How to help a loved one with depression

When we're together with our family or friends, there is a possibility that one or more of those in that room are living with depression or another mental health concern. One in 10 people is affected by the condition in Ireland, and as individual as our friends are, their experience with depression will be as unique. It can be a challenge to support someone with depression. We may have concerns and feel helpless yet willing to offer much-needed support. We may not understand the cause, or even be fully aware of the issue.

Depression is intrinsically complex with no clear understanding of why it happens. There can be many contributing factors from genes, age and gender to major life events, conflict, abuse, and loss.

While symptoms can vary, there can be tell-tale signs which highlight our worries. Behavioural changes and out-of-character actions are warning signs that there is something deeper occurring under the surface. Symptoms of depression can include:

• Irritability, frustration and angry outbursts
• Agitation, restlessness or anxiety
• Feelings of sadness, hopelessness, guilt, worthlessness or emptiness
• A distinct loss of interest or enjoyment in normal activities
• Ruminating on past failures or experiences
• Brain fog, poor concentration, difficulty making decisions or memory recall
• Unexplained physical issues such as shoulder or back pain, headaches and stomach upsets
• Tiredness, a distinct lack of energy, moving more slowly and sluggish
• Changes in appetite
• Insomnia or sleeping too much

When supporting a friend with depression, openness, awareness and communication is vital. "It can be very challenging to know what to say when a loved one is suffering from depression," says Charlotte Armitage, a psychologist and psychotherapist. "Symptoms of depression can present in a number of different ways but there are a number of things that we can do to support people if they are unwell."

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Listen, actively and without judgment. Really try to hear what the person is trying to tell you without offering advice

While we continue to fight the stigma of depression and other mental health issues, we can continue to challenge the taboo by talking openly. In doing this, we show our friends that we are conscious of their situation and are there to help with unconditional emotional support. Showing empathy and being non-judgmental provides someone with depression with a safe space to be honest about their own concerns.

“Listen, actively and without judgment,” says Armitage. “Really try to hear what the person is trying to tell you without offering advice. Sometimes when we try to offer advice or relate using our own experiences, it can feel as though we are being dismissive of what is being said to us.

“Aim to keep the conversation centred on what the individual is telling you and allow it to be about them. Having feelings heard and validated can be incredibly powerful. When we say ‘feeling heard’, this can be actioned through simply paraphrasing what that person has said to you in your response to them. For example, when a friend says, ‘I’m just so fed up. I’ve got so much work to do and feel like I can’t do it all. There aren’t enough hours in the day.’ You can reply with: ‘That sounds really challenging. It sounds as though the amount of work that you have on is really overwhelming you.’”

This active listening is not a call for advice. Offering your opinion on how they should eat, sleep or exercise at this stage is not what your friend needs. While lifestyle changes can be key in managing symptoms, it is unlikely the advice will be well received in the early stages. Instead, we can encourage constructive and slight change by extending an invitation for a walk in the fresh air or something similar while actively being with them.

“If your loved one is struggling to function in daily life,” says Armitage, “encourage them to slowly engage in normal activities. Be collaborative in your approach as this will empower your loved one to have some agency over their mental health. This feeling of empowerment can be cathartic and can help improve mental health.”

Set some activity goals and help your loved one work towards those goals by breaking them down into smaller, easily manageable steps

The recovery process takes time and patience. While there are no quick fixes, we must recognise that we are not there to fix their problems but just to literally be there for them when they need us. This means being a physical presence in their lives and not simply telling them that we are “there for them” and waiting for them to approach us.

“Set some activity goals and help your loved one work towards those goals by breaking them down into smaller, easily manageable steps,” says Armitage. “Many times, with depression, symptoms compound each other which is how people can quickly find themselves on a downward spiral. For example, if someone is struggling to sleep, they may feel tired for the following day. As a result of the tiredness, they don’t socialise, they don’t exercise, they are unproductive, and they don’t eat well. This then has an effect on the quality of sleep they have the following night, consequently impacting their quality of life the following day, further perpetuating the symptoms of depression, and the cycle continues.

Encourage your loved one to seek professional help

“You can see how, after a number of weeks of living like that, it can have a significant adverse impact on their physical and mental health. Trying to help your loved one to stabilise the essential functions of living – sleeping, eating, exercise, personal hygiene, interpersonal relating – can help to stabilise mood and improve mental health.”

It’s possible that a friend may not be aware they are managing depression and they may not know how to get help. Recognising a problem and subsequently seeking support is a big step and may require guidance.

“Encourage your loved one to seek professional help,” Armitage advises. “It is never too soon to reach out for help if you are struggling with your mental health and wellbeing. As the one supporting your loved one, ensure that you know your own limits. Sometimes we may really want to be able to help our loved ones and may think that we have the ability to, but this can be a dangerous mindset to have.

“It can lead to important warning signs being missed which can result in catastrophic consequences. If someone you know is struggling with their mental health, being under the care of mental health services is vital, as is early intervention. It’s the combination of family support, professional support and personal commitment to treatment that will aid in the recovery of mental illness.”

When supporting a friend with depression, it’s important to be aware of yourself also. There is only so much we can give, and without caring for ourselves we limit how well we can support others. Be conscious of your own needs in this scenario. Set boundaries when it comes to the type of support you offer and when you are available to your friend. And remember, there can be a significant emotional toll in spending time with loved ones with depression.

Recognise how much you can take on board and practise self-care.

Samaritans, (01) 116 123, jo@samaritans.org
Aware, 1800 80 48 48, supportmail@aware.ie
Pieta House, 1800 247 247