Like a thief in the night…

The recent deaths of popular personalities – fashion designer Kate Spade and celebrity chef Anthony Bourdain – have triggered a media frenzy on the topic of depression and suicide.

Many of us may not really know what depression is. Take it from me, I’m writing from experience. Let me point out the reality that the consecutive untimely demise of famous personalities should not be the basis for reaching out to people who encounter depression.

Depression is a sensitive topic to discuss. Some people prefer to sweep this under the rug when the issue is raised. Until of course, it hits home.

What does depression feel like?

You don’t want to live but you don’t want to die. You don’t want to talk to anyone but you feel very lonely. You wake up in the morning and simply wait for the night to come.

Everyone comes to a point in their life where depression comes to us like a thief in the night. Whether it is from abuse or loss of a loved one or financial difficulties, drug dependence or at the throngs of death because of a disease impossible to treat, depression is a slow mortifying event of the mind. It robs us of our happiness, sanity, then dignity.

What drives one to depression?

No one exactly knows. But 10-15% of us will be depressed in our lifetime. Several factors lead to depression, namely:

1. Genetic predisposition

2. Brain chemistry (neurotransmitters) imbalance

3. Female sex hormones (probably explaining why more women suffer from depression more than men)

4. Circadian rhythm disturbance (seasonal affective disorder)

5. Poor nutrition

6. Physical health problems

7. Drugs and alcohol

8. Stressful life events

9. Grief and loss

Why certain people are more predisposed than others may be a combination of the above factors. Suffice it to say, those that have multiple factors above are most likely to be depressed than others.

Dealing with depression

Seek help when you need.

It’s usually denial at first signs.

Recognising the little things that distract you or make your daily routine unusually difficult to bear eventually accumulate over time. We wake up one day, not only denying these, only to find out that those physiologic symptoms (heartburn, abdominal pain, headaches, easy fatigability, frequent urination) are not anatomical problems. It’s probably psychosomatic. The mind controls our whole physiologic function.

Changing lifestyle may be a good option.

The best medicine is seeking for help.

Easier said than done

The problem with depression is that it is filled with so much guilt feelings.

You know you’ll be fine but still feel awful.

You know there are people who love and care for you but doesn’t feel like they do.

You know you want to get better, but don’t know how to get there.

Like a thief in the night…

The only way depression ends is to end it all.

And standing in the sidelines when a loved one is battling with depression can be frustrating and a helpless, overwhelming experience.  Depression is an isolating illness.  The major mood is that of a sad, hopeless, discouraged, let down world. Many have persistent anger.  Social withdrawal and lack of interest is common among people with depression.  Joy is not found here anymore.

How can you help? (adapted from

  1. Learn about depression

People with depression can have very good days, even a few good days in a row, only to experience depressed mood once again.  There is an ebb and flow to depression that always isn’t understood by loved ones. From feelings of sadness and hopelessness to loss of interest or pleasure in normal activities, to anxiety and agitation, to trouble thinking and making decision, or to ending it all.

Because symptoms of depression can vary and change over time, the best way to understand depression in your loved one is to ask open-ended questions and use empathic listening.

2. Be there

Sometimes we feel that putting our loved ones with people who have the same problems or a support group may be the solution to the problem.  More often than not, the solution is just around the corner.  The best thing you can do is to show up when they need you.

You don’t have all the answers.  That’s fine.  Just sit and listen.  Ask the right questions – how can I help? and provide the assurances they expect to hear – I will be here for you and we can get through this together.

3. Encourage treatment

Depression seldom improves without treatment.  Some people may think that it’s just a phase and they can shake themselves free from that state.  Of course, it may be painful to point out what you notice with your loved ones.  But they will want to hear what you have to say.  After all, their symptoms are noticeable to them as well.  And they are subtle signs asking you if you’ve noticed them.  Express your concern.  Your willingness  to help.  What you’ve read about depression.  Treatment options.  And even if you have to accompany them to the doctor so that you get a clearer picture of what is happening.

4. Create a supportive home environment

Why your loved one is depressed is no ones fault. You can’t fix this.  But your just being their for the long haul means a lot through this difficult time. Lifestyle changes can make a big difference during the treatment process.

Healthy eating.  Low stress environment.  Helping with the appointments with the doctor. Making plans together. Positive reinforcement. In short, you may need to change your lifestyle as well in order to adapt to your loved ones. But isn’t that what love is all about?

5. Focus on the small goals

Depression feels overwhelming.  Even the act of getting out of bed can feel like a monumental task. Help your loved one set smaller achievable and realistic goals and tasks.  Patience and understanding when working through a depressive episode is of monumental help.

6. Know the warning signs of suicide

They’ll never let you know that it’s time.

The risk of suicide is highest during the major depressive episode.  There are red flags that we should be aware of: They talk about suicide, dying or death. They find means to attempt at suicide. The extreme mood swings – one day fine, the next day at the lowest ebb. Social withdrawal. Overwhelmed and hopeless. Engaging in risky and destructive behaviour. Saying goodbye.  Giving away belongings. Getting affairs in order. Personality changes.

We may not live in the same mental environment as those that go through depression, but we can help them live better lives.

One day at a time.

My mind wants me to die

They say that depression is like “living in a body that fights to survive, with a mind that tries to die.”

When my father passed away, my mom went through those moments called depression.

At first we all just thought that after his death, we would go through the usual cycle of grief and overcome the painful loss. It’s really easier to tell someone that “everything is going to be alright”. My mom was devastated. She stared into space every night and seemingly was lost in her own world with all the psychosomatic symptoms of illness. There was nothing I or my sister could do to help her. After all, how could you forget easily someone who had given you so much to remember?

He was gone. We needed to move on. He would have wanted it that way. We will survive. He would have wanted us to be happy. He is in a better place. There is no more hurt or pain.

I needed to repetitively remind myself and my mom of these thoughts. But the tears spontaneously flowed at every occasion. There were no happy thoughts.

What probably hurt most was the non closure of events when death came like a thief in the night. After all, a procrastinated demise has the opportunity to provide one last farewell and make amends in life. Unlike people who probably had to suffer tremendously before dying, my dad’s death had no goodbyes. One day he was just gone.

That’s where all the regret, guilt and depression were coming from. It was a feeling of betrayal on the part of death.

Depression is a sad state to be in. Sad when people are not waiting for happy endings but just waiting for the end. Everyone thinks that depression is just a phase we all go through and snapping out of it is easy. Watching my mom go through this at her phase in life was painful. Perhaps the reason why my grief was short was because I needed to be strong for her, more than her having to be strong for us. After all, after my dad suffered a stroke, she was the strength that kept all of us together. When he passed away, that pillar just gave way.

I will probably never know what lives in the mind of my mom. Even when I ask her about it, she tells me that when she has bouts of loneliness, there is nothing in her mind but a feeling of emptiness and fear.

More than two decades later, with psychiatric help, medicines and family support later, she is better on most days.

I know that there is no one stop shop for depressive disorder. But there is hope and help for anyone going through tough times. And mental illness is something we need to be aware of, talk about, and share.

It’s okay not to be okay. I’m with you on this journey. And I’m writing this for you.