What you don't say to a depressed person - (8/3/2021)

By Dr. Ron Gasbarro

After decades of practicing pharmacy, the pharmacist knows a few things about life. For example, when someone tells you that their dog is sick, you don't say, "Well, how old is she?" That question makes the owner feel sad. When someone tells you that they have lung cancer, you don't say, "Did you used to smoke?" That makes the person feel like she did something wrong. When someone tells you that he fell down the stairs and broke his ankle, you don't say, "Had you been drinking?" That makes the person feel defensive.

So, what does the pharmacist say when a patient presents an antidepressant prescription – a drug used to curb the severe symptoms of a mood disorder? What the pharmacist does not say what's one's neighbor said to his patient. "Oh, boy, was I depressed for a long time! I went from doctor to doctor, trying all sorts of pills. Nothing worked. But then I straightened it all out in my mind, got a divorce, changed jobs. I did it all myself! Those doctors don't know anything, blah blah blah..." Listen up! No. One. Cares. Especially the depressed person who has an entirely different set of circumstances. It's just unwelcome, self-centered noise. Just shut the front door!

The pharmacist does not offer advice. Regarding advice, someone once said, "Wise men don't need it, and fools won't heed it." Nevertheless, giving advice did not stop a patient's cousin from voicing his opinion on handling depression. "Do what I do! I play tennis. I look up old friends. I cook. I'll clean the whole house if I have to! Just snap out of it!" Tell that to someone who has stared at the vacuum for 6 weeks and noticed that everything in the veggie crisper was a moldy brown. 

The pharmacist does not judge by appearances. One of his patients was always happy-go-lucky. Big smile on his face. Always a joke to make you chuckle. So, when his wife found him hanging from the oak tree in the backyard, she told the pharmacist about the real person she knew. "He had a very dark side. Impenetrable. COVID did not help. He was petrified. I could not help him." 

What are the consequences of not getting treated for depression? Isolation, substance abuse (aka self-medication), loss of relationships, occupation failures, suicide. Are medications suitable for everybody? No. Some people need to talk to an objective person. One might start with a psychologist who can refer them to a psychiatrist if the problem is organic rather than situational (e.g., opioid addiction versus the understandable grief one feels when one's cat dies). If a medication is prescribed, the pharmacist will explain how to take it, when it might begin to work, and what to do if it doesn't. In addition, the pharmacist will keep tabs in terms of adherence to therapy – that is, timely refills – worrisome side effects and any financial considerations. 

There are appropriate ways to communicate with a person who is depressed. "I can't feel your pain, but I can be here for you. Even just to listen." "Let me know if you want to do something. I usually walk around the park in the afternoon." "I make a breathtaking tuna noodle casserole. I can bring some over, and we can pick at it together!" Keep it light. But remember that even if the person laughs along with you, it doesn't mean she feels any better. How does depression feel? Depression makes you feel like you are lost in the world, but really, all you want is to be found. Try to be that gentle yet guiding light for that depressed person. 

Ron Gasbarro, PharmD, is a recovering pharmacist and writer-in-residence at Rx-Press.


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