As someone who has treated hundreds of people with depression, and coped with it personally, I understand some of the fear and confusion about the condition and the challenge of what to say to loved ones, friends, or coworkers who suffer from it.
Part of the confusion stems from the word depression itself, which implies that it is just some fleeting emotion. However, clinical usage of the term refers to an actual illness, a debilitating (and common) medical condition affecting almost 15 million adult Americans. Depression interacts with a multitude of external factors, such as stress, socioeconomic and cultural factors, abuse, trauma, and others. But the condition is biologically driven, brought on by an interplay between genetics and hormonal and neurochemical signaling mechanisms in the brain and body.
It's challenging for the lay public to understand that depression isn’t due to moral failure, weakness, or lack of willpower. To be helpful to loved ones who struggle with episodes of depression, avoid these 5 comments:
1. "Why don’t you just do something to get over it?"
People who aren’t depressed are naturally fearful of the passivity and paralysis often seen in depression. In our can-do, self-motivated society, our instinctual reaction may be to tell someone to get up and change their destiny. While this impulse is understandable, a depressed person may feel even more despair when they hear this. They want more than anything to "get over it," but they can’t. Their energy level and self-confidence have bottomed out. Their mood and associated thoughts and behaviors are beyond their control if they have serious depression.
2. "Why can’t you just be happy?"
Depression causes your mind to focus on negativity and sadness. While some forms of therapy can gradually support people to reality-test their negative thoughts, it is not an automatic or instantaneous process. This type of therapy is more about achieving balanced perceptions of the world around you and accepting the good with the bad. Focusing only on artificial happiness can be disheartening and alienating for someone who isn’t able to see it at the moment. There is no quick fix, and to insist or expect that there is will only reinforce feelings of hopelessness and self-attack.
3. "Stay away from therapy and drugs."
People are often terrified of asking for help because of the stigma of mental illness and the perception of lack of self-control. They may be afraid to discuss personal matters with a stranger, or come from a culture where discussing emotions or family problems is considered shameful. Medications also are particularly scary, due to stories of addiction, dangerous side effects, pharma-company manipulation, and the general fear of altering or "losing" oneself. The vast majority of scientific studies and research, however, shows the benefits of psychotherapy and carefully monitored, judicious use of appropriate medication. Per a 1998 NIH study, up to 80% of people treated for depression can show significant improvement with one or more (or the combined use) of these modalities. Exercise, healthy lifestyle choices, and diet can also aid recovery from depression, but sometimes that isn’t enough. It’s best for people to keep an open mind and encourage an informed decision regarding their choices for treatment and recovery.
4. "You don’t have it that bad."
Sure, compared to starving children in a war zone, no one does. But that isn’t the point. depression is a self-contained, inward state for the afflicted individual. Often perfectionism and harshness toward the self accompany this mood state; in severe cases, these thoughts can become near-psychotic or delusional. We have seen rich and beloved celebrities who seemed to have it all commit suicide. We cannot assume that the cycle of self-punishment in a depressed mind is so easily assuaged, and we should not imply that such individuals are being ungrateful or selfish.
5. "You should stop being so negative."
It can be hard to be around someone with depression; their low energy and glum mood can be infectious. People instinctively recoil from the discomfort of those feelings, and sometimes openly express displeasure or anxiety about them to the afflicted individual. But the depressed person already feels critical toward themselves when they are in that state of mind. They feel very lonely, and when they hear others criticizing their depressive thoughts, that isolation just further increases while their depression worsens. Being supportive and nonjudgmental, and not taking a depressed person’s sometimes irritable or negative thoughts personally, is much more helpful to that person’s recovery.
Depression can feel like the loneliest place in the world for the afflicted individual. Well-meaning people can say things out of their own unease and concern, but without a fundamental understanding of how they come across to someone in an uncontrollable cycle of negative thoughts and hopelessness. The best way to help is to provide unconditional support, reassurance that their condition is an illness affecting them and can be treated, and directing them to the appropriate resources. You can then make a real difference for your friend or loved one.