What to do when depression strikes
New Zealand’s suicide rate is among the highest in the world. In fact, our young people top the statistics table between the ages of 15 and 19, with 15.6 suicides per 100,000 people, five times the rate in the United Kingdom and twice the rate in the United States. I’m sure I am not alone in hoping that this figure will change dramatically in coming years.
Some suicides seem to be ‘‘random’’ events and have no obvious warning signs. But all too often there is a ‘‘prelude’’, a history of depression or other mental illness, that occurs for weeks, months or years before the suicide. Detecting this as early as possible, and providing the appropriate timely support and help, surely has to be one of the focuses for us all, whether we are parents, friends, partners, neighbours, team-mates or health professionals.
So how do you know if someone is depressed? This isn’t as easy as it sounds. Depression is common – affecting one in five of us during our lives – but all too often it is ‘‘hidden’’ away, something that we still feel slightly ashamed to talk about. It can cause a wide range of symptoms – some people will present as being very sad, withdrawn and flat, but for others it can be much more subtle.
It might be a change in behaviour – becoming more irritable, less social, anxious or stressed. They can also have a reduced appetite, be sleeping more or less than normal and have a lack of enjoyment or engagement in activities that previously gave great pleasure.
Work or school performance might change, with grades slipping and job satisfaction gone. For partners, a change in libido might be a clue. For parents, it could be as subtle as noticing that your child isn’t engaged with their usual friend group, seems quieter than normal or is exhibiting ‘‘risky’’ behaviours such as drinking or drug-taking in an attempt to feel better.
If you think someone around you may be exhibiting any symptoms of depression, please pluck up the courage to talk to them and show them you are concerned – this may make all the difference. You don’t need to have special training to do this, you just have to be kind, non-judgmental and supportive. Find a quiet space and time, and ask them how they are. If they brush you off, try again with different words – tell them you are worried about them and why. Don’t give advice at this stage, just listen to what they have to say.
Offering to help someone through their depression is a hugely important gift to give them. Depression can be an incredibly isolating experience, with sufferers often reporting they don’t think anyone really cares about them, even though their rational side may know this isn’t the case. You don’t need to have all the answers to be able to support someone (that job is for the counsellors and doctors who may need to become involved), but by showing you care, and are willing to be by their side, you are giving them a reason to get help.
So what next? How can you help if you do know someone in this situation?
Firtsly, encourage them to get professional support. If they are ready to take this step, offer to help them – picking up the phone and talking to someone can seem daunting when you are depressed, so doing this together can be helpful. Even offer to go to their first appointment with them if they would like – you don’t have to stay in the room, but could wait outside, so they have someone to go for a walk and a chat with afterwards.
If they don’t know who to go and see, come up with some suggestions. GPs and practice nurses are often the first point of contact, especially if medication is needed, but if for any reason this doesn’t feel right there are plenty of other options. Sometimes it can feel easier to speak to someone remotely, rather than face-to-face – if that is the case, there are lots of helplines listed below that you can try, many of which have 24/7 counsellors. Local counsellors will usually be listed in the phone book or on Google, and your GP should know how to refer you to a free or low-cost option if price is a barrier.
As well as considering ‘‘talking therapy’’ and medication, there are lots of self-help steps that can be useful when you are helping someone manage their depression – ensure they are getting regular exercise, good sleep, and healthy meals as this will provide their brain with the basic tools it needs to
You don’t need to have all the answers to be able to support someone but by showing you care, you are giving them a reason to get help.
recover; encourage them to engage with friends, family members and activities they enjoy, even though their instinct may be to do the opposite; or offer to help them find an online or ‘‘actual’’ support group. Knowing you are not alone in your depression can be helpful.
Lastly, check with them regularly – being reminded that you care about them, and their happiness, is important. When the time is right, encourage them to talk to others in their life as well, so that the support role can be shared. And if you start to feel out of your depth, or are struggling to cope, make sure you get help and support for yourself as well.
If at any stage, there is any suggestion that they are feeling hopeless or suicidal, or simply expressing that ‘‘life isn’t worth living’’, take it seriously and act immediately – you can call the crisis numbers below and ask for help any time, even if it feels like breaking their trust, you could be saving their life.