How to identify signs of depression
"I'M worried about a family member. They seem really down, but they won't talk about it. How can I tell if they're depressed?" --Worried, Wellington.
Despite all the attention depression receives these days, it's really hard to spot sometimes. Depression is not "having a bad day", and it's also not an emotion: It's no more possible to be a "little bit depressed" than it is to be a little bit pregnant.
And it's not uncommon for people feeling depressed to hide it from others, often with a high level of success. People often talk of putting on a "mask", and how painful and excruciating that can be.
That can make it really hard for friends and family to know what's going on. Don't worry, it's not personal, the nature of depression means the person suffering feels they have to hide how they feel.
Depression also isn't an "illness", in the same sense as the flu, or diabetes.
At the risk of being really picky, I'm not even comfortable with the phrase "having depression", I think "experiencing depression" is more helpful.
Why? It's important from the point of view of expectations: studies have shown that when people are told their depression is due to a "chemical imbalance in their brain" they report less hope and faith in any treatment being able to help them.
When people believe the depression they're experiencing is due to a combination of factors (like their current circumstances, their history, grief, loss, trauma, substance abuse and / or their family history) they feel less broken and more hopeful about treatment.
So, back to your loved one.
If depression isn't a brain disease, what is it? Ultimately it's a series of behaviours, motivated by strong emotions, that result in a person being stuck in a deeply painful, hopeless mood state. This leads to withdrawal, isolation, and an overwhelming sense of hopelessness.
People experiencing depression generally believe themselves to be worthless, and the future to be a long, never-ending continuation of the misery they now feel. It results in an inability to feel pleasure, or enjoyment.
What not to do
Four things to avoid if someone close to you is experiencing depression:
• Don't ever, ever, ever try and "cheer them up" or suggest they need to get over it (or themselves). If they could, believe me, they would.
•Don't ask what's wrong, or quiz them about why they feel depressed. They likely won't know (which doesn't mean there aren't reasons, it's just unlikely to be one thing).
•Don't offer advice, tell them about how it's affecting you or what you've done when you've felt low or depressed.
•If they want help, support them to access it, but don't tell them what they need to do to get better (Of course if they are expressing a desire to harm themselves, then act. But being depressed doesn't automatically mean a person is suicidal).