When should someone else get help?

February 25, 2019

By: Ariel Blau, MSW, RSW, LCSW

Very often a client comes seeking my services because they are worried about someone else who has depression. This client finds that they are worrying enough about another person, to go seek help themselves. How does one decide what to do? The answer is a mixed “depends”, because everybody goes through something that looks like depression at some point, and everybody is different. The good news is that having a bit of a depressed spell is not worrisome in itself. A full-on depression is another story, as you will see below. 


Having a depressive episode is so common that at some point or other, one third of the population goes through one. If it so common, how does one know when something needs to be done about it? There are many factors to consider. The time factor of when it starts and how long it lasts is important. Most normal low mood periods are in response to a specific event or circumstance, and for a few weeks. The feelings communicate to us that something is not working and needs action. Once the situation gets resolved, mood changes, and everything goes back to how it was. This is not something to worry about, because timing is related to a specific event. On the other hand, is grief something to get alarmed about? 


Grieving is another emotion timed to a specific loss and looks a lot like depression. A loss happens when someone you care about moves away, goes through a divorce, or a family member passes away.  More complex losses are generated by some illnesses, immigration, and life transitions. Processing life transitions through grief is normal, and even necessary. Embracing these confusing feelings can help you resolve and shorten the process. If the process shifts over time, you are likely processing your grief effectively. 


You probably heard of seasonal affective disorder (or SAD). This happens when people feel low and with low energy during the dark winter. SAD involves a disruption of body rhythms due to lack of sunlight, and can result in lowered mood and energy. Is there anything that helps? The good news is that this light-related condition can get better with a few interventions. You can ask your naturopath about supplements, getting exposed to light with daily walks outside and bright lamps, and exercising. Your counsellor can help overcome gloomy thoughts. There is hope! 


When low mood is not following the seasons, loss, or a specific circumstance, and stays more than 2 or 3 months, then it is time to start paying attention because it could be a more serious depression. It is good to identify this condition with a health professional, because there can be very effective ways to overcome it. Here are some of the indicators of depression impact activity levels and other are related to the level of distress each person feels. 


The first thing you need to pay attention is how much the person has lost their previous energy levels. Lower levels of neurotransmitters in the brain, typical of depression, leave one feeling drained of energy. One feels that nothing one can do matters. 


Often people with depression abandon activities that previously delivered pleasure. Long-lasting loss of interest is a common indicator of depression. The usual pleasures that come from getting things done, seeing people, or even accomplishing small tasks, are gone. Soon one feels even worse for not doing anything. 


At worse, depression can change people’s thoughts and make them lose the sense that life is worth living. Pervasive negative thoughts of gloom are one of the serious indicators of depression, and sometimes feelings of doom. Who wants to feel like that? 


People with depression may also experience strong feelings of inadequacy, hopelessness and not being good enough. These awful negative thinking patterns can beset otherwise capable and intelligent people, and are not related to reality. The debilitating feelings result in lost confidence and effectiveness. 


Sometimes people with depression tend to feel more sensitive and cry often, for no obvious reason. They just feel sad and down. Their life seems as gloomy as their feelings, even though nothing might have changed externally! 


Increased isolation is another possible indicator that something needs to be checked out. Many individuals with serious depression don’t want to be seen in bad shape and start to isolate and withdraw from the world. When people who were social before withdraw over time, they may need to get help, or a few phone calls to get them out again. They may even fantasize of suicide as a way out of their gloom. 


For one, it is always important to ask people how they feel and get people help when they have suicidal fantasies, plans, and thoughts. I used to feel scared of finding out, but I overcame it because I quickly saw that it is amazingly helpful to the person to be able to share. It can save someone’s life! If you find out they are feeling this low, the hospital maybe the best place to have someone knowledgeable check for their wellbeing (some links below). While depression left unmanaged can end in such low states, the good news is that there are many things you can do to help the person not get into such dire situation. 


Usually, seeing a naturopath or other medical provider is the first step to rule out any organic causes. Many organic conditions such as low levels of certain vitamins, heart problems, or digestive conditions, even allergies, can make a person depressed. It is very good to know if something like this is involved because you can then get it under control! 


Effective medications, supplements and herbs are available from many medical orientations to help with mood. Naturopaths can look at underlying systemic issues, diet, and herbal supplements. Homeopathy is effective for many individuals. Psychiatric medications such as serotonin reuptake inhibitors have been improved and have widespread positive effects. Trans-cranial electrical stimulation using low levels of electrical impulses matching brain levels is an emerging technique currently undergoing research. It is not yet officially approved for treatment in many areas, but many folks that use it claim it has few side effects. Exercise and yoga can be very effective. 


Good sleep and diet are important things to consider for the depressed individual. The state of your gut is related to your moods, so eating affects your healing. There are other things you can suggest as well, such as helping them get to a counsellor or psychotherapist. 


The first support strategy a psychotherapist may try might be to get the person to agree to act against their feelings. It is called behavioral activation and consists of prioritizing activities that once were pleasurable and doing them even if one feels resistance. It helps to have a friend or partner help nudge the person along. Changing the person’s thoughts is another good strategy that psychotherapists use. Actively changing thoughts affects the brain positively. This can be done with affirmations, gratefulness and talk therapy. Cognitive Behavioral Therapy to change thoughts and psychodynamic therapies are found to be effective for people with depression. Sometimes just venting can help. 


For the friends and family of someone with depression, it is very important to realize that many of the attitudes and choices of a depressed person are dictated by the condition. It is important to not blame the person or criticize their character. Showing understanding, gently inviting them to join and helping them overcome their resistance can be supportive. Even offering a ride to help them get help is a great way to start. 

Disclaimer: This essay/blog is not intended as a substitute for a direct and specific consultation with a mental health provider. If you need a professional assessment for a condition, please see a trained professional.


If someone you know has a concern, we invite you to schedule an appointment with one of our IHI counselors. We both offer short meet-and-greet and regular appointments that can start the helping process:

Lauren Berger, RSW: https://ihi.janeapp.com/#/staff_member/13

Ariel Blau, RSW: https://ihi.janeapp.com/#/staff_member/38
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If you are thinking of suicide or think someone else may be, there is help.  Call your local crisis line or mobile crisis team or the police, or go to the emergency room of your local hospital.

Mental Health Helpline: 1-866-531-2600

Crisis Text Line: free, 24/7, confidential text message service for people in crisis. The service is currently available in Canada via SMS at 686868. Info about depression

Mood Disorders Association of Ontario:  https://www.mooddisorders.ca/faq/depression 


Ariel Blau has a formidable passion for helping his clients energize a joyful, loving and creative life. He has more than 30 years of experience helping people bloom. His formal education includes a Master’s degree in Social Work from New York University, a Master’s in Fine Arts from Brandeis University, and a great number of workshops, certificates and seminars. He has been studying mindfulness and how to bring compassion into the world for more than 15 years. His passion for helping others is matched by his enormous drive for continuous learning. Ariel completed his professional clinical training at Yale New Haven Psychiatric Hospital and served as  Lead Clinician at the Jewish Family Service of Greater New Haven.

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