Depression is a difficult topic to talk about, but it is even more difficult to live with. I used to guess how it could feel to suffer from depression, but it was not until the moment I experienced it. Then I realised how scarily strong and powerful the human mind is.
I am sure you have experienced sad moments in your life. Maybe a close relative passing away, a broken heart, big failures, etc. And I am sure you have already read some texts about things you learn while being depressed. But this article is not meant for people who are feeling sad or depressed. This is not an article about how depression made me stronger; about how I learned a million things about myself, about how I became aware of my strengths and weaknesses, etc. No. This is an article about how bad we are at giving advice or support to people dealing with mental illnesses.
As a disclaimer, I want to say that this is my personal opinion and experience. In the same way, there is not only one type of cancer or one type of infection, but there are also many people coping with depression. In fact, a recent study carried out in thirty European countries estimated that 27% of the total adult population have experienced or are experiencing some kind of mental disorder, so chances are that you might have to deal with a similar situation. However, I think the five lessons I learned are general enough to be worth sharing.
1. Depression starts far before being evident
This is quite obvious but we tend to miss the first signs of mental illness when they appear. This is dangerous since tackling the problem early could avoid a lot of suffering. I personally think the problem is that “How are you?” is a question that we are automatically used to answer by “Fine, and you?”. People are generally afraid/ashamed to show that not everything is fine at a given moment. The reasons for this could be diverse: feeling that you would bother the other person, not willing to tell a really complicated story or even not knowing exactly why you are not ok so… what should I say?
Nowadays people are paradoxically more and less connected than ever. I can text my friends in the United States and get an answer straight away, but is that real connection? Mobility and time issues made us a generation that tends to talk more by texting on their telephone rather than face to face. How can you spot that somebody is having a hard time by just reading his texts?
What to do:
I think that the way to go is to ask specific and meaningful questions. For example, your friend just left his (let’s assume for the rest of the article that this friend is a man) city and moved to another one. If you ask him “How is the move going?” he will automatically say something in the lines of: “Fine, thanks! It is a little bit tiring but also exciting!”. Why not making him know that you understand that this can be a difficult moment even if he feels fine at the moment? “How is the move going? I guess leaving [Insert city] behind is difficult but I am sure you will do great! How are you feeling about this?”. Give him room to talk about it and follow his status. Ask him two weeks later how he feels about it; let him know that you are there to talk about it and to help him find solutions. Advise him to discuss it with a psychologist so he can help him to organise his feelings. I cannot stress enough how important it is to encourage a person to visit a therapist as soon as the struggle becomes too heavy (my only regret is waiting so long before talking to somebody). Approaching somebody and encouraging him to seek therapy can be tricky. You cannot force the person to seek therapy, it has to come from him (with a little bit of help). This effort takes great strength and courage to acknowledge it. It is a timely decision so let the idea sink in for a little bit if needed to.
Something else that could work is asking multiple times. First times the person might have the feeling that you ask just to be polite, but after insisting through the time he might feel more open to share his feelings with you.
2. I do not need to hear that I am wrong
Depression comes in a lot of flavours. Each person has a wide array of reasons to feel that way and even if you think that some of the reasons are not valid at all, please, do not say it, I do not need to hear that.
I won’t share what triggered my situation, but I remember really well that day in January when I decided to seek help. My situation had worsened in the few weeks prior to that moment. I even reached the point of lacking any will power to do things that I used to like in the past. I went to the doctor so I could get an appointment with the psychologist and I just could not talk. How can I explain how I feel when even I do not know how I feel? Where do I start? I started having a chaotic and not disorganised monologue about everything while I could not stop crying. My doctor had her eyes wide open; I guess she did not expect that. The monologue quickly moved to how bad I was feeling about myself, how useless I thought I was, how lonely I was feeling, how many mistakes I made. I felt like a failure. And the last thing I needed to hear is what my doctor said: “Well, but here I see that you are working in this really good University and you achieved this and this, so there is no reason to feel that way”.
Nobody stops feeling that way just because somebody says so. I am even aware that what I say is not completely true, but I cannot stop feeling that way. The only thing that this kind of advice will do is make the person feeling guilty or stupid for feeling that way. Also, he is not telling you that he feels that way so you tell him the opposite, he is just sharing his feelings with you. If you try to prove him wrong you will never succeed, you will make him feel guilty, and feel that you are complimenting him because “is what people do in these situations”.
What to do:
I feel your desire to tell your friend that he is wrong and he is stupid for feeling that way. You might be right, but I can guarantee you that he might be quite aware of it already. Instead, you should try to understand why he feels that way and say: “I understand why you feel this way, and it’s okay to not feel okay. I do not agree with you at all and I wish you could see yourself the same way I see you. But I know that is the situation that makes you feel that way. I know you and I know you are not all these things but I am here to support you while we manage to make you feel better.”
3. I do not need you to tell me that I could do more
Depression is destructive. It makes you miss yourself, the person who you used to be and makes you wonder if you will ever be that person again. It makes you avoid contact with other people or social situations even if you are feeling lonely. It usually comes with sleeping problems, anxiety, lack of appetite and even vomiting. All these elements combined make you not only mentally but also physically weak. In my case, I used to struggle to get up in the mornings for work. Some days I spent two or even three hours in bed, wide awake but wondering: “Why should I go to work? What is the point? Why I am even here?” Then, when people were proposing to go have a drink or dinner I was just throwing excuses so I could avoid going. And it was not that I did not want to live a normal life or to get better, it was just that, those days, I could not cope with myself. Those days the last thing you want to hear is: “If you stay at home, you will never get better”, or “you are not really making an effort to get better”.
What to do:
Be understanding. Your friend is doing the best he can to get better. But sometimes the best he can do is get up in the morning and go to work with his super sad face. Some other days the best he can do is go to the cinema with another friend, do some exercise or even have a night out. Each day is different and you will need to understand it and not force him to do something he feels he cannot do.
Try to reinforce “good habits” by asking him how he felt about it or if he thinks that doing that activity made him feel better. Let him talk about it in a positive way so he can himself understand that is a small step towards improvement. Tell him how happy you are to hear that he managed to find the strength to do it. Tell him that he is brave for getting up in the morning.
What if your friend does not want to do anything? He opened to you so he might be more comfortable around you alone. You can propose to do something alone with yourself, but be always specific “Do you want to meet around this time to do THIS?”. If you expect initiative from his part you will wait forever. Sometimes going out with a group of people might seem a super big/unachievable task that you might not be ready to face. Break it down to two plans: “Why don’t we have dinner together and then we see if we join the others or not?” so it is easier for your friend to handle the situation and he will have a way to escape without feeling bad.
4. Sometimes you will not be able to help me, and you need to be ok with that
The previous point leads me to this one. Some days you just won’t be able to help at all and you need to be ok with that. Helping somebody with depression is tiring, difficult and might even make you feel really bad, so make sure you are ready and in a strong position to face it.
Your friend might be having three “more or less ok days” then a super terrible day. Do not panic, I guarantee you that he feels like he is not achieving anything; he is never going to get well, etc. But please, do not panic and try to stay positive or the situation will be worse.
What to do:
Tell him that you are there for him whenever he feels like talking. Tell him that getting better is something with small ups and terrible downs but you believe in him and you are proud of his efforts to get better even if that specific day has been horrible. If you are close enough, offer to come over to his place with dinner but be ready for: not today. Tomorrow, it will get better.
Also, by this point I hope your friend has already seen a psychologist and/or psychiatrist, ask him what would he/she say.
As a personal note, you might also be willing to share the task with a mutual friend (if he/she is also aware of the situation!) to make sure that YOU also have support for when you can just cope with the situation.
5. I am still here for you
As I said before, the feeling of being useless is quite common. Your friend can see that he is in a lot of need but he can feel like he is failing you as a friend. Personally, one of the problems of sleeping only 3 hours per night was that I had 21h per day to torture myself and turn in circles about my own situation. I was also afraid of sharing it because I felt that people will feel pity for me, or will stop telling me things from their life because I had “bigger problems to deal with”.
What to do:
For me, it was important to feel that I could also be there for my friends. Share your problems and day to day situations with him. It was a refreshing moment to think about something else at least for a few minutes. Also, it gave me the opportunity to build a stronger connection with some people, gaining the feeling of I am necessary for this person because she shared this with me and I want to help her.
In general, coping with a friend with depression is not easy at all. Whatever terminology you want to use, it is a fight or a journey that your friend might never leave behind. It is a constant work in progress that needs support from mental health professionals and friends. However, it is something that will teach you much more than you expect. And that knowledge will definitely make you stronger.