A four-level guide to supporting a loved one with depression

Depression can be hard on more than just the person fighting it: partners, family and friends too are often affected. My own journey with mental health has involved days of feeling guilty and ashamed of the toll it has taken on my loved ones, in particular my partner and my parents. It took me several years to understand that everyone needs help at some point or the other—that it is not shameful to ask for help.

But, apart from my own hesitations in asking for help, another barrier to receiving help was the lack of knowledge about what does and does not work. Mental health as a topic is only beginning to be understood, and there is much that people don’t know. As a result of this gap in knowledge, on many occasions, my loved ones ended up doing things that harmed instead of helped. Over time, I had to learn to insistently push back and defend myself against well-meaning but poorly designed efforts to help.

It is to close some of this knowledge gap that I am writing this short guide on how to be an ally to someone fighting depression.

If you are here because you are suffering yourself, I hope this will be an easy article to send to loved ones to help them understand what to do. If you are the loved one of someone suffering, this is for you. Thank you for your interest. It shows that you care, and if that care goes into learning something about what your loved one is facing, you will take a big step towards truly helping them. I have divided the sections into four levels: Beginner, Novice, Intermediate and Expert, so there are tips for each stage of understanding.

Don’t forget self-care

But before we get into all that, I want to point out: don’t forget your own self-care. The suffering of a loved one can feel urgent and can take over your life, but none of it should come at the cost of you—even your loved wouldn’t want that. So, be gentle with yourself: do what you can, and respect and reward yourself. At the end of the day, recovery is in the hands of the person suffering; you are just helping out, and every little bit counts.

No one can cure someone else, so don’t place that burden upon yourself. Expect frustrations and relapses, and be kind to yourself when they happen, because they can be really rough on you. I hope this helps!

A four-level guide to supporting a loved one with depression

Level 0 – Beginners: Completely discard the ‘tough love’

When I first told my parents that I was suffering from depression, their reaction was something that people with mental health struggles often face: denial, incomprehension and fear. It took them a very long time to accept that this was a new reality that they had not encountered before. As a result, they made many mistakes in those early days. Most of those mistakes fall under the category of ‘tough love’.

For more everyday forms of sadness, we often use a bit of ‘tough love’ on ourselves to ‘shake off’ the negative feelings and get going again. Many things that people with depression do also seem like they can be addressed by tough love: difficulty getting out of bed, spending too much time on social media or Netflix, or sometimes failing to even do the basics of eating properly and maintaining good hygiene. When you see all this happening, you may be tempted to tell the person exhibiting these behaviours to “pull up their socks”, “just get up and eat”, and so on.

Using tough love can be actively harmful

But tough love is not only unhelpful in these situations, it is also actively harmful. There are many excellent reasons for discarding tough love, but here is the most important one: no one is tougher on themselves than the person fighting depression.

Here is a mild version of what goes on in a depressed person’s head: Why are you not getting up? What is wrong with you? Get up RIGHT NOW. Come on, you can do it. Goddamn it, why aren’t you doing it? Why aren’t you even trying?’

This plays in our head, on and on, for hours. And none of it works. It doesn’t work because this isn’t everyday sadness. Nobody wants to be depressed. If you feel the depressed person is being lazy or indulging themselves, consider this: nobody who is indulging themselves is desperately unhappy doing it. The depressed person is miserable through all of it. There is deep suffering.

No one is tougher on themselves than the person fighting depression

When you add your external tough love to our self-inflicted tough love, all you do is make us feel even worse about ourselves: “Not only am I disappointing myself, I am also disappointing people who care about me.” This disappointment is a shovel we use to dig a deeper hole around ourselves.

A depressed person is fighting hard

People who have not experienced this chakravyuh cannot appreciate what it feels like to be in it. (Even those of us who have been in it forget what it’s like when we’re out of it!) If you could get a glimpse of what is really going on, I promise you’d be amazed by how hard a person with depression is trying to fight. Whenever you see a person with depression doing nothing, think of a duck on a lake: serene on the surface, but paddling furiously underneath.

So furiously are they paddling that they are exhausted from it. Do you remember how you felt the last time you were drop-dead exhausted? Did you have any energy left over to “pull up your socks” at that point? Were you able to do anything other than hope to rest? That is where your loved ones suffering from depression are at, though it does not seem so on the surface.

We know it is hard for you to see us be that way and do nothing, but if the choice is between doing nothing and giving a dose of tough love, please choose to do nothing. It will help more.

(Notice how I haven’t yet said you should talk to people with depression or give them advice. The talking bit is harder, and you are not ready yet.)

Level 1 – Novice: Gently Lend a Hand

After some time, I learned to react aggressively to attempts of ‘tough love’ on me. I felt horrible about getting angry with my loved ones, but now I know that anger was actually my friend; even though I did not know it then, and could not explain it to my parents, it was protecting me from the effects of their incorrect attempts.

But this kind of aggression led to a different kind of problem. It led loved ones to leave me alone when I was down. This was better than being subjected to unsolicited advice or provocations, but it was far from ideal. A person with depression is like someone who has fallen into a hole—we cannot extricate ourselves. Though we do need protection from harm, if that protection means further isolation, recovery can be delayed by years.

Luckily, there are many things other than tough love that loved ones can offer. To think of what you can do, focus on the real problem: that the person is drop-dead exhausted from their non-stop struggle against depression, and in their exhaustion, sees no way out. That is the thing to address: their exhaustion. If you can help reduce the degree to which they are overwhelmed, you will open up space for them to heal themselves.

Ask them what they need help with

How to reduce the overwhelm? Here’s a lovely tweet that a fellow warrior (blue salaam to you, A!) shared with me recently:

Ask your loved one what it is they need and/or have been struggling to do, and offer to help. If they’re running out of supplies at home, offer to take them to the store and shop with them, or if they’re not feeling up to even that, go buy them some supplies. If the dishes have piled up, do the dishes. If laundry has piled up, help with that.

Here’s the catch: they won’t tell you they need help. I still feel ashamed when I have to, because during these times I’m already feeling like I am a burden on my loved ones. What tends to help me is to be reminded that I’ve been there for my loved ones many times in the past, and that it is no big deal for them to take up some small tasks.

In this way, you can try and head off some of the arguments people with depression tend to use. They will say, “But I don’t see a time when I’ll be able to repay you, because this will last forever.” At this, tell them they will get better, and this isn’t about repayment anyway. They will think, “Look at me, I am wasting their time.” Head that off by saying it makes you happy to help out, and will they be so generous as to give you the opportunity to help? If someone says they are happy to do something for me, it is much harder for me to decline what I actually sorely need.

There have been days when I haven’t stepped out of the house even though I wanted to because I had no clean clothes to wear, and doing laundry and stepping out was just too much to ask. Anything you can do to take care of the must-dos of our day-to-day lives will help.

Notice how I still haven’t said you should talk to them about depression. You’re still not there yet.

Level 2 – Intermediate: Tell Your Loved Ones They Matter

Depression comes with an impressive feature-set that allows it to cling on to a person. One of the things it is amazing at doing is making people feel entirely worthless.

When I would be depressed, I’d feel like a total failure. Everything I had achieved in the past would seem meaningless and pointless. In the present, I’d be struggling so much to even eat three meals and take a shower that I’d feel like I was useless now, and would never be of any use to anyone again.

These feelings of worthlessness would make me feel like nobody would care or notice if I vanished. At their worst, they made me feel like the world will actually be a better place if I vanished.

Much of self-worth relies upon what others think of us and our role in their lives. This is what makes tackling feelings of worthlessness a good place for an ally to intervene.

Assure them that they are valued even with depression

Even if a loved one with depression is not being able to pull their weight right now, and may take a long time to get back to themselves, they are still precious to us. To understand the value of a human life, just imagine your life without them. How much of a hole they would leave, and how impossible it would be to fill that hole. As John Milton wrote in On His Blindness, “They also serve who only stand and wait.”

So tell your loved one: “Even if you do nothing for the rest of your life, the fact that you are there means a great deal to me. The fact that you exist, that you breathe and eat and sleep, that I can see you and talk to you, all of these are more precious than I can say.” We don’t have to fake this. It’s 100% true. It’s just that the person with depression has lost sight of this. (Thank you, I.D., for regularly reminding me when I forget).

No matter how much depression can constrict someone’s life, no matter how much it can debase a person and reduce them, it cannot in the slightest affect the fundamental value of their humanity. It cannot take away their past, nor erase their future potential.

Even if a loved one with depression is not being able to pull their weight right now, they are still precious to us

Avoid the guilt inducing approach

This can be tricky, so do avoid a common mistake: this is not about making the depressed person feel guilty. You are not saying, “How can you not think of the impact your going away would have on my life?” They have more than enough guilt. Instead, tell them that even right now, at their most depressed, they are precious to you. That even deeply depressed so-and-so is the one you want in your life.

Not too long ago, when depression brought one of its close friends, suicidal ideation, to the party inside my head, a friend told me (I’m paraphrasing), “Dude, you have already done so much, you don’t have to do a single thing more. You deserve a long life based on just what you’ve done so far. You can retire right now, rest on your laurels, grow fat, or whatever else you wish. You are that precious to me.” (thank you, R). It makes a big difference every time, and one never stops needing to hear it.

Level 3 – Expert: Be a Safe Space

Depression, at the heart of it, is not a mental ‘illness’. Instead, the real problem is not knowing how to process negative emotions and trauma. Depression is just a symptom of this underlying problem. Since this symptom itself is so severe, it can become an issue in its own right, and this is why we refer to depression as a mental ‘illness’. But at this advanced level of allyship, it is important to recognise the true cause of these symptoms.

As a society, we are very bad at understanding emotions. Indeed, we have been taught all the worst ways of dealing with them. We have been taught to distrust emotions and favour our intellect over our feelings. When emotions get strong, we are taught to suppress them so that they don’t affect our lives. This training starts very early, in our homes, and is reinforced at school and at work.

For some of us, whose emotions are not as powerful, this is not as much of a problem. But for those of us who feel more keenly, the pile of suppressed emotion grows rapidly, until our psyche cannot take it anymore. Depression is really our minds telling us: business as usual cannot go on. You need to do something about all this.

Suppression of emotions is not healthy

Why is emotion suppressed and denied? It is because something we have learnt that is completely back to front. We have learnt that if we give voice to an emotion, if we say something like “I think I am worthless and don’t deserve to live”, or “I will never get better”, then we will believe it more; in other words, giving voice to an irrational emotional thought will make it more real.

The exact opposite is true. Think of saying something in anger. Sure, anger makes us say and do things we do not mean, and we must apologise profusely, but often, having said something rude, we find the emotion loses its grip over us. We return to ourselves, and feel less possessed, and even wonder where those words came from.

When a person is dealing with deep depression, the most amazing thing another human being can do for them is tell them: “You can tell me anything. In this safe space, nothing you say will have any consequences on the outside world. Whatever you say is valid; even your most irrational thought hides a kernel of truth, hides something about what you are experiencing right now, or have experienced in the past. In this safe space between us, where there is no judgement and no dismissal, you can take out these thoughts and feelings, air them, and see what they have to tell you.”

A word on seeking therapy

I deeply value therapy, and encourage anyone struggling with even basic depression to try many therapists till they find one they connect with. But equally, I feel that in our world we have forgotten how to fundamentally be there for each other. A good friend can make the work of a therapist much easier. If you have it in your heart, be that good friend.

Because you know your loved one deserves it. Because survivors of mental illness are badass and tough as nails. Because you know that when they get their mojo back, they will add more to your life and to the world than you ever had to give them.

A variation of this article was previously published (in two parts) here