4 Tips for Helping a Depressed Person in Denial

This article was originally published on Sous le tapis and written by Margaux Damain, mental health writer and podcaster. 

How can you help a depressed person in denial? What should you say to a person with depression who doesn’t want help? How do you protect yourself as a caregiver? Why is a depressed person in denial?

If you are asking yourself these questions, you are in the right place.

How to help a depressed person in denial?

Helping a depressed person in denial requires patience, a non-judgmental approach, and an understanding of the illness. In other words, you must go gradually so as not to alienate the other person. Otherwise, you risk losing their trust, and it will then be more difficult to help them.

There is, however, an exception to the rule ⚠️

If the person suffering from depression has suicidal thoughts, is delusional, or has behavior that is dangerous to themselves or others, then you must call SAMU (number 15 in France) or SOS Psychiatrie. In this case, you do not wait to have the person’s consent because their life is in danger. The decision is not easy, but it is better to take the risk that the depressed person will be angry with you in the moment, rather than let them put themselves in danger.

Conversely, if you can afford to engage in dialogue, here are 4 tips for helping a depressed person.

Tip 1 : Inform yourself as much as possible

There are many stereotypes surrounding depression. For example, depression is not a lack of willpower, as some might believe. It is an illness that profoundly alters the brain and motivation.

By informing yourself as much as possible, you will have more empathy. You will have a better chance of using the right words and the right attitude toward a loved one’s depression.

Tip 2 : Bring about dialogue gently

Have you already felt impatience toward the person who is depressed? That is normal! Do not feel guilty.

Remember, however, that the other person experiences emotions disproportionately. What is “not a big deal” to you is experienced very poorly by the other. In other words, do not get angry; be patient, at the risk of alienating the person and losing their trust.

7 techniques for a benevolent dialogue

The goal is to lead the other person to verbalize their distress because it is necessary for becoming aware of their depression. Offer them a safe space for dialogue. How? Here are a few techniques to facilitate a benevolent conversation 👇

• Speak using “I” statements to remain non-judgmental
• Ask open-ended questions
• Refer to facts
• Listen carefully and a lot (active listening)
• Reduce guilt
• Speak about your own experience
• Tell the other person that you love them

Zoom on each technique

Speaking with “I” and saying, “I am worried about seeing you all day alone in your room,” does not have the same value and does not say the same thing as “You are sad” or “You are isolating yourself.” When you say “You are sad,” you use the “you” and you are passing judgment on the other. Despite your good intentions, the other person has not authorized you to judge their behavior and state. They may experience it as an intrusion and close up like an oyster! By attaching yourself to your own emotions (“I am worried”), you also show that you are interested in the other person and that you wish to help them.

Furthermore, you will notice that in the sentence “I am worried about seeing you all day alone in your room,” we are referring to facts (the fact of being in the room all day). Referring to facts is harder to deny.

Next, ask open-ended questions. Unlike a closed question (which is answered by “yes” or “no”), an open-ended question helps the person with depression elaborate and put words to their state. Do not name the depression (“You are depressed”), which could be swept aside by the other person who cannot stand the idea of being in such a state! Here are some examples of open-ended questions: “How are you feeling?”, “For what reasons do you feel / say / do that?”, “What makes you say / think that?”, “What would you need?”, etc.

Furthermore, do not hesitate to reassure the other person if they feel guilty. Feeling guilty is frequent among people in depression. Reassure them that it is normal not to accomplish things when going through difficult times. It is normal to need help in those moments. To reduce their guilt, you can also share your own experience (or that of a loved one). Showing your own vulnerability can help the other person open up.

Finally, you can remind them, tell them that you love them and that you are there for them. This helps create a climate of trust and safety.

Speaking to a depressed person: an example sentence to say ⤵️

“I am concerned about your health because you told me last time that you no longer had the energy or motivation to do activities that usually give you pleasure. I feel like you are very sad and lost right now. How are you feeling?”

Tip 3 : Show a lot of patience

Except in an emergency situation (suicidal thoughts, delusions, dangerous behavior), you must respect the person’s pace. If they are in denial, it is not without reason. It is a protection mechanism against an emotional shock that is too painful for them today.

The path to acceptance can be long, so do not get angry, do not try to convince or force the other person to recognize their distress. Additionally, take your time to help them. Finally, if you feel that you can no longer cope, take care of yourself and talk about it to trusted loved ones or even your attending physician.

Tip 4 : Encourage the person to seek treatment

Before reaching this stage, you have taken the time to dialogue with your loved one. The person in depression has been able to put words to their suffering, and this gives you an opportunity to encourage them to consult.

To encourage a depressed person to seek treatment, you can first advise them to go see their attending physician (or any general practitioner they trust). This will allow for a health check-up and proper guidance (treatment, care path). Furthermore, this can be useful if you think the person with depression is resistant to consulting a psychologist or psychiatrist initially.

If your loved one ends up recognizing their depression, is able to express it, and maintains their capacity for analysis, you can advise them to be accompanied by a mental health professional (psychiatrist or psychologist).

💡 Here are some useful resources:

• A complete article on depression published by the MSD Manual (reference health manual)
• An article on 7 tips for seeing a therapist when you have no money
• The Doctolib website to find a doctor or therapist near you
• For students: the free listening service Nightline (french service)
• In case of emergency: the national suicide prevention number: 3114 (free call 7j/7 and 24h/24) (french service)
• Read and hear our podcast with Raphaël about dépression 👇​

What NOT TO say or do with a person in depression

Here is a list of things not to do, at the risk of making the problem worse:

• Confronting them head-on (except in emergencies)
• Judging the person
• Minimizing their state
• Invalidating their emotions
• Infantilizing the other by doing things in their place
• Losing patience
• Using blackmail
• Stigmatizing them because they cannot overcome their problems
• Guilt-tripping
• Giving generic advice

That being said, remember: you are doing your best. If you feel that you are losing patience, if you feel helpless, or if you can’t take it anymore, talk to loved ones or a professional to get advice.

What to do in an emergency situation?

The 5 signs of an emergency situation

A psychiatric emergency requires rapid action on your part. In this case, you must call SAMU at number 15 (in France) or SOS Psychiatrie.

How can you recognize an emergency situation in a depressed person?

🔎 Here are 5 signs that should alert you:

1. The person in depression makes suicidal remarks. A suicide attempt is also an alarm signal.
2. They are delusional (ideas of persecution, ideas of ruin, or incurability…).
3. They have recurring anxiety attacks.
4. They have dangerous behavior toward others and/or toward themselves (self-harm, for example).
5. Their physical health is in decline: they suffer from anorexia, weight loss, dehydration…

Compelling your loved one: overcoming guilt

When a depressed person is in an emergency situation, the caregiver must sometimes take the difficult decision of a forced consultation or hospitalization. This act is imperative.

But how can we deconstruct the frequent reluctance faced with this necessity?

Your loved one refuses to seek treatment

The argument “they don’t want to” must be set aside in the event of a major crisis. In these moments, the person has lost their discernment. Their refusal is not an informed choice, but a symptom of their disorder. Hospitalizing them against their wish is not an option, but a protective obligation to avoid a fatal outcome (such as suicide).

You are afraid of the treatment

The argument “I’m afraid they’ll be given heavy treatment” should not prevent you from acting quickly. Indeed, when a life is at stake, the therapeutic approach must be uncompromising. If, for example, your loved one had a heart attack, doctors would give them heavy treatment initially because their life is in danger. It is the same thing with a person who is on the verge of killing themselves voluntarily or involuntarily.

You fear your loved one’s resentment

This fear is rarely justified in the long term. Decision-making by a third party is often a relief for the person in suffering. It allows the person to preserve their image (avoiding the shame of going to psychiatry alone) by shifting the responsibility onto others. Anger may arise initially, but it generally fades as soon as mental clarity returns. If animosity persists even after recovery, it indicates a psychological rigidity that also deserves therapeutic support.

You are afraid of a risk of abuse during hospitalization

In France, measures involving deprivation of liberty are strictly regulated. Apart from immediate danger to others, any forced hospitalization requires the joint validation of several health professionals and a family member. This double validation greatly limits the risk of error or abuse. Your intervention is therefore a supervised rescue gesture.

How to not burn out with a depressed person?

Some caregivers exhaust themselves trying to support their depressed loved ones. How can you protect yourself from a loved one’s depression? What resources are available for the relatives of depressed people?

Tip 1 : Find support for yourself

You cannot support someone if you are in difficulty yourself. It’s like on a plane: you must first put on your own oxygen mask before helping others. If your loved one categorically refuses to seek treatment, if you can’t take it anymore, if you are lost, then find the support you need and deserve.

This can be through a support group dedicated to caregivers, from your friends, or even from a professional (attending physician, psychologists, psychiatrists).

Tip 2 : Avoid doing things in place of the other

It can be tempting to do things for the depressed person. For example, you might be tempted to do their grocery shopping because the other is unable to go out or has a fear of crowds.

Occasionally, this can relieve the person in suffering. But the risk is creating a link of dependency between them and you. This is especially true if you have “savior syndrome”!

Thus, you will exhaust yourself while taking the risk of unintentionally fueling a sense of helplessness in the depressed person. If they are doing everything they can to get better, you can help them and give them a hand from time to time. But if they do not help themselves, then your efforts will be in vain.

Why is a depressed person in denial?

Why does a person suffering from depression refuse to see their own illness?

Denial as a temporary stage

Denial is not a whim but a defense mechanism against depression. It is an unconscious strategy of psychological defense.

Indeed, faced with a reality judged unbearable, denial acts as a protective shield that distances threatening information. The individual sets aside this perception for a time. In other words, this allows the person to gain the necessary time to mobilize their internal resources. They will face the emotional pain when they feel ready.

“There are psychiatrists, psychologists who are there to help us [as depressed people]. Initially, I was against psychiatry, against medication. Because it meant accepting the fact that I was overwhelmed by myself, that I could no longer manage my life.” – Testimony from Raphaël

Avoiding the anxiety of the unknown

Recognizing a depressive state is admitting to profound uncertainty. It raises paralyzing questions: “how to get out of it?” or “will I stay in this state indefinitely?”. Denial offers an illusory comfort by avoiding facing these distressing questions.

Moreover, depression is often linked to painful experiences or internal conflicts. Accepting the illness can mean opening a Pandora’s box and opening the door to traumatic memories or buried emotions. Denial is then like a rampart against this old suffering, judged unbearable to manage in the present.

Here is the translation for the final part of the article. As before, I have prioritized a faithful rendering of the original text while ensuring the scientific and psychological terms are accurate in both languages.

What is depression?

Depression is a genuine illness, and therefore not a lack of willpower.

When someone is in a depression, there is a malfunction in their brain regarding the communication between neurons. This malfunction affects the production and capture of several major neurotransmitters, such as serotonin, noradrenaline, and dopamine. These neurotransmitters are responsible for balancing and managing sleep, appetite, mood, motivation, and more. A deficit of these substances in the brain puts it into a state of “low power.”

Treatments for different forms of depression often aim to restore this balance. They include various classes of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), which work by increasing the quantity of these chemical messengers.

However, other treatments appear very promising… such as dancing! A meta-analysis published in 2024, which analyzed 218 clinical trials, revealed that dance could be a powerful antidepressant and might reduce symptoms of depression more than other physical activities, or even certain antidepressants. Nevertheless, researchers indicate that further studies are necessary before dance can be considered a standalone treatment.

The 9 common symptoms of depression

Here are 9 frequent symptoms in depressed individuals, as listed in the Diagnostic and Statistical Manual of Mental Disorders:

1. Depressive mood present most of the time (sadness, feeling of emptiness, hopelessness).
2. Markedly diminished interest or pleasure in all, or almost all, activities (anhedonia).
3. Significant weight loss or gain or a change in appetite.
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation (observable by others).
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt.
8. Diminished ability to think or concentrate, or indecisiveness.
9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, a suicide attempt, or a specific plan for committing suicide.

A psychiatrist is the one who will make a diagnosis of depression. However, your loved one can initially consult a general practitioner if that is more acceptable to them. The doctor will perform a general health check-up to refer them to the right person.

👋 Important: depression sometimes manifests differently in certain people. This is particularly the case for men!

Male depression: “louder” symptoms

In cases of depression in men, it is common to find “louder” symptoms such as:

• Irritability
• Anger
• Aggressive behavior
• Substance abuse (such as alcohol or drugs)
• And paradoxically, hyperactive sexuality, as the demonstration of sexual vitality may be expressed to compensate for low self-esteem.

It is important to be aware of this because these symptoms are very different from those currently listed in the Diagnostic Manual of Mental Disorders.

This discrepancy in symptoms is partly due to the injunctions of virility which prevent some men from showing signs of vulnerability. Consequently, they are more easily in denial and camouflage their distress.

👉 Discover now Raphaël’s testimony about his past depression: he tells us about the journey through depression and denial, triggered by a romantic breakup and an intense identity crisis. Read or listen to this testimony to understand the weight of depression and the hope rediscovered thanks to his loved ones, the help of a therapist, and introspection.

About this article:
This article was written in the context of the Erasmus+ KA210- YOU small-scale partnership project “comPASSION is sexy” (Project Code: 2024- 3- FR02- KA210-YOU-000295806), co-funded by the European Union. The project is a collaboration between Les Philentropes (France) and Olotites (Greece), focused on compassion-based approaches to youth empowerment, inclusion, well-being and mental health awareness.

Funded by the European Union. Views and opinions expressed are, however, those of the author(s) only and do not necessarily reflect those of the European Union or the European Education and Culture Executive Agency (EACEA). Neither the European Union nor the granting authority can be held responsible for them.

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