You are one of the most cheerful people I know – I would never have imagined that you suffer from depression. 

Well, now you know… I have had two major episodes (one untreated and one treated) in the past three years and probably had several more that were unidentified in my university years.  Research suggests that more episodes are yet to come (70-90% chance of recurrence) and could increase in severity (such a lovely thought).  Right now, I am doing OK, but watching out for warning signs as I try to manage this period of immense change – new job, new housemate, new boyfriend, new country, new city, new doctors… and hopefully a new (used) car!

I have asked myself many times why people didn’t or couldn’t see what was happening this past fall.  Hiding it was not really intentional, because I am normally a very transparent person, but for some reason I was very good at hiding the depression unless someone knew me really well. Even in the midst of the episode, I was not necessarily “depressed” every second of the day – just most of the day, and in certain interactions I was able to act “normal” (whatever that is).  Usually I could run to the bathroom when the weeping spells hit too.  By the time I got home though, all I wanted to do was sleep and hibernate from everyone.  I definitely withdrew from social interactions (stopped going to my Spanish class and quit my new-found ice hockey team), so you may not have even seen me in my normal social circles, or if you did, then it was on a “good” day when I felt up to facing people.  I think another factor was people’s reactions to the word “depression”.  This probably applies to anyone who is dealing with an illness, disease, or condition of any kind, but I got all sorts of advice and very little actual help.   People had lots to say on light therapy, various vitamins, St. John’s Wort, “how to relieve stress” and that kind of stuff, but no one realized how difficult it was just to do anything during the height of the episode - I was completely exhausted, my brain was constantly in a fog, I couldn’t concentrate properly and I could barely last an hour without weeping.   

At least half of the people suffering from major depression do not get proper treatment and I can understand why.  First of all, it is difficult to interact with anyone during an episode, let alone navigate the complex medical systems.  Mental health services are totally overtaxed, so it is incredibly difficult to get prompt treatment unless you are in a suicidal crisis.  Plus, the system itself is split into two pieces.  You have to go to one specialist (psychiatrist) to get medication and another (psychologist) for counseling even though most people respond best to a combination of anti-depressants and psychotherapy.  Even in Canada, the employee assistance program (which offered emergency counseling services) contact information was not posted anywhere.  I had to email my Human Resources person to get the phone number (so much for confidentiality).  Here in the States, it has taken me a whole week of research and phone calls and I still haven’t found a practice that will accept my condition and insurance.  I finally called the health advocacy service that my employer provides (thank goodness!) and they are still working on it (could take another week).  I can’t imagine trying to do this if I was in the middle of an episode!

I was reading information on how to help a friend or family member who is suffering from major depression and some things rung true for me.  Here are a few ideas, but from my own perspective…

1.  It was my mother who recognized the symptoms (from personal experience) and helped me identify what was happening to me. I remember how debilitating her depression was when I was a child and it made me realize that I needed to seek treatment before the situation got worse.  Before giving “advice” to someone with depression, it would be a good idea to research the disorder or find someone who has been through it to talk to your friend/family member.  I am still learning helpful things about myself just by reading up on major depression.

2.  I was incredibly grateful for anyone who helped me get the doctor’s appointments and counseling sessions that I needed.  There was one woman this fall who was so great in pointing me in the right direction even though she wasn’t the exact person I needed to contact.  If you know of someone suffering from depression (and who is ready to accept treatment), but they are having difficulty getting it all started… offering to help them make the phone calls (and even driving them to the appointments, drug store, therapy sessions, etc.) may be a life-saving way to help out.  Just keep in mind that they may not want to talk at all during the ride and not to push too hard if they say no!

3.  I went through a stage of complete exhaustion and every little thing was so hard that I felt paralyzed.  My apartment became unbearable, because I had no energy to clean or do laundry.  I couldn’t face going shopping and cooking food was way too big of a task to manage (I ate a lot of Domino’s pizza).   I was barely able to make it to work and back and obviously accomplished nothing productive there either.  A person living alone (and I suppose this would apply to someone with a family or roommates too) and trying to manage depression may need help with everyday chores.  They probably wouldn’t be up for any conversation, but if there is some way to let the person take a nap or something while someone cleans or does some laundry or leaves some frozen meals, it might help them get over the worst weeks without having to face a disastrous living space.  It is just like any other illness where you may have to be bed-ridden for a while and need extra assistance to get through the recovery period.  Once on their feet again, encourage them to start small before tackling anything too huge.

4. I had lots of offers if I had needed someone to “talk to”, but found that I was barely able to get out of bed, let alone “talk”.  It was great to have “talks” when I was feeling better, but not at the worst of it.  Major depression is not something that people can “snap out of” no matter how much support they have from friends and family.  It is definitely important to remind them of why you love them, but “talking about it” may not be an option until after medical treatment.  Practical support is definitely better than a vague offer of "someone to talk to".