The night before I entered a three-week partial hospitalization program for a major depressive episode, I invited two close friends over to my house. I explained the situation to them and asked them for their support. When they asked me how they could support me, I had no idea.  When one is in the thick of depression, it’s difficult to know what is needed and it’s certainly difficult to reach out for support.  Throughout my depressive episode, my wife had the very same question: “How can I help?” She wanted to support me, yet also didn’t know how.

Knowing how to support someone who is suffering from depression can be very challenging.  My goal for this post is to help provide ideas for those who are attempting to support someone with depression.  The support for people may look very different, particularly depending on the relationship one has with the person dealing with depression.  For that reason, I have separated  my suggestions into three categories based upon the relationship; 1) Spouse or family member, 2) Close friend, or 3) Acquaintance. While there may be some overlap amongst the three categories, there are also some significant differences.

Spouse or Family Member:  When supporting a spouse or family member, it is incredibly important to practice patience. (Note that from this point on, when I use the word, “spouse”, it is to include “or family member”).  Your spouse will most likely seem quite different in many ways while depressed compared to when they are mentally healthy. He/she may seem sad or emotionless.  He/she may not be able to do simple tasks around the house that they had normally done. In my case, I found myself sitting on the couch,  resorting to my bedroom, or following my wife around the house not knowing what I should be doing.  Practicing patience, understanding, and being empathetic will go a long way.

Offer to join your spouse for some of their appointments. My wife joined me for several appointments with my psychologist, hoping to gain some insights into what was going on with me and to learn how she might be able to support me. In addition, my wife and sister joined me for at least one of my psychiatrist appointments, particularly when I knew I was going to need their support. My wife was also at my side while at the intake meeting for the partial hospitalization program that I entered. Having her with me was hugely beneficial. She supported me morally and emotionally, as well as providing the support team with accurate answers to the questions that we had to field. Being severely depressed impacted my cognition and memory, so her support was indispensable.

Gently “push” your spouse to get exercise. I remember one bitter cold evening, my wife suggested that I go for a walk around the block. It was highly invigorating (relative to the major depression). Fresh air and exercise are both beneficial in overcoming depression. It may be nice to offer to join the person for a walk.  Understand that exercising, or even the idea of exercising, may feel like a massive chore for someone who is depressed, so there is a fine line in how much to push this piece. Consider asking him/her to walk to the store for an errand, if it’s not too far.  Asking to support with some of the chores around the house may be another way to get your spouse off of the couch or out of the bed.

Ask if there is anything you can do to support your spouse. Simply asking shows that you care and opens the door to a conversation. Do not be offended if the person is not very conversational. Engaging in conversations can be very challenging when depressed.

Provide resources for your spouse. If he/she is not yet a part of one, seek out support groups for him/her. If they are not seeing a psychologist, help him/her seek on out. Ask your spouse if it would be alright if you asked your friends or family members for a referral to a psychologist.

Close Friend:  There are several ways to support a close friend who is going through a challenging time of depression.  The first thing is to make sure to have the conversation. If you are concerned that a friend may have depression, ask the question. Let him/her know that you are concerned and worried.  It is really easy to isolate oneself when dealing with depression.  There’s a good chance that your friend, particularly in the case of males, may be masking his/her depression and may not be the one to broach the topic. Ask the question.

Ask if there is anything that you could do to support him/her. Your friend may not have an answer, but there is a chance that they do know and are able to articulate this for you. It is well worth asking.  Ask if he/she has the resources to support in their recovery. If not, offering to find resources would be a great way to help.

Reach out to your friend. Ask if he/she would mind if you check-in with him/her weekly or so. Ask him/her what the best way to reach out would be. In many cases, simply sending a text once a week or so to ask how he/she is doing is enough. Perhaps they prefer a phone call or an email. In any case, many people who are dealing with depression tend to isolate themselves and avoid friends. It’s important to take the initiative to reach out to your struggling friend.

Invite your friend out.  Again, this is a great way to prevent a friend from remaining inside and isolating him/herself.  It is not wise to drink alcohol when depressed (as alcohol is a depressant), so consider inviting your friend out for coffee, breakfast, or a lunch. Perhaps you could invite your friend to a movie.  One to one would most likely be the best scenario for any of these outings, as people who are depressed often do not want to be with a large group of people.  Consider inviting your friend to join you in an outdoor activity or a walk. This would provide fresh air and a bit of exercise. If you know a hobby or something that your friend typically would enjoy doing, offer that suggestion. I was really able to enjoy myself with a friend who invited me down to the river on a brisk winter day to take some pictures, as he knew that we both enjoy photography. He had to twist my arm gently, but this was a really positive day for me in the midst of my depression.  You may also consider having your friend over to your house to watch a movie or a favorite TV show.

If your friend is married, consider checking in with his/her spouse to see if there is any support the family may need.  Many times, when someone is ill with cancer or other serious illnesses, friends and neighbors create a rotation for bringing over a meal for the family. This rarely happens for one suffering from a mental illness.

Acquaintance: Just as with a good friend, if you’re concerned that an acquaintance may be suffering from depression, it’s worth asking the question. Be sure to ask in private and to let him/her know that you are asking because you are concerned.

Ask if there is anything that you could do to support him/her. Ask if he/she needs some resources and, if possible, offer to seek out resources for him/her.

Ask if you could reach out once in a while to support him/her. As mentioned above, a friendly text message to check-in to see how the person is doing weekly or so may be very supportive.

Encourage him/her to reach out to other trusted and loved ones.  Sometimes people resist reaching out for support.  Encouraging and supporting one in doing so could be very helpful.

In all of the cases, it is important to remember that depression is an illness, just as cancer or any other serious disease is an illness. Understand that it is not the person’s fault for being depressed, just as it is not the fault of anyone who has battled cancer, or again, any other serious illness. The person most likely does not want to be depressed and did not ask for it. He or she is not lazy, but ill.  Educate yourself on depression so that you can have a better understanding of what a person with depression may be experiencing.  Empathy and patience will go a long way! Be compassionate.  Offer support.

(Note: I feel obligated to mention that if you feel that someone is actually considering suicide, ask them the question directly. There is a false assumption held by some people that mentioning suicide will give the person an idea that they never had. This is not the case and has been shown by research. Asking the question will open up this dialogue that the person may never be able to discuss if not asked. If they actually have a plan, seek resources with the person immediately and call 911, if necessary.)

(Another Note: As always, comments to this post, or any of my other posts, are highly encouraged and would be greatly appreciated)