Things Not To Say

When someone you care about is depressed, offering advice or wisdom may be something you do with only good intentions in mind. However, the words you use may not convey the message you want to send, especially if you don't understand the nature of depression and mental illness.


"Snap Out of It" or "Try Harder" - Having someone tell you to try harder when you are already giving it your best effort can be demoralizing and may make a person with depression feel their situation is hopeless.

There are many reasons depression develops and a person cannot necessarily control all of the risk factors involved. Once a person has become depressed, it's not a matter of just "talking themselves out of" a low mood.

Like diabetes or hypothyroidism, depression can happen because the body is not making enough of substances it needs to function properly. A person with diabetes cannot will their body to make more insulin. Similarly, a person experiencing depression due to low levels of neurotransmitters can't simply "think" themselves into having more.

Similar to how people with diabetes might need treatment with insulin, people who have depression need medical intervention and support. For some people, this may mean taking medications that address chemical imbalances that can contribute to the condition.



The Chemistry of Depression

"Cheer Up!" - Your well-meaning exhortations to "cheer up" or "smile" may feel friendly and supportive to you, but they oversimplify the feelings of sadness associated with depression.

Just as someone who is depressed can't force their brain to make more serotonin, they also can't just "decide" to be happy. While there are certainly benefits to practicing positive thinking, it's not enough to cure someone of depression.

"But You Don't Look Depressed!" - How a person appears on the outside does not necessarily reflect how they feel on the inside. This is true of many mental illnesses, but also chronic illnesses and conditions that are sometimes deemed invisible.

The old adage that you can't judge a book by its cover rings true: It's not uncommon for people with depression and anxiety to try very hard to "put on a good face" and hide how they really feel from others.

What High Functioning Anxiety Looks Like - They may be embarrassed, confused, guilty, ashamed, or afraid of what would happen if other people found out that they were depressed. They may worry that they will be seen as incompetent at work or as a parent, or that their spouse, family, and friends will stop loving them. These thoughts can become very intense and, in fact, are characteristic of depression itself, even though they don't reflect reality.

Just because someone who is depressed tries to cover it up, it doesn't mean they want to be dismissed when they do choose to open up about how they really feel. It takes courage to speak openly about the pain they feel. If someone responds with doubt or disbelief, it may make them feel like talking about their depression is not safe.

It can also make them doubt themselves. When paired with the stigma attached to mental illness, those feelings of doubt may make them reluctant to seek treatment.

"It Can't Be That Bad" or "It Could Be Worse" or "You Think You Have It Bad. . ." - When you're talking to a friend who is depressed or going through a difficult time, resist the temptation to compare pain. Remember that pain (emotional and physical) is not only subjective but relative.

People with depression also lack the internal resources needed to cope with stress in an effective and healthy way. To you, an event or situation that constitutes a minor annoyance or inconvenience may feel like an insurmountable obstacle to your loved one with depression.

People often worry if they don't see a clear "reason" for their depression, and not knowing why they are depressed can make matters worse.

What someone's life looks like on the outside doesn't always reflect, or change, how they feel on the inside. Depression doesn't need a justification. The experience is highly personal, and even if you care about someone and want to help, be aware that you can never know for sure how it feels to be them.

Maybe a person's life could be worse, but depression isn't about how bad things are, it's about how bad they feel for that person at that moment.

Avoid making comparisons or staging a "competition" for who feels the worst. Doing so isn't helpful and can make a person with depression feel that you're minimizing their experience or not really listening to what they're telling you.

"It's All in Your Head" or "It's Your Fault" - While a deficiency of mood-regulating substances is technically occurring in the mind, the phrase "all in your head" tends to be dismissive. People who hear the phrase may also feel attacked, as though they are being accused of "making it up" or lying about how they feel.

Furthermore, depression very often is not just in someone's head but in their body as well. There are many physical symptoms of depression, including chronic pain, which are very real. Depression is a medical condition that can't be expected to improve without treatment.

Depression is not a condition someone chooses to have, and while researchers don't understand all the potential causes, they know that there are many factors.

One factor believed to play a significant role in depression is genetics. Some environmental factors may also play a role, perhaps by triggering an underlying inherited vulnerability to depression.

As with genetics, people can't always control environmental triggers such as the type of home environment they grew up in. It's well known that people who experienced trauma or abuse in childhood are at an increased risk for depression later in life.

There are some theoretically modifiable risk factors and lifestyle changes that can have an impact on symptoms, but simply telling someone with depression to "get out more" or recommending lifestyle changes they may not be prepared for can also be unhelpful. The symptoms of depression (such as fatigue and lack of motivation) can make mental and physical activity overwhelming and exhausting.

"Who Cares?" - When someone is depressed, they may carry feelings of guilt and shame. They may feel that they are a burden to the people in their lives, and these feelings can make depression worse and may even lead to suicidal thoughts or self-harming behaviors.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

Minimizing the pain of another person is not helpful and, for people who are dealing with depression, can be very hurtful and harmful.

When you're caring for (and about) someone who is depressed, you may say hurtful things when you are feeling frustrated or worried. If you find yourself thinking "who cares?" when you're listening to a loved one, recognize that it might be a sign you are burnt out.

You need to take care of your own emotional and mental health before you can help someone else with theirs. If you are feeling frustrated, irritated, or helpless, check-in with yourself and make sure that you have the support you need.

"You Don't Think About Anyone But Yourself" - It may seem, at times, like someone who is depressed is very preoccupied with their own life (or, more specifically, their own thoughts) but that doesn't make them selfish. Implying that a person with depression doesn't care about other people provides no comfort and only fuels feelings of blame, shame, and guilt.

"I Don't Understand" - Even if you have experienced clinical depression yourself, your experience may be different from someone else's. If you've never had depression, it may be hard for you to empathize. In either case, if someone you love is depressed, the best thing you can do is be open and willing to learn.

Rather than giving up on a conversation by saying "I just don't understand" or saying you do understand when you really don't start by reassuring your loved one that you care about them.

If you are struggling to understand what they need, be honest. Calmly explain, then be patient and ready to listen.

"This Too Shall Pass" or "Let It Go" - While this may be true, a person who is depressed may not have the perspective necessary to entertain the idea let alone believe it. Platitudes, clichés, and vague statements don't offer much for someone to hold on to in terms of hope.

A person who is depressed may have a hard time envisioning the future because they are overwhelmed by the present. It's also not easy to "let go" or "escape from" the past, especially for someone who experienced loss or trauma.

You may feel like you're offering hope by saying that eventually, things will get better, but a person who is depressed may be frustrated wondering how long they will have to wait.

Instead of pushing them to focus on the future or forget about the past, just do your best to be present with them at the moment. Just sit with them and try not to worry about saying the right or wrong thing: You may find the most helpful thing you can do is to listen.

It's tough to find helpful words to someone who is feeling depressed. Don't be afraid to say, "I am not sure what to say right now." Stay mindful that the words you know can make a big difference. And if you're not careful, your words might do more harm than good.

If you think you've said something hurtful in the past, apologize. Explain that you weren't sure what to say or that you didn't understand. An apology can help someone begin feeling better if your words haven't been helpful in the past.