How should I talk to a friend who is depressed?

If there is a friend with depression around us, we may do our best to take care of him and comfort him out of the desire to help others and empathy, try to reduce his pain, and hope that he will recover as soon as possible.

However, because most of us have limited understanding of depression and don’t know how to comfort them, we become cautious when talking to patients, fearing that our words will irritate the other person, or even worry that our unthought-out words will induce the patient to commit suicide. The result of this is that not only will you become very tired, but the other person will also blame themselves more, feel like a drag on others, and resist contact with others.

What are the things we cannot say?

1. "Why are you so pretentious?" (educational accusation type) 

“Hey, what a big deal, you are just depressed and crying. Be strong. You are just too young. We all came here without food at that time. Just grit your teeth and hold on.……” 

There are always some people who like to educate others from the moral high ground. It turns out that teaching is such a disgusting thing. The low mood and demoralization of depression do not mean cowardice and hypocrisy, they are part of the symptoms of depression. It's not that patients want to escape, be strong, overcome difficulties and be positive, but that they really can't muster the energy and are unable to do anything.

In other words, the diagnostic criteria for depression clearly state that the patient's work, social and life functions are affected by the disease and have declined. This decline is a symptom of the disease's suffering, not the patient's fault. Don't blame the patient for this.

2. "Be optimistic, there is nothing to worry about" (Standing and talking without backache type)

“Be open-minded and don't get into trouble. I see, you are just too idle. Tell yourself every day to be happy, smile more, and adjust well. If it doesn't work, I will enlighten you..." I have never experienced depression, so I really don't understand this disease. Patients may feel a little aggrieved and helpless, knowing clearly that it is not that simple, but unable to argue with it. Apart from a helpless smile, there seemed to be nothing else I could refute.  

If your message is "Don't overestimate the likelihood that something bad will happen," consider it concretely when he or she confides in you about specific events. For example, he is likely to be surrounded by a pessimistic possibility (for example, he did not reply to my message because he was angry with me). You can carefully bring up other possibilities (could he be in a meeting, or fell asleep). Don't argue with him, just provide these possibilities. This may bring new inspiration to his original thinking mode.  

3. “Everything will be fine” (Chicken Soup Type)

“Live a simple life and be happy. Everything is just right, and you will eventually get the little happiness you want, but it may take a few twists and turns. ” It is very difficult for patients with depression to empathize with "Chicken Soup for the Soul". (They will have the cognitive triad of "useless", "helpless" and "hopeless", feeling that they are worthless, trapped in a situation where no one can help, and there will be no hope in the future. )

When they hear these chicken soups coming out of your mouth, they will feel that they are harder to understand and that their "dark" thoughts will be harder to talk about. This will make communication between you less and more difficult. Likewise, if what you want to convey is not to have "overly catastrophizing" thoughts about the outcome of things, you can discuss the matter when he talks to you about specific problems, or you can take the initiative to ask him what he is thinking. “You look a little unhappy. Did you think of something? ”. In a specific incident, he may exaggerate the catastrophic consequences of the incident (for example, he may think that if he fails in this exam, his life will be over in the future). You can carefully inject new ideas to help him change his previous thinking mode.  

4. "Actually, I am also very stressed" (Comparing who is more miserable)

“In fact, I'm not in a good state either. I cried in my quilt for an hour after working overtime yesterday. I was under too much pressure. My brother-in-law was in a car accident and my dad is still sick. Everyone in this society is very difficult and depression is normal..." After listening to this, the patient collapsed even more. If things really are so hard, it won't feel better.

In fact, patients with depression are very powerless when they are depressed. They need not only understanding, but also comfort, support and strength. Taking care of yourself while caring for him will be a great example.

5. "You need to get well soon" (death-inducing ghost type)

“We all support your treatment. You should work hard to treat your illness and use various methods to strive for a speedy recovery and tide over the difficulties. ” It's hard to hate iron, we have done so much for you, why are you still like this? Patients with depression would prefer to be accepted for their current state and be accompanied by someone. If it were replaced by "We will accompany you to get better, accompany you to ups and downs, and take this difficult journey", maybe they will feel more at ease.  

There are several principles that can be followed when dealing with patients with depression:

1. Companionship is the longest confession of love

Many times, as long as we accompany him silently and let him feel that he is not alone, it is a good support for him. If his condition allows, he can take the initiative to talk about his current state and his feelings of self-blame. As friends, we listen silently and promptly correct the other person's extreme thoughts so that he does not think that these are all caused by himself. We can tell him that these are symptoms of depression, just like fever, headache, fatigue, and runny nose after a cold, and they will gradually disappear as the disease abates.

Allow him to be in any state, allow him to be like this now. Just accompany me silently. Of course, if a patient mentions suicidal thoughts or plans, immediate intervention is required.

2. Encourage rather than pressure

Support and encouragement are never wrong. But in the specific implementation process, some people will force the patient to do some tasks that he cannot complete, such as traveling, high-intensity exercise, etc.

Patients with depression have symptoms of lack of interest, lack of motivation, and decreased physical strength. Therefore, during the onset of the disease, some tasks that we think are simple are a huge pressure for patients with depression.

Therefore, as friends or family members, we should advise patients with depression to take appropriate rest or suspend current study and work until their condition improves and they are able to cope with these tasks. Some people, when facing patients with depression, will try to find some positive cases from history or life to "feed chicken soup" to the patients. But this will not have much motivating effect on the patient's emotions. And sometimes it makes them feel guilty and aggravates the patient's self-blame concept.  

3. Some small suggestions that can be provided to patients

①If the patient's physical condition permits, you can take him out for a walk and bask in the sun. Exercise therapy and light therapy are both important non-drug treatments for depression. Adequate light during the day can regulate the release of melatonin, adjust our biological rhythms, and improve our mood. Regular exercise can promote the release of monoamine transmitters in the brain and act as a partial antidepressant. As for the intensity and frequency of exercise, different studies have different conclusions, and many studies show that just exercising can help.  

②Provide the patient with a list of pleasant events. As the condition improves, the patient's interest gradually returns. This is when we can provide a list of enjoyable events. The list includes skiing, chatting with friends, listening to music, having afternoon tea, and more. Patients can pick and choose from this list what they can do. This not only gives patients a sense of accomplishment, but also improves their mood through these pleasant events.

Talking well is very important for patients with depression. It can really help support them when they are at their weakest. When he recovers, he will definitely regard you as his confidant, because you understand him best.

(The article comes from the "Youlai Psychology" public account, follow it to get more popular science. )