
Ask HN: How can I help my severely depressed significant other? - hamonping
Tonight I was reading this HN thread (http://news.ycombinator.com/item?id=5094277) in response to the Scientific American article on suicide.  Both the article and the comments helped me to understand the depression that my fiance lives with every day.  But I'm still lost.  She continues to suffer the effects of depression and I don't have the knowledge to help her.  I don't know what to say.  I don't know what to do.  And I don't know who to turn to.  If you are depressed and someone helped you, please tell me how they did that.  And if you have helped another person through depression, please tell me how.  It hurts to watch a loved one suffer and to be so utterly incapable of helping.
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DigitalSea
In all honesty, Hacker News is the last place I would be looking for advice
when it comes to serious matters like depression when there is a life
potentially on the line. If I were you I would seek the opinion of a
psychiatrist or doctor who can help you better understand the illness and
provide the best course of action for helping.

The best thing you can do in your situation is be supportive and patient for
your fiancée. I hope everything works out for you. Has your fiancée seen a
medical professional about their depression, if not, I strongly advise you get
them to a doctor ASAP.

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Crake
Does she have health insurance? If so, have her talk to her PCP about
antidepressants. You can be the best spouse in the world, but sometimes you're
fighting a chemical equation that will render your best efforts in vain. (It's
not your fault!) I know there's a lot of stigma around antidepressants, but I
was chronically suicidal for years and finally having access to health care
(and antidepressants) was literally the only thing that made a significant
change and finally stopped a rather overwhelming amount of constant suffering.
Offer to go with her if she's feeling anxious about a doctor visit. (You
didn't mention if she had anxiety problems, but depression and anxiety often
occur together.)

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relaunched
Please encourage he/she to get professional help and you may want to consider
talking to a professional yourself. When a partner is depressed, it definitely
takes its toll on the other.

Unfortunately, as you probably already know, you can't snap someone out of
their depression. I've found that you have to be responsible for your own
happiness and that happiness is a choice. While it's admirable that you are
trying to help, there's very little you can do and it all comes at a very high
emotional cost.

Best of luck.

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nvr219
Seeing a professional psychiatrist is the best thing I've done for myself, for
my job and for my marriage. I recommend doing that.

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brudgers
Unless there is an actual diagnosis of depression, then it may not be. In any
event, you are not qualified to treat it.

You can however, listen. Quietly. If you are asked for help, ask if she wants
to see a professional. Offer to go with her.

Then shut up again and listen. Quietly. Don't try to fix it. You are not
qualified.

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2eyes1screen
This is what I can tell you.

In my freshman year of college, I helped my best friend get through depression
at the moment when I thought he would take his life. We were like 300 miles
away, and despite the distance, I was lucky enough to be able to make a
difference.

My friend was going through what I think has been the hardest time of his life
(although throughout his life, he has been through some really tough times).
Also, my friend was a mere teenager in his middle teens and (in my opinion)
lacked support from family; both psycologically and financially.

Tips: A depressed person will say "you don't understand [how I feel]". Do NOT
try to convince this person that you do, and while you might want them to feel
like you agree with them and see where they are coming from, it is best not to
seem like you can understand their immense unhappiness.

Another thing to avoid is using yourself as an example of how things will be
OK. For example, don't say something like "yeah, my parents divorced when I
was young too, but look, I'm ok and so will u".

I think a depressed person's least concern is how your life is going (unless
it is your life that is depressing this person) so don't say things like "it
makes me sad to see you like this", because it will just feed a vicious circle
of sadness and nothing gets solved.

The final thing that I can tell you to avoid is saying something along the
lines of "you should see a psychologist/psychiatrist". I know, its ironnic,
but that will feel to the depressed like you want to send the burden of
helping this person out to a doctor.

also, don't say things like "I don't want you to ...(be sad, die, ...etc)"
because as I said before, its not about what you want, it is about how they
are feeling.

To do's:

Ask this person why they feel this way. Ask this person if they are
considering suicide...and I know what you may be thinking: "won't that put
ideas on their head or encourage them to do it?"

Sincerely, it is very unlikely that they are depressed and haven't though
about it. it will be rather a better way for you to understand this person and
take preven[tative?] measures if necessary.

Feel free to remind this person that you love him/her. (I'm hopping and
assuming that you do)

There is also a suicide hotline that will advice you on how to help this
person. On the other hand, i'd avoid calling 911 for help on this matter
unless your loved one is about to end it all. This is because of all the
terrible reprecussions that will arise out of that. Also, this is different
than referring a psychologist, since it will not throw unintended hints of
crazyness to your loved one.

Did you know that if a person makes a suicidal statement to "the authorities (
police, doctors, etc...)" they will get sent to a hospital for a long while to
"recover"? The problem is that these places don't really help your loved one
recover, they will just administer a lot of drugs and emprisson them for at
least a week in a medical facility that I hear is quite a miserable place to
be. (My friend went there and hated it).

Last but not least, here is a link on a PDF of QPR:

<http://www.scshare.com/downloads/MHA_QPR.pdf> (like the official what to
do(s) in these terrible times )

I wish you the best of luck and happiness to you and your fiance.

Last but not least, I want to recommend you the documentary called "Happy". I
believe it can show you ways to improve not only your fiance's emotional
situation, but also yours (whomever you are).

PS: I believe that while Hacker News is not the typical site to find advices
of this kind, I am glad you asked because while I like technology and
business, I know of other things, I like helping others and HN is pretty much
the only page where I care to get involved. So, to the selfish person _cough_
DigitalSea _cough_ , healthy human happiness is totally worth looking for in
any crevice one can look, even on the internet.

------
xijuan
It is very late when I read your post. But I am deeply touched by your
initiative and your effort to help your fiancé to go through such a hard time.
I could only wish that my bf (now ex bf)would be as supportive as you
have...and have not left me after I have experienced a hard time. I have
experienced mild depression in the past. Until now, I am not definitely sure
if it was severe enough to be called clinical depression but I had felt that I
had hit my lowest point and felt very down and uncomfortable. I also have a
friend who occasionally suffers depression. I did psychology as my
undergraduate degree so all my suggestions would either come from my own
experiences and things I have learned in courses. I suggest you to read into a
bit about cognitive-behavioural therapy and Carl Rogers' person-centered
therapy. I think Rogers' person-centered therapy is very easy to learn. In
fact, people in suicide hotlines are trained in person-centered therapy. Two
main aspects of this therapy are unconditional positive regard and empathy.
Unconditional positive regard means that accepting your fiancé for who she is
without disapproving feelings, actions or characteristics. And empathy of
course means understanding and appreciating your fiance's feelings. During a
therapy session, the therapist won't give suggestions to the client's
problems. Instead, the therapist would repeat what the client has said in
different wordings and ask relevant questions until the client figures out
what he/she really wants. When my friend is experiencing anxiety and
depression, I usually use some of these techniques. Here is the link to Carl
Rogers' famous therapy session (there are five parts to the therapy. The link
is the first part of it): <http://www.youtube.com/watch?v=ZBkUqcqRChg>

Of course, you should ask her to see a psychologist and a psychiatrist. But
beside those, in recent literature on depression, yoga and mindfulness
meditation have also shown to be very effective in treating depression and
anxiety. So I highly suggest your fiance to try those, especially considering
that yoga sessions are way cheaper than therapy sessions with a psychologist.

Also, exercising is very very important!! Exercising in and out of itself can
help relieve depression. Theoretically, during exercising, stress hormones are
expended and endorphins are released. If you have time, bring her out for a
run or something. I think for any people who are prone to depression,
exercising regularly is a must if you want to prevent depression.

I don't know if you know much about depression and how depression is
diagnosed. If you don't know, I suggest you to read about it, especially how
DSM diagnoses major depression. I want to make you highly aware that DSM
criteria are constantly changing and how we conceptualize depression is also
constantly changing. Just because your fiance is feeling very down for few
days, it doesn't necessarily mean she is having a major depression. Also just
because doctors think antidepressants would help her, it doesn't mean she
really needs to take it. Also depression comes in episodes. And most people's
depressive episode will be over in 6 months even without any treatment. It is
called spontaneous remission. Anyone who has the motivation to get better and
who receives LOTS OF SOCIAL SUPPORT will definitely get better sooner than
that. Oh I guess that is a very important thing to mention: SOCIAL SUPPORT! I
am very glad that you are offering her social support because social support
really really makes a difference. Please talk to her friends and family and
ask them to give her a lot of encouragement and support!

Last thing I want to say is that stress is what triggers depression in most
cases of a depressive episode. Therefore, reducing stress is also very
important. If you can help her with some tedious chores so that she doesn't
have to be stressed out about it, it would also help her dealing with her
depression.

