The pandemic has taken a toll on many of us, especially when it comes to our mental health. Four in 10 adults in the U.S. have reported symptoms of depression during the pandemic, an uptick from one in 10 adults before COVID-19, according to data collected by the U.S. Census Bureau and the National Center for Health Statistics.
Given the statistics, chances are you know someone who’s affected, and maybe you’ve been affected, too. Even as states drop mask mandates and vaccination rates increase, people with depression still face mental health challenges and will likely continue to do so post-pandemic. On the plus side, since we’re all online more, there are more ways for us to help one another: “Everybody, but particularly people with social anxiety — and there’s a high correlation between depression and anxiety — they are now in the habit of being online,” says Dr. Carol Landau, a clinical professor of psychiatry and human behavior at Brown University who wrote a book on how to prevent depression and anxiety in college-bound teens.
Given our even more frequent online behavior these days, there are more chances to connect with — and help — depressed loved ones through a screen. While you can’t treat your loved one’s depression (and you’re likely not qualified to do so anyway), Mashable spoke with experts who specialize in depression to find out how you can help support your loved one with depression from afar.
Know the definition and recognize the signs
According to the American Psychiatric Association, depression, or major depressive disorder, is “a common and serious medical illness that negatively affects how you feel, the way you think, and how you act.” There are a multitude of symptoms, and not everyone experiences them all.
Depression can make people withdraw from social situations, have a hard time going about their daily activities, or be reluctant to socialize altogether (or in pandemic times, be reluctant to make or follow through with virtual hangout plans). Symptoms can include feelings of sadness, hopelessness, lack of energy, trouble concentrating, and suicidal thoughts, according to the Mayo Clinic. A diagnosis is based on a person continuously (or almost continuously) experiencing five or more symptoms of depression, such as lethargy, feeling worthless, trouble sleeping or oversleeping, for at least two weeks.
It’s important to note that while people can experience sadness or grief from events like the death of a loved one or losing a job, sadness and grief aren’t the same as depression. However, virtual support can help a loved one in these situations, too.
It can be a challenge to recognize depression in a loved one when you’re not seeing them in person regularly. “I do think there are limitations on what you can see virtually,” says Landau, who says the primary symptom of depression in adults is sadness, but in teens, it can be irritability. But there are things you can do, she adds: “In addition to your friend’s self-report, you can notice or inquire about positive changes in self-care, sleep, eating, and other symptoms of depression. You can notice whether your friend is less physically anxious or agitated or lethargic and slowed down.”
Seek mental health resources together
When it comes to depression, sometimes the hardest step is the initial one. For some people, that may mean researching therapists or outpatient programs to treat depression.
Your friend might want to find professional help but their drive to do so might be missing because depression can zap people’s energy, says Natalie Dattilo, director of psychology at Brigham and Women’s Hospital. If your friend asks you to help or they’re open to the idea, hop on the phone or FaceTime and google mental health resources together.
“As a friend, a partner, or a loved one, you could maybe make that first step with them… that they might be reluctant to do,” says Dattilo. You can also offer to take this first step by yourself if they don’t feel up to it, but make sure they agree, and never go behind someone’s back and do it, because it can feel like a breach of trust, says Landau.
Dattilo has looked up resources for her patients when they want to explore extra help beyond what Dattilo provides. But if a loved one doesn’t want your assistance or is resistant to seeking professional help, don’t push it.
Reluctance is common, says Landau, because seeking psychological help is still seen as shameful or weak.
“A person has every right to not pursue mental health treatment if they don’t want to or don’t feel ready to. Sometimes giving our loved one the time and space they need can be the most helpful and loving thing to do,” says Dattilo.
Landau recommends the website Psychology Today as a resource for searching for qualified therapists. It also has search options for psychiatrists, treatment centers, and support groups. You also might want offer to help look through your friend’s provider network to make sure the therapist is covered by their insurance.
Send care packages and virtual reminders of your love
Care packages can be an effective way to remind your loved ones you’re thinking of them and that they’re important to you.
Even if your primary mode of communication is texts or video calls, you can send letters, self-care kits, baked treats, photos of good times you’ve shared, or funny objects or cards that align with the person’s sense of humor. If your friend is open to it, you can also talk about what you sent during phone calls or texts — it’s a conversation starter, and it might help them feel good.
You can also show your love virtually. Send e-cards, create a playlist of your favorite songs, compile a slideshow of mutual fun memories, watch a movie together online from afar, or make some popcorn and video chat together, suggests Dattilo.
These actions can all help remind your loved one they matter, especially when their depression sends them messages like “I’m worthless.”
“[A care package] is a way to connect and offer support from a distance, which may be more tolerable and more easily accepted than the pressure to socialize in person (or virtual),” says Dattilo.
Hang out with mutual friends
Socialization can drain someone with depression, but it can also uplift them.
If your friend is up for it, try to get them to attend a virtual hangout with you and mutual friends or family members, if that applies. The video chat app Houseparty, for instance, offers fun games, like trivia and Heads Up, or you could go with a standard Zoom or FaceTime.
Don’t make these sessions about your friend’s depression or even say that’s why you’re getting together, recommends Dattilo, who adds that if you wouldn’t rally a bunch of friends together for a Zoom call for the sole purpose of supporting a mutual friend with diabetes, then treat a depressed friend the same.
“It could have the potential to alienate the person or draw more attention to [their depression] than they would want,” she says. Instead, hang out because it’s fun, and because you care about your friend.
Take care of yourself, too
You might have heard of the saying “you can’t pour from an empty cup.” If you’re giving your all to your loved one with depression, you can’t take care of them or yourself.
But there are some tools to help you do both. Leverage technology like meditation, which can improve mental health, or exercise apps (physical activity can act as a buffer against depression) and invite your friend to join you. You can say something as simple as “I’m going to do this, do you want to try it with me?”
Dattilo recommends apps like the mood tracker Moody; the therapy, coaching, and self-care app Sanvello; and the meditation apps Insight Timer, Calm, and Headspace. She recommends these apps to her patients who struggle with depression. While apps are not a substitute for formal mental health resources, they can supplement any professional help your friend receives.
Don’t take it personally if your friend doesn’t want to join — they might not have the energy to do so — or if they sound miffed, as irritability is a symptom of depression, says Landau.
If you’ve contacted your friend a few times, and you’re not worried about them harming themselves, you could text them “Are you OK?”
“A lot of times a person can write back, ‘Yes, but I don’t feel like talking,'” says Landau. If you’re worried about your friend hurting themselves, there are resources you can connect with listed below.
“You take care of you… managing your own frustrations, your own disappointments, and your own anxieties about how they’re doing,” says Dattilo. “But at the end of the day, you can demonstrate and model what you’d like to see them do as well.” This can include utilizing a meditation app and seeing a therapist yourself.
Stay alert for warning signs
Your loved one may be coping healthily with their depression, such as talking regularly with a mental health professional or mentioning events or activities they’re looking forward to. But it’s important to be aware of red flags that could signal their depression has worsened or that they’re thinking of attempting suicide.
Some of these warning signs could include an increase in alcohol or drug use (that may or may not be out of character), self-harming, conversations that express the desire to die, giving away their possessions, or saying things like, “Thank you, you’ve been a really good friend.”
It can be harder to see these signs virtually. Dattilo suggests if your loved one is late for a scheduled phone call or misses it altogether, that could be a red flag. If they’re intoxicated during your call, are hung over a lot, or tell you they’re drinking more, that might raise your alarm bells. If you’re concerned, you can gently ask, “You don’t seem to be feeling great. Are you OK?” says Dattilo.
You could offer to call a crisis or text hotline together. If you’re concerned about their safety, ask if they think they need to go to the hospital. If they have a close friend or family member in the area, offer to call them so they can accompany your loved one to the hospital.
There are some times you might need to go ahead and connect your loved one with emergency resources, even if they say they don’t want help. If you’re concerned because they have a weapon in the home and say things like,”I just don’t want to be here anymore” or “people will be better off without me” or “it’ll never get any better, what’s the point of living?” or they have a history of attempting suicide or harming themselves, it is worth having a family member or loved one check in, says Dattilo. Calling 911 is an option as well.
Depression is a disorder of disconnection and it makes people forget there are people who love and care about them, says Landau. Your virtual support can help remind them that’s not true, and that you’re there for them if things take a turn for the worse.
If you want to talk to someone or are experiencing suicidal thoughts, Crisis Text Line provides free, confidential support 24/7. Text CRISIS to 741741 to be connected to a crisis counselor. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 8:00 p.m. ET, or email info@nami.org. You can also call the National Suicide Prevention Lifeline at 1-800-273-8255. Here is a list of international resources.