From time to time you or one of your friends may feel “down” or discouraged.

But what about those times when a friend’s activity and outlook on life stays “down” for weeks and begins to affect your relationship? If you know someone like this, your friend might be suffering from depression. As a friend, you can help.

 

Find out more about depression

Q. What is depression?

A. Depression is more than the blues or the blahs; it is more than the normal, everyday ups and downs. When that “down” mood is severe, along with other symptoms, lasts for more than a couple of weeks, the condition may be clinical depression. Clinical depression is a serious health problem that affects the total person. In addition to feelings, it can change behaviour, physical health, appearance, personal hygiene, academic performance, social activity and the ability to handle everyday decisions and pressures. Sometimes people who are depressed cannot perform even the simplest daily activities – like getting out of bed or getting dressed, others go through the motions, but it is clear they are not acting or thinking as usual.

Q. What causes clinical depression?

A. We do not yet know all the causes of depression, but there seem to be biological and emotional factors that may increase the likelihood that an individual will develop a depressive disorder. Research over the past few decades strongly suggests a genetic link to depressive disorders; depression can run in families. Bad life experiences and certain personality patterns such as difficulty handling stress, low self-esteem, or extreme pessimism about the future can increase the chances of becoming depressed.

Q. How common is it?

A. Clinical depression is a lot more common than most people think. It will affect more than 1.8 million Canadians this year. One-fourth of all women and one-eighth of all men will suffer at least one episode or occurrence of depression during their lifetimes. Depression affects people of all ages but is less common for teenagers than for adults. Approximately 3 to 5 percent of the teen population experiences clinical depression every year. That means among 100 friends on Facebook, 4 could be clinically depressed.

Q. Is it serious?

A. Depression can be very serious. It has been linked to poor school performance, attendance, alcohol and drug abuse, running away, and feelings of worthlessness and hopelessness. In the last 25 years, the rate of suicide among teenagers and young adults has increased dramatically. Suicide is often linked to depression.

Q. Are all depressive disorders alike?

A. There are various forms or types of depression. Some people experience only one episode of depression in their whole life, but many have several recurrences. Some depressive episodes begin suddenly for no apparent reason; while others can be associated with a life situation or stress. Some people suffer from bipolar depression in which their moods cycle between two extremes – from the depths of desperation to frenzied talking or activity or grandiose ideas about their own competence. This is different than mood swings where people have an overall stable mood with daily variations.

Q. Can it be treated?

A. Yes, depression is treatable. Between 80 and 90 percent of people with depression – even the most serious forms – can be helped. Symptoms can be relieved with proper psychological therapies, medications, or a combination of both. The most important step toward overcoming depression – and sometimes the most difficult – is asking for help.

Q. Why don’t people get the help they need?

A. Often people don’t know they are depressed, so they don’t ask for or get the right help. Teenagers and adults share a problem – they often fail to recognize the symptoms of depression in themselves or in people they care about.

Be able to tell fact from fiction

Myths about depression often separate people from the effective treatments now available. Friends need to know the facts. Some of the most common myths are these:

Myth: It’s normal for teenagers to be moody; Teens don’t suffer from “real” depression.

Fact: Depression can affect people at any age or of any race ethnic, or economic group.

Myth: Teens who claim to be depressed are weak and just need more attention or to pull themselves together. There’s nothing anyone else can do to help.

Fact: Depression is not a weakness, but a serious health disorder. Both young people and adults who are depressed need professional treatment. A trained therapist or counsellor can help them learn more positive ways to think about themselves, change behaviour, cope with problems, or handle relationships. A physician can prescribe medications to help relieve the symptoms of depression. For many people, a combination of psychological therapy and medication is beneficial.

Myth: Talking about depression only makes it worse.

Fact: Talking through feelings may help a friend recognize the need for professional help. By showing friendship and concern and giving uncritical support, you can encourage your friend to talk to his or her parents or another trusted adult, like a teacher or coach, about getting treatment. If your friend is reluctant to ask for help, you can talk to an adult – that’s what a real friend will do.

Myth: People who talk about suicide don’t commit suicide.

Fact: Many people who commit suicide have given warnings to friends and family. A signal or warning may be a statement such as “I wish I were dead,” “I can’t take it anymore; I want out,” or “My parents would be better off without me”. Some people even tell a friend about a plan to kill themselves before they actually do. If a friend talks like this, always take it seriously! Immediately make a responsible adult aware of what your friend has said. A parent, a teacher, a school nurse or counsellor can all help. If you are wondering if you should or shouldn’t tell someone, you will never regret it if you do, but you may regret it if you don’t.

Myth: Telling an adult that a friend might be depressed is betraying a trust. If someone wants help, he or she will get it.

Fact: Depression, which saps energy and self-esteem, interferes with a person’s ability or wish to get help. And many parents may not understand the seriousness of depression or of thoughts of death or suicide. It is an act of true friendship to share your concerns with a school guidance counsellor, a favourite teacher, your own parents, or another trusted adult. Once you worry about the safety of your friend there is no concern regarding confidentiality or privacy. Both you and your friend need help.

Know the Symptoms

• Loss of interest in previously enjoyed activities.
• Predominantly sad mood.
• Feelings of helplessness and hopelessness.

 

Get Help

• Find someone who can help.
• Don’t be afraid to take your friend to the emergency room yourself if you hear them speaking of death or suicide.

National Institute of Mental Health. What to Do When a Friend is Depressed: A fact sheet that describes how to spot depression in friends and get them help. Edition. Bethesda (MD): National Institute of Mental Health, National Institutes of Health, US Department of Health and Human Services; Reprinted June 2001 (Cited: 2004 July 27) (NIH Publication No. 01-3824 NIH).

Reviewed by M. Kodsi, M.D., Child and Family Psychiatrist.