Depression is a confounding condition, both for those who have it and for their friends and family. Mental illness often makes it extremely hard for the person with the disease to take action to get better. That’s hard to understand for anyone who has never had to deal with it. It’s the main reason people, even with the right intentions, often say the wrong things.
And what people say is important. “Words do matter,” says Dr. Philip R. Muskin, professor of psychiatry at Columbia University Medical Center and secretary of the American Psychiatric Association. “By avoiding stigmatizing statements, you can help stop the shame and fear that is often associated with mental illness. People living with depression fear being judged, and that’s one of the biggest reasons people avoid getting treatment.”
Here are seven things not to say to someone with depression, plus suggestions for what to say instead.
“Get over it.” No one expects a friend or loved one to “get over” diabetes or heart disease, but that is often the response when someone with depression expresses his or her feelings and emotions. Indeed, “get over it” may be the worst thing anyone can say to someone with depression. “Clinical depression is not a choice. Nobody chooses to be depressed,” Muskin says. Neither is depression a moral failing, a weakness of will or a phantom of the imagination. Depression is a medical disorder, a biological disruption of brain chemistry linked to and triggered by some combination of genetics, family history, past trauma, stress and other factors.
Instead, say something like, “What can I do for you?” “This is important, but it comes with a caveat,” Muskin says. “If you really want to be there and help someone, then you need to do what you say you’re going to do.”
[See: 9 Things to Do or Say When a Loved One Talks About Taking Their Life.]
“A lot of people have it worse than you.” People with depression often know this, too, and feel guilty about their condition. They don’t need more guilt piled on.
“It might be worth saying it bluntly — ‘If you feel this is overwhelming for you, please tell me. I care about you,'” Muskin says. This is especially true if the person might feel like life is not worth living. Say something like, “I want to get you the care you deserve,” Muskin says. “There is nothing shameful about feeling that way, and no one has ever become suicidal from a friend asking about those thoughts. The reverse is true. It is immensely emotionally relieving to be able to tell someone about such frightening thoughts.”
“Stop it.” “People know they shouldn’t be eating another half-gallon of ice cream. The problem with depression is each person who has it knows the right thing to do but can’t find a way to bring themselves to do it,” says Michael D. Yapko, a clinical psychologist, author and lecturer on depression. “Telling someone how they should feel or act doesn’t tell them how to do it.”
A better solution, he says, is to help the person “develop a realistic pathway to get there.” Suggest “let’s exercise together,” or “let me help you find someone to talk to about this.” “The reason to go to therapy is the hope that the therapist will provide a pathway to make it possible,” Yapko says. “Don’t encourage results without suggesting a means for producing it.”
[See: The Many Ways Exercise Fights Depression.]
“You’re crazy.” The American Psychiatric Association stresses the importance of avoiding derogatory language. Words such as psycho and crazy are not helpful. Neither are words like “suffering” or “victim.” Someone “has” depression; she doesn’t “suffer” from it.
Similarly, the APA says, it’s preferable to say someone has depression rather than “she is depressed.” “The basic concept is that the mental health condition (or physical or other condition) is only one aspect of a person’s life, not the defining characteristic,” the APA says.
“Just do something about it.” Depression is so insidious because it makes it very hard to do anything about it. “Depressed people make depressed decisions,” Yapko says. “When you use your feelings as an indicator of what to do, you make bad decisions.” That is often behind the battles people with depression get into with those around them. “They are responding to feelings instead of the larger goal,” Yapko says.
Instead, say, “If you don’t know what to do, let’s talk to somebody who does.” Go after the goal, not the feelings, Yapko says. “Offer to help them through it. Don’t get mad at them. Understand that helplessness is part of depression.” Even therapists get frustrated when patients don’t do what has been asked of them, he says. The point is to understand why they act that way. “Tell the person that trying something new may not feel good or attractive right now, but doing what they’ve been doing isn’t the solution,” he says.
[See: How to Find the Best Mental Health Professional for You.]
“You don’t need medication; you can pull through this.” That is for a mental health professional to decide. While it is very true that many cases of depression do respond to treatments other than antidepressants, like psychotherapy and exercise, some people do need medication, Muskin says. And those who are already on antidepressants should not stop taking their medication without speaking to their doctor first, he says.
“Everything will be OK.” Someone with depression can’t see that. It’s important to stay positive and encouraging, but it takes action to feel better.
Offer suggestions, such as, “Let’s do something together,” Muskin says. “Depression can keep a person from participating in everyday activities. But you can show your support by offering to go to a movie, or even a quick walk.”
Finally, sometimes the best thing to say is nothing. “Just listen,” Muskin says. “But make it clear you are listening.” When you do respond, stay calm and empathetic. “Getting angry and yelling are the worst things you can do,” Yapko says. “It is not helpful. They need support, and you may have to go out of your way to do things you would rather they do on own, like find a therapist, or take them to appointments, at least initially.”
More from U.S. News
Coping With Depression at Work
Could Your Summer Blues Be Seasonal Depression?
Am I Just Sad — or Actually Depressed?
7 Things You Should Never Say to Someone With Depression (and What to Say Instead) originally appeared on usnews.com
