Living with depression

Depression can trick people into believing things about themselves and the world which are simply not true. Depression is quite common. If you had a cold, you would do something to try to make it better. It's like that with depression. You're not weird for feeling the way you do.

While it may not feel as though you are ever going to get through the depression, it helps to know that people can, and do, recover. Some people who have recovered sometimes say depression has helped them to see themselves as a stronger person, able to cope better and make changes in their lives they were not able to before. If you are living at home it may be difficult to make all the changes you would like, but getting help for depression is the most first step.

Childhood, and especially adolescence, can be a difficult enough time without the additional challenge of coping with depression. Young people in crisis may feel their world has fallen apart, that everything is black or nothing makes sense. Worse still, young people experiencing depression often lose hope or the belief they can recover and lead a worthwhile life. But others who have come through episodes of mental illness are able to look back and see how mistaken their loss of hope was.

Discrimination and stigma

Many young people feel ashamed of having a mental illness and can sense other people's fear, prejudice and low expectations for them. Media coverage can give the wrong impression that people with mental illness are likely to be violent. Employers and landlords don't really want to know people who have a mental health problem.

Workmates or classmates and friends may turn their backs on a person they know who has depression. Even families and whanau and mental health workers can come across as over-anxious and controlling. None of this seems to help. Sometimes the discrimination feels worse than the illness itself.

Support and information

Young people with depression often do better if they have support people who are caring, non-judgemental and who see their potential. Friends and family or whanau may offer good support. Some get their best support from others who have been through the same kind of experience. Other people find a counsellor or another type of mental health worker who is supportive.

Older children can take part in decisions that affect them, if they learn about their condition and the types of treatment and support that are available. It's also useful for them to know about their rights as a mental health service user.

Using services

A lot of young people with depression, sooner or later, go to see their GP or a counsellor or are referred to mental health services.

If young people express fear that they might harm or kill themselves it is vital they get help immediately.

Sometimes it is hard for young people to seek help because they feel ashamed and want to hide their distress. Acknowledging they have a mental health problem and need help can be very scary. People with depression often say the best services are ones where they are listened to, treated as equals and are given support or treatment that works for them. Otherwise, the service is unlikely to meet their needs.

Recovery

Even if they continue to have episodes of mental illness, young people can still experience recovery and live a happy and worthwhile life.

Important strategies for recovery

Children and young people with depression have found the following strategies to be useful:

• Find someone to talk to. Don't bottle up your feelings, Most people with depression find that talking to a trusted friend, family or whanau member or counsellor helps.
• Learn about depression and the treatment options. Have access to information to help make sense of what has happened, know what to expect, and take an active part, as far as possible, in decisions about your treatment and support.
• Receive treatment and support from people you trust, who expect the best for you but are able to accept how you are at any time.
• If possible, have the continuing support of family or whanau and friends, who know about the condition and understand what they can do to support your recovery.
• Have the opportunity to get support from culturally appropriate support groups or advocates (trained supporters) who can help you to recover and stay well.
• Try to do some form of exercise or activity, even a five-minute walk is better than nothing. Don't beat yourself up if you don't manage to achieve a goal. Set small goals that you can reach.
• Make sure the food you eat is healthy and includes fresh fruit and vegetables. Often depression will rob you of hunger.
• Understand that alcohol, other drugs and cigarettes actually depress the nervous system - in other words they feed your depression. It may be hard when you wonder "What's the use, anyway?" but if you do drink or use other substances, or smoke, try to at least cut down.
• Read, watch TV or relax if you can't sleep, use the time. This can help to reduce the worries and negative thoughts which make the depression worse.
• Become familiar with the early warning sign of relapse, and be part of developing a plan to help you stay well. Health professionals involved in your care will help with this.
• Involve whanau/friends or other  people (eg. kaumatua or church minister) in your treatment team if you wish.
• Talk to your doctor or counsellor if you are considering stopping treatment and work together with them to find some ways to make sure you can stay well, but also address your concerns about the treatment. If you are on medication for depression it is very important that any decision to stop medication is made with the input of your doctor and any other members of your treatment team.

Family and whanau views

Families and whanau often experience real grief, isolation, powerlessness and fear as they witness their child or teenager struggling with depression. During a crisis they may find they cannot understand the young person's behaviour or communicate with them any more.

Even after a crisis they may find them withdrawn or hard to be around. Their feelings for their relative can swing from compassion for their pain, to grief at the loss of the person they once knew, to hostility towards their relative for disrupting their lives. Families and whanau often worry that their relative will never get better and may have to revise their expectations for that person.

Discrimination and stigma

Families and whanau may feel shame or embarrassment if their child or teenager behaves in an unusual way when they are very unwell. They may shut themselves off from their friends and neighbours or feel that these people are avoiding them. Families and whanau hurt when they see their relative being discriminated against or treated unfairly by adults and other children.

Support and information - family and whanau

Families and whanau often feel drained and stressed and need support to look after themselves as well as their relative with mental illness. Their other family or whanau relationships can get neglected when the needs of the person with mental illness have to take priority.

There are several ways families and whanau can get support. They can get in touch with other families and whanau who have had similar experiences. Some mental health services provide good support options for families and whanau. Families and whanau need information on the person's condition, their options for treatment and their rights.

Experiences with services

Families and whanau frequently find that services do not listen to their views about their relative. Ideally, families and whanau who are involved in caring for someone with mental illness need to be able to communicate freely with professionals about their relative. The family or whanau may also need some professional help to mend any rifts in their relationship with their child or teenager.

Recovery

Most families and whanau want to help their relative recover. If families and whanau can share information, skills and support with their relative and the professionals who look after them, the likelihood of recovery is much greater.

Living with a depressed child or teenager can be hard going for everyone. It can feel like a black cloud descending every time they come into a room and other family members may feel like they are treading on eggshells in order not to upset the depressed one.

Important strategies to support recovery

Families, whanau and friends of children and young people with depression have found the following strategies to be useful and important:

• Show your love with warmth and companionship, without being overly intrusive. Communication skills are needed to listen to the depressed child; encourage him or her to talk or cry. Accept your child's feelings as he or she experiences them, not as you think they should be. Affirm your child's strength and good qualities and try to maintain your own hope and calm.
• Support the child or young person to get help and, if necessary, go with them to appointments. If a young person refuses professional help, seek advice from family or whanau or other trusted adults. With younger children you must insist they get the help they need.
• Learn what you can about depression, its treatment, and what you can do to assist recovery.
• See yourself as part of the treatment team and, in particular, learn about the signs of relapse and, with the help of any health professionals involved, agree with the young person as to how you can help them stay well.
• Take any expressed suicidal thoughts or urges very seriously and seek outside help immediately.
• Understand the symptoms for what they are. Try not to take them personally or see the child or adolescent as being difficult.
• Help them to recognise stress and find ways of coping. This may include helping to solve problems that worry them.
• Encourage the young person to be more active, but without pushing or criticising them, as this may make things worse. Accepting them as they are and having realistic expectations for them is very important.
• Try to discourage them from drinking alcohol and encourage them to maintain a healthy diet which includes fresh fruit and vegetables, without forcing the issue.
• Try to keep the daily routine as normal as possible. The child or young person may need help with getting out of bed. Negotiate this with them, have meals together and gently encourage participation in household activities and chores.
• Look after yourself. Talk to trusted people about your own feelings. Try to have a few breaks to do things you enjoy, and keep your own interests and social contacts going. Do not allow a child's depression to stop your enjoyment of life. Set some boundaries and try to take some time out for yourself. It is important to maintain your own wellbeing.

See also: Depression in childhood/adolescence; Depression in childhood/adolescence - treatment

Support groups

See the support organisations (which include helplines) under Further information and support below.

Original material provided by the Mental Health Foundation of New Zealand, 2002. Edited by everybody, June 2005.