How to support a loved one suffering from mental illness

You can’t help someone with mental illness if you don’t understand what they’re going through.

The winter of depression

I am often asked: “How can I help someone suffering from mental illness?” The answer is surprisingly simple. The key lies in the empathy that can only come from a clear understanding of what they’re going through. Millions of people around the world face the scourge of mental illness every day. Tragically, the vast majority of them feel like they are misunderstood, abandoned, and left to face their demons alone. If you are struggling to understand the psychological problems of a loved one, do not beat yourself up about it. It is hard. Without appropriate guidance, it may even be downright impossible. Their feelings are usually more a product of a complex cascade of circumstances than of linear sequential logic. Someone faces a crisis. Crisis causes anxiety. Anxiety leads to depression. Depression leads to self-medication and sometimes, onwards to addiction. I will say it again: Understanding isn’t easy.

As an example: Watching someone you love slide inexorably ever deeper into the black pit of depression is not only heart-breaking; it is incredibly frustrating. It makes us feel helpless. Especially when one can’t see any obvious reasons for their depression. This is when we are often tempted to say well-intended but incredibly unhelpful things like, “Why don’t you just snap out it.” This leaves the sufferer feeling more isolated and alone than ever. What’s more, they often believe that they should be able to snap out of it and end up feeling worse because they don’t know how to. They have a disease. You can’t snap out of cancer. Understanding why they are anxious or depressed isn’t your job. If you are serious about helping, try to understand how they feel not why they feel. Even with the most common psychological problems like anxiety and depression, truly understanding the depth of their suffering is difficult. The common cry of our Vietnam vets comes to mind: You don’t understand what it’s like! You weren’t there man! People suffering from mental illness feel isolated, alone, misunderstood, and unheard. And that is where you should focus your attempts to ease their pain.

Educate yourself about their illness. Read up on it. This will help you understand that the causes aren’t always self-evident. For example, depression is very often a chemical problem requiring medication and not the result of some causal circumstance. Gaining knowledge about your loved one’s illness can help you avoid the common error of stigmatizing or stereotyping which just makes matters worse.

Pay attention. Listen with your heart as much as you do with your ears. Listen actively. When a person feels heard, they are more likely to open up and share what they are going through. When you are listening, be fully present and give them your undivided attention. Avoid answering calls or looking at your phone while they’re talking. Don’t offer solutions or contradict what they are saying. The most important helpful thing you can do is validate their feelings and empathize with them.

Do your best to understand what they are really going through. Depression can leech all the joy and colour out of their lives. A full-blown panic attack can make them feel as if they are literally dying. As I have said: People with mental illness feel lonely and isolated. What they need most is your loving, non-judgmental presence. As a supportive friend or family member, you can play a crucial role in their recovery journey. You can show your support by being there for them when they need you, offering a shoulder to cry on, and reminding them that they are not alone. If you do this and nothing more, you will significantly ease their suffering.

Encourage the sufferer to seek professional help. Like physical injury or infection by a pathogen, mental illness is a medical condition that requires treatment by a medical professional. Encourage the person to seek help from a mental health professional, such as a psychiatrist or a psychologist. You can offer to help them find a qualified professional and even drive them to appointments if necessary. Asking for and seeking help is not a sign of weakness. It is an essential courageous step towards recovery.

Help them develop healthy habits like regular exercise, healthy food, and good quality sleep. Healthy habits are a powerful way to manage their symptoms. For example, exercise is clinically proven to ameliorate the symptoms of depression.

Keep in mind that the cardinal principle of mental health is self-preservation. You can’t help anybody if you don’t look after yourself. Helping a person with mental illness is often challenging, frustrating, and emotionally draining. It is essential to take care of yourself and seek support for yourself if needed. Talk to a trusted friend or a mental health professional yourself if you start to feel overwhelmed or stressed by the challenge of living with someone suffering from mental illness. Having a supportive network is essential. If you are not a professional you can only “care to there”. Meaning that you can’t care so much that you begin to deplete your own precious emotional resources. To put it another way; you can be caring and generous but you still need to protect yourself with healthy and reasonable boundaries.

How can Metaphorical Therapy help?

If you can’t know what it feels like in the trenches without being in the trenches yourself, how can you understand someone else’s suffering.

The answer is to view their suffering through the lens of metaphor. For example; we view crisis through the metaphor of the siege of a medieval castle. Anxiety is examined through the metaphorical thunder and lightning of a tumultuous, terrifying, life-threatening storm. Depression is explored as a fight for survival through a long, harsh, unremitting winter. You can listen to these engrossing and entertaining metaphorical audio journeys presented through what we call MindMovies. You can listen to excerpts here:

https://metaphoricaltherapy.com/themes/holding_the_fort/

https://metaphoricaltherapy.com/themes/storm-of-anxiety/

https://metaphoricaltherapy.com/themes/winter-of-depression/

Upon listening to the full versions of these stories, patients have reported being moved to tears. They have said that they felt “heard” for the first time and that they felt a great surge of relief knowing that there was something they could share that would give others insight into the nature of their suffering.

Helping someone with mental health issues requires patience, empathy, and above all understanding. You can be a positive force and help them along their road to recovery. By educating yourself, listening actively, being supportive, encouraging professional help, helping them develop healthy habits, and taking care of yourself, you can make a real difference in their journey towards mental wellness. Your support can contribute to their healing and recovery process. But remember, what they need most is your non-judgemental presence and your understanding. The lens of metaphor can help you get much closer to that understanding.

Finally, the best way to help yourself and others with mental illness is to prevent it in the first place. Metaphorical Therapy’s Keystone Principles of Mental Health can do that: Self-preservation. Boundaries. Self-worth. Processing Emotion.

Dr Mark Whittington

1. Ch. B., M.P.M. FRANZCP

Consultant Psychiatrist

June 2023

AS THE NIGHTS GROW LONGER OUR MOODS GROW DARKER

The winter of depression

It was by no accident that we chose winter as the pivotal metaphor in the way that Metaphorical Therapy approaches the serious growing problem of depression. For some of us, the seasonal affective disorder appears to be a genuine problem. Here’s why it happens and how you might manage it better:

As one might expect, this form of depression varies somewhat according to geography. However, even in temperate regions, more than 3% of the population is affected. (In higher latitudes, like Tasmania this may rise as high as 10%.)

Scientists have revealed that darker moods are a result of the darker shorter days that disrupt our circadian rhythms. This is what causes some of us to develop symptoms of depression. While it is quite normal for most of us to have our ups and downs (and even for our downs to increase a little in winter) those suffering from Seasonal Affective Disorder experience the more intense symptoms of genuine clinical depression.

As these autumn days grow shorter, keep a look out for some of these common symptoms:

A sad mood that seems to last longer than usual.
A loss of interest in things you usually enjoy.
Disruption of sleep patterns.
Significant changes in eating or appetite.
Fatigue and general loss of energy.
Having difficulty concentrating or staying focused.

The most commonly reported symptoms of winter depression are hypersomnia, the desire to sleep more than usual, along with an increased appetite. Symptoms tend to first present in young adults and somewhat peculiarly affect three times as many women as they do men. Why, remains a mystery.

For each patient meeting the requirements for the diagnosis of seasonal affective disorder; many more fall just short of official guidelines. Instead, they are diagnosed with “subsyndromal SAD,” a milder but still burdensome condition.

By the way: There is mounting evidence of Summertime Seasonal Affective Disorder. But that is perhaps left for a brighter day.

Why does it happen?

The change in daylight disrupts our bodies’ release of melatonin, the hormone our brain releases to promote sleep. This part of our circadian rhythm; The biological clock that tells us when to sleep and when to wake up. Our biorhythms are cued by morning light. As the supply of daylight dwindles in winter, melatonin is released later. In other words, our inner alarm, conditioned over the months of summer, might be going off when our bodies are still in a state of biological night. As might be expected, things like shift work may add to this disruption of our circadian rhythms which are already out of whack, thanks to the shortening of the hours of daylight.

What can you do to avoid it?

First of all, Dr. Google is not to be trusted. Don’t be tempted to diagnose yourself. A professional diagnosis is the crucial first step toward treatment. Depression is a serious and dangerous mental health problem best to left to appropriately qualified and trained clinicians.

Once your diagnosis is confirmed one of the most common treatments for SAD that your doctor might recommend is sitting in front of a bright light. The emphasis here is on “bright”. Experts say the key is to look for a light equalling at least 10,000 lux. This is like sitting outside on a summer day in mid-December. This type of light is usually delivered by a specific type of lightbox like those recommended on the Yale School of Medicine website.

Experts recommend sitting in front of an appropriate light box for about 30 minutes. It is best to do this first thing in the morning in order to signal to the body that it’s time to wake up. This treatment can improve mood the very first day it’s used but needs to be repeated daily.

Metaphorical Therapy may help by employing key aspects of Cognitive Behavioural Therapy. Negative thinking breeds negative emotions. Metaphorical Therapy offers you structured ways to jettison redundant obsolete thinking. Concentrating on winter sports and wintertime hobbies may also be helpful. Remind yourself constantly that the situation is transient. As we say in our Winter of Depression podcast: Spring will come. Plan a summer holiday or simply look to the longer warmer days that lie ahead. If you suspect that the longer nights might be contributing to darker days, I recommend that you start by listening to Metaphorical Therapy’s Winter of Depression podcast. https://metaphoricaltherapy.com/themes/winter-of-depression/

Dr Mark Whittington.

1. Ch. B., M.P.M. FRANZCP

Consultant Psychiatrist

References:

https://medlineplus.gov/genetics/condition/seasonal-affective-disorder/#frequency

https://www.sciencedirect.com/science/article/abs/pii/016517819090116M

https://medicine.yale.edu/psychiatry/research/programs/clinical_people/winter/

https://medicine.yale.edu/psychiatry/research/programs/clinical_people/winter/obtain/

How to support a loved one suffering from mental illness

Winter Blues (Seasonal Affective Disorder)

Subscribe now