6 Ways to Support Someone With Major Depression

Major depression can be an isolating, painful, and bewildering illness to live with. Often, people will withdraw even from those closest to them due to shame, fear of being a burden, or simply because they have lost their impulse to socialize. “When we’re clinically depressed, there’s a very strong urge to pull away from others and to shut down,” says Stephen Ilardi, Associate Professor of Psychology at the University of Kansas. “It turns out to be the exact opposite of what we need.” Indeed, self-isolating can be profoundly damaging; social contact is a vital part of maintaining healthy emotional function and a significant predictor of your loved one’s overall wellness.

One of the most important things you can do to encourage social contact is to make yourself a safe space where your loved one can freely express themselves and talk through their feelings without judgment. In some cases, simply verbalizing what is going on inside them can be profoundly liberating. “Speaking out about what I was experiencing became the most powerful and empowering thing I have ever done,” says Nichole Hallberg, who initially kept her depression hidden from friends and family. “I am free. Free from the guilt, from the shame, from the powerlessness that comes with having a secret. Hiding it only made my life worse.” Nichole’s transformation, however, didn’t only happen because she started speaking—it happened because people listened to her without shaming, blaming, or rejecting her.

Listening, however, doesn’t just benefit your loved one. Rather, it is vital for you to understand what they experiencing in order to provide effective interventions, whether it’s being their cheerleader through a difficult phase or contacting emergency workers if they are suicidal. Be sure to not just make them feel heard, but to truly hear them so you can stay responsive.

It is common to want to talk your loved one out of their depression. After all, their emotions may appear to be wildly at odds with reality, and you may not be able to see a cause for their feelings of sadness, worthlessness, hopelessness, or guilt. But depression isn’t built on your logic, it is built on the illogic of the illness; what may appear to you to be unfounded thoughts, beliefs, and emotions are very real to your loved one. As such, minimizing their experiences or telling them their emotions are wrong will only confirm to them that you don’t understand what is happening to them. Similarly, trying to “tough love” them out of depression is doomed to fail because major depression is not about a lack of willpower or deficit of character, it is a serious illness that can’t be resolved by pulling oneself up by one’s bootstraps or looking on the bright side of life. Statements like these, even when they come from a place of well-meaning, can be profoundly damaging:

• There’s always someone worse off.
• Stop feeling sorry for yourself.
• Stop acting crazy.
• You have nothing to be upset about.
• You have to think positively.
• Count your blessings.
• Everything happens for a reason.

Finding ways to support someone with major depression is just as much about knowing what to say as knowing what not to say. Instead of trying to convince your loved one that their feelings are unjustified or easily changed, try saying:

• How are you feeling?
• You are important to me and I care about you.
• I’m here for you, even if I don’t completely understand what you are going through.
• I’m sorry you feel X, Y, Z, that must be very painful.
• Your feelings are not crazy or wrong.
• You have nothing to be ashamed of.
• You are not alone.

You will not be talking them out of their depression, but your love and support can provide a counterbalance to the distorted thoughts and feelings their illness is inflicting on them. While it may not be immediately apparent, this kind of support can be invaluable.

Depression Treatment at Bridges

Supporting someone with major depression, of course, goes beyond just talking—it requires actions, both big and small. Many people with major depression experience functional limitations to various degrees, and motivation to complete basic tasks can be elusive. Ask them if there is anything they need from you. If they are struggling with leaving the house, offer to go with them to run errands, accompany them to an appointment, or just take a walk. Offer to cook a few meals, do the laundry, babysit, or clean the house to lighten their load. Invite them to socialize in a way that is within their limits, even if it’s just going out for coffee or watching a movie at home. Sometimes even the smallest things can truly make a difference. “My husband puts all my medications in a pill box every Sunday,” says Elisabeth. “He’s a very organized person and I am not, especially not in the midst of depression. It helps me stay on track with my treatment, but also helps me know that I am not alone in this.”

In addition to positive actions, it can also important to take negative action. More specifically, avoid engaging in activities that can be harmful to your loved one’s mental health, including drinking and using illicit substances. This is particularly vital if they are using substances to self-medicate. It might seem like a fun night out drinking will be a much-needed break from their daily struggles or that giving them an Ativan to help them sleep is a kindness, but these activities can hurt them and hinder their healing process.

If you are worried for your loved one’s safety, it’s critical that you take action. If you think they are in danger of self-harm, call their doctor, therapist, a suicide helpline, or 911. Remember that it is always better to overreact than underreact in these situations.

While it’s important to know that you cannot fix your loved one’s major depressive disorder, guiding them toward the care they need is perhaps the greatest gift you can give them. This doesn’t mean telling them to exercise more, take supplements, or read a self-help book you heard was great. Rather, it means helping them connect with effective medical treatment.

If your loved one is not yet in treatment, suggest they start. This can be a delicate topic to bring up, as you don’t want to make them feel embarrassed or criticized. Start the conversation by reiterating that you love them and see that they are struggling. Assure them that it is not their fault and that they deserve to be happy and healthy. You may suggest that they talk to their doctor for a referral to a psychiatrist, or you may research psychiatrists yourself to have resources at hand. Offer to make the appointment for them and accompany them to their first visit if that will make it easier for them.

If your loved one is already in treatment but is not making progress, it may be time to suggest more intensive care, such as a residential treatment program. While residential programs can sometimes seem intimidating, they can offer the most comprehensive treatment experiences available to help your loved one recover as quickly as possible. These programs offer a safe, serene environment in which your loved one can concentrate fully on their healing with the support of expert clinicians and peers who will act as their allies throughout the treatment process. During their time in care, your loved one will participate in a range of evidence-based treatment modalities designed to address their symptoms, energize their spirit, and improve their overall quality of life.

We often think of mental health treatment as something that happens solely between mental health professionals and the person with the mental illness. However, friends and family can play an important role in the treatment process. For example, your input may be critical during assessment, as you are can provide information that your loved one cannot. Major depressive disorder can cloud one’s perspective and some people become so used to their symptoms that they fail to recognize them as symptoms at all. You may be able to identify parts of your loved one’s illness that they cannot and sharing this information with their treatment team can help them gain deeper insight into your loved one’s condition.

You can also participate in treatment in other ways. If your loved one is okay with it, you may want to accompany them to a psychiatrist or therapy appointment to better understand what they are experiencing, what their treatment entails, and what their prognosis is. You may also want to participate in family or couples therapy to help you both process the effects of mental illness on your relationship, strengthen your communication, and identify strategies for moving forward in healthy ways. If your loved one is in a residential treatment program, visit them and take advantage of any family programming offered; it can be invaluable for each of you individually and help you create a more loving, supportive, and meaningful relationship.

Always remember, however, that your participation ultimately hinges on the wishes of your loved one. Do not try to force yourself into their treatment if they do not want to include you, and don’t take it personally if they prefer to go through the process on their own. They have the right to keep their medical care private.