I have depression.

Actually, if you want to be specific, my diagnosis is much longer and more detailed than that. Depression is a lot shorter to say and to type.  Let us not be prisoners of mere words and move forward together.

I am lucky to have my spouse.  Not only does her active duty status provide me with top-notch medical care, she has also been a rock as I have struggled with my illness.  It is no exaggeration to say without her and my daughter I would probably not be here today.

My depression has taken its toll on her.  She’s an ICU nurse by trade, so she is used to some pretty awful things. Depression isn’t one of those things, however. I get the sense if I had had triple-bypass surgery or sepsis or renal failure she’d be Johnny-on-the-spot, but depression isn’t so simple.

Depression doesn't always look like this. Photo courtesy of worradmu.

Depression is not an illness you can necessarily see, and it can be particularly hard to get your arms around.  It doesn’t follow a playbook, it is different in its particulars for every person, and in my case at least it is cyclical: some days are much better than others. Sadly, those days don’t always announce themselves in advance.

It isn’t my intention to tell you about depression; there exist much better sources to get the nuts and bolts of depression if you need them. If you’re the spouse, friend, or caregiver of someone who suffers from depression, I’d like to talk to you.  There are some things you should know about your loved one’s depression, and they’re important.

First and foremost, it’s not your fault. Remember the scene in Good Will Hunting where Robin Williams’ character tells Matt Damon’s character “it’s not your fault” about 30 times, and Matt Damon ends up crying and having a breakthrough?  You’re Matt Damon in this scenario. Your loved one’s depression is not your fault.  With therapy your loved one and their therapist can put names to the demons, but you aren’t one of them.

Secondly, you shouldn’t necessarily have seen it coming and there isn’t anything you “should” have done to avert it. Depression isn’t a palm tree with shallow roots; depression is an oak with roots that spread from here until next Wednesday. Rome wasn’t built in a day, as they say, and the depression wasn’t either.  If you’re close to your loved one, you were too close to see it coming in any case.

Consider it this way: your loved one needs your support. Believe me on this one as I am speaking from experience.  Your loved one will have to visit the past to combat their depression. They need you in the present and in the future. You are not to blame, so don’t act like you are. Instead, focus on your loved one and how you can help.

How you can help is an excellent question.  The answer is “I don’t know.”  What I need isn’t necessarily what your loved one will need. Here are some thoughts that my wife and I have learned the hard way.  Take them as you will; they are written in tears and angst.  I do not recommend these as a composition medium, by the way.

Depression is a chronic illness. It is there, and it is going to be there for some time, and it might even be forever.  Drugs and therapy help, but they might not be the panacea you’re hoping for. Be prepared for a long struggle. If you expect the problems “to just go away,” you should meet your new companion: disappointment.  If your loved one had been diagnosed with diabetes or multiple sclerosis or rheumatoid arthritis, you probably wouldn’t adopt the “wish and hope” strategy. Depression won’t get better with that approach, either.

“Can’t you just get past this” is another winning strategy that you’re better off avoiding.  If your loved one could, unless they are a masochist of the worst order, they would, believe me. Depression hurts, and your loved one doesn’t want it any more than you do.

I should say that my wife hasn’t ever espoused either of those viewpoints, but the realization that depression is a chronic illness did take her some time to realize, and she’s a health care professional with more initials after her name than a Scrabble tournament. If she had trouble wrapping her noodle around it, be gentle with yourself if you have trouble, too.

Medications and therapy take time to work. My doctor does not like me to call them “drugs”. Meds (for short, and with no connotations of illicit activity) can take weeks to start to have their optimal effect, and they can do some pretty squirrelly things to your head and your body when you’re getting used to them.  If they don’t have the desired effect, you have to back off the meds slowly (woe betide the one who quits some of these drugs cold turkey, believe me !). After one med doesn’t work, you get to try a new one.  Repeat ad nauseam. This all takes time. Similarly, therapy can be pretty rough. Five years into therapy I still take a day or two every now and then to recover my emotional equilibrium.  Be prepared for the process to work itself out over the long haul.

As you travel that long road, be flexible! Your loved one is going to develop some coping mechanisms.  You will do the same. Please, please, please support them and work with them and figure out how to help them cope in positive ways. By the same token, please understand their coping mechanisms are there to protect your loved one and to help them (hence the name) cope.

Depression is hard on your loved one, and your being gentle and understanding makes things a lot easier. You will be frustrated, upset, and angry from time to time.  Remember to be mad at the depression and not the one who is suffering!

Like any long-term care provider, you also need to take care of yourself.  Perhaps you might even benefit from some therapy, a support group, or even just a weekly “sanity check” (perhaps an unfortunate choice of words, huh?) with your friends. You can’t be supportive if you’re at the end of your tether, so make sure you take care of you, too. It isn’t as if your loved one with the drugs and therapy can really begrudge you some alone time if you need it, right?

One of the beauties of the TRICARE benefit is self-referral to mental health providers.  Your support may well be covered by your health insurance.  Many websites and organizations are dedicated to helping people learn about, cope with, and support people with depression. These are also a great place to start. You know what they say, the family that makes TRICARE claims together…oh, never mind.

I hope you do not think I am being too glib about all this. If you’re just starting to deal with depression, you may want to take my jokes and feed them to me off your knuckles. I totally understand. Depression is hard. It almost cost me my life, and it almost cost my wife the best husband in the known universe. If you or a loved one is facing depression, you’ve got a tough row to hoe.  You aren’t alone, though, no matter how often it feels like you are. You can get through it.

That actually is the first thing I’ve told you in this article that is outside my experience. I’m not through it yet, so I’m not absolutely certain the end is out there. I will leave you, though, with my favorite quote from Winston Churchill. It sums up everything I have tried to say in seven small words: “If you’re going through hell, keep going.”

It is hard. You’re not alone. You can do it. And, it’s not your fault.