How can you support loved ones who are depressed?

Helping someone with depression can be difficult. If someone in your life is depressed, you may feel helpless and confused about what to do. Learn how to offer support and understanding and help your loved one find the resources they need to cope with depression. Here’s what you can do.

Learn the symptoms of depression

Signs and symptoms of depression vary from person to person. These may include:

• Feelings of sadness, tears, emptiness, or hopelessness
• Outbursts of anger, irritability, or frustration, even over minor issues
• Loss of interest or pleasure in most or all normal activities, such as sex, hobbies, or sports
• Insomnia or sleeping too much
• Fatigue and lack of energy, so even small tasks require extra effort
• Appetite changes – decreased appetite and weight loss or increased cravings for food and weight gain
• Anxiety, agitation or restlessness
• Slowed thinking, speech, or body movements
• Feelings of worthlessness or guilt, dwelling on past failures or blaming yourself for things that are not your responsibility
• Problems thinking, concentrating, making decisions and remembering things
• Frequent or recurrent mentions of death, suicidal thoughts, suicide attempts, or suicide
• Unexplained physical problems, such as back pain or headaches

For many people with depression, symptoms are often severe enough to cause noticeable problems with daily activities such as work, school, social activities, or relationships with others. Other people may often feel miserable or unhappy without knowing why. Children and teens may show depression by acting irritable or cranky instead of being sad.

Promote treatment

People with depression may not realize or accept that they are depressed. They may not be aware of the signs and symptoms of depression, so they may think their feelings are normal.

Often, people are ashamed of their depression and mistakenly believe that they can overcome it with sheer willpower. But depression rarely gets better without treatment and can get worse. With the right treatment approach, the person you care about can recover.

To help you can:

• Talk to the person about what you noticed and why you are concerned  .
• Explain that depression is a medical condition,not a personal fault or weakness, and usually improves with treatment.
• Suggest seeking helpfrom a professional – a medical doctor or mental health provider such as a licensed counselor or psychologist  .
• Offer to help prepare a list of questionsto discuss at a first appointment with a doctor or mental health professional  .
• Express your willingness to helpby making appointments, attending them, and attending family therapy sessions  .

If your loved one’s illness is severe or potentially life-threatening, contact a doctor, hospital, or emergency medical services.

Identify warning signs of worsening depression

Everyone experiences depression differently. Observe your loved one. Learn how depression is affecting your family member or friend—and what to do when it gets worse.

Consider these issues:

• What are the typical signs and symptoms of depression in your relative or friend?
• What behaviors or language do you observe when depression is worse?
• What behaviors or language do you observe when he or she is doing well?
• What conditions trigger more severe episodes of depression?
• What activities help most when depression gets worse?

Worsening depression should be treated as soon as possible. Encourage your loved one to work with their doctor or mental health professional to make a plan for what to do when signs and symptoms reach a certain point. As part of this plan, your loved one may need to:

• Consult doctor forinformation about adjusting or changing medications
• See a licensed psychotherapist
• Take self-care steps like making sure you eat healthy meals, getting the appropriate amount of sleep, and being physically active .

Understand suicide risk

People with depression have a high risk of suicide. If your loved one is severely depressed, prepare yourself for the possibility of feeling suicidal at some point. Take all signs of suicidal behavior seriously and take action immediately.

Take action if necessary:

• Talk to the person about your concern. Ask him if he is thinking about attempting suicide or if he has a plan for how to do it. Having a real plan makes you more likely to attempt suicide.
• Seeking help. Contact the person’s doctor, mental health provider, or other health care professional. Let other family members or close friends know what’s going on.
• Call a suicide hotline. 
• Make sure the person is in a safe environment. If possible, remove items that could be used in a suicide attempt. For example, remove or lock up firearms, other weapons, and medications.
• If the person is in danger of self-harm or suicide,  call your local emergency number immediately.Make sure someone stays with that person at all times.

Be on the lookout for warning signs of suicide

Learn about common warning signs of suicide or suicidal thoughts and stay alert:

• Talking about suicide – for example, using phrases such as “I’m going to kill myself”, “I wish I was dead” or “I wish I hadn’t been born”
• Obtaining the means to attempt suicide, such as buying a gun or stockpiling pills
• Withdrawing from social contact and wanting to be alone
• Having mood swings, such as being emotionally high one day and deeply discouraged the next
• Death, dying, or preoccupation with violence
• Feeling trapped or hopeless about a situation
• Increased alcohol or drug use
• Changing normal routine, including eating or sleeping patterns
• Doing risky or self-destructive things, such as using drugs or driving recklessly
• Taking turns giving away belongings or taking relationships when there is no other logical explanation for why this is being done
• Saying goodbye to people as if they will never see them again
• Developing personality changes or becoming severely anxious or agitated, especially when experiencing some of the warning signs listed above

provide support

Remember that your loved one’s depression is no one’s fault. You can’t fix a person’s depression, but your support and understanding can help.

Things you can do for your loved one:

• Encourage adherence to treatment. If your relative or friend is being treated for depression, help them remember to take prescription medications and keep appointments.
• Be willing to listen. Let your loved one know that you want to understand how they feel. When the person wants to talk, listen carefully, but avoid giving advice, giving opinions, or making judgments. Just listening and understanding can be a powerful healing tool.
• Give positive reinforcement. People with depression may judge themselves harshly and find fault in everything they do. Remind your loved one of their positive qualities and how important they are to you and others.
• Offering help. Your relative or friend may not be able to perform some tasks well. Make suggestions about specific tasks you might want to do or ask if there is a specific task you could take on.
• Help create a low-stress environment. Establishing a regular routine can help a person with depression feel more in control. Offer to make a schedule for meals, medication, physical activity and sleep, and help organize household chores.
• Find helpful organizations. Some organizations offer support groups, counseling, and other resources for depression.
• If appropriate, encourage participation in spiritual practice. For many people, faith, whether involvement in an organized religious community or personal spiritual beliefs and practices, is an important element in recovery from depression.
• Make plans together. Ask your loved one to take you for a walk, watch a movie with you, or work with you on a hobby or other activity they previously enjoyed. But do not try to force the person to do something.

What you can do for yourself:

• Learn about depression. The better you understand what causes depression, how it affects people, and how it can be treated, the better you can talk to and help the person you care about.
• Take care of yourself. Supporting someone with depression is not easy. Ask for help from other relatives or friends and take steps to avoid becoming frustrated or exhausted. Find your own time for hobbies, physical activity, friends and spiritual renewal.
• Finally, be patient. Depression symptoms improve with treatment, but it may take time. Finding the best treatment may require trying more than one type of medication or treatment approach. For some people, symptoms improve quickly after starting treatment. For others it will take longer.