5 ways to support a loved one with depression | Perspective

I am one of an estimated 16 million Americans who have experienced depression.

In response to a friend's question of what it is like, I told her it was as if a heavy gray curtain separated me from other people. They can't reach me through it, and I can't reach them.

"Like a glass wall," she said.

Exactly. I can see you and hear you, but I can't touch you. I may want to hold your hand, but I can't.

Internally I experience nearly constant negative self-talk. A sampling of the thoughts I had during a recent depression: I'm a bad mother. I don't do enough. The depression is my fault. I will never get better. I am screwing up my kid for the rest of his life. I am unworthy.

Everyone (I assume) has some kind of negative self-talk sometimes. When I'm depressed, my internal dialogue is hateful and abusive.

Depression also fills me with shame. I know it isn't my fault, intellectually, but my feelings tell me that it is. Because of that, I don't want to talk about it with anyone unless I know they won't judge me. Too many times I have had the experience of sharing about the depression, and have had people say very unhelpful things.

For example, you say, "You just need to exercise more." My brain says, "This is my fault for being lazy."

You say, "Medication is a failure." My brain says, "I am weak. I am a failure."

You say, "Mind over matter." My brain says, "Just try harder."

You say, "Maybe you need to be institutionalized." My brain says, "Oh, my God! I knew I was crazy! They'll take my child from me! I'll never live a normal life again!"

You say, "I feel alone a lot, too." My brain says, "I need to take care of this person, but I can't even take care of myself. I'm the worst."

Perhaps you are rolling your eyes, thinking, "Then what the heck can I say?" Since October is National Depression Awareness month, let me suggest some guidelines from my personal experience.

Rule Number 1: Do not offer advice. Your nonprofessional advice is much more likely to harm than to help. Though you have experienced sadness, this doesn't mean you understand depression. Sadness is a normal emotion, brought on by something external. Depression is an abnormal emotional state that colors everything — I'm not sad, I hate everyone and everything. I have no energy, no pleasure in life. Depression usually doesn't go away without treatment.

Rule Number 2: Provide practical help. When depressed, the smallest thing can seem absolutely undoable. Ask if you can help with child care so they can have a break. If they're not getting treatment for the depression, ask if they would like help finding a therapist or doctor.

Rule Number 3: Let them know you are there to listen if they want to talk, but don't keep asking how they are feeling. It's very painful to talk about my emotions when I am depressed. And if I'm having a good day, or a good hour, I don't want to dwell on the struggle. Pick up a book to learn more about the disease. The Noonday Demon: An Atlas of Depression is one, but there are many others.

Rule Number 4: Take care of your own needs. The glass wall is not your fault, it is a complicated process in the brain. We cannot be your support system when we are depressed. We cannot help you process your feelings about our depression. It's too much. Talk to a therapist yourself, seek support from the National Alliance on Mental Illness, or another support group. Loving someone with mental illness is a real challenge. Anyone would need help. But it can't come from the person who is struggling with basic daily life.

Rule Number 5: Believe that we will recover. Trust that we will come back.

None of us is perfect, no one responds perfectly when people they love are suffering. If you've broken one of the rules above, forgive yourself and try again.

When in doubt, say the following: I love you no matter what. I'm here for you if you need me. How can I help?

Julie Owsik Ackerman is a Philadelphia writing teacher and coach. julieack@gmail.com