Photo by Ignat Kushanrev on Unsplash
Photo by Ignat Kushanrev on Unsplash

How can you help friends or family members who are struggling with a mental health challenge? 

I’ve noticed that it’s quite common for people to struggle to know what they should do to support friends or family members going through a mental health challenge, and it’s also quite common to say counterproductive things in such situations.

With the aim of helping you better help those people in your life who are struggling, here’s a list of five things that are usually a *bad* idea to say to someone who is dealing with a mental health challenge, along with seven things it usually is a *good* idea to do in such cases.

Part 1: things that are usually a *bad* idea to say to someone who is going through a mental health challenge

1. “Just think positively.”

For most mental health challenges, the problem is not a lack of positive thinking, and even if it were, being told to “think positively” would not enable them to actually be able to do so. This advice also trivializes people’s problems and so can come across as quite annoying or condescending.

2. “Focus on everything you have to be grateful for. Other people don’t even have enough food to eat!”

While it may be true that their life objectively has a lot of good things in it, their mental health challenge is not going to go away just by observing that. Gratitude can be a very useful mindset, but it is not a solution to mental health challenges, and being told to be grateful for what you have can lead to feelings of guilt (e.g., “I’m such a screw-up that I can’t even be happy when I have all these good things!”)

3. “You have to choose to be happy.”

It’s extremely rare that people choose to have a mental health challenge, and very few people, if any, know how to take the ongoing action of “choosing” to be happy. This framing of “choice” can also come across as though you are blaming the person for their mental health challenge, which is likely to be counterproductive.

4. “Today is the first day of your new life!”

This assumes that they can suddenly break out of their old patterns by reframing their life as starting anew, but this is a very unrealistic assumption. 

5. You should read “The Secret”/”The Power Of Positive Thinking” (or similar books)

These are in a genre of books that tell you that your problems are the result of not thinking the right way and that if you just start to think differently (e.g., imagine yourself succeeding and believe it with certainty), you will suddenly start to have the life you want. These techniques usually do not work for people with mental health challenges and can leave the reader feeling blamed for how they feel.


Part 2: things that usually *ARE* helpful to do with someone who is struggling with their mental health:

1. Ask open-ended questions about how they’re feeling and what they’re experiencing, without pushing them to reveal more than they’re comfortable with. Listen carefully. Try to really understand what they are going through.

2. Learn about the condition. Reading a book or two about the condition they are struggling with, or talking to an expert about it, can help you better understand what the other person is dealing with and can improve your ability to support them in helpful ways. Keep in mind, however, that their manifestation of the condition may differ from the typical manifestation, so be careful about jumping to conclusions about what they must be experiencing.

3. Empathize with them and show compassion. Don’t blame them for what they’re experiencing. And don’t use their struggles as an excuse to spend a lot of time talking about your own struggles. Though if you have been through similar challenges, they may appreciate knowing that.

4. Encourage them (with gentleness and compassion) to seek professional help (e.g., an excellent psychologist or psychiatrist). If they’re struggling to get started, ask permission to assist, and if they agree, reduce the effort for them (for instance, by trying to track down an excellent professional and provide them with the contact info). Thankfully, most people will improve when they are given evidence-based treatment that is carried out by a competent mental health professional (though it may take a few tries and failures to find a treatment that works well).

If they aren’t willing to see a therapist, you can ask if they would be up for reading a book that is specifically designed to help people who have mental health challenges. If they agree, you can research what the best book is on the topic and buy it for them.

For instance, many people have benefited from the David Burns books Feeling Good (for depression) and When Panic Attacks (for intense fears, such as social anxiety and phobias). Chronic worriers may benefit from The Worry Cure by Robert Leahy. For people who are mean to themselves (e.g., engaging in negative self-talk), the book Self-Compassion (by Kristin Neff) may be useful. For people who have very intense emotions or who have Borderline Personality Disorder, The Dialectical Behavior Therapy Skills Workbook by Matthew McKay may be useful.

If the person expresses openness to it, you may also want to encourage them to engage in other healthy behaviors that may be beneficial (such as eating healthy food, walking outside daily, and getting regular exercise at the gym). It’s ideal if you can make these behaviors easier for them, such as by offering to go to the gym with them three times per week or by buying them a healthy meal delivery plan as a gift (with their permission, of course).

5. Avoid advice until they are ready to hear it. In an attempt to be helpful, people are often much too quick to give advice, which can be very frustrating to the receiver (especially when the advice-giver doesn’t really understand the circumstances well). The time to give advice is after you have done a lot of listening and when the other person has indicated that they would like your advice. If you aren’t sure if they want advice, you may want to ask something like, “Would it be helpful if I gave you some suggestions now for how to do X, or would that not be useful at the moment?” Of course, once they are ready for advice, you should absolutely give it. When you do give advice, try to make it clear when you are confident in what you’re saying versus when you aren’t as sure (and they may want to consult someone else, such as a mental health professional).

6. Do nice things for them that you know (based on past experience with the person) they’re likely to appreciate – whether it’s spending more time together, sending a random compliment, reminding them you love them, giving an extra hug, planning a fun activity for the two of you (that they feel well enough to enjoy), or offering to help them clean their apartment. What matters, of course, is what they would actually appreciate in their current state, not what you would appreciate if you were them, and not what they would appreciate if they weren’t in their current condition.

7. Make your help sustainable. Remember that it is not your job to “fix” this person’s mental health, nor will you be able to do so. Mostly, you can only help someone when they WANT to be helped and only in ways they are WILLING to be helped. It’s also important that you take care of yourself in the process. This person may have a mental health challenge for a long time, so (other than in cases of acute crises where extra action is needed), it’s not a good idea to extend yourself in a way that will not be sustainable. Don’t jeopardize your relationship with this person by taking on more than you can realistically handle, which could lead you to experience burnout or resentment. Just because someone is experiencing a mental health challenge does not mean you should let them violate your boundaries. If the person is acting in a way that is harmful to you, it’s important that you clearly assert your boundaries to prevent yourself from being harmed (while you continue to help in whatever ways you can, without giving up on those boundaries).


Conclusion

Everyone is different, so it’s always possible someone would benefit from items in the “bad” list above or dislike items in the “good” list. But I believe that following these guidelines will, more often than not, make you more effective at helping the people you love.

In summary, as a friend/family member, your job is to provide love, empathy, and the level of support that you can sustainably manage. Avoid giving shallow suggestions such as to “think positively.” Instead:

• ask open-ended questions

• learn about their condition

• empathize with their experience

• encourage the person to get high-quality professional help

• avoid giving advice (until they want it)

• do nice things

• make your help sustainable


This piece was first written on January 8, 2023, and first appeared on this site on May 28, 2023.



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