Have realistic expectations for the person

You should accept the person as they are and have realistic expectations for them. Everyday activities like cleaning the house, paying bills, or feeding the dog may seem overwhelming to the person. You should acknowledge that the person is not ‘faking’, ‘lazy’, ‘weak’ or ‘selfish’ and not push them to do activities that they feel are too much for them.

Acknowledge the person’s strengths

If the person judges themselves too harshly (e.g. saying that they are a weak person or a failure), remind them of their strengths and acknowledge any efforts they are making to get better. Let the person know that they are not weak or a failure because they have depression – strong and capable people can become depressed. Tell them that you don’t think less of them as a person.

Give the person hope for recovery

Encourage the person by telling them that, although they may not believe it now, with time and treatment, they will feel better. Offer hope of a more positive future in whatever form the person will accept and let them know that their life is important.

Providing ongoing support

Be clear and consistent about what support you can and cannot offer to the person and do not make promises that you cannot keep. Be upfront with the person about the limitations of your role as a first aider, e.g. you are not a counsellor. Ask the person whether what you are doing is helpful, and what else you could do to help.

What does not help?

Depression is a medical illness and it is not the person’s fault that they are experiencing depression. There’s no point in telling the person to “snap out of it”, “get over it”, “pull yourself together” or “get your act together”. If this was possible the person would do it. Do not tell the person “it is all in your head”, or that they just need to stay busy or get out more.

Do not trivialise the person’s experiences by pressuring them to ‘put a smile on their face’, ‘cheer up’, or to ‘lighten up’. Attempting to say something positive (e.g. “You don’t seem that bad to me”) can seem belittling or dismissive and should be avoided.

Avoid applying any labels to the person that they may find stigmatising, e.g. ‘mentally ill’. Also, do not use language related to a potential diagnosis when talking to the person, e.g. “It looks like you have major depressive disorder”.

Avoid speaking to the person with a patronising tone of voice and do not use overly compassionate looks of concern. Do not adopt an over-involved or over-protective attitude towards the person, but also avoid telling them there is nothing you can do about their situation.

Do not nag the person to try to get them to do what they normally would and avoid confrontation, unless necessary to prevent the person from carrying out harmful or dangerous acts. Do not suggest to the person that they use alcohol or other drugs to feel better.

WHAT IF I EXPERIENCE DIFFICULTIES WHEN TALKING TO THE PERSON?

If the person is not communicating well (e.g. speaking slower, less clear than usual or being repetitive), be patient and accept these responses as the best the person has to offer at the moment. Try to be as supportive as possible. Do not interrupt, criticise, express frustration or be hostile or sarcastic.

Try to see any irritable or unpleasant behaviours as part of the illness and not take these personally. If the person becomes angry during the conversation, do not make assumptions about the cause of their anger. Try to stay calm and acknowledge the person’s anger. However, do not accept abuse or compromise your own mental health when helping the person.

If the person doesn’t feel comfortable talking to you, encourage them to discuss how they are feeling with someone else.

If cultural differences are interfering with your ability to help the person, you should discuss with the person what is culturally appropriate and realistic for them. Be willing to adjust your verbal and non-verbal behaviours, e.g. the person may be comfortable with a different level of eye contact or may be used to more personal space. You can also talk to a mental health service that specialises in working with people from different cultural backgrounds, if available.

Helping someone who is depressed may evoke an unexpected emotional response in you. If you are feeling upset or worn out after helping the person use evidence-based self-care strategies.

Next week we will look at encouraging the person to seek professional help and self-help strategies.

Until then, keep your mental health, healthy.