I have revised and expanded this post for a magazine article that I wrote recently. If you haven’t read it before I hope that it’s helpful to you.
The person with depression usually can’t see a way forward. They may fervently believe that nobody can help them, and life is pointless. That doesn’t mean that they’re right, and there are plenty of things that you can do to help.
The type and amount of care that you can give will depend on your relationship with the person, but here are some ideas.
1. Understand the illness.
Learn all that you can about depression. The better you grasp the illness, the more effective you will be in giving your care and understanding. It will help you to understand why the person behaves the way they do, and better equip you to respond appropriately.
2. Seek Appropriate Treatment
This is such a far-reaching, wide-ranging topic that I would be foolish to give advice. Suffice to say that it will be helpful for you to explore the treatment options available in your area and suggest to the person that they need professional help. It might be helpful for them if you go along to the first or subsequent appointments. Often a person actually feels relieved to hear a diagnosis and know that they are sick and that they can be helped. This was really true for me.
If he or she won’t admit they need help then explain why you are concerned and perhaps provide them with some helpful written information to chew over.
3. Provide Emotional Support
Your partner or friend needs patience, care and understanding. They have a real illness, and just like someone with cancer they can’t just “snap out of it”. If they could, they would. Saying things that show ignorance about the illness is counterproductive and will reinforce their negative thinking.
The best way to communicate is to empathise, listen more than talk, and ask questions like “How can I support you?” or “How can I help?”
4. Keep the Illness Separate
The illness and the person suffering the illness are not the same thing, so keep them separate. When they express pessimism, anger, frustration, or sadness, it is the illness talking not the person. If you separate the two you will find it easier to cope emotionally. It will help you to be a more effective caregiver.
5. Listen Non-Judgmentally
Don’t try to talk a depressed person out of their feelings, no matter how irrational they sound. This is likely to compound the problem. It is better to remain neutral and say something like “You are obviously really suffering with this. What can I do to help you feel better?” Keep your suggestions, solutions and advice for another time. My wife has also found that posing suggestions as a question helps me to have some ownership of the solutions. It stops me feeling nagged too!
6. Make a Plan
Help the person to make a plan for coping with depression. Identify things that trigger or worsen the depression and things that make it better. Think through and list the ideas formally on paper. Help them to put this plan into action. Some positive, helpful things to include are getting to bed early, having adequate sleep, exercising regularly, drinking plenty of water and eating healthy foods. The plan will be an evolving document as things change, so be prepared to re-visit it on a regular basis. I often need my wife to remind me what works for my health as sometimes I go off track. This is a key role that the caregiver can play.
7. Look after yourself
As a caregiver you are likely to be under stress. You need to care for yourself by taking time out and recharging your batteries. Find other friends or relatives who you can talk to and rely on at a pinch. Sometimes you will need a sounding-board to keep things in perspective. Make sure you continue to live your own life as well, and spend time doing things you enjoy. My wife loves her part-time job for many reasons, but high on the list is escape. Although she is working, it’s a great mental break for her when home life is dominated by my illness.
There are services that provide education and support for caregivers. Through information sessions and support groups, you can talk to people who are in a similar position.
8. Organize their medicines
If your partner or friend is taking medicine for depression then it is crucial for them to follow their prescription. Too many people go on and off their anti-depressants depending on how they feel. This all but eliminates their effectiveness.
I take medicine at night without any problems, but if it wasn’t for my wife handing the pills to me I would never take them in the mornings. She also fills my scripts and tells me when to go to the doctor for more. It’s not laziness; it’s just the nature of depression. More than once I have spent hours in bed staring at my pills, but not had the mental energy to actually take them. If your partner or friend is not complying with their prescription, try to find out how you can help.
9. Support network.
Introduce the idea of joining a support network for depression. This will give them an outlet for discussing their problems and receiving input, and help them to discover that there are other (normal) people experiencing similar problems. There are depression support groups everywhere. Make sure that you find one that is positive and focused on recovery. Inward looking, pessimistic groups can be unhelpful.
10. Get out and About
One of the most therapeutic things that a depressed person can do is step out the front door. Natural light is very beneficial, especially early in the day. Exercise also has proven benefits. Something as simple as taking a walk or gardening should lift the person’s mood. Anything low-key that involves going out can also help; seeing a movie, meeting friends, or going out to eat, just to name a few ideas. The most effective way for me to get up and out the door is to take the kids to school. There is a set time to go, which gives me routine, and the kids are great company.
11. Help with daily tasks
When your body is heavy and your mind is dark, there is nothing harder than the burdens of everyday life. Something that seems minor to you may be an insurmountable task to your friend or partner. Ease their burden by helping with the daily load – running errands, doing the shopping, cooking, taking the kids out for a couple of hours. You may be surprised to find that helping with a very simple chore could relieve them of a lot of stress.
We had an old mattress that needed to go to the tip. My wife asked me to take it there for months, and over time it became a source of tension. But my thinking wasn’t rational and the thought of going to the tip overwhelmed me. When she understood what was really going on she asked a friend to take it. That was a huge relief to both of us.
12. Spend normal time together
Just spending time with the person lets them know that you care and want to understand their problems. Enjoy the reasons for being their companion in the first place. It’s important that they live as normal a life as possible. Help them to do this by carrying on your relationship with them in a normal fashion. Don’t let everything get dark and serious. Find some positive things and try to enjoy them together.
The points above are general by necessity. They don’t fit all circumstances, but I hope that you find at least a few helpful ideas.
Joylene 10 Sep 2008 @ 9:08 pm
an awesome and helpful article…. thanks!
ellen 13 Sep 2008 @ 10:30 pm
what a breath of fresh air to read your suggestions….thanks
Josie 18 Sep 2008 @ 2:55 pm
The thing that i find interesting about this blog is the US view of mental illness (particularly depression) is much more medicalised and illness-based than it is in the UK (where i’m from). Here it’s discouraged to view depression as an illness, but more of a life-stage or an emotion. Psychiatric professionals avoid labels at all costs – “Major depressive disorder” is referred to as “low mood” or “sadness” predominantly, and the label of illness is challenged.
I see there’s things wrong and right with both points of view, but i wonder with the US view – does it make a sense of hopelessness and helplessness? “I have an illness therefore there’s nothing i can do about it and you have to attend to my every need!”. It’s better than feeling guilty for not “pulling yourself together”, but sometimes i worry that it’s almost taken too seriously.
phd in yogurtry 23 Sep 2008 @ 6:51 am
Educating oneself in order to understand – that is a biggie. Understand and empathize rather than blame. Great list.
Kellen 24 Sep 2008 @ 6:17 am
This is an excellent article. I would only add diet. So many folks with depression try to use sugar, simple carbs and caffeine to lift their mood and energy levels. But what goes up must come down and they end up with a crash when these foods/chemicals wear off. A healthy diet of complex carbs and quality proteins will provide the body with the chemciials it needs to make more Serotonin and lift the mood naturally without those sugar/caffeine rushes – or the crashes that follow.
Depressed Man 24 Sep 2008 @ 8:41 pm
In response to the previous comment, diet has helped me a lot in treating my depression. Avoiding the high GI foods and staying on healthy nutrient rich, antioxidant rich fruits and vegetables has seen my energy levels soar. And as we all know, the more energy you have, the less depression can affect your life.
Adam 1 Oct 2008 @ 5:48 pm
Josie, I, on the other hand find it interesting that in Europe – not just UK – anxiety and depression are not treated as illness and just “mood changes”. That’s wrong. I met depressed Europeans that were unable to get better for 5+ years but after moving to USA they improved within a year thanks to meds+therapy. I don’t like meds, but certain illnesses can’t be healed without them.
And severe depression and anxiety are a real illnesses: certain chemicals in your brain are out-of-balance and that can’t be cured by therapy alone. I tried everything from exercise, yoga, meditation, dieting, maintaining diary, talking, light therapy to hiking. biking, hobbies and I was progressively getting worse, if it wasn’t for medications I would eventually expire, I’m afraid. Of course meds alone are not the answer either. They have to be dosed responsibly and minimally and they have to be custom-picked for a given person by a trained psychiatrist not an internist, which unfortunately happens in USA: they’re quick to prescribe Lexapro and Ambien. Meds have to be combined with behavioral therapy, self-observation and both mental and physical exercise. Of course, proper diagnosis and observation is required: periodic, non-accute, and non-chronic depression and anxiety can be treated, particularly in early stages, by behavioral therapy and self-observation. Depression related to sudden catastrophic life events, for instance, (post-traumatic, post-surgery) even if person has no history of any mental disorders can’t often be treated without meds. The same goes for chronic depression: if a person wasn’t able to snap out of it for years, they may not be able to do so without medications. In Europe, particularly Eastern countries, depression and anxiety is often not even recognized properly or even not taken seriously yet, there is no awareness. People are often labeled “weird”, “bad” or “crazy”. And a person seeing psychiatrist often ends up being “crazy” too. Therefore, people are refraining from seeing one in fears of being rejected and ridiculed by their friends.
It’s like cold versus flu, they may have similar symptoms: one will usually recover from a cold without medications, but flu may require drugs or a person of weaker health may die from common flu.
Anyway, I’m really glad I found this program and I wish I found it sooner, During my therapy my doctor gave me homework that involved tracking daily patterns of sleep and behavior and I still take notes and this app will help organize it all:)
Thanks!
Adam