People who get in touch with Birmingham Counselling Services sometimes say that they are depressed,have been diagnosed with depression, and would like to avoid taking anti-depressants by trying a “talking cure” instead, or that they are in close contact with someone who might have depression and are finding it difficult to know what to do and how to take care of themselves. There are many different signs and symptoms of depression of course, but some of them are very common. A person who has depression will often be described by a doctor as having “low mood”, a term which covers many elements such as sadness, tiredness, bad-temper and grumpiness, a general feeling of being unable to cope with life, including problems with personal hygiene, time-keeping, normal responses to and relationships with others. Sometimes there will be thoughts of self-harm or (rarely) of harming others. Whatever the signs, it is important to talk to the person exhibiting them, to remind them gently that they are not alone, that other people care about them and that doctors will help them. They might need reassurance that you understand what they are going through, that depression is not a willful refusal to get on with life. Rather it is like a ball and chain dragging them down, or a black cloud enveloping them and cutting them off from normal human contact. You might never know whether the depressed person has heard you at the time, but it matters that you say it.
A significant number of people might take self-harm to a point where others fear they are trying to take their own lives, whether or not this is the case. Depressed people can become overwhelmed by sadness or the physical symptoms they are experiencing. They might find that they can’t get out of bed in the morning or function on a day-to-day basis and feel that ending their lives would be easier than coping with ongoing life situations, current stressors, and the pain of the depression.
It is said that those who seriously intend to end their lives will appear calmer and happier than before and that those who seem despairing do not want to die but are asking as clearly as they can for help to carry on. This is such a complex and sensitive area that it is not really useful to generalise. What is important is not to leave things to chance.
Those of us who care about someone who we fear is heading in the direction of suicide should not be afraid to talk to them about it. Naming the thought, speaking it aloud to someone who will listen without condemning, can be a safety valve for that person. We can also ensure that we have contact details for the person’s doctor and the emergency services, including the emergency response team. Never be afraid to call NHS Direct (0845 46 470r 111 – the number is being changed over the next few months) for expert advice in a crisis. All calls are free of charge.
People who are experiencing severe depression and genuine suicidal thoughts will need prompt, effective help and treatment and ideally they will cooperate with those who are offering it, talking honestly to medical experts, taking prescribed medication, attending clinics and/or counselling sessions, agreeing to be an in-patient if a doctor deems it advisable. They might well need support during this time, but they will not want to feel spied on or suffocated with concern. And yes, it is difficult to get the balance right. It helps to remember that the person who is in this dark place is another adult, to be treated with respect and not made to feel patronised, and that they are not “going mad”.
Look out for Part Two where we will look at recognising that someone needs help and suggest some coping mechanisms for dealing with depression.