- “It is an illness, not some embarrassing personal failure or weakness”: Because unhappiness and normal human sadness are often described as “being depressed”, it is difficult for many people to realise that depressive illness is like an alien invading their chemistry and not only grossly handicapping their functioning but at times trying to kill the person.It is important to emphasise and indeed
to repeatedly remind the sufferer, that what they have is indeed an illness, that it is very painful and that it is treatable and will pass in time. Unfortunately, some depressive illnesses are very prolonged and/or very resistant to treatment, so that it takes considerable perseverance to keep up this message to the suffering person and indeed to yourself! - “I understand and I am here with you”: To state this phrase, again often needing to state it repeatedly, is very reassuring and emotionally intensely helpful. Obviously, it does not change any of the practicalities of the situation and it logically does not change anything but human beings are a mixture of logic and emotion. The emotional component of human beings, the one most damaged by depressive illness, is the component that benefits dramatically from this phrase.
- Spend time with the person, especially if they are suicidal: The person with depressive illness feels unable to function in the normal world and withdraws from interaction from those around them. They are not able to do the normal social things they used to be able to do, ranging from going out to a social event all the way to being unable to make normal telephone calls. Just being with the person affected and letting them know they do not have to entertain you or even particularly interact with you, is very supportive. For people who are suicidal, it is even more important that they not be left alone, especially if their suicidal ideas are very strong and you are awaiting the benefits of antidepressant medication.
- Compensate for the person’s inability to think: Depressive illness makes organising the simplest of things almost impossible. It is therefore immensely useful to the depressed person if you can organise their day to day necessary activities organise their childcare and home duties as best as possible and perhaps organise their finances. This may range from making sure their bills are paid on time to making sure they collect whatever salary, insurances or social security payments they are due. People with depressive illness become immensely disorganised and often need this form of intervention.
- The vital role of hope: Depressive illness progressively takes away the person’s hope that anything good can ever happen for the rest of their lives and tries to persuade them that in fact terrible things are likely to happen. When things get to this stage, the illness convinces them that suicide is the only logical solution to the inevitability of endless suffering and endless negatives. It is important to keep on insisting to the affected person that they do have an illness, it can be very effectively and fully treated and they will totally recover and be back to his or her normal self. It is usually necessary to keep on repeating these themes, as the illness keeps telling the person the opposite. It is also important to encourage the patient to keep on seeing their doctor and taking their antidepressant medication.
- Be aware of the possibility of suicide or self harm: Unfortunately, severe depression relentlessly persuades the sufferer that they would be better off dead. It is quite appropriate to ask the person you are concerned about
- if they have wished they did not wake up in the morning,
- if they have actually wished they were dead,
- if they have considered ways of ending their life,
- if they have made any plans to end their life and
- if they have in fact actually already attempted to end their life.
If the answer is definitely no to one of these questions, there usually is no need to ask the next series of questions on this list, as indicators of escalating suicide risk.
Do not be afraid your question will suddenly make the person think about suicide, never having contemplated it before. Almost all human beings fleetingly contemplate the possibility of not being alive at times of distress and certainly this is an almost inevitable possible option that crosses the minds of nearly everybody with depressive illness. Indeed, the person about whom you are concerned will usually be very relieved that the possibility of the illness forcing them to suicide is not a taboo subject and will be very relieved that you can discuss it with them.
If you are particularly concerned about the person involved harming themselves or committing suicide, do stay with them, until medical intervention can be arranged and you may wish to read the section on this site, “Some warning signs of Suicide”.
Important Disclaimer: This site is medical information only and is not to be taken as diagnosis, advice or treatment, which can only be decided by your own doctor.