Caring for the depressed can take a toll on family

CHENNAI: When her husband was diagnosed with clinical depression, Asha* was extremely supportive and understanding. The 45-year-old read up on the medical condition, and took time off work to spend more time at home. But as weeks passed by and she struggled with home, work and kids, she began feeling as if she was fighting a losing battle. And that's when she decided to see a therapist herself.
"On the days I was most tired, I would sometimes snap and then feel guilty. Finally, I reached a point where I was feeling frustrated, lonely and upset most of the time," she says.
In October 2016, the National Institute of Mental Health and Neurosciences in Bengaluru released a mental health survey that said one in every 20 Indians suffered from some form of depression.
According to a recent WHO report, over five crore Indians suffer from depression. But what one needs to realise is that the families of all these people also need to learn how to cope, deal with their own emotions and safeguard their own mental health.
The first step is recognising the red flags. "We are looking at major depression, not just someone feeling low and upset," says psychiatrist Dr N Rangarajan.
"You know someone needs help if they are less responsive, constantly cry, get angry or have severe mood swings, and these symptoms persist for more than two weeks."
Often, the response of the spouse is irritation or anger as the other person may not be able to pull their weight in the house. "They may not understand depression. For instance, husbands may get irritated wondering why their wife is crying all the time as many women often don't open up about what they are feeling," says Dr Thara Srinivasan, director, Schizophrenia Research Foundation (SCARF).
The immediate first response is to consult your family doctor who knows you and your spouse, says Dr Rangarajan. With minor therapy for a few days, exercise and proper nutrition, some people may improve. Otherwise, professional psychiatric help may be needed.
"Caregivers need to have a sympathetic approach as the patient is not doing anything wilfully," he says.
The spouse who plays caregiver needs to seek help from extended family and peers.
"You need to look after yourself - your emotion, anger, helplessness - and deal with it, and understand it is going to be tough till your spouse recovers," says Dr Srinivasan, adding that social support is very important.
"Never leave them alone as the risk of suicidal behaviour is highest when someone is going into depression or partially recovering. At the nadir, they won't have energy to do anything," says Dr Rangarajan.
If possible, developing a daily routine for them helps and so does exercise. Ensure they don't miss an appointment with the therapist. Speak to your boss to come up with alternate working arrangements so that it is easier for the caregiver as well.
Psychologist Dr Mini Rao feels that the caregivers also need care.
"Be gentle but firm with the patient and try to distract them," she says, adding that helping them maintain a normal daily routine, if they can, is important as isolation aggravates depression. "If you are out of your depth, call the psychiatrist for help," she adds.
Joining online support forums for caregivers and reading up also helps the carer. "That's why we also offer family therapy. Even a couple of sessions help as they can talk about their feelings and how they are coping and the patient also sees how much their family cares for them," says Dr Rao.