Depression, etc

[teigyr]

I have a somewhat quirky question but know that there is a vast knowledge base here. It's also late and I'm tired so I apologize!!!

I have a friend from H.S. who I've recently come back into contact with. She and I were good friends and I was hanging out with her pretty much exclusively in our formative years. I know she had tried to kill herself back in Jr. High (I think?) which was before I met her. Her brother has been diagnosed bi-polar, and she has been diagnosed clinically depressed. This is as of now.

She lives with her sister. Her sister works. My friend is going through a divorce and has a spinal problem which keeps on her on pain medication. My friend is on anti-depressants and morphine derivatives and exists. The California "low income" insurance is very restrictive and only allows her to exist but not to heal.

I've spoken to my friend a lot on the phone. I will go see her within the month. Her sister has pleaded with me not to give up on her (my friend) and they hope that she will want to leave the house and want to live, basically. On the phone, I can see that she is interested. I can talk to her about what's going on and we can be who we are...and I can ask her stupid questions like "why the heck are you DOING this?" and she sees it as it is but I also know (from my fear of heights) that things can't be cured as easily as that.

Any ideas? I e-mailed my ex-husband who has been diagnosed the same only he functions. I think he sees sides that are beyond me because my cure for stuff is "go for a walk". I mean I know beyond that but I guess I pull myself through it all and self-preserve. I think my simplistic way of thinking won't help. I don't want the system to give up on her and I know I am seen as maybe a way out, at least by her sister.

The scary thing is her sister is dating a guy who has talked of marriage. I asked what would happen to my friend (who doesn't work, who lives on public assistance, and who has no living parents now) and was told "well, she would live with us or live with her brother". My friend is my age (not that old, I daresay!!!) and it is so scary to see her without means.

I think she CAN work. She sees things as against her, like if people go out to lunch without her she thinks they don't like her and maybe they don't but that's life sometimes. She can move around. She isn't from an athletic family and they are a bit out of shape but that is all learned behavior. Diet, exercise and all of that CAN happen but coming from how I am, it sounds stupid to just say it to someone who hasn't left the house since forever.

So. For those who have been on medication or who have been through this, what should I do as a friend? My experience is me (who if I'm sad or depressed I run or walk and work through it) and my ex-husband who did try to kill himself, etc., but he was always able to work and put on a good face to the outside. I never 100% understood him though I tried and DH now is more like me than not. I always though some drugs were for maintenance but mostly they were for "curing" or getting someone through something rather than just letting them be numb. I guess it's been years since she's done much of anything.

There's a lot more history but that's the gist of it. I am not so sure my 1 hour phone conversations make a difference and maybe there is something I could do better. We joke about old times and I know she needs a friend but I also know it'd be stupid to think I'm "it" as far as making her come out of this.

Grrrrr. I'm half tempted to make her go for a walk when I go down there

[lph]

Well - coming from a family with a lot of depression but with only minor symptoms myself I can only add a few stray points:

- exercise does help. And "forcing" her in a friendly way might be necessary.
- being able to see ones depression from the outside is a good thing! but doesn't lessen it much, i.e. things like being unusually touchy when not invited to things can hurt just as much even if you know it's irrational.
- Depression can make you incredibly self-centered, and not always very nice. Realizing this isn't much fun either.
- having a place where you HAVE to function and CAN'T feel like a victim can help. Whether it's work, being a parent, or volunteering. Helps self-esteem, helps lift your thoughts, gives new input.
- You as a friend cannot cure her depression. You can help her in a few ways, suggest activities and go with her, but you cannot assume responsibility for her well-being.

Just some random thoughts. I'm sure people here who have been through "the real thing" will be able to add more. Best of luck.

[Mr. Bloom]

lph +1 +1 +1 +1

Depression is a disease that distorts perspective on things. Unfortunately, you have to get "over the hump" to do the things that make you better...but the disease often keeps you from getting "over the hump".

Don't get me wrong, I do believe that some folks get in a funk and choose to wallow in it. Others get there and simply don't know how to get out. I suspect that your friend falls in both categories...but if she's in constant pain and/or regularly medicated for pain, then that makes it double difficult.

I think she would benefit from a goal that she can achieve (like a 15 minute walk each day), structure in her life (a reason to get out of bed), and a supportive relationship.

She needs a friend to motivate her...but YOU have to be careful to not get sucked into her problem.

[makbike]

I agree with all that has been posted. Being a friend, listening, joking, etc are what she needs. She needs a purpose to get out of bed each day, does she have a pet? Listen to her, support her, be there for her but don't take on her problems. Sadly, one person's depression can drag a lot of caring people down so please be careful. In the end your friend has to decide she wants to get well or she wants to continue to live her life as it is.

[KnottedYet]

Yes, make her go for a walk!

Chronic pain-state is depressing both to the mind and to the body, and the only way to interrupt it is through physical activity. Whatever physical activity she will do. (Knitting/painting/drawing counts!)

When the body is used to being in pain, even if it's medicated, it begins to interpret all sensory input as some sort of pain. Getting moving is hard, but once it gets moving it begins to recalibrate sensory input so that non-pain is interpreted correctly.

Spinal pain really s*cks, but doing something physical can make a huge difference.

(our chronic pain patients are always amazed at what a change they feel in their pain intensity)

[LBTC]

teigyr - I agree with everything everyone has said. Thank you for caring enough for your friend to try to help. Be careful for yourself.

Does she have a pet? Can she have a pet? During a very low phase in my life (was I clinically depressed? when I look back now, I think so), I believe the reason I continued to function is that each morning my dogs and cats needed me to get out of bed and feed them and let them out and once I was out of bed I'd think, well, I'm up, I might as well go to work....

During the emotional roller coaster of illness over the past year and a half, my salvation has been this board - the support I've found here, the acceptance, encouragement, knowledge - it's helped to balance some very negative emotions and help me recognize that healing is taking place, however slow it may be. And here is where I discovered the power of butterflies. Such a simple visualization that can lift one's spirits even just a little, even just for a moment. As you know, I offer them to others often, and I've had more than one report that they've helped.

For you - butterflies to keep your spirit protected and happy; for your friend - butterflies to give her a glimpse of the joys in life that make it worth living....

Hugs,
~T~

[OakLeaf]

What lph said.

Is there any way she can get into therapy, and from individual into group therapy? (I don't mean an unsupervised lay support group, which can sometimes be very good and sometimes very damaging.) I know this raises a whole 'nother can of worms - even if insurance will pay for it, it's SO hard to find a qualified therapist, and within the small pool of qualified therapists she then has to find someone whose personality clicks with hers. But it's INCREDIBLY helpful to be able to talk about her issues in a safe place and get feedback from a professional and/or from people with similar experiences. You learn you're not a freak. You learn that what you do can affect others in both positive and negative ways. You learn what is and is not appropriate behavior - what you may have never learned in childhood - and you learn what are and are not appropriate risks for yourself to try.

My personal opinion: don't mess with cognitive-behavioral therapy. That's just the psychology equivalent of "Doctor, it hurts when I go like this." "Well, stop going like that. That'll be $200." Just my opinion, and go ahead and flame on, anyone who's a practitioner of that method.

If she's getting her meds from a primary care doctor, maybe she can get a referral to a psychiatrist. Often it takes several tries to find a med and a dosage that works and that doesn't have excessive side effects. Often, once you've been through that grueling process, a med that worked for a while just stops working and you have to do it all over again.

The issue of work is really, really thorny. Yes, it's important to have a reason to get out of bed in the morning. On the other hand, what one person might consider a low-stress job could easily cause someone else to decompensate. Or even if you maintain a level of functioning, you may not be able to keep up with a job in the competitive market. Then you're worse off than before you started, because you're reinforced in your sense of your own worthlessness and helplessness. So if she can find that rare job that's part-time, self-paced, low-responsibility and low-public contact, by all means urge her to try it, but don't encourage her to take too big of a step too soon.

Good luck and hugs to you and her.

-Oak, whose personal experiences aren't the only reason I no longer work with disabled clients.

[teigyr]

Thank you.

I know my parents were concerned when I told them I was back in contact with her and they said not to get sucked in. I haven't seen her in maybe 15-20 years so I think I'm a bit more mature now?!! In retrospect I had so much fun with her but all the signs were there. I didn't realize my parents saw all those signs also but that figures.

In talking to her sister, I learned she had been working as a H.S. teacher. She had a horrible principal that ultimately got fired but (and this is according to the sister), my friend was picked on. Also, she had been married and her soon to be ex-husband would get mad when he'd get home and find she hadn't been out of bed all day. He was deemed insensitive for not understanding though I might've been mad too had I been in that situation.

They have a lot of pets but since her sister takes care of them, there is no responsibility from my friend. My friend's sister is having surgery in a few weeks and another family member will come take care of her because my friend can't.

I'd say there is some enabling going on...I know my friend's sister isn't forcing my friend to do anything. She jokes and says my friend has been diagnosed bi-polar but she keeps waiting for the manic stage to show up so her garage will get cleaned.

I remember a long time ago, when we were in H.S., we went to take the pony for a walk. (Yes, I had a pony that I used to take for walks!) Something happened, I can't remember the sequence but the pony reared (my friend was in control of her) and I got upset and said something to the effect that she was doing something wrong. After that, my friend had asthma and could no longer be around the pony. Looking back at that and looking at now, where it seems like each hurtful situation causes something else she can't be around, it makes sense but that is scary in so many ways.

I know I can't force anything. When I was married to my depressed and bi-polar ex-husband I'd say things like "c'mon, I bet you'll feel better if we just go to the movies". I learned that sometimes people, when they feel forced, strike out and not in good ways.

Anyway, thank you all for some good things to think about. I still need to see her, she's out of state. It'll be hard, I learned she chain smokes (and her public assistance insurance won't pay for drugs to help stop that) and I am OH so allergic to that!

When I called her last night, also, she thanked me for calling. I learned that she (my friend) doesn't "make contact" with people either by computer or phone or whatever. She kept saying how much she appreciated me calling. So that is a good thing, I think.

[Tuckervill]

Don't get sucked in. That's all I keep thinking.

Call her once a week and be a friend like you'd be a friend to anyone. It's clear to me that she has bigger problems than just a "friend" can help. She is very ill, of course, but there's also that part about relishing the role, too. That's the part that you could get sucked into, the endless cycle of victim and savior. Think about what part of you is attractive to people like that, because it's clear they're seeing something in you they like.

I've been seriously depressed and suicidal, and so I understand completely how it feels not to be able to function. I didn't make a lifestyle out of it. Don't get sucked in.

Karen

[mimitabby]

she sounds like my sister. Good luck!

[teigyr]

I've been seriously depressed and suicidal, and so I understand completely how it feels not to be able to function. I didn't make a lifestyle out of it. Don't get sucked in.

Karen

Karen, was there ever a point where it was a choice? I think by getting help (or making help a priority) that is a way of wanting to get better. I'm stubborn and those times I've had setbacks either medically or whatever I get more and more insistent that I've got to beat whatever's going on. Giving up is never an option so I have trouble understanding when that happens.

No...I hope no getting sucked in. We're pretty well grounded here and I've got a lot going on in my own life. I know she needs far more help than I can give but the most important thing is she has to want it (the help, that is) and until that happens, there is nothing that can be done. I can help her want it, maybe, but I can't fix it.

We used to have a lot of fun and we did a LOT of stuff. We trekked around Canada when we were 18, we went to lots and lots of concerts in L.A., etc. DH and I still do a lot and I've talked to my friend about going to various places. She sounds interested. Last night we were laughing about silly things that happened when we were young. She's lost both her parents, which is so sad. I don't know the progression of what happened when because we're still catching up but I'm learning that I can ask her pretty much anything.

I guess my feeling is too, that if insurance won't pay for something necessary (like a therapist or tools to quit smoking) then her sister needs to pay for it. Maybe her sister is tired of that and maybe there is history there too but if something has to be done, it should get done. But then again her sister is providing a house, food, utilities....

grrrrrr. Yup, the girl is definitely going for a walk. Definitely. Walks are cheap.

[sgtiger]

(((((Teigyr)))))) ((((((Teigyr's friend)))))

It's great that you want to help your friend and I agree with what everyone else had said. Please understand that this is her battle, one that she will need plenty of help with, but I disagree with you that you can help her want to get better. She may tell you that she wants to get better but until she actually takes action there's not anything you can do. When and if she does that then you can be supportive by celebrating her successes (no matter how little), encouraging her, and offering her a different perspective than her own.

Starting with that walk is a great idea to get her out both for her physical and mental health. Hopefully it's something she will keep doing on her own. I agree with Oakleaf that a job at this time may not be the best for her. If she has any kind of setback she may use that as reinforcement for her not to move forward.

Does she do any type of craft? Perhaps encourage her to take one up. I used to know some people of limited mobility and dealing with ailing health that used their crafting skills to help others. It gave them a sense of self worth and a reason to get up in the mornigs, plus it keeps their minds occupied from focusing on their illness.

Examples:

-Friend R's mom likes to crochet. Mostly she crochets baby blankets that she donates to the hospital she has dialysis at. People started seeking her out to do full size throws for them so she now earns a bit of income that basically pays for more yarn and such.

-When I worked at Kmart, there was a gentlmen that came in regualarly to buy our inexpensive oops cans of paint which he used to paint birdhouses that he built from scrap wood he found. These he gave away to his community. If a kid in his neighborhood showed interest, he helped them to build their own.

-At my tellemarketing job(inbound calls only, so I wasn't pestering anyone, honest) there were a couple of very crafty women who knitted tiny preemie hats and shirts for local hospitals. I believe they did this for a charity organization which helped pick up part of the costs for supplies and whose members were willing to teach any newcomer the necessary skills.

It may take some research on her part to match up her interests to the right charity. I think that may be one of the things that Goodwill does, but I'm not entirely sure.

As for her treatment, is she getting any type of counseling at all? From my experience medication alone is not effective for long-term management for depression. She needs to learn coping skills to help her through what she is feeling and to deal with the stresses that comes with life. Medication is a tool that can help facilitate learning those skills but in of itself I feel that it is a poor substitution for treatment. They help to quiet down many of the negative emotions and thoughts that one is having but it can also take away from enjoying life too. IMHO, that's no way to live. She needs to seek a public clinic that concentrates on couselling. Usually they'll start out with one on one sessions with a licenced therapist and then she can move into a group setting when she is more comfortable opening up while continuing individual counseling.

The most important thing for her right now, IMO, is for her to take that first step. It doesn't matter what she does as long she puts in the effort to move forward. If she is able to that then she'll be able to build on it and move on her own momentum.(Is that clear?) Then you can encourage her and be a soft place for her to land when she falls.

~sg -who was a shut-in for a year of her life due to panic attacks that were symtoms of anxiety and depression (left untreated for years), almost lost everything, and realized I had to do it for myself- tiger

[Wahine]

I'm stubborn and those times I've had setbacks either medically or whatever I get more and more insistent that I've got to beat whatever's going on. Giving up is never an option so I have trouble understanding when that happens.

I hear ya. this was a problem for me when dealing with clients who were depressed. I could never figure out why they just didn't put in the effort to get better. It was very frustrating to me. I'm going through this with my family as well, I have a depressed sister and mother. As much as I wish I could convince my mom that she needs to take action to recover, she resists most of the suggestions I make. Interestingly enough, my depressed sister can come spend a weekend with her and she'll be way better for it. Go figure.

Over the years I've gotten much better at dealing with people in this state of mind. But I don't really have any advice. All I can say is good on ya for trying to help. (((((hugs)))))

[Tuckervill]

Yeah, it became a choice--that's why I'm still here.

But the choice isn't whether to stay depressed or not. The choice is the one right before me. What next action will make me move towards life and away from death? I'm sure she wakes up stunned and despairing that it's another day and she's conscious. That's the point she has to make a choice. Do I get up and take a shower and put on my clothes in spite of all the negative thoughts that go through my head at that point--I have no clean underwear because I procrastinated doing the wash and now I hate myself for that; I'm not going anywhere so why should I fix my hair?" etc. etc. It goes on and on. Take the choice towards healthy anyway. Do it in spite of every negative thought or emotion or circumstance.

That's where she has to make her choices, in atom-sized bites. Each bite should be towards health Sounds so simple but it's very, very very difficult. That's where the right medication can help.

The good thing is that each choice towards health makes the next one easier.

It's very hard to stay on the outside of that. I'm sure her sister has tried almost everything. My dad saved me once, just by physically getting me out of bed and dressed, and that made the next choice easier. My husband saved me once, just by making an appointment and putting me in the car. An institution would not be out of the realm of possibility if she were my friend.

As far as paying for stuff...there are all kinds of programs that will pay for health care. You can get pharmaceuticals for free, even Nicorette or whatever it she needs. I see that in ads very often. Even if she can't pay at all, she can go and leave that part for later. If I were her friend I would work to eliminate, if only in her mind, every excuse she can think of to get out of getting better. Make the choice towards health an easy one.

Karen

[lph]

A couple more random thoughts:

- maybe she's a checklist kind of girl. Depending on what feels like an effort, she could have a checklist of small, obtainable goals for a normal day. So instead of feeling completely pathetic she can see that she has in fact got out of bed (check), gotten dressed (check).... got the mail (check) - done other things that normal people do. Building blocks towards a more normal life.

- it can help making a conscious decision to have a good day (not brilliant, but not awful). Deciding on one positive thing to do, maybe just saying hi to a neighbour. Maybe just part of the day - decide that this morning WILL be one of the good mornings, then just let the afternoon be crappy... Taking hold of small parts of your own time and seeing that you can exert an influence.

this is sort of the way my mind works, anyways.