by Andrea Francisco
I knew something was terribly wrong when I came home one night many years ago and my husband was very agitated. He was irritable, and I could see a wild look in his eyes that I’d never seen before. I thought there was an explanation for the irritability — after all, he was working long hours the last few weeks, often coming home at 2 a.m., then starting the routine all over again a few hours later.
Who wouldn’t be tired and cranky with a punishing schedule like that?
I encouraged my husband to relax, but it just agitated him more. I tried to keep as calm as possible, but deep inside, my heart was pounding and I was genuinely afraid.
Years before we were married, this man had told me that he suffered from manic depression. As a naïve 22-year old, crazy in love with this smart, funny, handsome, worldly man, I heard the words but didn’t realize what they meant. I thought depression just meant that someone would feel sad for period of time — days, or weeks even, and then rebound.
I did not fully understand what manic depression was truly about, and what it would be like to have it in our lives. All the years we had been married, I had never seen my husband this way, and when I finally did, it dawned on me that this was the condition he had warned me about.
That night, I didn’t know what to do. The comfort and endearments I offered seemed to have no effect, except a detrimental one. I called my sister-in-law, and told her what was going on. She confirmed to me that this was indeed a sign of a manic episode, something I had never witnessed in all the time we’d been together. My sister-in-law kindly picked me up, and the next morning, she and I, along with another sister, called my husband to check on him. He was even more agitated than the night before. We could hear the strain and anger in his voice. His sisters and I then decided he needed immediate professional help.
Because he did not seem rational, and we could not convince him to go to the hospital, we made the difficult decision to call 911. He was taken by ambulance to the psychiatric emergency room, where he was held overnight and stabilized with medication. The next day, he was discharged, but not before he and I met with a social worker to ensure that my husband would seek treatment on a regular basis for his diagnosed condition.
It was at this time that I learned about the different types of depression. Clinical depression (sometimes referred to as major depression) is when one experiences feelings of sadness and hopelessness for an extended period of time, losing interest in the things he or she once enjoyed. In a clinically depressed state, one is unable to function normally.
Chronic depression has symptoms similar to clinical depression and could be ongoing for years, but is not as severe. A person suffering from chronic depression is most often able to function productively, albeit with only intermittent joy and satisfaction.
Then there’s manic depression, more commonly known as bipolar disorder, where one experiences cyclical bouts of depression that alternate with periods of elation or mania. Manic periods are usually preceded by hypomania, where the person feels very good and very productive. Indeed, productivity and elation can soar during spikes of manic behavior.
In general, depression can be genetic, in cases where there’s a chemical imbalance in the brain. Or it can be acquired in cases of chronic illness, death, trauma, or as a side effect of certain medications. Regardless of the type or its cause, depression is a dire medical condition that must be treated and managed, just like cancer or diabetes or any other serious illness. And, as with all such serious illnesses, depression not only affects the person suffering from it, but also the lives of the attendant spouse, partner and/or family members.
It’s been eight years since my eyes were first opened to the various forms of depression, and this is what I’ve learned:
- Just because you go to the best doctors and clinics, it doesn’t mean you’ll get the best treatment or that the traditional treatment is right for every patient. Although depression is overwhelming, and you’ll be glad for any help you can get, it’s important to research the medical provider’s background and specialization to make sure they have the right kind of experience to handle your loved one’s case. There are psychiatrists who specialize in medication management only, and there are those who are psychoanalysts. Talk to your loved one to make sure they’re comfortable with their provider; otherwise, doctor’s visits and therapy sessions won’t be productive.
- Hovering makes things worse, for you and for them. Depression and mood disorders are not like a fever — you cannot put a cool towel on your loved one’s head to soothe their pain. Unless you’re concerned there is a risk of self-harm (in which case your loved one should be in a hospital), there is no need to check on them every 15 minutes. Doing so will only frustrate your loved one and likely cause your own anxiety level to rise.
- Have a support system in place, for both your loved one and yourself. Develop a relationship with your loved one’s doctor so they can alert you to any potential crises. Have a team of trusted family members or friends who can help out when there’s an emergency and provide emotional support. Your support system also should consist of those people who remind you that you need to live your life, too. Having your support system will help you keep moving forward and give you a boost when you need it.
- It is just as important for the caregiver to take care of himself/herself. Caring for someone with any type of depression is emotionally, mentally and physically draining. Consider seeing a therapist to unload feelings of anger, resentment, sadness and frustration about your situation, or to share small joys and victories that may seem minor to someone with a normal life. Try meditating, practicing yoga, taking long walks, or finding a hobby to give your mind and emotions a break from the stress and anxiety. Eat well and get decent amounts of rest and sleep. These suggestions will help you feel revitalized, more grounded, prepared to deal with the challenges.
- Let the patient take responsibility for their illness, and help them stay on track. When your loved one is well, resist the temptation to mother them. Talk to them about staying on top of their doctor’s appointments. Some people with depression resent having to take their medication because of the side effects. Have a frank discussion about the importance of taking their meds regularly, but resist the temptation to dole out the meds. If you sense they are slipping, gently offer to make appointments for them or ask what might help them stay on a consistent medication schedule.
- It can only be managed — not cured — so there will be bad days. There is no vaccination or magic pill to make depression, or any mood disorder or mental illness, go away. Every book, doctor, therapist, mental health expert and social worker will agree with this fundamental truth. If a loved one of yours suffers from a mood disorder, you should be grateful for each good day they have, because that means it’s a good day for you, too.
Fortunately, my husband’s bipolar disorder has been well managed, more or less, in the last four years. He is one of the luckier ones because he is functional. Getting to a point where a depression or mood disorder is well managed depends on a combination of the patient’s willingness to own and manage the disease, having a good, caring doctor who focuses on both therapy and medication management, and having a good support system in place that allows for a healthy living environment.
Andrea Francisco lives and works in the New York metropolitan area.