10 Things To Never Say To Someone With Depression?

tough-questions

When I scrolled down my yahoo news feed and saw a post with the headline, 10 Things To Never Say To Someone With Depression, as someone who works in mental health with clients who suffer from major depression, I was intrigued.

It’s an important subject because depression is far more prevalent than we would like to admit. Knowing how to see the signs and talk to people can make a difference.

I respect the author, Julie Revelant for writing the piece. However, while I agree with portions of it, I either disagreed or found much of her list to be an oversimplification.  You can read her entire article here.

Speaking of oversimplification, there is only so much to be gleaned from a blog on a topic like this. There are too many variables to account for every situation.

Therefor before I get to my critique of what Relevant says you should not say, maybe something you should say to someone with depression is have you thought about talking to someone professionally? While many experience mild to moderate depression, others experience major depression that can be life threatening.  This is not something to be diagnosed and treated by someone not qualified to do so.

Keeping the above qualifier in mind: Here are the 10 things Relevant states you should never say to someone with depression and my take on it.

1. “Don’t think about it.”

This is not an absolute.  Some may think about their depression too much, others not at all. Negative emotions can be signals your subconscious is trying to send you that something is off.  Another word for not thinking about depression or problems, is denial.

A common point where I will agree with many of the things on Relevant’s list is while some of the phrases don’t work as statements, they may work as questions.

If you think someone is depressed and is thinking about it too much, perhaps you can ask them how is thinking about the problem helping?  Is it possible to focus on something else for a little while?  Is the person ruminating and dwelling on problems?  If so, you can assist them in focusing on solutions.  In this way they are still “thinking” about it but you are redirecting them towards the positive by changing the focus.

Further, by questioning and suggesting rather than stating, you are acknowledging and empowering rather than belittling and dismissing.

Here, Revelant quotes Dr. Susan Noonan, a certified peer specialist and consultant in Boston, Massachusetts, “The thing about depression is that it’s not something you can will away. It’s a biologically based medical condition of the mind and the body”.

 

depressioninterventions

I agree with the first part of the statement, in that alleviating depression requires some intervention. To try and will it away, on its own, is not enough. If the depression is mild maybe the person can intervene on his own.  For moderate to major depression, maybe a trusted friend or therapist’s help will be needed.

Where I respectfully question Dr. Noonan is when she refers to depression as a biologically based medical condition.  From this I infer that she believes all depression must be treated with medication and or by a psychiatrist.  And while those suffering from depression should have an initial evaluation by an M.D. and a psychologist, medicine is not needed for all.  In some cases a person may benefit from being on meds for life, others for a brief time, and others are capable of doing fine with talk therapy, and improving things like diet and exercise.  Never needing medication.

2. “Just think positively.”

If said on its own, I agree with Revelant that it should not be said.  But there is whole segment in the field of psychology called cognitive behavior therapy that is based on helping people see through cognitive distortions and redirecting absolute negative thinking. If a friend is depressed “because nothing ever works outs”… true, you should not say “just think positively.” However you can ask him, can you think of a time when anything, anything at all worked out? Usually that answer will be yes. Start with a small positive and build from there.

Ask him to forget about the big picture for a moment, and think about one or two things, no matter how small, that can move him in the direction he wants to go.

In this case you are not telling him to think positive but you are leading him to thinking positively or at least piercing the distortion, and having positive thoughts.

3. “Be grateful.”

One issue I have with the statement, “be grateful”, in addition to what Relevant talks about, is you run the risk of pushing the depressed person away.

rogers_empathy

On its own, be grateful doesn’t convey empathy or understanding.  But let’s assume you spent some time expressing empathy and understanding; asking (as opposed to telling) your friend if they have anything in their life to be grateful for can be a positive redirect.  Or an indication of a deeper level of depression than you realized if he doesn’t respond.

And if after gentle probing and or suggestions of things to be grateful for, your friend cannot find something, you may consider contacting another friend or loved one to help, and or reiterate the importance of talking to a professional.

4. “No one ever said life was going to be easy.”

Certainly not an ice-breaker.  If a friend is struggling with or didn’t meet a life challenge, after expressing empathy, possible questions to ask are:  What were your expectations?  What can you learn from this? What can you do differently moving forward?

Revelant states, “This statement makes it sound as if the person who is suffering has control of what is going on his brain”.  IF the depression has a biochemical connection than all of the talking in the world may be insufficient, unless it’s the talk that gets the person to the doctor.

retraining-brain

However, our brains do get trained to think and react in a certain way and it is possible to retrain them. If the need for medication is ruled out or perhaps in conjunction with, a person can, if not in total, gain a measure of control.

If negative messages and thinking have seeped into our brains and predominated for years and years, then it will take more than one catchphrase, or one therapy session to turn it around.  But in many cases it can be turned around!  “Obstacles” can become challenges.  “Failures” can become opportunities to learn and improve… or… present an opportunity to make a different choice that works out even better!

Events that occur are immutable.  They are what they are.  Perspective, how we look at them and respond are very mutable… we can change them!

5. “Turn to God.”

I generally agree with the original post here.  I would add that faith is not limited to God or even a higher power.  There is room for faith to help in an atheist or an agnostic as well.

Motivational speaker, Anthony Robbins, uses a metaphor of avoiding a car accident.  He says, we are taught, if we are about to get into a car collision and we look at what we are about to hit, we will indeed get into an accident.  However if we look away, we will turn away.  You can encourage others to look in the direction they want to go as opposed to focusing on what they view as the accident.  It is a, “my room is a mess”, versus “today I am going to clean my room” mentality.

As Robbins would point out, One focus’ on the problem, the other the solution.  Is it a guarantee?  Of course not.  But faith can be a powerful precursor/motivator that can drive action and be the spark that helps initiate change, and positively affect mood while in its pursuit.

One can find faith in many places:

  • God.
  • Spirituality.
  • Religion.
  • In yourself.
  • In a process that has worked for many others.
  • In a healer.
  • In a friend or family member.
  • In having a purpose.

6. “Stop feeling sorry for yourself.”

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Here, after expressing empathy, I would rephrase:  Are you feeling sorry for yourself?  If yes, ask why. Empathize, validate the feeling but then ask what would help you after feeling sorry for yourself?  This attempts to get your friend unstuck and moving forward.  If they don’t know, perhaps suggest keeping a journal, and free associative writing.

7. “I know how you feel—I’ve been sad, too.”

Relevant and the Dr. she quotes have a problem with this one.  I agree you shouldn’t say this just to say it. However, it can be okay if you truly can relate to how the person feels, and can offer an experience that is relatable to who you’re talking to.  In working with adults and abused adolescents, I have seen this work again and again.  As a facilitator of groups on various mental health topics, some of the most valuable moments come not from the educational materials handed out, or anything my co-facilitators or I said, rather the empathetic understanding of peers in the group who shared their similar experience.

And this is one of  those things where the situation or timing may affect the appropriateness of saying something like this to a friend, and his receptiveness to it.  Right after a person loses a loved one, they probably don’t want to hear, “I know how you feel”.  Five months later in a loss and grief group it may be beneficial to be surrounded by people who know how they feel.

8. “Get over it.” 

Yeah, not a fan of this one.  But in keeping with rephrasing, depending on the issue, you may be able to ask why do you think you’re having a difficult time getting over this?  Especially if the person has a history of being able to emotionally recover from depressing events such as breakups, not getting a job, etc..

9. “You don’t look depressed.”

Not as bad as number 8, but not a good lead in either.  My theory on this phrase, which is similarly used in response to when someone says they are terminally ill, is, it is a defensive response due to being caught off guard by sharing, and not immediately knowing what to say.

Relevant states that what the person hears is, “I don’t believe you or you’re a fake”.  What I hear is, the mask I have projected to keep you from knowing how depressed I am is working.

As with all of the above, the best thing you can do for your friend is get yourself to a place of empathy, make your friend feel heard and understood before attempting to go to positive redirection.  And if you gauge the moment to be right, at some point during the conversation you can offer positive reinforcement in an area(s) where your friend is doing/looking well.

10. “You need a hobby.”

At its worst this statement can come off as condescending, and at its best it can still come off as dismissive.

In question form, have you thought about a hobby?  Can take on a different meaning.  And follow the initial question with probing for areas of interest and you may come up with something. Pair this probing with the aforementioned empathy and understanding, while a hobby may not cure the depression, it may be able to assist.  Then it is not dismissive or condescending.

Revelant correctly points out that people who are depressed do lose interest in activities they use to enjoy.  Clinically, this is referred to as anhedonia . However not all people who suffer from depression suffer from anhedonia or the same degree of it. A little push and encouragement may be the thing that helps get your friend back on track.

As suggested in the beginning, both this and Relevant’s post are simplifications.  There is a broad range to depression, that is not limited from mild to major.  There is also bi-polar.

Treating clinical depression can be challenging enough for the trained professional, if a friend or family member reaches out to you with depression, I would encourage you to encourage them to seek professional help.

Practically speaking, a lot of people do prefer to talk to their friends.  In this situation you can bring your authentic intention to help.  Actively listen.  Provide empathy.  Provide validation. And if appropriate, ask questions and make suggestions that try to steer your friend to some positive thoughts.

If you are not comfortable or if your friend continues to use you as a crutch, and it is not helpful to him and stressful for you, then to take care of yourself and to keep from potentially enabling your friend, you may need to draw a boundary that is in the best interest of yourself and your friend.  Which circles us back to therapy.

RE: Therapy, there are many therapists who offer a sliding scale and there are other options for those with low-income.  You can try contacting a local graduate school and see if they have interns available for a low fee.

If a friend is resistant to therapy because they don’t believe in it…Encourage them to keep an open mind. If they tried it in the past and did not like the therapist, suggest there are good and bad of everything and to give it another try, especially if they have never been evaluated for medication.  There are natural remedy’s and diet changes to try first if they are uncomfortable with meds or that is their preference.  Full disclosure, I use a natural remedy called Sam-e (with b-complex) with some positive results.

Initially, the best thing you can do is just be there for your friend.  They probably realize you are not a pro and may not be looking to you for solutions rather just to be understood and perhaps for attention.  If someone comes to you beyond a level you’re comfortable with, then take care of yourself and gently let your friend know this.

Here are some referrals:

  1. National Suicide Prevention Lifeline 1-800-273-8255 (1-800-273-TALK)
  2. Befrienders Worldwide
  3. Families For Depression Awareness
  4. Teen Health and Wellness (this link offer hotline numbers for lots of teen issues)
  5. ULifeline (for college mental health)
  6. The Trevor Project (For LBGTQ)
  7. Postpartum Depression
  8. Vets Prevail 
  9. Crisis Help Line – Offers hotlines for many issues. 800-233-4357
  10. Crisis Text Line 

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THE ABOVE REPRESENTS MY PERSONAL OPINION.  WHILE I DO WORK FOR A MENTAL HEALTH AGENCY WITH THE JOB TITLE OF, MENTAL HEALTH REHABILITATION SPECIALIST, I AM NOT A LICENSED THERAPIST.  ANY WORDS IN THIS BLOG ARE NOT MEANT TO, NOR SHOULD THEY REPLACE THAT OF A DOCTOR OR LICENSED MENTAL HEALTH PROFESSIONAL.

The above article by Jeff Schubert provides links to other non schoobysports.wordpress.com sites. Neither Jeff Schubert nor schoobysports.wordpress.com has control over these sites and makes no representations whatsoever about the accuracy of the information they contain. The fact that schoobysports.wordpress.com links to another site does not mean that Jeff Schubert nor schoobysports.wordpress.com endorses or accepts any responsibility for the content of that site. If you choose to access any site for which schoobysports.wordpress.com provides a link, you do so at your own risk.

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