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.

2. Seek Appropriate Treatment

This is such a far-reaching, wide-ranging topic that I would be foolish to give advice. Suffice to say that it will be helpful for you to explore the treatment options available in your area and suggest to the person that they need professional help. It might be helpful for them if you go along to the first or subsequent appointments. Often a person actually feels relieved to hear a diagnosis and know that they are sick and that they can be helped. This was really true for me.

If he or she won’t admit they need help then explain why you are concerned and perhaps provide them with some helpful written information to chew over.

3. Provide Emotional Support

Your partner or friend needs patience, care and understanding. They have a real illness, and just like someone with cancer they can’t just “snap out of it”. If they could, they would. Saying things that show ignorance about the illness is counterproductive and will reinforce their negative thinking.

The best way to communicate is to empathise, listen more than talk, and ask questions like “How can I support you?” or “How can I help?”

4. Keep the Illness Separate

The illness and the person suffering the illness are not the same thing, so keep them separate. When they express pessimism, anger, frustration, or sadness, it is the illness talking not the person. If you separate the two you will find it easier to cope emotionally. It will help you to be a more effective caregiver.

5. Listen Non-Judgmentally

Don’t try to talk a depressed person out of their feelings, no matter how irrational they sound. This is likely to compound the problem. It is better to remain neutral and say something like “You are obviously really suffering with this. What can I do to help you feel better?” Keep your suggestions, solutions and advice for another time. My wife has also found that posing suggestions as a question helps me to have some ownership of the solutions. It stops me feeling nagged too!

6. Make a Plan

Help the person to make a plan for coping with depression. Identify things that trigger or worsen the depression and things that make it better. Think through and list the ideas formally on paper. Help them to put this plan into action. Some positive, helpful things to include are getting to bed early, having adequate sleep, exercising regularly, drinking plenty of water and eating healthy foods. The plan will be an evolving document as things change, so be prepared to re-visit it on  a regular basis. I often need my wife to remind me what works for my health as sometimes I go off track. This is a key role that the caregiver can play.

7. Look after yourself

As a caregiver you are likely to be under stress. You need to care for yourself by taking time out and recharging your batteries. Find other friends or relatives who you can talk to and rely on at a pinch. Sometimes you will need a sounding-board to keep things in perspective. Make sure you continue to live your own life as well, and spend time doing things you enjoy. My wife loves her part-time job for many reasons, but high on the list is escape. Although she is working, it’s a great mental break for her when home life is dominated by my illness. 

There are services that provide education and support for caregivers. Through information sessions and support groups, you can talk to people who are in a similar position.

8. Organize their medicines

If your partner or friend is taking medicine for depression then it is crucial for them to follow their prescription. Too many people go on and off their anti-depressants depending on how they feel. This all but eliminates their effectiveness.

I take medicine at night without any problems, but if it wasn’t for my wife handing the pills to me I would never take them in the mornings. She also fills my scripts and tells me when to go to the doctor for more. It’s not laziness; it’s just the nature of depression. More than once I have spent hours in bed staring at my pills, but not had the mental energy to actually take them. If your partner or friend is not complying with their prescription, try to find out how you can help.

9. Support network.

Introduce the idea of joining a support network for depression. This will give them an outlet for discussing their problems and receiving input, and help them to discover that there are other (normal) people experiencing similar problems. There are depression support groups everywhere. Make sure that you find one that is positive and focused on recovery. Inward looking, pessimistic groups can be unhelpful.

10. Get out and About

One of the most therapeutic things that a depressed person can do is step out the front door. Natural light is very beneficial, especially early in the day. Exercise also has proven benefits. Something as simple as taking a walk or gardening should lift the person’s mood. Anything low-key that involves going out can also help; seeing a movie, meeting friends, or going out to eat, just to name a few ideas. The most effective way for me to get up and out the door is to take the kids to school. There is a set time to go, which gives me routine, and the kids are great company.

11. Help with daily tasks

When your body is heavy and your mind is dark, there is nothing harder than the burdens of everyday life. Something that seems minor to you may be an insurmountable task to your friend or partner. Ease their burden by helping with the daily load – running errands, doing the shopping, cooking, taking the kids out for a couple of hours. You may be surprised to find that helping with a very simple chore could relieve them of a lot of stress. 

We had an old mattress that needed to go to the tip. My wife asked me to take it there for months, and over time it became a source of tension. But my thinking wasn’t rational and the thought of going to the tip overwhelmed me. When she understood what was really going on she asked a friend to take it. That was a huge relief to both of us. 

12. Spend normal time together

Just spending time with the person lets them know that you care and want to understand their problems. Enjoy the reasons for being their companion in the first place. It’s important that they live as normal a life as possible. Help them to do this by carrying on your relationship with them in a normal fashion. Don’t let everything get dark and serious. Find some positive things and try to enjoy them together.

The points above are general by necessity. They don’t fit all circumstances, but I hope that you find at least a few helpful ideas.

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.

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.

It is an interesting, wide-ranging discussion on bipolar disorder, that touches on many subjects that are worth pursuing. There is a small section at about the 45 minute mark, on being a caregiver of someone with a mental illness, which ties in nicely with our current series of posts.

In response to a question by Therese Borchard about being a caregiver, Stephen Propst from the Depression and Bipolar Support Alliance made some excellent points.

• There is no substitute for education about the illness. This is critical for the caregiver, in order for their subjectivity about the person to be replaced by objectivity about the illness. Understanding the illness and the behavior it causes helps the caregiver to separate it from the person.
• Mental illnesses are not solved in the short term; they present a long term problem. A caregiver has to have patience to stay with it over the long term.
• Caregivers need to look after their own well-being, to remain effective and minimize their own difficulties. They need to set boundaries with the ill person, and enforce them.
• Caregivers should never give up hope.

Anna’s next post is on recognizing and reducing the triggers that affect the person you are caring for.

• 40% of workers reported their jobs to be very or extremely stressful
• 25% viewed their jobs as the largest source of stress in their lives
• 26% said they were often or very often burned out or stressed by work.

A study by University of Melbourne researchers last year found that job stress accounts for 1/3 of depression cases in women and up to 1/3 of cases of cadiovascular disease in men.

These are amazing statistics.

The answer to tackling stress at work is two-fold. Firstly you can push to make changes to the job itself – a big picture approach. You need to have a clear idea of what is going wrong. The following table may help if the problem isn’t readily apparent.

Try to identify the causes of your stress, and work out what you would like to change to eliminate them. If you can discuss your problem with your manager he or she may be able to make immediate changes. If the source of stress is your manager then that’s another kettle of fish! See if there are procedures in place to deal with this. If there aren’t any then perhaps you can talk to an employee representative, HR department or Employee Assistance service.

Don’t be reluctant to talk about stress at work. No employer should subject their employees to work-related stress. They should take it as seriously as you do.

Changes to You

Secondly there are changes that you can make that you have complete control over.

• Make a to-do list. Organize your work to feel more in control. It’s easy to stop worrying about a future task if you record it on a list. Only record the tasks you are definitely going to do, not the long-term projects that are always on the backburner. Make sure you include a couple of things that you’ve already done, to get you off to a good start.

• Cut down on caffeine. Caffeine gets the adrenaline hormone pumping through the body and causing “fight or flight” alertness. This is stress in itself, so it heightens any other stresses that you are also dealing with at work. Drink lots of water and keep your brain well-hydrated.

• Exercise during the day. Regular exercise decreases the production of adrenaline which reduces the stress response. As a bare minimum go for a walk outside during your lunch break. Perhaps find a new place to buy lunch a few blocks away. Exercising outside of work hours will also help to cut your stress level during the day.

• Take breaks from your computer. It sucks the life out of you, so by the end of a long day you’re feeling irritable. Get away from the computer and connect with real people every now and then.

• Slow down. Do you rush to work in the mornings? Simplify things so that you’re not over-committed and rushed. Can you get up 15 minutes earlier for a calmer trip to work?

• Don’t forget to take vacations. The company won’t collapse without you (unless you own it).

• Work shorter hours. Limit your work day to what you agreed to with your employer. Working long hours is one of the main causes of work-stress. Protect your time and say “no” to requests that place unrealistic or unreasonable demands on you.

• Rise above office gossip. Gossip is almost always negative, it brings people down and undermines relationships. Avoid difficult people. Instead find positive, energetic people to be around. Deepen friendships that are positive.

• Create a relaxation routine. When something unexpected comes up you can deal with it without being stressed. A routine may be something simple like deep breathing exercises, a quick relaxation technique, a walk around the office or outside, a trip to the water cooler or a chat with someone.

• Take mini-breaks during the day. Use your relaxation routine to good effect. Make sure that you move around away from your workspace.

In my own experience most managers are willing to make at least some changes if you present them with the problem and a solution. If stress is impacting your health then it’s a high priority, and you need to be proactive. As for the changes to your own life? They will all make a positive difference so they are well worth adding to your work day. Don’t become another statistic from stress at work!