In thinking about writing this post, there were a lot of angles I considered coming from. Do I talk about how, in my work at a university, I frequently see students who are buried under the weight of this nebulous and frightening disease? Do I talk about family members or partners or friends or other loved ones whom I have been able to help or, in some terrible cases, not been able to help? What I hope my internal editorial struggle conveys is that depression is incredibly common. According to the CDC, about 1 in 10 adults report experiencing depression in their lifetimes. The number is even higher for young adults.
Seeing a friend, family member or loved one who might be depressed can be scary and overwhelming. But depression is both recognizable and treatable. This should bolster you, knowing that if you can catch depression in yourself or recognize it in a good friend or loved one, you can go a long way toward making someone’s life better.
Depression and other mental health issues are still incredibly stigmatized in the U.S., and so it’s important to remember a few things: people are never, ever at fault for their mental health problems, and treating them like they are only alienates them and makes it harder to help them. Second, you will probably not get a bouquet of roses from someone you are helping, but that does not mean you didn’t make a difference.
Below are some basic signs that you or a loved one might be depressed. Keep in mind that depression is complex, that this is not an exhaustive list, and that this is not in order of importance. It is a good place to start, however, if you are feeling concerned. Here are some common aspects of depression:
- Sharp and unexplained change in behaviors, including the following:
- Irritability, restlessness, or being easily angered (this is especially common for men).
- Feelings of guilt, worthlessness, and/or helplessness—like nothing matters or you can’t do anything right.
- Feelings of hopelessness and/or pessimism—like nothing will ever get better.
- Disinterest in activities, hobbies or work that were once very important or fun;
- Feeling very tired or excessive sleeping;
- Insomnia, early-morning wakefulness;
- Change in eating behavior, like overeating, skipping meals, or a loss of appetite.
- Difficulty concentrating, remembering details, and making decisions, especially if this was not an issue before.
- Thoughts of suicide or suicide attempts.
- Persistent aches or pains, headaches, cramps, or digestive problems that do not get better, even with treatment.
If this sounds like someone you know, it’s really important that you reach out to them. Here are some basic steps for talking about depression with someone you love:
Express your concern
If you see something, say something. Depression can be incredibly isolating, and so it’s very important to show that person you notice and are concerned.
Do this with as much care and kindness as possible, in a private and controlled environment. This is not a good discussion to have on the bus or in a crowded coffee shop. Talk about specific behaviors you’ve noticed, but don’t make the observations sound like you are accusing them of having done something wrong. Something like “I’ve noticed you’ve been missing a lot of work recently, I’m concerned that something might be wrong” is much better than “Why have you been missing so much work?” because it is less accusatory.
The person you are speaking with may rebuff you, get angry, or be relieved that they have someone to share with. It feels best when people are relieved, but don’t expect this reaction 100% of the time. If the person you are concerned about is angry at you, do not take this personally. Depression can come along with strong feelings of shame and anger, and this can make it easy for the person to deny the severity of what they are experiencing and lash out at you. Remember, bravery isn’t a lack of fear, it’s doing something despite your fear. Even if you are worried about their reaction, it’s still important to reach out.
Give your friend the space to express themselves and really listen. Don’t jump in, don’t talk about your own experiences (especially don’t tell that story about your cousin’s friend’s brother), and don’t give advice. Also, don’t be offended if they are not interested in telling you their life story. Create a welcoming and safe space, and allow your friend to be supported by you.
I know, I know, we just talked about not giving advice, but this is different. Having a resource or two on hand to give to your friend is incredibly important. This can be anything from a hotline, to the number for your therapist, to the counseling center at your university (if you’re still in school), to an article online talking about depression.
Check back in with your friend after a day or two and see how they are doing. Again, express your concerns, and listen. You can’t make someone get help, and you shouldn’t follow up in order to make sure that they do. This is mostly to let them know that you are consistently going to be there for them, and that you are not going to bail after one (likely very intense) conversation.
Lastly, here are some resources to keep in your pocket:
In an Emergency: Call 911. If someone is thinking about attempting suicide or if they have already attempted suicide, it’s critical to get highly trained professionals on your side. Don’t hesitate to call 911.
National Institution of Mental Health. Information about Depression: Interested in some more information about the prevalence and effects of depression? That is provided here in a helpful way and contains much more information about the many types of depression, treatment options, and experiences of those who have been diagnosed with depression. http://www.nimh.nih.gov/health/topics/depression/index.shtml
Suicide Hotlines. Sometimes it’s critical to have someone to talk to and give you strategies to not harm yourself, or to help you work through whether a friend is in need. These are free and most are available 24 hours. They have services specifically for veterans, Spanish speaker, and teens, among others. Call if you need help yourself, or if you need help helping someone else. Sometimes friends aren’t available or don’t have the right tools, and this is where these folks come in. http://www.suicidepreventionlifeline.org/
Online Emotional Crisis Support. Not everyone feels comfortable on the phone or has access to a private place to have a conversation. This is the chat room version of the service above. http://www.crisischat.org/
College Student Helpline. Depression for college students is very common. 18-24 year olds experience a wide range and, according to some researchers, the highest prevalence of mental health problems. These folks are specifically trained to help college students. http://www.ulifeline.org/
Grad Student Helpline. Many studies have shown that for whatever reason (high stress, high pressure environment, self-selecting factors), grad students are at a very high risk of poor mental health. Like the resource above, this helpline is specifically geared to help graduate students and to understand the issues they face. http://gradresources.org/
Photo by Anastasia Heuer