Depression - how to help?

I forgot to say - the depression isn't about the stroke....she actually doesn't believe she had a stroke, she thinks it was a panic attack. She spoke to a neighbour who has them and the same neighbour suggested she might have had a panic attack. I was there, it wasn't panic attack, but we don't disagree with Auntie as she is so insistent.

She says 'When I think of all I've lost it's no wonder I'm depressed'. She still has her husband, all three of her siblings, her health (though you wouldn't know it). The things she seems to be depressed about - friends who died years ago, what she would do if her husband died, the weather, all the clutter in their garage, the fact that she can't see me and her two sisters as often as she would like..... She says she doesn't feel wanted which feels like a huge insult to us, as we are a very close family and very involved with each other's lives. For her 70th birthday one of her sisters threw her a big party, my mother took her and her husband on holiday for a week, I look after her animals regularly when they go on holiday (actually moving into her house while she's away) or out for the day. She talks to several of us on the phone every day at length, and sees most of us at least weekly. When she had the stroke three of us spent three days at the hospital from morning until night with her. Those are just a few instances of how very involved we are as a family.

After the stroke, she was absolutely fine for a couple of weeks. During that time she had cards, letters, flowers, more visits than usual from everyone she knows....when all that died down she said she felt a bit 'low' and it just got worse.

About fifteen years ago she had cancer, from which she made a full recovery. Her two sisters between them made sure she was never left alone at all for several months, while all her radiotherapy and other treatment was completed. They made her eat healthily, made her take exercise and just did not leave her side for months, except for at night when her husband was there. My mother even got special permission to take several weeks of unpaid absence from work on compassionate grounds, after she had used all her paid leave up looking after Auntie. We wonder if my Aunt was expecting something similar after the mini stroke, and feels neglected because she isn't getting that level of involvement from us all. She has remarked recently on how she wasn't left alone when she had the cancer, and how everyone rallied round. The stroke left her completely recovered within days, there is nothing wrong with her physically at all, her husband has given up his job because she wanted him with her at all times. My Mum can't take an unpaid leave of absence to be there all day too!

I do wonder if she is trying to provoke a response from the family. For instance, she left a message on my Mum's answer machine yesterday '...(deep sigh), (long pause).... I NEED you...... (another sigh)'. Mum was out, but when she rang her back Auntie wasn't in. When Mum finally got hold of her today, it seemed that the 'problem' was that Auntie didn't know if she should put moisturiser on under her make-up. We were worried she had been taken ill.

I've been reading online abut depression. I understand that how you think can influence how you feel and she just seems to be thinking herself deeper and deeper into it. I know that regardless of the cause, she must be feeling dreadfully unhappy. I just wish I knew how to help.

Honey, it might help *you* to understand that one aspect of depression and anxiety is poor judgment. If your Aunt is doing things that seem to you counterproductive, it is not because she wants to feel bad, but because her judgment is bad. It is a symptom of her disease, not a sign that she is trying to prolong it.

Another aspect of depression and anxiety is limited control over negative thoughts. My husband has been treated for anxiety from time to time, and for him his thoughts can be like a runaway train, no matter how irrational he may know they are in some corner of his brain. Same for me and depression. Compare those thoughts to physical pain; you can't stop them by willpower alone.

I certainly understand your frustration, and I applaud you for your efforts to understand her disease better. I have to go get Iris, who won't stop crying for the sitter, so I will write more later. My advice for you now is to try not to judge your aunt, and try to maintain your compassion. That's all you can do, really. That and possibly try to get her to have her medication changed if it is really unhelpful. I will say that depression can be much harder if you get the sense that your loved ones think you should "snap out of it."

My thoughts and prayers go out to you -- not much is worse than watching a loved one suffer and feeling that you are powerless to help.

I'd just like to echo what Shaun said.
When I experienced Postpartum Depression, I thought that I should be able to make myself "snap out of it". When I was unable to do so, I felt even worse. In this way, depression feeds upon itself.
Another point I'd like to make is that one of the afteraffects of stroke is emotional lability. I've taken care of elderly stroke patients, "stiff-upper-lip" type gentlemen who found themselves crying like little children over the smallest of frustrations.
One more thing, is that not every anti-depressant will work for every patient. It might take some tweaking to find the right medication. Furthermore, it can take weeks or months for the medication to work. Antidepressants also work best in combination with psychotherapy.
A final thought: exercise has been shown to help with the symptoms of depression. I know, that's the great paradox and challenge: how do you motivate the depressed person to go out for a walk?
This situation sounds so frustrating for everyone involved. I wish I could offer more than my best wishes.
Rose

Strokes can cause depression and anxiety because of their effect on the brain.

I think your auntie saying she feels unwanted is really very understandable part of anxiety...it may be that she does need meds for more than just depression anxiety often accompanies depression but its not quiet the same and i can totally see how a small thing to most people like moisturise can trigger a chain of frustrating thoughts that all lead you to feeling life is totaly bad and sad...im sure it wasnt truly the decison to use it or not that made her call your mother it was more likely that she just needed a bit of comfort in a panic moment wich she mave have many of while medication kicks in...if you and your family want to help her the best thing you can do is learn about depression and take it with a grain of salt...if she calls up and seems to need attention over something small then let her know it was important to you....as long as she feels comfortable that your not being burdened by her and that you care you are helping just by being there much like a pregnant woman who wants icecream and hot suace at 2 am.Just stay on her about her medicne and letting her doctor know how its working.Doctors arent really great about knowing all the variations of depression and thus will throw the most popular meds at you and if you dont let them know then they assume all is well.The meds as were said do take alot of tweaking its hit and miss.She may not feel good socialising much outside her comfort zone until the meds work so maybe finding something she likes to do at home will help.