Living with depression

Living through depression is usually one of the most overwhelming, frightening, isolating and debilitating experiences a person can have. People in crisis may feel their world has fallen apart, that everything is black or that nothing makes sense. Worse still, people experiencing depression often lose hope or the belief that they can recover and lead a worthwhile life.

But those who have come through episodes of depression are able to look back and see how fallible their loss of hope was. Everyone with mental illness can lead a worthwhile life, even if it is not quite the life they had planned.

Discrimination and stigma

Many people feel ashamed of having depression 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 and friends may turn their backs on a person they know who has mental illness. Even families, whanau and mental health workers can be over-anxious, controlling and pessimistic about lives of people with depression. None of this helps. Sometimes the discrimination feels worse than the illness itself.

Support and information

People with depression often do better if they seek support people who are caring, unjudgemental and see their potential. 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. Their friends and family or whanau may offer good support.

People with depression can make more informed choices if they educate themselves about their condition and the types of treatment and support that are available. It is also useful to know about your rights.

Using services

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

If you fear you might harm or kill yourself it is vital you seek help immediately.

Sometimes it is hard for 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

Sometimes people are given quite pessimistic predictions about their lives by mental health professionals. But even if you continue to have episodes of depression, you can still experience recovery and live a happy and worthwhile life.

Important strategies for recovery

People with depression have found the following strategies to be useful and important.

• Learn about depression and the treatment options. Have access to information to help make sense of what has happened. Health professionals and others involved in assisting recovery should provide information in a way and at a pace that is comfortable for you.
• Take as active a part as possible in decisions about treatment and support. Being involved in decisions is the best way to ensure that you can make informed choices about what is best for you.
  
• Get treatment and support from people you trust, who expect the best for you but are able to accept how you are at any time.
  
• 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.  Involve family, whanau, friends or other important people (eg. kaumatua or church minister) in your treatment team if you wish.
• Have the opportunity to receive support from culturally appropriate support groups, organisations or advocates (trained supporters) who can help you to recover and stay well.
• Have the opportunity to recuperate - have time out and relax, but also feel encouraged to become more active as you are able.
• Take steps to improve your general health. Some daily exercise, a healthy diet, plenty of fluids, and relaxation can all be important in aiding recovery and keeping well.
• Sleep regular hours. Go to bed and get up at around the same time, and avoid sleeping during the day. Avoid drinks containing caffeine (tea, coffee, cola, so-called 'smart' drinks, etc). If you can't sleep at night, get up after 30 minutes and do something relaxing. Try to avoid worrying about not sleeping.
• Be realistic in what you expect of yourself, especially during an episode. When things seem too hard, take them on one step at a time.
• Do something enjoyable each day, and try to focus on positive thoughts and memories.
• Find the ways of coping that work best for you. These are different for each person, but are a critical first step on the path to recovery.
• Have the opportunity to make sure that your physical and spiritual needs are met.
• Become familiar with their early warning sign of relapse, and be part of developing a plan to maintain wellness. Health professionals involved in your care will help with this.
• Avoid or really cut down the use of alcohol and illegal drugs, as these may worsen the condition and increase the chances of relapse.
• Talk to your health professionals if you are considering stopping treatment and work together with them to find some compromise that will ensure continuing wellness but address your concerns about the treatment. It is very important that any decision to stop medication is made with the input of your doctor and ideally, your whole treatment team.

Family and whanau views

Families and whanau often experience real grief, isolation, powerlessness and fear as they witness their loved one struggling with depression. During a crisis they may find that they cannot understand the person's behaviour or communicate with them any more. Even after a crisis they may find their relative 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. Families and whanau often live through all this without support from their community or from mental health services.

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 depression. 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.

Recovery

Most families and whanau want to help their relative recover. Unfortunately, sometimes the person with depression blames their family or whanau and does not want them to be involved in their care. Research shows that 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.

Important strategies to support recovery

Family, whanau and close friends of people with depression have found the following strategies to be useful and important.

• Learn about the disorder, 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 clinical staff, agree with the person how you can help them stay well.
• Understand the symptoms for what they are. Try not to take them personally or see the person as being difficult.
• Help the person to recognise stress and find ways of coping. This may include helping to solve problems that worry them.
• Encourage the person to be more active, but without pushing or criticising them, as this may make things worse. Accepting the person as they are and having realistic expectations for them is very important.
• Help and encourage the person to lead a healthier life, including exercise, trying to do enjoyable activities and seeing the positive side of things.
• Encourage the person who has been unwell to continue treatment, and to avoid alcohol and drug abuse.
• Find ways of getting time out for yourself and feeling okay about this. Caring for a family or whanau member with depression can be stressful. It is important to maintain your own wellbeing.

See also: Depression; Causes of depression; Treatment of depression

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, May 2005.