Thursday Thirteen

We are soon coming up on National Suicide Prevention Week (September  7 - 12) and October has a Mental Illness Awareness Week (October 4 - 10) and National Depression Screening Day (October 8).

Better to advertise these things before the events, because folks who are suffering really don't need days or weeks or months. People with depression and suicidal ideation tend to live with it daily, taking things day by day. Sometimes they take it minute by minute.

Depression and thoughts of suicide or self-harm came come from out of nowhere, or they can have a physical cause. The truth is, mental health is something humans still don't understand, and probably won't for a long time. The brain is a complex organ, and all it takes is a little of the wrong something - and who knows what that something is - and things can get a little whacky.

So what do people who are having a tough time actually need?

1. They need empathy. Maybe you know why your friend hurts, or maybe you don't. It doesn't really matter. Acknowledge that the person feels bad and don't try to find a reason for it. The reasons may never make sense to you. The reasons may not make sense to the person who is miserable. But it is nice to know someone cares.

2. Tell the person that s/he is not alone. Let them know that you will listen without judgment or lecturing. Not just once or twice. Sometimes depressed people repeat themselves, particularly if the issue is ongoing and chronic. Depressed people can sense quickly when they've overstepped a line and frustrated a friend. If that happens, don't be surprised if the depressed person stops telling you things. Listening to someone who is hurting can be difficult and not everyone can do it. Urge your friend to get counseling if the situation seems perpetual or you can't handle it, but make sure that your friend knows you care and are trying to help the best you can. This can be very hard not just on you but also your friend; this is tough ground.

3. Remind the person that s/he is a good person and has value. Many depressed people have lost their sense of self-worth and/or purpose. They're not sure why they are still on the planet and can't figure out why nothing they do is good enough.

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“That's the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it's impossible to ever see the end.”  ―  Elizabeth Wurtzel, Prozac Nation

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4. Ask the person how you can help. Maybe all s/he needs is an ear. Maybe the friend needs a hug. Maybe s/he needs somebody to fix dinner every now and then. But don't move in and take over. Let the person guide you as to what s/he needs.

5. Remind the person of better times. Maybe you shared a fun shopping trip or you had a nice adventure together. Talk about things other than how the person feels for a while. Tell a joke or a funny story.

6. Be there when the person needs you. That might mean making a suggestion - going for a walk or seeing a movie, for example. Anything to get your friend moving and out of the house. Be ready to follow through, because the depressed friend will likely say "no" to whatever you offer. You may need to say, "I'm going to be there at 5 p.m. and we're going to dinner and hit the 7:30 movie. I'm driving." And then show up at the door. This one time isn't going to fix it, but it will let your friend know that you care enough to take action.

7. Tell your friend that it is okay to take things a day at a time. Acknowledge that tomorrow might not be easier - but then again, it might. But let it be okay if it isn't.

8. Try saying, "I'm sorry this has happened to you, but we can and we will get you through it."

9. Tell the person that life is worth living, and that even if s/he feels stuck and can't see a way out, there is always a different choice or option. The person simply hasn't found the right one yet, but hold his or her hand and tell them you will help them find what they need.

10. If your friend has started pulling away, you may need to pull back. If s/he stops calling or doing things with you, speak up. Tell the person you miss him or her and would like to spend time with them.

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“There is no point treating a depressed person as though she were just feeling sad, saying, 'There now, hang on, you'll get over it.' Sadness is more or less like a head cold- with patience, it passes. Depression is like cancer.” ― Barbara Kingsolver, The Bean Trees      

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11. If you are just realizing that your friend isn't well, apologize for not noticing. Please don't make them feel bad for "bringing you down" or something like that. Depression is not a choice, and no one with depression intends to be the party downer.

12. Don't tell the person that other people have it worse. They know that there are children starving, people sleeping in the streets, and folks with poor drinking water. That doesn't make their pain any better. It might make it worse, because it adds to the guilt.

13. Tell your friend that you believe in his or her strength, and that you accept the person the way they are now, not as you hope they will be.

Here are symptoms of depression. If you recognize these in yourself or in a friend, remember that depression is an illness and something that needs to be dealt with, perhaps with a doctor's guidance. It should never be taken lightly.

Feelings of sadness, tearfulness, emptiness or hopelessness

Angry outbursts, irritability or frustration, even over small matters

Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports

Sleep disturbances, including insomnia or sleeping too much

Tiredness and lack of energy, so even small tasks take extra effort

Changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people

Anxiety, agitation or restlessness

Slowed thinking, speaking or body movements

Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren't your responsibility

Trouble thinking, concentrating, making decisions and remembering things

Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide

Unexplained physical problems, such as back pain or headaches

For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Other people may feel generally miserable or unhappy without really knowing why.

Remember, depression is not a choice. It may occur once in a person's life, or may occur multiple times.

Here are warning signs for suicide:

Talking about killing or harming one’s self
Expressing strong feelings of hopelessness or being trapped
An unusual preoccupation with death or dying
Acting recklessly, as if they have a death wish (e.g. speeding through red lights)
Calling or visiting people to say goodbye
Getting affairs in order (giving away prized possessions, tying up loose ends)
Saying things like “Everyone would be better off without me” or “I want out”
A sudden switch from being extremely depressed to acting calm and happy

Here are causes and risk factors for depression:

Loneliness
Lack of social support
Recent stressful life experiences
Family history of depression
Marital or relationship problems
Financial strain
Early childhood trauma or abuse
Alcohol or drug abuse
Unemployment or underemployment
Health problems or chronic pain

For more information, check out these websites:

Hopeline
Mayo Clinic
Depression Symptoms and Warning Signs
National Institute of Mental Health


If you or someone you know is suicidal and you feel action must be taken immediately, call 911 or visit your nearest emergency room. There is also a toll-free, 24-hour hotline: National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889), where you may talk to a trained counselor.

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Thursday Thirteen is played by lots of people; there is a list here if you want to read other Thursday Thirteens and/or play along. I've been playing for a while and this is my 409th time to do a list of 13 on a Thursday. (I'm not usually so serious.)