How to understand and speak to a depressed person

Question: I have a friend who is battling terrible depression, and I often say the wrong things. I want him to know I care and I’d like to help, but I don’t think I’m getting that across and often stick my foot in my mouth. Do you have any advice for how to show up for him better? What can I say to someone who is depressed that would help?

Answer: To answer your question, I recruited help from one of my colleagues, Greg Thredgold, who has suffered from depression for over 40 years.

Thankfully, through the grace of G0D and a medical miracle, Greg has overcome depression and anxiety and found a passion for helping others deal with this terrifying, lonely and misunderstood disease. The tips in this article come from him.

Just so you know, the number of people diagnosed with depression is increasing by 20 percent a year. “At this rate of increase, depression will be the 2nd most disabling condition behind heart disease in the world by 2020” — Seligman, M.E.P. (1990). This means, like it or not, depression will be affecting you or someone you care about soon. It would be good for all of us to have greater understanding and more compassion for those who are affected.

Greg said, “The life of a depressed is a lonely hell with no hope in site. For 40 years I found myself walking on a tightrope between giving up and seeing how much more I could take. It is a life of often being ignored by family, friends, and others because they don’t know what to do or say.”

Greg said that when well-meaning people would ask “How are you?” his responses were usually not the truth. He translated what certain responses from a depressed person really meant.

• “I’m really okay” really means — “I just want to die.”
• “I‘m just cold and tired” really means — “I don’t want you to see my scars.”
• “Leave me alone” really means — “Show me you care enough to stay.”
• “I’m just worn out” really means — “I can’t take this anymore.”
• “I’m better, trust me” really means — “I’ve never been this bad.”

And the biggest lie of all was when he would fake a smile and say “I’m fine,” which really meant, “I am angry, depressed, alone, broken, worthless, ugly, hopeless, invisible, fat, useless, stupid, lost, suicidal, about to lose it, pathetic, in pain, distant, wish I could disappear, numb, and empty, etc.”

Obviously, a depressed person's world is darker than we realize.

David Burns said: “Depression can seem worse than terminal cancer, because most cancer patients feel loved and have hope and self-esteem.”

Greg said, “I was never looking for my family, friends, or others to have the perfect thing to say or do, and neither are the depressed people in your life. They just don’t want to be treated like a leper. When people don’t know what to do, they often do or say nothing. This means they are letting their fear of saying the wrong thing stop them from showing love at all. This is what you cannot do.”

“When a depressed person says, ‘I’m fine,’ look them in the eye and say, ‘No you're not!’ then give them a hug, listen, and just be there. I am only here today because of the tender mercies of a few people who did just this.”

He encourages us to reach out to those who are silently screaming for help and even when we feel uncomfortable, show love anyway.

Is there anything we should NOT say to a depressed person?

• “It’s all in your head! Just be happy!”

Of course it is in the head. It’s mental illness. This comment shows you have no idea what depression is.

What to say instead: “What can I do to help? ”

• “You shouldn’t be taking a pill to make your life better. Medication is bad.”

Unless you’re a doctor, don’t give medical advice. Finding the correct medication or balance of medications can take months and sometimes years. Over 40 years, Greg was prescribed 45 different medications that did not work. It was a struggle enough without friends and family playing doctor.

What to say instead: “I think it’s great that you are trying to get better and working with your doctor. I’ve heard medication can really help some people.”

• “Are you sure you aren’t getting depressed as a way to get attention?"
• "So many people are worse off than you.”

No one would wake up every day crying, terrified, empty and wishing they could die so people will pay attention to them. Telling them other people have it worse does not help — never, never, never say this.

What to say instead: “I’m not going to abandon you, even if your depression frustrates me.”

• “Depression isn’t real.”

Would you tell a blind person being blind isn’t real? This is actually one of the rudest things you could say.

What to say instead: “I have a hard time understanding depression. Is there a place I can go or a book I can read that will help me learn more about it? ”

• “If you were just more spiritual you would get out of this.”

Telling a depressed person that spirituality can fix it is like saying prayer can fix a flat tire.

What to say instead: "I'm praying for you."

Is there anything we could say to a depressed person that might help?

“Most people never say anything and basically ignore us. I was so grateful to the people who at least talked to me even if they said the wrong thing. One very special person in my life took the time to ask this question. ‘I don’t know what to say or how to deal with you sometimes. I get scared that I will say the wrong thing. Can you please give me some suggestions on how I can best help you without making it worse?’

This was the only person, other than my immediate family, that ever asked that question, and it meant the world to me. Please take the time to ask this question of the depressed people in your life.”

Depression is such a cruel punishment. There are no fevers, no rashes, no blood tests to send people scurrying in concern. Just the slow erosion of the self, as insidious as any cancer. And, like cancer, it is essentially a solitary experience. A room in hell with only your name on the door. — author unknown

“If you have never experienced depression, you cannot possibly understand what it’s like and you might not have the right words, but trust me, just being there is enough. When I was in the depths of depression, there was never a long line of people at the door wanting to help me. But everyone that did was an angel sent from above regardless of what was said or how it was said. Sometimes they said nothing and just listened, which literally saved me at times.”

On top of the chemical depression, your friend also deals with shame and fear that he is inadequate and even inferior to you because he struggles with this. He needs to know that you see his value accurately, as the same as yours and everyone else’s.

We all struggle with a fear we aren’t good enough, but this is magnified a hundred times in a depressed person.

You might want to remind him that depression is a class (a really hard class) he got signed up for (here in the classroom of life) but it doesn’t affect his value at all. You might tell him he is an amazingly strong soul and you admire his strength to keep fighting through it.

You can do this.

Kimberly Giles is a life coach and author of the new book CHOOSING CLARITY: The Path to Fearlessness.