8 Things You Shouldn’t Say to Someone With Depression
Depression is one of the most common mental health problems worldwide. It is also a common driver of addictive behavior. One study found that among people with a mood disorder such as major depression or bipolar disorder, about 32% also had a substance use disorder--that’s about four times the rate of substance use disorders in the general public. Common symptoms of depression include depressed mood, inability to enjoy anything, irritability, disturbed sleep or sleeping too much, weight changes, inability to concentrate, fatigue, lack of motivation, slow movements, aches and pains, substance use, reckless behavior, and thoughts of suicide or death. If someone you care about has depression, you probably want to help but it can be hard to know how. The following are some things you should avoid saying to someone with depression.
1.)“Snap Out of It”
If you’ve never experienced depression yourself, it can be hard to understand why someone can’t get out of bed, can’t focus, never seems to enjoy anything, never seems to be motivated, and so on. You may feel like they’re just not trying or they need someone to motivate them or wake them up. However, that’s not how it works. Telling someone to “snap out of it” or “cheer up,” even with the best intentions typically just makes things worse. Depression is a complicated problem and more and more research is showing that many forms of depression have physiological as well as psychological components. Telling someone to snap out of it may be like telling them to snap out of the flu.
2.) “Why Should You Be Depressed?”
We usually assume that if someone is depressed, they must be depressed about something. Often, this is true. Major life stressors such as a divorce, a job loss, or the death of a loved one can sometimes precipitate an episode of depression. Even a seemingly positive event like having a baby can cause depression. However, you don’t necessarily need a reason to be depressed, especially if you have had one or more episodes of depression in the past. It can occur spontaneously. Also, we all have different brains and different bodies and we all react to stressors differently. Even people who appear to have very good lives can be deeply depressed.
3.) “It Could Be Worse”
Similar to the point discussed above, “it could be worse” assumes you have to have a good reason to be depressed. You may be trying to put things in perspective, perhaps pointing out that there are people in your own neighborhood who don’t know where their next meal is going to come from, so you should feel pretty good about your life. Typically, this kind of strategy backfires. Someone with depression is just likely to feel bad about feeling bad. Also, a typical feature of depression is that you can’t imagine life getting better but it’s very easy to imagine life getting worse.
4.) “It’s All in Your Head”
People who haven’t experienced depression often imagine it as a problem of perspective--a short-sighted gloominess that would go away if you only looked at life differently. While it’s true that your thinking often contributes to depression, such as when you get stuck in cycles of rumination, worry, and cognitive distortions, there are two problems with telling someone depression is all in their head. First, it’s not all in your head. As noted above, recent research has found that much of depression may actually be in your body, particularly in the form of inflammation. Second, to the extent that depression is in your head, it’s nearly impossible to think your way out of it. The bleakness of your outlook doesn’t seem like depression; it seems like reality and it’s hard to argue yourself out of something you believe is true.
5.) “Don’t Be So Selfish”
From the outside, someone with depression can seem self-centered or even solipsistic--they don’t want to work, they don’t want to help out, they don’t even want to get out of bed because their life seems so uniquely horrible. However, there’s no sense at all in which depression is an indulgence. As discussed above, depression feels more like a trap and you can’t think or motivate yourself out of it. Calling someone with depression selfish only adds to their burden of self-loathing. Again, imagine calling someone with the flu selfish, and that’s similar to calling someone with depression selfish.
6.) “You Should Try Exercising”
While it’s true that exercise is excellent for your mental health and should be part of any treatment plan, it typically isn’t sufficient by itself. It’s not bad advice, exactly, it just falls woefully short. When you’re depressed, everyone has some advice for you and most of those people have never been depressed themselves. Advice either falls flat or it makes you feel like there’s one more thing you’re not doing. At the very least, it underscores how little someone else understands what you’re going through.
7.) “Have a Drink”
Some people assume that depression is just a matter of feeling stressed and having a few drinks will help them relax and cheer up. While a few drinks may temporarily make you feel better, in the long run, alcohol will make you feel worse. As discussed above, depression--and especially bipolar depression--significantly increase your risk of developing a substance use disorder. You get to rely on these temporary boosts--or moments of relief--and before you know it, you can’t get along without drugs and alcohol.
8.) “You Should See a Therapist”
As with the advice to exercise, telling someone to get therapy isn’t bad advice in itself but it tends to fall flat. There’s a good chance that someone with depression spends half the day thinking, “I should see a therapist,” but, again, it’s just one more thing they should be doing but aren’t. They probably don’t need you to remind them.
What may be helpful instead is to offer to help. Even in a mid-sized city, there are possibly hundreds of therapists. The thought of finding a good one, making an appointment, and actually showing up may feel overwhelming to someone with depression. Instead of suggesting they see someone, offer to help them with the process of finding a therapist and making an appointment. Try to remember that depression attacks the very faculties--motivation, optimism, focus--that you need to make a treatment plan and follow through. Seeing a therapist may seem like a simple thing to you but it’s not to them.
Depression is one of the most common co-occurring mental health issues along with substance use disorders. Depression typically comes first and substance use is more often a symptom and a way to try to manage the symptoms of depression. Any plan to treat addiction that doesn’t also address depression is not likely to succeed for long. If you have a loved one with depression, it’s important to see things from your loved one’s point of view. Plenty of well-meaning advice will either make no difference at all or make them feel worse. It’s far more helpful to be there for them, to listen, to try to understand, and to help them get treatment.
At Foundry, we know that there is usually a lot more to addiction than substance use. We use a variety of evidence-based methods to diagnose and treat any co-occurring mental health issues, including depression. Our methods include cognitive behavioral therapy, or CBT, dialectical behavioral therapy, or DBT, mindfulness meditation, yoga, Alpha-Stim, and others. To learn more about our comprehensive approach to treatment, call us today at (844) 955-1066.
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