Sunday, August 19, 2012

Advice given to depressed people

I considered titling this, "Advice for depressed people," and then realized what a mistake it would be.  This isn't about the advice depressed people, people like me, should be given.  This is about the advice that is given.  And as one might expect it will focus mostly on myself because I'm the depressed person I know best.

Apart from things like, "You should probably seek medical help," or maybe in certain circumstances, "Perhaps you should consider another doctor," there's not a lot of stuff a non-medical professional is going to be able to offer as advice that stands a legitimate chance of helping someone with depression on the depression front.

There's all kinds of other advice that might be helpful like, "If you hold the hammer further back you'll get more force," or, "Never bet your life on someone else remembering to use their blinker," or something like that.  There's all sorts of generally applicable advice in the world that has nothing to do with depression.

But lately I've been feeling bombarded with advice about how to get over depression, and while the frequency might have spiked this is not a new phenomenon.  That kind of advice, basically universally, sucks.  It's bad advice.  It's often frustrating advice.  It can be advice that makes one feel isolated, misunderstood, or trivialized.

Much of it comes from, I think, a misunderstanding.  It stems from the word depression.  English is a very word rich language, but we still have piles of words with multiple meanings and depression is one of them.  If you are a healthy person, and you feel depressed, it is a mistake to assume that's the same as what a depressed person feels.  The word is the same, but the word also means hole/dent in the ground and hopefully we can all agree that's not what you mean when you say, "When I feel depressed."

I think that's where most of the bad advice comes from, people think, "When I feel depressed I try X and it brings me back," and they think that'll work for the friend or family member with depression.  But if it would, if it really were that simple, it wouldn't be depression.  Treating the actual medical condition of depression as if it's simply ordinary feeling down and can be solved just as easily minimizes and trivializes what is a life wreaking condition.

My life is not a shambles because I'm feeling down.  Other people with depression who keep it together better than I do (who I both envy and admire) are not going around feeling shittier than they ought to, or on the verge of tears or breakdown more often than they ought to, because they're simply feeling somewhat down the same way that healthy people do.

It's not the same, and it can't be treated the same way.  Imagine, hypothetical healthy reader, if every time you felt down you were suddenly put on medication to cure your depression.  Imagine how viscerally wrong that state of affairs would be.  The reaction would be disproportionate and inappropriate, and quite possibly damaging.  It's the same way when you try to treat depression, the condition, as if it's the same a healthy person feeling depressed.

This does not mean that you shouldn't try to help.  It doesn't mean you should never offer advice on how you cheer yourself up.  But it does mean that you should never treat that advice as a cure.  It means you shouldn't act like you've found the cure to depressed person's problems because you've got this thing you do, or you just read a book that helps you with your down times, or whatever.  Because you don't.

You might have a short term solution, and that's nice.  Short term improvement is a good thing.  But unless you've discovered the alien mood normalization crystals that can be activated by the light of a full moon to reset someone's out of whack brain chemistry, you haven't stumbled on the cure.  Leave it to the doctors and don't belittle the depressed person's suffering by acting like it's easy to solve.

What not to do:
"I've been thinking about this depression thing you have, and when I feel depressed I get out of it by watching a movie.  You should watch a movie.  Then you won't be depressed."

What you might try doing:
"I don't know about you, but watching movies cheers me up, wanna watch a movie with me?"

Or something like that.


So, a couple of definite no-nos

One is, if a depressed person is reacting to something going wrong, as I was this morning, starting in with immediate criticism that they were doing the whole reacting thing wrong is not a good idea at all.  Now you're piling insult on the existing problem, and if you're doing it in such a way to imply that responding to bad-thing right would fix the depression you're also victim blaming.  You're telling depressed person that being depressed is their own damn fault because of their own fuckups.

At best you'll end up with depressed person justifiably pissed off at you.  At worst you'll throw them into a spiral of doubt, guilt, and shame.

Don't do that.

For that matter, don't do that to non-depressed people.  Everyone has their own way of dealing with adversity and, unless it's hurting someone, who are you to say that someone else's is worse than your own?  Discussions of the best way to respond to things for emotional well being may be worth having, but the moment of wrongness is not a good time.

Second thing:

Don't be self serving.

Say you want depressed person to do X, don't you dare - Don't you Dare - try to use their depression to leverage them into doing it for you.

If you want depressed person to do X then you saying, "[Friend] is really worried about your depression and I've been trying to think about what could be done, and I think what you really need is a project to give you purpose so I was thinking that if you were to do X that might help because you'd be able to feel like you accomplished something and..." is you being an asshole.

If you want a favor, if you want something done, if you could use the help, then state it as a favor, something you want done, or help.  By all means point out that you think this is something that might make depressed person feel somewhat better if you so believe it, but don't act like you're trying to help them when you're trying to get them to help you.

You may be able to do both at once, they may be helped as they help you, but manipulating them into helping you by using their medical condition as leverage is not the way to go about doing it.


I want to close on a piece of advice given to me probably ten years or more ago.  It's not good advice in the way that treating, "When I'm feeling down I X," as the ultimate solution is never good advice when responding to the condition of depression, it's got the same mistaking a short term fix for a solution problem that characterizes the kind of advice I was talking about before the first break.

I think it sticks in my mind because it was so unexpected.

I was a teenage boy in highschool, I was talking to a teenage girl about my age.  We met at summer camp (she went to the girls' camp associated with the boys' camp I went to.)  As I recall we met when we both avoided socializing by sitting under the same tree.  Anyway, we kept in touch via text message when camp was over, and at this particular time I was trying to explain what I felt like being depressed (this might have been before I was officially diagnosed for all I know) I don't know how well I described it.  I don't remember that end of things.

I just remember that after hearing everything she had a simple response, "You should masturbate more."

At some point there was a followup where she pointed out that it worked for her.  The exact details are not important.

I don't know whether this was the first thing that popped into her head, or the result of detailed thought ("He doesn't have a lot of friends, he doesn't get out much, most of his time is spent alone at the house, what do I do to cheer up when alone at the house?") but it seems to have been forever imprinted in my memory.

I have difficulty getting events in order, but that may have been my introduction to the truth that women can be every bit as much sexual beings as men.  I'd heard teenage boys talk about that topic all the time by that point, but that may have been my first introduction to the fact that teenage girls had similar practices.

More on topic, I think it's probably a good example of a sincere attempt to help that is none the less bad advice.  She tried to think of something that can make her feel good and alive and not-depressed, found such a thing, and shared it as a solution to a friend's problem.

Except it's not really a solution.  Would that it were that simple.

She was a teenager trying to help a long-distance friend through something that ten years, multiple medications, multiple psychologists, and multiple psychiatrists later has not been solved.  She had some pretty good excuses for why she might think her solution would work, I don't see excuses anywhere near as good for the people who give me what amounts to the same advice today: "You suffer from depression.  X helps me, a mentally healthy person, stop being down, therefore if you do it it will solve your depression."


  1. "You suffer from depression. X helps me, a mentally healthy person, stop being down, therefore if you do it it will solve your depression."

    Using this to pull out one line that kind of sums up why I'm responding...

    I got really frustrated this morning, because a friend of mine who I'm fairly certain suffers from medical depression (or close to it), tweeted "I think you just get to the point where you get so damn sick of being depressed & miserable that you just get up, say fuck it, & move on" and I was like "..."

    It made me really upset and I didn't know how to respond to her, because of course that's her response, but mine? I get to that point and it's when I decide to kill myself. It has happened several times, so I know that's what "say fuck it, & move on" means to me.

    I didn't want to be a debbie-downer and tell her this, though. Thanks partly to my lifelong clinical depression, I feel guilt when I complain about feeling bad too much (where "too much" is more than once a month), and I've been in really bad shape since May, and new medications to try and make it better are making it worse (when combined with my employment/income situation)

    1. I hope it works for her, but it's worth remembering that even in cases where it seems like that solved things, it doesn't always. Consider Hyperbole and a Half. The post Adventures in Depression seemed to end with solution. She had reached the point of "fuck it" and now she could do anything. Except, no. There's a reason that there hasn't been a new post since then. Turned out she was still depressed to a debilitating degree.

      So, like I said, I hope it works for your friend, but even when it seems good (i.e. not suicidal but hopeful) it's hardly universal that it actually works.


      And I hope things improve for you. Until then, complain here all you want.

    2. I'm sorry to hear Allie is not doing well.

    3. Last I heard which is apparently five months ago, she was gradually improving and had a solid support network of family, friends, and medical professionals.

      So hopefully things have kept on improving and they're better than one would at first guess.

  2. Complicated problems very rarely get better overnight. (Unless they're hypothyroidism and you're one of the people who actually responds to the standard treatment.) So any one-sentence Thing To Do To Get Better is likely not to be the actual solution.

    My difficulty - yeah, I'm going to make this bit all about me, please don't call me Michael Murphy - is that I want to help and I know I can't do much, so I drag up some bit of something which may or may not be of any use at all... like "forcing myself to go through the physical movements of smiling actually makes me feel a bit better, sometimes"... and I have to trust that that doesn't come across as offering The Cure.

  3. I know so few actually mentally healthy people that I'm always getting these kinds of advice from fellow sufferers. It doesn't piss me off, but it very much doesn't provide long-term help...but in my case I don't feel like it's meant to. It's just "hey, this could make you feel better for an afternoon or a weekend, and I would love for that to happen."

    Then there's my mom, who has bouts of mental illness but they aren't depression, and her advice is basically really close to useful, but not quite. Because it's always like, "You should make an appointment with your psychiatrist," and then repeating that 25 times. And it's true, I should (FUCK THAT WORD/CONCEPT!), but that's really only a long-term solution, and part of a long-term solution, and what I often need is direct help to get to sleep at a reasonable hour with my teeth brushed, and do it several nights in a row, to build a pattern where maybe I'll sort of be the kind of person who can 1) Call about getting a new psych 2) Successfully schedule an appt. and show up to it 3)Explain your life story/condition to said person and hold out for treatment that actually helps 4)Participate in treatment consistently Etc. Etc.

    It's like there's a whole staircase under the goal that can be invisible to non-depressed people.

    1. "It's like there's a whole staircase under the goal that can be invisible to non-depressed people."

      PREACH IT.

  4. This is a great post about bad advice. The difficulty of depression is that even those things that might make you happy tend to be temporary fixes, if they're fixes at all, to the underlying problem. Thanks for helping everyone understand.

  5. Thanks for this.

  6. I had a long term battle with Depression through most of my twenties. Spent my teens Bipolar (undiagnosed) and then some personal drama in my mid twenties led to the Manic part abruptly going away, leaving just the Depression. Its a heck of an adjustment to make when you have a long-term established method for dealing with Depression that consists of "hole up in a closet and wait a few weeks til you switch back to either Manic or Normal and can do things again".

    At any rate the sudden descent led to an awful lot of folks giving me an awful lot of advice that would have been oh-so-useful if I was getting over a breakup, or recovering from a death in the family, or the like, but was profoundly unhelpful for where I actually was. I don't know you, but for me everything from friends to psychologists to medication couldn't do much of anything until I found a path within my own head that made my own pre-existing tendencies work for me rather than against me. For me it was coming to genuinely accept that Depression was an externally imposed disease and not a fundamental part of who I was, and then getting mad at it. Essentially "I'm not going to let a g**d**n disease beat me". If I could externalize it I could fight it. Until then I was just blaming myself for it, and blaming myself for either not trying or not succeeding at all the random bits of advice that I got from well meaning friends/family/associates. And every piece of mis-aimed advice was just another round of ammo I could use against myself...

    So yeah. I have no idea if that's helpful or not. I'm just agreeing with the sentiment that it can be incredibly frustrating for folks who don't understand where you are coming from and what you're really dealing with to give you advice that just won't take. The only really helpful thing I have to say is, I genuinely found a way out (eventually). Maybe you will too.

  7. Consider Antidepressants as a step in the race, with the prize being recovery from depression so that we can achieve wholeness in Christ.