Thursday, July 19, 2012

Depressed Friends: What NOT to Say

According to the CDC, 1 in 10 adults in the US report being depressed. There is a good chance that someone you know has suffered from depression at least once. So what do you do when your friend tells you they're depressed? There are many ways that you can support a friend in need. However, there are some things that shouldn't be said nor done, no matter how good your intentions are.

As someone who has suffered from depression, here are a few things that people have said or done which only made things worse:

"Can't you just try to be happy?"
If you could cure depression just by making an effort to be happy, antidepressants wouldn't need to be prescribed. I've lost count of how many times I've had to fake a smile to get friends off my back. It didn't make me feel any better. In fact, I felt worse knowing that I had to pretend to be happy in front of people I thought I could be myself around. Granted, I most likely wasn't depressed when I met them, but that shouldn't keep them from being supportive and understanding during one of the worst times in my life. If you have a friend who is depressed, please do them a favor and don't pressure them to be happier.

"If you really wanted to die, you'd be dead already."
This one is a little more situation specific. Not all people suffering from depression are suicidal, but many of them are. Even if your friend has never talked about or attempted suicide in the past, you should never dismiss any sort of suicidal ideation. Suicide ideation is a term that describes the presence of suicidal thoughts, and sometimes even a formulated plan, but not necessarily an attempted or completed suicide. When my friend was texting me to talk about what I was going through, I admitted to her that I felt like I wanted to die. She then told me, "No you don't. If you wanted to die, you'd be dead already." Short of telling me to do it, there is nothing worse that she could have said. I couldn't trust her anymore. Even her girlfriend was appalled by it. If you know someone who is considering suicide, no matter how serious he or she may be, take it seriously. It could be the difference between life and death.

"You shouldn't take pills. That crap doesn't work."
Regardless of your thoughts on the efficacy of antidepressants, if you know someone who takes them, let it be. I get sick of hearing people complain about how we've become a Prozac nation, completely dependent on medication to make us feel better. I've noticed that these people also tend to think of depression as a made up disorder. Depression is not just a label for being really, really sad. Most antidepressants have one key function in common: they restore balance in the brain. The neurotransmitters serotonin, dopamine, and norepinephrine all impact mood regulation. However, when there isn't enough of one or more of them, it causes a chemical imbalance that can cause depression.

There are different classes of antidepressants. SSRIs, or selective serotonin reuptake inhibitors, work to increase the amount of serotonin in the brain. There's this little space between neurons called the synapse. Neurotransmitters pass through the synapse to get to the next cell. When they pass through too fast, the brain can't really benefit from them. So SSRIs work to stop the serotonin from passing through too fast, and it results in improved mood. There are also SNRIs, which work on serotonin and norepinephrine. NDRIs, such as Wellbutrin, are also prescribed. They inhibit the reuptake of norepinephrine and dopamine. When an SSRI failed me the last time, my psychiatrist put me on Wellbutrin and it worked great. Not all antidepressants are the same. What works depends on the person taking them. So before you decide to tell your friend he doesn't need medication, try to understand how and why they work.

In addition, here are just a few things you shouldn't do if your friend is depressed.

  • Force them to do something or go somewhere they don't want to. Even if you think they need to get out, they need to be willing to do so. Just be there for support when they want or need it.
  • Act like you're the victim in this situation. One of the biggest problems I had when I was at my worst was alienating my friends. I skipped classes I had with them, stayed behind when they went out for dinner, and didn't make any effort to see them. A couple of my friends told me how much it hurt them, and how it wasn't fair for them to have to deal with that. I understand that it sucked, but being made to feel even worse than I did was not good for me.
  • Make yourself unavailable. Your friend may not come to you often or even at all for support, but it's important that they know you're there. Make it clear that you're available during this painful time in their life. Don't try to hide from them in an attempt to avoid dealing with their disorder. You may not understand it, but you should still be supportive. 

What do you wish people wouldn't say or do to people struggling with depression? Leave a comment or email me at I'd love to hear from you!

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