A reader writes: My friend is depressed and I don’t know what to say or do. Any suggestions?

Certainly.  We all may encounter someone struggling with depression who needs help and support. I remember when a woman in my Bible study asked for prayer for depression.  A silence fell over the group. Five minutes passed and no one spoke or responded.  She glanced at the floor.  All I did was offer a word of support and encouragement.  To my surprise, three other women talked about their depression as well.  Others informed the group they were on medication.  Everyone breathed a huge sigh of relief and we got down to some serious prayer. Be ready.  Today may be your day to help break through the pain of silence in a friend’s life. Here us what you can do to help:

1)  Acknowledge the depression.  Don’t avoid talking about it. You may feel uncomfortable and not know what to say, but say what you’ve noticed (sad mood, change in appetite, etc.) and ask if your friend is feeling OK. Provide empathy and encouragement. And don’t be afraid to ask if your friend is having suicidal thoughts or feeling suicidal. Asking about suicide does not make a person think more about it. Rather, asking about suicidal feelings is helpful and may even prevent suicide.

2)  Get them help.  Depression is a serious illness that can lead to suicide.  About 15% of people with severe depression who don’t receive treatment die by suicide.  Because of this, it is important to consult a mental health professional. Reassure your friend that help does not mean failure. And let your friend know we have many good treatments for depression.

3)   Talk to her about her spiritual life. There may be areas of your friend’s life that need healing: trauma, abuse, negative experiences, etc.  When those issues are addressed, people improve. Addressing areas of bitterness and unforgiveness can also be part of the work. So find someone whose approach is more holistic, dealing with spiritual issues as well as the mind and body.

4)   Support her if she wants to try an antidepressant.  It may be just what she needs to get past this dark and difficult time. There should be no stigma in using medication to help lift depression and get your friend functioning again.

5)   Encourage realistic expectations.  Healing is often progressive and takes time. This process may involve tackling a number of tough life issues. Change may be gradual.

6)   Provide unconditional love and support.  Let the her  know she doesn’t have to put on a happy face and that you are there to pray for her and love her. A good friend helps provides support and encouragement. Both are needed to move forward.

7)   Suggest a daily routine even though your friend won’t feel like doing much of anything.  It is helpful to get out of bed, get dressed and go about her day regardless of how she feels. We encourage depressed people to activate — meaning, act as if they are not depressed and engage in life no matter how they may feel in the moment. Engagement with others, routines and connection all help lift a person’s mood.

8)   Suggest exercise and positive activities.  The benefits are both physical and emotional. Exercise releases natural endorphins to boost mood and helps more than people think. Maybe you could be an exercise partner. Also, suggest positive activities like painting, cooking, playing cards, etc.

9)   Let her talk about her feelings. Most of us  benefit from talking with a friend.  Remind her that there are people who care for her and are concerned about how she is feeling. As a friend, you are happy to listen and pray with her.

10) Most of all,  let her know she can get better. Hope is important to remain resilient. Treatments have improved and there is help.