Although depression is prevalent globally, our mental health and that of our peers have been something that has reached the spotlight. In the past, if you were wrestling with depression or a fragile mental state, it was something you had to keep to yourself in fear of being judged.
Depression and mental health have always been stigmatized in our society. It would hurt us to know we sat around idly as a friend struggled with depression, or even worse, followed through with their urges to hurt themselves and rid themselves of their pain.
The world has dealt with its fair share of problems, leading many of us to feel hopeless about tomorrow. According to the World Health Organization (WHO), depression affects an estimated 264 million people worldwide. On average, the 17 countries where surveys were conducted found that one in 20 people reported having an episode of depression in the past year. An estimated 76 to 85 percent of those suffering from mental health disorders lack access to the treatment they need.
Depression isn’t a condition confined by borders. Despite living in an advanced society like the United States, where access to exceptional care is broad, the disorder is prevalent among people who live here. According to the National Institute of Mental Health (NIMH), nearly 17.3 million U.S. adults experience at least one depressive episode, accounting for 7.1 percent of all adults. Females were more likely than their male counterparts to experience depression, affecting adults between ages 18 and 25 the most.
Depression Is More Than Just ‘The Blues’
There is a difference between major depressive episodes and experiencing the blues. For example, if your pet passes away or you fail a test, it’s common to deal with some minor depression. However, in most cases, it’ll go away with time, and you will be able to, at some point, occupy your mind with activities that make you happy. Clinical depression is much more severe. Someone who’s depressed may not have an issue in their life that would cause it. They could have what others see as the perfect life, which makes it even more challenging to understand.
This is one of the areas that’s misunderstood by others when they see someone else with depression. They might have no real reason to be depressed, but each day is a struggle to get out of bed and try to find the energy to fulfill their daily obligations. Others might see this and tell them, “get over it, it’s fine. Other people have it worse.” It’s one of the most frustrating things to hear if you’re depressed because it goes much deeper than that. Life can be fine, but if you have a chemical imbalance in your brain, it’s impossible to “get over it.”
If you’re concerned about a friend struggling with depression and want to help, it’s vital for you to understand the different types of depression and how to help your friend. Let’s take a look below about putting mental health first and the methods you can take to help your friend with depression.
What Are the Different Types of Depression?
Depression is defined as a mood disorder that causes persistent feelings of sadness or depressed mood. It results in a profound loss of interest in activities that once brought joy or pleasure. Depression often has the person asking, “What’s the point?”
If your friend is dealing with depression, the condition will affect how they think, feel, and behave, which interferes with their ability to carry on seemingly simple tasks. There are various causes of depression, some of which aren’t entirely understood by experts. Below, we’ll discuss the most common types of depression that people face.
Major Depressive Disorder (MDD)
The term “clinical depression” is often in reference to major depressive disorder (MDD), a mood disorder characterized by several key features. These include:
- Changes in sleep
- Changes in weight
- Loss of interest in activities a person once found joy in doing
- Depressed mood that lingers around no matter what you do
- Feelings of guilt and worthlessness
- Inability to concentrate
- Vivid thoughts of suicide and death
If your friend experiences most of these symptoms for longer than two weeks, a doctor will likely diagnose them with major depressive disorder. The only way to get an accurate diagnosis is to seek a professional opinion.
Persistent Depressive Disorder (PDD)
Persistent depressive disorder (PDD), also known as dysthymia, is a type of chronic depression that’s present most of the time for at least two years. It may be mild, moderate, or severe. In PDD, a person will experience brief periods where they aren’t depressed, but the relief of symptoms is short-lived. Although symptoms are less severe than major depressive disorder, they can be consuming and last a long while.
The symptoms of persistent depressive disorder you should look out for include:
- Anger and irritability
- Feelings of sadness
- Loss of pleasure and interest
- Feelings of guilt
- Inability to fall asleep or stay asleep
- Low self-esteem
- Sleeping too much
- Changes in appetite
- Feelings of hopelessness
- Lack of energy and fatigue
- Inability to concentrate
The National Institute on Mental Health (NIMH) found that 1.5 percent of adults in the United States struggled with persistent depressive disorder in the past year, affecting 1.9 percent of women and 1 percent of men. Researchers also found that 1.3 percent of all adults in the country will experience the condition at some point in their lives.
What Are the Different Types of Depression?
The first step to helping your friend is understanding the symptoms they’re facing. Since everyone deals with depression differently, their symptoms might vary. If your friend is experiencing depression, they could experience some of the following:
- They get upset easily or are unusually irritable.
- They appear sad or tearful.
- They might act more pessimistic than usual or reveal hopelessness about their future.
- They might talk about their emptiness, worthlessness, or guilt.
- They could be less interested in hanging out, or you might notice they’re communicating much less than usual.
- They have no energy, move slow, or appear listless.
- They eat more or less than usual.
- They are forgetful and have trouble making decisions.
- They neglect basic hygiene, like showering or brushing their teeth.
- They could make jokes about death or suicide.
Here is a list of the following that can help your depressed friend.
Listen to Them
The best thing you can do is listen and try to decipher what they’re saying. They might be asking for help without you realizing it, so pay attention. It’s important to start a conversation by sharing your concerns and asking questions like, “what’s on your mind?” Tread lightly, but also say things like you can see they’re having a hard time lately.
Your friend may not want your advice, so don’t take it personally, but try to get them to talk about how they feel. You can use the following active listening techniques:
- Show interest and empathy with your body language.
- Validate their feelings by saying you understand how they feel and knowing that what they’re going through is challenging. You should never insert toxic positivity, as that can make it worse.
- Ask questions to get more information about what’s going on without prying too much.
Your friend may not want to talk the first time you ask. Again, don’t take it personally as they’re going through a tough time. Make sure to continue telling them you care and keep asking open questions without pushing too much.
Find Support for Them
It’s possible that your friend doesn’t even know they’re battling depression, or it’s that they don’t know how to ask for help. They might understand therapy will help, but searching for a therapist and following through with an appointment can be overwhelming. If your friend seems genuinely interested in help, offer your support in helping them find a therapist. Encourage them to make an appointment and how beneficial it will be.
Encourage Them to Continue Attending Therapy
On a bad day, your friend won’t want to leave the house. They might be experiencing an overwhelming and debilitating day of depression, meaning their energy will be gone, and they’ll want to self-isolate. If they mention canceling their appointment, encourage them to follow through. Remind them how much better they felt after a previous session and that today’s session could produce the same results.
The information goes for medication as well. If a friend wants to stop taking the drug because they feel it isn’t helping, remind them it takes time, and remain supportive of their decision to start using the medicine. If they’re unhappy with the side effects, talk to them about speaking to the psychiatrist to change the medication. Abrupt cessation of antidepressants can lead to severe consequences.
Take Care of Yourself
If you have a friend you care about deeply who’s going through depression, it’s understandable if you want to drop everything and be by their side. It’s not wrong to help and be there for them, but you need to take care of yourself first. If you’re not healthy, you can’t give your friend the attention and support they need. It’ll cause you to feel burned out and have little emotion left for yourself.
Setting boundaries is crucial to keeping a healthy balance. For example, let your friend know you’re available to talk after work but not before. This will allow them to know you aren’t ignoring them, causing them to feel worse or cause any potential miscommunication.
If you’re concerned about them being unable to reach you, offer them something else they can work with while you’re busy. It may involve reaching out to a hotline, talking with a parent, or coming up with a code word that indicates the situation is dire and they need immediate help.
You could offer to stop by every few days to bring them meals instead of being needed on a daily basis. You should always involve other people to build a larger network of support.
Learn More About Depression
The reason we described the symptoms above is that it’s challenging to educate everyone in your life about a mental or physical issue you’re facing, then explaining it over and over again. Understanding the symptoms your friend is enduring and how they’re feeling will help them talk about what they’re going through. Since everyone experiences depression differently, understanding the jargon and general symptoms will help the conversations.
Offer to Help with Daily Tasks
A person dealing with depression will be the first to admit the challenges of completing routine tasks. Things like grocery shopping, laundry, or paying bills are hard when you’re zapped of energy. When you start getting behind, you won’t know where to start.
As much as your friend appreciates the offer, they might not know what they need help with accomplishing. Instead of saying something like “let me know what I can do,” try asking what they need help with that day. If their refrigerator is empty, ask them what they need from the store, or offer to go out and grab dinner. If the dishes are piling up, offer to come over and help get them done. Try and make it fun with music and a positive attitude.
Extend Loose Invitations
Making plans and following through with them isn’t easy for someone with depression. Even worse, canceling the plans will make them feel more guilty. A pattern of canceled plans might lead to you inviting them out less, causing more isolation and leading to worsened depression.
You must reassure your friend by continuing to invite them, despite them canceling or not accepting. Let them know you understand they’re in a rough patch and may not keep the plans. Let them know it’s OK not to hang out until they’re ready.
Although depression will likely improve with the right therapy, it’ll still take a while. As a friend, you have to remain patient while your buddy tries new medication and works through their issues with therapists. Successful treatment doesn’t always translate to depression going away entirely, and your friend may deal with symptoms for an extended period.
There will be good and bad days, and you shouldn’t assume their depression is cured because they’re on medication and seeking therapy. Don’t get frustrated on the bad days and think they’re going back on their progress. Some bad days don’t equate to them never getting better. Depression doesn’t have a definitive recovery timeline.
Stay in Touch
Even if you don’t see them all the time, remind your friend that you care about them and that you’ll be there in any form as they work through their depression. Checking in with a text, phone call, or stopping by on occasion can mean everything in the world to them. People living with depression will avoid reaching out and continue to withdraw themselves, so you might be responsible for doing the work to maintain the friendship. As long as you stay positive and supportive, your presence is doing more than you can think, even if they can’t tell you.
Things Not to Do
You should never take anything personally. Your friend’s depression isn’t your fault, nor is it theirs, so don’t take it personally if they lash out in anger, continue canceling plans, or not follow up. At some point, as we mentioned above, you have to focus on yourself, and it may require taking a break from the friend. It’s OK to get some space for your own mental health if you’re feeling drained, but don’t blame your friend or say something you might regret.
Never try to fix your friend. Depression is a severe mental health condition that requires professional help to overcome. It may be difficult to understand what depression feels like if you’ve never endured it, but it’s not something that goes away by not thinking about sad things. You’d never tell someone with cancer or diabetes to “get over it,” so don’t do it to someone with depression.
It may be hard not to, but don’t give advice. It may be tempting when you see some lifestyle changes are in store, but your friend probably doesn’t want to hear it at the moment. At some point, they might wonder what foods reduce depressive symptoms or how exercise is vital in producing endorphins that make you feel better, but until that happens, stick to listening and being empathetic.
Minimizing their experience is the wrong approach. You’ve heard the friend that says they’ve had it much worse than this person, but comparing their troubles to others doesn’t help. Your friend’s pain is real to them, so validating that pain might be the only way to help. You might want to lead with, “I can’t imagine what you’re going through, but you aren’t alone.”
What Should I Do If My Friend Has Suicidal Thoughts?
Self-injury and suicide are real outcomes stemming from depression, so knowing when to recognize the signs could be the difference between life and death. Pay attention to the following signs that could indicate your friend is having suicidal thoughts.
- Purchasing a weapon when you know they’re in a bad place
- Joking about death or dying
- Personality changes or frequent mood swings
- Partaking in risky or dangerous behavior
- Increased substance or alcohol abuse
- Giving away treasured possessions or getting rid of their belongings
- Saying goodbye with more feeling than you’re used to them expressing
- Pushing people away and wanting to be left alone
If you believe your friend is considering suicide, you should urge them to immediately seek help from their therapist. Tell them you’ll call for them if they’d like. They can also text HOME to the Crisis Text Line at 741741 or call the National Suicide Prevention Lifeline at (800) 273-8255.
If you’re concerned, you should take your friend to the emergency room. If possible, remain next to them until they’re feeling better and the thoughts of suicide dissipate. Do your best to ensure they can access alcohol, drugs, or weapons in the event they try to take their own life. Your concern may cause you to avoid bringing up the topic or encourage suicidal thoughts, but it’s helpful to talk about it.
Ask them if they’ve seriously considered taking their own life because they could want to talk about it with someone but aren’t sure how to bring up this sensitive topic. If they admit to these feelings, encourage them to call a therapist and discuss the thoughts to help them get to the root. Also, offer them the option to create safety plans in case they act on these thoughts.
Assure Them They’re Not Weak
If your friend has pondered suicide, they could also be contending with the guilt of even thinking that way. It’s your job to remind them they’re not weak and help them cope with this depression. Depression is an illness, and those living with it believe it’s a character flaw, not a disease.
Remind your friend that their depression is an illness caused by a chemical imbalance in their brain. Remind them how strong they are to continue with such a debilitating condition. It takes strength to battle these emotions, so they’re likely much stronger than they give themselves credit for being.