Supporting the Depressed Person

Yesterday, I said that I would write something about how to best support the depressed person. I basically said what not to do. It can be difficult to be supportive when one sees the depression going on and on. But there are some things which I believe to be helpful.

First of all, there are different levels of depression. Even within the diagnosis of major depression, there are mild, moderate, and severe levels. A person with severe major depression will need more support than a person with mild major depression. And a person with milder forms of depression (dysthymic disorder, adjustment disorder, etc.) will not need the same kind of support. Persons with more severe depressions need practical as well as emotional support (such as filling out forms to be absent from work, setting up therapy sessions, making sure that the person takes their medication accurately, or driving them to therapy). Persons with milder levels of depression need more emotional support. For them, the practical support may be helpful, but it may have more of a symbolic helpfulness (showing that you care).

So, keeping in mind that it is difficult to give guidelines that would apply to all depressed persons, here are some suggestions:

First of all, support the person being in treatment. Don't criticize them being in treatment. If they are still depressed after being in treatment, that doesn't mean that they need to stop it and "buck up." It may mean, however, that some type of change is needed in their treatment strategy.

If you don't think that their current psychiatrist or therapist is helping, you can suggest that they seek a second opinion without criticizing their current doctor. Or alternatively, you could even ask if it would be okay for you to speak to their doctor and give feedback about your concern that they are not improving.

Realize that they don't want to be depressed. They most likely want desperately to feel good. They are trapped in a maze. They don't know how to get out. Communicate to them that you understand that they want to feel better and that you are there to help.

If they talk negatively, give them gentle feedback. For example, if they said "I'm just stupid," you could reply that you don't believe that and that there is no evidence for it. They may not accept your reassurance or believe you, but it is probably better to provide a gentle confrontation than to say nothing.

Help them to get out of the house. Staying at home allows them to ruminate over their negative thoughts more. They may not want to get out, but give them encouragement to do so. Make it easy. You do the footwork. Buy the tickets to the movie or make the babysitter arrangements.

Don't take their depression personally. It can be helpful to look to see if you are doing anything that is contributing to their depression. By all means. But oftentimes, you will have nothing to do with their depression. If you don't take it personally, you can be of more help because you won't be defensive. Support the person, but don't take responsibility for them getting well.

If on the other hand, your self-examination leads you to believe that you are part of the problem, then try some marital therapy sessions to work on those issues.

If the depressed person is also abusing substances of some sort, don't assume that this is their only problem. Oftentimes, there is depression behind their alcoholism or drug abuse. AA can be helpful for alcohol abuse, but it is not likely to be an effective treatment for depression.

Give the other person positive reinforcements. These can be in the form of positive verbal statements ("You did a good job cleaning house today," or "You look nice") or taking them out. Don't be surprised if they disqualify your positive statements (finding ways of saying that they are not true or don't deserve compliments).

Look for a local depression support group. Take them and or attend with them, if they wish it.

Educate yourself about depression. Very thick books have been written about depression. You don't need to know everything that is in them. But it is helpful for you to realize that depression is sometimes a severe, complex illness. It is not just a feeling. Educate yourself about some of the complexities of depression.

Help them manage their medications if necessary. Depressed people may not take their medications correctly because of a variety of reasons. They may forget to take them. They may become pessimistic about the medication helping and stop taking it. They may not believe that they can afford the medicine.

Take care of yourself. Make sure that you have a social support network, too. That way, you don't burn out, and you have something to give.

Be ready to deal with your own feelings of resentment. It can be difficult being the spouse of a depressed person. Don't feel guilty about feeling that way, but don't just stew in your resentment either. Find someone with whom you can talk through your feelings.