SECTION F – DEPRESSION

Depression ... probably the most common issue that caregivers face. Ironically, depression is relatively simple to understand, as it is almost always caused by suppressed anger. Anger, in turn, is a reaction to emotional pain.  Therefore, when dealing with depression, the first step is to recognize the pain, then recognize the anger that has been suppressed - and the reasons why - and vent that anger. Refer to the previous section on how to deal with this anger.

F1.  SOURCES OF CAREGIVER PAIN

• Guilt - is there more that I can do?
• Helplessness - I cannot do anything to ease their pain.
• Betrayal - Family, friends, God - can't they do something? Feeling ignored.
• Blocked expectations, ambitions, good intentions, communications, goals, when all time is dedicated to the person being cared for.
• Failure - I am not perfect; I can't deal with certain things.
• Losses - real or perceived.

ANGER AS RESPONSE TO THE PAIN

Survival instincts arise, which are designed to act against the source of the pain. This is normal and healthy.

ANGER INTERNALISED & SUPPRESSED BY PAST BELIEFS

Various reasons, based upon beliefs learned in the past:

"Anger = Violence"

"People will reject me if I express anger" (Fear of rejection)

"I have no right to be angry" (Undeserving)

"I am not angry" (Denial of pain - stuck in head)

"I must be strong" (Arrogance of being super-human)

DEPRESSION IS THE RESULT OF THE MENTAL-EMOTIONAL-PHYSICAL ENERGY-DRAINING EFFORT TO DENY AND HIDE THE PAIN & ANGER

F2.  THE SIGNS OF DEPRESSION

• Lack of energy.
• Not feeling like yourself
• Sleeping more or waking up at odd hours.
• Concentration not as sharp, easily distracted or disconnected.
• Easily irritated or annoyed by people or situations.
• No longer have enjoyment in life or in hobbies, people, etc.
• Withdrawing from friends and social opportunities.
• Feeling alone, isolated even when people are around you.

 Depression means that you have low energy, which makes you more vulnerable to sources of pain. Therefore, you have less resources to give care.

F3.  COPING WITH DEPRESSION

1. Recognize depression as being a totally normal response to loss, past, present or future.
2. Identify your suppressed anger. Get it out of your body. Refer to the section on Anger. It is useful to remember that where depression is a heavy and 'stuck' energy-state, Anger contains movement of energy.
3. Express your anger. With loss comes anger. Admitting these feelings is safe and productive. It is plain healthy. Write about your anger or tell a friend who will simply listen. Do something physical. Focus your anger into something that serves and motivates you.
4. Give yourself permission to feel what you feel, be it sadness, anger, fear, numbness and all the other components of depression.
5. Seek ongoing support. Join a support group of like minded people. Ask a friend to just sit and listen to you. Ask that you not be judged or fixed by them... just to let you blow off steam.
6. Find a place, daily, where you can shed your role as a caregiver. Step away from it. Check you "needs and desire list" and take care of your wants.
7. Let go of your guilt. Don't allow feelings of self-judgment or shame sneak in.
8. Define and accept you limitations and make others respect them. Learn to say no and to ask for help when you need it.

F4.  PERSONAL EVALUATION

1.  How many of the signs of depression have I noticed in myself?
2. What good intentions, goals, and desires do I feel are blocked?
3. To what extent is my role as a caregiver all-consuming, with few other real     interests?
4. How do I deal with my anger, loss, and guilt? Do I seek support?
5. To what extent do I feel 'Jaded' (numb, seen-it-all, cynical, it-is-all-the-same, and      'there-is-no-end-to-all-this-suffering)?
6. What would I do with my time if it were impossible to be a caregiver?