You know your friend is struggling with depression or anxiety or some other mental health issue, but you don’t know what to say. You feel like anything you think about saying just sounds stupid and patronizing.
You also aren’t sure what to do. After all, you don’t want to intrude. You don’t want to be pushy, or bulldoze over their privacy. Or you already feel overwhelmed by something difficult in your own life.
Still you want to help. You just wonder, How?
Psychotherapist Colleen Mullen, Psy.D, LMFT, noted that many of us worry that we’ll just make the other person more upset or uncomfortable by revealing that we know something’s wrong.
Or maybe we don’t realize the extent of their pain. “I’ve seen many times how family members said in reflection, ‘I thought they were just going through something’ or ‘I didn’t think they were that depressed,’” said Mullen, founder of the Coaching Through Chaos private practice and podcast in San Diego.
Before her bipolar II disorder diagnosis, Julie Kraft also might’ve distanced herself from friends with mental illness—“not out of not caring, but rather, out of not knowing how to care. My silence would have only been a result of being terrified of saying or doing the wrong thing.”
However, there are many ways we can help—small ways that can be significantly helpful and supportive.
For Fiona Thomas, a writer who has depression and anxiety, this looks like a loved one ordering takeout and making her a cup of tea. “Feeling taken care of is a massive support because often I feel so mentally stimulated that I can’t do simple tasks or make decisions,” she said.
Thomas also finds it comforting when her husband tells her these words: “You won’t feel like this forever.” He reminds her of specific times they’ve laughed or enjoyed themselves, which reminds Thomas that “sad feelings do pass eventually.”
Below are other tips and examples of small ways to sincerely support someone when they’re struggling.
Check in. According to Thomas, author of the book Depression in a Digital Age: The Highs and Lows of Perfectionism, “the worst thing you can do is assume that someone with a mental illness will ask for help when they need it.” That’s because their instinct might be to isolate themselves (plus withdrawing from others is a symptom of depression).
Thomas suggested simply checking in, which might be anything from sending a text to see how they’re feeling to stopping by with food or their favorite coffee just to talk.
As Mullen added, you also can simply say, “Hi, I was thinking of you and wanted to connect.”
Ask directly how you can help. Kraft, author of the book The Other Side of Me: Memoir of a Bipolar Mind, suggested asking this question when the person is feeling well. “Doing this increases the chances of getting an honest answer, without a wall of defensiveness, hurt feelings, pride getting in the way, or being completely shut out,” she said.
Carolyn Ferreira, Psy.D, a psychologist in Bend, Ore., suggested saying: “I want to help you, but I’m not sure how. How can I really help you? What would you like me to do? What would you like me to say? What do you want me not to do?”
Offer specific examples. Sometimes, the person isn’t sure what they need. Sometimes, they don’t want to burden you. And sometimes, they’re simply too overwhelmed to think about it.
Ferreira shared these specific examples you might suggest: helping with finding a therapist or an inpatient program; providing childcare so they can get to a counseling appointment; giving a hug or advice; or just listening. For instance, you can say: I’d be happy to watch your kids while you go see your therapist.
Help with daily tasks. “During my darker times, it is easy for me to get overwhelmed by the normal daily tasks that come with being a busy wife and mom,” said Kraft, who has three children. “Getting groceries, keeping my house clean, or doing laundry can sometimes seem like climbing Mount Everest.”
This is why having a friend help with these daily tasks or just offer their help can be invaluable. “Sometimes just knowing that I have a support system waiting in the wings is enough to help me push through,” Kraft said.
Express your love and acceptance. Both Kraft and Ferreira stressed the importance of telling the person that you love and care for them. “This can fill our tanks and give us a reservoir of positivity to light up even our darkest moments,” Kraft said.
Ask thoughtful questions. For Kraft, it also means a lot when people take a genuine interest in trying to understand what it’s actually like to live with bipolar disorder. After all, part of being a compassionate friend is trying to see the world through the other person’s eyes, and heart.
Honor their tendencies. Respect how the other person wants to be supported—and how they are (if you know this). For instance, for Kraft, a self-described extreme introvert, phone calls are uncomfortable and “represent a million possible requests that I won’t be able to say ‘no’ to.” So when a friend texts or emails her, it means that they’ve not only listened but “are now respecting the way I’m wired.”
The same goes for when a friend suggests a coffee date a few months in advance, as “spontaneity does not exist in my world.”
“I feel incredibly safe and understood in that relationship. It all sends a powerful message to me that I’m not weird, I’m not high-maintenance, and I’m surrounded by people who are willing to help make life a little easier for me.”
Ask if they’re suicidal. This, of course, can feel like a scary topic to bring up. Many people also worry that if they ask this question, they’ll be putting the idea in the other person’s mind. You won’t. As Ferreira said, if the person is struggling with depression, chances are they’ve already thought about suicide.
She suggested directly saying: “Sometimes people who are depressed have thoughts of suicide; I’m wondering if you’ve had thoughts of suicide.” If they say they haven’t, she suggested telling them that they should let someone know if they ever do have these thoughts.
If they say yes, Ferreira shared these additional suggestions:
- Take them seriously, and encourage them to seek professional help. “Don’t assume that they’re looking for attention or being dramatic; they are more likely than not hurting greatly emotionally if they are thinking that death sounds better than living.”
- Empathize. Saying something like “I can see why you would be having those thoughts given your situation” can help the person to “feel heard and less likely to commit suicide.”
- “Tell them how much you love them and care for them.”
- Offer to keep them safe. Ask them if they have any specific suicidal plans—and if you can store any weapons they might have. (If you don’t want to do this, ask if there’s anyone else they can give the weapons to.) Some of Ferreira’s clients have asked their friends to hold onto their firearms when they’re suicidal.
- Check in regularly. “Some of my suicidal clients find it helpful to have some type of accountability or something to look forward to, so suggest a time when the two of you can send a quick text throughout the day.”
- Ask about their reasons for living—“and encourage them to keep showing up for those reasons.”
- Let them know that a lot of people experience depression (or whatever their illness) and suicidal thoughts at some point in their lives—and both are highly treatable. “People do feel better.”
For more information, check out this article on what to say to someone who’s suicidal, which also includes other helpful resources.
Ultimately, the kindest thing we can do is what we’d do for any loved one struggling with anything: Be there. Be there to listen. Be there to sit with their pain. Be there to encourage them to seek help. And be there to take some of the load off their shoulders.
“It is so comforting for me to simply have the knowledge that I have people in my life that haven’t backed away and have accepted me for who I am,” Kraft said. “People who have stayed. People who have let me know that if I did need them to deliver a meal or pick up my kids from school, they would. Without judgment.”