In the DSM IV, the technical term for chronic depression is "dysthymia" in which a person must suffer from the clinical symptoms of depression more days than not for at least 2 years. I usually refer to myself as a "depressive" someone not only given to major depressive episodes (I've had four already-and two to three is normal in the span of a lifetime-the two disorders are not mutually exclusive), but I also suffer from a chronic mood disorder.


Did I scare you off with all that technical language? What it comes down to is this-the majority of the time I'm depressed. I feel hopeless, I have low self esteem, I have trouble sleeping, I starve myself, and I don't have a lot of energy most days. There doesn't necessarily need to be a stressor or incident to trigger these feelings, or there maybe a trigger and an unnaturally sensitive response.


And I'm not alone in this.


So I thought I would continue my How To series with some tips on how to approach someone who suffers from this particular disorder.

1. Never say anything like "Oh just forget it", "Don't think those thoughts", or "It's not a big deal."

It's just plain insulting to think I've never tried that before. If I could just not think these thoughts, I wouldn't. In fact, I've spent thousands of dollars trying not to think these thoughts-I've spent money on everything from psychotropic medication to tylenol pm and corona. I could buy a house with all the money I've spent trying to "forget it" whether it be through gym memberships or therapy sessions. It's bad enough having these thoughts but having friends who don't fully credit how much dealing with chronic depression is a constant struggle-who are dismissive about how much effort one has to put in on a daily basis just to get up and do simple things like shower-doesn't help an already difficult situation.

2. Never quote Oprah, Dr. Phil, or the author of any popular self help franchise.


While it's reassuring to know that Armchair University is still giving out honorary degrees in psychology, dysthymia is an actual disorder which needs professional attention. You wouldn't allow some schmendrick who sort of knows about medicine kind of to set a broken leg. Well the composition of my neurons and the delicate balance that is my psychological disposition is even more complex, nuanced, and difficult to treat than a broken leg. If you wouldn't trust your leg to a pseudo professional, don't trust my wellbeing to one.


3. Don't be critical
Depressives often fall into a "helpless-hopeless" cycle, and critical comments can have a much more severe impact. Often such comments are offered in an attempt to give "tough love" or to jar the depressed person out of his/her state (in the same way an intervention is designed to catapult an addict into the revelation of the reality of his/her behavior). Unfortunately, tough love can be dangerous for a chronic depressive and may sink him/her even further into the helpless/hopeless cycle or augment his/her already skewed sense of self esteem. Depressives rarely need help seeing things that they have "done wrong" or "screwed up." Although you maybe trying to spur them to act, you may inadvertently be giving them another reason to see everything as a lost cause.


Or, in other words, not the time to say "I told you so."



4. Do not suggest that depression is the sufferer's fault.
You wouldn't suggest that schitzophrenia is a choice so why assume depression is one? I am often confronted with the idea that I am "in love with my own misery" or that I "don't want" to be happy or well adjusted (see number 3). Again, a fairly insulting premise. Where is the upside in being miserable all the time?


I certainly don't see this as a choice. How all you all don't feel this way most of the time is as mystifying to me as how I feel this way a majority of the time is to you. Doesn't mean I think it's a choice. There are many possible explanations. One of which is the administration of chemotherapy in infants has multiple long term side effects INCLUDING MOOD DISORDERS. So don't assume that my depression is a choice, it could be the result of a constellation of environmental and heriditary stressors.


5. Do what you can
The best advice I was ever given about how to deal with my depression was to keep busy, active and in the company of others. The more you can involve the person in activities, even if he/she seems hesitant or resistant, the better. Even if it's something simple like just stopping out for a cup of coffee or inviting the person to just come and sit on your couch. Even short one line emails are better than radio silence which may give the impressive that no one cares.

6. Offer to help (teamwork)
Depressives are often overwhelmed, even by simple things, like getting the mail or going grocery shopping. As a result they may neglect the activity altogether which can further depress them. Instead of being critical, "Why can't you just pick up the mail?", offer to help-"Do you want me to come with you?" Even if it seems unnecessary to you, it can be a huge aid to a depressive.


7. Just listen

Friends of depressives often offer advice because they feel that they are expected to do something without realizing that simply listening might be enough. Depressives are usually aware that their feelings and perceptions are abnormal and are embarrassed about sharing these ideas. In fact, their depression might be linked to a feeling of isolation because they are inhibited about sharing those feelings and ideas with others. Making it clear that you can sit and just listen without rushing judgement or trying to "fix" the situation is often enough one of the best and most effective ways of helping a depressive.


So now you know, any questions?