Not just the blues

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A normal life: that's all Linda really wants. She'd settle for semi-normal. It's not going to happen: her husband, Ray, suffers from clinical depression. On good days, Linda and Ray (pseudonyms), both 47 and living in Manitoba, keep busy with their two preteen sons. On her husband's bad days, Linda hangs out with the boys, telling them it's not their fault that their father can't play with them.

Normal? Linda knows she's not even close. When depression or manic depression (also known as bipolar disorder) -- which affect one of every 10 people -- grabs one family member, it sends the whole household reeling.

"At the beginning, it can be terribly confusing," says Carol Parker, a social worker at the Centre for Addiction and Mental Health in Toronto. Clinical depression usually develops gradually and can be mistaken for laziness or a passing bout of the blues. Many spouses try to cheer up their partner. When that fails, women especially blame themselves, says Katherine Boydell, a health services research scientist at Toronto's Hospital for Sick Children. In bipolar disorder, the first manic episode comes on like a tornado. "Everyone can get spun off their feet," says Parker. In the wild elation of mania, people may spend money compulsively, act promiscuously and even commit crimes. (Milder episodes, called hypomania, which give people high energy and boundless ideas, often look like professional success.) There's no point trying to reason with a manic person. The result for the family: fear and stress.

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Even after doctors diagnose and treat a depression, family life doesn't snap back to normal -- especially when drugs can't fully control symptoms. Spouses, children or parents often worry about a relapse. If, as in Linda's case, a spouse talks of suicide, loved ones may worry about leaving the depressed person alone. Although depression is never anyone's fault, family members often feel guilty about not doing enough.

It's also common to resent how everyone's life has been topsy-turvied. When Natalie was a teen, her mother, who had manic depression, would promise to get better, then end up in hospital again. Now a Dalhousie University student, Natalie remembers being angry and thinking she couldn't trust her mother or anyone else. Family members may have no one to talk to about what's happening. Often they experience a sense of loss and mourn the person who used to be and the life they once had together.

Children of depressed parents can have the most difficulties. "It's almost like emotional abuse but it's not intentional," explains Rhona Gulliver, a social worker who runs a New Brunswick education and support program called Journey of Hope. Parents may not be up to family outings and kids might put on a parenting hat themselves, as Natalie did for her mother until she turned 16. "I took over as mother for my brother without realizing it," she says. When she moved in with her aunt, she had to relearn how to be a kid and sister. Many children become stressed and resentful because they feel responsible for everything, observes pediatrician Miriam Kaufman of the Hospital for Sick Children.

Many marriages don't survive: a one-year U.S. study found the divorce rate for people with depression and manic depression was 70 per cent higher than for couples where depression was not a factor.

According to experts and survivors of depression, social stigma remains one of the worst effects, leaving family members feeling isolated. Natalie was so terrified that her peers would find out about her mother's illness, she once told friends that her mother was still in bed because she was drunk. Alcoholism seemed more acceptable than mental illness. Even within the mental health-care system there's stigma, says Boydell. "Families are not blamed directly for the illness, but it's implied that somehow there's something wrong."

To make matters worse, the illness can spread through the family. According to Dr. Kaufman, approximately 40 per cent of children of depressed parents experience depression. Spouses are at risk of frequent high levels of distress or even a mild depression of their own. It's not contagious per se, as experts used to think. Emotional burdens can cause depression in other family members, according to Nili Benazon, an assistant professor of psychiatry at Wayne State University in Detroit, who did a recent study on spouses of depressed people. It doesn't have to be that way: Benazon says better support could lighten that load and stop the spread.

protect yourself

Secure your own oxygen mask before assisting someone else: the advice for surviving a plane crash applies just as well to living with a depressed person -- you need to take care of yourself. The Journey of Hope, an eight-week education and support course for families affected by mood disorders and other severe mental illnesses, suggests the following:

- Join a support group (see Getting help to contact the CMHA).

- Set up a personal lifeline with a friend who will listen to you vent day or night.

- Don't abandon your interests and career to dwell on your family family member: having your own life outside the house will better serve your self-esteem and sanity.

- Read books and go to talks about mental illness so you better understand this intruder in your life.