How do I explain my depression?

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Question:  I can't win.  Every fall I start to get depressed and it happens at other times in the year.  Sometimes I just need to cry or be sad but my boyfriend feels like a failure if I'm not happy.  My parents think I'm just a drama queen because when I'm with my friends or my boyfriend I can be happy and laughing but then when it is time to get out of bed for school sometimes I just can't do it.  My boyfriend wants me to tell him how I"m feeling and I want to be honest with him, but then we fight because I don't want to hear a pep talk, I just want him to be there and love me.  How do I get them all to understand that this is real and I can't help it, but it isn't anybody's fault or job to fix it? Sometimes I just need to cry and be sad for awhile. 

Answer:  Psycho-education for families and friends is the most overlooked part of successful mental health treatment.  As a therapist usually my first job is to get my client to understand what you just said:  This is a disease, it isn't about fault and it isn't about fixing it, it is about learning to manage the symptoms and get on with your life.  This process usually takes me a couple of years so that fact that you are already there is a great sign.

There are four methods I would suggest to get the people you care about to understand what you need and what you don't:  direct conversation, writing them a letter, conversation with a third party, book or movie. 

If you are going to use any of the first three methods your first step is figuring out what you want and planning how you want to go into the conversation/explanation.  The format I suggest is:  1.)  Tell them what you are feeling 2.) identify what you think is triggering that feeling 3.) tell them what you are afraid will happen as a result of the conversation/letter 4.) tell them what you hope will happen next (with concrete examples of what you would like them to do instead of what they have been doing).   

When dealing with men conversations often go off the rails when talking about feelings because the man often wants the feelings to make sense (which feelings are not obliged to do), and/or because he has not been given direct instructions on what he is supposed to DO.  When men do not have an action plan they get nervous, especially if there is a crying woman in the room.  If you give your boyfriend a manual and tell him what his role is in helping you he is likely to be more relaxed and follow instructions. 

I generally suggest writing a letter which you then read aloud or have a trusted friend check for potential land mines that will cause the reader to be defensive.  After you have given the letter and time for the reader to digest follow up with a conversation for clarification. 

Sometimes past arguments and relationships represent a block to communication.  Perhaps your parents cannot take information coming from their daughter seriously.  In these cases if you are working with a therapist it is a great idea to get them involved for a joint session where they help explain what is going on for you.  Sometimes that masters degree will make the same words that you already used sound more real to a parent or boyfriend. 

Finally if you have read a book, seen a movie, or even heard a song which really captures the way you feel, try to expose the person to that media.  Sometimes Hollywood does a much better job than we ever could in explaining the way we are feeling, and while most guys are not rushing out to rent "Girl Interrupted" if you ask your man to watch it with you, he probably will. 

None of these people can know what it feels like inside you, even if they have dealt with depression themselves.  They don't need to know and if they are lucky they will never have to.  They do need to be educated, however, that even if there is no reason for them your feelings are real and they matter.  If they want you to be as healthy as possible they will not question your feelings or make you feel bad for having them, they will just support you in the way that works best for you.