I tried to help my childhood friend Nancy over the phone. She lives in Columbus, OH, and I live in suburban Philly.
First I want to acknowledge how difficult life is when we're in the midst of a depression. The word 'depression' is such a weak, ineffective term to describe the immense psychological anguish a person goes through, not to mention their lack of energy and the way their thoughts go round and round unstoppable: rumination, particularly bad when in bed.
So, yes, Nancy, I do understand what you're going thru even tho my own depressions mercifully abated 7 years ago, when my own bipolar illness 'resolved' itself, as the doctors put it.
Confusion and indecisiveness are to be expected with your depression, Nancy. Those are cardinal symptoms of the disease. But here's what you can do to help yourself, and help yourself you must and are capable of doing, difficult though it may be.
Get a piece of paper, Nancy, I said. We're going to write down your daily schedule. FORCE yourself to do many of the things on your list.
Nancy would constantly interrupt me with, "But I don't want to."
I simply replied, "I know it's difficult. Just do it. You want to get better, after all."
She was leaving for the dentist in 10 minutes. Good! Naturally she voiced her 'what ifs' about what the dentist might find wrong.
Again, this 'catastrophising' is part of the illness.
"Don't think about it," I said. "Let's get on with our schedule."
I suggested she remain out of her home after her dentist appt. After all, the home is where a person regresses or feels so comfortable w/no one watching they can do things like lie on the couch all morning and allow the ruminations to course thru their brain.
We discussed some places Nancy might go after the dentist. She admitted that when she's out of the house she doesn't feel as bad. I suggested she buy some food but she said she didn't want to so I said Okay, I know food shopping is really hard, find something easy to do like going to the library.
And in times like these, it's okay to buy your food at a convenience store.
Nancy is an artist. She's currently not doing any artwork b/c of her depression. I suggested some light artwork as that's something she used to enjoy. She enjoys nothing now. Her depression has been ongoing since February - 8 months - the longest it's ever been. She's on ineffective meds and I suggested she have a consult w/another psychiatrist there in Columbus, OH. If she lived here in Philly I could go over our Top Doc list with her.
Her therapist is utterly incompetent. Nancy sees her to lean on her for strength as she was doing with me on the phone. So what does the therapist tell her? "I think you have OCD, Nancy."
How can that possibly be helpful to a seriously depressed woman.
Nancy told me a group therapy session is meeting tonite, the same time as a drawing class she'd like to sign up for. She doesn't 'want to' attend either and I suggested she try real hard to attend one tho not to excoriate herself if she decided to stay home.
I reiterated that once you're in house mode we tend to stick there like glue! Hence my telling her to stay out of the house.
I suggested she attend the art class so she doesn't keep wallowing in depression. I also suggested she go for an aerobic walk every single day.
"I feel lonely when I walk by myself," she said.
"Too bad," I said. "Do it anyway. You've gotta fight this depression and not let it swallow you up."
We said goodbye to each other over the phone, Love ya Nancy, I said, and wished her well. Next day I emailed her that she may wish to attend a partial hospital program or day program such as the fine ones at our local Horsham Clinic.
When I talk to depressed people I am kind but very firm. They need guidance like a blind person needs a seeing eye dog. I'm proud that I have these skills, formed in my own dozens of years of suffering from depression, till the powers that be - the forces of the universe - converged to set me free from depression and mania.