To support a loved one who’s depressed, start by showing up
If we have a loved one who is suffering with depression, we want to let them know we care and help them cope in ways that encourage their recovery. But knowing what to say or do isn’t always easy.
Here, Dr. Debra Kissen, chair of the public education committee for the Anxiety and Depression Association of America, shares her tips for what is, and isn’t, helpful.
Don’t try to give advice
“People don’t want advice as much as love and support,” says Kissen, who is also the clinical director of Chicago’s Light on Anxiety Treatment Center.
It’s tempting to offer suggestions for what you think might help. Maybe they really would benefit from changing their diet, exercising, meditating, finding a therapist and other tools you’ve read about. But depression steals the energy and willpower to reach for any of those things that could have a healing effect.
“Think of it as having mono and someone telling you to go run a marathon when you literally don’t have the resources within you to push forward,” says Kissen. “At the end of the day, as much as we want to fix our loved ones and take away their suffering, we can’t.”
Validate their feelings
We may think trying to cheer someone up is helpful. But saying “It’s OK” or “It’s going to be OK” dismisses the severity of depression.
Other trivializing phrases — including “Just focus on happy thoughts,” “Snap out of it,” “Find something to keep you busy” — can make your loved one feel misunderstood, guilty and more alone than they already do.
So can pointing out all they seem to have going for them — a successful career, loving relationships, prominent status or any other stereotypical markers of happiness.
“When you see someone with a broken leg, you know it’s broken because they’re walking more slowly with a cast. Depression is an invisible illness,” Kissen says. “It’s harder for others to appreciate how someone may be feeling this way when they can’t see the wounds.
“But the signal you want to send is that what they’re feeling is valid and you believe in them and their ability to handle something even though it’s really hard.”
“The most helpful thing that you can do for a person who’s feeling depressed is to be there with them,” Kissen says. “Instead of asking, ‘Is there anything I can do?’ just show up.”
While that can mean sitting beside them on a couch, she advocates sharing an activity together.
“One of the most effective treatments is behavioral activation. That means getting someone moving about and engaging in activities the brain has found pleasurable in the past but they aren’t feeling motivated to do currently,” says Kissen. “Instead of just telling them to do something, say, ‘Let’s go for a walk. Let’s go paint some pottery.’”
Similarly, don’t ask if they’d like to hang out; instead give them a time when you’ll pick them up.
“You can’t utterly control the choices one is going to make,” says Kissen, “but trying to generally be there without judgement and with support is the most we can do for each other. And it’s powerful.”
Don’t shy away from talk of suicide
While engaging in such conversation might feel scary and uncomfortable, it’s important to create the space to talk if someone mentions death, suicide or other thoughts of harming themselves. It’s also OK to ask if they’re having suicidal thoughts.
“There’s a tendency to think if I talk to them about it, it might make it more likely that it’s going to happen, but that’s not the case,” says Kissen. “If someone mentions it, try to be brave and find out what they mean by that: Do you have a plan? Do you have the means? Is this something you’ve tried before? The most important thing is to try to be matter-of-fact.
“The more judgy and terrified you sound, the less likely they’re going to answer.”
Knowing specifics makes it easier to intervene and prevent a loved one from hurting themselves.
“If it sounds like there’s a specific plan, you can say, ‘I love you too much to let you do something you might later regret,’” Kissen says.
Then, have your friend or family member call their therapist if they are seeing one, a suicide hotline, such as 1-800-273-8255, or 911 to speak to a crisis intervention team. You can also accompany them to a walk-in clinic or hospital emergency room.
If your loved one is not being treated for depression, encourage them to seek professional assistance. Simply saying “You need help” isn’t likely to inspire action.
You may have to get them to that first appointment, whether it’s by helping them find a psychiatrist or psychologist, being with them as they make the call or driving them there.
Repeatedly showing up with that kind of support and acceptance helps to minimize the shame that often accompanies depression.
“It’s hard to keep feeling shame when you’re no longer hiding what you’re going through,” says Kissen. “When someone has a safe place to not be OK, that heals a lot.”
“This is not the new normal where forever more they will be in this deep, dark, hopeless tunnel,” she adds. “There are certainly combinations of medication and cognitive behavioral therapy that are quite efficacious at creating change and lifting depression. There is much to be hopeful about.”