In episode 283, I received a question from a listener who is concerned about their sister who struggles with depression and views life through an increasingly negative lens, In this post, I dive in and offer my thoughts, giving advice on helping to understand the situation and provide the support that might be needed.
Hi, this is a question for the podcast. My sister has been depressed on and off for over 20 years and has taken medication for much of it. Recently she has been diagnosed with ADHD and now takes medication for this although it has made no difference. I’m writing because she is in a place of sheer overwhelm and extremely low. Although her actual life is totally fine (although tiring as she has a 1 and 3 year old), she sees everything with an intensely negative lens and is extremely self-absorbed in the most negative possible way. I have always been someone she talks to and will continue to be but I just don’t know what to do or what she should do. She gets trapped in a negative spiral which links to terribly low self-esteem. She is especially bad at the moment and may be heading towards a breakdown. I am so worried about her but also so frustrated as nothing bad is happening in her life and the so I’m not sure how to help. If you’re able to talk about this problem on your podcast then I would be so grateful. Thanks so much for reading this and for your podcast in general.
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.
You can listen to this on Episode 283 of the podcast!
Thank you for the great question!
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