No matter where you live or what demographic you find yourself in there’s a good chance that someone you know is living with depression. Statistics show that 16.2 million Americans are currently living with depression in the United States. It is estimated that up to 15% of the world population will find themselves in a major depressive episode at one time in their lives.
Despite how common depression is in the United States population there is still a ridiculous level of stigma, misunderstanding, and well-meaning but flawed beliefs about those living with a depressive disorder.
What is a Major Depressive Disorder
Some believe that depression is defined as being REALLY sad about one thing or another. It can last longer than “normal” or be more severe than just being upset about something. However, a depressive episode goes much deeper than just being sad. In fact, the chemicals in our brains become so disrupted that even though a person going through depression may want very much to be “happy” again their bodies are unable to create the chemical components of happiness for any extended period of time.
According to the DSM-5, which clinicians use to diagnose an individual with depression, there are a number of criteria that must be met for a person to be diagnosed with clinical depression. An individual must exhibit five or more of the following symptoms for a period of two weeks or longer for a depressive disorder to be considered.
- Depressed mood most of the day, and a depressed mood nearly every day.
- Markedly diminished interest or pleasure in all, or almost all, activities during the day.
- Significant weight loss without dieting or weight gain. A decrease or increase in appetite nearly every day.
- A slowing of thought or diminished level of movement nearly every day. ( must be observable by others and not just subjective feelings of restlessness or being slowed down.)
- Fatigue or loss of energy nearly every day.
- Feelings of inappropriate guilt or worthlessness nearly every day.
- Diminished ability to think or concentrate, increased indecisiveness, nearly every day.
- Recurrent thoughts of death, suicidal ideation without a specific plan, or a plan to commit suicide.
Coping with A Major Depressive Disorder
If you were to put all of the people in the United States living with depression in a room you may be surprised to find out all of the vastly different ways that people are choosing to cope with this disorder. For some personalities, it is better to tackle a depressive episode head-on. For others, it is all they can do to hide away and let it pass on its own time. Some use self-harm to deal with their emotions. Others work out heavily, read books, use drugs and alcohol, or attend therapy. The ways that individuals cope with a depressive episode can be as vastly different as the individuals themselves.
There is no right or wrong way to cope with depression because each individual needs to find a way that works for their own personality. What works for one may be stressful or just plain awful for others. On the other hand, another person’s method may bore the first person to tears. There are ways of coping that are healthier than others, but in the end, it is important to keep in mind that depression aside everyone has their own ways and means of dealing with things.
What Not to Say to Someone Living with Depression
When a friend is going through a depressive episode there are many things that we may want to say to help them feel better. Unfortunately, some things may end up doing more harm than good even though we may mean well. If you have not personally dealt with depression it can be difficult to truly understand what your friend is experiencing, and that’s ok. However, to expect that individual to react as someone with their neurotransmitters in order is not getting to the root of the problem, and won’t be very helpful.
- Everyone gets a little sad sometimes
– yes, it’s true that everyone feels sad sometimes. However, it is important to remember that depression is a change in the neurotransmitters in an individual’s brain. It’s far more than “a little sad” and isn’t something they are often able to stop on their own. A depressed mood is a symptom of depression but is far from the only one that your friend is currently experiencing.
- You can’t just dwell on the past.
– It’s very true that it is unhealthy to dwell on the past. However, for those going through a depressive episode, it is common to get stuck in a loop of thinking to try to right a past wrong or punish themselves for a past deed. This is sometimes called Rumination or Repetitive Thinking. In depression, this repetitive thinking can take over our default mode network (DMN) which helps to control passive thought.
- You just need to try a little harder to be happy.
– This is a very dismissive statement when we understand that the individual may be trying very hard to be happy. Unfortunately, the brain is unable to produce the chemicals that allow endorphins to be released causing this to happen. It is not a conscious decision that can be made but rather a chemical process that is not working properly.
- You just need to grow up and face your problems.
– Many who are in a depressive episode find themselves there because they are unable to emotionally reconcile some event in the past. In reality, these individuals may go over their problems over and over to try to find a way to deal with them properly to no avail.
- It’s a beautiful day! What could you possibly be sad about?
– As mentioned above, when an individual is in a depressive state they are unable to feel happiness from things that would normally bring feelings of joy. It’s not that they are choosing to be happy but rather than they don’t currently have the capacity to be.
- Just stop thinking about whatever is bothering you so much!
–When a particularly traumatic event occurs it can cause the brain to get a bit stuck. There are studies showing that trauma can even physically alter the amygdala, hippocampus, and prefrontal cortex of the brain in some cases. With this in mind, it is easier to see how some individuals are physically unable to “just get over” things.
- You would feel better if you got out and exercised more.
– It is true that exercise can increase endorphins and give a temporary “happy” response to an individual. However, when the neurotransmitters in our brain that cause the release of endorphins are off-balance the positive effect of exercise is not one that is sustainable. It also does not get to the root of the problem but rather temporarily alters the symptoms.
- You’re so much stronger than this.
– When an individual is perceived as mentally “strong” it can be even more of a shock when they start to exhibit signs of depression and anxiety. However, quite often the fact that they are showing signs of depression may mean that they have been suffering for some time in silence and now their symptoms have become undeniable. It is also important to remember that depression is not a sign of weakness but a mental health disorder that can happen to anyone at any time.
- You just need to smile more often.
– An individual may be suffering through a depressive episode without anyone knowing because they greet each day with a smile on their face. A person’s outward appearance is not always a valid indicator of their mental condition. Some studies have shown that smiling more can increase happiness but it is important to remember that this is not a treatment for depression. It can also be dangerous to try to encourage your friend to mask their true feelings with a fake smile.
- You were fine the other day.
– As mentioned above, a person’s outward appearance is not always a good indicator of their mental state. One day may be easier than the next and often this happens in an unpredictable way for those in a major depressive episode. Many living with depression will also mask their symptoms in an attempt to not make their friends worry or bring attention to the fact that an issue is present.
- It’s time to move on and accept things.
– It is important to understand that everyone on this planet is an individual. What may seem like a minor offense to one person may be a strong insult to the next. What one person can easily accept and forget may be highly damaging to others. Just because you may not find something upsetting does not mean that your friend with depression’s feelings aren’t valid.
- You need to stop feeling sorry for yourself.
– Many individuals who are dealing with depression are not feeling sorry for themselves but rather holding themselves accountable for events in the past. It can be common for the mind to place unrealistic guilt, shame, and anger on an event when a person is in a depressive episode. More than feeling sorry for themselves it becomes a way of punishing themselves for past transgressions.
- Things aren’t even that bad/ It’s all in your head.
– As mentioned above, it is important to remember that we are all individuals. What may not seem like a big deal may be a huge one to someone else and that is ok. It is also important to keep in mind that as an outside party we may not have all of the details necessary to understand why an event is bothersome to others.
- If you got out and did more you would feel better.
– A person with depression may not be in a place where they want to be in social situations. One of the major symptoms of depression is fatigue. It may be exhausting to get out and do more. It is important to let your friend deal with things in their own way and in their own time. They may not be able to get out and statements like this can cause guilt and sadness because of decreased energy or interest in things they once loved.
- You don’t even look depressed!
– As mentioned above, a person’s outward appearance is not always a reliable indicator of their mental state. Many individuals in popular culture who have committed suicide in recent years showed no outward signs of depression. The same may be true for your friends. They may not want others to worry about them, they may not want to show weakness, or they may be in denial themselves about an issue being present.
- You’re so selfish. You never think of anyone but yourself.
– The symptoms of depression can be so overwhelming that a person can’t help but think about their decreased interest in things, decreased energy to do things, and other worrisome side effects. It is important to remember that the individual is not purposefully being vain but rather may very well be trying to come to terms with what is going on and find a way out of it.
- I was sad the other day. I totally understand how you are feeling.
– Depression is not the same as sadness. While you may mean well it is best to not compare depression to an episode of being somber or down. Depression can occur without warning and even in the absence of a traumatic event. It can be a life-altering condition and one that is overwhelming because your brain is doing one thing while you may be trying to do something completely different.
- Just stop whining about everything. Nobody cares!
– Do I even need to say why this one is wrong? I would hope not, but sadly this can be a common response from some in the “suck it up buttercup” camp. An individual who is dealing with depression is not whining when they vent or try to discuss their issue with you but rather trying to reconcile what is going on in their head.
- Just cheer up! It can’t be that hard.
– If it were as easy as just cheering up and getting over a depressive episode we wouldn’t have nearly the high number of individuals with depression in the United States as we currently do. Unfortunately, because depression is caused by a chemical imbalance it can be beyond the individual’s control or ability to change on their own.
- Other people have it a lot worse than you do.
– This may be true. This is one I would tell myself frequently. However, this is unfair to the individual dealing with depression. No matter how small it may seem to others or even to themselves it is important to remember that everyone’s feelings are valid.
How to Help a Friend Who is Dealing with Depression
Even though I have mental illness myself I understand how awkward it can be to find the right thing to say or the right thing to do when a friend is dealing with depression. However, there are a few great go-to options that you can try to show your friend that you care about them and while you may not fully understand what they are going through you still want them to know that you are there for them.
- I’m here if you need someone to talk to.
– A great way to be there for a friend with depression is to offer a non-judgemental ear. Offering to just be present and listen to what they have to say can often be enough. Only offer advice if asked for, but often unsolicited advice is best left for another time. Just having someone they feel safe getting their feelings out to can be helpful to many with depression.
- Is there anything I can do to help?
– Many times individuals in a depressive episode fall behind on chores, requirements, and self-care. This is not a sign of laziness but rather a side effect of the fatigue and lack of interest that can be caused by depression. Asking your friend with depression in a nonjudgemental way if they would like help with cleaning, running an errand, or other tasks can be a great way to help. Often they want these things completed but are physically or mentally unable to do them for themselves.
- It’s ok to feel the way you do.
– Take time to reassure your friend with depression that the way they are feeling does not make them weak, broken, or defective in any way. Rather, it is just an imbalance in the brain that may or may not have been caused by a traumatic event. Many with depression deal with negative self-talk and poor self-image. Having a friendly reminder that they are loved and that you will be there to help them through can be helpful.
If you or someone you know is suicidal it is important to reach out for help. You can contact the National Suicide Hotline at 1-800-223-8255.
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