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How to Talk to a Depressed Person

There's a ton of information out there about how to approach a depressed person who isn't getting treatment, is in denial, or doesn't have a good support system. That's great, because those are the people who really need some intervention. Unfortunately, there's not a lot out there about how to talk to a person who knows she's depressed, acknowledges it, and is working through it in ways that probably aren't obvious from the outside perspective. If you say the same things to Depressed Person #2 that you'd say to Depressed Person #1, no matter how good your intentions are, you're probably making a huge mistake. So, as a service to all those folks who are lucky enough to not have the first-hand experience of living with this disease in themselves or someone in their everyday life, here's a few little pointers.

Life is not a Zoloft commercial. Sometimes, people do have to live like this.

Don't get me wrong - antidepressants and anti-anxiety drugs can be lifesavers. They're not, however, magic. For most people with chronic forms depression, it's not as easy as going to the doc for a pill. Most antidepressants take at least two weeks to do any good. It takes time to find the right pill for the patient. People develop tolerances to antidepressants and they can stop working. There are some nasty side effects to consider. It can take years to find a combination that works. Some forms of depression are resistant to drugs. In that case, it doesn't matter how many times one goes to the doctor; it's still going to be there.

Not all depressions are the same. What worked for the friend of a friend might not work for your current friend.

It helps to understand the different kinds of depression before assuming that a depressed person doesn't have to live the way she does.

• Clinical depression refers to any kind of depression that the patient feels is strong enough to require treatment.

• There's major depression, also called unipolar depression or major depressive disorder. That's a depression that lasts at least two weeks and has some pretty severe symptoms, including suicidal ideation.

• There's good ol' dysthymia, or minor depression. In this disease, the disease is present for a minimum of two years, usually with low-grade symptoms and occasional major depressive episodes, making it a chronic condition that doesn't have a cure. It can only be managed, and it's wiley.

• Bipolar disorder (also called manic-depression) is a particularly ugly beast where depression is paired with manic episodes. I could write books on this one, thanks to spending years with a severely bipolar best friend. It's also a chronic disease with no cure, only management techniques.

• Atypical depression has depressive feelings that come and go, making it yet another chronic disease. Panic attacks are typical of atypical.

• Psychotic depression is major depression run amok. Hallucinations, delusions, irrationality, and super-high suicide rates.

• Postpartum depression happens because of hormone fluctuations after childbirth. Some women also experience depression during pregnancy for the same reason.

• Premenstrual Dysphoric Disorder means that depressive and anxiety episodes are rooted in menstrual hormone fluctuations.

• Seasonal Affective Disorder stems from sensitivity to seasonal changes and amounts of sunlight.
  

Learn more here

You are not Dr. Phil. Any version of "How's that's workin' for ya?" is probably not going to be well-received.

If your friend has a support system in place of people who see her daily, it's not your responsibility to question how she's handling her depression. Chances are, the husband who loves her, the mother who talks to her on the phone every day, the friends who see her and talk to her daily have already been on her ass. If you don't see what's going on up front and close on a regular, real-life basis, you don't have the information necessary to decide what is working and what isn't. Insisting on telling the person that you don't think it's working will do nothing but make her feel worse about herself. Depressed people don't need outside opinions about their lack of ability in handling the situation. They do a fine job of beating themselves up for their lack of coping ability all by themselves.

Ass u me. Don't do it.

Just because the depressed person is struggling with the disease, don't assume she's not taking care of herself. Don't assume she's not taking her meds, talking to her doctor, going to therapy unless she tells you she's not. These assumptions demean the depressed person and will make you look like an ass. Case in point, right here.

It's so not about you.

If you have a friend with diabetes, would you complain to her that you sure miss eating cake with her? If you have a friend who's an alcoholic, would you bitch about not being able to have a beer with her? If you have a friend with cancer, would you whine that she can't get together with you because she lacks energy from chemo? No? Then don't complain, bitch, or whine if your depressed friend can't provide you with emotional support during a depressive episode. Doing so will 1) damage your friendship, probably beyond repair, and 2) just make the depressed person feel worse. Again, a depressed person doesn't need to be reminded of her failures. She does plenty of that on her own.

Blah Blah Blah

Yeah, everyone tells you to be there to talk. Saying "I'm here for you" doesn't do a damn bit of good. Yep, you're there. Not telling me anything I don't know. In my experience, this sentence is said out of obligation. Any attempts at talking tend to be met with blank stares and changed subjects.

Ask specifics. "How are you feeling today?" "Is the depression any better?" "Can I take you to lunch/watch the kid for a few hours/bring you dinner/drop off a latte?" "You've been on my mind." Those are all good things.

If the depressed person doesn't want to talk about it, let her be. After talking about her depression to those closest to her, doctors, therapists, etc., maybe she just wants to talk about shoes or "My Name is Earl". Maybe she'd rather have a laugh with you over Barbie's feces-munching dog, instead of talking about all things dark and ugly. Don't take it personally if she doesn't spill her depressed little guts at your feet.

Be prepared to shuffle

Life with depression is a lot like listening to music on shuffle. You can be going along with a streak of excellent songs and bam! Suddenly, your iPod's blaring I've Never Been to Me and you don't know why because you're sure you ran that program that erases shit music from you iPod, but there it is. Sometimes you can listen to it and laugh because suck is hilarious! Sometimes you hit the forward button and "Born to Run" will come on. Sometimes you hit the forward button, and it's "Achy Breaky Heart" and you just can't handle it or anything else. Sometimes people will commiserate with just how awful that song is. Sometimes they'll sing along to make you laugh. Sometimes they'll lash out because they can't understand why you can't get over it; it's just a damn song. Sometimes you just hope the battery dies and ends it all. Sometimes you can say, "This sucks. This hurts. I'm uncomfortable and afraid but I have ways to deal. They may be sloppy, imperfect ways of dealing. So be it."

1. The Globe - Big Audio Dynamite II
2. Indianapolis - Bottle Rockets
3. Gimme Stitches - Foo Fighters
4. Not Fade Away - Buddy Holly & the Crickets
5. Jimmy the Exploder - White Stripes (a song that always makes me feel better because it's about a monkey jumping on the bed and you just can't go wrong with that.)
6. Little Ghost - White Stripes
7. Family Business - Kanye West
8. Tag-Tag - Q and Not U
9. Tried to be True - Indigo Girls
10. No Child of Mine - PJ Harvey