Families

Family members are often the first line of defense in helping someone with depression, therefore it is important to understand the signs and symptoms.  You may notice a change in your loved one even before the individual recognizes or is willing to admit they may be having a difficult time.

Here are some ways that you may help a depressed family member.

  • Learn about depression and its signs and symptoms.
  • Let your loved one know you are concerned.  You can ask questions such as, “I’ve noticed you are not quite yourself and wondered how you are doing?”
  • Listen without judgment and encourage your family member to talk about their feelings.  Depression often leads to withdrawal and isolation, so you may need to continually reach out offering gentle and consistent support.  Having someone to talk to can be incredibly helpful for someone experiencing depression.
  • Suggest a check up with your family doctor or mental health specialist.  Offer to go to the first appointment together.
  • Offer to help in making/keeping appointments, keeping the person on task with treatment, and assisting in chores around the house.
  • Be patient.  Even with optimal treatment, healing can take time.
  • Suggest activities like going for a walk.  Physical activity and exercise can be incredibly beneficial in helping combat depression.  Try not to become discouraged if your loved one is not up to it.  Forcing someone to engage in social activities when they are not feeling up to it may lead to increased feelings of worthlessness or failure.  Approach your family member with care, compassion, and understanding and offer the activity another time.
  • Be sure to take care of yourself.  It is important to remember to best support a loved one it is just as important to be sure to take time to meet your own emotional health needs.  By making sure to care for yourself, you will have the strength to be there for the person you care about.
  • Most importantly, giving unconditional love and support throughout treatment will be one of the best ways to help your family member.

Depression may pose a dangerous risk of suicide so it is important to know the warning signs.  If you feel your family member is in immediate danger call 911, go to your local emergency room, or contact The National Suicide Prevention Lifeline at 1-800-273-TALK to speak with a crisis counselor.  Here is what to watch for:

  • Talking about suicide, dying, or harming oneself.
  • Preoccupation with death.
  • Expressing feelings of hopelessness, or self-hate.
  • Acting in dangerous or self-destructive ways.
  • Getting affairs in order or saying goodbye.
  • Seeking out pills, weapons, or other lethal objects.
  • Sudden sense of calm after a depression.

Although it may be difficult to accept the person you know and love would consider taking their life, a person suffering from depression may see this as their only option as a way to end their unbearable pain.  If you have concerns, talk to them immediately and seek professional help.  Talking openly about suicidal thoughts or plans can save a life.

Family Therapy

Interpersonal stress is not only a precursor to depression, but marital/family dysfunction during the acute phase of a depressive episode is common and often leads to difficulties in multiple family domains.  Family therapy may be defined as any psychotherapeutic endeavor that explicitly focuses on altering interactions between or among family members and seeks to improve the functioning of the family as a unit, or it subsystems, and/or the functioning of the individual members of the family.  The goal of family therapy for depression is working with participants and their family to disengage from destructive forms of communication, and through that process, to reduce the symptoms of depression.  Therefore, the primary outcome in trials is not always the reduction of depression in the patient.

There are several family-oriented treatment traditions.

Psychoeducational Models:  Focus on altering negative attributions about patient illness, teaching coping skills, and providing support to patient and family.

Behavioral Models:  Based on learning theory and operant conditioning.  They typically focus on the parent or parent-child dyad and seek to improve skills by teaching about behavioral contingencies and reinforcement.

Object Relations Family Therapy:  A form of psychoanalytic therapy in which marital and family relationships are considered in terms of the projection of internalizing infant-parent patterns onto contemporary adult relationships.  The therapist takes a position of containment and comments on replication of patterns and working through toward a more complete integrated and realistic perspective.

Family functioning can be greatly improved by working as a unit and supporting one another, especially with dedicating to family therapy.

Sources:

Families for Depression Awareness

HelpGuide.org

Cottrell D, Boston P.  Practitioner review:  the effectiveness of systemic family therapy for children and adolescents.  Journal of Child Psychology and Psychiatry (2002).

Cottrell D.  Outcome studies of family therapy in child and adolescent depression.  Journal of Family Therapy (2003).

Diamond, G., Siqueland, L.  Current status of family intervention science.  Child and Adolescent Psychiatric Clinics of North America (2001).