Depression: Supporting a family member or friend

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Depression: Supporting a family member or friend

Helping someone with depression can be a challenge. If someone in your life has depression, may feel helpless and you may wonder what to do. Learn how to offer support and understanding and how to help your loved one get the resources to cope with depression. With the right approach, depression usually gets better. Here's what you can do.

Learn the signs and symptoms of depression

Depression signs and symptoms vary from person to person. They can include:

  • Feeling sad, down or "empty"
  • Losing interest in activities that were once a source of pleasure
  • Feeling hopeless, worthless or helpless
  • Feeling irritable or restless
  • Changes in appetite, and losing or gaining weight unintentionally
  • Sleeping poorly or oversleeping
  • Feeling fatigued or having decreased energy
  • Having persistent feelings of guilt
  • Having trouble thinking, concentrating or making decisions
  • Having thoughts of suicide
  • Abusing alcohol or drugs

Encourage treatment

People with depression may not recognize or acknowledge that they're depressed. They may not be aware of signs and symptoms of depression, or they may feel too hopeless to address the issue. People with depression may think that how they feel is normal and not the result of a mental health condition. All too often, people feel ashamed about their depression and mistakenly believe they should be able to overcome it with willpower alone. But depression seldom gets better without treatment and may get worse. Help the person you care about recognize the symptoms of depression and get treatment.

  • Talk to the person about what you've noticed and why you're concerned.
  • Explain that depression is a medical condition, not a personal flaw or weakness — and that it usually gets better with treatment.
  • Suggest that the person see a professional — a medical doctor or a mental health provider such as a licensed counselor or psychologist.
  • Offer to help prepare a list of questions for the person to discuss in an initial appointment with a doctor or mental health provider.
  • Express your willingness to help by setting up appointments, going with the person to appointments and attending family therapy sessions.

If your loved one's illness is severe or potentially life-threatening, contact a doctor, a hospital or emergency medical services yourself.

Identify warning signs of worsening depression

Everyone experiences depression differently. You can help your family member or friend by learning how depression affects him or her — and knowing what to do when it gets worse. You can do this by simply observing, or if the person is comfortable talking about depression, ask questions to help you understand.

Answers to the following questions can provide you with a guide for understanding how well he or she is doing:

  • What are the typical signs and symptoms of depression in your family member or friend?
  • What behaviors or language do you observe when depression is worse?
  • What behaviors or language do you observe when he or she is doing well?
  • What circumstances trigger episodes of more severe depression?
  • What activities are most helpful when depression worsens?

Worsening depression needs to be treated as soon as possible. Your loved one and his or her doctor or mental health professional need to work together to come up with a plan for what to do when signs and symptoms reach a certain point. This can include a number of things. For example, your friend or family member with depression may need to:

  • Contact his or her doctor to see about adjusting or changing medications
  • See a psychotherapist such as a licensed counselor or psychologist
  • Take self-care steps, such as being sure to eat regular meals, getting extra sleep or exercising

Understand suicide risk

People with depression are at an increased risk of committing suicide. Especially if your friend or family member is severely depressed, you should prepare yourself for the possibility that at some point he or she may feel suicidal. Learn and stay alert for warning signs of suicide, such as talking about suicide, being preoccupied with death, dying or violence, or doing risky or self-destructive things, such as using drugs or driving recklessly.

  • Talk to the person about your concern. Ask if he or she has been thinking about committing suicide or has a plan for how to commit suicide. Having an actual plan indicates a higher likelihood of attempting suicide.
  • Seek help. Contact the person's doctor, mental health provider or other health care professional. Let other family members or close friends know what's going on.
  • Call a suicide hot line number. In the United States, you can reach the toll-free, 24-hour hot line of the National Suicide Prevention Lifeline at 800-273-8255 to talk to a trained counselor.
  • Make sure the person's in a safe environment. If the person with depression lives in your home, you can make it a safer place by eliminating things that could be used to commit suicide. For example, remove or lock up firearms, other weapons and medications.
  • Call 911 or your local emergency number immediately if the person may be in danger of hurting himself or herself, or attempting suicide. Make sure someone stays with that person at all times.

Understand suicide risk

People with depression are at an increased risk of committing suicide. If you believe that a friend or family member is suicidal, you should:

  • Talk to the person about your concern. Ask if he or she has been thinking about committing suicide or has a plan for how to commit suicide. Having an actual plan indicates a higher likelihood of attempting suicide.
  • Call 911 or your local emergency medical number, a suicide crisis hotline, or the person's therapist.
  • Don't leave the person alone.

You can prepare yourself for the possibility that a friend or family member may at some time feel suicidal. If the person with depression lives in your home, you can make it a safer place — or at least a less likely place to attempt suicide. Either remove or lock up firearms, other weapons and medications.

You should also stay alert for common warning signs of suicide:

  • Talking about suicide, including making such statements as "I'm going to kill myself," "I wish I were dead" or "I wish I hadn't been born"
  • Securing the means to commit suicide, such as getting a gun or stockpiling pills
  • Withdrawing from social contact and wanting to be left alone
  • Dramatic mood swings, such as being emotionally high one day and deeply discouraged the next
  • Being preoccupied with death, dying or violence
  • Feeling trapped or hopeless about a situation
  • Increased use of alcohol or drugs
  • Changing normal routine, including eating or sleeping patterns
  • Engaging in risky or self-destructive behavior, such as using drugs or driving recklessly
  • Giving away belongings or getting affairs in order
  • Saying goodbye to people as if they won't be seen again
  • Developing personality changes, such as becoming very outgoing after being shy

Provide support

Remember that your loved one's depression isn't your fault or your loved one's fault. You can't cure his or her depression — but your support and understanding can help. You can provide support and encouragement in a number of ways.

  • Learn about depression. Find out much as you can about depression. Read about it. Talk to other people you know who have been treated for depression or have helped someone else cope with it. The better you understand what causes depression, how it affects people and how it can be treated, the better you'll be able to talk to and help the person you care about.
  • Listen. Let your family member or friend know that you want to understand how he or she feels and that you're willing to listen. Because of depression, your loved one may not feel like discussing his or her symptoms. So when he or she is interested in talking, listen carefully but avoid giving advice or opinions — responses that may discourage further conversation. Try not to judge or criticize the feelings your friend or family member expresses. Just listening and being understanding can be a powerful healing tool.
  • Give positive reinforcement. Depression can make people feel worthless. They may judge themselves harshly and find fault with everything about themselves, from their appearance to their job performance to their thoughts and feelings. You can remind your loved one about his or her positive qualities and how much he or she means to you and others.
  • Offer help. Your friend or family member may not be able to take care of certain tasks very well. Give suggestions about specific tasks you would be willing to do, such as balancing a checkbook, making a grocery list or mowing the lawn. Or ask if there is a particular task that you could take on.
  • Help create a low-stress environment. A regular routine and an organized environment can minimize stress and help a person with depression feel more in control. Make a schedule for meals, medication, exercise, sleep and household chores. You might also help create a system to organize things that can easily become cluttered or chaotic, such as bills, laundry, homework or files.
  • Locate helpful organizations. A number of organizations offer support groups, counseling and other resources for depression. For example, the National Alliance on Mental Illness offers free online and in-person education, discussion groups and classes for people with depression and their family members. Many employee assistance programs and religious organizations also offer help for mental health concerns.
  • Encourage sticking with treatment. If your friend or family member is in treatment for depression, help him or her remember to take prescribed medications and to attend scheduled appointments.
  • Encourage participation in spiritual practice. For many people, faith is an important element in recovery from depression — whether it's involvement in an organized religious community or personal spiritual beliefs and practices.
  • Make plans together. Depression steals away motivation, energy and interest. Ask your loved one to join you on a walk, see a movie with you, or work with you on a hobby or other activity he or she previously enjoyed. But don't try to force him or her into doing something.
  • Take care of yourself. Supporting someone with depression isn't easy. Ask other family members or friends to help, and take steps to prevent becoming frustrated or burned out. Find your own time for hobbies, exercise, friends and spiritual renewal.
  • Finally, be patient. Remind yourself that depression symptoms do improve with treatment, but it can take time. For some people, symptoms quickly improve after starting treatment. For others, it can take months or longer before you notice a difference. Finding the best treatment may require trying more than one type of medication or treatment approach.
Last Updated: 2010-05-27
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