A shared universe › Blog › How to support someone with depression · Español
They no longer answer your messages the way they used to, they have stopped coming to family meals, and when you ask, everything is “I don’t feel like it” or “it’ll pass”. You are worried, you want to help, and you don’t know whether to keep trying, wait or say nothing. A fair amount has been studied about what eases things for a person who is depressed and what, without meaning to, weighs on them more.
We all go through sad patches, and that doesn’t mean we have depression. The World Health Organization (WHO) describes it as a low mood, or a loss of interest in things that used to be enjoyable, lasting most of the day, nearly every day, for at least two weeks. It is often accompanied by tiredness, disturbed sleep, changes in appetite, difficulty concentrating, guilt or a feeling of worthlessness, little hope for the future and, at times, thoughts of death.
It is not unusual. According to the latest WHO figures, 5.2% of adults in the world have it, around 322 million people, and it is more common in women than in men. Nor is it a lack of willpower. Putting a name to it is a job for a professional; for you, it is enough to notice that something has changed and not look the other way.
In 2000, in Australia, Betty Kitchener, who had been teaching first aid for years, and her husband, the mental health researcher Anthony Jorm, launched mental health first aid courses: what an ordinary person can do when someone close to them is struggling, until professional help arrives.
To decide what to teach about depression, their team asked 167 people from Australia, New Zealand, the United Kingdom, the United States and Canada: patients, relatives and professionals. They kept the pieces of advice that at least eight in ten people in all three groups considered important, and published them in 2008. Here are some of them:
Those same recommendations also cover what doesn’t help. Almost all of it is said with good intentions:
Depression makes small things, like putting a wash on or paying a bill, cost a huge effort. It isn’t laziness, or selfishness, or pretending. Hearing you say so can be a great relief to that person.
Supporting someone with depression is usually not very showy. Much of the time it means still being there when the other person hardly responds.
Listening well is harder than it seems. There are some pointers in Really listening.
When a low mood lasts for weeks and affects daily life, it is a good idea for a professional to see it. The WHO encourages relatives and friends to suggest that help, and mentions psychological treatments such as cognitive behavioural therapy and interpersonal psychotherapy. In Spain, the first step is usually the family doctor.
You can ask whether they think they need help, offer to look up information, to book the appointment or to go with them. If they want you to come, go alongside them and not in their place: it is better for the decisions to be made by the person themselves whenever they can.
If they don’t want to, ask them why. Sometimes there are specific fears behind it (the cost, not having a doctor they trust, being admitted to hospital) that can be talked through. If they still say no, respect that and make it clear they can count on you if they change their mind. The exception is when their life is in danger. Reading something about why it is so hard to ask for help may help that person, and help you to understand them.
The WHO points out that depression can lead to suicide. If the person talks about death, about it not being worth carrying on or about it being better not to be here, don’t let it pass.
Asking them directly whether they are thinking of taking their own life does not put the idea in their head. In 2014, a team at King’s College London reviewed the studies on this question: none found that asking increased those thoughts, and some suggested that talking about it can ease them.
If the answer is yes, don’t keep it secret or carry it without help. If you think the danger is immediate, call the emergency services and don’t leave them on their own. In Spain you can talk to a person at the Teléfono de la Esperanza, 717 003 717, at any time. If you are thinking of ending your life, call 024: it is free and answered 24 hours a day. If you are in another country, call your local emergency number or a helpline there.
Living close to depression is wearing. In 1987, the psychologist James Coyne and his team interviewed 42 adults who lived with someone in the midst of depression. More than 40% were so affected that they met the criteria for being recommended psychological help themselves. What weighed on them most was their relative’s lack of interest in social life, their tiredness, their hopelessness and their constant worries.
Looking after yourself is not selfish: it is what allows you to keep going. Find someone to talk to about what you are living through, set aside time for yourself and ask for help for yourself too if you need it. In When supporting others wears you out there are ideas for not running out of strength.
There are seasons when keeping someone company is mostly waiting beside them. If it helps, you can light a “For someone” star in A shared universe with what you hope for that person, with neither their name nor yours. Whoever passes by will leave a touch or a line of encouragement, and you will know that more people are sharing that wait.