Getting along with a roommate can be challenging at times. It takes more than a little effort and diplomacy to work out the natural frictions that may develop in any such arrangement. The challenges of sharing refrigerator space, issues regarding timely rent and utility payments, discussions about mutual respect for privacy, or arguments over appropriate noise levels all pale in comparison to the difficulties of dealing with a depressed roommate.

Depression is a medical condition. While everyone experiences sadness, lack of energy, or even despair occasionally, depression goes well beyond the blues. We now know that depression is probably linked to problems with brain chemicals called neurotransmitters, namely serotonin and norepinephrine. These neurotransmitters act as chemical messengers, traveling from one brain cell to another to propagate signals that play a role in normal mood regulation. Among people with clinical depression, levels of these chemicals are believed to be so low that mood becomes uncontrollably disordered.

A depressed person is likely to exhibit behaviors that would challenge even the most accommodating of roommates. He or she may be sullen, sad, angry, irritable, lethargic, or even abusive. Some depressed people cry uncontrollably, with little apparent provocation, while others are likely to lash out in anger. Some eat too little, or too much, while others sleep too much — or struggle to sleep.

It’s important to realize that a depressed person is not him or herself. Despite any evidence to the contrary, he or she is not necessarily being belligerent, or acting out, or being aggressive, or slovenly, or selfish, or irresponsible by choice. If your roommate is depressed, chances are he is incapable of behaving like an ideal — or even a marginally acceptable — roommate, because he  simply cannot control his behavior any longer.

Short of cutting your losses and moving out, your best option is to bear with your roommate and try to encourage him to get help. Depressed people often do not realize — or do not wish to admit — that they have a real problem and need medical help. But medicine offers the best hope of recovery.  Once upon a time, people with depression were labeled melancholic, or called lunatics. They were either shunned or shut away in asylums where they languished, with no treatment, in often appallingly inhumane conditions.

Fortunately, we now recognize that people with depression are not “crazy.” Rather, they suffer from a largely treatable illness that deserves our compassion, understanding and patience. With medication and/or psychotherapy, most cases of major depression are now treatable. In some instances alternative treatments, such as electroconvulsive therapy, may be necessary. The important point is that people with depression can get better with proper medical care. 

What’s a concerned roommate to do?

If your roommate appears anxious, confused, indecisive, constantly sad, irritable or restless, he or she may be depressed. Rather than criticize her behavior, consider encouraging her to get help.

Don’t take seemingly antisocial behavior personally. If a depressed roommate fails to clean up after herself, or to respect your wishes regarding shared tasks, etc., it doesn’t necessarily mean she’s disrespecting you. She may simply be too depressed to behave as she normally would.

Encourage your roommate to seek help. If he refuses, consider contacting a family member who can help get him the medical attention he needs.

Depressed people (especially men) often turn to drugs or alcohol in an attempt to feel better. Rather than improving the situation, drugs or alcohol (or both) invariably make things worse. While it’s one thing to share a friendly drink with a roommate, enabling ill-advised behavior in a sick person is another thing altogether. Be advised. 

If your roommate talks about suicide, or threatens to commit suicide, it’s important to take immediate action. Threats should not be viewed as idle bids for attention; they may be genuine signs of an impending suicide attempt. Call your roommate’s doctor, a suicide hotline, or 911. If the threat seems credible, stay with your roommate until help arrives, and remove any potential means of harm from the immediate environment. Guns, for instance, are used to commit suicide more often than any other method. While depressed women are more likely to attempt suicide, far more men than women die from suicide in the U.S.

Of course, you need to look to your own needs, too. Assuming responsibility for the wellbeing of a depressed person takes time and energy. At some point, you may need to consider your options. If your roommate refuses to seek treatment, or will not take prescribed medications, and has rejected help from his or her own family members, you may need to consider making other living arrangements.