A Friend In Need: Getting Smart With Mental Illness
Medically reviewed by Carmen Fookes, BPharm. Last updated on April 14, 2021.
How Would You React To A Friend Struggling With Mental Health Issues?
Despite the fact that more than one in four people struggle with mental health issues, these very real disorders are still not really talked about.
Few people know how to react when a friend or family member discloses a mental health disorder. Comments like "You'll snap out of it" or "We all go through times like this", although generally well intentioned, can hurt. But there are simple things you can say and do that could make a significant difference to a suffering person's recovery.
Respond Like You Would If Somebody Told You They Had Diabetes or Asthma
Mental health issues, such as depression, anxiety, bipolar disorder and schizophrenia are just as deserving of support and empathy as other medical conditions such as asthma and diabetes. Too often people respond negatively or dismissively when somebody confides that they are not mentally well.
Instead of telling them to look on the bright side, to stop worrying, or offering advice; express your concern and tell them they are not alone in this, you will be there for them whenever they need your help. Ask them how you can support them or offer to drive them to their next appointment or to do their housework, or help them with their homework if they are still at school. The most important thing to convey is how much you care about them and that you will be available, should they need you.
What To Say
People who have experienced a mental health issue rate statements similar to the following as being the most supportive and helpful:
- I'm here for you
- I am not too familiar with your illness, but I understand that it is real and that is what is causing your thoughts and behaviors
- Although it may be hard for you to believe now, but the way you are feeling will change
- You are important to me and your life is important to me
- I care about you and want to help
- We will get through this together.
What NOT To Say
Not so helpful are the statements below, so try to avoid saying them:
- Stop acting crazy!
- It's all in your head.
- Everybody goes through times like this.
- What's wrong with you?
- You'll be fine.
- I can't help your situation.
- You have so much to live for; why do you want to die?
- I thought you would be better by now.
For more information, see the What Helps and What Hurts brochure, published by The Depression and Bipolar Support Alliance.
Listen, Listen And Listen Some More
Let your friend or family member talk. All too often when we talk to others, we end up talking about ourselves, or offering advice. Don't change the subject if your family member or friend opens up about their illness.
Instead allow them to talk freely and resist the urge to try and "solve the problem". Offer your support and acknowledge the fact that they have done the right thing in talking about it and that you have their back. Ask them if they are getting the treatment they want and need, and if not, ask them if they want your help in finding it. Keep their trust by not gossiping or sharing what they have told you with others, unless it is with their consent.
If you feel overwhelmed by what they have told you, or have any serious concerns about a person's risk of harm to themselves or others, contact a helpline such as the SAMHSA Treatment Referral Helpline 1‑800‑662-HELP (4357), or, if you are specifically concerned about their risk of suicide, the National Suicide Prevention Lifeline 1-800-273-TALK (8255) for confidential advice.
Educate Yourself About Their Disorder
Most people don't really know the difference between schizophrenia and bipolar disorder. Few understand the devastating consequences of depression or the isolation of anxiety disorders.
Take the time to familiarize yourself with specific features of your friend's or family member's condition. This can help you to understand certain behaviors and to know what to expect.
Briefly, people with schizophrenia often develop very odd or eccentric beliefs or behaviors. They may experience delusions, hallucinations, talk incoherently or in a way that is difficult or impossible to understand.
Symptoms of bipolar disorder vary but generally consist of episodes of mania - distinct periods of feeling excessively good or important - and periods of depression, with periods of mood stability in between.
Depression is a serious mental illness that can cause sadness, a loss of interest in normally enjoyable things, and changes in appetite or sleep. Most people with anxiety disorders will go to great lengths to avoid situations where they may be humiliated or judged by others such as social gatherings, public speaking, or meeting new people.
Look Out For Warning Signs...And Act On Them
Occasionally, people with depression or bipolar disorder suffer from severe symptoms that are best helped by hospital admission.
If you are supporting someone with a mental illness, it is a good idea to prepare for a crisis before it happens. Find out who to contact and write a plan of what to do during a crisis, should it occur. Your plan should include helpful phone numbers, such as those of your friend's doctor, family members and the National Suicide Prevention Lifeline 1-800-273-TALK (8255). If you find yourself in an emergency situation, ring 911.
Symptoms And Signs That Warrant Expert Help
Admission to hospital can occur voluntarily or involuntarily. Involuntary admission - or a forced admission against someone's will - is only used as a last resort if the person's life or other peoples' lives are in danger. Hospital admission may be needed for people that:
- Experience hallucinations (seeing or hearing things)
- Threaten other people or try and take their own lives
- Have delusions (believe things that aren't true)
- Have not slept or eaten for days
- Cannot care for themselves on a daily basis
- Have symptoms that are interfering with their life
- Need specialist treatment such as electroconvulsive therapy
- Have significant problems with alcohol or other substances
- Whose symptoms have not improved or who have relapsed with their current treatment.
What You Can Do In A Crisis
During a crisis, your friend is likely to be acting irrationally, and there is a possibility their actions may scare you. It is important to stay calm, and talk slowly. Reassure them that you are here to help and ask them simple questions, like "How can I help?". Repeat the same question patiently, over and over again, if necessary. Enlist support from family members, friends, neighbors or your church if you can.
Follow your crisis plan and call your friend's doctor if there is time and the situation is manageable. If you feel threatened, call 911, especially if danger is imminent. Both police and ambulance usually prioritize 911 calls about people experiencing a mental health crisis.
Try not to take what your friend says personally. They cannot help the way they behave in a crisis situation.
What You Can Do...Day-To-Day
A common feature of mental health disorders is withdrawal from social events, family, and friends. Even if your friend constantly declines your invitations, keep on asking. It can be a comfort for them to just know that you care. Set time aside time just to spend with them, one-on-one.
Encourage your friend's healthy behaviors such as exercise, healthy eating, and getting enough sleep. Be mindful that alcohol can interact with most psychiatric medications and affect their effectiveness as well as fueling symptoms of the person's underlying disorder, so avoid events or peer situations that encourage alcohol consumption while your friend is recovering. Contact a helpline such as the SAMHSA Treatment Referral Helpline 1‑800-662-HELP (4357) if you think your friend might have a problem with alcohol or other substances.
Still Take Time Out For Yourself
Helping somebody recover from a mental illness can be demanding and stressful. Make sure you set aside time to still do the things you want and need to do. If you ever feel overwhelmed, ring a general helpline such as the SAMHSA Treatment Referral Helpline 1‑800‑662-HELP (4357) who can provide you with support and advice. It may be good to connect with others in a similar situation as you, and numerous support groups are listed on Mental Health America's webpage or you can join a relevant drugs.com support group.
Finished: A Friend In Need: Getting Smart With Mental Illness
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- Parekh R. Warning Signs of Mental Illness. American Psychiatric Association. Updated July 2018. https://www.psychiatry.org/patients-families/warning-signs-of-mental-illness
- My Friend Has a Mental Health Disorder. How Do I Support Him/Her? CampusMindWorks Updated 2018. http://www.campusmindworks.org/students/helping/how_do_i_support.asp
- How To Help Someone In Crisis. Depression and Bipolar Support Alliance. 2021 https://www.dbsalliance.org/support/for-friends-family/how-to-help-someone-in-crisis/
- Get Immediate Help. MentalHealth.Govt. Updated March 2020. https://www.mentalhealth.gov/get-help/immediate-help/
- SAMHSA’s National Helpline. SAMHSA. Updated Jan 2021. http://www.samhsa.gov/find-help/national-helpline