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It can be hard to watch your friend, loved one, or partner struggling with depression.  The distress can be overwhelming for those on the outside.  Depression can be expressed in many different ways and treatment is often most successful with a multifaceted approach.  You want to “fix them”, you want them to “be more positive”, or you want them to “take more action” and participate in life.  However, well intentioned, you should be mindful of what you say, how you say it, and your tone.

  1. Don’t say something like Get Over It!  Depression is an individual issue.  Sometimes, it is chemical, sometimes it is environmental, sometimes it is due to past experiences, and sometimes it is related to current situations.  If they could just get over it, they would have by now.  If they could just snap out of it, they would have by now.  The depressed person experiences these helpful words as judgmental and yet another thing they cannot do right.  It is more likely to compound their sadness, negative outlook, and sadness. Instead of that, you can help them challenge their negative outlook or see the situation in a ask healthier more positive life.  Sit with them in this moment instead of bashing them for chewing over the past.  Just help them hold or express how they are feeling now.  Be present with them in this moment.
  2. Don’t say  Someone Else Has it Worse or What Do You Have to Be Sad About? They are likely already negatively comparing themselves to you, non-depressed people, others in their profession, or others their age.  Depressed people may lack the resources to cope with situations that you see as minor.  To them depending on the severity of their depression, the situation or issue may seem like trying to climb Mount Everest.  Remember that depressive reasoning does not always make sense.  That is what your loved one is working on in therapy–changing their thinking.  You should also check in with your own feelings.  Are you saying this out of frustration and irritation?  Are you burned out on helping them manage their mood?  Do ask them to express what may be driving their depressive thoughts at this time.  Do help them determine whether these depressive thoughts are horror stories that they could rewrite into a story of triumph and overcoming.
  3. Don’t say Did You Take Your Meds?  Unless your loved one has a history of noncompliance with medications (mental health or physical health), do not lead with this.  It invites more negative thinking, feelings of guilt, feelings of punishment, and self-loathing.  Instead, invite your loved one to review a checklist created by their therapist and shared with you.  What are the things to do, ask, and consider to keep the depression from deepening or to get him/her out of the slump?  These should be steps that you have all agreed upon.  For example, making sure I am getting enough sleep, sticking to a routine no matter what, engaging in some physical exercise daily, eating healthy and nutritious foods, reviewing coping thoughts, taking their medications as prescribed, and journaling.  If you know those things are on the list, then you can ask the depressed person if they have done those things.  If not, then, ask how you can join them in doing those steps.  Make it safe for them to hold themselves accountable for engaging in healthier thoughts and actions.
  4. Be aware of the signs of worsening depression If you loved one is in therapy, s/he should have developed a list of these already.  If they have not, suggest it as a focus for treatment or ask if the therapist has discussed it with them.  Some providers like myself, actively invite significant others or family into treatment to get another perspective of the patient’s distress.  Review the list with your loved one to see if there has been a status change.  Ask to share changes you are noting either in a joint session or via phone or note with the therapist.  Talk to their prescriber if there is a medication issue.
  5. Ask about suicidal thoughts. Often this is an uncomfortable conversation.  However, the risk for self-harm or suicidal behavior is higher for individuals with depression.  It must be addressed.  Listen for feelings of helplessness, hopelessness, plans for selff-harm, and feelings of worthlessness.  If your loved one has a history of suicide attempts or thoughts, it becomes even more important to be aware and be proactive.  Again, it may mean alerting their therapist, psychiatrist, or primary care physician to the situation.  It may mean calling the suicide hotline in your area or the national suicide hotline, or ultimately, you may have to call 911 to involuntarily hospitalize them (i.e., Baker Act them).  Psychiatric hospitalization is designed to help them be safe if you cannot keep them safe at home, adjust medications or start medications if they have not been compliant, and to receive acute therapeutic treatment to help stabilize their mood.

In the United States, you can reach the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255)

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