QUESTION: I am very concerned about my best friend.
She has been depressed for quite some time. There are moments she comes out of it, but when she's down, she is convinced that nothing can help her. I've suggested all kinds of things - hypnosis, pills, therapy, exercise - but she refuses even to given them a try. She won't even visit the doctor or tell her parents.
I'm fairly sure that she's considered suicide - I came across a suicide note she wrote - but she won't talk about it. Is there any way that I can help her?
Yours sincerely,
Phoebe
ANSWER: I've experienced both sides of depression, and first, let's run through what you mustn't do. Don't try to cheer her up. Don't tell her jokes. Don't suggest that she “be kind to herself”. Don't say she needs a holiday. Don't say: “It's fine to cry.” These remarks will only confirm to her that nobody understands her, and will, to be honest, push her even further into the mire than she already is.
So what should you do? Firstly, tell her that when she says there's no hope, she should remember that it's her depression speaking and not her. This is a concept that's extremely important for both of you to understand. There are three people in this relationship - you, her and the depression - and the depression is something you must tackle together.
If, out of her mouth, you hear the depression speaking (and every time she says there's no hope, it's the depression that is talking), you can behave as you like. You can treat it as a very unhappy child, or you can be as manipulative and untruthful as you like. Depression has no moral sense.
Secondly, get her to a doctor. Of course she'll refuse, but here you must use all your cunning. Tell you couldn't care less if she wants to go or not, she's got to go for your sake. Tell that you're going mad with worry, and that if anything were to happen to her you wouldn't be able to live with yourself if you thought she hadn't seen a doctor. Offer to come with her yourself. Get angry if, after that, she still refuses to go. It's the depression that you're getting angry with, not her.
Ask her why she doesn't kill herself. This isn't as callous as it sounds. Simply ask her the reasons that prevent her - and force her to make a list of some positives in her life. Or, if not positives, positive negatives, such as not wanting to upset people around her or not knowing how to kill herself successfully. When someone asked me that when I was suicidal, I found it a real turning point.
Try caring for her, and putting your arm round her and doing things for her, but at the same time don't overdo it. Depression is often a result of what's known as “learned helplessness”. As a child, she probably learned that nothing she does makes any difference to the way she's treated, so she feels utterly powerless. So give her a bit of power. Ask for help yourself over something minor. Make her feel wanted and useful. Say that, however depressed she is, it always makes you feel better when you see her. Tell her that she's needed. Give her life some meaning.
Fewer people kill themselves in wartime when they're all pulling together and they have a common cause. Help her to feel that she is, in her own way, valuable - by making her valuable.
The Independent
* For help with depression, contact the South African Depression and Anxiety Group (www.sadag.org)