What to say to someone with depression

It can be difficult to know what to say to someone with depression, but "I'm here for you" is one of the most helpful things you can say. Other statements that people who have experienced depression rate as being the most supportive include:

• I am not too familiar with your illness, but I understand that it is real and that is what is causing your thoughts and behaviors
• Although it may be hard for you to believe now, but the way you are feeling will change
• You are important to me and your life is important to me
• I care about you and want to help
• We will get through this together.

Despite the fact that more than one in four people struggle with depression or other mental health issues, these very real disorders are still not really talked about.

Depression and other mental health issues such as anxiety, bipolar disorder and schizophrenia are just as deserving of support and empathy as other medical conditions such as asthma and diabetes. Too often people respond negatively or dismissively when somebody confides that they are not mentally well.

Instead of telling them to look on the bright side, to stop worrying, or offering advice; express your concern and tell them they are not alone in this, you will be there for them whenever they need your help. Ask them how you can support them or offer to drive them to their next appointment or to do their housework, or help them with their homework if they are still at school. The most important thing to convey is how much you care about them and that you will be available, should they need you.

What not to say

The following statements are not really helpful, even though you may mean well, so try to avoid saying them:

• Stop acting crazy
• It's all in your head
• Everybody goes through times like this
• What's wrong with you
• You'll be fine
• I can't help your situation
• You have so much to live for; why do you want to die
• I thought you would be better by now.

Listen

Let your friend or family member talk. All too often when we talk to others, we end up talking about ourselves, or offering advice. Don't change the subject if your family member or friend opens up about their illness.

Instead allow them to talk freely and resist the urge to try and "solve the problem". Offer your support and acknowledge the fact that they have done the right thing in talking about it and that you have their back. Ask them if they are getting the treatment they want and need, and if not, ask them if they want your help in finding it. Keep their trust by not gossiping or sharing what they have told you with others, unless it is with their consent.

If you feel overwhelmed by what they have told you, or have any serious concerns about a person's risk of harm to themselves or others, contact a helpline such as the SAMHSA Treatment Referral Helpline 1‑800‑662-HELP (4357), or, if you are specifically concerned about their risk of suicide, the 988 Suicide & Crisis Lifeline for confidential advice.

Educate yourself about their disorder

Most people don't really know the difference between schizophrenia and bipolar disorder. Few understand the devastating consequences of depression or the isolation of anxiety disorders.

Take the time to familiarize yourself with specific features of your friend's or family member's condition. This can help you to understand certain behaviors and to know what to expect.

Briefly, people with schizophrenia often develop very odd or eccentric beliefs or behaviors. They may experience delusions, hallucinations, talk incoherently or in a way that is difficult or impossible to understand.

Symptoms of bipolar disorder vary but generally consist of episodes of mania - distinct periods of feeling excessively good or important - and periods of depression, with periods of mood stability in between.

Depression is a serious mental illness that can cause sadness, a loss of interest in normally enjoyable things, and changes in appetite or sleep. Most people with anxiety disorders will go to great lengths to avoid situations where they may be humiliated or judged by others such as social gatherings, public speaking, or meeting new people.

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Look out for warning signs and act on them

Occasionally, people with depression or bipolar disorder suffer from severe symptoms that are best helped by hospital admission.

If you are supporting someone with a mental illness, it is a good idea to prepare for a crisis before it happens. Find out who to contact and write a plan of what to do during a crisis, should it occur. Your plan should include helpful phone numbers, such as those of your friend's doctor, family members and the 988 Suicide & Crisis Lifeline. If you find yourself in an emergency situation, ring 911.

Symptoms and signs that warrant expert help

Admission to hospital can occur voluntarily or involuntarily. Involuntary admission - or a forced admission against someone's will - is only used as a last resort if the person's life or other peoples' lives are in danger. Hospital admission may be needed for people that:

• Experience hallucinations (seeing or hearing things)
• Threaten other people or try and take their own lives
• Have delusions (believe things that aren't true)
• Have not slept or eaten for days
• Cannot care for themselves on a daily basis
• Have symptoms that are interfering with their life
• Need specialist treatment such as electroconvulsive therapy
• Have significant problems with alcohol or other substances
• Whose symptoms have not improved or who have relapsed with their current treatment.

What you can do in a crisis

During a crisis, your friend is likely to be acting irrationally, and there is a possibility their actions may scare you. It is important to stay calm, and talk slowly. Reassure them that you are here to help and ask them simple questions, like "How can I help?". Repeat the same question patiently, over and over again, if necessary. Enlist support from family members, friends, neighbors or your church if you can.

Follow your crisis plan and call your friend's doctor if there is time and the situation is manageable. If you feel threatened, call 911, especially if danger is imminent. Both police and ambulance usually prioritize 911 calls about people experiencing a mental health crisis.

Try not to take what your friend says personally. They cannot help the way they behave in a crisis situation.

What you can do, day to day

A common feature of mental health disorders is withdrawal from social events, family, and friends. Even if your friend constantly declines your invitations, keep on asking. It can be a comfort for them to just know that you care. Set time aside time just to spend with them, one-on-one.

Encourage your friend's healthy behaviors such as exercise, healthy eating, and getting enough sleep. Be mindful that alcohol can interact with most psychiatric medications and affect their effectiveness as well as fueling symptoms of the person's underlying disorder, so avoid events or peer situations that encourage alcohol consumption while your friend is recovering. Contact a helpline such as the SAMHSA Treatment Referral Helpline 1‑800-662-HELP (4357) if you think your friend might have a problem with alcohol or other substances.

Still take time out for yourself

Helping somebody recover from a mental illness can be demanding and stressful. Make sure you set aside time to still do the things you want and need to do. If you ever feel overwhelmed, ring a general helpline such as the SAMHSA Treatment Referral Helpline 1‑800‑662-HELP (4357) who can provide you with support and advice. It may be good to connect with others in a similar situation as you, and numerous support groups are listed here on Mental Health America's webpage or you can join a relevant drugs.com support group.