How to talk with someone who has depression

It’s world mental health day so I wanted to write about my experience with depression and share my thoughts on how you might want to speak with a friend of yours who is going through poor mental health.

I feel hugely grateful that I haven’t had a major depressive episode in over three years but prior to that I had a nine year stint where I was grappling with it constantly. Depression can be completely bewildering for the person suffering, but it can also be deeply confusing for the person’s friends and family. Once I had finally acknowledged that I was suffering from depression and started cautiously telling people, I noticed that many people didn’t know what to say in response. Partly, I think it’s due to a fear of saying the wrong thing but in some cases it may also be down to a misunderstanding about what depression actually entails. I heard on the grapevine that a few people had said something along the lines of "what’s Nick got to feel depressed about?" Or "he’s always super outgoing and his life seems great, I’m sure he’ll be better soon". This is just to fundamentally misconstrue what this disease is all about.?

My life WAS great in so many ways around the time I was feeling most depressed - however having depression was like wearing a pair of sunglasses which made me see the world around me in the bleakest, most miserable colours possible. Yes, the depression was initially triggered, I think, by a stressful legal dispute I was having with an ex employer but it soon became an all-encompassing filter which negatively affected every area of my life. Plus I think I’d had depressive tendencies from quite a young age but had got very adept at masking them with a shiny, happy veneer of a character that I could effortlessly slip into when out in social situations.

So here are some of the key points to bear in mind when trying to help someone in your life who has depression:

Do:

? Tell the person who is suffering that it’s OK that they can’t cope. Let them know you realise that depression is incredibly widespread (300 million people suffer from it worldwide, according to the WHO) and that it’s normal for human beings to go through periods of their lives where they feel like they are buckling. They are not alone, and there is help out there for them. I remember when my aunt said this to me when we were sat in a cafe in London together, with tears streaming down my face. As ridiculous at it sounds, it was the first time since the depression took hold of me that I’d properly appreciated that it wasn’t just me who was so uniquely hopeless as to be unable to cope. I think those words from her marked the beginning of a long journey of me trying to be kinder to myself, rather than beating myself up for every single failing, no matter how big or small. That is a journey that continues to this day and I have certainly made significant progress on that front in recent years.

? Be compassionate and understanding. Even if you haven’t been through depression yourself, and can’t imagine exactly what it’s like, try to be sympathetic and withhold any judgment. That may sound glaringly obvious but in a climate where the stigma and misunderstanding surrounding depression have still not disappeared, it’s worth repeating. Tell them you love them and want to be there for them. Remember that in many cases there will be a strong sense of shame attached to people suffering from depression which may inhibit someone from being really candid about the depths of their torment. They may feel they have no right to burden you with their problems and want to spare you from having to empathise with them. When I was at my lowest ebb I remember feeling that I was an awful person and so there didn’t seem like there was much to talk about with concerned friends! Plus I didn’t think any of them would really understand what depression was like if they hadn’t experienced it personally so again it was a waste of time speaking about it. (I still think it must be incredibly hard to imagine what depression feels like if you’ve never had it, but hopefully with the increased amount of publicity that mental health issues are receiving, people can appreciate the severity of depression even if it’s never affected them personally).?

? Be there for them. Let the person know that you want to be there for them while they go through this incredibly challenging phase. What that means in real terms is that you will check in with them regularly, understand that they probably aren’t going to be able to be a great friend to you while they are feeling so low but let them know that you are thinking of them and that you love them. I withdrew from wanting to see friends because I convinced myself that if they saw me in my diminished, miserable state that they wouldn’t want to be friends with me and because the pressure of trying to play the part of the ‘normal’, upbeat person I’d been previously was just beyond me at that point. I also, misguidedly, felt so self-indulgent having ‘issues’ and didn’t think it was fair to dump those on others. A loving, kind text message can mean such a huge amount when you’re depressed. Encourage other mutual friends / relatives to be in contact with the person suffering, without broadcasting details of what the person is going through (it’s not your story to tell, but you may need to give a flavour to help people understand the gravity of the situation). My wife Julie now says that she wished she’d been quicker to tell my friends and family that I was depressed after I started going downhill. Even though I would have been mortified at the time to think people were having to work out a plan to help me, shining a light on my depression certainly would have helped me to start fighting the sense of shame and guilt that comes from bottling these things up.

? When talking to a depressed person, do a lot of listening. When someone admits to you that they are feeling low, there can sometimes be a temptation to want to ‘rescue’ them. Totally understandable and that instinct comes from a very good place, but it can lead to you trying to impose solutions on them that may work for you but simply aren’t the right fit for them. Focus instead on really hearing what the person is going through. The act of being heard / verbalising what’s going on internally can be incredibly powerful for the sufferer of depression so try not to allow your own experiences / history to dominate proceedings. Instead, ask them what they would find helpful from you. Also, try not to be too obviously shocked if the contents of their minds, once revealed, show themselves to be pretty gruesome. The person suffering needs to know they can open up to you without feeling like you’re going to recoil. It’s important to remember that, certainly for me, there was a big gap between thoughts and actions - ie at various points I was thinking about suicide multiple times per day, but have never been close to going through with it. That said, you must of course notify the appropriate authorities if you think there is a genuine chance this person might be in danger of hurting themselves or others.

? Encourage them to seek professional help. You most likely aren’t a trained psychotherapist and so it will be impossible for you to provide the therapeutic attention that people with serious depression could really benefit from. However you can offer to support them by researching potential resources available and saying, for example, you’d be happy to accompany them to appointments etc if they feel that would be useful.

? Encourage them to make lifestyle changes that can help to combat depression. Clearly you can’t force another person to do something, but you certainly can lead by example. Encourage your friend or family member to lead a healthier, mood-boosting lifestyle by doing it yourself: maintain a positive outlook, eat better, avoid alcohol and drugs, exercise, and lean on others for support. Invite your friend to join you in uplifting activities, like going to a funny movie or having dinner at a favourite restaurant. On the flipside, be conscious that if you’re with someone who is depressed then their self discipline may be much reduced from its normal levels and so if you’re getting trashed then they may feel compelled to join in, even if they know that ultimately it will make them feel much worse the next day. Finally, I don’t know about you but I feel significantly happier when I unplug myself from the carnival of horrors that is the news cycle in 2024. Ignorance can indeed be bliss!

Don’t:

? Don’t be surprised if someone who is going through a very tough time acts like everything is fine when actually they’re really struggling. Depression can turn you into a world-class liar who can fool yourself and everyone around you into thinking you’re OK when you’re not. I suppose that’s partly because if you have managed to drag yourself out to see a friend then it’s a relief to have a night off from wading through the sewer of your depressed mind and to talk about anything other than how you really are feeling. For me, having my friends view me as someone who was no longer the same old carefree fun guy they had previously known was also very daunting and not a mental transition I was feeling brave enough to undertake when feeling depressed. I guess the idea that one day I would return to being my shiny old self was a big hope for me, and that would be harder to achieve somehow if my friends saw the state I was in at that point - almost like opening Pandora’s box. Totally illogical of course but hey, that’s depression, the ultimate head-spinning mindf*ck.

? Don’t take it personally if your depressed friend gets angry with you or doesn’t seem receptive to your help. When I was most depressed, I didn't want people to see the state I was in. So I’d cancel on friends, ignore phone calls and messages and do my utmost to disappear from view. But I’d also get really angry with some friends / colleagues / relatives who I perceived had let me down in some way. Anger is a very common side effect of depression and it’s inevitably those closest to you who bear the brunt unfortunately. ?If you really want to help your friend, you need to stay close to them even when they seem to be shying away from you or actively trying to drive you away.

? Don’t suggest they “snap out of it” or “pull themselves together”. Luckily I don’t think anyone ever said this to me. I would have really wanted to punch them if they had. So for those who haven’t quite grasped this, or think that depression is another snowflake millennial affliction like avocado on toast - depression isn’t the same as being in a grump or a sulk. It’s a medical condition. If someone breaks their leg, should they just ‘pull themselves together’? Right. Believe me, the person feeling depressed would like nothing more than to click their fingers and feel happy again. But it’s never that simple and it can be a very long, lonely road to recovery or even to just coping with the new normal of a life that still carries the fingerprints of depression on it.?

? Don’t say “Wow, you seem so outgoing / popular etc, who would have guessed you’d be depressed?” Depression doesn’t discriminate between people who have been fortunate in life and those who haven’t. When you learn that people as talented and loved as Brad Pitt, Lewis Hamilton, Reese Witherspoon, Owen Wilson, Freddie Flintoff, Stephen Fry, Channing Tatum, Britney Spears, J.K. Rowling, Michael Phelps, Gwyneth Paltrow, Lady Gaga, Anne Hathaway and Cara Delevingne have all suffered from depression at various points in their lives, it makes you realise that how ‘great’ someone’s life might superficially seem has little bearing on their mental health.?

? Don’t have unrealistic expectations. It can be frustrating to watch a depressed friend or family member struggle, especially if progress is slow or stalled. Having patience is important. Even with optimal treatment, recovery from depression can take a long time. Even after I spent 10 weeks doing therapy five days per week at a centre in London, I still had numerous relapses of varying degrees of severity. Managing depression is a process you have to work at every day. There are very few shortcuts.?