You see so many posts about it being ok to talk and it's ok to not be ok; but one thing that I have found is that it’s really not that easy to recognise if things are not ok. People think they are coping or can manage or it will simply pass. By the time they realise they are not ok, the depression has taken hold, plus they may have a strong feeling of not wanting to be a burden.
Depression is a powerful illness that consumes you and sometimes it sneaks up on you like a ninja warrior. It's mighty and stealthy, and able to knock someone off their feet in the blink of an eye when nobody even noticed that he or she was even there, lurking in the shadows. They have good days and feel like they are getting through things, then without warning, they are just not coping at all. The cycle and darkness consume them, and the battle starts all over again to try to clear the fog.
So how do you recognise when something isn’t right?
The signs and symptoms
Sleep and Fatigue
Has there been a change to the person's sleep pattern? This can be at both ends of the spectrum.
Fatigue, lack of motivation and desire to partake in activities that they would normally enjoy can be a sign that something isn’t quite right. Mental fatigue is quite debilitating when it hits and can be frustrating which only heightens the depression further. Everything they do may feel exhausting to them when previously it never caused them an issue and they will feel sluggish and drained constantly.
On the opposite end of the scale there is insomnia. Waking earlier than usual and feeling unable to rest fully through the night. Do they wake more frequently and not go into such a deep sleep? The lack of quality sleep will increase anxiety for someone who is suffering which simply exacerbates the situation.
Lack of interest
Have they stopped taking an interest in something they previously enjoyed? This could be a hobby or a social activity. Do they seem to be lacking in the ability or desire to feel joy, happiness, or pleasure?
This can also cause an issue for people’s sex drive. The desire is diminished and also the ability to enjoy sexual relations with their partner can also be affected. For some males this will also lead to issues with erectile dysfunction.
Feeling helpless, hopeless and self loathing
Do they have a very dark and bleak outlook on life? They may make comments that affirm a belief that things will not get any better for them, or there is no use in trying with things and that they will ruin anything they get involved in.
People suffering with depression will feel trapped and hopeless and that there is no point even attempting to get out of this darkness. They may compare themselves to others a lot and point out areas where they feel inferior.
Constantly criticising themselves out loud or in their mind can be a huge issue for someone with depression. This results in a feeling that they are worthless, or they may be racked with guilt or simply unable to see past any faults they may perceive they have.
Changes to appetite or weight
Another sign of mental health is also within the physical body. A significant weight gain or loss of 5% or more can be an indication that emotional or psychological support is needed.
Some foods that are higher in fat and sugar can be consumed to try to make ourselves feel better in the short term. That along with fatigue and lack of interest in activities and exercise, can result in a weight gain for many who suffer.
On the flip side weight loss can be experienced due to a lack of interest in food and in things that give you pleasure. Also having a reduced appetite due to stress will create an impact on weight loss.
Irritability and mood swings
A person’s mood can fluctuate when suffering with depression between irritable and snappy, extreme anger and outbursts or deep sadness.
This is a sign many people who are close to someone with depression, will notice quite quickly. Those snap changes to moods and outbursts are a clear sign that someone is struggling to deal with day-to-day life and situations.
This particular symptom can be pretty damaging as many of the activities that they engage in are harmful to themselves or may cause issues for their loved ones.
This escapist behaviour can include substance abuse or gambling; or they could also turn their hand to more dangerous pastimes and activities such as extreme sports. Their driving style may also be affected and find they drive much more carelessly or even dangerously on occasions.
Someone facing depression often will have issues remaining focused on tasks and activities. Their mind will wonder and will struggle to focus on directions and instructions. This can cause issues in relationships, work or education as the distractions they experience are often perceived as a lack of interest or consideration.
Memory can also be affected and the minds ability to retain and process information is altered when experiencing mental fatigue and depression. There are so many areas of the brain that get involved with the creation and retrieval of memories. Disruptions to the mind that involve any of these areas, can affect how you process memories and also impact on your ability to concentrate.
Physical aches and pains
Someone with depression may find they experience an increase in physical aches and pains or ailments within the physical body. These symptoms could include chronic joint pain, limb pain, back pain or gastrointestinal problems. Issues with the stomach area are often associated with stress and trapped emotions.
The therapy I use to treat patients works quite often with the mind body connection. The founder of RTT, Marisa Peer once described physical issues as the minds way of screaming and letting us know that there is something that needs to be dealt with.
Physical pain and depression actually have a biological connection. The neurotransmitters that affect our experience of pain and our moods are serotonin and norepinephrine. Dysregulation of these transmitters are linked to both depression and pain.
How to support someone with depression
Understanding the below points are important in supporting someone with depression:
They have no control over it
Someone with depression has no control over the fact that they are suffering this condition. It’s not something they can simply turn off and ignore. Just like having the flu or a virus, it takes over the body and in this case the mind too without the person being able to stop it taking hold.
Anyone can have it
Depression doesn’t just affect those who are not happy with their lives. Someone can have a wonderful, amazing life and seem to have everything anyone could ever want, but still end up with depression. It really doesn’t matter whether someone has anything to be sad about; depression is more than just sadness and it takes over for a number of reasons. The life they are living isn’t always a factor in it developing.
Other actions you can take to support or help someone through a period of depression:
Many of those with this condition will isolate themselves and will drift out of touch with friends and family. Simply checking in with them and showing them your support by reaching out can be a huge gesture and help them to begin connecting and opening up.
Listen without judgement
Try not to feel responsible for fixing a loved one’s problems or feel that you should convince them that these negative and self-loathing thoughts they have are wrong. These feelings are so deep and real for them, your best option is to respect and acknowledge their feelings. This will help them to feel supported and more likely to open up and talk their feelings through with you.
Encourage professional help
There are so many options and treatments available to help people with depression. Not every form of treatment will suit and will be something they will need to choose for themselves. Counselling, therapy (including RTT) and medication are all highly affective. There are a number of charities able to support counselling too if waiting lists are long. If they are unsure where to start, finding the right provider and form of treatment is the best place to start. Help them put a list together of providers and options they can choose from.
Suggest additional connections to help them through this illness. This could be in the form of social support through friends’ groups, community groups or specialist support groups. Social media is great for finding support and groups within your local area.
Healthy eating and exercise can help boost peoples feel good hormones and help to combat depression. Support and encourage healthy living by doing it with them where possible.
Suicide is no joke
Any mention of suicide or hurting themselves should be taken very seriously. I personally have lost two people close to me through suicide, and can honestly say both times was a complete shock. We all think people are not capable of these acts, but in reality in the depths of depression, anyone is capable. If you feel they are in danger call 999 or any of the below:
References: The Link Between Depression and Physical Symptoms Madhukar H. Trivedi, M.D., Therapist Aid LLC·