Depression is a common and treatable mental illness that affects millions of people of all ages and from all walks of life. Researchers estimate that nearly 7% of adults in the U.S. have depression every year, and around 1 in 6 people will experience depression at some point in their lifetime.
For many people with depression, friends and family are often the first line of defense in their fight. But when someone close to you is struggling, it may not be easy to know what to do or say.
Recognizing the signs of depression and understanding safe ways to offer help can go a long way to support their recovery.
What is depression?
Depression – also called major depressive order or clinical depression – is a complex condition, and researchers aren’t exactly sure what causes it. It’s believed that several factors may contribute to the development of depression, including:
- Brain chemistry. An imbalance of chemicals in your brain called neurotransmitters may play a part in your mood.
- Genetics. While an official link hasn’t been made, research shows that someone who has a family member with depression is much more likely to develop the condition than the general population.
- Hormone changes caused by pregnancy, postpartum issues, thyroid problems and other issues. It’s one reason women are about twice as likely as men to become depressed.
- Traumatic or major life events, including sexual abuse, grief, a divorce or breakup, as well as major life changes such as a new job, marriage or a move.
- Chronic medical conditions, such as diabetes, heart disease, kidney disease and others.
- Medications. Some medicines have been linked to depression, especially in older adults.
- Substance use, including alcohol, can cause depression or make it worse. Nearly 30 percent of people with substance misuse problems also have depression.
- Age. Older adults are at a higher risk for depression. Living alone or lack of social support are contributing factors.
When someone close to you is struggling with depression, it’s important to understand these basic facts:
- Depression is a serious mental health condition.
- Your friend or family member isn’t just lazy or unmotivated.
- When someone is depressed, you can’t “fix” them.
- The risk of suicide is real.
- There are ways you can help.
- There are resources out there for people who need them.
What are the symptoms of depression?
The signs of depression can vary from person to person. Some people may have symptoms that interfere with their day-to-day activities. Others may feel generally sad or unhappy without knowing why. Children and teens tend to show depression by being irritable and cranky rather than sad and hopeless.
In general, you should be concerned if your friend or loved one:
- Feels very sad, hopeless or worried.
- Has lost interest in things that once brought them pleasure or joy, including work, hobbies, sex and other activities.
- Is easily frustrated or irritated, even over little things.
- Feels fatigued, sluggish and physically drained, making even small tasks difficult to complete.
- Has appetite or weight changes.
- Is oversleeping or not sleeping enough.
- Has trouble concentrating, making decisions or remembering things.
- Expresses strong feelings of worthlessness or guilt.
- Engages in risky or escapist behavior, such as substance misuse, compulsive gambling, reckless driving or dangerous activities.
- Complaints of physical ailments, such as headaches, stomach aches or body pain.
For someone living with depression, there can be a mix of good and bad days. But when these symptoms are prolonged or intensify, it may be a sign their depression is getting worse.
In some cases, worsening depression may lead to suicidal thoughts or tendencies.
Does depression impact men differently?
Men, women and people of all gender identities experience depression, but their symptoms can be different. Statistics show that more women than men suffer from depression. But a closer look tells a different story. While men are diagnosed with depression at half the rate of women, they die by suicide 3 to 4 times as frequently.
Men who have depression are often undiagnosed and resist treatment for a variety of reasons, such as:
- Sadness isn’t the primary symptom. Men are more likely to be irritable or angry and develop physical symptoms, such as digestive issues, erectile dysfunction and headaches.
- Society encourages men to suppress their feelings. Men are less likely to talk openly about their emotions or feelings, even with family and friends.
- Men are worried about the stigma around mental health. Men’s depression is often triggered by financial, legal or work-related issues, which they associate with failure, weakness or disappointment.
What are the signs of suicide?
When depression becomes severe, some behaviors might indicate that a person is at risk for suicide, including:
- Intense changes in mood.
- Extreme agitation or anxiety
- Withdrawal from friends and family.
- The sudden switch from being extremely down to acting calm and happy.
- Engaging in risky or self-harming behavior.
- Getting affairs in order (giving away prized possessions, saying “goodbye” to people).
- Saying things like, “Everyone would be better off without me,” or “I want out.”
- Increased use or misuse of substances.
- Looking for ways to end their life, such as searching online.
If you sense a loved one is in distress and may be suicidal, it’s important to help them get immediate help:
- Help them get in touch with their therapist if they have one.
- Offer to text or call 988, the Suicide & Crisis Lifeline together, or call or text yourself if the person is unwilling.
- Drive them to the nearest emergency room.
- Call 911 if there is an immediate risk of harm. Tell the operator you are calling about a mental health emergency.
- Stay with them until they are connected to help.
How can I support and safely encourage someone with depression?
People with depression often may not recognize or acknowledge their symptoms. It may also be difficult for them to ask for help. Here’s what you can do:
- Express empathy and concern. Talk to the person about why you’re worried about them. Assure them that depression is not a personal flaw or weakness and remind them there are people who care about them and what to help.
- Listen without judgement. Listening and being understanding can be powerful tools. Avoid giving advice or opinions.
- Suggest they get help. If they don’t already have a therapist or doctor, suggest they seek help from a behavioral health or health care provider. A primary care clinician can be the best place to start.
- Ask how you can help. Offer to help set up and/or attend appointments and ask if they’d like help preparing a list of questions and notable changes that can be addressed at an initial consultation.
- Be patient. Depression is treatable, but it can take time for symptoms to improve.
- Take care of yourself. Supporting a friend or family member who is dealing with depression can take a toll on your mental and physical health. Ask other relatives or friends for help and take self-care steps to avoid burnout.
What resources are available for those who need help?
Several organizations offer resources for depression. Here are some of the most trusted:
- Substance Abuse and Mental Health Services (SAMHS) Helpline offers treatment referrals for substance abuse or mental health services.
- National Alliance on Mental Illness (NAMI) produces information on mental health conditions, including signs and symptoms, treatment options, statistics and advanced research.
- Anxiety and Depression Society of America (ADAA) maintains a large directory of mental health professionals organized by location and specialty.
- American Psychological Association (APA) offers a psychologist locator that allows you to search for therapists by name or location.
- Centers for Disease Control and Prevention (CDC) Division of Mental Health offers expert information on prevention, management and treatment of depression as well as additional tools and resources. The CDC’s free mental health quiz helps debunk the myths and eliminate the stigma around mental health.
- Depression and Bipolar Support Alliance (DBSA) provides support and education for those with mood disorders.
- Mental Health America (MHA) maintains a variety of tools and resources, including an interactive online space called Screening to Supports (S2S) for those wanting to take more control of their own mental health.
There’s no need to wait for care. Indigo Online Care is here to help.
If someone you know is struggling with depression, they don’t have to wait for care. Indigo Online Care is available. Same-or next-day appointments are available, in most cases.
Online care is a great place to start, even if it’s just to start a conversation. Our online care clinicians can also prescribe medications to manage depression symptoms, make self-treatment recommendations around diet, exercise and sleep improvement, and coordinate a referral to a trained mental health specialist if needed.
Indigo video visits are available every day from 8 am to 8 pm
If someone you know is in severe distress or has suicidal thoughts or behaviors, seek emergency treatment immediately. The following resources are free, confidential and available 24/7:
- Dial 988 for the National Suicide Prevention Lifeline
- For veterans and their loved ones, dial 988 then press 1 for the Veterans Crisis Line.
- Text HOME to 741-741, the Crisis Text Line.
- Contact the Substance Abuse and Mental Health Services Administration’s national helpline at 1-800-662-HELP (4357).