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What can you do to help someone suffering from depression who doesn't want your help? Sometimes the answer is "not a lot," but sometimes you can be very helpful. Here are some tips on what to do and what to avoid.

Some of the things people do to "help" depressed friend and family members tend to backfire. It doesn't help to tell a depressed person to look on the sunny side of life. It doesn't help to tell people they have so much to live for (they don't feel it to be true) so they shouldn't want to die. It doesn't help to tell people you can't do anything about their situation (even if you can't), or that they should have snapped out of it already. It is extremely unhelpful to label depressed people as lazy or unskilled or "losers".

Even if you have the social skills to avoid making a depressed person feel worse, it can still be a challenge to find the right opening to talk about depression. Some approaches that often work include:

  • "You are important to me. Your life is important to me."

  • "I may not understand what you feel, but I would like to help."

  • "I don't know how long your depression will last, but I think it will end eventually, and that makes it worth it to hang in there."

  • "The way you are feeling now will eventually change."

  • "Tell me what I can do to help you."

Inviting a depressed person to tell you what you can do to help them does not mean that you automatically have to do it. You are free to set reasonable boundaries. Consider the example of flight attendants dealing with a sudden depressurization of a jet airline cabin. They put on their oxygen masks before they help others. You have to be healthy yourself to take on the task of helping someone who has depression. You can simply explain, honestly, and without anger, that there are some requests that you cannot fulfill because you do not have the resources of time, money, or emotional strength. Just do what you can.

Don't expect a depressed person to be a mind reader. When you feel you need to assert your boundaries, let them know in a kind but clear way.

Beyond offering sympathetic listening, what more can you do? These are suggestions that should be made for nearly every person who has depression.

  • Encourage a depressed person to see a doctor. Depressive symptoms can be aggravated by other diseases, and by inappropriate medication. Sometimes changing a medication or controlling an infection or diabetes makes a huge difference in emotional health.

  • Offer to help your depressed friend or loved one to find a therapist. Offer to go with them for their first visit, making sure they get to the office and go through with the session, but respecting their misgivings.

  • Encourage depressed people to discuss all their symptoms with their doctors. That doesn't mean that you should encourage hypochondria. Encourage treatment.

It is also important to establish realistic expectations for treatment, at least for yourself. It usually takes several adjustments in medication or dosages of antidepressants to begin to lift depression. When someone has major depression, you may be called on to help in big ways. However, sometimes helping in small ways is what someone needs to power through depression on their own.

It can be very difficult to find the right way to talk about suicidal feelings. Caring, present, non-judgmental friends can do a lot to help people who want to die to keep on living, but when your friend starts waving a weapon around, it's time to call the authorities to get help.

Friends and family members who help people who have depression are not always appreciated as the depressed person is recovering, but they are usually held in very high regard when the depressed person has recovered. Be as supportive as you can be, and realize that your kudos may come much later.