Behavioral health
Tips help families survive depression
Here’s how to help families cope
Patients with clinical depression don’t suffer alone. Statistics gathered by national psychiatric associations indicate that as many as 40% of the spouses of depressed patients develop their own mental health problems.
Sharing tips with family members on coping with a loved one’s depression will not only help your patient recover more quickly, it also may prevent health problems in your patient’s family members.
"What you hear most when you talk to spouses of depressed patients is grief," says W. Daniel Hale, PhD, a licensed psychologist and a professor of psychology at Stetson University in Deland, FL, which recently hosted a one-day conference, Recognizing and Responding to Depression.
"They complain that the person has changed. The person looks and feels like a different person. The person they’ve loved and enjoyed for years is gone. It’s hard for family members not to feel rejected by the depressed patient," he says.
Case managers can support the families of depressed patients by offering them tips for coping with their loved one’s depression and helping their loved one recover. "Sometimes, with the best of intentions, family members do and say exactly the wrong thing, and the situation worsens," he notes. Hale suggests case managers share these strategies with the families of depressed patients:
• Develop a clear understanding of the condition. "When you listen to someone with depression talking, you can hear the depression. You learn to recognize it," he says. "But many family members don’t really understand clinical depression."
He suggests that in addition to any educational materials case managers may have on depression, they also encourage family members to read first-person accounts of the depressive experience.
• Accept limits. "Family members, just like health care professionals, must accept that there is a limit to how much they can help the depressed patient," Hale explains. "Even with the best of intentions, there is a limit to how much even the most supportive family member can help."
• Seek support. "Living with a depressed person is a major stressor. Case managers should encourage family members to share their concerns with a close friend, a member of the clergy, or a support group."
• Avoid taking words or actions of patient personally. "One of the best things you can do for family members, is to help them realize that often it’s the depression and not their loved one saying or doing hurtful things," says Hale.
• Maintain your own routine. "Case managers should encourage family members not to give up their own lives," he urges. "They should keep up activities that reward and uplift them. Those activities help family members recharge emotionally."
• Maintain your own perspective on life. "Encourage family members to hold fast to their own views on life. Tell family members not to get sucked into the depressed person’s perspective that life is bad."
• Form your own support team. "Encourage family members to get in touch with their family physician and maintain regular contact," Hale says. "There are many ways that family members may need medical advice and assistance as they live through this experience."
Of course, coping skills may prevent the family members of depressed patients from developing their own health problems, but they won’t necessarily help your patient’s efforts to recover.
Hale and his colleagues interviewed 50 individuals who had suffered from clinical depression and asked them what their families and friends had done to help them. "What they reported was that family and friends were well-intentioned but often said the wrong things," Hale explains.
Participants in the first set of interviews listed actions they would take and statements they would make to a depressed loved one. Then, another 60 individuals who had suffered from clinical depression determined which of the actions or statements would have been useful to them during their depression, and which would have been counterproductive.
Dos and don’ts
From the interview responses, Hale and the research team created a list of do’s and don’ts:
• Allow the depressed person to cry. "Trying to prevent a depressed person from crying was seen as less helpful than letting them cry it out," he notes.
• Give physical and verbal support. "Physical reassurance and affection were seen as very helpful, as were statements that the person still was very important to the family. Repetitive statements of support and affection were also very helpful."
• Allow the person to talk about depression. "Letting patients talk about their feelings and letting them know it was OK to talk about being depressed was seen as very useful," notes Hale.
• Include him or her in family activities. "It’s not easy for depressed individuals to operate at 100% capacity, but the people we surveyed also said it wasn’t good for families to avoid making demands on the depressed person," notes Hale. "The depressed person doesn’t want to feel as if he or she is incompetent or not needed."
• Avoid useless cliches. The survey also revealed a list of phrases that individuals said were not helpful and should be avoided by family members. Those include:
— "Cheer up!"
— "Don’t be sad."
— "Don’t let things get to you."
— "Stop feeling sorry for yourself."
— "You’ll feel better if you improve your attitude."
"It takes a little sensitivity training for family and friends to learn how to help a depressed loved one," says Hale. "Depression isn’t something you cure by putting a key in the lock and turning. It takes consistent expressions of love and concern. It’s a gradual chipping away. If families realize that, they will be more effective in helping depressed patients recover."
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