When the Darkness Closes In: Walking with a Loved One Dealing with Depression

Sometimes life gets hard and we are disheartened by obstacles we face. Job losses, sickness, losing loved ones are just some of the challenges that come our way in life. Typically, we rally our resources and regroup to face these challenges. This is entirely normal, but if it feels like your loved one can’t get up again and back into the fray, they may be dealing with depression.

Depression isn’t merely being in a bad mood or feeling sad and melancholic. It is far deeper than that. Depression is something a person cannot simply “power through” by sheer will of force, particularly severe depression which may be the result of their brain chemistry not working as it should.

It is not a sign of weakness to feel overwhelmed by depression. What a person dealing with depression needs is not another guilt trip or suggestions of quick fixes, but compassionate professional care and help for them to find the peace and healing that God intends for us all.

If you think your loved one may be dealing with depression, one of the best things you can do is to get informed about what depression is and is not. This will position you to better help your loved one by knowing the causes and treatment options for depression.

What is Depression?

Depression is one of the more widespread mental illnesses in the world. It affects people from all walks of life – according to the World Health Organization, around 350 million people worldwide suffer from depression. In the United States, about 17 million people of all races, ages, and economic backgrounds are affected each year.

Children and teens are also affected. As many as one in every eight teens may have depression, while as many as one in every thirty-three children may suffer from depression. Depression occurs more often in women than men, and it may manifest itself differently – in men, they are likely to be tired, irritable, and angry, showing reckless behavior. In women, depression often manifests as sadness, worthlessness, and guilt.

While we all have episodes or seasons where we experience negative emotions, depression presents generally as an extended period where a person feels intense sadness, feeling helpless, worthless, and hopeless.

People who suffer from depression may have symptoms in common, but as noted earlier, these don’t all look the same, they don’t last the same amount of time nor are they equally severe. Some symptoms may occur with a change in seasons.

According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition), a manual used by mental health professionals to diagnose mental disorders, a person has depression if five or more of these symptoms present for at least two weeks:

• Feeling guilty or worthless almost every day
• Having a hard time recalling details, concentrating, and making decisions
• Feeling tired or lacking the energy to do the simplest tasks
• Having no or little interest and pleasure in activities you used to enjoy
• A marked loss or gain in weight, with either too much or too little interest in eating
• Feeling down and sad for no reason
• Not being able to sleep, or sleeping a lot
• Not caring about what happens in the future, or hopelessness
• Thinking often about death or suicide
• Feeling restless or sluggish
• Having sad, anxious, or empty feelings
• Aches or pains such as headaches, cramps, and digestive problems without a clear cause

These symptoms may or may not apply to your loved one. If you think your loved one has symptoms of depression, it is important to take immediate action and move toward getting a diagnosis. To accurately diagnose depression, a detailed clinical evaluation must be done by a medical or mental health professional such as a psychologist or psychiatrist.

What Causes Depression?

Depression doesn’t usually get caused by one specific event or situation. Several factors can come together to bring about depression, and these vary from individual to individual. Depression can come about because of significant life events such as divorce or losing a loved one.

On a physiological level, genetic factors can cause depression. Depression can run in families, and so a person with a close relative that struggles with depression may be more likely to have it too. Also, when the levels of certain chemicals in the brain that carry signals through the nervous system (called neurotransmitters) are lowered, that can cause depression as well.

Sometimes, medications taken for conditions such as diabetes, heart disease, and cancer may cause side effects that contribute to depression symptoms appearing.

Different Types of Depression

There are several types of depression, including:

Severe or major depression: which typically interferes with day-to-day functioning. It is marked by feelings of worthlessness or guilt, a pervasive sad mood, and being unable to feel pleasure or happiness.

Seasonal affective disorder: where depression comes and goes with the seasons, typically beginning in the late fall and early winter, dissipating during the spring and summer.

Psychotic depression: which occurs when a person has severe depression along with a form of psychosis (such as hallucinations or delusions).

Dysthymia or persistent depressive disorder: this is when one has symptoms of depression for at least a year or two. Someone with dysthymia may have episodes of major depression and periods with less severe symptoms as well.

Perinatal depression: which is depression that can occur in women during pregnancy or after they’ve delivered the baby (postpartum depression).

Dealing with depression can also be one of the phases in someone with Bipolar disorder, which is usually marked by episodes of high-energy mania or less severe hypomania (fiery temper and irritability or euphoria) and low-energy depression marked by sadness and hopelessness.

Dealing with Depression: Treatment Options

The good news about depression is that it can be treated in more than 80% of people afflicted by it. It can be treated with psychotherapy, medication (antidepressants), or a combination of both.

Psychotherapy works by paying attention to the causes of depression, working to help change negative thoughts, which often cause and maintain depression. A psychiatrist can prescribe medication, and it may take a few tries to find the right drug and dosage that works best for you.

It helps to know the type of depression your loved one is struggling with to be aware of what needs to be done for their healing. A skilled psychotherapist is typically experienced in treating all kinds of depression and will work with your loved one to develop a treatment plan that understands their unique story and specific needs.

If you or your loved one are people of faith, you may want a treatment option that factors that dimension in their treatment plan. Christian psychotherapists use a faith-based approach to treating depression which entails using the spiritual resources of prayer and Scripture, alongside a variety of well-attested evidence-based therapeutic methods such as:

• Cognitive Behavioral Therapy, which helps people manage harmful thoughts and behaviors by becoming more aware of how thoughts, feelings, and actions may contribute to depression, and replacing negative perceptions with healthy ones.
• Psychodynamic Therapy, which seeks out the root cause of the depression by helping a person learn more about themselves and working through issues in their past, including their relationships, to arrive at better self-understanding and move beyond guilt.
• Interpersonal Psychotherapy, which addresses conflict and helps one work through their relationships with loved ones that may be contributing to their depression or making it worse.
• Electroconvulsive therapy (ECT), which, along with other brain stimulation therapies, may work for people with severe depression that aren’t responding to antidepressant medications.

If someone you know is dealing with depression, it is important to empathize with them, to understand that it’s not just a passing mood. Depression is an illness that incapacitates people, and it leaves them at the mercy of feelings of hopelessness, emptiness, and brokenness.

Don’t ignore negative changes you see in them, or comments about suicide, offer them support, patience, and understanding. Encourage them and help them to see a mental health professional. When they have seen a professional, help them to stick to their treatment plan, and if they need help to get to their therapy appointments, you can ensure they have a ride there and back.