How to Help Someone With Depression

How to Help a Friend or Loved One with Depression

How to Help Someone With Depression

Helping a friend or loved one with depression can be challenging. For many people with depression, the symptoms are severe enough to cause problems with day-to-day activities (e.g.

, attending school or getting to work each day), but others might feel miserable or overwhelmed without knowing why.

If someone in your life has depression, whether or not that person has a diagnosis, you might feel at a loss for how to best support that person.

The most important step toward helping a loved one with depression is to understand the symptoms. The course of major depressive disorder is variable, and symptoms vary from person to person. Familiarizing yourself with the possible symptoms will help you better understand what your loved one is experiencing.

Symptoms of Major Depressive Disorder (MDD)

The essential feature of a major depressive episode is a period of at least two weeks marked by either depressed mood or loss of interest or pleasure in nearly all activities. In children and adolescents, the mood is more ly to present as irritable than sad.

Other symptoms can include the following:

  • Feelings of sadness, emptiness, or hopelessness
  • Angry outbursts and irritability
  • Insomnia or hypersomnia
  • Loss of interest in normal daily activities (sports, interests, even sexual activity)
  • Significant weight loss or weight gain due to changes in appetite
  • Psychomotor agitation (restlessness) or retardation (slowed down)
  • Fatigue or loss of energy nearly every day
  • Difficulty thinking or concentrating or indecisiveness nearly every day
  • Recurrent thoughts of death, recurrent thoughts of suicide, or a suicide attempt or suicide plan
  • Symptoms cause impairment in social and occupational functioning

5 Ways to Help

People with depression might not acknowledge that they’re struggling. Lack of awareness about symptoms of depression can cause people to consider their feelings normal or dismiss them as a time-limited struggle. The stigma of seeking treatment for depression can also cause people to attempt to overcome treatment independently.

#1. Encourage Treatment

Depression seldom gets better without treatment, and it can actually worsen over time. Research shows that both antidepressant medications and cognitive therapy are effective in alleviating symptoms. Other treatments include interpersonal therapy, electroconvulsive therapy, and neurofeedback.

It can be difficult to encourage treatment, particularly if the person doesn’t acknowledge the depression. It helps to consider some talking points:

  • Share what you’ve noticed and talk about why you’re concerned.
  • Suggest a physical with a general practitioner as a first step to rule out any other medical issues that might cause the symptoms
  • Explain what you’ve learned about the symptoms of depression and how depression can negatively impact people
  • Offer to accompany your loved one for the physical and to any other appointments
  • Help your loved one prepare a list of questions to ask the doctor or psychotherapist

#2. Practice Compassionate Listening

If your loved one tends to internalize emotions, he or she might feel overwhelmed when you share your concerns about possible symptoms of depression. The best thing you can do at the moment is use compassionate listening. Your loved one’s depression is not for you to fix, but being present and listening to your loved one talk can help that person feel heard and understood.

Use these phrases:

  • I am here for you
  • You’re not alone in this
  • I might not understand exactly how you feel right now, but I want to help you
  • Tell me what I can do to help

Avoid using these kinds of phrases:

  • This is just a phase; it will pass
  • Everyone feels this way sometimes
  • Why can’t you see the positive?
  • Snap it
  • The more you think about it, the worse you will feel
  • Think about all the great things in your life!

More often than not, sitting in silence and use nonverbal cues to communicate support is more helpful than trying to find the perfect words.

#3. Offer Assistance with Daily Tasks

Depression can make everyday tasks, driving and grocery shopping, feel impossible. Ask your loved one how you can help in small ways:

  • Help schedule appointments
  • Provide a ride to and from appointments
  • Grocery shop and do other tasks with your friend
  • Offer to take walks together a few times a week
  • Ask if you can help around the house
  • Offer to go watch movies or get the house together

#4. Recognize a Crisis and Respond

The risk of suicide exists at all times during major depressive episodes. The most consistent risk factor is a past history of suicide attempts, but most completed suicides are not preceded by unsuccessful attempts. Living alone, being male, and having prominent feelings of hopelessness also increase the risk of suicide.

If you believe your loved one is at risk of suicide, do not leave that person alone. Dial 9-1-1 and stay with your loved one.

#5. Take Care of Yourself

Caring for a loved one with depression can be complicated and overwhelming. Be sure to attend to your own personal needs, create appropriate boundaries, and seek help from a therapist or support group.

1. Robert J. DeRubeis, Greg J. Siegle & Steven D. Hollon, “Cognitive therapy versus medication for depression: treatment outcomes and neural mechanisms,” Nature Reviews Neuroscience, Volume 9, 788-796 (October 2008) | doi:10.1038/nrn2345

2. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, American Psychiatric Publishing, Washington, DC (2013): Pages 160-168.


6 Ways to Help a Loved One With Depression

How to Help Someone With Depression

It can be easy to feel overwhelmed, frustrated, and helpless when someone you love has depression — or when you suspect they might but don’t know how to tell for sure.

For starters, it’s key to know the differences between feeling down in the dumps and having a more serious mental health problem that needs treatment, says April Thames, PhD, an associate professor of psychology and psychiatry at the Keck School of Medicine at the University of Southern California in Los Angeles.

Feeling down is typically a temporary setback that is usually triggered by an external event an argument with a family member or a setback at work, Dr. Thames says.

It doesn’t interfere with day-to-day functioning for an extended period of time, and somebody feeling this way will still engage in activities they enjoy doing, at least after several days.

It tends to last for only a few days or a week at most, she adds.

In contrast, clinical depression typically involves symptoms withdrawing from friends and losing interest in activities one used to enjoy — and these symptoms persist for a much longer period of time, Thames says.

In order for someone to be diagnosed with clinical depression, the symptoms must last at least two weeks and must demonstrate a change in one’s previous level of functioning, states the American Psychiatric Association.

People with depression also have a very different mindset from people who are feeling down. “A person feeling down usually has hope that things will change for the better,” Thames says. “The person with depression feels that their situation is hopeless and will not change.”

Signs and symptoms of depression to look out for, according to the Mayo Clinic, are:

  • Expressing feelings of sadness, emptiness, or hopelessness
  • Feeling irritable, frustrated, or angry over small things
  • Sleeping much more or less than normal
  • Having changes in appetite — either eating more or less than normal and gaining or losing a lot of weight
  • Having anxiety, restlessness, or agitation
  • Having unexplained physical problems, back pain or headaches
  • Difficulty thinking, concentrating, remembering things, and making decisions
  • Expressing feelings of guilt or worthlessness, or ruminating on past failures
  • Mentioning death or suicidal thoughts.

If someone you care about has been diagnosed with depression or is showing any of these symptoms, knowing how to respond is key. Here are six ways to help.

RELATED: 12 Surprising Facts About Depression

1. Bring Up Your Concerns With Your Loved One

If you notice signs of depression in your loved one, it’s important to calmly share your concerns in a way that’s nonjudgmental, says Ole Thienhaus, MD, a professor of psychiatry at the University of Arizona College of Medicine in Tucson. It’s also crucial to give your loved one space to talk about what they’re feeling.

“Listening is the most important part of beginning to help,” Dr. Thienhaus says.

To get them talking, you may start by sharing the changes you’ve observed recently that worry you, Thienhaus says. When you do this, don’t be critical — just state the facts as you see them in a neutral way and pause often to give them room to respond to what you have to say.

“Avoid any suggestion that they have no reason to feel so sad,” Thienhaus adds. This means not saying things , “Look at all the good things in your life” or “Look at how much worse off so-and-so is, but she doesn’t let her problems get her down.”

Why is this harmful? Many people with depression already believe they should be able to “snap it” or should be “mentally strong,” Thames says, feelings that can stand in their way of seeking treatment for depression.

RELATED: What Are the Benefits of Fish Oil for Depression?

2. Help Your Loved One Get Treatment for Depression

Somebody with depression may need help seeking care, both because of a sense of stigma or shame and because their illness makes it harder for them to manage tasks finding a mental health provider or scheduling an appointment. Suggesting that you can do these things for them, remind them when the appointment is coming up, and accompany them to the visit can help them get treatment sooner rather than later.

If they’re hesitant to see a mental health professional such as a psychologist or psychiatrist, see if they’re willing to visit their primary care doctor, especially if this is someone they already know well and trust, Thienhaus says. Although it’s best to see someone specializing in mental health, the important part is getting connected to some form of help when needed.

You may also have to rethink the words you use to talk about depression treatment because different people may have distinct ways of viewing the condition, Thames says. Some people, for example, may not know to use the word “depressed” to describe how they feel, and might instead perceive their symptoms as being “stressed out” or “not myself,” for example.

“Matching the language that the person can identify with is important when attempting to intervene,” Thames says.

RELATED: 8 Depression Symptoms You Shouldn’t Ignore

3. Support Your Loved One in Their Day-to-Day Routine

While starting treatment is a crucial component to managing depression, your loved one may still need help with their daily functioning.

One good way to help may be offering to go to a therapy appointment with them to hear directly from their mental healthcare provider, says Michelle Riba, MD, a clinical professor of psychiatry and associate director of the Comprehensive Depression Center at the University of Michigan in Ann Arbor.

You can also offer to help them with tasks that may feel overwhelming, grocery shopping, laundry, or cleaning the house, or simply suggest you take a quick walk around the block together to get them out and about, Dr. Riba says.

Establishing a routine is also very helpful, says Thames. You might try to make that walk happen every day, for example. Regular physical activity can help ease stress and release endorphins and other neurotransmitters, or chemicals in the brain, that play a role in boosting mood, Thames says.

One form of treatment for depression is behavioral activation, which involves engaging in activities one find meaningful, such as doing an enjoyable form of exercise or volunteering, according to the Beck Institute for Cognitive Behavior Therapy in Bala Cynwyd, Pennsylvania.

Encouraging your loved one to do activities that give them personal satisfaction is important — but don’t go overboard with activities and socializing, Thames cautions.

“Most people try too hard to fix the situation by forcing the loved one to do activities and socialize,” Thames says. “This is not always a good thing because it can produce additional stress and inadvertently exacerbate symptoms.”

RELATED: A High-Fiber Diet May Help Lower Depression Risk

4. Look for Signs That Treatment Is Working

There are lots of little ways to tell when treatment works — it will be clear in the ways that your loved one looks and acts, says Angelos Halaris, MD, PhD, a professor of psychiatry and behavioral sciences and director of outpatient clinical services at the Loyola University Chicago Stritch School of Medicine.

As they improve, someone with depression may start making better eye contact with you instead of looking down to avoid eye contact due to feeling vulnerable or anxious. Other signs of improvement, according to Dr. Halaris, include:

  • Smiling occasionally and having more relaxed instead of tense facial features
  • Having a calmer demeanor
  • Isolating less and interacting with people more
  • Eating and sleeping better

RELATED: The 10 Best Foods to Soothe Seasonal Depression

5. Be Alert to Signs That Treatment Is Not Working

On the other hand, the absence of any such signs most ly means that one’s depression is not improving and may be getting worse, Halaris notes, adding that a major concern in the absence of improvement is whether your loved one is having suicidal thoughts.

“This is where you need to very gently raise the question whether they are having even fleeting thoughts of their life not being worth living,” Halaris says.

According to Mayo Clinic, signs your loved one may be considering suicide include:

  • Making statements such as “I wish I were dead” or “I wish I hadn’t been born”
  • Purchasing a gun or hoarding pills
  • Fixating on violence, death, or dying
  • Withdrawing from social contact with others
  • Feeling hopeless or trapped in their current situation
  • Telling people, “goodbye,” as if they’re going to disappear
  • Getting their affairs in order or giving away their belongings with no other plausible explanation for doing so

If your loved one shows signs of considering or planning to take their own life, Halaris and Riba recommend taking steps to reduce their risk of attempting or completing suicide, such as:

  • Make every effort to convince them to see a specialist if they aren’t already — and make sure to go with them to this appointment.
  • Seek a different approach to therapy.
  • Remove any guns from the home.
  • Ensure they’re not hoarding medications, which might be used for an overdose. If you see signs of this behavior in your loved one, Riba advises treating this as an emergency and taking them straight to the hospital or call an ambulance.

If you’re worried that your loved one is getting worse but they’re not considering or showing signs of any dangerous behavior, ask to join them for part of their next psychiatry or counseling session or voice concern to their provider.

You may suggest that you sit in on counseling sessions with their psychiatrist or therapist on a regular basis, Riba says.

This will let you give feedback on how treatment seems to be working, hear what your loved one and their doctor are saying, and better understand how you may be able to help.

RELATED: How to Cope With Anxiety and Depression

6. Make a Plan for Recognizing a Relapse

When you’re in it for the long haul with someone who has depression, it’s important to understand that depression is a chronic illness with symptoms that can flare up periodically, just you might expect with physical conditions heart disease or diabetes.

“Knowing and accepting that there will be ups and downs can help mitigate any personal frustration one may experience when dealing with a depressed loved one,” Thames say. “Family members or loved ones dealing with someone who has depression may want to seek out personal therapy to help them cope and adjust to the person's mood.”

Although depressive episodes can go into remission with proper treatment, the potential for future relapses can take a toll on relationships, says Thienhaus. That makes it important to talk to your loved one when they’re in remission so that together you can form a plan for how to recognize and respond quickly when a relapse is on the horizon.

“Recognizing the early signs is important in order to gently intervene,” Thienhaus says.

You can also encourage lifestyle habits that may help keep depression at bay, Riba says, such as:

  • Healthy eating and exercise habits
  • Minimizing stress
  • Getting plenty of sleep
  • Limiting alcohol and drug use
  • Sticking with any depression treatment plans for therapy or medication

RELATED: 8 Health Problems Linked to Not Getting Enough Sleep

Resources We Love (for Both Your Loved One and You)

Plenty of free resources are out there to help you find treatment and get support for your loved one — or for yourself as a caregiver.

Substance Abuse and Mental Health Services Administration (SAMHSA)

SAMHSA has a treatment locator for various types of mental health issues, as well as a free, confidential, 24/7 hotline for treatment referrals. You can reach their hotline at 800-622-HELP (4357).

National Suicide Prevention Lifeline

This lifeline is comprised of a national network of crisis centers that offer confidential, 24/7 support geared toward suicide prevention. You can reach this lifeline at 800-273-8255.

National Alliance on Mental Illness (NAMI)

NAMI has support groups for patients, family members, and caregivers, as well as crisis support and an online chat.

You can call the NAMI HelpLine at 800-950-NAMI (6264) Monday through Friday between 10 a.m. and 8 p.m. Eastern Standard Time. You can also reach them by email (info@nami.

org), or you can text their crisis support team 24/7 at 741741 for free support with a trained crisis counselor.


6 Do’s and Don’ts for Supporting Someone Who Has Depression

How to Help Someone With Depression

You’ve noticed some changes in your friend that concern you.You’re not sure if it’s depression or just a bad few days, but you want tohelp. So where do you start?

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Clinical psychologist Adam Borland, PsyD, gives some strategies that can help you provide support.

How can you tell if someone is dealing with depression?

Depression touches most Americans, whether they experience it personally or it affects someone they know. In fact, The National Institute of Mental Health reports it’s one of the most common mental health disorders in the United States — an estimated 17.3 million adults were living with depression in 2017.

So how can you tell if a friend is just a bit sad or hassomething deeper brewing? “There certainly are telltale signs,” Dr. Borlandnotes. “But since you don’t necessarily see that person every day, you may haveto do more detective work.”

He recommends watching for behavioral changes or anything that could be character for your friend. Some depression symptoms include:

  • Lack of engagement:They lose interest in activities they used to enjoy or want to hang out less.
  • Change in communication patterns: Youused to chat or hang on the regular, and now they’re MIA.
  • Changes in hygiene and sleepingpatterns: They’re sleeping less — or all the time. Their appearance andhygiene no longer seem to be a priority.
  • Displays of sadness or anger: Theirtemper now has a hairpin trigger, or maybe they seem more down than usual.
  • Withdrawal from social outlets:They’re missing from activities where they were formerly fixtures.

How to help someone with depression

Dr. Borland recommends some do’s and don’ts to get the conversation going:

Do: Practice assertive communication

Rather than making depression taboo, talk openly with yourfriend about your concerns. Dr. Borland recommends cultivating the art ofassertive communication: You take ownership of your feelings and concerns andcommunicate them without finger-pointing. And you listen and provide yourfriend with unconditional emotional support.

To do this, practice using “I”statements. “Begin sentences with, ‘I’m worried,’ ‘I’m concerned’ or ‘I’ve noticed.’Then explain your concerns to your friend,” he suggests. “Avoid saying, ‘Youdon’t seem yourself,’ or ‘You haven’t been hanging out as much as youusually do.’ They can create defensiveness in the person receiving the message.”

Do: Show empathy

Put yourself in your friend’s shoes in a nonjudgmentalway. Think about how you would feel if you were coping with symptoms ofdepression and how you would want friends to react. Maintain eye contact whenlistening, and say things , “That sounds hard. I’m sorry you are goingthrough this,” and “I’m always here for you.”

“And if you’ve dealt with depression yourself, self-disclosure can be very powerful,” Dr. Borland points out. “You’re giving your friend a gift by opening yourself up and sharing that you understand.’”

By responding to your friend in an open and empathetic way,you show them that they aren’t a burden.

Do: Set boundaries

It’s OK to be specific about when you can — or can’t — bethere for your friend. For example, let your friend know that it’s better foryou to talk after your kids are in bed. And don’t accept abusive or violentbehavior. If they don’t stop, do what’s best for your health and safety.  

Self-care is also key. Monitor your own health and well-being so you have something to give when the going gets tough. Supporting someone with depression can take a lot you. Learn your limits and when it’s time to recharge your batteries. Explain to your friend that while you’re there for them, a mental health professional has the training and tools needed to effectively treat them.

Do: Be patient

There is no quick fix for depression. The recovery processtakes time. You’re less ly to get frustrated with, or give up on, yourfriend if you’re hunkered down for the long haul.

Don’t: Think you can fix it

Recognize that supporting your friend does not mean fixingtheir problems. A person with depression often needs treatment to seeimprovement — and that’s something only a medical professional can provide.  

Don’t: Give up

But what if your friend rejects your efforts even when you’vedone all the right things?

“Their rejection may be a defense mechanism. They realizeyou’re recognizing their symptoms and that they’re not doing as good a jobhiding them as they thought,” explains Dr. Borland. “It’s easy to reactnegatively to a friend who’s unwilling to get help. But stick with them andmaintain communication. Continue to check in on your friend and encourage themto get help.”

Dr. Borland also recommendstrying to be there with your friend instead of for your friend. “Itmeans I’m in this with you, even if you push me away,” he says.

What to do if your friend has suicidal thoughts

If you are concerned your friend may harm themselves,don’t dismiss your gut. Instead:

  • Pay attentionto anything said about suicide, other forms of self-harm or a world thatdoesn’t include them.
  • Keep the lines of communication openso they know they can talk to you when they have these feelings.  
  • Encourage themto get professional help.

That help may include outpatient therapy and psychotropic medications prescribed by their primary care doctor or a psychiatrist. If you think your friend is in immediate danger, call 911 or take your friend to the nearest emergency department.

Remember: Your friend’s situation is not hopeless. other illnesses, depression can be treated with the right medical help and the support of friends you.


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