Part Four: When Someone You Love is Depressed

Before you proceed with this article, please take a moment to read the previous articles here on this subject or at the very least, read Depression - Myths and Facts so that you understand the medical realities of Depression.

When to Suspect Depression

First and foremost, if you see enough of the symptoms described in Depression -- Myths and Facts, you can be fairly sure that Depression is the problem.  However, if you don’t have enough contact with the person to know for sure about those kinds of changes, be alert to a general sense of the person just “not being himself/herself” for some extended period of time.  Whether or not Depression is the explanation, something worthy of attention is clearly going on. 

Common Mistakes in Dealing with Depressed People

As mentioned in What to Do about Depression, a depressed person’s ideas about what to do are often counter-productive.  So too, are the efforts of many caring others who make their best, uneducated guess about how to intervene.  Following then, are some of the most common mistakes made by well-intended others, along with explanations for the poor results that generally follow.

Ignore it, hoping it will go away.  Maybe you aren’t sure how to be helpful, and opt for doing nothing rather than risk doing accidental harm.  Or perhaps you just don’t know what to do, and are marking time until the depressed person gets things sorted out on his/her own.  Whatever your motivation might be for saying nothing, the effect is leaving someone completely alone in dealing with a painful problem; this leaves them to assume that you can’t see it, don’t care, or don’t want to be involved.  It might also cause them to question their own judgment, wondering whether they are imagining how bad they feel.  All of these effects feed into the negative thinking which is naturally a part of Depression, and can therefore make it worse.

Tell them why they should feel better.  You might presume that depressed people need to be reminded of how fortunate they are, and how many advantages they enjoy over millions of other people on the planet.  For a simple case of lost perspective, this would be a good intervention.  For Depression, it fails to have the desired effect, and also leaves sufferers feeling judged and talked down to at a time when they could really use some caring support.

Express judgment rather than concern at the changes you see.  It is true that depressed people are a lot less fun to be with, and are probably not keeping up with their normal duties in the relationship.  The same would be true if they had pneumonia or cancer, yet few of us would dream of criticizing a sick person for not keeping up, because it would be unfair and demoralizing.  Well, a depressed person is sick, and judging or criticizing them for it will make a bad situation worse.

Tell them they should just get over it, buck up, work their way out of it, etc.  To speak to a depressed person this way just shows your lack of understanding about Depression.  This is not where the damage ends however, as once again, it leaves the depressed person feeling judged and criticized rather than supported, which can actually deepen the Depression.

Encourage unhealthy coping strategies, such as alcohol use.  Depression taxes the body quite severely, and nothing that further compromises the system is a good idea.  Alcohol in particular, is a bad idea, because it is a nervous system depressant, which means it will intensify the physiological problems that are fueling the Depression in the first place.  Whatever short-term relief it may appear to provide is more than offset by the long-term exacerbation of the illness.

Interfere with their efforts to self-manage their depression.  Very competent self-management of Depression involves quality nutrition, regular exercise, consistent rest, and minimizing of stress.  The depressed person needs free rein to pursue these choices as much as possible, regardless of how little that fits with your own preferences.  Anything less than total support in these areas constitutes sabotage.

Pressure them to do what you think they should be doing to reduce their Depression.  Everyone experiences Depression in their own unique way, and what helps varies from person to person as well; it can vary from one day to the next for the same person.  Well-intended directives can be very off-target, not to mention coming across as pushy and insensitive at a difficult time.

Avoid the subject of suicide, for fear of giving them “ideas.”  If someone is that depressed, they will be thinking about it anyway, and probably at much greater length than you have.  At best, avoiding the subject means a lost opportunity for the depressed person to talk through some thoughts and restore perspective.  At worst, it can result in a missed opportunity to intervene and help at a critical time, with potentially tragic results.

What You Can Do to Help

Learn about Depression.  Through the articles on this website and other resources that may be suggested by your family doctor, you can increase your understanding of Depression, and therefore your ability to be an effective ally for others who are dealing with it.  The more you learn, the more you’ll understand that people with Depression are dealing with a medical problem, not making a lifestyle choice.

Express your concerns.  Let depressed people know that you’ve noticed some changes, that you care, and that you’re there.  This lets them know that they aren’t quite as isolated as they may be feeling, which is generally a help. 

Be non-judgmental.  Encourage depressed people to help you understand their experience, rather than assuming that you know, or telling them what they should be thinking or feeling.  When you ask respectful questions rather than making uninformed assumptions or directives, a depressed person will feel much more accepted and supported. 

Don’t diagnose the condition.  Your best bet is to share your observations of specific symptoms and changes; be descriptive and objective, and let the facts tell the story.  Whether it’s Depression or something else, the person will be better able to realize that something is wrong, and to take appropriate action when ready.

Don’t prescribe coping strategies.  While it’s true that some basic self-care strategies seem to be universally useful in coping with Depression, it’s hard to say, in a given moment, what is the best thing for a particular individual to do.  For instance, spending time with others can be either uplifting or exhausting.  Physical exercise can boost energy, or expend the very last bit of it that someone has left.  Your best bet, rather than recommending specific strategies, is to support a depressed person in pursuing whatever choices help him or her to get stronger in each day as it occurs.

Create positive opportunities, but don’t pressure a depressed person to participate.  For instance, you might invite them to come out for an evening walk with you, but don’t try to force them into it.  This is the most active and effective way that you can help: make it easier for them to take care of themselves by helping with that little extra boost of motivation when their energy is running low.  Don’t let it turn into a debate or power struggle, however, as that will make things worse rather than better.  If they say no, let it go, while assuring them that the invitation remains open for the future.

Broach the subject of suicide if your gut instinct tells you it may be a factor.  Most depressed people do not have active thoughts of suicide, but enough do that it’s worth monitoring.  For people who are not intensely suicidal, it may be a relief that you bring it up; it invites a candid discussion which may well restore perspective and reduce or eliminate the thoughts, at least for a while.  Be prepared to intervene if a depressed person has very specific thoughts of self-harm, an idea for how to do it, and access to the means necessary to follow through.  Your local hospital or police can help you with this if necessary, should you find yourself dealing with a high-risk situation that you are unable to diffuse.

If you have any questions about this series of articles, please feel free to contact me for additional information.

Copyright © 2006, Elizabeth Babcock, LCSW.  All rights reserved.


Related articles:

How to Talk to a Loved One Who Needs Help

Depression Series, Part One: Depression -- Myths and Facts

Depression Series, Part Two: Who Gets Depressed, and Why? 

Depression Series, Part Three: What to Do about Depression 


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