To see a family member or loved one grappling with depression can be a deeply painful experience, but often people are uncertain about how to communicate with or support them. On this Depression Awareness Month, here are some insights on how to help your loved ones through their mental health journey.
To understand someone going through depression, it is important to know the difference between occasional sadness and various clinical manifestations of depression.
“Everyone feels sad occasionally, but the question is, when does sadness shift from a natural emotion, which has its beneficial aspects for our psyche, to a disorder that’s more harmful than helpful?” Dr. Jeffery C. Lawrence, attending psychiatrist at Interfaith Medical Center in Brooklyn, New York, told Medical Daily.
According to Dr. Lawrence, “not all sadness is unhealthy.” For example, if a person is going through grief, it is a natural and healthy process but needs professional help when the grieving person is at risk of self-harm, has thoughts of suicide, or when the sadness is directed toward their self-worth.
“While many use the term ‘depression’ to describe pathological sadness in everyday talk, the word itself is not a specific diagnosis. It’s a rather broad term describing a range of certain mood-related conditions,” Dr. Lawrence said.
There are three primary types of depression that need attention.
Major depressive disorder (MDD) – Also known as clinical depression, it is a chronic mental illness where a person feels extremely depressed or irritable for a period of two or more weeks. The symptoms of MDD are so severe that they interfere with the person’s job, social life or even safety and they may hardly have any “good days.”
Persistent depressive disorder (PDD) – It is less acute and severe than MDD but involves a sustained period of feeling down. According to DSM 5 (the Diagnostic and Statistical Manual of Mental Disorders – fifth edition), a person is considered to have comorbid diagnoses of PDD and MDD when they experience major depressive symptoms continuously for two years.
“In my personal opinion, however, two years seem like a long time to wait, and intervention should be taken sooner,” Dr. Lawrence said.
Adjustment disorder with depressed mood – This is a condition in which a person has an excessive reaction to a stressful event or trauma such as death, break up, or work issues. People with this diagnosis often find therapy beneficial.
Know the signs
To know if a person needs help, it is important to notice the changes in their behavior. Watch out for signs such as withdrawal from activities that interest them, lack of concentration, neglect of personal hygiene, too much or too little sleep, constant fatigue, slow gate, restlessness, feelings of low self-esteem and extreme guilt.
“It is also important to note if they talk about self-harm or suicide, this alone waves the red flag for help. In fact, even if they are ‘bluffing’ or doing it for the attention they may be suffering from a personality disorder or traits of a personality disorder called Borderline Personality Disorder. So, either way, it is good they are getting into the mental health care system for a chance at therapeutic interventions,” Dr. Lawrence said.
If the signs of self-harm or hurt are in pregnant women or people who recently had a child, you should approach them carefully and understand that they need urgent professional help, he added.
How to talk to a depressed person?
“When talking to someone about their depression, there are three things to remember: One – to be nonjudgmental, two – to be an active listener, and three – to avoid unsolicited advice,” Dr. Lawrence said.
Know that it is not our role to invalidate their feelings, Dr. Lawrence noted. Avoid asking them to try harder to be happy or placing blame on them. Summarizing what you heard, and giving reaffirming statements or a supportive nod while listening to them can help, but giving unsolicited advice can make them feel dismissed, defensive and irritated.
“If you do have something burning to say about their situation, you can ask if they just want you to listen or if they would like some advice and see how they respond. Remember the most important thing is to lead them in the direction of professional help, not for you to be the professional help,” Dr. Lawrence explained.
How to get them professional help?
Some people have inhibitions to seek professional help for depression, fearing social taboos or due to apprehensions about medications or lack of motivation. Identifying these barriers is the first step.
“Having a mental health care provider is seen as a sign you are doing well in life and taking proper care of yourself. If they are worried that they are going to be seen as weak or feel they should be able to get better by themselves, remind them it takes more strength to ask for help than to do things by yourself. If they are in fear of needing medication, remind them that it is no different than an illness such as high blood pressure or diabetes. You are simply taking medicine to help get your physical brain back in balance, and that is if you need it all as sometimes therapy is enough,” Dr. Lawrence said.
Apart from medical help, adopting healthy lifestyle habits can also help in their mental health journey.
“Exercising, meditation, eating right, taking some vitamins that have been shown to improve mood like fish oil or B6, getting into nature and making sure to get some sunshine for vitamin D are all going to decrease stress and help put your mood back in equilibrium. And lastly, besides adding in the good, it’s also just as important to avoid/remove things that are bad for you. This means drugs and alcohol, toxic people and toxic environments,” he added.
If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org