Discussing Depression

What do I say?

Talking about symptoms of depression with a friend

When you notice potential symptoms of Major Depressive Disorder (MDD) in a friend, it is essential to approach the conversation with empathy and care. Choose a private and comfortable setting to talk, and express your concerns gently, focusing on changes you've observed rather than making direct assumptions about their mental health. Remember, MDD is a complex and deeply personal experience, and your friend may not immediately recognize or accept their condition. For example, you might say, "I've noticed some changes lately, and I'm concerned. How have you been feeling?" This non-judgmental, caring approach can encourage your friend to open up. Additionally, open-ended questions such as “How have you been feeling?” rather than yes-or-no questions such as “Have you been feeling depressed?” give your friend the floor to speak to how they feel in their words, and better open up the conversation.

Encourage your friend to seek professional help, emphasizing that MDD is a treatable condition and they don't have to navigate it alone. Offer to assist them in finding a mental health professional or to accompany them to an appointment (more on that below), but respect their autonomy and decision-making process. You can also provide them with information from reliable sources, such as the National Alliance on Mental Illness or the American Psychiatric Association, to help them understand MDD better.

Supporting a friend with MDD is about being present and patient. Regular check-ins, engaging in activities they enjoy, and celebrating any progress (no matter how small it may seem) can be incredibly supportive. However, it's also crucial to look after your own mental well-being. If you find the process overwhelming, don't hesitate to seek support for yourself.

Be patient and understanding as they navigate their path to recovery. MDD affects everyone differently, and the journey to wellness can have ups and downs. Celebrate the small victories and be a source of positive reinforcement!

How do I respond when my friend tells me they think they are depressed?

When a friend confides in you about feeling depressed, it’s important to respond with empathy and support and to do so without judgment. Here are examples of phrases that you may consider using in this scenario:

• “I am sorry to hear that you’re feeling this way. I’m here for you and I care about you.”

• “If you want to talk more about what you’re feeling, I’m here to listen. You’re not alone in this.” 

• “You’re important to me, and your feelings matter. We’ll get through this together.”

How do I respond when my friend tells me they are suicidal?

Responding to a friend who expresses suicidal thoughts requires immediate action. Below are examples of some supportive phrases you can use in this situation.

First, open with support and compassion:

• “I’m really glad you told me how you’re feeling. It’s brave of you to share this, and I am here to support you.”

• “Thank you for sharing what you’re feeling. Please know that I’m here to listen.”

• “You’re not alone in this. I am here to be with you and help you.”

Clarify if there is confusion:

• “Are you feeling suicidal?”

• “Are you thinking about ending your life?”

Of note, contrary to popular belief, using the word “suicide” or phrases such as “are you thinking about ending your life?” do not increase the likelihood that someone will complete suicide.

Transition into helping them be safe:

• “Can we talk about how to get you feeling safe?”

• “Can we go to the hospital together? I value you as a friend and I want you around.”

As a friend, when should I call 911?

• Your friend explicitly expresses thoughts or threats of self-harm or suicide.

• Your friend engages in behavior that is immediately life-threatening or harmful to themselves or others.

• Your friend is unresponsive, unconscious, or in a state where they cannot care for themselves.

Importantly, your friend’s life is the most important thing in this scenario. It’s normal to fear that your friend will be upset with you for calling 911, but if their life is in danger, getting them to safety is the priority.

What are some symptoms of Major Depressive Disorder?

Symptoms of Major Depressive Disorder may include:

• Persistent feelings of sadness or hopelessness

• Irritability or frustration

• Loss of interest or pleasure in most or all normal activities

• Sleep disturbances such as insomnia or excessive sleeping

• Significant changes in appetite or weight

• Feelings of worthlessness or excessive guilt

• Recurrent thoughts of death, suicidal ideation, or suicide attempts

How does my friend find a provider that takes their form of insurance/payment?

• They can visit their insurance provider’s website and locate the provider finder page. This should assist them in finding care in the area that accepts their insurance.

• They can call their insurance provider to have them assist in finding a provider in their area.

• Use FindTreatment.gov.

• See “Mental Health Providers: Tips on Finding One” for more tips and suggestions.

I’m not sure if I’m ready to talk to my friend about MDD, but I want to help them. What are some things I can do?

• Spend quality time together, offering companionship without pressure.

• Encourage routine activities, motivating them to join in regular, low-stress activities such as daily walks or hobbies.

• Respect their space by understanding if they need time alone, but reminding them that you are available when they are ready.

• Share your support of mental health with them indirectly by sharing supportive messages on social media. We post letters and reminders weekly for you to share!

WHAT PEOPLE WITH MDD HAVE TO SHARE WITH YOU:

Published: March 9, 2024.

Written by Kevin Singh (Medical Student). Edited by Alexandra Lawlor (Medical Student) and Max Smith (Medical Student).

References:

1. Mayo Clinic Staff. (2023, April 5). Depression: Supporting a family member or friend. The Mayo Clinic. www.mayoclinic.org/diseases-conditions/depression/in-depth/depression/art-20045943.

2. Raypole, C., Korrell, K., Santamarina, S., Juby, B., Crooks, F., Legg, T. J. (2024, January 12). How to Help Someone with Depression. Healthline. www.healthline.com/health/how-to-help-a-depressed-friend#recognizing-symptoms.