Supporting Loved Ones with Depression

Have you ever reached out to someone to vent and received unsolicited advice? Maybe you tried to vent about a partner and the response you received was to be more patient. Maybe you complained about work and were told to just quit.  Maybe you shared that there was a family event that you weren’t looking forward to and then got a lecture about boundaries. How have you felt in those moments? I’m guessing, not great.

There are times when we need advice from the people we trust or need to be talked out of some story our anxious brains are telling us that probably isn’t true. But a lot of the time, we already know that our thoughts are not realistic, or we have some idea of what we need to do next and all we need is for someone to listen and then let us work through it ourselves.

Before attempting to support a loved one with depression, it is important to check in with how you feel. Are you afraid they will hurt themselves? Do you feel helpless? Desperate to find a solution? Irritable because you don’t know why they feel this way? Are you taking their behavior personally? Feeling abandoned or anxious when they withdraw? If so, your attempts to help, while well-intentioned, might end up hurting more than helping.

There are a lot of ways you can support people who are struggling with depression including: encouraging them to seek professional help, reminding them to take any doctor prescribed medication on time and as directed, suggesting that they eat healthy meals and get enough sleep and exercise, or offering to talk to them about how they are feeling. These means, when used in an appropriate way, can be incredibly helpful. However, if you are pushing coping skills on your loved one who seems resistant to your advice, you might unconsciously be trying to soothe your own feelings rather than helping the person that you are claiming to support. Often, when people cannot tolerate how someone else’s mental state is making them feel, they will try to change the other person’s mental state rather than self-soothe or self-reflect. This can lead to the person struggling with depression feeling an increase in shame and guilt rather than feeling cared for.

People who are feeling depressed, especially those who are in or have been in therapy, often have some idea of what coping skills might be useful to them however they may lack motivation or energy to do them. Symptoms of depression can include diminished pleasure in activities that used to feel enjoyable, a decrease or increase in appetite, fatigue, difficulty sleeping, difficulty getting out of bed, inability to concentrate or make decisions, and feelings of hopelessness. Therefore, the things they can do to help themselves feel better are harder for them to do that they would be for you. Pushing them to do something about their depression can increase feelings that nothing they do is good enough, that they are a burden to others, or that the depression is their fault.

So, what can you do instead? Ask and be okay with whatever answer you get.

Ask if your loved one wants to talk about what is wrong. If they say yes, listen without judgement, try not to take what they are saying personally, validate how they feel even if you don’t understand, and avoid unsolicited advice. If they tell you they don’t want to talk about it or don’t know what to say, offer to sit with them in silence, give them a hug, or curl up on the couch and watch a movie together. Remind yourself that their reluctance to talk is likely not because they don’t trust you or don’t appreciate you but because talking about it may feel too hard or they might have no idea why they feel this way and literally do not know what to say.

Ask your loved one what they need from you. If the person asks for space, again remember, this is not about you. They are not pushing you away because they don’t care about you but because they do not have the energy to engage with someone else or might feel vulnerable having someone see their pain. Offer to sit in another room but stay close or keep your phone handy in case they need you. Sometimes your loved one may not know what they need. Validate that it is okay not to know.

If your loved one has a therapist, ask how they and their therapist have agreed to handle the depressive episode. Ask if there is a safety plan or coping skills that you can help with. If they say no, focus on taking care of yourself rather than trying to convince your loved one to let you help.

Ask your loved one if there are any tasks they need help with. Sometimes people who are in a depressive episode might not want to talk or get out of the house, but they may need help washing the dishes or folding the laundry. Offer, but give your loved one permission to decline.  Often people who are struggling with depression might feel embarrassed about their appearance or the appearance of their home. You can give reassurance that you understand that depression has made it hard for them to take care of themselves and you would like to help in a judgment-free way however if they still insist that they do not want help, respect their boundaries and let them know that you will be there if and when they are ready.

It can also be really helpful to give reassurances to loved ones that their depression is not their fault, that you are capable of being present with them even when they don’t feel their best, and that you are proud of them for the ways they are taking care of themselves. Highlight the small things they are able to do for themselves like brushing their teeth when it is hard to get out of bed or taking a few bites of something when they do not have an appetite. Continuing to go to work is a huge accomplishment that deserves to be celebrated.  

If you’re reading this and feeling stressed, I invite you to take a few deep breaths and give yourself some compassion. It can be very scary, confusing, and sad when someone that you care about is struggling with depression. It is okay to feel the way that you feel and if you have been pushy in trying to help, that is completely understandable. I applaud you for wanting to support the people that you love. This is just a gentle reminder to focus on the impact of your behavior rather than the intention and remember that there are some things you just can’t fix. Sometimes simply letting someone know that you care for them and are there to help if they need it is enough. Sometimes people need permission to not be okay and the most powerful thing you can do is tell them it is okay that they are struggling. If that seems scary to you, I encourage you to get support. Reach out to family and friends, speak to your own therapist, and look for resources to help you understand depression. The 988 Lifeline is a good resource for people struggling with mental health but can also support those who are trying to help people struggling with mental health.

Exceptions:

 There are times when giving someone space may not be safe. For example, if someone has expressed that they intend to kill themselves and have both a plan and means, do not leave them alone. You may be able to respect whatever else they have asked for but let them know that you will stay with them until you know they are safe. If that isn’t possible, it might be necessary to drive them to a hospital, call emergency services, or intervene in another direct way such as informing another safe person who can help keep them safe. But be realistic about this. People can have thoughts about death without any intention of acting on them and by over-reacting to soothe your own fear, you may be pushing them away rather than keeping them safe. If you are unsure if your loved one is in danger, you can call 988 for advice or consult with a professional.