Just as people experience depression in many different ways, there are many different forms of ‘conversation’ we can have to support someone going through it. Here, Professor Jim Lucey explores how we can communicate in helpful, meaningful ways when someone we love has depression.
Starting the Conversation
Depression is the biggest unmet health need of our time; globally, more than 300 million people experience depression. It is the largest cause of disability in our society, affecting one fifth of the population at some stage.
In reality, at least one member of every family in Ireland will experience this problem. Given the scale of the issue, it is worth considering why we struggle so much to talk to each other about it.
People experience depression in many different ways: some seem outwardly to be their usual selves, whilst others are unable to do any of the things that would be part of their normal daily activities. Depression can cause people to feel unbearable pain or deadening numbness; certainly, it impairs our ability to think, speak and feel connected to others.
Our difficulties with this communication are indicative of other anxieties. Many of us are afraid of this “conversation”. We are afraid of saying the wrong thing; we fear it will do more harm than good. For all of our national reputation for the “gift of the gab”, we have deep-rooted beliefs that “the least said is soonest mended”. Our culture is full of the attitude parodied by the late Seamus Heaney, when he said “whatever you say…say nothing at all”.
There is a better way to think about this. Listening has taught me that there are many different forms of “conversation” involving a wide variety of very different people in distress. Sometimes, “talking” is not what is needed; sometimes, we just need to “listen”. We might call this kind of conversation “listening-talk”.
It is fair to say that “listening-talk” is different from our usual sort of chat. This communication is potentially a more thoughtful, more considerate exchange. This “listening-talk” is about hearing others’ distress and, sometimes, just being there, “holding” or “holding on”, at least for a time. It’s about creating an environment where we hear each other in more helpful way.
How can we do this? It helps to think about ‘”who” the person is, rather than “what” we ought to say. When we consider “the other person” in distress, we become less preoccupied with our own “speech”.
Listening helps us recover our lost empathy. The other person invites us to ‘Walk in My Shoes’ and the conversation becomes less about an “interrogation” and more about a relationship.
Building a Bridge
“Listening-talk” forms a bridge that connects us to other people at different stages of their journey. These conversations are between the young and old, between women and men, between employers and colleagues, between neighbours and friends. These conversations are between all of us.
No one is saying this communication is going to be easy. The dialogue is two-way. The difficulties are often mutual. It may help to reconsider the time and the place, and to look for a better moment, but there is no perfect opportunity.
Awareness of each other helps here too. Teens and young adults may be more at ease talking about their mental health to a trusted adult, rather than directly to their parents. Parents may not feel comfortable talking to their children about their own or other family members’ mental health. Adults may find difficulty in talking to their elderly parents about their mental health or possible dementia. In each situation, a trusted adult friend or a mentor could help to make engagement safe.
“Listening-talk” is not about giving advice. It’s best to avoid saying things like “why don’t you go for a walk… or join a gym…or have a nice warm bath?’. If someone doesn't want to talk, “listening-talk” means hearing and accepting that response, while always leaving the avenue open.
Instead of persisting in the same way as before, maybe, next time, consider sending a supportive text, offer to pop around , or simply ask “how can I support or help you?”.
It’s easy to feel that you have got it wrong when you are trying so hard to be supportive, but don’t reproach yourself. Guilt only makes the connection more difficult.
Take Small Steps
Try taking small steps. Speak gently. If you don’t feel that you are making a difference, look for an alternative to your anger and frustration. Practice kindness. Don't feel the need to offer solutions. It’s not necessary to say to someone “I know exactly how you feel”. The reality is that you probably don’t.
And don’t feel that you have to have all the answers. “Listening-talk” is not about making the deal. It isn’t judgmental. It’s about listening, being there, reaching out, and holding on.
Is this effective? Yes, it can be. The best evidence is that families and friends with more open communication are more able to be supportive, and that can help.
This “listening” conversation never harmed anyone. “Listening-talk” is not dangerous. The tragedy is that so many continue to experience distress without ever being able to have that conversation at all.
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Prof Jim Lucey
Prof. Jim Lucey is Medical Director of St Patrick’s Mental Health Services, Dublin, since 2008, and Clinical Professor of Psychiatry at Trinity College Dublin. He has been working for more than 30 years with patients suffering from mental health problems. In addition to medical management, he maintains his clinical practice at St Patrick`s, where he specialises in the assessment, diagnosis and management of Obsessive Compulsive Disorder (OCD) and other anxiety disorders. He gives public lectures and is a regular broadcaster on mental health matters on RTÉ radio, featuring on ‘Today with Sean O’Rourke’.