Most of us will experience a mental health difficulty like depression, anxiety or addiction during our lives. And at some point, most of us will have a friend or family member who is mentally unwell.
Our culture tends to view people with mental health problems in one of two ways. Either they have brought it on themselves and need to ‘pull their socks up’, or they have a ‘disorder’ and need help because they’re incapable of helping themselves.
When faced with a friend who is suffering it is tempting either to blame them for their problems and try to shake them out of it, or to leap into ‘rescuer’ mode and try to fix them.
Neither extreme is a good solution. We can end up angry and resentful if we hold them responsible for their problems, or burnt out from all our attempts to help. They can end up more defeated and self-critical than ever if they feel culpable, or kept in a guilty and powerless state if they can’t respond to our efforts.
As a therapist and psychology academic I am often asked to give advice on supporting friends when they’re in difficulty. Here are seven thoughts on how you can help without either rescuing or blaming.
If we’ve had a particular difficulty ourselves, or know somebody else who has, it’s easy to assume we know what it’s all about. But these things can be very different for different people, so it is vital to start with listening to what it’s like for your friend. Some people experience depression as a flat low feeling, whereas for others it feels more desperate and frightening. Some people harm themselves for a release of tension, whereas for others it is a punishment, or a kind of soothing.
Similarly we might have thoughts about what will help our friends based on our own experiences or assumptions, but it is better to check in with them. If they are struggling they may not know for sure what’s best, but they might know what to avoid because it makes things worse. You could make a list together of some possibly helpful things to experiment with.
2. Be present with them.
Once somebody has a label like ‘depression’, ‘PTSD’ or ‘personality disorder’, people around them often start to treat them very differently. If somebody was distressed, or quiet, or acting strangely last time we saw them, it is easy to expect that they’ll be the same the next time. Often one of the best things we can offer, as a friend, is to be present with them however they are on this particular occasion, instead of treating them as their label, or as how they were last time.
It can be useful to have some time out ourselves, before seeing them, in order to put ourselves in a good place to be with them as they are today. We may have to scale down the kinds of things we normally do together, but doing an activity that isn’t all about their mental health can really help.
3. Get support yourself.
If somebody we care about is suffering it can take a big toll on us too, for all kinds of reasons. We may feel guilty or hopeless, we might give a lot of our time and energy to supporting them, or we might find ourselves picking up on their feelings and finding that we’re also low or anxious after seeing them. It’s important that supporters get support too. Think about who you could lean on a little more. There are helplines and counsellors available for carers and others in supporting roles.
4. Know the limits of what you can offer.
When somebody is suffering we often want to do anything we can to help, and it is easy to offer more than we’re able to give. The experience of offering something and then having to pull it away again can be rough on both of you. If your friend asks for a particular kind of support it is okay to ask for some time to think about it before responding. Think about the other demands in your life, what your limitations are, and how long you might be able to offer it for.
5. Be part of a wider support network.
Linked to point 4, everyone has different skills and none of us can be everything to somebody. You might be great at practical support but not very good at sitting with somebody who is crying. You might be a wonderful person in a crisis, but need a lot of space if you’re around somebody else day in day out. For these reasons the ideal situation is to have a network of support rather than just you. Think about whether there are others – friends, family, professionals – who could offer support too.
6. Maintain your boundaries.
Most people who are suffering will be kind to those around them, but some people can become quite insular when they are struggling. It is definitely important to give them a break on this, but it is also important that you know your boundaries. For example, it’s not okay for your friend to ask you to keep the fact that you’re supporting them a secret; or to expect you to be their only means of support or their therapist; or for you to be the recipient of threats or other behaviours which would be considered abusive under other circumstances. It is okay for you to change what you can offer if these things happen, or if your situation changes.
7. Be flexible.
Finally, it is easy to get stuck in your role as your friend’s supporter. Over time this can actually make it more difficult for them to shift out of their role as the one needing support. Don’t treat your friend as somebody who only gets help and never gives it. When we’re suffering it can feel incredibly powerful to realise that we are valued and still capable of supporting others – even in small ways.
Also, there will certainly be times in your lives when your positions are reversed and you are the one needing help. After what they’ve been through your friend may well have just the expertise and experience you need, so be prepared for your roles in each other’s lives to shift over time.
Mind has an extensive section on supporting people with mental health problems, and lists of further contacts.
Rethink provides information and a helpline for carers, friends and family.
There are also support groups and helplines available for those offering ongoing support through www.carersuk.org and www.carers.org.