How can I best help my depressed friends & also take care of myself?
November 12, 2013 10:04 AM   Subscribe

I watch many people who I care a lot about suffer from depression. I would sincerely do anything to help them, and do whatever I can think of: conversations, little notes and random texts, hanging out, offering help with thinking through options if they want it, etc. But, as someone who is lucky to not have 'been there', it's hard to know when I'm crossing a line and what's really needed. In fact, I think most of my efforts translate to "I know you mean well, but..." even though I'm also one of the few people these friends go to when things get bad. On top of worrying and trying to help, I also spend (probably too much) time thinking about what they're going through and what would be most helpful. It's exhausting for me and stressful, but it's personally not an option not to care. I end up internalizing this stuff and it affects my normal activities, even though at the end of the day, I'm not the one suffering. I want to be as good a friend and resource as possible to these people I truly care about and also want to avoid falling victim to anxiety or depression myself because of it. Any tips from either the 'been there' - depressed and knows what's helpful - perspective or the sincerly-caring-friend side of this equation would be much appreciated. Thanks.
posted by anonymous to Health & Fitness (15 answers total) 10 users marked this as a favorite
One thing to keep in mind is that, should your loved ones need some time to push away from you for awhile, make sure you don't take it too personally. I would let them know that you're available anytime they need you, but that you are not disappointed with them if they feel that they're not up to interacting or talking about their issues.

Knowing there's someone there who isn't angry that I don't feel like talking is a HUGE help to me when I'm in a depressive time.
posted by xingcat at 10:14 AM on November 12, 2013

I want to be as good a friend and resource as possible to these people I truly care about and also want to avoid falling victim to anxiety or depression myself because of it.

It sounds like you're doing plenty, and your friends appreciate it. Maybe not in the moment, but it's on them to say "I know you mean well, but..." If they're coming to you when they need you, then believe what they're telling you - they appreciate you and you're helping.

As for your stress/anxiety over this - depressed adults need support but they don't need anyone doing harm to themselves through caring for them. Nobody wants the burden of knowing that their illness is causing someone else harm. Take care of yourself. That way you can be a friend without burnout, without stress, without anxiety.
posted by headnsouth at 10:16 AM on November 12, 2013 [1 favorite]

In general, the best things you can do for a friend with a chronic illness are: keep in touch, listen if they want to talk about it, adapt the stuff you do together to fit their restrictions, and don't try to second-guess their treatment plan.

Depression is a chronic illness. So all that is stuff you can do for a depressed friend too.

It sounds like the last one — not second-guessing their doctors or therapists — is gonna be the hardest one for you. Your job as a friend is not to cure their depression, or to give them advice on how to get better. Your job is just to show up and hang out. Once you accept that fact, things will probably get less exhausting for you.
posted by Now there are two. There are two _______. at 10:38 AM on November 12, 2013 [2 favorites]

Exhausting yourself worrying about your friends is anxiety - yours, not theirs. You need to put your own self-care first.

Also know that you can solve or fix other people's depression. You can be a good friend, you can offer to help in any way that works for them AND you. But they're adults, they're in charge of their own selves, not you. I know this isn't what you asked, but you might find that a little time with a therapist helps you better draw boundaries between yourself and others' -- which will help you help them (and yourself).
posted by ldthomps at 10:40 AM on November 12, 2013 [1 favorite]

You can care without by default taking responsibility for other people's care. If you are doing so much for so many friends that it's beginning to impact your quality of life, then you are doing too much. For your very closest friends, checking in once a day, making sure they eat once a week, and listening and hanging out as needed. For someone in serious crisis, that can mean staying over too but the number of times I've done that (as either the needer or the friend) can be counted on one hand.

In other words, resist the urge to get sucked into other people's emotional drama, even when their internal worlds are stormy and dark. Don't make their drama or despair your drama or despair.

Also, keep in mind that nothing you can do will cure someone else's depression, so this isn't a question of trying hard enough or trying harder.
posted by DarlingBri at 10:42 AM on November 12, 2013

It sounds like most of your stress/burnout is coming not from the time you spend with your friends, but from worrying about them - and worrying that you're doing the right thing for them.

This may sound kind of obvious, but I think it's important to be reminded that you cannot fix your friends. You can't cure their depression. It's not about you. Really, all you can do is make things a little bit easier. And when you're being a good listener, and only trying to make things a bit easier, you're really unlikely to make things worse.

I mean, let's say you wanted to help Friend A. If your goal is just to make their day a bit easier to get through, maybe you invite them to get ice cream. There's pretty much no way that inviting them to get ice cream is going to make their depression worse. Now, it's possible that they won't feel up to getting ice cream, and they'll decline. Or maybe they'll go anyway, and either they'll end up having a good time, or maybe they were right and it's kind of a bad time for both of you.

The worst case scenarios here are fairly fleeting - they may feel a bit bad for declining, or you may feel a bit bad that inviting them to get ice cream wasn't the way to make them feel better for a few hours, but in the larger scheme of clinical depression, that's pretty much just a small wave in an ocean.
posted by lunasol at 10:43 AM on November 12, 2013 [1 favorite]

It's wonderful that you are such a caring friend, and while I understand that you can't just stop being a caring friend, you have to understand that even if you're the most caring friend in the whole world, you cannot fix your friends.

Depression is an illness, and it's one that often does not improve without treatment. Your friends need treatment, and while having a good support system is very helpful, it's not a replacement.

I also agree to not take it personally if your friends push away from you for a little while.

And as for your stress/anxiety over this, setting some boundaries and taking care of yourself doesn't mean that you don't care and doesn't mean that you are a bad friend. It would be totally reasonable to say "Friend, I love you and care about you, but I cannot drop what I am doing right now to handle your crisis."

I've been on both sides of this equation. In fact, a few years ago I had to tell one of my closest friends that she could not call me relentlessly when she was depressed or anxious. (She would call my cell, then my house, then my boyfriend, then my cell again...). I felt terrible, I knew she was suffering, but I had to tell her I could not be a substitute for the treatment that she needed. I told her I would help her find a therapist, drive to see her, help her out with whatever she needed, but I had to set some boundaries for my own sanity.
posted by inertia at 10:53 AM on November 12, 2013 [2 favorites]

Get them to do stuff. Action helps, as opposed to sitting alone stewing in their own juices. They'll always favor inaction - i.e. will find reasons not to accompany (that's part of the depression). Talk them into it anyway. Make it seem like they're doing YOU a favor by coming along.

Resist cheery urgings (e.g. "Isn't it beautiful out here?"). It will make them feel worse that they can't see things this way, and they'll feel irritated if you keep urging this. Instead let them bumpily adjust, in their own way, to wherever you're bringing them and whatever activity you're involving them in.

Don't over-stimulate (lots of chatter), that too will irritate them, and cause them to retract further into themselves. There's got to be a balance, and you need to be sensitive. Lure them into an activity, preferably involving physical movement. And don't push too hard....make it a lure/pull rather than a coax/push.

Most of all, don't "play into" the depression. They're seeing the world through dark grey glasses. And they KNOW they're doing this, and realize, to at least some extent, that it's not an accurate view. They lack the ability to switch perspectives; they're stuck. So if they tell you everything sucks, or if they recite a litany of sad stories, resist the urge to sympathize. They will gobble that sympathy like candy, and it will reinforce their perspective, which requires the opposite of reinforcement. Just treat them normally. Don't indulge their negative spiel, just keep bringing attention and conversation back to the here and now. It doesn't help depression to "talk about it". Non-depressives have trouble understanding this, but it's important to remember that they need to be in the world, in the present, in the external, not burrowing ever deeper into their depressive internality.

Most of all, don't take the depression seriously. It's not a "thing". It's just a stuck perspective, and playing to (or reinforcing or justifying or solidifying) that perspective will be totally counter-productive. There's nothing real there....that's why it's called mental illness! To be sure, every depressed person has an arsenal of sad stories and grievances they'll spew ad infinitum. But know that the depression comes BEFORE all that. Everyone has issues and problems. Depressed people obsess over them and suck on them like pain lozenges. Don't play into that; you're not helping. And if you solved all their problems, they'd just find or create or imagine new ones to obsess over.

Also: try not to get brought down, yourself. it's contagious. If you really want to help, be strong. It helps to know there's nothing real there; it's just a stuck perspective. Nothing more. So be as "normal" as you can be, even if you're getting nothing but weird energy and "meh" responses from the person. You need to be the solid one.
posted by Quisp Lover at 10:53 AM on November 12, 2013 [2 favorites]

I can't speak for everyone, but what has been a huge help for me is that I have talked to my husband about it when I WASN'T in an emotional hole. We talked when I was emotionally okay about what he can do to help me, what isn't helpful, etc. The reality is that every depressed person needs different things. Some people need space and to distance themselves a bit while they get things back under control, other people need affection and comfort and the presence of other people to help pull them out, other people need distraction. There is no way to know what your friends need without talking to them about it. Ask them what sorts of things are and are not helpful when they are having a rough go.

And as others have said, you can't saddle yourself with their suffering any more than you should saddle yourself with the stress of a friend's broken bone or diabetes. This isn't yours to fix. This isn't your burden to bear. Depression is an illness that cannot be cured by cheering them up or doing things for them. Depression REALLY can't be cured by your worrying about it. I'm dead serious. Knowing that my depression was so worrying and stressful for a friend of mine would make me feel guilty and probably worsen my emotional state. Oh, and please don't go all Pollyanna and "Life is so wonderful!". Few things are more annoying than listening to fake forced uber happiness and positivity when you're in a depressed state. It is no doubt well intentioned, but not the way to go about it.

Honestly, sometimes the best and most helpful thing you can do is just try to behave as normally as possible. No special gestures or gifts. Maybe an extra phone call or offer to hang out, but other than that just be normal. It can be really nice and a relief to be able to spend "normal" time with someone instead of having someone treat you like you're about to shatter and break all the time. Sometimes the concern and extra affection is nice, but sometimes I really just want to act like everything is normal and pretend that my emotional state isn't ruining and changing every part of my life.

but again, you can't know what your friends need unless you talk to them each about it and ask what they would appreciate the most.
posted by PuppetMcSockerson at 10:53 AM on November 12, 2013 [2 favorites]

One more thing. Avoid "Would you like....?"

Their answer will always be "No". Anything other than lying in bed seems like friction, so the prospect of any activity at all will rub them the wrong way. That's the mechanism that fuels the depression, and reinforces the lethargy.

So don't ask. And don't try to extra-pleasing. E.g. don't "cook their favorite foods" or "take them to their favorite places". Their lack of delight will make them feel much worse. They'll see how depressed they are (in comparison to how these things used to make them feel), and that's a nasty reinforcer of the depression.

Instead, just activities - action - period. Bring them shopping for something dull. Go for a walk just ANYWHERE (doesn't have to be somewhere beautiful....they probably wouldn't recognize or appreciate it anyway; in fact, their own non-appreiation might depress them). Get them to count change or solve a puzzle or build something arty with you. Have them watch the kids or install insulation or rake leaves.

Take the initiative, and don't take no for an answer (again: the answer is always "No"). If you keep asking them what they want, or how they feel, you're just sending them on a trip back down the tunnel.
posted by Quisp Lover at 11:05 AM on November 12, 2013 [3 favorites]

Their stuff is not your stuff. You are not responsible for their happiness, you cannot fix them, and you cannot solve their problems on their behalf no matter how much you think you can. You are responsible for you and you alone, which means that when they are in the pit of despair, you need to stay up top on solid ground, not get down in the pit with them. This is a really hard thing for us to understand as empathetic human beings, but it is essential for your well-being, and theirs. Treat them like they are not depressed, because it's one thing to acknowledge depression, but it's another to feed it by babying that person too much. This will come with practice, and as someone who was depressed and suicidal for some time, I appreciated the people in my life who were constant because they pulled me out of my funk by example.
posted by These Birds of a Feather at 1:59 PM on November 12, 2013 [1 favorite]

In order to be helpful, it's very important you don't view every person with depression the same way. Just because different people have an experience that is labeled "depression" does not mean they are the same experience or they are the same things. Therefore, also, what will be helpful to one person's life, will be different from what is helpful to another.

Further, I also recommend you don't attribute everything they say or do, or every aspect of their personality to "depression" when you think it's not "normal". This is what's done, unfortunately, by about 99.9 percent of the population. Anytime someone with depression has any thoughts or acts in a way that is outside the norm (average) it is explained away as being attributable to their illness. This is bullshit and is just a maneuver used to enforce the domination of prejudiced ideas of what a "healthy" person is supposed to think.

I think it's great that you have this much concern for your friends. I think, sadly, it's very rare, at least in the US, for people to care too much about their friends as it's seen as taking away time and energy from their own interests. Just make sure you sometimes get a little acknowledgement or appreciation for your effort and care, otherwise it can be a bad situation as then it becomes completely non-reciprocal.
posted by Blitz at 2:41 PM on November 12, 2013 [1 favorite]

I found this book to be helpful when I was dating someone who was depressed and was worried that I was becoming depressed myself. You might also find it helpful. There are a lot of resources and support info out there on the internets for people who are affected by depression in a secondary way.

Speaking as someone who is actually clinically depressed and is in treatment for it, I would like to stress very much that you need to respect your friends as people with their own individual differences and their own experiences of depression. Depression is not an illness that is always experienced in exactly the same way by everyone. It doesn't have consistent causes, why should it have consistent effects? The approaches suggested above may work for some people and not for others. Personally, if someone tried to bully me into doing what they told me to do, I would be likely not to speak to them again. But you may find that you have a friend who is chronically indecisive and is paralysed by their depression and actually is okay with having firm suggestions made about what to do.

So I definitely endorse asking your friends what they find helpful. I know someone who retreats from everyone when depressed and pestering her to stay in touch is actually the single worst thing you can do. I vacillate between needing a lot of time to myself because I am an introvert and the little energy I have needs to be recharged by myself, but then also needing social activities and contact with people I trust. Group activities are really bad, but one-on-one or a few good friends are fine. There are also the times when I really need someone else to instigate contact so I don't wind up feeling that no one actually wants my company. And there are the times when I realise that I cannot expect people to psychically know when I need them and I ring and am clear about what I need. But I've had some experience managing my depression over many years.

Allie Brosh, creator of Hyperbole and a Half, has gotten quite a bit of press on the blue, not least because of her posts about depression. This is just one person's experience and it changed - she describes how she goes from feeling too much to not feeling much of anything. She also writes about the various responses from friends, particularly the unhelpful ones. So if you have a friend who tries to talk to you about their dead fish, start by acknowledging that the fish are dead and it sucks.

I also agree very much with just behaving normally. If your friend(s) wants to talk about what they're going through, listen non-judgementally. It can be very easy for people to think that their friends would hate them if they knew what was going on in their heads, and it can actually help to talk about it. You are not their therapist, but listening without trying to fix anything or getting angry or adding fuel to their misery is a really good thing. Talking about normal stuff and doing what you would do with them if they weren't depressed is great as well, as long as you respect that they may not be up to some things because they literally may not have the energy. It's a fine line, being supportive without being indulgent; being normal without pushing. It's great that you want to be there for your friends and please do. But also please look after yourself and don't invest your own self-worth in how well they're doing, because that's really not something you can control.

Good luck, thanks for caring and thanks for asking!
posted by Athanassiel at 10:02 PM on November 12, 2013 [1 favorite]

Allie Brosh, creator of Hyperbole and a Half, has gotten quite a bit of press on the blue, not least because of her posts about depression.

Yes, you might find it helpful to listen to this interview with her from today's Fresh Air, in which she specifically addressed some of what you're asking about.
posted by torticat at 10:56 PM on November 12, 2013

The thing I appreciate most is friends who don't drop you but also let you be flaky. Part of how they do that is by not setting themselves up to resent me when I'm flaky - i.e., by taking good care of themselves so I can trust I'm not imposing on them.
posted by Salamandrous at 3:28 PM on November 13, 2013

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