When someone we love is suffering, we want to help. But when he or she is suffering from a mental illness, that help can be hard to give.
Depression alters a person’s sense of reality and makes other people’s perceptions difficult to believe. When my husband asked me, “Are you really okay?” instead I heard, “You aren’t doing a very good job handling your new role as a mother.” When my mother-in-law said, “I’m happy to come and help,” I had no idea that she was really saying, “Please let me help—you need it!” My husband, mother-in-law, family, and friends all knew something was wrong with me, but I couldn’t understand their concerns.
I am not a doctor, psychologist, or professional of any kind, but I have been through the painful process of admitting that I have depression—and of needing help to recognize my disease. Based on my experiences, here are a few questions to ask yourself before having the painful conversation about depression with someone you care about.
1. Is it really depression—or just a bad couple of weeks?
Depression doesn’t usually come on suddenly and with a clear explanation. (Although you should still reach out to your loved ones no matter why they are suffering!) Depression, even depression that begins with a job loss or grief, builds up over time and looks different than a bad mood or period of grief. Here are a few signs to look for:
- A loss of pleasure in things she ordinarily enjoys. She’s slowly stopped showing up for church or given up your monthly reading group.
- A lack of energy to do even simple tasks. Her neat house is a wreck and she’s called in sick more than usual.
- Extreme sadness. She seems stuck in grief she cannot escape, even after weeks or months. Or the smallest things leave her crying for hours.
- Difficulty concentrating. She can never find the word she’s looking for and she’s suddenly more absent-minded than she used to be.
- Difficulty making decisions. She shuts down when you ask her where she’d like to go for lunch. (Watch out for a “deer-in-the-head-lights” look instead of a “I-do-know-where-do-you-want-to-go”-type discussion. The former is a sign of depression. The later is annoying, but also normal.)
- Irritability. She snaps at you much more often than she used to. Or, as in my case, she becomes an increasingly aggressive driver.
If you think someone is going to hurt herself or someone else, get help right away—even if you aren’t sure she’s depressed.
2. Can you talk to her with love?
Chances are, your concerns aren’t going to be well received. Your loved one may feel like you are accusing her of something or telling her that she’s failing to meet your expectations. Or she may feel guilty for alarming you, making her depression temporarily worse.
Bottom line—few depressed people are ready to hear that they’re depressed. That doesn’t mean they don’t need help, but that a friend who wants to help has to go in with the “right mindset”:
- She may reject what you have to say—and that’s okay.
- She may just need to talk—and you will listen.
- She may annoy you—and you can focus on her feelings instead of yours.
- She may feel attacked and say something cruel—and you can forgive her in advance.
- She may not understand what you’re saying—and you’re willing to repeat your explanation patiently.
- She may be embarrassed—and you’re able to use discretion about who else to talk to about her.
- She may feel overwhelmed—and you’re willing to support her until she’s found the professional help she needs. (You cannot treat her depression for her, so do make sure you don’t become her only support system.)
Having this “right mindset” is a lot to ask of anyone. If you aren’t up to the challenge, perhaps you can find someone else—another family member, partner, or friend—to talk with her instead. No one is perfect, but the more loving and forgiving the intervention is, the more likely a depressed person is to listen.
3. How can you get her attention?
Although you should be as loving as possible, this isn’t the time for subtlety. Don’t beat around the bush to share her feelings—give her a reason to explain her behavior or to blame it on herself and she will take it. Here are a few ideas to get you started:
- “I care about you.” Remind her that she does matter to someone.
- “I’m worried about you.” Express concern, but choose your words carefully if you don’t want her to blame your feelings on herself.
- “Talk to me about it. I’d love to listen.” Listen without judging or giving advice. When she’s finished, you can always suggest, “This problem sounds really hard. Maybe you should talk to someone about it.”
- “I noticed that you were really upset after you bumped into someone yesterday. That isn’t like you.” Be sure to have specific concerns in mind to help her see that she has a problem.
- “When you’re ready to get help, I’m here for you.” You cannot make a depressed person own her illness, but you can be there to help when she does. If she is ready to get help, her doctor is a great place to start. You can also find psychiatrists and therapists at Psychology Today.
- “Let me bring over dinner tomorrow night.” Find something you can do to relieve her stress and give her the opportunity for some much needed rest. Sometimes a few days of pampering can pull a person back from the brink.
Here are a few lines to avoid when you’re expressing concern to a depressed person. I’ve heard all of them and, no matter how well intended, they never failed to make me feel guilty, ungrateful, and worthless.
- “You’re making me worried!”
- “I know how you feel.”
- “You’re strong. I know you can handle this.”
- “Don’t blame me. I’m just trying to help.”
- “Get over it!” or “Keep a stiff upper lip.”
- “Cheer up. You’ve got a great life!”
- “You just need to pray more.”
- “Take it easy.”
4. Know your role and your limits.
Depressed people can unintentionally drain the emotional, spiritual, time, and monetary resources of their friends and family. It is important to set boundaries for yourself and stick to them. You best know what you have to give, but no layperson can treat a loved one’s depression on her own. Remember—it is not your responsibility to save your friend. You can help. You can love. But she is ultimately in charge of her own life.
I am not at all qualified as a psychiatrist or psychologist, but I do like to share my personal experiences with depression and what I learned from them. Do you have any advice borne from your own experience? Let us know in the comments.