How to Empathize with Depression

Whether the suffering is ours or that of a loved one, we can all get better at supporting

Learn
9 min

Stop saying "lighten up" or offering suggestions. Instead, learn tips for encouraging vulnerability.

How to Empathize with Depression

Whether the suffering is ours or that of a loved one, we can all get better at supporting

Learn
9 min
Thank you for your feedback!
Oops! Something went wrong
while submitting the form.

What is empathy?

“Nobody listens or cares

I've been depressed and I've questioned my existence for the past 10 years. People say they care or to reach out and help, but everytime they do, nobody cares to hear what I have to say. The worst part of being depressed is everyone expects you to act like you're not, and if you are, then no one wants to be around you. I'm so sick of people making me feel like my mental health is important but don't put in any effort to show that it is. Society has given up on me, I've given up on me.

I know I'm supposed to do what I feel is right and not be concerned about other people's validation, but it would be nice to know if someone actually f***ing cared. Some people need a support system and I've been s*** on in that department my entire life.

Maybe people will start to listen if I just end my life.”


Whether you yourself or a loved one is suffering from MDD, it is important to learn and utilize the power of empathy. For ourselves, an understanding of empathy allows us to more thoughtfully examine our thoughts and feelings before taking any actions. For others, a greater understanding of empathy will enable us to encourage a complete ‘digestion’ of our loved one’s thoughts and feelings - allowing him or her to reach closure instead of continuing to privately churn through harmful thoughts. Either way, empathy is critical for how we handle the initial concerns of MDD.

The word “empathy” has been poorly defined and overused in the media and has therefore approached losing its meaning entirely. While gentle, whispery-voiced, well-intentioned gurus may suggest that empathy is a way of acting, I’d humbly suggest that such ideas miss the mark entirely. Empathy is not about being nice. It’s not about being gentle or loving. Empathy, literally defined as “feeling in” another person, is all about diving into the person’s emotional experience with him or her so that one’s thoughts and emotions can be fully revealed. Instead of hugs and kind, gentle whispers, we are there to facilitate a complete pouring out of everything that is going on inside of an emotional person’s mind. Such an experience doesn’t require enlightenment or incense; it only requires the right words. Finding these right words can be easy given the practical methods for empathy that have been developed by mental health professionals. Of the available approaches, I find the most effective and actionable approaches to empathy to be those described by Dr. David Burns, MD, a psychiatrist and Emeritus Adjunct Clinical Professor at Stanford University. In this section, we will discuss these approaches to empathy so we can begin to use them as we encounter mental illness in ourselves and loved ones.

Imagine a loved one is suffering from MDD and makes the following statement:


“I’m totally worthless. I can’t do anything right, and every time I try, I just mess up more and more. There’s no point in living like this. I wonder if the world would just be better off without me.”


This is an emotionally-charged statement. People do not suddenly make statements like these after some frivolous disturbance. On the contrary, a statement like this is a red flag - a signal of a profound, lasting disturbance in this person’s life. We cannot appreciate the sentiment in its entirety - rather, this statement is merely the superficial crashing wave of a deeper ocean of disturbance that needs to be dived into and further explored. We must therefore respond to such a statement with a kind curiosity; it is time to listen and learn - not teach. A moment like this is a call to empathy.

An empathic response is going to address two main concerns that someone may feel while expressing emotional thoughts or feelings. The first concern that one will feel is whether the conversation partner is receptive to his or her emotional expression. An emotional person will check for this by watching for the following signals:

  • Is the conversation partner listening? 
  • Is the conversation partner interrupting my expression with advice or shallow encouragement?
  • Is the conversation partner interested in learning more?

The second concern of an emotional person is whether the environment is safe for vulnerability. They will check for this by watching for the following signals:

  • Is the conversation partner also being vulnerable?
  • Is the conversation partner acknowledging my emotion and taking it seriously?
  • Does the conversation partner respect me, or am I being judged?


Dr. David Burns has described different approaches to empathy in his writings, and here they have been adjusted to address these two principle concerns: receptivity to the emotional expression and safety for vulnerability. Here are six approaches to crafting to an empathic response to this emotional statement:


“I’m totally worthless. I can’t do anything right, and every time I try, I just mess up more and more. There’s no point in living like this. I wonder if the world would just be better off without me.”


  1. Validation: Affirming that you’ve heard, processed, and can understand the person’s thoughts or feelings. For example: “Wow - things have been really tough.

By validating, we’re confirming that we’ve processed their statement and are therefore receptive to the emotional expression.

  1. Thought empathy: Communicating back some of the person’s most poignant thoughts in his or her own words. For example: “You feel like you just can’t do anything right and wonder if the world would be better off without you.”

By providing thought empathy, we’re demonstrating that we’re actively paying attention and are therefore receptive to the emotional expression.

  1. Feeling empathy: Synthesizing a person’s thoughts to guess some emotions he or she may be feeling. For example: “You must feel completely hopeless.

By providing feeling empathy, we’re demonstrating that we’re actively processing their thoughts and feelings and are therefore receptive to the emotional expression.

  1. How you’re feeling: Sharing your own reflection about how you feel from his or her statements. For example: “I’m feeling sad hearing this.

By communicating how we’re feeling, we’re being vulnerable and creating a safe environment for vulnerability.

  1. Compliment: Highlighting some of the positive aspects of a person’s reflection and what it reveals about him or her. For example: “I’m impressed by how you’ve continued pushing forward despite this pain.

By complimenting, we’re demonstrating respect instead of judgment and are therefore creating a safe environment for vulnerability.

  1. Curiosity: Inquiring into a piece of the reflection to uncover more about what the person is thinking and feeling. For example: “What are some of these things that you feel you keep messing up?

By being curious, we’re demonstrating that we are interested and therefore receptive to the emotional expression.


So, what would an empathetic response look like if we combine all of the pieces? Let’s take a look at a response that utilizes all of these strategies:


Statement: “I’m totally worthless. I can’t do anything right, and every time I try, I just mess up more and more. There’s no point in living like this. I wonder if the world would just be better off without me.”

Empathic response: “Wow - things have been really tough. You feel like you just can’t do anything right and wonder if the world would be better off without you. You must feel completely hopeless. I’m feeling sad hearing this. I’m also impressed by how you’ve continued pushing forward despite this pain. What are some of these things that you feel you keep messing up?”


Notice that this entire exchange is oriented around observing the person’s thoughts and emotions and trying to encourage them to extract more from their mind. There are no problem-solving statements like, “you just need to give yourself a break” or “you’ll feel better if you get out of the house for a while”. There are no shallow encouragements like, “everything will be okay” or “don’t worry; this will get better with time”. There is no disbelief or impatience like “it’s all in your head” or “just get over it”. Those with MDD have an innate understanding that whatever they’re dealing with is difficult and serious. Their thoughts and feelings require complete acknowledgement, inspection, and reflection in order to be properly digested. 

Like the digestive system, our emotional health requires emotions to be processed and moved out of the body through some outward expression - like conversation or art. Empathy allows for such mental digestion to occur. Non-empathic responses like problem solving, shallow encouragements, disbelief or impatience block this digestion and worsen irritation. This is why learning to empathize is so important; we must let the expression flow. Hopefully, with this new understanding of empathy, we can better encourage this important mental digestion to take place in ourselves and in loved ones suffering from MDD.

Improving one’s capability to empathize requires much practice. The six methods can be combined and switched according to the conversation to craft a sincere, natural response. With repetition, your juggling of the six methods described above can become second-nature. We must begin by recognizing that all attempts to empathize must be sincere; attempting to empathize from a shallow or disbelieving disposition will quickly be sniffed out by your conversation partner. One way to avoid inauthenticity is to mix and match only a few of the six methods. Not all six methods need to be combined in each of your responses; you can be creative in how you combine and reorder the methods in your response. We can try combining a receptivity method with a vulnerability method. For instance:

  • Thought empathy + how you’re feeling: “You feel like you just can’t do anything right and wonder if the world would be better off without you”; “I’m feeling sad hearing this.
  • Feeling empathy + compliment: “You must feel completely hopeless”; “I’m impressed by how you’ve continued pushing forward despite this pain.

Or, we can simply reply with methods demonstrating our receptivity:

  • Validation + curiosity: “Wow - things have been really tough”; “What are some of these things that you feel you keep messing up?


In order to keep the reflection going, it may be necessary to include curiosity in all of our responses. Asking questions will allow us to continue to dive deeper into the ocean of the other person’s experience, bringing everything to the forefront so that nothing is left unexplored. Complete exploration - or in other words, complete digestion -  of all these thoughts and feelings is our goal as the empathic conversation partner.

Why is mental digestion so important? Let’s do an experiment. You have one instruction: don’t think about a pink elephant. Don’t think about him! Don’t imagine what he looks like, how tall he is, or what he’s doing! Do you see what happened? You probably formed an intricate image of a pink elephant in your mind even though you weren’t supposed to. Ironic Process Theory is a psychological theory that describes that the thoughts we attempt to suppress are more likely to come to the surface. Just like a beach ball pushed down into the water, the harder we push, the more violently it shoots to the surface. Such is the case with depressive thoughts. When our depressive thoughts are purposely avoided, told to be ignored, or prematurely dismissed, we will only obsess over them even more. A major function of mental digestion is to bring all of our beach balls to the surface: with all of our unexplored, suppressed thoughts no longer being pushed down, we will obsess over them less. We’ll be able to move on.

An additional aspect of psychology being leveraged in an empathic response is Gestalt psychology. In conjunction with Ironic Process Theory, Gestalt psychology describes how the human mind is primed to obsess over ‘unfinished business’ and craves closure. This is the same psychological phenomenon that is leveraged by cliff-hangers at the end of shows, increasing our likelihood of continuing to the next episode. Therapists and marketers alike have noticed that, until humans reach closure, they will wonder about or obsess over ‘unfinished business’. In MDD, many come to conceptualize their depressive thoughts as a sort of ‘unfinished business’, and have difficulty moving on without feeling they’ve reached complete digestion of these thoughts. This lack of complete exploration of depressive thoughts and feelings creates an obsessive thought pattern, which is common in MDD. Empathic listening allows us to fully explore the thought and feeling patterns of the person with MDD, allowing them to bring closure to certain issues. Arriving at this closure will make their thoughts less obsessive, decreasing the amount of times their sled runs down the same path, keeping their sled’s path shallow and easy to escape.

As we encounter depressive thoughts in ourselves or others our first response must, therefore, be empathy. As we identify emotionally-charged expressions, we should focus on crafting replies that demonstrate our receptivity and encourage vulnerability. We can demonstrate our receptivity to the emotional exploration by validating, providing thought empathy, feeling empathy, or demonstrating curiosity. We can also encourage vulnerability by sharing how we’re feeling as we hear the person’s disclosure and by including occasional compliments. These methods for empathy allow for complete digestion of thoughts and feelings instead of the more common conversation-stopping methods like problem-solving statements, shallow encouragements, or statements of disbelief. By remaining curious and by creating a receptive and vulnerable environment, we will be able to encourage complete digestion of the thoughts and feelings. By reaching complete digestion of these thoughts and feelings, those with depression will obsess less over their depressive thoughts, will be able to reach closure, and will be able to finally start moving on.

©2021 Hyka Therapeutics. All rights reserved. Our website services, content, and products are for informational purposes only. Hyka Therapeutics does not provide medical advice, diagnosis, or treatment. Hyka does not endorse companies or products. See additional information.

Are you a provider?

Learn about how Hyka can help your
practice and patients at hyka.io

© 2021 Hyka Therapeutics. All rights reserved. Our websites, content, and products are for informational purposes only. Hyka Therapeutics does not provide medical advice, diagnosis, or treatment. Hyka does not endorse companies or products.

Hyka Therapeutics Inc.

Harvard Innovation Labs
125 Western Ave, Boston MA 02134
hello@hyka.io