When a friend or loved one lets us know they are seeking treatment for a broken bone, heart disease, or cancer, most of us would rush to provide encouragement and support. Sadly, when those same loved ones share that they are experiencing challenges with their mental health, we may find it difficult to know how or when to offer support. Mental illness is often and unfortunately stigmatized in our society. This may lead to many people deciding that they feel uncomfortable sharing their mental health struggles, or asking for help in seeking treatment.

How You Can Help

As friends, we can help to care for our loved ones, even when their illness is one we know little about, and have little experience discussing. Below is a short list of things you may notice when a friend is having a mental health crisis. Please remember this list is not meant to be all-inclusive, and you should check in anytime you feel a loved one is struggling.

9 Signs of Mental Health Challenges

1. Isolating oneself

If a friend has lost interest in the activities they once enjoyed, are not responding to texts or phone calls, or seems to be avoiding their regular social interactions.

2. Crying

Crying is a normal response to many “big” emotions and events. However, if your friend seems to be crying more than usual, or at times that seem odd to you, there may be something deeper that is impacting them.

Suggested Read: It’s Okay For Everyone To Cry

3. Risky Behavior

Is your normally cautious friend suddenly driving 20 miles over the speed limit? Have you noticed your frugal relative spending hundreds of dollars gambling? Perhaps you’ve noticed a sharp increase in alcohol consumption, misuse of prescription drugs, or even illicit drug use. These can all be red flags that your friend is disregarding their own wellbeing.

4. Self-Harming

Cuts or burns could be an indication of self-harm, especially if your friend is wearing long sleeves or pants during warmer weather.

5. Mood Swings

Your loved one may be deliriously happy and excited one moment, and suddenly angry and withdrawn in the next. We all go through waves of emotion, but erratic changes may be cause for concern.

6. Extreme Distraction

Have you noticed that your friend seems lost in thought no matter what you two are discussing? Do they often miss parts of a conversation with no clear reason? Perhaps they’ve mentioned feeling unable to concentrate at work. They may be distracted with thoughts that they are unable to process in a healthy way.

7. Overwhelming Fear

Your loved one may mention intense fears over what seem to be minimal or non-existent situations. Their worry may become so intense that they feel unsafe driving, going to work, or leaving their home.

8. Changes in Behavior

You know your friend best, and you know when things are just “off” with them. Perhaps their appetite seems to have increased greatly, or disappeared altogether. You may get texts in the middle of the night as their insomnia rages, or they may sleep through their alarm and miss important commitments. If something seems very out of character for them, it may be reflective of their unbalanced and unusual emotional state. 

9. Threatening Suicide

This may seem like a given, but if your loved one mentions or hints at thoughts of suicide, please take them seriously. If the danger seems immediate, consider offering to sit with them, driving them to the emergency room, or calling 911. Even if you’re not sure if they are serious, it’s better to be safe and seek help.

4 Ways You Can Help

Mental health and mental illness are not two sides of a coin. Think of it more as a sliding scale that anyone can find themselves moving through on any given day. Often, it is up to each of us to ask, with deep empathy, “How are you?” and to be ready for an answer that is not always neat or tidy.

1. Talk About It

It is possible to bring up things you have noticed without having the person feel shamed or judged. 

Instead of: “Geez, you hardly eat anymore. You’re already so skinny.”
You could try: “I’ve noticed some changes in your appetite, are you feeling ok?”

Instead of: “Why don’t you ever come for our weekly dinner anymore? Everyone thinks you’re avoiding us.”
You could try: “You haven’t joined our group for dinner the last few times. Is there anything you’d like to talk about without so many people around?”

By focusing on facts you have observed, you can offer support without them feeling that you are angry or upset with them.

2. Share Your Concerns with Someone You Trust

Be transparent, and let your friend know you are sharing your concern with others. Reach out to other supportive friends, family, clergy,  teachers, coaches, or counselors. It is a heavy weight to be a friend’s sole support. If it’s an emergency, don’t hesitate to dial 911.

3. Be Supportive

There are many ways you can offer support to someone, regardless of the particular challenges they are facing. They may be having trouble keeping up with daily tasks, such as preparing meals or getting laundry done. It may be helpful to see if they would like a ride to an appointment, or help getting some shopping done. While you can never force someone to seek help, you can certainly suggest it, and let them know that you will support them in any way to get the help if and when they choose to do so.

Suggested Read: Empathy Versus Sympathy: What Do We Need?

4. Don’t Give Up on Them

There are many ways you can continue to check in with and be present for your loved one.

  • Call or text regularly, whether or not they respond. 
  • When planning a gathering, resist thinking “They won’t come anyway, so I shouldn’t invite them” Instead, extend the invitation, let them know you would love to see them, and let them make their own decisions. 
  • Make a specific offer to help. You could let them know that you would love to watch their children for a few hours, and ask them which day would be best. Or volunteer to bring over a meal, and offer two choices for them to pick from. 
  • Reassure them with clear and simple words that you care, and that you will continue to be there for them, no matter how they are feeling. Let them know that your love is not conditional on them “snapping out of it” or “feeling happy again,” but rather is a love you feel towards them as a whole person.

Continuing The Support

Remember, the first step in addressing mental health issues is to talk openly about it. When someone we love is experiencing severe challenges with their own mental health, knowing we are there to love them through it can be quite literally life-saving.