The Effects of Depression in Families

Dealing with the Effects of Depression in Families:  The Value of Reaching Out for Help to Fight Against Chronic Depression
By: Eulalia Miles

My Family
Ohana means family. Family means nobody gets left behind or forgotten.” (Lilo and Stich)

I have always considered myself a resilient person. After all, despite the many challenges we’ve faced, my husband and I have always loved each other and work well as a team. Together, we raised our children to be academically minded, Christian-service oriented, and family-focused. Our family, however, has struggles that are known by some but perhaps not fully understood by most. We have three children on the autism spectrum, two young adults and one teenager. Recently, two of our children’s chronic depression developed into a long-lasting severe episode and our family was hit with the added demands of such problems combined with the physical and emotional exhaustion of several years caring for our youngest child’s several chronic illnesses. We started to feel overwhelmed, a not uncommon emotion for a couple that has been in stress for so long. But this time, the added burden of these chronic illnesses nearly broke my family, a family that had already been strained from living in survival mode for too many years.

Because I faced these added challenges, I frequently asked myself: “Will we be strong enough? What am I lacking? Why are those things happening to us?” Those questions, although not helpful, are sometimes common to one in emotional pain, or one trying to help a loved one suffering from mental health problems but unsure of what to do. When mental or chronic illnesses affect a member of the family it also affects the whole family unit. Waiting too long to get help can lead the individual and the family down a painful and heartbreaking path. The sooner the family gets help, the better prepared they’ll be to help the member in need and the sooner the whole family will obtain healing and comfort.

My Community
The community is another very important support system for a family that is in distress. Our family has found comfort in religious community groups and our extended family. Nevertheless, these same groups, if not ready or educated to understand and accept the differences and needs of a family with special needs, also can be an added challenge to the family. I have experienced times of support and times of isolation, but above all I have witnessed families that have been isolated and forgotten by their communities and extended families. I believe that most of those situations occurs due to the lack of understanding the community has about mental and chronic illnesses and the taboo that still portrays such problems as excuses to not function fully. I have heard many say about my children, “they are lazy” or “it is all in their heads, there is nothing wrong with them.”

Living with the effects of depression and suicide threats in the family perhaps can only be fully understood by those who live it on a daily basis. We suffer with our loved ones and we suffer from our community’s lack of understanding about mental health. Maybe only those that have a loved one who is in the deep dark pit of depression know how others’ good intentions can so easily hurt or push those already hurting over the edge. Recently, we had two opposite experiences that demonstrated how a community can affect a family in distress.

My Experiences
The first event occurred when our family attended church services in a small congregation next to the hospital where our youngest child was receiving treatment. We were hundreds of miles away from home, but at that small church gathering the members were trained and aware of mental health illnesses. That Sunday we were asked no awkward questions despite our children’s unusual behaviors, just welcoming hellos, offers of help, and an exchange of phone numbers. Coincidently, that Sunday a miracle occurred after a Sunday school lesson by a special speaker trained by the Mayo Clinic. The speaker gave a lesson on how to support those who are affected with depression and anxiety. The speaker also taught about suicide prevention and how to reach out to family members, friends, and neighbors. That Sunday School lesson was essential to save my child’s life because it made me aware of how severe my child’s depression was. That night I admitted my son to an inpatient psychiatric award for severe depression and suicide prevention at the Mayo Clinic, preventing the possible tragedy of my son taking his own life.

The second experience was when we got back home after an entire month at the hospital treating our two children at the Mayo Clinic. It was a painful return to reality when we got home and realized that we no longer had the Mayo Clinic support group of friends that we had leaned on for help; my husband, our children, and I were alone again. Soon our children were back to isolation and for our youngest child the stress of confronting her past became too much. A week after we arrived back home, our youngest, feeling alone and misunderstood by her community, broke down. After our first Sunday back from the children’s treatment, we experienced terror and despair in a manner that we had never thought possible. For the first time we felt that our family was in danger of breaking; our youngest child’s chronic depression and instability had finally influenced and affected the family as a whole. My husband and I had felt strong, resilient, and truthful to our faith for so long, but we were now on the verge of despair. That Sunday night both of our children considered suicide. (If you feel that you or a loved one is in such a danger, you should contact your local emergency room or the 24-hour National Suicidal Prevention Lifeline at 1-800-273-TALK). That night, my husband and I spent hours calming and watching our children, praying that the morning would bring a new start.

Getting Help
And while these new starts do exist, they do not come instantly. They have to be built with hard work and a lot of perseverance. The good news is that with commitment and hard work, mental health problems are treatable. While some may find success with a few sessions of psychotherapy, others with severe, chronic issues may need a combination of treatments, such as individual psychotherapy, marriage and family counseling, and medications, to provide a more long-term solution to the problem.

However, no matter your needs, looking for help sooner than later is essential for a more positive and successful result of your treatment. Waiting too long to reach for help is something that we witnessed in our community. We saw beautiful families breakup because they waited too long for help. We are still concerned and shaken by the problems families with special needs face on a daily basis. We have several friends that did not reach out for help in time because they were ashamed to get help until it was too late to save their families and their marriages.

It was difficult for us. It is still difficult! We have to care for adult children when we were almost to the point of enjoying an empty nest. We have been in survival mode for so long that the small but important things that we used to enjoy had to be re-learned, such as Friday night dates and evening walks as a couple. We had to make an effort to spend time together, to strengthen our “relationship house,” a term used by marriage scholar Dr. John Gottmann in his book, The Seven Principles for Making Marriage Work. It means strengthening your relationship and knowledge about each other (the couple). We had to make a conscious effort to leave behind the problems for a few hours each week and spend time together, enjoy time by ourselves, and learn to be a couple again, without the children. We had been a team working together to survive a battle against the mental illness of our children, and in that battle had to be reminded to take time for ourselves as well.

Family is an important key for the healing process of an individual, as they can help heal and also change family behaviors that may be influencing the behaviors causing the depression. Recent studies have shown that treating depression and mood disorders with Interpersonal Psychotherapy (IPT) and Couples Behavioral Therapy (BCT) as a family unit is more effective than individual therapy alone, although it is still a fairly new approach. At the Mayo Clinic, the Mood Disorder Program offers a comprehensive combination of therapies such as cognitive behavioral therapy, dialectical behavioral therapy, acceptance and commitment therapy, or behavioral activation and, when needed, the use of medication or other medical procedures. Because my son’s stay at the Mayo Clinic was an emergency short stay only, we did not get the family component offered at the other programs at the clinic. However, the individual healing was still very efficient for my young adult son. The Mayo Clinic taught him skills that he could take into the outpatient therapy sessions, enabling us to add the family component later as his treatment progresses. We recommend one of the self-help books used at the Mayo Clinic, Mind and Emotions.

Finding the right treatment is also an essential step in treating mood disorders. Studies have shown that psychotherapy that uses therapy approaches such as cognitive behavioral therapy (CBT) have a longer and more efficient effect in treating mood disorders than medications alone. Although my son had been to therapy for depression and taken medication for many years before his admission to the Mayo Clinic, the CBT approach, together with the behavioral activation and biofeedback that he is now using, has helped my son even more than medications. My entire family is now currently visiting a family therapist in addition to our children attending individual therapy and seeing a psychiatrist for medication. We are also doing biofeedback (a relaxation technique for anxiety and depression) that seems to help as well. Our new approach is working better, treating the family as a whole while finding ways to support each other to heal.

Reaching out. If you find yourself in a situation like ours, where your family is constantly under stress, remember that reaching out for a support group or therapist is not a sign of weakness but something that will make you stronger as an individual and as a family. As we found out after so many years, adding a few hours to our busy schedule to socialize and to attend a support group did not only strengthen us but also energized our relationships and helped us make connections with others. A marriage and family therapist can help you cope with all kinds of family stresses; even if you feel that you don’t have a big marital problem to work on, you still have family and individual stress that coping skills can help relieve. Depression, mental illnesses, chronic illnesses and so many other problems are real. They may be invisible to those suffering and their family, but it does not make it less painful or less important.

There is hope and help available. You do not have to suffer alone. And you do not have to suffer for long because there is treatment. A competent professional can help you find the best treatment for you and your loved ones. Because depression affects a family as a whole, healing will be more meaningful and long-lasting when all members are involved in the process. There is always hope. With the right support, hard work, and help from those you love you can overcome these mental illnesses. The journey is not easy, and may not even come to a clear, complete end, but it is full of small and happy little miracles that fill lives with light and purpose. You and your loved ones are worth the help, because a broken family is still a loving family. As Stitch said in the movie Lilo and Stitch, “This is my family. I found it all on my own. It is little and broken but still good, yeah … still good.”

For research support click here.