"I'm worried about a family member. They seem really down, but they won't talk about it. How can I tell if they're depressed?" Worried, Wellington.

Despite all the attention depression receives these days, it's really hard to spot sometimes. Depression is not "having a bad day", and it's also not an emotion: It's no more possible to be a "little bit depressed" than it is to be a little bit pregnant.

And it's not uncommon for people feeling depressed to hide it from others, often with a high level of success. People often talk of putting on a "mask", and how painful and excruciating that can be.

That can make it really hard for friends and family to know what's going on. Don't worry, it's not personal, the nature of depression means the person suffering feels they have to hide how they feel.

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Depression also isn't an "illness", in the same sense as the flu, or diabetes. At the risk of being really picky, I'm not even comfortable with the phrase "having depression", I think "experiencing depression" is more helpful.

Why? It's important from the point of view of expectations: studies have shown that when people are told their depression is due to a "chemical imbalance in their brain" they report less hope and faith in any treatment being able to help them.

When people believe the depression they're experiencing is due to a combination of factors (like their current circumstances, their history, grief, loss, trauma, substance abuse and / or their family history) they feel less broken and more hopeful about treatment.

So, back to your loved one.

If depression isn't a brain disease, what is it? Ultimately it's a series of behaviours, motivated by strong emotions, that result in a person being stuck in a deeply painful, hopeless mood state. This leads to withdrawal, isolation, and an overwhelming sense of hopelessness.

People experiencing depression generally believe themselves to be worthless, and the future to be a long, never-ending continuation of the misery they now feel. It results in an inability to feel pleasure, or enjoyment.

What not to do

Four things to avoid if someone close to you is experiencing depression:

Don't ever, ever, ever try and "cheer them up" or suggest they need to get over it (or themselves). If they could, believe me, they would.

Don't ask what's wrong, or quiz them about why they feel depressed. They likely won't know (which doesn't mean there aren't reasons, it's just unlikely to be one thing).

Don't offer advice, tell them about how it's affecting you or what you've done when you've felt low or depressed.

If they want help, support them to access it, but don't tell them what they need to do to get better (Of course if they are expressing a desire to harm themselves, then act. But being depressed doesn't automatically mean a person is suicidal).

• Questions will remain anonymous

Where to get help:

Lifeline: 0800 543 354 (available 24/7)
Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
Youth services: (06) 3555 906
Youthline: 0800 376 633
Kidsline: 0800 543 754 (available 24/7)
Whatsup: 0800 942 8787 (1pm to 11pm)
The Word
Depression helpline: 0800 111 757 (available 24/7)
Rainbow Youth: (09) 376 4155
CASPER Suicide Prevention
If it is an emergency and you feel like you or someone else is at risk, call 111.

To add on the bottom of any domestic abuse stories:

Where to get help:
If it is an emergency and you or someone you know is at risk, call 111.
Women's Refuge: 0800 733 843
Victim Support: 0800 842 846
Lifeline: (09) 522 2999
Family Violence Info Line: 0800 456 450

- nzherald.co.nz

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