What Not to Say to a Depressed Mate

You mean well, but it’s easy to say the wrong thing to a loved one with depression. And that may only add to their troubles. Here are the top statements to avoid and what to say instead…

Which piece of advice will most likely cheer up a clinically depressed person?

A. “Pull yourself together.”
B. “Look on the bright side.”
C. “Don’t worry. It’s nothing serious.”

The answer: None of the above. Such statements probably will make a depressed mate or friend feel worse.

That’s because depression – an illness characterized by extreme sadness, changes in sleep patterns, appetite, energy level or mental focus – is a touchy subject and difficult to talk about.

Unlike high blood pressure or other health conditions, “there’s unnecessary stigma attached to depression,” says Richard Shadick, Ph.D., director of the counseling center at Pace University in New York. “Some people still view it as a sign of weakness.”

And that makes for awkward conversations on both sides. But talking about depression easily and openly isn’t impossible. With some forethought, you can find the right words to help ease depression’s pain.

Here are 9 statements to skip, and the right way to start a dialogue.

1. “Snap out of it.”
Depression is a miserable experience; no one would choose to have it, says psychologist Shosana Bennett, Ph.D., author of Pregnant on Prozac and a postpartum depression survivor.

If depressed people “could snap out of it, [they] would’ve done so,” she says.

People with depression can’t will away the illness any more than they could asthma or diabetes. Like those other conditions, depression has a biological basis.

Imaging studies show that the parts of the brain that regulate mood, thinking, sleep and appetite function abnormally in people with depression. Key mood-regulating brain chemicals, such as serotonin, norepinephrine and dopamine, are unbalanced as well.
Better to say: “I’ve noticed you haven’t been sleeping well lately, and I’m concerned. Why don’t I set up a doctor’s appointment for you?”

Some people won’t see a doctor for depression but will agree to a visit for specific symptoms – such as insomnia, loss of appetite or constant fatigue, says Julie Totten, president and founder of Families for Depression Awareness.

2. “Just think positive.”
People with depression often perceive themselves and the world in an overly negative light. They're incapable of seeing the bright side of a situation.

“It’s like you’re wearing these foggy, distorted lenses, which filter out all positive input from the environment,” Bennett says.

When she was depressed, she literally saw the world in drab gray shades, she says.

Implying that recovery should be quick and easy may leave them feeling more discouraged than ever.

Better to say: “We’ll get through this.” This lets the depressed person know the world won’t always seem so dark and hopeless. At the same time, the statement acknowledges that recovery is a process.

Plus, “use of the word ‘we’ is very important,” Bennett says. “A [depressed] person feels all alone, so it’s crucial to reinforce the idea that you’re there for them.”

Treatment with psychotherapy and/or antidepressants can help, and with time can regain a brighter perspective.

3. “Relax. It’s no big deal.”
“Truth is, depression really hurts a person’s ability to function,” says Thomas Wise, M.D., psychiatry professor at George Washington University School of Medicine in Washington, D.C.

It can seriously disrupt home, work or school life, and wreck relationships. Left untreated, depression can even lead to suicide.

About 30%-40% of people who die by suicide have major depression, according to the National Mental Health Information Center (NMHIC).
Better to say: “Do you feel like you want to hurt yourself?”

If someone is seriously depressed, don’t be afraid to discuss suicide.

“People often worry that asking this question will plant the idea,” Totten says.

In fact, asking just lets them know you understand the seriousness of their situation, she says. It also helps you determine if there’s imminent danger.

If they answer “yes,” reassure them that such feelings are temporary. Then call the National Suicide Prevention Lifeline (800 -273-TALK or 800-273-8255) to speak with a crisis worker, who’ll help identify your next step.

4. “I know exactly how you feel.”
This statement sounds empathetic, but really isn’t. If you’ve never been clinically depressed, you can’t know what it feels like.

Even if you have, no two people experience this illness the same way.

“Nobody can know how anyone else feels unless they ask and listen carefully to the answer,” says Elizabeth Babcock, LCSW, a psychotherapist in McMurray, Pa.

Better to say: “Do you want to talk?”

But preface your question with a statement that lets the person know you want to understand, Babcock suggests. For example: “I can’t imagine how hard this must be for you.” Or, “I don’t know what it’s like to experience what you’re going through, but I’d really like to understand it better – if you want to tell me.” Or, “I’ve been depressed, too, and I can’t know what your experience is like, but I know mine was really hard.”

After you state your concern, ask questions and really listen to the answers.

5. “Have a drink. You’ll feel better.”
“Alcohol may lessen the immediate pain of depression, but over time, it only makes the hurt worse,” Wise says.

Trying to self-medicate with alcohol or other drugs can also lead to addiction and new problems. Plus, abusing alcohol or other drugs increases the suicide risk by impairing judgment and promoting impulsive behavior.
Better to say: “Want to go for a walk?”

Exercise is a proven mood-lifter, according to a 2005 University of Texas Southwestern Medical Center study. Researchers found it’s as effective as antidepressants in treating mild to moderate depression.

Walking together also helps the person stay physically healthy and socially connected.

Plus, it’s good for you too, which is important. It's easy to overlook your own health when caring for someone else.

Or pick another cardio activity your depressed loved one once enjoyed, even if they can’t get pleasure from it right now. If they’re reluctant, say it’s a favor to you. For example: “I’ve been wanting to try this yoga class. Will you come with me?”

6. “Stop feeling so sorry for yourself.”
A judgmental tone makes depressed people feel sadder.

“[They’re] already judging themselves quite harshly,” Babcock says.

If you’re critical, they’re “being abused from within and without,” he says.

Better to say: “This can happen to the best of us.” Rather than fueling misplaced self-blame, send a message that depression isn’t their fault.

This also underscores the fact that it’s a common illness striking women of every age and background. One in four U.S. women will experience serious depression at some point in her life, according to NMHIC.

7. “You have so much to be happy about.”
The criticism here is subtle. “All this statement does is guilt-trip,” Bennett says.

Depression sufferers may know intellectually that they have a good job and great family. Still, they’re unable to feel happy.

“They may end up wondering, ‘Am I just a spoiled brat?’” Bennett says.
Better to say: “You seem really down lately. Is there anything I can do?”

Acknowledging that something’s wrong is often a relief.

“This lets the depressed person know that you can see [the problem] too,” Babcock says. “It’s not something imaginary.”

You’re also reminding them that you’re there to help.

8. “Wait and see how you feel tomorrow.”
That approach might have worked for Scarlett O’Hara. But depression that sticks around for weeks or months isn’t going to suddenly disappear when the sun comes up the next day. The sooner the person seeks treatment, the faster they can start feeling better.

Better to say: “There’s a lot of help out there.”

“Instill hope that there are effective treatments available,” Shadick says.

If this is the first time they've been depressed, offer to set up an appointment with their doctor, which can confirm or rule out medical causes for the symptoms.

Because deeply depressed people may be too demoralized to speak up for themselves, go with them on the first visit or call ahead to let the doctor know your concerns, Totten advises.

You can also suggest seeing a mental health professional if the other person is open to the idea. Search online and ask people you trust for referrals to clinics, psychologists or psychiatrists.

9. “It’s all up to you now.”
Depression is very treatable, but full recovery takes time, commitment and support.

Without helping hands, patients may be more likely to feel discouraged and give up when challenges arise, as they inevitably do.

Better to say: “Can I watch the kids while you go to your appointment?”

Or offer to help however you can.

Suggesting specific ways you can make things easier helps depression sufferers pinpoint what they need. And when it's your idea, they may also feel it’s less of an imposition to lean on you.
Once you see improvement, point that out too.

“Be specific about how you see them returning to their old selves,” Bennett says. “That way, they have hard evidence that they're coming back.”

For example, you might say: “It’s nice to hear you singing in the shower again.” Or you've noticed he's eating better or flashing his beautiful smile.

Your words have tremendous power to help a loved one find help and stick with treatment. At every stage, one of the best things you can say is, “I’m on your side.”

Linda Wasmer Andrews is a freelance writer who specializes in health and psychology. She’s co-author of If Your Adolescent Has Depression or Bipolar Disorder: An Essential Resource for Parents (Oxford University Press).

Could You Be Depressed?
Depression affects 20 million people in any given year and is a serious enough disorder to compromise one's ability to function normally day to day.