Information For Family Carers And Friends
You can get support if you are a carer, friend or family member of someone living with depression.
Being a carer might mean you can claim certain benefits that might help you and the person you care for. For more information, please see the Mental Health and Money Advice services website:www.mentalhealthandmoneyadvice.org/en/welfare-benefits/what-benefits-are-available-for-mental-health-carers/
You could also get in touch with carer support groups or sibling support groups. You can search for local groups in your area online or ask your GP.
You can ask your local authority for a carers assessment if you need more practical support to help care for someone.
As a carer you should be involved in decisions about care planning. There are rules about information sharing and confidentiality which may make it difficult for you to get all the information you need in some circumstances.
You can find out more information about:
How can I support the person that I care for?
You might find it easier to support someone with depression if you understand their symptoms, treatment and self-management skills. You can use this to support them to get help and stay well.
Below are some initial suggestions for providing practical day to day support to someone with depression.
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Bring Up Your Concerns With Your Loved One
If you notice signs of depression in your loved one, its important to calmly share your concerns in a way thats nonjudgmental, says Ole Thienhaus, MD, a professor of psychiatry at the University of Arizona College of Medicine in Tucson. Its also crucial to give your loved one space to talk about what theyre feeling.
Listening is the most important part of beginning to help, Dr. Thienhaus says.
To get them talking, you may start by sharing the changes youve observed recently that worry you, Thienhaus says. When you do this, dont be critical just state the facts as you see them in a neutral way and pause often to give them room to respond to what you have to say.
Avoid any suggestion that they have no reason to feel so sad, Thienhaus adds. This means not saying things like, Look at all the good things in your life or Look at how much worse off so-and-so is, but she doesnt let her problems get her down.
Why is this harmful? Many people with depression already believe they should be able to snap out of it or should be mentally strong, Thames says, feelings that can stand in their way of seeking treatment for depression.
They Fake Or Force Their Smiles
When someone is hiding depression, they learn how to act as if theyre happy. They look normal and cheerful around friends and family, hiding their inner struggles. These individuals may feel that theyre letting people down if they admit their depression. They force happiness to hide their depression and appear like theyre doing okay.
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Can Depression Be Prevented
Many people wonder if depression can be prevented and how they may be able to lower their risk of depression. Although most cases of depression cannot be prevented, healthy lifestyle changes can have long-term benefits to your mental health.
Here are a few steps you can take:
- Be physically active and eat a healthy, balanced diet. This may help avoid illnesses that can bring on disability or depression. Some diets including the low-sodium DASH diet have been shown to reduce risk of depression.
Mild And Moderate Depression
These are the most common types. More than simply feeling blue, the symptoms of mild depression can interfere with your daily life, robbing you of joy and motivation. Those symptoms become amplified in moderate depression and can lead to a decline in confidence and self-esteem.
Recurrent, mild depression
Dysthymia is a type of chronic low-grade depression. More days than not, you feel mildly or moderately depressed, although you may have brief periods of normal mood.
- The symptoms of dysthymia are not as strong as the symptoms of major depression, but they last a long time .
- Some people also experience major depressive episodes on top of dysthymia, a condition known as double depression.
- If you suffer from dysthymia, you may feel like youve always been depressed. Or you may think that your continuous low mood is just the way you are.
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How To Help Someone With Depression
Feeling down or depressed from time to time is normal. But if these feelings last 2 weeks or more, or start to affect everyday life, this can be a sign of depression.
Depression can develop slowly. Someone who’s depressed does not always realise or acknowledge that they’re not feeling or behaving as they usually do.
Often it’s a partner, family member or carer who first realises that help’s needed. They may encourage their friend or relative to see a GP, or find some other source of support.
What You Could Say
These phrases might help if youre not sure what to say:
- Do you want to talk about it? Im here whenever youre ready.”
- What can I do to help today?
- Youre not alone, even if I dont completely understand how you feel.
- Youre important to me.
- That sounds hard. How are you managing?
- Im sorry youre experiencing this Im here for you.
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Youre Important To Me
Its always nice to know youre loved or wanted. When someones depressed, they may feel the exact opposite.
Thats why telling someone that theyre important to you, that you need them in their life, and that they matter can be so comforting. You can also be more specific about what you love about them or how you appreciate them for something they do.
Be Alert To Signs That Treatment Is Not Working
On the other hand, the absence of any such signs most likely means that ones depression is not improving and may be getting worse, Halaris notes, adding that a major concern in the absence of improvement is whether your loved one is having suicidal thoughts.
This is where you need to very gently raise the question whether they are having even fleeting thoughts of their life not being worth living, Halaris says.
According to Mayo Clinic, signs your loved one may be considering suicide include:
- Making statements such as I wish I were dead or I wish I hadnt been born
- Purchasing a gun or hoarding pills
- Fixating on violence, death, or dying
- Withdrawing from social contact with others
- Feeling hopeless or trapped in their current situation
- Telling people, goodbye, as if theyre going to disappear
- Getting their affairs in order or giving away their belongings with no other plausible explanation for doing so
If your loved one shows signs of considering or planning to take their own life, Halaris and Riba recommend taking steps to reduce their risk of attempting or completing suicide, such as:
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How Common Is Depression
Major depression is one of the most common mental illnesses in the country. An estimated 17.3 million adults in the US reported having at least one major depressive episode over the course of a year, a 2017 report by the Substance Abuse and Mental Health Services Administration shows.
Thats 7.1% of all adults ages 18 and older. Women have a higher prevalence of experiencing a major depressive episode than men .
Depression is especially crushing for the workforce: Its the number one leading cause of disability worldwide, according to the World Health Organization. The total economic burden of MDD is estimated to be $210.5 billion per year in the United States alonea figure that reflects costs associated with missed days, reduced productivity, treatment for depression, and suicide.
How Can I Help The Doctor Make A Proper Diagnosis
Before your appointment, write down your concerns about depression and specific symptoms of depression you might have. Itâs also helpful to get an in-depth family history from relatives before meeting with your doctor. This information can help the doctor make an accurate diagnosis and ensure effective treatment. Before your visit, think about and write down:
- Your mental and physical health concerns
- Symptoms you’ve noticed
- Causes of stress in your life
- Questions you have about depression and depression medications
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They Seek Acceptance And Love From You
A person hiding depression doesnt want to be dishonest with the people who love them, but they feel like theyll be a burden if they admit theyre depressed. Or they may try to protect their heart from rejection. They desperately need acceptance and love from those around them but act the opposite. They may even push people away to project theyre doing fine.
Can Depression Be A Symptom Of Other Mental Health Problems
Depression can be a part of several mental health problems, such as:
If feelings of low mood or suicidal thoughts are the reason you first speak to your doctor about your mental health, your GP might offer you treatment for depression without realising that you are also experiencing other symptoms.
If you think you’re experiencing other symptoms, you can talk to your doctor about this to make sure you’re getting the right treatment to help you. See our pages on seeking help for a mental health problem for information on how to make sure your voice is heard, and what you can do if you’re not happy with your doctor.
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Do You Want To Talk About It Im Here When Youre Ready
You cant force someone to talk but knowing youre available can really help them feel supported.
If they havent been forward with you about their depression, you may want to mention youve noticed theyre having a hard time and youre there if they want to talk. If you simply ask, Are you OK? they may be used to pretending and reply Im fine.
If theyre not ready to talk now, remind them youre here for them when theyre ready. They may remember your offer and come to you when theyre having a hard time and need someone to talk with.
Severities Of Clinical Depression
Clinical depression can often come on gradually. So it can be difficult to notice when something is wrong. You might try to cope with the symptoms without realising you’re unwell. It can sometimes take a friend or family member to suggest something is wrong.
The severity of clinical depression depends on how much impact it has on your daily life:
- mild clinical depression has some impact
- moderate clinical depression has a significant impact
- severe clinical depression almost impossible to get through daily life
You can have clinical depression and other mental health disorders. For example, anxiety, psychosis or other difficulties.
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Causes And Risk Factors
While some illnesses have a specific medical cause, making treatment straightforward, depression is far more complicated. Certain medications, such as barbiturates, corticosteroids, benzodiazepines, opioid painkillers, and specific blood pressure medicine can trigger symptoms in some peopleas can hypothyroidism . But most commonly, depression is caused by a combination of biological, psychological, and social factors that can vary wildly from one person to another.
Despite what you may have seen in TV ads, read in newspaper articles, or maybe even heard from a doctor, depression is not just the result of a chemical imbalance in the brain, having too much or too little of any brain chemical that can be simply cured with medication. Biological factors can certainly play a role in depression, including inflammation, hormonal changes, immune system suppression, abnormal activity in certain parts of the brain, nutritional deficiencies, and shrinking brain cells. But psychological and social factorssuch as past trauma, substance abuse, loneliness, low self-esteem, and lifestyle choicescan also play an enormous part.
Who Is At High Risk For Depression
Those most at risk for developing depression include women, the elderly, those with a personal or family history of depression, chronic stressors, those with other concurrent mental and physical health conditions, low socioeconomic status, and those taking medications that may cause depression, like birth control or some anxiety medications.
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Changes In Appetite And Weight
Weight and appetite can fluctuate for people with depression. This experience may be different for each person. Some people will have an increased appetite and gain weight, while others wont be hungry and will lose weight.
One indication of whether dietary changes are related to depression is if theyre intentional or not. If theyre not, it may mean that theyre caused by depression.
People who die by suicide usually show symptoms first. Often people will talk about it or make a first attempt before succeeding in ending their life. If you think someone is at immediate risk of self-harm or hurting another person:
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but dont judge, argue, threaten, or yell.
If you think someone is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
What Not To Say To Someone With Depression
What not to say
Just remember: Advice isnt the same as asking for help. If they ask for your advice, give it if you so choose. But dont offer them helpful solutions or statements that seem like a cure for their depression. This can feel judgmental or not empathetic.
- Just think happy thoughts. I dont understand what you have to be so sad about.
- Everything will be OK, I promise.
- I cut out sugar, and I was cured! You should try it.
- You just need to snap out of this.
- So many people out there are worse off than you.
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How Can Depression Symptoms Lead To A Depression Diagnosis
To be diagnosed with major depression, you must have at least five of the symptoms listed above with at least one of the first two nearly daily for at least 2 weeks.
Depression symptoms can last weeks, months, or sometimes years. They can affect personality and interfere with social relationships and work habits, potentially making it difficult for others to have empathy for you. Some symptoms are so disabling that they interfere significantly with your ability to function. In very severe cases, people with depression may be unable to eat, maintain their hygiene, or even get out of bed.
Episodes may happen only once in a lifetime or may be recurrent, chronic, or longstanding. In some cases, they seem to last forever. Symptoms may appear to be precipitated by life crises. At other times, they may seem to happen at random.
Depression And Older Adults
Feeling down every once in a while is a normal part of life, but if these feelings last a few weeks or months, you may have depression. Read this article to find common signs and symptoms of depression, treatment options, and if you or your loved one may be at risk for depression.
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Remind Them You’re There For Them
Depression can feel as though no one understands what you are feeling or even cares enough to try to understand, which can be isolating and overwhelming.
Research has shown that people tend to withdraw when they are depressed, so reaching out to a friend in need is an important first step. If your friend isn’t ready to talk, continue to offer your support by spending time with them and try to check in regularly, either in person, on the phone, or by text.
When you reach out to a friend, letting them know that you are going to be there every step of the way can be very reassuring.
You may not quite know what this will look like at first, but know that just reminding your friend that you are someone they can lean on can mean the world.
Other Types Of Depression
There are different types of depression, and some conditions where depression may be one of the symptoms. These include:
- postnatal depression sometimes new mothers, fathers or partners develop depression after they have a baby this is known as postnatal depression and it’s treated in a similar way to other types of depression, with talking therapies and antidepressant medicines
- bipolar disorder also known as “manic depression”, in bipolar disorder there are spells of both depression and excessively high mood the depression symptoms are similar to clinical depression, but the bouts of mania can include harmful behaviour, such as gambling, going on spending sprees and having unsafe sex
- seasonal affective disorder also known as “winter depression”, SAD is a type of depression with a seasonal pattern usually related to winter
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What Are Signs And Symptoms Of Depression
How do you know if you or your loved one may have depression? Does depression look different as you age? Depression in older adults may be difficult to recognize because older people may have different symptoms than younger people. For some older adults with depression, sadness is not their main symptom. They could instead be feeling more of a numbness or a lack of interest in activities. They may not be as willing to talk about their feelings.
The following is a list of common symptoms. Still, because people experience depression differently, there may be symptoms that are not on this list.
- Persistent sad, anxious, or “empty” mood
- Feelings of hopelessness, guilt, worthlessness, or helplessness
- Irritability, restlessness, or having trouble sitting still
- Loss of interest in once pleasurable activities, including sex
- Decreased energy or fatigue
- Moving or talking more slowly
- Difficulty concentrating, remembering, or making decisions
- Difficulty sleeping, waking up too early in the morning, or oversleeping
- Eating more or less than usual, usually with unplanned weight gain or loss
- Thoughts of death or suicide, or suicide attempts
If you have several of these signs and symptoms and they last for more than two weeks, talk with your doctor. These could be signs of depression or another health condition. Dont ignore the warning signs. If left untreated, serious depression may lead to death by suicide.