How do we support someone struggling with mental illness?

When someone shares that they are struggling with their mental health, how should we respond? Whether it’s a friend, family member, co-worker or even a stranger on social media, well meaning responses, such as “Let me know if there’s anything I can do to help”, can actually add to the struggle. Often we don’t really know what would be helpful to us in moments of mental or emotional distress, or we may be convinced there isn’t anything that could possibly help. That makes it impossible to tell well meaning people how they can offer support so we thank them and leave it at that. Those well meaning friends and acquaintances may end up feeling helpless and unsure of what to do, afraid of following up or may even end up assuming that we’re ok and don’t need any further support. And so the cycle continues.

So what can we do to help our friends help us? And how can we help each other?

There was a brilliant discussion about this over on Facebook (yes, really!!) in the Harry Potter and the Sacred Text Common Room group. Lots of people were sharing the things that helped them, arrangements they had with friends or family and how they support others in times of crisis. It was really evident from the discussions that, just as each person’s experience of mental illness is different, the methods of support that work best are different for each individual. There were lots of brilliant suggestions and the group have kindly allowed me to share some of them here.

Consider choice and consent

Before we get into the suggestions, there was one really important element in the discussion that came up time and time again: that of choice and consent. Here are some of the thoughts that were shared:

“I find it really important to first ask for consent when we’re trying to support someone. I used to always try and fix things for people, but that’s often not what they’re looking for. So I like to ask simple (not overwhelming questions). Some questions I ask when a friend is struggling: -“Do you want to talk about it or do you want me to just be here with you?” (a follow up can be “would you like a distraction?”), “Are you looking for advice/ feedback about this, or do you want me to just listen?”, “Do you want me to check in with you daily for a bit or would that be overwhelming?”, “Do you want to pencil in a time to talk/hang out, or not right now?” I think for me the main point is offering concrete simple options, so the person struggling can have agency but hopefully not feel too overwhelmed.”
“I find it usually helps if I ask yes or no questions, like “do you want to talk about it?“ “Do you want to talk about something else?“ “Do you want to watch a funny movie?“ I think a lot of the time, what people need is just to talk or do something together without necessarily talking about how they’re feeling.”
“The simplicity of yes/no choice is wonderful, and the “no” option is also super important for me. I hate and fear surprises and do not experience them as a form of care even when they’re “good” surprises, but when friends offer a simple yes/no choice it has been a brilliant “best of both worlds” way of caring — none of the bad of how I experience surprises as nonconsensual, but still very very low effort for me.”
“The best thing people have done for me when I was having a rough time was to drop off food or say, “I’m sending you x unless you don’t want it.” It removed the need to try and make choices, which was too much for me in that moment, the only choice was, do you want a pizza to show up in an hour or not?”

When we are struggling we are more vulnerable. For some people, having to make even simple choices is completely overwhelming whilst for others maintaining that agency and having control over those choices is absolutely vital. This means that in order to know what is most helpful for those in our networks – and for ourselves – it is important to think and talk about it on our good days so that the tools are ready when it gets difficult, and the actions we take are genuinely supportive.

Here are some of the suggestions of actions that could be helpful:

Check in

“I ask my friend, every day, “how are you doing?” This is something she has told me is helpful. A lot of days she doesn’t answer, but some days she says she wants to call me and talk about it. My consistent, I’m here for you and I care a lot about you, means a lot.. or so I hope so”

It doesn’t have to be every day but checking in with the people we love is a simple way to let them know we’re thinking of them and there if we need them.

Allow space for silence

“Sometimes the form of support I want most is space and a tolerance for my unavailability.”
“I have a few friends with whom I can just say “no thank you” as a response to “how are you,” and I find that so helpful.”

“When I am really struggling, a message from a friend that just says “Haven’t talked in a while. Thinking of you. Hope you’re doing okay.” or something can help. And then be okay with me not answering for a while. Sometimes the support that I really value from friends is when they tell me they’re there for me whenever I need it, but they also tell me they love me even when I’m not up to even answering a text message.”
“I message privately, keep it short, tell them it’s totally OK if they don’t have the spoons to respond, but I’m here to listen in a 1:1 way.”
“Sometimes having that person who just texts/calls/writes to say “thinking of you, love you, sending love and hope” without expecting a response can be really nice, too. The need to reply to a message/voicemail can feel overwhelming. Similarly, snail mail can be awesome for low-pressure, creative connection (even if you’re neighbors!).”

Sometimes even the simple act of responding to messages is just too much for us to handle. Holding space for that need to be silent is therefore a really important form of support for some people. Complete silence can cause concern so it may be worth agreeing with loved ones something simple to send in acknowledgement that you/they are ok but don’t have the energy to respond fully – you could choose an emoji, symbol or short word.

Find alternatives to ‘how are you?’

“My best friend was struggling with bipolar and was able to articulate how she hated socializing because she didn’t want to talk about herself and couldn’t muster up any care for other people’s lives. We settled on doing a photo sharing “challenge”. We picked a photo challenge list (google it, there’s a zillion) and texted photos every day for a month. It allowed us to share trivial and important things without the “how are you today” hurdle.”
“My friend shows she cares when she isn’t at her best or I’m not at mine by sending me really random news articles.”

Keeping in touch doesn’t always have to look like ‘how are you’ – sharing photos, random articles, blog posts or Buzzfeed quizzes can be a fun way to stay in regular contact with loved ones without putting pressure on them to go into the ins and outs of what’s going on in their life/brain.

Acknowledge – don’t try to ‘fix’

“One of the most helpful things for me is the agreement I have with one of my friends that if either of us are struggling the other won’t try to ‘fix’ it. We don’t offer advice, we don’t say ‘it’ll be ok’ we say that’s really shit and I’m so sorry you’re going through it’. It is such a relief to have that space where someone simply acknowledges the struggle without the need to then try and find a bright side or offer a solution. It helps me feel seen and often helps me navigate to a more hopeful place, simply because I haven’t been forced there by someone else. Sometimes you just need someone to acknowledge your pain.”
“Offer acknowledgement that isn’t overly chipper, e.g. “I hear you — that sounds really hard.””

There isn’t always something that will help when we’re in moments of distress or crisis. Sometimes, unfortunately, we have to go through the middle to come out of the other side. We don’t need external acknowledgement to validate what we’re going through – but it can be reassuring to get it nonetheless. In those situations, it can be comforting to know you’re not alone and to have someone acknowledge your experiences and pain.

Offer specific things you can do

“Say “I’d love to support you in a way that is good for you.” and offer a few specific ideas, based on what you know of the person, providing a range of options that are within reach for you. “Maybe Specific Thing X, Specific Thing Y, or Specific Thing Z?”
“I write cards — could be super short, a small painted card and “I’m thinking of you.” 
“I offer very specific things — “I baked two loaves of bread, would you like one.?””
“I will try to act on a need that I can intuit but they might not think to ask for: “here is some extra cat food, my cat can’t have this style anymore” “I got a good deal on dog food, and thought Chester might use some.””

“When my mom was in hospice and after she passed, dozens of people said, “Let me know if you need anything,” but when it was framed that way all I could think was, “… I need my mom back?” The ones who stood out were those who said, “Do you need me to take the dog out?” and “What kind of food would you like? I’ll pick it up on the way.” (We had more than enough food, but what everyone else had brought was almost exclusively pasta, and I hadn’t had any veggies in days.) I know it’s tougher during a pandemic, but if you can safely be with them in person, offer to field their phone calls (love the idea of the “out of office” message!), get them out of the house, run errands for them. One of my cousins even offered to be the “bouncer” at the door and kindly but firmly let people know we couldn’t handle any more visitors, which I would never have thought to ask for, but so appreciated. Of course this was all specific to my situation, but I think in general it’s helpful to imagine what you might need if you were in the other person’s position.”

Coming up with something that will help us when we’re in the middle of a darker period can feel impossible so having someone fill in the brain power bit can be helpful. You might think about things the person in crisis has said helped in the past, or just use your knowledge of them to come up with suggestions. These could be practical, such as the suggestions above for dog walking and picking up groceries, or things that might brighten their day “I just finished a book I think you’d like, would you like me to pop it through your letterbox?”.

Be present

“Tricky in a pandemic, but I’d say show up and witness. Be a shoulder to cry on, a friend to make sure they eat and drink, a friend to nap with, a friend to binge watch trashy TV with, a friend to walk your dog or clean the litter box when they’re too exhausted, and sometimes the friend to drive you to the hospital or treatment. Be there however you can.”
“Asking them to do something with you they know you like (and that might also help them) can turn the attention away from them and make them feel normal and helpful.”

Know yourself, know your people

“I know how hard it is to watch someone you care about suffer, but you do have to remember that an action that might be a relief to one person could potentially make a different person feel like garbage. Considering someone’s love language (as cheesy as that is) can be a really good way to figure out how to offer support to a loved one who’s having mental health issues. For example, my love language is quality time. I’m going to turn down a friend’s offer to drop off food or do my laundry because that would actually make me feel like even more of a burden and wouldn’t help my depression at all. But if they check in and tell me that they would love to have a video chat or watch a silly movie or do some other activity with me that will get me out of my own head for a bit without requiring me to leave the house, I would more than likely say yes. Because that’s what makes me feel valued.Obviously this will only work with someone that you know well enough to know or be able to guess their love language, but I’ve found it to be a good metric to use with my friends.”

As touched on at the beginning of this post, knowing what works for you and what works for the people you love is a vital part of ensuring you get and give help that feels genuinely supportive. Some of the actions suggested above seem contradictory but there is no one-size-fits-all answer. It’s also important to acknowledge that there is no one-size-fits-me-all-the-time answer, and what helps may change over time/depending on circumstances. Check in with yourself and your loved ones during the good times and be open about the forms of support that are useful. You could even share this post and highlight any of the suggestions above that resonated with you, asking friends/family in return what helps them.

I’d like to leave you with one final piece of wisdom from the discussion:

“The first conversation is often the hardest! At some point, mental health just starts to become a topic you talk about with certain people, like how is your family, how is school/work, read any good books lately, how are you, really? Once you get to that point it gets way, way easier to have less high pressure conversations and just be honest about what’s going on without the slightly unhelpful ‘fix it’ alarms going off everywhere.”

There are so many people and organisations working tirelessly to battle the stigma around mental health and mental illness but there is still a long way to go. Wherever possible, wherever we have the energy, headspace and feel safe and comfortable to do so, we must try to normalise these conversations. Because having ups and downs in our mental health is normal. It is part of being human. And the more openly that is acknowledged the better we can all support one another.

Go gently, friends.

Jen x

Do you have any suggestions you’d add to the ideas above? Let us know in the comments or reach out on social media.

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