Being there without fixing anything: how to support someone with depression

First things first: if you, or the person you are supporting, are having thoughts of suicide, call 024 in Spain. It is free, confidential and open 24 hours a day, and it also helps family and friends. If there is immediate danger, call 112. Outside Spain there are local lines, such as 988 in the United States or Samaritans (116 123) in the UK; anywhere else, call your local emergency number. This text is general information and does not replace a professional.

In this series I have written a lot about what it feels like from the inside. At 41 I was diagnosed with major depression, among other things, and a good psychologist is helping me keep going. I told that story in Diagnosed at 41 and in Thanks to my psychologist.

Today I want to look at the other side of the table. At the mother who does not know what to say. At the friend who sends a message and gets no reply. At the partner who wonders if they are doing something wrong. This one is for the people who stay close.

First: understand what it is

Depression is not feeling sad for a few days. According to the World Health Organization, it means a low mood or a loss of interest in almost everything for most of the day, nearly every day, for at least two weeks. It often comes with tiredness, sleep problems, changes in appetite, trouble concentrating, excessive guilt and hopelessness.

The WHO estimates that it affects more than 5% of adults. It is not rare. You probably know someone who has it, even if you do not know it.

There is another point in that same fact sheet worth keeping in mind: effective treatments exist, both psychological and medical. Depression can be treated. That does not make it easy, but it does change the horizon.

Understanding this helps the person supporting for a very practical reason. Once you know it is a health problem, you stop reading certain things as indifference, laziness or contempt. The person who does not pick up the phone is not punishing you. They have run out of strength.

What actually helps

There is no recipe. Everyone needs different things, which is why asking is usually the most useful move. Still, mental health organisations such as Mind and the Mental Health Foundation agree on several points:

• Listen without rushing to fix things. You do not need answers. Often what brings relief is someone sitting nearby who does not change the subject.
• Ask what they need. "What would help right now?" is more useful than deciding for them.
• Keep in touch without demanding a reply. A short message saying "thinking of you, no need to answer" takes the pressure off.
• Offer concrete help. Do the shopping, cook something to freeze, put a wash on. Small tasks turn into mountains when there is no energy.
• Keep doing things together. A short walk, a series on the sofa. Do not let depression take over the whole relationship.
• Gently remind them that things can change. Without promising deadlines, but without letting hopelessness have the last word.

One of my songs, «Entre cuatro paredes», captures what it looks like from the inside: «No me apetece salir de la habitación» ("I don't feel like leaving the room"). The person supporting often lives that line from the other side of the door. The temptation is to push it open. Often it helps more to knock, say "I'm here" and wait.

Phrases that don't help (even when said with love)

Almost nobody says these things with bad intentions. They come out of nerves, helplessness, or because it is what we have heard all our lives. But they tend to make the other person shut down. Guides such as HelpGuide and Mind list very similar examples:

• "Cheer up" or "think positive." If it were a choice, nobody would choose depression.
• "Other people have it much worse." Comparing pain does not reduce it. It only adds guilt.
• "It's all in your head." That is exactly what the person fears others think of them.
• "You have to make an effort" or "try harder." It sounds like a reproach, and lack of strength is part of the problem.
• "You should be better by now." Recovery takes its own time, and it is not a straight line.
• "Well, you don't look depressed." Many people with depression function on the outside while sinking on the inside.

And here are a few that usually open the conversation:

• "I'm sorry you're going through this. I'm here."
• "I don't know exactly how you feel, but you matter to me."
• "Do you want to talk, or would you rather we just sit together for a while?"
• "Is there something specific I can take off your plate this week?"

They do not need to be perfect. The intention shows more than the wording.

Encouraging professional help

Supporting is not treating. However much you love someone, you cannot be their therapist, and it is not your job. What you can do is make the path easier.

In Spain, the first door is usually the family doctor, who can assess and refer to mental health services. The Mayo Clinic suggests very practical steps: offer to book the appointment, go along to the first visit, or help prepare a list of what they want to say. For someone with no energy, that list can make the difference between going and not going.

If they do not want to, you cannot force them. The advice is to be patient, not turn it into a fight, and leave the door open: "Whenever you're ready, I'll help you find someone."

If they are already in treatment, support still counts. Remembering an appointment, asking how it went without demanding details, understanding that finding the right medication or approach sometimes takes more than one try. The patient school of the regional health service of Castilla y León adds something important for families: follow the professionals' guidance and do not push outings or trips as if they were a cure.

Look after yourself too

This part gets skipped a lot, and it should not. Supporting someone with depression is tiring. Sometimes for months. And if you go under, you cannot hold anyone up.

The same organisations that give advice on helping insist on the same things:

• Your mental health matters too. Taking time for yourself is not abandoning anyone.
• Set limits. You cannot be available around the clock. Saying so calmly is healthy for both of you.
• Share the load. Ask other relatives or friends to get involved, and tell them exactly how.
• Find your own support. Talk to your doctor, a professional or someone you trust. You do not need to share the other person's private life; just talk about how you are doing.
• Keep your own life going. Your plans, your exercise, your friendships. Not as a luxury, but as fuel.
• Don't blame yourself if you can't do it all. You are not responsible for curing anyone.

If you notice you are persistently exhausted, irritable or low, that deserves attention too. Carers sometimes need caring for as well.

When to get urgent help

There are moments when support is no longer enough and you need to act straight away. Get urgent help if the person:

• Talks about wanting to die, not wanting to wake up, or being better off gone.
• Says they are a burden to others.
• Says goodbye in an unusual way or gives away things that mattered to them.
• Shows intense hopelessness, or a sudden calm after a very bad stretch.
• Has hurt themselves or says they might.

If you are worried, ask them directly whether they are thinking about suicide. Asking does not put the idea in anyone's head; it is often a relief when someone finally dares to name it. I go into this more calmly in Let's talk about suicide without taboo.

What to do in that moment:

• If the danger is immediate, call 112 (or your local emergency number) or go to A&E. Do not leave the person alone.
• If it is not immediate but you are worried, call 024 in Spain. According to the Spanish Ministry of Health, it helps people with suicidal thoughts and also their family and friends, and there is a chat option.
• Book an appointment with the family doctor as soon as possible.
• Do not promise to keep it secret if there is risk. You can promise that you will not leave them alone.

What music can't do, and what it can

I write about this from my own story, but I do not want to overstate what songs can do. A song does not replace a psychologist or a treatment. For me it has been company, not a cure.

Even so, a lyric can sometimes be a bridge. In «No me aparece una ilusión» there is a line that goes: «No encuentro la fuerza, la motivación» ("I can't find the strength, the motivation"). Some people cannot explain what they feel and, when they hear something like that, they say: "that's it." If someone you love plays you a sad song, maybe they are not asking you to cheer them up. Maybe they are showing you where they are.

To close

If you are supporting someone with depression, you do not have to do it perfectly. You need to be there, listen, offer concrete help, make it easier for them to reach a professional, and look after yourself so you can keep going.

Depression can be treated. Asking for help works, for the person supporting too. And if at any point there is risk, 024 and 112 are there for exactly that.

This text is part of Mental health without taboo, the series where I talk openly about what I live with and where to find support.