If a friend tells you they've just been diagnosed with depression, you may be unsure about what to say, or how you should say it. How can you best communicate your love, support, and understanding? Well, for one thing, you can start by thanking them for sharing with you, because it may have been a tough thing for them to do. But after you do that, you've got to strap in, educate yourself, and be supportive for this particularly eventful bit of their lives.
For some people, a depression diagnosis is emotionally loaded; for others it is a non-event, and for others it's even a blessed relief — but there's no universal reaction to it, and it can be a complex, diverse, emotionally knotty experience. The period of time when a person begins treatment — when the reality of the diagnosis and what it means are just beginning to settle in — can be one of the most vulnerable, and it's crucial that they've got the help they need to get through it.
Diagnosis may not be a life-changing moment (though for some it definitely is), but it's definitely an Event, and will shape what happens in the future. I have a friend who quietly celebrates the day of her diagnosis every year, because it marked the point where her emotional maelstrom was given a name and legitimacy, and she could start moving forward into trying to cope with it. Whether or not your friend comes to regard their diagnosis in such a positive light is up in the air — but no matter what, you can take steps to support them. Step one: hugs. Steps two and onwards: a bit more complicated.
Recognize That This Might Be A Complicated Time For Them
Diagnosis means immediate relief, right? Not so fast. Getting to that point can be fraught, and while the first sensation may well be a sense of relief or validation, there's also likely a lot to impact. As with any disease or disorder, putting a name on it involves two levels of consequence: the immediate, and the more longterm.
Even if people exhibit positive emotions at the first diagnosis, they may also be experiencing fear, concern, confusion or shame. A lot of this is down to the taboos and misconceptions about mental health in modern society; our lack of mental health literacy means that, particularly for those without much experience of depression beyond media portrayals, the first diagnosis can be a shock.
And there may also, unexpectedly enough, be feelings of rage or denial. Dr. John Groyol told Psych Central that "even when a definitive diagnosis is made and accepted, there may be additional concerns about the unknowns of the disorder: its course and outcome, worries about work, effects on family and frustrations about physical and emotional limitations. It is not unusual for these concerns to be expressed as anger, which may further deepen the depression." Do not expect your friend to react in any one way; go with how they're feeling in the moment.
Remember That They Are Not Their Diagnosis
Depression is serious, but it's not everything. When dealing with a friend who has just been diagnosed, it's important to remember to balance these two aspects when discussing things: depression shouldn't be minimized, but it also shouldn't be blown up and spoken about as something that will ruin their life and overtake all of their future choices. It can be a tricky balancing act to perform, so don't be worried if you occasionally strike the wrong tone. Think of it as rather like if somebody had been diagnosed with any other chronic health condition: it explains a lot of symptoms they've exhibited in the past, and it'll define parts of their life going forward, but it doesn't define their personality or who they are.
Watching out to see if your friend is either downplaying or becoming overly panicked about their diagnosis — and trying to help them see things more clearly if they do — can be an important part of supporting them at this point. Be reassuring and practical. Respond to "Ah, my diagnosis doesn't really matter" with something like "It does, but it's OK." Conversely, a reaction like "Oh my god, my life is over because of this diagnosis" should be met with calming responses. Talking about famous people who've had depression and are still successful and open about it, can be a positive way to keep it in perspective.
Ideally, diagnosis will be accompanied by packs of information from the counsellor or GP, in which they outline what depression actually is and how the specific treatment plan for your friend will work. No matter what, though, it's a good idea to get more of a complete picture about the realities of depression, from the side effects of various medication to what causes the disorder.
The "cause" thing is, for some people, a very big deal. Guilt and worry about somehow bringing it on themselves by being weak or not thinking in the "correct" way, or other self-punishing thoughts, can easily accompany depression diagnoses — both because of erroneous societal beliefs about the disorder and because that's what depressive thinking patterns do. It's something to help your friend nip in the bud as soon as you can.
Luckily, it's relatively easy to read up on the disorder, and learn that depression is a complex issue related to genetics, brain chemistry and various environmental factors; you don't have to be a PhD to understand that it's nobody's fault.
And this should go without saying, but: don't tell anybody else about your friend's diagnosis without their express permission. Don't just assume it's OK to share their information. It's their disorder, not yours.
Do Not Get Angry Or Push Your Own Emotional Agenda On Your Friend
The Time To Change organization, a UK-based center devoted to ending mental health discrimination, has some excellent first-person accounts of what it's like to be diagnosed and emerge from that first stage into treatment. Those pieces contain some excellent tips for anybody looking for ways to be supportive from the very beginning — and one surprisingly common theme that turns up among the recently diagnosed is a wish that people not act angrily towards them.
Anger towards a newly diagnosed friends is a frequent (and not wholly incomprehensible) reaction, particularly if the depressed person hasn't been discussing their feelings openly or has been seeking support elsewhere. Depression diagnoses in friends can make you feel as if you haven't been good enough to them, and that, perversely, can lead to fights. Monitor yourself for these kinds of angry emotions towards your friend, and if you feel them bubbling up, stop yourself — yelling or staring an argument absolutely won't help your friend.
Beyond anger, though, the writers of these pieces also often ask that you try to keep your own agenda about how you think things should be treated, or how depressed people "should" act, off the table. No "You can't be depressed, you were cheerful last Saturday!" No "So if you're so depressed, why aren't you on antidepressants?" No "I think you need to get a lot of sunshine." If you're not their primary caregiver and they're an adult, it's their own thing; you're a support person for their treatment, not the main core of it. Check yourself.
Examine Your Own Assumptions
In addition to research done with your newly diagnosed friend, now is a very good time to look inward, to make sure that you have all your ideas about depression straight and can be a good help going forward. It's a time to ask mental health professionals any questions you may have about depression in general; it's also a time to free yourself from any myths about depression that you may believe.
Do you think that all depressives are suicidal? That they're somehow dangerous? That depression can be fixed magically with a bunch of medications? That antidepressants are addictive? That just doing a few cheering, happy things every day will "cure" someone struggling with depression? All of these are relatively common misconceptions, all of them are untrue, and none of them are particularly helpful to bring to the table when it comes to supporting your friend. If you truly want to help your friend, get your facts right.