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How to Help Someone With Depression
by Stephanie Trelogan , Caring.com Senior Editor
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Know the Warning Signs of an Older Adult's Depression
Older adults often face stressful situations, including chronic illness, financial problems, and loss of independence. Add that to physical and emotional isolation, and you've got a recipe for depression. But there's a big difference between situational unhappiness and clinical depression. Feelings of sadness and anger are natural after a catastrophic event like a heart attack or the death of a loved one, but when those feelings linger for months on end and prevent an older adult from enjoying life at all, it's more than a normal reaction to grief. Here are some practical suggestions for helping someone with depression.
Sometimes it's hard to tell the difference between depression and just a case of the blues. Depression is more than just feeling sad or "down." Depression affects a person's thinking, emotions, behavior, and physical health. A depressed person may feel empty inside, or may no longer enjoy activities she once loved. She may complain of aches and pains that can't be explained or treated. When someone has several of these symptoms for weeks or months, it's likely that she's clinically depressed. If you think someone has a case of depression, it's a good idea to familiarize yourself with the warning signs. And it's also helpful to know what specific indicators to look for:
- Lack of interest in personal appearance. One of the most obvious signs of depression in older adults is when they stop caring about their personal appearance. If the person you're caring for used to take great pride in her looks but no longer bothers with makeup, she may be feeling depressed.
- Increased complaints about aches and pains. Depression can actually amplify physical pain, turning minor irritations into severe discomfort. If your once-stoic friend or relative won't stop complaining about her sore feet, she may be suffering from more than just bunions.
- Social withdrawal. Depressed older adults tend to push other people away -- especially those they love the most. If the person you're caring for suddenly starts making excuses not to see you or other family members or friends, it's worth checking into what's really going on.
Bring up the Subject of Depression When an Older Adult seems Down, and Encourage a Visit to the Doctor
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Break the taboo. Depression is a taboo subject for many older adults, and they may have an especially tough time thinking of it as an actual illness. But the first step toward helping someone who's depressed is letting her know you care about her and support her.
Broach the subject carefully. Instead of plunging directly into a tough discussion about therapy or treatment, try asking what's going on. "I've noticed you haven't been sleeping well and you've been so irritable lately. You just don't seem like yourself. Are you okay?" Of course, there's no guarantee that your tactful, gentle probing will open the floodgates, but it's worth a shot.
If she agrees to see the doctor: In the best-case scenario, you've had a great heart-to-heart with the person in your care and she's agreed to talk to a psychotherapist or psychiatrist about her mood. In the worst case, she's repeatedly brushed off your attempts at discussion and doesn't want to hear another word about it. In that case, you might want to try another approach: Suggest a checkup with her primary care doctor. An older adult may be less resistant to this idea, and she may be more willing to listen to a doctor who urges her to get help.
If she resists: If she's resistant to the idea of seeing a doctor because she's embarrassed or afraid, help her understand that a diagnosis of depression isn't the shameful secret it once was. It doesn't mean she's "crazy" or is going to be taken away to a nursing home. What's more, her test results are private, so no one but she and her doctor needs to know.
If she refuses: If she refuses to see a doctor, there's not a whole lot you can do. You can't force the issue unless she's psychotic or suicidal, or her depression has progressed to the point where she can no longer take care of herself. If none of those circumstances apply, your best bet is to enlist other family members and friends to try to persuade her to seek help.
Support an Older Adult with Depression During Treatment
- Provide practical daily help. When someone is diagnosed with depression, the doctor may prescribe antidepressant medications and/or psychotherapy. The doctor may also recommend lifestyle changes. You may need to drive her to appointments, remind her to take new medications, help her get out more, or help her make other lifestyle changes.
- Help her stay as physically active as possible. Make sure you talk to her doctor about what activities are appropriate before beginning any exercise program. Find activities you can do together, such as a morning walk around the neighborhood. Exposure to sunlight can help break the cycle of sleeping during the day that many depressed people fall into.
- Structure the day around activities that give her pleasure and a sense of purpose. For example, meet friends for lunch or enjoy a leisurely walk through the mall.
- Join a support group -- for either or both of you. Talking to other people who're struggling with similar issues can be enormously comforting and helpful. It's also a great way to connect with other people her age and caregivers.
Get her to a professional. Even if a primary care doctor diagnosed the depression, the person may still benefit from seeing a mental health professional. Not all primary care physicians are comfortable treating depression.
Provide reassurance. Older adults are often anxious about taking antidepressants, either because of the stigma they associate with such medications or because they're afraid of potential side effects. Assure the person in your care that the doctor can work with her to find the medication that's most effective with the least-severe side effects.
Here are some other things you can do to support her:
If you've tried everything you can and nothing seems to help, remember it's not all up to you. In the end, it's really the responsibility of the person suffering from depression to get help for herself. If she won't talk to her doctor or comply with treatment, you can't make her do it. Keep offering support and provide positive reinforcement when she takes those difficult steps toward recovery. If feelings of guilt or sadness about the situation overwhelm you, you may need help coming to terms with the fact that your loved one isn't going to get help. Ask your own doctor for information about support groups and other resources to help you manage your own feelings.
The Questions I Asked
The question so many ask when we lose a family member or a friend that is fighting a terminal illness that is dear to us. Why did it happen, what was the reason? Sometimes these answers are easy to come by. Just as we know that they will fight and we will fight with them, yet the battle will be lost. We can understand and acknowledge they will fight and hold on as long as possible. We go through the process with them. Moreover, when it ends we are hurt and lost but we also say they fought hard.
Then there are those diseases that are not easily understood. Diseases that no one talks about openly. You do not see it many times, because it can be masked so well that it is not seen. It is hard to get your arms around it. I have encountered this disease recently, because of a dear friend.
The disease “DEPRESSION” its ultimate goal to those it attacks is to bring them down, to make them give up. To make them feel worthless in a jungle of time and space. These effects are all so real to those that suffer. Unfortunately, we as outsiders never see it. We do not see the pain that they are living with. We do not see the torment that they are going through. However, for the individuals it attacks it is forever there, always lurking, calling them to an end that nobody wants or sees coming. An end that will cause far more questions than answers. Will cause anger, remorse and even more questions.
This past year I lost a very dear friend to this disease Our dear friend Jeff. I did not see it coming; I did not see it in him. I did not see the torment that was inflicting such pain on his body mentally. I did not ask all the right questions I wondered for many a night. He talked of what we were going to do; He talked of how we were going to have a good time on a 4th of July weekend. He talked about Bar-B-Ques and Bon Fires, cold beverages and good company. He did not talk about the pain. He said that he was tired lately, that he had not been sleeping well. He had battles like most of us with money, bills, family, friends, ex wives and girlfriends. However, he never once said that he was depressed, he never once said “help me” and in the end, he did not win that battle. Oh he would comment on how he always wanted to “help others more”, and that he felt like he was never doing “enough for anybody”. Because friends stepped forward and helped where they could, and gave him physical things to make it easier for him to regain his footing on the turmoil that he saw all around him.
Now I believe that his pain was so great that the things that he wanted most were in front of him, in family and friends. The problem is he could not see it. You see the help that he was being given instead of it making him feel worthwhile it was making him feel more useless, it was making him feel that he had less, that he was not worthy. He always wanted to give to everyone, he wanted to give back and yet he felt like he could not. Many times, he would say that he could never repay all that was done for him. Yet he was giving his friendship, his smile, his caring for others. He was thinking that he had to give of physical things, money, physical items, and work. He did not see the goodness that he was casting around him.
He was unable to see all the good through the pain that he was having. He was unable to see all the good he was sowing, because of those sleepless nights. He could not bring himself to see any of this because of the PAIN. This unfortunately is what I feel that I have learned now that he is gone. He was a true friend to my family and me. He would spend hours helping us out and taking care of all the little things. He always possessed this knowledge of what we needed and what was going to work best. He had an infectious laugh and kind heart. He had a way to make you feel good and to make you forget the things that were bothering you.
Through his death, I have had the pleasure to me many of his friends from where he lived previously. I had a chance to learn more about him. I had time to learn what made Jeff tick and to see what brought other people so close to him. It is amazing the gift that this man really did have. He had affected so many people with his infectious way and sense of humor that you stand back and have to wonder again, why?
However, through his death I learned a valuable lesson in life. How many times we take the everyday for granted and every day we may take those around us for granted. However, when you had that one person that one friend that when things were tough or you were having that kind of day you could call, is now gone, it is then that I realize all that I lost. It is then that I realize what we many times forget, that the one that we count on may be looking for us to extend a hand and help. Moreover, in many ways that help is to listen not to speak. Just LISTEN! How many times do I think that I did not listen, really listen?
I know that our dear friend to my family and me is at rest and in peace. He left us with many questions to try to answer and over time, we will realize that we will never be able to answer many of them. We will always wonder why, and what if, and could we have done something different. Nevertheless, one thing that he did leave me with, was knowing that we will all miss him, and I will remember him, and I will always respect him, and most importantly I feel that i have told his story. Do not ignore what may be in front of you. Listen and you truly can learn, and you can help.
Rest in Peace my good friend Rest in Peace