Depression is a topic that is often overlooked in the Muslim community but it seems to be growing at an alarming rate. Think of five of your closest friends – chances are that one of them OR their immediate family is depressed. In the United States, depression affects about 1 in 20 individuals over the age of 12 or about one individual in every five families. Sometimes symptoms are obvious and sometimes they aren’t as clear, but if you know someone who is depressed or you know someone who is struggling with a depressed loved one, you are probably wondering if or how you can help.
The number one thing a person can do to assist someone experiencing depression is to be supportive. However, many people don’t know how to be or think they know how when they actually don’t; which ends up causing more harm than good.
Although there are many kinds of depression that affect individuals differently, here are five general guidelines from a psychotherapist on how you can help.
1. Avoid giving unsolicited advice
Often times those with depression just want someone to talk to and understand where they are coming from. Listening without judgment gives the depressed person the invaluable opportunity to get their feelings off his or her chest and allows them to sort out their thoughts. When you rush to give advice you are interrupting this cathartic process and disrupting what clinicians call the “holding space.”
In laymen’s terms, the holding space refers to being completely present and supportive of someone wherever they are in the five-stage changing process. The five stages are:
- Pre-contemplation (not ready for change)
- Contemplation (getting ready for change)
- Determination (ready for change)
- Action (actively making change)
- Maintenance (keeping up the change)
When this process is prematurely sped up or pushed along, the person with depression will either ignore the unsolicited advice or will start to build up resentment towards the person forcing the change.
Genuinely listen to your friend and use empathy, not sympathy. If you want him or her to feel understood, reflect back what they said to you in your own words. Ask exploratory questions and avoid figuring out the solution, just concentrate on understanding the situation. Remember just your presence and being a witness to their suffering can make a world of difference to them.
2. Avoid guilt-tripping them
As someone who has provided psychotherapy to both individuals and families, I can tell you that one of the most damaging things a person can do to “help” their loved one with depression is guilt-tripping them. People guilt-trip because they figure that if they point out all the blessings the depressed person has, this will make them grateful to Allah and feel better.
The problem with this method is that often times family members and friends will start out with good intentions, but as they encounter resistance from the person with depression, they become increasingly critical and say things like, “You are so ungrateful,” and, “You have no reason to be unhappy.” This causes the depressed person to feel worse because now in addition to wanting to feel better and being unable to internally, there is external pressure coming down on them as well. The added pressure of being a ‘bad Muslim’ causes a tremendous amount of guilt that only compounds the negative effects of the disease.
Do not assume your friend is minimizing the blessings in their life. They know the blessings are there, but it’s hard to see them clearly because of a mental fog. Instead of telling your friend about all the things they need to be grateful for, offer opportunities for gratefulness. Talk about funny experiences you had, things you hope to do together in the future and fun things you can do in the moment.
3. Do not question their efforts to get better
Many people do not realize that the feeling of anger is frustration projected outwards, while feelings of depression are anger turned inwards. People with depression are unhappy with themselves and often times have low self-esteem, hopelessness, and feelings of worthlessness. When someone outwardly or covertly accuses the depressed person of being lazy it makes them wonder: “Is this just one more bad thing about me?” As a friend, it is not your job to figure out if the person is trying hard enough; your role is to help as needed.
Pretend like your depressed friend has the flu. Everyone knows that flu and depression are different, but there are some parallels that can be made. If your friend has flu, would you ask them, “Are you really trying your hardest to get better?”. When your friend with the flu is overcome with a headache, cough and muscle aches do you accuse them of being lazy? These questions are inflammatory and offer no benefit to the person who is sick. So just as you would be generous with kindness by making chicken soup and sending friendly texts to your friend with the flu, you would similarly offer equivalent support to the person experiencing depression without questioning their recovery process.
4. Do not get mad if your friend doesn’t reciprocate
It is essential to know that it is not personal if your friend or family member is not calling you as frequently as they used to. Depression drains the energy from the mind and body. Clinical criteria for depression includes (but is not limited to) feeling lethargic, slowing down and isolating one’s self. Therefore, if your loved one is not initiating as much contact as before, know that it has nothing to do with you or how much they care about you.
Although the person with depression might not want to go out, offer to do things with them anyway. Activities that include exercises like walking in the park is preferable because studies show that sunlight, spending time outdoors and exercise all help fight depression. Other low-key options are going out for lunch, chatting over coffee or browsing a local bookstore. If your friend doesn’t follow through, don’t be surprised and periodically try again every once in a while. Remember that from an Islamic perspective, knowledge with good intention plus good effort will yield a win-win result. If your friend or family member goes out with you and feels better, that’s an accomplishment, and if your friend doesn’t go out with you, insha’Allah you will be rewarded based on what you set out to do.
5. Do not become your friend’s depression therapist
It is important to provide assistance and support to your friend in their time of need; however, if he or she develops a dependency on you to function or get by in their day to day life, then they need professional help. There are many hidden dangers in trying to substitute friendship with professional help like developing a co-dependent relationship or overlooking suicidality. These risk factors can impede the recovery process and prolong the course of recovery.
Gently offer the suggestion of getting help from a professional. There are many good places to start, including a primary care doctor, guidance counselor, university counseling center or local psychotherapist. If your friend is nervous about getting professional help, offer to drive them to the first appointment, and set up something fun to do after. If you are trying to help an older family member that has a lot of stigma about going to treatment, offer to attend the first session with them.
In a nutshell, offering genuine support on your friend or family member’s terms (within healthy limits) is the best way to assist him or her with depression. Trying to prematurely speed up the recovery process, taking things personally or offering the wrong kinds of support are surefire ways to make him/her feel worse in the long run. It is very difficult to see someone you care about feeling down, but know that your kind gestures, loyalty, and efforts are not just appreciated by your friend, but by Allah . Taking care of your loved one can be an act of worship because you are also looking after one of Allah’s slaves.
Abu Hurairah reported that the Prophet said:
“He who removes from a believer one of his difficulties of this world, Allah will remove one of his troubles on the Day of Resurrection; and he who finds relief for a hard-pressed person, Allah will make things easy for him on the Day of Resurrection; he who covers up (the faults and sins) of a Muslim, Allah will cover up (his faults and sins) in this world and in the Hereafter. Allah supports His slave as long as the slave is supportive of his brother.” [Muslim]