Supporting a Loved One with Depression: Tips for Caregivers

How to assist and support friends and family in treating depression?

Hello Dr.
Ding,
My boyfriend has recently been experiencing long-term stress due to family issues and has sought help at a psychiatric clinic.
The doctor diagnosed him with mild depression and mild symptoms of schizophrenia.
The prescribed medications (for one week) are as follows: 1.
Diphenidol 50mg, one tablet twice daily 2.
Lorazepam 1mg, one tablet at bedtime 3.
Leeyo 10mg, one tablet after dinner.

Since starting the medication, he has experienced sleepwalking and incoherent speech during the night, and during the day, he feels lethargic and lacks motivation to work.
I have read that the side effects of medications may diminish or disappear with continued use, but we are concerned about the potential for addiction.
If he develops a tolerance to the medication and requires higher doses, is that truly beneficial for his health and condition?
Another concern is that my boyfriend was originally very optimistic, outgoing, and cheerful, and the family-related stressors are not something that can be resolved quickly.
During the treatment period, especially when he experiences side effects from the medication at night, how can I best support him? Are there specific behaviors I should watch for, and if I notice them, should I address them quickly or seek help from others? Thank you, doctor.

Linda, 30~39 year old female. Ask Date: 2016/12/19

Dr. Ding Shuyan reply Psychiatry

Hello, in the first few days of starting medication, if you experience physical or mental symptoms that you haven't had before, it is important to consider the possibility of side effects from the medication.
Some side effects may gradually diminish after continuing the medication for a few days, but this is not always the case; some may not improve and could even worsen, which should be reported to your physician.
Regarding experiences such as sleepwalking or speaking incoherently at night, it may be worth considering an adjustment in the medication.

You mentioned addiction or tolerance dependence, which typically arises after long-term use of high doses of medication.
The challenges in treating depression or schizophrenia mainly revolve around the effectiveness of the medication.
Currently, there are no tests available that can help us select effective medications in advance or avoid those that may have side effects.
Fortunately, antidepressants and antipsychotic medications are theoretically less likely to lead to drug resistance.
If the treatment is ineffective or the side effects are too difficult to tolerate, switching medications is also an option.
During the illness, especially with depression, negative thinking can be more prevalent, leading to feelings of wanting to give up or emotional instability.
I recommend encouraging him to follow the physician's prescriptions and lifestyle adjustments, while also monitoring for any suicidal thoughts or plans that have not yet been acted upon.
Discuss these concerns during follow-up appointments with the physician.
If you notice any signs of suicidal behavior, it is crucial to seek emergency medical attention immediately.

Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2016/12/19

More Info

Supporting a loved one with depression can be a challenging yet rewarding experience. It’s essential to approach this situation with empathy, understanding, and a willingness to learn about the condition. Here are some tips for caregivers, particularly in the context of your boyfriend's recent diagnosis of mild depression and mild symptoms of schizophrenia.

Understanding the Diagnosis
First, it’s crucial to understand that depression and related disorders can manifest in various ways. Your boyfriend's symptoms, such as sleepwalking and incoherent speech, may be side effects of the medications he is taking. The medications prescribed, including Diphenidol, Lorazepam, and Leeyo, can have sedative effects, which might contribute to his lethargy and lack of motivation during the day. While some side effects may diminish over time, it’s essential to monitor his reactions closely.

Communication is Key
Open and honest communication is vital. Encourage your boyfriend to express how he feels about the medications and any side effects he experiences. It’s important to create a safe space where he feels comfortable sharing his thoughts without fear of judgment. This can help you both identify patterns in his behavior and mood, which can be useful for his healthcare provider.

Encourage Professional Guidance
Since your boyfriend is already under the care of a mental health professional, encourage him to discuss any side effects or concerns about his medications with his doctor. It’s not uncommon for patients to experience side effects when starting a new medication, and adjustments may be necessary. Reassure him that seeking help is a sign of strength, not weakness.

Be Patient and Supportive
Depression can lead to feelings of hopelessness and despair. As a caregiver, your role is to provide emotional support. This can include:
1. Listening: Sometimes, just being there to listen can make a significant difference. Avoid trying to "fix" his problems; instead, validate his feelings and let him know that it’s okay to feel the way he does.

2. Encouragement: Gently encourage him to engage in activities he once enjoyed, but be mindful not to pressure him. Small steps can lead to significant improvements over time.

3. Routine: Help him establish a daily routine that includes time for self-care, such as exercise, healthy eating, and relaxation techniques. Routine can provide a sense of normalcy and stability.

Monitor for Warning Signs
Be vigilant for any warning signs that may indicate worsening symptoms or a crisis. These can include:
- Increased withdrawal from social interactions
- Expressions of hopelessness or worthlessness
- Any talk of self-harm or suicidal thoughts
If you notice any of these signs, it’s crucial to seek immediate help from a mental health professional or contact emergency services.

Take Care of Yourself
Caring for someone with depression can be emotionally taxing. Ensure you are also taking care of your mental health. Engage in activities that bring you joy, seek support from friends or family, and consider joining a support group for caregivers. This will help you maintain your well-being and be a more effective support for your boyfriend.

Conclusion
Supporting a loved one with depression requires patience, understanding, and a proactive approach to their care. By fostering open communication, encouraging professional help, and being a source of emotional support, you can help your boyfriend navigate this challenging time. Remember, recovery is a journey, and your support can make a significant difference in his healing process.

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