What it looks like

Depression can happen with or without a triggering event and means we can be sad when it doesn’t make sense to be sad.
Depression can be identified in the way it affects someone’s feelings, thoughts, actions, and body. People don’t have to have every symptom to be diagnosed.

Feelings:

• Depression, sadness, sorrow, feeling down
• Apathy, numbness, lack of emotinoal response
• Unable to be cheered up
• Lack of motivation
• Guilt, low self-esteem, shame
• Anxiety, restlessness, worries, fears
• Irritability, anger, impatience
• Hopelessness, helplessness, despair

Thoughts:

• Cynical (i.e. “the world is a horrible place”, “people will always let you down”, “there is no solution to our problems”, etc.)
• Difficulty problem solving
• Self-critical, self-shaming
• Short-term memory impairments
• Difficulty concentrating
• Indecisiveness

Actions:

• Decline in school or work performance
• Social withdrawal or isolation
• Stopping hobbies or other previously enjoyed activities
• Decline in self-are (usually due to lack of energy, motivation, and/or self-esteem)
• Difficulty completing everyday tasks like laundry, doing the dishes, showering, etc.

Physical Health:

• Sleeping too much or too little
• Eating much more or much less than usual
• Lower energy than usual that cannot be attributed to another health condition
• Aches, pains, and headaches
• Unexplained weight loss or weight gain
• Loss of libido

Unhelpful responses

Well-intentioned responses can still land badly, so it’s important we’re aware of common mistakes when trying to help someone with depression.

People often misunderstand the difference between depression, grief, and sadness. The statements below might “work” for sadness, but not depression.

But why are you sad? 
Asking this once is okay, but continuing to push for a reason “why” can be unhelpful. People with depression often cannot explain or “justify” why they feel so sad. Asking why repeatedly can make people feel guilty that they are sad when they “don’t have a reason to be.”

This will pass, you just need to ride it out.
The average length of a depressive episode is 5 months, but that length of time reduces significantly with treatment. By reducing the length of an episode, we can prevent suicide and unnecessary suffering. Importantly, getting  help or treatment for a current depressive episode helps prevent future depressive episodes as well.

You have so much to be grateful for. 
This statement implies that the person should not feel sad because they have reasons to feel good. This denies the very nature of depression (i.e. being sad when it does not make sense to be sad). This can result in additional guilt and shame.

You just need to take some time for yourself.
People do not experience episodes of mental illness or depression because they were “bad at self-care”. You can do everything right in terms of self-care and still be severely depressed. We do not want to minimize the struggle of people with depression by suggesting they just need to take care of themselves more to get better.

How to help

Reach out

If you think someone might be depressed, you should take the initiative to reach out rather than assume the person will ask for help if they need it. This is because depression can cause beliefs like: “No one cares about me”, “I should be able to handle this on my own”, or “I don’t deserve help”.

Follow up consistently

Low self-esteem and the belief that people do not care about you are common with depression. When people are suffering from depression, they need reminders “more than usual” that they are thought of and cared for. Text, call, message, and drop-by regularly.

Help with practical tasks

People with depression can use all their energy just to get through the day. Offer to help with practical tasks like cleaning, groceries, cooking, homework, child care, errands, etc. Practical help can express great care, especially if you aren’t quite sure what to say.

Sitting “shiva”

Adapted from Jewish tradition, sitting shiva in this context simply means offering to be in the same physical space as someone while they are suffering. No talking is required. This could mean offering to come over and just be in the same space as you do work, read, or watch tv. The point of this is to help the person feel less alone through the presence of another person.

Find distractions

Sometimes emotions are just too overwhelming for someone to handle and the person simply needs to be distracted from their pain. Something that can be helpful is to ask the sufferer, “is there anything that has helped distract you, even a little bit, from how bad you feel?” If they can identify something, do it with them or help them get access to it. If they cannot identify anything, offer to help experiment with them and brainstorm ways they might be able to distract themselves.

Adjust your expectations

A very difficult aspect of depression can be the fact that you cannot do everything you’re normally able to do when you’re not depressed. This can further fuel intense feelings of shame, self-doubt, and self-criticism. It can be helpful for other people to give someone with depression “permission” to step back from responsibilities or commitments made when feeling well.

Be curious

If you are nervous about saying the “wrong” thing to someone with depression, a safe approach is simply to be curious about what the person is going through. Asking things like, “what was that like for you?” or “what has today been like?” or “can you tell me more about that?” communicates that you care to know what they are going through and are not making any assumptions.