Testosterone fuelled depression
Part 3 How to support a
man with depression
I have come to realise that most people
do want to help their loved one through their depression, but very often they
just don’t know how. So I’ll begin here with some excerpts from my book on
general support and then will get a bit more detailed on how to help men
specifically.
If you have a friend or relative with depression, it can be very difficult for your relationship. And one thing that is true but makes it even harder in some respects is that your support can be invaluable to your loved one. Your support can be a priceless tool in their recovery. However it is not an easy road for you and some people find it more difficult than others. Understanding why your loved one acts a certain way and may have changed in their behaviour is hard. But I would encourage you to try, even a little bit of support is better than none. You can't be the total support for your loved one though, and you yourself may need supporting, depending on the severity of the depression. Relationships do not have to be lost or destroyed, but it will need you to be open, to put aside preconceptions and to be willing to learn everything you can about this potentially debilitating illness.
Look at depression as if it was an
illness like diabetes. If this person had developed diabetes how willing would
you be to support them in learning about the problem and in knowing how you can
help if they have an acute episode and in their ongoing care? Knowledge is
actually a powerful tool and there is a lot of information available nowadays
about depression (see websites listed at the end of this post). The Bible
actually talks about people perishing for lack of knowledge (Hosea 4:6). I would encourage you to find out as much as
you can about depression. As you read about depression and perhaps talk to
others who have been through it, remember though that everyone experiences it
differently. Which makes it very important to learn what your loved one's
individual symptoms are.
It is essential that the person with
depression is getting the right professional care. But they may not even
realise that what they are going through is depression. If they are a Christian
(and particularly a male Christian), acknowledging that they have this illness
might actually be very hard for them and create feelings of guilt and failure
as a Christian. Although people are beginning to be less judgmental than they
used to be it can be embarrassing and humiliating to admit to it in a church
situation. It could also be that they believe that what they are going through
is normal and that they just need to learn to cope or it could be that they
feel too low to even address the issue. Whatever their reason for not facing
it, for their recovery to start they will need to acknowledge that they are
depressed and then take the next step of seeking help. Getting the right
professional help can be a journey in itself and can be one in which you can be
of assistance. It usually means seeing a GP first, and possibly getting a
referral to a psychiatrist or psychologist. It is important though to find a
practitioner who the depressed patient relates to. Unfortunately this may mean
trying a few, which can be very difficult when you are depressed. So part of
your support may involve ensuring that they are seeing someone regularly and
even going with them to their appointments if that helps them get there.
Recognising depression and seeking help
is the first step towards recovery. It can be very difficult if your loved one
will not admit that they are suffering from depression. You may need support
yourself in this situation, a counsellor, or at the very least a good friend to
off-load to regularly. In your prayers ask God to give you a key to overcoming
the barrier that your loved one has up.
When looking at the treatment of
depression its helpful to understand that medication alone is not the total
answer. Depression, particularly if it is severe needs to be approached from
several angles and almost all counsellors and medical professionals agree that a
combination of medication and some form of counselling/talk therapy is best. It
will probably also be beneficial to look at some lifestyle changes to help in
your loved one’s recovery.
You can assist your loved one to develop
personal strategies to help them cope. However, sometimes a person with
depression will resist help. Its important to realis
Remember you are more likely to get someone
to listen to any advice you give if you have spent time listening to them and
their issues and if they feel that you understand (and that you are trying and
want to understand) even a little of what they are going through. However be
very wary when giving advice or your opinions, as if they feel judged at all
they will find it hard to confide further in you. Depression causes a person to
be overly sensitive to perceived rejection and judgment. So even if you do not
agree with what they are saying be very careful about expressing that. And
never ever disparage the feelings that they express. Even if you don't
understand completely, the fact that you would like to and that you are taking
the time to learn about their condition, both in general from reading and
specifically from them, will be the basis of them accepting your support. This
may need persistence on your part as when someone is depressed it can be hard
to talk about how they are feeling and they need to feel sure that the person
they are talking to really does want to know and is not just being 'nice' by
asking. It may take several attempts to get someone talking openly. Remember, ‘people don't care what you know until they know that you
care’ (anon).
Be open and honest in your conversations
about their mental health. Ask about how they are feeling and find out what
things help them when they are low. You can talk about what you have read about
depression and whether it’s applicable to them. By being open in this way you
will show the person that you are there for them and that you care and support
them. Remember though that you cannot change their depressed state by reasoning
with them and you won't make them feel better by 'jollying' them along. You do
not have to agree with the way that they see things. But the way they see
things is a reality for them, Try to enter their world and to understand how
they are feeling without judgment.
If you have never experienced depression
yourself it can be very hard to understand a loved one who is going through it.
Its OK to say that you don't understand and don't
know how to help, but that you love them
and want to spend time with them. If you can, encourage the depressed person to be open in how
they are feeling. Of course this means that they must trust you with what they
say. This is an actual quote from what the close friend of a depressed person
wrote in an email to her friend when she wanted to help but didn’t understand
her friend’s depression (it resulted in the depressed person feeling cared
about and opened the dialogue between them),
“I really want to encourage you to be
totally open and honest in how you are feeling.. as I can see that you are down and sad,
tired and gloomy etc.. but I have no idea what is going through your head.. for
example; you may be feeling like you 'have a dark cloud over you and nothing
gives you joy' or that you feel physically and mentally as though you are
'under anaesthetic' and can only function in slow motion…or that you are
thinking that 'the only way out is death'...or that 'God is punishing
you'....or whatever
is going through your mind. All I can see is the outside and would really love
to understand you and your illness more...even to walk with you daily through
email diary entries of exactly how you feel ... not that I can always help you,
but I will at least know what is happening in your head and try to understand
something of why you behave or look the way you do... know what I mean?”
That openness can only happen with the
trust that you as the support person will have to develop. The depressed person
often struggles with intense feelings of being judged, or of being thought
insane or even of being 'put away' if people really knew what was going through
their head. To really help a depressed person you need to encourage them to be
totally open with their thoughts and feelings, to let someone into their world
no matter how dark or bad or scary. In fact, the worse their world is the more
important it is to let someone into it. Don’t ask why or how come…this is too
analytical. You are not trying to analyse their feeling (as they probably won’t
make sense anyway), you are trying to encourage the person to express them.
As an observer you may be able to help
your loved one discover what circumstances trigger episodes or make their
depression worse and what activities are helpful. It may be helpful to discover
what the differences are in language and behaviour when the depression is bad
and when they are doing well. These are all areas that it may be hard for the
person going through depression to actually see for themselves.
Find out what things cause stress to your
loved one. A low-stress environment is needed for them to recover. For me
meeting new people was stressful. For many, talking on the phone can become stressful
and is often very hard to do, even to close friends and family. It may be that
receiving bills is a particular stress. Maybe you could help them organise
things like bills or household chores. Sometimes it can be helpful to create a
schedule for activities, i.e. meals, exercise, medication etc. I found that
dividing the day into three time slots was helpful – morning, afternoon and
evening. When my depression was bad I could only handle one activity a day in
only one of those time frames (i.e. either morning, or afternoon, or evening) I
was careful not to book two things on one day. For example if I had a doctor's
appointment in the morning I would not go shopping in the afternoon, or if I
had a church meeting in the evening I made sure I rested during the day. Weekly
household chores can be divided up to be done throughout the week. With
depression it can be hard to even think about what to do and when. That's why
having it written down means you don't need to think or make a decision about
what you are going to do that day. It is important to have something to do
every day, even if it is only getting the dishes done. Something should be
achieved every day, no matter how small. Be sensitive to their feeling guilty though
that they are not able to do these tasks and be careful not to come across as
if you are telling them they should be doing them. Help in these areas will
probably only be received when you have spend time listening to them and they
feel sure you are not judging them. It’s a fine line to walk between helping
them like this and ensuring they don’t feel worse because they do need help in
these areas. Try to look at it with them as you are both a team working through
the issues of depression rather than you telling them what they should do.
You may find that your loved one does not
want to go out or socialise. However do try to get them out of the house
regularly. With depression it is very common to lose interest in things that
would normally give pleasure. For example, if they used to like movies try to
encourage them to go with you to see a film even if they now have no real
desire to. But don't expect them to be too grateful or enthusiastic, and they
may well tire very easily. Sitting and having a coffee in a cafe may be
difficult as the depressed person often finds it hard to communicate and to
socialise, but even just being with them as you both sit and watch people go by
is getting them out. Let them know its ok with you just to sit and not talk. Be
sensitive though and don't try to force them to do anything. Gently and
persistently encourage them to go out with you and to do some of the things
they may have previously enjoyed. Just remember also to accept the limitations
that this illness puts on them.
A person with moderate to severe depression
is not able to pull from themselves the resources to push themselves. Normally
as humans when we are tired we still have reserves inside us from where we can
pull a little extra energy when needed, but that is not the case with
depression. There are no reserves, there is nothing there, so when you get
tired, you have to rest or sleep. You just don't have anything else to draw
from.
Never ever ignore a person's comments
about wanting to die. Even if they don't seem to be that bad. Some people are
able to cope with everyday activities and hold down a job, while underneath
they are struggling with depressive feelings and thoughts. Many try to put on a
'brave face' but this can be destructive in that it creates a situation where
they deny their depression, and in hiding how they feel they are not able to
resolve anything. If someone you know starts to talk about death, or even if
they just mention it in passing, pursue the matter with them.
You may worry that talking about it will
make them more likely to act on it, but experts agree that this is not the case
and that talking about it and bringing it out in the open is better. Ask them
if they have thoughts about how they would do it. If they have actually
considered a plan of how they would do it this indicates a higher risk. Giving
away their possessions, saying meaningful goodbyes to people, getting their
affairs in order, feeling trapped or hopeless about a situation and withdrawing
from friends and family can all be warning signs. You can talk to them about
how it would affect their loved ones, but do this not from a perspective of how
selfish it would be, but how their loved ones would miss them. People with
depression are not thinking normally. They will have distorted views on some
things. For example it is common for a person contemplating suicide to think
and totally believe that their children may be better off without them, or that
they will simply get over their parent's death. Because of this distorted
thinking reasoning with them logically does not usually work.
If necessary contact the person's
therapist or your local hospital. There are emergency hot-lines for mental
health and there is always 000. It may be a good idea to get the contact number
of their doctor or mental health care provider if you are worried they are
going down this path.
Be sensitive. Be aware of how they are
reacting to what you say and do when you try to help them. Look for what seems
to work and what doesn't. What works for one person may not work for another. And
sometimes the depressed person may need help to recognise what is actually
working.
Be yourself. Just be open and honest.
You are not their counsellor. You are a friend who loves them and cares for
them. Even if it means saying you don't know what to say or do to help them,
but that you love them and you will be there for them. It may be easier for you
if you see your role as not being there to give them answers but to listen.
Remind them regularly that this is
something they are going through and that it will not last. They are probably
feeling as though they'll never get through it and that this is how they'll be
for the rest of their life, which makes life hardly worth living. Remind them
that it is a treatable illness. It may take some time and work, but they will
come through it. You may need to remind them constantly of this. It is
important to continually remember that it is treatable, so what your loved one
is going through will not be forever, and also that it is an illness.
Sometimes just holding someone's hand, or
hugging at the right time can say more than a thousand words. When their minds
will not allow the words of comfort that you give to mean anything, your touch
may be what gets through to them. Be sensitive though, as there may be times
when physical attention in not welcome. Don't take this personally. If you feel
comfortable and are able to offer, give them a gentle massage.
Reassure them that God loves them. There
is nothing they can do to increase or decrease his love, They don't have to DO
anything to receive his love. He just loves them. He loved and died for them
while they were sinners, he loves and died for them while they have depression
too. They have not failed God as God sees them through Jesus' righteousness on
the cross. Show them God's love through your love. They may respond negatively
when you say words of encouragement, but don't stop saying them.
Look after yourself. You cannot help
another person if you do not look after yourself first. You must ensure that your
own needs are met as well as helping your loved one's needs. If they are not in
a position to be meeting your needs then you will need to look for support
elsewhere. Have time out for yourself. It is not easy living with someone who
has depression, especially if it is severe. However remember that most
depression is treatable, so this is a journey that your loved one and you are
going through, and you will both come out at the other end. If you find that
you are beginning to feel overwhelmed with feelings of anger, frustration or
helplessness in regard to the situation do not hesitate to seek some counselling
for yourself. It will assist both you and the person you are trying to help.
Being with a depressed person actually
has the potential to bring out repressed feelings of depression in their family
or close friends. It can be very draining to be around someone who is depressed
and you will not always feel loving and caring or feel like being sensitive.
That's OK. Make sure you get some time out for yourself. Understand that the
depressed person is unable at this time to give you what you may need as much
as they may wish they could. You need to have your own time with your
supportive friends. Seriously consider going to a support group for fellow carers
of people with depression or seeing a counsellor.
What not to do:
Tell someone to 'snap out of
it'. This not
only belittles how a person is feeling it suggests that they actually have the
ability to change it. When the person can't do this they feel even worse, as
though they are letting others down and a failure because they should be able
to just stop feeling like this. This increases the feelings of low self-worth
which are a basic component of depression. It can also foster a pattern of
hiding the depression and therefore not facing it and working through the
issues involved.
Try to rationalise why they
should not be depressed. This
may seem to be a good idea and make sense to you, but will not work, partly
because often they are in a distorted reality where they cannot see things as
they really are. It may also increase their feeling of it being hopeless
particularly if they can understand rationally why they should not be depressed
and yet still have the feelings of depression. This may reinforce the feeling
of helplessness which is often a cornerstone of depression. Depressed people
will have negative views of themselves and almost every thing around them.
Their perception of things is illogically pessimistic. Challenging them on this
does not help, particularly in severe cases. The chemical imbalance needs to be
addressed before their dysfunctional thinking can be challenged. And anyway,
this is usually best done by a professional. (Although it may be that when the
person is at this stage of recovery, i.e. working with their health provider on
their thinking, that they ask you to help them to recognise the negative
thoughts.)
Minimise or deny the depressed
person's experience. This
may make the depressed person feel that they cannot open up to you about their
depression. It will also increase their feelings of isolation and helplessness.
Its important to accept that their perception is their reality.
Compare the depressed
persons experience to yours or others. Everyone’s experience of depression will
be different to some degree. While it may be helpful to express that you
understand the depths of deep emotional darkness (if you do), do not presume
that your experience is the same as theirs. This is true especially when you
may be trying to think of things that may help. What helped one person may not
help someone else. Of course its worth trying things that may have helped
others, but be aware that if they try something that helped someone else, but
it doesn’t work for them, this may cause more feelings of helplessness and
guilt.
Spiritualise the
depression. Be
very careful what you say about God and faith in relation to depression. More
than likely the person concerned will already be feeling guilty and as though
they have failed God. They have probably already tried to improve themselves
through prayer and reading the bible. It is possible that a component of the
depression may be an attack of Satan, however this is
something for someone
qualified and with experience in this area to work though. Prayer and work in
this area should be part of a holistic approach, which will possibly include
medication and
counselling. Remember, every good and perfect gift comes from
above. Solutions to prolonged
counselling, or medication See
my previous blog on the spiritual side of depression for more on this. In the
story of the four friends who lowered a sick man down to Jesus (Luke 5:18,19)
the sick
person could not do anything, it was up to his friends’ actions. If
they had not done this he would
not have been healed. They did not just sit
around praying for him and reading the scriptures to him
(though they may have
done that too). They took action to help their friend. Don't get all ‘spiritual’
on them. Prayer is effective and
the Bible is powerful, but if they are not receptive to this, you can
pray and
apply scripture over them when you are not with them. What they need most
spiritually is
to see God’s love through you.
Some specifics on supporting
men
A reminder of the differences between
male & female depression:
Men tend to:
|
Women tend to:
|
Blame others
|
Blame themselves
|
Feel angry, irritable & ego
inflated
|
Feel sad, apathetic & worthless
|
Feel suspicious & guarded
|
Feel anxious & scared
|
Create conflicts
|
Avoid conflict at all costs
|
Feel restless & agitated
|
Feel slowed down & nervous
|
Need to feel in control at all costs
|
Have trouble setting boundaries
|
Find it ‘weak’ to admit self doubt
& despair
|
Find it easy to talk about self doubt
& despair
|
Use alcohol, TV, sports & sex to
self medicate
|
Use food, friends & ‘love’ to self
medicate
|
Adapted from ‘Male Menopause’ by Jed
Diamond
|
|
Studies in the psychology of masculinity
have shown that men in our society traditionally see themselves as being tough,
independent and unemotional. They do not generally want to seek help with
personal problems - either physical, emotional or mental. How do we change
this? Well, as a society we need to help men see that many other men have
similar problems. Bringing awareness, acceptance and non-judgment to depression
and its issues are the first steps.
Some men are so out of touch with their
emotions that they don’t realise that they are having emotional or mental
problems, such as depression, even though they may be exhibiting symptoms in
these areas. It can be very hard for men to examine their feelings, particularly
depressed men. They are not used to doing this and it may seem as if it will
take everything they’ve got and is too high a cost to get to those feelings.
If you can get your man to talk about his
feelings and what he is experiencing with depression, just focus on listening
and trying to understand what it is like for him. Don’t offer suggestions while
he is opening up to you. His feelings may seem very strong and hard to accept,
but don’t take them personally. Its not about your or even your relationship.
Beyond Blue has a website called Man
Therapy, specifically for men with mental health problems. Its written by men,
for men, uses humour and may even at times seem a little crude to us
good-Christian-women, but I highly recommend it. It has a ‘manly’ quiz (http://mantherapy.org.au/#MindQuizMain) which will help men to
determine if they do have depression, and need to see a doctor.
Remember, when
medical treatment is combined with spiritual and emotional
treatments, people recover faster than using just one treatment method.
For women trying to help their male loved
one, even using different terminology may be helpful, for example using the
term ‘consultation’ instead of ‘therapy’ or the term ‘skills’ instead of ‘personal
development’. Avoid using words that make him feel worse. A man in the
doldrums of depression doesn't need to hear, "How can you be depressed
with all God has done in our lives?" (He's probably already feeling as
though no one understands, and this just confirms it.) Avoid preaching:
"Just read your Bible more and get right with God, and your depression
will go away”.
Encourage fellowship with other men. Of
course a depressed man may find this difficult in which case if he has a
particular friend he relates to encourage and make it easy for them to get
together. Women will often relate with each other and share things over coffee,
but men relate with each other better while they are involved in an activity.
Fishing, golfing, gardening - whatever your loved male is into, encourage him
to do with a friend. Encourage any exercise. As discussed in a previous blog,
in general men tend to show their depression in physical ways, so it makes
sense that any positive physical activity will be beneficial.
Care for yourself. This has already been
mentioned but I can’t emphasise it enough. If you do not look after yourself
you wont be able to help anyone else. You need to know that it is not up to you
to fix someone else’s life. You can only do your best, and that will be
different for everyone. You need to be able to hand your loved one’s depression
to God, and to know that God loves your husband/son/brother/friend more than you
do. He can and will use the experience with depression to bring something good.
Be open with family and close friends…no
hiding or secrets. This is a general statement but may be difficult if the man
in your life with depression does not want other people to know. You really
can’t go against his wishes, except to make it clear to him that you may need
to talk to a close friend of your own about it for your own support.
Having a husband/partner with depression
can be very difficult. Society, and especially church society, view men as the
ones who are suppose to be strong, not weak. As wives it can be a struggle to
adjust to this reversal of strength and dependence while the ‘head of the home’
is going through depression. It may feel as though the woman needs to be strong
for both of them. It also means you are living in a house with someone whose
condition will probably be affecting the whole household in a negative way. Not
only that but it may undermine your very relationship. Try to always remember
that it is a medical issue for which there is treatment which means it is
temporary. Remind yourself that the person you love and who you committed to is
still there, but is struggling themselves with the changes that this illness
brings. It may be helpful to emphasise to your loved one that you know he has
not intentionally chosen to be depressed.
Accept and love your spouse. This is
probably the most important thing you can do for your depressed man. He may
well push you away, especially emotionally. You may well need to rely on God
for the grace and patience that’s needed. Try to separate his (depression
caused) actions from the person that you know him to be. If you haven’t read
the books on Love Languages by Gary Chapman (http://www.5lovelanguages.com/) this might be a good time to
do so and to show him your love through his personal love language. Remember,
you are not his therapist, your role is to love and listen, not to fix his
depression.
While women usually internalise their
depression men may lash out and may seem to be blaming and attacking you and
others (even though they are probably feeling as though they are to blame on
the inside). Depressed men often frustrate and alienate those they love the
most. It's almost as if they have a need to blame someone for their depression,
and the one who loves them the most is the easiest to target. Anger often
accompanies depression in men, but do not allow abuse, or disrespect. Do not
let his anger begin fights if possible. Walk away from it. If he does become
abusive, physically, emotionally or mentally, you have every right to and
should seek help. Even if he is not normally an angry man, and you know it is
caused by his depression, loving him does not mean you put up with abuse.
Try to see the depression as the enemy,
not your partner as the enemy. That way you can fight the depression together,
not fight each other.
If you hear comments such as “I wish I
wasn't around," or "You and the kids would be better off without
me", take them seriously. He needs professional help. As mentioned in a
previous blog, although many more women attempt suicide than men, it is the men
who succeed more often.
Finally, encourage the man in your life
with depression to just be honest with God as David and Job were. Its OK to not
understand and to question God. David did that many times in the Psalms. We can
do that without losing our faith. We can even wonder if God is bringing us to a
place of death, as Job did when he cried, "Though He slay me, yet will I
trust Him" (Job 13:15). The important thing is to continue to trust God.
Even Jesus, who is our example, felt that God had forsaken Him. And yet even in
that He knew that God was in control. Keep in mind that feelings and knowing
are two very different things. And when we cry out to God to remove the thorn
of depression from our life, we need to remember God’s answer to Paul. “My
grace is sufficient for you, for My power is perfected in weakness” (2
Corinthians 12:9).
Help lines in
Australia
- · Lifeline 13 11 14
- · Men's Line Australia 1300 78 99 78
- · Salvo Care Line 1300 36 36 22
- · Kids Help Line 1800 55 1800
- · Salvo Youth Line (02) 8736 3293 (Sydney local call)
- · Child Abuse Prevention Services 1800 688 009
- · Suicide Call Back Service 1300 659 467
Helpful websites
Specifically for men:
- http://www.mensline.org.au/Depression.html
- http://mantherapy.org.au
- http://demonsfilm.net/
Information and support about depression:
- · Beyond Blue www.beyondblue.org.au
- · Mind Health Connect www.mindhealthconnect.org.au
- · Black Dog Institute www.blackdoginstitute.org.au
- · Mind Spot Cinic www.mindspot.org.au
______________________________________________________________________________
I’m not a trained professional.
I have just gathered information from
reputable sources and presented it here.
Its not meant as specific advice for individuals.
Please, if any of this resonates with you
seek professional help.
If you want information on how to do that
please email me…ruthch31@gmail.com
_________________________________________________________________________________
_________________________________________________________________________________
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