Post No.: 0239
Some people remark about those with depression who’ve suffered in silence, “Why didn’t you just say so?” Not understanding that for many sufferers of the condition, depression precisely involves the problem of not being able to ‘just say so’ or share one’s problems; of being too stoic, independent-minded and stubbornly believing that one should deal with every problem oneself and show strength (at least on the surface) at all times.
People who vocally criticise and moan about various things all of the time don’t tend to be the ones who’ll become severely depressed (although they could still be suffering from immense anxiety and a degree of depression) because they’re more likely to get attention and help as a consequence of explicitly voicing their concerns. They share their problems with others, whereas the severely depressed keep them to themselves for various possible reasons, such as shame or not wishing to burden other people. Even if a depressed person does seem to vocally complain about things, it could still mean that there’s so much more that they’re holding back from disclosure and privately bearing upon their shoulders alone i.e. the problem could still be far deeper or feel far worse than even their expressed grievances reveal.
A problem shared is a problem halved, as it were, but for many people with depression, they can’t or don’t want to share their problems or share their true extent with other people. They want to give the impression that they’re fine and so we may think they are, but we must understand that this could be a façade. And if a sufferer’s silence or pretence of feeling fine fools us, we might fail to offer them the help they need.
We might also believe that someone’s low mood is just a passing phase too, which it can be but we shouldn’t assume it will be, especially if the person’s life is stuck or hasn’t changed for the better and they haven’t practically moved on – which could be a sign that they’ve not emotionally moved on either (e.g. they’re still doing the same old routines, seeing the same old people and/or are stuck in the same old places as before). So we must always follow up and maybe directly probe the issue deeper, in a compassionate, gentle and sensitive way, and not assume there’s (genuine) improvement unless the sufferer’s life has somehow been fundamentally and meaningfully positively changed too – because the same old routines, people and/or places will most likely mean the same old feelings and habits as before too.
If we care, we should therefore support and help enact positive change in a depressed person’s physical environmental situation i.e. it’s not just about emotional help but practical help (e.g. helping them get outside and into green spaces more, making sure they’re eating well and exercising, maybe going on a holiday with them if they’ve not been for ages, or their house could be redecorated to signal a new chapter in their life if they cannot move away). A mere positive change in mental perspective alone can help, but as quickly and easily as one can see the glass half full, one can see a glass half empty again, and it only takes a short moment of lowness to end it all if one is feeling that the glass is closer to empty again.
So practical environmental changes and support for a sufferer can be more enduringly useful. (This is also related to ‘nudging’ and channel factors – to change a behaviour or mind, one can start by changing the environment to make those behavioural changes easier to do.) Words or advice like, “I’m here if you ever want to talk” or “Try to get some exercise” are great – but offering practical support and proactive encouragement like being the one to initiate conversations about their state of mind and buddying up with them for trips to the gym are even better. The things you do are usually more supportive than the things you say.
As we primarily concentrate on our own concerns (e.g. work, young children, the broken car that needs fixing), we in our day-to-day lives can fail to pay proper attention to other people in a meaningful way. For example, assuming that asking, “How are you?” and receiving an answer of, “I’m okay” means that a person is definitely okay. Such responses are usually just habitual reflexes. There are cultural differences but in some cultures it’s not the social protocol to respond with an answer that isn’t along the lines of, “I’m okay” or repeating back, “How are you?” A lot of formal social greetings are therefore empty and a lot of responses are mere platitudes – as things to politely say but people don’t really want or expect to hear other people’s life stories or become impromptu counsellors after they’ve just met for the day, if a deep conversation wasn’t on the pre-arranged agenda. So, if you really want to know how someone is, you’ll have a far better chance of eliciting the truth by asking the person more deliberately, in private, when you and she/he can and are willing to dedicate the time to talk in case a conversation ends up running long, and during a context other than when you’re both just greeting for the day.
Assuming that someone is fine when they’re not is one way people around a depressed person who is suffering in silence can easily fail to detect the signs, their lack of desire or lack of motivation for life. Some even unfortunately dismiss any direct comments, when a sufferer happens to hint about suicide, as ‘being silly’ or ‘nonsense’. This includes people who are seen or interacted with regularly. Yet these are clues – big clues – regarding suicide ideation if we pay attention to other people more keenly.
So those suffering in silence can often give subtle, indirect or even direct hints about their condition if one pays attention to them, such as using phrases like, “I didn’t ask to be born” or “The trick is to keep breathing”. Anyone stating – and it’s difficult to say this nonchalantly or as a joke – that they wished they were never born should, with just a bit of thought, be an extremely clear red flag to any listener. A non-depressed person would almost never think or say that in a serious manner – only someone contemplating or who has contemplated ending her/his own life.
Try not to ever reply with lines like, “Don’t be stupid (you drama queen)” or, “What have you got to complain or be depressed about?” in a dismissive, judgemental or assumptive rather than inquisitive manner, as if you know everything about another person’s life. That just makes sufferers feel a hundred times worse because they’ll feel ever more isolated and ignored. It’ll make them want to revert back to complete silence and keep their problems to themselves even more after deeming such tentative forays into trying to speak out as failures. They will have legitimate things to complain about because everyone has causal reasons for being exactly the way they are, and that’s based upon some of the most empirically-verified scientific theories of how this entire universe operates, and the increasing amount of evidence regarding how mental health disorders arise.
We can try to be positive and compassionately explain that things could be much worse for someone who’s feeling depressed, but it’s counterproductive to bluntly dismiss their feelings because you think they don’t really have it that bad to have anything to complain about, such as if they’re not in debt or self-harming – this might make it seem like they ought to get into debt or slash their wrists before they’ll be taken seriously by others :(.
Although not always the case, look at their eyes – if they’re chronically dark then that might be an external sign of prolonged internal suffering and tiredness. At least relative to how they generally were before – are they taking care of their own appearance? Vanity at the other extreme could also indicate a psychological problem but people who are healthy tend to put at least a little effort into how they look, especially if they go out or if it’s a special occasion. Read Post No.: 0198 for more about the symptoms of depression.
Although these symptoms alone don’t necessary point to depression, a sufferer of depression may also have no desire for dating, a relationship, marriage, having children or even sex. A lack of interest or pleasure in life (anhedonia) is a key symptom of depression, along with sadness or dysphoria, and other somatic symptoms. If they’re not thinking about ending their own life then their only drive could be to just recover and get to a state of good health first. Whilst they’re without good health, they’re doing nothing – they feel they can’t do anything. And people who care need to do much more than just tell people to look after their own health – they already know but they’d appreciate some practical support, even if they’re reluctant to ask for it because perhaps they’re too shy, introverted or don’t want to be a burden on others.
Some people are somewhat more used to pain or abuse for not knowing any differently. Some people think they even deserve pain. Some think they should try to handle it all alone whether they think they deserve it or not or can handle it alone or not. Depressed people can feel like they don’t deserve happiness. They can feel like damaged goods and no one should even be in a relationship with them. For some, if they loved somebody that much, they cannot be selfish enough to bring them into their own troubled world – so if they loved somebody that much, they may stay away from them or implicitly tell them to get away because the depressed person believes the other person deserves better than them. This may also include not ever having children for they believe the mental health risk could be passed on. This is not to say that sufferers who are in relationships or who want children are being selfish, because their partners are not coerced into the mutual relationship and genetics are only a part of the picture.
They can feel joy when they see other loving couples get together and find their soul mates, but they don’t see that future for themselves. They can root for others who are down in luck, hope they make that leap, hope someone else gives them a chance and hope their life turns out fine in the end, but they don’t root for themselves or see that happy future for themselves. They want to see other people being happy, being couples and living happily ever after – but they might not see that for themselves, at least presently. A close, compassionate partner in their life might be exactly the thing they need to help heal their body and mind, but it could be the very thing they feel they don’t deserve. So an intimate relationship might be good for their health? Or it might not make enough of a difference because many people in loving relationships have committed suicide too, and it won’t have been their partners’ faults at all.
The opinions and decisions of different sufferers of depression can be highly individual though. If you suspect that someone is suffering in silence then I hope you’ll find the courage to enquire compassionately but frankly about it with them. And please don’t rely on merely mentioning once that you’re there for them and assume they’ll ever come to you and open up like that – proactively, directly and periodically ask how they’re doing without being incessant. They will not be offended but grateful, even if it might require some patience until they are fully ready themselves to talk about it…
Meow. You could save a life :)!