New Leaf Counseling Group, LLC I Diverse Counselor & Therapist Team I Charlotte, NC
When a loved one has gone through a traumatic experience, is struggling with depression or anxiety, or has high stress levels, it can often seem like there’s no right thing to say.
You try your best to cheer them up and reach out but are met with defensiveness or the person shuts down, or you just don’t even know how to approach the situation, so it seems better not to even bring such a painful topic up and you just keep your relationship as though everything is normal, for everyone’s sake.
This is an article about how to help a Loved One with mental illness - including a list of what to do and what not to do in these situations, and then I’ll address more serious situations more specifically:
What Do I Say?
The two most important concepts to use are to acknowledge the difficulties that person is
experiencing and to be present. Because we love those around us, the immediate impulse is often to “fix” the person, or to tell them it’ll be okay, or to provide them with advice about how to get better. Realize that you are providing support by validating them. Here are some suggestions:
#1 - How to Help A Loved One With Mental Illness
DO let them share without providing advice:
People are sharing their feelings in order to be heard and validated; they’re not asking for advice. Is it possible that with your outside viewpoint it’s easier to see how they could get out of their current situation? Absolutely. But if someone reaches out and is sharing, don’t think they’re asking, “How can I fix this?” What they’re asking is: “Will you listen to me and understand that this is really hard?”
#2 - How to Help A Loved One With Mental Illness
DON'T tell people “I understand” or “I know just how you feel”:
There’s an almost instinctive response when someone is sharing a problem to commiserate and explain why you have been in a very similar place. We do this because we want people to know they’re not alone. The problem is, despite your best intentions, no one can truly understand where your loved one is but him/her at that very moment. Each situation is unique and you are a different person than they are. To be loving and supportive, let them tell you what they’re going through, and listen for the differences. Remember: they’re asking for you to listen, and to see them in their struggles. No two people in this world have the same paths. You love this person in their differences, so let them be different even in
the way that they are struggling.
#3 - How to Help A Loved One With Mental Illness
DON'T tell people “it’ll be okay”:
Notice the future tense of the sentence: It will be okay. It’s possible, and we all hope with the people we love that it will be okay in the future…but you can’t know that. And, more importantly, it’s not okay now and that’s the relevant time period we’re talking about.
Now is hard. Now for them might feel like drowning. Now is when they need you to hear them. It seems contradictory, but the most affirming thing you can give to your loved one is to say: “NOW IS TERRIBLE. You can’t fix now and neither can I. But I’m here now even though it’s really awful, and I’ll be here until we see how now might change.”
#4 - How to Help A Loved One With Mental Illness
DO openly dialogue if you’re deeply concerned by asking if they want to hurt or kill themselves:
Our culture hides discussions of self-harm (cutting or other self-destructive habits) and suicide, but I’ve witnessed over and over the enormous relief people exhibit when I ask if they are suicidal or have thoughts of harming themselves. Recognize that using the word “suicide” openly does not cause someone to kill themselves. People are often afraid to ask if someone is suicidal because they are worried it might plant an idea in their head and the person will possibly get worse. The opposite is true: bringing the topic out into the open in a calm manner can create the opportunity for dialogue.
You’re letting your loved one know they don’t have to keep any internal emotional pain they are going through a secret. Many people who are severely depressed worry intensely about being a burden to the people they love; you can help by using direct words and questions as calmly as possible.
What Do I Do?
Recognize that you are not the person ultimately responsible. Our relationships with loved ones are deeply important to our being in the world and you may feel you are the only one who can help. Just as you make decisions in your own life that are affected by others but are your decisions, it’s ultimately up to your loved one if they seek help. Your love and support can make an enormous difference, but you can’t save someone. Be careful with your own energy and boundaries; if the person you love is severely depressed or has suicidal thoughts, they need to be in the care of qualified mental health professionals. Encourage them to consider therapy, or to make an appointment with a primary care doctor or psychiatrist.
#5 - How to Help A Loved One With Mental Illness
This is what we do for one another when we are simply present, listening,
attentive, and compassionate. Holding space means letting the other person be whoever they are in that moment, and letting that be okay. If they’re mad, let them be mad. If they’re broken, let them be broken. Don’t rush to fix things. Holding space means letting the air between you breathe, letting the person know you’re there, and that you are witnessing their struggle and not looking away. This is a gift beyond measure. There will be time later for picking up pieces.
#6 - How to Help A Loved One With Mental Illness
Sometimes when people are going through a hard time they pull away from
even their closest friends, their spouses/partners, or anyone who knows and loves them. If someone you love drops off the map and you’ve had some indication it’s because of emotional trouble, keep calling. Keep texting. Even if you get no response. It matters. That person may not be responding, but you’re letting her or him know that you’re still out there, caring, missing them. Send funny memes. Reference shared jokes. You may be the first person he or she calls when it’s finally time to reach out.
#7 - How to Help A Loved One With Mental Illness
Do the Little Things:
Recognize that every day or moment is not going to be a time for sharing or talking. Provide reminders for the person that you care by allowing them space but by doing little things you know they love. If you feel awkward or uncomfortable talking, remember actions speak loudly.
When Should I Be REALLY Concerned?
The following are warning signs to look for that can indicate severe problems: *
1. Sudden changes in behavior – Has their overall behavior changed markedly? This could
include talking about feeling hopeless or trapped, talking about suicide or death, or other
changes like increases in use of drugs or alcohol.
2. Self-isolating – Are they removing themselves from activities they previously enjoyed,
withdrawing from socializing, or not willing to engage and completely isolated?
3. Mood swings – Are they more irritable than usual, or even angry? Depression doesn’t always present itself as sadness, and people who are depressed aren’t always sad or withdrawn. Mood swings, irritability, and even anger outbursts sometimes come with the territory for certain age groups like teenagers, but are still worth noting.
4. Problems at work or school – Have you noticed that sudden problems have cropped up,
like unusual absences, slippages in performance, or reports from teachers or coworkers
that something just isn’t right?
5. Changes in sleep/eating patterns – This can go in either direction: either the person is
sleeping less than before or a lot more than before; they may be overeating or
* I’ve included other links at the bottom of this post that can help distinguish “red flag” warning signs, but know that this is not an exhaustive list. If in doubt and concerned for the basic safety of your Loved One, please call "911" immediately.
What If It’s a Crisis?
First and foremost, if you have any doubts about your loved one’s immediate safety, call 911. It’s better to be wrong in this instance than to misjudge. Suicidal thoughts exist on a spectrum: the low end is when someone thinks something like, “I don’t want to wake up in the morning.” The high end is when a person who has the intention, plan and means to carry out their suicidal thoughts. There is no single reason or cause for suicide or suicide attempts, and no way to predict when someone might go from the low end of the spectrum to a suicide attempt.
If the person is willing to get treatment, there are two immediate resources to connect him or her with mental health services: the first is to look up the number for local mobile crisis. Local mobile crisis services offer 24/7 coverage and have trained mental health professionals who can meet the person in their home or community to perform an evaluation and take over safety planning and treatment. Program the number into your phone. Program it into their phone.
Second, you can take him or her physically to an ER of a hospital that has a psychiatric unit. Going into your local emergency room, even voluntarily, often results in patients waiting for days or weeks for inpatient treatment unless that hospital also has a psychiatric unit. If you don’t know which hospitals have psychiatric units, call ahead and ask.
Can People Get Better?
ABSOLUTELY Yes. There is recovery from severe depression, suicidal thoughts, or attempts. But recovery is not a clear path and there aren’t many measurable goal posts on the way to emotional stability. We can’t quantify suffering so the process can be messy, even for me as a therapist working with people who are struggling. This is why it’s so important to have your loved one connected with licensed mental health professionals, medication management providers if necessary, as well as other social supports.
While there are no quick fixes, there ARE evidence-based treatments (both biologically and psychologically focused) that address depression and underlying issues. Stability comes gradually, but it can come and I’ve not only witnessed it but experienced it.
All this being said, just know connecting to someone you love can include awkward conversations or silences. You might not say exactly the right thing, but trying matters. And when you feel like you’re in over your head, maybe it’s time to support them seeking therapy or getting a doctor’s appointment to discuss medication.
Watching the people we love struggle can be agonizing, but we grow stronger when we are connected to others, so don’t give up. The message that you want them to hear is, “I love you. I’m here for you. I’m worried about you. You’re not alone.”
For more information about suicide, including warning signs, statistics, and information on
treatment approaches, visit the American Foundation for Suicide Prevention: https://afsp.org
If you are interested in supporting a Loved One with mental illness, consider contacting our diverse counselor and therapist team of professional clinicians at New Leaf Counseling Group in Charlotte, NC at 704-774-3078 to schedule a free initial consultation - or click here to book an appointment online. We are ready and waiting with room for you to GROW.