Building Relationships that Work when Depressed

Everyone we interviewed said that being less alone was an important part of dealing with depression. As Joey described it, “probably the healthiest thing going on for me right now is just making sure that I have ample social connections.” This section focuses on the many roles relationships played for people we interviewed as they strove to cope with and heal from depression by being less alone. (To learn more about the toll depression can take on relationships, see ‘Depression & relationships’.)

For most people, “ample social connections” referred less to a certain number of relationships and more to a mix that in combination provides understanding, compassion, and support. People described different views of what that ideal mix is and different strategies for creating it – but all viewed relationships as a vital resource that merits careful nurturance. As Marty put it, “you’re not alone…. There’s help for everybody out there, you just have to put in the effort.”

 

Ryan says it's essential to have someone who can support you without judging.

Ryan says it's essential to have someone who can support you without judging.

Age at interview: 19
Gender: Male
Age at diagnosis: 13
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Well I, I don’t think you can do it solely by yourself, I think you need somebody who actually can support you and not judge you basically to say like, “You’re normal, you’re okay”. You know because when you feel like this, you feel like nobody has ever felt like this. No one could possibly be as low as you feel right now. So somebody who understands, maybe somebody who’s been there and then the coping mechanism, a healthy one, you know, like an outlet you know? Whether that’s talking to somebody, whether that’s exercise, whatever. I think there’s positive ways to deal with this still…

Relationships can change

Many people said important relationships in their lives had changed for the better over time, either naturally or as the result of their own concerted action. Several people spoke about connecting with parents after lengthy periods of separation — for example, Sierra Rose found that her mother was there for her during a crisis in a way that created “a turning point” in a historically difficult relationship. Sam said despite differences with his parents, he has been “taking steps to mend our relationship… and that they have reciprocated has been a huge relief.” Sophie described a long-standing friendship that “started from the bottom” and continued to stretch as they both grew up.

 

Myra says over time her mother came to accept her depression and offered increased support.

Myra says over time her mother came to accept her depression and offered increased support.

Age at interview: 28
Gender: Female
Age at diagnosis: 27
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She accepts that that I have depression now. She accepts that I have it. And she doesn’t tell me what to do about it. She’ll, like she’ll just say, I pray for you on a daily basis. I check up on you whenever I can, like I’ll call or something, you know? And that’s, that’s kind of how she seems to be dealing with it which I appreciate.

 

When his father deepened his religious faith, Colin felt less judged for his depression and more fully supported by his parents.

When his father deepened his religious faith, Colin felt less judged for his depression and more fully supported by his parents.

Age at interview: 20
Gender: Male
Age at diagnosis: 18
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The one positive experience I’ve had with religion was probably maybe three years ago. My father had this big spiritual overhaul, kind of like a new born Christian and it made him a much nicer person.

Like I don’t adhere to any beliefs myself, but all I can say is it really softened him a lot and he’s a lot nicer than he used to be. After having this and doing things I would never see him doing. He like goes to bible meetings and group sessions and he leads this men’s group now.

Stuff I would never have associated with my father. But he’s a much more, he’s not gentle he’s still fairly a hard stoic man, but he’s a lot more easy to communicate with and he doesn’t feel as judgmental as he used to.

 

As Sam and his friends matured, they were better able to support each other to cope with depression in healthy ways.

As Sam and his friends matured, they were better able to support each other to cope with depression in healthy ways.

Age at interview: 23
Gender: Male
Age at diagnosis: 19
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A good number of my close friends do also deal with symptoms of depression, not all. And as we have gotten better about managing our symptoms and looking at them in a healthy way, the relationships have become mutually beneficial in which neither party is taking too much from the other party, in which we are both supportive of each other and understanding of each other and sympathetic toward each other, but in which we also have other frameworks of support in addition to each other, which I think has been really key for me.

Setting realistic expectations

People described many kinds of relationships that can be gratifying and helpful — but only if they are approached with realistic expectations. As Sophie put it, what is key is “knowing who you can go to and who is willing to help when you have problems.” Teddy emphasized the importance of knowing who to trust, saying “when I really get like a hand to… be given out I’ll take that hand and I won’t, I won’t let go. Because there have been times when I have grabbed the wrong hand and it’s gotten me worse.” Pete spoke, with a spark of humor, about looking for “just a regular person” he can talk to — someone who can “let me be upset and let me go through the pain I have and let me just be there one day at a time. A person that brings sushi.”

 

Crystal knows she can turn to her roommate when she hits a low point, but would not expect help from friends who think of her as an extrovert.

Crystal knows she can turn to her roommate when she hits a low point, but would not expect help from friends who think of her as an extrovert.

Age at interview: 20
Gender: Female
Age at diagnosis: 15
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What’s really nice is having someone who has gone through what you have been through. And really understands you know what you need.

Because it’s hard to say to like, I don’t know some of my friends and my acquaintances who know me in my extroverted sense. You know, “Hey I’m having a crash right now. I need you to help take me to the bathroom and like take off my clothes and like put me in the shower like I can’t do that on my own.” And they’ll probably ask me you know, “But you’re such an energetic person you know, you can,” They won’t, they won’t really understand, there’s a disconnect but my roommate since she’s been through that kind of situation and she knows, and like we’ve had like more deep in depth conversations about what it’s like and on our own personal ways going through depression. You know she, you know completely understands and she’ll like do whatever is, whatever is possible to like help me out because she knows what it feels like.

…she knows exactly what to do to help me when I’m in my low. Typically when I’m in that dark place, I’m anxiety takes over my entire body, my muscles hurt and I’m not really able to move so what she’ll do is she’ll take me, help me get into the shower like the basic things, I can’t really eat on my own, she does a lot of those things for me and it’s been really helpful.

 

Colin learned to take the mask over his depression off with friends, while keeping it on around strangers.

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Colin learned to take the mask over his depression off with friends, while keeping it on around strangers.

Age at interview: 20
Gender: Male
Age at diagnosis: 18
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So those masks that you’ve had, where, what have you done with those masks?

They’re still very much on with some people, with people I don’t trust. But with, they’re almost completely gone with closer friends. And that’s fine with me. Because I feel like I don’t really need support from strangers. Like I don’t need to know, that like that’s not really their business, I guess. But having the support from closer friends, is amazing and being open with them. Because even people who I considered friends since I was like in middle school didn’t know. And that just, once I thought about it, it was really weird to me because it’s such an integral part, of me.

Yeah.

And it just seemed like I had kinda been lying the whole time. And so yeah, I don’t know, I’m slowly, but surely, getting rid of the masks that have been unhealthy.

Many of the people we interviewed described the need to be careful about expecting true understanding of depression from friends and relatives — particularly those who have not themselves experienced it. Mara described how frustrating it can be when expectations on either side are unrealistic, saying “you’ll be revealing something to a friend you think is getting closer and you disclose something and they go, ‘Oh, I totally get were you’re coming from.’ And you want to go ‘No you have no idea what I’m going through you, you live a completely different life and… chances are you have no idea what I am feeling.’” In order to avoid this disappointment, a number of people learned it was most realistic to seek real understanding from just one or two select people and to expect empathy rather than understanding from most. Sally, for example, says she doesn’t expect her boyfriend to understand: she just appreciates when he will “just lay there with me or hug me or something like that. Just enough to be present but not overbearing.”

 

Shayne says she doesn't need someone else to know what she is going through; she just needs support.

Shayne says she doesn't need someone else to know what she is going through; she just needs support.

Age at interview: 27
Gender: Female
Age at diagnosis: 13
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But to have someone who can be there and say, What you’re going through is ok and even if I don’t understand the pain that you’re feeling, just know that I’m here for you anyways, to recognize that you are going through something and that I’m going to be supportive by being here with you. Unless you want me to go sit over in the other room, then I’ll go sit in the other room and you can be over here by yourself and I’ll be supportive from you wherever you want me to be supportive from basically. Because like sometimes you want to be alone, you’re like, “No I need to cry for ten minutes in my room. Leave me alone.” You know, or you know, sometimes you just want them to sit with you when you cry. You know it just, it varies, it depends. You know, it’s how your feeling which can be so many different things and all the things all at once. So it’s, it can be overwhelming in so many ways.

On-line communities

Many of the young adults we spoke to described expanding their social networks on line – and many found these web-based connections valuable both for gathering information about depression and for creating “virtual communities”. Some people successfully connected with peers who were experiencing depression in combination with other diagnoses or conditions. Web-based relationships allowed for a greater sense of control: as Shayne observed “you can get really awkward when you’re depressed; when people ask you how you’re doing, you just start crying …. When I was really awkward, I had online support.”

 

On-line connections helped Devin feel less alone with the combination of depression and anorexia he was experiencing.

On-line connections helped Devin feel less alone with the combination of depression and anorexia he was experiencing.

Age at interview: 21
Gender: Male
Age at diagnosis: 16
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There’s tons and tons of forums that I’ve definitely used and have talked to people, asking them how they feel about certain things, like if they’ve, if they have the clinical depression, have they run into the same problems that I have, like the anorexia or if they’ve had like a, I like to know other people’s stories, if they’ve had similar pasts that I do and I’ve had and it, it’s nice to see that you’re not alone. That you know, you, your mind tends to think that way and you’re the only one with these problems, that this is just you, you’re going to have to deal with it on your own. And then finally speaking to someone who’s having those same feelings has had similar experiences is just again another relief. It may be kind of sad to see that other people have had to deal with the same things you have had to deal with, but it’s definitely nice that you can connect with other people now.

 

Whitney could both get and give help in her on-line community.

Whitney could both get and give help in her on-line community.

Age at interview: 29
Gender: Male
Age at diagnosis: 9
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On Facebook I belong to like the Bipolar Foundation.

And there’s a lot of different, like CBT therapy they have a whole bunch of different groups on there. And, um, you know I enjoy helping other people out so there’s a website called Seven Cups of Tea, and you can actually become like an online counselor and actually help people listen to their problems and like I’ve been there and I’ve done that. And there’s a whole bunch of different topics that they can talk to you about and you can just select whatever you want, that you want to address and so I do that and that kinda helps me get out of my depression. Because I don’t feel so alone.

People can request you and a lot of people have requested to talk to me that I’ve talked to before and it’s and a lot of the issues that they go through, it’s just they do feel alone. And I think that is more the issue I have dealt with people, it’s just feeling alone constantly.

 

Because she worried that disclosing her depression would induce harsh judgments, Sierra Rose felt that on-line relationships felt safer, because they were more under her control.

Because she worried that disclosing her depression would induce harsh judgments, Sierra Rose felt that on-line relationships felt safer, because they were more under her control.

Age at interview: 18
Gender: Female
Age at diagnosis: 11
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There are depression chat rooms and those have helped me. I have friends online that I have never met in person they’re in you know Illinois, or New Jersey or you know Florida and we’re all connected by this one thing, this feeling of hopelessness, this depression, and honestly being able to sit there and open up to somebody on the internet is so much easier than sitting there and opening up to somebody you know in real life. Because the people you know in real life, you can see their judgment, you have to see them every day you can’t just, you know, up and quit talking to your mother or your best friend because you feel like you disclosed too much. On the internet you don’t have to respond to their messages, you don’t, you can block them, you can delete them, you can stop all communication with them. If you feel like you’ve ever disclosed too much and you just need to stop, if it ever becomes too overwhelming. There’s definitely an upside to the internet.

Others had less positive experiences. Nadina, for example, worried that on-line chats conveyed “so much incorrect information that it can be pretty hard to tell the difference between what is true about depression and what is not.” Jason was so skeptical that he never even tried web-based forums, anticipating that on-line interactions would lack seriousness, carry emotional risks, and feel too “transient.”

Candor, acceptance and realistic perspectives

The capacity to be completely open and honest about depression and “get rid of masks that have been unhealthy” was described as important by a number of people we interviewed. Several people found that once the removed their own masks, others removed their too. Violet said some of her friends also have depression, which she “didn’t know until I came out and said it and they were like “really you do,” like “I’ve been on Prozac for this many years,” and I was like “really” you know just to know that they had struggled and I didn’t even know it.” Joey had a similar experience, noting that when he said he was taking medication for depression lots of other people would say “oh yeah, me too!” Some people talked about the limitations of sharing feelings and experiences with other people.

 

For Nadina, sharing experiences goes a long way -- but she still feels each person is isolated with their own problems.

For Nadina, sharing experiences goes a long way -- but she still feels each person is isolated with their own problems.

Age at interview: 23
Gender: Female
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…a lot of my friends have similar feelings like I do, like feelings of inadequacy and, feeling like they’re never good enough, um, my significant other especially. And I feel like though that, we’re kind of alone even though we can, we share each, each other’s experiences. We, we alone can only understand what we’re feeling, we can be as vocal and descriptive as we possibly can, but when it really comes down to it we’re still isolated in our own issues and problems. And it’s good to talk about it and it’s good to relate, but it’s, it’s hard to really like take yourself and place yourself in somebody else’s shoes completely. Like you can be and, as empathetic as possible, sincerely empathetic, but that’s really all you can do at that point.

 

Jason found that opening up to his friends about depression increased his trust in them.

Jason found that opening up to his friends about depression increased his trust in them.

Age at interview: 25
Gender: Male
Age at diagnosis: 22
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Yeah, you know, and recently you know, I’ve been more open to like, maybe also because I’m almost graduating, so I’m more open about such things but. I’ve been more open with friends I trust about my issues. And I think that helps just to like, relieve some of the stress. For example, I previously I wouldn’t talk to them, and you know, I’ll make up, say, excuses and say that , you know, I was, you know, I had a, I was, I had a fever. That’s why I didn’t go to this place, or whatever. And now I’m more open to telling them that, you know, I was having such issues, or I’m more open to just telling them that, “Oh, I’m in a pretty bad state recently. I’m feeling very down, so part of me, if I don’t want to go to your place or if I don’t seem very friendly.” So I’m more open to being more open about my feelings and also more open about telling them why I feel this way.

Yeah. How have people responded to that?

I think, first of all, I think people here. I would say that you know, having depression or mental issues is pretty prevalent here, just because of the high stress, suffocating, high pressure environment. So I think for the most part, because people I revealed this to are close friends have been really supportive, just because they’re my also close friends, and also because a lot of them faced similar issues. Or at least because we’re in similar environments, so they can sympathize. But overall, people have been very, I think pretty supportive and very sympathizing, which is reassuring. Because I thought that some of them would just leave me and some of them would, you know, look at me with disdain because of the supposed stigma, but it’s been more liberating than I expected.

For some, feeling accepted, or as Pete says like you “matter to society” and to “friends and family,” is a critical element of healthy relationships. Natasha says it nice to have friends “who understand… If I don’t talk to them for like a week or two … they’re not judgey and angry about it.”

 

Elizabeth says her husband supports her without enabling her, and her relationship with him provides a comforting sense of security.

Elizabeth says her husband supports her without enabling her, and her relationship with him provides a comforting sense of security.

Age at interview: 28
Gender: Female
Age at diagnosis: 17
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I wouldn’t have married him if he wasn’t like this, but he’s just always really been there to hold my hand and support me without doing something for me and I think that’s what I really needed in a relationship. Someone to be supportive and loving and be kind of a coach in some ways to remind me, but not enabling in any kind of way…

So you know, the depression definitely has impacted every romantic relationship that I’ve had, the difference with him though is that the love is unconditional. I can be depressed and we’re still going to be married and he’s still going to love me. He can have a bad day and I still feel the same way. And I think that just generally the acceptance that I feel and the security that I feel helps ward off the depression in a lot of ways. I, you know, it’s not his responsibility to ward it off, but it helps with that, definitely, because if I feel loved and secure and safe and happy and we’re having a good time and laughing and everything is good then that really helps.

A number of people said relationships that provide them a “reality check” about their own feelings and perspective were crucial. Sam said he has gotten so much from relationships that help him perceive himself and his symptom in a way that “is healthier and more balanced.” Ben noted that he gets good perspective from his aunt on whether his medications are working effectively to clarify his thinking.

 

An outside perspective helps Violet escape spirals of negative thought.

An outside perspective helps Violet escape spirals of negative thought.

Age at interview: 23
Gender: Female
Age at diagnosis: 22
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I mean I know that not everybody can have a partner at the time when they need it you know it doesn’t just happen that way but to have anybody, a friend, a parent, anybody that can just remind you to just take a deep breath you know “give yourself a break cut yourself some slack,” I think that’s been one, a very big thing in helping me realize, ok just let me just take a step back here and before I get myself all worked up before I’m beating myself up, let me just remember that you know everybody has made a mistake at some point.

 

Mara looks for relationships with people who can balance her subjective depressed feelings with a more objective view of reality.

Mara looks for relationships with people who can balance her subjective depressed feelings with a more objective view of reality.

Age at interview: 18
Gender: Female
Age at diagnosis: 14
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I had some really good friends and some people I could rely on really well who were always there to say, like I understand or not necessarily that they understood, but what they could say to me was , “I may not know exactly what you are feeling, but I want you to know objectively, here’s what’s going on. Objectively, you are a worthwhile person. Objectively, people care about you. And whatever subjective feelings you’re having right now, just know that those are totally not valid, that’s not reality.” So I think, yeah, it was just a mix of those two things, just valuing myself and knowing that I was valued by other people. Which can be really hard, I think, because if I hadn’t had that group of friends at that time, I think it would have been a lot more difficult to recognize.”

Fostering strong networks and getting a “fresh start”

A number of people we interviewed decided to change or expand their social networks by moving. Some people found these moves to be beneficial, particularly when they involved a transition away from places where mental illness was not well supported or accepted to places that constituted a better fit. When Nadina moved from the Southern to the Western part of the country, for example, she found people to be “way more understanding about depression and stuff like that.” More than a few people who moved, however, found the results disappointing because a geographic fix is just “not how depression works.” Colin said when he went to stay with a friend in another part of the country to get geographical distance from his problems, “I thought everything would be fine and then after about a week there, I just started losing myself again.”

 

Casey felt less alone when he got to college, where there was significant public discussion about mental illness.

Casey felt less alone when he got to college, where there was significant public discussion about mental illness.

Age at interview: 22
Gender: Male
Age at diagnosis: 15
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So I went to like a very kind of like, progressive liberal arts school and there was a, a pretty large dialogue there surrounding like mental health and that like, it exists, and everyone has it, whether or not it’s going great, and that there’s a huge stigma around it and you should be able to talk about it. And I like, so I would like literally just like see posters about this. I knew people who talked about having mental illnesses and like things that like, things like I deal with but also things like I think probably way harder more than I deal with. And we’re like this doesn’t, you know, make me somehow like less than, or whatever this is, just like a thing that is in my life and I was kind of like hmm. And I never like looked at any of the student groups or whatever but I think it really changed the way that I thought about things just to be around kind of like that dialogue in the air almost.

See also ‘Depression & relationships’, ‘Going public with depression?’, and ‘Depression, bias, & disadvantage’.