As we continue moving through Mental Health Awareness Month, I thought it might be a good time to revisit supporting a loved one or friend who is living with mental illness. I have discussed this in past posts: What Not to Say to Someone with a Mental Illness, Being Present, and Helpful Words to Say to Someone with Depression. Take a look at these after you read this post, if you are interested in learning more.
Often, it is difficult for people to know how to talk to or support someone with a mental illness. I think this comes from not understanding what mental illness is and from the stigma that surrounds mental illness. There are frequent negative impressions of mental illness in movies, television shows, and on social media. Government officials are presenting false information about mental illness and treatments for these illnesses. I think there has been improvement in the presentation of mental illness in movies, television, shows, and social media. In contrast, I think government officials are going in the opposite direction, which is dangerous. However, talking about that requires its own post.
When movies or television shows present characters who commit crimes or do other negative things as having a mental illness, they are perpetuating the stigma that hurts so many of us. I think the negative image makes it difficult for people to learn how to interact with those of us who live with mental illness. Maybe if I share my thoughts on how to interact with me when I am struggling, I can provide some ideas for others.
First, I would urge people not to be afraid of people living with mental illness. We are not dangerous. We are people just like everybody else. Our illness may make us seem unapproachable. We may be withdrawn or overly excited. These are part of our illness. Depression can make us seem sad. We may isolate ourselves. Don’t let this discourage you from reaching out. We welcome kindness just like everyone else.
I was in a cancer support group the other night. Someone shared something that I think is a great way to interact with someone with a cancer or mental illness. This person shared that when she is struggling, she has a friend who will ask, “Do you need me to talk or listen?” That is such an incredibly empathetic and powerful question. It acknowledges that the person who is struggling knows what kind of support they need. It demonstrates that the person asking the question is willing to provide the support in the manner their friend or loved one needs.
Let’s consider how this might look when someone is struggling with depression. The question is asked. “Do you need me to talk or listen?” Obviously, two responses are possible. If the person, let’s say it’s me, says “I need you to talk.” Here is what that conversation might look like:
“What are you feeling?” (I think “what” is better than “how” because it already acknowledges that you recognize the person is feeling something.
“I am struggling. The depression is very heavy right now.”
“I understand that you are feeling depressed. You have told me in the past that this is a very dark feeling. Is that what you are experiencing right now?”
“Yes, I feel trapped, and the darkness feels heavy.”
“Are you considering harming yourself?”
“No, I just feel like the depression is overwhelming me.”
“I am glad you are not considering harming yourself. I can be with for a while. Would it help if I stay with you?”
“Yes. I need help distracting myself from the thoughts I am having.”
“I know you have several coping strategies for that. Maybe we could try one.”
“That might help. Can you help me get started on one? I don’t know where to begin because I feel so overwhelmed.”
“Definitely. Maybe we could start by listening to some music or writing something.”
“I would like to listen to music. Can you put something on?”
“Definitely. We can listen together. Do you want to listen to a particular musician?”
At this point the conversation can continue into music. You have given the person (me) a chance to try a coping skill. You ascertained that the person did not have thoughts of harming themself. By engaging with the person in their coping skill, you are letting them know they are not alone.
What if you are communicating with the person by phone call or text? You can still engage with them. You might support the person as they put music on. You can continue the conversation as they listen to music, or you can make a commitment to call or text them in a short while to check back in and see if they are doing okay or if they need further support. I think it is important to check back in a few times. This lets the person know you are interested in how they are doing and that you are there for them and invested in how they are doing.
If a person says they need you to listen. You simply listen without judging. You are being an empathetic ear. You are providing your loved one or friend an opportunity to share what they are going through and feeling. If you are physically with the person, be sure that your body language is open and caring. Look at the person while you listen. Whether you are in person, talking on the phone, or even texting be sure that you are giving your loved one or friend your full attention. They/we need you in this moment. It is important to be an active listener. So, acknowledge what the person is saying. You might repeat back what they are saying in a way that lets the person know you are listening. This might be saying something like:
“I hear you saying that the depression feels overwhelming, is that how you are feeling?”
After this allow the person to continue sharing. Listen actively. Check in to see if the person wants you to talk at any point.
Whether you are talking or listening it is important that refrain from judging. The last thing the person needs is judgement. They need support. They/we need to know that someone cares about them. Often, depression tells a person that they are alone or that there is no one in their lives who understands. By being present for your friend or loved one you really are making a difference.
One thing that is important is an awareness of the person’s safety. Depression often carries with it self-harm and suicidal thoughts. As you check in with your loved one or friend, ask them if they are having thoughts about harming themselves. I know this question can be difficult to ask, but it is important. There should be no judgement in this question. The depression or other mental illness is causing the self-harm or suicidal thoughts. In most cases the person really does not want to harm themselves.
What do you do if the person expresses thoughts about harming themselves? If the person is in immediate danger, you should call 911. If the person is not in immediate danger, you can call the 988 Lifelinefor support. In some cases, the person might have a mental health provider who can be called. It is okay to ask the person if there is someone you should call.
Some people with mental illness have safety plans. I have one. This is a plan that outlines how to support the person and what to do when the person is having self-harm or suicidal thoughts. For more on safety plans, please check out this article I wrote: Creating a Safety Plan for Times of Suicidal Crisis. It details how to create a safety plan and why a safety plan is important.
Being present for a loved one or friend with depression or other mental illness can be challenging, but you can be there for the person. You can learn to talk or listen. If you would like to learn more about supporting a loved one with mental illness you can read an article I wrote for NAMI Glendale here: Supporting a Loved One Living with Mental Illness: 8 tips from a peer's perspective.
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