Skipping tons to wish my American Buffistae a Happy Thanksgiving! I miss hanging out here with you guys. Hope you have a wonderful holiday!

{{amyth}} I am so sorry. Wishes for comfort and strength to all your brother's loved ones. It is good to hear that SIL has a close family. It helps so much.

Shir! Go you with the making positive changes in the world! It is really inspiring.

Family is about to descend upon me so I may be scarcer than usual.

I have to ask a bit of advice from those of you that suffer from depression. My sister is having a really bad time of it right now. She has had problems with depression for decades, but this is the worst it has been in years. She hasn't even been to work in over a week. My cousin has been staying with her during the day to just be there.

They are messing with her meds trying to help, but it is bad. I think maybe she got out of whack because she has lost about 40 pounds and I am sure that affects the chemistry too. Her place of employment for the past 20 some years was recently sold too so big uncertainty in her life.

I am just feeling so completely helpless to do anything for her. I don't know what to say or do, and really I would do anything if it would help. Any advice would be appreciated.

lisah, while handwritten thank-yous are the ultimate in gracious correspondence, I'm sure both Jilli and Judith Martin would back me up in saying that rather than causing yourself physical pain, a computer-printed personal note slipped into the thank you card would be a perfectly cromulant substitute. I know the last couple of thank you cards I received were done in that fashion, and it made me feel quite thanked.

{{{Laura}}} I don't have any experience with what you're going through but I can offer hugs and I know someone wise will be chiming in soon.

I have succumbed to wakefulness and completed my grocery list but I still don't have to get out of bed for at least 45 minutes.

I'm making the sweet potatoes which are usually cooked in bacon grease vegetarian style this year. I don't think Facon makes its own grease so I'll be experimenting with extra virgin olive oil instead. Crossing my fingers that the dish still turns out om nom nommy since I'm changing it so our sole veggie guest can have some.

{{{Laura}}} I wish I had some good advice for you, but I'm not sure I do. When depression gets that bad everyone trying to help can almost make things worse because, at least in my case, I don't feel like I deserve the help. Make sure she knows you are there for her, but don't try to force help on her. Be there when she asks for it.

Laura, what a tough situation. Sending your sister some good vibes.

The last time I was seriously depressed, my friends and family took turns calling me frequently to chat. They also recruited friends and acquaintances who might not otherwise call, to talk to me about their experiences with depression. It helped tide me over until the meds kicked in. This was at a time when I was living in Arizona, so no one was physically near enough to do much more. It did help. Their reminders that the problem was a physical one, taking place in the physical brain rather than just being "all in my head" helped. Knowing that I was not alone, that even if they were far away, they still cared, that helped.

If you are worried that she is suicidal, do talk to her directly about it. A reminder that it is far too permanent an action, and that things are going to get better if she can just hold on long enough, can be more useful than worrying that saying the "s" word might give her ideas.

This link [link] may be of some use, from the Depression and Bipolar Support Alliance.

Also, understand that if she does become determined to commit suicide, there may be nothing you can do to stop her. A determined person will find a way around all precautions, even the ones that the most skillful of professionals can come up with. I do not say this to discourage you. Do the best you can. But it is possible that your best may not be good enough. And that will not be your fault. One time to be especially mindful of suicidal intentions, is after treatment has started working. At its worst, depression is paralyzing. When it starts to lift, the patient may have the energy to act, before actually starting to feel enough better to stop wanting to. I am not trying to cause panic, so I hope this isn't too much.

On a lighter note, laughter can do a lot, in the moment and in the long term. If there is are comedians she likes, or a particular genre of comedies, finding some audio or video for her could be of some use.

ETA: I also remember a therapist telling me that listening to sad music makes a person feel sadder, except for the Blues. But listening to happier music can help too.

I am just feeling so completely helpless to do anything for her.

First, what others have said -- there's only so much you can do. But a few ideas that may help ease the situation.

Can cousin get her out of the house? Doesn't have to be anything big, just getting out and getting sun. Weather permitting, even sitting on the porch can help.

Breaking out of the routine can also help. Again, doesn't have to be a big deal. Even checking out a new TV show might break her out for a little bit.

Laura, it's hard to answer without knowing a bit of your sister's personality. Knowing what the person responds to and what they resist helps one develop an approach. However, there are definitely times when a depressed person needs some tough love. They're stuck in a hole and sometimes they won't see anything but the walls of that hole unless they're forced to stick their head above ground. When they say something that's relentlessly negative, it can be good to give them a reality check, preferably in a Socratic manner so they don't accuse you of being a Pollyanna.

There's an app I've used in when in my worst depression to try to track mood and what things might be making it worse. Just the act of tracking makes me have to examine my life instead of making assumptions about it. It's available for Mac, Windows and as a web app:

[link]

I think having someone there with her is a good thing. When depression is really really bad, many people have trouble even getting out of bed and they fall further and further into hermitry even though that can be exactly what they don't need. If your cousin can somehow go on walks with her or do something to get her moving, I think that would help some.

This season can be hard not only because of holiday family stuff but because the days are so short. Try to help her get on a schedule that she's not sleeping away any of those daylight hours. Candles can help make the early nights a bit cheerier.

Nutrition is important. Make sure she's not deficient in anything because some deficiencies can cause depression. Tryptophan is the pre-cursor for serotonin production. It's present in turkey, milk and other foods so if she's resistant to taking L-Tryptophan in pill form, maybe she'll eat foods that contain it. Stay away from things that bring on crashes like sugar, caffeine and alcohol.

Lisah, I would agree that a typed note with your signature should be just fine.

What everyone said about depression. Ask directly if she's suicidal, and if so, whether she has a plan. And if she's really determined, she will find a way. But it's one area where I've found directness to be most effective.