When someone is struggling with depression, even daily tasks can feel insurmountable. But there are steps you can take to help a loved one.
Fashion designer Kate Spade was found dead in her New York apartment on Tuesday, after an apparent suicide. Before her death, Spade, 55, suffered from depression, but had not received treatment, according to her sister, who spoke with the Kansas City Star.
However, her husband, Andy Spade, said in a statement that she was “actively seeking help and working closely with her doctors to treat her disease.” She suffered from anxiety and depression, he said, and was taking medication.
“We were in touch with her the night before and she sounded happy,” he said. “There was no indication and no warning that she would do this. It was a complete shock. And it clearly wasn’t her. There were personal demons she was battling.”
He added, “She was actively seeking help for depression and anxiety over the last 5 years, seeing a doctor on a regular basis and taking medication for both depression and anxiety. There was no substance or alcohol abuse.”
Spade is not alone. More than 16 million American adults, or 6.7% of the adult population, have experienced at least one major depressive episode in the last year, according to the Anxiety and Depression Association of America.
“There is hope and there is recovery,” said Dan Reidenberg, the executive director of Suicide Awareness Voices of Education, a nonprofit based in Minnesota. “Treatment does work. By far, most people who experience depression live and function successfully and go about their lives.”
Major depression — defined as a mood disorder that causes a persistent feeling of sadness and loss of interest — is more common in women than in men, and the median age of onset is 32.5 years old, although it can occur at any age, the ADAA said.
Other causes of suicide
Some 37% of adults with major depressive episodes do not receive any treatment at all. More adults suffer from other types of mental illnesses, including anxiety disorders and obsessive compulsive disorder, which can also make life difficult without treatment.
Some people hide their depression from others, making it very hard to detect. What’s more, depression and suicidality aren’t always linked, Winston said. “There are people who die of suicide where there’s no evidence they were previously depressed, or no one can find evidence they were depressed,” she said.
Or, someone may die of suicide because they feel immense shame, or they have been diagnosed with a terminal illness, she said. “It’s not always depression.”
What to look out for
Feelings of emptiness, hopelessness and guilt are common for those experiencing depression. It helps to know the signs, recognize them and then encourage treatment, according to the Mayo Clinic, a nonprofit academic medical center based in Rochester, Minn.
Common symptoms of depression include feelings of sadness, tearfulness, loss of interest or pleasure in activities. But symptoms also include tiredness, or even sleeping too much, feelings of worthlessness or guilt, changes in appetite and unexplained physical problems.
In some people, especially children and teens, depression may show up as irritability or crankiness rather than sadness. That symptom is often misunderstood, said Sally Winston, co-director of the Anxiety and Stress Disorders Institute of Maryland. Friends and family members may “get mad at them because they’re not their usual self,” she said.
Those at risk might actually talk about suicide or watch television shows and movies about it, or read books or online articles about it, Reidenberg said. He or she may mention death, suicidal thoughts or make statements like “I wish I hadn’t been born,” or, “I feel like I have no future,” or, “I feel hopeless.”
If you think someone is suffering, “ask them directly and clearly,” Reidenberg said. Withdrawing from social contact and wanting to be left alone, increasing use of alcohol or drugs, saying they feel trapped or hopeless and giving away belongings or getting affairs in order can also be signs.
How to offer help
One of the best ways to help: Assist in setting up a doctor’s appointment for someone who is struggling — including helping finding someone who accepts their insurance, if possible. Go with them if needed, help with transportation and continue to follow up, the Mayo Clinic says.
Prepare a list of questions to ask the doctor or mental health provider. Think about a team of loved ones who can reach out to the person at risk at different times, and at different ways. It may be just as uplifting to hear from a friend who lives far away as it is to hear from a close confidante.
Finances should not be a barrier, Reidenberg said. Even for someone who is uninsured, there are free resources, including suicide hotlines and texting lines, and mental health professionals who allow patients to pay on a sliding scale. That scale may even go down to zero, he said.
The nonprofit organization United Way is another affordable mental-health resource, he said. The emergency room is another option if needed, because patients can go there for an evaluation and be treated, even without showing proof of insurance.
When to intervene
The days following a high-profile death may be an even more important time to do this: Exposure to someone else who has died by suicide, even if that person is a celebrity, is one of the risk factors for suicide and can lead to copycat suicides, according to the NIMH.
Someone who is already considering suicide might be more at risk after Spade’s death. In fact, after actor Robin Williams died of suicide, there was a 10% increase in suicides in the U.S., with a particular uptick among people ages 30 to 44, according to researchers at Columbia University.
“They start to identify with the person who has died,” Reidenberg said. “They might think, ‘Here is someone who had fame and fortune and access to good care and was married and had a child. If she can’t make it, how can I make it?’ But you can lead a functioning, successful life.”
How to talk about it
Broach the subject carefully. Ask directly if your friend or loved one has considered suicide, Reidenberg said. Research suggests that talking to someone about suicide isn’t going to lead them to taking their life, nor will it put the thought into their head, he said.
“If they are, in fact, really thinking about it, talking might give them a sense of relief,” he added. “Then, you can form a connection, which will be helpful in getting them the help they need.” It also allows you to let family members and friends know what’s going on.
Make sure the person is supervised and in a safe environment and eliminate anything that they might use to harm themselves, such as weapons. Call a suicide hotline, like the National Suicide Prevention Lifeline at 1-800-273-8255. And, if there is immediate danger, call 911.
Maria LaMagna covers personal finance for MarketWatch in New York.
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