When confronted with someone else’s strong emotions—intense joy or heartbreaking pain—we often do not know how to react. In the case of joy, the other person usually doesn’t mind, because his feelings console him. But in the case of pain, things are completely different. Misunderstood suffering can make the sufferer isolate himself from the very people who could help him. So, how can we really help someone who is suffering?

The way in which depression manifests itself in our lives makes it, at times, easier to be identified by those not affected than by the person suffering from it. If we find ourselves noticing that someone close to us suffers from depression, it’s very likely that our common sense will not be enough to help the one suffering. We might need to use counterintuitive strategies, which we can learn best by informing ourselves directly from experts.

Depression can be healed, and the help of a loved one throughout this entire process is priceless. If needed, a friend can help the person suffering from depression to cope, overcome his/her negative thoughts, and regain his/her energy, optimism and ability to enjoy life. However, for this to happen this friend first needs to recognise the symptoms of depression manifested in the other person.

Learn to recognise when a loved one is suffering from depression

According to the Depression and Bipolar Support Alliance, an international NGO whose goal is to raise the awareness of depression, there are a few indicators which should be considered as warning signals:

The person seems to not be interested in anything which used to interest him before—he is no longer motivated at work, or he no longer finds pleasure in the sexual relationship, in his hobbies or other activities he used to enjoy. If he pushes family members or friends away and generally avoids social activities, this is a first signal.

A depressed person will express a dark, pessimistic view on life. He will be unusually sad, irritable, impatient, critical, or emotionally unstable. He will talk about helplessness and despair.

He might constantly complain about headaches, stomach problems, back pains. He will say he is tired or even exhausted all the time.

Lack of sleep or excess sleep betray possible depression when it is coupled with an inability to make decisions, to get organised, or to be totally focused on what he is doing.

If the person eats more or less than usual, if he suddenly gains or loses weight, this is again an alarm signal.

A person suffering from depression might turn to an abusive consumption of alcohol or drugs, sedatives or even painkillers.

When it comes to older people, the charitable organisation, Age UK, says symptoms might be a little bit harder to notice, but they are there for those who look for them: an empty fridge or cupboard (which might point to poor nutrition), neglecting physical health (they no longer wash themselves or care for their appearance), and the lack of joy when they receive company are all sings that the elderly person might be experiencing a mood disorder. A person who knows them well will be able to tell if they are experiencing loneliness and sadness in old age compared to how they used to be full of affection and enthusiasm.

How to help someone suffering from depression

“Depression can cause people to shut down and withdraw, which can feel like rejection,” says mental health activist JoEllen Notte in a BCC documentary. “I suffer from depression myself and I know how tough it can be,” says Notte, “but I want to talk to the partners—the people living with the people who are living with depression. I know it’s not easy for you, either.”

“Don’t take it personally,” Notte says. “If your partner had a broken leg and didn’t want to go out dancing, it wouldn’t hurt your feelings. Well, depression is like that, too. Depression is debilitating, and while it may look like people are simply turning down time with you… often the truth is, they just can’t do it.”

Writer Steven Skoczen described depression as resembling a cold which wears you down and confines you to your bed. It’s like “you wake up one morning, and wonder if you have the flu again. You’re zapped, and even getting out of bed seems hard. You think about the day ahead, all the meetings and appointments and people you have to see, and you wonder how exactly you’re going to do all of that with the energy level you have. Getting out of bed is hard enough. … You skip your shower … You shove whatever food requires no energy to make into your mouth, and you get to work. Your 8-hour day feels like it’s closer to 18. By the time it ends, you’re barely standing. You make it back home, and collapse on the couch. You feel zapped, off, and sometimes weird, dark thoughts stop by. You find something that eases the tiredness and darkness … Maybe it’s a beer. Maybe it’s just sleep. This keeps up, day after day.”

Skoczen strongly claims that this is the context in which “you can totally help”. How? He says: “Listen. Sit like a bump on a log, and listen. I promise you. Promise you like just writing that out brought tears to my eyes, I promise you that will actually help.”

“Some people have pointed out: ‘But it doesn’t address the root cause!’ That’s true. But the middle of a depressive episode isn’t the time to worry about root causes. That’s like talking about chainsaw safety while you have a severe leg wound. Yes, chainsaw safety is good. But maybe tend to the leg wound first.” Cognitive behavioural therapy can have a positive impact over the long run in depression, Skoczen says. “But those are long-game solutions. You are triage.” To those who have suffered from depression themselves and are tempted to immediately come with solutions for the ones suffering from it this very moment, Skoczen says: “There’s a time and place where it’s appropriate. Here’s how you’ll know it: When the person asks you, ‘Hey, you got any ideas on how I could take this on?’ That is your cue. If you haven’t heard that, sit, ask, listen. Here’s why—by simply sitting, asking, and listening, you are giving a person who feels fundamentally disempowered by a weird thing happening to their brain a sense of control back.”

The writer warns that this path of listening may give birth to a negative feeling in the one trying not to voice his well-intended ideas: “Note that keeping all those great, helpful, well-intentioned ideas in will not make you feel any better. But it will massively help them. Why? Because you neutralise the toughest thing about depression. Depression is massively, massively isolating.”

Some brief recommendations on the NHS site sketch a few ways in which we can help a person suffering from depression:

– Let them know you care, and are there to listen.
– Accept them as they are, without judging them.
– Gently encourage them to help themselves, for example, by staying physically active, eating a balanced diet and doing things they enjoy.
– Get information about the services available to them, such as psychological therapy services or depression support groups in their area.
– Stay in touch with them by messaging, texting, phoning or meeting for coffee. People who are depressed can become isolated and may find it difficult to leave their home.
– Try to be patient.

British doctor Radha Modgil provides very practical solutions. In a BBC podcast about the concrete ways in which we can help someone suffering from depression, she says, “You could help them with practical chores like shopping or washing because sometimes these everyday things are so hard to do when you’re experiencing depression.” Then, we can offer our company. “If they don’t feel like talking then just sitting with them and doing something simple like watching TV can help. Sending regular messages and calling them is really important.”

When the risk of suicide is real

In the most serious cases, it’s possible that the person suffering from depression entertains suicidal thoughts. Suicide is a very real risk when a person is depressed, warn Melinda Smith, Lawrence Robinson and Jeanne Segal, in a guest piece published by HelpGuide.com. “It may be hard to believe that the person you know and love would ever consider something as drastic as suicide, but a depressed person may not see any other way out. Depression clouds judgment and distorts thinking, causing a normally rational person to believe that death is the only way to end the pain they’re feeling.”

Experts say there are a few sings which show that a depressed person is entertaining suicidal thoughts: he speaks about suicide, death, self-harming, or is preoccupied with death. He expresses feelings of despair or hatred towards himself. He behaves in self-destructive ways. He settles his accounts and says “goodbye” to his loved ones. He researches pills, weapons or other lethal objects. He seems suddenly calm, after a period of depression.

“If you think a friend or family member might be considering suicide, don’t wait, talk to them about your concerns. Talking openly about suicidal thoughts and feelings can save a person’s life, so speak up if you’re concerned and seek professional help immediately!” experts say. If the person does not seem willing to see a psychologist or psychiatrist to get help for these thoughts, if he cannot promise he will not harm himself, or if the suicide risk seems imminent, the best is to either call a local centre for suicide prevention, an ambulance or even take the person to the emergency room yourself. In such circumstances, specialists recommend making sure the person does not have weapons, drugs or other objects he might use to take his life, and not leaving him alone.

How to take care of yourself, too

Depression is not contagious. However, it is vital, when you want to contribute to the emotional recovery of a loved one suffering from depression, to also equip yourself emotionally to deal with a wide range of feelings. When trying to help someone suffering from depression, you may be surprised to notice that you feel helpless, frustrated, angry, concerned, guilty and sad. This happens because the encounter with depression is a challenge for whose who indirectly suffer from it. It is thus important not to neglect your own health, so that you are not overwhelmed by the very problem you are trying to solve.

The ring theory, introduced by psychologists Susan Silk and Barry Goldman, will prove very useful in the endeavour to protect your mental health when helping someone suffering from depression. Their theory is meant to be a reference point for crisis situations that are not centred on us, and integrates our need to emotionally unload when under pressure.

When faced with a challenge (in this case the challenge of helping someone going through a crisis situation), we all need and wish to pour our hearts out to someone. However, when we try to create a balance and not just listen but also be heard, we can err by asking to be heard by the very person who is suffering, who does not even have the necessary resources for himself, let alone for somebody else. The ring theory or the theory of concentric circles is one method to follow in these circumstances. It follows a few simple steps.

The first step is to draw a small circle in which we place the person suffering. Around this circle, draw another one which contains the person/persons who are most close to the suffering one. Then, in the other circles, which keep getting wider and wider, include the people in the order of their closeness to the suffering person. You will thus have a series of concentric circles looking like this:

The one suffering in the middle, the partner/children/parents in the next circle, close friends in the next, and distant friends, coworkers, and strangers in the largest circle. You will include yourself in the circle where you belong. Then, follow the theory’s basic principles: (1) the only person who is allowed to say anything to anyone is the person in the centre; (2) you will not “complain” to the people who are part of a smaller circle than yours. You will just give those people your support, listen to them, and help them. You will only offload on people who are part of a circle wider than yours.

Balance is one of the first things we need when we come close to someone who is suffering from depression. We need the same balance when we step back and evaluate the help we are capable of offering.

Matthew Johnson, relational researcher and professor at the University of Alberta, said that someone’s efforts to help a loved one suffering from depression really help even when they don’t feel the positive effects right away. “Efforts from a partner to help alleviate stress may prevent the development or worsening of mental health problems and, in fact, could help keep the relationship healthy.”

Probably the most valuable element of balance we can take out of this evaluation is that it’s good not to be discouraged and to do our best to help the ones who are suffering. Even if we do not see immediate results, one day we will know just how much our efforts have helped them.

Alina Kartman is a senior editor at ST Network and Semnele timpului.