Showing posts with label How carers or friends can help. Show all posts
Showing posts with label How carers or friends can help. Show all posts

Friday, November 4, 2022

How carers or friends can help - Part 1

Marja is sharing about "A lonely Place" in depression. The loneliness and disconnectedness we, who are prone to depression or bipolar depression, can feel at times when we go through depression, is possibly the worst part of the whole experience of depression.

I can identify with Marja's feeling as I often felt that way too whenever I go through depression. I am not able to feel love in any way. And that is extremely painful as I am someone who feel very deeply and love deeply whenever I am well. How I long to love and be loved though I can't feel it because during depression the chemical in our brain has become unbalanced and not able to send the right messages to our brain. So I can't think and feel aright.

Marja wrote on her Blog "Roller Coaster":

I need a friend who will listen to me and just be with me for a while, without making me feel bad about being the way I am. I need a friend who will not tire of sticking with me as I work my way out of the hole I'm in. I need a friend who will love me, no matter how ugly I feel. I need someone I can count on. I need someone who will remind me that God is there. Read more of Marja's sharing....


No man is an island. We all need family and friends in our life to make us a complete person and for us to live a meaningful life. Recently, I shared about my struggles with the issue of "What is the meaning of Life" whenever I go through severe depression. The lack of ability to know and feel the love of God, the love of my family, church brethren and friends, makes me feel life is so meaningless and it is so difficult to go on day by day. I felt as if I am left on a obscure island, isolated from the world and living a life that is utterly useless, and there is no way out of it at all. I am doomed to face the extreme loneliness and helplessness every day. I yearned for human contact but there is none because no one knows how to get onto that island. If someone tried hard enough, maybe they can come on a boat and they might find me. But no one seems to be trying. In my own distorted mind and inability to feel, even God seems so far away. I know He is there and I longed for someone to just give me that assurance again. The loneliness, pain and hopelessness one can feel during a severe depressive episode is beyond description. And another very difficult part of it is that it goes on for days, weeks, months and for some people even years. Day in day out, night in night out, week in week out, etc. You have to go through it yourself to know how it is like. But I sincerely pray that my family and friends will not need to go through these experiences themselves in order to pray and encourage me.

Many times it was the thought of God and my aged mother which prevented me from ending my own life. Note: If you are reading this article and you undergoing severe depression with suicidal thoughts or tendency, please stop reading and seek help immediately! There is help for depression. It can be treated. Don't suffer alone. Reach out and call someone! If you are in Singapore, you can contact these people in Singapore.

During severe depression, I often wonder how to carry on in such a utter pain, misery and loneliness? Who will understand and who will help? Thank God that He is with me and Marja, and all of His other precious children whenever we have to go through severe depression. No matter how we are not able to feel God's love and presence during that time, He never leave us nor forsake us. He is very near to us and it is He who is sustaining us. For underneath us is His everlasting arms. True, during depression I just couldn't feel anything of God's love or presence with me, but that is only because at such a time the chemical in my brain has become distorted. When I am better or well, I will know once again His everlasting love and mercies, which has been unchanging.


Marja's sharing reminded me of a question a dear church friend, Wee Chin, who just asked me yesterday on how she can help me if she notices that I am either a little manic or depressed besides praying. I thank God for her willingness not only to pray for me but also to help in some ways. Several months ago, my brother-in-Christ, Chee Yean, asked me the same question after I shared with him about my experiences with bipolar disorder especially my severe depressive episodes which often lasted for 3 to 6 months or longer.

DBSA and other mental/psychological health sites have many useful articles for sufferers and carers/friends of person with bipolar disorder (manic-depressive illness) or depression, etc. As these articles are on public domain and meant to help us, I will try and post some of these articles on my blog by and by, for our prayers and help.

The following is taken from the website of Depression and Bipolar Support Alliance (DBSA) :

Family and Friends' Guide to Recovery From Depression and Bipolar Disorder

When a friend or family member has an episode of depression or bipolar disorder (manic depression), you might be unsure about what you can do to help. You might wonder how you should treat the person. You may be hesitant to talk about the person’s illness, or feel guilty, angry, or confused. All of these things are normal.

There are ways you can help friends or family members throughout their recovery while empowering them to make their own choices.

The Five Stages of Recovery

It can be helpful to view recovery as a process with five stages. People go through these stages at different speeds. Recovery from an illness like depression or bipolar disorder, like the illness itself, has ups and downs. Friends and family who are supportive and dependable can make a big difference in a person’s ability to cope within each of these stages.

1. Handling the Impact of the Illness
Being overwhelmed and confused by the illness.

An episode of mania or depression, especially one that causes major problems with relationships, money, employment or other areas of life, can be devastating for everyone involved. A person who needs to be hospitalized may leave the hospital feeling confused, ashamed, overwhelmed, and unsure about what to do next.

What friends and family can do:

  • Offer emotional support and understanding.
  • Help with health care and other responsibilities.
  • Offer to help them talk with or find health care providers.
  • Keep brief notes of symptoms, treatment, progress, side effects and setbacks in a journal or personal calendar.
  • Be patient and accepting.

Your loved one’s illness is not your fault or theirs. It is a real illness that can be successfully treated. Resist the urge to try to fix everything all at once. Be supportive, but know that your loved one is ultimately responsible for his or her own treatment and lifestyle choices.

2. Feeling Like Life is Limited
Believing life will never be the same.

At this stage, people take a hard look at the ways their illness has affected their lives. They may not believe their lives can ever change or improve. It is important that friends, families, and health care providers instill hope and rebuild a positive self-image.

What friends and family can do:

  • Believe in the person’s ability to get well.
  • Tell them they have the ability to get well with time and patience. Instill hope by focusing on their strengths.
  • Work to separate the symptoms of the illness from the person’s true personality. Help the person rebuild a positive self-image.
  • Recognize when your loved one is having symptoms and realize that communication may be more difficult during these times. Know that symptoms such as social withdrawal come from the illness and are probably not a reaction to you.
  • Do your best not to rush, pressure, hover or nag.

A mood disorder affects a person’s attitude and beliefs. Hopelessness, lack of interest, anger, anxiety, and impatience can all be symptoms of the illness. Treatment helps people recognize and work to correct these types of distorted thoughts and feelings. Your support and acceptance are essential during this stage.

3. Realizing and Believing Change is Possible
Questioning the disabling power of the illness and believing life can be different.

Hope is a powerful motivator in recovery. Plans, goals, and belief in a better future can motivate people to work on day-to-day wellness. At this stage people begin to believe that life can be better and change is possible.

What friends and family can do:

  • Empower your loved on to participate in wellness by taking small steps toward a healthier lifestyle. This may include:
    • Sticking with the same sleep and wake times
    • Consistently getting good nutrition
    • Doing some sort of physical activity or exercise
    • Avoiding alcohol and substances
    • Finding a DBSA support group
    • Keeping health care appointments and staying with treatment
  • Offer reassurance that the future can and will be different and better. Remind them they have the power to change.
  • Help them identify things they want to change and things they want to accomplish.

Symptoms of depression and bipolar disorder may cause a hopeless, “what’s the point?” attitude. This is also a symptom of the illness. With treatment, people can and will improve. To help loved ones move forward in recovery, help them identify negative things they are dissatisfied with and want to change, or positive things they would like to do. Help them work toward achieving these things.

4. Commitment to Change
Exploring possibilities and challenging the disabling power of the illness.

Depression and bipolar disorder are powerful illnesses, but they do not have to keep people from living fulfilling lives. At this stage, people experience a change in attitude. They become more aware of the possibilities in their lives and the choices that are open to them. They work to avoid feeling held back or defined by their illness. They actively work on the strategies they have identified to keep themselves well. It is helpful to focus on their strengths and the skills, resources and support they need.

What friends and family can do:

  • Help people identify:
    • Things they enjoy or feel passionate about
    • Ways they can bring those things into their lives
    • Things they are dissatisfied with and want to change
    • Ways they can change those things
    • Skills, strengths and ideas that can help them reach their goals.
    • Resources that can help build additional skills
  • Help them figure out what keeps them well.
  • Encourage and support their efforts.

The key is to take small steps. Many small steps will add up to big positive changes. Find small ways for them to get involved in things they care about. These can be activities they enjoy, or things they want to change, in their own lives or in the world.

5. Actions for Change
Moving beyond the disabling power of the illness.

At this stage, people turn words into actions by taking steps toward their goals. For some people, this may mean seeking full-time, part-time or volunteer work, for others it may mean changing a living situation or working in mental health advocacy.

What friends and family can do:

  • Help your friends or family members to use the strengths and skills they have.
  • Keep their expectations reachable and realistic without holding them back.
  • Help them find additional resources and supports to help them reach their goals step-by-step.
  • Continue to support them as they set new goals and focus on life beyond their illness.
  • Help them identify and overcome negative or defeatist thinking.
  • Encourage them to take it easy on themselves and enjoy the journey.

People with depression or bipolar disorder have the power to create the lives they want for themselves. When they look beyond their illness, the possibilities are limitless.

What you can say that helps:

  • You are not alone in this. I’m here for you.
  • I understand you have a real illness and that’s what causes these thoughts and feelings.
  • You many not believe it now, but the way you’re feeling will change.
  • I may not be able to understand exactly how you feel but I care about you and want to help.
  • When you want to give up, tell yourself you will hold of for just one more day, hour, minute - whatever you can manage.
  • You are important to me. Your life is important to me.
  • Tell me what I can do now to help you.
  • I am here for you. We will get through this together.

Avoid saying:

  • It’s all in your head.
  • We all go through times like this.
  • You’ll be fine. Stop worrying.
  • Look on the bright side.
  • You have so much to live for why do you want to die?
  • I can’t do anything about your situation.
  • Just snap out of it.
  • Stop acting crazy.
  • What’s wrong with you?
  • Shouldn’t you be better by now?

What to find out:

Contact information (including emergency numbers) for your loved one’s doctor, therapist, and psychiatrist, your local hospital, and trusted friends and family members who can help in a crisis

Whether you have permission to discuss your love one’s treatment with his or her doctors, and if not, what you need to do to get that permission.

The treatments and medications your loved one is receiving, any special dosage instructions and any needed changes in diet or activity.

The most likely warning signs of a worsening manic or depressive episode (words and behaviors) and what you can do to help.

What kind of day-to-day help you can offer, such as doing housework or grocery shopping.

When talking with your love one’s health care providers, be patient, polite and assertive. Ask for clarification of things you do not understand. Write things down that you need to remember.

Helping and getting help

As a friend or family member you can provide the best support when you’re taking care of yourself. It helps to talk to people who know how it feels to be in your situation. Talk with understanding friends or relatives, look for therapy of your own, or find a DBSA support group.

DBSA support groups are run by people, families and friends affected by depression or bipolar disorder. They are safe, confidential, free meetings where people can learn more about depression, bipolar disorder, and how to live with the illnesses.

One father of a daughter with bipolar disorder says, “DBSA support groups help take a lot of stress out of your life. As a family member, you have to be as prepared as possible, and accept that things will still happen that you aren’t totally prepared for. DO all the research you can. Build a long list of dependable resources and support people, so when a situation arises, you know where to turn and how to take the next step. This really helped my family when we needed it.”

A mother of a son with depression says, “When you are in the middle of a situation, it’s hard to see what’s happening, but when you sit in a support group meeting across from someone who is going through the same things, it gives you perspective.”

Depression and Bipolar Support Alliance (DBSA) has a complete section with information for family and friends to help a loved one on their recovery to wellness.


Thank God for Marja's "Living Room" ministry which is a Support Group for people with mood disorders.

Regards,|
Nancie
March 2008



Thursday, November 3, 2022

Helping someone with mood disorder

(taken from the website of Depression and Bipolar Support Alliance (DBSA)

Mood disorders such as depression and bipolar disorder (also known as manic-depression) affect millions of people. Their family members and friends are affected too. If someone you love has a mood disorder, you may be feeling helpless, overwhelmed, confused and hopeless, or you may feel hurt, angry, frustrated and resentful. You may also have feelings of guilt, shame and isolation, or feelings of sadness, exhaustion and fear. All of these feelings are normal.

What you need to know:

  • Your loved one’s illness is not your fault (or your loved one’s fault).
  • You can’t make your loved one well, but you can offer support, understanding and hope.
  • Each person experiences a mood disorder differently, with different symptoms.
  • The best way to find out what your loved one needs from you is by asking direct questions.

What you need to find out:

  • Contact information (including emergency numbers) for your loved one's doctor, therapist, and psychiatrist, your local hospital, and trusted friends and family members who can help in a crisis.
  • Whether you have permission to discuss your loved one's treatment with his or her doctors, and if not, what you need to do to get permission.
  • The treatments and medications your loved one is receiving, any special dosage instructions and any needed changes in diet or activity.
  • The most likely warning signs of a worsening manic or depressive episode (words and behaviors) and what you can do to help.
  • What kind of day-to-day help you can offer, such as doing housework or grocery shopping.

When talking with your loved one's health care providers, be patient, polite and assertive. Ask for clarification of things you do not understand. Write down things you need to remember.

What you can say that helps:

  • You are not alone in this. I’m here for you.
  • I understand you have a real illness and that’s what causes these thoughts and feelings.
  • You may not believe it now, but the way you’re feeling will change.
  • I may not be able to understand exactly how you feel, but I care about you and want to help.
  • When you want to give up, tell yourself you will hold on for just one more day, hour, minute - whatever you can manage.
  • You are important to me. Your life is important to me.
  • Tell me what I can do now to help you.
  • I am here for you. We will get through this together.

What you should avoid saying:

  • It’s all in your head.
  • We all go through times like this.
  • You’ll be fine. Stop worrying.
  • Look on the bright side.
  • You have so much to live for; why do you want to die?
  • I can’t do anything about your situation.
  • Just snap out of it.
  • Stop acting crazy.
  • What’s wrong with you?
  • Shouldn’t you be better by now?

Download a quick guide to "What Helps and What Hurts" here.

Some people are able to stabilize quickly after starting treatment; others take longer and need to try several treatments, medications or medication combinations before they feel better. Talk therapy can be helpful for managing symptoms during this time.

If your friend or family member is facing treatment challenges, the person needs your support and patience more than ever. Education can help you both find out all the options that are available and decide whether a second opinion is needed. Help your loved one to take medication as prescribed, and don’t assume the person isn’t following the treatment plan just because he or she isn’t feeling 100% better.

There is hope:

As a friend or family member of someone who is coping with bipolar disorder or depression, your support is an important part of working toward wellness. Don’t give up hope. Treatment for mood disorders does work, and the majority of people with mood disorders can return to stable and productive lives. Keep working with your loved one and his or her health care providers to find treatments that work, and keep reminding your loved one that you are there for support.

page created: May 3, 2006
page updated: November 2, 2006
(First posted here on 12 Feb 2008)

Monday, October 6, 2008

Recovery steps for depression and bipolar disorder or manic-depressive illness

Dear Friends,

Thanks for stopping by this Mission 4 Monday post.

I am thankful to God that I can continue to serve Him through this blog.

One of the missions of my blog is to share with others God's goodness and mercies to me in managing clinical depression and bipolar disorder, as well as to share resources that will benefit a person with a mood disorder and information for their family and loved ones.

Depression and bipolar disorder are mood disorders, real physical illnesses that affect a person’s moods, thoughts, body, energy and emotions.

Treatment for these illnesses can also have ups and downs. As much as we may want it to, wellness often does not happen overnight. It is normal to wish we could feel better faster or to worry that we will never feel better.

It is important to know that we can feel better, and that ultimately we are in charge of our recovery. There are many things we can do to help ourselves. God is with us and He has provided helps that we can make use of by His grace and strength. We need to pray that God gives us grace and wisdom to make use of all the means available and suitable to our particular condition. We each need to discover what works best for us as we are very unique and different from one another. There is no one single solution but God will help us as we look to Him.

Relief of symptoms is only the first step in treating depression or bipolar disorder. Wellness, or recovery, is a return to a life that we care about. Recovery happens when our illness stops getting in the way of our life. We may still experience the symptoms once in a while, but we can learn to manage our conditions so that we can be as functional as possible and our symptoms no longer hinder or crippled us.

To work towards wellness or achieve wellness may take time and effort, and much prayers to God for grace and wisdom to make use of available resources and help, for Him to make these means effective to us. A support network of our family and loved ones, and working closely with our health professionals such as our medical doctor and therapist or counsellor are extremely crucial too.

I am thankful to God that He has provided me with a very caring and kind psychiatrist who is determine to equip me with the necessary knowledge and skill to manage my condition so that I can be more functional and be a useful person in the community. With medical helps and learning to keep a mood chart to monitor fluctuations on my mood, and various other coping strategies, I am beginning to learn how to recognize early symptoms of relapses or worsening symptoms, and what I can do to get better.

Earlier in my diagnosis of bipolar disorder or manic-depressive illness last year (2007), I have benefited from some sessions of counseling or talk therapy with a Christian lady counselor who helps me to understand my confusing past, what is mood disorders and how it can affect my thoughts and feelings, and how God is sustaining me and working all things for His glory and my good. Through her help, by the mercy and providence of God, I have embarked on a new journey of understanding God, myself and others better and how best I can love God and others, and serve Him and His people.

It is my joy and privilege, to share this journey, with you dear Readers. It is my sincere prayers that the resources and sharing on this blog will continue to glorify God as you sense His presence with me, strengthening me and uplifting me. May these posts also brings hope and comfort to you knowing that you are not alone and that God has provided resources and means for you and I to manage our condition. Through this affliction, we will know more and more of His sufficiency and mercy. Nothing in this world will last forever, not even our health but only our relationship with God through our Lord Jesus Christ. He will never leave us nor forsake us, and He is lovingly working all things for His glory and our good (Romans 8:28). We are more than conquerors through Him Who loved us (Romans 8:37)!

The following encouraging article on "Recovery steps for depression and bipolar disorder or manic-depressive illness" is taken from the website of Depression and Bipolar Support Alliance (DBSA)

Relief of symptoms is only the first step in treating depression or bipolar disorder. Wellness, or recovery, is a return to a life that you care about. Recovery happens when your illness stops getting in the way of your life.

What is Recovery?

SAMSHA (the Substance Abuse and Mental Health Services Administration/Center for Mental Health Services) (http://www.samhsa.gov/) defines recovery as:

Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.

Next Steps in Recovery

Depression and bipolar disorder are mood disorders, real physical illnesses that affect a person’s moods, thoughts, body, energy and emotions. Both illnesses, especially bipolar disorder, tend to follow a cyclical course, meaning they have ups and downs.

Treatment for these illnesses can also have ups and downs. As much as we may want it to, wellness often does not happen overnight. It is normal to wish you could feel better faster or to worry that you will never feel better. However, know that you can feel better, and that ultimately you are in charge of your recovery. There are many things you can do to help yourself.

Relief of symptoms is only the first step in treating depression or bipolar disorder. Wellness, or recovery, is a return to a life that you care about. Recovery happens when your illness stops getting in the way of your life. You decide what recovery means to you.

You have the right to recover according to your needs and goals. Talk to your health care provider (HCP) about what you need from treatment to reach your recovery. Your HCP can provide the treatment(s) and/or medication(s) that work best for you. Along the way, you have a right to ask questions about the treatments you are getting and choose the treatments you want.

It can also be helpful to work with a therapist, family member, friend and peer supporters to help define your recovery. Your definition of a meaning life may change at different times in life. At times, depression and bipolar disorder might make it seem difficult to set a goal for yourself.

Sometimes it might feel almost impossible to think about the things that you hope for or care about. But goal setting is an important part of wellness, no matter where you are on your path to recovery. Work on what you can when you can.

Setting Goals

Identifying life goals is the heart of the recovery process. When we see a future for ourselves, we begin to become motivated to do all we can to reach that future. Goals can be big or small, depending on where you are in your recovery journey.

Ask yourself:

  • What motivates me?
  • What interests me?
  • What would I do more if I could?
  • What do I want?
  • What do I care about, or what did I care about before my illness?
  • Where do I want my life to go?
  • What brings me joy?
  • What are my dreams and hopes?

It can help to start small and work up to larger goals. You might want to begin by setting one small goal for yourself at the beginning of each day. As you move forward with your recovery, look at the different areas of your life and think about your short and long term goals.

Short term goals might include:

  • Be out of bed by xx:00 am.
  • Finish one household chore.
  • Call a DBSA support group.

Long term goals might include:

  • Get training or experience for a job.
  • Change a living situation, e.g., find an apartment
  • Build a relationship with a friend or family member.

Remember break your goals down into small steps at first. Looking at a goal such as 'move to a new city' can be difficult to visualize and plan all at once. Ask yourself what you need to do first. What can you do now that will help you eventually reach this goal? Not only will this help move you closer to your goal, but it will also help give you a positive feeling of accomplishment.

What are some things I can do that might help me feel better?

Know the difference between your symptoms and your true self. Your HCPs can help you separate your true identity from your symptoms by helping you see how your illness affects your behavior. Be open about behaviors you want to change and set goals for making those changes.

Educate your family and involve them in treatment when possible. They can help you spot symptoms, track behaviors and gain perspective. They can also give encouraging feedback and help you make a plan to cope with any future crises.

Work on healthy lifestyle choices. Recovery is also about a healthy lifestyle, which includes regular sleep, healthy eating, and the avoidance of alcohol, drugs, and risky behavior.

Find the treatment that works for you. Talk to your HCP about your medications' effects on you, especially the side effects that bother you. Remember to chart these effects so that you can discuss them fully with your HCP. You might need to take a lower dosage, a higher dosage, or a different medication. You might need to switch your medication time from morning to evening or take medication on a full stomach. There are many options for you and your HCP to try. Side effects can be reduced or eliminated. It is very important to talk to your HCP first before you make any changes to your medication or schedule.

Talk with your HCP first if you feel like changing your dosage or stopping your medication. Explain what you want to change and why you think it will help you.

Treatments for Depression and Bipolar Disorder

Treatments that work can help you:

  • Reach your goals.
  • Build on the strengths you have and the things you can do.
  • Plan your health care based on your needs.
  • Live your life without the interference of symptoms.

Treatments can include some or all of these elements: therapy, medications, peer support, and overall lifestyle changes.

Medications for Depression and Bipolar Disorder

Your HCP might prescribe one or more medications to treat your symptoms. These may include:

■ Mood stabilizers: These medications help balance your highs and lows. Some mood stabilizer medications are called anticonvulsants, because they are also used to treat epilepsy.

■ Antidepressants: These medications help lift the symptoms of depression. There are several different classes (types) of antidepressants.

■ Antipsychotics: These medications are primarily used to treat symptoms of mania. Even if you are not hallucinating or having delusions, these medications can help slow racing thoughts to a manageable speed.

Talk Therapy

There are many types of talk therapy that can help you address issues in your life and learn new ways to cope with your illness. Goal setting is an important part of talk therapy. Talk therapy can also help you to:

  • Understand your illness
  • Overcome fears or insecurities
  • Cope with stress
  • Make sense of past traumatic experiences
  • Separate your true personality from the mood swings caused by your illness
  • Identify triggers that may worsen your symptoms
  • Improve relationships with family and friends
  • Establish a stable, dependable routine
  • Develop a plan for coping with crises
  • Understand why things bother you and what you can do about them
  • End destructive habits such as drinking, using drugs, overspending or risky sex
  • Address symptoms like changes in eating or sleeping habits, anger, anxiety, irritability or unpleasant feelings

Peer Support

Support from people who understand is another important part of recovery. There are many ways to get this support. DBSA offers a variety of ways to interact with your peers, such as support groups, discussion forums, and an interactive chat room.

Lifestyle

A healthy lifestyle is always important. Even if symptoms of depression or bipolar disorder make things like physical activity, healthy eating or regular sleep difficult, you can improve your moods by improving your health. Take advantage of the good days you have. On these days, do something healthy for yourself. It might be as simple as taking a short walk, eating a fresh vegetable or fruit, or writing in a journal. A talk about lifestyle changes should be a part of your goal setting with your HCPs.

You have the power to change. You are the most important part of your wellness plan. Your treatment plan will be unique to you. It will follow some basic principles and paths, but you and your HCPs can adapt it to fit you. A healthy lifestyle and support from people who have been there can help you work with your HCP and find a way to real and lasting wellness.

Family and Friends' Guide to Recovery From Depression and Bipolar Disorder

When a friend or family member has an episode of depression or bipolar disorder (manic depression), you might be unsure about what you can do to help. You might wonder how you should treat the person. You may be hesitant to talk about the person’s illness, or feel guilty, angry, or confused. All of these things are normal.

There are ways you can help friends or family members throughout their recovery while empowering them to make their own choices.

The Five Stages of Recovery

It can be helpful to view recovery as a process with five stages. People go through these stages at different speeds. Recovery from an illness like depression or bipolar disorder, like the illness itself, has ups and downs. Friends and family who are supportive and dependable can make a big difference in a person’s ability to cope within each of these stages.

1. Handling the Impact of the Illness
Being overwhelmed and confused by the illness.

An episode of mania or depression, especially one that causes major problems with relationships, money, employment or other areas of life, can be devastating for everyone involved. A person who needs to be hospitalized may leave the hospital feeling confused, ashamed, overwhelmed, and unsure about what to do next.

What friends and family can do:

  • Offer emotional support and understanding.
  • Help with health care and other responsibilities.
  • Offer to help them talk with or find health care providers.
  • Keep brief notes of symptoms, treatment, progress, side effects and setbacks in a journal or personal calendar.
  • Be patient and accepting.

Your loved one’s illness is not your fault or theirs. It is a real illness that can be successfully treated. Resist the urge to try to fix everything all at once. Be supportive, but know that your loved one is ultimately responsible for his or her own treatment and lifestyle choices.

2. Feeling Like Life is Limited
Believing life will never be the same.

At this stage, people take a hard look at the ways their illness has affected their lives. They may not believe their lives can ever change or improve. It is important that friends, families, and health care providers instill hope and rebuild a positive self-image.

What friends and family can do:

  • Believe in the person’s ability to get well.
  • Tell them they have the ability to get well with time and patience. Instill hope by focusing on their strengths.
  • Work to separate the symptoms of the illness from the person’s true personality. Help the person rebuild a positive self-image.
  • Recognize when your loved one is having symptoms and realize that communication may be more difficult during these times. Know that symptoms such as social withdrawal come from the illness and are probably not a reaction to you.
  • Do your best not to rush, pressure, hover or nag.

A mood disorder affects a person’s attitude and beliefs. Hopelessness, lack of interest, anger, anxiety, and impatience can all be symptoms of the illness. Treatment helps people recognize and work to correct these types of distorted thoughts and feelings. Your support and acceptance are essential during this stage.

3. Realizing and Believing Change is Possible
Questioning the disabling power of the illness and believing life can be different.

Hope is a powerful motivator in recovery. Plans, goals, and belief in a better future can motivate people to work on day-to-day wellness. At this stage people begin to believe that life can be better and change is possible.

What friends and family can do:

  • Empower your loved on to participate in wellness by taking small steps toward a healthier lifestyle. This may include:
    • Sticking with the same sleep and wake times
    • Consistently getting good nutrition
    • Doing some sort of physical activity or exercise
    • Avoiding alcohol and substances
    • Finding a DBSA support group
    • Keeping health care appointments and staying with treatment
  • Offer reassurance that the future can and will be different and better. Remind them they have the power to change.
  • Help them identify things they want to change and things they want to accomplish.

Symptoms of depression and bipolar disorder may cause a hopeless, “what’s the point?” attitude. This is also a symptom of the illness. With treatment, people can and will improve. To help loved ones move forward in recovery, help them identify negative things they are dissatisfied with and want to change, or positive things they would like to do. Help them work toward achieving these things.

4. Commitment to Change
Exploring possibilities and challenging the disabling power of the illness.

Depression and bipolar disorder are powerful illnesses, but they do not have to keep people from living fulfilling lives. At this stage, people experience a change in attitude. They become more aware of the possibilities in their lives and the choices that are open to them. They work to avoid feeling held back or defined by their illness. They actively work on the strategies they have identified to keep themselves well. It is helpful to focus on their strengths and the skills, resources and support they need.

What friends and family can do:

  • Help people identify:
    • Things they enjoy or feel passionate about
    • Ways they can bring those things into their lives
    • Things they are dissatisfied with and want to change
    • Ways they can change those things
    • Skills, strengths and ideas that can help them reach their goals.
    • Resources that can help build additional skills
  • Help them figure out what keeps them well.
  • Encourage and support their efforts.

The key is to take small steps. Many small steps will add up to big positive changes. Find small ways for them to get involved in things they care about. These can be activities they enjoy, or things they want to change, in their own lives or in the world.

5. Actions for Change
Moving beyond the disabling power of the illness.

At this stage, people turn words into actions by taking steps toward their goals. For some people, this may mean seeking full-time, part-time or volunteer work, for others it may mean changing a living situation or working in mental health advocacy.

What friends and family can do:

  • Help your friends or family members to use the strengths and skills they have.
  • Keep their expectations reachable and realistic without holding them back.
  • Help them find additional resources and supports to help them reach their goals step-by-step.
  • Continue to support them as they set new goals and focus on life beyond their illness.
  • Help them identify and overcome negative or defeatist thinking.
  • Encourage them to take it easy on themselves and enjoy the journey.

People with depression or bipolar disorder have the power to create the lives they want for themselves. When they look beyond their illness, the possibilities are limitless.

What you can say that helps:

  • You are not alone in this. I’m here for you.
  • I understand you have a real illness and that’s what causes these thoughts and feelings.
  • You many not believe it now, but the way you’re feeling will change.
  • I may not be able to understand exactly how you feel but I care about you and want to help.
  • When you want to give up, tell yourself you will hold of for just one more day, hour, minute - whatever you can manage.
  • You are important to me. Your life is important to me.
  • Tell me what I can do now to help you.
  • I am here for you. We will get through this together.

Avoid saying:

  • It’s all in your head.
  • We all go through times like this.
  • You’ll be fine. Stop worrying.
  • Look on the bright side.
  • You have so much to live for why do you want to die?
  • I can’t do anything about your situation.
  • Just snap out of it.
  • Stop acting crazy.
  • What’s wrong with you?
  • Shouldn’t you be better by now?

What to find out:

Contact information (including emergency numbers) for your loved one’s doctor, therapist, and psychiatrist, your local hospital, and trusted friends and family members who can help in a crisis

Whether you have permission to discuss your love one’s treatment with his or her doctors, and if not, what you need to do to get that permission.

The treatments and medications your loved one is receiving, any special dosage instructions and any needed changes in diet or activity.

The most likely warning signs of a worsening manic or depressive episode (words and behaviors) and what you can do to help.

What kind of day-to-day help you can offer, such as doing housework or grocery shopping.

When talking with your love one’s health care providers, be patient, polite and assertive. Ask for clarification of things you do not understand. Write things down that you need to remember.

Helping and getting help

As a friend or family member you can provide the best support when you’re taking care of yourself. It helps to talk to people who know how it feels to be in your situation. Talk with understanding friends or relatives, look for therapy of your own, or find a DBSA support group.

DBSA support groups are run by people, families and friends affected by depression or bipolar disorder. They are safe, confidential, free meetings where people can learn more about depression, bipolar disorder, and how to live with the illnesses.

One father of a daughter with bipolar disorder says, “DBSA support groups help take a lot of stress out of your life. As a family member, you have to be as prepared as possible, and accept that things will still happen that you aren’t totally prepared for. DO all the research you can. Build a long list of dependable resources and support people, so when a situation arises, you know where to turn and how to take the next step. This really helped my family when we needed it.”

A mother of a son with depression says, “When you are in the middle of a situation, it’s hard to see what’s happening, but when you sit in a support group meeting across from someone who is going through the same things, it gives you perspective.”

page created: May 10, 2006
page updated: December 29, 2006


May God continue to enable us who suffer from mood disorders to equip ourselves with means to get better and be more functional.

May God also enable our loved ones and family to understand our condition and how best they can pray, encourage and help us to get better.

May God's presence with you and the assurance of your love gives you hope and courage to press on knowing that He is able to make a way for us where there seemed to be no way.

For more Mission 4 Monday posts, visit Peggy.

Thanks again for stopping by! Thanks for all your prayers and encouragements!

Take care and God bless :)

About depression, bipolar disorder (manic-depressive illness) and mental illness or mood disorders:
1. About bipolar disorder (manic-depressive illness)
2. Myths and Facts on Mental Illness
3. Treatment of bipolar disorder
4. Various pamphlets and articles on bipolar disorder for sufferer and carer

For friends and carers:
1. Helping someone with mood disorder
2. Family and Friends' Guide to Recovery from Depression and Bipolar Disorder
3. How Carers and Friends can help

Other recent related posts:

1. Trust during rough times
2. Finding meaning in a life with bipolar disorder
3. Mental illness (depression, bipolar disorder, etc) is an illness like any other
4. Video on "Depression - A Stubborn Darkness"

Tuesday, March 4, 2008

How carers or friends can help - Part 2

Dr. David P Murray produced a series of 6 video messages on "Depression and the Christian" which are very helpful to both sufferers and their carers/friends. These video messages were a great help to me last January when I first started reading and researching further into depression. I am particularly helped by the very balance and biblical view Dr David P Murray shared in his messages and the various helps he suggested.

These 6 messages are available on
.pdf, .mp3 and video formats which can be downloaded from the website of Sermon Audio.

Dr. David P Murray served as the Pastor of Lochcarron Free Church of Scotland from 1995 to 2000, and then of Stornoway Free Church of Scotland (continuing) from 2000 to 2007. In August 2007 he accepted a call to be the Professor of Old Testament and Practical Theology at Puritan Reformed Theological Seminary in Grand Rapids, Michigan.


In his 6th message, Dr David P Murray wrote on the topic "The Carers":

INTRODUCTION

We have been studying depression from a biblical perspective, and have covered five areas so far:

•The Crisis
•The Complexity
•The Condition
•The Causes
•The Cures

We now come to the final area of our study – The Carers. For our purposes, the carers are the depressed Christian’s family, friends, and fellow-Christians, who will be involved to one degree or another in helping the sufferer to get better. Usually these carers will have no medical training and often they will have very limited or incorrect knowledge of mental illness. However, they have a critical role in helping a depressed person get better. Research has shown that mental health patients will get better much quicker if they have someone close to them whom they can confide in and get support from.

This lecture, then, will consider ten areas for carers to consider when trying to help a depressed person get better.

1. Study

As Christians, we surely want to be the person whom our loved ones turn to in time of need. And, when they do turn to us, we want to be able to help them and not hurt them further.

It is, therefore, imperative that we learn about depression and other mental illnesses in order to avoid the very common mistakes that lay-people often make when dealing with the mentally ill, and in order to be of maximum benefit to those who are suffering.

Apart from studying how Jesus dealt with the ill, the weak, and the distressed you might want to read some of the very helpful books, written from a Christian perspective, which are now available. In order of readability and usefulness they are:

Overcoming Spiritual Depression by Arie Elshout.

I’m not supposed to feel like this by Chris William, Paul Richards, and Ingrid Whitton Broken Minds by Steve and Robyn Bloem.

A Practical Workbook for the Depressed Christian by Dr John Lockley

Another book, of course, is the well-known Spiritual Depression by Dr Martyn Lloyd-Jones. However, you should be aware that Dr Lloyd-Jones does not deal with every aspect of depression as an illness, but rather only with some of the spiritual consequences of depression.

A book which is written from a non-Christian perspective, but which is still useful, is Mind over Mood by Dennis Greenberger and Christine Padesky.

It is important to remember that reading these books will not turn you into a mental health professional, but it will make you more useful and helpful to loved ones in distress.

2. Sympathy

Thoughtful and prayerful study of mental illness should naturally and automatically increase our sympathy for those who suffer with it. By sympathy we mean an ability to communicate that we truly understand the problem and the symptoms, that we are deeply concerned, and that we will do all that we can to help. In many cases, such sympathy can have powerful therapeutic effect on the sufferer. The lack of it can only multiply the pain and deepen the darkness. Consider the following quote from Russell Hampton, who suffered himself from depression:

"If there were a physical disease that manifested itself in some particularly ugly way, such as postulating sores or a sloughing off of the flesh accompanied by pain off an intense and chronic nature, readily visible to everyone, and if that disease affected fifteen million people in our country, and further, if there were virtually no help or succour for most of these persons, and they were forced to walk among us in their obvious agony, we would rise up as one social body in sympathy and anger. There isn’t such a physical disease, but there is such a disease of the mind, and about fifteen million people around us are suffering from it. But we have not risen in anger and sympathy, although they are walking among us in their pain and anguish."

It will greatly help you to sympathise if you always remember that you could just as easily be in the same position, suffering the same illness.

For who maketh thee to differ from another? and what hast thou that thou didst not receive? now if thou didst receive it, why dost thou glory, as if thou hadst not received it? (1 Cor.4:7).

If you treat depressed people with impatient contempt, you may, like many others before you, have to learn sympathy the hard way.

3. Support

Support follows sympathy. It involves being available to listen and talk either in person or at the end of a phone. It includes praying with the person, especially as the mentally ill may find it impossible to put words and sentences together in prayer. It means unconditional love, love which is maintained even when you do not agree with every decision your loved one is making, and even when they may unjustly turn on you. It requires practical help such as child-minding to enable a young mother to get a few free hours each week, or such as taking an elderly person out in the car to give them a refreshing change of scenery. It demands wisdom to know when you are getting out of your depth and more professional support is needed from medical services. The benefits of such supportive friendship cannot be overestimated:

The presence, the availability, just the existence of a friend like this provides a tremendous degree of comfort to the depressed person, as it demonstrates in physical terms how much he is cared for, accepted, loved, as he is, warts and all. It is not difficult for the depressed person to go on to realise that if individual Christians can love him that much, how much more will God do the same.

Unconditional friendship is the key, as is loyalty. The real friends are the one who can accept the depressed person as he is – on good days, bad days, sad days, frightened days and angry days. Friends like this don’t put pressure on in any way, but allow the sufferer to be himself, however horrid that may seem to be. As one of my depressed friends said, “It’s a relief not to have to put on a disguise.”

On a congregational level, pastors and officebearers should encourage a supportive atmosphere: For our churches to be really effective in supporting those with mental health difficulties, we need to establish a culture where everyone in the local church knows that it is acceptable to have problems
from time to time, and that the church as a whole – and especially its leadership – is there to support church members during these times as well as in times of success.

The Church should be especially aware of the need to “support the supporters”. To be an effective support to the mentally ill is physically, mentally, emotionally, and spiritually demanding. As Christians we need to be conscious of the need not only to support the depressed person but also to minister to the needs of their nearest and dearest.

4. Stigma

There is still a stigma attached to mental illness, and depression in particular. Ignorance and misunderstanding have filled the public mind with many prejudices and falsehoods. As a result, many still view mental illnesses such as depression as a choice, or as a sign of weakness, or as an excuse to opt-out of life. The depressed person may also share these mistaken beliefs, and so double their sense of guilt and failure. Consequently, they will often be very reluctant to admit what they are feeling, and so go for many long months or even years without asking for help or seeking treatment.

Following steps 1-3 above will help to reduce this stigma. But the Church can also help by making clear that Christians do not have to be perfect with no problems, and by demonstrating that when people do experience problems they will not be ignored or avoided.

Also, the preacher should present a balanced view of the Christian life, as represented in the Psalms, over a third of which deal with fear, anxiety, and despair. This is part and parcel of normal Christian experience in an abnormal world. Let us remind ourselves again and again:

For who maketh thee to differ from another? and what hast thou that thou didst not receive? now if thou didst receive it, why dost thou glory, as if thou hadst not received it? (1 Cor.4:7).

Almost anyone can experience mental health problems, given the wrong sequence of life experiences and stressors.

5. Secrecy

As is clear from the above, it often takes a huge amount of courage for someone to admit to depression, often due to the fear of what people will say. If someone, therefore, trusts you enough to confide in you, then you must maintain the strictest confidence. There must be no “sanctified” gossip – “I’m just telling you this so that you can pray about it…!” It is tragic that so many depressed Christians have to prolong their secret suffering because of a justified fear that no one can keep a secret in the Church! The Church is in desperate need of Christians who are known to have this simple talent – they keep confidences.

6. Self-esteem

Depression and anxiety bring to the surface deeply rooted self-doubts and self-criticism. The depressed person will often feel useless and worthless. They will have very low self-esteem. What should we do to address this?

Some Christians are reluctant to give people any praise or encouragement because of the risk of making a person proud. However, it is safe to say that pride is one of the least risky vices for someone who is depressed. Pride results from having an over-inflated view of oneself. Depression involves the opposite.

Other Christians misconstrue the doctrine of original sin and total depravity to mean that there is no kind of “good” in anyone, and so again fail to say anything positive to the person. However, without minimising the wickedness of the human heart and without denying our inability to do anything pleasing to God apart from through faith in Christ, we should feel free to encourage the depressed person to have a more realistic view of themselves by highlighting their God-given gifts, their contributions to the lives of others, their usefulness in society, and, if they are Christians, their value to the Church. For example, a depressed young mother may feel a total failure in every area of her life because she has not got a perfect home or perfect kids. We can help such a person to see that she achieves a lot in a day even though she might not manage to do everything she would like. We might remind her of all the meals she makes, clothes she washes and irons, the shopping she organised, and so on, and so help her to see herself and her life in a more accurate and realistic light.

It is wrong to pat ourselves on the back when something has been accomplished as a result of our initiative. It is equally wrong, however, to focus on what we have not accomplished. In 1 Corinthians 15:10 we have a clear example of humility accompanied with a healthy opinion of one's accomplishments: "But by the grace of God I am what I am: and his grace which was bestowed upon me was not in vain; but I laboured more abundantly than they all: yet not I, but the grace of God whichwas with me." Paul knew very well that he daily offended in many things (James 3:2; cf. Rom. 7; Phil. 3:12), and yet he did not go so far as to cast out all his accomplishments. I do not believe that this is God's will. In contrast to sinful forms of self-confidence and self-respect, there are also those that are good, necessary, and useful. Without a healthy sense of these, human beings cannot function well. We may pray for an appropriate sense of self-confidence and selfrespect, clothed in true humility, and we must oppose everything that impedes a healthy development of these things (be it in ourselves or others) with the Word of God.

7. Subjectivism

One of the most common tendencies in depression is to focus on feelings, and to base beliefs and conclusions on these feelings. This is especially true of Christians. They may feel forsaken and so conclude they are forsaken, etc. There is also the tendency to read Bible passages and books which address the feelings in the hope that this will help to restore true feelings, whereas such a focus tends only to make things worse.

We should encourage the depressed person to move away from the realm of the subjective and to instead think on the objective truths of Christianity – things which are true regardless of our feelings – justification, adoption, the atonement, the attributes of God, heaven, etc.

8. Speak

The general rule is to listen much and to speak little. However, here are a number of things not to say:

• Pull yourself together
• Don’t get so emotional
• O, you’ll soon get over it
• It’s a sin to be depressed
• Just believe the promises
• Smile, it can’t be that bad
• Well, things could be worse
• At least it’s nothing serious
• You should confess your sins
• You are not still on medication, are you?

The more you understand depression the less likely you will say such hurtful and damaging things.

9. Suicide

If you suspect someone is considering suicide then you should sensitively and wisely ask the person if they are thinking along these lines. This will not plant suicidal thoughts in their minds, but may allow the suicidal person to admit to this and to seek professional help.

In Broken Minds, the pastor Steve Bloem gives a number of reasons he has, at times, used to convince himself not to commit suicide:

• It is a sin and would bring shame to Christ and His church.
• It would please the devil and would weaken greatly those who are trying to fight him.
• It would devastate family members and friends, and you may be responsible for them following your example if they come up against intense suffering.
• It may not work and you could end up severely disabled but still trying to fight depression.
• It is true – our God is a refuge (Ps.9:10)
• Help is available. If you push hard enough, someone can assist you to find the help you need.
• If you are unsaved, you will go to hell. This is not because of the acts of suicide but because all who die apart from knowing Christ personally will face an eternity in a far worse situation than depression.
• If you are a Christian, then Jesus Christ is interceding for you, that your faith will not fail.
• God will keep you until you reach a day when your pain will truly be over.

10. Slow

It is important to realise that there are no easy answers and there are no quick fixes in dealing with depression. It usually takes many months and in some cases even years to recover. You should, therefore, take a long-term view and patiently wait for improvement. Don’t get frustrated over lack of progress and be aware that temporary relapses may occur.

Patience is essential, because, by the nature of illness, the depressed person is likely to go over the same ground time and again, needing the same reassurance that was given a day, a week or a month ago.

In the meantime let us take our depressed Christian brethren continually before the throne of grace and plead, “Lord, he whom thou lovest is sick.”

CONCLUSION

In the course of these lectures we have been looking particularly at how depression affects the Christians. In closing I would like to refer back to something which I have touched upon now and again – the way God will sometimes use depression to bring an unconverted person to the Saviour. If you are unconverted and feeling depressed, at least part of the solution may be repentance from your sins and faith in Christ. That is not to say that you may not need medication and counselling as well. However, medication and counselling will only be a temporary solution if you do not seriously address your spiritual state before God. Pills might get you through this world, but they will not be available in hell, the place of ultimate torment, despair, and gnashing of teeth.“Believe in the Lord Jesus Christ and you shall be saved.”

Other messages in this series of lectures on "Depression and the Christians":

The Crisis

The Complexity

The Condition

The Causes

The Cures