My father died in July of last year, the day following his 89th birthday. He died of natural causes and in his own bed. There were many times in Dad’s life that I was not certain that those two would be possible as Dad died after living a lifetime with severe depression.
Depression was a constant in Dad’s life. At times it defined and confined his life and his choices. At other times it was more of a quiet background note – like a steady bass sound that could not be ignored but which did not prevent you enjoying or engaging with the music of your choice.
Over the course of my adult life there was a sea change in the way in which depression was diagnosed and treated. I watched as the treatment options expanded and improved. I experienced a new generation of doctors more inclined to engage with family members and recognise our role in the life of their patient. I experienced the growing openness about discussing depression. With relief and gratitude, I saw the courage of people such as John Kirwan help us to develop a collective vocabulary to talk about depression, about what it means, and about how to respond to it and support those who live with it.
I know that there is no one way in which people experience depression. Equally, the experience of each person caring about and supporting someone with depression is specific to their circumstances and the nature of the relationship – whether parent, child, sibling, friend or partner. I know that my mother’s experience of supporting Dad was different to my own and the impact of Dad’s illness on her life greatly exceeded the impact it had on mine.
I can only share what I learned from my experience as an adult child supporting my father, and my mother, to cope with Dad’s depression and the way in which it impacted on all our lives.
Understand the implications of the illness for your role
I learned that I needed to understand enough about the illness to appreciate what that meant for the role I could play and the implications for what I could do and what I could not do.
I learned that I could not bargain with depression or negotiate with it. When depression meant that Dad believed that the best option for him and his family was for him to die, I could not rationally explain to him that this was not true. I could not expect him to understand, or accept, that my view of his world was that he had much to live for and still much to offer me and others. I had to accept his current reality and work to support him to get to a time when that reality changed for him.
I am, by nature, an empiricist and find rational analysis irresistible. However, I had to learn to accept that depression was not a problem I could solve by rational analysis and it could, and would, assert itself in ways that I could not change.
I also learned enough about depression to accept that I could not “fix” Dad or cure the disease. Depression is an illness and needs to be treated like any other disease by those who are trained to do so.
My role was to support Dad – to connect him with the treatment that he needed, to support him through the process of treatment and at times to act as an advocate to ensure he and my mother had access to the professional support and assistance they needed to cope with the reality of his illness.
I couldn’t cure Dad, but I could continue to believe that treatment would be successful and he could regain a life that was not robbed of all joy and feeling by depression. I learned that part of my role was to be what I called “an ambassador for the future” – to maintain the possibility of a future that was not defined by the symptoms of the disease and to ensure that when the doctors had done their job there was a future available to Dad that he could embrace and enjoy.
I came to think of Dad as like a Russian doll toy. When the depression was at its worst all that there was of him was the very small doll that is at the centre of the toy – the one that is most fragile and vulnerable but which still looks like the other layers of the doll. I needed to maintain the possibility that at some future point the outer layers would be restored and the doll would once again be stable and able to stand upright unaided.
It is not about you – it is about the illness
Experience taught me that depression can act as a powerful filter of facts and can distort the reality of the person experiencing depression. That meant I had to learn to not take personally things that were directed at me personally.
This was one aspect in which recourse to rational analysis was useful. Depression meant that Dad did not always recognise or acknowledge acts of kindness or support – or even my presence. I had to learn not to take that personally but to recognise it as a symptom of the disease. I came to realise that rejection of me was part of a generic rejection of the external world – not a targeted, specific rejection of me. It was not about me – it was about the disease. Rational understanding told me I could not make my support for Dad conditional on the quality of his response to my support.
Depression drives people into themselves and it sucks energy from them. It does not leave them with the energy to manage their own lives – let alone to accommodate you and your life. I needed to decide when and how I stayed connected to Dad’s life when depression did not allow him to recognise my role in his life or his role in my life.
I also gradually learned to accept that when Dad was well I couldn’t confront him with how he behaved when he wasn’t well. I could not hold him hostage for behaviour that was dictated by the illness. I found other places to take the hurt and anger that his behaviour sometimes caused me. Other people supported me to deal with that, which allowed me to continue to engage with Dad as he needed.
Be kind to yourself
Supporting someone with depression is unlikely to be the only responsibility you have. As with everything, you are no good to anyone if you do not take care of yourself first. It may also be that supporting someone with depression is the work of years – not weeks or months – so you need to pace yourself for the long haul.
You can set limits to what you can and can’t do and for how long. It is okay to give yourself a break. It is not always possible to do everything you might want to. Be honest about what you can do and for how long and don’t beat yourself up about what you decide. What you can do will change over time consistent with other demands in your life – only you can determine what the best balance is.
Make sure you have support and find people you can talk to about what is happening. I made an early decision that one of the ways I would cope with Dad’s illness was not to dissemble about what it was. If people asked me what was wrong with Dad I would tell them that he was suffering from depression. It was one way by which I normalised his illness. It was also one way by which I was able to identify those with whom it was possible for me to talk about how I was feeling and what was happening for me and Dad and those with whom such conversations were not possible.
Finally, while it is true that although you can’t cure or fix the depression, it is also true that you can make a difference in the life of the person living with depression. You can stay connected and engaged with them, and with those whose lives are impacted by the episodes of depression, and continue to care about and for them.
Vitally, you can keep alive the version of themselves that depression takes from them and importantly you can be present in their life to welcome back the person they are when the depression retreats.
Carolyn Risk has worked in private practice and as a senior public servant. She lives in Wellington and is self employed as a barrister and public policy consultant.
Sarah Taylor is the co-ordinator of this series, a senior lawyer, and the Director of Client Solutions at LOD NZ, a law firm focused on the success and wellbeing of lawyers. If you’d like to contribute to this series, please contact Sarah: firstname.lastname@example.org