It’s time to talk
Supporting Someone with mental health issues can be difficult and Stressful. Alex lloyd has tips on how best to be there for loved ones
A PROBLEM shared is a problem halved – but opening up to a loved one about mental health struggles can be incredibly difficult.
Whether that’s down to lacking the right words, feeling shame or simply not thinking people will understand, finding the courage to talk can elude us.
More than two-thirds of British adults say they have pretended to be fine when asked if they are ok, with nearly four in 10 worrying that the questioner is just making small talk, according to a recent survey by charity Mind and bank Santander.
This means it might be up to family and friends to initiate the conversation when someone seems to be suffering with depression, an eating disorder or other forms of mental ill health.
“often when somebody experiences distress or is not coping, the symptoms they experience or the circumstances that bring them there make it hard for them to recognise it,” says Chris o’sullivan of the Mental Health Foundation (mentalhealth.org.uk).
“But if you notice a change in behaviour – whether that’s sadness and anger, or more subtle signs like being distracted – it is better to bring it to their attention than leave it in the hope it will get better.
“Mental health problems can become a lot harder to treat than if they are recognised early.”
HOW TO OPEN THE CONVERSATION You know you need to voice your concerns, but how do you put them into words?
“It can seem like a daunting thing to talk about, but we’ve all had conversations about bereavements, break-ups and other life events – mental health is the same,” reassures Chris.
“You don’t need to be a psychologist or have special training – they just need someone who can reach out to them with warmth and compassion.”
Natasha Devon, mental health campaigner and author of A Beginner’s Guide To Being Mental: An A to Z (£12.99, Bluebird), says the classic conversation opener of “How are you?” can actually be an effective tool – if used in a particular way.
“There is a really simple trick of asking twice,” she explains.
“When we say ‘How are you?’, we just throw it straight back to the other person with ‘I’m fine thanks, how are you?’. The interaction doesn’t mean anything.
“But if you ask ‘How are you really feeling though?’ it encourages them to think about it and shows you genuinely want to listen.
“Finding the right words is a challenge because we don’t have a huge lexicon when it comes to our emotional and mental health.
“Sometimes the ones available just don’t describe how we are feeling, or the language is scary.
“Asking them to rate their mood by a number can work – and get them to compare the number to previous days.”
Be sure to switch off your phone, give them your full attention and listen in a calm and patient way, says Graham Carrington of Time To Talk Mental Health UK (timetotalkuk.org.uk). “Listening can be beneficial just by itself, without the need to give advice,” he says.
“But listening nonjudgmentally is hard. For example, if someone you love is self-harming, that can be painful to hear. You need to keep your own emotions in check. “Have patience too – it can be hard for them to start talking initially. Give them space and quietness.”
He recommends waiting for a time when no one else is around and during an activity where you don’t have to make prolonged eye contact, so they feel less pressured.
“A car journey or a walk can be a good situation rather than making them sit down for ‘a talk’,” Graham says. “Keep the conversation open – tell them you will be checking in on them in a week or whatever, if they don’t mind? It gives them accountability.”
Avoid going into problem-solving mode initially or interrupting with your own experiences – and don’t be put off if they give you the brushoff to start.
“You may need to talk to them more than once or ask in a different way,” says Chris.
“What’s the worst that can happen? They will think you are a caring and perceptive friend.”
The Samaritans have a handy SHUSH acronym to aid you when listening to someone in distress: Show you care, Have patience, Use open questions, Say it back, Have courage.
TAKE CARE OF YOURSELF TOO
Being a shoulder to cry on is a challenge, no matter how much you love the other person.
Providing stable and reliable support is crucial as a carer for someone with mental health issues.
You need to ensure you keep any promises, such as a daily call or weekly shopping trip, because letting them down can reinforce feelings of worthlessness.
This means it is vital to be honest about what you can realistically give to them from the outset and don’t overpromise.
“Anyone who feels and cares for a person with a mental health problem is doing a great service – it’s a supreme act of love and compassion to be there, because it is not easy,” says Chris.
“It can feel quite isolating, particularly if support services are overwhelmed and a lot falls on you.
“But the expression ‘You can’t serve from an empty vessel’ applies to carers. Don’t give away your last bit of energy to someone else – it’s not selfish to leave a little for you.”
Try to maintain some interests outside the caring relationship, lean on friends you can trust, access peer support services for carers through organisations like rethink Mental Illness (rethink.org) or talk to your own GP if you are struggling.
recognise you are an unpaid carer as much as someone looking after a loved one with a physical condition.
People supporting a loved one with mental health problems often do not realise they are taking on this role because of the ‘invisibility’ of the illness. But you are still providing emotional support and may also be assisting with day-to-day tasks and medical appointments.
WHEN TO SEEK OUTSIDE HELP
If you feel your loved one needs professional support, encourage them to access this and assist them to do so, within your limits.
This could be planning out a call to their GP and sitting beside them for the consultation, or putting useful numbers in their phone, like the Samaritans.
Natasha recommends The Hub of Hope, an app which gives you instant access to a list of all support services near your postcode.
Ultimately, if you are concerned about someone’s immediate safety, take them to A&e or call 999.
“If you fear they are having thoughts of suicide, it is best to ask them directly,” urges Chris. Use the S word, rather than ‘You won’t do something silly, will you?’ and don’t be frightened of the response.
“It could save their life.”
You don’t need to be a psychologist or have special training – they just need someone who can reach out to them with warmth and compassion
Natasha Devon, author of A Beginner’s Guide To Being Mental