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How to support a friend who is struggling with their Mental Health

Trigger warning: Mention of suici*e

Having social connections and support from those close to us can make a huge difference when we are struggling with our mental health or going through tough times.

Loneliness and isolation can make issues worse for some people, so it is important to know how to support your friends and those close to you if they are struggling.

1) Check up on them – If you know that your friend is struggling it can be good to send them a message or get in contact with them in some way to ask how they are doing. This can feel heart-warming for the individual for it allows them to see that they are cared about. When people are asked how they are, they may reply ‘fine thanks’ or ‘okay,’ but if you have the inkling that this isn’t true and that they are struggling more than they are saying then let them know that you are always there for them and that if they do feel like they are in a dark place then they can talk to you anytime because you love them and care about them a lot.

2) Invite them out places but understand if they say no – Being invited out places can make people feel included and thought about, and sometimes going out places can serve as a distraction from their struggles and can give people something to look forward to, but people may say no if they are too anxious or have a low social battery, and if this is the case please be understanding and empathetic and do not make the person feel guilty for saying no.

3) Be there for them when you can and validate their feelings – Sometimes people need to vent about how they feel, and this can serve as a release for them. Validate how they feel, don’t say things like ‘others have it worse,’ ‘you have nothing to be anxious about,’ ‘be grateful,’ ‘you need to control your thoughts’ etc as saying these sorts of things could be hurtful to the individual. Instead, you could say things like ‘that must be hard for you,’ ‘I am here to listen,’ ‘I understand that you are feeling very scared and this must be very tough for you’ etc. Just be as validating and as gentle as possible.

4) Learn about their condition – If you have a close friend or loved one with a complex condition, it might be best to do a little bit of research into their condition, so you don’t unintentionally say something that makes matters worse. For example, if you have a friend with OCD, you would want to know that they cannot control their thoughts so telling them to do so could be very counter-productive, and telling someone with OCD that their thoughts may mean something or could come true or be real could be very dangerous, and reassuring and individual over and over again could potentially fuel the OCD cycle. It could be helpful to learn about the best ways to interact with someone with a specific condition and know what is good to say and what is harmful to say, and ask the individual what helps and what sort of things shouldn't be said as they know themselves best.

5) Set boundaries for yourself – Although it is great to help a friend when they are struggling, do not let it degrade your own wellbeing or take up all of your energy or thoughts, if you need a break or can’t help them with something, tell them that you do need to go. Say it in a gentle way and tell them that you do always care about them so that they know that they haven’t done anything wrong and that they’re not a burden, but just explain that you need to maintain your own wellbeing. Your own needs are just as important as the needs of your friend, whether you have a mental illness or not - remember that. It is okay to say that you need a break or can’t help with a certain issue. Ask if they have anyone else who can help them if you need to take a break or ask the individual if you can put them in touch with someone else if you are unavailable.

6) Don’t judge what your friend tells you or if they say something that confuses you - Some people may have mental health struggles that impact them so much that they struggle to do things that most people take for granted, so please be understanding if your friend is struggling with something such as hygiene or daily duties, they may either not have the energy or motivation to do it or may be too consumed by symptoms to do something. As well as this, if your friend opens up about something they are experiencing such as intrusive thoughts, then please do not judge as intrusive thoughts are ego-dystonic meaning that they are what the person is most against, and if someone is opening up to you about them it means that they trust you A LOT, so please be understanding and try not to react in shock if someone tells you about their intrusive thoughts. As well as this, some people may have complex symptoms such as psychosis which could make them lose touch with reality and do or say some things which may confuse you, please be empathetic and don’t give the individual a hard time due to this, some people may have OCD obsessions where they may ask for reassurance about something that could seem ‘bizarre’ to you, but again, please be understanding, your friend is going through a difficult time and they do not need judgement.

7) Do little acts of kindness for them – Tagging your friends in posts which you think they would like, sending them memes or quotes, writing them a little letter saying how much they mean to you, making them something etc. These little things can mean the world to someone when they are struggling. It allows them to feel connected to people and shows that they are cared about and thought about.

8) If things are really serious, put them in touch with professional help – Informing your friend about services, organisations and helplines may be beneficial so that they can see what support is available and have a way to seek professional help if they ever experience a crisis. If your friend isn’t receiving any specialist mental health support, then you could encourage them to seek the help of a psychologist, psychiatrist or therapist and help them find local mental health services.

9) If your friend is saying things, hinting things or has a change in behaviour that concerns you, then see if you can bring it up to them in a non-judgemental and gentle way - If you suspect that they are feeling suicidal, then ask them. This can be a difficult topic to bring up, but it is sometimes needed as it shows people that it is okay to open up. If the person is at risk in any way – do NOT keep it a secret. Try to be calm, empathetic and comforting, if you react in shock or seem startled they may feel ashamed and may not want to talk about their feelings any more.

10) Don’t try to make the person be positive - This does link to some of the other points, but this is important sometimes. People need to know that it is okay to talk about the darkness and pain that they feel without superimposing positivity over it, and having someone there to listen and who cares makes a huge difference as people need to feel heard. It’s important for people to know that it is okay to cry, it is okay to struggle. Let the person know that they don’t have to feel guilty for not being positive, and let them know that they don’t need to feel guilty for any of the symptoms or struggles which they may be experiencing.

11) Ask about the information you want to share - Ask the person if they are open to you sending them information on their condition that may help. This can be great for some people as some people may be very open to receiving information and suggestions on things that may help them or support them along their journey, but others may see it as quite invalidating if someone who does not have the condition and may not fully understand it starts giving advice. Be understanding if the person says that the advice you are giving them is not helping or if they say that they only want to receive information that may help them if it relates to a certain topic (eg. self-care strategies, management strategies etc).

12) Spend time with your friend - If you are spending time with the individual, try to engage in activities that may help calm them or which they may enjoy such as painting, playing sport, dancing etc. These sorts of things may take someone's mind off the struggle for a short while and may allow them to feel calm and find hobbies which they may also be able to do on their own or when they are having a bad day. Having fun with friends also gives a wonderful feeling of connection and can give someone a break from what's going on inside their mind.

13) Know that the person cannot simply snap out of it - If a person could just stop their symptoms then it wouldn't be a 'mental illness,' so please do not expect the individual to just 'snap out of' or 'get some control' of their symptoms. Finding ways to manage the symptoms takes time.

14) Ask the person what they need - Sometimes people need a hug, ask someone first. Sometimes people need to be left alone, if a person says that they want to be left alone and you know that they do not pose a risk to themselves then let them have some alone time. Ask a person what they want and what they feel they need, and if they say they 'don't know' then just be a good friend or ask them if they want you to do something specific, for example 'would it help if I did this?' rather than having a question which is so open ended.

15) Validate even if you don't understand - Understand that some of the things that frighten or upset your friend may not make sense to you at all, but to them it is very real and they need someone to be there for them and to listen whilst they are struggling.

16) Understand that there isn't really a 'quick fix' - It isn't your responsibility to 'heal' the person of their condition, but listening, being there and connecting to the individual and showing that you love them unconditionally makes a massive difference.

17) Be very mindful of what you say to people - Some things that you would usually talk about could be incredibly triggering or harmful for a person with a specific mental health struggle to hear. You may feel like a person needs to face certain things or 'be more open', but if someone has told you that they do not feel comfortable talking about certain topics or if mentioning certain things impedes their recovery - then please respect that and take it seriously. They are asking you not to mention certain things for a completely valid reason and the person knows themselves best.

18) If you don't understand what a person is experiencing then ask questions - Trying to help someone with something you don't fully understand can backfire, and if you don't know how to validate someone as you don't understand what they are going through it can make the person feel unheard. It can help to ask the person about something if you do not understand it, they are not likely to expect you to understand the issue fully - but to be as understanding as you can be. Asking questions shows that you care and want to help the person more, but if someone says that they don't want to answer, or if they don't feel like saying much, then be okay with that as well.

These are just some tips on how to support a friend who is struggling with their mental health. Having social connections and support can make the outcome a lot better for someone with a mental health condition and can allow someone to cultivate more self-compassion and feel validated so that the shame around their struggles dissolves.

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