Helping a depressed friend

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By Amanda Milligan on December 11, 2018

If you or someone you know is considering suicide, call 9-1-1 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

On average, there are 129 suicides every day, and for every suicide 25 more people attempt suicide.

The numbers are staggering, but there are ways we can help.

It can be intimidating to talk about suicide or ask people about what they’re going through, but this guide will explain how to help someone who is suicidal.

How to Tell If They’re Suicidal

Sometimes people will exhibit multiple signs, but others won’t exhibit any.

But to start, it’s helpful to look for the signs of suicide:

How to Help Someone Who is Suicidal

If you suspect someone you know is considering suicide, Mental Health First Aid teaches you to follow the ALGEE action steps.

1. ASSESS for risk of suicide or harm: The best way to find out if someone is considering suicide and determining the urgency of the situation is to ask them:

Are you having thoughts of suicide?

Do you have a plan to kill yourself?

Have you decided when you’d do it?

Do you have everything you need to carry out your plan?

IMPORTANT NOTE: Some people believe that mentioning suicide might cause someone to consider suicide for the first time. This is not true, so do not be afraid of this outcome. You’re much more likely to help someone feel less alone if they were considering it.

If they have a plan and are ready to carry out that plan, call 911 immediately. How you respond to other answers will depend on the situation, but always call 911 if you’re unsure. It’s better to be safe that for someone to lose their life.

Additionally, not having a plan doesn’t mean they’re not in danger. All thoughts of suicide must be treated seriously.

If you think the person is in danger, you need to keep the person safe. Stay with them for as long as you can, because an actively suicidal person shouldn’t be left alone. If you can’t stay, find someone who can until help arrives.

If you determine the person is having suicidal thoughts but there’s no immediate danger, engage in conversation with them if possible.

2. LISTEN nonjudgmentally: If the person does not appear to be in a crisis, encourage them to talk about what they’re thinking and how they’re feeling. It can be hard to hear someone you know is experiencing distress, but when you listen and genuinely care, you can have a calming, positive impact on them, and you can start to learn more about what is at the root of their suicidal thinking.

You may not fully understand what they’re going through, and that’s OK. What’s important is that you’re accepting of what they’re saying, acknowledge it and genuinely try to imagine what it might be like for them. Staying patient and respectful can make a world of difference.

If, while you’re listening, you discover they may in fact be in crisis, return to the ASSESS step in No. 1.

3. GIVE reassurance and information: Reassurance is crucial, as people having suicidal ideation may not have much hope. Clearly state to them that suicidal thoughts are often associated with a treatable mental illness, and if you feel comfortable, you can also offer to help them get the appropriate treatment. You can also tell them that thoughts of suicide are common, and that you don’t have to act on them.

4. ENCOURAGE appropriate professional help: If you are concerned for the person’s immediate safety, call 911.

If you’re concerned but it’s not an immediately urgent situation, make sure the person has a safety contact available at all times, whether it’s a loved one or mental health professional. Another great resource is the National Suicide Prevention Hotline: 1-800-273-TALK.

If the crisis has passed, or the person wasn’t actively suicidal but has suicidal thoughts, encourage the appropriate psychological or medical help. If you want to provide further assistance, offer to call medical professionals if they don’t already have one to schedule an appointment, or do any of the other legwork required to get them help. Remind them that recovery is possible with treatment.

5. ENCOURAGE self-help and other support strategies: Ask the person to think about what has helped them in the past. Perhaps a particular therapist, family member, friend or spiritual leader has given them support, or maybe a particular community, like a church or club, has been there for them. They should tap into their support system as much as possible during this time.

REMEMBER: These steps don’t have to necessarily go in order. Apply them in whichever way makes sense for you and the person you’re addressing.

To learn more support strategies, take Mental Health First Aid. The course will teach you how to identify, understand and respond to signs of mental health or substance use issues.

Remember: Always remember to practice self-care after a crisis situation. These types of encounters won’t be easy for you, but your confidence and support can make a huge difference in someone’s life.

8 Ways to Help a Friend or Family Member With Depression

Depression doesn’t happen in a vacuum. It causes a ripple effect that touches everyone surrounding the person. Family members and friends often feel helpless, not knowing how to reach out or what to do to help their suffering loved one.

It would be nice if the depressed person could vocalize their needs, so that friends and families knew exactly what to say and do. However, according to J. Raymond DePaulo Jr., MD, a former professor of psychiatry and the director of the affective disorders clinic at the Johns Hopkins School of Medicine in Baltimore, their relationship skills are significantly diminished. Communication becomes problematic because the person is embarrassed to say how they feel, anticipating judgment.

How does a family member proceed, then, with little or no direction? Every individual is different in how they handle the beast of depression, but here are a few universal things you can try that will empower both you and your loved one toward recovery and hope.

RELATED: Total Brain: Learn to Measure — and Improve — Your Mental Health and Fitness

1. Educate Yourself About Depression and Other Mood Disorders

You may not be able to cure your loved one. But you can better understand his or her condition by educating yourself about depression or the kind of mood disorder he or she has. Reading up on your loved one’s illness will help you feel more in control of the situation and give you more patience to tolerate the confusing or frustrating symptoms.

Here are some places to start:

  • Families for Depression Awareness helps families recognize and cope with depression and bipolar disorder to get people well and prevent suicides. They offer education, training, and support to unite families and help them heal while coping with mood disorders.
  • Depression Bipolar Support Alliance Family Center is a place of “compassion, hope, and understanding” that provides a wide variety of family-focused resources and information, such as How to Help Someone in Crisis, Help With Symptoms and Treatment, and Help With Relationships.
  • National Alliance on Mental Illness Family Support Group is a peer-led support group for family members, caregivers, and loved ones of individuals living with mental illness. You can gain insight from the challenges and successes of others facing similar circumstances.

2. Ask Questions and Dig for the Root Cause

The best way to understand a subject is to research it like a journalist and ask a lot of questions. With depression and anxiety, asking questions is critical because the terrain is so vast and each person’s experience is so different. Chances are that your friend is not going to voluntarily cough up the information that you need, because he or she is too ashamed of the symptoms and afraid he or she will be judged. To better know what’s going on, you must dig for the information. Here are a few questions to consider:

  • When did you first start to feel bad?
  • Can you think of anything that may have triggered it?
  • Do you have suicidal thoughts?
  • Is there anything that makes you feel better?
  • What makes you feel worse?
  • Are you under stress?

You know your sister, friend, brother, or father better than most mental health professionals, so help them solve the riddle of their symptoms. Together consider what could be at the root of their depression: physiologically, emotionally, or spiritually. Where is the disconnect?

3. Help Them Identify and Cope With Sources of Stress

It’s no secret that stress is a significant contributor to depression. Chronic levels of stress pour cortisol into your bloodstream and cause inflammation in your nervous system and every other biological system. In a study of rats published in May 2017 in Scientific Reports, conducted by researchers at universities in Aarhus and Aalborg, Denmark, stress was shown to reduce the brain’s innate ability to keep itself healthy. The hippocampus, which regulates mood, shrinks, negatively impacting our short-term memory function and learning abilities.

Stress also interrupts healthy coping strategies, which makes a person more vulnerable to mood swings. Your job is to help your loved one identify sources of stress in his or her life and brainstorm about ways to reduce it. These don’t have to be dramatic changes. Small tweaks to your day, like employing some deep breathing techniques, can go far in reversing the detrimental effects of stress.

4. Encourage Them to Seek Out a Support Group

It doesn’t matter what the illness is — cardiovascular disease, colon cancer, fibromyalgia — a person needs support in her or his life to fully recover: people with whom they can vent and swap horror stories, folks who can remind them that they are not alone even though their symptoms make them feel that way.

Research shows that support groups aid the recovery of a person struggling with depression and decrease chances of relapse. The New England Journal of Medicine published a study in which 158 women with metastatic breast cancer were assigned to supportive-expressive therapy. These women showed greater improvement in psychological symptoms and reported less pain than the women with breast cancer who were assigned to the control group with no supportive therapy. Brainstorm with your friend on ways to get more support. Research and share with your friend various groups (online or in town) that might be of benefit.

5. Remind Them That They’re Incredibly Strong

“When you’re depressed, you don’t believe that you’re worthy of love,” explains Dr. DePaulo in Understanding Depression: What We Know and What You Can Do About It. That’s what makes relationships and especially communication so difficult. One way of nudging them to recovery is by reminding them of their strengths. Use concrete examples. Cite times in their lives they exemplified courage, stamina, compassion, integrity, and perseverance. Use photos, if you have them, of accomplishments in the past or victories that will bolster their confidence and encourage them down the path of healing.

6. Make Them Smile, Because Laughter Helps and Heals

As I mentioned in my post “10 Things I Do Every Day to Beat Depression,” research says that laughing is one of the best things we can do for our health. Humor can help us heal from a number of illnesses. When I was hospitalized for severe depression in 2005, one of the psychiatric nurses on duty decided that one session of group therapy would consist of watching a comedian (on tape) poke fun at depression. For an hour, we all exchanged glances as if to say “Is it okay to laugh?” The effect was surprisingly powerful. Whenever the “black dog” (as Winston Churchill called depression) has gotten a hold of a friend, I try to make her laugh, because in laughing, some of her fear and panic disappear.

7. Let Them Know They Won’t Always Feel This Way

If I had to name one thing a person (or persons) said to me when I was severely depressed that made me feel better, it would be this: “You won’t always feel this way.” It is a simple statement of truth that holds the most powerful healing element of all: hope. As a friend or family member, your hardest job is to get your friend or brother or dad or sister to have hope again: to believe that they will get better. Once their heart is there, their mind and body will follow shortly.

8. If You Do Only One Thing, Let It Be Listening

You could disregard everything I’ve written and just do this: Listen. Suspend all judgments, save all interjections … do nothing more than make excellent eye contact and open your ears. In her bestselling book Kitchen Table Wisdom, Rachel Naomi Remen writes:

“I suspect that the most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention. And especially if it’s given from the heart. When people are talking, there’s no need to do anything but receive them. Just take them in. Listen to what they’re saying. Care about it. Most times caring about it is even more important than understanding it.”

Helping a friend with mental health problems like depression

I was diagnosed in 2008 with depression and anxiety. Suddenly, the rumble of feelings that had been gradually affecting my life more and more had a label and I was given something concrete to tell my friends and teachers, which explained why I hadn’t “been myself lately.”

For all the relief of facing treatment, it was a fairly daunting thing. I started by telling someone who I trusted deeply because I wasn’t too sure what it all meant myself and, just like me, she didn’t get it. The essential thing was, though, that she was there; giving me time to cry and time to talk, without making any comment, but offering her care and a hug. That was enough.

Other friends weren’t so understanding. I found it monstrously frustrating trying to open up to someone who would turn around and say, “yeah me too,” or start talking about themselves, when I needed only comfort, not comparison. With time I began to realise that people don’t have much of a vocabulary for mental ill health – we never got taught in school how to respond when someone says, “I’m struggling,” let alone how to cope if we’re struggling ourselves.

If a friend tells you that they are suffering with mental distress, you might feel pretty mixed up too. You might feel worried, angry, scared or confused. I’ve written these 7 tips based on my personal experience of talking about mental health problems. I hope that they suggest how you can manage your friendship and offer support.

1. Look after yourself

First and foremost, you need to look after yourself. It is ok to say to your friend that you don’t feel like you are able to support them if you are feeling bogged down yourself. Being a great friend means remembering to care for yourself first so that you can be strong when your friend really needs you.

2. Ignore myths

There are a lot of myths in the media and whispers that get passed around about mental health. If you are interested, there is nothing shameful about reading up and learning from reliable sources what is really involved – chances are it’s not nearly as scary as you think. This way, you can be there for your friend and offer some understanding.

3. Listen

It is important to listen to your friend and to hear what they are saying. You might want to try to fix their problems or to find a solution to what they are struggling with, but often it is better just to offer a shoulder to cry on, rather than to try to be Superman. Your friend will appreciate you saying, “I am here,” rather than “You need to…” People are often tempted to say, “I understand,” but everyone’s journey is personal and unique to them. It is good to offer your listening ears and to allow your friend the space to express themselves, rather than making comparisons with your own experience.

4. Limit questions

As you care for your friend, you’re bound to have questions. Sometimes, your friend won’t be able to answer them because it’s often as bewildering for them as it is for you, or they might be tired out from talking, so ask enough to help you understand, but not so much that it is intrusive – remember these are very personal things and your friend has had to be brave to open up to you. They may or may not want to tell you a lot, so let them take the lead.

5. Respect courage

It takes an awful lot of courage to stand up and tell someone you are suffering with mental health problems, even your closest friends. Your friend might feel nervous that they will lose your friendship or that you will judge them. It’s a privilege when someone shares intimate details of their life, so treat them carefully and gently and let your friend know they can trust you.

6. Hang on in there

Your friend may want more time alone than before, or they might be snappy, tearful or even hyperactive sometimes and you might feel that your friendship is changing. It’s never easy but try to remember that your friend is still the person you know and love, even when they are struggling.

7. Seek Support

It’s important to keep your friend’s personal issues confidential but if you are concerned speak to a trusted adult like a teacher or your parents. Equally, if you’re feeling troubled or if supporting your friend is getting you down, it’s ok to take some time for yourself and to talk to someone. Your friendship is important but so are you.

Learning that someone you love is suffering is always tough, whether it is a friend or a family member. It isn’t always easy to support someone that you love either and it’s ok that sometimes you might feel pretty fed up or down yourself. However, offering someone compassion and friendship when they are at their lowest is a brave and tremendously kind thing to do and above all, you should feel proud of your love for your friends.

I took a risk in opening up to my friends about my problems and, sometimes, they didn’t offer the support that I had hoped for. The ones who really helped were the ones who didn’t say, “Everything is going to be ok,” or “I understand,” but who were simply there, for a moan or a giggle or offering a hug just like always and who were delighted to see me when I began to come out the other side.

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About Wiley Reading

A sad person gazing out a window with a hand on their chin. Source: Img Kid

Depression is a drag. Everyone who has it experiences it differently, but we all agree that it sucks.

Sometimes, however, I wonder if people who don’t have it understand – like really truly understand – just how overwhelmingly painful it is.

For example, while it seems that people most commonly use the term to express fleeting feelings of sadness or disappointment, depression is actually a chronic physical illness with symptoms that are mostly invisible.

And although we’ve come a long way in our ability to treat it, we still don’t really know what causes it or why treatments work and don’t work.

It’s an exasperating disease to live with because being sad or frustrated or sleepless or numb for long, repetitive periods of time is exhausting – especially when you can’t prove to anyone that you’re really sick.

Even if your depression is manageable enough for you to leave the house, it can affect everything in your life.

It can interfere with your productivity, or even just the way you seem to your superiors at work – which has consequences for your performance reviews and ultimately the stability of your employment.

It can make your loved ones and friends want to be around you less because many people dislike the kind of negativity depressed people can become steeped in.

In its worst form, depression can lead to death. It’s a serious and draining disease to live with.

In a broad sense, fortunately, having depression doesn’t make you quite the social pariah it used to.

Diana Morales, vice president of public education at Mental Health America, started a survey in 1996 and found that “only about 38% of people viewed depression as a real health problem. But when they finished the survey in 2006, 72% of people viewed depression as a real health problem.

We’ve made good progress in de-stigmatizing having depression, but we haven’t made great strides in de-stigmatizing actually acting like you have depression – which most of us can’t help but do.

A simple Google search for “people with depression are selfish,” for example, yielded 1.3 million results.

Just like you can’t stop a headache with the power of your mind, most of us with depression are stuck with our symptoms, even if we are managing our depression with medication or other techniques.

While it’s wonderful that we’ve begun to fight the misinformation and prejudice surrounding depression, we’ve got a ways to go when it comes to compassionately and lovingly treating people with depression like they have a serious disease.

“Awareness” is great, but at the end of the day what I need is to be surrounded by people who actually understand my illness and know how to support me.

So here’s a guide to how to support a loved one with depression.

1. Don’t Ever Say ‘You’re Too Much’

When someone with depression is told “you’re too much,” especially from someone close to them, it can send them spiraling into guilt and anxiety and crushing sadness.

People with depression often have distorted ideas about how loved and supported they are, so hearing “I can’t deal with you” or variations on that theme from someone they love and trust can mean they generalize that sentiment to everyone close to them.

Imagine for a moment hearing “you’re too much for me” from every single loved one in your life. That’s what depression does to you. It makes you feel like a burden to the world.

This doesn’t mean that you need to be a constant source of emotional support for a depressed person. It’s not your job to take care of anyone else’s mental health.

A good way to take care of yourself without sending your depressed loved one spiraling is to say things like “I need not to be the only one you talk to about this stuff” or to address specific behaviors that you would like them to stop or change.

Being positive and encouraging is also helpful: “I’d love if you went on a short walk while I finish up this e-mail to my boss. I’m so proud of you for taking care of yourself, and I appreciate that you are committed to helping me feel supported as well!”

2. Do Not Shame People for Being Negative

Depression remakes the world into a landscape of negativity.

For example, something that happens for me during a depressive episode is that I can “connect” better to negative feelings than positive ones.

If my boss praises me at work, trying to experience a positive emotion of pride or gratitude feels like pretending. I have a hard time experiencing the positive emotions usually associated with praise when I’m depressed.

If someone criticizes me, though, anger, frustration and guilt are much easier to access.

Depressed people aren’t simply choosing to see the negatives and ignore the positives. The positives are as inaccessible to us as junk food in a vending machine when you have no quarters. We are really, truly unable to access positive feelings.

If the negativity is bumming you out, focus on what you want out of interactions.

Ask things like “Did something nice happen to you today?” Or deflect essays on what went wrong with their day with questions like, “Your hair looks beautiful today! Did you do it differently?”

Something that I find to be helpful is acknowledging that for people with depression, there are some days when, legitimately, nothing feels good for them. So, if you need a break from the Depression train, make it about you.

Don’t act like they need to try to find positivity where there is none. Tell them you need positivity so you’d like to talk about something positive, even if they don’t have anything positive going on.

And if they absolutely can’t redirect, take a break to surround yourself in the positivity you need and come back later.

3. Do Help Them Adhere to Medication Routines If You Can (But Don’t Question Their Medical Decisions)

Sometimes taking medication regularly is incredibly important.

Sometimes, I’m on a medication that makes my soul feel numb and my behavior and affect (outwardly) are pleasant and calm, but I feel like I’m living my life in a mildly depressing fish bowl.

Times like that are times when I want my loved ones to say, “Oh my god, that sounds awful. Yes, I think it’s a good idea for you to talk to your doctor about transitioning off your medication.”

The only “rule” about medication that should ever be enforced by a loved one is that if you are thinking of harming yourself or others, you get help immediately.

Anything else – want to switch to a new doctor, want to stop taking a medication that seems like it’s helping, want to take an extra anxiety pill – these are decisions you must support.

4. Do Understand That Depression Doesn’t Mean ‘Sadness’

Depression is a condition with a variety of symptoms – fatigue, disordered thinking, sleep problems. These are all symptoms of depression.

Irritability is a very common symptom, for example, and rarely are people who experience this symptom extended any sympathy.

Naturally, it’s hard to be compassionate if someone is grumping at you – and naturally, adults can (to some extent) control their own behavior (so you shouldn’t feel that you have to tolerate bad behavior because someone has depression), but irritability from depression can be as hard to control as sadness or insomnia.

Validation is as good a tool as there is for dealing with depression manifesting as irritability.

While not allowing someone to speak to you in a way you don’t want, you can validate their feelings of frustration or general malaise. I never get tired of hearing “That sounds so hard. I’m so sorry you’re feeling frustrated.”

5. Do Validate, Validate, Validate

Validation isn’t just a good tool for dealing with irritability, it’s a good tool for dealing with every aspect of having a loved one with a chronic illness.

Logic will not help.

Someone with depression is not living in the same universe as you. The laws that govern your universe do not exist in theirs.

It can be incredibly frustrating to have people act like what you are experiencing is not real, or is wrong, or is not reality.

I desperately wish I could believe myself when I say “my friends think I’m valuable and worth spending time with” when I’m having a depressive episode, but for me, at that time, saying that sounds as silly as saying “my eyebrows are the size of elephants.”

It can be very difficult to explain this alternate reality to someone who does not have mental illness. Please try to understand that rational thinking will not work because logic literally doesn’t exist in the universe we currently inhabit.

***

Having depression is exhausting.

My depression is well-managed, and I still have very bad days. But even on my good days, I spend a lot of time and energy managing my mood, my sleep, my diet, my activity level, and my relationships so that I can continue to function.

It takes effort, patience, and compassion to love someone with depression. I don’t think anyone would argue that it’s easy.

But we deserve love and companionship, too.

We need your patience, your compassion, and your love – even more when we’re having a difficult day or week or month. We know it’s hard. We know it’s not fair. But we also love you, value you, and appreciate your support very, very much.

I feel incredibly lucky to have people in my life who are able to support me in the ways I have mentioned above. It takes a village to kick depression’s ass.

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Wiley Reading is a Contributing Writer at Everyday Feminism. Wiley is a New Jersey-born artist, writer, environmentalist, and social justice advocate located in Burlington, VT. He works as a community health worker for the Greater Burlington YMCA, and writes for Disrupting Dinner Parties, a small collective feminist blog. Follow him on Twitter @wreadinggo.

Read this article in Slovak language HERE.

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9 Ways to Help a Friend or Family Member With Depression

All of a sudden your best friend stops calling. She no longer wants to join you for yoga on Saturday mornings. The last time you saw her she looked fragile and sad, like someone else was living in her body. Her husband doesn’t know what to do so he solicits your help in cheering her up.

Or maybe it’s your sister. She has been struggling with depression for a few months now. She’s been to a psychiatrist and is on an antidepressant, but she doesn’t seem to be making much progress.

What do you do?

I’ve been on the giving and the receiving end of kind-hearted attempts to lift depression more times than I’d like to count. While every case of this maddening mood disorder is unique and responds to different treatments, there are a few universal things you can try to guide your depressed friend or family member down the path of healing and recovery.

1. Educate yourself.

Although people are better educated on depression and anxiety today than they were two decades ago, we still have a long ways to go on understanding how the brain operates: why some people smile as they get run over by a truck, and others cry uncontrollably at the mere thought of that. It turns out that more is going on in our noggin than just a bunch of lazy neurotransmitters that can’t deliver messages to certain neurons.

You don’t have to be a neuroscientist to help a friend or a family member with a mood disorder, but some basic knowledge on depression and anxiety is going to keep you from saying well-intended but hurtful things. It’s just hard to help someone if you don’t understand what she is going through.

2. Ask lots of questions.

Whenever one of my kids gets sick or injured, I start in with a series of questions: Where does it hurt? How long have you felt bad? Does anything make it worse (besides school)? Does anything make it better (besides ice-cream)? Just by asking a few basic questions, I can usually get enough information to determine a plan of action.

With depression and anxiety, questions are crucial because the terrain is so vast and each person’s experience is so different. Your friend may be so desperate that she’s had a suicide plan in action for weeks, or she could just be under a lot of stress at work. She could be having a severe episode of major depression, or just need a little more vitamin D. You won’t know until you start asking some questions.

Here are a few to consider:

  • When did you first start to feel bad?
  • Can you think of anything that may have triggered it?
  • Do you have suicidal thoughts?
  • Is there anything that makes you feel better?
  • What makes you feel worse?
  • Do you think you could be deficient in Vitamin D?
  • Have you made any changes lately to your diet?
  • Are you under more pressure at work?
  • Have you had your thyroid levels checked?

3. Help her learn what she needs to know.

I used to rely on my doctors to tell me everything I needed to know about my health. I don’t do that anymore, because they don’t know me as well as my family and friends. Psychiatrists and psychologists have expertise in some areas, which can be critical feedback as a person begins to tackle the monster of depression; however, there is so much other valuable information tucked away in memories with friends and families that could guide a person out of despair.

For example, during this most recent relapse of mine, my older sister kept insisting that I probe into my hormonal imbalances. “You haven’t been well since you’ve had your kids,” she said. “Part of this depression has to be hormonal.”

My mom reminded me that thyroid disease runs in our family and suggested I get my thyroid checked out. Initially, I was annoyed with their opinions since it required more work on my part. When I couldn’t take the pain anymore, I sought out a holistic physician who could piece together my problems with my thyroid and pituitary glands and address the hormonal imbalances that contribute so heavily to my depression.

You know your sister, friend, brother, or father better than most mental health professionals, so help him solve the riddle of his symptoms. Together consider what could be at the root of his depression: physiologically, emotionally, or spiritually. Where is the disconnect?

4. Talk about stress.

You can be drinking kale and pineapple smoothies for breakfast, lunch, and dinner; meditating with Tibetan monks for eight hours a day; sleeping like a baby at night — and yet, if you are under stress, your veins are flooded with poison and your mind is under fire.

About five pages into every psychology book there is a paragraph that says that stress causes depression. I think it should be on page one. There is just no way around it.

Stress is bad, bad stuff, and as long as it’s pouring cortisol into your bloodstream, you aren’t going to get well. So one of the biggest jobs of a friend or relative of someone who is struggling with depression is to help the person construct strategies to reduce stress.

She doesn’t need to quit her job. She can keep her kids. However, she may need to make some significant lifestyle changes and be sure to introduce self-care into every day. What is that? Five-minute breaks here and there to take some deep breaths, or an hour massage once in awhile, or maybe a day off here and there to sit by the water, golf, or go for a hike.

5. Talk about support.

It doesn’t matter what the illness is — cardiovascular disease, colon cancer, fibromyalgia — a person needs support in her life to fully recover: people with whom she can vent and swap horror stories, folks who can remind her that she is not alone even though her symptoms make her feel that way.

Research shows that support groups aid the recovery of persons struggling with depression and decrease chances of relapse. The New England Journal of Medicine published a study in December 2001 in which 158 women with metastatic breast cancer were assigned to a supportive-expressive therapy. These women showed greater improvement in psychological symptoms and reported less pain than the women with breast cancer who were assigned to the control group with no supportive therapy.

Brainstorm with your friend on ways that she can get more support. Research and share with her various groups (online — like the Facebook group I started — or in town) that she might benefit from.

6. Remind her of her strengths.

Just yesterday morning I was having suicidal thoughts during yoga. It was one of those painful hours when I couldn’t stop thinking about how soon I could die. Instead of being gentle with myself, I started comparing myself with a few incredibly accomplished people I swim with — the kind of people who swim across the English Channel for giggles — and tend to make the average person feel pathetic.

Later in the day, I went for a walk with my husband, still fighting the death thoughts as we strolled along the rocks bordering the Severn River at the Naval Academy, our favorite route. We were talking about how jealous we were of couples who didn’t have kids (in some ways, not all), how damaged we feel after 13 years of parenting, but how much we’ve evolved as human beings because of all the struggles we’ve endured in that time.

“You’re strong,” he said.

I balked. “No, no I’m not,” I said. I was thinking strong meant swimming the English Channel, not fighting suicidal thoughts in yoga.

“Yes, you are,” he insisted. “You have a 200-pound gorilla on your back constantly. Most people would roll over and give up, coping with booze, pot, and sedatives. Not you. You get up and fight it each day.”

I needed to hear that. In my head, I categorize myself as weak because of the constant death thoughts, when, in reality, the fact that I can accomplish stuff in spite of them means I’m strong.

Remind your friend, sister, brother, or dad of his strengths. Bolster his confidence by recalling specific accomplishments he’s made and victories he’s won.

7. Make her laugh.

As I mentioned in my post “10 Things I Do Every Day to Beat Depression,” research says that laughing is one of the best things we can do for our health. Humor can help us heal from a number of illnesses.

When I was hospitalized for severe depression in 2005, one of the psychiatric nurses on duty decided that one session of group therapy would consist of watching a comedian (on tape) poke fun at depression. For an hour, we all exchanged glances like “Is it okay to laugh? I sort of want to die, but this woman is kind of funny.” The effect was surprisingly powerful. Whenever the “black dog” (as Winston Churchill called depression) has gotten hold of a friend, I try to make her laugh, because in laughing, some of her fear and panic disappears.

8. Pass on some hope.

If I had to name one thing a person (or persons) said to me when I was severely depressed that made me feel better, it would be this: “You won’t always feel this way.” It is a simple statement of truth that holds the most powerful healing element of all: hope. As a friend or family member, your hardest job is to get your friend or brother or dad or sister to have hope again: to believe that he or she will get better. Once his or her heart is there, his or her mind and body will follow shortly.

9. Listen.

You could disregard everything I’ve have written and just do this: listen. Suspend all judgments, save all interjections — do nothing more than make excellent eye contact and open your ears. In her bestselling book, “Kitchen Table Wisdom,” Rachel Naomi Remen writes:

I suspect that the most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention. And especially if it’s given from the heart. When people are talking, there’s no need to do anything but receive them. Just take them in. Listen to what they’re saying. Care about it. Most times caring about it is even more important than understanding it.

Originally posted on Sanity Break at Everyday Health.

Image: babyessentials.com.au

9 Ways to Help a Friend or Family Member With Depression

By Claire Howard on May 24, 2018

More than 16 million men and women in America – roughly 6.7 percent of the adult population – have had at least one major depressive episode in the past year, making it one of the most common mental illnesses in America. In addition, 3.1 million adolescents are affected each year.

Many people experience the lonely feeling of short-term sadness or a “blue” mood, but unless it lasts for more than two weeks and is detrimental to a person’s ability to work, carry out usual daily activities or have satisfying personal relationships, it is not indicative of major depressive disorder.

Depression is not caused by one thing and often involves the interaction of diverse biological, psychological and social factors. The underlying emotion of depression is one of powerlessness and the inability to change a situation like:

  1. A seasonal change (loss of natural sunlight in the fall and winter months)
  2. Long-term poverty
  3. Being a victim of a crime
  4. Side-effects of certain medications
  5. Bullying
  6. A death of a close loved one
  7. Having a baby
  8. Difficulty of finding a job
  9. Premenstrual changes in hormone levels
  10. Intoxication or withdrawal from alcohol
  11. Caring full-time for a person with a long-term disability

Seeing a loved one or someone you care about live with depression can be very hard, but it is important to intervene early before it becomes serious enough for them to consider self-harm. It is especially important to remember that you must be non-judgmental in your approach so you don’t exacerbate the problem or push them away from their support system. To ensure that you provide the best care you can, here are a few communication skills to remember:

  1. Ask questions with a genuine concern and listen to the answer to better understand.
  2. Clarify your understanding by restating what you heard and summarizing their facts and feelings.
  3. Listen to the tone of voice and non-verbal cues. They can reveal issues that are not being verbally communicated.
  4. Do not interrupt with phrases like “I see” or “ah” or “okay.” It can slow down or even stop the conversation altogether.
  5. Be patient with the process in which the person is communicating, even if they are speaking slowly, repeating themselves or not speaking clearly.
  6. Do not be critical or express frustration because of what the person is revealing.
  7. Do not use language like “pull yourself together” or “cheer up” or “it will be alright.”
  8. Do not interrupt to tell them a story about yourself or give your point of view.

One way to help aid the mental health of your loved one is to become trained and certified to identify and respond to signs and symptoms of depression. Find a Mental Health First Aid course near you and #BeTheDifference in the life of someone who may need your support today.

9 Ways to Be There for a Friend, Without Giving Advice

Source: Source: .com

Some years after my decision to divorce, I thanked my parents for not pressuring me one way or the other on the “stay-or-go” issue. Making that hard decision myself really forced me to grow, I told them.

My dad replied, “We knew there would be pain whether you got divorced or didn’t. And we knew you had to choose that pain for yourself.”

That was the best advice I ever got—and it wasn’t exactly advice.

I think about this incident often, particularly when another adult asks me to give advice or when I’m nervy enough to butt in without being asked. As fellow Psychology Today blogger Thomas Plante points out in a funny and insightful blog post, giving advice can be fraught with peril. Some people react rebelliously and do the very thing you advised against. Others get defensive and attack you, leading to the bewildered reply, “I was only trying to help!” Still, others ask for advice but then tell you a million reasons why your suggestions won’t work. Why the negative reactions? Plante points out that many people view advice as an infringement on their personal freedom or an attack on their competence.

Does that mean you should say nothing when a friend or relative faces a dilemma?

I don’t think so. While it’s dangerous to give advice, it’s also dangerous, and perhaps unkind, to say nothing or to back away from a friend’s need to talk about a painful situation. Your withdrawal could be interpreted as cold and distancing, or, worse, uncaring. Even if you end up feeling that you haven’t helped much, many friends feel grateful just because you’ve been willing to take the time to help grapple with their issues. That accomplishment will make you both feel better. That’s the upside.

But before you dive in to help, there are at least five more difficult truths to consider.

  1. An adult has the right to make their own decisions about their life. Ultimately what they do is their choice. (For the purposes of this blog, I’m assuming the person is 25 or over—that is, with complete brain development and in possession of all their faculties—and that there is no risk to anyone’s life or limb involved.)
  2. The other person has to live with the decisions they make. You don’t.
  3. You can never really know the totality of another person’s situation. What they tell you may be the tip of their personal iceberg.
  4. If you have a stake in the outcome of your friend’s action, maybe you can’t be unbiased. Like an honorable judge, recuse yourself from the case.
  5. You have likely made some bad decisions in your own life. If you remind yourself of this fact, it will keep you humble and avoid a superior, “I know best” stance.

Advice-Giving and Beyond

With one exception, the nine tips below will enable you to help a friend without giving direct advice about action to be taken. The goal is to respect their right of self-determination and to strengthen their sense of self:

  1. Just be there. Listen. Your very presence can be a comfort to a friend. Sometimes keeping someone company while they go through their trials is a gift in itself.
  2. Empathize with the other person’s situation. Try, “You are in a tough situation”; Sounds like you’re between a rock and a hard place”; or “I’m so sorry you have to face this kind of problem right now.”
  3. Use the skill of tentativeness. “Tentative” means “not fully worked out, uncertain, or hesitant,” from the Latin, meaning “to try.” Instead of assuming an expert stance, take a tip from the Buddhists and offer observations with a “beginner’s mind.” For example, say, “I could be wrong, but it seems to me….”; “It sounds like…”; “Maybe you are feeling…”; “I’m not sure, but perhaps you worry that…”; or, “If you felt comfortable doing it, you could consider trying ….” When you use this skill, you communicate that you don’t have an easy solution all wrapped up in a bright red bow. If the problem were simple, your friend wouldn’t need you!
  4. Tell a story. Instead of giving direct advice, tell a brief story about what happened to you or someone else (without violating anyone’s confidentiality) that could shed light on your friend’s situation—“Do you want to hear what happened to me when I was in a similar situation?” As Emily Dickinson wrote, “Tell the truth but tell it slant.” But don’t make your story so long that you steal the spotlight from your friend.
  5. Expand your friend’s perspective. If your friend seems to be afflicted with tunnel vision, help them expand their perspective. You could say, “There could be another way to look at this. What about…?” You could also expand perspective by pointing out the consequences of their actions to their future self: “This may seem like a good idea at this moment, but how will you feel in a week? A month? A year?” And you can shrink an overstated problem with a saying like, “This too shall pass.” If you dare, help them empathize with the other person in the conflict.
  6. Validate your friend’s feelings in the situation. If you honestly think your friend is right, say so: “You have every right to feel hurt (or angry, suspicious, sad).” Once when I was describing an extremely difficult situation, a friend exclaimed to me, “But that’s not fair to you!” Her blunt comment dissolved my confusion, put some iron in my spine, and helped me be fairer to myself in the future.
  7. Ask, “What would make you feel best about yourself?” and other identity questions. Identity questions help your friend get in touch with the values that make them the person they are. Here are some others: “What is really important to you?”; “What kind of life do you want to lead?”; and, “What kind of person do you want to become?”
  8. Ask, “How can I help?” But be prepared to set boundaries if direct help would draw you too tightly into your friend’s knotty problem.
  9. If you feel compelled to give direct advice, do it. Some friends truly want and need to hear your opinion. Honest feedback, even when it may be hard to hear, can be just the tonic they need. Emphasize that your friend can take your advice or leave it. And perhaps you could add, “Of course I don’t know all the details. You are the decider. And whatever you decide, you’re still my friend!”

What might work with one friend might not work with another. Use your good judgment. Ideally, your advice will strengthen your friend and give them more confidence in their own judgment in the future. And if you feel like you are getting in too deep, remember that ultimately it’s your friend’s job to solve their own problems, not you. If you do feel overwhelmed, consider recommending professional help.

Sometimes I find my own advice—or non-advice—almost impossible to follow. In fact, right at this moment, I can feel my halo slipping down my head. I have broken every one of these guidelines, just in the past year. But there’s a way to save the situation: If, like me, you ever find yourself blurting out advice and then regretting it, you could follow up with a comment like, “But of course the choice is up to you.”

What about you? What advice has helped or hurt you? What works when you give advice?

Meg Selig is the author of Changepower! 37 Secrets to Habit Change Success (Routledge, 2009). Like her on Facebook or follow her on Twitter.

(c) Meg Selig, 2014

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

Dear ACF,
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 the one out of every 10 adults in the US 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 also deep-dived into my and others’ personal experience with this important issue. Here’s what you need to know.

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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.

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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. Note: If your friend seems suicidal, go straight to the National Suicide Prevention Lifeline—or your area’s equivalent if you’re outside the US—for advice.) 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.

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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.

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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.

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What You Can Do to Help

It’s hard, too, to be on the outside and not know why someone you care about is all of the sudden in the dumps and no longer enjoying things they used to or should love. As a friend, the best thing you can do is listen and be there for the person. Here are some tips:

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Be honest and express your concerns. Dr. DeGroat recommends noting any significant changes in behavior, 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 behaviors, 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 behaviors, 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?”

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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!”

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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:

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 okay, 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.

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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.

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Enlist the help of others. You can get guidance from a professional (a school guidance counselor, the National Suicide Prevention Hotline, 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.

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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:

  • Kevin Breel: Confessions of a depressed comic – TEDx
  • Depression Lies – Wil Wheaton
  • Personal Stories of Depression – Anxiety and Depression Association of America
  • Depression: personal blogs and stories – Time to Change

Suggest counseling or other medical professional help. If your friend’s depressive symptoms are interfering with life (e.g., failing out of school, skipping work frequently, avoiding social contact, engaging in risky behaviors, 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 center 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.).

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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 the National Suicide Prevention Hotline: : 1–800–273-TALK (8255).

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Sincerely,
Lifehacker

Photo by aureman.

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