What if your friend, mother, sibling, or father-in-law is severely depressed but refuses to recognize it?
Most of us have been there at least once in our life: the awkward spot where you know a loved one has a mood disorder or drinking problem, but is too stubborn to admit it and to proud to get help. You might see the consequence his behavior is having on his children, his job, or his marriage, but he is blissfully blind or is in too much pain to see the truth.
What can you do, short of taking the person by his shoulders, shaking him, while screaming, “Wake the hell up and see what you are doing?!?”
It’s very complicated.
Because people are different.
Mood disorders vary.
And families are as unique as the illnesses themselves.
After doing a bit of research and consulting with a few mental health professionals, I have compiled this list of suggestions, to be read as merely that: suggestions.
1. Educate yourself.
The first responsible thing you can do is to educate yourself. Because you can’t really spot a type of disorder without knowing its symptoms. In guessing that a sister is depressed, you should know if there have been any significant changes in her diet, sleep, energy, and so forth. You can’t really assume your brother-in-law is bipolar based on Matt Damon’s performance as a pathological liar/bipolar freak in “The Informant!” or that a friend is obsessive-compulsive because her behavior resembles Jack Nicholson’s in “As Good As It Gets.”
Educating yourself is not only going to help you gather the facts that you need in order to know how sick your loved is, but it is going to help you feel more in control of the situation—so that you can guard yourself against the fruitcake that will be hurled at you come Christmas dinner. It won’t be a TOTAL surprise.
2. Gather the information.
Here comes the fun part. You get to pretend you are a detective for a month or so and gather any facts you can about the person without a) invading her privacy, or 2) bringing on an awkward confrontation. If you think she is depressed, ask about her diet. “Are you still eating Chipotle’s Burrito Bowl for lunch? No? Why not? Are you still playing tennis on Tuesday nights? Why have you stopped? What book are you reading for your book club? Have you hosted any of the meetings recently? It’s helpful to get together with any mutual friends and/or family members who would have additional information, so that together you can get a truer picture of what’s going on. The person may tell you something that contradicts your sister’s information, and the discrepancy can be even more significant than either of the answers. After studying the symptoms of the disorder that you think your loved one has, you will better know the information you need to find out.
3. Make a plan.
Here’s where it gets hard, because there is no right solution, and you can’t know the appropriate approach until it’s over. There is, of course, the intervention: when you gather together family and friends of the person and you all publicly confront the person with his behavior. Everyone either expresses a way that he/she has been affected, or reads a letter, or does something that ultimately communicates, “Dude. Uncool.” The intervention is the most extreme approach, and isn’t right for every situation. It can be when a person is in danger of either hurting himself or hurting someone else –by suicide, recklessness, or severe substance abuse. In some cases, police may even need to be called.
As much as we’d like to be able to force a sibling or friend or parent into treatment, we simply can’t. They have to meet strict criteria for being committed involuntarily to an inpatient hospitalization program. Someone has to prove that they are incapable of meeting their own basic survival needs (paying bills, proper hygiene, nutrition) or that they are a danger to themselves or others. States vary with regard to the criteria, but it is not easy to make the case because you have to bypass all those human rights and stuff that we have.
So, that leaves ….
4. State the facts.
You’ve studied up. You have the evidence. You know that she is depressed, but not so severely that she presents a risk to herself or to her family. And yet … the disorder is clearly wreaking havoc on her home life as well as her friendships and job. What do you do?
You start with the facts, and depending on how the conversation is going, you end with the facts. No one can dispute facts. They are what they are. They have no emotion or judgment or attitude attached to them. And they are especially heard when spoken from a person who has done her homework.
For example, when I was in that spot—being confronted by a friend about my severe depression six years ago—she simply listed a few things that I couldn’t deny: 1) there was food on my robe, 2) I couldn’t stop crying, 3) I had lost 15 pounds in two months, 4) I wasn’t speaking in coherent sentences, 5) she wasn’t the only one worried about me — there were at least three others.
My husband could have told me in vague language that he was worried about me, but I probably wouldn’t have listened because he wasn’t a doctor and he wasn’t laying down concrete evidence. I could hear what my friend was saying because I knew she had done her homework and was merely calling out the obvious, not making a general judgment of me.