The following letter shows how depression affects every generation in the family. In our noon Web chat tomorrow, I’ll be joined by the letter writer below and one more person with a history of depression. We will talk about the difference between depression and sadness and how to deal with both. We will also talk about what family members can do.
Dear Dan,
My brother is in his 40s and has been divorced for eight years. His heart was broken unbearably by his divorce as he was still in love and wasn’t expecting this.
He is always just staving off the profound loneliness by throwing himself into his work as a teacher-administrator, marathon running, and similar intense activities. Over these last eight years, I have been an ear for him to share his feelings. He is very stoic but also forthright about his profound loneliness.
He recently cried deep, anguishing tears to me. I sensed all I could do was affirm his pain. I suggested that it is often darkest before the dawn and he reminded me I’ve been saying that for the last year.
I was afraid he was suicidal and I asked him if he would be all right that night. He said he was and reassured me that as distraught as he was, he wasn’t considering harming himself, and I believe him.
Can you offer me any advice to pass on to him? It is so difficult to see him suffer.
– Worried Sister
After eight years of suffering, the problem goes beyond the very human experience of grief and loneliness and becomes a clinical issue of depression. I don’t want to oversimplify this and suggest that if he simply gets treatment for depression (generally psychotherapy and medication are pretty effective), his problems will go away.
If there is a clinical depression, it means that his brain, the organ he needs to work through this, is impaired by an imbalance of neurotransmitters like serotonin.
I want to respect how he experiences his anguish as profound loneliness. I think loneliness is one of the great human fears. And most humans I know do what your brother does, work hard, stay busy, ruminate often, and stay away from our demons.
Almost everyone has experienced the difference between the feeling of loneliness and the fact of being alone. One hurts and one doesn’t.
Loneliness is the pain of grasping for something we think is essential and don’t have. We tell ourselves we can’t survive without companionship. Or that we all feel alone because we are defective or unlovable. Or that this loneliness we feel now will last forever.
Sometimes loneliness is a symptom of depression. When I suffered clinical depression years ago, loneliness and shame were with me constantly.
Your brother can learn through psychotherapy that when his mind is racing, it’s simply a racing mind rather than the voice of truth. And when he aches for something different, it’s just an ache that feels sad and painful.
So he can become less afraid of his own mind.
But even good psychotherapy cannot cure one’s sense of loneliness and isolation. This must be done by expanding one’s lens and caring for more than one’s own pain.
Your brother has many talents that could benefit others. What a great gift to the world if he could get involved with Big Brothers Big Sisters of America or the Boys & Girls Clubs of America or any other charitable group. I have found in my work that reaching out to others not only helps diminish the pain of isolation, it also can lessen the impact of depression.
Your letter also raises a difficult issue of what we can say to a loved one who is depressed. Certainly becoming a cheerleader or motivator creates only more distance. Understanding and empathy are the first steps, but you don’t want to reinforce your brother’s self-pity either.
When someone is feeling sad and distressed, he typically feels out of control, so the last thing you want to do is try to “take over.” So I would simply ask him questions about the big picture: “What would you like to do with your life and how can I help?” “Would you like your life to be different?” “Do you have any ideas about how to make that happen?”
We will talk much more about these issues tomorrow.
– Dan
drdangottlieb1946@gmail.com