If you've ever known someone with depression or have battled it yourself, you're deeply aware of the accidental insensitivity that can often come with it. For those who may not understand the complexities, it's easy to say things that have the potential to do more harm than good.
While the U.S. has one of the lower clinical depression rates in the world, the number of people it has an impact on is still significant. An estimated 1 in 10 Americans suffer yearly from the illness.
So how can we help someone who may be affected? According to Dr. Adam Kaplin, an associate professor in the departments of psychiatry and neurology at Johns Hopkins University, it's not just your words, but your actions that can be the most supportive.
"It's best not to say anything that is going to make them think that what they're dealing with is because of a lack of coping skills, personal weakness or a character flaw," Kaplin tells The Huffington Post. "The worst part of depression is that it narrows the field of vision into a very small tube so they can't see the options. A lot of [the goal of helping] is giving people a hope that things will get better."
Kaplin advises that while every case is different, there are some general principles to follow when it comes to helping those who find themselves in this situation. Below find the six things people shouldn't say to someone with depression.
1. "I know how you feel."
Empathy is a great trait to possess, but in certain cases it's best not to try to relate if you really don't know what the other person is going through, Kaplin says. If you do have experience with depression, it may help to share with them that they're not alone -- as long as you're not making the conversation completely about you. "Each person experiences depression in their own way," Kaplin explained. "Telling someone you know... invalidates what they’re going through so just saying 'that must be difficult' validates that they’re having a hard time and their suffering is real."
2. "Suck it up."
You may not intend to trivialize someone's condition -- but with phrases like "suck it up" or "just be positive," you may be doing just that. "What [most people don't realize] about depression is that it’s debilitating to concentration, focus and sleep. It changes lives and people get off of trajectory of where they’re heading," Kaplin explains.
Kaplin says that it's crucial not to underestimate the impact of depression. Approximately 20 million American adults suffer from mood disorders in a given year.
3. "Cheer up."
"The phrase 'cheer up' is like a close cousin of 'suck it up,'" Kaplin says. Telling someone to be cheery isn't going to do much -- in fact, it may make them feel worse. Kaplin suggests instead of advising them to perk up, try just offering your presence. "Just listening to what that person is going through and saying something like, 'Wow that must be hard,' gives them validation that it's a difficult time. If they could cheer up, they would have by now."
4. "You have to be strong for your kids."
When trying to comfort someone with depression when children are involved, the process may be a little bit trickier. Kaplin explains that while you may think you are helping out by giving advice about the kids -- or even offering to help by watching them for a few hours -- it may be misinterpreted. "They may be sensitive to that and think, 'Oh, she thinks I am a terrible parent,'" he says. "I think there are ways to help and put it in a way that is sensitive to those thoughts."
If you are trying to help with the kids, Kaplin suggests offering to plan an outing for your family and their family, and keep it as an open invitation. "This way, you aren't accusing anything, you're just trying to be helpful [while remaining] diplomatic and leaving them a choice [to accept or decline]."
5. "It's all in your head."
Like "suck it up," this also falls into the territory of minimizing what may be going on -- and it may not be entirely possible to just "think your way" out of depression. In a 2011 blog post on Psychology Today, licensed psychologist Dr. Clifford Lazarus explains why actions, not just thoughts, are key to overcoming the illness:
One of the most effective psychological therapies for depression is called "Cognitive Therapy" (CT) that aims to alleviate depression by changing people's thoughts from negative biases to more positive patterns. Ironically, despite extensive research and clinical experience that would seem to validate CT's effectiveness, simply combating negative thoughts and replacing them with more rational beliefs rarely helps depression.
This is not really surprising when you consider that you can't simply talk people out of, or have them just think themselves out of, phobias, right? To truly conquer a phobic reaction a person must face, approach and confront the fear -- that is, he or she must take behavioral steps and specific actions, not merely think about it differently or just acknowledge that the fear is irrational. Similarly, challenging irrational beliefs, focusing on more positive thoughts, and trying to change depressive, cognitive schemas is not very likely to shift one's mood out of depression. What will do the trick, however, is to change how one acts.
When it comes to a loved one with depression, Kaplin says it can often feel like you've done something wrong and you're being shut out, but just realize that it's nothing personal. "It can feel like that person is cold and isolated and it feels that way because that illness has isolated that person from their own feelings," Kaplin says. "[As they overcome depression], their tunnel vision begins to expand and they're able to see more possibilities. As people get better, their world will broaden."
6. "Just think -- there are others who have it worse than you do."
While you may be trying to put things into perspective, it may not be received that way. "[The key] is to recognize their suffering as opposed to being dismissive," Kaplin says. "With a phrase like this, there may be an underlying issue in that we don't really know what to say, so we're trying to make ourselves feel better by trying to make the person suffering feel better."
Kaplan suggests that instead of offering perspective, just saying nothing or hanging out with someone for a little while may be a good idea. "A lot of times it's just recognizing that you can't always take someone's pain away, so it's just a matter of being comforting," he says. "There are certain messages that you do want to put forward. Just knowing that you're not alone is half battle when it comes to depression, so just being there and connecting will help."
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Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.