Extra Help for Mood Disorders
 

The more serious the mood disorder, the more essential family members
and friends are to recovery. Depressed people may be too indecisive or
hopeless to seek treatment. When people are elated, they may fear that
medication will take away their creativity and energy. Becoming thoroughly
informed and using the following steps can help people with mood disorders
understand what is happening to them and how treatment can help:

• Recognize what is happening: The easiest way to spot a mood
  disorder is by noticing your own reaction. If you feel pushed away,
  criticized, or as though you’re the only one making an effort, the
  other person may be depressed. If you feel annoyed by constant
  chatter, late hours, or recklessness, the person may be manic.

• Offer feedback: Assure people that their disinterest, indecisiveness,
  pessimism, poor hygiene, tiredness, and even difficulty feeling love
  are symptoms of depression and not just because they aren’t trying
  hard enough. Elated people may not be receptive to feedback.
  During less euphoric intervals, they may be able to understand how
  they are putting themselves or others in jeopardy.

• Communicate your conviction that help is available and that the
  person will feel better. Get a pep talk from a professional if you have
  your own doubts.

• Arrange and accompany people to initial therapy appointments:
  Before treatment takes effect, depressed people may have trouble
  articulating their difficulties and absorbing what has been discussed.
  Take notes and ask questions that loved ones might overlook.

• Give professionals feedback on early signs that medication is
  helping: Often, the family notices changes before depressed or
  manic people do.

• Maintain as normal a relationship as possible: Don’t give in to wishes
  to withdraw. Engage loved ones in leisurely walks, massages, card
  games, and small talk or read to them. Remind them that enjoyment
  and interest will come in time.

• Assure people that they are still valued: Express affection. Remind
  them that their mood is separate from who they are, that their “old
  self” will return and that they will be able to overlook their manic
  mistakes or temporary lack of accomplishment.

• Avoid criticisms and anything that will aggravate self-condemnation.
  Break tasks into small, achievable steps. Offer to clean with them to
  keep them focused or shampoo their hair. Let hygiene go to minimum
  standards until treatment takes effect.

• Interrupt excessive sleep when people are depressed: Sleeping more
  than nine hours a day can aggravate the problem.

• Avoid cliché questions and advice: “What’s wrong?” “You’re not
  trying hard enough.” “Think positively.” “Try to relax.” “Slow down.”
  Depressed people may be incapable of positive thoughts or of
  verbalizing what is wrong. Such advice makes them feel worse.
  Seriously manic people cannot slow down without medication.

FRIENDLY CAUTIONS

Avoid asking friends and relatives for help who are pushy, disinterested,
inept, or rigid. Attempts to involve them in your recovery can delay
progress. Be cautious of bad advice. Input that makes you feel worse about
yourself is probably not correct. Be especially careful of people, self-help
groups, and even professionals who tell you that medication is a crutch. Do
not argue with bad advice or try to make others understand. Thank people
for their concern and tell them you’ll consider what they are saying.

MEDICATION

Antidepressants and mood stabilizers are safe and nonaddictive. Side
effects will go away with time and “experimenting” to find the most effective
medication. Sedating antidepressants are important when insomnia
accompanies depression. Tranquilizers such as Valium, Xanax, and Ativan
can aggravate depression, but when prescribed with an antidepressant can
be helpful. Stimulants such Ritalin and Dexedrine are energizing but should
be prescribed only under special circumstances in conjunction with
antidepressants. The herb Saint-John’s-wort can be taken when people are
reluctant to use medication if they are not sun-sensitive, at risk for
cataracts, or need rapid results. However, prescription medication is
necessary for many depressed people and most people who have had a
manic episode.

PROFESSIONAL HELP

Counseling is very important when depression is related to a past trauma, a
recent loss, or troublesome thinking, behavior, and interaction patterns.
Even when medication alone eliminates all symptoms of depression or
mania, some counseling is important to help people understand the nature
of their disorder, future need for medication, and ways to reduce stress.

NATIONAL NETWORKS AND SUPPORT GROUPS

Because mood disorders often cycle or reoccur, it can be enormously
helpful to share experience and wisdom with others who have traveled the
same path. Many communities have a local chapter of Depression and
Manic-Depressive Association listed in the newspaper or phone book.

Resources can be found by calling local mental health centers. There are
national networks, newsletters, Websites, and books that offer additional
assistance:

• National Depressive and Manic-Depressive Association and
  newsletter: 730 North Franklin St., Suite 501, Chicago, IL 60610-
  3526, 800-826-3632, www.ndmda.org.

• American Association of Suicidology: 4201 Connecticut Ave. NW,
  Washington, DC 20008, 202-237-2280.

• SPAN (Suicide Prevention Advocacy Network): 5034 Odin’s Way,
  Marietta, GA 30068, 888-649-1366, www.spanusa.org.

• National Depression Screening Project: 800-573-4433.

• Bipolar Network News: 5430 Grosvenor Lane, Suite 200, Bethesda,
  MD 20814.

• National Foundation for Depressive Illness: PO Box 2257, New York,
  NY 10116, www.depression.org

• Polars’ Express (a newsletter): MDDA-Boston, 115 Mill St., PO Box
  102, Belmont, MA 02178, 617-855-2795, mmddabps@sprintmail.com

• General Internet sites and links: www.athealth.com/, www.cmhc.com

• Books: The Depression Workbook by Mary Ellen Copeland (New
  Harbinger Publications, 1992); His Bright Light by Danielle Steel, her
  son’s story; (Delaarte, 1998); Darkness Visible by William Styron
  (Vintage Books, 1992).