Major depressive disorder can cause many emotional and physical problems, and significantly reduces the quality of life of those affected. However, there are effective treatments available to those with depression.
How to tell if someone is depressed
The signs and symptoms of depression differ from person to person.
According to the American Psychiatric Association, the signs and symptoms of depression vary from mild to severe.
Someone may be depressed if they:
- Appear sad or hopeless, or if they express feelings of worthlessness or guilt
- Have lost interest in activities they once enjoyed
- Are sleeping more than usual or are unable to sleep
- Seem tired or lack energy
- Are eating more or less than usual
- Appear agitated or restless
- Have trouble concentrating, remembering, or making decisions
- Are angry, irritable, or frustrated
- Appear more introverted than usual
- Are moving or speaking slower than usual
- Express thoughts of suicide or have attempted suicide
Signs and symptoms of depression in older adults
The Mayo Clinic state that depression often goes undiagnosed and untreated in older adults. This is because the signs may be different or less obvious in this age group.
Signs of depression in older adults can include:
- Memory difficulties or personality changes
- Complaints of unexplained physical aches or pain
- Neglected appearance or poor hygiene
- Lack of desire to socialize or do new things
Signs and symptoms of depression in children and teenagers
Depression in children and teenagers is marked by many of the same signs of depression in adults. There may be some differences, however.
Young children may:
- Be irritable
- Become clingy
- Refuse to go to school
- Report aches and pains
- Fail to make expected weight gains
- Be irritable, sensitive, frustrated, or angry
- Perform poorly at school, or have a poor attendance record
- Avoid social interaction
- Use drugs or alcohol
Symptoms must last at least 2 weeks to be considered depression, and should not be linked to the effects of medication or another medical condition. On average, a depressive episode lasts from 6 to 8 months without treatment.
How to talk to someone with depression
Support from friends and family is very important for people with depression.
Often, people with depression may not realize or acknowledge they are depressed. Family and friends can be the first ones to notice the condition in others. Their support and encouragement can play an important role in the treatment and recovery process.
If a friend or family member is showing signs of depression, people should gently express concern for them. Explaining that depression is a medical condition, not a weakness or a flaw, is a helpful step. It is also good to highlight the importance of seeking treatment from a doctor, counselor, or psychologist.
People should be willing to listen to their problems and allow them to express their feelings. Simply being able to voice concerns and express feelings can be a big help to those with depression.
It is important to avoid judgment or criticism. People should not underestimate the seriousness or severity of depression and the impact it can have on someone's life. They should not suggest that those with depression simply "snap out of it."
Being gentle, yet persistent, is the key. People should keep in touch with those with depression to provide ongoing support and encouragement where possible.
How to encourage those with depression to seek help
Getting help from a doctor, a licensed counselor, or psychologist is an important step in the treatment of depression.
As those with major depressive disorder often lack the motivation or energy to seek treatment, people should offer assistance wherever required. Help could include researching suitable counselors or setting up appointments.
It can be useful to help the person with depression to make a thorough list of symptoms, key personal information, and medications and supplements to discuss with their healthcare provider. Drawing up a list of questions to ask at the first appointment is also useful.
If a friend or family member is experiencing a particularly severe or potentially life-threatening depressive episode, people should contact a doctor, hospital, or the emergency services immediately.
Treatment for depression
The main forms of treatment include:
- Psychotherapy - a type of psychological counseling or talk therapy
- Medication - antidepressive drugs that can be prescribed by a doctor or psychiatrist
A hospital stay or residential treatment program may be recommended for severe cases or if there is a risk of suicide.
In addition to a treatment plan, the Mayo Clinic list a number of lifestyle and other changes that may help relieve symptoms of depression. These include:
- Learning what can trigger depression symptoms, and making a plan to help avoid or manage such triggers
- Avoiding alcohol and recreational drugs
- Practicing self-care by eating a balanced diet, exercising, and getting enough sleep
- Receiving support and encouragement from family and friends
Alternative and complementary therapies such as acupuncture, Yoga, meditation, massage, art therapy, and guided imagery may also offer some relief. However, these alone may not be enough to treat depression. They should only be used alongside psychotherapy, medication, or both.
Providing support during treatment
Support, compassion, and patience during the treatment process are extremely important for recovery. Friends and family should be willing to listen to those with depression and provide them with positive feedback and encouragement.
People experiencing depression can benefit from help with making and keeping appointments, and making sure to stick to a treatment plan.
Friends and family of people with depression can provide support in the following ways:
- Encouraging friends or family members with depression to eat healthily and to maintain an active lifestyle
- Helping them to buy groceries and cook meals
- Going with them on walks or to the gym
- Inviting them to social events but not forcing them to go along
- Offering to help out with household responsibilities where possible
It can be helpful to get information about available services for those with depression. These services include local support groups and local or national helplines.
What to do if someone is suicidal or abusing alcohol
People with depression are at an increased risk of suicide and alcohol abuse.
A person who suspects that someone is at risk of suicide can contact a suicide hotline for help.
All signs of suicidal behavior should be taken seriously and addressed immediately:
- People should voice their concerns to the person and ask if they are thinking about suicide. If they have an actual suicide plan, it indicates an increased risk of a suicide attempt.
- The person's doctor or psychiatrist can provide help. Close friends and family members should also be informed.
- A suicide hotline, manned by trained counselors, can provide additional crisis support. The 24-hour National Suicide Prevention Lifeline in the United States can be reached at 1-800-273-TALK (1-800-273-8255).
- People should make sure the person is in a safe environment and remove medications and potential weapons.
- If it is an emergency situation, they should call 911 for emergency assistance. It is important to make sure the person is accompanied at all times until emergency responders arrive.
Alcohol or drug abuse
Some people with depression turn to alcohol or drugs in an attempt to relieve symptoms. These may appear to work in the short term, but they worsen feelings of depression over time.
If someone with depression is struggling with alcohol, they should be encouraged to discuss the issue with their doctor. The person must want to get help for their problem, however. It is not possible to force them.
How to look after yourself when caring for someone with depression
Although it may be difficult at times, maintaining a positive outlook and having realistic expectations throughout the treatment process is important. It's important to remember that recovering from depression can take time and that those with depression often display anger, hostility, and negativity to the people around them.
Caregivers should remember to look after their own needs and mental health during this time. They should only take on what they can, and ask other friends or relatives to help so they don't get burned out. It is important that they make time for activities they enjoy, such as socializing, exercise, and hobbies.
- If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Call 911 or the local emergency number.
- Stay with the person until professional help arrives.
- Remove any weapons, medications, or other potentially harmful objects.
- Listen to the person without judgment.
- If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 1-800-273-8255.