Help Someone with Depression

If you know someone close to you that is suffering from depression, it can be difficult, confusing, and saddening, not just for him or her, but for you as well. You want to be able to help your loved one, but you need to make sure you also say and do the right things. Even if it seems they aren't listening to you, they are trying. If you are looking for some ways to help someone cope with depression, these tips are exactly what you need.

Steps

Talking to Your Loved One About Depression

  1. Get help immediately if your friend is considering suicide. If this person is considering suicide, please seek help immediately by calling 911 or taking him to the nearest emergency room.
    • In the U.S., you can also call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or 800-SUICIDE (800-784-2433).
  2. Watch for symptoms. If you suspect your loved one has depression, take stock of his behavior to get a sense of his level of depression. Make a list of the symptoms that you notice.
    • Frequent, prolonged, and/or seemingly unprovoked sadness
    • Lost interest or pleasure in things that were once enjoyed
    • Significant loss of appetite and/or weight
    • Overeating and/or weight gain
    • Disrupted sleep patterns (either unable to sleep or sleeping too much)
    • Fatigue and/or loss of energy
    • Increased agitation or decreased movement noticeable by others
    • Feelings of worthlessness and/or excessive guilt
    • Difficulty concentrating or feeling uncertain.
    • Recurrent thoughts of death or suicide, attempting suicide or having a plan for suicide
    • These symptoms may last for 2 weeks or more. They may stop and come back again. These are called “recurrent episodes.” In this case, the symptoms are more than just a “bad day.” They are a severe change in mood that affects the way someone functions in everyday life.
    • If your friend has had a death in the family or another traumatic event, she may exhibit depressive symptoms and not be clinically depressed.
  3. Have a conversation with your loved one about their depression. Once you have recognized that your loved one is suffering from depression, you should be honest and have an open conversation with that person. [1]
    • If your loved one won't admit that there is a serious problem at hand, he will have a hard time getting better. Or you can talk to another close, trustable friend or relative about the person facing depression. They might handle these things better.
  4. Explain that depression is a clinical disorder. Depression is a medical condition that can be diagnosed by a doctor. It also can be treatable. Reassure your loved one that the depression they’re feeling is real.[1]
  5. Be firm. Make it clear that you are worried about your friend. Don't let her brush it off by saying she's just having "a bad month.” If your friend tries to change the subject, steer the conversation back to her emotional state but if she/he gets aggressive (openly hesitates to talk) about it drop the subject. Find another appropriate time to talk about this.
  6. Don't be confrontational. Remember that your loved one is suffering from an emotional problem and is in a very vulnerable state. Though it's important to be firm, don't come off too strong in the beginning.
    • Don’t start by saying, "You're depressed. How are we going to deal with it?" Instead, start off with: "I've noticed that you've been pretty down lately. What do you think has been going on?"
    • Be patient. It takes a while for a person to open up sometimes, so give it as much time as they need. Just try not to let him blow off the conversation.
  7. Know that you can’t “fix” the depression. You probably want to help your friend as much as you can. But there's no simple way to "fix" depression. You can encourage her to get help, and you can be there for her. Ultimately, however, it's up to your friend to want to get better.[2]
  8. Discuss the next steps. Once your friend recognizes that he is depressed, you can talk about ways to start addressing it. Does he want to talk to a counselor? Does he want to see a doctor about a prescription treatment? Is there any aspect of his life that's beating him down? Is he dissatisfied with his life or lifestyle?

Helping Your Loved One Get Help

  1. Recognize when your loved one should seek professional help. Before you two try to tackle the problem on your own, understand that untreated depression is very serious. You can still help your friend, but he should also see a mental health professional. There are different types of therapists, each of whom offers different skills or specialties. These include counseling psychologists, clinical psychologists and psychiatrists. You can see one or a combination of different ones.
    • Counseling psychologists: Counseling psychology is a field of therapy that focuses on helping skills and helping people overcome difficult times in their lives. This type of therapy can be short or long-term and is often problem-specific and goal-directed.[3]
    • Clinical psychologists: These are trained to administer tests to confirm a diagnosis and therefore, tend to focus more psychopathology, or the study of behavioral or mental disorders.[4]
    • Psychiatrists: These may use psychotherapy and scales or tests in their practice, but are typically seen when medication is an option the patient wants to explore. In most states, only psychiatrists can prescribe medication.
  2. Give your loved one some referrals. For help finding a counselor, consider recommendations from friends or family, religious community leaders, a local community mental health center, or a medical doctor.[5]
    • Other professional associations like the American Psychological Association may provide search functions for locating their members in your area.[6]
  3. Offer to make an appointment for your loved one. If your loved one is unsure about seeing a medical professional, you might consider setting up the appointment for him. Sometimes, it can be difficult for someone to take this first step, so he might need your help doing so.[7]
  4. Accompany your loved one to the first appointment. You can accompany your loved one to see the doctor so he is more comfortable.
    • If you talk directly with the mental health professional, you might have the chance to tell her briefly about your loved one’s symptoms. But keep in mind that this counselor will likely want to talk to your loved one alone.
  5. Encourage your loved one to find a good counseling fit. If the first counseling session doesn’t work out well for your loved one, encourage him to try another counselor. A bad counseling experience can put someone off the whole idea. Remember that not all mental health professionals are alike. If your loved one doesn’t like his counselor, help him find a new counselor.
  6. Suggest different types of therapy. Three main therapies have most consistently shown a benefit to patients. These are cognitive behavioral therapy, interpersonal therapy and psychodynamic therapy. Your loved one may benefit from different types of therapy depending on his situation.[8]
    • Cognitive behavioral therapy (CBT): The goal of CBT is to challenge and change beliefs, attitudes, and preconceptions that are thought to underlie depressive symptoms and effect change to maladaptive behaviors.
    • Interpersonal therapy (IPT): IPT focuses on dealing with life changes, building social skills, and addressing other interpersonal issues that may contribute to depressive symptoms. IPT may be particularly effective if a specific event (such as a death) has triggered a recent depressive episode.
    • Psychodynamic therapy: This type of therapy aims to help a person understand and cope with feeling that derive from unresolved conflicts. Psychodynamic therapy focuses on identifying unconscious feelings.[9]
  7. Suggest the possibility of medication. Antidepressants can help a depressed person feel better while they undergo counseling. Antidepressants affect the neurotransmitter of the brain to try to counteract problems in how neurotransmitters are made and/or used by the brain. Antidepressants are categorized based on the neurotransmitters they affect.[10]
    • The most common types are SSRIs, SNRIs, MAOIs, and tricyclics. Names of some of the most widely used antidepressants can be found by searching for antidepressants online. [11]
    • If an antidepressant alone isn’t working, your therapist might recommend an antipsychotic. There are 3 antipsychotics (aripiprazole, quetiapine, risperidone) and an antidepressant/antipsychotic combination therapy (fluoxetine/olanzapine) approved to be used along with a standard antidepressant for treating depression when an antidepressant alone is not working.[12]
    • A psychiatrist may suggest trying a few different medications until one seems to work. Some antidepressants backfire on some people. It’s important that you and your loved one monitor how the medication affects him. Take special note of any negative or unwelcome change in mood immediately. Usually, switching to a different class of drug will fix the problem.
  8. Pair medication with psychotherapy. To maximize how medication works, your loved one should continue to visit a mental health professional on a regular basis while taking the medication.[13]
  9. Encourage patience. Both you and your loved one should be patient. The effects of counseling and medication are gradual. Your loved one will be attending regular sessions for at least a few months before noticing an effect. Neither of you should give up hope before the counseling and medication has had time to work.
    • Generally speaking, it will take at least three months to see any lasting effect from an antidepressant.
  10. Determine if you should get permission to discuss treatment. Depending on your relationship with this person, you might see if you can get permission to discuss treatments with his doctors.[14] Normally, someone’s medical records and information are confidential. There are special considerations regarding records privacy when mental health is concerned.[15]
    • Your loved one would most likely need to give written permission for you to discuss treatments.
    • If your loved one is a minor (under the age of consent), the parent or guardian will have permission to discuss treatment.
  11. Make a list of medications and treatments. Compile a list of medications that your loved one takes, including dosages. List the treatments he is receiving as well. This will help in making sure that your loved one is following his treatments and keeping up with his medications.[14]
  12. Communicate with others in the person's support network. You should not be the only person who is trying to help your loved one. Get in touch with trusted family, friends, or clergy. If the depressed person is an adult, be sure to ask him for permission first to speak with others and rally support. By talking to others, you will pick up additional information and perspectives about your loved one. This will help you feel less alone with the situation.
    • Be careful when you tell other people about the person's depression. People can be judgmental if they do not understand the issue fully. Carefully choose whom you tell.

Communicating with Your Loved One

  1. Be a good listener. The best thing you can do is listen to your loved one talk about the depression. Be prepared to hear anything that he or she may say. Try not to look too shocked even if he or she is saying something truly awful, because that will shut them down. Be open and caring. Listen without judgement.[16]
    • If your loved one will not talk, try asking a few gently phrased questions. This might help him open up. Try asking how he spent his week, for example.
    • When your loved one tells you something upsetting, encourage him or her by saying, "It must have been very difficult for you to tell me that," or "Thank you so much for opening up."
  2. Give your loved one your full attention. Put away your phone, make eye contact, and show that you are giving 100 percent of your effort to your conversation.
  3. Know what to say. What a person suffering from depression needs most is compassion and understanding. Not only do you have to listen well, but you need to be sensitive about what you say when you talk about the depression. These are some helpful phrases to use when talking with your loved one:[14]
    • You are not alone in this. I'm here for you.
    • I understand you have a real illness and that's what causes these thoughts and feelings.
    • You may not believe it now, but the way you're feeling will change.
    • I may not be able to understand exactly how you feel, but I care about you and want to help.
    • You are important to me. Your life is important to me.
  4. Don’t tell them to “snap out of it.” Telling someone to "snap out of it" or "lighten up" isn't usually a helpful thing to say. Be sensitive. Imagine feeling like the world is against you and everything is falling apart. What would you want to hear? Realize that depression is a very real and painful state for the sufferer. Don’t use phrases like these:[14]
    • It's all in your head.
    • We all go through times like this.
    • You'll be fine. Stop worrying.
    • Look on the bright side.
    • You have so much to live for; why do you want to die?
    • Stop acting crazy.
    • What's wrong with you?
    • Shouldn't you be better by now?
  5. Don’t argue about how your loved one is feeling. Don’t try to talk the depressed person out of his or her feelings. The depressed person’s feelings may be irrational, but saying that he or she is wrong or arguing with him or her is not the way to go. Instead, you might try saying, "I’m sorry that you’re feeling bad. What can I do to help?"
    • Be aware that your loved one may not be honest about how bad he is feeling. Many depressed people are ashamed of their condition and lie about their depression. If you ask, "Are you okay?," and he says, “Yes,” think about asking in a different way to get at how he really feels.
  6. Help your loved one see the positive side of things. When talking with your loved one, try to hold as much positive conversation as possible. Don't be forcefully perky, but show your friend a better angle of their life and situation.

Being There for Your Loved One

  1. Stay in contact. Call your loved one, write him an encouraging card or letter, or visit him at home. This will show that you will stick by him no matter what. There are many different ways to stay in contact with the person you care about.[16]
    • Make a point of seeing your loved one as often as you can without overwhelming him.
    • If you're working, email him to check in.
    • If you can't call every day, communicate through texting as often as you can.
  2. Take your loved one for a walk. Your loved one may feel better, even just a little bit, if he spends some time out of the house. It can be monumentally difficult for a person suffering from depression to get outside in the first place. Offer to do something that your loved one might enjoy in the fresh air.
    • You don't have to train for a marathon together. Just try going for 20-minute walk with your loved one. He may feel a little better after engaging in some physical activity outdoors.
  3. Get out into nature. Some studies have shown that connecting with nature can reduce stress and elevate mood. [17] According to research, walking in green areas can help a person’s mind get in a meditative state, contributing to further relaxation and improved mood.[18]
  4. Enjoy the sun together. Getting some sunshine will elevate a person’s vitamin D levels, which can contribute to improved mood.[19] Even just sitting on a bench and soaking in some sunlight for a few minutes can be helpful.
  5. Encourage your friend to pursue new interests. Your friend may get distracted, even momentarily, from his depression if he has something to engage in and look forward to. While you shouldn't force your friend to take up skydiving or learn the entirety of the Japanese language, encouraging your loved one to have some interests can help shift the focus away from his depression.
    • Find some uplifting literature for your friend to read. You can read together in a park, or discuss the book.
    • Bring over a movie by your favorite director. Your friend can fall in love with a new range of movies, and you can keep your friend company while you watch.
    • Suggest that your friend try to express his artistic side. Drawing, painting, or writing poetry can help your friend express himself. This is also something that you can do together.
  6. Acknowledge your friend’s achievements. Whenever your friend achieves a goal, acknowledge and congratulate him. Even small goals, such as taking a shower or going to the grocery store, can be significant for someone who is depressed. [16]
  7. Be there to improve your loved one's everyday life. You can encourage your loved one to try new things and get outside, but sometimes the best thing you can do is be there for all the mundane things. This can help your loved one feel less alone.[16]
    • Being there for low-key activities like making lunch or watching TV can make a big difference.
    • You can ease the depressed person’s burden by helping with the small things. This might be running errands, shopping for food and necessities, cooking, cleaning, or doing your loved one's laundry.[16]
    • Depending on the situation, giving your loved one healthy physical contact (such as a hug) can help him feel better.

Avoiding Caretaker Burnout

  1. Step back every so often. You may become frustrated when your well-meaning advice and reassurance are met with sullenness and resistance. It is important that you don’t take your loved one’s pessimism personally. It’s a symptom of the illness, not a reflection of you. If you feel that this pessimism is taking up too much of your energies, take a break and spend time doing something that you find inspiring and enjoyable.
    • This is especially important if you live with the person and find it hard to get away otherwise.
    • Direct your frustration at the illness, not the person.
    • Even if you don't hang out, make sure to check in at least once a day so you know your loved one is coping.
  2. Take good care of yourself. It is easy to get wrapped up in your friend’s problems and lose sight of yourself. Being around a person who is depressed could bring your mood down, or you may get your own issues triggered. Recognize that your feelings of frustration, helplessness, and anger are perfectly normal.
    • If you have too many personal issues of your own to sort out, you may not be fully able to help your friend. Don't use your friend's problems as a means to avoid your own.
    • Recognize when your efforts to help the other person are keeping you from enjoying your life or taking care of the things that matter the most to you. If your depressed loved one has become too dependent on you, that is not healthy for either of you.
    • If you feel that you're getting seriously affected by your friend's depression, seek help. It may be a good idea for you to see a counselor yourself.
  3. Make time for life away from your depressed loved one. Although you're being an incredible friend by providing emotional and physical support, remember to schedule some "me time" so you can enjoy a healthy and relaxing life.
    • Hang out with plenty of friends and family members who are not depressed, and enjoy their company.
  4. Be healthy. Get outdoors, train for a 5K, or walk to the Farmer's Market. Do what you have to do to retain your inner-strength.
  5. Make time to laugh. If you can't make your depressed loved one laugh a little bit, take the time to hang out with funny people, watch a comedy, or read something hilarious online.
  6. Don't feel guilty about enjoying your life. Your friend is depressed, but you are not, and you are allowed to enjoy your existence. Remind yourself that if you're not feeling like your best self, you won't be able to help your friend.
  7. Educate yourself about depression. If you know someone with depression, you must have an understanding of what they're going through. Most people don't understand what it's like to have a disorder like depression. This general ignorance makes life far more difficult for depressed people. Having just one person who doesn't judge or criticize, who knows to give them some slack, could literally be a lifesaver for any of them. Read up on depression and talk to a mental health expert, or maybe a person who has had depression or a similar disorder.



Tips

  • Remind your loved one that he is never alone and that if he ever needs to talk to someone, you’ll be there.
  • Let the depressed person know that you understand their problem. Don't let them think they are a burden to you.

Warnings

  • If you can, in a crisis, try to call a health care professional or suicide hotline before involving the police. There have been incidences where police intervention in cases of people in mental crisis have resulted in traumatization or death. When possible, involve someone you're sure has the expertise and training to deal specifically with mental health or psychiatric crises.[20][21][22]
  • Monitor possible suicidal gestures or threats. Statements such as "I wish I were dead," or "I don’t want to be here anymore" must be taken seriously. Depressed people who talk about suicide are not doing it for attention. If the person you care about is suicidal, make sure that a doctor or trained professional is informed as soon as possible.

Related Articles

Sources and Citations

  1. 1.0 1.1 http://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression/art-20045943
  2. http://www.helpguide.org/articles/depression/helping-a-depressed-person.htm
  3. http://www.div17.org/about-the-field-of-counseling-psychology/what-is-counseling-psychology/
  4. http://www.div17.org/about-the-field-of-counseling-psychology/counseling-vs-clinical/
  5. http://www.apa.org/helpcenter/choose-therapist.aspx
  6. http://locator.apa.org/
  7. http://www.depressionalliance.org/information/getting-help
  8. http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf
  9. http://www.webmd.com/depression/guide/psychodynamic-therapy-for-depression
  10. http://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046273
  11. http://abcnews.go.com/Health/MindMoodNews/story?id=6761204&page=1
  12. http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001403
  13. http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf
  14. 14.0 14.1 14.2 14.3 http://www.dbsalliance.org/site/PageServer?pagename=help_friends_family
  15. http://www.hhs.gov/ocr/privacy/hipaa/understanding/special/mhguidance.html
  16. 16.0 16.1 16.2 16.3 16.4 http://www.depressionalliance.org/information/day-day-support
  17. http://www.crchealth.com/troubled-teenagers/feeling-depressed-get-some-fresh-air/
  18. http://www.huffingtonpost.com/2014/09/23/walk-nature-depression_n_5870134.html
  19. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908269/
  20. The Washington Post: Distraught People, Deadly Results - Officers often lack the training to approach the mentally unstable, experts say (USA)
  21. Center for Public Representation on patterns of police violence against people with psychiatric disabilities
  22. Police Brutality's Hidden Victims: The Disabled