Supporting Someone with Depression

According to the Mayo Clinic, watching a friend or family member struggle with depression can wear you down. You might feel helpless, or hopeless, or just plain frustrated that nothing you say seems to land. The most useful thing you can do is learn how the disorder actually works and get familiar with the resources available. That knowledge changes how you show up for the person.

Depression looks different from one person to the next, but a few patterns come up again and again. There's a heavy, persistent sadness that some people describe as feeling empty. Activities that used to bring pleasure stop mattering. Hopelessness and a sense of worthlessness take over. Restlessness creeps in, and with it comes trouble concentrating or making even small decisions.

People who are depressed often don't seek help, and the reasons vary. Some assume the feelings will lift on their own. Some don't accept that what they're dealing with is depression at all. Others carry guilt or shame about it, or they read it as a personal weakness, something they ought to be able to tough out alone. The reality is that depression almost never resolves without professional support. With the right care, symptoms can ease and a person can return to functioning the way they did before things went dark.

If someone you care about is showing these signs, there are concrete steps you can take. Start by naming what you've observed. Tell them about the specific changes you've noticed and say that you're worried. Offer to walk them through what the symptoms of depression actually are, so the conversation has something to anchor to.

It helps to frame depression as a medical condition. When someone understands that this is a common illness rather than a flaw in their character, the shame loosens its grip a little.

Point them toward a professional. A psychiatrist, a licensed counselor, or a psychologist are all solid places to begin. Most clinicians agree the strongest approach pairs counseling with medication. A psychiatrist can evaluate the situation and prescribe medication when it fits, and there are a number of antidepressants to choose from; the psychiatrist can lay out how they differ, how well they work, and what side effects to expect. A psychologist or licensed therapist handles the therapy side, and cognitive behavioral therapy (CBT) is the method most often used with depression.

You can also help them put together a list of questions to bring to that first appointment. Writing these down ahead of time gives the person a clearer grasp of the diagnosis and the treatment choices in front of them. And say out loud that you want to be part of this: offer to drive them there, or to sit in the appointment with them. If the person is suicidal, go straight to emergency services in your area. Crisis hotlines are also there for exactly this.

Depression can deepen when it isn't treated, so it's worth paying attention to the direction things are moving. Are the symptoms getting louder? Are there particular behaviors, phrases, or shifts in how they speak that tend to surface when things are bad? And on the other side, what do you notice when they're doing better? If the symptoms are clearly worsening, don't wait. The person needs to work with their psychiatrist or therapist on a crisis plan, which might include scheduling an appointment with their therapist right away.

One reader, Kim B., shared her own experience living with depression. She described having long stretches, months and sometimes longer, with no symptoms at all, and then a bout arrives and she feels as though no one grasps what she's going through. She tries to explain it, she said, but it's hard when the very person you most want to understand you simply can't. Usually it isn't malicious. The people around her just haven't lived it themselves, so empathy for that kind of anguish is out of reach for them.

What she wanted others to hear was that they aren't alone. She feels steadier and more sure of herself when she knows people are behind her, safer in a group than by herself, and she only wished that feeling stayed with her all the time. For her, the worst part of depression is the loneliness. It doesn't depend on whether anyone else is in the room. She could stand in a packed stadium, everyone around her screaming for their team, and still feel like the most isolated person alive. She knows she isn't the only one; she's met others who carry the same dread, the same loneliness that tightens around them.

She wants to get better. The question she kept circling was how: how do you reshape your outlook so you don't feel utterly alone even when you clearly aren't? Her answer started with a realization that sounds simple and isn't. People who suffer from depression are not freaks of nature, she wrote. They aren't broken or incapable, though some people do suffer to that severe a degree, and the depression that shuts us down has to be redirected somehow. Easier said than done, she admitted.

The way through, for her, meant facing her fears alongside someone she wasn't afraid to be with, someone she could let inside her circle of trust (she joked, 'I'm watching you, Focker!'). Someone who accepts you when it feels like no one else will. Someone who, even on your worst day, looks at you and says they're proud of you, that they love you, that they want the best for you. That person is different for everyone, which is probably for the best, since otherwise it would be one exhausted human being. For Kim, it's her wife, and she said she'll always hold on to her.

Reference: Depression (major depressive disorder). (n.d.). Retrieved December 20, 2014, from the Mayo Clinic.