For starters, it’s key to know the differences between feeling down in the dumps and having a more serious mental health problem that needs treatment, says April Thames, PhD, an associate professor of psychology and psychiatry at the Keck School of Medicine at the University of Southern California in Los Angeles. Feeling down is typically a temporary setback that is usually triggered by an external event like an argument with a family member or a setback at work, Dr. Thames says. It doesn’t interfere with day-to-day functioning for an extended period of time, and somebody feeling this way will still engage in activities they enjoy doing, at least after several days. It tends to last for only a few days or a week at most, she adds. In contrast, clinical depression typically involves symptoms like withdrawing from friends and losing interest in activities one used to enjoy — and these symptoms persist for a much longer period of time, Thames says. In order for someone to be diagnosed with clinical depression, the symptoms must last at least two weeks and must demonstrate a change in one’s previous level of functioning, states the American Psychiatric Association. People with depression also have a very different mindset from people who are feeling down. “A person feeling down usually has hope that things will change for the better,” Thames says. “The person with depression feels that their situation is hopeless and will not change.” Signs and symptoms of depression to look out for, according to the Mayo Clinic, are:
Expressing feelings of sadness, emptiness, or hopelessnessFeeling irritable, frustrated, or angry over small thingsSleeping much more or less than normalHaving changes in appetite — either eating more or less than normal and gaining or losing a lot of weightHaving anxiety, restlessness, or agitationHaving unexplained physical problems, like back pain or headachesDifficulty thinking, concentrating, remembering things, and making decisionsExpressing feelings of guilt or worthlessness, or ruminating on past failuresMentioning death or suicidal thoughts.
If someone you care about has been diagnosed with depression or is showing any of these symptoms, knowing how to respond is key. Here are six ways to help. RELATED: 12 Surprising Facts About Depression
1. Bring Up Your Concerns With Your Loved One
If you notice signs of depression in your loved one, it’s important to calmly share your concerns in a way that’s nonjudgmental, says Ole Thienhaus, MD, a professor of psychiatry at the University of Arizona College of Medicine in Tucson. It’s also crucial to give your loved one space to talk about what they’re feeling. “Listening is the most important part of beginning to help,” Dr. Thienhaus says. To get them talking, you may start by sharing the changes you’ve observed recently that worry you, Thienhaus says. When you do this, don’t be critical — just state the facts as you see them in a neutral way and pause often to give them room to respond to what you have to say. “Avoid any suggestion that they have no reason to feel so sad,” Thienhaus adds. This means not saying things like, “Look at all the good things in your life” or “Look at how much worse off so-and-so is, but she doesn’t let her problems get her down.” Why is this harmful? Many people with depression already believe they should be able to “snap out of it” or should be “mentally strong,” Thames says, feelings that can stand in their way of seeking treatment for depression. RELATED: What Are the Benefits of Fish Oil for Depression?
2. Help Your Loved One Get Treatment for Depression
Somebody with depression may need help seeking care, both because of a sense of stigma or shame and because their illness makes it harder for them to manage tasks like finding a mental health provider or scheduling an appointment. Suggesting that you can do these things for them, remind them when the appointment is coming up, and accompany them to the visit can help them get treatment sooner rather than later. If they’re hesitant to see a mental health professional such as a psychologist or psychiatrist, see if they’re willing to visit their primary care doctor, especially if this is someone they already know well and trust, Thienhaus says. Although it’s best to see someone specializing in mental health, the important part is getting connected to some form of help when needed. You may also have to rethink the words you use to talk about depression treatment because different people may have distinct ways of viewing the condition, Thames says. Some people, for example, may not know to use the word “depressed” to describe how they feel, and might instead perceive their symptoms as being “stressed out” or “not myself,” for example. “Matching the language that the person can identify with is important when attempting to intervene,” Thames says. RELATED: 8 Depression Symptoms You Shouldn’t Ignore
3. Support Your Loved One in Their Day-to-Day Routine
While starting treatment is a crucial component to managing depression, your loved one may still need help with their daily functioning. One good way to help may be offering to go to a therapy appointment with them to hear directly from their mental healthcare provider, says Michelle Riba, MD, a clinical professor of psychiatry and associate director of the Comprehensive Depression Center at the University of Michigan in Ann Arbor. You can also offer to help them with tasks that may feel overwhelming, like grocery shopping, laundry, or cleaning the house, or simply suggest you take a quick walk around the block together to get them out and about, Dr. Riba says. Establishing a routine is also very helpful, says Thames. You might try to make that walk happen every day, for example. Regular physical activity can help ease stress and release endorphins and other neurotransmitters, or chemicals in the brain, that play a role in boosting mood, Thames says. One form of treatment for depression is behavioral activation, which involves engaging in activities one find meaningful, such as doing an enjoyable form of exercise or volunteering, according to the Beck Institute for Cognitive Behavior Therapy in Bala Cynwyd, Pennsylvania. Encouraging your loved one to do activities that give them personal satisfaction is important — but don’t go overboard with activities and socializing, Thames cautions. “Most people try too hard to fix the situation by forcing the loved one to do activities and socialize,” Thames says. “This is not always a good thing because it can produce additional stress and inadvertently exacerbate symptoms.” RELATED: A High-Fiber Diet May Help Lower Depression Risk
4. Look for Signs That Treatment Is Working
There are lots of little ways to tell when treatment works — it will be clear in the ways that your loved one looks and acts, says Angelos Halaris, MD, PhD, a professor of psychiatry and behavioral sciences and director of outpatient clinical services at the Loyola University Chicago Stritch School of Medicine. As they improve, someone with depression may start making better eye contact with you instead of looking down to avoid eye contact due to feeling vulnerable or anxious. Other signs of improvement, according to Dr. Halaris, include:
Smiling occasionally and having more relaxed instead of tense facial featuresHaving a calmer demeanorIsolating less and interacting with people moreEating and sleeping better
RELATED: The 10 Best Foods to Soothe Seasonal Depression
5. Be Alert to Signs That Treatment Is Not Working
On the other hand, the absence of any such signs most likely means that one’s depression is not improving and may be getting worse, Halaris notes, adding that a major concern in the absence of improvement is whether your loved one is having suicidal thoughts. “This is where you need to very gently raise the question whether they are having even fleeting thoughts of their life not being worth living,” Halaris says. According to Mayo Clinic, signs your loved one may be considering suicide include:
Making statements such as “I wish I were dead” or “I wish I hadn’t been born”Purchasing a gun or hoarding pillsFixating on violence, death, or dyingWithdrawing from social contact with othersFeeling hopeless or trapped in their current situationTelling people, “goodbye,” as if they’re going to disappearGetting their affairs in order or giving away their belongings with no other plausible explanation for doing so
If your loved one shows signs of considering or planning to take their own life, Halaris and Riba recommend taking steps to reduce their risk of attempting or completing suicide, such as:
Make every effort to convince them to see a specialist if they aren’t already — and make sure to go with them to this appointment.Seek a different approach to therapy.Remove any guns from the home.Ensure they’re not hoarding medications, which might be used for an overdose. If you see signs of this behavior in your loved one, Riba advises treating this as an emergency and taking them straight to the hospital or call an ambulance.
If you’re worried that your loved one is getting worse but they’re not considering or showing signs of any dangerous behavior, ask to join them for part of their next psychiatry or counseling session or voice concern to their provider. You may suggest that you sit in on counseling sessions with their psychiatrist or therapist on a regular basis, Riba says. This will let you give feedback on how treatment seems to be working, hear what your loved one and their doctor are saying, and better understand how you may be able to help. RELATED: How to Cope With Anxiety and Depression
6. Make a Plan for Recognizing a Relapse
When you’re in it for the long haul with someone who has depression, it’s important to understand that depression is a chronic illness with symptoms that can flare up periodically, just like you might expect with physical conditions like heart disease or diabetes. “Knowing and accepting that there will be ups and downs can help mitigate any personal frustration one may experience when dealing with a depressed loved one,” Thames say. “Family members or loved ones dealing with someone who has depression may want to seek out personal therapy to help them cope and adjust to the person’s mood.” Although depressive episodes can go into remission with proper treatment, the potential for future relapses can take a toll on relationships, says Thienhaus. That makes it important to talk to your loved one when they’re in remission so that together you can form a plan for how to recognize and respond quickly when a relapse is on the horizon. “Recognizing the early signs is important in order to gently intervene,” Thienhaus says. You can also encourage lifestyle habits that may help keep depression at bay, Riba says, such as:
Healthy eating and exercise habitsMinimizing stressGetting plenty of sleepLimiting alcohol and drug useSticking with any depression treatment plans for therapy or medication
RELATED: 8 Health Problems Linked to Not Getting Enough Sleep
Resources We Love (for Both Your Loved One and You)
Plenty of free resources are out there to help you find treatment and get support for your loved one — or for yourself as a caregiver. Substance Abuse and Mental Health Services Administration (SAMHSA) SAMHSA has a treatment locator for various types of mental health issues, as well as a free, confidential, 24/7 hotline for treatment referrals. You can reach their hotline at 800-622-HELP (4357). National Suicide Prevention Lifeline This lifeline is comprised of a national network of crisis centers that offer confidential, 24/7 support geared toward suicide prevention. You can reach this lifeline at 800-273-8255. National Alliance on Mental Illness (NAMI) NAMI has support groups for patients, family members, and caregivers, as well as crisis support and an online chat. You can call the NAMI HelpLine at 800-950-NAMI (6264) Monday through Friday between 10 a.m. and 8 p.m. Eastern Standard Time. You can also reach them by email (info@nami.org), or you can text their crisis support team 24/7 at 741741 for free support with a trained crisis counselor.
