- Show you care. Depressed people feel isolated in their pain and hopelessness. Tell your depressed family member or friend how much you and others care about the person, want the person to feel well, and are willing to help. Listen and sympathize with the person's pain.
- Acknowlege the relationship impact. In a caring way, let the person know that depression affects you and others in the family. Your relationship, including intimacy, household responsibilities, and finances, are all adversely affected when someone is depressed.
- Be informed. Read a brochure, Family Profiles (see www.familyaware.org), or a book, or watch a video on depression and share the information with the depressed person. Stress that depression is a treatable, medical condition, like diabetes or heart disease, not a sign of weakness. Assure the person that people with depression do feel better with treatment.
- Use a symptom list. Go through the depression symptom list with the person who is depressed or have the person take a confidential evaluation that will guide him or her toward medical help. Take the symptom list to the appointment for discussion with the medical professional.
- Reach out. Find other people to help you get your loved one into treatment, especially medical and mental health professionals such as your primary care physician or a psychiatrist, psychologist, or social worker. Think of others to whom the depressed person will listen, such as family members, relatives, teachers, friends, or a member of the clergy, then enlist their help.
- Seek immediate help If at any time your depressed family member or friend talks about death or suicide or may be harmful to you or others, seek immediate help. Contact your doctor, go to your local emergency room, or call 9-1-1.
People with depression are suffering from a medical condition, not a weakness of character. It is important to recognize their limitations.
- Do not dismiss their feelings by saying things like "snap out of it" or "pull yourself together."
- Do not force someone who is depressed to socialize or take on too many activities that can result in failure and increased feelings of worthlessness.
- Do not agree with negative views. Negative thoughts are a symptom of depression. You need to continue to present a realistic picture by expressing hope that the situation will get better.
Often when you try to help someone who is depressed, your help is declined or nothing you do seems to help. You end up feeling rejected and discouraged that there is nothing more you can do.
Depressed people may reject your help because they feel they should be able to help themselves, and feel worthless when they can't. Instead, they may withdraw or start an argument in an effort to resolve their difficulties. In addition, people with depression have negative thoughts and feel so hopeless that they do not see recovery as a reality.
Fifty percent of people with bipolar disorder have a lack of insight, so they do not realize they are ill. For example, people with bipolar disorder may believe they are a "high-energy person." This makes family involvement in seeking and managing treatment even more critical.
With these difficulties in mind, what can you do if your help is turned away?
- Provide consistent support. Over time, if you consistently show support, the depressed person will see that you are resolute and may accept your help. Continue trying some of the tips discussed in this section.
- Discuss your feelings. When your help is refused, restate how much you care for the person. Let the depressed person know how you feel, gently, by stating an example of the support you have offered and how it makes you feel when it is rejected.
- Focus on behaviors. If the depressed person is reluctant to seek help, then don't try to convince the person that depression is causing the problems. Instead, talk about the depressed person's behaviors and the ways in which treatment can help. For example, after you have listened and sympathized with the depressed person's feelings, try to agree on wellness goals (e.g., consistent sleep and feeling less irritable). Then, try to assign some action steps that you can agree on to reach these goals (e.g., after two weeks, if the person does not improve, you will set up a medical evaluation).
- Agree on professional help. It is important to make sure your loved one gets the professional help he or she needs. Sometimes a primary care physician can seem less threatening, or a psychotherapist, or a couple's therapist.
Helping someone who is depressed and reluctant to seek treatment can be very trying and frustrating. As much as possible, try to enlist the aid of family members, friends, and medical professionals in this process.
Each year, 3 to 6 million Americans under the age of 18 suffer from depression. Although the symptoms of depression are the same as those for adults, children and teens may not be able to express their feelings as well or may exhibit different emotions. Look for signs of declining school performance (e.g., poor grades), frequent temper tantrums, outbursts of crying, or unexplained irritability.
Your child must receive treatment for depression. Children need to learn how to continue to develop and find ways to cope. In addition, teens suffering from depression are at risk for committing suicide, the third leading cause of death among 15 to 24 year olds.
Treatment of depression for children and teens includes psychotherapy and medication. Psychotherapy helps children and teens learn how to express their feelings and gain critical communication skills. The use of medication is an emerging field in child psychiatry, and medications have been approved for children in certain age groups.
Having a spouse with bipolar or depression can be extremely draining, especially if your spouse is refusing help. Women who are married to men often find that their husbands feel pressure to "tough out" most medical conditions—mental health related or not. This can create a seemingly impermeable barrier to getting help for a spouse. You may find this PDF on helping a Depressed Husband helpful, if you find yourself in that group.