My Thoughts

Thank you for the question. I hear a lot of care in this question, but I also hear a lot of judgment. Her experience is clearly different from your own internal experience and it is hard to put yourself in her shoes and imagine how she can feel this way. I understand where your frustration comes from. It can absolutely be hard standing on the sidelines of someone’s depression, especially if that person is a family member. Trust me, as a therapist, it can definitely be difficult at times to see someone’s situation from the outside and see the things that could be helping them. What seems like an obvious answer or low-hanging fruit to me might seem impossible for them to grasp.

But that’s how mental health issues work. They wouldn’t be a problem if they were easy to solve. There are certain cleaner issues like grief or reactional depression due to a big change in life circumstances that are simple enough to understand. But things like chronic depression don’t work the same way. They are often inherently illogical, which is also frustrating for the person living with it and the knowledge that they “should” feel better just makes them feel even more guilty and feeds into the depression further. I don’t want to be too harsh on you, but you need to realize how it sounds when you say things like “her actual life is totally fine.” That’s not for you to decide. That’s your external evaluation of it. There may be a lot of factors that are good, smooth, taken care of, etc. in her life, but depression is a subjective experience. Especially as chronic major depression is not a reaction to circumstances, it’s a persistent experience that is very self-sustaining.

Having a one-year-old and a three-year-old is also very taxing for some people. She may be still in a phase of postpartum depression with the little one. You also don’t necessarily know what goes on behind the scenes in her everyday parenting life – it could be that parenting is very hard for her, which makes her feel guilty and more depressed etc.

What can you do to help?

So let’s talk about what we can productively do here. It’s awesome that she trusts you and you are a person that she feels she can always come to with issues. That speaks a lot to your relationship and what kind of listener you are. As a family member and confidant, you don’t need to know how to help her. That’s not your job. Your job is to be there for her to the extent that you can. It’s not your responsibility to fix her situation and you are also allowed to have your own boundaries. Sometimes you may not have the space to be there for her in the same way and that’s alright.

You mentioned that she is on medication for her depression, but you didn’t mention whether she receives any therapy. If you feel like she needs to have someone that she talks to who is less afraid to rock the boat and might be willing to challenge her about things, that’s where a therapist comes in. They can provide the accurate empathy necessary to build a good working relationship and then they can use that relationship to help move her toward change. Therefore, it might be useful for you to orient her toward getting some treatment. This can absolutely be communicated from a place of care. Ideally, you are going to try to avoid making her feel guilty or like a burden for bringing these things to you. You could say something like, “I love you so much and I love being someone you come to. I’m worried about you, though. You seem like you are having a harder and harder time. This is something that I can’t help you with because I don’t know how. I want you to have relief, but it doesn’t seem like that’s happening. What about getting some professional help. Do you need help finding someone that you could talk to?”

You need to be honest with yourself as well about how good of a support you can be. You could even tell her that you are too close to the situation to be helpful right now because you get caught up in it too and you don’t want to cause her any further harm. Your role is not to approve of her choices, it’s just to be a sister. You can empathize with her pain without understanding or trying to solve it. That doesn’t mean you have to just drop everything to let her constantly vent to you. You also don’t have to play into her negative spiral by agreeing with everything she says. You might want to focus more on recognizing that she’s struggling, telling her that you care and see her pain, and remind her that she is loved. If you have some practical things you can do to help, cool. But you don’t have to.

Understanding from their perspective

If you do want to understand better, I would encourage some curiosity. Clearly, her subjective feeling is very different from the picture that you see on the outside. You could always bring that up to her and ask her what it feels like. This can be done by saying something like, “I don’t want to make you feel guilty about this, but I just see life so differently and I want to understand more of what life is like for you. I know you’re not making it up, but it’s just hard for me to imagine what it feels like. Can you tell me what depression is like for you? It seems like it doesn’t necessarily matter whether things are “good” or “bad” in your life.”

And again, I’ll reiterate that you can redirect her toward professional help. You can recognize her pain, express concern, and see if she can be nudged toward a therapist or a psychiatrist to re-evaluate whether her medications are working. In the end, she is also allowed to be depressed. She’s presumably not doing anything wrong by being depressed. Unless she’s at risk of harming herself or her family, then you can maybe just let her be. Provide whatever support you can and not more than that. And otherwise, recognize that this is part of how her personality is structured and that it doesn’t necessarily have anything to do with you, even if it is a little frustrating at times.