You’ve noticed some changes in your friend that concern you. You’re not sure if it’s depression or just a bad few days, but you want to help. So where do you start?
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Clinical psychologist Adam Borland, PsyD, gives some strategies that can help you provide support.
How can you tell if someone is dealing with depression?
Depression touches most Americans, whether they experience it personally or it affects someone they know. In fact, The National Institute of Mental Health reports it’s one of the most common mental health disorders in the United States — an estimated 17.3 million adults were living with depression in 2017.
So how can you tell if a friend is just a bit sad or has something deeper brewing? “There certainly are telltale signs,” Dr. Borland notes. “But since you don’t necessarily see that person every day, you may have to do more detective work.”
He recommends watching for behavioral changes or anything that could be out of character for your friend. Some depression symptoms include:
- Lack of engagement: They lose interest in activities they used to enjoy or want to hang out less.
- Change in communication patterns: You used to chat or hang on the regular, and now they’re MIA.
- Changes in hygiene and sleeping patterns: They’re sleeping less — or all the time. Their appearance and hygiene no longer seem to be a priority.
- Displays of sadness or anger: Their temper now has a hairpin trigger, or maybe they seem more down than usual.
- Withdrawal from social outlets: They’re missing from activities where they were formerly fixtures.
How to help someone with depression
Dr. Borland recommends some do’s and don’ts to get the conversation going:
Do: Practice assertive communication
Rather than making depression taboo, talk openly with your friend about your concerns. Dr. Borland recommends cultivating the art of assertive communication: You take ownership of your feelings and concerns and communicate them without finger-pointing. And you listen and provide your friend with unconditional emotional support.
To do this, practice using “I” statements. “Begin sentences with, ‘I’m worried,’ ‘I’m concerned’ or ‘I’ve noticed.’ Then explain your concerns to your friend,” he suggests. “Avoid saying, ‘You don’t seem like yourself,’ or ‘You haven’t been hanging out as much as you usually do.’ They can create defensiveness in the person receiving the message.”
Do: Show empathy
Put yourself in your friend’s shoes in a nonjudgmental way. Think about how you would feel if you were coping with symptoms of depression and how you would want friends to react. Maintain eye contact when listening, and say things like, “That sounds hard. I’m sorry you are going through this,” and “I’m always here for you.”
“And if you’ve dealt with depression yourself, self-disclosure can be very powerful,” Dr. Borland points out. “You’re giving your friend a gift by opening yourself up and sharing that you understand.’”
By responding to your friend in an open and empathetic way, you show them that they aren’t a burden.
Do: Set boundaries
It’s OK to be specific about when you can — or can’t — be there for your friend. For example, let your friend know that it’s better for you to talk after your kids are in bed. And don’t accept abusive or violent behavior. If they don’t stop, do what’s best for your health and safety.
Self-care is also key. Monitor your own health and well-being so you have something to give when the going gets tough. Supporting someone with depression can take a lot out of you. Learn your limits and when it’s time to recharge your batteries. Explain to your friend that while you’re there for them, a mental health professional has the training and tools needed to effectively treat them.
Do: Be patient
There is no quick fix for depression. The recovery process takes time. You’re less likely to get frustrated with, or give up on, your friend if you’re hunkered down for the long haul.
Don’t: Think you can fix it
Recognize that supporting your friend does not mean fixing their problems. A person with depression often needs treatment to see improvement — and that’s something only a medical professional can provide.
Don’t: Give up
But what if your friend rejects your efforts even when you’ve done all the right things?
“Their rejection may be a defense mechanism. They realize you’re recognizing their symptoms and that they’re not doing as good a job hiding them as they thought,” explains Dr. Borland. “It’s easy to react negatively to a friend who’s unwilling to get help. But stick with them and maintain communication. Continue to check in on your friend and encourage them to get help.”
Dr. Borland also recommends trying to be there with your friend instead of for your friend. “It means I’m in this with you, even if you push me away,” he says.
What to do if your friend has suicidal thoughts
If you are concerned your friend may harm themselves, don’t dismiss your gut. Instead:
- Pay attention to anything said about suicide, other forms of self-harm or a world that doesn’t include them.
- Keep the lines of communication open so they know they can talk to you when they have these feelings.
- Encourage them to get professional help.
That help may include outpatient therapy and psychotropic medications prescribed by their primary care doctor or a psychiatrist. If you think your friend is in immediate danger, call 911 or take your friend to the nearest emergency department.
Remember: Your friend’s situation is not hopeless. Like other illnesses, depression can be treated with the right medical help and the support of friends like you.