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Depression: Supporting a family member or friend with depression

By Mayo Clinic staff
Original Article:http://healthfinder.gov/prevention/PrintTopic.aspx?topicID=33

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Depression: Supporting a family member or friend with depression

Your support can benefit a family member or friend dealing with depression. You can help him or her get professional care, develop good self-care habits and monitor symptoms.

By Mayo Clinic staff

Depression is a medical illness that affects the mind and body. It can affect how a person feels, acts and thinks on a daily basis.

Friends and family members of a person with depression may also feel the impact of the disease. If someone in your life is depressed, you may worry about his or her well-being, or you may notice its effect on your relationship. You may feel sad or helpless about how the illness robs your loved one of enjoying life or engaging in everyday activities.

When a friend or family member experiences depression, you can help the person seek appropriate care, develop coping skills and create a low-stress environment. You can offer emotional support and compassion. And you can learn to take care of yourself and manage the impact of the disorder on your own life.

Educate yourself about depression

You can help a loved one with depression by educating yourself about the disease. Read about it. Talk to other people you know who have been treated for depression or have helped someone else cope with it. The more you understand about what causes depression, how it affects people and how it can be treated, the better equipped you will be to talk to and help a friend or family member with signs of depression.

You can begin by learning to recognize signs and symptoms of depression:

  • Loss of interest in normal daily activities
  • Feeling sad or down
  • Feeling hopeless
  • Crying spells for no apparent reason
  • Problems sleeping or oversleeping
  • Trouble focusing or concentrating
  • Difficulty making decisions
  • Unintentional weight gain or loss
  • Irritability
  • Restlessness
  • Being easily annoyed
  • Feeling fatigued or weak
  • Feeling worthless
  • Loss of interest in sex
  • Thoughts of suicide or suicidal behavior
  • Unexplained physical problems, such as back pain or headaches

Encourage prompt treatment

People with depression may not recognize or acknowledge that they're depressed. They may not be aware of signs and symptoms of depression, they may be embarrassed about their illness, or they may feel too hopeless to address the issue. They may also think that how they feel and think is normal and not the result of illness.

Therefore, you may help a person recognize the illness and seek treatment:

  • Talk to the person about what you have observed and why you are concerned.
  • Suggest that the person see a mental health provider or his or her primary care physician.
  • Explain that depression is a medical condition that is usually treated successfully.
  • Explain that some signs and symptoms associated with depression could be caused by other medical conditions that should be ruled out.
  • Offer to make an initial appointment.
  • Help prepare a list of questions to discuss with a physician or therapist.
  • Offer to attend initial appointments.
  • Express your willingness to attend family therapy.

If your loved one's illness is debilitating or life-threatening, you may need to intervene by contacting a doctor, hospital or emergency medical services.

Create a wellness guide

Everyone experiences depression differently. Not everyone will demonstrate all signs and symptoms, and changes in signs or symptoms may indicate a worsening of depression. You can help your family member or friend by learning how depression affects him or her. You may learn this by simply observing, or if the person is comfortable talking about depression, you may want to ask questions to help you understand.

Answers to the following questions can provide you with a guide for understanding how well he or she is doing:

  • What are the typical signs and symptoms of depression in your family member or friend?
  • What behaviors or language do you observe when depression is worse?
  • What behaviors or language do you observe when he or she is doing well?
  • What circumstances trigger episodes of more severe depression?
  • What activities are most helpful when depression worsens?

Provide support

You can provide support and encouragement in a number of ways.

  • Listen. Let your family member or friend know that you want to understand how he or she feels and that you're willing to listen. Because of the depression, your loved one may not have the energy or inclination to discuss his or her symptoms. So when he or she is interested in talking, listen carefully but avoid giving advice or opinions — responses that may discourage further conversation. Never disparage feelings your friend or family member expresses.
  • Give positive reinforcement. Depression can make people feel worthless. They may judge themselves harshly and find fault with everything about themselves, from their appearance to their job performance to their thoughts and feelings. You can remind your loved one about his or her positive qualities and how much he or she means to you and others.
  • Encourage consistent disease management. If your friend or family member is in treatment for depression, help him or her remember to take prescribed medications and to attend therapy appointments.
  • Help create a low-stress environment. A regular routine and an organized environment can minimize stress and help a person with depression feel more in control. You can help a family member or friend make a schedule for meals, medication, exercise, sleep and household chores. You might also help create a system to organize things that can easily become cluttered or chaotic, such as bills, laundry, homework or work files.
  • Offer help. Your friend or family member may not be able to take care of certain tasks very well. Give suggestions about specific tasks you would be willing to do, such as balancing a checkbook, making a grocery list or mowing the lawn. Or ask if there is a particular task that you could take on.
  • Make plans together. Depression steals away motivation, energy and interest. Ask your loved one to join you on a walk, see a movie with you, or work with you on a hobby or other activity he or she previously enjoyed. Don't try to force him or her into doing something.

Understand suicide risk

People with depression are at an increased risk of committing suicide. If you believe that a friend or family member is suicidal, you should:

  • Talk to the person about your concern. Ask if he or she has been thinking about committing suicide or has a plan for how to commit suicide. Having an actual plan indicates a higher likelihood of attempting suicide.
  • Call 911 or your local emergency medical number, a suicide crisis hotline, or the person's therapist.
  • Don't leave the person alone.

You can prepare yourself for the possibility that a friend or family member may at some time feel suicidal. If the person with depression lives in your home, you can make it a safer place — or at least a less likely place to attempt suicide. Either remove or lock up firearms, other weapons and medications.

You should also stay alert for common warning signs of suicide:

  • Talking about suicide, including making such statements as "I'm going to kill myself," "I wish I were dead" or "I wish I hadn't been born"
  • Securing the means to commit suicide, such as getting a gun or stockpiling pills
  • Withdrawing from social contact and wanting to be left alone
  • Dramatic mood swings, such as being emotionally high one day and deeply discouraged the next
  • Being preoccupied with death, dying or violence
  • Feeling trapped or hopeless about a situation
  • Increased use of alcohol or drugs
  • Changing normal routine, including eating or sleeping patterns
  • Engaging in risky or self-destructive behavior, such as using drugs or driving recklessly
  • Giving away belongings or getting affairs in order
  • Saying goodbye to people as if they won't be seen again
  • Developing personality changes, such as becoming very outgoing after being shy

Take care of yourself

Supporting someone with depression isn't easy. You may find yourself stressed, and you may even begin to think that things won't improve. It can be even more difficult if you have others to care for as well.

Share your feelings with a caregivers' support group or discuss the situation with a therapist, relative or confidante. See your doctor if you develop any problems that you think require medical attention.

And finally, remind yourself that with appropriate treatment, most people with depression do improve.

MH00016

May 30, 2008

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