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Understanding depression in women

Depression is a serious condition that can impact every area of your life. It can affect your social life, relationships, career, and sense of self-worth and purpose. And for women in particular, depression is common. In fact, according to the National Mental Health Association, about one in every eight women will develop depression at some point during her lifetime.

If you’re feeling sad, guilty, tired, and just generally “down in the dumps,” you may be suffering from major depression. But the good news is that depression is treatable, and the more you understand about depression’s particular implications for and impact on women, the more equipped you will be to tackle the condition head on.

Signs and symptoms of depression in women

The symptoms of depression in women are the same as those for major depression. Common complaints include:

Differences between male and female depression

Although some of the signs and symptoms of depression are the same for both men and women, women tend to experience certain symptoms more often than men. For example, seasonal affective disorder—depression in the winter months due to lower levels of sunlight—is more common in women. Also, women are more likely to experience the symptoms of atypical depression.

In atypical depression, rather than sleeping less, eating less, and losing weight, the opposite is seen: sleeping excessively, eating more (especially carbohydrates), and gaining weight. Feelings of guilt associated with depression are also more prevalent and pronounced in women. Women also have a higher incidence of thyroid problems. Since hypothyroidism can cause depression, this medical problem should always be ruled out by a physician in women who are depressed.

Causes of depression in women

Women are about twice as likely as men to suffer from depression. This two-to-one difference persists across racial, ethnic, and economic divides. In fact, this gender difference in rates of depression is found in most countries around the world. There are a number of theories that attempt to explain the higher incidence of depression in women. Many factors have been implicated, including biological, psychological, and social factors.

Biological and hormonal causes of depression in women

• Premenstrual problems – Hormonal fluctuations during the menstrual cycle can cause the familiar symptoms of premenstrual syndrome (PMS), such as bloating, irritability, fatigue, and emotional reactivity. For many women, PMS is mild. But for some women, symptoms are severe enough to disrupt their lives and a diagnosis of premenstrual dysphoric disorder (PMDD) is made.
• Pregnancy and infertility – The many hormonal changes that occur during pregnancy can contribute to depression, particularly in women already at high risk. Other issues relating to pregnancy such as miscarriage, unwanted pregnancy, and infertility can also play a role in depression.
• Postpartum depression – Many new mothers experience the “baby blues.” This is a normal reaction that tends to subside within a few weeks. However, some women experience severe, lasting depression. This condition is known as postpartum depression. Postpartum depression is believed to be influenced, at least in part, by hormonal fluctuations.
• Perimenopause and menopause – Women may be at increased risk for depression during perimenopause, the stage leading to menopause when reproductive hormones rapidly fluctuate. Women with past histories of depression are at an increased risk of depression during menopause as well.
• Health problems – Chronic illness, injury, or disability can lead to depression in women, as can crash dieting or quitting smoking.

Psychological causes of depression in women

• Focusing on and rehashing negative feelings – Women are more likely to ruminate when they are depressed. This includes crying to relieve emotional tension, trying to figure out why you’re depressed, and talking to your friends about your depression. However, rumination has been found to maintain depression and even make it worse. Men, on the other hand, tend to distract themselves when they are depressed. Unlike rumination, distraction can reduce depression.
• Overwhelming stress at work, school, or home – Some studies show that women are more likely than men to develop depression from stress. Furthermore, the female physiological response to stress is different. Women produce more stress hormones than men do, and the female sex hormone progesterone prevents the stress hormone system from turning itself off as it does in men.
• Body image issues – The gender difference in depression begins in adolescence. The emergence of sex differences during puberty likely plays a role. Some researchers point to body dissatisfaction, which increases in girls during the sexual development of puberty.

Social causes of depression in women

As with men, social factors can also play a part in causing depression in women, along with lifestyle choices, relationships, and coping skills. These may include:

• Marital or relationship problems; balancing the pressures of career and home life
• Family responsibilities such as caring for children, spouse, or aging parents
• Experiencing discrimination at work or not reaching important goals, losing or changing a job, retirement, or embarking on military service
• Persistent money problems
• Death of a loved one or other stressful life event that leaves you feeling useless, helpless, alone, or profoundly sad

Treating depression in women

For the most part, women suffering from depression receive the same types of treatment as everyone else. The main treatment approaches are psychotherapy and antidepressant therapy. However, there are some special treatment considerations for depression in women.

Depression, hormones, and the reproductive cycle

Hormone fluctuations related to the reproductive cycle can have a profound influence on a woman’s mood. In light of this possibility, you and your doctor should always look for connections between your depressive symptoms and the female reproductive cycle.

• Is your depression connected to your menstrual period and a possible effect of PMS?
• Are you pregnant and struggling with complications and concerns related to the vast changes you and your body are undergoing?
• Are you struggling with the baby blues after recently giving birth?
• Or are you approaching menopause and dealing with hormonal and emotional fluctuations?

All of these milestones in the reproductive cycle can influence or trigger depression. It’s also important to consider mood-related side effects from birth control medication or hormone replacement therapy.

How depression treatment is different for women

Specific aspects of treatment must often be modified for women. Because of female biological differences, women should generally be started on lower doses of antidepressants than men. Women are also more likely to experience side effects, so any medication use should be closely monitored.

Finally, women are more likely than men to require simultaneous treatment for other conditions such as anxiety disorders and eating disorders.

Self-help for depression in women

You can make a huge dent in your depression with simple lifestyle changes: exercising every day, avoiding the urge to isolate, eating healthy food instead of the junk you crave, and carving out time for rest and relaxation.

Feeling better takes time, but you can get there if you make positive choices for yourself each day and draw on the support of others.

Expose yourself to a little sunlight every day. Sunlight can help boost your mood. Take a short walk outdoors, have your coffee outside, enjoy an al fresco meal, people-watch on a park bench, or sit out in the garden. Aim for at least 15 minutes of sunlight a day. If you live somewhere with little winter sunshine, try using a light therapy box.

• Talk about your feelings to someone you trust, face-to-face. Share what you’re going through with the people you love and trust. Ask for the help and support you need. You may have retreated from your most treasured relationships, but they can get you through this tough time. If you don’t feel that you have anyone to confide in, look to build new friendships. Start by joining a support group for depression.
• Try to keep up with social activities even if you don’t feel like it. When you’re depressed, it feels more comfortable to retreat into your shell. But being around other people will make you feel less depressed.
• Get up and moving. Studies show that regular exercise can be as effective as antidepressant medication at increasing energy levels and decreasing feelings of fatigue. You don’t have to hit the gym. A 30-minute walk each day will give you a much-needed boost.
• Aim for 8 hours of sleep. Depression typically involves sleep problems. Whether you’re sleeping too little or too much, your mood suffers. Get on a better sleep schedule by learning healthy sleep habits.
• Practice relaxation techniques. A daily relaxation practice can help relieve symptoms of depression, reduce stress, and boost feelings of joy and well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.

Premenstrual dysphoric disorder

Most women are all too familiar with premenstrual syndrome (PMS). Unwelcome symptoms of PMS such as bloating, moodiness, and fatigue appear and reappear each month at the same time in the menstrual cycle. For most women, these premenstrual symptoms are uncomfortable but not disabling. But for up to one out of ten women, symptoms are so distressing and disabling that they warrant a diagnosis of premenstrual dysphoric disorder (PMDD). PMDD is characterized by severe depression, irritability, and other mood disturbances. Symptoms begin about 10 to 14 days before your period and improve within a few days of its start.

Self-help for PMDD

There are many steps you can take to improve PMDD symptoms. Many involve simple lifestyle adjustments.

• Exercise – Regular aerobic exercise can reduce the symptoms of PMDD.
• Dietary modifications – Changes to your diet may help reduce symptoms. Cutting back on salt, fatty foods, caffeine, and alcohol is recommended. Eating plenty of complex carbohydrates is also recommended.
• Nutritional supplements – Vitamin B-6, calcium, magnesium, Vitamin E, and tryptophan have all been shown to benefit women suffering from PMDD.
• Herbal remedies – Evening primrose oil and chaste tree berry are herbal supplements that have both been studied and found to be effective in the treatment of PMDD.
• Stress reduction – Relaxation techniques and other strategies to reduce stress may help with PMDD symptoms. Yoga and meditation are particularly effective.

Understanding depression in men

Depression affects millions of men of all ages and backgrounds, as well as those who care about them—spouses, partners, friends, and family. More than just a dip in mood in response to life’s setbacks and disappointments, depression changes how you think, feel, and function in your daily life. It can interfere with your productivity at work or school and impact your relationships, sleep, diet, and overall enjoyment of life. Severe depression can be intense and unrelenting.

• Depression in men can often be overlooked. Many men find it difficult to talk about their feelings so they tend to focus on the physical symptoms that often accompany depression. This can result in the underlying depression going untreated.
• Men suffering from depression are four times more likely to commit suicide than women.It’s important for any man to seek help with depression before feelings of despair become feelings of suicide. Talk honestly with a friend, loved one, or doctor about what’s going on in your mind.
• There is plenty men can do to overcome depression. The important thing is to recognize the symptoms.

Am I depressed?

If you identify with several of the following, you may be suffering from depression.

• you feel hopeless and helpless
• you’ve lost interest in friends, activities, and things you used to enjoy
• you’re much more irritable, short-tempered, or aggressive than usual
• you’re consuming more alcohol, engaging in reckless behavior, or using TV, sports, and sex to self-medicate
• you feel restless and agitated
• your sleep and appetite has changed
• you can’t concentrate or your productivity at work has declined
• you can’t control your negative thoughts

Signs and symptoms of depression in men

Men are far less adept at recognizing symptoms of depression than women. A man is more likely to deny his feelings, hide them from himself and others, or try to mask them with other behaviors. The three most common signs of depression in men are:

• Physical pain. Sometimes depression in men shows up as physical symptoms—such as backache, frequent headaches, sleep problems, sexual dysfunction, or digestive disorders—that don’t respond to normal treatment.
• Anger. This could range from irritability, sensitivity to criticism, or a loss of your sense of humor to road rage, a short temper, or even violence. Some men become abusive or controlling.
• Reckless behavior. A man suffering from depression may exhibit escapist or risky behavior such as pursuing dangerous sports, driving recklessly, or engaging in unsafe sex. You might drink too much, abuse drugs, or gamble compulsively.

Triggers for depression in men

Biological, psychological, and social factors all play a part in depression in men, as do lifestyle choices, relationships, and coping skills. Stressful life events or anything that makes you feel helpless, profoundly sad, or overwhelmed by stress can also trigger depression in men, including:

• Overwhelming stress at work, school, or home
• Marital or relationship problems
• Not reaching important goals
• Losing or changing a job; embarking on military service
• Constant money problems
• Health problems such as chronic illness, injury, disability
• Recently quitting smoking
• Death of a loved one
• Family responsibilities such as caring for children, spouse, or aging parents
• Retirement; loss of independence

Help for depression in men tip 1: Seek social support to reduce stress and feel happier

Work commitments can often make it difficult for men to find time to maintain friendships, but close relationships are vital to helping you get through this tough time.

• The simple act of talking to someone face to face about how you feel can be an enormous help.
• The person you talk to doesn’t have to be able to fix you; they just need to be a good listener, someone who’ll listen attentively without being distracted or judging you.
• If you don’t feel that you have anyone to turn to, it’s never too late to build new friendships and improve your support network.

Finding social support to beat male depression

• Reach out to family and friends. Accepting help and support is not a sign of weakness and it won’t mean you’re a burden to others. In fact, most friends will be flattered that you trust them enough to confide in them.
• Participate in social activities, even if you don’t feel like it.When you’re depressed, it feels more comfortable to retreat into your shell. But being around other people will boost your mood.
• Join a support group for depression. Being with others facing the same problems can help reduce your sense of isolation and remove any stigma you may feel.
• Volunteer. Being helpful to others delivers immense pleasure and is also a great way to expand your social network.
• Meet new people with common interests by taking a class or joining a club.
• Walk a dog. It’s good exercise for you and a great way to meet people.
• Invite someone to a ballgame, movie, or concert. There are plenty of other people who feel just as awkward about reaching out and making new friends as you do. Be the one to break the ice.
• Call or email an old buddy. Even if you’ve retreated from relationships that were once important to you, make the effort to reconnect.

Help for depression in men tip 2: Exercise for greater mental and physical health

When you’re depressed, just getting out of bed can seem like a daunting task, let alone exercising. But regular exercise can be as effective as antidepressant medication in countering the symptoms of depression in men. It’s also something you can do right now to boost your mood.

• Aim to exercise for 30 minutes or more per day—or break that up into short, 10-minute bursts of activity. A 10-minute walk can improve your mood for two hours.
• The most benefits for male depression come from rhythmic exercise—such as walking, weight training, swimming, martial arts, or dancing—where you move both your arms and legs.
• Adding a mindfulness element is particularly effective. Focus on how your body feels as you move—the sensation of your feet hitting the ground, for example, or the wind on your skin.
• Joining a class or exercising in a group can help keep you motivated and make exercise a social activity. Or find a workout buddy, and afterwards have a drink or watch a game together.

Help for depression in men tip 3: Eat a healthy diet to improve how you feel

What you eat has a direct impact on the way you feel.

• Minimize sugar and refined carbs. You may crave sugary snacks, baked goods, or comfort foods such as pasta or French fries, but these “feel-good” foods quickly lead to a crash in mood and energy.
• Reduce your intake of foods that can adversely affect your mood, such as caffeine, alcohol, trans fats, and foods with high levels of chemical preservatives or hormones.
• Eat more Omega-3 fatty acids to give your mood a boost. The best sources are fatty fish (salmon, herring, mackerel, anchovies, sardines), seaweed, flaxseed, and walnuts. 
• Try foods rich in mood-enhancing nutrients, such as bananas (magnesium to decrease anxiety, vitamin B6 to promote alertness, tryptophan to boost feel-good serotonin levels) and spinach (magnesium, folate to reduce agitation and improve sleep).
• Avoid deficiencies in B vitamins which can trigger depression. Eat more citrus fruit, leafy greens, beans, chicken, and eggs.

Help for depression in men tip 4: Make healthy lifestyle changes to lift your mood

Positive lifestyle changes can help lift depression and keep it from coming back.

• Get enough sleep. When you don’t get enough sleep, your depression symptoms can be worse. Sleep deprivation exacerbates anger, irritability, and moodiness. Aim for somewhere between 7 to 9 hours of sleep each night.
• Reduce stress. Too much stress exacerbates depression but there are healthy ways to cope. A daily relaxation practice can help relieve symptoms of depression, reduce stress, and boost feelings of joy and well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.

Professional treatment for depression in men

If support from family and friends and positive lifestyle changes aren’t enough, seek help from a mental health professional. Be open about how you’re feeling as well as your physical symptoms. Treatments for depression in men include:

• Therapy. You may feel that talking to a stranger about your problems is ‘unmanly,’ or that therapy carries with it a victim status. However, if therapy is available to you, it can often bring a swift sense of relief, even to the most skeptical male.
• Medication. Antidepressant medication may help relieve some symptoms of depression, but doesn’t cure the underlying problem, and is rarely a long-term solution. Medication also comes with side effects. Don’t rely on a doctor who is not trained in mental health for guidance on medication, and always pursue self-help steps as well.

Helping a man with depression

It often takes a wife, partner, or other family member to recognize a man’s symptoms of depression.

Talking to a man about depression

Many men don’t exhibit typical depressive symptoms—but rather anger and reckless behavior—so you may want to avoid using the word “depression” and try describing his behavior as “stressed” or “overly tired.” It could help him to open up.

• Point out how his behavior has changed, without being critical. For example, “You always seem get stomach pains before work,” or “You haven’t played racquetball for months.”
• Suggest a general check-up with a physician. He may be less resistant to seeing a family doctor than a mental health specialist at first. The doctor can rule out medical causes of depression and then make a referral.
• Offer to accompany him on the first visit with a mental health specialist. Some men are resistant to talking about their feelings, so try to remove roadblocks to him seeking help.
• Encourage him to make a list of symptoms to discuss. Help him focus on his feelings as well as physical ailments, and to be honest about his use of alcohol and drugs.

Depression: A problem for many older adults and the elderly

Depression is a common problem in older adults. And its symptoms affect every aspect of your life, including your energy, appetite, sleep, and interest in work, hobbies, and relationships.

Unfortunately, all too many depressed seniors fail to recognize the symptoms of depression, or don’t take the steps to get the help they need. There are many reasons depression in older adults and the elderly is so often overlooked:

• You may assume you have good reason to be down or that depression is just part of aging.
• You may be isolated—which in itself can lead to depression—with few around to notice your distress.
• You may not realize that your physical complaints are signs of depression.
• You may be reluctant to talk about your feelings or ask for help.

You can feel good at any age

Depression isn’t a sign of weakness or a character flaw. It can happen to anyone, at any age, no matter your background or your previous accomplishments in life. Similarly, physical illness, loss, and the challenges of aging don’t have to keep you down. You can feel better and enjoy your golden years once again, no matter what challenges you face.

Signs and symptoms of depression in older adults and the elderly

Recognizing depression in the elderly starts with knowing the signs and symptoms. Depression red flags include:

Depressed seniors may not feel “sad”

While depression and sadness might seem to go hand and hand, many depressed seniors claim not to feel sad at all. They may complain, instead, of low motivation, a lack of energy, or physical problems. In fact, physical complaints, such as arthritis pain or worsening headaches, are often the predominant symptom of depression in the elderly.

Medical conditions can cause depression in older adults

It’s important to be aware that medical problems can cause depression in older adults and the elderly, either directly or as a psychological reaction to the illness. Any chronic medical condition, particularly if it is painful, disabling, or life-threatening, can lead to depression or make depression symptoms worse.

These include:

Depression as a side effect of medication

Symptoms of depression can also occur as a side effect of many commonly prescribed drugs. You’re particularly at risk if you’re taking multiple medications. While the mood-related side effects of prescription medication can affect anyone, older adults are more sensitive because, as we age, our bodies become less efficient at metabolizing and processing drugs.

Medications that can cause or worsen depression include:

If you feel depressed after starting a new medication, talk to your doctor. You may be able to lower your dose or switch to another medication that doesn’t impact your mood.

Dementia vs. depression in older adults

Never assume that a loss of mental sharpness is just a normal sign of old age. It could be a sign of either depression or dementia, both of which are common in older adults and the elderly. Depression and dementia share many similar symptoms, including memory problems, sluggish speech and movements, and low motivation, so it can be difficult to tell the two apart.

Whether cognitive decline is caused by dementia or depression, it’s important to see a doctor right away. If it’s depression, memory, concentration, and energy will bounce back with treatment. Treatment for dementia will also improve you or your loved one’s quality of life. And in some types of dementia, symptoms can be reversed, halted, or slowed.

Help for depressed seniors tip 1: Find ways to stay engaged

If you’re depressed, you may not want to do anything or see anybody. But isolation and disconnection only make depression worse. The more engaged you are—socially, mentally, and physically—the better you’ll feel.

The importance of face-to-face connection

On your own, it can be difficult to maintain perspective and sustain the effort required to beat depression. That’s why support matters—so make an effort to connect to others and limit the time you’re alone. If you can’t get out to socialize, invite loved ones to visit you, or keep in touch over the phone or email.

But digital communication isn’t a replacement for face-to-face contact. Do your best to see people in person on a daily basis. Your mood will thank you! And remember, it’s never too late to build new friendships. Start by joining a senior center, a book club, or another group of people with similar interests.

Ways to help you feel connected and engaged in life again

• Get out in to the world. Try not to stay cooped up at home all day. Go to the park, take a trip to the hairdresser, or have lunch with a friend.
• Volunteer your time. Helping others is one of the best ways to feel better about yourself and expand your social network.
• Take care of a pet. A pet can keep you company, and walking a dog, for example, can be good exercise for you and a great way to meet people.
• Learn a new skill. Pick something that you’ve always wanted to learn, or that sparks your imagination and creativity.
• Create opportunities to laugh. Laughter provides a mood boost, so swap humorous stories and jokes with your loved ones, watch a comedy, or read a funny book.

Help for depressed seniors tip 2: Healthy habits matter

When you’re depressed, it’s hard to find the motivation to do anything—let alone look after your health. But your health habits have an impact on depression symptoms. The better care you take of your body, the better you’ll feel.

Move your body

Exercise is a powerful depression treatment. In fact, research suggests it can be just as effective as antidepressants. And you don’t have to suffer through a rigorous workout to reap the benefits. Anything that gets you up and moving helps. Look for small ways to add more movement to your day: park farther from the store, take the stairs, do light housework, or enjoy a short walk. It all adds up.

Even if you’re ill, frail, or disabled, there are many safe exercises you can do to build your strength and boost your mood—even from a chair or wheelchair. Just listen to your body and back off if you’re in pain.

Eat to support your mood

Your dietary habits make a difference with depression. Start by minimizing sugar and refined carbs. Sugary and starchy comfort foods can give you a quick boost, but you pay for it later when your blood sugar crashes. Instead, focus on quality protein, complex carbs, and healthy fats, which will leave you satisfied and on an emotional even keel. Going too long without eating can also worsen your mood, making you tired and irritable, so do your best to eat something at least every 3-4 hours.

Support quality sleep

Many older adults struggle with sleep problems, particularly insomnia. But lack of sleep makes depression worse. Aim for somewhere between 7 to 9 hours of sleep each night. You can help yourself get better quality sleep by avoiding alcohol and caffeine, keeping a regular sleep-wake schedule, and making sure your bedroom is dark, quiet, and cool.

Help for depressed seniors tip 3: Know when to seek professional help

Depression treatment is just as effective for older adults as it is for younger people. However, since depression in older adults and the elderly is often triggered or compounded by a difficult life situation or challenge, any treatment plan should address that issue. If loneliness is at the root of your depression, for example, medication alone is not going to cure the problem. Also, any medical issues complicating the depression must be addressed.

Antidepressant risk factors for older adults and the elderly

Older adults are more sensitive to drug side effects and vulnerable to interactions with other medicines they’re taking. Studies have also found that SSRIs such as Prozac can cause rapid bone loss and a higher risk for fractures and falls. Because of these safety concerns, elderly adults on antidepressants should be carefully monitored.

In many cases, therapy and/or healthy lifestyle changes, such as exercise, can be as effective as antidepressants in relieving depression, without the dangerous side effects.

Alternative medicine for depression in older adults and the elderly

If you can’t tolerate antidepressants or are worried about the risks, there are a number of herbal remedies and supplements which have shown promise in treating depression. However, even natural supplements can cause interactions with certain medications you’re taking or lead to unpleasant side effects, so talk to your doctor and do your research on drug interactions.

• Omega-3 fatty acids may boost the effectiveness of antidepressants or work as a standalone treatment for depression.
• St. John’s wort can help with mild or moderate symptoms of depression but should not be taken with antidepressants.
• Folic acid can help relieve symptoms of depression when combined with other treatments.
• SAMe may be used in place of antidepressants to help regulate mood, but in rare cases can cause severe side effects.

Counseling and therapy for older adults and the elderly

Therapy works well on depression because it addresses the underlying causes of the depression, rather than just the symptoms.

• Supportive counseling includes religious and peer counseling. It can ease loneliness and the hopelessness of depression, and help you find new meaning and purpose.
• Therapy helps you work through stressful life changes, heal from losses, and process difficult emotions. It can also help you change negative thinking patterns and develop better coping skills.
• Support groups for depression, illness, or bereavement connect you with others who are going through the same challenges. They are a safe place to share experiences, advice, and encouragement.

Helping a depressed older adult or senior

The very nature of depression interferes with a person’s ability to seek help, draining energy and self-esteem. For depressed seniors, raised in a time when mental illness was highly stigmatized and misunderstood, it can be even more difficult—especially if they don’t believe depression is a real illness, are too proud or ashamed to ask for assistance, or fear becoming a burden to their families.

If an elderly person you care about is depressed, you can make a difference by offering emotional support. Listen to your loved one with patience and compassion. You don’t need to try to “fix” someone’s depression; just being there to listen is enough. Don’t criticize feelings expressed, but point out realities and offer hope. You can also help by seeing that your friend or family member gets an accurate diagnosis and appropriate treatment. Help your loved one find a good doctor, accompany him or her to appointments, and offer moral support.

Other tips for helping a depressed elderly friend or relative:

• Invite your loved one out. Depression is less likely when people’s bodies and minds remain active. Suggest activities to do together that your loved one used to enjoy: walks, an art class, a trip to the museum or the movies—anything that provides mental or physical stimulation.
• Schedule regular social activities. Group outings, visits from friends and family members, or trips to the local senior or community center can help combat isolation and loneliness. Be gently insistent if your plans are refused: depressed people often feel better when they’re around others.
• Plan and prepare healthy meals. A poor diet can make depression worse, so make sure your loved one is eating right, with plenty of fruit, vegetables, whole grains, and some protein at every meal.
• Encourage the person to follow through with treatment. Depression usually recurs when treatment is stopped too soon, so help your loved one keep up with his or her treatment plan. If it isn’t helping, look into other medications and therapies.
• Make sure all medications are taken as instructed. Remind the person to obey doctor’s orders about the use of alcohol while on medication. Help them remember when to take their dose.
• Watch for suicide warning signs. Seek immediate professional help if you suspect that your loved one is thinking about suicide.

Helping a depressed friend or family member

Depression is a serious but treatable disorder that affects millions of people, from young to old and from all walks of life. It gets in the way of everyday life, causing tremendous pain, hurting not just those suffering from it, but also impacting everyone around them.

If someone you love is depressed, you may be experiencing any number of difficult emotions, including helplessness, frustration, anger, fear, guilt, and sadness. These feelings are all normal. It’s not easy dealing with a friend or family member’s depression. And if you don’t take care of yourself, it can become overwhelming.

That said, there are steps you can take to help your loved one. Start by learning about depression and how to talk about it with your friend or family member. But as you reach out, don’t forget to look after your own emotional health. Thinking about your own needs is not an act of selfishness—it’s a necessity. Your emotional strength will allow you to provide the ongoing support your depressed friend or family member needs.

Is my friend or family member depressed?

Family and friends are often the first line of defense in the fight against depression. That’s why it’s important to understand the signs and symptoms of depression. You may notice the problem in a depressed loved one before he or she does, and your influence and concern can motivate that person to seek help.

Be concerned if your loved one…

• Doesn’t seem to care about anything anymore.
• Is uncharacteristically sad, irritable, short-tempered, critical, or moody.
• Has lost interest in work, sex, hobbies, and other pleasurable activities.
• Talks about feeling “helpless” or “hopeless.”
• Expresses a bleak or negative outlook on life.
• Frequently complains of aches and pains such as headaches, stomach problems, and back pain.
• Complains of feeling tired and drained all the time.
• Has withdrawn from friends, family, and other social activities.
• Sleeps less than usual or oversleeps.
• Eats more or less than usual, and has recently gained or lost weight.
• Has become indecisive, forgetful, disorganized, and “out of it.”
• Drinks more or abuses drugs, including prescription sleeping pills and painkillers.

How to talk to a loved one about depression

Sometimes it is hard to know what to say when speaking to a loved one about depression. You might fear that if you bring up your worries he or she will get angry, feel insulted, or ignore your concerns. You may be unsure what questions to ask or how to be supportive.

If you don’t know where to start, the following suggestions may help. But remember that being a compassionate listener is much more important than giving advice. You don’t have to try to “fix” the person; you just have to be a good listener. Often, the simple act of talking to someone face to face can be an enormous help to someone suffering from depression. Encourage the depressed person to talk about his or her feelings, and be willing to listen without judgment.

Don’t expect a single conversation to be the end of it. Depressed people tend to withdraw from others and isolate themselves. You may need to express your concern and willingness to listen over and over again. Be gentle, yet persistent.

Ways to start the conversation:

• I have been feeling concerned about you lately.
• Recently, I have noticed some differences in you and wondered how you are doing.
• I wanted to check in with you because you have seemed pretty down lately.

Questions you can ask:

• When did you begin feeling like this?
• Did something happen that made you start feeling this way?
• How can I best support you right now?
• Have you thought about getting help?

Remember, being supportive involves offering encouragement and hope. Very often, this is a matter of talking to the person in language that he or she will understand and respond to while in a depressed mind frame.

Taking care of yourself while helping a depressed person

There’s a natural impulse to want to fix the problems of people we love, but you can’t control a loved one’s depression. You can, however, control how well you take care of yourself. It’s just as important for you to stay healthy as it is for the depressed person to get treatment, so make your own well-being a priority.

Remember the advice of airline flight attendants: put on your own oxygen mask before you assist anyone else. In other words, make sure your own health and happiness are solid before you try to help someone who is depressed. You won’t do your friend or family member any good if you collapse under the pressure of trying to help. When your own needs are taken care of, you’ll have the energy you need to lend a helping hand.

Tips for taking care of yourself

Think of this challenging time like a marathon; you need extra sustenance to keep yourself going. The following ideas will help you keep your strength up as you support your loved one through depression treatment and recovery.

• Speak up for yourself. You may be hesitant to speak out when the depressed person in your life upsets you or lets you down. However, honest communication will actually help the relationship in the long run. If you’re suffering in silence and letting resentment build, your loved one will pick up on these negative emotions and feel even worse. Gently talk about how you’re feeling before pent-up emotions make it too hard to communicate with sensitivity.
• Set boundaries. Of course you want to help, but you can only do so much. Your own health will suffer if you let your life be controlled by your loved one’s depression. You can’t be a caretaker round the clock without paying a psychological price. To avoid burnout and resentment, set clear limits on what you are willing and able to do. You are not your loved one’s therapist, so don’t take on that responsibility.
• Stay on track with your own life. While some changes in your daily routine may be unavoidable while caring for your friend or relative, do your best to keep appointments and plans with friends. If your depressed loved one is unable to go on an outing or trip you had planned, ask a friend to join you instead.
• Seek support. You are NOT betraying your depressed relative or friend by turning to others for support. Joining a support group, talking to a counselor or clergyman, or confiding in a trusted friend will help you get through this tough time. You don’t need to go into detail about your loved one’s depression or betray confidences; instead focus on your emotions and what you are feeling. Make sure you can be totally honest with the person you turn to—no judging your emotions!

Encouraging a depressed person to get help

While you can’t control someone else’s recovery from depression, you can start by encouraging the depressed person to seek help. Getting a depressed person into treatment can be difficult. Depression saps energy and motivation, so even the act of making an appointment or finding a doctor can seem daunting. Depression also involves negative ways of thinking. The depressed person may believe that the situation is hopeless and treatment pointless.

Because of these obstacles, getting your loved one to admit to the problem—and helping him or her see that it can be solved—is an essential step in depression recovery.

If your friend or family member resists getting help for depression:

• Suggest a general check-up with a physician. Your loved one may be less anxious about seeing a family doctor than a mental health professional. A regular doctor’s visit is actually a great option, since the doctor can rule out medical causes of depression. If the doctor diagnoses depression, he or she can refer your loved one to a psychiatrist or psychologist. Sometimes, this “professional” opinion makes all the difference.
• Offer to help your depressed loved one find a doctor or therapist and go with them on the first visit. Finding the right treatment provider can be difficult, and is often a trial-and-error process. For a depressed person already low on energy, it is a huge help to have assistance making calls and looking into the options.
• Encourage the person to make a thorough list of symptoms and ailments to discuss with the doctor. You can even bring up things that you have noticed as an outside observer, such as, “You seem to feel much worse in the mornings,” or “You always get stomach pains before work.”

Supporting your loved one’s depression treatment

One of the most important things you can do to help a friend or relative with depression is to give your unconditional love and support throughout the treatment process. This involves being compassionate and patient, which is not always easy when dealing with the negativity, hostility, and moodiness that go hand in hand with depression.

• Provide whatever assistance the person needs (and is willing to accept). Help your loved one make and keep appointments, research treatment options, and stay on schedule with any treatment prescribed.
• Have realistic expectations. It can be frustrating to watch a depressed friend or family member struggle, especially if progress is slow or stalled. Having patience is important. Even with optimal treatment, recovery from depression doesn’t happen overnight.
• Lead by example. Encourage your friend or family member to lead a healthier, mood-boosting lifestyle by doing it yourself: maintain a positive outlook, eat better, avoid alcohol and drugs, exercise, and lean on others for support.
• Encourage activity. Invite your loved one to join you in uplifting activities, like going to a funny movie or having dinner at a favorite restaurant. Exercise is especially helpful, so try to get your depressed loved one moving. Going on walks together is one of the easiest options. Be gently and lovingly persistent—don’t get discouraged or stop asking.
• Pitch in when possible. Seemingly small tasks can be hard for a depressed person to manage. Offer to help out with household responsibilities or chores, but only do what you can without getting burned out yourself!

The risk of suicide is real

It may be hard to believe that the person you know and love would ever consider something as drastic as suicide, but a depressed person may not see any other way out. Depression clouds judgment and distorts thinking, causing a normally rational person to believe that death is the only way to end the pain he or she is feeling.

When someone is depressed, suicide is a very real danger. It’s important to know the warning signs:

• Talking about suicide, dying, or harming oneself
• Preoccupation with death
• Expressing feelings of hopelessness or self-hate
• Acting in dangerous or self-destructive ways
• Getting affairs in order and saying goodbye
• Seeking out pills, weapons, or other lethal objects
• Sudden sense of calm after a depression

If you think a friend or family member might be considering suicide, talk to him or her about your concerns as soon as possible. Many people feel uncomfortable bringing up the topic but it is one of the best things you can do for someone who is thinking about suicide. Talking openly about suicidal thoughts and feelings can save a person’s life, so speak up if you’re concerned and seek professional help immediately!

The road to depression recovery begins with a single step

It’s the Catch-22 of depression: recovering from depression requires action, but taking action when you’re depressed is hard. In fact, just thinking about the things you should do to feel better, like going for a walk or spending time with friends, can feel overwhelming. That’s why it’s important to start small and slowly build from there.

Start small and stay focused

Draw upon whatever resources you have. You may not have much energy, but you probably have enough to take a short walk around the block or pick up the phone to call a loved one.

Be patient with yourself and celebrate each accomplishment. The steps may seem small, but they’ll quickly add up. If you continue to take positive steps day by day, you’ll soon find yourself feeling better.

Depression self-help tip 1: Stay connected

When you’re depressed, the tendency is to withdraw and isolate. Even reaching out to close family members and friends can be tough. Compound that with the feelings of shame and the guilt you may feel at neglecting your relationships.

But social support is absolutely essential to depression recovery. Staying connected to other people and the outside world will make a world of difference in your mood and outlook. And if you don’t feel that you have anyone to turn to, it’s never too late to build new friendships and improve your support network.

• Reaching out is not a sign of weakness and it won’t mean you’re a burden to others. The truth is that most people are flattered if you trust them enough to confide in them. Your loved ones care about you and want to help.
• Look for support from people who make you feel safe and cared for. The person you talk to doesn’t have to be able to fix you; he or she just needs to be a good listener—someone who’ll listen attentively and compassionately without being distracted or judging you.
• Make face-time a priority. Phone calls, social media, and texting are great ways to stay in touch, but they don’t replace good old-fashioned in-person quality time.  The simple act of talking to someone face to face about how you feel can play a big role in lifting the fog of depression and keeping it away.
• Try to keep up with social activities even if you don’t feel like it. Often when you’re depressed, it feels more comfortable to retreat into your shell, but being around other people will make you feel less depressed.
• Find ways to support others. It’s nice to receive support, but research shows you get an even bigger mood boost from providing support yourself. So find ways—both big and small—to help others:volunteer, be a listening ear for a friend, do something nice for somebody.
• Care for a pet. While nothing can replace the human connection, pets can bring joy and companionship into your life and help you feel less isolated. Caring for a pet can also get you outside of yourself and give you a sense of being needed—both powerful antidotes to depression.

Depression self-help tip 2: Get moving

When you’re depressed, just getting out of bed can seem like a daunting task, let alone working out! Butexercise is a powerful depression fighter—and one of the most important tools in your recovery arsenal. Research shows that regular exercise can be as effective as medication for relieving depression symptoms. It also helps prevent relapse once you’re well.

To get the most benefit, aim for at least 30 minutes of exercise per day. This doesn’t have to be all at once—and it’s okay to start small. A 10-minute walk can improve your mood for two hours.

Exercise is something you can do right now to boost your mood

• Your fatigue will improve if you stick with it. Starting to exercise can be difficult when you’re depressed and exhausted. But research shows that your energy levels will improve if you keep with it. You will be less fatigued, not more, once it’s part of your routine.
• Find exercises that are continuous and rhythmic. The most benefits for depression come from rhythmic exercise—such as walking, weight training, swimming, martial arts, or dancing—where you move both your arms and legs.
• Add a mindfulness element, especially if your depression is rooted in unresolved trauma or fed by obsessive, negative thoughts. Focus on how your body feels as you move—such as the sensation of your feet hitting the ground, or the feeling of the wind on your skin, or the rhythm of your breathing.

Depression self-help tip 3: Do things that make you feel good

In order to overcome depression, you have to do things that relax and energize you. This includes following a healthy lifestyle, learning how to better manage stress, setting limits on what you’re able to do, and scheduling fun activities into your day.

Do things you enjoy (or used to)

While you can’t force yourself to have fun or experience pleasure, you can push yourself to do things, even when you don’t feel like it. You might be surprised at how much better you feel once you’re out in the world. Even if your depression doesn’t lift immediately, you’ll gradually feel more upbeat and energetic as you make time for fun activities.

• Pick up a former hobby or a sport you used to like.
• Express yourself creatively through music, art, or writing.
• Go out with friends.
• Take a day trip to a museum, the mountains, or the ballpark.

Support your health

• Aim for eight hours of sleep. Depression typically involves sleep problems; whether you’re sleeping too little or too much, your mood suffers. Get on a better sleep schedule by learning healthy sleep habits.
• Expose yourself to a little sunlight every day. Lack of sunlight can make depression worse. Take a short walk outdoors, have your coffee outside, enjoy an al fresco meal, people-watch on a park bench, or sit out in the garden. Aim for at least 15 minutes of sunlight a day to boost your mood. If you live somewhere with little winter sunshine, try using a light therapy box.
• Practice relaxation techniques. A daily relaxation practice can help relieve symptoms of depression, reduce stress, and boost feelings of joy and well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.

Depression self-help tip 4: Eat a healthy, mood-boosting diet

What you eat has a direct impact on the way you feel. Reduce your intake of foods that can adversely affect your brain and mood, such as caffeine, alcohol, trans fats, and foods with high levels of chemical preservatives or hormones (such as certain meats).

• Don’t skip meals. Going too long between meals can make you feel irritable and tired, so aim to eat something at least every three to four hours.
• Minimize sugar and refined carbs. You may crave sugary snacks, baked goods, or comfort foods such as pasta or French fries, but these “feel-good” foods quickly lead to a crash in mood and energy. Aim to cut out as much of these foods as possible.
• Boost your B vitamins. Deficiencies in B vitamins such as folic acid and B-12 can trigger depression. To get more, take a B-complex vitamin supplement or eat more citrus fruit, leafy greens, beans, chicken, and eggs.

Depression self-help tip 5: Challenge negative thinking

Do you feel like you’re powerless or weak? That bad things happen and there’s not much you can do about it? That your situation is hopeless? Depression puts a negative spin on everything, including the way you see yourself and your expectations for the future.

When these types of thoughts overwhelm you, it’s important to remind yourself that this is the depression talking. These irrational, pessimistic attitudes—known as cognitive distortions—aren’t realistic. When you really examine them they don’t hold up. But even so, they can be tough to give up. Just telling yourself to “think positive” won’t cut it. Often, they’re part of a lifelong pattern of thinking that’s become so automatic you’re not even completely aware of it.

Put your thoughts on the witness stand

Once you identify the destructive thoughts patterns that you default to, you can start to challenge them with questions such as:

• “What’s the evidence that this thought is true? Not true?”
• “What would I tell a friend who had this thought?”
• “Is there another way of looking at the situation or an alternate explanation?”
• “How might I look at this situation if I didn’t have depression?”

As you cross-examine your negative thoughts, you may be surprised at how quickly they crumble. In the process, you’ll develop a more balanced perspective.

When to get professional help

If you’ve taken self-help steps and made positive lifestyle changes and still find your depression getting worse, seek professional help. Needing additional help doesn’t mean you’re weak. Sometimes the negative thinking in depression can make you feel like you’re a lost cause, but depression can be treated and you can feel better!

Don’t forget about these self-help tips, though. Even if you’re receiving professional help, these tips can be part of your treatment plan, speeding your recovery and preventing depression from returning.

Depression self-help checklist

Use this checklist to track your progress using these self-help tips to deal with depression. Feeling better can take time, but try comparing how you feel on days when you make lots of ticks on the checklist to those when you make few or none.