Dear Lifehacker, My friend hasn’t been herself lately. She seems terribly sad and withdrawn, and I don’t know how to help her. What’s the best way to approach someone who might be depressed? Signed, A Concerned Friend
Photo by aureman.
Kudos to you for looking for a way to help your friend. It’s hard to see someone you care about sink into sadness, and to not know what to say or do to help. Depression is an illness that affects a great many people — not just those suffering from major or clinical depression, but the people close to them too. To help you find the best way to support your friend, I sought advice from mental health experts and deep-dived into personal experiences. Here’s what you need to know.
What Depression Is (And What It Isn’t)
The first step is to understand, as much as possible, what your friend is going through. From the outside, depression could look like regular sadness — the kind that touches all of our lives at times and brings us down before we eventually move on. Depression, however, is more extreme: symptoms last longer, emotions are more intense, and everyday life is simply harder to maintain. Clinical psychologist Dr Jeffrey DeGroat offers this example:
A person who is sad may not study for a few days, avoid going out with friends over the weekend, or skip a couple days of school/work. While a friend who is depressed might not study for weeks on end, avoid spending time with friends and family for weeks on end, and may fail classes or lose their job.
Depression is not sadness. Sadness is common, normal, and, many would say, essential to us as human beings. You might be able to cheer up a sad friend with jokes, encouragement or problem-solving. Depression, on the other hand, is a medical illness or disorder that can sometimes be devastating (every 30 seconds, somewhere in the world someone takes his or her life. You can’t talk or distract a person out of depression any more than you can talk or distract someone out of having the flu or a heart attack. Often, people with depression don’t know why they have that overwhelming feeling of despair or, on the flipside, extreme apathy. Sometimes it doesn’t make any sense. Comedian Kevin Breel stated it so well in his TED talk:
Real depression isn’t being sad when something in your life goes wrong. Real depression is being sad when everything in your life is going right.
Looking back at my own experience, it can feel like you're in a dark hole, like the air has been squeezed out of you, and, at its worst point, feeling completely numb. But people who are depressed are usually pretty good at pretending otherwise for fear of scaring people away. If you want to know more about what it's really like, go read this incredibly brilliant and accurate explanation (in web comic form) by Hyperbole and a Half.
Unfortunately, depression is hard for even mental health professionals to pinpoint and treat, since there are several different forms of this illness, from debilitating major depression to more unique forms, such as Seasonal Affective Disorder (SAD) and postpartum depression. The signs of depression also vary by individual and can include extreme sadness, irritability, difficulty concentrating and/or just a feeling of emptiness.
The most important thing to know is depression is more serious than sadness, and so there are some things that are better to say and do than others.
What You Can Do to Help
It's also hard to be on the outside and not know why someone you care about is all of a sudden in the dumps. As a friend, the best thing you can do is listen and be there for the person. Here are some tips:
Be honest and express your concerns. Dr DeGroat recommends noting any significant changes in behaviour, mood or personality, and then trying to talk to the person about it:
People can exhibit symptoms of depression in many different ways: sadness, irritability, social withdrawal, self-destructive behaviours, loss of interest in activities, change in appetite, change in sleep, and so on. Therefore, rather than determining if your friend or loved one is depressed based on one symptom or another, I would recommend noting if there is any significant change in the person's behaviours, mood, or personality.
If there is, I would recommend beginning by asking your friend how things are going. Your friend may be primed and ready to discuss their feelings, and your invitation to talk might be just what they were waiting for.
You might say something like, "I've noticed you've seemed really down lately. Is something bothering you?"
Don't offer advice or try to "fix" them. If your friend wants to talk, acknowledge/validate her feelings -- "That sounds rough. I'm sorry you're feeling that way" -- without offering advice or positive platitudes ("You'll get over it!" "Look on the bright side!" "Do yoga while watching the sunrise!"). As James Altucher writes:
Nobody wants to die. But its hard to go from wanting to die to suddenly being cheered up. If you say, "I want to die" and everyone else says, "oh, cheer up, there's so much to live for" that's sometimes a hard thing to hear. It's not like you're going to suddenly say, "you know what? You are totally right. I'm cheered up now!"
You cannot solve their problems. Your job is to become a better listener and just be there for the person. Specific things to avoid saying, according to Ventre Medical Associates include:
"There's nothing really wrong with you. It's all in your head."
"Your life is great. What do you even have to be depressed about?"
"Would you just snap out of it already?"
Make sure they know you're there for them. If your friend denies any problems or doesn't want to talk, don't force them to admit they're depressed, Dr Groat says. Instead, stay in contact frequently (emails, quick calls to say hello), much like you would if a loved one is grieving. Ventre Medical Associates says you can show support by offering to do something together: "Even if they don't have interest in the activity itself, the social bonding may help reinforce the fact that they need not suffer alone." Check on if she's eating ok, sleeping well, getting sunlight, and exercise. Even doing just one small thing daily, like making the bed every morning, can help when you feel overwhelmed.
Don't take it personally. Hope Racine writes on the Huffington Post about a few lessons she learned while loving someone with depression, including stop wondering if you somehow caused the depression. Also, trying to help someone in emotional distress can be draining and stressful for you, so remember to take care of your own emotional health too.
Enlist the help of others. You can get guidance from a professional (a school guidance counsellor, Lifeline or others you know) to help find the best strategy to help a loved one. You could also talk with friends in common to do the same.
Help the other person understand about depression, if you can. If you've been through depression yourself, sharing that fact could take away any fear the person has of sharing what they're going through. Just keep in mind that there's no one-size-fits-all "solution" to depression, so your experience and what might have helped you isn't necessarily appropriate for the other person. Some people need medication just be able to get out of bed in the morning, others find psychotherapy helpful, others take it one episode at a time.
Regardless, it would help to show your friend you understand that depression isn't: a sign of weakness, something they should be embarrassed about, or something they should hide. Depression carries a terrible stigma, and that keeps people from getting the help they need. You can refer your friend to these resources to show that they're not alone, those feelings won't last forever, and the condition is treatable:
Depression Lies - Whil Wheaton
Personal Stories of Depression - Anxiety and Depression Association of America
Depression: personal blogs and stories - Time to Change
Suggest counselling or other medical professional help. If your friend's depressive symptoms are interfering with life (failing out of school, skipping work frequently, avoiding social contact, engaging in risky behaviours and so on), Dr DeGroat says he'd recommend talking to them about seeing a psychologist or therapist. You could help your friend find a centre or a therapist (and if the therapist doesn't work out, as sometimes happens, encourage her to keep at it until she finds someone who can help. It takes time.).
What if they want you to back off or are reluctant to get help? Remind them that sometimes we need to get a mental check-up just like we get other medical exams. You might have to collaborate with other friends and family members if it gets very serious and your friend still resists. No one would avoid the doctor if they were having severe heart pain or broke their leg, depression is no less of an important health issue.
Again, most importantly, if your friend begins to express any hints she might hurt herself or someone else, you should contact the authorities for help, because you can't do this on your own. This is the number again for Lifeline: 13 11 14.
If depression is affecting you or someone you know, call Lifeline on 13 11 14.
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