How to help someone with depression

Depression is a horrible, solitary, debilitating, mental health condition. As a sufferer myself I found myself feeling alone, isolated, and deeply unmotivated. Many people suffer from depression and their friends and relatives clearly want to help. However, that help can sometimes be misguided and damaging.

This post explores the effect the wrong sort of help can have and, importantly, what might be the best way to help.

A few days ago I read a post on LinkedIn. It was a well-intentioned piece aimed at an audience of well-balanced self-starters. Let me be clear, I am not critical of the post itself – it works for the writer’s audience (even if it is a little simplistic, clickbaity, and shallow). The post exemplifies the type of advice that is generally bad for people with depression.

Here’s the post …

1 way to raise your SELF-CONFIDENCE:
1. Surround yourself with people who tell you:
“You CAN,”
“You SHALL,”
“You WILL.”
Naysayers are ten a penny. Be discerning about who you allow to participate in your journey.
Personally, I have always preferred to be alone…. Than in bad company! Any thoughts, please? Wishing you all a wonderful weekend with people who truly care about your future!

This post, especially those three ‘motivational’ phrases, typify the type of wrong and damaging kind of advice people with depression are often given.

Before I go further let me be clear. I am not a medical professional nor qualified in any way to provide anything more than my personal perspective. Your own experiences, as a friend or relative of someone with depression, may be radically different. If you think you may be suffering from depression then seek help from your family doctor or mental health professional. If you know or suspect someone is suffering from depression then encourage them to do the same.

What is depression?

Depression is a chemical imbalance in the brain or may have a more physical cause such as a damaged region of the brain. It’s important to understand this is a medical condition not someone choosing to be moody. There’s some debate about the root causes but the majority view is, currently, that a chemical called serotonin has a lower concentration in your brain than it ought. Depression, as with all mental health problems, is a complex disease with many nuances and this is a very simplified explanation of depression.

My experience of depression.

My own experience with depression was described as high functioning. I had a chronic (long-lasting) low-level depression. So, externally I seemed fine. Internally I was a stew of conflicting feelings, mainly negative and self-defeating. Depression would adversely affect me at the most inopportune moments.

An example. I loved my job as a scrum master working for a company building mobile apps. As the company grew and my boss got promoted there was an opportunity for promotion and I was told I was in the line-up. As I left the meeting I was elated. Bizarrely though, as I walked out of that meeting, my mind was saying “Don’t f**k this up. I’m going to f**k this up.” Sure enough, my mind did all it could to wrench this opportunity from my grasp. I failed, overslept, lacked motivation, and didn’t deliver what I should have. I never got promoted and in fact, I was finally subjected to disciplinary measures for poor performance. I was in a trough of depression.

But as a high functioning sufferer of depression, I soldiered on. One day though, it became too much. I arrived in London on the train and simply could not go on. I turned around and caught the next train home – telling my boss what had happened and admitting to depression.

I went to the doctor and started a long path of recovery. Medicines, counselling, and a supportive partner all helped drag me out of this flump.

I have since gone on to find the help of a therapist to get me through a difficult period in my life. The passing of my mum, separation from my partner and son, selling the family home, and loss of my job all happened in an eight-month timescale. In the past, without getting my depression treated and without someone to help talk through things, I would have struggled to cope.

The wrong words for people with depression.

Back to the article. In it, the author suggests, that to build self-confidence, you should be surrounding yourself with positive people. These people should utter phrases such as YOU CAN, YOU WILL, YOU SHALL and, sure, this works for someone in a normal state of mind. There usually follows a round of high-fives and rambunctious activity.

Unfortunately, statements of this type tend to have the opposite effect on someone with depression. We are told by friends, relatives, and colleagues to just get up and pull ourselves together. Good advice, right?

Wrong. Advice like this serves to amplify the feelings of hopelessness. Our minds compare our inability to get out of bed or that we’ve been sat in PJs for days with the simple prompt to get out and pull ourselves together.

It goes like this:

You will! – I bloody well can’t.
You shall! – I bloody well won’t.
You can! – Oh go away and leave me alone!

They feel slightly worse than when the advice started.

Positivity and depression don’t sit comfortably together and there is a considerable disconnect between the two mindsets. It may seem like good advice but the effects can be counterintuitive. Often dangerously so. The positive words of encouragement simply serve to reinforce the negative feelings a person with depression has.

How can you help someone with depression?

It’s not easy. It takes patience and time. One of the first things you need to ensure is you look after yourself. Make time for your own mental health especially if you are a close relative or partner of the person with depression. It can be a slippery slope of first experiencing empathy and then sympathy and starting to experience symptoms yourself.

As I’ve already discussed, a person with depression is unlikely to respond to motivational statements. What’s needed is quiet support, just sitting and listening, non-judgementally. Trying to understand their feelings can be hard but is vital. Just don’t get sucked down the slope towards your own experience of depression.

Encouraging your friend or relative to seek help is important. It’s likely your first port of call will be your friend or relative’s family doctor. Helping to make an appointment. Explaining to the receptionist the urgency of the appointment and then accompanying them to that appointment will all be invaluable steps. You may need to convince the family doctor to come and visit rather than trying to force your friend or relative to go to the clinic. Alternatively, a phone consultation might be more effective.

You should reassure your friend or relative that seeking help is OK. There is no need to be ashamed of having a mental health condition. It can be and should be treated – in just the same way you’d seek help for a broken bone or the flu.

The doctor will probably prescribe some medicine – in the UK this is likely to be a Selective Serotonin Reuptake Inhibitor or SSRI. These are the most common type of medicines that are prescribed to people with depression. They may also suggest a type of talking therapy called Cognitive Behavioural Therapy (CBT). This was my experience.

The role of medicine is to regulate mood. To smooth out the troughs, and sometimes peaks, of someone’s feelings. This can take many weeks or months, so it’s important to maintain quiet support during this time. As the person with depression begins to recover the doctor will carefully monitor their progress. They’ll check to see that the medicine is working and if not try a different dose or different medicine.

They may also put you in touch with the local crisis team. These are a group of social workers and medical professionals who are on call should things become too much for the person with depression. They will help them through any crisis and try to help ensure they are safe from harm. They will be able to access your friend or relative to the appropriate services and this may include hospital-based care.

Antidepressant medicines are not intended for long term use. They are not a cure. Their role is to get someone with depression stable. To get their mind into a space where they can begin to consider the next steps.

When you see the person’s mood begin to stabilise then it can be time to try and get some semblance of normality back into your friend’s life. It is totally possible to get through depression and to experience remission from this condition. Your help, support, and understanding can be a key pillar of someone’s recovery.

The next steps will vary according to your friend or relative’s needs and mental state. It might simply be going for walks. Nature is an excellent antidepressant. Once they start to feel stronger then it may be time to suggest therapy of some sort and, again, your doctor will be able to recommend a suitable service.

The above is a simple path to recovery with you providing essential support. It will be very different for any person with depression and you should look for advice on how to help and how to make sure you preserve your own mental health. Resources are at the bottom of this article.

Depression and work

Employers should understand depression. Mental health conditions need to be treated and part of this is time off work to get medical and psychological help as well as take the time to rest and recover. My own employer was great. I got the time off I needed as sick leave, I was offered counselling and I was not pressured to return to work before I was ready.

Resources to get help for yourself or a friend suffering from depression

Helping someone with depression – MIND UK – Call 0300 123 3393
NHS Advice on Depression – NHS UK
Depression: Supporting a family member or friend – Mayo Clinic
The Samaritans – Dial 116 123 to talk
British Association of Counselling and Psychotherapy