HOW CAN I BE SUPPORTIVE?

Treat the person with respect and dignity

Recovery, for the most part, must be led by the person and you should resist the urge to try to cure the person’s depression or to come up with answers to their problems. Each person’s situation and needs are unique. It is important to respect the person’s autonomy while considering the extent to which they are able to make decisions for themselves, and whether they are at risk of harming themselves or others. Equally, you should respect the person’s privacy unless you are concerned that the person is at risk of harming themselves or others.

Offer consistent emotional support and understanding

Although you may not be able to understand exactly how the person feels, let them know you care and want to help. Tell them that they are important to you, they are not alone and that you are there for them.

It is more important for you to be genuinely caring than to say all the ‘right things’. Let the person know that although their experience is very personal and painful, they are not alone. Often just taking the time to talk to or be with the person lets them know that someone cares.

The person needs additional support and understanding to help them through their illness, so you should be empathetic, compassionate and patient. It is important to be persistent and encouraging when supporting someone with depression. You should be consistent and predictable in your interactions with the person.

People with depression are often overwhelmed by irrational fears and you need to be gentle and understanding of someone in this state. You should offer the person kindness and attention, even if it is not reciprocated. Your support is likely to be having a positive impact, even if it does not feel this way.

Encourage the person to talk to you

Encourage the person to talk about their thoughts, feelings, symptoms and any other problems they are experiencing. Explore with the person how their symptoms affect their daily life. Ask them if stress is a problem for them and, if it is, encourage them to find ways to reduce stress in their life. You can also ask whether something has happened to them recently that is contributing to how they are feeling.

If the person does not want or have the energy to talk about how they are feeling, do not put pressure on them. Let them know that you are available to talk when they are ready. If the person finds it difficult to discuss their thoughts and feelings openly, suggest an activity that may make it easier for them to talk, e.g. have a cup of tea, go for a walk. You can also let the person know about available services where they can talk to someone else, e.g. a telephone counselling service.

Be a good listener

You can help someone with depression by listening closely to them without expressing judgement. The key attitudes involved in non-judgmental listening are acceptance,

genuineness and empathy. Adopt an attitude of acceptance of the person by withholding any and all judgments that you have made about the person or their circumstances. Set aside any negative beliefs and reactions in order to focus on the needs of the person you are helping and choose your words carefully so as to avoid causing offence, e.g. if you feel the person is being lazy, you should not express this.

You can convey genuineness to the person by using body language that matches your verbal communication, e.g. telling the person you accept and respect their feelings, while maintaining an open posture and appropriate eye contact. Demonstrate empathy by showing the person that they are truly heard and understood, e.g. saying, “What you are going through must be difficult.”

Use the following non-verbal skills to reinforce non-judgmental communication:

• Sit alongside the person and angled towards them, rather than directly opposite them.
• Notice how much personal space the person feels comfortable with and respect that.
• Use the level of eye contact that the person seems most comfortable with.
• Maintain an open body position (e.g. not crossing arms, as this may appear defensive).
• Avoid distracting gestures (e.g. fidgeting with a pen, glancing at other things or tapping your feet or fingers), as these could be interpreted as a lack of interest.
• Be aware of the person’s body language, as this can provide clues as to how they are feeling or how comfortable they are talking with you.

Be an active listener. Reflect back what the person has said to you before responding with your own thoughts. Do not interrupt the person when they are speaking, especially to share your own opinions or experiences. It is important to listen carefully to the person even if what they tell you is obviously not true or is misguided. Respect the person’s feelings, personal values and experiences as valid, even if they are different from your own, or you disagree with them.

Other ways to be a good listener include:

• Ask questions that show that you genuinely care and want to understand what they are saying.
• Ask open-ended questions to give the person an opportunity to say what they want to, e.g. “How are you feeling?” rather than “Are you feeling sad?”.
• Use minimal prompts when necessary to keep the conversation going, e.g. “I see” and “Mmmm”.
• Be okay with pauses and silences. While they may feel uncomfortable, the person may need time to think or find the right words.
• Check your understanding by restating what the person has said and summarising facts and feelings.
• Listen not only to what the person says, but how they say it, e.g. their tone of voice.
• Use the same terminology that the person uses when discussing their experience, except if the person uses unhelpful or stigmatising language.
• If the person holds stigmatising attitudes towards mental illness, do your best to model acceptance.

Next week we will look at realistic expectations, and acknowledging the persons strengths.

Until then, keep your mental health, healthy.