Therese Borchard has written an excellent post on her Beliefnet blog, describing her 12 step program for staying on top of depression. It is one that she devised herself but is similar to the 12 step programs that addicts use.

One of her important points is that it takes an awful lot of work to get better and then stay well. I agree wholeheartedly. It seems that those who actively participate in their treatments have the most success in returning to and maintaining good health. They are active in learning about the illness, in locating resources, in finding the right treatments, and they are determined to pull things around. It doesn’t help to be passive about depression.

Therese’s experience of nearly giving up on traditional medicine rings true. For the first few years of being treated my family doctor experimented with various drugs with little success. I was fortunate to find a great psychiatrist on my first attempt, but it involved a good dose of my own research. When my doctor suggested a psychiatrist I declined and asked him to refer me to the one I had chosen. I know that most people don’t have the time or inclination to do this, but it was important for me as the point in which I became active in my treatment. I had been labeled “treatment resistant” for too long.

I would point out that when medicines are used it is not just about finding the right drug or mix of drugs, but also making the right diagnosis in the first place. This sounds very basic but misdiagnoses are very common. It is awful being treated for the wrong mood disorder.

Therese has developed her system very purposefully. Remaining healthy requires a plan; much more than passive acceptance. I definitely suggest you try her 12 steps, with some shaping to suit.

• The word “melancholic”, meaning depressed, comes from the Greek word for “black bile”.

• Two out of three people suffering from depression do not seek or receive proper treatment.
• 92% of depressed African-American males do not seek or receive proper treatment.
• Depression affects over 50% of nursing home residents.
• Depression is among the most treatable of psychiatric illnesses. 70 percent of those suffering from major depression can fully recover if properly treated (World Health Organization).
• 80% to 90% of people who receive treatment for depression show improvement.
• An estimated 50% of unsuccessful treatment for depression is due to non-compliance with medicines.

• Major depression is about four times more likely in people with chronic back pain than for the general population.
• Amongst chronic pain sufferers music can help reduce the pain by more than 20% and can alleviate depression by up to 25%.

• One in four families has at least one member with a mental disorder
• Pre-schoolers are the fastest-growing market for antidepressants. At least 4% of preschoolers in the U.S. (over a million) have clinical depression.
• Antidepressants stimulate the growth of new neurons in the brain. So does exercise.

• Depression happens to strong, not weak people.

A recent post was titled Ways to Insult Someone with Depression. This post is the flip-side, with things to say that are helpful.

1. Be On Their Side

• The depressed person will often be defensive, so an accusatory tone is not helpful. Try to convey a sense of understanding. It isn’t helpful to say “Why can’t you just get out of bed?” Instead try “You seem to have trouble getting out of bed in the mornings. What can I do to help you in this area?”

• The person may have lost perspective on how big a problem actually is. They will find it hard to hear that what is insurmountable for them is actually not such a big deal. It is unhelpful to say “What’s your problem? You’re upset about nothing.” Instead try “You seem to be finding this issue a big deal at the moment. Can we solve it together?”

• When I was very sick, I often thought that my wife was trying to ruin my life. To counter that kind of thinking she would often say “We are a team. I am on your side.”

• Depression is an awful illness, a whole world away from pure sympathy-seeking. So you should treat it as such. “I trust you. If you had a choice in the matter you wouldn’t choose to have depression. How about we search for some solutions together?”

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The person with depression usually can’t see a way forward. They may fervently believe that nobody can help them, and life is pointless. That doesn’t mean that they’re right, and there are plenty of things that you can do to help.

The type and amount of care that you can give will depend on your relationship with the person, but here are some ideas.

1. Understand the illness.

Learn all that you can about depression. The better you grasp the illness, the more effective you will be in giving your care and understanding. It will help you to understand why the person behaves the way they do, and better equip you to respond appropriately.

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