Action Strategies: Family and Depression

Like the flu, depression is a highly contagious disorder that can be transmitted socially, jumping from one family member to others. And just as individuals can be depressed, so can whole families, often without their awareness.

As perniciously as it operates in individuals, depression in a family can suck up all the energy of a household, turning what was once a home into a black hole of negative emotions. Usually, such depression is disguised. It tends to show up in bouts of physical illness and a general air of irritability and negativity.

Typically, family members isolate themselves and withdraw into their own spaces, under the protective custody of a computer or TV. And pessimism, sarcasm or silence becomes the dominant style of family exchanges.

Whether or not depression has already moved into a household, families can act to inoculate their members against the disorder. By employing a few basic strategies, families can prevent depression from taking up residence and commandeering their interaction patterns.

• Armed with the knowledge that depression can spread in families, be on the lookout for it. The sooner you spot it, the faster you can help the individual out of it and contain the risk.

  Be aware of how depression tends to show itself at different ages. Young children may be defiant, not overtly sad. In school-age children, depression can manifest as underachievement and withdrawal from activities. Among teens, it is often disguised in smoking, drinking or drug use. Older people often lack an appetite for food or life.

• It is important that families take steps to safeguard their members. A great deal of research proves that the more family-like connections you have, the more inoculated against depression you are.
• Develop skills around positive thinking and positive talking in the household.

  Much as families inherit genes that make them vulnerable to a specific disorder, families often inherit a negative thinking style that carries the germ of depression. Typically it is a legacy passed from one generation to the next, a pattern of pessimism invoked to protect loved ones from disappointment or stress. But in fact, negative thinking patterns do the opposite, eroding the mental health of all exposed.

  When Dad consistently expresses his disappointment in Josh for bringing home a B minus in chemistry although all the other grades are As, he is exhibiting a kind of cognitive distortion that children learn to deploy on themselves—a mental filtering that screens out positive experience from consideration.

  Or perhaps the father envisions catastrophe, seeing such grades as foreclosing the possibility of a top college and thus dooming his son's future. Such exchanges, repeated over time, gather hidden power to become part of a person's belief system.

  Instead, set up guidelines for healthy communication. Make everyone aware of the common types of distortions:

• Catastrophizing. Exaggerating the harmful effects of a disappointing event.
• Personalizing. Seeing yourself or your child as the cause of a disappointing outcome.
• All-or-nothing thinking. such as knowing you're not perfect but feeling like a total loser.
• Overgeneralizing. Interpreting one disappointment as part of an inescapable pattern.
• Filtering. Focusing on negative aspects of an experience while ignoring the positive side.

  Make an agreement among family members to be habit breakers for each other (in the privacy of home) when someone slips into negative thinking. Remind each other.

• Make sure that your family has an ongoing supply of positive experiences and a bank of them to call on when times get rough. Negative experiences carry so much psychological weight that, for an environment to be perceived as benign, positive experiences need to outnumber negative ones 5 to 1. In my experience, a ratio of 2 to 1 is more realistic, especially at first. Shoot for 5 to 1 in the long run.

  Inventory positive and negative interactions as a family. When you eat breakfast together, how does it go? Is it on balance a positive or negative experience?

  What action plan does the family need to use to build more positive experience and lessen the negative? For example, encourage activities in which family members include each other in various combinations. Just going to the movies together can be a highly positive shared event.

• Insist on getting together regularly for meetings to survey emotional needs for the week. Ask, "What do you need to make this work for you?"

  If Sara has a big test on Friday, then one parent might plan to be especially available on Thursday evening for support, perhaps for helping Sara review her information if she wishes, and for seeing that bedtime is observed, which may be a special time for a backrub.

  Checking in on people's well-being contributes to a sense of connectedness that is a major buffer against depression at every stage of life. Paying as much attention to family feelings as to the roster of family activities is one of the best protections against depression.