How To Help A Friend With Depression

The first step toward defeating depression is to define it. But people who are depressed often have a hard time thinking clearly or recognizing their own symptoms. They may need your help.

 

Signs to Look For 

Have you noticed a friend or friends with any of these symptoms persisting longer than two weeks?

Do they express feelings of: 

  • Sadness or "emptiness"?

  • Hopelessness, pessimism, or guilt?

  • Helplessness or worthlessness?

Do they seem: 

  • Unable to make decisions?

  • Unable to concentrate and remember?

  • To have lost interest or pleasure in ordinary activities – like sports or band or talking on the phone?

  • To have more problems with school or family?

Do they complain of: 

  • Loss of energy and drive –so they seem "slowed down"?

  • Trouble falling asleep, staying asleep, or getting up?

  • Appetite problems; are they losing or gaining weight?

  • Headaches, stomach aches, or backaches?

  • Chronic aches and pains in joints and muscles?

Has their behavior changed suddenly so that: 

  • They are restless or more irritable?

  • They want to be alone most of the time?

  • They’ve started cutting classes or dropped hobbies and activities?

  • You think they may be drinking heavily or taking drugs?

Have they talked about: 

  • Death?

  • Suicide – or have they attempted suicide?

 

About Depression 

What is depression?
Depression is more than the blues or the blahs; it is more than the normal, everyday ups and downs. When that "down" mood, along with other symptoms, lasts for more than a couple of weeks, the condition may be clinical depression. Clinical depression is a serious health problem that affects the total person. In addition to feelings, it can change behavior, physical health and appearance, academic performance, social activity and the ability to handle everyday decisions and pressures.

What causes depression?
We do not yet know all the causes of depression, but there seems to be biological and emotional factors that may increase the likelihood that an individual will develop a depressive disorder. Research over the past decade strongly suggests a genetic link to depressive disorders; depression can run in families. Bad life experiences and certain personality patterns such as difficulty handling stress, low self-esteem, or extreme pessimism about the future can increase the chances of becoming depressed.

How common is it?
Clinical depression is a lot more common than most people think. It affects 19 million Americans every year. One-fourth of all women and one-eighth of all men will suffer at least one episode or occurrence of depression during their lifetimes. Depression affects people of all ages but is less common for teenagers than for adults. Approximately 3 to 5 percent of the teen population experiences clinical depression every year. That means among 25 friends, 1 could be clinically depressed.

Is it serious?
Depression can be very serious. It has been linked to poor school performance, truancy, alcohol and drug abuse, running away, and feelings of worthlessness and hopelessness. In the last 25 years, the rate of suicide among teenagers and young adults has increased dramatically. Suicide often is linked to depression.

Are all depressive disorders alike?
There are various forms or types of depression. Some people experience only one episode of depression in their whole life, but many have several recurrences. Some depressive episodes begin suddenly for no apparent reason, while others can be associated with a life situation or stress. Sometimes people who are depressed cannot perform even the simplest daily activities – like getting out of bed or getting dressed. Others go through the motions, but it is clear they are not acting or thinking as usual. Some people suffer from bipolar disorder in which their moods cycle between two extremes – from the depths of despair to frenzied talking or activity or grandiose ideas about their own competence.

Can it be treated?
Yes, depression is treatable. Between 80 and 90 percent of people with depression – even the most serious forms – can be helped. There are a variety of antidepressant medications and psychotherapy alone. People with moderate to severe depression most often benefit from antidepressants. Most do best with combined treatment: medication to gain relatively quick symptom relief and psychotherapy to learn more effective ways to deal with life's problems, including depressions.  This most important step toward overcoming depression - and sometimes the most difficult - is asking for help.

Why don't people get the help they need?
Often people don’t know they are depressed, so they don’t ask for – or get – the right help. Teenagers and adults share a problem – they often fail to recognize the symptoms of depression in themselves or in people they care about.(1) 

 

What To Do 

These things usually do NOT work...  

  • Telling or forcing someone to "Snap out of it!"
    Depression is an experience rather like being dead, in that depressed people feel disconnected from life and not really living - spectators rather than participants in the game of life.  No one wants to feel like that, so we often "put a brave face on" to hide our depression. Hiding or denying depression just helps it to "fester" and grow - it creates a situation where the depressed person is separated from their true feelings and therefore ill-equipped to resolve or "move forward" through them.  Separation from our true feelings always creates an experience of unreality and a lack of spontaneity and "aliveness". This makes the misery of depression even worse. When people say "snap out of it" or similar words, they are not only encouraging the depressed person into an artificial, dysfunctional "separateness" from what is really going on inside them, but they are also abusing someone who, while depressed and feeling bad about themselves, is ill-equipped to defend their self from abuse. Depressed people are very vulnerable to words or actions that can be construed as critical, blaming or punishing. Criticism, blame or punishment increase the feelings of low self-worth that are a fundamental, underlying cause of depression.  There are exceptions to every rule, and there are occasions when ordering or encouraging a depressed person to "make an effort" or move out of their "withdrawn comfort zone" can enable them to climb out of a rut of low self-confidence, confront a problem they are avoiding, or break the chains of a negative perception of an opportunity that is presented to them. This is an example of intervention healing and as such, should only be tried when we are pretty sure that we are genuinely acting in the interests of the depressed person (having examined our own agenda) and have a reasonable prospect of success. Success is judged primarily by the depressed person later acknowledging that our interference was helpful. Intervention healing is only healing if the process is founded on, and enhances, respect for the healee as opposed to a boosting of the healer's ego, power or influence.

  • Trying to draw someone out of depression by persuasion, contrived cheerfulness or funny jokes.
    These things only work with very mild temporary feelings of depression.  In a persistent depressed mood the sufferer is in a "depressed reality" which the sufferer cannot easily and voluntarily let go of.  Trying to cajole, entice, manipulate or force the sufferer to rejoin the "ordinary world" can even be counter-productive - it can make the depressed person worse and maybe drag yourself down also.  Repeated failed attempts to "bring someone out of depression" can make their (and your) feelings of helplessness much worse - feeling helpless is one of the cornerstones that keeps depression in place.  People who are depressed would like others to "understand" what they are experiencing - especially to understand how overwhelmingly powerful their depressed experience is. Attempts to minimize or deny the sufferers' experience can increase the feelings of frustration, isolation and helplessness that are already crippling the sufferer.

  • Correcting destructive, illogical, pessimistic viewpoints
    Depressed people are prone to negative perceptions (i.e. miserable, pessimistic, angry or destructive views of themselves, other people, events, prospects etc), negative thinking and negative talking and negative (or absent) activities.  Amateur "helpers" instinctively try to "correct" these negative outpourings from depressed people.  However, this unreality cannot be directly corrected by reasoning or persuasion because it is driven by emotional & chemical energies. These negative energies need to be cleared before dysfunctional beliefs, perceptions and thinking can be effectively corrected by Cognitive Therapy techniques. 

These things often help... 

  • Being sensitive - noticing what effect your words and actions have on the person
    We speak of this as "feeling your way" into being a constructive supporter - learning by experience what is helpful and what isn't.

  • Have integrity - Be natural - Be yourself!
    Avoid taking on an "act", "image","false front" or "role" e.g. as "Caring person" or "Problem-solver", "Counselor" or "Healer". Depressed people are often vulnerable to cruel exploitation, in which a caring, counseling or "Let me fix you" kind of act or behavior is really put on as an image-booster (ego trip) for the person trying to be supportive.  Have the courage to be genuine - if you don't feel caring, then for goodness sake don't put on a pretence of it!  False or self-centered support rarely works. It can even re-bound on the person who is playing "a part" instead of genuinely and spontaneously expressing their true feelings and nature. The acid test of sincerity and genuineness is that you are not hurt or angry or frustrated if the depressed person does not respond in the way that you want them to.  If you genuinely feel caring, and counseling or healing flows naturally, then by all means do it, but don't "beat yourself up" if you do not feel caring or sympathetic - being honest and genuine and in touch with your real self and your real feelings is helpful to both of you.

  • Look after your own needs and support and those of others in the situation
    Being around someone who is depressed can be very "wearing" or "draining". You might also find yourself getting frustrated or angry. Don't judge yourself harshly about this - just get the relief, breaks and support that you need. Feelings that are ignored or "bottled up" are likely to make things worse and are detrimental to health and healing.  People who are markedly depressed often have very little to give to others. Being demanding or critical in this situation is likely to increase their depression (they already feel bad about being dysfunctional) and decrease how much they can give to you, to a job, or to others e.g. children etc.

  • Both of you may benefit from spending time: 

    • apart and alone

    • separately with supportive friends and in revitalizing activities

    • together with supportive friends and in re-vitalizing activities

    • with a professional counselor, therapist, healer, stress consultant or your GP

    • in a formal or informal self-help and support group of fellow sufferers or carers (2) 

 

For a complete listing of resources, visit the Illness, Health Care Information Resources webpage.

 

(1) Taken from the Federal Citizen Information Center website, 1-29-03.
(2) Taken from the stress-counseling.co.uk website, 1-29-03.