Do you know someone with a mental health diagnosis? Is it someone you care about? Someone you love? Do you know someone who is extremely distressed? Anxious? Depressed? Struggling with something similar?
It can be so hard to know how best to help. You can be so desperate to do the right thing but never sure what that is. So desperate to take the pain away but with no idea how to even start.
I have written this post in response to these questions and these feelings.
Here are 9 clear actionable steps you can take:
Sometimes the frustration of not knowing how to help can lead us to panic, withdraw or even become angry. Not because we want to do any of these things. But because watching someone we care about feel significant levels of distress, in ways that are out of our control, can lead to surprising responses inside ourselves as well.
The more resilient you are feeling, the more help you will be able to offer. If you burn out, you will have little to be able to give. Therefore consider your own coping mechanisms. What do you usually do to manage your own stress? Who do you lean on when you are feeling overwhelmed?
If you feel you don’t have any concrete coping skills that you can turn to, here are the skills I recommend learning. Click on each skill for the specific exercises.
You can also practice these skills with your friend/loved one.
2. Remind yourself and your loved one that they are not their diagnosis
Diagnoses can become the focal point of someone’s identity. It can be a trump card that obliterates or makes us forget the other attributes that our friend/loved one has. Diagnoses also come with a lot of shame and stigma attached. Therefore remind the person that they are the same person they always were. They are just having a very difficult time, and more likely than not they are having a normal response to abnormal life events.
3. Educate yourself
Spend some time finding out what the diagnosis means. Look for information that has been written about the diagnosis and explains what it might feel like for the person you care about. Look for the recommended course of action and any resources that are out there. For example, if the distress is anxiety related read this post for information on why the physical feelings occur. Then read these three posts (one, two, three) for some practical strategies to help them feel safe, grounded and better able to manage.
Educate (involved) others on the resources you have found, and what it might feel like to be in the position of your friend/loved one. Keep previously agreed confidential information between you and your friend/loved one.
4. Be present and open to discussions
Diagnoses and distress often lead to silence. They lead to fear and uncertainty about what is ok to talk about, and when it is ok to do it. The silence can then be interpreted to mean that it is not ok to talk about what is happening, or it is shameful to do so.
You would be amazed by how effective it is to tell someone that it is ok to talk, that you are there to talk about anything at all. You could ask, “How are you feeling?”, “How is your anxiety?”, “Do you know what makes it easier or harder for you?”. Then be led by the other person and their responses.
The most important thing? Ask how they would like to be supported, and what they do to self-soothe when they feel overwhelmed. Agree which bits you can do to help, which bits others can take on, and how your friend/loved one will let you know whether that works for them or not. Agree on how they will let you know if things start to feel worse.
If your friend/loved one doesn’t want to talk the first time, this doesn’t mean they never will. It also doesn’t mean they don’t value the option or your presence. Trust that if you put the option out there they will open up to you when they feel ready.
Check in when you can. Texts and calls are great. Face to face meetings are even better.
5. Offer to do research together
People often feel unsure about their diagnosis, or their distress. Even after seeing a doctor or other professional it is common for people to feel lost or confused. Therefore, ask what your friend/loved one knows about what’s happening for them and what the plan is. Then offer to look up resources together.
Together you could look up:
- potential therapists and appropriate professionals
- charities that specialise in the experiences your friend/loved one is currently having. Find what resources they have.
- local groups that could be interesting, such as support groups but also walking or other interesting events.
- soothing exercises that they could do, or even better you could do together. See the exercises in point one.
- support lines. Print or write these out so that any time they feel alone or unsafe they know exactly who to contact.
6. Help out with tasks
Help out where you can. When people are low, overwhelmed or struggling, it can make doing the usual activities of daily living very difficult. Therefore, find out if you can help arrange and get your friend/loved one to appointments. Offer to set up medication reminders on their phone. Offer to make meals, do chores or any task that may be too much of a burden right now for them. Taking the bins out and making calls can be so helpful.
At the same time, don’t do everything. You want to be present and helpful for the tasks that feel a burden, and at the same time empowering and supportive. Remember, some days will be better than others. Being flexible in your approach and offering to collaborate on a task can be more useful than taking over. Be led by your friend/loved one.
7. Ensure your friend/loved one knows they are wanted
Invite your friend/loved one out. Invite them to engage in activities with you, ones you know they enjoy. The more activities people participate in and the more people they feel connected with, the better. At the same time make it clear that it is ok for them to say no. The aim is to remind the person that they are still wanted, valued and at the same time their needs are understood.
8. Prep yourself with what to say and what not to say
Remind yourself not to say: “snap out of it”, “don’t cry”, “it's no big deal”, “you don’t look ….. (insert diagnosis here)”. Even when said with the best intention these comments can be undermining. Also, fun fact, crying releases stress hormones so encouraging tears can be a good idea
Your friend/loved one’s inner critic is likely to be running wild right now. Telling them hurtful and untrue things. They may be beating themselves up constantly. Therefore use statements like: “I am here for you”, “I may not be able to understand exactly how you feel but I really care and want to help”.
If you have no idea what to say, remember this… Soothing touch such as hand-holding or a hug releases feel-good hormones that decrease the stress response. So don’t feel the need to say anything, just be there, offer to sit in silence and hold them… Don’t be shy, but be led by the person.
9. Know what to do in a crisis
This may not be applicable to you. So, ignore this if it isn’t.
If not…
We never want to have to think about this. However, sometimes we have to. And it is better to be prepared.
If you are worried that your loved one is in a worrying place and you can’t be sure they will keep themselves safe, the faster you respond the better. Firstly, speak to your loved one and ask what you can do. If you don’t feel able to address your concerns directly, or able to talk about self-harm or suicidal ideation, say that you noticed that they seem more distressed/low than usual. Ask if they would they speak to someone? Support them to arrange an appointment with their healthcare provider.
Equip yourself with a list of local 24-hour helplines. This link has a comprehensive list of international crisis numbers. Call them, or support friend/loved one to do this.
Know where you can go to get support. If you are in the UK A&E is open 24/7. They have people available at all times to manage a mental health crisis. Get your friend/loved one to this safe environment as quickly as you can.
That is all for now
I realise that this won’t cover everything. Each person needs different kinds of support. This is just a framework that you can build upon with some resources attached. However, the summary is, your loved one hasn’t changed but they probably need you now more than ever. By being present, patient and open to conversation (or just sitting together) you will be more useful and grounding than you can imagine.
If you say or do the wrong thing, don’t worry. This happens. Notice what happened, apologise and know that you can do something different next time.
Good luck. Know that there are various therapists and charities available for you to talk to at any time.
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I am a Clinical Psychologist trying to get psychology out of the therapy room and into everyday life. I do this by offering free advice on my Blog and on Instagram. I also offer private therapy online over video link.
Please share this article if you found it useful, or think it will benefit someone you know.
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Disclaimer: Please note, the information in these posts is not intended to be therapy and does not constitute a therapist/client relationship. If you are in need of support, please contact your doctor or mental health provider.
Originally published at drsoph.com.
