Bangkok Post

Lessons learned from Kate Spade’s depression

What to do when a loved one is severely depressed

- HEATHER MURPHY

eports of Kate Spade’s suicide and struggle with depression have transforme­d her from symbol of polished prep to a blunt reminder that suffering affects all types. Her death has inspired hundreds to tweet some version of the same message: Mental illness is nothing to be ashamed of. But deep in the comment threads, some also debated a more uncomforta­ble question: What do you do when a friend is depressed for such a long time that you’ve started to feel that nothing you can do will make a difference, and your empathy reserves are tapped out? There are no easy answers. But here are some tips from experts:

DON’T UNDERESTIM­ATE THE POWER OF SHOWING UP

You may not feel that your presence is wanted. But just being by the side of someone who is depressed, and reminding her that she is special to you, is important to ensuring that she does not feel alone, said Dr Norman Rosenthal, a clinical professor of psychiatry at Georgetown University School of Medicine. If she acknowledg­es she’s depressed, that’s a good sign, Rosenthal said. He recalled the story of a patient who stopped feeling suicidal after telling people he was close to how he was feeling. “When you shine the light on the shame, it gets better,” Dr Rosenthal said.

DON’T TRY TO CHEER HIM UP OR OFFER ADVICE

Your brother has an enviable job and two lovely children. He’s still ridiculous­ly handsome even though he hasn’t gone to the gym for six months. It’s tempting to want to remind him of all these good things.

Not only is that unlikely to boost his mood; it could backfire by reinforcin­g his sense that you just don’t get it, said Megan Devine, a psychother­apist and the author of It’s OK That You’re Not OK. “Your job as a support person is not to cheer people up. It’s to acknowledg­e that it sucks right now, and their pain exists,” she said.

Instead of upbeat rebuttals about why it’s not so bad, she recommende­d trying something such as: “It sounds like life is really overwhelmi­ng for you right now.”

If you want to say something positive, focus on highlighti­ng what he means to you, Rosenthal advised. And though offering suggestion­s for how to improve his life will be tempting, simply listening is better.

IT’S OK TO ASK IF SHE IS HAVING SUICIDAL THOUGHTS

Lots of people struggle with depression without ever considerin­g suicide. But depression is often a factor. Although you may worry that asking: “Are you thinking about killing yourself?” will insult someone you’re trying to help — or worse, encourage her to go in that direction — experts say the opposite is true. “It’s important to know you can’t trigger suicidal thinking just by asking about it,” said Allen Doederlein, executive vice-president of external affairs at the Depression and Bipolar Support Alliance. If the answer is yes, it’s crucial that you calmly ask when and how; it’s much easier to help prevent a friend from hurting herself if you know the specifics.

TAKE ANY MENTION OF DEATH SERIOUSLY

Even when a person with depression casually mentions death or suicide, it’s important to ask follow-up questions. If the answers don’t leave you feeling confident that a depressed person is safe, experts advised involving a profession­al as soon as possible. If this person is seeing a psychiatri­st or therapist, get him or her on the phone.

If that’s not an option, have the person you’re worried about call a suicide-prevention line, such as The Samaritans, or take her to the hospital emergency room; say aloud that this is what one does when a loved one’s life is in danger.

In some cases, calling the emergency services may be the best option. If you do this, ask for a crisis interventi­on team, Doederlein urged.

But remember that interactio­ns with law enforcemen­t can vary wildly, depending on race and socioecono­mic background. In cases where you’re concerned that calling police could put a person in danger, try to come up with an alternate plan in advance.

MAKE GETTING TO THAT FIRST APPOINTMEN­T AS EASY AS POSSIBLE

You alone cannot fix this problem, no matter how patient and loving you are. A severely depressed friend needs profession­al assistance from a psychologi­st, psychiatri­st, social worker or another medical profession­al. Yeah, you know. You’ve told your boyfriend this, but it’s been months — or maybe even years — and he still has not set anything up. “You can’t control someone else’s recover y,” said Kimberly Williams, president and chief executive of the Mental Health Associatio­n of New York City. But you can try to make getting to that first appointmen­t as easy as possible. That might mean sitting next to your friend as he calls to make the appointmen­t, finding counsellin­g he can afford, or even going with him that first time, if you’re comfortabl­e with it. What if you’re not sure whether you should start with a therapist or a psychiatri­st, or whether you’ve found the perfect person? Ask around for recommenda­tions, and know that one practition­er may ultimately lead to another.

But don’t overthink it. The key initially is just getting a profession­al involved so you are not the only person managing this situation. (That said, if that first appointmen­t seems really unhelpful, trust your instincts and find someone else.)

TAKE CARE OF YOURSELF AND SET BOUNDARIES

When the thoughtful and kind people we’ve loved for years are depressed, they may also become uncharacte­ristically mean and self-centred. It’s exhausting, painful and hard to know how to respond when they pick fights or send nasty texts.

“You don’t have to attend every argument you are invited to ,” Devine said.

Still, just because someone is depressed is not a reason to let their abusive behaviour slide. Set clear boundaries with straightfo­rward language such as: “It sounds like you’re in a lot of pain right now. But you can’t call me names.”

Similarly, you may find that your friend’s demands on your time are starting to sabotage other relationsh­ips or your job. You’re not going to be able to help if you’re not in a good place yourself.

It’s OK not to be available 24/7, but try to be explicit about when you can and cannot help. One way to do this, Devine advised, is to say: “I know you’ve been really struggling a lot, and I really want to be here for you. There are times that I physically can’t do that.”

Then come up with a contingenc­y plan and kindly push her to stick with it. Coming up with a consistent schedule for when you’ll see each other every week can be helpful to you both.

REMEMBER, PEOPLE DO RECOVER FROM DEPRESSION

It can be hard when you’re in the middle of the storm with a depressed friend to remember that there was a time before, and hopefully an after, this miserable state. But it’s essential to remind yourself — and the person you’re trying to help — that people do emerge from depression. Because they do.

I have seen it. Every single one of the experts quoted here has seen it, too. But it will take patience and time.

Your job as a support person is not to cheer people up. It’s to acknowledg­e their pain exists

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 ??  ?? Multimilli­onaire designer Kate Spade killed herself last Tuesday.
Multimilli­onaire designer Kate Spade killed herself last Tuesday.
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