top of page
Search

Depression: Dark Night of the Soul (What to do and how to help)

  • Writer: Leanne Braddock
    Leanne Braddock
  • May 8, 2022
  • 8 min read

““What is depression like? It’s like drowning, except everyone around you is breathing.”

“I love this quote. It perfectly describes how absolutely alone and terrifying it is to be imprisoned inside the inescapable bog that comprises serious depression. You feel utterly helpless, leaden, dull, unable to move. You are trapped—an unwilling witness to those living what appear to be happy lives. Anger at everyone’s obliviousness to your condition invades your lungs, heart, and spirit. The waves of pincer-like pain keep pummeling your brain as your body is dragged down, down, down onto the inky, cold depths of the ocean floor, choking you. The question: Stay fetal-like or fight your way to the surface? By Sherry Amatenstein, LCSWApr 21, 2022”[1]


If you or someone you love have found themselves in the depths of depression, these words sound all too familiar. Some days, just the thought of dragging yourself to the bathroom may seem like a laudable feat, much less getting dressed, fixing breakfast, or caring for anyone else. The sounds of laughter can sound like mocking, and clients have asked, “Why? Why can’t I feel anything?”


Sadness vs. Depression


Almost all humans feel sadness at some point in their lives. We feel sad when friends move away, when we have an argument with a family member, or when a pet dies, for example. When we are sad, it usually lasts for a few days or a week or so, until we think it through and come to terms with the situation. Or, psychologically speaking, when we make it part of our new life narrative. But depression is something different. Depression is generally more pronounced, deeper, and longer-lasting, and we have difficulty making sense of what we are experiencing, because our known coping systems are not working to rid us of the depressive effects.


Depression is characterized by some, or sometimes all, of the following:

  1. feeling depressed throughout each day on most or all days

  2. lack of interest and enjoyment in activities you used to find pleasurable

  3. trouble sleeping, or sleeping too much

  4. trouble eating, or eating too much, coupled with weight gain or weight loss

  5. irritability, restlessness, or agitation

  6. extreme fatigue

  7. unwarranted or exaggerated feelings of guilt or worthlessness

  8. inability to concentrate or make decisions

  9. suicidal thoughts or actions, or thinking a lot about death and dying


What causes depression? There is no simple answer.


Some depression can begin as a response to a life event. Loss of any kind, be it loss of a loved one to death or divorce or other relationship loss; loss of employment or identity; loss due to theft or other crime; trauma due to natural disaster or sex abuse; and conflict with others, are some of the triggers that can increase the chances of developing depression. The social isolation and stress of two years in the pandemic have seen an increase in both anxiety and depression.[2]


Depression can occur due to physical factors, too. We know “people who are diagnosed with heart disease have an increased risk of developing depression… The prevalence of depression among cardiac patients ranges from 20 to 30 percent.”[3] Other serious illness, certain medications, and substance abuse can trigger depression. Age and gender may affect depression. Women are about twice as likely as men to become depressed. Post-partum and depression during menopause account for two times during a woman’s life when she may be more at risk for depression. The elderly are also more at risk of being depressed, perhaps made worse by living alone or not having an adequate social support.[4]


There seems to be a genetic factor involved in many mental health issues. While depression in your family does not predetermine that you will also suffer from depression, it does place you at greater risk. It’s always a good to know your family medical history. Unfortunately, mental health history is often a secret in families, so you might have to do some digging or acute listening to family stories. A family history of substance abuse might have been an attempt at self-medication for depression.


Some people may refer to depression as a “chemical imbalance in the brain,” and point to that as a cause. While not fully understood, “chemicals are involved in this process, but it is not a simple matter of one chemical being too low and another too high. Rather, many chemicals are involved, working both inside and outside nerve cells. There are millions, even billions, of chemical reactions that make up the dynamic system that is responsible for your mood, perceptions, and how you experience life.”[5]


Or, depression may happen for no known reason. This is probably the most frustrating and often embarrassing (to the client) of all. He/she doesn’t know what is happening and thinks they are literally “going crazy.” Depressive episodes may occur all of a sudden, or come on gradually. Sometimes depression may be such a part of someone’s life, they can’t remember when they didn’t feel a bit “blue.” Some depressive episodes come in cycles that may or may not include a manic episode. Depressive episodes may start at any time during an individual’s life, from the teen years to old age.


Regardless, when a depression strikes, it’s important for the individual and individual’s family to learn the symptoms and understand it is not the individual’s fault. Let me repeat that. It is not the person’s fault. It is NOT YOUR FAULT.


What to do:


It is critical for you, the client/patient and your family to assess the severity of the depressive episode, and then to take appropriate action. One way to do that might be to take one of the online assessments available if a therapist hasn’t yet been contacted.[6]


What family members/trusted friends should do:


The client/patient should always be given the greatest amount of participation in their own care as safety allows. What do I mean? Ask the client/patient first before you do anything unless he/she is in imminent danger.


1. Do not say, “Snap out of it.” It won’t help and it will erode trust.

2. Suicide Risk Assessment:

a. A family member or trusted friend should ask these questions:

i. Are you feeling hopeless about the present/future? If yes, ask...

ii. Have you had thoughts about taking your life? If yes, ask...

iii. When did you have these thoughts, and do you have a plan to take your life? If yes, ask...

iv. Do you have the means? If yes, remove the means if safe to do so.

v. Have you ever had a suicide attempt?

b. If the answers are yes, particularly if iii, iv and v are all “yes”, call 911, go to the Emergency Room, or call the National Suicide Prevention Hotline

1-800-273-8255 (24/7). Do NOT leave the person alone.

c. If i and ii are yes, ask the person if he/she would like to talk through what is going on.

3. Ask the person if he/she would like to talk with a professional therapist. If so, go to https://www.psychologytoday.com/us “Find a Therapist”. You can enter a number of criteria (insurance, gender, religion, etc., of therapist desired) to find a therapist in your local area.

4. When a person is depressed, family members should continue to treat the individual with compassion and care while encouraging him/her to seek help from a therapist and medical doctor.

5. If, at any time, you suspect the individual is having suicidal thoughts or feeling hopeless, repeat #2.


Like any other medical illness, depression needs to be treated and monitored regularly. Just like we don’t blame the patient for getting diabetes or cancer, it doesn’t make sense to blame someone who suffers from depression for their illness. However, like with other illnesses, there are courses of treatment to follow where the provider and the client/patient work in concert with one another. Just like a cardiologist tells her patient to lose weight and eat a healthy diet to avoid another heart attack, a therapist gives his client certain instructions to follow to reduce the effects of depressive symptoms to aid in recovery.


What the you, client/patient should do:


1. Depression is not your fault. Be kind to yourself.

2. Reward yourself for each victory, even the small ones.

3. As much as possible, stay in the present.

a. I find that clients struggling with depression are often focused on the past or on shame. Clients struggling with anxiety are often focused on the future, or anticipatory anxiety. By focusing on the past and the future, they often fail to be present in their own lives and end up in a repeating cycle of regret. While the prospect of being present while depressed may seem daunting, practice focusing on each person, each action, and each happening. That can actually help to distract you from what depression is trying to pull you into your head to think about.

4. Improve your self-talk and those you talk to.

a. Not that Facebook is the oracle of mental health, but I did see a statement on a post worth repeating: “If we are the ones who talk to ourselves the most all day, shouldn’t we make sure we’re our best cheerleaders?”

b. Take stock of what you say to yourself and to others. If your best friend or sister or brother were feeling depressed, would you say that to them? Does it make you feel better about yourself or feel worse?

5. Try Gratitude.

a. Several recent studies[7] have stated that showing gratitude has positive effects on the person showing the gratitude or giving the thanks as much as the one receiving it. They were more optimistic, felt more positive about their lives, had overall higher “happiness” scores, and in one study, even reported exercising more frequently. All this, and it helped someone else!

6. Be honest and open with your therapist and physician.

a. Honesty with your therapist is crucial to your recovery. She will be driving blindfolded if you are not completely truthful.

b. Your physician needs to know how those medications are affecting you, both good and any side effects. (It’s also a good idea for your therapist and physician to have an open dialogue and to keep in touch about your treatment.)

7. Complete all assignments the therapist gives or have an honest discussion with your therapist about why those assignments are not workable. Again, this type of open communication is crucial between the two of you.

8. If you are having thoughts of suicide, tell someone ASAP; call 911; go to the Emergency Room; or call the Suicide Prevention Hotline 1-800-273-8255[8]


There is Hope


Depression can be treated and the results can be life-changing. It may take some trial and error to find the right medication, but be patient. The medications which are given to regulate depression now are so much better than those available even five to ten years ago, but it may take time to get the right dosage regulated.


And habits, particularly in the way we think and the way we talk to ourselves, are not changed overnight. But like any good habit, persistence wins the day. The combination of medication and talk therapy, particularly cognitive behavioral therapy (changing the way we think to change the way we feel) has been shown as the most effective treatment for depression. However, other therapies have emerged, which some have found helpful including eye movement desensitization and reprocessing (EMDR), and other therapies[9] when CBT isn't working.


All journeys begin with the first step. Why not begin yours today?

Blessings,

Leanne

-------------------------------------------------------------------------------------------------


Author’s Note:

Nothing in this blog post substitutes for psychotherapy with a licensed provider. If you are suffering from depression, please reach out for help today to one of the resources below.


Resources:

- National Suicide Prevention Hotline 1-800-273-8255

- www.Psychologytoday.com “Find a Therapist”

- Substance Abuse and Mental Health Services Administration https://www.samhsa.gov/find-help/national-helpline



 
 
 

Comments

Therapist's Thoughts on a Quiet Day

leanne.braddock@gmail.com

©2022 by Therapist's Thoughts on a Quiet Day. Proudly created with Wix.com

bottom of page