It’s difficult for healthy people to fully understand what depression feels like. It’s more than feeling “down.” People with depression don’t experience normal emotions. They blame themselves for things that aren’t their fault…or get angry for trivial reasons…or misinterpret disagreement as rejection and increasingly withdraw from normal interactions.

Important:
Don’t expect someone with depression to “snap out of it.” It is a disease. You can’t solve depressed people’s problems, but you can help them get the help they need. What to do…

Don’t take it personally.
It’s easy for your feelings to be hurt when you’re dealing with someone who is depressed. His/her communication skills may be impaired, and he will find it difficult to give the expressions of support that are normal in healthy relationships.
Remind yourself that it’s not about you. When you are helping someone who is depressed, try to be objective and keep your emotions out of it.

Point out recent changes.
Denial is one of the main defense mechanisms of depressed people. They often don’t recognize—or choose not to recognize—that they’re depressed.

Without being judgmental, explain what you’ve noticed. Stick to the facts. Maybe he sleeps all the time or is less active than he used to be. He might have given up activities that he used to enjoy. He probably spends more time alone—watching TV, using the Internet, etc. He might be overly sensitive or get angry easily.

You can suggest (but not insist) that the changes might be due to depression. Encourage him to get professional help.

Important:
Don’t expect that one conversation will change things. You might have to bring it up repeatedly. Also, men and women tend to react differently when people bring up their depression. Men are more likely to get angry and defensive…while women tend to feel hurt.

Explain why he needs help. A depressed person is highly vulnerable to criticism. Try not to give the impression that you’re blaming or judging. Do help him understand that his behavior is affecting his loved ones.

Example:
You might point out that some behaviors, such as a hair-trigger temper, are frightening. Simply saying, “You’re different than you used to be,” might encourage him to get help.
Encourage exercise.

Studies have shown that people with mild-to-moderate depression who exercise three or more times a week for about 30 minutes each time improve about as much as those taking antidepressants. Those who continue to exercise are less likely to have future episodes of depression than those who rely on medications alone.

Any form of exercise is likely to be helpful, but aerobic exercise—swimming, biking, fast walking—is probably superior to other types of workouts. It increases brain levels of endorphins, the so-called “happy hormones.” It also boosts confidence.

Join him in social activities. Social isolation is one of the hallmarks of depression. But people with depression want human contact even when they’re too insecure or withdrawn to seek it out.

You can help him overcome his reluctance by introducing him to safe social settings without a lot of pressure. You could, for example, accept a dinner invitation from close friends, those with whom your loved one won’t feel as though he has to perform. Or you could go to an art opening or other social event where you will be around other people but your loved one won’t have to engage unless he wants to.

Keep at it. Start conversations. Ask about his day. Make plans to meet for lunch or dinner. You’ll probably get a lot of rejection, but keep trying.

Important:
Being around someone with depression is draining. Allow yourself to back away when you feel that you can’t cope with it anymore. Take a break, and take care of yourself. Then, when you’re feeling strong, reach out again.

Ask about suicide.
It’s an uncomfortable topic, but it is essential to talk about. Up to 15% of those with serious depression will end their lives by suicide.

If you’ve talked to your loved one about depression and he admits that it’s a problem, follow up by asking something such as, “Are you having thoughts of hurting yourself? Have you thought about suicide?”

Few people will admit to having these thoughts unless they’re asked—the majority of suicides come as a complete surprise to loved ones. People who are depressed are ashamed of having these thoughts, and they don’t want to put a burden on their loved ones.

Bringing up the subject gives him permission to talk about it. If he is having suicidal thoughts, you will know that the depression is serious and that it is urgent that he get immediate help.

Source: Richard O’Connor, PhD, a psychotherapist in private practice with offices in Canaan, Connecticut, and New York City. He is former executive director of the Northwest Center for Family Service and Mental Health and author of Undoing Depression: What Therapy Doesn’t Teach You and Medication Can’t Give You (Little, Brown). UndoingDepression.com

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