How to "Be There" for a Depressed Person

So. I’ve talked about things not to say to a depressed person before. People have often asked me how, then, one should go about it instead.

One of the nicest things that ever happen to depressed people is when one of our close friends or family members tells us emphatically that they want to “be there” for us. This is great. Depressives aren’t easy to deal with, and anyone who chooses to do so deserves respect.

However.

There are right ways to go about being supportive, and there are wrong ways to go about it. I’m going to try to illuminate some of the right ways here. Don’t worry, it’s not hard.

  • Be honest and specific about the extent to which you are able and willing to help.
  • If you’re not, one out of two things will happen–the depressed person won’t take you seriously and won’t come to you for help anyway, or they will overestimate the extent to which you can help them, and this leads to extreme frustration for both of you.
  • If you’re very busy most of the time, tell them a specific time when you’re free to talk. This is important because depressed people often feel even worse at the thought of there being nobody available to talk to them, or of people being busier than they are.
  • If you’re available to listen but have no idea what to say in response, tell them that. They might be able to suggest ways to respond, or they might tell you that just listening helps.
  • If you don’t really like hearing depressing things for personal reasons but still want to help, explain that, and offer to help them do things to take their mind off of their depression, such as watch movies or cook together. Sometimes, that helps as much or more than just listening to someone.
  • Be a bit kinder than you would normally be.
    • Depressed people are, for lack of a better word, very fragile. They get upset by things that “normal” people don’t get upset by.
    • This is not the time to make “constructive criticism” or point out mistakes that the person has made. For instance, some depressed people have substance abuse problems. Do not say “You need to stop drinking or else you’ll only get worse.” All that does is make the person feel guilty and ashamed. First of all, you’re (I’m assuming) not a therapist, so you’re not an expert on how to cure depression. Second, if you’d like to make suggestions for improvement, frame them them very carefully. Perhaps, “I’ve noticed that you tend to feel worse after you’ve been drinking. Have you thought about trying to stop?”
    • If this sounds like sugarcoating or handling people with kid gloves, maybe it is. Maybe it seems silly to you. But remember that this isn’t about you. It’s about someone else.
    • In relation to the first point I made, be really sensitive about how you tell the person that you’re busy/otherwise unavailable and can’t talk to them or help them. Don’t just be like, “I have to go to bed now. Bye.” Say something like, “I need to go to bed because I’m really tired, but I hope you feel better and I’ll talk to you again soon.” Remember that unless you specify that you’re tired but that you wish you could help, a depressed person is likely to assume that you’re just trying to give them the slip. Try not to be offended by this. It’s not because you haven’t been a good enough friend; it’s just how their brain works.
  • Remember that there are many ways to help.
    • If you’re not comfortable listening to someone talk on and on about really sad things, that’s perfectly understandable and okay. If you still want to help them, there are other ways.
    • As I mentioned earlier, one thing that really helps depressed people is getting them out of bed/off the couch and doing something. Offer a pleasant but engaging activity that doesn’t require too much social interaction or new situations–watching movies, cooking, exercising, going to see a lecture or exhibit, going to a small social gathering (NOT a huge party with lots of drinking), taking a walk, going shopping, etc. If you’re both students and have a lot of homework/studying to do, you can invite the person to do that with you. Even if you’re not actually interacting, it’s nice to be around people.
    • You can also help in very small but practical ways. Get notes for them if they miss class (but encourage them to try to go next time), tell mutual friends that they’re going through a hard time and need extra support, help them search for a therapist or psychiatrist, that type of stuff.
  • Don’t make it about you.
    • I can’t stress this enough. Honestly, the shit that can come out of a depressed person’s mouth is pretty ridiculous at times. I’m obviously not proud to admit this, but I have occasionally been known to scream (electronically or otherwise) things like “FINE GO AHEAD AND HATE ME” and “I GUESS YOU WON’T CARE IF I DIE” at people.
    • This, I’m sorry to say, is just part of the package. Depression really fucks with people’s ability to process things rationally. Although there are things you can do to avoid such a reaction (see “Be a bit kinder than you would normally be,” above), it may still happen, and it’s not your fault. Don’t make this about yourself, don’t react defensively, don’t accuse the person of not appreciating your friendship.
    • If they say something that really does bother you, it’s perfectly fine to bring it up when they’re calmer and less upset. But don’t do it while they’re freaking out about something.
  • Be really careful if you’re communicating via texting or the internet.
    • The reason I say this is because this is where I’ve most often seen things go terribly wrong. Written communication has a way of seeming much more curt, rude, and inconsiderate than it really is. Depressed people are already overly sensitive to things like this, so communicating in writing can make it even worse.
    • That’s not to say that you should rule texting and the internet out entirely. Just take care to make up for the lack of body language. You can’t smile reassuringly, touch someone on the shoulder, or hold their hand over the internet. So if you’re saying something that can be interpreted ambiguously, be very cautious. With depressed people, there’s a certain Murphy’s Law–if it can be interpreted negatively, it will be.
    • Some ways to combat this are to use emoticons to help convey emotion, to express things more clearly, and to ask the person how he or she is interpreting what you’re saying as a way of checking in.
  • Try not to offer advice unless they ask for it.
    • This is a big one. I’ve written before about the tendency of people to want to “fix” others by immediately offering them advice, but this really fails when it comes to depressed people.
    • First of all, depression is different from ordinary sadness in a qualitative, not quantitative, way. In other words, it’s not “more” sadness, it’s a “different” sadness. What works for you when you’re feeling a bit down probably isn’t going to be what works for someone with a clinical disorder. This is why all those entreaties to “just put yourself out there!” and “just smile!” and “just get some sleep!” really, really fall on deaf ears when it comes to depressed people. Trust me, we’ve tried all of that, and much more.
    • Second, advice probably isn’t what they’re looking for (unless they tell you so). When people are upset, not only are they not in the right frame of mind to evaluate your suggestions accordingly, but what they probably really want is for someone to agree that things are hard for them and to sympathize with that. In other words, don’t be like, “Oh, that’s no big deal, you can just try x, y, and z.” Try “Wow, that must be really hard for you, but I believe that you’ll get better.”
  • Never ever make the person feel guilty or indebted for needing your help.
    • This is rarely done maliciously; I think it’s usually by accident. Sometimes people who are close to a depressed person become frustrated or resentful, which is natural. However, just because it’s natural doesn’t mean you should necessarily express it–at least not in the way that most people do.
    • If you find that helping the person is taking up too much of your time and energy, that’s absolutely a fair conclusion to come to. But that doesn’t mean you have the right to blame the depressed person for it. You choose how to spend your time, not they.
    • The correct way to address this, in my opinion, is to explain calmly that you feel like you’ve been putting too much of yourself into helping this person. Explain that, since you’re not a therapist, you can’t devote as much time and energy as the person might need. Clarify that you still care about them, but that you need to focus on yourself more.
    • The reason this is so important is twofold. First of all, depressed people can’t help the fact that they need support. They just do. Making them feel ashamed of that does no good. Second, some depressed people are suicidal, and one of the biggest causes of suicidality is feeling like a burden to others. This is why you should try not to make a depressed person feel like a burden to you.

    So there you go. I’m sure there will be a followup post to this because it’s such a big issue for me. Feel free to ask if you have any questions!

    On People Who Think They're so Damn Funny

    [Snark Warning]

    Like many depressives, I have a love-hate relationship with humor. A well-crafted joke, anecdote, or cartoon can cheer me up during the worst times, but because of the various cognitive deficits associated with depression, I have a lot of trouble processing humor when it’s directed at me or my life.

    Enter another thing I have a love-hate relationship with: Facebook. As one of those rare people who’s “out” about having a mental illness (to shamelessly borrow terminology from the LGBT community), I occasionally post something related to my current troubles on my Facebook. Most of the people who bother reading it are fairly good friends of mine who know what’s going on and often stop by and leave a nice comment or a simple “<3″ on those posts.

    But then there are people who insist on trying to force a joke about the situation. These well-intentioned but insufferably clueless people are the bane of any depressive’s life. They’re our friends, sometimes even pretty good ones, and as much as we know that they mean well, it can be very painful to have a really difficult aspect of your life reduced to a dumb joke like that. And it’s nearly impossible to find a way to respond–any suggestion that the joke was out of place is inevitably met with “but I was just trying to lighten the mood” or “I just wanted to cheer you up.”

    Here’s the thing, though–you can’t fix a depressed person anyway. (Sometimes, you can’t even fix a depressed person if you’re a psychiatrist or psychologist.) The most you can do is offer a message of support and refrain from trying to turn a depressed person’s misery into a big huge joke.

    Honestly, I doubt that even healthy people are actually “cheered up” by jokes made at their expense. I can’t imagine that’s pleasant for anyone who’s already in kind of a bad mood. But it’s especially unpleasant for a depressed person and can trigger all sorts of nasty stuff.

    I think people have a huge fear of others’ unhappiness. The moment you see a sad person, you immediately want to drag them, kicking and screaming, out of their sadness, whether they asked you to or not. This is understandable, but it should be avoided, not only because there’s so little you can really do, but because you should try to understand people before you try to help them.

    If anyone ever bothered to ask me what they could do to help me feel better, you can guarantee I wouldn’t say “crack a dumb joke at my expense.” And, don’t worry, I wouldn’t say “sit here for hours and listen to me cry,” either. I would probably ask you to have a conversation about something interesting, like politics or culture, with me. Or I’d ask you to come over and bring a good movie. Or I’d ask you to bake some cookies with me. Or, I’d say, “Nothing, but thanks for asking.”

    What people don’t understand about depression is that it’s different from normal sadness not only in quantity, but in quality. To put it more simply, it’s just a different kind of sadness. When someone has a depressive episode, they go to a really dark place that healthy people don’t go to ever. Not even when their significant other breaks up with them or something like that. It’s a darkness that can’t be lit up by a stupid joke. Really, it can’t be fully lit up by anything. But human connection, love, and support can sometimes help.

    Obviously, not everybody is willing to provide that for everybody else. That’s fine, and that’s how it should be. But if you can’t give me what I need to feel better, don’t give me something that makes me feel worse, either.

    Like many problems that I come across in my life, this turns out to be something that’s actually a much larger issue. I believe that the reason people are so desperate to immediately try to “lighten the mood” the instant they see something unpleasant is because our culture has an extreme fear of negative emotion. We avoid it like the plague, and it comes as no surprise to me that most of our culture’s solutions for achieving happiness seem to focus on eliminating things like fear, sadness, and anger entirely, rather than incorporating them into one’s life in a normal, healthy way. Clearly, what I have isn’t healthy, but it’s only the extreme end of spectrum. I see this sort of blind and terrified avoidance of anything that’s sad, whether it’s severe like depression or totally normal, everywhere I look.

    If you’ve just read this and realized that what I’m describing sounds exactly like you, I hope you’re not offended. If you are, my apologies. But I hope you trust that behind all this snark is a lot of pain.

    And, if you’re still reading, I have a challenge for you. Next time you come across a post from a friend that’s unhappy in some way, don’t rush to make a joke about it. Don’t try to drag your friend away from what they’re feeling. If you absolutely need to comment on it somehow, say “I’m sorry, that really sucks,” or “I hope you feel better.” I guarantee that unless you happen to be Jon Stewart, that’ll work better than any joke.

    I’ll leave you with a quote by Dutch priest and writer Henri Nouwen:

    “The friend who can be silent with us in a moment of despair or confusion… that is a friend who cares.”

    I'm Not Sorry

    [TMI Warning]

    As a person with a mental condition that often drastically affects interpersonal relationships, I’m a total pro at apologizing. I do it practically every day. Here’s a sample of depression-related things I’ve apologized for lately:

    • crying
    • being too tired to meet up with a friend
    • being late
    • leaving early
    • getting upset when a friend acted insensitively
    • needing to talk to someone
    • saying something negative
    • needing to go be alone for a bit
    • writing something emotional
    • being unsure of whether a friend really cares about me or not
    • not understanding a joke
    • not being dressed well/not having makeup on
    • taking criticism too harshly
    • not wanting to be in a big group of people
    • not wanting to drink
    • being quiet
    • not having an appetite

    Now, I realize I should be counting my blessings for the fact that I now have friends who understand me and my brain enough to be able to accept those apologies–in high school it was much worse. But at the same time, I’ve become acutely aware of how inauthentic I’m being when I apologize for the various ways in which my depression manifests itself. Sure, I’m sorry if the way I am makes life difficult for people or makes them uncomfortable. But apologizing implies that I could’ve avoided the situation had I been more attentive or considerate, just like when one apologizes for, say, forgetting a friend’s birthday or for spilling hot coffee on someone.

    I can’t avoid being fatigued or upset or sensitive, though, any more than a diabetic can avoid needing insulin shots.

    Of course, most people who don’t know me very well don’t even know that I’m depressed. Thankfully, I’m not required to wear a scarlet letter “D” on my shirt. But even if they do know, I feel compelled to apologize every time my behavior deviates from that of a healthy person, just to remind them that I’m well aware of the fact that the way I am can be an inconvenience for people.

    The truth is, though, that insofar as “I’m sorry” means “I messed up,” “my bad,” “this is on me,” “I should’ve known better,” “I should’ve tried harder,” “I should’ve been a better person,” and the like–I’m not sorry. It’s not my fault. I couldn’t have stopped it. There’s nothing I could’ve done. I’m getting treatment and trying my best to recover, and that’s as much as I should be held responsible for. I’m not even to blame for not getting treatment sooner, because I was a kid and had no idea there was anything wrong with me. I’d been told “that’s just how you are” all my life.

    I wish I could stop apologizing for having an illness. But until people understand it well enough to react to my apologies the way they’d react to an asthma sufferer who apologizes for getting out of breath, I can’t.

    I’m still not sorry, though.

    Things Not to Say to a Depressed Person

    [Snark Warning, TMI Warning]

    You would think that most people have this depression thing figured out by now. Almost everyone knows at least one person who has it. And by depression, I’m referring to major depressive disordernot feeling sad, not having the blues, not going through a breakup or divorce, not losing your job, not having PMS. Major depressive disorder.

    Anyway, apparently some people still aren’t clear on how to deal with a friend or family member who’s depressed, so I’ve written this list of things not to say to them. Seriously, please don’t say these things.

    • Why are you so miserable all the time? Would you like a detailed description of my brain chemistry? No? Then don’t ask this question. Also, quit it with that annoying mildly-offended tone. My emotions aren’t a personal attack on your values.
    • You know, I was depressed once, but I just pulled myself out of it. You know what, good for you. I’m truly happy that you were able to do that. But not everyone can, ok?
    • Stop being so sensitive. Lower your blood pressure! Now! Can’t do it? Wow, you’re so lazy, relying on doctors and medications to help you do something the rest of us can do ourselves.
    • But what could you possibly have to be depressed about? Depression isn’t “about” anything. It just is.
    • You’re just trying to make my life difficult. Actually, I’m just trying to get by and stop wanting to kill myself. Your life is quite honestly the last thing on my mind right now.
    • You just need to get a boyfriend/get out more/exercise/eat better/sleep more/take herbal pills/get laid/do art. Actually, yeah, tried all those. Let’s leave the medical advice to my doctor, shall we?
    • Why can’t you just go out and have fun with us? Because I get exhausted starting at 7 PM, because you and your friends bore me, because I don’t want to be asked why I’m not smiling all night, and because being depressed isn’t like going through a breakup–it can’t be solved by drinking or dancing or having sex with random people.
    • But you’re so young! Ahhh, this one always gets me. Suicide is the third leading cause of death for teenagers and college-age adults, right behind car accidents and homicide. So clearly I’m not exactly the first young person in the history of human society to be depressed.
    • You just need to learn how to control your emotions. Yes, that’s what therapy’s for. Thanks for the protip, though.
    • Why do you have to ruin everyone’s mood all the time? Because you’re letting your mood be ruined by the fact that someone in your vicinity has an illness. Also, if you’re so concerned about your mood, imagine what it’s like to live inside my mind 24/7.
    • Smile! Or else what? Will I fail to do my duty by Brightening Someone’s Day? Are you offended by my neutral facial expression?

    Now, a disclaimer: this post was meant more for the purpose of humor (a sense of which I do, believe it or not, have) than anything else. So don’t get on my case for hating on healthy people. However, if someone you care about has depression, you might want to take my suggestions into account. Saying stuff like this only makes people with depression want to isolate themselves from you every more than they already do. Might earn you a dirty look, too.

    So, now that you know what not to say to a depressed person, you might be wondering what you should say to a depressed person. Look out for a post regarding that.

    The Kindness of Strangers

    Another reason I got this blog (other than to give me an outlet to complain about the status of my other blog) is to write about my life a bit more, because it bothers me that I hardly ever write in my journal anymore. And Xanga, obviously, is definitely dead. And Facebook is just too cluttered with stupid quizzes and other junk that I get yelled at for complaining about, because apparently, if I don’t want to know what sex position or color of underwear you are, I am a selfish bitch who doesn’t care about other people.

    (Does that make any sense to you? Because it really doesn’t make any sense to me.)

    Anyways, the particular event that I most want to write about at this moment is my own personal introduction into the world of stupid drivers, airbags, and kind strangers, which occurred yesterday on a lovely intersection in Kettering, Ohio, as I drove my little brother (seven years old) and my sister (four) home from daycamp.

    Namely, somebody decided that it would be a good idea to begin making their left turn directly into the line of motion of my car, after I had already entered the intersection, while the traffic light was still yellow and not red, and without stopping or slowing down significantly as they approached an intersection in which, technically, pretty much everybody but them had the right of way. Including, obviously, me, currently traveling at about 45 miles per hour, about 5 over the speed limit.

    As I noticed the presence of a vehicle seemingly oblivious of the fact that it was headed directly into a collision with myself, I slammed on the breaks, already knowing that I was, to put it succinctly, fucked. I collided into the offending vehicle with the upper left side of my car and got spun into a conveniently-located telephone pole, which, had I been going faster, would certainly have shattered my windshield and probably killed (or at least injured substantially) me, since it was right in front of my face. My car slammed into the pole. The airbags exploded. There was smoke and a really, really weird smell in the air. My face started stinging.

    Then my car started rolling backward, but luckily I had the presence of mind to put it in park, turn it off, and get both of my siblings out and onto the sidewalk. My sister was crying. I calmed her down. My brother, being a little boy, was excited. I let him marvel at the fire truck and ambulance that quickly arrived. I began calling both of my parents, but they were on their lunch breaks and didn’t have their phones with them.

    At this point, my adrenaline-fueled energy began to subside, and I noticed my bleeding toe. Then I realized that I wasn’t sure if the crash was my fault or not. The woman in the other car was getting strapped onto a gurney. That’s when I really started crying.

    I was sitting on the sidewalk and freaking out when I felt hands on my shoulders and heard a woman’s voice telling me that it was okay, that she saw what happened and it wasn’t my fault, and that everything would be fine and the police would get there soon. I turned around to see who this angel was. She looked to be nearing the end of her middle age, but had two daughters, both younger than me. The two girls immediately took over watching my siblings, buying them a bottle of water, stroking my sister’s hair, and letting my brother excitedly show off his Nintendo DS to them.

    Over the next hour or two (I have no idea at ALL how long it was), the woman stayed with us, talking to the police, keeping me company, and waiting until my dad could get there and take us home. Her daughters helped me get everything out of the crashed car and put it into my dad’s. I kept telling them that if they need to leave, they should go ahead, but all three of them insisted that they’d only been going to the library, so they weren’t in any hurry.

    The whole story had a happy ending. Other than my cut toe, there were no injuries among me and my siblings. The woman in the other car had asthma and was being sent to the hospital for that, so she was fine. She got a citation for an illegal left turn. I got praised heavily by the woman who stayed with me and by the police officer for keeping a cool head and getting my siblings out of the car immediately.

    My poor car got sent to the shop, but it’ll be fine. Only one corner of it was wrecked, anyway. It could’ve been so much worse for everybody involved.

    But, most importantly, I met three people who made a difference in my life and further cemented an already-firm belief of mine that most people have more good in them than bad. It gave me hope.