What to say to someone who cycles through depression?

[Tap]

I have someone in my life who cycles through severe depression for a few days each month.  (I have no control over this person getting therapy and they have told me that they would never go to therapy. I know they need it, but I can't make them. )  If you deal with these issues or if you have experience, can you give me insight on what I can say/do for this person during these times to be of help to them, or at least just not make it worse for them?  Any books on how to deal with being the person on the outside? This person is connected to my life permanently through a family member, so cutting them out, is also off the table.  (I have family members who are bipolar and this person seems very similar and has what looks like irregular but clearly defined mania/depressive cycles)

 

Example:

I am at the mall on Thursday with my daughter shopping.  This person wanted to come over to my house but we weren't home at that moment.  She texts me a general "when will you be home" and when I don't answer in 8 minutes ( I was driving and hadn't go the text yet) she says " Why do you hate me?".  I call her on my Bluetooth and we have  general conversation of      her: why do you hate me.....me: I don't hate you...her: you didn't respond to my text....me:I was driving, you texted me just a few minutes ago and I don't always respond right away anyways, you know that....her: you didn't respond because you hate me....me: I just brought you hot, homemade cookies at midnight last night to surprise you, if I hated you, I would have not done that....her: I didn't eat any of the cookies, my friends ate them all, I know you hate me.....me: you are going on vacation with me next week, if I hated you, you wouldn't be invited......

 

The conversation continues with a similar pattern for about 5 minutes and then I just tell her we will talk when I get home. UGGGGHHHHH! I then get random texts of general paranoia for 4 hours until we get home and someone can go be with her.  I want to be kind and supportive, but sometimes it is hard to when this person is pushing me further away. But then the depression clears, they are great again and life goes on, until the next rough day. I try to keep calm and just reaffirm the positive and give examples of how we do care for her, but it seems to pointless sometimes, because it looks like a cycle that will never end. I can't avoid her on these days because she has purposefully hurt herself in the past (not suicide, more like cutting etc) if she is left alone.

 

Today I talk to her, she is in a fine mood and we are talking about the vacation, what food we are taking, what days we are going to be there....and everything is fine again.

 

Help! 

 

 

ETA: I want to be supportive and kind and even though I will never say the right thing, I want the person to know that they are loved.  I think most specifically I need help figuring out what to say when the statements are so irrational and just go in a circle, like the example above.   I know this person has no control over the devastation they feel, and can't imagine living in such a scary world, that you feel those who supposedly love you, actually hate you.  :0(

 

 

ETA: this person will not get medical treatment/esting for this in anyway.  She doesn't go to doctors unless it is for a specific, significant issue (broken finger etc) and never for general health.

[gardenmom5]

has she had her vitamin d3 levels tested?  they should be a minimum of 50, and just getting them up to 30 can make a huge difference to mood volatility.  so can good quality b vitamins.  stress uses more b vitamins leaving many deficient.  stress and depression have a similar impact upon the brain.

 

they're a good first place to start.  I'm not saying they replace therapy for antidepressants for someone who needs them.  but those should be corrected first (and if someone needs antidepressants, they'll work better.)

[Melissa in Australia]

:grouphug: :grouphug:

[bettyandbob]

How are her health habits in general. Exercise and diet will not solve this problem, but developing a good routine may take an edge off. If it's a routine long enough she may notice that her problems seem worse if she's missed a run or seem better after yoga, etc.

 

So, since you are going on vacation together, maybe start a routine together and after the trip check in with each other to make sure you both are keeping up. If you visit her one day and she seems bad AND you were planning to stay get her to go for a long walk (exercise and being outside). I d put it in terms of her being your partner in exercise, like she's helping you, not you telling her to do it.

 

Really you know she needs professional help, but in your position I'd try to encourage good health habits.

[marbel]

Can you talk to other family members to enlist their help?   I'm wondering if she is your SIL married to your brother; if so, what does he have to say?   (Obviously I  might have that family relationship wrong!)   Or your husband's sister - what does he has to say about it?

 

When she is not in a depression cycle do you talk about it?  If she is an an up mood does she forget about the times she is down, or brush them off, or deny it?   A relative of mine used to tell me I was overreacting to her; that's when I started limiting contact.

 

I have known a couple of people like this.  Honestly, I have had to limit contact with them because their problems, which they admitted to but refused to seek help for, were starting to affect me and my own family relationships.  I understand that's not possible for you but if you have someone to share the burden with that might help.

 

Remember if this individual does hurt herself it will not be because of anything you did or didn't do.  :grouphug: :grouphug:   It is a hard thing to deal with.

[Plink]

I have a similar person in my life.  Pointing out the obvious is often helpful to get him out of a loop.  

 

"You sound scared."

"This really worries you doesn't it."

"It isn't easy to feel anxious."

"I can see how upset this is making you."

 

I'm not feeding the circle by saying that his perception is wrong, yet I'm acknowledging his pain.  Sometimes the admission of fear is enough to get him to realize that the true problem isn't the issue he is discussing, but something inside his own mind.  Sometimes not.  

 

You are a wonderful person to want to help.  Sending you hugs.  

[Aura]

Your story sounds similar to mine. One of my sisters suffers from mental problems and is paranoid and even delusional. She is supposed to be on medicine, but she keeps coming off/trying to come off. She won't see a counselor. She insists that she doesn't need a counselor or the meds...or at least once things calm down, then she doesn't need the meds anymore.  :glare: (Things calmed down BECAUSE you were on your meds!) She does nothing through diet or exercise or any thing that would be helpful. She refuses to acknowledge that she has a problem...it's all someone else's fault that there are problems. (My sis's issues are more constant and less cyclical.)

 

I try not to say anything that encourages her paranoia. When she gets on one of her rants, I listen and ask questions to clarify (she often contradicts herself so she can be confusing) and then try to change the subject: Can I get you something to drink? Do you want to go inside/outside?...That kind of thing.

 

And I don't initiate contact, as sad as that is. I don't know how to help someone who refuses to acknowledge she has a problem. I don't want her issues to pull down my family, particularly the kids. And I don't want to enable her, either.

 

I don't know whether I should directly confront her paranoia, "You are imagining things. No one has hacked your Facebook account (or whatever). Have you talked to a counselor about this?" or whether I just continue to keep my mouth shut.

 

 

 

I don't want to hijack your thread. I'm just wondering in cases like yours and mine, cases where people refuse to acknowledge that they have a problem, is it better to pass the bean dip or to challenge the false assumptions? And by better, I mean better for the person who is mentally ill.

 

[alef]

I have a similar person in my life.  Pointing out the obvious is often helpful to get him out of a loop.  

 

"You sound scared."

"This really worries you doesn't it."

"It isn't easy to feel anxious."

"I can see how upset this is making you."

 

I'm not feeding the circle by saying that his perception is wrong, yet I'm acknowledging his pain.  Sometimes the admission of fear is enough to get him to realize that the true problem isn't the issue he is discussing, but something inside his own mind.  Sometimes not.  

 

You are a wonderful person to want to help.  Sending you hugs.  

The type of validation LibertyH describes may help, it is giving verbal recognition to the reality of the person's experience without casting judgments on that experience. 

 

I doubt that trying to change these person's thought patterns while in the grasp of a depressive episode will do any good. Do be on the alert for any signs of suicidality. There is not much you can do when an adult refuses necessary mental health care.

 

Edited to correct auto corrects incorrect correction...

[Plink]

Do be on the alert for any signs of municipality. There is not much you can do when an adult refuses necessary mental health care.

 

Municipality?

[Aura]

Municipality?

I was wondering about this, too.

[Ottakee]

This is soooo tough as there really isn't much you can do if they won't see a doctor and/or therapist.

 

Like someone else mentioned, if they do start meds and they work well, they feel better, and then therefore don't need the meds anymore and stop taking them. Well, they were doing so well as the meds were working well. It becomes a vicious cycle.

 

Some things that can help (but certainly are not replacements for doctors and therapists) include:

Vit D levels up to a higher end of normal

FIsh oils---about 1000mg of EPA per day (not just total fish oil)

Exercise

OUTSIDE time

regular sleep/wake times

a diet higher in protein and less refined carbs

something the "Need" to do so that they have a reason to get up, get out of the house, etc. daily

 

Make sure you take care of yourself and your sanity as well as it can become very draining trying to deal with someone with a mental illness when they won't seek help.

[alef]

Municipality?

:cursing: auto correct... was supposed to say suicidality...I'll go back and fix that

[Plink]

LOL  I actually googled and tried to figure out what in the world I was supposed to be alert for.  

 

Autocorrect hates me too.  I once typed ski and it was changed to skin.  Ever invited someone over for some fun skin time?  Yikes!

[PinkyandtheBrains.]

This almost seems like severe PMS.

If it cycles monthly it may be PMDD

[PinkyandtheBrains.]

has she had her vitamin d3 levels tested? they should be a minimum of 50, and just getting them up to 30 can make a huge difference to mood volatility. so can good quality b vitamins. stress uses more b vitamins leaving many deficient. stress and depression have a similar impact upon the brain.

 

they're a good first place to start. I'm not saying they replace therapy for antidepressants for someone who needs them. but those should be corrected first (and if someone needs antidepressants, they'll work better.)

Upping my Vit D made difference in so many areas of my health including monthly cycles. My doctor prescribes 50000 iu weekly dose for me. I get tested every three months to make sure my levels are okay.

 

Worth checking since it's a simple fix if it helps.

[Flowing Brook]

I am going to second the severe pms.  I know a lady that just falls apart every month. Thinks people hate her and are saying things that they are not. She thinks the world is coming to an end. It is terrible. The rest of the month she is amazing to be around.  If I were you I would recommend she see a doctor.  Also she should  chart her cycles to see if this could be the case

[Unicorn.]

Agree with severe pms/pmdd.  If it's just a few days a month, this is likely the cause.  I have similar reactions, but learned a long time ago to recognize it.  I can either get severely depressed, or extremely angry, or both. I'm not talking normal pms moodiness.   As soon as I catch it, I go and take Ibuprofin.  I don't know why it works for me, but it does.  I do think taking vit d3 would help tremendously, as does physical exercise and  getting outside.  The hard part is forcing one's self to get out and get moving, but it does help. 

[Tap]

Thanks for the great ideas so far.  I appreciate it so much!

 

 

 

It does not seem to correspond to her cycles. PMS/PMDD were my original thoughts when I met her. I have watched for that, but I have seen it be before, after or in the middle of her cycle.   She is on the pill so she is regulated and it doesn't seem to correspond. 

 

The cyclic behavior is more of a predictable roller coaster than a time based cycle. It seems to happen every 3 weeks or so, but it does vary too.  Extreme happiness (like Christmas morning happiness on a random Tuesday afternoon) with very high energy, and boisterous behavior for a day or two, followed by a day of edginess and then a couple days of depression with day one being the worst (you hate me), day two being just sad/reflective (Let hash out all of our past issues-again), day three being sad/getting better (lets hug and spend time together).  Then there are a couple of week of average behavior.  For most of the month this person is great!  They are fun and loving...it is just that the 3-4 bad days that are really hard to handle.  I only deal with it a minimum amount of time, but I really feel for the person who is in the relationship with them. The partner is very forgiving of this time and all of the accusations that come along with it, but it gets old and and is wearing them down too.  I only get 'you hate me' the other person gets accusations of cheating and what not.  

 

I am going to head into an area with limited internet connection for a few days so I may not be able to respond to this thread but will still be able to read it. (It takes a long time to upload.) If it seems like I dissappeared, I just can't post but am still reading, I promise!

[alef]

It does sound rather like  bipolar.  She should really be under a doctor's care. Lithium is often used to treat bipolar disorder, and there are over the counter lithium supplements that some people use to regulate moods. If she would be open to trying a supplement it might be worth considering, though I am cautious about suggesting anyone try to self medicate for such a condition.

[Laurie4b]

This doesn't actually sound like depression. It sounds more like borderline personality disorder (the manipulation of the paranoia, the cutting, not being able to stand being alone)  for a few days a month and that doesn't make sense at all (personality disorders don't occur a few days a month). I think the folks suggesting something related to the menstrual cycle are likely to be right.

 

I would talk with her during her normal times about what you can do to help during the off times. First of all, explore how self-aware she is. "Have you noticed that there seem to be times when you're not yourself?"  Be descriptive not interpretive: "What should I say to you when you say that I hate you?" vs. "What should I do when you're paranoid? " 

 

Right after she's acted odd, try to find out where she is in her cycle .

 

She may be more willing to go to the doctor about a hormonal problem than a psychological problem. (There may be less stigma in her mind.)

[Farrar]

Well, I clicked on this thread prepared to say, "ignore it" and "nod and say vague, supportive things but don't let it get to you."  Because that's how my dh is.  He has taken medication for his anxiety and has had therapy.  He just has these periods of mopiness anyway where he has to question everything. I've learned to ride through it and let it be.  It's just him.  I now have a much longer view of it - that it's a small fraction of his life, that most of the time he's fine.  That overall it's not that bad.  And that there is no "right thing" to say.  I mean, it's like a glitch that will clear itself up if I don't mess with it and just smile and am nice.  There's no way to "fix" it.

 

But what you're describing is just borderline abusive.  Honestly, I would maybe confront her about it when she's in a good space and say that you really understand that this is her mood cycle and you love her but that you can't be her punching bag when it comes around.  Maybe say to her that if she's feeling down and paranoid and angry to just say that to you and you'll text or say nice, supportive, reassuring things back every time, but you shouldn't have to listen to the accusations.  Really, it sounds like she's using you to give her the words she needs, but that really needs to be an internal conversation.  When she has a thought like that, she needs to respond to herself with the kind of logic you're giving out.

[Jean in Newcastle]

I agree with it sounding bipolar.  

[DianeW88]

Well, I would probably avoid this person as much as possible.  This type tends to be soul-sucking to all of those around them.  It would be a different story if the person was getting help, trying to address the issue, and needed support.  What you have is a black hole.  Don't fall into it.  And that is soooo hard not to do.

 

I had a bipolar college roommate who refused to take her meds, and refused all treatment with counselors.  I had to move out.  And, I understand that  you may not be in a position to dismiss this person from your life as easily as one can with a college roommate.  But I would try to minimize contact until she decides to get help.  It isn't worth your own peace of mind and accelerating stress levels.