Mental Health First-Aid: How To Help Someone With Depression

By Wasim Kakroo

MAJOR depression is one of the most frequent mental health problems in Kashmir. As per MSF report (2015), the proportion of the adult population in the Kashmir Valley suffering from symptoms of probable depression in 2015 was 41%, representing 1.6 million adults. Chances are that there might have been a substantial increase since then in the number of people developing symptoms of depression due to ongoing conflict and COVID-19 pandemics also might have caused an incline in the percentage of affected people.  Depression, as opposed to transient emotions of sadness, is a complicated mental illness that continues for at least two weeks or indefinitely if not treated properly. Depression commonly hinders a person's ability to work, attend school, keep a daily routine, and have satisfying relationships. Depression, however, is treatable, and professional help is available for those suffering from it.

A person having symptoms of depression, may battle with a variety of emotions on a daily basis, have pessimistic thoughts, act erratically, or abuse drugs or alcohol to handle the distress caused by depression. Some of the most significant side effects of depression are mental health crises such as suicidal ideation and non-suicidal self-injury. Mental health first aid (knowing how to assist a person who is depressed), which anyone can provide, can be helpful to treat these and other mental health emergencies and encourage people to seek professional care.

How do I know if Someone has Depression? 

If you find that the person's mood, behaviour, energy levels, habits, or personality has changed considerably, consider depression as a possible cause. However, you should not attempt to diagnose the individual with depression because only a professional mental health professional can do so. Do not dismiss the signs you have observed as something that will go away of their own.

It is critical to learn about depression so that you can identify the signs and symptoms and assist someone who is developing depression. Take the time to learn about depression, including its causal factors, symptoms, and treatments, as well as what services are available in your region to deal with it such as the department of psychiatry in your local district hospital or professionals such as psychiatrists and/or clinical psychologists working in private. The knowledge base about depression can be developed by reading trustworthy material from reliable websites or in books, reading about or listening to other people's experiences with this mental illness, and getting guidance from individuals who have suffered and then recovered from depression.

Signs of Depression:

Although the degree of depression can range from feeling irritable to feeling suicidal, the following are some frequent symptoms that you may observe. You should feel worried, if the following symptoms persist and have an impact on the person's functioning.

  • A very low mood
  • Loss of enthusiasm and interest in previously pleasurable activities
  • Lack of energy and weariness
  • Feeling worthless or guilty when they are not at fault
  • Frequent thoughts of death or suicide
  • Difficulty focusing or difficulty in decision making
  • Moving more slowly than usual
  • Getting agitated and unable to sit at one place
  • Sleeping less or sleeping excessively
  • Poor or lack of appetite or eating excessively
  • Changes in eating habits might result in either weight reduction or gain.

Each person is unique, and not everyone who is depressed will exhibit the classic signs or symptoms of depression. Many persons who suffer from depression may also suffer from other mental health issues such as anxiety or substance abuse problems. However, do not presume that any symptoms you have observed indicate that the person is depressed.

How should I talk to someone who may have Depression?

Contrary to popular belief, talking about depression improves rather than worsens the situation. If you suspect that someone from your acquaintance is depressed and in need of assistance, evaluate if you are the ideal person to contact them or whether someone else would be more suited. Inquire with the individual whether they are willing to speak with you or if they would prefer to speak with someone else.

Talk to the person and encourage him to speak if you feel you are the best person to talk to  or if there is no one else to talk to.

Spend time with the individual and gently bring up your worries with them, such as mentioning that the person seems depressed today. Allowing the person to choose when to open up about his depression might be beneficial. However, if the individual does not begin a dialogue with you about their feelings, you should initiate the conversation.

It is critical to select a good time when both you and the other person are available to chat, as well as a private location where both of you feel comfortable. Let the person know you care about them and are prepared to assist them. Inquire if the person would like to talk to you about how they are feeling. Concentrate on how the individual is feeling and the changes you've seen over a period of time. If the individual says that he or she feels low or down, you should question how long they have been feeling that way and if they have told anybody else about how they are feeling.

When approaching the individual, be prepared for a wide variety of emotions (e.g., relief, apathy, anger). They may deny that they are going through changes in their mood, behavior, or everyday functioning. Remember that the person's thoughts, feelings, and beliefs reflect their own understanding of the world in that state of mental health, which you must accept without question. You should respect the person's interpretation of their symptoms.

Some individuals who have healed from depression may have a reemergence of their symptoms. Don't assume that the individual is unaware of depression; they, or someone close to them, may have suffered from it in the past. However, even if the individual has already experienced depression in the past, don't assume they'll be able to handle the present bout.

What can I do to Help? 

Show respect and dignity for the person. Recovery must be driven by the individual for the most part, and you should avoid the urge to try to cure the person's depression or provide solutions to their issues. Each person's condition and requirements are distinct. It is critical to respect the person's independence while taking into account their ability to make decisions for themselves or whether they are in danger of hurting themselves. Unless you are worried that the individual is in danger of hurting themselves or others, you should also respect the person's privacy.

Provide emotional support and understanding on a regular basis. Even if you don't understand what the individual is going through, let them know you care and want to assist. Tell them how important they are to you, that they are not alone, and that you are here for them. It is more essential for you to be sincere in your care than it is for you to say all of the "correct things." Let the individual know that they are not alone, even though their experience is highly personal and traumatic. Taking the time to talk to or be with someone can often be enough to show them that someone cares. You should be sensitive, compassionate, and patient since the individual requires more assistance and understanding to help them through their illness. When helping someone who is depressed, it is critical to be persistent and supportive.

Irrational fears frequently overwhelm those suffering from depression, so you must be patient and empathetic while dealing with them. Even if the depressed person does not reciprocate, you should show kindness and attention to them. Even if it does not feel this way, keep in mind that your support is likely to be having a positive impact.

Encourage the depressed individual to engage in a conversation with you. Encourage the depressed person to express their feelings, thoughts, symptoms, and any other issues they are having. Examine how the person's symptoms influence their day-to-day life. If they say stress is an issue for them, encourage them to look for methods to minimize stress in their lives. You may also inquire about recent events in their lives that may be influencing their feelings and behavior. Do not put pressure on a depressed person if he does not want to talk or have the energy to talk about how they are feeling. Let them know you're available to speak with them whenever they're ready. If the individual finds it difficult to express their feelings and ideas openly, offer an activity that will make it comfortable for them to do so, such as having a cup of tea or going for a stroll. You can also inform the individual about various options that helps them to speak with someone else, such as a telephone counseling service.

Listen attentively. You may help someone who is depressed by paying attention to them and without passing judgment. Acceptance, genuineness, and empathy are three important attitudes in nonjudgmental listening. Accept the individual as they are by putting aside any and all judgments you may have formed about them or their situation. Set aside any negative beliefs or reactions in order to focus on the requirements of the person you're assisting, and select your words carefully to avoid offending anybody; for example, even if you think the person is behaving lazily, you shouldn't say so to them. Body language that complements your verbal communication, such as telling the individual you accept and respect their sentiments while keeping an open stance and proper eye contact, can indicate authenticity to the person. Demonstrate empathy by showing that you have genuinely listened and comprehended the individual.

Have reasonable expectations for the individual. Accept the person for who they are and set reasonable expectations for them. Simple day to day home chores such as cleaning the house, paying bills, etc. may appear to be burdensome to the person. You should accept that the individual isn't "faking," "lazy," "weak," or "selfish," and you shouldn't pressure them to do things they feel they can’t do.

Help the person recognize their abilities. If the individual is severely judging themselves (e.g., calling oneself a failure or a weak person), remind them of their strengths and praise any efforts they are making to improve their life. Let the individual know that having depression does not make them weak or a failure; even the most capable and powerful people may get depressed. Tell them you don't believe they're any less of a person.

Help the depressed person to believe that he or she will heal. Support the person by reminding them that, even if they don't believe it right now, they will feel better with time and treatment. Give the individual hope for a better future, and let them know that their life matters.

What isn't Helpful?

Depression is a bio-psycho-social problem and not the person's fault if they are depressed. It's pointless to advise someone to "snap out of it," or "get over it". This individual would do it if it was that easy for them. Do not tell the person that "it's all in their heads" or “they should offer Salah and read Quran and it will all end” or that they simply need to be more active or occupied.

By suggesting the individual to ‘put a smile on their face,' ‘cheer up,' or ‘lighten up,' you are trivializing their experiences. Trying to be optimistic (e.g., "You don't seem that awful to me") might be seen as dismissive or demeaning, and should be avoided.

Avoid labeling the individual with terminology that they may find stigmatizing, such as "pagal" (crazy) or “tensioniy”. Also, while speaking with the person, avoid using language that implies a possible diagnosis. Your job is not to diagnose the person.

Avoid using a patronizing tone of voice or excessively sympathetic looks of worry when talking to the person. Avoid being overly engaged or over-protective of the individual, but also refrain from completely abandoning them.

Avoid confrontation unless it is absolutely essential to keep the person from committing harmful or hazardous behaviors.

What if I have Problems Conversing with the Person? 

Be patient and accept the person's responses as the best they have to offer at the time if they are not communicating properly (e.g., speaking slowly, less clearly than usual, or being repetitious). Make an effort to be as helpful as possible. Interrupting, criticizing, expressing irritation, or being angry or sarcastic should be avoided at all costs.

Try not to take any irritated or unpleasant behaviors personally and instead consider them as part of the disease. Make no conclusions regarding the source of the person's anger if they become enraged while talking. Maintain your composure while acknowledging the other person's anger and frustration. When assisting the person, however, do not tolerate abuse or jeopardise your own mental health.

Encourage the person to talk to someone else about their feelings if they don't feel comfortable talking to you. If cultural differences are preventing you from assisting the individual, talk to them about what is culturally appropriate and practical for them. Be open to change your verbal and nonverbal behaviors; for example, the individual may want a different degree of eye contact or more personal space. You can also contact a specialized mental health service.

Should I Encourage Them to Seek Professional Help? 

It's critical that you know when to persuade the person to get professional help. When depression lasts for weeks and interferes with a person's ability to function in everyday life, professional treatment is required. Do not assume that the person's depression will go away on its own. Keep in mind that early treatment of depression is critical for the greatest results.

Discuss with the depressed individual and their caregivers how seeking professional help from psychiatrists and clinical psychologists can be beneficial and ask the individual and his family members whether they believe it would be beneficial to them. Discuss getting professional help in a way that normalises it, such as by describing it as a natural activity to do and explaining that mental health issues are common and treatable.

If they believe they need assistance, talk to them about the professional help that is available in their area and urge them to use them. If the person requires assistance, volunteer to assist them.

Encourage the individual to prepare a list of questions to share with the health professional at their initial session if they decide to seek professional treatment. If the individual wishes for you to accompany them to a doctor's visit, you must not fully take over since a person suffering from depression needs to make their own decisions as much as possible.

The author is a Child and Adolescent mental health counselor at IMHANS-K and can be reached at [email protected] 

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