Depression: Supporting a family member or friend

Helping someone with depression can be a challenge. If someone you know has depression, you may feel helpless and wonder what to do. Learn how to support and understand them and help them get the resources they need.

The more you learn about depression, how it affects people and how it can be treated, the better you'll be able help someone else.

Here's what you can do.

Depression symptoms vary from person to person. They can include:

• Feelings of sadness, tearfulness, emptiness or hopelessness.
• Angry outbursts, irritability or frustration, even over small matters.
• Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports.
• Sleeping too little or too much.
• Tiredness and lack of energy, so even small tasks take extra effort.
• Reduced appetite and weight loss or increased appetite and weight gain.
• Physical problems that can't be explained, such as back pain or headaches.
• Anxiety, restlessness or nervousness.
• Slowed thinking, speaking or body movements.
• Feelings of worthlessness or guilt, focusing on past failures, or blaming yourself for things that aren't your responsibility.
• Trouble thinking, concentrating, making decisions and remembering things.
• Frequent or repeated mention of not wanting to live, suicidal thoughts, suicide attempts or suicide.

For many people with depression, symptoms can affect daily activities at work or school. Depression also can affect social activities and relationships with others. Other people may feel generally miserable or unhappy without knowing why. Children and teens may show depression by being cranky rather than sad.

People with depression may not know or admit that they're depressed. They may not be aware of the symptoms of depression, so they may think their feelings are normal.

People often feel ashamed about their depression, mistakenly believing they should be able to overcome it with willpower alone. But depression seldom gets better without treatment and may get worse. With the right treatment, it can get better.

Here's what you can do to help:

• Talk to the person about what you've seen and why you're worried about it.
• Explain that depression is a health condition — not a personal flaw or weakness — and it usually gets better with treatment.
• Suggest seeking help from a professional. A health care provider is a good place to start. You also could see a mental health provider, such as a licensed counselor or psychologist.
• Offer to help prepare a list of questions to discuss in the first appointment with a health care provider or mental health provider.
• Express your willingness to help by setting up appointments, going along to them and attending family therapy sessions.

If a person's depression is severe or potentially life-threatening, contact a health care provider, a mental health provider or emergency medical services.

People may experience depression in different ways. Learn how depression affects a person by watching them. Learn what to do when it gets worse.

Consider these issues:

• What are the typical signs of depression?
• What behaviors or language do you see when depression is worse?
• What behaviors or language do you see when this person is doing well?
• What triggers bouts of more severe depression?
• What activities help most when depression worsens?

Worsening depression needs to be treated as soon as possible. Urge a person with depression to work with a health care provider or mental health provider to create a plan for what to do when symptoms reach a certain point, including whom to contact. In some cases, the provider may need to adjust or change medicines or recommend additional treatments.

People with depression are at an increased risk of suicide. If a person is severely depressed, they may feel suicidal at some point. Take all signs of suicidal behavior seriously and act immediately.

Take action if needed:

• Tell the person why you're worried. Ask if they're thinking about suicide or have a plan for how to do it. Having a plan means it's more likely they'll attempt suicide.
• Seek help. Contact the person's health care provider, mental health provider or another health care professional. Let other family members or close friends know what's going on.
• Contact a suicide hotline. Ask for advice and what resources are in your area. Or urge the person at risk to contact a hotline for counseling.
  • In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline. It's available 24 hours a day, every day. Or use the Lifeline Chat. Services are free and private.
  • U.S. veterans or service members who are in crisis can call 988 and then press "1" for the Veterans Crisis Line. Or text 838255. Or chat online.
  • The Suicide & Crisis Lifeline in the U.S. has a Spanish-language phone line at 1-888-628-9454 (toll-free).
• Make sure the person is safe. If possible, get rid of things that could be used to attempt suicide. For example, remove or lock up firearms, other weapons and medicines.
• Call 911 or your local emergency number right away if a person could harm themselves or attempt suicide. Make sure someone stays with the person at all times.

Learn and stay alert for common warning signs of suicide or suicidal thoughts:

• Talking about suicide — for example, making statements such as "I'm going to kill myself," "I wish I were dead" or "I wish I hadn't been born."
• Getting the means to attempt suicide, such as buying a gun or stockpiling pills.
• Withdrawing from social contact and wanting to be left alone.
• Having mood swings, such as being emotionally high one day and deeply discouraged and irritable the next.
• Being lost in thought about death, dying or violence.
• Feeling trapped or hopeless about a situation.
• Increasing the use of alcohol or drugs.
• Changing the normal routine, including eating or sleeping patterns.
• Doing risky or self-destructive things, such as using drugs or driving recklessly.
• Giving away belongings or getting affairs in order when there's no reason to do this.
• Saying goodbye to people as if they won't be seen again.
• Having personality changes or being severely anxious or upset, particularly with some of the warning signs above.

Remember that depression isn't anyone's fault. You can't fix someone's depression, but your support and understanding can help.

You can:

• Urge the person to stay with treatment. If someone is in treatment for depression, help them remember to take prescriptions and keep appointments.
• Be willing to listen. Let them know that you want to learn how they feel. When they want to talk, listen carefully. But don't give advice or opinions and don't judge them. Just listening and being understanding can be powerful healing tools.
• Give positive reinforcement. People with depression may judge themselves harshly and find fault with everything they do. Remind them about their positive qualities and how much they mean to you and others.
• Offer help. A person may not be able to take care of certain tasks well. Suggest specific tasks you'd be willing to do. Also, ask if you can take on a particular task.
• Help make their life less stressful. Creating a regular routine may help a person with depression feel more in control. Offer to make a schedule for meals, medicine, physical activity, social support and sleep, and help organize household chores.
• Find helpful organizations. Many organizations offer support groups, counseling and other services for depression. For example, the National Alliance on Mental Illness, as well as employee assistance programs and many faith-based organizations, offer help for mental health concerns.
• Urge them to take an active part in their faith, if faith is a part of their life. For many people, faith is an important part of recovery from depression — whether it's taking part in an organized religious community or personal spiritual beliefs and practices.
• Urge the person to take self-care steps. That includes eating healthy meals, getting the right amount of sleep and being physically active.
• Make plans together. Ask the person to join you on a walk, see a movie with you, or work with you on a hobby or other activity they enjoyed before. But don't try to force them into doing something.

To keep from burning out:

• Ask for help. Caring for someone with depression isn't easy. Ask other relatives or friends to help. Tell them what you need.
• Take steps to stay healthy. Find time for yourself. Do what you enjoy, stay physically active, check in with friends and renew your spirit.
• Be patient. Depression symptoms improve with treatment, but it can take time. Finding the best treatment may require trying more than one type of medicine or treatment approach. For some people, symptoms quickly improve after starting treatment. For others, it will take longer.