If you’ve been following my blog closely, you’ve probably noticed that I’ve become something of a keyboard warrior, zealously ranting about stigma and voicing a general state of dissatisfaction with how mental health is treated and discussed in society. You can probably see why, when one of my key intentions is to start challenging the people around me to change the way they think about mental health.
But, as an old Greek flatmate of mine once told me “opinions are like arseholes – everyone’s got one”. So, it is important to recognise that I need to provide answers, too. Changing peoples’ attitudes involves supporting them to find ways of contributing to the agenda.
So, with that in mind I thought it might be a good starting point to offer some simple and straightforward advice. Advice for those of you who are looking to support someone with a mental health problem but just don’t quite know how yet. Or perhaps you have a mental health problem and want to give your friends and family some advice on how to help you.
The people on the internet who know about these kinds of things say that lists are a very simple and effective way to communicate on a blog. Taking this as gospel, I have thus carefully crafted 8 ‘top tips’ for you to think about. These top tips are based broadly on my own experience rather than any kind of empirical or scientific evidence. They won’t always be right and I would encourage you to exercise your judgement in how you use them. But they are simple acts and I hope will provide a good point to start from.
So here goes:
1. Acknowledge your friend’s problem
One of the worst things about having a mental health problem is feeling like you need to 'act normal' all of the time. Sometimes, squeezing out a few words of small talk can feel like a titanic struggle. Or you might be late to work after a fraught 1-hour sleep, and struggling to stay awake at your desk. The anxiety and energy spent trying to behave like you’ve got things under control can make things so much worse.
What I really want when I am down or anxious is not to have to pretend. I don’t need permission to indulge in my anxiety or depression – but if people can just say “how’s it going today?” or “I know you’re not feeling great, just do what you have to do” it makes such a big difference.
2. Ask them if they want to talk about it
One of the things I often notice is that people tend to feel a bit awkward when approaching conversations about mental health. Usually I get the feeling that they aren’t really used to it, and worry that they will say something wrong or ‘set me off’. You get a sense that people are treading on eggshells, a little.
So, I always think that asking for permission is a good idea. Literally asking “do you want to talk about it?” or “are you OK talking about it?” can be useful both to settle your, and your friend/colleague/family member’s awkwardness about discussing the topic.
3. Listen with real compassion and presence
Opening up about your mental health problem can be terrifying. I’ve lived with it for so long now I can’t really remember what it was like to share it for the first time. But I remember the process wasn’t fun. This is down firstly to the stigma attached to mental illness and the fear of judgement that comes with sharing your problem. And secondly because it can feel pretty scary to ‘make it real’ by talking about it. This doesn’t mean you should avoid the topic however (see points 1 and 2, above!).
So, if you have started a dialogue about it, make the effort to listen, with your eyes, your ears, and your heart. This is not easy. It can feel like a lot of hard work for the listener and the topic is hardly jovial. But responding with genuine empathy and understanding shows your friend that you really care about and value them - something which they may doubt due to their illness.
On the other hand, if you are looking at your phone, getting distracted by what is going on over your friend’s shoulder or trying to move the conversation on, they are more than likely to pick up on your vibes. They are likely to rationalise that their problems are boring or too much for anyone to bear, and put the shutters back up.
4. Try not to solve the problem or offer ‘fixes’
This is an incredibly difficult thing to do if you care about someone. Our instincts tell many of us that we need to pick the problem apart and offer an answer that will work to solve our friend’s pain. In spite of your best intentions, this is unlikely to be helpful. Why?
Well, firstly, your friend is likely to have tried this over and over with a limited degree of success. It is quite possible that the process of trying to ‘solve’ the problem could actually make it worse, since their problems, like mine, weren’t really ones that can be ‘solved’. And if they do need to be solved, then there are very specific ways of doing that which predominantly sit in the domain of mental health professionals.
Secondly, neither of you may realise it, but trying to ‘solve’ their mental health problem might send some of the wrong, but very subtle unconscious signals to your friend. Signals that say: “I’m more in control than you and I have it all figured out, so you just need to follow my lead”. This can reinforce a lack of self-esteem or perceptions about how much control your friend has over their feelings.
Thirdly and finally, you can all-too-easily create a sort of ‘ding-dong’ argument which basically looks like this:
Friend: “I feel rubbish, no one can help me”
You: “Have you tried X?”
Friend: “No it won’t work”
You: “"What about Y?”
Friend: “Tried that and it didn’t work”
You: “OK, what about Z”
Friend: “No I don’t like option Z”
You: (getting frustrated now) “Well your attitude isn’t exactly helping”
Friend: “Neither are you. I told you no one could help, see”
[CUE AWKWARD SILENCE]
We’ve all been there with our partners. Don’t let it happen between you and your poor depressed or anxious friend!
I cannot emphasise enough how much better it is to just listen and express empathy. Something like “wow that sounds rubbish, I’m really sorry to hear about it. What can I do to make things easier?” works much better. Or offer practical and straightforward help. Three memorable examples were:
My boss letting me take it a bit easier at work for a few days and not giving me grief for coming in late
Katherine buying dinner and cooking for me so I could rest up after bad week, not long after we started dating
My mum sending me a ‘care package’ when I was at Uni and feeling low
5. Don’t make it into ‘A Big Deal’
Quite an interesting one, this. Sometimes all it takes is a subtle look for you to know someone thinks your illness is ‘A Big Deal’. So, try to think of it as just ‘something which happens in life’ and practice non-judgement. That means not saying “whoooaoaaaaaa sounds mental!” or “This is something you should be telling a psychological professional, not me!”. It also means not making ‘that’ facial expression which says “This is awkward, I’m not sure what to do here!”.
Working as a coach and business psychologist, people tell me extraordinary things. I remember a few years ago when I was assessing a senior manager for a client. I’d only known him for 15 minutes before he told me that driving makes him so anxious that he nearly shits himself right there in the car, and it wasn’t unusual to see him at the side of the road taking a dump. This could have been seen as a huge overshare in the context but I didn’t bat an eyelid because I knew how important it was for him to be able to open up about this.
People don’t tell you things like that if you treat their worries or neuroses as ‘A Big Deal’. On the other hand, treat it like the most ordinary thing in the world and they will learn to trust you and share what’s really going on for them, so that you can help.
6. Don’t forget about them
I remember during my first episode of depression & anxiety, I regularly struggled to get out of bed and would go into school late. But one of my best mates, Graham (pictured below) still used to come around to my house every morning to see if I was walking in with them. More often than not, I would decline or if I accepted, not say a word on the walk to school, but still he came. Knowing that my friends were still there for me and still valued me as a friend was really important, and it was a critical part of my recovery. Can you imagine how hard it would’ve been to get better if I thought I had no friends left?
So, if your friend has a mental health problem, keep on inviting them, calling them or texting them. Keep on being patient with them. Chances are they desperately want to be able to join in and wish they could just get over their anxiety just to be themselves with you, for once. But they just can’t today.
Your persistence will mean a lot, and when it’s all over, they will remember you for it. And thanks to Graham for making a difference.
7. Make sure they are getting help
This is a simple one in theory. If a friend is struggling, they really need to be getting treatment and support. So check in with them and ask if they’ve been to see their GP. Encourage them to go and see a counsellor or therapist and make sure they tell the people close to them.
It is absolutely critical that people who have a mental illness are surrounded by people who can help, and don’t feel alone. This is for two reasons:
The longer people wait for treatment, the longer they will take to get better. And by that, I mean, for every day you allow your problem to go on, you are probably adding at least two extra days at the back end. Don’t let them hang around. It’s such a waste of time.
Those who have a support network and are getting treatment are less likely to die by suicide.
As my next point will detail, this doesn’t mean the problem is yours. Unless your friend has truly lost touch with reality, they are still responsible for themselves and you can’t make them do anything. But some gentle encouragement to explore the possibility of seeking support might make all the difference.
8. Look after Number One
The most important thing to remember is this: If someone tells you about their mental health problem, the burden is not yours to carry. You do not need to help this person if you don’t have the energy or skills to do so. Remember to do what you can, but it’s also OK to say no sometimes.
Like Katherine and my mum will say, helping someone’s mental health problem can be quite addictive at first. You are flattered that the person trusts you enough to tell you and you can’t help falling over yourself to help. But in the long run, both of them have found it better to spread the load around. So, encourage other people to be involved and allow your friend to take ownership for sorting out their own problem, with your help - if they want it, and only when you have the resources to give it.
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