Lupus and Depression

by Karyn Moran Holton, Suite101.com

For people with a chronic illness like lupus, scleroderma, or rheumatoid arthritis, the holidays can be a time of utter loneliness, depression, and even despair. This is especially true for the "letdown" period after the holidays. After the New Year, for example, there are at least 3 months of winter looming ahead, with dreary days, and cold weather.

During the holidays, more people are treated for mental illnesses and severe depression, and suicide rates escalate dramatically. Other factors that can contribute to depression are Seasonal Affective Disorder (SAD) in which a person becomes depressed during the winter months, and "cabin fever" when a person who is partially disabled is unable to leave home due to snow, ice, and winter conditions, and chronic pain that is aggravated by the cold and damp weather.

Depression can overwhelm even the most "together" and "happy-go-lucky" individual. So it's not surprising that even a "mild" case of depression can be traumatic, or even dangerous, to a lupus patient. So what do you do if you, or someone you love is being consumed with depression, or even "the blues"?

Here's what NOT to say, from a great site on depression (see link at the bottom of this article):

"What's *your* problem?"
"Will you stop that constant whining? What makes you think that anyone
cares?"
"Have you gotten tired yet of all this me-me-me stuff?"
"You just need to give yourself a kick in the rear."
"But it's all in your mind."
"I thought you were stronger than that."
"No one ever said life was fair."
"As you get stronger you won't have to wallow in it as much."
"Pull yourself up by your bootstraps."
"Do you feel better now?" (Usually said following a five minute conversation
in which the speaker has asked me "what's wrong?" and "Would you like to talk
about it?" with the best of intentions, but absolutely no understanding of
depression as anything but an irrational sadness.)
"Why don't you just grow up?"
"Stop feeling sorry for yourself."
"There are a lot of people worse off than you?"
"You have it so good, why aren't you happy?"
"It's a beautiful day!"
"You have so many things to be thankful for, why are you depressed?"
"What do you have to be depressed about?"
"Happiness is a choice"
"You think *you've* got problems..."
"Well at least it's not that bad."
"Maybe you should take vitamins for your stress."
"There is always somebody worse off than you are."
"Lighten up!"
"You should get off all those pills."
"You are what you think."
"Cheer up!"
"You're always feeling sorry for yourself."
"Why can't you just be normal?"
"Things aren't *that* bad, are they?"
"Have you been praying/reading the Bible?"
"You need to get out more."
"We have to get together some time." [Yeah, right!]
"Get a grip!"
"Most folks are about as happy as they make up their minds to be."
"Take a hot bath. That's what I always do when I'm upset."
"Well, everyone gets depressed sometimes!"
"Get a job!"
"Smile and the world smiles with you, cry and you cry alone."
"You don't *look* depressed!"
"You're so selfish!"
"You never think of anyone but yourself."
"You're just looking for attention."
"Have you got PMS?"
"You'll be a better person because of it!"
"Everybody has a bad day now and then."
"You should buy nicer clothes to wear."
"You catch more flies with honey than with vinegar."
"Why don't you smile more?"
"A person your age should be having the time of your life."
"The only one you're hurting is yourself."
"You can do anything you want if you just set your mind to it."
"This is a place of BUSINESS, not a HOSPITAL" --> after confiding to
supervisor about my depression
"Depression is a symptom of your sin against God."
"You brought it on yourself"
"You can make the choice for depression and its effects, or against
depression, it's all in YOUR hands."
"Get off your rear and do something." -or- "Just do it!"
"Why should I care?"
"Snap out of it, will you?"
"You *want* to feel this way."
"You have no reason to feel this way."
"Its your own fault."
"That which does not kill us makes us stronger."
"You're always worried about *your* problems."
"Your problems aren't that big."
"What are you worried about? You should be fine."
"Just don't think about it."
"Go Away."
"You don't have the ability to do it."
"Just wait a few weeks, it'll be over soon."
"Go out and have some fun!"
"You're making me depressed as well..."
"The world out there is not that bad..."
"Just try a little harder!"
"Believe me, I know how you feel. I was depressed once for several days."
"You need a boy/girl-friend."
"You need a hobby."
"Just pull yourself together"
"You'd feel better if you went to church"
"I think your depression is a way of punishing us." ---My mother
"Sh*t or get off the pot."
"So, you're depressed. Aren't you always?"
"What you need is some real tragedy in your life to give you perspective."
"You're a writer, aren't you? Just think of all the good material you're
getting out of this."
This one is best executed with an evangelical-style handshake,i.e. one of my
hands is imprisoned by two belonging to a beefy person who thinks he has a lot
more charisma than I do: "Our thoughts and prayers are with you." This has
actually happened to me. Bitten-back response: "Who are 'our'? And don't do me
any favors, schmuck."
"Have you tried camomile tea?"
"So, you're depressed. Aren't you always?"
"You will be ok, just hang in there, it will pass." "This too shall pass." -
Ann Landers
"Oh, perk up!"
"Try not being so depressed."
"Quit whining. Go out and help people and you won't have time to brood..."
"Go out and get some fresh air... that always makes me feel better."
"You have to take up your bed and carry on."
"Why don't you give up going to these quacks (ie doctors) and throw out those
pills? Then you'll feel better."
"Well, we all have our cross to bear."
"You should join band or chorus or something. That way you won't be thinking
about yourself so much."
"You change your mind."
"You're useless."
"Nobody is responsible for your depression."
"You don't like feeling that way? So, change it."

I don't know about you guys, but I personally have heard at LEAST 50% of these things during the course of having lupus. If I had been going through a bout of depression at the time, it probably would have sent me over the edge!

From the same site, a list of things that you could say that might help someone who is going through a depression, for whatever reason!  The things that didn't make me feel worse are words which 1) acknowledge my depression for what it is (No 'it's just a phase')  2) give me permission to feel depressed (No 'but why should you be sad?')

"I love you!"
"I Care"
"You're not alone in this"
"I'm not going to leave/abandon you"
"Do you want a hug?"
"I love you (if you mean it)."
"It will pass, we can ride it out together."
"When all this is over, I'll still be here (if you mean it) and so will you."
"Don't say anything, just hold my hand and listen while I cry."
"All I want to do know is give you a hug and a shoulder to cry on.."
"Hey, you're not crazy!"
"May the strength of the past reflect in your future."
"God does not play dice with the universe." - A. Einstein
"A miracle is simply a do-it-yourself project." - S. Leek
"We are not primarily on earth to see through one another, but to see one
another through" - (from someone's sig)
"If the human brain were simple enough to understand, we'd be too simple to
understand it." - a codeveloper of Prozac, quoted from "Listening to Prozac"
"You have so many extraordinary gifts--how can you expect to live an ordinary
life?" - from the movie "Little Women" (Marmee to Jo)
"I understand your pain and I empathize"
"I'm sorry you're in so much pain. I am not going to leave you. I am going to
take care of myself so you don't need to worry that your pain might hurt me."
"I listen to you talk about it, and I can't imagine what it's like for you. I
just can't imagine how hard it must be."
"I can't really fully understand what you are feeling, but I can offer my
compassion."
"You are important to me."
"If you need a friend..... (and mean it)"

You might notice that some of the "Don't say" suggestions are the same as the "Do say" suggestions. It all depends on the situation, and the person. Even if your mind goes blank, and you don't know what to say, listen! Sometimes, a listening, non-judgemental ear can do so much! It really helps to know that there's at least one person who doesn't think you're "crazy" or "lazy" or "just-looking-for-attention"!

If you are the one who is experiencing depression, you should definitely tell your doctor or health care provider about it. Even if you blow it off as "the blues" or "the blahs", it could be caused by a number of different things, including your medications, so be sure to address it! You don't have to feel like that! Your doctor may recommend a med change, a referral to a specialist, therapy, or any number of other things that can help you! Remember: You're not alone, and depression is nothing to be ashamed of!

Recommended Books:
The Lupus Book: A Guide for Patients and Their Families by Daniel J. Wallace
Lupus: Alternative Therapies That Work by Sharon Moore
New Hope for People with Lupus: Your Friendly, Authoritive Guide to the Latest in Traditional and Complementary Solutions by Sara J. Henry

© 2000 Karyn Moran Holton, Originally published on Suite101.com

Karyn Moran Holton is contributing editor to Suite101.com's Lupus site, which features articles, news, links and more on Lupus.  Visit her web site at http://www.suite101.com/welcome.cfm/lupus.  She is a young wife, mother of three very small, very loud and (usually) very moist children.  She is a nurse who has been diagnosed with lupus for the past 3 years, and has spent most of that time trying to raise awareness about lupus and other under-appreciated autoimmune diseases.

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