What Not to Say to Someone With Depression (& What to Say Instead)

I recently talked about what makes depression a real illness and discussed how it can affect one's life. By pointing out that one cannot empathize with someone who is depressed unless they themselves have dealt with depression (and even then, all of our experiences are different and range in duration & severity) I feel that it is now important to talk about how we should talk to someone that struggles with depression. 

*First, a preface that turned into a bit more of a rant than I intended*

As a millennial, I hear a lot from older generations that we millennials are "too sensitive" and "take everything personally" and "get triggered too easily." I have a huge problem with these accusations because first of all, there is no such thing as being "too sensitive." Sensitivity is not a character flaw nor is it something that should be fixed. Sensitivity is simply part of the way we were brought up--a result of all of our life experiences and situations that molded us into who we are today. If a parent ever tells you that you're "too sensitive" then maybe you should turn that finger right back around (please don't do this unless you want to be shot) (I'm kidding...but probably don't HAHA) and tell them that they're the one who coddled you when you fell as a toddler or became enraged over teachers grading your papers unfairly...the list goes on. (I'm not saying those are bad things, because they're not. But everything that happens in our lives affect who we are.) The things we experienced as children inevitably shaped who were are today, and aside from that fact... some of us are actually just born highly sensitive.

I've had a soft, sensitive, tender heart since I popped out of the womb. I've always taken things personally and shed tears more often than what I assume to be the norm. (Is it normal to cry when you drive past a dead squirrel? Asking for a friend.) But I also am very compassionate and kindhearted and receptive to others' needs because of my sensitivity. It is not my fatal flaw, and I shouldn't be "less sensitive." And neither should you. My point in bringing up sensitivity is that oftentimes articles that counsel "What Not to Say to ___" get criticized (again, in my experience it is usually by older folks) for being nonsense because they are making us all too sensitive. "Those people should just toughen up--I shouldn't have to censor myself to make someone else feel better!" Well guess what? Mental illness rates are higher than ever before. Of course, there are a myriad of things that contribute to this--I'll save that for another article. But I have had so many insensitive things said to me that have sent me spiraling into a relapse. I struggled with severe anorexia nervosa for 3 years of my life and relapsed four times. I still relapse with anxiety & depression (honestly, almost daily) and my PTSD is triggered at the most random of times. Not every relapse is due to a comment from someone else, but a lot of times those comments are what push me over the edge. Sometimes comments from others have literally sent me so deep into a depressive episode that my hopelessness was enough to want to die.

If we can teach people how to be more considerate and understanding to those of us struggling with mental illness, why wouldn't we? Why wouldn't I use my voice to try to reach those people who could potentially say the RIGHT thing to someone who is on the edge of life and death? Call me too sensitive, but I'm just trying to save some precious, vulnerable humans out there. Why? BECAUSE I'M SENSITIVE. Sue me. Don't sue me. I have anxiety. And no lawyer. Okay. 

*end rant, and on to what you came here for...*

When someone struggling with depression thinks/says...

No one understands.

What to say: You're not alone in this. I'm here for you no matter what, even if I don't understand I will try my very best. (And then actually do that.) 

What not to say: Other people have it way worse than you. (OR ANY VARIATION OF THIS !!!)

This is hopeless. I wish to die.

What to say: You are so important to me. If you're gone I will be broken and devastated. (Don't guilt them, but let them know they're important to you. Depressed individuals are more likely to put others first due to their [usual] hatred toward themselves and lack of prioritizing their own feelings.)

What not to say: You're being so dramatic. You don't actually want to die. Don't tell me that. You're not really going to kill yourself. (All of those things are so wrong and yes, they probably DO want to die and VERY WELL MAY kill themselves.)

I can't do this anymore.

What to say: Just give 'em a hug. And reassure them that you know they can even if they can't see it and that you're there to help. If it helps, use the "10 second" rule. You can do anything for 10 seconds. Then repeat that over and over and over and over...hey, they made it another day. 

What not to say: Stop feeling sorry for yourself. There's nothing wrong. Your life is fine. (You can't compare your experiences here. No matter how seemingly 'fine' one's life is, depression is a disease and can affect anyone at any time. Celebrities seem to have it all, right? Isn't it odd the amount of celebrities that go to rehab but the amount of joyous minimalists?) 

I'm too broken. I'm stupid. I'm insane.

What to say: You're not going crazy. Depression is real but let's try to manage it.

What not to say: You're so negative. You're so miserable. Be more optimistic. You're always depressed. I'm tired of you complaining all the time. Snap out of it. (Avoid all "you're so" statements. Unless you're saying fabulous or funny. Or sexy.)

I'm such a burden to everyone.

What to say: I'm not going to leave, abandon, or give up on you. So buckle up, and don't worry about me. I'll make sure to take care of myself, too, so that I can be there for you. <--Only say this if you truly are stable and can take on the responsibility. 

What not to say: Then get better so we can stop having to worry about you. I think your depression is a way of punishing me. It's your own fault. Stop being so needy. I've had to miss so much work/school/other obligations for you.

You don't get it. No one gets it.

What to say: No, I don't. But I can be whatever you need me to be and try to offer my compassion.

What not to say: Yeah, I get it. I was depressed once for several days. I just started working out/eating clean/drinking tea and then I was okay. (DO NOT OFFER ANY HEALTH, FITNESS, SLEEP, SUPPLEMENT ADVICE UNLESS YOU ARE A DOCTOR.) (ALSO: NO I WILL NOT GO VEGAN.)

And, finally, here are some more things you should NEVER say. Like, ever:

Why are you depressed?

It's all in your head.

Stop feeling sorry for yourself.

You have it so good.

Happiness is a choice.

Have you been praying?

Just get out more.

You're being selfish.

A person your age should be having the time of your life! (<--Ouch, thanks dude.)

Depression is a symptom of your sin against God. (Yep, I've really heard that one.)

What doesn't kill you makes you stronger.

I can't be around you right now, you're so depressing/miserable/rude.

You should get a hobby. (Yes, let me take up tango while my body is so fatigued that I cannot move!)

This too shall pass! 

You are responsible for your happiness! Change your mind! 

My favorite is when someone asks how I'm doing, and I respond honestly (I'm not about saying 'I'M GOOD HOW ARE YOU?!' when really I want to throw up everywhere and crawl in a hole) and then they are caught off guard so they say, "Oh... well you look great!!" That's usually what happens. Like..."Oh, thanks? I feel terrible and wish I was not alive right now but I'm glad my face is aesthetically pleasing to you. Have a blessed day." 

So what helps?

What helps me is getting a back rub. Sometimes I feel like talking and sometimes I don't. Usually, I don't but I should or I stay stuck in my head. I need someone to listen and respond without offering advice or trying to "fix" things. Depression comes and goes in waves. I know that the super intense moments will eventually pass, so I just have to get through them one at a time.

What would you add to this list of what to say or not to say? If you struggle with depression, what helps you? 

Photos courtesy of Gemma Correll (She's amazing!)

Is Depression a Real Illness? {Pt 2}

After tackling the beast called anxiety, I figured it's time to touch on yet another topic that I personally deal with and am highly fascinated by. (Yes, the brain is fascinating and even though I curse mine I am genuinely intrigued by its functioning--or lack thereof--ha.)

First of all, this article explains a lot of the research showing how real depression is as an actual illness. A key excerpt that I believe is vital for people to understand:

"Depression is, indeed, a culture-bound syndrome and at the same time it is a very terrible disease, which cannot and should not be equated with low or bad mood, sadness, or any other "aberration from the norm of happiness": it differs from these normal mental states symptomatically in the intensity of suffering experienced, in its character (such as resistance to distraction and other symptoms of the paralysis of the will, expressed among other things in the characteristic lack of motivation), and in its functional effects. An occasionally sad person is not dysfunctional, a depressed one is--depression destroys relationships and renders one incapable of performing one's duties, it is as real and serious a handicap as any physical one. Neither should depression be seen as an exaggeration of normal mental states, differing from them only quantitatively, or equated with normal reactions to particularly traumatic life events... As anyone who has experienced depression or observed closely persons suffering from depression knows, this absence of an external cause often leads the suffering individual to suspect oneself of madness."

Depression is a real and often lethal disease. Clinical depression affects not only mood and thoughts, but also the physical body. Individuals coping with depression have a higher level of stress hormones present in their bodies, and the brain scans of depression patients show decreased activity in some areas of the brain (1). 

Being depressed is not simply having a case of the blues. 

"Depressed" is not an adjective that should be thrown around lightly. Imagine if you complained to a cancer patient that you had a slight stuffy nose as they were unsure if they would be able to make it through the month alive. Now imagine you say "that's depressing" or "I just got really depressed for a sec" to someone who ACTUALLY struggles with severe depression. What a slap in the face.

As we've all heard before (yet most choose to ignore this wise advice) it is of no use to tell someone with depression that "it's all in your head," or "you should eat X and do Y workout," or "you're so miserable and negative to be around," or "you just need to think positive," ... the list goes on. (I've had some very invalidating and insulting remarks made while in a deep, deep state of suicidal depression. I'm not being overly sensitive--I will admit that I am quite the HSP and empath--but these remarks have cut me deep and only worsened the guilt which adds fuel to the depressive fire.)

So, no, being sad is not a legitimate medical illness but clinical depression most certainly is. 

There are a wide array of symptoms that can present themselves when one is depressed. For the sake of not making this a laundry list, I will list the symptoms I have experienced:

• Persistent sad, anxious, or "empty" mood (the empty, numb, catatonic state is the scariest to me)
• Feelings of hopelessness & pessimism (as an otherwise optimistic person)
• Irritability (more than just typical teenage angst, or in my case...22 yr-old angst?)
• Feelings of guilt, worthlessness, & helplessness (constantly...even when I'm doing somewhat okay)
• Loss of interest in just about everything (except puppies)
• Lack of energy; debilitating fatigue (I cannot even lift an arm or cry)
• Talking & moving very slowly (I'm talking like the sloth in ZooTopia)
• Difficulty concentrating, remembering, making decisions (I have severe memory lapses...severe enough to freak out my family)
• Difficulty sleeping even though I'm exhausted OR sleeping 12+ hours a day (Nap queen)
• Lack of appetite (Not very fun when you have to eat recovery amounts of food)
• Thoughts of death or suicide, creating a suicide plan (these feel very impulsive and I can tell it is my brain malfunctioning when it gets this bad...I'm not a suicidal individual)
• Body aches, headaches, cramps, digestive problems (my GI disease worsens when I'm depressed)
• Inability to participate in life. At all. (And that's the kicker)

So why, even with all of those terrible symptoms of depression, are many individuals not recognizing it as a real disease? Why do so many poke fun at or downplay the seriousness of depression? Why are depressed individuals seen as lazy, dramatic, sensitive, dark, stupid... Why can we not call out of work depressed but a coworker can call in with a head cold? Why, with all of the information that we have on this terrible disease, is it still so misunderstood? 

As I stated in part one of this series on mental illnesses, this lack of knowledge is simply a lack of experience. One cannot truly empathize with a sufferer unless they themselves have been through the experience. I can sympathize with someone who lost their husband in a car crash but I cannot empathize. My dad can sympathize that I am struggling with a chronic illness, autoimmune issues and a wide array of mental illnesses but he cannot empathize. Our lack of experience can try to be replaced by studying and trying to understand these circumstances that we have not faced but ultimately it will never be enough. (But, that's not to say we shouldn't try to understand.) 

Unless every person on this earth were to experience depression there will be no way to ultimately end the negative stigmas surrounding the disease. (And any mental illness, for that matter.) It's unfortunate, but it is also great. Because that means that the ignorance of those who don't understand is simply a byproduct of their privilege. It is a huge privilege to not have to battle mental illness every single second of every day. Heck, I'm jealous of that privilege! So yeah, sucks for us struggling but great for those who aren't!

The crux of this post is that depression is a very real illness and must be treated as such. I don't mean treated in the medical sense, (though medical and/or behavioral intervention is often crucial) but rather in the relational sense. If you are someone who has no personal experience with depression and someone in your life struggles with it, please know that you likely will not ever understand what they face on a daily basis. Try not to get frustrated with their apparent miserable attitude or laziness. Be patient with them when they flake on you or let you down. The battle that wages in their head is large enough without the guilt put on them by those they love. They are not trying to act this way. 

I don't write all of this to make loved ones feel bad about their efforts. It takes a very patient, kind, understanding person to maintain a relationship with a depressed individual and I very much recognize that. I just know that most of the time, I wish those around me understood that I'm not acting this way because it's just who I am as a person. My heart is loving, motivated, kind, selfless, and happy. My brain, when in a depressive state, likes to act the complete opposite, try as I might to change it. But that is the nature of depression. It is truly one of the largest burdens I have had to deal with in my life. It's an illness, not a character trait. It's a disease, not a choice. It's the way my brain is currently responding to a chemical imbalance and the relationship between all of the little faulty neurons in there, not me trying to be a lazy, flaky, dark, miserable, hopeless human. 

So, yes, depression is a real illness.

References:

1.  http://www.healthcentral.com/depression/just-diagnosed-822-143.html