Maggie and Me (a philosophical dialogue): Helping our friends who are suffering from depression

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Maggie:  I want to talk about depression today.  Is that okay?

John:  Sure.  But is there a specific reason this topic has come up?

Maggie:  Are you asking if I am depressed?

John:  A little bit.  Just wondering if this is a personal topic or a topic relating to your friends?

Maggie:  It may be a little personal, especially because of the coronavirus.  But mostly I am worried about someone else.  She is going through a very difficult time right now and is really depressed. 

John:  What are you worried about?  Can you give me some specifics?

Maggie:  She is lonely, really lonely, right now.  She told me that she doesn’t have any friends and, even worse, the people she is forced to deal with every day are happy that she is struggling.

John:  Schadenfreude!

Maggie: Schaden-what?

John:  That’s Schadenfreude.  It’s a German word and it refers to the pleasure people take when misfortune happens to someone else, and it’s the worst kind of evil! 

Maggie:  I am going to need a little more explanation.

John:  Schadenfreude happens a lot in schools and workplaces where fellow-students and colleagues actually want others to struggle and fail.  And what is even sicker is that these people experience joy over their colleague’s misfortune because they actually think it makes them look better.  

Maggie:  That is exactly what my friend is dealing with. Exactly!  She gets beat up every day by the people around her.

John:  Physical abuse?  Or verbal?

Maggie:  Not physical, verbal.  A couple of the people she works with verbally beat on her. I have seen it.  They just keep taking shots at her.  Again and again and again.  But the others just sit back and watch, taking pleasure in the abuse. 

John:  Abusers are bad enough, but at least they are acting out in the open.  People with Schadenfreude are worse. They hide their abusiveness behind a mask of friendliness while taking joy in another’s pain.

How is your friend dealing with it?

Maggie:  She quoted a poem to me a few days ago. It went like this:

“You have taken from me my closest friends
and have made me repulsive to them. . . .
You have taken my companions and loved ones from me;
the darkness is my only friend.”

John:  Wow, that is a really sad poem.

Maggie:  It’s in the Christian scriptures, if you can believe that. 

She is so depressed it is hard to watch.  It’s like she has been beat upon so much that she struggles to get out of bed each day.  She told me today that she has sunk to the place where even one little positive connection, one little text saying something nice, can keep her going through the rest of the day, and she can’t even get that.

John: Depression can be challenging to overcome.

Maggie:  I read that it affects one in six Americans, but it is especially bad when it hits young adults. 

John:  Why do you say that?

Maggie:  Because depression is a leading cause of suicide among young people like me, and suicide is the second leading cause of death among us. 

And did you know that young women like me are twice as likely to be depressed? 

John:  I did know that and it makes me sad.  And bit worried.

Maggie:  Why worried?

John:  Because I worry about you, but also about all young people.  We are going through tough times in the world right now.  So I worry. 

Maggie:  What I want to know is how to help people who are depressed, like my friend. 

I never know what to say.  And I worry that I am going to say something to make the depression worse.  So I usually just avoid the topic, or even my friend. But I don’t want to do that any more.  I want to help.

John:  I love your compassion. 

This is an important topic.  So let me think about it for a few minutes before we start. 

Maggie: Okay.  I will wait over here.  (Waiting patiently…)

John:  All right, I am ready.  I think we should break this down into dos and don’ts to provide some organization to the discussion.  Does that work for you?

Maggie:  Let’s talk about the don’ts first, okay? Then the dos?

John:  Sure. 

The Don’ts

The FIRST DON’T is don’t avoid a depressed person. 

Depression is often coupled with and compounded by extreme loneliness, just like with your friend.  And being with a depressed person can help her or him. 

Maggie:  Do you mean like hanging out?

John:  Presencing can take many forms.  Being physically present is the best option, obviously.  But you can call, text, or chat online.  You are only limited by your imagination.  Remember what your friend said, “Even a single text could brighten her day.”

Maggie:  Presencing?  Is that a word?

John:  It is now!

Maggie:  You are so funny, making up words.  But I agree with you.   Like I said earlier, I sometimes avoid my friend because I am afraid of making matters worse, but I shouldn’t do that.

John:  There is not a single study or a single piece of credible evidence to suggest that we can make matters worse by being present with a lonely or depressed person.  Not one!

Maggie:  I get that.  But sometimes I don’t know what to say when I am around her.  I worry about saying the wrong thing.

John:  That brings us to our SECOND DON’T: don’t worry about what you should or shouldn’t say. 

I have never read a study that suggests that talking to people about their loneliness or depression makes it worse.  Not one.  In fact, discussing these topics actually helps.  This is true even with suicide.  So just talk about things like you normally would.

Maggie:  Is it okay to actually bring these topics up first?

John:  Sure.  If your friend doesn’t want to talk about them, she will tell you.  But maybe she does, and doing so could really help her. You won’t know unless you have the courage to raise the issues. 

Maggie:  Is there anything I shouldn’t say?

John:  Yes, which brings us to our THIRD DON’T: don’t give advice.

Many people love to give advice, especially about how to fix mental health issues.  “Meditation helps depression.”  “Give up coffee and drink tea.”  “Just decide to be happy.”  “Pull yourself up by your own bootstraps.”  “Pray more.”  And here is my favorite: “Read these inspirational quotes.  They help me.”      

When you give advice like this you are telling the depressed person that she can cure herself with one or two easy fixes.  But for most people, this is not true. 

Maggie:  What if I know about something that can help?

John:  You may think you know something that can help, but you don’t.  You are not a trained psychologist, so you don’t know what her issues are.  You don’t know if the depression is chemically based or caused by trauma in her life. You don’t know a lot of things. So don’t give advice; just be a good friend.

Maggie:  I never thought about it that way.  I suppose that when I give advice I am really saying to her that I am somehow better than her, smarter than her, healthier than her.  That  has to hurt.

John:  You are so smart.  I appreciate you.

Maggie:  What is our fourth don’t?

John:  Our FOURTH DON’T is don’t pretend that depression or loneliness is something that is easily fixed, because it’s not.

Depression can be the result of chemical imbalances, previous trauma, or other diseases of the body.  It is not easily or quickly fixed and we shouldn’t think it can be.

Maggie:  No one would suggest quick fixes for a serious bodily injury, so we shouldn’t do that for mental health issues either, right?

John:  Yes, exactly.  Which brings us to our FIFTH DON’T: don’t diagnose depression.  We are not doctors, so we shouldn’t pretend to be.  Someone may actually be depressed or they may be experiencing a period of extreme sadness or they may be drinking too much, we don’t have the expertise to know which is which.  So we shouldn’t pretend that we do.

Maggie:  But what can we do?  What do I tell my friend?

John:  Within the context of your friendship, you can suggest that she see a professional.  But let’s talk about that in a minute or two.

Maggie:  Okay.

John:  Well, that is the don’ts.  There are others, but I think this gives us a working list at this point. Why don’t we turn to the dos?

Maggie:  Good.

The Dos

John:  The FIRST DO is actually the only exception to the don’t give advice rule: do advise people who are depressed or going through a period of sadness to seek professional help.

Maggie:  That seems smart, but it is harder than you think.

John:  Can you explain that?

Maggie:  Young people don’t like to be told that they may need mental health help. There is a stigma to that.

John:  I see what you are saying now.  That stigma about mental health issues pervades all ages, not just young people, and it is so stupid. 

Maggie:  It seems stupid to me too, but can you explain why?

John:  Think about it like this.  We have one body; we are one person.  But we have chosen to believe that some injuries or imbalances or struggles are acceptable, while others are embarrassments.  For example, injuries to the heart or spine are culturally acceptable.  Even cancer.  No one faults anyone for these types of injuries.  But chemical imbalances in the brain or psychological injuries caused by childhood trauma are not acceptable.  Depression or sadness or despair are not spoken about, and are even hidden from public view. 

This makes me angry!  We are one person.  Just one.  So we shouldn’t pick and choose which injuries or traumas or imbalances or struggles are socially acceptable, and which are embarrassments to us.

Maggie:  Why does this make you so mad?

John:  Because people refuse to get help as a result of this stigma on depression. No one, anywhere, would ever break a leg and say “No, I can’t go to the doctor.  I am embarrassed to talk about my broken leg.”  But we do this all the time with mental health issues.  It’s just wrong!

Maggie:  I agree with you.  We need to change.  But back to my question, how do I suggest to my friend that she should get help?

John:  You want to avoid harsh statements like “You need help.” Or “You are sick and should seek help.”

You can make the suggestion in caring manner, though.  You could say something like “Have you considered talking to a doctor about your depression?  I could help you find someone good to talk to.” 

Maggie:  I get it now.  Thanks.  What is our second do?

John:  The SECOND DO is be present.  As we discussed above, just being around is helpful to people suffering from depression or loneliness or sadness. 

Maggie:  Sometimes it is hard to be around depressed people.

John:  I know.  It is a weird phenomenon, but people who are depressed or lonely often respond by isolating themselves or pushing people away.  This is especially the case when the cause of the depression or loneliness is, at least in part, caused by negative interactions with others.  But the proper response is to continually be present, not to turn away.  Does that make sense?

Maggie:  Yes, but it is hard. 

John:  I agree, but being a friend is hard sometimes.  If we really want to help, like we say, we will keep at it.

Maggie:  I know.  Like you always say, tenacity is a key virtue.

John:  It is, especially in relationships and friendship.  So keep at it.  Things will get better and you will be happy that you persevered.

Which brings us to the THIRD DO.  Do be a good listener.  Many times people with depression just need someone to talk to; they just need a friend.  So let’s be that friend.  Listen well, pay attention, ask good questions, and let them know you are interested in what they say.

Maggie:  Friendship therapy.

John:  Yes!  That is an excellent way to put it.  A good friend is a great help in times of need.  You got this!

Which brings us to our FOURTH DO.  Do be persistent and patient.

Maggie:  I agree with this.  Sometimes it is hard to get my friend to talk.  She refuses to open up.  But after awhile, after I continue to talk with her, she seems to open up. It takes time, but it happens eventually.

John:  Great example.  So we need to be persistent and patient with depressed and lonely people.

Maggie:  Again, we need to be a good friend and this is exactly what a good friend would do.

John:  We could all use more friends like you.

Maggie:  Thanks.  What is the next do?

John:  The FIFTH DO is do be a friend.  Fight the depression together with your friend.

Maggie:  What are some practical examples of things I can do to help her?

John: Just doing the things you would have done in the first place will help.  Get coffee, go to the usual hangouts, text each other, those sorts of things.

Maggie:  Okay, anything else?

John:  I have read that exercise seems to help people who are depressed and doing it together helps people who are lonely.  So try walking together or hiking or shooting baskets or going to a climbing gym or kayaking.  Anything really.  Again, your imagination is your only limit.

Maggie:  I know that physical activity helps me when I am sad.

John:  Me too.

And there is one FINAL DO.  Do exercise good judgment.  Some friends may need physical contact, such as a hug, and others may not want that.  Some may need physical presencing and others may prefer texting.  You will need to make good judgments about this.  But if you are friends, you will have a good idea of what to do.

Maggie:  I think that is enough for now.  I have a pretty good idea of the things to do and not do.

John:  Okay. 

What this really comes down to is being a good friend, whether or not a person is depressed, lonely, or suicidal.  Right?

Maggie:  I couldn’t say it any better. 

John:  We have lost the art of friendship in modern American society and we would all be better off if we could get that back.

Maggie:  I think so too.  I am glad we are friends.

John:  Back at you.       

 

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