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Depression: Supporting a family member or friendBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/depression/MH00016
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Depression: Supporting a family member or friend
Help a family member or friend dealing with depression get treatment and find resources.By Mayo Clinic staff
Helping someone with depression can be a challenge. If someone in your life has depression, you may feel helpless and wonder what to do. Learn how to offer support and understanding and how to help your loved one get the resources to cope with depression. Here's what you can do.
Learn the signs and symptoms of depression
Depression signs and symptoms vary from person to person. They can include:
- Feeling sad, down or "empty"
- Losing interest in activities that were once a source of pleasure
- Feeling hopeless, worthless or helpless
- Feeling irritable or restless
- Changes in appetite, and losing or gaining weight unintentionally
- Sleeping poorly or oversleeping
- Feeling tired or having less energy
- Having persistent feelings of guilt
- Having trouble thinking, concentrating or making decisions
- Decreased capability and performance
- Having thoughts of suicide
- Abusing alcohol or drugs
People with depression may not recognize or acknowledge that they're depressed. They may not be aware of signs and symptoms of depression, so they may think their feelings are normal.
All too often, people feel ashamed about their depression and mistakenly believe 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 approach, the person you care about can get better. In addition, here's what you can do to help.
- Talk to the person about what you've noticed and why you're concerned.
- Explain that depression is a medical condition, not a personal flaw or weakness — and that it usually gets better with treatment.
- Suggest that the person see a professional — a medical doctor or a mental health provider, such as a licensed counselor or psychologist.
- Offer to help prepare a list of questions for the person to discuss in an initial appointment with a doctor or mental health provider.
- Express your willingness to help by setting up appointments, going with the person to appointments and attending family therapy sessions.
If your loved one's illness is severe or potentially life-threatening, contact a doctor, a hospital or emergency medical services.
Identify warning signs of worsening depression
Everyone experiences depression differently. Learn how depression affects your family member or friend — and learn what to do when it gets worse. Observe your loved one. Consider these issues:
- 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?
Worsening depression needs to be treated as soon as possible. Your loved one should work with his or her doctor or mental health professional to come up with a plan for what to do when signs and symptoms reach a certain point. As part of this plan, your loved one may need to:
- Contact his or her doctor to see about adjusting or changing medications
- See a psychotherapist, such as a licensed counselor or psychologist
- Take self-care steps, such as being sure to eat healthy meals, get enough sleep and be physically active
Understand suicide risk
People with depression are at an increased risk of suicide. If your loved one is severely depressed, prepare yourself for the possibility that at some point he or she may feel suicidal. Take all signs of suicidal behavior seriously, and act immediately.
Take action if necessary:
- 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.
- Seek help. Contact the person's doctor, mental health provider or other health care professional. Let other family members or close friends know what's going on.
- Call a suicide hotline number. In the United States, you can reach the toll-free, 24-hour hot line of the National Suicide Prevention Lifeline at 800-273-8255 to talk to a trained counselor. Use that same number and press 1 to reach the Veterans Crisis Line.
- Make sure the person is in a safe environment. Eliminate things that could be used to commit suicide. For example, remove or lock up firearms, other weapons and medications.
- Call 911 or your local emergency number immediately if the person may be in danger of self-harm or suicide. Make sure someone stays with that person at all times.
Stay alert for warning signs of suicide
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 commit 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 the next
- Being preoccupied with death, dying or violence
- Feeling trapped or hopeless about a situation
- Increasing use of alcohol or drugs
- Changing 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 is no other logical explanation for why this is being done
- Saying goodbye to people as if they won't be seen again
- Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above
Remember that your loved one's depression isn't anyone's fault. You can't fix the person's depression — but your support and understanding can help.
What you can do for your loved one:
- Encourage sticking with treatment. If your friend or family member is in treatment for depression, help him or her remember to take prescribed medications and to attend scheduled appointments.
- Be willing to listen. Let your loved one know that you want to understand how he or she feels. When the person wants to talk, listen carefully, but avoid giving advice or opinions or making judgments. Just listening and being understanding can be a powerful healing tool.
- Give positive reinforcement. People with depression may judge themselves harshly and find fault with everything they do. Remind your loved one about his or her positive qualities and how much the person means to you and others.
- Offer assistance. Your friend or family member may not be able to take care of certain tasks very well. Give suggestions about specific tasks you'd be willing to do, or ask if there is a particular task that you could take on.
- Help create a low-stress environment. Creating a regular routine may help a person with depression feel more in control. Offer to make a schedule for meals, medication, exercise and sleep, and help organize household chores.
- Locate helpful organizations. A number of organizations offer support groups, counseling and other resources for depression. For example, the National Alliance on Mental Illness, employee assistance programs and many religious organizations offer help for mental health concerns.
- Encourage participation in spiritual practice. For many people, faith is an important element in recovery from depression — whether it's involvement in an organized religious community or personal spiritual beliefs and practices.
- Make plans together. 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. But don't try to force the person into doing something.
What you can do for yourself:
- Learn about depression. The better you understand what causes depression, how it affects people and how it can be treated, the better you'll be able to talk to and help the person you care about.
- Take care of yourself. Supporting someone with depression isn't easy. Ask other family members or friends to help, and take steps to prevent becoming frustrated or burned out. Find your own time for hobbies, physical activity, friends and spiritual renewal.
- Finally, be patient. Depression symptoms do improve with treatment, but it can take time. Finding the best treatment may require trying more than one type of medication or treatment approach. For some people, symptoms quickly improve after starting treatment. For others, it will take longer.
- Depressive disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed July 10, 2012.
- Helping a friend or family member with depression or bipolar disorder. Depression and Bipolar Support Alliance. http://www.dbsalliance.org/site/PageServer?pagename=about_publications_helping. Accessed July 11, 2012.
- Depression. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/depression/index.shtml. Accessed July 10, 2012.
- Get help. National Suicide Prevention Lifeline. http://www.suicidepreventionlifeline.org/GetHelp/Default.aspx. Accessed July 9, 2012.
- Men and depression. National Institutes of Mental Health. http://www.nimh.nih.gov/health/publications/men-and-depression/index.shtml. Accessed July 10, 2012.
- How family and friends can help. National Institutes of Mental Health. http://www.nimh.nih.gov/health/publications/men-and-depression/how-family-and-friends-can-help.shtml. Accessed July 10, 2012.
- Miller L, et al. Religiosity and major depression in adults at high risk: A ten-year prospective study. American Journal of Psychiatry. 2012;169:89.
- When you fear someone may take their life. American Foundation for Suicide Prevention. http://www.afsp.org/index.cfm?page_id=F2F25092-7E90-9BD4-C4658F1D2B5D19A0. Accessed March 22, 2012.
- Kennebeck S, et al. Evaluation and management of suicidal behavior in children and adolescents. http://www.uptodate.com/home/index. Accessed March 13, 2012.
- Warning signs of suicide. American Foundation for Suicide Prevention. http://www.afsp.org/index.cfm?page_id=0519ec1a-d73a-8d90-7d2e9e2456182d66. Accessed April 30, 2012.
- McDowell AK, et al. Practical suicide-risk management for the busy primary care physician. Mayo Clinic Proceedings. 2011;8:792.
- Kung S (expert opinion). Mayo Clinic, Rochester, Minn. July 23, 2012.