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Researchers argue about why the differences exist, but they agree that men and women are distinct creatures when it comes to emotion. These gender differences can affect emotional health.

Stereotypes of the way men and women are expected to deal with their emotions pervade our culture and society, easily eliciting images of overly reserved men and excitable, emotional women. Boys are told to suck it up; girls are told to let it all out. But do gender differences actually exist between men and women, and if so, how do they affect our emotional health?

The research is mixed regarding the emotional differences between the sexes. Strong evidence has been found that there are differences in the way men and women detect, process, and express emotion. Other studies show that men and women share more emotional similarities than differences.

The stereotypes of reserved men and emotional women are widespread and do affect the way young boys and girls are raised. Some researchers argue that we may be ingraining gender differences that do not naturally exist by accepting and passing on these stereotypes to our children. Other researchers believe these differences have developed due to the evolutionary roles placed on men and women to survive and thrive.

While researchers debate these gender differences, they agree that the differences ultimately can have a negative effect on members of both sexes.

Emotional Women, Emotional Men

Recent research has shown important ways in which men and women react emotionally and perceive emotion in others:

• A global study of 55 cultures found that women tend to be more emotional, agreeable, extroverted, and conscientious than men.
• Women read other people’s emotional reactions better than men, regardless of whether they receive those emotional cues verbally or visually.
• Women reported experiencing love and anger much more intensely than men did in another assessment of gender differences in emotional response. These women also smiled more when recalling memories of happiness or love.
• Men and women respond to stress in different ways. Women display greater sadness or anxiety than men, while men show an increase in blood pressure and a tendency toward alcohol craving.
• Women are more inclined than men to experience disgust when exposed to stimuli intended to elicit an emotional reaction.

And those are just studies over the past few years. Decades of research have found numerous differences in the ways men and women interpret emotions and react emotionally. Also, studies have found that gender differences matter more than sexual orientation — a heterosexual woman and a homosexual woman have more in common emotionally than a heterosexual woman and a homosexual man.

Why these differences occur is less easily explained:

• Some research has found that the differences may be rooted in cultural stereotypes. For example, women are perceived as being more emotional and behave that way because it’s believed that’s what women do, while men express emotion only when the situation warrants it.
• Parents may have a hand in promoting these gender differences, expressing disapproval with boys who cry or express other “weak” emotions while shrugging off similar behavior in girls.
• Other studies posit an evolutionary cause for these gender differences in emotion. Men serving as hunter-gatherers needed to take more risks and be more dominating, while women who stayed home and cared for young needed to be more nurturing and cautious. These roles have resisted change as human society has progressed, and indeed, progress may cause these roles to become even more pronounced.

How Gender Differences Affect Health

Gender differences in emotional processing and response have direct consequences on the physical and emotional health of men and women. Overly emotional women tend to be at greater risk for depression, anxiety, and other mood disorders, while men who repress their feelings tend to be at greater risk for physical ailments such as high blood pressure, and also tend to indulge in more risky behavior and vices such as smoking or drinking.

Researchers and doctors have several different proposals for dealing with these differences. Some argue that we should accept these gender differences, based on the fact that feminine women and masculine men tend to be happier than those who are gender-atypical. According to this line of reasoning, boys and girls should be allowed to develop both stereotypical and non-stereotypical emotional responses without judging them or trying to shape them.

Others believe that parents can help dull or negate these stereotypes by refusing to reinforce them. For example, fathers who take a more involved role in child-rearing tend to raise children who don’t fall into the stereotypical sex roles of the stoic male or expressive female.

Whether you’re trying to bring up children without gender stereotypes or looking after your own emotional health, be aware of these gender differences and how they affect both men’s and women’s experiences of the world.

Losing your cool isn’t always because of everyday stress. Find out why emotional health issues like frustration and impulsivity could be symptoms of adult ADHD.

Have you ever been stuck in traffic and found yourself pounding the steering wheel and feeling like your head might explode? If that’s an all-too familiar scenario, you could have adult ADHD.

About 50 percent of kids with attention deficit hyperactivity disorder (ADHD) grow up to be adults with ADHD, and some adults with ADHD aren’t aware that they have it. Hyperactivity symptoms of ADHD seen in kids may be replaced with emotional health symptoms such as frustration and impulsivity in adult ADHD.

A recent study by Massachusetts General Hospital found that more than half of adults with ADHD have emotional health problems related to excessive emotional reactions to everyday events. They also found that this combination of ADHD and the inability to control emotions tends to run in families and could affect more than 5 million American adults.

“The areas of the brain that are responsible for hyperactivity in ADHD are also responsible for emotional control, so it is not surprising that these symptoms overlap,” says Guy K. Palmes, MD, associate professor of psychiatry at Wake Forest Baptist Medical Center in Winston-Salem, N.C.

“ADHD runs in families, and if a child has ADHD, usually one parent has it,” Dr. Palmes says. “Although studies say that about 4 percent of adults have ADHD, I suspect that about half of adult ADHD is not being diagnosed and many adults have ADHD and don’t know it.”

Emotional Health and ADHD Symptoms in Adults

For adults with ADHD, excessive emotional reactions can occur quickly in response to normal stresses that would be difficult but acceptable for people without adult ADHD.

Common emotional health symptoms associated with adult ADHD can include:

• Depression
• Mood swings
• Impulsivity
• Outbursts of anger
• Frustration
• Impatience

“Controlling my emotions can be most difficult even with therapy and medication,” says David G. Hanley, a 61-year-old sales professional from West Hartford, Conn., who was diagnosed with ADHD as an adult.

“Being in sales and dealing with a four-year economic collapse has been tough,” Hanley says. “I have to constantly deal with my tendency for impatience and intolerance. You can’t be successful in sales if you alienate your accounts.”

In adults who aren’t diagnosed or treated for ADHD, excessive emotional reactions can lead to problems in social, family, and business relationships. Untreated adult ADHD is also a common trigger for substance abuse problems.

Getting Adult ADHD Symptoms Under Control

The right diagnosis and treatment can turn around emotional distress. “Finding out there was a reason and a treatment for my symptoms has been a blessing,” Hanley says. “With medication and therapy, I am now able to let go of the things I can’t control, and life is definitely easier.”

Talk therapy and sometimes medication both help control adult ADHD symptomsand can lead to better emotional health. “It’s important for people with ADHD to learn what triggers their symptoms so they can start to anticipate and manage their stress,” explains Palmes. Talk therapy, a form of counseling, can help with that.

Try these other strategies as well:

• Get educated about ADHD.
• Use organizational strategies like making lists and carrying a calendar.
• Get to work early and plan projects for the time of day when you are most able to concentrate.
• Practice relaxation techniques such as deep breathing, meditation, and progressive muscle relaxation.
• Get enough sleep and exercise.
• Avoid self-medication with drugs and alcohol.

Don’t let ADHD ruin your emotional health. If you haven’t been diagnosed but have symptoms, especially if you had ADHD as a child or have a family history of ADHD, talk to your doctor and take steps to regain control over your life.

I’ve always found it curious that more suicides happen in the spring than in any other season. According to the Center for Disease Control and Prevention and the National Center for Health Statistics, suicide rates are lowest in the winter months and highest in the springtime.

What’s so bad about April and May? The sun is out, winter coats have disappeared, people start throwing Frisbees, even our dogs are strutting down the streets with wide grins. Why the anxiety and depression?

1. The Shoulds

The pressure to be happy – it is a fast track to the Black Hole. You think since colleagues are whistling as they hold the door for you at work that you should whistle as well. Or at least WANT to whistle. It’s the comparison thing. It happens to me every year. The voices in my head sound like this: “Be happy. Be happy!!!! Everyone is happy. You’re wearing sandals! Bye bye black wool! Colors, look at that! Pastel blouses! Your yard has a freakin tulip. This is the life. BE HAPPY.”

I classify these symptoms under the “Should” disease, a file in the gray matter of my brain that holds a LOT of material.

2. Chaaaaaannnnnge

For highly sensitive people—and most people who struggle with chronic depression and anxietyare highly sensitive—any kind of change will trigger panic. Our bodies detest any kind of alteration in life style. If a snowstorm that has the kids home for a week is dependable and static and constant, then it actually feels better than a beautiful spring day, because our sensory system isn’t uttering an SOS to the limbic system, our emotional center. Psychologist Elaine Aron explains in her book, “The Highly Sensitive Person,” that a subtle adjustment like a shift in seasons messes with the nervous system and sends the highly sensitive person into a state of overarousal, which unfortunately has nothing to do with sex drive.

The change in us is as physical as it is mental. Just as the lack of sunlight may alter brain levels of certain mood-controlling chemicals – such as the hormone melatonin — in January and February, the same moody chemicals and their messengers get confused when the light comes out in the spring. Although the light is preferable to darkness, change still feels bad.

3. Allergies

Emerging research has identified a link between allergies and depression. At least people who suffer from allergies seem to be at a higher risk for of depression. That makes sense. The headaches, sleeplessness, fatigue associated with allergies are all are symptoms of depression, as well. Anahad O’Connor of the New York Times did the homework:

Several large studies have found that the risk of depression in people with severe allergies is about twice that of those without allergies. In 2008, researchers at the University of Maryland reported that this link may help explain a widely established — but poorly understood — increase in suicides during the spring every year. Analyzing medical records, the authors found that in some patients, changes in allergy symptoms during low- and high-pollen seasons corresponded to changes in their depression and anxiety scores.

A Finnish population study in 2003 found a link between allergies and depression; however, women were much more likely to be affected. In 2000, a study of twins in Finland also showed a shared risk for depression and allergies, a result of genetic influences, the authors wrote.

So there you have it! Three theories on why I’m not as happy as whistlers dressed in pastels and the Frisbee-throwers during the months of April and May, and why I have to work harder at sanity during the springtime.

There’s an absolute link between your emotional health and your physical well-being, so take time to nurture both.

To be completely healthy, you must take care of not only your physical health, but youremotional health, too. If one is neglected, the other will suffer.

Understanding the Physical Health and Emotional Health Connection

There is a physical connection between what the mind is thinking and those parts of the brain that control bodily functions. According to Charles Goodstein, MD, clinical professor of psychiatry, New York University School of Medicine in New York City, and president of the Psychoanalytic Association of New York, the brain is intimately connected to our endocrine system, which secretes hormones or chemicals that can have a powerful influence on your emotional health. “Thoughts and feelings as they are generated within the mind [can influence] the outpouring of hormones from the endocrine system, which in effect control much of what goes on within the body,” says Dr. Goodstein.

“As a matter of fact, it’s very probable that many patients who go to their physician’s office with physical complaints have underlying depression,” he says. People who visit their doctors reporting symptoms of headache, lethargy, weakness, or vague abdominal symptoms often end up being diagnosed with depression, even though they do not report feelings of depression to their doctors, says Goodstein. Depression causes you to be over-aware of physical discomfort.

While unhappy or stressed-out thoughts may not directly cause poor physical health, they could be a contributing factor and may explain why one person is suffering physically while someone else is not, Goodstein adds.

Physical Health and Emotional Health: Examples of Links

There are many circumstances that support the link between physical health and emotional health, including:

• White-coat syndrome. This is a condition in which a person’s blood pressure increases the minute they step into a doctor’s office. In white-coat syndrome, anxiety is directly related to physical function — blood pressure. “If you extrapolate from that, you can say, what other kinds of anxieties are these people having that are producing jumps in blood pressure? What is the consequence of repeated stress?” asks Goodstein.
• Personality and heart disease. Some people are more at risk of heart attack because of their personality, specifically those “hard-driving, hard-charging” Type A individuals.
• Chronic disease and depression. People who are having a hard time coping with a chronic illness are more likely to become depressed.
• Physical symptoms of emotional health distress. People who are clinically depressed often have physical symptoms, such as constipation, lack of appetite, insomnia, or lethargy, among others.

And on the other hand: “Those individuals who have achieved a level of mental health where they can manage better the inevitable conflicts of human life are more likely to prevail in certain kinds of physical illness,” says Goodstein.

Physical Health and Emotional Health: Caring for Both

The best way to care for your total health, emotional and physical, is to follow the advice of your mother:

• Eat right. A healthy, regular diet is good for the body and mind.
• Go to bed on time. Losing sleep is hard on your heart, may increase weight, and definitely cranks up the crankiness meter.
• If you fall down, get back up.Resilience in the face of adversity is a gift that will keep on giving both mentally and physically.
• Go out and play. Yes, work is a good thing: It pays the bills. However, taking time out for relaxation and socializing is good for your emotional health andyour physical health.
• Exercise. Exercise is proven to improve your mood and has comprehensive benefits for your physical health.
• See the right doctor, regularly. Going to the right doctor can make all the difference in your overall health, especially if you have a complicated condition that requires a specialist. But if your emotions are suffering, be open to seeing a mental health professional, too.

Total health depends on a healthy mind and body. Take time to nurture both.

You’ve probably heard your share of stories like the following told by Marcelle Pick, Ob/Gyn NP, on the site “Women to Women”:

A patient came in to see me describing constant heavy bleeding menorrhagia. We tried dietary changes, supplements and other purely physical approaches, with only minimal improvement. I began to probe for the emotional basis of her condition. She shared a description of her marriage to a man who did not support her emotionally and was often verbally abusive. I helped her see the connection between her relationship and her symptoms. One day a few months later, she came into my office and told me she had finally found the courage to leave the relationship. Her heavy bleeding stopped the next day, and has not returned.

The story was especially intriguing to me because I had the opposite happen to me when I was living abroad my sophomore year at college. The Gulf War was about to erupt and there were tensions in pockets of France. Our program director instructed us to keep a low profile, yet a fellow student was hit with a glass bottle by a Muslim fanatic yelling some anti-American sentiments. I was anxious and depressed. Maybe I would have fared okay if I had self-medicated with some of the red wine that was on the table every night, but I was newly sober, which wasn’t fun — schlepping myself to 12-step support groups in strange places where I didn’t understand half of what they said. My body literally shut down and I stopped menstruating (amenorrhea) the whole time I was there. No angel came to me and informed me that I was with child, so I knew I wasn’t pregnant.

Our body holds our emotions.

Some people will break out in hives during a stressful period; others get shingles. Many developmysterious, unexplained illnesses that will disappear when their emotional issues are resolved. For those who maintain that our physical symptoms are completely unrelated to the content in our hearts and souls, consider “broken heart syndrome,” the sudden heart failure that is brought on by emotional trauma. Different from a heart attack, broken heart syndrome is caused by a flood of hormones that impedes the ability of the heart muscle to pump. According to a 2005 Johns Hopkins study, a number of emotions — including joy and surprise — can cause it, not just sadness.

I was complaining to my psychiatrist last visit about all the side effects of my medications — the toll they could be taking on my body, especially over time.

“Lithium could kill my kidneys,” I said, “and I have no idea what the others are doing.”

She listened and then responded with rationale that I have often used in my argument to anti-medication friends on why it’s not always best to let a depression dissolve on its own.

“These medications do have risks,” she said, “but so does depression. It wears the body down over time.”

Most people know that depression can be triggered by various illnesses, especially cardiovascular disease, diabetes, hypertension, and arthritis. However, it might be news that untreated depression can actually increase the risk of developing some illnesses. In fact, a 2007 Norwegian study found that those participants with significant depression symptoms had a higher risk of death from most major causes, including heart disease, stroke, respiratory illnesses (such as pneumonia and influenza), and conditions of the nervous system (like Parkinson’s disease and multiple sclerosis).

The good news is that by treating depression — and by attending to your emotions — you cut down on physical illnesses. A new study published in the January 2014 issue of Psychosomatic Medicine found that the treatment of depression before any apparent signs of cardiovascular disease can decrease the risk of heart attacks and strokes by almost half.

In the mindfulness-based stress reduction (MBSR) course that I attended at the local hospital this spring, we often located areas of tension in our body — places we hold our stress — and deliberately relaxed those muscles as we practiced deep breathing. In one homework assignment, we described the physical sensations in our body as we experienced something negative. Then, in formal meditation, we would direct our attention to those places and breathe into and out of them, trying our best to let go.

With lots of practice, the idea is that we would be able to hear our bodies earlier in emotional dips so that we wouldn’t end up with shingles or menorrhagia or amenorrhea. By attending to our emotional distress — and by treating depression and anxiety — we can become more resilient to illness and disease.

Keep your emotional health in great shape with these self-esteem boosting tips.

Taking care of your emotional health is as important as taking care of your physical body. If your emotional health is out of balance, you may experience high blood pressure, ulcers, chest pain, or a host of other physical symptoms.

When you feel good about yourself, it’s much easier to cope with life’s little ups and downs as well as bigger events, such as divorce or a death, says Jeff Gardere, PhD,a licensed clinical psychologist in New York City.

Here are 10 ways you can practice better stress management and boost your self-esteem. These strategies will help you stay resilient through everyday stresses and when larger personal issues arise.

1. Grow your circle of friends. “It’s very important that you have a support group of friends and family,” Gardere says. “You need people whom you can talk to about your problems — people who will listen to you when you need to get things off your chest — so that you know you’re not alone in whatever it is.”

2. Learn more. “Knowledge is power,” Gardere says. If you have a problem, learn whatever you can about the issue or the health condition you’re facing. The more you know, the less you will fear what might happen, Gardere says.

3. Get moving. Any form of exercise that you enjoy will do. “Regular exercise works as a good partner for people who are on medication,” Gardere says. Exercise also works well for people who have mild or moderate depression and don’t need to be on medication. Think of it as a great tool for stress management.

4. Have sex. Intimacy within a committed relationship has all sorts of emotional benefits — it can help make you feel good about yourself and boost self-esteem. “Figure out a schedule that works for you and your trusted partner — that could be once a week or three times a week or twice a month,” Gardere says.

5. Develop a passion. Everyone should have at least one hobby, Gardere says, whether it’s taking care of plants, collecting antiques, or listening to music. You should do something that brings you some real joy — a passion that’s all yours and that no one can take from you. Having a hobby and taking pride in it is a great way to boost self-esteem.

6. Eat and drink in moderation. Alcohol can be a good stress reducer, but you must indulge in extreme moderation, Gardere says. The same advice applies to indulging in food. You can eat what you want and enjoy it as long as you eat smaller portions and get regular exercise, he says. Maintaining a healthy weight is important for your physical and your emotional health.

7. Meditate or practice yoga. These types of activities are effective for stress management. Meditation is a focused form of guided thought. Yoga and tai chi, while movement-oriented, are also proven stress busters.

RELATED: Surprising Pros and Cons of a Bad Mood

Other stress-reducing techniques include deep breathing and progressive muscle relaxation. If you’re unsure of how to get started, take a class and learn how to practice on your own for 30 minutes, three times a week.

8. Manage your time. If you make a schedule and set goals for yourself for the week, “you’ll be more on top of your days, and when you’re more on top of your days, you’re more on top of your life,” Gardere says. As you cross off the tasks on your to-do list, you will feel a sense of accomplishment which will help reduce stress, he adds.

9. Get enough sleep. “People who get a good night’s sleep wake up with more energy and tend to be more productive,” Gardere says. If you are overly tired, every task and responsibility can seem exaggerated, and even small problems will feel like big ones.

10. Learn to say no. If you try to do more than you can handle, you will only end up frustrated and stressed out. If someone asks you to do something you absolutely can’t do, say no. At the very least, ask for help. And if you can’t do it, explain why kindly but firmly.

Nurturing your mind is as important as nurturing your body, and it will make you better able to handle whatever life throws at you. However, if your emotional problems are serious and you can’t seem to shake them yourself, or if you’re having issues with anxiety or depression, it’s very important that you see a mental health professional and get help, Gardere says.

By Angela Timashenka Geiger, Chief Strategy Officer, Alzheimer’s Association

Special to Everyday Health

The brain is your body’s control and command center. Its power is complex, vast, and awe-inspiring — which means the idea of taking care of it can be intimidating.

Recent surveys suggest that an overwhelming majority of people realize they can reduce their risk of cognitive decline. What they don’t know is what to do and where to start.

The potential to lower your risk of cognitive decline lies in many of the same healthy habits that are also good for your health in general. The Alzheimer’s Association released these 10 Ways to Love Your Brain in honor of Alzheimer’s and Brain Awareness Month:

1. Break a Sweat

Exercise isn’t just about looking good for swimsuit season. Several studies have found anassociation between physical activity and reduced risk of cognitive decline. Engage in regular cardiovascular exercise that elevates your heart rate and increases blood flow to the brain and body.

2. Hit the Books

Some of the strongest evidence for reducing risk of dementia revolves around years of formal education — and this doesn’t mean getting an Ivy League degree. It can be as simple as taking a class at a local college or community center or online. Formal education in any stage of life will help reduce your risk of cognitive decline and dementia.

3. Butt Out

The reasons to quit smoking are endless, but you can add that it may help reduce your risk of cognitive decline. Quitting smoking can reduce risk to levels comparable to those for people who have not smoked.

4. Follow Your Heart

You know it’s good for your body, but did you also know it can be good for your brain? Evidence shows risk factors for cardiovascular disease and stroke – obesity, high blood pressure, and diabetes — negatively impact your brain and cognitive health. Take care of your heart, and your brain just might follow.

5. Heads Up!

Another evidence-based tip for reducing your risk of cognitive decline: Avoid head injuries. A brain injury can raise your risk of cognitive decline and dementia, so wear a seat belt, use a helmet when playing contact sports or riding a bike, and take steps to prevent falls.

6. Fuel Up Right

Recent surveys suggest more than two out of three people said you can reduce your risk of cognitive decline by eating one or two of the right “superfoods” — a misconception, since there is no research showing that individual foods make a difference. What we do know: Eating a healthy and balanced diet that has more vegetables and fruits can help reduce the risk of cognitive decline. Although research on diet and cognitive function is limited, certain diets, includingMediterranean and Mediterranean-DASH (Dietary Approaches to Stop Hypertension), may contribute to risk reduction.

7. Catch Some Zzzs

You know the feeling: When you don’t get enough sleep, you just feel “off,” and you’re not functioning at full capacity. There are long-term risks as well: Not getting enough sleep due to conditions like insomnia or sleep apnea may result in problems with memory and thinking.

8. Take Care of Your Mental Health

Some studies link a history of depression with increased risk of cognitive decline, so seek medical treatment if you have symptoms of depression, anxiety, or other mental health concerns. Also, try to manage stress.

9. Buddy Up

Those lunch dates with your friends are fun, but they may have a more positive effect than you thought. Staying socially engaged may support brain health, so pursue social activities that are meaningful to you. Find ways to be part of your local community — if you love animals, consider volunteering at a local shelter. If you enjoy singing, join a local choir or help at an after-school program. Or simply share activities with friends and family.

10. Stump Yourself

Six out of 10 respondents in a recent survey thought that the right puzzle, game, or app could reduce their risk of cognitive decline. But helping to keep your brain healthy goes beyond any single tool. Challenging yourself to think in new ways may have short and long-term benefits for your brain. Complete a jigsaw puzzle, do something artistic, or build a piece of furniture. Play games, such as bridge, that make you think strategically.

All of these tips add up to a big boost for your brain. Research has suggested that combining good nutrition with mental, social, and physical activities may have a greater benefit in maintaining or improving brain health than any single activity.

Angela Geiger is the chief strategy officer for the Alzheimer’s Association. Her accomplishments include developing and launching the organization’s first-ever integrated consumer education campaign to raise concern about Alzheimer’s disease as a critical public health issue. She has a variety of conferences and publications, including The Shriver Report: A Woman’s Nation Takes on Alzheimer’s and Chicken Soup for the Soul: Living with Alzheimer’s & Other Dementias. The Alzheimer’s Association is the world’s leading voluntary health organization in Alzheimer’s care, support and research. The association’s mission is to eliminate Alzheimer’s disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health.

All of a sudden your best friend stops calling. She no longer wants to join you for yoga on Saturday mornings. The last time you saw her she looked fragile and sad, like someone else was living in her body. Her husband doesn’t know what to do so he solicits your help in cheering her up.

Or maybe it’s your sister. She has been struggling with depression for a few months now. She’s been to a psychiatrist and is on an antidepressant, but she doesn’t seem to be making much progress.

What do you do?

I’ve been on the giving and the receiving end of kind-hearted attempts to lift depression more times than I’d like to count. While every case of this maddening mood disorder is unique and responds to different treatments, there are a few universal things you can try to guide your depressed friend or family member down the path of healing and recovery.

1. Educate yourself.

Although people are better educated on depression and anxiety today than they were two decades ago, we still have a long ways to go on understanding how the brain operates: Why some people smile as they get run over by a truck, and others cry uncontrollably at the mere thought of that. It turns out that more is going on in our noggin than just a bunch of lazy neurotransmitters that can’t deliver messages to certain neurons. You don’t have to be a neuroscientist to help a friend or a family member with a mood disorder, but some basic knowledge on depression and anxiety is going to keep you from saying well-intentioned but hurtful things. It’s just hard to help someone if you don’t understand what the person is going through.

2. Ask lots of questions.

Whenever one of my kids gets sick or injured, I start in with a series of questions: Where does it hurt? How long have you felt bad? Does anything make it worse (besides school)? Does anything make it better (besides ice cream)? Just by asking a few basic questions, I can usually get enough information to determine a plan of action. With depression and anxiety, questions are crucial because the terrain is so vast and each person’s experience is so different. Your friend may be so desperate that she’s had a suicide plan in action for weeks, or she could just be under a lot of stress at work. She could be having a severe episode of major depression, or just need a little more vitamin D. You won’t know until you start asking some questions. Here are a few to consider:

• When did you first start to feel bad?
• Can you think of anything that may have triggered it?
• Do you have suicidal thoughts?
• Is there anything that makes you feel better?
• What makes you feel worse?
• Do you think you could be deficient in vitamin D?
• Have you made any changes lately to your diet?
• Are you under more pressure at work?
• Have you had your thyroid levels checked?

3. Help them learn what they need to know.

I used to rely on my doctors to tell me everything I needed to know about my health. I don’t do that anymore, because they don’t know me as well as my family and friends. Psychiatrists and psychologists have expertise in some areas, which can be critical feedback as a person begins to tackle the monster of depression; however, so much other valuable information is tucked away in memories with friends and families that could guide a person out of despair. For example, during this most recent relapse of mine, my older sister kept insisting that I probe into myhormonal imbalances. “You haven’t been well since you’ve had your kids,” she said. “Part of this depression has to be hormonal.” My mom reminded me that thyroid disease runs in our family and suggested I get my thyroid checked out. Initially I was annoyed by their opinions since it required more work on my part. When I couldn’t take the pain anymore, I sought after a holistic physician who could piece together my problems with my thyroid and pituitary glands and address the hormonal imbalances that contribute so heavily to my depression.

You know your sister, friend, brother, or father better than most mental health professionals, so help them solve the riddle of their symptoms. Together consider what could be at the root of their depression: physiologically, emotionally, or spiritually. Where is the disconnect?

4. Talk about stress.

You can be drinking kale and pineapple smoothies for breakfast, lunch, and dinner; meditating with Tibetan monks for eight hours a day; sleeping like a baby at night … and yet, if you are under stress, your veins are flooded with poison and your mind is under fire. About five pages into every psychology book there is a paragraph that says that stress causes depression. I think it should be on page one. There is just no way around it. Stress is bad, bad stuff, and as long as it’s pouring cortisol into your bloodstream, you aren’t going to get well. So one of the biggest jobs of a friend or relative of someone who is struggling with depression is to help the person construct strategies to reduce stress. They don’t need to quit their job. They can keep their kids. However, they may need to make some significant lifestyle changes and be sure to introduce self-care into every day. What is that? Five-minute breaks here and there to take some deep breaths, or an hour massage once in awhile, or maybe a day off here and there to sit by the water, golf, or go for a hike.

5. Talk about support.

It doesn’t matter what the illness is — cardiovascular disease, colon cancer, fibromyalgia — a person needs support in her or his life to fully recover: People with whom they can vent and swap horror stories, folks that can remind them that they are not alone even though their symptoms make them feel that way. Research shows that support groups aid the recovery of a person struggling with depression and decrease chances of relapse. The New England Journal of Medicine published a study in December of 2001 in which 158 women with metastatic breast cancer were assigned to a supportive-expressive therapy. These women showed greater improvement in psychological symptoms and reported less pain than the women with breast cancer who were assigned to the control group with no supportive therapy. Brainstorm with your friend on ways to get more support. Research and share with your friend various groups (onlineor in town) that might be of benefit.

6. Remind them of their strengths.

Just yesterday morning I was having suicidal thoughts during yoga. It was one of those painful hours when I couldn’t stop thinking about how soon I could die. Instead of being gentle with myself, I started comparing myself with a few incredibly accomplished people I swim with — the kind of people who swim across the English Channel for giggles — and tend to make the average person feel pathetic. Later in the day, I went for a walk with my husband, still fighting the death thoughts as we strolled along the rocks bordering the Severn River at the Naval Academy, our favorite route. We were talking about how jealous we were of couples who didn’t have kids (in some ways, not all), how damaged we feel after 13 years of parenting, but how much we’ve evolved as human beings because of all the struggles we’ve endured in that time.

“You’re strong,” he said.

I balked. “No, no I’m not,” I said. I was thinking strong meant swimming the English Channel, not fighting suicidal thoughts in yoga.

“Yes, you are,” he insisted. “You have a 200-pound gorilla on your back constantly. Most people would roll over and give up, coping with booze, pot, and sedatives. Not you. You get up and fight it each day.”

I needed to hear that. In my head, I categorize myself as weak because of the constant death thoughts, when, in reality, the fact that I can accomplish stuff in spite of them means I’m strong.

Remind your friend, sister, brother, or dad of their strengths. Bolster their confidence by recalling specific accomplishments they’ve made and victories they’ve won.

7. Make them laugh.

As I mentioned in my post, “10 Things I Do Every Day to Beat Depression,” research says that laughing is one of the best things we can do for our health. Humor can help us heal from a number of illnesses. When I was hospitalized for severe depression in 2005, one of the psychiatric nurses on duty decided that one session of group therapy would consist of watching a comedian (on tape) poke fun at depression. For an hour, we all exchanged glances like “Is it okay to laugh? I sort of want to die, but this woman is kind of funny.” The effect was surprisingly powerful. Whenever the “black dog” (as Winston Churchill called depression) has gotten a hold of a friend, I try to make her laugh, because in laughing, some of her fear and panic disappear.

8. Pass on some hope.

If I had to name one thing a person (or persons) said to me when I was severely depressed that made me feel better, it would be this: “You won’t always feel this way.” It is a simple statement of truth that holds the most powerful healing element of all: hope. As a friend or family member, your hardest job is to get your friend or brother or dad or sister to have hope again: to believe that they will get better. Once their heart is there, their mind and body will follow shortly.

9. Listen.

You could disregard everything I’ve written and just do this: listen. Suspend all judgments, save all interjections … do nothing more than make excellent eye contact and open your ears. In her bestselling book, “Kitchen Table Wisdom,” Rachel Naomi Remen writes:

I suspect that the most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention. And especially if it’s given from the heart. When people are talking, there’s no need to do anything but receive them. Just take them in. Listen to what they’re saying. Care about it. Most times caring about it is even more important than understanding it.