Thursday, July 10, 2014

Understanding Depression

If you were to do a survey of people on the street, you would probably come away with a general consensus that depression means "feeling sad", an idea which is way off the mark. Questions about the frequency of depression would probably be answered more accurately though as most people would suggest that "everyone feels sad sometimes".

I've talked about depression and Asperger's syndrome before, in the very early days of this blog. Back then I talked about how common it was in people with Asperger's syndrome and what some of the possible causes could be. This time I want to look at what depression is and how to support people who live with it.

What does depression feel like?
It's hard to explain what depression feels like to someone who has never experienced it before but it's something that those of us who have loved ones with depression really need to understand.

Many people describe depression as a kind of "fog", or a hole. It's about living under conditions where everything seems to be negative.  Depression alters a person's perspective so that happy moments are not recognized for what they are and sadder moments are enhanced and deepened by negative thought processes.

For example; if a person with depression has a car crash, then they are likely to become fixated on their car, the bills and how unlucky they are to have had the accident.  A person without depression will still acknowledge the bills but will be happy that they weren't injured in the crash. 

Depression and Self-Harm
While depression can sometimes include recognized forms of self-harm, like cutting, reckless behavior and in extreme cases, suicide, it isn't generally recognized that depression nearly always includes less visible elements of self-harm. The following examples demonstrate some of these;

  • Negative Self Talk; This is quite common with depression. Essentially it involves the depressed person constantly putting themselves down. It may not even be verbalized and could all be "in their head" but regardless, it becomes a form of self-bullying.  This is extremely harmful behavior because just as believing in oneself is one of the keys to success, constant talk of failure will lead to actual failure.

  • Closing down Communication; One of the side-effects of depression is that as other people around you try to help without fully understanding your feelings, they invariably become irritating. This can lead to depressed people ending relationships and friendships, failing to return calls and in some cases even running away from their families.  Many people trying to help people with depression don't realize that they are dealing with depression and instead concentrate on a visible behavior, such as cutting or alcohol abuse. The discussions quickly become critical of the given behavior and instead of providing much needed support, push the person with depression further away - and in some cases, lead them to try to hide symptoms of their depression. In the case of cutting, this often drives people to cut in areas which are less visible to those around them. Closing down communication is actually a very harmful activity.

  • Inactivity; When you're feeling positive, you can take real pleasure from many activities and indeed you can often find the silver lining behind activities which are not so pleasant.  People with depression however will find every activity to be a chore. They will instead attempt to spend time doing nothing . Inactivity causes ones thoughts to turn more inward, about oneself. It means that depressed people spend more time meditating on their depression than actually doing anything about it. It also means that they avoid many activities which could otherwise make them feel better.

  • Turning to Vices; People with depression often turn to vices to use as crutches. These vices could include obvious things like drugs, alcohol, gambling or sex or they could include the less obvious vices. Binge-eating of unhealthy foods particularly chocolates (candy) and ice cream is a common vice. Another is unhealthy interactions on social media; facebook can be bad at times but other sites, like ask.fm and snapchat are far, far worse.  Binge shopping is also a vice, as  is constant partying with intent to forget. Believe it or not, some seemingly positive things such as extreme fitness and over-reliance on church and prayer can also be vices.


How Parents, Relatives & Friends can help people with Depression
One of the hardest things to accept about depression in adults is that you can't help anyone who doesn't want to be helped and you usually can't reach people who are depressed because they've closed down communication.  You can tell a person that they have a problem with alcohol or with an unhealthy attraction to the wrong crowd as much as you like but if they're depressed, chances are that they won't hear or remember a word you say. Even if they do, they're unlikely to acknowledge the problem.

Often, a person with depression has to "hit rock bottom" before they will even acknowledge that a problem exists.

Unfortunately, sometimes problems with depression can continue for years or even decades untreated. Unless a person is considered to be a danger to themselves and others, there's nothing that society can do to intervene.  It's literally their right to be depressed.

There are however a few things you can do;

  • Let others do the talking; If you're the primary caregiver for a person with depression, it's very difficult to prevent yourself from speaking out about their negative behaviors. There is however, a fine line between simply being annoying (nagging about vices) and driving a person away from you.  Speaking out can sometimes ruin friendships and break up families. Sometimes, it's best to just accept what you have and get others to do the speaking out for you. After all, it's less of a problem if a more distant friend is dropped from the relationship.

  • Provide a Safe Haven; If a depressed person does not have anywhere to go, they will leave themselves more open to harm by taking up lodgings in harmful places. To provide a safe haven, you need to keep your home free from stress. Make sure that the depressed person knows that they won't be subject to constant scrutiny and questions about their lifestyle. Again, leave that to others.

  • Become Support, not Rescue; You need the depressed person to actually hit rock-bottom as a consequence of  their actions. This won't happen if you keep rescuing them or supplying them with funding. You need to take a support and safety role, not prevent the inevitable from happening.

  • When the depressed person requests help, help them find it; Eventually your depressed person will realize that they need to seek help, whether that's AA or some other form of rehab, counselling or psychotherapy.  When the depressed person either seeks it themselves or is ordered to report there by authorities, you need to be provide support to help them find the right service and stay the course.


Other Articles
My 2007 series dealing with depression is here;
Apologies for some of the terms (eg: Aspie) in these articles. A lot has changed in the last seven years.

5 comments:

Chris - the Social Maze said...

In my experience of living with Asperger's Syndrome, depression can be the result of having social communication difficulties that are not properly understood or recognised.

If you find yourself constantly facing social rejection, trying to win people over by saying something funny and finding you instead upset people, having to constantly try harder to socialise and face failier time after time, while you see others enjoying more friendships and relationships - that can result in a lot of depression.

Another thing is when you misunderstand things people say. People may be well meaning but as one with asperger's you are liable to get the wrong impression about something said about you, or someone else or something important to you. It can play on you mind for days on end.

Many people with asperger's spend much of their lives being misunderstood, and not having the type of support they really need.

I believe for these types of reasons, asperger's people are liable to depression.

Anonymous said...

Personally I feel that Society as a whole doesn't really have that level of understanding. However in time they will as more and more people are being constantly diagnosed with Asperger's Syndrome.

I've struggled with a lot of things in my life only to later understand that I'm the one making up scenarios in my head. I still can get depressed but in most cases I know it is in my head. Meditation and enough sleep seem to help a lot for me.

As a person with Asperger's Syndrome my biggest frustration is when people want you to explain your Asperger's Syndrome so you tell them it's complicated to explain. In reply they say "You can speak so how can it be complicated to explain". I experience more frustration and stress than depression nowadays.

I really hate it when people you meet expect a fucking explanation when you tell them you have Asperger's and when you try to get your way out of it the people only wanna know more.

Ambivalent Anthony said...

I was diagnosed with severe depression four years ago and put on sick leave. A year ago my wife started talking about me possibly having Aspergers, and I was diagnosed in April this year.

My theory is that depression is about having a contradiction, a conflict, in one's life, between one's expectations and the reality. It just happens that many people with Aspergers will always encounter these contradictions because the "world is built by neurotypicals".

For me, however, the situation got easier as before I didn't know what was wrong, what the conflict was. It was just this, well, black hole of depression. Now I have a much better view on it, knowing I have Aspergers. At least there's hope to find those contradictions.

That is not to say things are supposed to be easy if you know you have Aspergers - every day I meet challenges I know I will meet for the rest of my life. And developing coping mechanisms is hard work. Just like people who are not depressed have hard time imagining what it is like, people who don't have Aspergers have difficulty knowing precisely how an AS mind works... So a whole lot of work must be done by the person him/herself. Not that easy, if you're depressed and lying on the couch with no will to live.

As to drugs, vices and such, I agree fully that people notice such things much more readily than the underlying problems. But if one, say, drinks heavily because of depression, and is depressed because of a problem he isn't able to figure out (meaning not even figuring out the problem itself, let alone figuring out how to solve a problem that is known) and the people around him start to help him 'fight the bottle', a lot of energy is spent on fighting a symptom rather the cause... A person might fight alcoholism his entire life without actually touching the underlying problem, which he needs to blur out with Jack. It is, however, true that there are few people capable of helping in finding the real problem. Even therapists and such who are supposedly trained to help in that are, in many cases, useless (personally met about a dozen professionals for three years and even received six months of ECT before being 'diagnosed' for Aspergers - by my wife, not them).

At this point, if you're depressed, it would be politically correct to say to you: Keep fighting! But I know that is precisely the thing you're tired to do. So what I say instead is: I know. But keep breathing. For most purposes, that is enough.

Stephanie said...

You took a subject that can be very difficult to articulate and made it much more tangible. Usually when I try to write about depression, it ends up being very metaphoric. Drowning (without dying) and holes are common metaphoric themes that creep up. I'm less familiar with the fog; it always seems more tangible than that--like being smothered.

Anonymous said...

Yup this is defiantly true for me! I hate my autism sometimes