Suggestions for the Loved ones of someone who suffers from Depression
-By someone who suffers-

I have been asked by Bishop Johnson to talk about depression and specifically to the support people who are trying to aid and help a person with depression. I approach this topic with humility and pray that my remarks will be clear and concise. I would also ask the congregation to strive to invite the spirit of the Lord to be here because at the end of the day that is what really counts anyway.

"When I had journeyed half of our life’s way,

I found myself within a shadowed forest,

For I had lost the path that does not stray.

Ah, it is hard to speak of what it was,

That savage forest, dense and difficult,

Which even in recall renews my fear:

So bitter--death is hardly more severe!"

The things that I say will mainly be based around personal experience and scriptural understanding. I would like to start off by defining the way I will be referring to depression in this talk. Depression is a difficult thing to define because everyone experiences the emotions of happiness and sadness. In that sense, depression can be considered something universal. The depression I'm going to discuss is called "clinical" depression. This is the depression of breakdowns, and disability. For this talk to be effective it is important for me to be able to communicate to you what depression is. It is almost indescribable and can be, at times impossible to relay in language. The best descriptions of clinical depression that I have found come from writers.

Andrew Solomon describes depression:

"Depression is the flaw in love. To be creatures who love we must be creatures who can despair at what we lose, and depression is the mechanism of that despair. When it comes, it degrades oneself and ultimately eclipses the capacity to give or receive affection. It is the aloneness within us made manifest, and it destroys not only connection to others but also the ability to be peacefully alone with one self. Depression is grief out of proportion to circumstance. It can be best described in metaphor and allegory"

Another writer, William Styron writes:

"What I had begun to discover is that mysteriously and in ways that are totally remote from normal experience the grey and drizzle of horror induced by depression takes on the quality of physical pain. But it is not an immediately identifiable pain like that of a broken limb. It may be more accurate to say that despair, owing to some evil trick played upon the sick brain or the inhabiting psyche, comes to resemble the diabolical discomfort of being imprisoned in a fiercely overheated room. And because no breeze stirs this cauldron, because there is no escape from this smothering confinement, it is entirely natural that the victim begins to think ceaselessly of oblivion. One does not abandon even briefly one's bed of nails but is attached to it wherever one goes. The sufferer finds himself a walking casualty of war, thrust into the most intolerable social and family situations. There he must, despite the anguish devouring his brain, present a face approximating the one that is associated with ordinary events and companionship. He must try to utter small talk, and be responsive to questions, knowingly nod and frown, and (heaven forbid) even smile. But it is a fierce trial attempting to speak a few simple words."

I have felt this many times. Many days before I gave this talk I have been apprehensive about whether I would be healthy enough to stand before you and be responsive and sociable. It is difficult to rely on yourself when you never can predict which self will emerge on any given day. 

Finally, in Job we read: 

Job 7:20, 3:20-22. What shall I do unto thee, 0 thou preserver of men? Why hast thou set me as a mark against thee, so that I am a burden to myself?

Wherefore is light given to him that is in misery, and life unto the bitter in soul; Which long for death, but it cometh not; dig for it more than for hid treasures; Which rejoice exceedingly, and are glad, when they can find the grave? 

These men describe depression and some of the effects that it has on a person. In my opinion it is one of the most difficult afflictions a person can suffer in this life. Given that, I offer a few ideas to consider when dealing with a person suffering from depression. Following those ideas I will offer a few suggestions as to how a person in the support group can help.

The first thing to consider is that the person who is suffering from severe depression is not acting like themselves. I will say this again, The first thing to consider is that the person who is suffering from severe depression is not acting like themselves. I have heard the analogy of an oak tree which grows from the ground. At a certain point in time, a vine begins growing up the oak tree. In time this vine starts to overtake the oak tree and smothers the leaves that are naturally occurring from the tree. From a distance an observer could not tell the difference between the the leaves of the tree and the leaves of the vine. From a closer view you can see that the vine is actually overtaking the tree and there would be very few tree leaves left. In like manner, depression can erode a persons psyche so that from a distance they look like themselves, but in reality they are overtaken by the disease of depression. This observation is critical for the support person to understand. 

The second idea which I think is helpful to consider is that of agency. In Mormon theology agency is considered to be, or at least talked about as, the one thing that God has given everyone, that it is sacred and Lucifer does not have power to abrogate it. This concept is true. I repeat, this concept is true. However, in many instances there are limitations to this agency. When a person is suffering from a brain a disease it affects the way they think. Thus, it logically follows that this altered thinking is not the volition and will of the person himself. A simpler, less opaque example than depression is one of dementia. The demented person does not necessarily think and act in a way that is completely controlled by his will. The illness of depression is similar. 

People around depressives expect them to get themselves together. Our society has little room for moping. Spouses, parents, children, and friends are all subject to being brought down themselves and nobody wants to be close to measureless pain.

This idea that agency can be abrogated is very scary for many Latter Day Saints. People like to make sense of their world. If they are presented with a situation that could challenge their idea of agency their world would not make sense. To use an analogy, if the laws of physics were to be suddenly changed so that if we dropped a ball, instead of falling down, it rose up we would probably be unnerved a little. 

I would like to share a brief example from my mission. As a missionary, I was taught that if you were completely obedient and kept every jot and tittle of the law that you would be happy. Many people are familiar with the statement from Ezra Taft Benson about work. 

"One of the greatest secrets of missionary work, is work. If a missionary works, he will get the spirit, if he gets the spirit, he will teach by the spirit, and if he teaches by the spirit, he will touch the hearts of the people and he will be happy. There will be no homesickness, no worrying about families, for all times, talents, and energies will be centered on the work of the ministry. That's the secret. Work, work, work, there is no satisfactory substitute, especially in missionary work." 

A person with depression can follow strict rules, work hard, and still suffer intolerably. Keeping these concepts in mind, I offer six suggestions for the support person when trying to help the depressive. 

The number one thing that you can do and if there is anything to be gained from this talk is this: 

You must surrender all judgments about the victims' character. The depression sufferer will be beaten down enough by society that you do not need to add insult to injury by challenging his or her character. The world's view of people with problems is, "They created their bed, let them lie in it." There is nothing of Christ in that attitude. The depression sufferer at times feels like they are drowning in the ocean. The support person who is calling to them might say, "Keep your chin up," or "If you would just swim harder." What the support person on the shore cannot see are the invisible chains and shackles underneath the water chaining the depressive, which is preventing him from swimming to shore. Most often the drowning person cannot communicate this to the person on the shore. Therefore it is vital that the support person listens carefully and to not misinterpret a statement of, I can't do that," to mean "I won't do that." Feeling safe with a person who is non judgmental is probably one of the greatest keys to recovery in depression.

The second suggestion:

Do not pressure the depressive as it relates to the time of their recovery and wellness. Depression can last for months and even years "You know not the day, nor the hour" when recovery will come. This does not mean you should stand by idly waiting. It means to not place expectations on the person's recovery. Many times the depressive will feel they are disappointing the members of their support group or loved one who is supporting them. Therefore, added pressure for them to recover actually adds another catalyst for them feeling hopeless and helpless. 

In my life, the greatest gift I wanted to give my parents was to be happy myself. I realized at a young age that what they really wanted was for me to be happy and healthy. It added great pressure and broke my heart to be unable to give them my happiness and validate their excellent parenting and substantial sacrifices. 

The third suggestion:

Educate yourself about the illness so you can be able to separate fact from fiction. Depression can be a "garbage bag" diagnosis and there is much misnomer out there. Educating yourself about depression within the medical and psychological communities will prove very helpful. 

The fourth suggestion:

The fourth suggestion that I would make which may seem counter intuitive, is this: Do not dive too deeply into religious worshipping during the worst of their depression. This does not mean you abandon Christ's gospel. Many times the depressive is suffering so deeply, has perfectionism and their efforts are driven to extremes with religious orientation. The danger of this is that a person can break their testimony or faith without fully grasping the true nature of their affliction. Again, remember that a depressed person is not necessarily thinking with a healthy mind and remember the analogy I gave from my mission. Working harder, praying harder and fasting too long, can sometimes be counterproductive in this case. 

The fifth suggestion:

Know that it is not your love that is flawed. Many times the support people feel guilty and have mixed feelings regarding the suffering of their loved one. This can be very difficult to do. My wife has dealt with this with me. If I feel depressed she can think and feel that it is something she has done when in reality, she hasn't done anything. Remember to take time to take care for yourself. If you are run down and exhausted you may be vulnerable to being drawn into the downward spiral of despair, as well. 

The sixth suggestion:

Provide opportunities for the depressive to be in nature and in uplifting environments. Time, sunshine, and safety are very therapeutic for persons suffering with depression. They are not necessarily cured by these things but they can help mitigate the suffering. 

I wanted to end this talk with a couple of poems. One is an excerpt nom Lord Byron which for me describes how I feel when I am in pain:

But silent let me sink to earth

With no officious mourners near

I would not mar one hour of mirth,

Nor startle friendship with a fear. 

"Aye, but to die, and go," alas!

Where all have gone, and all must go!

To be the nothing that I was

Ere born to life and living woe! 

Count o'er the joys thane hours have seen,

Count o'er thy days from anguish free,

And know, whatever thou hast been,

'Tis something better not to be. 

Sometimes I might feel this way and may give in to total despair but I pray unceasingly to have the faith of Job. 

Job 19:25-26 For I know that my redeemer liveth, and that he shall stand at the latter day upon the earth: and though after my skin worms destroy this body, yet in my flesh shall I see God: Whom I shall see for myself, and mine eyes shall behold, and not another. 

Jesus Christ has descended below all. During my darkest moments, I can relate to Christ when he felt like the Father had forsaken him. I am comforted by the words of Isaiah, and I try to remember that the agony I feel is just that, agony not reality. 

Isaiah 49:15-16 "Can a woman forget her sucking child, that she should not have compassion on the son of her womb? Yea, they may forget, yet will I not forget thee. Behold, I have graven thee upon the palms of my hands; thy walls are continually before me." 

Finally, I want to end with my favorite poem. It is important to the caregiver because as caregivers of depressives we need to be able to see through the illusion of illness with our spiritual eyes and remember that the Lord looketh upon the heart.

Touch of a Masters Hand