10 Ways to Help a Friend Who is Struggling with Mental Illness

It’s painful to watch someone struggle, especially people we love. People may struggle with mental illness for many reasons: genetic predisposition, body chemistry, life circumstance. No matter the reason, there are ways we can help.

Here are ten ways you can help a friend who may be struggling with mental illness.
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1- Know potential signs of mental illness. Although these things aren’t exclusively signs of mental illness, it can be helpful to keep these things in mind: Feeling sad or down. Confused thinking. Reduced focus and concentration. Excessive fear, worry, or guilt. Mood highs and lows. Significant increase or decrease in sleep. Paranoia. Impulsive, risky choices. Drug or alcohol abuse. Suicidal thinking. Excessive anger, hostility, or violence. Major changes in eating habits. Reduced pleasure in activities. Inability to cope with daily stress. If you see some of these showing up in a friend’s life, keep reading.

2- Be a person who assists in getting help. To start, you can offer to help make phone calls and screen counselors using online services. You could babysit while your friend attends therapy sessions, or even volunteer to go with him if he feels nervous going alone. Encourage your friend to see a primary care physician for regular screenings and medical care. What about when things escalate or you see symptoms increasing? If you’ve browsed my website, you’ve probably seen my extensive list of crisis resources that covers everything from PFAs to domestic violence shelters that accommodate pets. But if you’re ever unsure where to start, please call the Re:Solve Crisis Network (888-796-8226). They want you to call “before a crisis becomes a crisis,” so you don’t need to feel weird about it. They can help make sure your friend is safe or point toward resources that might be a better fit. Re:Solve is also an option if you’re unsure whether your friend is in immediate danger or may be expressing an intense emotional experience without intent to complete suicide. It’s not your judgment call, so just contact someone at Re:Solve. Oh, and please don’t be afraid to call 9-1-1 (or drive to the hospital) if someone is in danger.

3- Avoid cliches. Pray about it. Just have faith. It could always be worse. Isn’t it about time to let that go/ get over it? God doesn’t give us more than we can handle. You get it. If you’ve never suffered with mental illness, don’t pretend to know what your friend is going through. It’s better to say other things, such as, I wish I knew what to say. Can I sit with you? I’m here with you, and you aren’t alone. Here’s a funny meme I saw yesterday.

4- Don’t use illnesses as adjectives. Can we acknowledge how simple yet profound that is? When you see someone struggling in a social situation, don’t call him autistic. When that guy at work is acting totally self-absorbed, don’t call him a narcissist. Stop calling your friend bipolar because she was happy yesterday but feels sad today. When said like that, it sounds like you don’t understand the diagnoses associated with such disorders. Plus, you aren’t qualified to diagnose your friend, and even if someone else has talked to her about that diagnosis, she is not her illness. So cut it out. Oh, and don’t use the “c” word (‘crazy,’ in case you needed clarification). Admittedly, that has been the most difficult one for me to shift. It has become so normalized in our culture that it’s difficult to remove from the vernacular. Instead try to say things like, “That game last night was intense!” or, “I’m feeling overwhelmed and unsteady right now,” or, “Her behavior has seemed erratic to me lately.” We’ve got options, not excuses. For more examples of words to avoid, here’s a list. The reason this language shift is important is because it will eventually lead to a cultural change and end stigmas attached to mental illness. No matter the type or severity of a friend’s mental illness, that person doesn’t need to feel sensationalized.

5- Belonging. Include your friend when making plans. Invite him to hang out even if you’re sure he will say no. Save a spot for him at the table, and then allow him to sit in silence if he needs to. Making space for someone who is struggling is invaluable, especially when they’re entering into that space with authenticity and vulnerability. Companionship fights the lies that thrive when a person is isolated.

6- Love. This looks different for everyone. If you’re comfortable enough with the person to ask, then consider something like, “I’m trying to find a way to express to you that I care about you and that you aren’t alone in this. Can you think of any specific ways I could do that which would be particularly meaningful to you?” But, maybe not. Maybe your friend feels unlovable, can’t put words to what she needs, or isn’t responsive. Luckily, the five love languages aren’t just for sweethearts. If you know your friend’s love language, focus your efforts there. If you’re unsure, try something in each of the five areas and see what sticks. Or, if you’re comfortable enough in the relationship, just ask. Again, seeing your friend as a person beyond the mental illness is key here. Allow your friend to have a voice wherever possible.

7- Boundaries. This may be more important than you realize. (Check out my detailed blog about boundaries here.) When it comes to supporting friends struggling with mental illness, the more the merrier! Nonexistent boundaries will leave us burned out and exhausted. Rigid boundaries shut out our loved ones. But with a balanced approach, we spend as much time investing in self-care as we invest in caring for others. It’s the old put on your oxygen mask before helping the person next to you analogy. A wise step here is to align yourself with the primary caretakers. If your friend is living with parents or a spouse, ask those people how you can be helpful, or share concerns with them when you see things that are a little off. And definitely support your friend’s family! Take a meal, bring coffee, send a text, write a note: the possibilities are endless.

8- Grace and understanding. Plans may change at the last minute. A yes may turn into a no. Leave space for that. Treat a friend with mental illness similarly to how you’d treat that friend if he or she had a cold or the flu: graciously.

9- Nonpredatory behavior. This should probably go without saying, but don’t take advantage of people suffering with mental illness. Don’t use your friend’s phobia to prove a point. Don’t use someone in a manic state to finish painting your living room. Don’t use someone who has been traumatized to normalize your own experience. Don’t use your friend abusing alcohol to have a party buddy when you feel lonely.

10- Be present, and ask your friend. As with many issues in our culture, the most obvious answer is often the most overlooked. Show up! keep your word and follow through. When you’re not sure what your friends need, just ask. They may not have clear answers right away, but it’s worth a shot. At the end of the day, there’s no perfect formula. Here are some conversation starters to consider:

  • I’ve been feeling worried about you. When is a good time for us to talk about what’s going on?
  • What can I do to help you talk about these issues with someone else you trust?
  • How else can I help?
  • It seems like you’re going through something difficult. How can I help you find the help you need?
  • I’m concerned you might not be safe. Have you thought about harming yourself or anyone else?
  • Can you save these numbers in your phone in case you ever need to talk? Re:Solve (888-796-8226) and National Suicide Prevention Hotline (800-273-8255)

What have been helpful things you’ve done for a friend? How has someone helped you? Spend some time today thinking about a specific person in your life and how you might take a balanced approach to supporting that person.

Published by Jessica Gage, MA, LPC, NCC

I am a Licensed Professional Counselor in the Commonwealth of Pennsylvania (license #PC007550) and a National Certified Counselor.

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