Community Psychiatry’s Leela Magavi, M.D. was featured in INSIDER discussing the most sensitive way to speak to someone with depression. 

By: Sarah Fielding | January 22, 2021

If you’ve never experienced depression yourself, it may be difficult to know how to help a loved one with the condition. While you may have the right intentions, certain phrases or sentiments can exacerbate symptoms of depression rather than help.

Here’s what you shouldn’t say to someone with depression and how you can support them instead.

What is depression?

It can be challenging for someone who has not experienced depression to imagine the overwhelming weight of it.

“Depression feels like there is no pleasure or joy in life,” says Anjani Amladi, MD, a psychiatrist in Sacramento, California. “It’s so much more than being sad. Depression robs people of things they once loved, and for many people, they feel like nothing will bring them joy again.”

Over 264 million people worldwide have depression, but symptoms vary from person to person. They can include:

  • Feeling hopeless, worthless, guilty, and/or sad
  • Difficulty concentrating
  • Loss of libido
  • Inability to feel pleasure
  • Sleep disturbances
  • Appetite changes
  • Suicidal thoughts

The causes of depression are nuanced and varied and can include some combination of:

  • Genetics
  • Brain chemistry
  • Chronic medical conditions
  • Environmental circumstances

When interacting with a person who has depression, your words and actions can have a tremendous impact. Here are some potentially harmful things to avoid saying.

1. Don’t tell them to cheer up

If a person with depression could simply “cheer up” they would, and telling them to do so can add to their distress. Common phrases to avoid telling a person with depression include:

  • “Cheer up”
  • “Think positively”
  • “Just smile”
  • “Snap out of it”

“Reciting platitudes and inundating the conversation with toxic positivity could exacerbate the feelings of guilt and shame that individuals with depression already combat on a day-to-day basis,” says Leela R. Magavi, MD, a psychiatrist and regional medical director at Community Psychiatry in Newport Beach, California.

Instead of trying to overload them with positivity, try doing these things instead:

  • Empathize with their situation
  • Spend time with them
  • Ask them if they want to talk about their feelings
  • Tell them, “you matter”

2. Don’t invalidate their feelings

If a person with depression opens up to you about what they’re experiencing, it’s critical that you provide a safe, non-judgemental space for them to do so. Some examples of what not to say when someone talks about their depression include:

  • “You don’t seem sad”
  • “I haven’t noticed a change in your attitude or behavior”
  • “It’s all in your head’
  • “I’ve dealt with worse”

When you dismiss a person’s depressive feelings, it may signal to them that they shouldn’t open up again, are being dramatic, or are at fault for feeling the way they do.

Instead, Gail Saltz, MD, clinical associate professor of psychiatry at the NY Presbyterian Hospital Weill-Cornell School of Medicine, says to remind them of these things:

  • Depression is an illness and not their fault
  • You are sorry they are experiencing it
  • Treatment can help them
  • You will help them through this and find treatment

3. Don’t blame them

Again, depression is usually a result of factors outside of a person’s control, such as genetics, environmental factors like abuse or poverty, stress, and brain chemistry.

Using phrases like “You wouldn’t feel this way if you did this..” or “It’s your fault that you feel this way” places unnecessary blame on an individual already struggling.

“This could lead to demoralization and feelings of helplessness,” says Magavi. “Depressed individuals can feel like social outcasts, and consequently, the knowledge that someone who supposedly loves them may perceive them negatively could lead to self-injury and suicidal thoughts or attempts. I have evaluated children and adults who have stopped eating and getting out of bed entirely subsequent to a painful conversation with a loved one.”

Alluding to or clearly blaming someone for their depression can be detrimental. Instead, remind your loved one that having depression is not their fault, does not make them weak or lesser than, and that you’re here for them in any way they need.

4. Don’t ignore them

It can be tempting to give a depressed person space or ignore a difficult situation, but it can come with consequences for the person you care about.

“Ignoring is abandonment which often makes the depressed person feel more alone, rejected, and worse,” says Saltz.

Instead of “giving them space,” Magavi recommends engaging them in ways such as:

  • Asking them to join you on a weekly walk
  • Bring them food and discuss fun memories you share
  • Send them a playlist of their favorite songs
  • Write them a letter detailing the things you love about them

“Depression is a real mental illness, and recovery is a process. And like any of us who have ever recovered from an illness, accident, surgery, we all need help sometimes,” says Amladi.

5. Don’t tell them other people have it worse

Telling someone “be grateful for what you have” or “other people have it worse” will do nothing but make them feel like they’re wrong for feeling the way they do.

“The level of pain a person is experiencing is not a competition,” says Amladi. “While it is true that others may appear to have it worse than a person struggling with depression, it doesn’t negate the feelings a person living with depression has. What may seem like a small problem to others can feel insurmountable to someone living with depression.”

Only the person experiencing depression fully understands how they feel. While they may seem to be doing alright on the outside, they can still be in daily combat with themselves.

“Depression is highly personal and does not warrant a justification of any kind. Any comparison could completely minimize and dismiss someone’s daily life experience,” says Magavi.

Choose instead to validate their feelings by affirming that every emotion they have is warranted and that their experience should not be minimized. Provide a safe space for them to communicate without fear of judgement.

6. Don’t shame them

It can be difficult to help someone treat their depression, but it’s important not to get frustrated. Using the following phrases will only make them feel worse:

  • “You only think about yourself”
  • “You’re crazy”
  • “You should think about how this is affecting others”

“A common misconception is that people with depression are selfish when in reality, it’s quite the opposite,” says Amladi. “People living with depression care deeply about other people and the impact they have on their lives. They often experience guilt about being depressed, feel like they are a burden, and often blame themselves for not being able to feel better.”

These chastisements can endanger your loved one. “Shaming, stigmatizing, and guilting a depressed person is likely to worsen their depression. Suicide is a major concern in depression, and shame is often associated with suicide,” says Saltz.

How to help someone with depression

The first step is creating a safe space for a loved one with depression to share how they feel. They may be reluctant to speak openly about their depression for fear of worrying others.

To encourage open communication and ensure they feel heard, Magavi suggests:

  • Asking open-ended questions
  • Voicing your own feelings as a means of breaking the ice on tougher discussions
  • Listening without judgment
  • Asking them how you can help
  • Check-in with them regularly even if they aren’t able to reciprocate

Watch out for signs their depression is worsening. Suicidal thoughts may exhibit as extreme mood swings, sleeping too little or too much, talking about feeling hopeless or wanting to die, and withdrawing.

“Ask if they have a plan, if they say yes, remove anything they planned to use — medicine, a gun,” says Saltz. “If they have an active wish or plan, take them for emergent help, a same-day appointment with a psychiatrist or to the emergency room, or call the suicide hotline.”

Click here to read the entire article on INSIDER.

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