Chapter 14: How to Help a Friend with Depression

Depression. We've all heard of it. Most of us will come into contact with it at some point in our lives. Depression is a difficult and miserable experience to go through, and it's something that either you or someone you love will have to deal with. However, it isn't just the victims who are impacted. What about their friends? Victims of depression need steady, supportive friends to rely on in times of need. If you're the friend of a depression victim and are confused and worried, then worry no longer. This article is for you.


This Chapter is dedicated to Michelle Hew for her continuous support and positive aura in fighting for a better person without depression.


Steps:

1. Research. If you don't know much about depression, it's harder to recognize dangerous symptoms and be able to offer some relief. It's not hard to learn a lot about depression. There are websites, books, magazine and newspaper articles, and of course, many doctors. Ask people who know the disease about what it really is. Look it up and determine what type of depression your friend has/may have. Look over the symptoms, various medications and other treatments. The more you know, the easier it is to help.
2. Listen. Although you may think that the last thing your friend wants to do is talk to you about depression, you could be wrong. Sometimes a friend just needs someone to talk to. Actively listen without judging or giving advice. Depression is an issue that people sometimes feel they must hide, in order to maintain their usual life. Either that or they are only just coming to terms with it themselves, let alone the idea of letting other people in on it. However, from time to time, your friend may open up, or express the desire to talk to you. When this happens, be understanding and kind. Don't interrupt, don't try to convince them they're wrong, and try not to react in horror. It can be difficult to hear about how terrible your friend feels, but remember that they're trusting you. Value this trust and keep it close.
3. Acknowledge. Tell the person suffering from depression that you've noticed that they seem down or depressed lately.
4. Find out why your friend is depressed. Did they just have a bad break-up or did their parents get divorced? Ask them if there is anything you can do to help. Ask carefully and gently, and don't get upset if they're slow to tell you. Some people take longer than others to talk. If they say they don't have a reason, it's probably true.
5. Try to understand. Every person's story is different, and so it is impossible to completely understand. However, keeping an open mind and putting yourself in your friend's shoes can help you come closer to them. Once you've done your research, you should know a lot more about depression. Apply the symptoms and emotions to yourself, and contemplate how you would feel if this was happening to you. Call upon things your friend has done or told you, and try to understand why and what they mean. In times of need, having someone understand can be all the relief in the world.
6. Don't tell your friend that life is still worth living and that this situation will improve and the sadness will get better. This trivializes their pain and will not help.
7. Encourage your friend not to abuse drugs/alcohol/nicotine. People with depression can be much more vulnerable to the negative effects that occur when recreational drugs wear off. If your friend is taking antidepressant or anti-anxiety medication, encourage them not to make any changes without talking to their doctor or psychiatrist. Taking more than they were prescribed can be dangerous, and going off the medication suddenly may make them feel much worse. Avoid alcohol as well - nobody is going to conquer depression with a hangover. Then of course, smoking will not help either.
8. Be patient. Because depression is heavy, slow moving and unpredictable, it can frustrate and even anger those who are trying to help. Remember that depression is a complex disease, and try to understand that the depressed person is not herself or himself right now. If your friend doesn't seem to appreciate your efforts, or is pushing you away, don't walk off in a temper. Give them space or give them comfort if they need it, and be there for them, no matter how much they believe you don't need to be.
9. Advise them to seek professional help. They may deny that they need it, or tell you that "it's okay" or they'll be "fine". If they react this way, stop pestering them about it for a while. Over time, the idea might grow on them. Depression is not something that goes away by itself after a while. This is probably the most difficult step. Sometimes, a depressed person is more than happy to talk about it, go to a therapist, have people know, and start the healing process. But other times, they will argue, refuse, deny things, and often get angry and defensive. It is a serious mental illness. However, just because your friend doesn't want you to get involved, it doesn't justify you standing there and letting the problem get worse. Be sensible. If you friend is sounding like they are harming themselves or are thinking of suicide, you need to alert somebody.Encourage the person to start with a family doctor or local mental health associations. Offer to help them find resources or counseling services.
10. Don't push too hard. If it makes your friend feel worse to face up to their problems, do not force them to continue. Sometimes analysing a person's past can make them feel worse rather than better; in this case, focus on how they feel now and how they want to be in future, and forget whatever caused them to feel depressed. Leave it in the past until they are ready to either deal with it or let it go.

"Depression can be a serious ailment, especially if the person does not feel supported. You can help by knowing the right ways to be supportive and offer assistance."

Tips:

• Stress, anxiety and a long period of significant low mood can cause or worsen depression. If your friend is prone to any of these conditions, they must attempt to overcome them through stress management, positive thinking and any other therapies or techniques that may be effective.
• People can and do recover from depression. Never lose sight of that, and without pushing it in the depressed person's face, make sure they remember it too.
• Even if a person does not 100% recover from depression, as may be the case for severe sufferers, it is still possible to live a normal, productive and happy life as the sufferer gradually learns new coping mechanisms.
• Don't press them too hard. Talk on their terms and only go as deep as they go. Otherwise they will just turn away from you.
• Waiting for them to confront the problem with you can be hard; hint that you're there for them to make the process easier.
• Keep them talking, talking helps but give them ways to work out their problems privately too, don't force them to be dependent on you.
• Sometimes they just want to vent. Don't start spitting out possible solutions until you know the full extent of the problem. A good listener can sometimes be vastly more helpful than someone who tries to offer solutions.
• If a person finds their thoughts and feelings too troubling to talk about, the best thing you can do to help them is to distract them; play a game, tell them a story, listen to some music, watch a film. There is no time limit to recovery and a depressed person does not have to confront all their darkest fears straight away. Take it steady, go at their speed. They may feel ready to open up to you at a later date.
• If you honestly mean it and can do so with an open heart, offer to be there 24/7. Tell them that you welcome their phone calls at all hours. You will rarely, if ever, receive a middle of the night call. But a sincere offer sends a message of support that will be heard.
• Try not to give them advice, try to just guide them.
• A lot of times depressed people just want to be alone, so don't push. If you can, try to get them interested in going out with friends and doing things again. Even getting them to be happy again for a couple hours means there is still hope!
• If a person has put their problems aside for even a moment, then for that moment they overcame their depression. Tell them this.
• Remember that having a mental illness still carries a stigma in our society. So, before you discuss the depressed person's condition with a third party, ask their permission to do so. You want to help them, not make them subject to the gossip mill.
• Do not try to make them feel better by reminding them how much better their lives are than other people's.
• Be gentle. Depression can be dark, confusing and angry, but it can also be tender, hurtful and full of sensitive tears. Don't yell or be rough-keep your voice and body language soft and don't force your friend into anything.
• Do things for your friend. Helping with work, distracting them or temporarily cheering them up, defending them from others...preventing and blocking everyday hassles does make a difference.
• Make sure the people who need to know, know. Although your friend may be furious at you, parentsneed to know if their child is depressed. You may be their friend, but parents may be able to reach out and help in the ways you can't. In any case, they deserve to know. However, if the depression is triggered or made worse because of troubles, violence, or abuse at home, do not tell the parents. Instead, alert a teacher or some other form of authority.
• Recovery can be hard work and it may take a while. It probably won't happen overnight, or even in a few days or weeks, depending on how severe the depression is and the trigger factors causing it, if any. It is possible to experience "blips" or temporary relapses on the road to recovery; this is normal, so be gently reassuring when it happens, and remind them how far they have come.
• There are organisations set up to support people suffering from low moods and depression. "Venting" thoughts and feelings to these organisations can be very helpful.
• If your friend is suffering badly, encourage them to see their doctor. Go with them if necessary. Encourage them to discuss their options with the doctor - counselling or cognitive behavioural therapy can be very helpful and are also effective at preventing sufferers from "relapsing" into depression after they have recovered.
• If your friend is prescribed antidepressants, make sure they are aware that they can request other forms of therapy at the same time, for example counselling or cognitive behavioural therapy. Antidepressant medication can help to "muzzle" the depression, improving a sufferer's quality of life, but it won't make the problems go away. That's what talking therapy is for. However depresssion can be due to biological factors rather than life events and in these circumstances counselling can be at best unhelpful and at worst damaging. Whatever your friend decides is best for him/her, respect that decision
• Antidepressants and other forms of therapy such as counselling may actually make a person feel worse for a while. Medication can have many side-effects, and talking therapies may kick up problems and distressing feelings that have been long buried. It is totally normal for a person to find these things distressing; it should get easier as time goes by. Make sure your friend knows you are there for them if they need your support.
• Don't ask them to "cheer up" or "snap out of it". People with depression aren't capable of just doing it so simply, so be sensitive to that. It'll only make them feel guilty about their condition.

Warnings:

• Depression can be very serious. It often takes a professional to take care of it.
• Never tell them that their problems are stupid or that there is nothing to worry about. They'll stop talking.
• Many people with depression will turn down your offer of assistance. Don't take it personally.
• If you believe your friend may be at risk of harming themselves or others, take them to their doctor or a drop-in accident and emergency center.
• Self-harm could be the precursor to thoughts of suicide, so watch them closely and continue to provide gentle encouragement and reassurance. However, self-harming does not definitely mean that a person will become suicidal, it usually indicates that a person has significant personal problems and may simply be a cry for help.
• If your friend does any of the following things, you should call the National Suicide Prevention Lifeline / Befrienders for referrals or seek immediate help.
  • Talks about "wanting to die," or "wishing it was all over."
  • Begins stockpiling medication, buys guns or gets them out of safety lockers, or does anything else to make a suicide attempt easier.
  • Begins giving away possessions.
  • Writes notes to try to "tie things up," even if they are not explicitly talking about a potential attempt.
  • Begins abusing drugs or alcohol, or eating dramatically less.
• Many suicide attempts happen when people begin to feel slightly better, rather than in their very deepest depression. When someone is at rock bottom they may not have enough energy to do anything; when their energy starts to return, that is when they may take action.
• Most people who try to kill themselves do talk about wanting to die or not wanting to live first. Don't ignore these warning signs.