I’ve looked up to my big brother Mike my entire life. And I’ve had plenty of reasons to do so. A natural leader, as well as a strong and accomplished athlete, Mike is also funny and kind, super smart and handsome. He and his wife Lisa met in high school, where they were not only voted homecoming king and queen, but went on to nab the title of prom king and queen as well. Everyone—students and teachers alike—loved them.

After college, Mike and Lisa married and had two beautiful children, a son Jared and then a daughter, Kristen. She was just a toddler when Mike first began displaying signs of depression—to the outside world, anyway. When things got really rough, they decided that getting a fresh start might help. They moved, first to California and then to Arizona. I was crushed that my role models and best friends were now thousands of miles away. So I watched Mike’s tenuous mental health journey mostly from afar as one bout with depression turned into another, longer struggle, and then another. After Mike was finally correctly diagnosed a few years ago with bipolar disorder, the tide started to turn. But it’s been a difficult, scary, and often painful journey for him, and also for his family. Recently, I sent Mike the article, “How Do You Serve a Friend in Despair,” (https://www.skyline725.com/how-do-you-serve-a-friend-in-despair/2/) by David Brooks. I wanted, as always, to know his thoughts. During our ensuing conversation, I asked if he’d be willing to share his experience and observations about mental health with all of you. Having served as an ambassador for the National Alliance on Mental Illness, or NAMI (https://nami.org/Home), Mike readily agreed to share his story. Here’s his post, and as always, feel free to offer your thoughts.

Serving a Friend with Mental Illness

By Mike Jarecki

I’ve dealt with clinical depression on and off during my adult years. That diagnosis changed to bipolar disorder as I entered retirement. I told one of my friends (an alcoholic and sexual abuse survivor) that I had bipolar disorder. He said “I would never have thought that.” I was tempted to say, “What does a person with bipolar disorder act and look like?” 

The singular description of how depression (a part of bipolar disorder) felt to me is “I can’t enjoy anything.” I strived to understand and answer the “why” of depression and resulting suicide attempt. I discovered that traumatic events and genetics can be culprits but the reality is, no one knows for sure.  

In fact, the medical community knows very little about exactly how medicines and treatments for depression actually work. Professionals who treat mental illness often have a hard time coordinating care with other medical specialists. It is good to see that new medicines and treatments are appearing more frequently as a result of increased funding and research. But we desperately need more. Some traditional medicines and treatments are continuing to be prescribed, like talk therapy, first utilized by Sigmund Freud, even though much of his other work has been challenged or debunked by modern science. This shouldn’t be surprising, given that Freud’s theories on treating mental illness were developed more than 100 years ago, during the highly repressive Victorian era, and without using modern scientific methodology or being subjected to any sort of rigorous scientific analysis.  

Other traditional therapies for treating depression, such as electroconvulsive therapy, or ECT, have been highly stigmatized for years, but, at a 70% success rate, ECT has long been an amazingly effective treatment for depression. I had far more than the typical amount of ECT treatments—I may just hold the record—and for me, they were lifesaving. However, new brain stimulation techniques are less costly, require less time and are more effective. But many of them are still under development. 

I’ve been happy to see that the approach to therapy has changed dramatically during the past few years, especially that it’s frequently much more individualized. Therapy, together with effective medical management, has been the gold standard for effectively treating my mental illness.

If a friend of mine, like the friend of David Brooks, was showing signs of depression, I’d be brave and directly ask my friend if they were thinking about suicide. If they said yes, I wouldn’t “suggest” anything. I would insist my friend (or I) call 988, and/or go to the nearest ER or behavioral health hospital. I’d stay with them until we could agree on the next steps. If they convinced me that they weren’t contemplating suicide, then I would work with them on a plan to get immediate help. Taking those steps, however difficult, could save a life.

The most challenging and frustrating situation occurs when a friend has been unsuccessful at becoming mentally stable, because anything you say will most likely be rebuffed by the disease of depression. My suggestion is to then treat them like they have any other disease, such as cancer, heart failure, Parkinson’s, etc. Show empathy. Offer help. Be there with whatever support they need that you can deliver on.

Mental illness is a brain disease that can’t be cured by the willpower of the suffering. In fact, at one point, depression convinced me that I had no hope of recovery, no matter what I did, because I felt like no one could truly understand how I felt. What definitely did help was people who were supportive, who really listened to me, and who I knew would do anything to help me. I came to believe they would always love me, no matter what. And I was right.

Photo by Kent Morin.