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How do I support my friend and their mental health?

Updated: Nov 16, 2023

It’s a really common question I get, and it tends to go along the lines of:

“my friend has got xxx, what can I do?”

“my cousin has got xxx, what does that mean?”

“my sister is in hospital/rehab, do you think I should call her?”

And the answer is “I’m not sure, but I know how you can find out”.

Supporting friends, family and colleagues with their mental health is no easy task and can be daunting for a lot of people, but considering ¼ adults in the UK have a mental health condition, the chances are you’ve done it before and will do it again. For now, we are going to stick to the basics.

Ok so you’re friend is in a place where they’ve either acknowledged or been told that they have mental health difficulties. As I said before, I get a lot of messages or have conversations along the lines of “my friend told me they’ve got xxxx, what does that mean?”

To this I would always say “have you asked them?”. This might feel like an obnoxious answer, but trust me here. ‘Curiousity’ is the word you need to keep in mind. This is really important because say your friend has told you they have a diagnosis of depression, psychosis, EUPD – whatever it is – you can get 10 people in a room, all with that same diagnosis, and they will all have different emotions, behaviours, reactions, strengths, difficulties, feelings about the diagnosis, how they’d like to be supported – because I’m sure you’ve realised, they are all humans with their own history, opinions, preferences and beliefs. Shocking, I know.

Ok, got it, so what’s next?

It is important to hold in mind that for some people, it would have used up a lot of their energy to tell you their diagnosis, they might have been concerned with how you’d respond or what saying it aloud may feel like. Others may feel fine talking about it. So something you can do, before you dive in with questions, is check with your friend whether it is ok if you ask some questions about it. For example, “I don’t know much about xxx, do you mind if I ask you about it?”. It might also be worth caveating it with “you don’t have to answer them if you don’t want to” – because they don’t.

If they are comfortable, or decide at a later time that they are comfortable, you could cover some very basic things, but try your best to not give opinions, advice (no matter how good you may think it is or if it has helped you) or tell them they are being sensitive/dramatic/silly (because they aren’t).

Some things you could ask:

- How are they?

- What is it like for them?

- When are things more difficult?

- When are things more easy?

- Have they got anyone else around them that supports them?

- How did they find out about their diagnosis?

- What was it like getting that diagnosis? Did they agree with it?

- What do they find helpful/unhelpful by those trying to support them?

It is really common for your first natural urge to be to solve this for them – they are your friend, why wouldn’t you want to make things better? However, hold in mind that if it was that simple, your friend would have probably done it already – don’t underestimate your friend or how complicated mental health can be.

If you friend does want to talk, try to not think about this space as reciprocal. It’s doesn’t tend to be helpful to offload on your friend as they are trying to offload on you. As humans, if we sense that someone else is stressed or upset, we tend to hold back or filter what we are saying – so if they are trying to tell you how crap they feel, and you respond with telling them how crap you feel, it can end up being an unhelpful space in some circumstances. Try your best to just listen, be curious and empathise – don’t make comparisons to your experiences. Also, don’t pretend you know exactly what they are going through or how they feel, because remember as I said before, we all have our own unique experiences, interpretations and emotions, and also, they may only choose to tell you a small portion of the story at that time, and if you run off explaining how your Aunt Betsy had the same thing, then it can shut down conversation rather than open it up.

So you want to support your friend but not sure how exactly?

Once again, have you asked them? Remember curiosity is key. “I really want to help you like you’ve helped me before, is there anything that comes to mind that I can do?”

Some people find it hard to say, or don’t know, what they would find most helpful. You could give suggestions and see what they say. But also they’re you’re friend, you know what they like. So maybe you could organise to cook them dinner, do an activity, go for a walk/run, send them a little present or actively call them to check-in. If you do anything like this, you can always check in and ask “is it helpful or unhelpful when xxxxx?”. Sometimes keeping a sense of normality is the most helpful thing.

Keep being curious. Keep communicating.

Supposedly ¼ adults in the UK have a diagnosable mental health condition. Personally, I think it is higher than that. So even though that 1 friend has chosen to speak to you, there are lots of others around you who may have similar difficulties or maybe you do. Keep in mind “how would I like to be treated?”.

What about you?

It is great if your friend feels able to talk to you about their difficulties, but it can also be tiring like anything and you need to take care of yourself. Sometimes people feel selfish prioritising themselves but hold in mind that if you stay well, you can continue to help your friend. Some things you could consider:

- Encourage the person to reach out to other people too, like family or professionals, so that they don’t rely on you. For example, you may go on holiday or get sick and be unable to support them.

- Set boundaries – let them know how you can support them, this might include not when you’re at work, or during the night, but you’re open to weekly chats or daily check-ins.

- If supporting your friend(s) starts to feel overwhelming, or you notice it is impacting on your sleep, mood or eating, then it is important to let your friend know you need to take some time to look after yourself. This is also why it is important for your friend to have multiple support sources.

- Talk to someone about your own feelings – whether this is a friend, family or professional. It can really help to share what is going on for you.

A quick note on talking about suicide and self-harm.

There is a common myth that talking about suicide or self-harm may give people ideas or encourage them. I want to be very, very clear – that is a complete myth and there is lots of research on the importance of having these conversations. It is more unhelpful to not allow someone to talk about suicide and/or self-harm as they can be stuck holding those really distressing thoughts and emotions on their own. If you need further advice or support on this topic in particular:

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