In medicine, a depressed mood, a loss of joy and interest, and a lack of drive are defined as the core symptoms of depression. In addition, professionals define supplemental symptoms. These include sleep problems, feelings of guilt and rumination, as well as concentration difficulties and changes in appetite. Doctors diagnose depression when several of these symptoms persist for at least two weeks and significantly slow down daily life.

Sadness feels unpleasant, but it often occurs in waves and slowly subsides when the person is comforted. Depression, on the other hand, feels heavy and constant, draining energy, sleep, and confidence.

The term "behavioral patterns" describes the recurring actions and reactions that come with depression. Typical behavioral patterns in depression include, for example, withdrawing from family or friends or constantly postponing tasks. Some people mask their suffering and appear to function completely normally. These behavioral patterns do not arise from laziness or weakness, but rather from the aforementioned symptoms of depression.

If you want to gain clarity as a friend or family member, look out for these behaviors:

• Many people with depression cancel plans because they lack the strength and hope.
• Some only manage to do the bare essentials and procrastinate on other things because the mountain of tasks seems too high.
• Some appear irritable because their thoughts are constantly spinning and every noise frays their nerves.
• Sleep often falls out of rhythm. Some barely sleep and wake up very early, while others sleep for a long time and still remain exhausted.
• Eating habits change as well. Some lose their appetite, while others eat more than usual, especially in the evenings.

These patterns show that the person needs help—not that they are not trying hard enough.

If your observations point toward depression, support him or her in getting treatment.

It is better to start a conversation with observations rather than judgments. For example, you could say: "I've noticed that you're spending a lot of time alone, and I'm worried about you." Then, ask an open question like: "How are you really doing today?" Listen, summarize briefly, and ask what would feel good right now. Avoid phrases like "Pull yourself together" or "Others have it worse," because such statements cause pain. Inform them that depression is a very widespread and, above all, treatable illness.

Motivate the person to make an appointment with their doctor. They will conduct a consultation, assess the situation, and issue a sick leave note if necessary. Most importantly, they will provide information about psychotherapeutic treatment and share contacts. Offer to accompany them and help with filling out forms.

Psychotherapy means that someone with psychological and therapeutic training explains the illness, sets goals together with the affected person, and guides them through helpful exercises. For example, behavioral therapy helps to plan small steps, stop rumination, and reduce self-devaluation. In the course of therapeutic treatment, it may turn out that medication can offer additional stabilization. The doctor will then check the benefits and side effects and decide on the intake and the specific antidepressant together with the affected person. Motivate the person to stick with the therapy and to be patient.

The Digital Health Application (DiGA) deprexis complements the treatment. Through easy-to-understand modules, the application guides users through exercises based on cognitive behavioral therapy. deprexis helps monitor mood, set goals, and stay on track. Doctors can prescribe the DiGA, and health insurance providers typically cover the costs. Motivate the person to give themselves this additional support in their daily life.

You provide stability by being and remaining reliable and reachable. It is best to speak with the person in a particularly calm, clear, and friendly manner. Suggest small steps that are manageable today. Actions such as "ten minutes of fresh air on the balcony" or "drinking a glass of water" count. Praise not only results, but also activities and attempts. And do not make reproaches if something does not work out. Remind them that setbacks are normal. Finally, it is important that you also take care of yourself and get some rest.

• …wants to be alone: Respect the wish, suggest a time for a brief phone call, and remain reachable.
• …no longer wants to go out: Offer a very small activity accompanied by you, and accept a "no" without applying pressure.
• …says a phrase like "I can't go on anymore": Ask openly about suicidal thoughts and talk about it together. Emphasize your availability and provide emergency numbers. Take a deep breath together, have something to drink, and plan a walk, a trip to the cinema, or a phone call together for the next day.

Many friends and relatives of people with depression find it difficult to find the right words. Here are three examples:

• Showing belonging: "I see how hard this is for you, and I am walking this path together with you."
• Reducing feelings of guilt: "You didn't ask for depression, and you don't need to feel ashamed of it."
• Offering concrete help: "I will call the doctor's practice tomorrow, and I'd be happy to come along with you."

Keep your sentences short, warm, and honest. And repeat them if the person doubts themselves.