Reaching out to someone who may be depressed
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* Teddi Dineley Johnson

Feeling sad for a few hours or even for a few days is a normal part of being human, but when the feelings linger for several weeks or longer, it could be a depressive illness. If someone you know or care about seems depressed, there are ways you can help.

Depressive disorders are common — so common that among all medical illnesses, major depression is the leading cause of disability in the United States, affecting 15 million adults or about 5 percent to 8 percent of the adult population in a given year. Depression interferes with every aspect of a person’s life, including how they sleep, eat and feel about themselves.

Of the 35 million Americans ages 65 and older, more than 6.5 million suffer from depression. For reasons that are not known, women tend to have more depression than men.

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/40/4/24/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/40/4/24/F1)

“There are a couple of things depressed people hear routinely, such as ‘snap out of it,’ ‘pick yourself up by your boot straps,’ or ‘it’s all in your head,’” says Ken Duckworth, MD, assistant clinical professor of psychiatry at Harvard Medical School and medical director of the National Alliance on Mental Illness. “This is one way people dismiss or oversimplify this experience.”

To help someone who is depressed, you must first learn to recognize the symptoms of depression, Duckworth says.

## Know the signs

For some people, depression is mild and temporary. For others, it can be severe and persistent, and feelings of sadness are common. Doctors use the term “major depression” to refer to the more severe type of depression. Sleep disturbances and problems thinking, remembering and concentrating are common. Though depression can affect people differently, other common symptoms include weight loss or weight gain, negative thoughts, anxiety, loss of energy, loss of interest or pleasure in doing things, anger and hostility, inability to make decisions, suicidal thoughts and feelings of hopelessness, emptiness, pessimism, worthlessness or guilt. Some people experience unexplained physical problems such as back pain, headaches and digestive disorders, and for many the loss of energy becomes so great that even the smallest task can seem daunting. Unfortunately, many people are reluctant to talk about their feelings.

Helping someone you know who shows signs of depression is an art, not a science, Duckworth says, noting that it’s important to lead with your loving relationships or feelings for the person.

It’s easier to help someone who is depressed when she or he acknowledges that they’re depressed, Duckworth says, because then it becomes a shared problem that the two of you address together. If the person doesn’t want to admit that that she or he is sad or depressed “but it is obvious to everyone around them, that is a different challenge.”

![Figure2](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/40/4/24/F2.medium.gif)

[Figure2](http://www.thenationshealth.org/content/40/4/24/F2)

Photos and art courtesy iStockphoto

Listen to what your friend or loved one is telling you, because talking through their feelings can help them see that they need help. Proceed gently, because many people feel vulnerable.

If a friend or loved one brings up an area that is problematic for them, such as sleeplessness, take advantage of the opportunity to suggest that an evaluation might be helpful. Primary care doctors are good at diagnosing depression, Duckworth says. If necessary, make the appointment for your friend and go with her or him to see the doctor. Help is also available from mental health specialists who work in community health centers or private clinics.

Offer emotional support, encouragement, patience and understanding. Try to bolster the person’s self esteem. Invite the person to take a walk or jog, or to accompany you on an activity they enjoy. Strive to be a good listener.

![Figure3](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/40/4/24/F3.medium.gif)

[Figure3](http://www.thenationshealth.org/content/40/4/24/F3)

Never ignore comments about suicide. When in doubt, call 911 or the toll-free, 24-hour National Suicide Prevention Lifeline at 800-273-8255 to talk to a trained counselor. If necessary, contact family members, friends, a minister or other spiritual leader. And remember to never leave a suicidal person alone.

## Talking to teens about depression

According to the National Institute of Mental Health, about 3 percent to 5 percent of the teen population experiences clinical depression every year. Depressed teens, however, tend to be more irritable than sad.

“Teens tend to become more agitated and they make more impulsive and bad decisions,” Duckworth says. “One thing to look for is when they lose interest in their friends. Teens who are depressed also don’t perform well in school. Are they interested in the same activities they used to be interested in? If those things are not happening, that is usually a sign that some help may be a good idea.”

![Figure4](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/40/4/24/F4.medium.gif)

[Figure4](http://www.thenationshealth.org/content/40/4/24/F4)

Keep in mind that suicide is the third leading cause of death among 15- to 19-year-olds, which is why children and teens with symptoms of depression need to be evaluated by a health care provider.

>> For more tips on helping someone who may be depressed, visit [www.nami.org/depression](http://www.nami.org/depression) or [www.nimh.nih.gov/health/topics/depression](http://www.nimh.nih.gov/health/topics/depression)

*   Copyright The Nation’s Health, American Public Health Association