Brief overview of my encounters with depression

NOTE: this post is just my own personal experiences with encountering people with depression, and my views on depression. May not be that helpful if you actually have depression, but might help people who don't have depression gain a little insight on the topic. 

Everyone will experience a measure of depression at some point in their lives, but clinical depression is diagnosed based on whether the degree of depression and the duration of it is such that it is affecting your daily life. For example, is it preventing you from eating, or sleeping, or going to work, is it making you have suicidal thoughts. It is classified as a mental health disorder. It is extremely common, and is a difficult topic to discuss with people if you have it, or vice versa.

A lot of people don't consider depression to be a serious illness and think it is something you can just snap out of. They are confusing clinical depression with mild 'ordinary' depression caused by an external factor such as not getting a job. When there is prolonged depression even though there is no obvious external factor (for example several months later after losing a job) this is more clinical level and medical advise should be sought.

I can tell you about my own encounters with depression. For the longest time living in the UK I had seasonal affective disorder (self-diagnosis), giving me a degree of depression which I struggled with for the longest time. It might have been considered to be sub-clinical, but there were times I felt like I'd plummeted to the depths of despair. I felt I could only be happy if I had some sort of validation from a certain person or people (very typical for the teen years), even though it was completely irrational. It felt like there was nothing I could do to bring me out of it, life felt meaningless, an endless desert wasteland stretching out into eternity. But then very often the following day, I would be fine. Total 180. Even though nothing in my life had changed. That could be a subject for a whole other post.

I had a friend who has depression. The interesting thing is, when you first meet her, she seems like a very happy, bubbly character. This kind of contradiction is not uncommon (Robin Williams). At the beginning I would suggest all kinds of things she could try out or do. For example: getting work, volunteer work, finding a hobby, looking at inspirational You Tube videos, meditation, that kind of thing. She kind of looked into these options, but... The YouTube video I told her to watch, she didn't, telling me her illness made her uninterested in anything. She worked part time teaching English to children, barely 2-3 hours a week, refusing to travel further distances from her home to get more work. Even though being at home alone made her feel worse. You get the picture. 

She was a patient at her local government hospital in Hong Kong, and told me she would see a mental health doctor once every few months. Generally these meetings were not very helpful, and she had tried several different anti-depressants. The last anti-depressant she had been given to try was Mianserin, meaning she had gone through SSRIs, tricyclics, and St John's Wort. None of them worked mostly because it seemed she had not tried them for long enough, and also she was resistant to taking them. The Mianserin for example, the minimum dose is 10mg a day, but the doctor told her she could start on 5 mg a day. My friend automatically said, well I know it's not going to work then, so only tried taking it for a week before stopping them. On one hand her attitude towards anti-depressant medication taking (and everything else for that matter) was pretty annoying, but then again there are a couple of things to be said about anti-depressants. A) In many cases anti-depressants do not help even when they have been taken correctly for an appropriate length of time. B)Anti-depressants have side effects (as do many other drugs). Having said this most people on anti-depressants are on SSRIs, whose most common side effects are mild and not serious. 

Psychological therapy should always be considered first before drugs. For example group therapy, or seeing a counsellor. The problem was that she didn't have any money, and couldn't afford any treatment that required paying for. Her clinic ran workshops for mental health patients, such as basket weaving, flower arranging and meditation. All of which she attended, and they helped a little, but when they ended that would be it and she would still be left feeling awful. She wouldn't get a full time job, but would try and drag me out during the week and get me to hang out with her aimlessly wandering around shops and restaurants for hours in a day. After indulging her a couple of times at the beginning I eventually had to stop. I had my own life to live, and she was hardly the most stimulating company for me to spend hours of my time away from my family with. I knew that her lack of motivation was a symptom of the disease, but it was still frustrating to see her being exactly the same as she always was, complaining about being depressed, years later. I started avoiding her or restricting our meetup times to a couple of hours. Even two hours seemed arduous, but she would take offence if I wanted to head out earlier. She had been so positive and bubbly at the beginning of our relationship, and at the end she was emotionally draining me every time I went near her. 

I am a healthcare professional, and she was a friend I really wanted to help. But in the end I couldn't help and didn't even want to be around her anymore. It is also hard to tell where the disease ends and the person begins. People are just naturally messy and willfull and difficult to manage. Plus depressed people are depressing to be around - sorry to cause offense. But this is just to say... Where do you draw the line between trying to help and trying to preserve your own sanity? 

Depression is a difficult and complex illness to treat, and requires a professionally trained person to help. You can make suggestions, such as acupuncture, or meditation, but just leave it at that. In the end she moved back to the UK, and the last I heard she was doing temping work. Sometimes a change in scenery and circumstance can help. I hope it is helping her.