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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.

Untreated depression can have tragic consequences.

In March of 2015 the young copilot of a Germanwings jet airliner encouraged his senior pilot to take a break, barricaded himself in the cockpit, and calmly and deliberately crashed the plane, killing all 150 people aboard. At least as horrific as the act was the revelation, days later, that the copilot had been diagnosed with and had been receiving treatment for major depression. 

Violent acts by depressed people are, fortunately, rare. Depression, however, can be a debilitating condition. Friends and family can be helpful, but often aren't. This article suggests some basics for being truly helpful to a friend or family member who is depressed.

How Can You Tell Someone Is Depressed?

Different people experience depression in different ways, but there are recurring themes. If you are one of the more than 19 million teens and adults in the United States who have depression, the feelings do not go away. Here are some of the most common depression symptoms [1]:

  • People who are depressed lose interest in doing things for fun. Younger adults, children, and adolescents may also be irritated.
  • People who are depressed usually have significant disturbances in both sleeping patterns and weight. They may be unable to sleep, or they may want to sleep all the time. Adults who are depressed usually gain weight, but children who are depressed usually lose weight.
  • People who are depressed may feel life it not worth living or they are worthless.
  • People who are depressed usually having difficulty concentrating.
  • People who are depressed often suffer random aches and pains.
  • People who are depressed often abuse alcohol or drugs (prescription or otherwise) in an attempt to self-medicate.
  • People who are depressed may harbor, or just have repeatedly to deal with, thoughts of suicide.

Important Facts About Depression

Helping someone who is depressed requires understanding a few things about the disease. If you don't understand depression, your efforts may not be helpful. They may even make the situation worse.

No one can simply snap out of major depression.

Major depression is not always disabling, but it is not something that a depressed person can simply will away.

Most people who have depression do not cause harm to themselves or to others.

Typically, the internal moral compass and care for others win out over any impulses to do harm. Only about 1 in 5,000 men and 1 in 20,000 women in any given year (in the United States) commits either suicide or homicide. However, it is important to take threats of suicide, or homicide, seriously.

When someone who is depressed doesn't connect with you, it isn't necessarily "you."

Depression is not personal.  People who are depressed may lack the energy to think clearly or to exercise self-control. They may say things that upset you when they become angry, and regret them later.

Hiding depression won't make it go away.

It doesn't help to enable depression. (Consider the example of the mental health professionals who did not report the Germanwings co-pilot's suicidal musings.) Giving people excuses for not showing for work, not participating in social activities, or not living up to their obligations does not help them get better.

You can't "fix" someone else's depression.

Their recovery is ultimately up to them. However, you can be supportive, within boundaries.

How To Help Someone Who Is Depressed

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.

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