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Communicating with a depressed person


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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

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English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

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Last Updated: 08/30/2022

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How to behave with a person with depression. Instructions - Meduza

Depression is one of the most common mental disorders: according to the World Health Organization as of February 2017, more than 300 million people worldwide suffer from it. The scale of the problem in Russia is harder to assess. Experts talk about almost eight million Russians suffering from depression, but specify that, most likely, there are much more of them - people with depression often do not seek help because of shame or unwillingness to admit the seriousness of their condition. Depression can be underestimated not only by the patients themselves, but also by their relatives. At the request of Meduza, the author of the remain_nameless telegram channel about mental health, Daria Chagina, tells how to properly behave with a person suffering from depression, so as not only not to harm him, but also to help. nine0003

Recognize the importance of the problem

Pop culture has taught us that depression is a kind of seasonal blues: many of us have heard (or said) "I'm depressed today." Of course, any person experiences bouts of melancholy and depression - due to lack of sleep, problems at work, a quarrel with a loved one, and even bad weather. But as soon as the surrounding circumstances change, everything returns to normal. Depression, on the other hand, is arranged differently: its causes can be deeply hidden, it greatly affects a person’s life, and only in 40% of cases goes away on its own - and even then not completely. nine0003

Depression is expressed primarily in a constant depressed state, chronic fatigue and loss of interest in things that used to please. In addition, the disease can be accompanied by various somatic manifestations: a person either suffers from insomnia, or, conversely, constantly wants to sleep. Doesn't want sex. He cannot concentrate on anything and loses his ability to work. Loses appetite or, conversely, begins to overeat. Depression can also lead to a complete loss of interest in life, a suicidal state and suicide. The diagnosis is made if the duration of symptoms is at least two weeks - but depression can last for months or even years, and it must be treated. nine0003

Risk factors for depression can range from psychological shocks or trauma, dysfunctional family situations or lack of parental love, as well as genetic predisposition or various diseases, as well as alcohol or drug use. Moreover, psychogenic depression (caused, for example, by the death of a loved one, divorce or violence) does not necessarily come immediately - people experience difficult events in different ways, and sometimes the reaction to them comes with a delay. nine0003

Show that you are there

Depressed people don't just feel lonely, they often feel ashamed and guilty about their feelings and emotions. For fear of being misunderstood, ridiculed, or rejected, they prefer to remain silent about their experiences, do not seek help, or refuse to acknowledge the seriousness of their situation. Left alone with their feelings, many try to suppress and hide them - and only more convinced of their own "abnormality", worthlessness and uselessness. As studies confirm, it is this feeling of separation from other people that can lead to suicidal thoughts - therefore, the support of relatives and friends is especially important for depressed people. Make it clear that you are there no matter what, the person’s condition does not affect your attitude towards him in any way, you understand the depth of his suffering and are ready to help. nine0003

Do not discount the feelings and experiences of a depressed person

If you have never had depression, then you are unlikely to be able to fully understand the state of your loved one. Do not try to compare it to a "bad day" or just a difficult period in life (for example, a session or a job change) and do not offer a person with depression to "pull themselves together" or "tune in to positive." Even if you sincerely want to express support, such advice will only devalue the feelings of a person who is faced with depression, because he knows that everything is not so simple. People in this situation often hear, “Others have worse problems than you”, “It’s all in your head”, “Do something useful”, but all this only causes more shame, guilt or annoyance due to helplessness in the face of illness. Hearing something like this, a person may conclude that you will never understand him, and close up - then it will be much more difficult to help. If you don’t know what to say in such a situation (and this is normal), just hug, say: “I can’t even imagine what you are experiencing right now, but I see that it is very difficult” - and let the person show feelings in the way he it's necessary. nine0003

Don't take the words and actions of a depressed person personally.

People with depression are generally not able to lead the same active lifestyle as before. For example, they stop responding to messages and calls, refuse offers to go out to dinner or to the movies, they may even miss your birthday or wedding. This looks strange and insulting: after all, quite recently everything was in order, and today a person comes up with reasons to avoid a meeting. And if he nevertheless agrees to it, he can behave indifferently and not even try to pretend that he is interested in listening to you. nine0003

It's not about you at all - it's just that in a depressed state, most often there is no strength for anything. Even such simple, ordinary things as getting out of bed, taking a shower and preparing breakfast require a lot of effort. It is all the more difficult to go somewhere where there will be a lot of people. In addition, communication with people itself, even if it is not binding, requires a return, for which a depressed person does not have enough emotional resources. Remember that depressed people feel and appreciate the support of their family and friends, but they simply cannot respond to it in the same way as before. nine0003

Suggest seeking professional help

Depression doesn't often go away on its own—but even if it does, it can come back. According to statistics, 50% of people who have had a depressive episode in their lives have a second one after some time, and 80% of people who have two depressive episodes in their medical history sooner or later have a third. So if you suspect depression, a person should definitely see a specialist - first of all, a psychiatrist who can prescribe drugs if necessary. True, it is also very difficult for many to take this step: going to the doctor is considered something like a “last resort”, an admission of defeat. Antidepressants are also treated with great apprehension, although now there is a large selection of funds - and a competent specialist will be able to choose the right ones in each individual case. Yes, it doesn’t always work right away, but often you can’t do without medication. nine0003

Your loved one may be seriously afraid of going to the doctor because of the fear that he will be labeled as "mentally ill", "registered" or even "put in a fool". In fact, psychiatric registration was canceled back in the early 90s, and a person can be placed in a hospital against their will only by a court decision - or if a person poses a threat to himself and is not able to take care of himself. But if your loved one is still haunted by the fear of free medicine, advise him to contact a private specialist - if possible. nine0003

Tell the person with depression that more and more people are going to therapy and it really helps. After all, with a fracture, your friend would go to the surgeon - so in this case, you need to see a doctor. Offer help in finding a psychiatrist, offer to give a ride to an appointment or just see them off. But in no case do not shame and do not force.

Help with the simplest things (but in moderation)

When a person close to you cannot do some things due to illness, there is a desire to take everything upon yourself. You really can help, but here you need to know when to stop. nine0003

If you live together, help with daily chores: waking up and going to bed on time, remembering to take a shower or soak in the bath, eat well, and remember to take medication if prescribed. The correct daily routine helps to maintain some kind of balance even in the most difficult condition. You can try to involve a person in physical exercises - studies confirm that sports help in the treatment and prevention of depression. Moreover, it is the regularity of classes, and not their intensity, that plays the key role - you need to exercise for at least three months and for 45-60 minutes. Workouts on a pulse of 120-130 beats per minute are best suited: running, walking, swimming, cycling, tennis, dancing. nine0003

Offer useful applications

When depressed, it is useful to monitor how your mood changes over time - there are many paid and free mobile applications in Google Play and the App Store for this. For example, Moodnotes. When creating the application, the developers relied on the method of cognitive behavioral therapy, so in it you can not only note what you think about and how you feel today, but also track what causes certain thoughts and moods. You can also keep a mood diary through the How Are You and MoodPanda apps. nine0003

Mindfulness meditation apps can also be useful. It forms the basis of Mindfulness-Based Cognitive Therapy (MBCT), which is now gaining popularity in the United States. The main goal is to help get rid of the tendency to automatically respond to thoughts, emotions and life events. Perhaps the best mobile app for this is Headspace; it's available on both iOS and Android, but it's a paid subscription for $12.99 a month (I must say it's loved by many who don't have a depression problem, too). A free alternative to it could be Stop, Breathe & Think. But, of course, we must remember that neither meditation nor a mood diary can replace treatment, but can only be a help (well, it doesn’t hurt to discuss these practices with your doctor). nine0003

Be attentive and patient

The process of treating depression is long and hard. How much time and effort it will take depends on the severity of depression (mild, moderate, severe), and on the chosen treatment method (only taking pills, only psychotherapy, or both), and on how quickly it turned out to pick up the right pills and their dosage and, finally, whether it was possible to find a suitable psychotherapist. It also happens that a psychotherapist is good, but not suitable. Even if you have done everything you could and the healing process has begun, you should not expect an immediate result. Don't ask, "Are you feeling better?" - It may seem to a depressed person that progress in his treatment does not meet your expectations. nine0003

Instead, ask delicately from time to time if he remembers to take his pills, if he misses psychiatric and/or psychotherapist appointments, and if so, try to carefully find out why. For example, in psychotherapy there is such a thing as "resistance" - the patient's subconscious opposition to the process of psychotherapy. This phenomenon is associated with the fear of change, because it is far from always easy and painless to come to a cure. Resistance in psychotherapy can be expressed in many ways, including just missing meetings or refusing to continue psychotherapy in principle. Dealing with this is the work of a psychotherapist, but a careful, confidential conversation with a loved one can also help. nine0003

Take care of yourself

Being around a depressed person can be exhausting. Especially if this is a person close to you, to whose condition you cannot be indifferent. Nevertheless, do not forget the main rule from the instructions for behavior in emergency situations: you must first put on the oxygen mask. You may feel like you have to stay strong for your loved one, but you don't have to sacrifice your comfort and convenience. Don't forget that you have your own worries and feelings. If you make it your goal to get your loved one out of depression at all costs and forget about everything else, there is a risk that you will undermine your own health. To avoid this, try to clearly define what you are ready and able to do and what you are not. Listen to your feelings and emotions and seek support if you need it (including from a psychotherapist). After all, you can do little to help a depressed person if you yourself are not okay. nine0003

Daria Chagina

The editors are grateful for the help in preparing the material to the head physician of the Udensrose clinic, Evgeny Iznova

Valuable instructions: how to communicate with a person in depression - and not screw up

How Zigmant learned from a psychologist Do's and Don'ts of Dealing with a Depressed Person. And also found out how to help the patient get out of this state.

– First of all, it is worth understanding that depression is a disease, and quite serious, says Pavel . - It is very difficult to identify it yourself, but there are several reasons for concern. If you have fatigue, sleep and eating disorders, lack of interest in anything - these are already alarming bells. Of course, if this state lasts two or three days, then it's okay. But if two weeks or more - you should think about contacting a specialist.

HOW NOT TO BE WITH A DEPRESSED PERSON

No need to pretend that nothing is happening

– Again, depression is a disease. It is not always possible to understand the causes of its occurrence, but one thing is for sure: any disease needs to be treated. You should not put pressure on a person and force him to go to the clinic, but you should definitely say something like: “Listen, I think you are sick. And I think you need to see a doctor. I believe you can do it!" Although there are times when depression can no longer be cured and it leads to death. But it's better not to mention it. nine0003

Don't say it's okay

- A depressed person should never say, “Hey, everything's fine! Look at the world! Let's go have some fun!" and even more so to offer to drink alcohol to “relax”. After all, the main cause of depression lies in the fact that a person sees the world in black colors and cannot look at problems with different eyes. Therefore, you do not need to encourage him to take any decisive action, except for going to the doctor. nine0003

It is impossible to cause vivid feelings

– Communication with a depressed person should be done at a low intensity, says Pavel. - No "Let's go to the water park for a ride!" - only slow walking, calm conversation, social acceptance: a person needs to be told how good he is, that you feel good with him and how much you love him.

It is strictly forbidden to mix antidepressants. - Therefore, self-medication, even with such frivolous (as it seems to us) diseases, like depression, is strictly prohibited. Antidepressants are not for everyone. There are times when pills relieve lethargy in a person, and he commits suicide. After all, before that he did not have the strength to go to the window, and after taking the medicine they appeared. But the negative thoughts didn't go away. nine0003

HOW TO DEAL WITH A DEPRESSED PERSON

Taking them out for walks

According to Pavel, exercise is one of the best ways to overcome or prevent depression. However, it is worth considering the sluggish state of the “sick” and not offering him intense loads. It is best to just walk with him - and the more the better.

Exposure to bright light

It is good for a depressed person to be in bright sunlight for a long time. Ideally, outdoors. If you don’t pull him out of the house, then you should at least make sure that the windows are not curtained and the sun shines into the room. nine0003

Show programs about the tropics

If the weather is not good and there is no sun, then you can just watch beautiful programs about the tropics together with the “sick”, where there is a lot of color and light. This also works positively and can help. And in the best cases, even reverse the development of the disease.


Giving literature about depression to read

Some experts advise giving “sick” people good literature to read about their illness – this can be a great help in the early stages. How to determine what literature is good? Pavel says that it is worth trusting those articles where there are links to various studies. But materials without links should be treated with caution. nine0003

Encourage physical activity

Any movement is good for the "sick", and any inaction is bad. If a person does not want to go for a walk, do not leave him at home alone. Encourage them to get up, make the bed, wash the dishes, sweep the floor, peel an orange, eat, play a board game (where there is a lot of fine motor skills) - in a word, at least somehow move.


WHAT TO TALK TO A DEPRESSED PERSON

It is better to talk to the "sick" on abstract topics, but most likely he will start talking about his problems anyway.

Learn more