and that things improve for you both.

[Hollybobs]

Hi Gavin, it sounds like you've come a long way!

You say you have a "soft spot" for the unwell- I hope you are able to show yourself similar compassion, I can't imagine you could would purposely make yourself "broken beyond repair", I can't imagine it was "your fault".

I don't think that generally severe depression is a lack of people "taking control" of themselves and recovery is when people just try very hard and then things improve, not from what I've read on here. It is fantastic that that approach worked for you, however and I am trying to incorporate applicable elements of the feedback I get into providing help. I think achievable, enjoyable, constructive tasks could be good when Rosie is up to them and I can be there for her when she is :).

[honeyforasalteyfish]

Hi Gavin, it sounds like you've come a long way!

You say you have a "soft spot" for the unwell- I hope you are able to show yourself similar compassion, I can't imagine you could would purposely make yourself "broken beyond repair", I can't imagine it was "your fault".

I don't think that generally severe depression is a lack of people "taking control" of themselves and recovery is when people just try very hard and then things improve, not from what I've read on here. It is fantastic that that approach worked for you, however and I am trying to incorporate applicable elements of the feedback I get into providing help. I think achievable, enjoyable, constructive tasks could be good when Rosie is up to them and I can be there for her when she is :).

Don't get me wrong I still suffer from depression. I take antidepressants daily, and a drug meant to boost their effects. I meant no offense.

Honestly it wasn't until I went on an effect cocktail of medicine that I was able to overcome the situation. Initially because I was having ideas of reference I was diagnosed as psychotic. Which is why I felt broken beyond repair.

I believed some whacky things, but was unwilling to seek help. I didn't want what was going on to be real, and part of it wasn't. I was sick, and I didn't know why.

Everybodies battle is different, and hard to quantify. Good luck they are lucky to have you as a friend. I shall now cease and desist.

With one final note thank you for your understanding, and again very much good luck in helping them I was a wreck for two years I can't imagine what I put the people that care through when I was like that. It can be managed, so there is hope. Good night, good luck, and thank you.

[Hollybobs]

Oh no, no offence taken and hopefully none given. I wanted to hear from people and feel privileged you shared your experiences, it has ALL been helpful. When I wrote my paragraph it was in a soft tone in my head but I can read it back and it could be read snippily- not how I intended at all!

Only reason I said anything regarding taking control is because I didn't want anyone reading this and thinking less of themselves because they couldn't do the same and it is often a symptom of depression that you can't. I appreciate you aren't as well now as you'd ideally like to be but I am still impressed that you are living much more comfortably than previously. Good night! Thank you.

[TriciaJ, RN]

Holly, is there any kind of support group in your area for family members who are in your shoes? After all, you are the one reaching out right now, not your loved one. We can all make various suggestions for how to help her, but who's helping you?

I hope you can find a group near you who can help you navigate this; help you be supportive without enabling; how to quit walking the tightrope you've been on. You're going to be exhausted second-guessing yourself. Time for some care for the caregiver.

[Graduatenurse14]

I would post on a depression forum where people who are dealing with the same thing are. There also may be a subforum for friends/family. She is lucky to have you!!!!

Good luck!

[NurseStorm, BSN, RN]

Hi :)

I have also suffered from severe depression and over the past few months have been doing the best I have for a very long time. What I would recommend is

1) Never asking "why" or assuming there is a reason for the overall depression. Many/most times there is not, and most people with depression do not even understand why themselves. As Viva had said, don't say things like well think of what all you have, a lot of people had it worse- this is so unhelpful! Many people already feel guilt as it is because they don't know why they feel this way, they may feel ashamed and even stupid that they are feeling this was when there is "no reason" for it. If you feel she seems worse or something, you could ask "Is there anything that happened in the last few days that is making you feel worse, or has it come on it's own?" Or something along the lines of that..

2) As others have said, simply being present and supportive. Not always pushing for "something to get done" even if that is what our nursing instincts want us to do. Just loving her, bringing her food she likes, letting her know how much you are there for her and let her know you are willing to talk about anything she wants whenever she wants. Trying to perhaps incorporate gently some small activities between the two of you. For me, watching a tv show with someone was something that required not much effort and could distract you for a bit and maybe give you a smile or a little laugh even when very down. Something like going for a walk was very hard for me to do in my deepest times, but others are different so depends what she feels like. Things like the adult colouring books can be a kind of relaxing mind distraction as well with little effort required.

3) Offering to help her get treatment/take her to appointments if she is interested, but not pushing her excessively. You may want to encourage her to try a different med if she is open to that discussion, she can talk with her dr. about what would be recommended. I also had no effect with zoloft when being on it about 7 months. Celexa helped me much more as well as a small dose of seroquel at bed time. (What really made the biggest difference for me though was when my psychiatrist realized I had adhd, and got me medicated for that and I did more reading and learned more strategies for better coping. That dx has changed my life). If she can see a psychiatrist this would be best, proper diagnosis and treatment is key. I suffered for years mild-moderately, then quite severely for close to a year. I hope she would be willing and able to see someone who can give her more guidance and help. She has to make the decision though.

4) Again, not sure how severe she is, but once I was a bit more stabilized with my meds and was able to actively do more to try to improve even more, I did a book/cd program called the mindful way workbook by John D. Teasdale PhD. It is available on amazon. It is an 8 week program of mindfulness, meditation etc. Helps "retrain" your brain in some of the patterns we can get stuck in that further exacerbates the depression and/or anxiety. If she is severe, obviously she will need to get medication that is more effective before being able to undertake something like this. It takes about 40min-1hr a day, so it's not a full day or anything but I know when I was at my darkest I definitely wouldn't have been able to commit and force myself to do it. Just nature of the beast that you just can't do things like that sometimes. You can't just "use willpower". Over time I felt it did help my anxiety and overall contentment

5) If you have any pets, taking them to visit when you see her may be helpful if she is a person who likes animals (if she doesn't own any). My cats were a big help to me, just to have them around and they would always want to come cuddle which felt supportive when I was alone. Petting an animal can be therapeutic and relaxing too.

Hope some of this helps :) Another nice thing you could do would be give her a little care basket. Some comfort items. Maybe her favourite candy or chocolates, a really nice smelling candle, fuzzy blanket, adult colouring book and markers/pencil crayons.. just aim by things she likes but can't go wrong with a fuzzy blanket and nice smelling candle. It's not that these things will "fix her" but it means a lot to know someone cares, is thinking of you, and wants to give you a bright spot in the day.