A good friend is there for you when you’re feeling blue; laughs with you when you’re happy; and, of course, is always game to act as a top-notch wing-woman.
What a good friend doesn’t do, however, is act as a therapist.
If you have a friend with depression, you may want to get in there and help them directly. But while you should remain supportive, it’s far more helpful in the long run to get them set up with professional support. Here’s how to do exactly that.
Step 1: Open up a conversation about your friend’s depression
A nonjudgmental, open-ended conversation not only gives your friend the opportunity to talk about what’s on their mind, but also shows how much you care about them.
Here are some tips to gently start a helpful conversation about a friend’s depression:
- Pick the right time and place. Try sometime on the weekend when you both have downtime, and are able to relax and open up.
- Pick a “safe space,” like your mutual favorite restaurant, so your friend feels comfortable.
- Maintain a positive, welcoming, compassionate tone of voice.
- Ask too many questions. An exploratory conversation about overall feelings doesn’t need to include all of the details of your friend’s life.
- Bring up the conversation in front of other people. Finding a comfortable time and place to talk about this serious topic often does not include other people; you don’t want to come across like an intervention.
- Make it about yourself. Everyone has gone through hard times, but everyone’s experiences are also different! Maybe something that helped you get through negative emotions won’t be helpful for your friend. You also want the conversation to circle around them, not you!
Step 2: Know what you’re (generally) planning to say in advance
Open the conversation gently, and in an open-ended manner. Adapt these examples to fit your own style and personality:
- “Hey, how are you doing with everything? I noticed you seem a little bit sad these days, I just wanted to say that you can always talk to me if that’s something you would like to do.”
- “Just wanted to let you know that I’m so grateful for you! I care about you a bunch, so I wanted to talk to you about something.”
- “The other day, I noticed you weren’t really acting like your usual self – would you like to talk about it?”
- “Sometimes life can get crazy – have you thought about seeking help?”
Not sure what to say? Put yourself in their shoes! How would you like someone to approach you about a situation like this? Maintaining compassion for your friend is key for the conversation to go well.
It’s also very important to listen to your friend fully and let them tell you what’s on their mind. You might be the first person to hear their thoughts, which is a great privilege in a relationship and definitely significant to keep in mind while you react to their words. Show them that no matter what they say, how badly they might feel, you’ll be there for them when they need you.
Step 3: Offer to help them find help
If you feel comfortable bringing up the topic of therapy or seeking help, encourage your friend to reach out to a professional! You might also help them find that professional:
- Research online with your friend: There are many great national online directories of therapists. On Zencare, for example, you can watch therapist videos to get a sense of what the therapists are like, and help your friend set up a free initial call.
- Ask around for recommendations in your area: It’s helpful to hear from people that you trust about the resources in your community. You might start by asking around friends or family, but don’t be afraid to approach people in outside circles as well.
Keep in mind that therapy is does not look the same for everyone – just because one therapist helped someone doesn’t mean that they would be effective for your friend.
There are many dimensions of effective therapy – the type of therapy treatment, the personality of the therapist, the personality of the client, etc. – so make sure your friend picks out professionals who sound fitting for them, as they know best.
For example, your friend may respond well to a therapy approach in which they learn skills and tools to overcome their depression, like cognitive behavioral therapy; or they may prefer an approach that helps them understand and identify where the depression stems from, like psychodynamic treatment. There’s no right or wrong with therapy preferences!
Step 4: Help your friend prepare for treatment
Once you’ve narrowed down some options for therapists and the timing is right, offer to help your friend prepare! Here are a few ways to do that:
Figure out payment
Are they going through insurance, paying out of pocket, or using out-of-network benefits? Either way, your friend has options! Read up on these different options in order to help your friend figure out the best way to afford therapy:
- Looking for a therapist who takes your friend's insurance is typically the lowest cost way to find a therapist, generally a $20-$50 copay; however, in large cities like NYC and Boston, therapists who take insurance and are good are typically booked out for weeks or months. Looking only within your health insurance network can significantly limit your pool of therapists to choose from. If you have a high deductible plan, you may have to pay the full therapist session fee anyway for until you meet that amount.
- Paying out of pocket means your friend will pay the therapist's full session fee, without the financial assistance of your health insurance plan. For example, your friend's therapist may charge $150 per session, in which case they would pay that amount after each appointment. This allows your friend to choose any therapist and prioritize fit and quality, rather than limit options by only searching among therapists who take their insurance.
- Using health insurance out-of-network benefits is a great way to keep the pool of therapists broad, while also getting some financial assistance from the health insurance company. Your friend pays the full price of their sessions upfront, and then (depending on their plan), receives a reimbursement via check from their insurance company.
Prepare for the initial phone call
The initial phone call is a great opportunity for your friend to assess fit with each therapist they're considering. Help them prepare for the call with the following:
Questions to ask each therapist:
- Does you have experience working with clients in similar situations or who have depression?
- Can you tell me about your approach to treating depression?
- When do you currently have openings in the week?
- Would I come in weekly for sessions? (Most therapists want to see clients with depression weekly, rather than biweekly or monthly, to ensure progress is being made, and the client's depression is improving.)
Questions the therapist might ask them:
- Tell me a bit about what you're going through.
- Have you been in therapy before?
- What has worked in the past, and what hasn’t?
Shopping around for therapists is essential in attaining the right therapeutic alliance. Having a conversation with your friend about how the interaction went after each new clinician may help them explore their personal preferences.
Know where to go, and what to do
Your friend may benefit from a checklist of what to know and where to go, like:
- Where is the office located?
- How would they make session payments? Does the therapist accept cash; is there a user portal where I enter my credit card information; or do I pay upfront every session?
- How long will the first session be? (Intakes are often longer, around 50-60 minutes.)
Step 5: Be patient and encouraging
The best thing you can do as a friend is to simply be there in a way that effectively communicates that you care – there is no rushing when it comes to supporting a friend with depression.
Having multiple conversations about depression and its treatment before your friend takes action is completely okay! Even after treatment begins, know that the length of a depressive episode can vary by person, and it can be recurring through life for many people.
Therapy doesn't yield instantaneous results, so ongoing treatment and patience are important. Your support throughout their time in therapy can go a long way.
As your friend embarks on their journey towards better health, check in every once in awhile and let them know they’re on your mind. And remember: People with depression often feel isolated and alone – one of the most important things you can do as a friend is to let them know that they’re not.