What not to say to a depressed person

http://www.lifescript.com/Health/Centers/Depression/Articles/What_Not_to_Say_to_a_Depressed_Mate.aspx?p=1

by starpilot • 15 years ago

24 14 15 years ago

This is for sure an interesting link- I'm not sure why it's getting front paged on Hacker News though. Anyone care to elaborate?

Again, I'm not discussing the quality of the link, just its relevance on HN.

itg• 15 years ago

Whenever the issue of depression comes up, I always see at least a few comments that have the "just snap out of it" line, which doesn't help anyone and is a terrible thing to say.

Hisoka2• 15 years ago

Entrepreneurs especially are prone to the ups and downs of life, as they have enormous stake in their startup

jleader• 15 years ago

Perhaps there are a lot of depressed HNers, who don't want to talk about it, and this is their way to try to let the rest of us know about it?

GvS• 15 years ago

I don't agree with first point. If someone told me to visit doctor I would feel offended and I don't think taking "happy" pills solves the problem. You should deal with source of depression not results and snapping out of it with support of someone close is good way to do it. Other points are really good advice though.

thaumaturgy• 15 years ago

Not sure if this belongs on HN or not, so I won't promote it or flag it. But, if it does get legs, there are a couple of points in the article I'd like to counter. For background: my mother (and most of her family) suffers from bouts of diagnosed clinical depression, sometimes acute and sometimes chronic, and sometimes as severe as leading to self-harm. I'm not immune; although at an early age I developed some mental safeguards against the worst of it, I am actually right now quietly battling the worst case of severe depression that I've ever had. There are a lot of articles out there written to be helpful to those that are depressed, or those who are not but have friends or family members that are. Most of them are terrible.

So, from the article:

> But talking about depression easily and openly isn’t impossible.

Yes, it probably is. Unless you are very close to the person, it's really unlikely that they're going to talk to you about it, and prying is only going to cause them to withdraw more. Because of the stigma attached to depression, withdrawal is a common tactic, and the more that a person withdraws, the worse their depression gets.

> Better to say: "We’ll get through this."

Ugh. Written by someone who's never experienced this. The withdrawal mentioned above is caused in part by a severe feeling of being alone; there's no such thing as "we" to someone who's truly depressed. Nor is there any way to convince them that the future will magically improve; a depressed person doesn't see any chance of that happening, and saying "we'll get through this" just tells them that you aren't taking their problems as seriously as they are.

Think of it like this: to a depressed person, you and they are in the middle of miles and miles of desert, with no resources anywhere to be found. They are at the bottom of a deep pit, and you are still topside. When you say, "We'll get through this", it's the same as yelling that down from the top. To the depressed person, you aren't both in the same situation, so while you may get through this, they have at the time no hope of it.

> Better to say: "Do you want to talk?"

Again, they're most likely to say, "No." Yes, they want to talk, but no, they won't talk, because they're not likely to get anything helpful from it.

> Better to say: "This can happen to the best of us."

Meh. This really depends on just how well the depressed person understands depression. In my case, I'm aware that far more people struggle with it than many believe, so I already know it can happen to the "best of us". I think there's some danger there though in implying that the depressed person isn't one of the best of us, which probably isn't what you intended.

> Better to say: "There’s a lot of help out there."

This is just horrible. It feels like you're dropping them off at someone else's doorstep. "There's a lot of help out there" implies, "You should get some help! Good luck!" And, meddling with their doctor or appointments is probably not wise, either; depression is often a very private matter.

...OK, so that's the article. Now here are my suggestions:

First, be sure that you want to get involved. Depressed people can be extremely difficult to work with. They can, and often will, drag you down with them, no matter how strong, self-confident, or happy you are. You may as well think of depression as a force of nature in this case. If you aren't prepared to deal with that, then don't -- you'll only be hurting yourself. As much as you may care for someone else, you must put your own needs first.

Second, if you're going to get involved, be prepared to get very involved. Don't half-ass it, because that won't help anyone. This doesn't necessarily mean meddling, though; it just means, you have to commit to following through and sticking with it. Depending on the person, this could be a week-long, several-month-long, or life-long commitment.

Third, make an effort to understand their problems. I believe very strongly that few people are truly depressed without cause. I think that psychological depression is a kind of magnifier; when things start to go bad, for a depressed person, they go really bad. Is the person depressed because of relationship problems? Is the person depressed because of financial trouble? Personal health? A project not going well? You have to figure out what the root cause is. If you can figure it out, you might be able to help them address it, and that is probably the most helpful thing you can do.

Fourth, distract them. One of the damnable things about depression is that it feeds into itself quite nicely. The depressed person starts out with a problem, they begin to become depressed by it, they start to obsess about the problem. Many depressives are self-aware enough to know at this point that they're becoming depressed, so then they start to become depressed that they're depressed, and so on.

You have to take baby steps though. A depressed person is likely also having self-image problems, so a lot of social events are off the table. Offering to take them out to coffee or lunch can be a good first step; an outdoor physical activity like a hike or walk is a good one, too, if they're up to it; spending a few hours with them playing a favorite game of theirs or being otherwise social with them in a comfortable environment can help a lot.

When you leave, they'll still be depressed, but they'll recognize that, for a while, you made them a little happier, and that will have a huge impact on them.

Hope this helps someone.

edit: This wasn't quite long enough. :-) The article mentions briefly that changes in habit can be indicators of depression. I can't really emphasize this enough. Depression usually disrupts a person's normal habits, and that's one of the best indicators of depression. It's also a good way to help a depressed person get back on track: you can gently guide their habits (sleep schedule, eating, exercise) back into a normal routine. There may be resistance to this, depending on what's going on, but it's a good thing to look into. For example, if you suspect a friend may be suffering from depression, and you sometimes attend a gym together and have noticed that they haven't been there lately, call them and ask them if they'll meet you there to spot you on some equipment. It can keep you from getting too invested in their issues, while also helping them regain a little stability in their personal life.

mrmiserable• 15 years ago

I'm sorry to hear about your current struggles, fwiw from an internet stranger, I wish you the best of luck.

I too suffer from pretty severe depression, and, like you, am going through a particularly acute bout at the moment. I'll likely be checking myself into a clinic at some point in the next 24 hours regardless, but I'd be really interested in hearing more about the 'mental safeguards' you mention in your first paragraph.

sixtofour• 15 years ago

I had a very roughly similar reaction as yours.

My impression of the article is that it was written for women who may already relate closely to the hypothetical depressed friend or family member. I wonder if my negative reaction to most of the advice was based on how uncomfortable I am, as a male and as me, with the idea of someone trying to relate that closely to me in most circumstances, never mind depression.

Tichy• 15 years ago

I still can't agree to the premise that depression always has a biological basis (except for the obvious that humans are biological beings). No doubt there are some cases, but it seems to me frequently if somebody is depressed they might have an external reason for it.

Yes, I know about the measurements of brain activity, serotonin and whatever. That doesn't necessarily prove that people are depressed because of a malfunction - those things could as well be a result of the depression, rather than causing it.

mannicken• 15 years ago

Oh, I think I have a winner: "I would be better off if you killed yourself"

I wish I was making this up but one my friends told me that shortly after I was diagnosed with severe depression. We are no longer friends.

Joakal• 15 years ago

For Australians: http://www.beyondblue.org.au/index.aspx?link_id=89.587

wisty• 15 years ago

Disclaimer - I am not an expert.

The title might as well be "What not to say to someone being burnt alive at the stake".

Reality - 90% of the time, there's nothing you can say that will make a depressive magically get better. You can offer support ("I love you", "You're a great friend") or suggest they get help. You shouldn't say very destructive things (suicide jokes are a no-no). But most of the things you say will not, in themselves, make much of a difference. Worrying about whether you are saying the right thing is a waste of energy. It's better to address the real problem, which is quite often their lack of activity (which magnifies their underlying worries).

You can't help a depressive, simply by talking at them. It does help a bit to have a friendly chat. It helps to invite them out for a meal, or some exercise, or whatever else.

But the idea that someone else's depression is something you can control purely by talking at (not to) them is mostly rubbish. Perhaps sometimes they do need a shoulder to cry on. Just make sure you are available when they do.

Hisoka2• 15 years ago

I feel most people just aren't emotionally intelligent enough to know how to talk to a depressed person. When they talk to a depressed person, part of them is still thinking about their own lives, what they would do, prior experiences, etc.. but they don't get it.

You really have to know what it's like in their situation. What they faced in the past. What adversities they had to overcome. Why they have that negative mindset. Part of the reason they're depressed is because they feel no one understands them. They feel alone in their thoughts. Listening is key, as is truly being present, understanding first, then responding.

But I think it really shouldn't come down to a scenario where you have to talk to a depressed person... We're such an isolated society. Men, especially don't like to have meaningful conversations with each other - it's taboo. We rather talk about women, or sports. We may be surrounded by many people, have 24/7 access to social networks, but we don't feel connected. Bottling up emotions is not a healthy thing.

Lastly, the only people in this world who really care about you are your parents, and possibly a significant other, maybe siblings too. That's a very lonely harsh truth. I get this feeling sometimes when I sit next to a co-worker, or even a stranger in the train. I always think to myself: this person has no value whatsoever to my life. And I can never have an impact on his... He doesn't care if my startup fails or if I can't find a wife. The fact everyone lives, and dies by themselves really does make me depressed at times.

crazydiamond• 15 years ago

> 1. “Snap out of it.”

When I was depressed and suicidal as a kid, my dad said "Just snap out of it" angrily. That was the best thing strangely enough. I sought competent help which helped me become a normal person within a year. If I had had my folks trying to help me out of it, I would never have got out of it. Too much "support" and hand-holding can lead to a depressed person not wanting to leave his/her depression since he gets attention, and often can make others feel guilty for it.

What not to say to a depressed person

Related Stories