Someone searched on my blog for the following and it caused me to go cold.
How to stop enabling depression
The amount of misunderstanding in that one simple statement is enormous. I just wrote a blog about addiction, and now I am back on depression. So here we go. Depression and addiction are often present at the same time in the same person and the two very different diseases get confused all the time. I am a rare example in that I don’t touch substances of any kind and I have in the past suffered from a major depression. So I am kind of unusual in that I wasn’t self-medicating my depression with alcohol or drugs. A lot of depressed people think along the following lines…
“I am miserable and I need relief oh look there is a bottle of whiskey or there is a line of coke, that will make me feel better.”
They do the drugs, it makes them feel better for a short period of time, the euphoria wears off they use again. The cycle gets worse and worse and worse until the cannot feel joy without the substances. That is the cycle of addiction, not depression. I am not a therapist, or doctor…but this is how I see it having been through what have, and what I have seen with addicts in my family and circle of friends.
An addict chooses to pick up a drink or use drugs. It is an active choice on their end to engage in this behavior. A depressed person who does not use alcohol or drugs is not choosing that personal hell, it is a chemical in balance in their brain. Both diseases have a biological or genetic component and both are medical problems, but one involves the use of a substance, while the other does not.
To “enable” an alcoholic you must make it OK for them to drink, not point out to them that drinking is the real source of their problem, and allow them to treat you horribly in the process. Most addicts lash out at those closest to them the entire time they are going down. When you stop enabling the addict you usually have to cut them off, stop talking to them and make them know that you think their addictive behavior is self-destructive. Everything about the addicts behavior is getting the substance and using. They will do nearly anything to keep alcohol or drugs in their lives including betraying friends, robbing from them, putting them in jeopardy and causing them harm.
Now lets look at a person who has the illness of clinical depression who is NOT using. Where is the source of depression coming from? It could be from a number of sources such as a death, divorce, loss of job, medical bills, work related stress, tension in a marriage or just simple biology as in someone with bi-polar disorder or chronic depression. Now if these dark moods have evolved into medical depression what could a friend or loved on do to help the person suffering? Should a friend confront the depressed person? Get in their face tell them they are causing their own pain, label them depressed and stop talking to them? I would think that would be the absolute opposite of what you might want to do to a person who is probably suicidal. Bi-polar disorder especially, has been extremely well-studied and is clearly a biological problem that requires medication. Thinking you can talk a person out of bi-polar disorder with happy thoughts or positive thinking is downright dangerous, it would be about the same as thinking you could talk a person out of schizophrenia or any other type of psychosis. Also a person suffering from depression is not going to actively attack those around them in the same was as an addict. For instance, a person suffering from depression usually just shuts down, they aren’t stealing a friend’s computer to pay for their cocaine habit.
The differences between the two diseases are why the treatment for depression and alcoholism is so vastly different. Addicts go to rehab, and usually some type of 12-step program to try to stop using. Depressed people get on medication or into some type of therapy. The difference is the addict is also willfully part of their own destruction. Even though addiction is a disease and there are biological and genetic components to it, the addict is still an active participant in their demise. No one is forcing them to use, they choose to pick up the bottle, down the pills, or shoot up. The depressed person is not choosing to not get out of bed, to not eat, to not find joy in pretty much anything. A depressed person should not be “cut off” or confronted for causing their own illness. And of course as I have discussed on this blog before there are always people who aren’t quite medically depressed but for whatever reason have hit the wall and given up. There is a fine line between being to the point of needing medical intervention and just a change in attitude. But in general cutting off a person who is suffering from the real medical illness of depression in order to “help” them would bring about the opposite effect. The depressed person would feel that much more isolated, unloved and alone and a depressed person needs compassion not “tough love”. An addict will just continue using so when you cut them off they will return to their drug of choice, until of course they make the decision that the drug is the real problem and seek help. Again since most addicts also suffer from an underlying depression the distinctions between these two illnesses get murky.
With about 30 seconds of research I found this highly misguided group.
From what I could tell the website hadn’t been updated in five years and they weren’t holding meetings anymore. From what I could find the entire concept was based on one book, by one woman. There were some other groups that I found as well, but I couldn’t tell how large this particular approach to depression had become. It certainly didn’t seem like the huge and organized group that is Alcoholics Anonymous or Narcotics Anonymous. And I know there are people who criticize both AA and NA for being ineffective as the success rate is low, but I have known many people that have greatly benefited from AA, NA and rehab, so I am not sure what to think. I also know there are also 12-step programs for nearly every affliction, I just don’t necessarily agree that the 12-step approach works for every malady, especially depression.
I had a strange incident with two people who were not close friends of mine who decided for their own benefit to stage some sort of “intervention” on behalf of my depressed state. They really knew nothing about my background and yet felt entitled to tell me at length in writing about my so called psychological troubles. They didn’t know that I was at that point off medication and on the long road to recovery, they made assumptions that weren’t true and were way off base in most of what they were telling me. They were also doing this to benefit themselves as they were pulling out of a contract with me. Basically they found a weakness and exploited it. I found the whole thing sad, pathetic and manipulative and have since cut both of them out of my life entirely. Hardly the benevolent friends helping me in need that they tried to hide behind. I hadn’t harmed them in any way, they were just in a bind and needed a scapegoat.
I am not an expert by any stretch of the imagination I can only speak of my own experience and that of people I have known over the years. I was not choosing to have panic attacks, I wasn’t choosing run away anxiety, lack of sleep, loss of appetite, wild mood swings, black thoughts, suicidal tendencies or the inability to feel joy. What happened to me was reactive depression due to my sudden divorce and it was biological in its nature. What got me out of it was medication, therapy and time. I think what also helped in my recovery was my active choice to not engage in self-destructive behavior such as drinking, doing drugs or engaging some other type of addictive type of activity.
Cognitive behavioral therapy (CBT) is one form of therapy that does help re-train a depressed person’s brain into a more positive outlook but even most proponent’s of this type of therapy would argue that in many severe cases medication is also needed as well as traditional therapy. Even in the book “Feeling Good” by David D. Burns, MD he touts CBT but at the same time goes on extensively about medication for depression and the possible pros and cons of its use. He also does not tout CBT as an overnight cure as recovering from a serious depression takes time for anyone. Some severely depressed patients respond positively to electroconvulsive therapy, which is fairly radical treatment directly on the brain, not exactly a 12-step program. As scary as this treatment has been portrayed in films and other media ECT can be quite effective in patients with severe depression who are not helped by other means.
I wish deep in my heart that people would stop misunderstanding what is probably one of the largest medical health problems of the past century and will continue to be a problem in the decades to come. I had no clue until I went through it myself, but my depression was so much more overpowering than any extended weekend of feeling sorry for myself. What I suffered from and what millions of other suffer from all over the country is a real serious medical condition that if left untreated can lead to intense suffering and for some suicide. We need to stop blaming the people stricken with depression for causing their illness and instead try to get them the help they need. I am eternally grateful to my many friends, relatives and loved ones that had the patience to see me through my bout with this horrible disease instead of deciding to stop “enabling” me and cut me off only to have me spiral downward. What helped me the most was not rude interventions with scolding, tough love and lectures but when my friends sat me down and begged me to get medical help. The friends that cut through the static in my head the most were friends who had struggled with depression themselves. Had people decided to stop “enabling” my behavior and cut me off I might not be here right now to type this blog.