First and foremost, be patient. This is a wound that will only heal with time. And don’t worry. There’s nothing for you to fix.
Be supportive. This refers back to patience. You will temporarily have to pick up some extra responsibilities, because there are things your loved one can’t do right now, like dishes, running errands, or laundry. They just can’t. They’re not being lazy, they are actually incapacitated.
You will also have to help them with self-care, by reminding them to eat, shower, and brush their teeth. If they are not sleeping well, buy an over-the-counter sleep aid and remind them to take it, because if they sleep poorly, that will drastically worsen their depression. Inversely, if their sleep gets better, they will have an easier time with their depression.
Since this is what is considered a situational depression, these problems will not be long term. The depression will probably be over in less than a year, and will gradually get better day by day. It may even be better in a few months, depending on how quickly your loved one processes their loss.
If you can make an appointment for them with a therapist, do so, and offer to drive her/him to her/his first appointment. If they hate the therapist, try again with someone else. A therapist can teach your loved one coping tools that will help ease her/his suffering. You can learn coping tools alongside your loved one, both for you to use yourself, as well as for you to remember so that you can remind your beloved to use specific tools. If you would like to borrow some of my tools, I have a list here with explanations of how to use them: Coping Tools You Can Borrow! – The Goldfish Painter
Let them be angry, and remember that if they get angry with you for doing nothing wrong, it’s their grief talking and that their anger probably Continue reading →
Talk to your friend about what activities are soothing, as well as what the things they really need to hear from you are. Encourage them to write these things down, with the goal of giving you the piece of paper to keep, so that you can say or do helpful things when they are having a hard time. Note: it is also very important that they make a similar list for them to refer to.
Some of the things you can say that might make a difference are:
Breathe slowly. You’re going to be okay. You’ve always gotten through this is the past, all you have to do is wait it out. I know you are strong. This will be over soon.
You are so loved, I care about you deeply, and I will help you any way you need if you tell me how.
We can get you out of this situation if we need to. (Make sure you can follow through on this.)
You are not in danger. This is your anxiety trying to take you over. I am here to help you feel safe. (If they will not respond positively to you saying that their reaction is coming from their anxiety, just promise them you will keep them safe.)
Some actions you can take to help are:
Try to remove your friend from the situation that is causing the anxiety response, like a social or family situation, the store, the mall, or a party/formal event. Go outside with them and encourage them to breathe in slowly through the nose while counting, and breathe out for half as long out of the mouth. This physically slows their heart rate. You can count out loud for them to help them concentrate, and feel cared-for. You can also offer them the option of leaving the situation entirely, if possible. It’s okay to cancel plans with friends and family in order to help your friend function. It’s something that they will need sometimes. If their friends and family can’t be understanding or supportive, they are going to lose those people eventually anyway.
Remind them to eat. Low blood sugar can trigger an episode. When you go somewhere with them, keep a piece of fruit with you.
Encourage your friend to get in to see a therapist if they don’t already. If they can’t afford it, there are some therapists who offer sliding-scale pricing, which means your friend would pay according to what they make. When they see the therapist, they should go in with goals in mind. These goals could be “I want to be calmer in public places.”, “I want to feel less anxiety.”, or “I want to struggle less with my daily life.” The therapist will then help them build tools and skills to use every day that are aimed at lessening their pain. If your friend is reticent to go to therapy, offer to help them find a therapist and to drive them to their first appointment.
Remind them often that they are loved and supported, in and out of anxiety episodes.
Remind them to do any of the activities they wrote down as “soothing”. It’s easy to forget your tools when you’re in crisis.
Please remember that your friend can get better and experience less anxiety, but they will probably never fully recover. The goal is not to be cured, the goal is to learn to live successfully, in as little pain as possible. Most of the responsibility to get better rests on your friend’s shoulders, not on yours. Make sure you take care of your own mental health before reaching out to help your friend. It’s okay to sacrifice a little for them, but if you find yourself slipping into a depression because of their situation, take some time to yourself to get better, and then return to your friendship refreshed. Since your friend has a mental illness, they should be understanding if you express the need to take care of your own mental health for a while.
It is very loving and honorable that you want to help your friend. If you have a very close relationship and you are willing to take on more responsibility, this has more ways you can help: How Outsiders Can Help – The Goldfish Painter
All people on the internet can do for you is to listen and respond. We can offer our support through words and remind you that you are not alone. We will be here in the middle of the night. We will hear you, and we will try to help.
Move forward with the hope of treatment and remission. You need to be seeing a psychiatrist and a therapist. Depression is hard, and you may not have much energy or functionality today. That’s okay. Make your one task for the day “Make an appointment with a psychiatrist”, and even if there is a long waiting list, set the appointment and put it on your calendar so that you will have help in the future. Do the same thing tomorrow, only with a therapist.
If you already have a psychiatrist and therapist, stay vigilant in keeping your appointments and taking your medicine. Start to build your toolbox of coping strategies,(that link is to a list of all of my coping tools) and use it when you’re in pain, even if that means you are using it all day, every day. You cannot be cured, but your pain can be managed. For your next appointment, take any notes you can on your symptoms, triggers, medicine effects/side-effects, sleep problems, eating problems, and daily moods. There is no wrong way to take these notes, just write down information every couple of days about things you experience in your illness. The important thing is that you have everything written down for the doctor.The doctor will only be as good as the information you give them, and you are your best and only advocate as the patient. Don’t rely on only your memory to communicate with your doctor, because memory is fickle and fallible, and doubly so with Continue reading →
When you first start psychiatric medication, you honestly don’t know what you’re doing. I wish that there was a class on how to be a good and helpful patient that anyone could take for free when they get their first script, but instead, I will write out the things I believe are crucial in order to make significant progress aided by meds.
Patient Skills For a Lifetime
Although I am not a doctor or any sort of health professional, I do consider myself a “professional patient,” due to the past 13 years of dealing with bipolar disorder, major depressive disorder, and generalized anxiety disorder. All that time, I have been in treatment with psychiatrists, psychologists, therapists, general practitioners, and specialists in various fields. The following is what I’ve learned.
One psychiatric medication does not work the same on everyone. And if you’re already telling other people about your meds (what works for you and what doesn’t), then please read the disclaimer that needs to come before any advice you hand out.
Sometimes a psych med has the effect of causing health problems, making things worse, or affecting you in a way opposite of its intended purpose. An example is that for some people, some antidepressants can cause suicidal ideation, and some antipsychotics can cause hallucinations. These effects happen to a small minority of people, so this doesn’t mean you shouldn’t try them. Because…
Psychiatric medication can save your life. A med can bring you back from the brink. A med can improve you enough to be able to use coping skills, which is difficult in a nonfunctional place…
Doctors are stabbing in the dark when you begin treatment.This means that you will probably have to try more than one medication before you find one that works. Once you find one that works, then you will need to…
Adjust your dosage and time of the dose with the guidance of your doctor.Often, a medication that works for you a little bit can work for you a lot after you figure out what time(s) of the day make you feel best. This is often called “tweaking the dose.”
To learn how the dose needs to be tweaked, you will need to KEEP NOTES.Print out a mood chart from the internet (search “mood chart”-it’s easy). Go to Kinko’s or the library if you don’t have access to a printer. I know some apps do the same thing, so look for those instead if you’re inclined. Or just keep a notebook. It doesn’t matter how you do it as long as you have the following information in an easy to read way:
Your daily mood status
What you are taking, what time and how much (you don’t need to write down the things that don’t change every day)
Your mental illness symptoms, especially anything severe or unusual for you
Other health problems
Any problem behaviors or events (like self-harm or episodes)
Any insight you notice about how you are being affected
Bring your notes with you to the doctor.Some doctors’ appointments are as short as 10 minutes, so every sentence counts. Having all the information on hand eliminates the need for telling long, rambling stories full of irrelevant details. This is probably the most important thing to do in your relationship with your psychiatrist.
The other night, my husband made a minor comment that made me feel bad, and I fell into a thought spiral on the thought “It’s not supposed to be this hard.” I started crying. I sank deeper into dark ideas, feelings of hopelessness and worthlessness and meaninglessness. When the sadness became too great for my brain, it turned to pure fear instead. My mind’s solution to fear is often to ascribe meaning to it that isn’t there, just because it needs to have a reason to be afraid. This time, my mind picked ghosts. The room around me was full of ghosts. They all stood still, with their hands at their sides, all silent, all staring at me. There must have been at least 30 of them. There was not enough space between any of them for me to leave the room or even get off the couch.
I called out to my husband to help me and told him about the ghosts. He tried to help me fact-check by telling me that there couldn’t be ghosts because ghosts are not real. That didn’t work this time. I could see them. I could feel them looking at me. My husband is a creative problem-solver when I’m in crisis, so he was on top of the situation. He told me that there were no ghosts in the bedroom, so we could go in there and be safe. He made a path through the ghosts with his body so that I could follow behind him without touching them. It worked. The ghosts stayed out of the bedroom, so I stayed in it. I moved on to other troubling beliefs, but none as bad as the audience of 30 translucent spirits in the living room.
Those ghosts were a psychotic symptom, somewhere in a mix between hallucination, delusion, and paranoia. Mental illness symptoms are rarely simple or plain. Everything is a mixture of gradients. It’s been a long time since I’ve had such a striking and problematic psychotic episode.
I also had a night when I put together many pieces of “evidence” that my husband was cheating on me. It was full-fledged paranoia. I was seeing meaning and clues in everything. I spent the afternoon in a perpetual fit of Continue reading →
I don’t like that I’m not supposed to say that I’m disabled. I was told recently that what I’m supposed to say is “person living with a disability.” I was told this by a healthy person with healthy privilege. Something is not right here.
I don’t know for sure, but I’d bet my cat on the idea that a healthy person coined the idea of “people living with disabilities.”
I am completely supportive of trying to make the world a kinder place, and if saying only “a person living with a disability” instead of “a disabled person” is what we need to do to make people with disabilities (which I am not opposed to saying as long as “disabled person” is still something people can call themselves) feel more accepted, safe or supported, I will do it. But I will not give up my right to call myself disabled.
The word “disabled” is incredibly powerful to me. It took me years to accept that I am truly limited in a way that most people aren’t. Before I accepted that I was disabled, I measured my life against healthy standards instead of standards that are realistic for someone with my disorders. Because I did not yet acknowledge Continue reading →
When you see a therapist, it’s good to go in with goals in mind. Those goals can be big or small, broad or narrow. Some of my goals in the past have been “reduce depression”, “cope with anxiety”, “build a healthier relationship with food and lose weight”, “learn assertiveness skills”, “set firm boundaries with parents”, and “minimize psychotic episodes”. At your first therapy appointment, be ready to set one or more goals. Your therapist may ask you directly what your goals are, or they might let you direct the session. Either way, let them know what your goals for therapy are.
It’s important to see a therapist with whom you are comfortable, but most people are not comfortable with their therapist for the first handful of appointments with them. It’s perfectly normal to be nervous and uncomfortable in therapy at first. The hope is that you will gradually learn that you can trust your therapist. If you have a deep dislike or disrespect for your therapist right away, leave. But if you’re just nervous, awkward, or uncomfortable, then try giving them 4 sessions before you decide whether you need to find someone else. Therapy is awkward at first, especially if you grew up in an environment where it wasn’t okay to openly and honestly express emotions. If you grew up in an emotionally accepting family, therapy will be easier to dive in to. If you didn’t, then it might be a little hard to open up, but there is nothing you could say or express to a therapist that would be inappropriate or out-of-bounds. This is the one person who legally must keep your secrets and is not there to get anything out of your relationship other than employment. They are only there to help you, and they have chosen that as their life’s work.
You can say as much or as little as you want in a therapy session. I encourage you Continue reading →
When you’re deep in a depression, not much appeals. Nothing sounds fun. Nothing seems worth doing. When that happens to me, I know I’m not just bored. I’m depressed. Losing interest in things you usually care about is a normal and typical symptom of depression. For many very lucky people, sadness passes in a day or so. For those of us whose sadness lasts weeks and expands into full depression, we need a plan. Deep depression can lead to suicide or suicide attempts. If you’re going to stay alive, you need tools to help you do so. Suicide happens when the pain you experience exceeds your ability to cope with it, so if you’re going to stay alive, your options are to lower the level of pain or increase your coping ability. This explanation is not original to me, so don’t credit me for it. I use it because it’s a clear and simple analysis of a messy state of mind.
So. You’re depressed. Time to get to work. Self-care is where you begin. Self-care is easier than all-out self-love, which is often not possible when you’re depressed. Taking a shower, brushing your teeth, or eating something is a good place to start. If you’re severely depressed, all three of those things may be impossible. If those things remain impossible for more than two weeks, you need medical intervention (click to learn how to be a “professional patient”). If that’s where you are right now, then the job I assign you for today is to make a doctor’s appointment. That is the only task you need to do today. You can do one thing. You can spend the rest of the day watching TV and crying (or whatever you do to cope) if you need to, just get that one thing done. It’s the first step to saving your own life.
If you are still able to do something like take a shower or feed yourself, you might be able to get through this without medicine. Granted, if you have a mental illness diagnosis, you DEFINITELY need to call your doctor immediately, but if you have a situational depression from something like losing a job, ending a relationship, or grieving a loved one, you might do just fine with some added coping skills.
Steps To Surviving A Depression or Depressive Episode
Lower your standards. You are not having a normal time in life so you cannot have normal expectations of yourself. Make your daily list short. Celebrate small victories, like any act of personal hygiene. Even brushing your teeth is a win when you’re not really so hot on staying alive. Your life right now is monumentally challenging, and recognizing and respecting your current abilities go a long way toward better self-esteem.
Make a List. Write down the things you can reasonably get done in a day. For example, today I’m getting sick, and I’m worn out and a little depressed. So the list I made today was “weigh self, make pill case, drink coffee, shower, dress, work on my website, eat dinner”. That’s all that I’m requiring of myself today. On better days, I know I can do more, so I write more down, like exercise or socializing. Cross things off as you go along to show yourself that you’re getting things accomplished, and if the next thing on your list seems too hard, write a time down next to it for half an hour to an hour from now, so that you can take that time to gather your strength, courage, and energy to do the next task. I frequently have to do that with showering, otherwise, it won’t get done. I sit for thirty minutes just mentally preparing. Same goes for exercise. You can refer back to your list throughout the day, and if all the tasks are crossed off at the end of the day, please be proud of yourself for that.
Set realistic goals. If you are not up for company, cancel plans. If your job is killing you, take time off or apply for disability benefits (in the U.S.). If you can’t get your chores done, only ask 5 minutes of yourself a day, and don’t beat yourself up for it. If you can’t do your homework, talk to your professor (this is really important if you’re a student. When you are honest with a teacher or professor about your mental-illness-caused limitations, they will be much more likely to be lenient on deadlines and work with you to help you complete a class.) If going to school is killing you, take a semester off. Be realistic about what things are threatening your life. Do not expect to be more resilient than others. Do not hold yourself to the same standards you did when you were healthy. And don’t measure yourself against an ideal, healthy person who does not exist. Instead, measure yourself according to your values, and how well your actions line up with what is truly important to you.
Be sweet to yourself. Use kind language when you speak to yourself, always, but especially when you’re depressed. I know this is very challenging. I’ve been meaner to myself than anyone has ever been to me, most often in episodes or during depressions. No matter who you are or what you’re experiencing, you’re a worthwhile person, and who you are is absolutely enough. What you’re feeling now won’t last forever; you will live again. Be as patient with yourself as you would be to someone you love who is hurting. Say kind things. Be nice. You deserve to be treated well, especially by yourself.
Write down your feelings. Even if the act of writing makes you cry very, very hard. When you’re finished, you will have a deep feeling of calm that could last up to a few hours. Writing is a proven effective therapeutic activity with very clear and real results. You might not want to want to do it, but it truly will help you cope almost immediately.
Get sunlight. Go outside, even if you just sit on your front porch for five minutes. Sunlight stimulates chemicals in our bodies and brains that are important to mental health, like lithium and vitamin D. Having the right balance of chemicals is more than half the battle with depression. You are also more likely to see something beautiful if you go outside. It’s amazing out there, always.
Pick soothing activities. Write down one or two to do today. Pick something like watching TV, coloring, reading, or playing with a fidget toy. Mess around on the internet. Anything easy that’s not challenging and won’t steal your limited and precious energy.
Get good sleep. Insomnia and depression often go hand in hand. If this is you, med up. There are lots of over-the-counter sleep aids, and I’ve had good luck with most that I’ve tried. I recommend Unisom, Alteril, and melatonin. Most people would be fine taking just one of these OTC sleep aids, but you can ask your doctor if they can be combined. You might sleep for a long time, which is not a bad thing. Sleep is foundational, and doubly so if you’re mentally ill. Set an alarm for noon and try to stay up until eight in the evening. Take your sleep aid at seven and you’ll probably be asleep in the next hour or two. This schedule allows lots of time to sleep without messing up your circadian rhythm and turning your sleep habits upside down.
Hug a pillow while watching TV. I don’t know why this helps me with depression, but it really does.
If you are currently suicidal, put this number in your phone! 1-800-273-8255
If you’re working through a depression right now and you feel suicidal, call this helpline: 1-800-273-8255. Whatever your current situation, nothing is permanent. It is possible for things to get better. Don’t believe that it can’t ever get better, because that’s not true. It can always get better.
By Emily Harrington, The Goldfish Painter
I am not a doctor or any sort of mental health professional. I am a psychiatric patientwith multiple mental illnesses that I have survived for 13 years now. My secondhand knowledge comes from doctors, psychologists, therapists, books, college courses in psychology, and the internet. My firsthand knowledge comes from the feelings, experiences, thoughts, symptoms, problems, and solutions that I have lived through. I know myself well, but again, I am not a professional. The information on this site is not a replacement for getting an actual diagnosis or professional help. Coping skillsare fantastic, and I hope you learn some here and that they help you, but please seek and continue real medical treatment if you are struggling with mental illness. I wish you the best. You can do hard things.
One of the biggest worries of a mentally ill person is that they are a terrible burden on their friends and family. As an outsider, most of what you can contribute is verbal. Regularly remind your loved one that they are not a burden, they are not going to lose you, you love them, and that it’s okay to be upset. Physical contact is also very powerful: a hand on the back, a squeeze of the hand, or a hug can make an enormous difference in the current mental state of your loved one in crisis. If it’s appropriate to your relationship, lay with them and hold them, or let them put their head in your lap so that you can pet the side of their head. This sounds very basic and very infantile, but the difference you’ll make is enormous. Just being present with your sick loved one is powerful. Try to listen without judgment, and try not to give advice, only reassurance that they’re safe and loved. If your loved one is very sick and not making good choices, keep them at home. Even a trip to the grocery store could be catastrophic for their state of being. If they’re not making sense, do not let them cook or drive, and keep a close eye on them to keep them safe.
If your loved one is suicidal, take them immediately to the emergency room, because they’re going to need to Continue reading →
There is only one thing I have held back from a therapist in the past, and even that would have been far more beneficial to have said than to have kept to myself. That one thing was “I am actively planning my suicide.”
I held this back because I know that the only two pieces of information a therapist is legally allowed to report (other than child abuse) are 1) if you are planning to hurt yourself or 2) if you’re planning to hurt someone else. If they find this out, they can work to have you held in a hospital for 72 hours to assess your mental health and try to make you safe again.
I held this back because I didn’t want to be stopped in my progress toward suicide. I had already decided and was putting the necessary steps in place for a successful exit. Continue reading →