It's common to feel confused, lonely, or hurt when you watch someone you love go through a hard time. Even more so, it is natural to feel a sense of concern for a loved one who is experiencing symptoms of depression and to wonder what the best way to support them is.
You’re not alone in this process. According to the Anxiety and Depression Association of America (ADAA), in the United States, in 2017, 17.3 million adults over the age of 18 lived with depression. In addition, Persistent Depressive Disorder (PDD) affects approximately 1.5 percent of the U.S. population in a given year (about 3.3 million American adults).
What is High-Functioning Depression?
High-functioning depression or Persistent Depressive Disorder (PDD; formerly called dysthymia) is a form of depression that typically lasts at least two years. On the outside, people suffering from PDD don’t display many signs of a mood disorder. For the most part, they can work, maintain their household, manage interpersonal relationships, handle parental responsibilities, and to some extent, they seem to enjoy their lives.
But, with high-functioning depression, external appearances are deceiving. On the inside, individuals dealing with chronic, low-level depression feel empty and unmotivated. They manage to put on a good show, but they feel physically, emotionally, and spiritually drained by their unsatisfying and inauthentic existence. The depression they experience is as real as the depression of a person diagnosed with major depression. Still, their symptoms manifest in a muted form, sometimes detected only by people very close to them (e.g., their partners).
Symptoms of High-Functioning Depression
The primary symptom of persistent depressive disorder (PDD) is a low mood for most days over two years for adults and one year for children and adolescents.
Other symptoms of dysthymia may include:
- Poor appetite or intense hunger
- Getting too much or too little sleep
- Low energy and feeling fatigued
- Poor self-esteem and self-worth
- Limited concentration and decision-making
- Feeling hopeless or pessimistic about the future
- Similarly to other conditions, these symptoms cannot be explained by another mental or medical condition. In addition, these symptoms must have an adverse impact on functioning.
How To Support Someone with PDD
1. Learn about depression
The more you know about depression, the more equipped you’ll be at responding to the potential changes in how your partner feels, thinks, and acts. Be aware that there are various types of depression. Like PDD, some types may be more difficult to detect; because people can go on with their usual routines. Others, like postpartum depression, may be directly linked to life changes. Learning more about these types of depression can help you detect symptoms, alert, and understand your partner.
2. Help them open up and identify their emotions
People struggling specifically with PDD put on a good show, despite feeling physically, emotionally, and spiritually drained. Creating a safe and supportive environment for them to open up and express their true feelings to you- without judgment- is already a huge step. Giving them the room to safely display some signs of their mood disorder is the first step towards them exploring, relieving, and coping with their emotions.
3. Be an active listener
Nobody is expecting you to know everything about PDD, but you can always listen to what your partner wants to share on the matter. It would be valuable to your partner to feel actively heard throughout their experience. Active listening requires listening attentively to the speaker, understanding what they’re saying, responding and reflecting on what’s being said, and retaining the information. The six primary active listening skills involve more than just hearing someone speak. When you’re putting active listening skills to practice, you should use the following six techniques: paying attention, withholding judgment, reflecting, clarifying, summarizing, and sharing.
4. Ask how you can help
Other than listening to what is being shared, you can also openly ask your partner what they need or may find helpful. Each of us may need something different when we’re feeling down. Hence, open communication is crucial. It’s important not to assume what your partner needs or doesn’t need. Instead, ask them directly. Also, understand all answers you may get. For example, you can ask:
- How is your energy level today?
- Is there anything you would want to do right now?
- What activities felt good the last time you felt this way?
- How can I best support you? What do you need from me right now?
- Would you like to spend time alone today, or would you prefer to hang out with others?
5. Find activities to do together
If your partner finds a bit of motivation and has the will to spend some time on an activity, you can propose and arrange indoor or outdoor activities with them. Based on what you know they usually like or find meaningful or based on ideas on this chart, you to plan an activity together.
6. Don’t take it personally
Be aware, chances are that your partner will not enjoy the activity as much as you want them to. Still, engaging in activities can generate some positive feelings in the depressive cycle of emotions. Their mood may be negative, irritating, or upsetting, but this does not have to do with you. Additionally, note that besides activities, depression can affect: sex drive, intimacy, communication, and romantic needs.
7. Keep it in perspective
It may be essential to remember that this is more than just the blues. Depression is not a personal choice — it’s a medical condition. This is comparable to someone with a broken arm. They can’t mend it back together at will. If they could, they would have probably done so already. For example, if your partner is having difficulty keeping up with chores, they aren’t being lazy or trying to get away with doing less around the house. It may be helpful to watch this video or play this game to understand better what living with depression feels like. Depression can make even the simplest tasks feel exhausting. If you live together, sit down as a couple and figure out how you can work together to get both of your needs met. If something they usually take care of feels like too much right now, consider asking them what they feel they could better handle at this time. For example, watering the plants may feel less tiring than washing the dishes.
8. Stay Flexible
Depression can affect someone’s ability to participate in everyday activities. Someone experiencing depressive symptoms may intend to go out with you on Saturday night, but when the time comes, their mood has shifted. This mood shift reduces the motivation to get out of bed. It’s not because they’re not trying hard enough! Don’t blame or shame them for breaking plans; stay flexible, and consider alternative activities within their comfort zone instead. Instead of going out for dinner, maybe you can spark their interest by suggesting cooking homemade food together. Instead of going to a party, stay in, drink some wine, and talk in a cozier atmosphere. Sometimes they may simply need some alone time; try to be respectful of their needs, remembering not to take it personally.
9. You are not there to fix them
We live in a reality of constant problem-solving. When an issue pops up, we feel very distressed with its occurrence. In addition, we usually feel the urge to resolve it; whether it affects ourselves or somebody we care about. The truth is that whatever we do, emotions will be coming and going; sometimes generating enjoyable feelings; sometimes not. Feeling the urge to escape from them can immediately backfire. Think about it like this; you place your index finger at one end of a tube and pull to free it. The grip only gets tighter. The harder you pull, the tighter the grip becomes. Alternatively, if you push your finger further into the trap and move it around a bit, the grip loosens and your finger can actually be removed. Removing your finger from the tube's hold needs time, unrushed moves, and patience. Similarly, there are no quick fixes for depression. Instead of pushing towards a “magical” resolution of the negative emotion, you can accept your partner’s feelings and confusion; ask them what their triggers are, what they do to cope, and what part they want you to play in their coping strategies.
10. Encourage them to seek professional support
Encourage them to seek professional support. As much as you want to support them, you are not your partner’s therapist. It’s important to recognize your limits and encourage seeking out professional support. You can gently suggest: “I think you’re doing a great job handling this; I bet it’s not easy. I want to see if we’re doing everything we can to get through this. What do you think about working with a therapist to give us more tools to work with?”. If that turns out to be an option for you, make sure you are supportive during the treatment; emotionally and practically. For example, encourage their effort and make sure they find time for therapy.
11. Take care of yourself
We are not saying it only to be nice to you; we mean it. You need to be supported and healthy yourself. So, make sure you engage in some self-care in order to support your partner fully. You are also experiencing emotions. You should not undermine, nor underestimate the emotions you face; compared to what your partner faces. All emotions and needs you are experiencing are valid and important too. Thus, secure some time and space for yourself.
Written by Alexandra Symeonidou, Intern Psychologist at AntiLoneliness
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