The misery of depression extends beyond those suffering it to their families and friends.

Depressed people often frustrate and alienate those around them. "Try not to take it personally," says San Francisco psychiatrist Michael Freeman, M.D. "They have an illness. They can't help it." Of course, that's often easier said than done. It's very difficult to control your temper when a close relative or friend never returns your calls, hardly gets out of bed, answers you in monosyllables, acts completely self-absorbed, seems to have no interest in you or doing anything you liked to do together, and doesn't keep dates or follow through on commitments. Get mad if you must, but then, get over it. Keep reminding yourself that the person is ill, and not responsible for his or her many failings.

Depressed people often engender tremendous guilt in those around them. "You think: 'Nothing I do seems to help, so there must be something wrong with me,'" Dr. Freeman says. There's nothing wrong with you, nothing to feel guilty about. You can't relieve clinical depression with love alone any more than you can cure heart disease or cancer with just love. People who are depressed need professional help. Many require medication.

Reassure the children of depressed parents that the illness is not their fault, says Eda Spielman, Psy.D., a Boston-area psychotherapist. "Otherwise," she says, "children may blame themselves for the parent's condition, feel guilty, and become more vulnerable to depression themselves." Also reassure the parents of depressed children in the same way. The illness is not their fault, and they can't "fix" it. The depressed person has to get professional treatment.

On the other hand, social support improves treatment results in many serious illnesses, such as heart disease and -- according to some studies -- breast and skin cancer. Many experts believe that social support also helps treat depression. Keep reaching out to your depressed loved one, just to reinforce the fact that you care. Call. Send affectionate notes. Invite the person to movies, concerts, ball games, parties, and other events. But keep your expectations low -- as close to zero as possible. Chances are that the depressed person won't respond to you, or that if you get a response, it won't be that of a normal individual. But depressed people notice outreach efforts and appreciate them, even with their illness renders them incapable of acknowledging your love and devotion.

If the person responds to you after a long period of silence and neglect, work hard not to be sarcastic: "So, after 121 phone calls, you finally call me back. Thanks a lot." Try to accept the contact as matter-of-factly as possible: "Oh, hello, Marcy. It's nice to hear from you. How are you feeling?"

Don't feel that you have to apologize to others for your depressed loved one's lack of sociability or responsibility. When mutual friends remark that the person never RSVPed for their anniversary party, simply explain that he or she has been seriously depressed, and that the illness has crippled the person's social skills.

Guard against falling victim to depression yourself. Don't get dragged into the emotional whirlpool that has sucked your loved one into an emotional abyss. "Stay involved with other people," Dr. Spielman urges. "Work at not becoming isolated." Solidify other family and social connections. Pursue hobbies and other interests. Have fun. Consider getting some counseling yourself.

How can you help a depressed loved one through depression? Here's what you can -- and should -- do:

Urge your depressed loved one to get professional help. That's what the person needs. If necessary, offer to make an appointment with the person's doctor, or therapist, or psychiatrist, and drive the person there, or arrange for a cab.

Learn more about the condition yourself. The National Institute of Mental Health's Depression Awareness, Recognition, and Treatment (DART) Program offers a free booklet, "Helping the Depressed Person Get Treatment."

For free brochures on depression and its treatment, check out the NIMH's DART order form. You can also call (800) 421-4211 or mail a request to: DART, 5600 Fischer Lane, Rockville, MD 20857

Source: NIMH Depression Awareness, Recognition, and Treatment (DART) Program

next: Dealing with the Depressed Person's Denial and Refusal to Get Help

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Reviewed: 01/2006