Our brains are the most complex Control Centre we know of, built with billions of nerve cells (neurons) and providing hundreds of electrical pulses per second. Each neuron makes about ten thousand connections to neighbouring neurons to the extent that there are about as many connections in a single cubic centimetre of brain tissue as there are stars in the Milky Way. Hardly surprising then, that when our Control Centre malfunctions, as is the case when depression strikes, it wreaks havoc with what we might otherwise call ‘normal’ processing and functioning.

In practical terms, this means that a typical sufferer of depression may find themselves:

• Struggling to concentrate and process information

• Withdrawing from social interaction and loved ones

• Seeing things in very black and white, all-or-nothing terms

• Experiencing disturbed or excessive sleep patterns

• Feeling tired all the time, especially on waking up in the morning

• Skipping meals and daily hygiene routines

• Feeling a prolonged anxiety or sadness that they often can’t ascribe to any particular event

• Stopping hobbies and activities they used to like doing

• Feeling helpless and hopeless and worthless

• Suffering from low self-esteem and confidence

• Ruminating on problems and what’s not working

• Uncontrollably thinking negative and/ or destructive thoughts

When we see such profoundly negative changes in the well-being of our friends and loved ones, we often jump to the rescue with well-meaning comments, only to be met with a rebuttal, anger or the depressed person simply distancing themselves from us. The problem is that often what we say is born out of our own unease with how they are rather than out of a fundamental understanding of, and empathy with, the depressed person. In short, as tempting as it may seem to tell a loved one to try not to let themselves feel so depressed, or that there are others worse off, or the dreaded ‘just try and pull yourself together and get through it’, this approach is likely to do more harm than good.

Let me explain why…

Depression is not a choice. It isn’t due to weakness, moral failure or lack of willpower. If the person could do what you are suggesting, then they would, believe me! The problem is that they can’t, but focussing on it highlights their personal failure to get their life back on track. It reinforces what they already believe about themselves which is that they are a failure and there is no hope.

So how can you help someone suffering with depression?

1. Let them know that you’re there for them – unconditionally. Depression can feel like the loneliest place in the world for the person affected. So make time to be with them. It doesn’t have to be for long periods of time. It doesn’t have to be intense. It doesn’t even have to be ‘in person’.  A short  “I can see you’re having a hard time at the moment; I’m here for you when you need me.” note is good enough. Just be available.

2. Don’t judge. If you take them flowers and find a week later that they have let them die, get them some more. If you took them some fruit or a pastry but when you next visit it’s still there on the side, just pop it in the bin. Resist the temptation to form an opinion.

3. Listen, really listen, to how they’re feeling but don’t even think about interpreting it – it’s their reality not yours. Offer a hug or a hand or a hanky, but just hold back from making a comment.

4. Refrain from offering advice unless they ask for it. If you want to do something more, ask whether they would mind you washing the pots, or bringing round a meal or doing a spot or washing/ ironing/ gardening. And don’t be offended if they say ‘no’.

5. Encourage them gently to keep to as normal a routine as possible and facilitate this where you can.

6. Reassure them that their condition is temporary and treatable and they won’t always feel so bad. Direct them to any appropriate resources if they are open to this.

7. Offer hope but not of the ‘unbridled’ kind. If you are a naturally exuberant person – the proverbial puppy dog with two tails – try and tone it down a little. Let them know that when all this is over (setting the expectation that things will indeed be better one day), you will still be there and so will they.

8. If you can see the problem behind the depression, try and find a way to work with the individual to find an acceptable solution, but make sure the timing is right.

9. Let them know you believe in them and it doesn’t matter if they don’t believe in themselves right now.

10. Don’t make them feel any more guilty than they are already if you’re being negatively affected by their illness. They have enough to struggle with just trying to keep themselves afloat and will already be beating themselves up, without having the added guilt of knowing that they have brought you down with them. Find other ways to keep yourself mentally and emotionally well while you’re supporting the depressed person.

Depression is not a choice. It can strike anyone at any time. As Dorothy Rowe [1983] writes; “It seems to be […] a period of unhappy withdrawal, an uncomfortable hibernation where the person comes to realise that something has gone wrong with his life and that something needs to be put right.”  Help them put it right, their way.