Marion Richard, psychologist with the Pros-Consulte network, answers three questions for us on the topic of "Helping a loved one suffering from depression."
Suffering from depression
You may be familiar with the situation where you have noticed that someone close to you is suffering. However, suffering does not necessarily mean suffering from depression. Here are some signs that may be observed in a person suffering from depression, as well as some recommendations regarding the condition in question.
How can you tell if a loved one is suffering from depression?
One of the first signs is undoubtedly inhibition, which manifests itself in withdrawal, isolation, and a loss of interest in activities that previously brought the person pleasure or satisfaction. This loss of desire is associated with what is known as a loss of vitality, or in other words, the "desire to desire": on the one hand, the person does not feel the need to do things they enjoy, and on the other hand, they may seem almost indifferent to the idea of not feeling desire or excitement. This is also referred to as anhedonia, or the loss of the ability to feel pleasure: it is not that the person does not want to feel anything, but rather that they are unable to feel pleasant emotions.
In addition, this loss of ability to feel or desire pleasure is also found in the sexual sphere, particularly through a loss of libido. It is not a question of feeling extremely sad, but rather of feeling intense emotional pain coupled with an inability to feel emotions of pleasure. The person may find themselves crying without understanding or knowing why they feel sad. Next, the most telling symptom of a depressive syndrome is psychomotor retardation, i.e., the person has immense difficulty thinking, speaking, and moving quickly.
People suffering from depression report a lack of concentration (e.g., being able to read a simple text while remaining focused), attention (following a normal conversation from start to finish), and memory (being able to remember everyday details, temporary information, etc.). The person may also feel heavy and find it very difficult to move. These signs contribute to both mental and physical fatigue: everything becomes slow and exhausting, even simple everyday tasks (doing the dishes, taking a shower, cooking, etc.). Some people may also suffer from pain, particularly muscle pain.
People suffering from depression often experience sleep disorders, whether it be difficulty falling asleep, sometimes leading to hypersomnia or insomnia, or hypersomnia. The person, already feeling constantly tired, cannot find rest in sleep. In addition to these various symptoms, eating disorders may also develop, resulting in weight loss or gain, especially when accompanied by binge eating. Similarly, there may be an increase in addictive behaviors: for example, the person may smoke or drink more alcohol than usual.
Finally, in some cases, in connection with this depressive mood, the person may have intrusive thoughts, particularly dark thoughts or thoughts related to death, to the point of expressing suicidal thoughts. According to the DSM V*, these signs must have been present for at least 15 days in order to be considered a major depressive disorder.
* Diagnostic and Statistical Manual of Mental Disorders.
What behaviors should I avoid and adopt with my loved one suffering from depression?
Among the behaviors to avoid, judgmental attitudes and comments are definitely off-limits, such as: "It'll pass, stop making excuses for not doing anything"; "Get moving and you'll feel better!" etc. It is important to remember that people suffering from depression generally do not understand what is happening to them: they no longer recognize themselves and do not understand why their daily habits seem to be completely hampered by their condition. In addition, it is common to see people suffering from depression constantly expressing feelings of guilt: adopting a judgmental attitude towards them would reinforce this process of guilt and therefore risk aggravating the symptoms.
On the other hand, it is much more helpful to take a supportive and facilitating stance: "What can I do to help you?"; "Is there anything you need?" etc. Social support is one of the most beneficial factors in terms of improving major depressive disorder. This does not mean taking away the person's autonomy, but offering them support, which will allow them to ask for help rather than remaining withdrawn.
We often hear and read that it is about being empathetic and/or understanding: in fact, it is mainly about being available to the person even if we do not necessarily understand what is happening to them. As for empathy, which is defined as the ability to feel as if we were the person suffering without ever forgetting that we are not that person, it is not the main focus either, even though it can obviously be helpful. In fact, it is mainly reserved for the healthcare professional that the person suffering will consult.
For the latter, the most important thing is first and foremost that their suffering is heard, recognized as such, and never denied, negated, rejected, or judged. For someone who is suffering, one of the worst things to say is, "You have everything you need to be happy, so why aren't you okay?"
How can you protect yourself when you are in contact with a loved one suffering from depression?
It can sometimes be difficult to be close to someone suffering from depression. For example, due to their constant low mood, some people tend to feel more irritable and easily annoyed by trivial things. As a result, conflicts can arise due to a certain aggressiveness, and it can sometimes be very hard to cope with this on a daily basis.
One of the first things to do when you notice that a loved one is suffering from depression is to advise them to consult a dedicated professional (psychiatrist, clinical psychologist, psychotherapist). It is important not to try to "cure" the person, as this could also put you at risk. For the loved one, it is first and foremost a matter of being there, offering support, not judging, and not avoiding the person who is suffering.
Without forgetting yourself! Sometimes, the loved one themselves may feel guilty for wanting to do enjoyable activities, experience pleasant emotions, or even... feel good. It is essential to continue to think about yourself and take care of yourself when supporting someone who is suffering. Maintaining a social life (family, friends, loved ones, colleagues, etc.) is not only helpful, but also a factor in good mental health.
In any case, only the following healthcare professionals are qualified to recognize, diagnose, and treat a major depressive episode: general practitioners (as they are usually the first to see the person), psychiatrists, and clinical psychologists. It is therefore important never to ignore what you observe and to seek help from these professionals so that you can better help the person suffering from depression and avoid exposing yourself (too much) to their suffering.
