Depression doesn’t play favorites. Men and women, the young and the old, and even those people who seemingly have everything can suffer from the complex disorder that makes all facets of life just so hard.
While most mental illnesses are quite rare, major depression is exceedingly common. Nearly 7 percent of American adults — an estimated 16 million people in 2016 — had at least one major depressive episode, according to the National Institute of Mental Health.
As common as it is, the stigma around depression persists, which is why it matters when celebrities and other well-known people reveal their own struggles.
Earlier this year, TODAY's Carson Daly opened up about his struggle with generalized anxiety disorder. Actress Alyssa Milano recently revealed she has the same issue, and that it likely was "triggered" by her postpartum depression, following the birth of her first child in 2011. "The Good Place" star Kristen Bell has spoken out repeatedly about dealing with anxiety and depression.
"I like hearing that it helped somebody. And that will always drive me to continue to overshare," Bell told TODAY.
The chances are good that you know someone with depression. And chances are you’ve often wondered what to say — and what not to say — to your friend, colleague or family member who is battling the illness.
People who suffer depression say the feelings of despair and hopelessness may never be truly understood by those who have never experienced it. But there are ways we can help our friends and loved ones.
I’m here for you
“Don’t just say it, mean it,” said psychologist Dr. John Grohol, founder and chief executive of PsychCentral.com.
That means once you say those words, check in regularly with your friend or family member who is struggling. And offer to help them with tasks like finding a therapist, keeping appointments or any support they may need. “For a depressed individual to learn that someone is there for them is huge,” he added.
Let’s do something
People with depression can get into a state of ruminative thinking, basically replaying negative events or agonizing over how particular situations could have played out differently.
Unfortunately, rumination can lead to worsening depression. “Rumination isn’t just worrying, it’s more of a fixation on a past event or even a fixation on what someone said and what that may mean,” said psychologist Dr. Avie Rainwater of LifeCare Psychology Group in Florence, South Carolina.
While therapists help people deal with this type of negative thinking, you can help, too, if a person is willing. Doing an activity together that is both mentally and physically challenging can help potentially distract someone who is in the midst of ruminative thought patterns, said psychologist Dr. Carl Tishler, adjunct associate professor of psychiatry and psychology at The Ohio State University.
“Say, let’s go for a walk, let’s go kickboxing, let’s go to a yoga class, let’s do something together,” said Tishler. “A person could be very surprised at how good they feel after doing something with someone.”
I don’t know exactly what you’re feeling, but it has to be hard
Depression is a complex condition with genetic, biological and psychological components.
Reaffirming that you may not understand the disease, but you do recognize that it is real and often difficult to control can be beneficial for both you and your loved one.
“Acknowledging that depression sucks,” can be the start of a good conversation,” said Grohol, allowing the depressed individual to talk without fear of judgement.
Sometimes, say nothing
You can’t put a price on the power of being a good listener. “It really is OK to say nothing, to not offer advice, and to simply sit and to listen,” said Tishler. Since feelings of loneliness and isolation can often overwhelm someone with depression, your mere presence can help. “Don’t underestimate the power of shared humanity,” said New York City-based psychologist Dr. Alison Ross.
All you need is a little retail therapy:
There is nothing less helpful and potentially damaging than minimizing someone’s pain.
“People with depression don’t choose to be sad or pessimistic and saying something trite that doesn’t acknowledge the difficulty of depression is not helpful at all,” said Ross.
Remember: Clinical depression is a mood disorder best treated with a combination of medication and psychotherapy, along with lifestyle changes like exercise and stress reduction.
Don’t you want to get better?
This kind of statement implies that a depressed individual is at fault.
“Depression can be tough to treat, and no medication or treatment is one hundred percent effective all the time,” said Ross. Among many depressed patients there are already feelings they aren’t strong enough or “good enough” to fight the illness, and “piling on” with negative comments that imply they are in complete control of their well-being is destructive, adding to stigma, she said.
Oh, hey, I was depressed once
Everyone likes to talk about themselves, but occasional feelings of sadness are not the same as clinical depression.
“People want to be empathetic and immediately want to explain how they handled their own experience with something sad that happened to them, but unless that person is struggling with clinical depression they have no clue what their friend is feeling,” said Rainwater. Instead of talking about yourself, let your friend or family member talk about their own feelings.
Suck it up, there are people worse off than you
Clinical depression can lead to problems with jobs, education, and relationships.
Some research shows the persistent change in mood, behavior, and feelings — all hallmarks of depression — may also up an individual’s risk for heart disease and diabetes, among other ailments, according to the World Health Organization.
Know it can be difficult for a person in the throes of a depressive episode to “look outside” of their own situation.
Your best bet in trying to talk to someone you care about who has depression is to remember that you alone can’t “fix” them, but you may be able to lessen their feelings of loneliness and isolation, said psychologist Dr. Arthur Nezu, Distinguished University Professor of Psychology at Drexel University, Philadelphia.
This updated post was originally published in November 2015.