Depression (from the Outside)

Depression (from the Outside): The Balancing Role of Love

We have considered depression from the inside. It can also be devastating to those on the outside.

Consider the situation of a family of an adult child suffering from severe chronic depression.

The child may have lost all assets, have a failed marriage, be unemployable, be on the streets. The child has no energy, and simply huddles in gloom. Does not respond to efforts to help or encouragement. There seems to no fix or end, and the child seems to lack any initiative to undertake or follow through on steps that might help. The specter of suicide is always present if the depression is deep.

The parents flounder in loss and frustration. Fear and guilt harp that they should do everything possible, and yet, they do not know what to do, nothing has worked to date, and they wrestle with their own needs, limitations and exhaustion.

So, what of love? Does it provide guidance?

Consider two scenarios.

In the first, the parents, probably in their late 40’s, 50’s or 60’s, have the child move in. They choose to do whatever possible.

The child sequesters himself in a bed in a dark room. Comes out only to eat, and then with minimal or no talking. The child may or may not take the changing batteries of pills prescribed by physicians. The parents try to engage, encourage, to no effect. They try to install a routine since they have heard that might help. No effect. The child does not move or follow routines without regular prodding, and then only reluctantly and for the moment.

To the extent not otherwise covered, they pay for medical counseling, drugs, therapies. They attempt to have the child join support groups. Again, the child does not keep appointments unless they prod and take him. They need to clean, cook, wash the child’s laundry. Get him to take showers. A gloom hangs over the household. At some point, they may be afraid to leave the child alone if the depression is too deep.

If there are other children in the house, they breathe in the darkness and cannot help but be affected. They cannot have friends over. They wonder if they also have a “gene” or whatever it is for depression. They feel abandoned as the parents’ energy and time focus on the depressed child and the “situation.” They cannot wait to leave. They themselves may fall into depression, anger, escapism or other dysfunctional behaviors .

The parents see this as well. And are further conflicted.

The parents’ finances and retirements dwindle. They fall into the trap of living in the depression of their child. As days move into months into years, hopelessness and depression sets in for them as well. They are exhausted. The dreams of a secure and peaceful retirement have dissipated into a dark reality.

Without question, the parents are acting in love. But love does not demand martyrs. As in many trials, love does not require passive acceptance of a grim situation, but rather allows for a pause, refocus and considered approaches. The latter is a valid choice.

Consider a second scenario.

The parents take a breath and consider all needs (themselves, the depressed child, others who may be affected), resources (government financial aid and programs, medical, support groups, residential assisted-living homes), costs (financial, emotional, relational, health) and options that are most likely to best address the various aspects of the situation. It is a hard situation. Nothing will be perfect. They accept that. They will do the best they can. And hope.

They may instinctively establish some emotional distance to protect Self, objectivity and some level of energy. That is okay. It is not abandoning the child. Self-preservation is not selfish or a failure. The detachment may help them cope and more effectively assess needs, resources and options.

They consider their needs, including the need for them to retain energy and wellness if they are going to be effective (and, still have some form of life beyond the doors of depression). They realistically assess their financial and emotional resources. They want to be “there” for the long haul to the extent reasonably possible, but that means that they also need to be mindful of themselves. They assess their strengths: what they, as parents of an adult child, may give that is unique and supportive, beyond the outside resources of medical and counseling treatments.

Depending upon severity of the depression and availability, they may seek group homes or other settings that offer counseling and continuing support for the child. The parents maintain regular contact, let the child know of their love, even if the child does not visibly respond. Somewhere, in the back of the child’s mind, the reaffirmations of care may perhaps help with the feelings of abandonment and isolation.

In the interim, they remain mindful and talk with others who may be affected: see how they are doing and their needs. They discuss and establish a plan and limits on what they and other family members can and are reasonably able to do under the circumstances.

As a reality check, parents and other family members typically do not have the training, detachment, energy or time to work with deeply depressed individuals, 24/7, over extended periods of time. They are not professionals. Their personal options are really pretty limited and they need to accept that. One of the best things family members can do, consistent with their resources, is simply marshal up professional and care resource options, try to get the child connected, check with the professionals on the support roles that they can best provide, and continue to let the child know of their care.

The two scenarios may or may not be wholly realistic, but are presented to make a point. In each, the parents are acting with love. The question is which is more likely to be sustainable in the long run? Which is more likely to embrace love for all concerned in a very tough situation? Which is likely to allow retention of at least some joy in life?

In these situations—as in situations involving drug addiction, alcohol addiction, mental illness, dementia and other plagues of the spirit—love allows a realistic assessment and balancing of multiple needs, resources and options. It is a love of many factors, including the “forbidden” consideration of self, and others who may be affected. It is a pause and assessment. It is a realism and consideration of what resources are reasonably available and sustainable.

And if the child dies: from an overdose, alcohol, suicide. What then?

Typically, there will be a time of guilt-infused “what if’s” intermixed with numbness, sadness, and exhaustion. Questions of whether something said or not done could have made a difference.

The short answer is “No.” At some point, the depressed child—faced with a life in shambles, seeming inability to recover, feelings of isolation, crushing waves of dark, and the seemingly impossible task of rebuilding—may have simply have chosen to stop the pain. The wave of darkness and pain overwhelmed the will to live. If psychologists, medicines, professional therapeutic treatments could not save the child, what more could the parents have realistically done than to give their love and contribute what they reasonably could? The child is at peace. It is done. It is time for the parents to now also make peace and move on.

No approach, decision or plan is going to be perfect. All approaches will have some costs. There may be mistakes or approaches that do not work. Love does not require perfection. It rather favors understanding, kindness, and, in this instance, a balanced, considered and multi-factored approach.

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