What You Need to Tell Family and Friends When You are Feeling Depressed

Family and friends are your immediate support system. Individuals with depression may avoid sharing their symptoms with their family or close friends due to the perceived stigma. Some don’t share their feelings to avoid being a burden on others and then there is this fear of being perceived as weak and needy. Unless you have a very critical and judgmental person who is not accepting of depression as an illness, your family and friends would appreciate your efforts to reach out and be candid about your depression. It is important that you educate your family about depression using scientifically-based information. Local chapters and websites for organizations such as the National Alliance for the Mentally Ill (NAMI) and the Depression and Bipolar Support Alliance (DBSA) have information for family members and friends regarding depression. Information about depression is also available at the National Institute for Mental Health website. You also have to advocate for yourself in how you want to be treated when going through the throes of depression. Literature on depression shows that criticism, hostility, and an attitude of emotional overinvolvement can lead to more chances of depressive symptoms returning (Hooley et al., 1986). Some pointers in this direction are listed below (Langlands et al., 2008):

• Emphasize to your support system that depression is no body’s fault but is an illness, which is treatable and has a good prognosis.
• Your family and friends need to know that there is a fine line between what constitutes a concern and encouragement and what amounts to “controlling.” Use examples to define these behaviors for your family so that they are aware when their way of supporting you may be making you feel worse.
• Share with your family and friends the traits you are hoping for them to display in their interactions with you such as being empathetic, non-judgmental, respecting your individuality, and being supportive and appreciative of your strengths while also guiding you if you need more support.
• Advise your family and friends to refrain from using critical labels such as being “weak,” “lazy,” “faking,” “selfish,” and “attention seeking.” Depression is not a character flaw as promoted by these labels.
• Educate your family about recognizing early signs of depression so that they can assist you in getting timely help and also at the same time respect your decision if you don’t want to seek help.
• Educate your family about situations when you are not comfortable discussing your symptoms and need more space.
• Emphasize that you want people to be genuinely caring and not just say all the “right things.”
• Inform your support system that when you are really feeling down, saying things such as “get over it,” “snap out of it,” “put a smile on your face,” “get your act together,” or “lighten up” are not helpful and may even backfire.
• Tell your support system that when you approach them with a problem, you may be only reaching out for a person who can listen and empathize with you and that you are not necessarily seeking a 'cure' or a 'solution' to your problems.

Depression can make it difficult for you to initiate any kind of social contact. Use the following dialogue with your friend or social support person to educate them about this pattern (Ilardi, 2009):

“I really want us to get together more often, but because of the depression, I might have trouble taking the initiative sometimes. Would you be willing to stay on me about it – to call me anytime you haven’t heard from me in a while, and to insist that we set something up?”

Adapted from the The Complete Guide to Self-Management of Depression: Practical and Proven Methods.

HARPREET S. DUGGAL, MD, FAPA

REFERENCES

Hooley, J. M., Orley, J., & Teasdale, J. D. (1986). Levels of expressed emotion and relapse in depressed patients. British Journal of Psychiatry, 148, 642-647.

Ilardi, S. (2009). The depression cure. Philadelphia, PA: Da Capo Press.

Langlands, R. L., Jorm, A. F., Kelly, C. M., & Kitchener, B. A. (2008). First aid for depression: a delphi consensus study with consumers, carers and clinicians. Journal of Affective Disorders, 105, 157-165.