Susan J. Noonan, MD, MPH, starts her new book, When Someone You Know has Depression: Words to Say and Things to Do, with a disturbing scenario:
“I just don’t know what to do,” Melinda says. She reaches for her purse and takes out a tissue, dabbing carefully at corners of her eyes. We are sitting in the family room, an alcove barely larger than a closet just outside the psychiatric emergency room. She has come in tonight with her husband who, she has been explain to me, has been slipping farther and farther into a dark depression. “I came home today, and he was sitting at the dining room table with his gun next to him. When I came in he just stared at me blankly.” She pauses, drawing in a sharp breath to compose herself. “I can’t have that, not around the kids.” I reassure her that we will take good care of her husband, that he is being admitted to the psychiatric ward. “I just want to help him get better, but I don’t know what to do,” she says, finally breaking down into sobs.
As this example shows, mental illness doesn’t just affect the person with the diagnosis — it impacts the entire family. The good news, though, is the entire family can be part of recovery as well. With over 6% of the U.S. population, or about 15 million adults, dealing with depression each year, the vast majority of us know someone struggling with this disorder. In her new book, When Someone You Know has Depression: Words to Say and Things to Do, Noonan offers guidance to friends and family of those dealing with depression and bipolar disorder.
Noonan, also the author of Managing Your Depression: What You Can Do to Feel Better, is actually an emergency medicine doctor by training, but her personal struggles with mental illness led her to becoming a Certified Peer Specialist, counseling others with mental illness. The book arises from her personal experience. She notes, “While sitting at a roundtable discussion on mood disorders with parents, spouses, and patients at Massachusetts General Hospital in Boston, I heard serious frustration coming from the supporters of those who have depression and bipolar. Family members and close friends are usually the first to recognize the symptoms of depression and the ones providing daily support. Most felt powerless to know what steps to take, what to say or do in response to symptoms, or how to change the course of the illness.” This book is an attempt to assuage that frustration, to offer understanding, guidance, and hope at what can be a confusing and frightening time.
Her book provides a comprehensive overview for families of how to help their loved ones, from understanding the disorder to identifying relapses in their early stages and planning for recovery. The book starts with an overview of depression and bipolar disorder, including theories about its origins, signs and symptoms, and how these disorders can manifest differently in different populations, specifically men, women, and adolescents.
Having set the groundwork, Noonan then focuses on how to support someone with depression. She offers concrete suggestions while also anticipating potential barriers. For example, she recommends setting aside time regularly to check in with the depressed individual. She asks, “Do you feel awkward doing this? That’s not uncommon — many people in your position do. But most people with depression actually find it helps to talk about it. Talking does not make the depression worse; your family member may be relieved to know that his depression symptoms make sense, have a name, and that his condition is common and legitimate.” She then walks you through how to have this conversation, describing active listening and coaching on how to ask questions. She also incorporates skills from a variety of therapeutic realms including CBT and mindfulness. For example, she delves into cognitive distortions common in depression and provides guidance about how to gently challenge these negative thoughts.
Noonan also addresses important topics like how to find professional help and the tricky situation of what to do when the individual you care deeply about refuses to get the help you know they need. And she devotes a chapter to the all-important subject of self-care for caregivers. She identifies many of the frustrations caregivers experience, acknowledging, “You, as the healthy one, may feel a loss and sense of isolation since your depressed love one is not as available to you in the past.” She highlights the symptoms of burnout and offers advice for managing through difficult times.
Overall, Dr. Noonan has written a comprehensive and useful book, worth a read for those who have a loved one struggling with depression.
When Someone You Know has Depression: Words to Say and Things to Do
John Hopkins University Press
Paperback, 134 pages