Depression is a serious mental health condition. When a loved one suffers from depression, social support is an undeniable factor that facilitates recovery. If a friend, family member or loved one suffers from depression, you may feel inclined to help them. It is likely that you feel confused, overwhelmed, disoriented and anxious about how to help them best. There are misconceptions about what is healthy help, what is unhelpful and what is enabling that individual to stay exactly where they are without improving.
Psychoeducation
Become informed about what depression actually is.
It is a mental illness that is real, with actual symptoms, and subsequent biochemical changes in the person’s system, that prevents them to “just snap out of it”.
Depression is not just feeling sad... Depression is feeling lonely, hopeless, helpless, and desperate. Depression is hating yourself for feeling like this and blaming yourself even more. The worst part of depression, though, is the numbness that it carries; the inability to feel anything at all, the emptiness.
You cannot fix it with logic and reason- otherwise there wouldn't be anyone suffering from this disease, would there..?
Symptoms of depression include:
-Pessimism and hopelessness
-Persistent feelings of guilt, worthlessness and helplessness
-Persistent sad, anxious or “numb”/empty feelings
-Changes in appetite (overeating or appetite loss)
-Changes in sleep patterns (insomnia or sleeping too much)
-Loss of interest and motivation in activities once pleasurable
-Change in energy levels, fatigue
-Restlessness and irritability
-Physical symptoms (pains, headaches, cramps) that are not medically explained and won’t go away
-Suicidal thoughts or attempts
-Loss of interest in sex
-Difficulties in concentration, memory and decision-making
These symptoms have to be persistent for at least 2 weeks for a clinical diagnosis of depression.
Being sufficiently informed about depression symptoms will prevent you from offering unhelpful advice such as “it is all in your head” or "you shouldn't feel this way" , or "think happy thoughts".
Compassionate active listening and understanding
If you intend on helping your loved one, know how to do so. You need to show understanding and patience with their condition. Validate their emotions and their difficulties, instead of disregarding them as unimportant or unreal. A depressed individual can feel even more lonely and helpless, if their experience is denied and not acknowledged by someone they care about. This can increase feelings of shame and guilt, thus perpetuating their condition.
Encourage them to seek professional help
Depending on the duration and intensity of their condition, and given that depression a real illness, it makes perfect sense to encourage your loved one to look after themselves and seek professional help by visiting a psychologist. You may want to offer to help them find one, accompany them to their appointment or support them in some other preferable way.
You would definitely urge them to visit a doctor, should they have a physical injury- so why should the approach towards mental health be any different?
This can be a sensitive topic, since it greatly depends on the attitude of this person towards mental health professionals, psychotherapy and mental health stigma issues.
In my experience, however, even people that may have had little to do with mental health issues in the past, will be more willing and open to the option of seeking help themselves if they are pushed close to their own limits.
With awareness comes intention towards action; if this person realizes that their condition require external assistance, then previous reluctance may dissolve.
Every little thing helps… Supporting through recovery
When you suffer from depression, every minor daily activity can feel like an insurmountable obstacle. That’s why treatment focuses on engaging the individual back into "life" with simple daily tasks.
Be sure to encourage your loved one through these difficulties; praise every little achievement and show faith and confidence in their ability to feel better.
Be cautious though; expressing that you believe in them should not pose any pressure or judgement to their current condition. It is important for them to know that they are allowed to feel bad, and you are there for them, regardless.
If you are uncertain about what you could do to help, ask them. Brainstorm with them, if they are unmotivated. Offer to accompany them, if they struggle to make the decision to get out of the house and do an outdoor activity. Make small gestures that express your affection and care; for a depressed person, feeling that the others accept them and care about them despite their condition can mean the world to them.
Avoid judgement, criticism, minimization
All the above can be done more easily, the better informed and well-educated you are about depression. Often, our automatic response towards someone we care about is the “tough love” approach; trying to shake the other person into motivation and motion, to bring them in touch with reality.
This is unlikely to work effectively for someone with depression, though. In this occasion, tough love would be like beating down someone who is lying on the ground already; it will most probably be conceptualized as criticizing and aggressive.
Be conscious with judgemental and criticizing comments towards your depressed loved one; the beliefs about themselves are more frail and negative, therefore instilling further guilt in them will not motivate them, but will worsen their situation.
Do not minimize their pain and struggle by claiming it is all in their head, or that it is up to their own willpower to get better.
Do not compare their situation with other people’s stories about depression; each experience is unique and should be respected as that.
Help your loved one set their own goals and cheer them on while they’re attempting improvements, without judging them as not trying hard enough when they fail.
No unsolicited advice
No-one really likes being given advice without asking for it, right? The same applies for depressed people. Ask them instead, Could I help you in some way?
Ask them if they would like to hear your opinion on their problem, or better yet- wait for them to ask for your advice.
Offering advice without them asking for it can come across as patronizing and condescending.
The underlying message you are implying to them, and the subsequent way this may be interpreted and further analyzed from a depressed person's perspective, is:
“I know much better than you do”-> “I am better than you”-> “You are worthless”.
Be there
Offer your full presence and undivided attention to your loved one, when you are with them.
The realization that someone else is fully there for you , to support you through your worst, can be invaluable to anyone- let alone to someone who is paralyzed in a depressed state.
Don’t take things too personally
People with depression may also suffer social consequences, and this is a vicious circle : they tend to isolate themselves, their friends feel helpless and confused about how to support them, they eventually withdraw from them, and this perpetuates the social isolation of someone with depression.
Moreover, their social skills may be affected by depression, since it is difficult to establish deep emotional connections with others when you feel so numb and empty yourself.
Their view towards themselves, the world and the future may be so dark and bleak, that they may sound insensitive, harsh and self-defeating at times.
They may be irritable and even have an anger outburst towards you. Don’t take their negative remarks personally, though; this is the depression and the hurt talking, not them.
Of course the depression is still a part of them, yet do not make them accountable for any hurtful comments they may make towards you.
Know the difference between helping and enabling
Helping is empowering, supporting, comforting, and facilitates recovery and growth. Enabling is engaging in behaviours that you may think help the depressed person, but actually contribute to the problem by maintaining the situation as it is, without promoting change. The difference between the two is really subtle.
Enabling means doing something for the other person , that they could and should be doing by themselves, in order to take small steps towards recovery.
One of the defining points between the two is the frequency of the help, and whether it is the exception, or the rule.
For example, maybe you have agreed to help your depressed loved one clean their house. Perhaps you even offered to come by, do the dishes and clean up their mess for them. Or you offered to buy them groceries.
This is help; it is supporting, if it happens a few times.
However, if you get into the habit of passing by everyday to do their dishes and clean the living room for them, or buy everything off their supermarket list daily for them, it is not supportive help anymore- it is enabling them to stay where they are.
Even if you have the best intentions, you don’t really help them if you offer to do too much for them.
You actually deny the opportunity of improvement and motivation from them. Your loved one may start expecting that you will come to the rescue to help them out every time they may need to, but this may in fact delay them from getting better themselves.
After all, behavioural activation (becoming re-engaged with simple daily activities) is one of the main goals of treating depression; let them reactivate themselves instead of becoming part of their problem or start making excuses for them. Short-term it may be helpful, but long-term it will not be beneficial.
Take care of yourself
No matter how much you care about your depressed loved one, be aware that you cannot fix their depression for them. No-one can. Ultimately, only the depressed individual can get out of their condition; you can help them get there, you can hold their hand throughout their journey, but still cannot fix it for them.
This responsibility is not yours, and the more you may get involved without putting yourself as a priority, the more challenging and exhausting the whole process can actually get.
Know and respect your own boundaries, realize what you’re willing and able to do -and maybe sacrifice- from your own life in order to help your loved one. You are entitled to your own emotions about the situation, you are allowed to not withstand it indefinitely.
For instance, if the depressed person is your romantic partner, be aware that the severity of the depression may have significant effects on the relationship between the two of you.
It is not uncommon for one romantic partner to not be able to bear the situation and to walk away; and that is ok, if this was their own boundary that they had to respect and honour.
Be committed to communicate openly and honestly with your loved one, even when this may seem overbearing or frightening. Suppressing your thoughts and emotions or withholding your opinions from your loved one out of fear and worry that they can get hurt may actually damage your relationship, because it can built resentment and frustration between you, not to mention that your loved one would most likely benefit if you shared your authentic opinion with them, instead of sugar-coating challenging truths.
Remind yourself of your own needs, keep an active stance on the rest of your life, and be prepared to seek support yourself (for instance, join a depression support group) if the challenge seems too heavy to bear.
Remember, if you empty your own resources, then you cannot offer your help and support to your loved one anymore.
You are not selfish, it is true; You are the priority.
When you are strong and resilient, you can be most supportive to your loved one in need.