Depression (Photo credit: Wikipedia)

Someone searched for the following phrase on my blog, and it caused my blood 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. I am a rare example in that I’ve suffered from depression but I don’t abuse substances.  I wasn’t self-medicating my illness 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 until the cannot feel joy without the drugs.  That is the pattern of addiction, not depression.

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 is not an addict is not choosing that personal hell.  They have biological illness that is out of their control. Both diseases have genetic components and they’re both major medical problems.

Of course some emotionally manipulative people will use the label of depression to refuse to take responsibility for their hurtful actions or self-destructive ways. Not every person or situation falls neatly into any category, especially with mental illness.   During my depression I had many well meaning friends who blamed me for my illness.  I had text book depression:

• Wild mood swings
• Loss of appetite
• Panic attacks – some so severe they would last for hours
• Suicidal thoughts
• Inability to sleep for any length of time – waking after just a few hours
• Difficulties with concentration and focus
• Complete loss of libido
• Lack of joy

I was a mess.  However, I wasn’t in control of these symptoms.   I couldn’t simply turn on happy thoughts and stop it.  I knew whatever was going on in my brain was a physical problem because I had never had symptoms like that before, and the physical effects were so overwhelming.  Like everyone I had periods of feeling sad, but the panic attacks and inability to focus were acute and new to me.  My sleep patterns were all about two or three hours long and then I would be bolt upright.  It didn’t matter how much coffee I drank or didn’t drink or how many Melatonin pills or over the counter sleeping medication I took.  My body didn’t want to sleep more than three hours, that was a physical side effect and it’s considered text-book depression.  What I needed was medication, therapy and time to heal – not tough love.

There are also a lot of misconceptions about depression.  Some people seem to think that a depressed person

• Is really just lazy
• Isn’t motivated
• Has a bad habits – such as sleeping too much, or dwelling on negative thoughts
• Is just pessimistic or has a bad attitude.

Because it isn’t always obvious to tell a truly depressed person from an emotionally manipulative one, depression is a tricky illness.  After all mental illness isn’t something that’s visible to the naked eye, and the tests for it are largely inconclusive.   So someone who wants to give up and not take responsibility for anything they do could just label themselves depressed and wallow in their misery. It’s not always easy to know who is really suffering from a medical condition and who isn’t.

But at the same time a sufferer can learn to mask their illness.  I have known people with depression who held demanding jobs while raising children. Others who have outwardly seemed perfectly healthy yet when left alone descended into fits of despair.  I was extremely sick and yet I never missed a day of work.  Over time I learned I could hide my symptoms to appear functioning in some situations.   A busy schedule wouldn’t have changed my illness, it probably would have just prolonged my recovery.

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 emotionally attack those closest to them the entire time they are disintegrating.  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.  The addict’s main purpose in life is getting the substance and using.  They will do nearly anything to keep alcohol or drugs their top priority including betraying friends, robbing from them, putting them in jeopardy and causing them harm.

By comparison a depressed person who is not using, is not going to act out in the same way.  Where is the source of depression coming from?  It could be 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. Should a friend confront a depressed person about giving up their disease?  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 is clearly a biological illness 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 with depression is not going to actively attack those around them in the same was as an addict.  For instance, a depressed person usually just shuts down.  They aren’t going to steal your computer to pay for their cocaine habit.

Addicts go to rehab, and usually some type of 12-step program to try to stop using. Depressed people get on anti-depressants, anti-anxiety medication and usually go 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.

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. 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 seek help.  Again since most addicts also suffer from an underlying depression the distinctions between these two illnesses get murky.

I’ve heard countless stories from readers of this blog about depressed relatives and loved ones who isolate themselves.  They verbally demean and attack anyone who tries to help them, and push away any hope they have for a recovery.   Again even in these situations, there is not much anyone can do for the depressed person.  A relative or loved one’s behavior is not going to change their mental illness.   If you’re in this situation, you’re NOT the cause of that person’s mental illness.  If they’re tearing you down, and constantly hurting you, the best thing for you to do is to disengage.   Try to get that person help, but not at the expense of your own emotional and mental well-being.  That’s not the same thing as enabling an addict.  People who give an alcoholic booze, or make it easier for the alcoholic to drink are enabling the addict.  A loved one or relative is NOT encouraging or making another person’s mental illness worse unless they’re either abusing that person or preventing them from getting medical help.

Unfortunately when I battled my disease I had a few friends who blamed me for being sick.  The people who helped me out the most, my friends who had also suffered from depression.  Instead of judging me they listened.  They knew I needed help and tried to get it for me.  I got books, recommendations on therapists, and patience.

I was not choosing to have panic attacks, 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 a sudden and extreme trauma.  I was also suffering from bouts of Post Traumatic Stress Disorder.  I got better thanks to an anti-depressant, therapy and time.  What also helped in my recovery  was my active choice to not engage in self-destructive behavior such as drinking, or doing drugs.

Cognitive behavioral therapy (CBT) is one form of therapy that does help re-train a depressed person’s brain into a more positive outlook.  In his book “Feeling Good“, David D. Burns, MD touts the benefits of CBT but at the same time goes on extensively about the pros and cons of anti-depressants and anti-anxiety drugs.  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 seems, ECT is quite effective in some patients.

With about 30 seconds of research I found this highly misguided group.

http://www.depressionanonymous.org/

From what I could tell the website hadn’t been updated in five years and they were no longer holding meetings. The entire concept of Depression Anonymous seemed to stem from one book, by one woman.   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 who have greatly benefited from AA, NA and other 12-step programs, so I am not sure what to think.

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 self-pity.  What I suffered from and what millions of others suffer from all over the world is a real medical condition that if left untreated can lead to intense suffering, and for some suicide.

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.

Related articles

• Treating Depression: New Research on What Works; Psychotherapist Douglas Baum Says We Can Improve the Odds of Identifying the Right Treatment for Each Patient (prweb.com)
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• *Addiction & Mental illness can go Together* (catherinelyonaddictedtodimes.wordpress.com)
• Growing up with Depression (julietjeskeblog.com)
• Depression is Such a Bitch (julietjeskeblog.com)
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