Two of my most popular posts have been 12 Ways to Care for a Depressed Person and Things to Say to Someone with Depression. Why have they been popular? Judging from comments I’ve received, they struck a chord for the practical help in dealing with a depressed person. A view from the other side, so to speak.

I’ve just read a very helpful article at Psych Central that is in the same vein. Helping Someone with a Mental Health Concern is written by psychiatrist John M. Grohol. Of particular interest to me are his insights on effective listening and empathizing with a mentally ill person. It is invaluable advice for someone in a caring role.

To read the article click here.

I recently found an article in our local Sydney Morning Herald that made for some sad reading.

Professor Cummins from Deakin University has been researching the well-being of different societal groups for the last 6 years. The studies measure the degree to which different people are satisfied with their lives.

In the most recent study (October 2007) 3,750 caregivers were asked questions about health, relationships, safety and community involvement. A caregiver was defined as someone who looks after a frail, disabled or mentally ill relative.

According to the study caregivers have the lowest level of well-being of any group in the community. Further, the rate of moderately depressed caregivers was found to be 56% (general population is 6%), while almost 40% exhibited severe or extremely severe depression. As you can imagine the typical caregiver suffers a high level of dissatisfaction with life. And this is even in the presence of mitigating factors like a high income or being in a relationship.

This is tragic stuff. It really highlights to me the importance of looking after yourself as a caregiver. Have boundaries, have breaks without feeling guilty, maintain some part of your life that is separate from the person you’re caring for, build a support network (formal or informal), or join a support network, and find somewhere to fit in a bit of fun.

As a caregiver you need to stop yourself falling in a heap. You need to be resilient to mental illness, and you are far more effective in giving care to another if you remain healthy yourself.

This is the 5th and last post in a series by Anna on “Being a Caregiver”. Earlier posts are The Depression Dialog , Know the Enemy , Trigger Unhappy and Keeping Your Mind Together.

I’ve written a lot about being a caregiver in my last 4 posts, but in this one I’d like to share with you the book that really saved my own sanity. It is “Loving Someone with Bipolar Disorder” by Julie A. Fast and John D. Preston.

In the first few months after James’ diagnosis I read a lot of material to educate myself. The problem was that most of it was factual information on depression and bipolar, but it didn’t tell me how to manage practical things like James’ irritability. The info simply described the symptom without ideas for its management.

From pages 1 to 2: “This book can provide you with the tools you need to be a resource and support for your partner instead of a crisis manager and constant caretaker.” This is exactly what I needed!

The book was written specifically for caregivers. Julie Fast has bipolar disorder, as does her partner of 10 years, and the result is a book with real insight.

At its heart is the idea of creating a holistic treatment plan.

The first aim is to develop a symptom list that you can use to identify when your partner’s behavior starts to change. Once that has been worked out the second aim is to create a “what works list” to treat those symptoms before they progress to a full blown episode. The third step is to work out what triggers the symptoms in the first place. These are often outside events, situations or behaviors that once modified or eliminated really make your partner far more stable. Once you understand the triggers well, then the goal is to stop the mood swing from starting in the first place. If it does start then the “what works list” comes into play.

Of course this strategy requires recording your partner’s behavior over time e.g. by keeping a journal.

The rest of the book focuses on the needs of the caregiver. (Obviously your partner achieving greater stability is already a significant help).

The chapter on “Your Emotional Response” starts you on the road of looking after your own needs. It discusses issues like anger, grief, guilt and feeling trapped. For me, it was almost a springboard for seeing a counselor.

The chapters on work, money and sex cover practical issues that cause distress. They were all helpful chapters, but for me the chapter “The Hard Truths” had more impact. This chapter really lays it on the line and forces you to face the reality of your relationship. Are you prepared to stay with your partner if things don’t change? Tough reading.

My favorite chapter is “The Bipolar Conversation”, which teaches you how to avoid pointless fights when you partner is baiting you. The book ends with “Laughter and Joy”, an inspiration to leading a normal life again. From this I learned to structure in happy times in our lives.

A brilliant book. It may be about bipolar, but the application is much wider and relevant to all mood disorders. It would greatly help any caregiver living with a depressed partner.

Here is the link to the book on Amazon (not an affiliate link).

I recently found a wonderful book called “505 Ways to Encourage a Chronically Ill Friend” by Lisa J. Copen. Since we are two-thirds of the way through Anna’s series on “Being the Caregiver” a quick overview of the book fits in well.

The best thing about the book is the practical ideas for helping an ill person. They are not platitudes like “If there is anything I can do…” but ways to be proactive with providing your support.

The book is focused on the chronically ill, and applies to the whole range of mental illnesses, but it would also be relevant to helping friends in any kind of need.

With the author’s permission I’m listing my favorite twenty.

3. Put meals into disposable containers and attach a note saying “This doesn’t need to be returned.”

5. Arrange for your friend’s kids to have a night with your children.

15. Treat her to a gift of movie rentals via postal mail through a service ($7-15 a month).

18. Mop the floors.

21. Ask, “Do you have an errand I can run for you before coming over?”

42. Don’t say, “Let me know if there is anything I can do.” People rarely feel comfortable saying, “Yes, my laundry”. Instead pick something you are willing to do and then ask her permission.

44. Buy a magazine subscription for her on her favorite topic.

59. Say, “I’d like to bring you dinner next week. Would Monday or Tuesday night be better?”

81. Ask her if she wants to house-sit when you are on vacation. New surroundings may feel like a mini-vacation.

116. Take her kids for a movie and ice cream.

152. Watch your friend’s children so she and her spouse can have a night out.

180. Ask her if she’d like you to help rearrange her furniture for a fresh feeling in her house.

197. If a massage would feel good (it doesn’t always), give her a gift certificate for one.

199. Help her with her children’s birthday parties – but don’t take over; let her make all the decisions.

304. Clip cartoons that will make her smile.

316. When you leave ask, “Do you have mail I could drop off for you?”

406. Talk about normal everyday things, not just the illness.

424. Help her children pick out gifts for her on special occasions like Mother’s Day.

462. Go with her to the doctor and then go get coffee or lunch afterward. Medical visits get lonely and depressing.

468. Teach her how to use the Internet so she can learn more about her illness from medical websites.

The book is available by direct purchase from the Rest Ministries website.

This is the 4th post by Anna on being a caregiver. Earlier posts are The Depression Dialog, Know the Enemy and Trigger Unhappy.

I’ve been asking James to take our old mattress to the waste dump for about 4 months. Today, I decided enough was enough. I asked an understanding friend (whose husband also has depression) to help me transport it. She has a car with roof racks. It took a while but we got it onto the roof, and tied it down with baling twine. It was not exactly satisfactory, but James had taken the rope to work and left it there.

So we drove that way and the mattress stayed on for about a mile before sliding. We checked it, and checked it again, and continued like this until we were nearly there, when a truck passed us with speed and the mattress flew off altogether. (Queen size by the way.) The twine was still intact, but the mattress handles were shredded. So we eventually limped in to the dump, mattress carefully balanced on top and hazard lights on. It was a funny experience and we had a lot of laughs.

I’ve written about this because it says a couple of things about how I handle my role as a caregiver.

Know the limits of what your partner or friend can do
Removing a mattress was overwhelming for James. He put it off, and ignored it, and put it off some more. The reason was that the task – mental as much as physical – was insurmountable to him. It’s quite different from laziness, as anyone with depression will know. But the mattress was stopping me from getting to my wardrobe and it had to go. My frustration was building up, despite knowing what was going on in James’ mind. I decided to just do it myself rather than let it become a big issue. That’s not to say I’m being a doormat. When I stop and think about it I recognize what’s happening under the surface and take a practical approach.

My support network is crucial
I have a small network of friends who will help me in this sort of situation. Through bitter experience, I know that some people are understanding about mental illness and others are not. My close friends are. I also know not to wear them out, so I share my problems around. They give the emotional support I need when I’m not getting it at home. They let me vent, they help me in practical ways, and they still share good times with me. They also think highly of James even though they know how awful he can be. That’s very important to me. I’m very fortunate as a caregiver to have supportive people around me. I know that many people are struggling along without much help. I can’t emphasize enough how important it is to develop those supportive relationships, for friendship, for emotional support and for practical help for things like moving mattresses.

My mental health is crucial
I have to be proactive about having time out, having a break from the intense times, and even some fun. I used to feel guilty about this, but it’s actually wise to keep looking after your own health. My family are good with giving me practical help, like taking the kids, when I need to do something on my own.

Learn to forgive and grieve
It’s easy to feel sorry for myself, but I’ve learned to forgive and move on. James forgives me for a lot of things too; it’s not a one way street. I’ve had to mourn the life that I thought James and I were going to enjoy together. He is not at all like he was when we married. But I always remind myself that I should be thankful for what we have, and what I have, and not dwell on what we don’t have, and to pray on all occasions.

Click here for the fifth and final post in this series, Loving the Person You Care For.