We know that mental health issues—including depression—are incredibly common (about 16 million Americans, or 6.7% suffer from depression alone, according to the NIH). And recent tragedies like the passing of Kate Spade only make that all the more clear. But what we don't always know is what to say, or how to help, a friend who counts themselves as one of those 16 million. What do you say to someone who's dealing with depression? How do you offer them help without coming off like you understand what they're going through when you really don't, or without offending them? It's a significant challenge to anyone looking to be a good friend.
We talked to Lynn Bufka, PhD, licensed clinical psychologist and Associate Executive Director of Practice, Research and Policy at the American Psychological Association for the best practices to support your friend, and get them the help they need.
Show You Care
"People always care when a friend has depression, but often inadvertently say things that aren't helpful," Bufka admits. That's because it's tough to know how to empathize when you haven't experienced depression firsthand. "The first thing is to show you care. Acknowledge what they're feeling, so they know they're not alone. Tell them they matter to you—that's important to convey," Bufka says. It's also easy to try to cheer up a friend by telling them that this will pass, or that they'll just... get over it. It's especially easy to try that route if your friend doesn't seem depressed. "While that may be true, if you're feeling depressed, you don't feel like that," Bufka points out. "Think of Kate Spade. On the exterior, she looked like she had everything together, but if she felt so distressed that she killed herself, things were not OK."
Admit You May Not Get It
You may not totally understand how your friend is feeling, but there's no reason to hide that. "Acknowledge that you want to be supportive, and while you may not understand, you want to be there to listen to them," Bufka suggests.
Offer Concrete Help
As soon as a friend comes to you with the suspicion (or even if you suspect on your own) that they have depression, try your best to offer actual, concrete help. "Ask your friend, 'Do you have a professional you can work with?' If they don't, offer to find them someone. You can even suggest going to the first appointment with them, and sitting in the waiting room," Bufka says. Do your best to be an actionable ally.
Get Them Outside
If your friend has already been struggling long-term with depression, it's often useful to try to get them, as much as possible, to be active with you. "One of the things that's hard for people being treated for depression is that they often look at the world with dark glasses, and nothing seems interesting or fun or enjoyable. But if they can be persuaded to engage with things they like, it may be better than they thought," Bufka says. Tell your friend that you know they may not feel like it, but you used to enjoy going on hikes together, and invite them to do that with you again. "Getting active is something we know is helpful," Bufka says. "Trying to get them to do something they enjoyed previously can be tough, but valuable. Accept that you might be turned down, but find the balance between continuing to offer and also allowing them the space they want."
If It's Serious
If you're worried that your friend is suffering from very severe depression, you may want to take more serious steps. First, ask them if their therapy is helping, or if their therapist is up-to-date on how they're feeling. You can also offer additional resources. "If you're really concerned with your friend's personal safety, tell them that, and make it clear that your concern is out of love for them," Bufka says. If even that doesn't help, you can take the drastic step of hospitalization, or you may want to contact their partner or parent, fill them in, and offer to help with escalation and getting proper treatment.