Coping with Depression and Thoughts of Suicide

Depression is not a character flaw. It is often the most normal response to a stressful situation: the death of a loved one, divorce, job loss, health problems, and even happy events that bring back sad memories. During the pandemic, many events that should have been happy had to be deferred, including weddings, family reunions, and long-planned trips. When you mourn any type of loss or face an unknown future, you may experience depression.

Sometimes depression passes on its own as the situation changes—you can take that trip another year—but sometimes it lingers on. In that case, whether for yourself or someone else, intervention is crucial.

The Types of Depression

Short-term depression is most often situational; when you have held the funeral for a loved one, when you find a new job, or when your health problems improve your mood changes. You begin to eat normally again, you interact with friends, you are able to focus on your responsibilities, and you take care of yourself. You may need help to overcome situational depression, but eventually, you move on.

Clinical depression continues daily for at least two weeks and locks you in an unhappy place. While the symptoms may be similar to those for situational depression (for example, poor nutrition and sleep, social withdrawal, and fatigue), clinical depression interferes with your ability to function, may alter your thought processes and physical health, and may stem from disturbances to your neurotransmitters. 

Psychotic depression includes delusions, hallucinations, and similar disturbances. Perinatal depression occurs specifically during or after pregnancy. The seasonal affective disorder is triggered by seasonal changes, usually in the fall and winter.

TIP: Both situational and clinical depression may lead to suicidal thoughts if they go untreated. If you or someone you know is depressed, you can find help by calling:

• 911 (or the hospital emergency room) if there is an immediate danger to you or a loved one
• National Suicide Prevention Lifeline: 1-800-273-8255 (beginning in July 2022, call 988)
• National Alliance on Mental Illness (NAMHI) hotline: 1-800-950-6264 (NAMI)
• National helpline for substance abuse and mental health (SAMHSA): 1-800-662-4357 (Help)
• Crisis Text Line 24 hours a day, seven days a week: text HELLO to 741741
• Clergy: your local clergy are often trained to help.

TIP: Getting sunlight or the equivalent from special lighting may relieve seasonal affective disorder. The FDA has approved a hormone treatment (brexanolone) to counter post-natal depression. See your physician for more treatments that provide proven relief for all types and degrees of depression, including psychotic depression..

Sources of Stress and Depression

Depression is a sign of extreme stress. It may help you to know that some of the stress you may feel, especially during the pandemic, is shared by many individuals. The American Psychological Association interviewed over 3,000 people of different backgrounds, ages, genders, income levels, and political affiliations. They found consistent sources of stress in worries over healthcare, mass shootings, climate change, safety, abortion laws, and immigration. When you add personal setbacks and worries on top of this layer of existing stress, depression is often the result. 

From childhood, the risk of stress and depression rises until it affects 4.6 percent of 45- to 64-year old men and women, although they exhibit depression differently. Women are more likely to experience guilt, sadness, and worthlessness, and men are more likely to feel tired, irritable, or angry. More and more children and teens experience stress and depression, leading to anxiety, eating disorders, and substance abuse.

Several studies, including a 2010 study by the Centers for Disease Control and Prevention, have found that the risk of depression decreases and overall mental health increases after the age of 65. However, the risk doesn’t disappear and may be aggravated by medications and illnesses. The causes of stress also change as we age, moving from work and parenting, for example, to loss of loved ones, social life, a sense of purpose, physical capabilities, or connections to children. 

Handling Your Own Depression

Whether clinical or situational, depression is closely linked to stress. Therefore, many of the SMaRT coping strategies, especially exercise and healthy eating, are the same for stress and depression.

If you are depressed, you need to talk. Talking to family and friends may help. Social links are important in restoring a sense that you are valued and supported. They may involve activities and experiences that help you relax and regenerate your sense of optimism, happiness, and well-being.

The best approach, however, is to talk with a professional, especially if your depression interferes with your ability to take care of yourself, leads you to substance abuse or self-harm, or doesn’t begin to fade after a week. A professional might find an underlying physical cause for your depression, recommend a support group or medication, or set up family therapy.

As your depression eases, you might try the following strategies:

• Looking for the positive in a negative situation

Example: Morgan’s significant other broke up after a year-long relationship. Morgan began crying at odd times and believed that love was no longer a possibility. After speaking with friends and family, Morgan began to reframe the situation: only one year was wasted on this relationship, and now there was the possibility of finding someone who was a much better match.

• Taking problem-solving steps

Example: Ali was diagnosed with Stage 2 cancer; the word “cancer” is frightening and stressful regardless of the stage. Ali was irritable with everyone, impatient with sympathy, and found his old joys to be juvenile and silly. But as Ali consulted with his doctor, researched his cancer on line, and began to change his eating and exercise habits, he found himself more in control. He couldn’t change the diagnosis, but he could choose and participate in the treatment and improve his general health. That renewed sense of his own abilities to problem solve helped Ali find his way out of depression.

• Seeking support

Example: Andrew and Priscilla lost their jobs at the same time because of corporate downsizing. They both worried about being unable to pay bills and about ever again finding a job in their field with coworkers they liked (and missed) so much. They spent a lot of time in bed or playing video games, eating nonstop, and sharing their anger on social media. After joining a group of other people who were downsized, they found support, were able to spur each other to apply to new jobs, shared job hunting and interviewing techniques, and passed along information about ways to economize and get financial help until a new job emerged.

TIP: You may recover from situational depression because of your own resilience, but the depression that recurs has an underlying source and should be treated. Unhealthy levels of stress, as indicated by depression, have a negative impact on your career, health, and relationships.

Handling Depression in Someone Else

Someone with depression may need help in seeking support, visiting a mental health professional, and remembering to take medicine or other measures of self-care. Provide concrete, specific suggestions about ways you can assist (transportation to their next appointment, laundry on Saturday, grocery shopping on Wednesday, a walk this morning). 

The depressed person needs support, encouragement, and patience—a feeling of being understood and valued. Spending time together, especially in a physical activity like walking, will boost those feelings of support, energy levels, and the ability to cope. Remind them that they matter and urge them to see their primary care physician or a mental health professional. 

If you can’t think of anything to say, simply listen. Listening is a gift. A gentle touch may also go a surprisingly long way of connecting emotionally.

Anger over the symptoms does not help, nor does the offer of quick fixes like vitamins or “toughening up.” Do not dismiss the feelings as exaggerated, imaginary, or inappropriate; they are real and overwhelming to the person feeling them.

TIP: Children often lack the ability to describe what they are feeling; depression may disguise itself as disobedience, skipping school, or engaging in reckless behavior. If you are worried about a child’s depression, keep a log of the child’s moods and make an appointment with the child’s pediatrician.

Responding to Suicide Threats

Both situational and clinical depression may lead to suicide. People with depression may or may not clearly threaten suicide. They might say, “I wish I were dead,” or I just can’t take it anymore.” 

If someone starts giving away their favorite possessions or says “goodbye” inappropriately, they may be considering suicide. If someone goes from major depression to happiness for no clear reason, they may have decided upon suicide.

If you fear suicide, remove all weapons from the home. Do not leave the person alone; urge them to visit a mental health professional; or take them directly to the emergency room. Call one of the hotlines on consult a mental health professional yourself to support you in your efforts.