

What not to say to a depressed person - starpilot
http://www.lifescript.com/Health/Centers/Depression/Articles/What_Not_to_Say_to_a_Depressed_Mate.aspx?p=1

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thaumaturgy
Not sure if this belongs on HN or not, so I won't promote it or flag it. But,
if it does get legs, there are a couple of points in the article I'd like to
counter. For background: my mother (and most of her family) suffers from bouts
of diagnosed clinical depression, sometimes acute and sometimes chronic, and
sometimes as severe as leading to self-harm. I'm not immune; although at an
early age I developed some mental safeguards against the worst of it, I am
actually right now quietly battling the worst case of severe depression that
I've ever had. There are a lot of articles out there written to be helpful to
those that are depressed, or those who are not but have friends or family
members that are. Most of them are terrible.

So, from the article:

> _But talking about depression easily and openly isn’t impossible._

Yes, it probably is. Unless you are _very_ close to the person, it's really
unlikely that they're going to talk to you about it, and prying is only going
to cause them to withdraw more. Because of the stigma attached to depression,
withdrawal is a common tactic, and the more that a person withdraws, the worse
their depression gets.

> _Better to say: "We’ll get through this."_

Ugh. Written by someone who's never experienced this. The withdrawal mentioned
above is caused in part by a severe feeling of being alone; there's no such
thing as "we" to someone who's truly depressed. Nor is there any way to
convince them that the future will magically improve; a depressed person
doesn't see any chance of that happening, and saying "we'll get through this"
just tells them that you aren't taking their problems as seriously as they
are.

Think of it like this: to a depressed person, you and they are in the middle
of miles and miles of desert, with no resources anywhere to be found. They are
at the bottom of a deep pit, and you are still topside. When you say, "We'll
get through this", it's the same as yelling that down from the top. To the
depressed person, you aren't both in the same situation, so while _you_ may
get through this, they have at the time no hope of it.

> _Better to say: "Do you want to talk?"_

Again, they're most likely to say, "No." Yes, they _want_ to talk, but no,
they won't talk, because they're not likely to get anything helpful from it.

> _Better to say: "This can happen to the best of us."_

Meh. This really depends on just how well the depressed person understands
depression. In my case, I'm aware that far more people struggle with it than
many believe, so I already know it can happen to the "best of us". I think
there's some danger there though in implying that the depressed person isn't
one of the best of us, which probably isn't what you intended.

> _Better to say: "There’s a lot of help out there."_

This is just horrible. It feels like you're dropping them off at someone
else's doorstep. "There's a lot of help out there" implies, "You should get
some help! Good luck!" And, meddling with their doctor or appointments is
probably not wise, either; depression is often a very private matter.

...OK, so that's the article. Now here are my suggestions:

First, be sure that you _want_ to get involved. Depressed people can be
extremely difficult to work with. They can, and often will, drag you down with
them, no matter how strong, self-confident, or happy you are. You may as well
think of depression as a force of nature in this case. If you aren't prepared
to deal with that, then don't -- you'll only be hurting yourself. _As much as
you may care for someone else, you must put your own needs first._

Second, if you're going to get involved, be prepared to get _very_ involved.
Don't half-ass it, because that won't help anyone. This doesn't necessarily
mean meddling, though; it just means, you have to commit to following through
and sticking with it. Depending on the person, this could be a week-long,
several-month-long, or life-long commitment.

Third, make an effort to understand their problems. I believe very strongly
that few people are truly depressed without cause. I think that psychological
depression is a kind of magnifier; when things start to go bad, for a
depressed person, they go _really_ bad. Is the person depressed because of
relationship problems? Is the person depressed because of financial trouble?
Personal health? A project not going well? You have to figure out what the
root cause is. If you can figure it out, you might be able to help them
address it, and _that_ is probably the most helpful thing you can do.

Fourth, distract them. One of the damnable things about depression is that it
feeds into itself quite nicely. The depressed person starts out with a
problem, they begin to become depressed by it, they start to obsess about the
problem. Many depressives are self-aware enough to know at this point that
they're becoming depressed, so then they start to become depressed that
they're depressed, and so on.

You have to take baby steps though. A depressed person is likely also having
self-image problems, so a lot of social events are off the table. Offering to
take them out to coffee or lunch can be a good first step; an outdoor physical
activity like a hike or walk is a good one, too, if they're up to it; spending
a few hours with them playing a favorite game of theirs or being otherwise
social with them in a comfortable environment can help a lot.

When you leave, they'll still be depressed, but they'll recognize that, for a
while, you made them a little happier, and that will have a huge impact on
them.

Hope this helps someone.

edit: This wasn't quite long enough. :-) The article mentions briefly that
changes in habit can be indicators of depression. I can't really emphasize
this enough. Depression usually disrupts a person's normal habits, and that's
one of the best indicators of depression. It's also a good way to help a
depressed person get back on track: you can gently guide their habits (sleep
schedule, eating, exercise) back into a normal routine. There may be
resistance to this, depending on what's going on, but it's a good thing to
look into. For example, if you suspect a friend may be suffering from
depression, and you sometimes attend a gym together and have noticed that they
haven't been there lately, call them and ask them if they'll meet you there to
spot you on some equipment. It can keep you from getting too invested in their
issues, while also helping them regain a little stability in their personal
life.

~~~
mrmiserable
I'm sorry to hear about your current struggles, fwiw from an internet
stranger, I wish you the best of luck.

I too suffer from pretty severe depression, and, like you, am going through a
particularly acute bout at the moment. I'll likely be checking myself into a
clinic at some point in the next 24 hours regardless, but I'd be really
interested in hearing more about the 'mental safeguards' you mention in your
first paragraph.

------
Tichy
I still can't agree to the premise that depression always has a biological
basis (except for the obvious that humans are biological beings). No doubt
there are some cases, but it seems to me frequently if somebody is depressed
they might have an external reason for it.

Yes, I know about the measurements of brain activity, serotonin and whatever.
That doesn't necessarily prove that people are depressed because of a
malfunction - those things could as well be a result of the depression, rather
than causing it.

------
wisty
Disclaimer - I am not an expert.

The title might as well be "What not to say to someone being burnt alive at
the stake".

Reality - 90% of the time, there's _nothing_ you can say that will make a
depressive magically get better. You can offer support ("I love you", "You're
a great friend") or suggest they get help. You shouldn't say very destructive
things (suicide jokes are a no-no). But most of the things you say will not,
in themselves, make much of a difference. Worrying about whether you are
saying the right thing is a waste of energy. It's better to address the real
problem, which is quite often their lack of activity (which magnifies their
underlying worries).

You can't help a depressive, simply by talking at them. It does help a bit to
have a friendly chat. It helps to invite them out for a meal, or some
exercise, or whatever else.

But the idea that someone else's depression is something _you_ can control
purely by talking at (not to) them is mostly rubbish. Perhaps sometimes they
do need a shoulder to cry on. Just make sure you are available when they do.

------
mannicken
Oh, I think I have a winner: "I would be better off if you killed yourself"

I wish I was making this up but one my friends told me that shortly after I
was diagnosed with severe depression. We are no longer friends.

------
GvS
I don't agree with first point. If someone told me to visit doctor I would
feel offended and I don't think taking "happy" pills solves the problem. You
should deal with source of depression not results and snapping out of it with
support of someone close is good way to do it. Other points are really good
advice though.

------
crazydiamond
> 1\. “Snap out of it.”

When I was depressed and suicidal as a kid, my dad said "Just snap out of it"
angrily. That was the best thing strangely enough. I sought competent help
which helped me become a normal person within a year. If I had had my folks
trying to help me out of it, I would never have got out of it. Too much
"support" and hand-holding can lead to a depressed person not wanting to leave
his/her depression since he gets attention, and often can make others feel
guilty for it.

------
Joakal
For Australians: <http://www.beyondblue.org.au/index.aspx?link_id=89.587>

------
jleader
Perhaps there are a lot of depressed HNers, who don't want to talk about it,
and this is their way to try to let the rest of us know about it?

------
Hisoka
I feel most people just aren't emotionally intelligent enough to know how to
talk to a depressed person. When they talk to a depressed person, part of them
is still thinking about their own lives, what they would do, prior
experiences, etc.. but they don't get it.

You really have to know what it's like in their situation. What they faced in
the past. What adversities they had to overcome. Why they have that negative
mindset. Part of the reason they're depressed is because they feel no one
understands them. They feel alone in their thoughts. Listening is key, as is
truly being present, understanding first, then responding.

But I think it really shouldn't come down to a scenario where you have to talk
to a depressed person... We're such an isolated society. Men, especially don't
like to have meaningful conversations with each other - it's taboo. We rather
talk about women, or sports. We may be surrounded by many people, have 24/7
access to social networks, but we don't feel connected. Bottling up emotions
is not a healthy thing.

Lastly, the only people in this world who really care about you are your
parents, and possibly a significant other, maybe siblings too. That's a very
lonely harsh truth. I get this feeling sometimes when I sit next to a co-
worker, or even a stranger in the train. I always think to myself: this person
has no value whatsoever to my life. And I can never have an impact on his...
He doesn't care if my startup fails or if I can't find a wife. The fact
everyone lives, and dies by themselves really does make me depressed at times.

------
guillaume_a
This is for sure an interesting link- I'm not sure why it's getting front
paged on Hacker News though. Anyone care to elaborate?

Again, I'm not discussing the quality of the link, just its relevance on HN.

~~~
itg
Whenever the issue of depression comes up, I always see at least a few
comments that have the "just snap out of it" line, which doesn't help anyone
and is a terrible thing to say.

