If you have a friend or family member with major depression, you might be wondering how you can help them. This can be particularly challenging, as people with depression often withdraw from others and may even try to push you away.
Helping people with depression involves understanding what is going on with them and also avoiding some very common pitfalls.
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Not everyone who is depressed has major depression. Other conditions can cause depression, and these require different types of support. Also, we all get depressed sometimes, usually because of a life event or stressful situation.
Major depression also called a major depressive disorder¹, is defined as intense, overwhelming symptoms that interfere with everyday life and last more than two weeks.
The signs that someone you know might have depression include:
Expressing sadness, hopelessness, or extreme worry
Not enjoying activities that normally give them joy. This might manifest as turning down an offer to do something they would normally say yes to.
Irritation or frustration
Changes in appetite, which might include comfort eating, eating more junk food, or, alternatively, not eating.
Changes in sleep pattern - sleeping too little or too much
Difficulty with concentration or memory
Talking about harming themselves
If somebody you care about is showing these signs, you should gently encourage them to get help. Avoid pushing too hard, especially if your loved one is someone who typically doesn’t like to talk about or show their feelings. (Men, for example, can tend to struggle with admitting they are depressed and may withdraw if pressed too hard on the matter.)
Depression is treated² by using three key tools: psychotherapy, medication, and lifestyle changes.
Medication is generally not used alone, and all three factors are typically needed for success, although some people may lean more towards one treatment method over another. For example, some people might prefer not to take medication if they can avoid it, while others might be resistant to talk therapy.
You can support your friend or loved one by helping them with all of these areas. This might be as simple as reminding them to take their meds.
If you are particularly close to your friend or family member and they don't have anyone else in their life that they trust, they may want you to go with them to their therapy appointments for moral support. If they don't have a car or can't drive, offer to drive them to appointments and work with the rest of their social or support network to make sure they always have a ride.
When it comes to lifestyle changes, one of the most important is seeking social support. People with depression are advised to reach out and stay in contact with friends and family. Other lifestyle changes that you might be able to help with are:
Exercise. Many people are more likely to exercise if they have a “buddy” keeping them accountable. Help your friend find an activity they enjoy doing and even consider doing it with them. Even a half-hour daily walk can help.
Nutrition. Depression can affect eating patterns, and it can often result in people binging on sugary snacks. Help by recommending alternatives. If they're too depressed to cook, consider coming over with a meal now and then or ordering them delivery services.
Sleep. Practicing good sleep hygiene is really important. Encourage your friend to keep to a sleep schedule.
Stress reduction. Don't add to their stress, but instead be willing to listen.
There are several other ways you can help a friend or family member experiencing depression.
Many people with depression don't want to get treatment. There is a lot of stigma about mental health, and people are often prone to denial or don't want to admit to what they might perceive as a weakness.
Talking to them³ about what you have noticed, making it clear that you don't consider it a personal flaw, and letting them know that treatment can make things better, can help them break through that wall and get the treatment and support they need. You can offer to help them prepare for their first appointment and go with them if needed.
Invite them out for walks, outings, and other activities. However, don't put a lot of pressure on your loved one to go on outings. Start by suggesting a short and simple activity that you can do together and then gradually build up to lengthier and more frequent outings from there.
Remember that not enjoying things is a symptom of depression, and so is not having enough energy.
It's great if they come, and it's better if you can be flexible enough to catch them on a good day. Even if they choose not to participate, inviting them reminds them that you care and value them, which can help them feel better.
They may not thank you for it at the time, but if your friend or loved one is talking about harming⁴ or killing themselves, make sure their care team or their immediate family members know.
If they are in active distress, consider this an emergency. Try to get them to go to the ER with you so they can get urgent treatment. If they refuse, you might have to call for emergency help, even if it’s against their will. It’s always better to be safe. Never ignore or minimize suicidal comments.
If your friend owns a firearm, offer to remove it from the premises until they feel better. Handgun ownership⁵ is associated with much higher suicide risk, simply because having a gun handy makes it so much easier to act on those urges. It also means suicide attempts are much more likely to succeed.
Removing guns from the home can be a key element of protecting somebody with depression from themselves. This can be a difficult conversation to have, but it is a necessary step to take.
If the person with depression is a close relative, it can be worth considering family therapy. Family therapy can help you learn better-coping skills both to help your family member and to support your own self-care needs.
If the person with depression is your child, it is really important to seek therapy for them, and consider getting it for yourself, too. Dealing with a child with depression can be extremely stressful and frustrating, especially as they tend to act out and develop behavioral problems at home and school.
While you should never tell somebody with depression to cheer up and get over it, it can help them to hear reminders of their positive qualities. Tell them how much you appreciate them, remind them of the good things they have done, etc. If they have creative hobbies, give them lots of praise (thinking your creative work sucks can also be a symptom of depression).
Sometimes people with depression can't handle everyday tasks. Offer to swing around with an extra portion on days when they can't manage cooking. Help with cleaning or suggest a cleaning service so that dirt and clutter don't build up and become a vicious cycle. They may be too depressed to clean but not having cleaned can be making them more depressed.
Ask if there's anything you can do to help them in other areas, such as child care.
There are many support groups that can help people with depression, but your friend or family member may be too depressed to start looking or feel as if they don't deserve the help. Offer to take on the search for them and help them find groups and organizations suitable for them.
It's important to understand that if your friend or loved one is snapping at you, it's not personal. The depression is talking, not them. Understand that they aren't being lazy or unmotivated. Being depressed can make a person physically tired, just from fighting the negative thoughts.
Understand that you aren't to blame for this, and you can't fix it; they have to fight this themselves, and all you can do is be there to help and support them.
On the other hand, if you are experiencing depression, it can be hard to explain the feeling to someone who has never had it themselves.
Often, people get desperate to help their friend or loved one, which can lead to them falling into some common pitfalls.
It's very important to be a supportive listener when somebody is depressed. However, many of us fall into the trap of saying things that make the person feel worse. They include:
Snap out of it/just get over it
You don't have things so bad
It's all in your head
Everyone goes through tough times
You should be feeling better by now
I thought you were better than this
In other words, don't belittle their depression, don't imply that they are a failure because of it, and don't try to "cheer them up." You may well be able to give them a brief respite, but you aren't going to do it by telling them to feel better.
It's a symptom of depression to refuse help⁶. It's easy just to give up and walk away when the person pushes you away, refuses to let you help, or says negative or unkind things to you.
Instead, keep gently checking in and keep offering help. You need to be there with them even if you can't be there for them.
The last major pitfall is to become so concerned about helping your friend or family member that you stop taking care of yourself.
If the person with depression is a close friend or an immediate family member, it's very easy to end up using up all of your energy on them and not being able to help anyone else.
Make sure to practice good self-care by:
Getting enough sleep
Eating healthy food
Getting some exercise
Setting boundaries and acknowledging that you can't do everything. You can't be a caretaker around the clock, and you are not their therapist. Ideally, team up with others who are willing to share the load.
Keep your own plans with friends, appointments, and outings. If you plan an outing and your depressed friend is too sick or otherwise unable to go, find somebody else to go with you.
Consider getting therapy yourself.
Join a support group for family members of people with depression.
Don't abandon your other friends. They are your support network.
Practicing good self-care is vital when taking care of others and helps preserve your relationship with them by avoiding burnout and resentment. As they say on airplanes, put on your own oxygen mask first before helping someone else.
If you have a friend or family member suffering from major depression, you really can help, and it's important to believe that.
You should offer them support, both moral and logistical, help them seek help, and at the same time, take the right measures to make sure you don't get burned out.
Help by providing food, getting them to appointments, and by being a good friend even if they don't seem to want you around right now. You can help them get through this difficult time and get back to being themselves again.
Depression | Cleveland Clinic
Depression Treatment | Help Guide
Depression: Supporting a family member or friend | Mayo Clinic
Depression | NIH: National Institute of Mental Health
Handgun ownership associated with much higher suicide risk | Stanford Medicine News Center
6 Do’s and Don’ts for Supporting Someone Who Has Depression | Cleveland Clinic