6 Things Not To Say To Someone With Depression

01/29/2014 08:37 am ET | Updated Aug 18, 2014
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If you've ever known someone with depression or have battled it yourself, you're deeply aware of the accidental insensitivity that can often come with it. For those who may not understand the complexities, it's easy to say things that have the potential to do more harm than good.

While the U.S. has one of the lower clinical depression rates in the world, the number of people it has an impact on is still significant. An estimated 1 in 10 Americans suffer yearly from the illness.

So how can we help someone who may be affected? According to Dr. Adam Kaplin, an associate professor in the departments of psychiatry and neurology at Johns Hopkins University, it's not just your words, but your actions that can be the most supportive.

"It's best not to say anything that is going to make them think that what they're dealing with is because of a lack of coping skills, personal weakness or a character flaw," Kaplin tells The Huffington Post. "The worst part of depression is that it narrows the field of vision into a very small tube so they can't see the options. A lot of [the goal of helping] is giving people a hope that things will get better."

Kaplin advises that while every case is different, there are some general principles to follow when it comes to helping those who find themselves in this situation. Below find the six things people shouldn't say to someone with depression.

1. "I know how you feel."
know how you feel

Empathy is a great trait to possess, but in certain cases it's best not to try to relate if you really don't know what the other person is going through, Kaplin says. If you do have experience with depression, it may help to share with them that they're not alone -- as long as you're not making the conversation completely about you. "Each person experiences depression in their own way," Kaplin explained. "Telling someone you know... invalidates what they’re going through so just saying 'that must be difficult' validates that they’re having a hard time and their suffering is real."

2. "Suck it up."
suck it up

You may not intend to trivialize someone's condition -- but with phrases like "suck it up" or "just be positive," you may be doing just that. "What [most people don't realize] about depression is that it’s debilitating to concentration, focus and sleep. It changes lives and people get off of trajectory of where they’re heading," Kaplin explains.

Kaplin says that it's crucial not to underestimate the impact of depression. Approximately 20 million American adults suffer from mood disorders in a given year.

3. "Cheer up."
cheer up

"The phrase 'cheer up' is like a close cousin of 'suck it up,'" Kaplin says. Telling someone to be cheery isn't going to do much -- in fact, it may make them feel worse. Kaplin suggests instead of advising them to perk up, try just offering your presence. "Just listening to what that person is going through and saying something like, 'Wow that must be hard,' gives them validation that it's a difficult time. If they could cheer up, they would have by now."

4. "You have to be strong for your kids."

When trying to comfort someone with depression when children are involved, the process may be a little bit trickier. Kaplin explains that while you may think you are helping out by giving advice about the kids -- or even offering to help by watching them for a few hours -- it may be misinterpreted. "They may be sensitive to that and think, 'Oh, she thinks I am a terrible parent,'" he says. "I think there are ways to help and put it in a way that is sensitive to those thoughts."

If you are trying to help with the kids, Kaplin suggests offering to plan an outing for your family and their family, and keep it as an open invitation. "This way, you aren't accusing anything, you're just trying to be helpful [while remaining] diplomatic and leaving them a choice [to accept or decline]."

5. "It's all in your head."
all in head

Like "suck it up," this also falls into the territory of minimizing what may be going on -- and it may not be entirely possible to just "think your way" out of depression. In a 2011 blog post on Psychology Today, licensed psychologist Dr. Clifford Lazarus explains why actions, not just thoughts, are key to overcoming the illness:

One of the most effective psychological therapies for depression is called "Cognitive Therapy" (CT) that aims to alleviate depression by changing people's thoughts from negative biases to more positive patterns. Ironically, despite extensive research and clinical experience that would seem to validate CT's effectiveness, simply combating negative thoughts and replacing them with more rational beliefs rarely helps depression.

This is not really surprising when you consider that you can't simply talk people out of, or have them just think themselves out of, phobias, right? To truly conquer a phobic reaction a person must face, approach and confront the fear -- that is, he or she must take behavioral steps and specific actions, not merely think about it differently or just acknowledge that the fear is irrational. Similarly, challenging irrational beliefs, focusing on more positive thoughts, and trying to change depressive, cognitive schemas is not very likely to shift one's mood out of depression. What will do the trick, however, is to change how one acts.

When it comes to a loved one with depression, Kaplin says it can often feel like you've done something wrong and you're being shut out, but just realize that it's nothing personal. "It can feel like that person is cold and isolated and it feels that way because that illness has isolated that person from their own feelings," Kaplin says. "[As they overcome depression], their tunnel vision begins to expand and they're able to see more possibilities. As people get better, their world will broaden."

6. "Just think -- there are others who have it worse than you do."
worse than you

While you may be trying to put things into perspective, it may not be received that way. "[The key] is to recognize their suffering as opposed to being dismissive," Kaplin says. "With a phrase like this, there may be an underlying issue in that we don't really know what to say, so we're trying to make ourselves feel better by trying to make the person suffering feel better."

Kaplan suggests that instead of offering perspective, just saying nothing or hanging out with someone for a little while may be a good idea. "A lot of times it's just recognizing that you can't always take someone's pain away, so it's just a matter of being comforting," he says. "There are certain messages that you do want to put forward. Just knowing that you're not alone is half battle when it comes to depression, so just being there and connecting will help."

Have a story about depression that you'd like to share? Email strongertogether@huffingtonpost.com, or give us a call at (860) 348-3376, and you can record your story in your own words. Please be sure to include your name and phone number.

Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.

Also on HuffPost:

  • Summer Weather
  • Seasonal Affective Disorder (SAD) is most commonly associated with winter blues, and it afflicts about 5 percent of Americans. But for less than 1 percent of those people, this form of depression strikes in the summer. Warm weather depression arises when the body experiences a "delay adjusting to new seasons," says Alfred Lewy, MD, professor of psychiatry at Oregon Health and Science University, in Portland. Instead of waking and enjoying dawn, the body has a hard time adjusting, he says, which could be due to imbalances in brain chemistry and the hormone melatonin. More from Health.com: 10 Tips for Dating With Depression The Most Depressing States in the U.S. Depressing Jobs: Career Fields With Hight Rates of Depression
  • Smoking
  • Smoking has long been linked with depression, though it's a chicken-or-egg scenario: People who are depression-prone may be more likely to take up the habit. However, nicotine is known to affect neurotransmitter activity in the brain, resulting in higher levels of dopamine and serotonin (which is also the mechanism of action for antidepressant drugs). This may explain the addictive nature of the drug, and the mood swings that come with withdrawal, as well as why depression is associated with smoking cessation. Avoiding cigarettes -- and staying smoke free -- could help balance your brain chemicals.
  • Thyroid Disease
  • When the thyroid, a butterfly-shaped gland in the neck, doesn't produce enough thyroid hormone, it's known as hypothyroidism, and depression is one of its symptoms. This hormone is multifunctional, but one of its main tasks is to act as a neurotransmitter and regulate serotonin levels. If you experience new depression symptoms -- particularly along with cold sensitivity, constipation and fatigue -- a thyroid test couldn't hurt. Hypothyroidism is treatable with medication.
  • Poor Sleep Habits
  • It's no surprise that sleep deprivation can lead to irritability, but it could also increase the risk of depression. A 2007 study found that when healthy participants were deprived of sleep, they had greater brain activity after viewing upsetting images than their well-rested counterparts, which is similar to the reaction that depressed patients have, noted one of the study authors. "If you don't sleep, you don't have time to replenish [brain cells], the brain stops functioning well, and one of the many factors that could lead to is depression," says Matthew Edlund, M.D., director of the Center for Circadian Medicine, in Sarasota, Fla., and author of "The Power of Rest."
  • Facebook Overload
  • Spending too much time in chat rooms and on social-networking sites? A number of studies now suggest that this can be associated with depression, particularly in teens and preteens. Internet addicts may struggle with real-life human interaction and a lack of companionship, and they may have an unrealistic view of the world. Some experts even call it "Facebook depression." In a 2010 study, researchers found that about 1.2 percent of people ages 16 to 51 spent an inordinate amount of time online, and that they had a higher rate of moderate to severe depression. However, the researchers noted that it is not clear if Internet overuse leads to depression or if depressed people are more likely to use the Internet.
  • End Of A TV Show Or Movie
  • When something important comes to an end, like a TV show, movie, or a big home renovation, it can trigger depression in some people. In 2009, some "Avatar" fans reported feeling depressed and even suicidal because the movie's fictional world wasn't real. There was a similar reaction to the final installments of the Harry Potter movies. "People experience distress when they're watching primarily for companionship," said Emily Moyer-Gusé, Ph.D., assistant professor of communication at Ohio State University, in Columbus. With "Avatar," Moyer-Gusé suspects people were "swept up in a narrative forgetting about real life and [their] own problems."
  • Where You Live
  • You can endlessly debate whether city or country life is better. But research has found that people living in urban settings do have a 39 percent higher risk of mood disorders than those in rural regions. A 2011 study in the journal Nature offers an explanation for this trend: City dwellers have more activity in the part of the brain that regulates stress. And higher levels of stress could lead to psychotic disorders. Depression rates also vary by country and state. Some states have higher rates of depression and affluent nations having higher rates than low-income nations. Even altitude may play a role, with suicide risk going up with altitude.
  • Too Many Choices
  • The sheer number of options available -- whether it's face cream, breakfast cereal or appliances -- can be overwhelming. That's not a problem for shoppers who pick the first thing that meets their needs, according to some psychologists. However, some people respond to choice overload by maximizing, or exhaustively reviewing their options in the search for the very best item. Research suggests that this coping style is linked to perfectionism and depression.
  • Lack Of Fish In The Diet
  • Low intake of omega-3 fatty acids, found in salmon and vegetable oils, may be associated with a greater risk of depression. A 2004 Finnish study found an association between eating less fish and depression in women, but not in men. These fatty acids regulate neurotransmitters like serotonin, which could explain the link. Fish oil supplements may work too; at least one study found they helped depression in people with bipolar disorder.
  • Poor Sibling Relationships
  • Although unhappy relationships with anyone can cause depression, a 2007 study in the American Journal of Psychiatry found that men who didn't get along with their siblings before age 20 were more likely to be depressed later in life than those who did. Although it's not clear what's so significant about sibling relationships (the same wasn't true for relationships with parents), researchers suggest that they could help children develop the ability to relate with peers and socialize. Regardless of the reason, too much squabbling is associated with a greater risk of developing depression before age 50.
  • Birth Control Pills
  • Like any medication, the pill can have side effects. Oral contraceptives contain a synthetic version of progesterone, which studies suggest can lead to depression in some women. "The reason is still unknown," says Hilda Hutcherson, M.D., clinical professor of obstetrics and gynecology at Columbia University, in New York. "It doesn't happen to everyone, but if women have a history of depression or are prone to depression, they have an increased chance of experiencing depression symptoms while taking birth control pills," Dr. Hutcherson says. "Some women just can't take the pill; that's when we start looking into alternative contraception, like a diaphragm, which doesn't contain hormones."
  • Rx Medications
  • Depression is a side effect of many medications. For example, Accutane and its generic version (isotretinoin) are prescribed to clear up severe acne, but depression and suicidal thoughts are a potential risk for some people. Depression is a possible side effect for anxiety and insomnia drugs, including Valium and Xanax; Lopressor, prescribed to treat high blood pressure; cholesterol-lowering drugs including Lipitor; and Premarin for menopausal symptoms. Read the potential side effects when you take a new medication, and always check with your doctor to see if you might be at risk. More from Health.com: 10 Tips for Dating With Depression The Most Depressing States in the U.S. Depressing Jobs: Career Fields With Hight Rates of Depression