Tips to Help Someone With Depression | Relationship Skills

Hey there everybody, and welcome to this video on being in a relationship with someone who has depression. I'm your host, Dr. Donnellice Snipes. Before we get started, please remember to click the bell and subscribe to be notified anytime we release new videos. In this presentation, I'm going to explore the symptoms of depression, identify strategies to support the person in coping with their symptoms, explore how their symptoms impact you, and help you identify strategies for self care. So for depression and in this series of videos, I'm using the DSM criteria as well as other symptoms that are often present but may not actually be in the DSM 5. So for the mnemonic here we have disease case. The person is depressed, sad or anhedonic, which means they just, they're not feeling much of anything. They just feel blah, irritability, sleep changes, exhaustion, agitation and restlessness, shame and guilt, eating changes, concentration difficulties, apathy or loss of interest or motivation, suicidal thoughts, and exaggerated or catastrophic thinking. So let's talk about each one of these in terms of the person. In order to support them, it's going to be important that you help them identify their triggers, their vulnerabilities and their solutions. So what triggers encourage them or prompt them to feel depressed or sad? And likewise, what triggers or things in their environment might help them feel happier? What vulnerabilities do they have that may be contributing to their depressed mood? Maybe they're sitting in the dark all the time. Maybe they are deficient in vitamin D, for example, or a variety of other vitamins. So it can be helpful to encourage them to explore what might be contributing to this because a lot of times when fe people feel depressed, they're just, they're done. They feel hopeless, they feel helpless, they feel exhausted, they can't think clearly. So as a supportive person, sometimes it can be helpful to encourage them to explore these things. And, and like I said, with triggers, we want to explore triggers that trigger the distress as well as triggers that might help them feel better. The next one is irritability. People with depression may sometimes get irritable. It's like, I'm tired, I'm exhausted, I don't want to do anything, leave me alone. That's the stress response. That's the body saying fight or flee. I don't have the energy to deal with life and why are you bothering me? I don't have the energy to deal with you either. Okay? So recognizing that irritability and saying to yourself, what is this behavior? Saying and working with the person to identify things that trigger their irritability. When they're depressed, what things make them more irritable? And how can you help them buffer against that? For example, maybe when people are feeling depressed, phone calls, when the phone ringing causes them to feel more irritable, or somebody texting them a lot causes them to feel more irritable. Whatever it is, help them identify things that are triggering that stress response, triggering that irritability, and say, okay, how can you mitigate that? How can you either shut it down or minimize the impact? What things make you more vulnerable to being irritable? For example, when people are depressed and we're going to talk about sleep changes in a second, they may not be getting good quality sleep. And when people are not well rested, it increases their irritability. So if they recognize that, hey, I'm feeling depressed, I'm not sleeping well, that increases my irritability, okay, they know they're more vulnerable to, to being irritable with people. So what safeguards can they put in place so they are not as likely to be triggered? And it's important to ask the person, you know, what are their solutions? What has worked in the past for them? If they don't have anything, then you can try to, you know, brainstorm with them. But it's important to encourage them to identify things that'll help them feel safer, more in control, more empowered when they start realizing, hey, there are things I can do, there are things I've done in the past that have helped sleep changes. Some people sleep too much, some people get insomnia, and it's going to be important again to work with them. Vulnerabilities. If you are sleeping too much, maybe that means. Or if the person is sleeping too much, maybe, maybe it means they're spending too much time inside and their circadian rhythms are out of whack, so they need to adjust their schedule and look at their sleep hygiene. Maybe they are not. Maybe they have insomnia because they're not sleeping well when they do sleep. And because they have insomnia, they're kind of living on caffeine, and that caffeine is keeping them from getting good sleep. So that's a vulnerability for sleep changes. But then working with them to identify what are some solutions that you think might work for you to improve your sleep. Looking at sleep hygiene, for example, that can be one thing. And encouraging them to think, when you do fall asleep, when you have been able to fall asleep or maintain your circadian rhythms, what's been different or what is it that you could start doing to address those sleep Changes. What is it that's keeping you from getting good sleep? Sometimes people who are depressed, when they lay down to go to sleep, all of those things that they're stressed about and worried about and feeling hopeless and helpless about just come flooding into their brain. Okay, you know, that is something that they can start figuring out. What can I do to quiet my mind so I can relax enough to go to sleep? Helping people recognize again that getting inadequate quality sleep not only contributes to exhaustion and depression and inflammation, but it also contributes to what we call intrusive thoughts. So sleep hygiene is important. And asking them, instead of telling them what to do, asking them what is it that I can do to facilitate this? Being compassionate with them if they're sleeping all the time or they don't have the energy to get off the couch instead of getting angry, which, you know, we'll talk about the impact on you in a minute, instead of getting angry, trying to be compassionate and recognize that they are doing the very best that they think they can at the moment. Exhaustion, if you're not getting good sleep, whether you're sleeping too much but it's bad sleep or you're not sleeping enough, you're likely going to feel exhausted. And that exhaustion can also come out as, as it feels like it's harder to do everything, your body feels like it's weighted down, like you're walking into 100 mile an hour wind. And with everything that you do, so doing normal activities of daily living, like taking a shower and getting dressed and making your bed, that can feel exhausting. So doing the extras like vacuuming the house or going grocery shopping, maybe more than the person can do because they've been doing that. And the only parallel I can think of that somebody who hasn't had depression might be able to understand is get a backpack or a rucksack and fill it with 50 pounds or so of weight and try carrying it around when you do everything for a day and notice how much more exhausting it is. And yes, I said 50 pounds and I didn't say if you're a 300 pound person, you know 50 pounds it, when you're depressed, it feels twice as hard to do everything. Agitation and restlessness is also a symptom of depression. Sometimes when people are depressed, they're also anxious. They're fearful of rejection, they feel guilty for not being able to have the energy to do the stuff they want to do. And they start to get into this spiral and that triggers their stress response, their HPA axis, which can make them feel more have more difficulty sitting still. They don't have the energy to do anything, but they also are having difficulty sitting still. So they're in this constant paradox, which can be really dagum frustrating. Encouraging people to just recognize when they're feeling agitated, when they're feeling restless, and again, what might be triggering that? Maybe there's something that is stressing them out and triggering irritability and so their body's responding okay. If so, what is it that might help you feel less restless or more relaxed? What is it that might work for you? For some people it's grounding activities. For other people, it's going on a walk. For other people, it's engaging in, you know, some sort of hobby or maybe even just talking with somebody. S stands for shame and guilt. People with depression may have, may feel depressed, may feel hopeless and helpless because they feel they're in inherently bad because they have a core sense of shame. But people who are depressed may also feel shame and guilt because of their depression. They feel ashamed of not being able to do the things they used to do or do the things that they can do when they're not in a depressive episode. They feel ashamed and guilty for not being able to meet people's expectations. And, and a lot of times the guilt that people feel when they're depressed is self imposed. They're assuming other people are angry with them. They assume, they're assuming other people are feeling bad because of their actions, that guilt is internalized. And they say, you know, I'm not doing these things, therefore it must mean I'm a bad person. And that's shame. Shame is a feeling of core ungoodness. I, I'm not a good person. Guilt is about something you did or didn't do. Eating changes are also common in depression. Some people will overeat, especially high fat, high sugar foods because that triggers the release of dopamine and serotonin and endorphins and other things. Some people will not eat much because their stomach is just upset and tied in knots and they have no appetite. Okay, you know, we want to be compassionate and not judgy about what people are eating or when they're eating and be respectful of their boundaries and say, okay, you know, what can we do here to arrive at a compromise? Concentration. When people are depressed, they're exhausted and concentration is just nil. And we want to recognize that if somebody is depressed, they will have often have difficulty focusing on one thing at a time. So if you're talking to them, turn off the television. If they're watching television, don't talk to them because they are going to have difficulty concentrating on multiple things. And they may have difficulty concentrating for a long period of time. And when I say long, I mean 15 minutes or more on any one thing. Driving may be difficult. Reading a book may be difficult. Anything that requires sustained mental energy may be difficult. Because guess what? They have no energy. Apathy, loss of interest, and loss of motivation. And this is different than being sad. This is not having a desire to do anything. Things that used to make them happy just don't anymore. They're like, yeah, I could go out and go rock climbing or I could go out and go shopping. But no, I don't. I don't have the energy. It's. I just don't have it in me. Remember, dopamine is your motivation chemical. When people are unmotivated, it often means their dopamine is low. Now, I'm not saying go out and take dopamine supplements. Don't. No, that's not what I'm saying at all. What I'm saying is recognizing that depression is not just as simple as low serotonin, for example, which is what most people point to. It's when one neurochemical gets out of balance, everything else gets out of balance. Thinking about, what are they motivated to do? Or how can I help you get motivated to do the things that you want to do right now? And for people with depression, because their energy is so low, because their concentration is so low, a lot of times it can be helpful to break things down and say, okay, you know, what would it take for you to get motivated to do this thing? Let's break it down into smaller chunks so it doesn't feel so overwhelming. And it's also important to encourage them to be compassionate with their self and think, what is it with this limited amount of energy that I have with my depression right now? What is it that I want to use my energy to do? Suicidal thoughts are also not uncommon in people with significant depression. And it's important to recognize when people are having suicidal thoughts and not dismiss them and go, oh, you're overreacting, or you're just trying to get attention. If people are expressing these thoughts, they're feeling very hopeless and helpless and powerless in their current situation. And it's important to pay attention and get them some help. If people are having suicidal thoughts, it doesn't mean they're going to be, quote, locked up. You know, there are a lot of people that see therapists who are having these thoughts. They don't intend on acting on them, but they're having these thoughts. So it's important at that point to get them with a physician or a therapist who can help them start taking more active steps. They may not be motivated for this. So it's going to be important, for example, to examine why they're not motivated. For a lot of people, the thought of, oh my gosh, I've got to find a therapist, then make an appointment, then get dressed, then drive there, and blah, blah, blah, blah, blah, it's just completely overwhelming. So if they're motivated, if you can get them to agree that, yes, I will go see somebody, then it may be helpful to ask them, do you want me to make an appointment for you? Don't do it for them unless you've asked first. You always want to empower them first. If they are expressing suicidal thoughts and you are concerned, it's also possible to have them seen, for example, in an emergency room. And only you can make that decision about whether the person's in an acute emergency at that point in time. But never, never take suicidal thoughts for granted and exaggerated or catastrophic thinking. When people are depressed a lot, a lot of times their brain goes to the worst possible scenario. They're already feeling hopeless, helpless and powerless. So literally everything may feel like the end of the world. Literally everything may feel like it's going to end up in the worst possible scenario because they are viewing the world from a hopeless, helpless, powerless perspective. And so if they actually were completely powerless in the situation, yet might end up catastrophically. So it's important to recognize that this all or none thinking is not that uncommon. Now, it can be helpful to encourage them to really step back and look at the facts here, validate that they're feeling overwhelmed, that they're feeling like this is the end of the world, and encouraging them to look at. All right, so let's look at the facts for and against your belief. Now, we've talked about the person you know, and for each one of these symptoms, I really encourage you, especially when they are not in the midst of an episode, to sit down and talk about each symptom, what makes them more vulnerable to it, what triggers it, and what works for them. What would be helpful for them to address that symptom when they are in a depressive episode. That can give you a game plan. So you feel empowered, you feel like you've got some tools, you feel like you have something that you can offer, and the person is the one that has helped you create this roadmap. If you will. So you're not forcing your ideas on them. You're not saying, well, let's try this. And they're like, no, that's stupid. You can say, well, in the past you've said this works for you, so would you be willing to try it now? In terms of you, we need to recognize as the caregiver or the loved one, this is going to have direct impact on you. When you're watching your loved ones suffer, it can feel agonizing. You too can feel hopeless and helpless and powerless. So creating this plan can help you feel a little bit more empowered. It can help you feel like you've got more direction. But it's also important to look at each of the symptoms and recognize the impact that has on you. When you are living in a house, for example, with somebody who is clinically depressed 24, 7, the energy in that house can have an impact on you. If you're empathic at all, then a part of you is going may feel for that person and that can be draining. So it's important to recognize for you what can you do to nurture your happiness, to nurture your sense of personal power, not to rub it in their face, but so that doesn't draw you down. When you're in a relationship with somebody who's irritable, it can be natural to get irritable back. Okay. Doesn't do any good. If they're irritable and you're irritable back, it's just going to escalate. Having compassion for that irritability and saying, okay, you know, they're, they're having a moment right now and not holding on to that anger, stepping back and saying, okay, what do I need to do? For me, if this person is feeling irritable right now, what do I need to do in order to respect my own personal, emotional and cognitive boundaries? Just because they're irritable or depressed doesn't mean you have to be. Sleep changes. If their sleep is all over the place, it's important to recognize how that's impacting yours. If they're getting up three, four, five times throughout the night, then it may be more difficult for you to get good quality sleep, which is going to contribute to exhaustion and make you more vulnerable to depression yourself. What do you need to do in order to make sure that you are getting adequate quality sleep? If you are not rested, if you are not taking care of you, if you're not recharging you, then ultimately you're not going to be able to be Nearly as effective at supporting them. Same thing is true with exhaustion. There are going to be days, whether it's physical exhaustion or emotional exhaustion, that dealing with your loved one just feels completely overwhelming. And a lot of people will jump down to shame and guilt may feel guilty for that. You, they may feel guilty for saying, you know what, I just, I need to get away. I just, I can't be steeped in this energy all day today. It's important to recognize your thoughts, wants and needs and recognize when your brain and your body is telling you, you know what, I'm exhausted, I'm drained, I need to recharge so I can be there to help charge up this person. Agitation and restlessness Some as I mentioned, sometimes when people are depressed, they may be very agitated, they may have difficulty sitting still. And for some of us, when an somebody in our environment is agitated, it stresses us out. So it's important to recognize if people, the person that you're trying to support is feeling restless again, what do you need to do to be supportive of them? You know, you can say, what is it that we can do? Or look at the plan that you made and say, what are some options? Because you're restless right now and it's stressing me out. What can we do to resolve this situation? The person with depression isn't completely numb to what's going on. They may not have the energy to try to nurture you back, but they may notice. So it's important to be open and communicative. Eating changes. That's another thing that often bothers people when they're in a relationship with somebody who has depression. Because a lot of times, as I mentioned, people who are depressed eat high fat, high sugar foods. And that may not be your preference. You may look at how they're eating and recognize that that's not really all that helpful or healthy for them. However, it's also important to recognize that they're doing the best they can to survive right now. And part of the way they're eating may be a method, if you will, of self medicating instead of being judgy about it, encouraging them to explore how they can get the nutrients they need in order to support their body factory and allow them to eat, you know, the foods that they're eating right now. So instead of trying to say, well, you shouldn't be doing that, they probably know they shouldn't be doing that, but they're doing the very best that they can right now. Your concern as a supportive person is, okay, I see that you are maybe self medicating with food. All right, and how can we also ensure that you're getting all the nutrients you need in order to help you move toward, you know, remission or recovery? Their concentration may be kind of shot. And this could feel rejecting to some people if the person with depression is unable to concentrate on discussions with you, for example, or they are really forgetful. All right, Recognizing that that's a symptom of the depression and starting to make lists, starting to do things in shorter chunks. So you are working with the energy that they have. And the only analogy I can really make is if you have a really old iPhone, for example, and the battery only lasts 15 minutes. Okay, okay. So whenever you get that phone charged up, you have 15 minutes to do whatever you think is most important. That's all that the phone can handle at that point before it needs to recharge again. So what, how are you going to make use of that 15 minutes? Apathy and loss of interest or loss of motivation. As I mentioned, breaking things into chunks can be helpful. Encouraging them to try things if they're willing. You know, you don't want to nag them because that's going to trigger that irritability. But encouraging them to try things can be helpful. You know, would you be willing to try going out on a walk with me? Would you be willing to try doing this? If they have suicidal and back to motivation, if they're not motivated to do the things that you used to do together or motivated to do the things that they need to do, quote unquote, in order to keep the household running smoothly? There may be some anger that comes up. And recognizing that and addressing your own anger and frustration and thinking, okay, being angry about it ain't going to motivate them. So what is it that I need to do? Do I need to use that energy to do their chores, to do that, the stuff that they normally would do until they get better? Do I need to use that energy instead of feeling angry, Do I need to use that energy to just go take a break right now? How is it that I can use my energy if they're having repeated suicidal thoughts? This is terrifying and exhausting for people. So it may be important to work with a counselor or work with their counselor, if they're seeing one, to say, okay, what is it that I need to do in order to support this person and make sure that they're safe? And finally, as I mentioned, that exaggerated and catastrophic thinking can get overwhelming. If you are not a catastrophic thinking type person when the person who's depressed is having this catastrophic thinking. It can feel exhausting, feel like Chicken Little. And it's important to step back and recognize that they are feeling like a bunny rabbit in a huge, dangerous world right now. And they're feeling like everything is the end of the world, all right? And it's important for you to say, okay, that's how you're feeling right now. It doesn't mean that's how I have to feel. Not taking on their catastrophic thinking, setting your own boundaries can also be helpful. And modeling how you think. Being assertive, saying, okay, I hear you, what you're saying, I hear your point of view, this is mine, doesn't mean mine's right and yours is wrong. It just means that's yours and this is mine. That may give them some food for thought. Help us continue to make practical mental health tools available to everybody. Join the channel@docsnipes.com YouTube donate@docsnipes.com donate and like subscribe, comment and share to help us get the word out. Every person's depression may look a bit different. There is no one SIIZ fits all way of supporting people with depression. It's important to understand their vulnerabilities, triggers and interventions that work for them. So ask them, when you weren't feeling this way, what was different, or when you felt this way in the past, what helped you feel better? It may be helpful to encourage mindful awareness of their vulnerabilities and triggers. So if they start feeling feeling irritable or start presenting as irritable, encouraging them to stop and look around and go, okay, what in my environment is triggering this right now and what might I be able to do? What might I be able to do to address it? And self care is also vital to help you cope with the vicarious distress as well as your own feelings of frustration or helplessness in the relationship.