I have written stuff like this before, but it bears repeating.
First of all, you need to know this. Anybody can treat depression. Prior to all of the manufactured cognitive approaches accompanied by buckets of antidepressants, the only thing we ever needed was someone to believe in us. Someone that we trusted who, when they told us we were all right and that tomorrow is gonna turn out just fine, helped us settle in to their message of love and support. Once in a while, the depression has gotten so bad that, for a few of us, antidepressants and maybe a stay in the hospital for a while is required. But for the vast majority, depression is not hard to treat all.
There is this thing out there called the diagnostic statistics manual. It is a large but very antiseptic book that defines characteristics within most every emotional malady known to man. The descriptions include a small paragraph with a list of numbered criteria that supports the diagnosis. It doesn’t tell you how to treat a person with these ailments, it just describes what the ailments are. It is very general, very one-dimensional, but can be helpful in at least offering a blueprint about the disorder.
With depression, this book limited the criteria nine points description. Two of which are as follows: hopelessness and worthlessness. So, if you are depressed, you can almost always count on that you don’t measure up in any part of your life and you don’t think that tomorrow is going much better, either. No worth, no hope.
When I first started psychotherapeutic practice in 1991, I really didn’t know my ass from apple butter. I passed all the clinical tests after having studied a boatload of therapeutic theories, but when it came to actually living breathing human being sitting in front of me, I said the same dumb thing that every other clinician in the world always starts out their sessions. I asked the person, “How are you feeling.”
People already know how they’re feeling, and you have a pretty damn good guess, otherwise they wouldn’t be sitting in front of you, now would they?
Instead, I have started thousands of sessions with the following words that have not only been disarming but let the person in front of me know that I not only cared about them and was invested in making them feel better, but I had a pretty good idea of the depth of their sadness and helplessness. I would say, literally to the letter, “Holy crap, I am beyond impressed that you were able to get out of bed today let alone drive to my office. You want a cup of coffee?”
I was always so impressed with the resilience of people and the abject difficulty that they addressed their issues that I couldn’t help let it come streaming out of my mouth.
When you encounter somebody with depression, the idea is to make sure they know you care. This is so annoyingly cliche that I hesitate to even put it in print, but if you give a shit, they’ll know. And if you take the time to listen, looking into their eyes and keeping yourself present to their expression and their feeling, you’ll let them know that they really matter, and that it makes a big ass difference to you that they not only talk about their feelings, but let you into this toxic road of bullshit that they can’t get out of their head.
One time a client said that another name for a “state of depression” is having “a case of the “fuck its.” I so get that. You just don’t give a damn, and if you did, you feel too run down, too low on energy, too hopeless to make the effort.
Your caring for somebody with this awfulness can turn them on a dime if you truly let them know that your life is better for having them in it. Don’t get too grandiose, though. Stay away from big fat statements like, “who you are and why you’re hear is far larger in every fashion imaginable compared to your feelings of the moment.” Unless your Julia Roberts or Anthony Hopkins, delivering a line like that is going to come off cheesy and forced.
I have sat back in my chair countless numbers of times and found myself speechless in the descriptions of sheer difficulty people had to walk through. I would literally tell these folks, “You know what? I don’t know what the hell to say right now. But I am going to cancel the next hour so you can just sit here and say whatever the hell you feel like. Want another cup of coffee?”
The treatment of depression comes down to three things: Time, Understanding, and Attention. Depression isn’t shit compared to an available ear, a loving heart and an attentive and available spirit.
Another thing. No one would ever leave my office without-back in the day-my pager number and now my cellphone number. And I give them homework. One, exercise. Walk twenty minutes in the morning and at night. That is an absolute must, no matter how hard it can be. Two, wake up every day saying this: “Something amazing is going to happen today.” And make sure that you write down three things that happened great in your day before you go to sleep.
And there is one more thing that I have found that you need in your treatment arsenal. I got this from a dear friend long ago. She did this effortlessly and, when she said it, you knew that she meant it: “I am with you.”
Mean it when you tell that to somebody that has depression. They don’t want to go through this alone. Be “with” them on the journey, with the encouragement and direction to follow through with the walks, the statement of possibility, and the three good things that happened every day.
You’ll bring somebody you love back to life again. I promise you will. And it will change the course of their life.
By entrusting us with your feelings, we help you take steps that you see necessary to begin and put forth the energy to make the needed change.
Now notice something: Trust in a coach, mentor, or guide helps you see what's in front of you. We see a Coach for Your Heart a little like an emotional Sherpa, somebody that helps you climb your mountain by pointing out where to best step along the path.
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