Supporting a loved one through mental health struggles

7 minute read

Watching someone we love go through mental health struggles can be incredibly painful. We desperately want to do something to help, but often feel disempowered and impotent in the face of their distress.

So what can we do to support them?

The first, and most important thing, is to listen to them. By “listen”, I don’t mean jump in with solutions, tell them what to do, or try to fix it for them. This is harder than it sounds. As a therapist myself, you would think I would be good at this, but when it comes to my own family and friends, I hear myself offering solutions and trying desperately to make it better for them.

This comes from a good place - we want to help, and it can feel almost unbearable to witness such anguish in our loved ones, so of course we want to do something to try to make it better.

We need to notice this urge and remind ourselves that we are doing something helpful and important by just listening to them.

It can be hard to understand issues such as anxiety and depression if we have not experienced them ourselves. Unfortunately, this lack of understanding can lead us to say some unhelpful things. Try to avoid telling people that they “don’t need to worry” if they are feeling anxious, or that “things could be worse” if they are feeling depressed.

We mean well when we say things like this, but they discount the validity of depression and anxiety, making it sound like people can choose not to feel this way. Sadly, this is far from the case.

Some people may not want to talk about what they are struggling with and might be grateful for distraction and other topics of conversation. Some people might want a lot of support, others might just want the occasional text message. By asking the person what they need from us, we are showing our respect for them, and allowing them autonomy.

What is active listening?

Active listening is the first skill taught in counselling training. It is learning to shut up and make space for the person who is talking. It involves non-verbal communication, such as nodding, saying “mmm” and facial expressions. It is a skill and takes practice, but it is such a helpful skill to refine.

When we are really listening to someone, they feel heard. They have space to think through what they are saying, space to feel the impact of what they are saying, and they can feel so much less alone.

What if they don’t want to talk?

It can be particularly hard if someone doesn’t want to talk, but maybe they are not ready, or are scared to open up. All we can do in this case is let them know that we are there for them and happy to talk when and if they feel ready.

Sometimes, people fear judgement around mental health issues, so being open about our own experiences can help to alleviate that fear.

Encourage them to seek further support

People can be really scared about opening up to their GP or seeking other professional support, but this can be such an important part of the recovery process. Although you obviously can’t force them to get help, you can encourage them to, and reassure them about the process. Perhaps offer to accompany them to the GP, or to help them to write a list of what they would like to say.

Mental health support is a massive part of what GP’s do, and they are very used to talking about mental health concerns. There is no shame in struggling with mental health. Most of us encounter mental health issues at some point in our lives and it is about time we moved right away from any remaining stigma.

Sadly, some of the old stereotypes are still around about mental health and people can fear over-reactions from professionals, or even being admitted into an inpatient facility. Your loved one might therefore need reassurance about these fears.

Empower rather than take over

It can be tempting to rush in to organise support for the person and even perhaps to take control of the situation. Again, while this comes from a good place, it is often not the best way. Better to ask the person what they need and what they would like from you. This encourages the person to think about their needs and learn to voice them.

It might be that the person wants you to take control and ease their load in some way. A really tricky element of supporting others is being mindful of our boundaries. Before we jump in to agree to take on responsibility for things, we need to check in with ourselves whether we have the space emotionally or practically to do so.

Managing our own well-being

This brings us on to the delicate balance of managing our own load whilst supporting others. It is no good taking on everyone else’s troubles and then feeling overwhelmed and emotionally burnt out ourselves. We are not generally taught how to prioritise our own needs. In fact this can be seen as being “selfish” and people who endlessly give to others are held up as being virtuous and inspiring. In our society, we are often taught to be caring for the needs of everyone else, even if this means ignoring our own needs.

Far from being the ideal, I believe this is actually a really unhelpful standard. If children were taught to be aware of their needs and to be able to express those needs, it would not only improve their future mental health, but also encourage them to set good boundaries and have higher self-worth.

So by modelling this approach to a loved one, we can actually help them to learn how to take better care of themselves.

You can think of these boundaries as an umbrella, protecting you from the downpour and creating enough space for your own well-being.

What if you fear for someone’s safety?

If you think that someone is in danger of harming themselves in some way, this can feel really frightening and overwhelming. If the risk seems immediate, you can call 999 or get them to the nearest A&E department.

If you think they are safe for now, but you are concerned that they could be at risk at some point, you can give them some crisis support numbers, such as The Samaritans (call 116 123 or email jo@samaritans.org) or Shout, the crisis text messaging service (text 85258). In situations like this, it would be really important to encourage them to speak to the GP, or even speak to the GP on their behalf if they are reluctant and you think they are at risk. The GP won’t be able to discuss them with you, but at least they are then aware of the issue.

Supporting someone who is considering harming themselves is a particularly heavy load to carry and I would really urge you to seek support for yourself in situations like this.

When someone you love is self-harming

Self-harm is another painful and distressing thing to witness in a loved one and it can be hard to understand why a person would harm themselves in this way.

Although this is not easy, try to avoid panicking; rather just gently ask your loved one how they are and whether they are able to talk about their reasons for self-harming, and ask how you can support them.

So often, people self-harm as a way of trying to keep themselves afloat. It seems counterproductive but many people report using self-harm as a coping mechanism.

It is really important to seek professional support with self-injurious behaviours, as this can be a tricky thing for people to manage without the right support. The best starting place would be the GP, unless you believe someone is in danger of serious harm, in which case call 999 or take them straight to A&E.

Here are some options for further resources:

There is a free app called Calm Harm. The Mix provides support for people under 25 struggling with self-harm. There are also The National Self Harm Network (NSHN) Forum, and Harmless.

Supporting someone who is grieving

Our society does not handle grief well at all. We are uncomfortable around death in general and have some pretty awful in-built messages about how people “should” grieve.

The first thing to do is try to let go of any idea of what is the right way for the person to be grieving. There is no right or wrong. Everyone’s experience is different and personal.

The second thing is to give them time. And I don’t mean a few months, or even a few years. Grief is a process that takes as long as it takes. It can’t be hurried or rushed through and, sadly, it can’t be worked around either. The only way through it, is through it.

We seem to have the belief that we shouldn’t talk to bereaved people about their pain or the person who has died, as we worry we will make them sad. This is such a shame - they are already sad. They are constantly sad. The most helpful thing for people who are grieving is permission to talk about their pain as much as they need to.

And please never tell anyone that they need to “move on” or “put it behind them” or worse, “not dwell on it”. This is so damaging, as it stops people from feeling free to express their pain and so they hide it away, creating further anguish and isolation.

It might help to reassure the person that grief is exhausting, it stops you from being able to concentrate, makes you question your sanity and drains away all of your energy and motivation. Many people worry that there is something wrong with them and can be grateful to hear that this is all totally normal.

To sum up…

It all comes down to making the space to listen to whatever your loved one is going through and to asking them to let you know what they would like from you. Remember to take care of your own well-being and to reach out for more support if you are concerned about their safety.

The charity Mind also has some helpful information about supporting loved ones, which you can find here.

If you would like further information or support, feel free to get in touch.