Today is World Suicide Prevention Day. In that vein, I thought I’d offer this thought on helping people struggling with depression, in hopes that it may be useful to someone who knows that just saying “get help” isn’t enough to actually help.
The thing that strikes me, each time a prominent figure commits suicide, is the way there’s a huge outcry of “I wish he/she had just reached out and gotten help.” That and listing suicide prevention numbers. While I get the urge to be helpful, and don’t doubt that suicide prevention hotlines have helped millions of people, the sad reality is that depression is something people who are plagued with it deal with for a lifetime, not just in moments of crisis. What’s really needed is to lift the veil of secrecy and shame around depression and mental illness so those who suffer can be helped along the way, not just when it just becomes too much to bear anymore.
The saddest thing I’ve read with regards to depression, probably ever, was a comment on an acquaintance’s Facebook post after Robin Williams’ tragic death. The person had written something about the sadness of losing another great person to depression, and how those who suffer with depression need to be able to speak up about their experiences to help get rid of the stigma that keeps us suffering in silence until we can’t take it anymore. One of their friends responded that, unfortunately, the reality is that some places will fire you if they know you struggle with mental illness so it’s not safe to speak up publicly about such things.
Just typing that now makes me incredibly sad. Can you imagine a world where people who are diagnosed with cancer have to keep that news to themselves, lest their employer find out and fire them? Or diabetes, or lupus or MS or any other disease? It’s a preposterous thought…yet, that’s just what we expect people with mental illness to do. Suffer in silence. Not acknowledge there’s anything wrong. And keep looking happy and being productive all the while, because nobody likes a sadsack or negative person. That’s a huge burden to put on someone, especially someone who is struggling with depression already.
As a person who is lucky to have my own lifelong depression issues mostly in check thanks to being able to afford good doctors and expensive medication–because if you think health insurance parity in terms of coverage for mental health treatment actually works, sadly, you’re wrong–I want to do my part to help dispel the notion that a person living with mental illness has something to hide and needs to be ashamed. Depression sucks, and can kill. It’s a disease, not an indication of a person’s worth or an imagined thing that people can just get over by thinking positive thoughts or having a better attitude.
So, based on my experience, what can you do to help a friend or family member who suffers from depression or who you suspect may be suicidal? I honestly think that the one biggest thing you can do is help them get help. It’s one thing to wish or say “please get help” to a person struggling with mental illness; it’s quite another to be a person in the throes of depression and actually get that help.
If you have the flu, you call your primary care doctor and make an appointment, knowing that your insurance will probably cover all or most of the cost of the visit as well as any medication you might need. Even if you don’t have a regular doctor, it’s easy enough to go to urgent care or, if sick enough, the emergency room. Depression, though, is quite different. If you already have a therapist you know and trust, you’re lucky…and even then, the chances that visits to that therapist or psychiatrist are covered by insurance at an equal rate to other healthcare providers are slim.
Some insurance providers require you to go through ridiculous pre-authorization processes, getting the therapist to provide a written treatment plan then having each group of five session approved. A lot of the good doctors just don’t mess with insurance at all and leave it to you to sort out with your insurance provider, or just pay out-of-pocket. Me–even though my insurance provider allegedly does provide equal coverage for mental health treatment, actually getting it covered is a joke. You submit your claim and it comes back as “denied because this required pre-authorization.” You call and argue that–hello, mental health parity and they can’t require pre-authorization. You wait a few months while they review the case, then finally receive word that, oh, you’re right, and the claim has been approved. But just that one time…the next time you submit a claim for the SAME doctor and the SAME diagnosis, the exact same thing happens and you have to go through the process all over again. Try navigating all that while you’re too depressed to function–or even just mildly depressed.
The red tape of finding a doctor and navigating the insurance BS is a huge part of the battle of depression, IMO, so helping someone who is struggling with that part would be huge. Especially the insurance part, with all the idiotic intricacies–being that person’s advocate and helping navigate that rabbit hole would be a godsend. Helping them find a therapist, schedule appointments, coordinate insurance requirements and paperwork–these may seem like little things to you, but to a person who is struggling to just wake up in the morning and go about their life each day, it could really mean a lot.
Of course, I offer this piece of advice from the standpoint of someone who is not in crisis and is merely living with this disease and has been doing so for a long, long time. I know others who suffer have great advice–whether it’s “don’t tell me it’s in my head,” or “don’t tell me I’d feel better if I’d just do yoga or exercise or eat organic or some other thing” or “don’t treat me like I’m a lesser person because I have a disease that’s just as real as cancer or any other physical disease” or a million other things. I don’t presume to know everything about depression–I just hope that being one of the voices publicly acknowledging the struggle of depression helps make someone who suffers alone feel a bit of comfort, or helps someone who’s watching a loved one suffer feel a little bit empowered to help.
For resources and information about suicide prevention visit IASP’s website. And to those who have lost loved ones to suicide, my heart goes out to you.