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How To Help A Friend Who Is Struggling With Mental Health Issues

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Elisabeth Shaw, CEO, Relationships Australia NSW, provides helpful advice about how to help a friend who is struggling with mental health issues.

At present, we can all feel a bit below par. The isolation, lack of easy access to our usual activities and supports, loss of home/work boundaries and perhaps some slippage of self-care, all contribute to lower morale, at least on some days. Add to that work uncertainty, perhaps some relationship challenges, home schooling, worry about elderly parents, and there is a swirling cauldron to be managed.

It can be hard to know how much suffering is too much. Is my struggle any worse than anyone else’s? Do I have a right to complain or to take time out and rest?

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Sometimes we get a measure of this by those nearest and dearest, and how they are travelling. It is a comfort to us to know our peers can feel similarly. What do we do then when we notice that a friend is, compared to others, really seeming to be suffering? Perhaps we start by thinking they are having a bad patch, and that our support as their friend will be enough. We might spend time listening, being a cheer squad or motivator. We might offer our best ideas and suggest that we do more together, like go walking or see other friends. These are all good things to do, and by association, we get the pleasure of feeling useful, we can feel like it pays back for times our friends have been there for us, and we see our efforts really helping our friends, who recover and move on.

Of course, friends don’t always take our good advice and suggestions, but despite this, seem to benefit from us being there.

What if it doesn’t work though? What if our friend is really stuck, or really suffering in a longer term, more entrenched way? What if this current bout of unhappiness is part of a pattern, and is beyond ordinary melancholy and moving more towards life threatening suffering? It can be hard to know what role a good friend should play, and if our friend seems to be especially relying on us, or is otherwise very isolated, we might feel caught.

depression

Add to that if they tell us things and make us promise not to tell anyone else, and the role of friend can become very intense and perhaps more of a responsibility than we thought we signed up for. There is no clear roadmap for this, and indeed our friend might be saying “if you are really my friend you will…” and the list of obligations at the other end of that sentence can be hard to refuse in that context.

Here are some tips to help you best navigate this uncertain ground:

  1. Set your boundaries. Your role is that of a friend, not mental health worker, nurse, personal carer or ambulance officer. A friend is a special role within what might be a bigger support team. It is important to feel brave enough to set limits when you are out of your depth, or what is needed is more than you can reasonably provide from the position if “friend”. If your friend needs specialist assistance, you stepping into that role might accidentally impede him/her from getting the professional assistance they needed.
  2. Share the load. There is a difference between gossiping with other friends and engaging a support team. Respect your friend’s vulnerability and not betray them with broad disclosure about them, but at the same time if you know other friends are aware of the situation, work out a support plan based on what friends can offer. If professional assistance is needed, say clearly “as your friend I can take you to an appointment, or research good contacts and support you getting help.” Be really clear when required: “this is more than I can do. I am a good friend, and so need you to get the help you need, as I am not it.” Once a psychologist or similar is in place, your role as friend can proceed unencumbered.
  1. Self-care. Taking time for yourself and thinking through what is best for you is not being selfish, it is being sensible. You may have obligations and needs of your own that also need to be met and being a good friend should not mean your life is on hold. Indeed, being really invested in self-care can offer good leadership to your friend.
  2. Be prepared to break confidence in service of safety. It is ok to say to your friend that what they are asking is unreasonable. Being asked to hold confidences about risk or self-harm for example, if not reasonable. It doesn’t happen often, but it can be the case that you have to risk the friendship in order to get your friend the help they need. In such cases, hopefully when your friend is feeling better, s/he will see you had good intentions.
friends

Friendship offers us some of our greatest pleasures in terms of close affinity, camaraderie, great memories and shared fun. For brief periods we can move into more direct caring, support and assistance when required, as life throws us all many curve balls. It is important to tell the difference between this reciprocal ebb and flow and something more entrenched and worrisome. If it is hard to know what to do, and you want to test your ideas and experiences against something more objective, getting separate professional advice for yourself as well as you friend can be really helpful.

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If you are concerned about the mental health of a friend or loved one, Relationships Australia NSW is a non-profit organisation that provides a variety of professional support services. For more information, visit: www.relationshipsnsw.org.au

Elisabeth Shaw is CEO of Relationships Australia NSW and a clinical and counselling psychologist specialising in couple and family work.

Written by Elisabeth Shaw

Elisabeth Shaw is CEO of Relationships Australia NSW and a clinical and counselling psychologist specialising in couple and family work.

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