What to Say to Someone Who's Depressed, According to Mental Health Experts
Even before the coronavirus crisis, depression was one of the most common mental health disorders in the world. And now, months into the pandemic, it’s on the rise. Recent research found that “depression symptoms prevalence” in the U.S. was more than three times higher than it was pre-pandemic. In other words, the number of American adults experiencing depression has more than tripled, so, it’s quite likely that you know at least one person living with depression — whether you're aware of it or not.
Depression — also called clinical depression — is a mood disorder that causes distressing symptoms that affects how you feel, think, and handle daily activities such as sleeping and eating, according to the National Institutes of Mental Health (NIMH). This is different than feeling low or down for a short period of time, which people often describe as "feeling depressed" or being someone "who's depressed". For the sake of this article, we're talking about and using those phrases to refer to people who are clinically depressed.
Anyway, just because depression increasingly more commonplace, doesn’t mean it’s any easier to talk about (thanks to stigma, cultural taboos, and lack of education). Let’s face it: Knowing what to say to someone who's depressed — be it a family member, friend, significant other — can be daunting. So, how can you support your loved ones in need? And what are the right and wrong things to say to someone who has depression? Mental health experts answer those questions, sharing exactly what to say to someone who is sad, suffering from clinical depression, and more. (Related: The Stigma Around Psychiatric Medication Is Forcing People to Suffer In Silence)
Why Checking In Is So Damn Important
While the past months have been particularly isolating (due in large part to social distancing and other necessary COVID-19 precautions), odds are they’ve been even more so for those with depression. That’s because loneliness is "one of the most common experiences of those who are depressed," says Forest Talley, Ph.D., a clinical psychologist and founder of Invictus Psychological Services in Folsom, CA. "This is frequently experienced as a sense of isolation and neglect. Most of those who are depressed find this both painful and understandable; their sense of self-worth has been so battered that they readily conclude, 'No one wants to be near me, and I don't blame them, why should they care?'"
But "'they'" (read: you) should show these people who may be depressed that you do care. Simply letting a loved one know that you’re there for them and that you’ll do anything to get them the necessary help, "provides a measure of hope that they desperately need," explains board-certified psychiatrist Charles Herrick, M.D., chair of Psychiatry at Danbury, New Milford, and Norwalk Hospitals in Connecticut.
That said, they might not respond right away with open arms and a banner that reads, "gee, thanks for giving me hope." Rather, you might encounter resistance (a defense mechanism). By simply checking in on them, you may alter one of their distorted thoughts (i.e. that no one cares about them or that they're not worthy of love and support) which, in turn, might help them to be more open to discussing their feelings.
"What the depressed person doesn’t realize is that they have unwittingly pushed away the very people who could be of help," says Talley. "When a friend or family member checks in on the depressed individual, it acts as an antidote to these distorted views of neglect and lack of worth. It provides a counterpoint to the flood of insecurities and self-loathing the depressed person is otherwise constantly experiencing."
"How they respond or react is based on that person and where they are in their lives — supporting them and being patient is going to be really important throughout this process," adds Nina Westbrook, L.M.F.T.
What’s more, by checking in and opening up a dialogue, you’re also helping to de-stigmatize mental health."The more we can talk about depression in the same way that we talk about other concerns in the lives of people we care about (i.e. family, work, school), the less stigmatizing it is and the less people will feel some sense of shame or guilt about why they're struggling," says clinical psychologist Kevin Gilliland, Psy.D, executive director of Innovation360 in Dallas, TX.
"Don't worry too much about asking all the right questions or having the right phrase about how to help them," says Gilliland. "What people really want to know is that they're not alone and that somebody cares."
Yes, it’s that simple. But, hey, you’re human and slip-ups happen. Maybe you started to sound a little like a lecturing parent. Or perhaps you started offering unsolicited and unhelpful advice (i.e. "have you tried meditating lately?"). In that case, "just stop the conversation, acknowledge it, and apologize," says Gilliland, who even suggests laughing about the whole situation (if it feels right). "You don't have to be perfect; you just have to care and be willing to be present and that is hard enough. But it's powerful medicine."
It’s Not Just What You Say, But How You Say It
Sometimes delivery is everything. "People know when things are not genuine; we can feel it," says Westbrook. She emphasizes coming from an open-minded, open-hearted place, which will help ensure that even if you fumble words, the person close to you will feel loved and valued.
And try to see them in person (even if six feet apart). "The terrible part about COVID-19 is that what may have been necessary to manage a virus [social distancing] is horrendous for humans," says Gilliland. "The single best thing for humans and our mood is being in relationships with other humans, and that's face-to-face doing things together, and having conversations that help us think about life differently — even just to forget about the pressures of life."
If you can't see them in person, he recommends a video call over a call or text. "Zoom is better than texting or emailing; I think sometimes it's better than a normal phone call," says Gilliland. (Related: How to Deal with Loneliness If You're Self-Isolated During the Coronavirus Outbreak)
That being said, the do’s and don’ts of what to say to someone who's depressed are the same whether IRL or over the internet.
What to Say to Someone Who's Depressed
Show care and concern.
Try saying: "I wanted to drop by because I'm concerned. You seem depressed [or 'sad,' 'preoccupied,' etc.]. Is there anything I can do to help?'" The exact word — be it the big D or "not yourself" — is not incredibly important, says Talley. What matters is that you’re taking a direct approach (more on this later) and expressing concern and care, he explains.
Offer to talk or spend time together.
While there's no one answer for 'what to do say to someone who is depressed', it’s important to make sure that they know you are there for them, be it to talk or to just hang out.
You can also try to get them out of the house for a bit — as long as coronavirus-friendly protocols (i.e. social distancing, mask-wearing) are still possible. Suggest going for a walk together or grabbing a cup of coffee. "Depression often robs people of the desire to engage in activities that they had found rewarding in the past, so getting your depressed friend to re-engage is very helpful," says Talley. (Related: How My Lifelong Anxiety Has Actually Helped Me Deal with the Coronavirus Panic)
Be their #1 fan (but don't overdo it).
Now's your time to show them why they're so valued and loved — without going overboard. "It’s often encouraging to explicitly tell your friend or loved one that you are a big fan of theirs, and although they’re having a tough time seeing beyond the dark curtain created by depression, you can see where they’ll eventually push through and be free from their current doubts, sadness, or grief," says Talley.
Can’t find the right words to say? Remember that "sometimes actions speak louder than words," says cognitive neuroscientist Caroline Leaf, Ph.D. Drop off dinner, swing by with some flowers, send some snail mail, and "just show them that you are around if they need you," says Leaf.
Simply ask how they're doing.
Yes, the answer might very well be "terrible," but the experts encourage inviting a conversation by simply (and genuinely) asking how your loved one is doing. Allow them to open up and really listen. Keyword: listen. "Think before you respond," says Leaf. "Take at least 30-90 seconds to listen to what they’re saying because this is how long it takes the brain to process information. This way you do not react impassively."
"When in doubt just listen — don't speak and never advise," says Dr. Herrick. Obviously, you don't want to be totally silent. While being a shoulder for a friend in need is an excellent way to be empathetic, try also saying things such as "I hear you." If you've dealt with a mental health challenge before, you can also use this time to empathize and commiserate. Think: "I know how much this sucks; I've been here, too."
…and if you’re concerned for their safety, say something.
Sometimes — particularly when it comes to safety — you just have to be direct. "If you are concerned about your depressed friend or loved one's safety, just ask," urges Talley. "Explicitly ask if they have thought, or are thinking, about hurting themselves or killing themselves. No, this will not cause someone to consider committing suicide who had otherwise never given it a thought. But it might cause someone who is thinking of suicide to take a different path."
And while sensitivity is essential throughout these types of conversations, it’s especially important when touching upon topics such as self-harm and suicide. This is a great time to emphasize how much you’re here for them and want to help them feel better. (Related: What Everyone Needs to Know About the Rising U.S. Suicide Rates)
Remember: Suicidality is just another symptom of depression — although, yes, much weightier than say a decreased sense of self-worth. "And while it strikes most people as an odd thought or even an unwanted thought, sometimes depression can get so bad that we just don't see a life worth living," says Gilliland. "People are afraid that [asking] is going to give someone a [suicidal] idea. I promise you; you're not going to give them an idea — you may actually save their life."
What Not to Say to Someone Who Is Depressed
Don't jump into problem-solving.
"If the depressed person wishes to talk about what is on his/her/their mind then listen," says Talley. "Don't offer solutions unless this is requested. Of course, it is fine to say something like 'Do you mind if I suggest something?' but avoid making it a problem-solving seminar."
Leaf agrees. "Avoid turning the conversation toward you or any advice you have. Be present, listen to what they have to say, and stay focused on their experience unless they specifically turn to you for advice."
And if they do ask for some insight, you can talk about how finding a therapist is a monumental step in recovery (and maybe even crack a lighthearted joke about how you're not a therapist yourself). Remind them that there are experts that have a multitude of tools to help them feel better. (Related: Accessible and Supportive Mental Health Resources for Black Womxn)
Don't place blame.
"Blaming is never going to be the answer," says Westbrook. "Try removing the issue from the person — discussing depression in terms of it being its own entity outside of who this person is, rather than [saying or inferring] they're 'a depressed person.'"
Talley says if you're thinking that this is an obvious one, you should know that it happens more often than you'd think — and it's usually inadvertent. "Unintentionally, this sort of blaming can come through when people focus on problem-solving, which often involves correcting some perceived deficiency in the depressed individual."
For example, telling someone to "focus on the positive" — a problem-solving statement — can infer that the depression exists because the person is focusing on the negative. You'd never want to unintentionally suggest that the depression is their fault...when, of course, it's not.
Avoid toxic positivity.
"When someone you love is depressed, avoid overly positive statements such as, ‘everything will work out in the end’ or ‘be grateful for what you do have,’” says Leaf. "These can invalidate the other person's experiences and make them feel guilty or shameful for how they feel or the fact that they cannot be happy." This is a form of gaslighting. (Related: Toxic Positivity Might Be Bringing You Down—Here's What It Is and How to Stop It)
Never Say "You Shouldn't Feel That Way.”
Again, this can be considered gaslighting and is simply not helpful. "Remember, their depression is not the same as the clothes they wear. If you want to offer advice over things your friend/loved one intentionally chooses, then give them fashion advice, a nutritional discovery, or your latest/greatest stock pick. But don't tell them they should not be depressed," says Talley.
If you’re having a particularly hard time being empathetic, then take the time to find some resources and read up on depression online (think: more mental health stories from trusted websites, National Institutes of Health, and personal essays written by people with depression) and equip yourself before having a heart to heart with someone who is suffering through depression.
In the End, Remember Your Goal
Westbrook reminds you of this very important note: "The goal is to get them back to being them," she explains. "When they're depressed, [it's as if] they're no longer who they are; they're not doing the things they love, they're not spending time with their loved ones. We want to [help] remove the depression so they can get back to who they are." Enter this conversation from a place of genuine love and compassion, educate yourself as much as possible, and be consistent with check in's. Even if you're met with resistance, they need you more than ever right now.