Finding the Right Words to Say When Someone is Depressed
What you say or don't say can hurt or help
Jake (whose name is changed to protect his confidentiality) was eight years old when his father died suddenly. He described his family’s reactions and what they expected from him. You’re the man of the family, now. You’re a big boy; there’s no time for tears. Your father is in a better place.
Jake’s father’s death was rarely discussed within his immediate family. There was an assumption that you just move on and that talking about it will make things worse. Their motives may have been good, but the end result left him suffering and alone. This hardened Jake to the world and contributed to a low level of depression that lasted into adulthood.
Regardless of its causes, learning how to talk about depression — along with grief, sadness, or trauma — is essential.
Today is World Mental Health Day and a good time to examine how we can handle a loved one’s feelings of depression.
Depression can surface during tough times (like a financial setback or divorce). It can accompany grief and loss and is a component of PTSD (post-traumatic stress disorder, which is a complex response to trauma). It also may linger as dysthymia (a low-level but persistent form of mild depression) or can manifest as a more severe condition (sometimes diagnosed as major depression or bipolar disorder), fueled by genetic and biochemical triggers.
According to the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorder commonly used to diagnose psychological conditions), a diagnosis of depression must include at least five or more symptoms which should be present within a two-week period of time. Signs and symptoms can include a depressed mood, loss of interest in enjoyable activities, appetite or weight changes, sleep difficulties, agitation, fatigue, difficulty concentrating, feelings of worthlessness, excessive guilt, or suicidal thoughts.
We all encounter some degree of hardship and tragedy. The dose and intensity vary from person to person, situation to situation, but none of us remain unscathed. Transient feelings of sadness, depressed mood, and even despair are normal responses to distressing events.
When depression persists, though, it shapes our view of the world and can become entrenched. Like gazing through a cloudy, gray-tinted glass, depression colors our perceptions and thinking. Hopelessness, negativity, and feelings of worthlessness contribute to inertia and a muted response to otherwise joyful events. Many depressed people question the meaning of life — along with whether it is worth it to keep on living. It feels lousy to be depressed.
Jake’s experience with his family and their response to grief is all too common. As a practicing psychologist, I have heard my share of unhelpful and even damaging reactions to grief, loss, and depression that only make matters worse. Even if you have never suffered from depression, you can still learn how to respond when friends, family members, or even your co-workers are struggling.
What should you say — or not say? There are a few basic guidelines to consider:
1. You can never fully understand what another person is feeling.
You may have had a similar experience or think you know what they are going through; however, each person is different. When someone you love is depressed, approach them with a sense of curiosity, concern, and compassion. Learn by asking them directly what they think and feel.
2. Recognize that stigma and fear prevent people from seeking help.
No one chooses to be depressed. Yet, when depression takes hold, neuronal connections in the brain are changed. It is not their fault. Fears of being perceived as weak, ineffective, needy, crazy, or a burden on others prevent people from sharing their distress or seeking help. Most people go to a dentist when they have a toothache; it is much harder to ask for help when your sense of self is on the line.
3. Check your own judgments and beliefs.
Some children were raised to suppress or “shake off” negative emotions. There was no room for any expression of sadness or fear. You might carry these beliefs into adulthood and expect others to bounce back quickly, harboring strong opinions about when sadness is warranted. You might easily express sympathy when a friend’s loved one has died but withhold support when another friend bemoans a relationship break up two years after the fact. Depression colors their world, regardless of whether you believe it is justified or not.
4. You don’t have to “fix” someone’s depression.
Nevertheless, you can support and guide them to get the help they need. This is especially relevant when it involves a loved one. Don’t just give them the number of a crisis line. Ask what they need. Offer to stay with them if they are lonely or distraught. Tell them you will accompany them to an appointment with a licensed mental health professional.
(Note: if your child is depressed, let them know you will support them and find the help they need. This is a situation where your involvement is essential — even if they resist.)
The list below includes examples of what we should say — or not say — to a family member, co-worker, student, neighbor, or friend who seems depressed.
First, what not to say:
It’s time you get over this and move on.
Everyone has it rough.
I am tired of hearing about it. Go talk to someone else.
You don’t really have anything to complain about. Think about all the other people who have it worse.
Don’t you think you are exaggerating a bit? Aren’t you being a bit dramatic?
Just get over it.
You have always been way too sensitive. Time to toughen up a bit.
I know exactly what you are going through.
If only you exercised more, you wouldn’t be depressed.
You’re just a kid. You have nothing to worry about.
Don’t tell strangers about what you are feeling. Keep it within the family.
I had it a lot worse than you. You should feel lucky that your life is relatively easy.
Sometimes, listening to a loved one’s feelings of depression is, well… depressing. You might feel ill-equipped to provide support, burdened by your worries for them, or frustrated that nothing seems to help.
Yet, it falls on you to withhold judgment and restrain yourself from expressing comments that minimize or belittle their struggles. This is a time to find other outlets for your frustration or fears; otherwise, your statements may lead to your loved one feeling worse.
The following are some alternatives. Here is what you might say instead:
I have noticed you seem down lately. Can we talk about it?
I won’t think any differently about you if you are going through something difficult.
I am here for you no matter what.
Everyone goes through tough times. And it is normal to feel down or hopeless when bad things happen. Your feelings are understandable.
I will hang in there with you while you go through this rough time. Is it okay if I check back in a bit and see how you are doing? (Note: Don’t just tell them they can reach out to you any time. It’s a nice thought, but they most likely will not follow up.)
I know that talking about what is bothering you might be uncomfortable, but I want to listen. Please let me know when you are ready. Can I check back with you in a bit to see if you might be ready to talk later?
What you are going through (e.g., grief, trauma, loss, a relationship break-up, unemployment) is so painful. Anyone would feel bad. I know it takes time to get through something like this. Let’s think about what might make it even a little easier to get through this.
I know that sometimes when people feel depressed, they think about hurting themselves or even ending their life. Have you had thoughts like these? Can you tell me more about what you may have considered and when you have these thoughts?
In short, you want to convey your openness to learning what they are experiencing, along with your compassionate understanding that yes, depression feels lousy, but that there are tools available that can help. Your acknowledgment of their pain goes a long way.
If your loved one’s depression persists, and especially if it involves threats of self-harm, treatment with a licensed mental health professional is necessary. Offer to help them find a licensed professional or encourage them to reach out to their primary care physician.
If you suspect they might be thinking about suicide, ask them about this directly. You are not putting thoughts in their head. (See these resources about suicide prevention and advice about how to talk to someone who might be suicidal.) If they express an immediate urge to hurt themselves and cannot ensure their safety, contacting your local hospital emergency department or calling the national suicide hotline at 988 is essential.
It can be especially hard to express your concerns when a child, spouse/partner, or other close family member is involved. The fear of not saying the right thing can stop you in your tracks. Expressing your concerns might seem awkward or contrived at first. But that’s okay. What you say doesn’t have to be perfect. However, letting your loved one know that you are eager to listen, will continue to care about them no matter what, and want to help is sufficient. Your compassion and persistent faith in them provide the much-needed support to help them through this difficult time.
This article was originally posted on September 19, 2023 on Medium as part of a Wise & Well Special Report: The United States of Depression. If you or a loved one is depressed, it’s vital to talk about it. Because depression increases the risk of suicide, consider calling the confidential National Suicide Prevention Lifeline at 1–800–273-TALK (8255) for English, 1–888–628–9454 for Spanish, or call or text 988. Global support in 44 languages is available from Befrienders Worldwide.
For more of my articles about health and wellness, join me on Medium at https://medium.com/@gailpostphd
Disclaimer: Please note that my articles are for informational purposes only and are not to be taken as mental health or medical advice. If you are in need of personal guidance, please reach out to mental health professionals in your community.
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