Depression often doesn’t hit us over the head. It can be insidious, creeping in gradually over time. A gradual lack of enjoyment in usually pleasurable activities. A subtle change in sleep patterns, either experiencing significant difficulty falling asleep and mid-dle-of-the-night awakening or finding oneself sleeping more than usual or craving sleep despite having gotten a “normal” amount the previous night. One might start to eat more or less than usual, gaining or losing a significant amount of weight. Decreased energy. Increased guilty thoughts and feelings. Difficulty concentrating, needing to reread things more than usual in order to comprehend or retain facts. Folks with depression might experience hopeless and helpless feelings; these can be subtle, as in “What’s the point of doing all this work if the judge will rule against me anyway? or “What I do has no real impact.”
It is not unusual for someone who is experiencing depression to start doubting her value, to wonder “What would it be like if I weren’t here anymore?” “What would it be like if I were dead?” These thoughts are more frequent than one might imagine, and are often breezed over, with the assumption, “Everyone has thoughts like that, don’t they?”
If you have those kinds of thoughts, it’s incredibly important that you process them with someone. Spouse. Friend. Sibling. Co-worker. Someone who knows you and who has your best interest at heart. It’s very important to check in with yourself from time to time as well. Don’t assume “Everyone has those thoughts at times and they’re no big deal,” or “I can handle it like I handle everything else.”
If you hear a colleague or client say something like that, even if they dismiss it as a joke or it seems to have been said in anger or frustration, it is very important to check in with that person. Not everyone who attempts or completes suicide reaches out in some sort of way, but many folks do. They might even unconsciously be doing so. An important caveat here is to not be afraid to ask someone about their statements. Don’t let your concern that they’ll be embarrassed or you might have misread the situation lead you not to say something. There are lots of ways to check in with someone that are not threatening or intrusive. Just asking them if they’re okay, noting that you heard what they said and it was concerning, “feeling them out” to see how serious was what they said. One method of getting someone to open up a little is to start by sharing your own experiences with sadness or “burn out” or frustration or depression.
It’s important to validate their feelings, to acknowledge how hard it must be, and to encourage them to share more with you. “Tell me more about that.” “Wow, that sucks. Does it really have you down?” It’s equally important not to minimize their feelings by saying, “Goodness, tell me about it. I know exactly what you feel.” While that can seem like a supportive response, there is no way you can know EXACTLY how they feel and most people are aware enough of that that a response like that can feel dismissive or like you’re making it about you. That said, sharing with them that you’ve sought help or know someone who has might go a long way toward their feeling comfortable enough to seek it for themselves. If they are important or valuable to you, certainly let them know that. ●
Michael Prudent, M.D. is a practicing Psychiatrist (Therapist) in Midtown Atlanta, GA. Dr. Prudent graduated from Southern Illinois University School of Medicine in 1988 and has been in private practice for 30 years. He completed a residency at Medical University of South Carolina. Dr. Prudent also specializes in Neurology.
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