The number of people affected by mental illness is on the rise. In 2018, the American Psychological Association (APA) reported that about 18% of adults in the U.S. were actively seeking treatment for a mental health disorder. One of the most common conditions, according to the survey, was depression. Unfortunately, rates of depression have skyrocketed since the onset of the COVID. In fact, the APA estimates that four times as many adults have reported symptoms of anxiety and depression since the pandemic began.
With so many people experiencing depression, it is likely that someone in your circle is struggling with the condition. While some people are comfortable talking about it, others may shy away from the conversation. So it is important to learn how to talk to someone with depression to keep lines of communication open with friends and loved ones.
What Is Depression?
Depression is more than just a feeling of being sad or having a rough time with a momentary occurrence. According to the APA, depression is defined as "a negative affective state, ranging from unhappiness and discontent to an extreme feeling of sadness, pessimism, and despondency." They also note that the feelings are significant enough that they interfere with daily life.
There are different types of clinical depression. For instance, many people are familiar with postpartum depression that can occur after the birth of a child. Other forms of depression include major depressive disorder, persistent depressive disorder, and seasonal affective disorder.
Depression can look different for each person that is experiencing it. According to the National Alliance on Mental Illness (NAMI), symptoms of depression can include:
- Changes in sleep
Increased or decreased appetite
Lack of concentration
Loss of interest in preferred activities
Depression is diagnosed based on the elements laid out in the Diagnostic and Statistical Manual (DSM). According to the National Library of Medicine, a person can only be diagnosed with depression if they have experienced five of the following characteristics for a period of at least two weeks, and they have affected their daily life:
- Changes in appetite
- Changes in sleep patterns (trouble sleeping, sleeping too much)
- Depressed mood
- Difficulty concentrating or making decisions
- Feelings of agitation or sluggishness
- Feelings of worthlessness
- Loss of interest in activities, especially ones that were enjoyable before
- Low energy or fatigue
- Suicidal thoughts or attempts at suicide
According to NAMI, there are several different treatment options for people experiencing depression. Some treatments include:
- Clinical therapy - This can include clinical behavior therapy (CBT) practices, marriage and family therapy, as well as others.
- Holistic approaches - These include meditation, acupuncture, and others to form a comprehensive treatment plan.
- Medication - Depression has been shown to be reduced by antidepressants, such as selective serotonin reuptake inhibitors (SSRIs).
- Combination - Depression can be treated with both medication and therapy simultaneously, which has led to higher rates of improvement.
How to Talk to Someone With Depression
Having to talk to a loved one that is experiencing depression is no easy task, especially since the National Library of Medicine notes that people experiencing depression often struggle to communicate with others due to their illness. It's important to remember that, although the conversation may be difficult for you, it is equally as difficult, if not more so, for your loved one.
There is no clear right or wrong way to talk to your friends and family about their experience with depression, but there are communication strategies that can be helpful guides.
Ask If They Want to Talk
Asking your loved one if they want to talk may be the most direct way of starting the conversation. They may already know what you mean when you pose the question, but remember, it's a vulnerable topic and may be difficult for them to talk about. It can be helpful to note that you just want to check in with them. Some helpful phrases in starting the conversation may be:
"How have you been feeling lately?"
"I noticed you didn't come to [certain event], are you okay?"
"Do you want to talk about anything? If not, I'm still here if you need me."
Discover How/If You Can Help
If your loved one is able to have a conversation with you about their depression, ask them how you can help. There are a lot of ways to show your friends and family that you want to support them. Just being there to listen to their experience is a great way of doing just that. People facing depression often suffer from low energy, disrupted sleep, and lack of appetite. This means that there are several ways you can help. Some good phrases are:
"What can I do today to help you?"
"Do you want to get food with me right now?"
"Can I call you tomorrow to check in?"
Talk About Coping Strategies
Knowing what your loved one is doing to manage their depression may help you understand where they are at with their mental health. Maybe they are already attending therapy, or are even on medication. Remember to validate how they are feeling, and encourage them to stick with their treatment plan. If your loved one has not yet sought help, encourage them to connect with a mental health professional or supportive organization. Some ways to start this conversation are:
"How are you managing your depression?"
"Have you talked to someone about how you are feeling?"
"Can I help you look for therapists that you are interested in?"
Let Them Know You Care
Talking about mental illness is difficult because of the stigma that surrounds it. Providing validation and support for your loved one is important to let them know that they are in a safe, non-judgemental space at this time of intense vulnerability. Some helpful phrases to let them know you care are:
"That sounds difficult and I'm here to help however I can."
"I'm sorry you're going through this, and I'm here for you."
"I care about you and want to support in any way that I can."
Avoid Giving Advice
A common pitfall of people trying to comfort their loved ones with depression is advice-giving. It's best not to give any unsolicited advice. If your loved one does ask, feel free to provide words of support. Responding with empathy and kindness is important, so it's good to stay away from any advice that may feel belittling to their experience. Some phrases to avoid are:
"Everything's going to be fine."
"Everybody gets sad sometimes, you'll get over it."
"There are people out there that have it much worse than you."
"I started working out and I feel great, you should try it."
"Everything happens for a reason."
Ways to Reach Out Digitally
In today's world, it can be more difficult to meet people in person, but that doesn't mean that you can't support your loved ones with digital tech tools. There are many ways to reach out that will help your friends and family know that you care.
If you can't meet with your loved one in person, it's still beneficial to reach out to them over text. It may be more tricky than an in-person conversation, but the same strategies are helpful in showing support and keeping communication open. Some helpful texts to send to start the conversation are:
"Hey, I haven't seen you in a while and I wanted to check in?"
"Hi, how have you been lately? I'm here if you need me or want to talk."
"Hey, just wanted to say that I'm here if you want to talk about anything."
Other Messaging Apps
You can also provide support and comfort to loved ones using other virtual tools such as What's App or other messaging apps. It can feel more daunting to know what to say when you have to write it down, but don't let that deter you from connecting with those you care about. Some helpful messages to send to show support are:
- "I may not understand exactly what you're going through, but I care about you."
"That sounds really difficult, and I want to support you in any way I can."
"I'm sorry I can't be there in person, but I'm still here for you."
One way you can offer a more 'present' conversation is by talking with your loved one through video calls, such as with Zoom or FaceTime. This can be a good way of making sure you have set aside enough time to talk with your loved one, and it may help you better empathize with them and show your support.
It may also be nice for them to hear your voice and see the face of someone who cares about their wellbeing. Just like you would during an in-person conversation, ask them how they've been, if they'd like to talk about it, and then listen to their responses. Provide support and validation for their feelings, and make a plan to check in with them at a later date.
When people are struggling, they may share subtle information online by reposting a graphic about depression, sharing a sad note on their Instagram story, or writing a status that reflects their depressed mood or diagnosis. Although this can be a sensitive matter, there are ways for you to connect with these friends.
For instance, try to message them privately, either on the social media channel where they initially shared their post or via private text. This can be as simple as saying, "Hey, I've been thinking about you. How are you?" or referencing their post directly and saying, "Hey, I saw your post and wanted to let you know that I'm here if you want to talk."
However, if they aren't ready to talk about it at this time, don't force them. Validate their feelings and experiences and let them know that you care. If they mention that they are searching for help, offer to look for resources with them and send them information that you think would be helpful.
You may also want to establish a check-in date. Saying something like, "I'll reach out to you on Friday to see how you are" helps them to know that you can be a continuing source of support. When you check in, this will reinforce the idea that you care about them and confirm that you will follow through with your promises.
Concerns About Suicide
Depression can lead to suicide. If you are concerned about your loved one taking their own life, there are steps you can take to manage your worry and potentially, help your friend or family member.
Know the Signs
It's important to know the warning signs so that you can take action and possibly save a life. Noticing changes in behavior or the presence of new behaviors are incredibly important according to the American Foundation for Suicide Prevention. According to AFSP warning signs for suicide can be broken down into three categories: talk, behavior, and mood.
Talk- Noticing changes in what your loved ones talk about, such as feeling hopeless or experiencing unbearable pain
- Behavior - Behavioral changes, such as giving away their possessions or calling/visiting people to say goodbye
- Mood - Some mood changes to look out for are loss of interest, anger, or sudden improvement of mood
Communicate Without Fear
Don't be afraid to say "suicide." At one point in time, people believed that mentioning the word could increase the odds of a person taking their own life. Mental health experts no longer believe this to be true. In fact, they recommended that you use the word "suicide" to encourage communication and open a dialogue. If your loved one is showing signs that suggest that they may be considering suicide, don't be afraid to ask them directly if they are having thoughts about ending their life.
Use Recommended Techniques
There are suicide prevention protocols that can help you respond to others that may be contemplating suicide, and help you save a life. In 1995, Paul Quinnett of the QPR Institute developed the Question, Persuade, and Refer model for suicide prevention. The steps include:
- Question - Ask the person directly if they are thinking of killing or harming themselves.
- Persuade - Talk to the person and try to convince them to seek help.
- Refer - Guide them to the appropriate resource to help them, such as a medical professional.
One way of supporting them is to put them in contact with the National Suicide Prevention Lifeline, where they can chat with a trained professional that is available 24/7 by calling 1-800-273-8255.
Lastly, keep in mind that it's not an easy thing to know that someone you care about is dealing with mental health struggles. It can also be challenging to learn how to talk to people with depression. Reaching out to open the conversation, listening to what they have to share, and providing emotional support are great ways to show them you care and stay connected.