We often talk about depression, but it usually happens from the point of view of the disease and the patient, how it affects people and what are its diagnostic signs and what are the treatment options available to deal with a condition like that, but in the midst of that we treat ourselves - as companions, friends or family of the depressed person as a party Neutral, and ineffective in this process, which is a big mistake, increasing in size on holidays and joyful occasions, which for the depressed person stands in a completely opposite area.
black cloud
Depression is one of the most prevalent mental illnesses globally, trailed by only anxiety disorder, which affects about 14% of the world's population (1).
Depression belongs to the list of "mood disorders", so its most important symptoms are feeling sad continuously for more than two weeks, in addition to several other symptoms that affect the quality of life, the productivity of the individual and his social relationships (2).
Anxiety disorders, on the other hand, have a list of their own, however, 60% of depression cases have symptoms of an anxiety disorder and vice versa, as these two disorders tend to occur together in the same person (3).
Concerning our Arab region, depression prevalence is approximately 13-18% among all groups, but women have twice the number of cases compared to men (4).
When we talk about depression, we have to take into account all age groups, including children and adolescents. Contrary to what some might think that depression is an adult disease, but according to the World Health Organization (WHO), it is present in 1.1% in children between the ages of 10 -14 years, increasing to 2.8% in adolescents aged 15-19 years (5).
Therefore, depressive symptoms that may appear in children at any age should not be neglected.
Children may also suffer from depression (communication sites)
On the other hand, the chance of developing depression increases with age, with the proportion of depressed patients over the age of 60 years reaching 13.3%, according to the latest systematic review, published in Neuroscience and behavioral reviews in January 2022. (6) There is no single factor responsible for depression, but rather it happens as a result of the combination of several genetic, environmental and psychological factors that work together to create this disorder, as well as determine its severity and impact on the individual, so any individual may be exposed to depression if the presence of these agrees factors together.
Eid sorrows
Holidays are meant to be festive occasions, when families and friends gather around feasts, have fun, and enjoy a relatively long vacation away from work.
But the holiday period carries its own concerns, which may affect anyone with the so-called "Holiday blues", meaning the sadness that afflicts the individual during the holiday period, so what if the person is already suffering from depression?
According to a 2014 report from the National Association of Mental Illness (NAMI), 24% of people with some kind of mental illness (such as depression or anxiety) report that holidays make their symptoms worse (7).
Therefore, the holidays may be a burden for the depressed patient, and cause exacerbation of symptoms, rather than an opportunity to enjoy with the family and recreation away from work.
The reasons for this burden vary between the great financial burden that the head of the family bears in particular, such as new clothes, a lot of food, gifts and greetings, and the high expectations of all family members of the necessity of “feeling happy” on Eid, which is often not achieved, which leads to more frustration.
Perhaps the feast is a reminder of loved ones who are not here today, which creates a feeling of loneliness despite the hustle and bustle of family gatherings (8).
(For more, read the Meydan report: A feast without a "chokehold"... Your guide to overcoming the festive depression).
Watch the signs
The role you will play in your friend's life depends on how strong your relationship is, and how much secrets and feelings you share.
You probably already know that your friend is depressed or anxious, is seeing a psychiatrist, and may be taking one or more medications.
Perhaps your friend himself does not know that he has one of these disorders, but is suffering in front of you, so it is useful to be aware of symptoms of depression or anxiety and try to identify them in those around you as a first step towards help.
Of course, you can't play the role of the doctor and rush to diagnose your friend, but you may notice some symptoms that indicate a problem, and call for a friendly talk with your friend and advise him to see a doctor.
Everyone suffers from a feeling of sadness and a desire to isolate from time to time, and perhaps loss of appetite, sleep disturbance, and a feeling of frustration with life circumstances, but it is not necessarily evidence of a problem.
The problem begins when these symptoms exacerbate to the extent that it affects the daily life of the individual, hinders his self-care and cleanliness, and pushes him to leave work or neglect his responsibilities, or when he begins to talk about death and self-harm (9).
A depressed patient suffers from constant sadness, desire for isolation, and a feeling of hopelessness in life.
(communication Web-sites)
In addition to the previous symptoms, you may notice that your friend has become less talkative than usual, slow-moving, forgetful, feels guilty and empty, and has lost interest in the hobbies he used to enjoy.
You may also notice symptoms of an anxiety disorder, such as worrying excessively about the future and loved ones out of proportion to the real course of things, excessive nervousness and constant tension, difficulty sleeping and loss of appetite, or even extreme fear of one thing, or fear of leaving the house ( 10).
Keep in mind that women and the elderly are more likely to have these disorders, but that doesn't mean that children and adults are off the list.
Helping hand
Now you know your friend is in real trouble and needs help, but you need to be careful about talking to him about it, so that he doesn't turn off help altogether.
Mental illness and treatment by a psychiatrist still carry a social stigma around the world, and perhaps especially in our Arab region.
In fact, your friend may be well aware that they have a problem, but refuse to go to the doctor to escape stigma and abuse.
You should learn to use appropriate, neutral language when talking about mental illness, not only between you and your friend, but during public gatherings and discussions as well.
You may be well-intentioned, but if your friend hears you mocking psychiatric patients and calling them crazy at one time, how can you expect him to trust you when you try to convince him to visit a doctor?!
Here it is necessary to separate the person from the disease, as if you say so-and-so suffers from depression or anxiety, and not so-and-so is depressed and anxious, because mental illness does not define the personality of the sufferer.
Using the right language when talking about mental illness, and correcting others when they speak in a way that stigmatizes the mentally ill, may lead your friend to trust you and turn to you on his own, so keep this in mind at family and friend gatherings (11).
The other thing is to underestimate the complaint of a mental patient, especially someone with anxiety or depression.
For example, your friend expresses his sadness or inability to get out of bed in the morning, and you tell him that it is normal and happens to everyone, and then you start comparing his condition with yours.
A person needs 'validation', to believe that his suffering is real, that what he feels and what he is going through is really difficult, and that he is not pretending to be sad or trying to get attention.
You may not understand what your friend is going through because you haven't been through it before, but giving his talk credibility and empathy gives him a sense of safety to talk to you, which gives you a real chance to help him.
Choosing the right time and place to talk is also a very important factor. It is better to speak from person to person rather than in a large group facing one person, in a private place so that no one can hear you talking.
It's also important to pick the right opportunity, when your friend is in relatively good shape, not overburdened or stressed, as these factors may affect his or her receiving your speech and not giving it enough weight.
It's important to lower your expectations of him responding to advice the first time, always expecting that your talk will be met with resistance, denial, or downplay from your friend.
It is best to talk to your friend in a private and quiet place, at a time when he or she is not stressed or stressed.
In that case, you can use some persuasion strategies, but gently, calmly, and without coercion.
Use your relationship as a motivation for your friend to seek help. Tell him that the help of a specialist will positively affect your relationship, and his relationship with everyone around him, without making him feel pressure or guilt towards you.
In the meantime, be sure to mention the good things about your friend, and all the positive qualities that you like about him, so that your message is “You are a good person, and I hope to see you better” rather than “You are a bad person, and you should improve yourself.”
A depressed person may feel unloved and hopeless in life, so your words may give him some hope.
Also, you can draw his attention to specific behaviors and situations that represent the problem you see, without attacking his person.
If you want to tell your friend that he has become more nervous lately, use statements that begin with "I" instead of "you", in addition to believing, such as saying, "I know that you are suffering and that you do not mean to hurt anyone, but I am concerned that your nervousness has increased in recent times." This may hurt others, do you agree with me?"
After you have earned your friend's trust, offer them real help, such as going with them for their first psychiatrist appointment, providing them with some addresses and numbers of trusted doctors, or even trusted online psychotherapy services (12).
psychological emergency
Well, you have already succeeded in convincing your friend to see the doctor, but that is not the end of the day, in periods when symptoms of the disease are exacerbated, you have to be more careful in monitoring your friend.
In 2019, 700,000 people worldwide lost their lives due to suicide, and depression is a big factor in this number (13).
It is common for people to think that people who talk about suicide a lot do not really want to commit suicide, and that those who want to end their life will do so quietly, but this is a completely wrong belief.
Pay attention to warning signs of suicide, such as your friend repeatedly talking about wanting to die, or wanting to kill yourself, or wishing he hadn't been born at all (14).
Pay attention to the warning signs of suicide, such as your friend repeatedly talking about wanting to die, or wanting to kill yourself, or wishing he hadn't been born in the first place
Not only that, but just being preoccupied with talking about death and violence, abrupt withdrawal from social life and wanting to be alone as well.
Your friend's thoughts may reveal themselves when he says goodbye to those around him as though he'll never see them again, or heeds his will at an inappropriate timing.
Also, be careful if you notice that your friend has become reckless while driving or crossing the road, or has started or increased drug or alcohol use.
You need to be prepared with a specific contingency plan, especially around the holidays when everyone is busy partying and you may not be able to contact your friend's doctor in time.
Keep the emergency numbers for your country and the address of the nearest hospital that can handle suicides in case the worst happens.
In the end, the person with depression needs a strong support network of family and friends, who can understand and accept him, and do not stigmatize him or shun him away, because he feels worthless and hopeless in life, guilt towards everyone, and a loss of desire for everything, even helping himself.
Don't just learn how to deal with a person with depression, but also talk to your friend and ask him what he likes and how you can help him, but don't promise him what you can't do or he will lose his trust in you.
Finally, remember that you are not a psychiatrist and you cannot help your friend alone without professional help, and accept that there are limits to what you can do for your loved one and that there is nothing wrong with that.
———————————————————————
Sources
1- Mental health statistics 2022
2- Depression (major depressive disorder) – Symptoms and causes – Mayo Clinic
3- The Comorbidity of Anxiety and Depression |
NAMI: National Alliance on Mental Illness
4- Depression: Prevalence and Associated Risk Factors in the United Arab Emirates - PMC.
5- Adolescent mental health.
6. The global prevalence of major depressive disorder (MDD) among the elderly: A systematic review and meta-analysis - ScienceDirect
7- Mental Health and the Holiday Blues |
NAMI: National Alliance on Mental Illness
8- Holiday Depression Triggers What Causes Holiday Blues?
9- Helping Someone with Depression
10- Anxiety disorders - Symptoms and causes - Mayo Clinic
11- How You Can Stop Mental Illness Stigma |
NAMI
12- How to encourage someone to see a Therapist |
NAMI: National Alliance on Mental Illness.
13- Suicide worldwide in 2019.
14- Depression: Supporting a family member or friend – Mayo Clinic