How to support someone struggling with a mental health issue - Part 1

life crisis relationships Aug 16, 2021

Over the years I’ve had a lot of clients come to therapy, not because they themselves are struggling with a mental health issue, but because their significant other or some member of their family is experiencing a mental health crisis. Considering 1 in 4 adults experience a mental health challenge at some point in their lifetime, it’s highly likely you might find yourself caring for someone who’s struggling with their mental health.

Watching someone you love struggle with a mental health issue can be a scary experience leaving you frustrated and vulnerable if you don’t know how to help them. It can feel like the person that you once knew has been replaced, like something straight out of a b-grade body snatchers horror movie.

Strapped to a rollercoaster of emotions, watching your loved one try and fail to feel better or indulge in self-destructive behaviors, like substance abuse or anti-social behavior, you might find yourself looking for ways to eject yourself from the relationship. 

While it might be difficult to see a clear path forward, there is always hope. With the right resources, diagnosis, and treatment plan, most mental health issues are treatable, and that those suffering can eventually live enriched and meaningful lives. Many relationships successfully endure a mental health crisis and become better for it. 

Figuring out exactly how to help someone who may or may not recognize they need help is a bit daunting. Let’s look at some of the common barriers that may arise for you when trying to help someone with a mental health issue.  

  • Uncertainty about how to discuss the problem at hand: Talking about mental health can feel like the stakes are extremely high, and for the person struggling with a mental health challenge, it might be hard to discuss because even they can’t quite figure out why they feel the way they do. It can also elicit feelings of shame, blame or guilt since they think they should be able to “just get over it”.

  • Confusion about how to help: Thankfully, there are so many options available to support someone who’s struggling, however, it can be confusing to determine which is the best option - particularly when you don’t know what’s really happening or what the underlying problem is.

  • Taking it personally: We all have a vision of how our relationships should be, and how life should unfold, so a mental health issue can dramatically disrupt these hopes and ideas. This experience is usually accompanied by feelings of loss, sadness, fear, and maybe even anger or resentment. It’s hard not to make it about you in some way because you’re now part of the equation. This is a surprisingly typical concern.

  • Feeling responsible: Seeing our loved one’s struggle evokes a lot of negative thoughts and emotions for some individuals. Thought’s such as ‘Did I cause this problem’ or ‘I feel guilty that I’m okay, but my partner isn’t, or ‘I’m afraid that I’ll make things worse if I try to help’. All these thoughts are universal. You’re not alone in this experience.

  • A lack of acknowledgment or denial: The biggest challenge of all might be when our loved one fails to acknowledge, or denies, that they might be experiencing a mental health problem, and subsequently rejects or resists an offer of support. The medical term for this denial is called anosognosia, and we’ll discuss this in more detail in part 2 of this article.

 

“Kindness begins with the understanding that we all struggle.”

- Charles Glassman

 

Stay focused on what is possible when the person you love gets the help they need!

While learning how to support a loved one who’s experiencing a mental health issue can take time and effort, your involvement is a critical part of their recovery. Research shows that familial and social support is one of the most important factors that assist in overcoming a mental health crisis. Know that change is possible and hope is not an unrealistic feeling.

Seeking and engaging in help can also provide you with the support and guidance you might need to ensure that your own wellbeing is maintained and even improved. (In Part 2, we’ll discuss more tips for self-care when helping someone through a mental health challenge).

To learn some practical things you can do to help, review this step-by-step guide to supporting someone who’s struggling with a mental health issue.

1 - Assess the Situation

First, let’s explore the difference between a mental health crisis and a mental health emergency.

A mental health emergency is a life-threatening situation in which an individual is threatening to do something to harm themselves, such as suicide. Or, perhaps they are severely disorientated or out of touch with reality, have a severe inability to function, or are otherwise distraught and out of control.

If someone tells you that they are feeling suicidal or can’t go on, it is very important to encourage them to get help. You or they should call 911 (US ONLY) or visit your nearest emergency room (ER) for immediate assistance. Another option is to encourage them to call the National Suicide Prevention Lifeline at 1(800) 273-8255 (US ONLY) or access the Online Lifeline Chat Service or visit the National Suicide Prevention Lifeline website: www.suicidepreventionlifeline.org. The folks who man these lifelines are mental health care professionals who work with people in severe distress. 

A mental health crisis is a situation where there may not be an immediate danger or in a life-threatening situation, however, there is a distinct impact on an individual’s ability to effectively function. Maybe they start sleeping all day and miss work, retreat from attending social gatherings, lash out at unexpected times, engage in risky behaviors, including the abuse of substances, or give up on pursuing things that have always been important to them.

While these things do not represent an immediate threat, left unattended, they may eventually result in a mental health emergency.

 

2 - Engagement

If someone you love is suffering from a mental health issue, chances are, you aren’t the only one who’s noticing. Gathering the support of friends and family can be a vital part of giving that person get the help they need. Friends and family can offer important information to health professionals about what’s going on - information the person might not even realize about themselves. 

Surrounding them with a compassionate community also helps them feel less alone in their struggle. It lets them know they have not been abandoned, even if they don’t feel like themselves.

 

“Listening better. Caring more. Being there. It’s not big changes, but the little ones in our daily lives that make all the difference. With little ways to love more, big things happen.”

- Yehuda Berg

 

3 - Education

While Googling any type of health issue, mental or physical, can lead you down a dark hole, education is the best way to understand what’s happening when a mental health issue arises. Just be careful to seek validated information from reputable resources simply because there is a lot of information on the internet, and unfortunately not all of it is reliable.

When you understand possible underlying causes of an issue and are keen to watch for signs and symptoms that may be attached to the problem, it will help you to:

  • Understand how severe an issue is and what the options are for treatment.

  • Feel more compassionate and empathetic to what a person is going through, especially when the way they are behaving is less than desirable. 
  • Feel more in control of the situation, knowing the issue is not untreatable. It also helps you have realistic expectations of the ups and downs that may occur throughout the healing process.

4- Communication

The key to solving any problem is honest, clear and kind communication. Sadly, there’s often so much lost in translation, even at the best of times, and more so when the person we’re trying to support is struggling with overwhelming emotions and distorted thoughts.

To connect with this person, we need to learn to slow things down and be very intentional about what we say, and the environment in which to have an effective conversation.

Setting Up the Conversation:

  • Find a place to talk where you can have a private conversation and where you won’t get interrupted. This might be at home, at a park or anywhere that feels calm and comfortable. Meeting at a bar might not be the best plan since alcohol can get in the way of authentic communication and can increase already sensitive emotions, like sadness or anger.
  • Be aware of your tone and the volume of your voice when speaking with them. If you seem anxious or amped-up, it will only add stress to the situation. Staying calm is essential for this conversation.
  • Feel free to express your concern and mention behaviors you’ve noticed, but do this in a compassionate way, free from blame or judgment.
  • Ask questions and really listen to the answers. You may have assumed a person is thinking or experiencing one thing when it is something else entirely.
  • Know what you want to say before you begin so you have some touchpoints throughout the conversation. You don’t have to script anything (because it’s a conversation, not a speech), but knowing what you need to talk about ahead of time will keep you from getting distracted or derailed.


Having the Conversation: What to Say.

Acknowledge that the person is dealing with an overwhelming situation. Keep it simple and honest. Say something like, “I can see that this is very hard on you,” or “I’m sorry you’re going through such a difficult time.”

Recognize their autonomy and agency as an individual. Ask them “What can I do to help?” or “What do you feel you need?”

Extend an invitation to help. Again, respecting their autonomy to address their own issues. Say something like “Would you be willing to accept my help?” It’s important to remember that someone is allowed to decline an invitation, so be ready to receive a ‘no’.

What’s Not a Helpful Conversation: What to Avoid Saying.

Perhaps the worst thing you can do is minimize what the person is going through or belittle them for having a problem.

Here’s what NOT to do:

  • Everyone’s experience is unique so you should never compare their situation to someone else’s by saying something like, “My mom had the same problem last year and it turned out she just needed more D vitamins.”
  • Helping someone through a mental health challenge can be the ultimate test of your patience, but resist telling someone to “Just get over it.”
  • Resist diagnosing their problems or prescribing specific solutions by saying, “You know what you’re problem is? You’re depressed. I bet if you got up earlier and went for a run every day you would be fine.”
  • Whatever you do, don’t make it about you by saying, “I know exactly how you feel.”

The best strategies for helping someone you care about to acknowledge and address a mental health challenge are to do your research, gather the support of friends and family, communicate clearly and above all, operate from a place of empathy and compassion. 

While it may feel like you’ve lost the person you once knew, know that with the right treatment plan and some compassionate support, transformation is completely possible.

Stay tuned for Part 2, where we’ll discuss ways to care for yourself when your loved one is experiencing a mental health challenge, including self-care practices, avoiding career-burnout, and considerations for when the person your concerned about refuses help.

If you or someone you care about is struggling with a mental health issue – take that important step and contact me to schedule a free 30 minute phone consultation.

 

If you’re not already subscribed, be sure to sign up for MANifest Mondays, my free weekly email designed to offer more tools and tips for improved mental health and quality of life. 

Cheers,

Simon G. Niblock, MA, LMFT, is a licensed psychotherapist, specializing in men’s mental health and wellness. He provides tailored psychotherapy services and online programs for men and is the author of the Anxiety Workbook for Men, Evidence-based Exercises to Manage Anxiety, Depression, and Worry.
Important Notice: The content in this article is for informational purposes only. It does not replace direct professional mental health, medical treatment, or professional care in any way. Seek the support of a physician or other qualified healthcare provider to diagnose and treat any mental health concern directly. Contact 911 or your local emergency services number if you are experiencing a mental health emergency. 

References

Aruma. (2021). Ten Things Not to Say to Someone with a Mental Illness. Accessed: https://www.aruma.com.au/about-us/blog/10-things-not-to-say-to-someone-with-a-mental-illness/

Boresntein, J. (2019). How to Support Someone with Mental Illness. Brain and Behavior Research Center. Accessed: https://www.bbrfoundation.org/blog/how-support-someone-mental-illness

Lund, S.G. (2021). Five Ways to Love Someone with Mental Illness. Accessed: https://sus.org/5-ways-to-love-someone-with-mental-illness/

MentalHealth.Gov. (2021). How to Talk About Mental Health. Accessed: https://www.mentalhealth.gov/talk/friends-family-members

NAMI. (2021). Tips for How to Help a Person with Mental Illness. Accessed: https://www.nami.org/Get-Involved/NAMI-FaithNet/Tips-For-How-to-Help-a-Person-with-Mental-Illness