How to BE the assistance everyone needs to combat depression

While it is a step forward to provide much-needed assistance to those seeking help, I think a better approach is to educate everyone on how to BE the assistance.

People in general do not have a positive impression of a psychiatric institution. They do not want to be associated with it, thus the possibility of approaching them for help is expected to be low. Before I wrote this piece, I asked my students to name some words that they'd relate with psychiatric institutions and they came up with words such as "scary," "dangerous," "places for crazy people" and "screaming." Imagine someone who is already suspected of having depression sees medical staff turning up at the entrance and being taken to the HCMC Psychiatric Hospital, what will happen to their stress level after that?

Clinical depression is more than feeling sad: it is a medical condition that saps a person's energy, interest, and joy in life. Psychologists can often link chronic stress to clinical depression. Depression has a known set of symptoms, but a person should be particular to two warning signs:

- Depression causes sadness, but also anhedonia - a loss of pleasure in activities a person previously enjoyed, such as seeing friends or doing hobbies

- Depression can sometimes cause suicidal ideation

According to the Stanford School of Medicine, around 50 percent of depression is genetic, and we are 2 to 3 times more likely to develop the condition if we had a depressed parent or sibling. Traumatic experiences early in life also makes us more vulnerable. Stress alone does not cause depression, but for a vulnerable individual, stress may play an important part in the development. Depression can become a chronic problem because with each episode, the amount of stress required to trigger depression decreases. Eventually, depression may arise "out of the blue," requiring no stress at all to trigger it.

Ideally we would like to see those who are stressed to voluntarily raise their hands and say "I need help," but we know that is unlikely to happen. Deep down inside however, there is a yearning desire to tell someone about their situations. There are a few steps we can all take to lighten the load off the shoulders of people around us.

- Empathy: In order to share their issues, people with stress need to speak to those they can trust, and feel that their issues can be understood. We need to cast aside our judgement and develop the ability to share someone else's feelings or experiences by imagining what it would be like to be in that person's situation.

- The environment: Is it conducive to have a discussion? Consider a location that is more private with a spaced-out seating area rather than a crowded and noisy coffee shop.

- Ensure that both parties are ready to communicate and not distracted by other factors such as phones, doodling, playing with pens or picking fingernails.

- Mindful and active listening: We need to listen without judgement, criticism or interruption, while being aware of internal thoughts and reactions that may get in the way of the discussion. We also should listen attentively to the speaker, understand what they're saying, respond and reflect on what's being said, and retain the information for later.

- Smile: Combined with nods of the head, smiles (at appropriate times) can be powerful in affirming that messages are being listened to and understood.

- Eye contact: While it is normal and usually encouraged for the listener to look at the speaker, eye contact can also be intimidating. Be mindfully aware if the speaker is feeling uncomfortable with your eye contact.

- Mirroring: Automatic reflection/mirroring of any facial expressions used by the speaker can help to show sympathy and empathy in more emotional situations.

- Positive reinforcement: Some positive words of encouragement may be beneficial to the speaker. However we should use them sparingly so as not to distract from what is being said or place unnecessary emphasis on parts of the message.

- Remembering a few key points, or even the name of the speaker, can help to reinforce that the messages sent have been received and understood.

- Questioning: By asking relevant questions the listener also helps to reinforce that they have an interest in what the speaker has been saying.

- Reflection: Closely repeat or paraphrase what the speaker has said in order to show comprehension.

- Summarization: We should take the main points of the received message and reiterate them in a logical and clear way, giving the speaker a chance to correct if necessary.

- Resist the temptation to give any advice, especially during the early stages of the discussion. In many cases, a stressed individual just wants a pair of listening ears, someone they can trust to share their personal issues. If you feel the need to give advice, be mindful with the choice of words. For example, instead of using words like "you should...", try using phrases such as "would you like to consider..."

Never underestimate the impact you can make to improve someone else's life. Our collective contribution of effort can and will make a big difference.