I was recently asked by a journalist what I would recommend “never” to say to someone who has depression. That’s a very good question. In my recent book When Someone You Know Has Depression: Words to say and things to do (2016), I focus mainly on the positives. By that I mean statements that are encouraging and received well by a person in the midst of a mood disorder. Today I will turn things around and give you some examples of what doesn’t work, and why.
There are about three dozen negative comments I can think of off the top of my head, and they fall into several categories. Most family members and close friends mean well and are trying their best. It’s hard to stay positive when you are fatigued, stressed, or frustrated in dealing with the illness, but you want to avoid accidentally saying these things or blurt out snap clichés. They are not helpful to the person and often times make things worse by breaking down the trust and communication you are trying to build.
The first is to avoid saying anything that is dismissive or invalidating. Your family member who has depression has a right to his or her feelings and thoughts, even if you don’t agree with the content. When you recognize and disagree with the person’s impaired thinking, negative or distorted thoughts, don’t tell him how to think and feel. Gently show him that the errors in his logic are inconsistent with his life experiences. Instead of saying “No you don’t’”, or “How could you possibly think…” in response to something he says, it would be preferable to respond with “I hear you feel you’re ___. That must feel awful. Where do you think that comes from? What about the time___?” and offer some concrete evidence in his life that counteracts his statement.
Invalidating statements are things like “There are people worse off than you,” or “It’s all in your head.” This disregards her symptoms as being valid and imposes guilt upon the person for having them. It ignores the fact that 41,000 people who have depression died by suicide in the United States in 2015. Minimizing her thoughts and feelings by saying something like “Oh, everybody has a bad day” or “I was depressed for 3 days once” is another way of sending the message that her situation is not serious and legitimate. Another, “Don’t be so depressed,” “You have it so good – why can’t you just be happy?” or “Snap out of it” gives the message that he or she could just “will away” the illness, and dismisses it as the biologically based medical condition of the mind and body that it is.
Another category to avoid are statements that are judgmental, blaming or critical. These are comments such as “It’s your own fault,” “You’re just looking for attention,” “You need to get a job [or hobby, boyfriend, volunteer].” Or “You should get off those pills and stop seeing that quack doctor,” and “You should go to church and pray.” Try not to impose your personal opinion on your family member’s life and decisions during an episode of depression.
It is also not helpful for you to make assumptions or jump to conclusions about the person who has depression, how or what he feels or thinks, especially without the full facts. This is definitely not helpful and can ruin your relationship with him or her. One example is “You must have your period,” or “It’s PMS.” The comment “Just try a little harder” assumes that the person is not making an effort, which is also judgmental, critical and dismissive.
Here are a few additional comments in the “DON’T DO” list that you would do well to avoid.
- Stop feeling sorry for yourself
- Pull yourself together
- Get your act together
- Lighten up
- Have you tried herbal tea? [or vitamins]
- Just don’t think about it
- Quit whining
- But you look so happy all the time
- This too will pass
And top on my list of personal disliked comments, merely saying…
“Hang in there!”
Susan J. Noonan MD, MPH is a physician and certified peer specialist, author of two books and blogs on managing depression for her own website, Psychology Today and The Huffington Post, and a patient with firsthand experience in mood disorders. Her recent book, When Someone You Know Has Depression: Words to say and things to do (JHUP 2016), is a companion to Managing Your Depression: What you can do to feel better (JHUP 2013). She can be reached at www.susannoonanmd.com.