For Family and Friends - Depression Toolkit



For family and friends

University of Michigan
December 10, 2014

We’re in this together.​

This section of the website is just for you, to help you better understand how the dynamics of relationships, home and work life are impacted when someone becomes depressed, how you can best help the depressed person in your life, and how you can make sure you don’t lose track of your own health and well being in the process.

What’s going on?

Standing in the depressed person’s shoes​

It is hard for people struggling with depression to function normally. Every aspect of life can be impacted. Individuals can be too tired to contribute at home or at work. They may lose interest in healthy activities such as eating right, exercising, sex, or responsible parenting. Moreover, the symptoms of depression can diminish or even do away with an individual’s sense of joy.

People struggling with depression can feel overwhelmed and unable to overcome all of these symptoms. Not surprisingly, a strong sense of guilt is common as well. They know that their lack of interest and initiative place a burden on everyone else. It’s common to feel guilty about letting other people down and/or causing hurt or angry feelings to develop.

Before reading further in this section, you might want to get a clearer picture of exactly what someone with a depressive illness is experiencing. Click on Learn about your diagnosis to read more about the most common symptoms of depression, treatment-resistant depression, bipolar disorder, anxiety disorders and substance abuse.

Why do I feel this way?

Standing in your own shoes​

Friends and family members can find themselves dealing with a whole range of uncomfortable emotions of their own when living with someone who is depressed. Rest assured – you’re not alone.
  • Frustration -- It’s understandable to feel irritated that the person isn’t “pulling their weight,” can’t meet obligations, or can’t even follow through with simple things.
  • Anger – It’s possible that the person may function well in some circumstances, such as at work, but experience symptoms more acutely – and take them out on others – when at home. This is a common source of anger and conflict within families living with someone who is depressed.
  • Confusion – Unlike a physical ailment like a broken leg, it’s not always easy to understand the limitations of people with depression. Why can’t they do chores, or attend a school function? It can also be hard to know when it’s appropriate to discuss your own situation or needs when it seems that the depressed person seems so self-absorbed.
  • Withdrawal – Just as the depressed person commonly retreats from regular activities and seems withdrawn, the family can pull away as well, adapting to new ways of functioning without the person.
  • Anxiety -- It’s common to feel anxious about when and whether the loved one will recover and be “back to normal.”
  • Guilt – Family members may feel responsible for causing the problem, or may feel guilty about the frustration they are experiencing.

What can we do?

Strategies for moving forward together​

Acknowledge what you’re dealing with. Depression is not simply a “bad mood” or a passing case of “the blues.” Depression is a real illness. It is difficult and frustrating disorder and affects not only the individual, but everyone who cares about him/her. It will take a significant effort on the part of the patient and the family to recover from the impact of depression.

Accept your starting point. No family is perfect. Depression can aggravate the negative dynamics that may already be present in the family. Those dynamics can make it harder for both the patient and the family to make the life changes needed to overcome depression. Conversely, a full recovery from depression will not necessarily resolve every problem in the family.

Cultivate a “we’re in this together” attitude. A person who is struggling with depression can feel completely alone. In fact, every person in the family can feel isolated by the presence of depression. Fostering a partnership with the depressed person confirms that you intend to work together to overcome the obstacles that lie ahead.

Don’t blame the person who is depressed, or yourself. It’s easy to want to attach blame when things go wrong or challenges seem insurmountable. But it’s only when the blame stops that recovery can begin for everyone. No one – not the person with depression nor his/her spouse, parents or children – is responsible for the occurrence of depression. Yet everyone can take responsibility for helping to manage it.

Set realistic limits and expectations. Understand that the symptoms experienced by the person who is depressed, as well as possible side effects from medication, may take a toll on his/her abilities. At the same time, recognize that you cannot take up the slack on everything. Prioritize daily activities, chores and responsibilities, knowing that everything may not get done. It can also be helpful to think small. Look for small, manageable ways to improve things, like making mealtime easier and more enjoyable.

Find better ways to communicate and negotiate. While addressing your own needs, help the person who is depressed speak up for his/her own needs as well. You may want to refer to books or articles for tips on improving communication, dealing with anger, building patience, etc. A counselor or someone outside of the family may be able to help everyone build better communications skills.

Keep emotions from overwhelming the situation. Emotions are an expected part of daily life for every family. But it’s important to keep emotions from growing too intense or interfering too frequently, contributing to a destructive chain of events. For example, when one family member nags or complains, another may grow angry and withdraw. Although these actions and reactions may be understandable, they are nonetheless not helpful. Rather than bottling up feelings until they eventually explode, look for ways to express emotions without resorting to criticism or hostility.

Discuss, plan and execute good things. Talk with the person who is depressed about things you might do together that would be enjoyable as a couple or as a family. Remember that it’s the thought behind the gesture – not its size – that’s important. Taking a walk or seeing a movie can provide a needed respite and provide pleasure for everyone involved.

Get active. When depressed, people often are not interested in or motivated to exercise. But physical activity, even modest activity like a short walk, can yield positive benefits right away. Encourage the person to do something physical by offering to join in, and making a commitment to increase your physical activity together. Need some ideas? Check out the exercise section of this website.

Reach out to others. Support groups exist for the friends, family members and caregivers of people struggling with depression. Look for one in your community as a way to connect with people facing similar situations. You may also want to explore help and support that might be available through local social services or faith-based initiatives, including counseling, child care and meal services, to help you better manage the needs of your household.

Looking out for yourself

Before you can care for someone else, you need to take care of yourself.

All of strategies outlined in this section recognize the importance of self-care for the caregivers as well as the person struggling with depression. As a caregiver, it’s important to recognize that your health and the health of the person who is depressed are interconnected. His/her distress can become your distress. One recent research study indicated that as many as 40% of people who live with someone who is depressed may be sufficiently distressed themselves to meet the standard for needing psychological intervention. If you are concerned that you, too may be experiencing depression, or if you are having sleep problems or experiencing pain, click on the Are you depressed? link to find self-administered questionnaires that may help you identify a need to seek professional help for yourself.

This website provides in-depth information about how someone struggling with depression can develop his/her own self-care plan to complement the other components of treatment. Many of these same self-care strategies can be adopted by caregivers to keep themselves healthy. Visit take care of yourself for ideas you can put into practice.

“Suppose your beloved says she doesn’t love you anymore. If you listen only on the surface, you think she’s had enough of you and wants to leave. Of course, that makes you sad. But if you listen deeply, with all your heart, you might hear something else—that she’s suffering and her needs are not being met, perhaps her needs for attention and connection. Rather than feeling hurt or attacked and storming off, you can try harder to be deeply present at such a critical moment. If you do, you might uncover truths that neither of you realized.”

Cuong Lu, Wait: A Love Letter to Those in Despair

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