Supporting people with depression: practical ways to help

Depression is more than just having a bad day or feeling sad. According to the American Psychiatric Association, it’s a common mental health condition that can affect all aspects of your life, including your thoughts, feelings, and behaviors.

There are many treatment options for people with depression, but having the support of loved ones can make a big difference in managing the condition.

But what’s the best way to provide this support?

Here, Dr. Jeff Temple, director of the UTMB Center for Violence Prevention and a licensed psychologist, explains how to help someone with depression.

A good first step is to learn as much as possible about the situation your loved one is dealing with.

According to the Cleveland Clinic, depression is a mood disorder that involves persistent sadness and loss of interest in daily activities. Temple says it can vary from person to person, but some common symptoms include the following:

• negative thoughts
• sad
• Decreased interest in doing things you used to enjoy doing
• despair
• irritability
• changes in sleeping and eating

“However, individual differences vary greatly,” Temple said. Other symptoms of depression may include:

• fatigue
• difficulty concentrating
• Headache
• stomachache
• sexual dysfunction
• Thoughts of self-harm or suicide

There are many forms of depression that can be diagnosed, including:

• ‌‌Clinical depression (major depressive disorder)‌: Persistent feelings of sadness or worthlessness for at least two weeks, plus difficulty sleeping, changes in appetite, and loss of interest in daily activities. It is the most common and severe form of depression, affecting an estimated 1 in 10 adults each year, according to the American Psychiatric Association.
• ‌‌Postpartum depression:‌ A form of depression that occurs after childbirth.
• ‌‌Seasonal Affective Disorder:‌ A form of depression that usually occurs in the fall and winter, when the weather is cold and dark.
• ‌‌Persistent depressive disorder (PDD):‌ A mild to moderate form of depression that lasts for at least two years but is less severe than clinical depression. This is sometimes called high-functioning depression.

Sharing your inner thoughts and feelings is a vulnerable thing. Encourage them to talk about their feelings, ask questions and reassure them that you are a safe person to talk to.

The National Alliance on Mental Illness (NAMI) says communication is a simple and effective way to support people with depression. Tell the people you care about and ask them how they feel.

When they open up, talk to them kindly, listen to their reactions with your full attention, and stay calm and rational.

Temple says the last thing someone with depression needs is harshness or criticism. Talk to them kindly and offer ways you can help.

You can offer support in big and small ways, such as offering to walk their dog, pick up groceries, or help clean the house.

“Let your friends or loved ones know that you are someone they can turn to and offer help,” Temple says.

If someone with depression opens up to you about their mental health, give them your full attention and try to understand what they are going through.

According to NAMI, don’t try to solve their problems, but just listen and understand what they are saying.

Show them you’re paying attention by making eye contact and occasionally restating what was said to show you’re listening and understanding.

Depression can manifest itself as persistent negative thoughts that are untrue but difficult to ignore. That’s why Temple recommends reminding your loved ones that negative thoughts are only temporary.

“If they find themselves thinking ‘I’m worthless and life sucks,’ don’t let them accept that fact,” he said.

Instead, Temple recommends helping them challenge those ideas. “Ask them to list the reasons why they think they are worthless, but also list all the reasons why they are not worthless. The idea will slowly shift into something more accurate.”

Don’t be afraid to ask if they want to harm themselves. It’s a sensitive topic, but testing may ultimately save their lives.

NAMI recommends asking specific questions such as “Have you ever thought about harming yourself?” or “Have you ever thought about suicide?” If they answer “yes,” important follow-up questions include:

• “Have you ever tried to hurt yourself before?”
• “Have you ever attempted suicide before?”
• “Have you ever thought about what to do?”
• “Do you have a plan?”

“Asking doesn’t make it more likely to happen,” Temple assured.

Temple recommends stepping up your efforts to get them extra help if they are considering self-harm.

Encourage your loved ones to call the Suicide and Crisis Lifeline at 988 or call yourself to connect with resources in your area.

According to the Cleveland Clinic, a common symptom of depression is a loss of interest in activities you once enjoyed.

Help your loved one remember their favorite hobbies and do them together. These activities could be running, reading, watching movies, playing video games, going out to eat, crafting, or anything else that used to make them happy.

“It’s very difficult to do these things when you’re depressed, but do them anyway,” Temple said. “It’s hard to feel sad when you’re doing something you love.”

Depression should not be dealt with alone. Offering support is the best thing you can do, but professional treatment may be needed to make real progress.

Help people with depression by participating in the process of finding the right doctor or therapist, Temple said.

Once they find a doctor, consider attending a session with them or hearing how it’s going if they’re willing to share.

Avoid blaming the person with depression or urging them to get better.

“Think of it like any other illness. You wouldn’t tell someone with cancer or heart disease to ‘buck up,’ or tell someone with COVID-19 to stop coughing,” Temple said. “Depression is real, scary, and hard. Be patient.”

Depression comes with a lot of uncontrollable emotions. If someone is going through an emotional roller coaster with depression, believe them and listen to them.

Saying things like “Things could be worse” or “Everything happens for a reason” may seem like an attempt to cheer someone up, but these feelings can actually be harmful.

Don’t dismiss their feelings; instead, affirm them by saying, “I hear you” and “Your feelings matter to me.”

Depression often causes people to withdraw and behave differently. Making them feel guilty about their depression will only make it worse, especially since they are likely already feeling guilty.

If they cancel or abandon plans, respond kindly and tell them you understand. If your relationship changes while they’re depressed, don’t take it personally.

Getting treatment for depression is an important but daunting step. If your loved one says they are not ready to get help, allow them to make a decision in their own time.

In the meantime, consider helping them identify smaller steps they can take to make progress, Mental Health America reports. For example, start with their work life, relationships, stress levels, or sleep.

Depression comes in waves. One day your loved one may feel great, and other times they may feel down. Stay alert and constantly check in with how they are feeling, even when things seem to be going well.

You can ask questions like: “How are you?” and NAMI’s “How are you doing?”.

Learn what triggers may indicate a depressive episode. The more you ask, the more you will know.

Helping someone with depression can feel challenging, especially because you don’t want to make your friend or loved one’s situation worse. Temple says the best thing you can do is be there for them, but also take care of yourself.

“Caring for someone with depression is a difficult task. It’s easy to become depressed, which can lead to doing or saying hurtful things that make you feel guilty and make the person with depression even more depressed,” he said.

In other words, put on your oxygen mask first.

“Once you’ve done that, let your friends or loved ones know that you are someone they can turn to,” Temple says.