When people are grieving they go through five distinct stages. Although originally developed to help people suffering from a terminal illness and for coping with bereavement the "five stages of grief" have since been developed for many life situations that involve personal loss.
For a number of factors it’s increasing every year. One current reason is that many more people than usual are facing uncertainty due to the COVID-19 worldwide pandemic.
Self-isolation and social distancing because of the virus has only caused to make a depressed person’s sense of isolation worse. Then there is the anxiety – a condition often linked with depression – of increased financial worries.
If someone you know has depression and they turn to you there are several things you can do to help them. There are also several things you definitely shouldn’t do.
However the first thing to realize is that while you can be a valuable support, anyone suffering from depression really needs to seek professional help as soon as possible. They will need to see a therapist who is experienced in treating depression.
Depression left on its own is most often a progressive condition. That means it’s going to get worse.
It is thought to be caused by several factors. An expert can guide someone suffering as to what might be the likely cause of their depression.
These types include clinical depression, situational depression, seasonal depression, perinatal depression, bipolar disorder and premenstrual dysphoric disorder (PMDD).
What’s a diagnosis of clinical depression?
Many people who seek help will get a diagnosis of clinical depression. Also sometimes called a major depressive disorder or major depression, it has specific diagnostic criteria.
This is written in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) that’s the guidebook published by the American Psychiatric Association. It’s used by experts to diagnose most mental health disorders including clinical depression.
The DSM-5 says that somebody has to be experiencing five or more of the following symptoms in the same fortnight. These cannot be because of another medical condition or from substance abuse.
These symptoms need to have caused the person significant distress or impairment in occupational, social or other important areas of functioning. At least one of these symptoms has to be either “markedly diminished interest or pleasure” or “depressed mood”.
Depressed mood most of the day, nearly every day.
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
Fatigue or loss of energy nearly every day.
Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
Diminished ability to think or concentrate, or indecisiveness, nearly every day.
Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
So if you think someone is depressed or they tell you they are it’s helpful to know what to say and do. The first thing is to realize it’s difficult to know the right words to say to someone in this condition.
So don’t be afraid to say: “I don’t really know what to say to you right now.” That will take the pressure off you.
Often the best thing you can offer to someone who’s depressed is your just being there. Providing a shoulder to cry on can be very comforting.
Before knowing what to say that might provide help it’s perhaps more useful to understand what not to say and do.
What not to say or do to someone with depression
Dismiss their feelings in any way.
Compare their feelings to other people such as saying: “My cousin has it worse than you and they don’t get like this” or “You think you’ve got it bad…”
Play down their symptoms by saying such as: “Well, you don’t look depressed.”
Show any lack of concern.
Say that they are being selfish by saying such as: “You just think of yourself all the time.”
Be dismissive by saying something like: “You’ll get over it!”
Use phrases that might have good intentions but that might just seem as if you are making their depression sound easy to get through: “You just need to cheer up” or “This won’t last forever.”
Say anything that suggests it’s their fault such as: “It’s all in your head” or “It’s not that bad.”
Offer them drink or drugs in an attempt to deal with it. While it might push the negative feelings down for a few hours it doesn’t mean they have gone away. They will still be there and often the drinking or drug-taking just exacerbates feelings of despair and isolation.
Remember it’s often extremely difficult for someone with depression to open up. This may be due to feeling guilty, ashamed, embarrassed or bewildered.
Deep inside they may sense they have to look at a past trauma. This can seem overwhelming – a very big and frightening thing to do.
Or there is still a lingering stigma in some places and with some people about having depression. The person suffering with depression might not want people to know.
A depressed person might be anxious they will be looked down on as they are seen to “not be coping”. So as someone they have turned to, or if you have noticed that someone is depressed, you can ask them how they are – and let them know you’re always there for them.
What can I say and do for someone with depression?
Let them know you really care.
Ask them how you can help them.
Remember that really listening – without judgement – is one of the most loving things you can do.
Look after any immediate things they need doing. This builds trust.
Say you will help them find a therapist.
Always show understanding and empathy.
Be with them in the here and now.
Stay with them and do not be anxious about having to say exactly the right thing.
Give them a feeling of hope that they can get through it.
Show them unconditional love. Tell them you love them.
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A person with a personality disorder thinks, feels, perceives, behaves or relates to others quite differently than the average person. Signs of a personality disorder usually emerge in adolescence and can range from mild to severe.