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DEAR MAYO CLINIC: My brother has been diagnosed with depression. I want to help him, but I do not know what to do. Can you give me ideas for how best to support him?
ANSWER: When a loved one is affected by depression, it can be difficult to understand what is happening or what you can do to help. It is OK to be confused and wonder how you can assist.
Clinical depression is an incredibly complex and individualized process. Understanding depression spans multiple levels of knowledge, from genetics and brain biology to culture and situational stress. Yet despite all the information, universal truths or simple solutions do not exist.
Gaining perspective on what your brother is experiencing can be critical to the support process. Visualizing depression as a downward spiral is one way to simplify and understand clinical depression.
The downward spiral may begin with the person feeling worse than usual from physical, social or psychological stressors. A worsened mood may lead to taking part in fewer meaningful day-to-day activities. Self-criticism and stress increase due to mounting responsibilities or missed opportunities. Depressive thinking may encompass guilty thoughts, pessimism and irritable behavior.
As the spiral develops, a complex dynamic emerges. Your loved one becomes increasingly stressed while simultaneously less capable of coping with this stress. The response of the brain to this dynamic is to slow, stop and depress. A person can get stuck at the bottom of the spiral for weeks, months or years.
The silver lining is that if people can spiral down, they can spiral back up. However, depression affects the motivation, energy and curiosity needed to spiral up.
It is challenging not to be able to fix a loved one's depression. But you can help them get started to move on an upward path and support them in their journey.
Here are some suggestions to offer support and understanding:
Depression signs and symptoms vary from person to person and can include:
Symptoms can be severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships. Other people may generally feel miserable or unhappy without knowing why.
Children and teens may show depression by being irritable or cranky rather than sad. Clinical depression does not require profound sadness or intensely negative feelings. Rather it can be a lack of positive emotion.
People with depression may not recognize or acknowledge their symptoms. They may have difficulty seeing the point of getting treatment. This is where you can be most helpful.
Consider the following:
You can assist your loved one in the healing process.
Consider these ideas:
People with depression are at an increased risk of suicide. If you believe your brother's illness is severe or in a potentially life-threatening emergency, you may need to:
Supporting someone with depression is challenging. Part of the challenge is witnessing a loved one's struggle and knowing you cannot complete the path for that person. Understand that emotions such as frustration, helplessness or anger may be natural responses to a loved one having depression.
Practice acceptance and coping with difficult emotions by permitting yourself to prioritize your mental health. Devote time for hobbies, meaningful experiences, physical activity and other valued relationships. — Dr. Erik Wing, Psychology, Mayo Clinic Health System, La Crosse, Wisconsin
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