A Friend Indeed: Helping Your Friend Cope with Depression

Everyone experiences emotional highs and lows - it's an inescapable fact of life. With maturity and experience, we learn to roll with the punches, to take things in stride. We learn to appreciate the good times without taking them for granted - knowing that even in bad times, as a friend of my family used to say, "This too shall pass."

True depression, however, does not work that way. It doesn't "just pass". True clinical depression is a chemical imbalance in the brain, a real upset of a person's ability to cope with what would be minor annoyances to a non-depressed person. Depression - to reinterpret a quote by Jack Nicholson's character in the movie As Good as it Gets - can make you feel evicted from your life. Activities that the depressed person once enjoyed no longer hold much appeal, and everything is sad, gray, and uninteresting.

It is estimated that 26.2 percent of adult Americans (about 1 in 4) suffer from major depression in a given year (NIMH: "The Numbers Count. Mental Illness in America"). With numbers that high, it is likely that you know at least one suffering person within your circle of friends. Though frustrating (for one thing, depression can cause your friend to withdraw from social activities, leaving you feeling abandoned or as if you've done something wrong), there are many things you can do to help your friend through this difficult time. And you can do this without missing out on your own life in the process.

Don't Blame Yourself

Like diabetes, the flu, or a bad kidney, depression is an illness beyond the control of the person suffering from it - and certainly beyond yours. In fact, many people suffer from depression for a lifetime(or its cousin, bipolar disorder, to name one), despite their best efforts to seek out treatment for their illness.

While lacking a reliable support system can hamper a depressed person's recovery, it is also true that taking your friend's depression as a burden on yourself can hamper his progress just as much. After all, how can you be helpful to your friend in need if you have not first taken care of yourself? Although it is difficult sometimes, if you refuse to feel guilt for not being "good enough" or not saying "the right things" to your friend, you will both be healthier for it. Your friend is only human - but so are you!

Offer Support without Blame

Still, many well-meaning friends and family members say things to the depressed such as:

"Pull yourself up by your bootstraps!"

"Get over it!"

"It's just the winter blues; you'll feel better in the spring." (Interestingly, suicide rates are actually higher in the spring than in the winter.)

Most people are just trying to be helpful, trying to offer a light at the end of the tunnel to a loved one who is feeling quite hopeless. But there is a fine line between being supportive and trying to take away your friend's suffering by invalidating it. Although it is tempting to offer up gems of hope and wisdom, resist the urge at all costs! When a person suffering from depression is told the above things, what she often hears instead is:

"You're not trying hard enough."

"Any normal person would be over it by now. Therefore, you are not normal."

"You're making a big deal out of nothing. You're too needy."

In other words, your friend feels as if she is being blamed for, again, a chemical imbalance ultimately out of her control. And she has probably already done a good job of blaming herself.

Instead, offering the following statements can help your friend feel safe in sharing his burden with you, if indeed he is ready to do so:

"I know you feel lonely and out of control, and I know you're scared. I'm here for you to talk to, as soon as you are ready."

"This is my first encounter with depression in a friend. Can you explain to me in more detail how it makes you feel, so I can figure out how best to be here for you?"

"I'm sorry I can't help you feel better. But is there anything I can do to help while you work through this?"

By using statements like the ones above, you can demonstrate to your friend that you are sensitive to her feelings of hopelessness and guilt, and that you want to do the very best you can to help her through those feelings. You can't take the feelings away, you can't take away her responsibility to seek help, but you can offer companionship and caring. Believe it, your friend appreciates your efforts far more than she is able to express at this time.

Understand that Recovery Takes Time and Effort

Responses to therapy and medication vary widely, so even when the depressed vigilantly seeks help, the road to recovery can be long. It is important to keep this in mind when interacting with a depressed friend. Usually he won't want your pity, but rather your understanding that although he is doing everything he can to manage his illness, how long and just how much work it will take is ultimately beyond his control. In fact, that's part of the problem with depression, and as his friend it is important that you know it. (Remember that line about being evicted from life?)

Do NOT Attempt to "Medicate" Your Friend

Concerned friends are often so eager to see their friend "snap out of"' a depression that they will attempt all manner of tactics, such as taking their buddy out for a night of heavy drinking, to "drink the sorrows away." Not only does drinking a large amount of alcohol not ease the symptoms of depression over the long-haul, but it can actually make the problem worse. In large doses, alcohol is itself a powerful depressive drug. If your friend is on prescription antidepressant medication, the addition of even a small amount of alcohol can - and often does - have a dangerous, even deadly effect. The bottom line: If your friend is depressed, find an activity other than drinking if he seems ready to venture into the world of socialization. And if your friend tells you he cannot drink because he is on antidepressant medication, BELIEVE him.

It goes without saying that all other forms of recreational drugs must not be used. Although some drugs act as intense mood-enhancers, the typical crash-and-burn effect that drug users endure after a binge may be even worse in someone already chemically imbalanced. This can lead to increased suicidal tendencies and even psychoses ("a serious mental disorder (as schizophrenia) characterized by defective or lost contact with reality often with hallucinations or delusions") (MedlinePlus.gov).

Learn the Suicide Warning Signs and Be Ready to Respond

Suicide (or attempting it) is a common symptom of severe depression. According to the National Center for Injury Prevention and Control (NCIPC), it is the 8^th leading cause of death in men. It is the 3^rd leading cause of death in people aged 15-24. That's HUGE. In other words, if your friend is talking about suicide, take it VERY seriously. It may seem like your friend is just trying to get attention - but to borrow an old cliché, "better safe than sorry". Remember that your friend is in a state of complete despair, unable to "snap out of it". You don't want ignoring the signs of suicide to be on your Top Ten List of Things to Regret.

The statistics are staggering (suicide even being in the top ten causes of death at all is staggering in itself). However, suicide can and often is curtailed by a concerned close friend or family member.

A more complete list of suicide warning signs can be found at WebMD: "Depression: Recognizing the Signs of Suicide.". To summarize, here are some pointers to keep in mind.

1. Listen carefully if your friend starts talking about death a lot, or starts saying things like how much easier it would be to no longer be alive. Conversations or statements like these should set up major red flags.

2. If your friend suddenly starts doing crazy stunts like walking into busy traffic without looking, driving excessively fast, or recklessly playing with firearms: Be very watchful. These are major signs of suicidal or even homicidal tendencies.

3. If your friend starts writing "goodbye" letters, or makes statements like, "I just want to tell you this now, in case I don't get to talk to you again," be wary. He may be trying to subtly hint that he wants to commit suicide, but may be too ashamed to say it openly.

Any of the above behaviors is reason enough to encourage your friend to get help quickly. However, if it seems that she might attempt suicide at any moment do not hesitate to call 911. When it gets that bad, her life may very well depend on you, her caring friend.

Being a Friend Indeed

Lastly, it is important to understand that your friend needs your friendship now more than ever. It is important that you not take personally that she might withdraw from socializing, or just not feel up to doing the things you used to like to do together. Don't contribute to her isolation if you can help it. Continue to invite her to your non-drinking outings. Drop by her home with special dishes she likes to eat, or with offers to help with housework, or even just for much-needed companionship.

Above all, don't chastise your friend if he doesn't want to join you for awhile. He needs time to work through the depression, and patience from his friends. Don't downplay his feelings, for to him they are real and intense. Make yourself available to him whenever you can. With luck, treatment, and patience he will come out of it, and your friendship will be even stronger than it was before.

Your friend is in need. Hey, it happens to the best of us. But if you can be there for your friend now, you just might find that the reward later outweighs the effort: You will have acquired a lifelong friend indeed.

And that, my friend, is something to be happy about.