Depressed friends helping friends with depression?

Dear Blind Leading the Blind,

It's not clear if your friend has been formally diagnosed by a clinician or is simply showing some common signs of depression (e.g., feelings of sadness, hopelessness, change in sleep pattern, etc.), but your desire to help is as clear as it is noble. It’s common to encounter mental and emotional challenges when supporting a loved one with depression, even for people without a history of their own mental health issues. With that said, it’s good to remember that you’re not responsible for treating your friend’s depression. Fortunately, there are many ways you can help them through this difficult time without neglecting your own mental and emotional well-being.

The concern that your friend’s depression will resuscitate your own mental health issues is a legitimate one. Though depression itself isn't contagious, some people do have patterns of thought that may make them more susceptible to developing depression, referred to as a “cognitive vulnerability.” More specifically, people who tend to focus on and negatively interpret stressful life events could be more likely to develop depression. However, it’s still unclear as to how long this cognitive impact could last. So, while your friend’s depression isn’t contagious, there are some cognitive factors that might have the potential to impact you, depending on how much you tend to ruminate on negative thoughts.

If you choose to help, however, you may first want to reflect on what kind of support you would like to be for your friend and how much energy and emotional reserve you have available to offer. You might consider talking this through with a mental health professional to ensure you have the support you need. If you decide that helping your friend is something you are ready and able to do, the following tips may come in handy:

• Address your own needs. If you’re frustrated with or sad about your friend’s depression, try not to let those feelings to accumulate. Tell your friend know how you’re feeling. Otherwise, they may notice your negative mood or frustration, making both of you feel worse. You may also want to identify people and resources (like a mental health professional) to turn to for support if your friend’s depression triggers yours in any way. In addition, learn to recognize the signs that your own mental and emotional toll has tipped too far. These signs may include symptoms of depression, stress, and anxiety. Additionally, it’s not uncommon for people in a helping role to experience feelings of guilt, isolation, anger, sadness, or exhaustion. If you begin experiencing these signs, you may want to remove yourself from the situation for a time to take care of yourself.
• Set boundaries. Acting as a therapist isn’t your responsibility. Be honest with your friend and let them know that you want to help, but that you’re concerned about maintaining your own mental health. If at any point it becomes too much, it's okay to step away from the situation.
• Listen instead of giving advice. Express your concern and ask questions, but try not to attempt to diagnose or fix your friend’s problems.
• Express empathy and reinforce the point that your friend is not alone. Let them know that you care. Some example phrases may include “I’m here for you” and “I may not understand your pain, but I can offer my support.”
• Research and refer. Individuals experiencing depression often feel exhausted and unmotivated, which makes it difficult for them to seek treatment. You could help your friend by researching local therapists, psychologists, and psychiatrists who specialize in depression. You might also help your friend schedule the appointment or even accompany them to the visit if they want.
• Pitch in. When your friend is in a depressive state, they may find it difficult to complete necessary and seemingly easy tasks. Lend a hand by offering to help around the house or driving your friend to appointments.
• Get moving. Research shows that regular physical activity may reduce symptoms of depression. Going on walks or attending yoga classes together may help relieve some of your friend’s symptoms. Check out the Go Ask Alice! Fitness archives for more information on ways to get moving.  
• Sleep. Lack of sleep is not just a symptom; it may also exacerbate depression. Keeping up good sleep hygiene (both quality and quantity) is a healthy habit for both you and your friend.
• Learn ways to intervene if someone expresses suicidal thoughts. People with depression are at a higher risk for suicide, and immediate interventions are recommended if your friend starts sharing suicidal thoughts. It may help to learn the warning signs and how to help.

There are lots of questions about depression in the Go Ask Alice! Blues & Depression archives that you may look over and think about. If you’re keen on talking with a mental health professional, check out Finding low-cost counseling in the Go Ask Alice! archives for tips on locating someone in your area.

Depression can be difficult to cope with, whether it’s affecting you, a friend, a coworker, or a loved one. Your ability to empathize combined with your background knowledge of and experience with depression may help you help your friend — the degree to which you become involved in their recovery is up to you.