When a Loved One is Depressed
by Bradley T. Wajda, D.O.
I would argue that loving and being loved is the greatest gift life has to offer. Loving someone- whether it’s aspouse, a child, a friend or other family members - leads us to experience both great joy in sharing life with them as well as great concern over their well-being. It is easy to express concern over their physical health and safety by reminding them to drive safely or to eat healthier. For many people, it is much more difficult to express their concern over a loved one’s psychological health and safety.
The very people we so closely identify with can be the ones we have the most difficulty talking to about mental health concerns. The most important first step is that you must overcome your fear about beginning the conversation. We don’t want problems to be present so we often ask questions in such a way as to encourage a “no” answer, e.g., “You’re not depressed are you?”
Definitely avoid asking questions that sound like you don’t really want to hear how they feel. It is absolutely necessary for you to be non-judgmental. Just because you don’t see a reason for them to be depressed doesn’t mean that they can’t be genuinely depressed. Tell that person why you are concerned. While it is not your place to make a diagnosis, we do want to get our loved one to a professional who can diagnose what is going on and treat it if necessary.
Include the signs and symptoms that you believe represent their depression (it may be helpful to review these before the conversation). Point out that depression is a common illness and not a personal weakness or character flaw. Depression is a curable illness that rarely gets better if left untreated. Many people don’t want to seek treatment because of the stigma of being labeled a “mental health” patient, but it is important to point out that there are many medical causes of depression as well.
Furthermore, the stigma of being seen as a “mental patient” is often moot because friends and co-workers have likely noticed the same depression that has you concerned for them- whereas the treatment is completely confidential. Nobody will know about the treatment- they will only see the improvement. The sooner your loved one seeks qualified treatment, the sooner they will feel better. If they complain about failed attempts at treatment before, simply remind them there are many different professionals from which to choose. They can undoubtedly find a professional they connect with or that can provide new treatment options.
“Have you thought about suicide?” - it is an uncomfortable topic but essential to talk about. Up to 15% of those with serious depression will end their lives by suicide. You can’t “put the idea in their head”- you are not that powerful. You are simply giving them permission to discuss it. If they tell you they are suicidal then get help right away- don’t argue with them or try to talk them out of it on your own. Take any mention of suicide seriously and call 911 or the Suicide Prevention Hotline at 1-800-273-8255.
The following are signs from the Suicide Prevention Hotline that may mean someone is at risk for suicide. The risk of suicide is greater if a behavior is new or has increased and if it seems related to a painful event, loss, or change:
- Talking about wanting to die or to kill themselves.
- Looking for a way to kill themselves, such as searching online or buying a gun.
- Talking about feeling hopeless or having no reason to live.
- Talking about feeling trapped or in unbearable pain.
- Talking about being a burden to others.
- Increasing the use of alcohol or drugs.
- Acting anxious or agitated; behaving recklessly.
- Sleeping too little or too much.
- Withdrawing or isolating themselves.
- Showing rage or talking about seeking revenge.
- Displaying extreme mood swings (including happiness because they have decided on a way out of their emotional pain).
Fact: 3.7% of the adult U.S. population reported having suicidal thoughts in the past year.
Be concerned about immediate safety and take steps to prevent a suicide attempt while seeking help. Remove all potential weapons and get rid of any alcohol, drugs, or medicines.
Finally, the issue of affordability of care may arise. Many people don’t seek treatment because they don’t believe they can afford it. There are many resources including county mental health services at no cost (or low cost) as well as some universities or other institutions offering programs at reduced fees. The fact is that help is available.