We have all had conversations that took us by surprise. In our busy culture, many times we pass by one another saying, “How are you?” as we keep right on walking. How many times has someone asked you that question and you respond with “good” or “ok” without even the slightest thought? One of the things that I love about being a Patient Advocate is that when I ask our patients how they are, typically they are willing to open up and discuss those difficult life circumstances they are facing. His Hands can be a safe place for them, where they do not have to pretend that everything is alright and where they can receive encouragement and support.
I meet with patients who have a variety of barriers or life circumstances that are challenges to them. Depression is a common reality that comes up often in discussions in my office. October is National Depression Awareness Month. Graduate students from Mt. Mercy University will be coming on a clinic day to offer our patients a free screening for depression. Some people are already aware that depression is something they struggle with, while others may walk around for years or decades without realizing what their symptoms mean. According to the Anxiety and Depression Association of America (ADAA), depression is the leading cause of disability in the United States for people between the ages of 15 and 44. It affects over 16.1 million adults in the US each year, which is 6.7% of the population over the age of 18.
We may see patients with depression here at the clinic, but chances are, you also know someone who falls into that 6.7% of the adult population who is affected by depression. If one day you said, “How are you?” and someone confided in you that they were struggling with depression, would you know what to do? It is a huge step for someone to have the courage to be honest about a having a mental health issue, so your initial response to them can make an impact.
So, what can you do to help someone with depression?
React with empathy and compassion.
Being vulnerable with others can be difficult. We can have the urge to “fix” the situation, especially when it involves someone we care deeply about. However, a good first step is just to affirm the person in their courage to tell someone they are struggling. Practice active listening and ask good, open-ended questions (but be careful not to overwhelm them with questions). Stay positive with the person and emphasize that there is hope.
Educate yourself on depression.
While medical or mental health professionals are the only ones to diagnose depression, it can be helpful to be familiar with the symptoms so that you can be empathetic and understanding if someone comes to you and expresses a struggle with depression. The following are symptoms of major depressive disorder according to Mayo Clinic:
Feelings of sadness, tearfulness, emptiness or hopelessness
Angry outbursts, irritability or frustration, even over small matters
Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
Sleep disturbances, including insomnia or sleeping too much
Tiredness and lack of energy, so even small tasks take extra effort
Reduced appetite and weight loss or increased cravings for food and weight gain
Anxiety, agitation or restlessness
Slowed thinking, speaking or body movements
Feelings of worthlessness or guilt, fixating on past failures or self-blame
Trouble thinking, concentrating, making decisions and remembering things
Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
Unexplained physical problems, such as back pain or headaches
Encourage them to connect with their doctor or counselor.
It is wonderful to have support of friends and family during a depressive episode, but it is also important for a person to talk to a professional. Encourage them to see their doctor or to set up an appointment with a counselor. They may even need you to just sit in the room by them for support while they make that appointment. Then make sure to follow up and see how the appointment went.
Recognize a crisis.
For some individuals, depression can reach the point that they feel suicidal. If someone mentions thinking of harming themselves or indicates in any way that they wish that they no longer want to live, help is needed immediately. Some doctors will work in a patient that day. For others, waiting a few hours to get help may not be a possibility. If someone is an immediate threat to themselves, call 911 or go to the emergency room. Even in a crisis situation involving depression, try your best to remain calm and to let the individual know how much you care about them.
Let them know you care.
Many people who struggle with depression feel shame or embarrassment. If someone confides in you, make sure that they know that you still care about them, that you do not see them differently or think less of them. Some people can be afraid to bring up the subject of depression again for fear of offending or reminding the person of depression. However, if someone has opened up to you, following up and showing concern will let them know that you care about them and will encourage them.