How to Help Someone With Depression

If your spouse, friend or coworker is behaving differently, you can help

Nicole Golston

Reviewed by

Dilip V. Jeste, M.D.

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En español

Published January 17, 2024

A woman comforting a distressed man with her hand on his shoulder

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Something isn’t right. Maybe your loved one is withdrawn, or has lost their sense of humor, or increasingly passes on activities that used to excite them. Or a standout colleague at work is falling behind on projects and doesn’t participate like they used to. Perhaps a good friend isn’t sleeping well, is eating less and talking more about death and dying. If you suspect depression is the culprit, you may be right.

Up to one in five U.S. adults have at some point been diagnosed with depression by a health care provider, according to a 2020 report from the Centers for Disease Control and Prevention. Major depression is diagnosed less often in older adults. The diagnosis point is key: Depression isn’t simply a prolonged period of the blues. It’s a real medical condition — a diagnosable mood disorder, often with biological underpinnings. And like other serious health conditions, it is both distressful and interferes with day-to-day functioning.

But unlike many other health conditions, the illness often goes undiagnosed or untreated, especially in older adults. Which is why it is so important for loved ones, colleagues and friends to speak up when they see potential signs of it. But how do you go about intervening in a way that’s respectful and appropriate? Here is what doctors say.

Step 1: See the signs

The first step in being able to help is knowing the signs of depression. A radical shift in behavior can be a warning, says neurologist Nida Usmani, M.D., of Kaiser Permanente in Tucker, Georgia.

“The common thing I look at is a lack of interest in things that they like,” Usmani says. “For example, if someone likes gardening or if someone enjoys talking to people, then suddenly they just shut off and don’t want to do what they were doing,” she says. A sudden, radical change isn’t necessary, though. For some people, depression comes on gradually, then sticks around.

Other signs may include a persistent sadness, feelings of worthlessness and hopelessness, lack of energy, irritability, frustration, loss of appetite and even physical aches. Some men may come across as more angry than sad. Some people have thoughts of suicide or self-harm. If you notice these signs or if a friend or loved one tells you they’re feeling this way, there are ways you can help.

Step 2: Share your concerns

If the signs are there, try having a chat. Tackling that conversation can range from a straightforward, loving talk to one that requires strategy and finesse. Managing the conversation depends on how receptive the person with depression is to hearing and then acting on your concern and their condition, says Clevevoya D. Gaston, a licensed professional counselor in Atlanta.

You might start with something like: “Hey, I am concerned about you. I notice [some changes] and I love you. I am here for you. I want to assist you in feeling better, so let’s talk about some ways or some resources that are available to help you,” Gaston says.

If you’re met with resistance or assurances that everything is fine, try changing tactics. Seeking help from a friend or family member who may get a better reception because of their closeness to the person with depression could help.

Still roadblocked? Try an activity your loved one used to enjoy as a way to reengage with them. “If you know they like going to a museum, take them,” Gaston says. “Then, after the museum when they are feeling their best, you can say, ‘How did you feel about going to the museum? I wonder how you could do more of this … the things you like.’”

Step 3: Find ways to interrupt the negative thoughts

People with depression tend to see the glass as always empty. And dwelling in negative thoughts can make depression worse. You’ll need to remain encouraging rather than critical, says psychiatrist Karl Benzio, M.D., cofounder and medical director of Honey Lake Clinic, a Christian mental health treatment center in Greenville, Florida. The person with depression is usually aware that something is wrong and that they are not functioning well.

“Try not to be judgmental or critical, because they are already critiquing themselves, calling themselves inadequate or a failure. Negative, self-condemning, self-critical thoughts are pretty common for people who are struggling,” Benzio says. “Try to stay away from comments [such as], ‘you’re lazy, you’re broken, you’re worthless.’ Also, be careful not to see the way they are now as their long-term potential.”

Urging your loved one to open up about their feelings can interrupt their negative self-talk, Usmani adds. If the person with depression says, “I hate this,” you can respond with questions: “‘What makes you say that?’ Or ‘What are your thoughts about this?’” Keep the questions open-ended rather than asking the kind that yield conversation-ending yes or no answers.

However, if you notice the severity of symptoms is worsening and your loved one is in crisis, get help immediately.

"If a person is going to hurt themselves or somebody else, then there is no decision to make. You just need to get that person in the car and bring them [to a hospital], Usmani says. "This is a crisis. That person is not thinking normally."

Step 4: Help them find help

For those not in an active crisis, therapy is a great place to start. You can take steps to help your loved one find a therapist to talk to.

If your loved one is employed, consider urging them to take advantage of their organization’s employee assistance program, or EAP, which can connect staff with therapists. Most large and medium-size companies have EAPs, as do many small firms. Yet fewer than 10 percent of employees use them each year, often because they don’t know they exist or worry about stigma.

At Emory University’s EAP, counselors regularly hear from employees concerned about a family member with depression or from family members seeking help for an employee, says Gaston, who is outreach coordinator and family liaison officer at the university’s Faculty Staff Assistance Program.

Suicide Prevention

If someone you know is considering suicide, call, text or chat 988, the Suicide & Crisis Lifeline, to reach a trained counselor 24/7. Counselors listen, provide support and share local resources. Veterans who dial 988 can press 1 to reach a responder trained in crisis intervention and military culture.

Be ready for the counselor to ask about symptoms, the person’s motivation to get help and their safety risk, she says.

Emory University’s EAP, for example, offers eight sessions of talk therapy at no cost. It also offers referrals to community psychologists, psychiatrists and licensed therapists for longer term counseling. Importantly, EAP services are confidential, even for family members making the call. “That is privileged communication between whoever is calling and FSAP,” Gaston says.

Step 5: Offer to be the doctor’s at-home eyes and ears

As your loved one begins work with a professional, it’s vital to stay alert and share any insights on their condition with the provider.

“Often, the patient isn’t a very good historian or leaves a lot of stuff out, or doesn’t think something is important,” Benzio, says. That’s when going along to appointments and sharing any observations with the provider is invaluable.

“Allow the patient and professional to have their private time to talk,” Benzio says. “But at the beginning or end of the session, say ‘I’d like to share some things I am not sure my spouse was open enough about or recognized was important.’”

He offers an example of a patient who “used to play basketball with the grandkids when they came over on the weekends and now he just sits in a chair and watches.” The patient might not notice the subtle changes in their life, but the spouse does and can convey to the doctor how much this person has changed.

“If you are in a situation that your spouse or loved one is struggling with depression,” Benzio says, “these interventions … will not only help them feel better but also significantly prevent the decline or the spiral that this depression cycle can lead to.”

7 extra ways you can show support*

The good news is that many people will overcome a depressive episode with treatment, although the process can take time, Benzio says. “It took a while to get this way, so it is going to take a little while to dig out. But it is very possible to dig out.”

He offers several steps you can take to help your loved one with depression.

1. Be positive and engaging. Remind your loved one of their past accomplishments or of the assets they possess. Recount what they have, for example, “we have three great kids, we have five great grandchildren, we have a house, we have stable finances,” he says. Whatever those realistic things are may help remind them of their gifts.

2. Create a team environment. Similar to animals in the wild, people are safer as part of a pack than if wandering alone. The worst thing for a person suffering depression is to be left alone with their thoughts, Benzio says. “You want to remind him that ‘Hey, you are part of a group. You belong. You’re connected.’”

3. Encourage proper sleep, nutrition and exercise. Getting a good 7 to 8 hours of sleep every night is so important. When the brain gets rest, it can operate at full capacity. Eating the right foods also helps the body. “Exercise is a great, natural antidepressant and it releases endorphins, those natural opioids that allow us to feel better about ourselves,” Benzio says.

4. Promote physical touch. Whether you are sitting on the couch together or taking a walk, try holding hands. The goal is connecting. Sexual activity with a partner, which releases endorphins and oxytocin, can also further a sense of not being alone.

5. Create a daily structure. To counteract the listlessness that sometimes comes with depression, ensure that each day has value and purpose. Encourage the person with depression to get out of bed at the same time every day, and get dressed — not just staying in pajamas. They should bathe every day or every other day and cook favorite healthy meals. Such actions go a long way in ensuring self-care.

6. Encourage your loved one to help others. People get a huge lift when they are purposeful, says Kaiser Permanente’s Usmani. She shared a story of one patient who couldn’t drive because of seizures and had a family that wasn’t particularly supportive. When the patient reached out to her 85-year-old neighbor who needed someone to help walk her dog, she took on the task. Her depression soon resolved without medication.

7. Take care of you, too. Don’t neglect your own self-care. The healing journey takes time and it’s important not to neglect your own health. Put your proverbial mask on first, Benzio says, so that you can continue to help others. All that good advice about nutrition, sleep and exercise — it applies to you, too.

*Depressive episodes may not always be treatable by lifestyle changes. If your loved one's condition does not improve or worsens after trying these methods, encourage them to seek medical help.

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Nicole Golston is a freelance writer living in Tucker, Ga. She covers a range of topics including autism, mental health and business.

Dilip Jeste, M.D., is a geriatric neuro-psychiatrist who conducts clinical research on mental health and mental illnesses in older adults. He has published papers and books on various topics including depression in late life. He is a past president of the American Psychiatric Association and the American Association for Geriatric Psychiatry, and President-Elect of the World Federation for Psychotherapy.