Helping a Friend

Here’s how you can help a friend with their mental health problems.

Key takeaways

• Friends can offer valuable support to people who are struggling with their mental health, but it’s important to take care of yourself while you’re supporting someone else

• The first step is to open up a conversation and listen without judgment or trying to fix the problem

• You don’t have to deal with a friend’s mental health crisis alone. Reach out to professionals for advice and help

Supporting friends with their mental health

Supporting a friend with their mental health isn’t very different from helping them with a physical health problem. You can help by

• Helping them find a medical practitioner.

• Offering practical support.

• Listening and empathizing with how they feel.

Mental health conditions can be more stigmatizing than many physical health problems, so you can also help reassure them and normalize talking about mental health.

When supporting another person, physically or emotionally, it’s also important to take care of yourself. This can be easier if several people work together to take care of a mutual friend, but avoid sharing information about a friend’s mental health without their permission.

How can I tell if a friend has a mental health problem?

Mental health problems should only be diagnosed by a medical professional, as it’s very easy for people without training to misunderstand the symptoms. You can’t know for sure whether your friend has a mental health problem, but some warning signs to look out for include

• They stop spending time with people (social withdrawal).

• You notice changes to their sleep or appetite.

• They stop carrying out their usual hygiene routines.

• They seem to have dramatic changes in their mood, especially if this occurs quickly.

• They start abusing alcohol or drugs.

• They frequently talk about suicide or death, even if this is in passing or presented as a joke.

• You notice a deterioration in their performance at school or work.

• They stop doing activities they used to enjoy.

• They develop new difficulties with concentration or memory.

• They report feeling disconnected, or as though things aren’t quite real.

These signs don’t tell you for sure that someone is suffering from a mental health problem, but they are valuable warning signs.

Talking about mental health

Talking about mental health is essential, especially with a friend who might be struggling. Unfortunately, these conversations can be tricky to navigate, and many people are unsure how to start.

If you want to talk to a friend about their mental health, especially if you’re concerned about them, here are some things to bear in mind.

Don’t push a conversation they’re not ready for

You can’t force someone to accept help, and many people who are experiencing mental health issues might not be ready to talk to you about what they’re dealing with. Respect their privacy and let them know that you’re there for them. They’re more likely to feel safe opening up if they don’t feel pressured.

Don’t avoid talking about difficult topics

Some people worry that talking about difficult topics such as self-harm or suicide might encourage their friend or loved one to take their own lives. Research shows that the opposite is true. Allowing your friend to talk about their feelings without judgment, even if they make you uncomfortable, can help reduce the chances of serious harm.^[2]

Don’t expect to cover everything in one conversation

Mental health issues are often long-term, and people who are struggling are unlikely to be ready to share everything all at once. Follow their lead and expect to have many conversations over days, weeks, or even months.

Advice on how to help

Even once you know that a friend needs support with their mental health, you might not know what you can do. Here’s some advice to help you offer effective support to people you care about.

Make sure you are prepared

Talking about mental health issues, especially to a friend who is struggling, isn’t something most people do regularly. It’s a difficult conversation, and most people will feel out of their depth. Take some time to prepare for this conversation. This might include

• Thinking carefully about what makes you think your friend is struggling

• Doing some research about their condition, if they already have a diagnosis

• Taking care of your own mental health and making sure you’re ready

• Thinking of ways to take care of yourself after the conversation

• Preparing a list of resources to suggest, but only offer this if your friend decides they’re ready

• Being ready for them not to be willing to talk

Dedicate time and space

Talking about mental health issues can be vulnerable and awkward. Make things as easy as possible by making sure that you have privacy and plenty of time before starting the conversation.

Avoid diagnosing and prescribing

If your friend is struggling with their mental health, they’ve probably tried several different ways to make themselves feel better. Telling them what you think is wrong with them, or how they should deal with it, is unlikely to be helpful.

This is particularly true if your diagnosis or suggestions have come from social media. With so much misinformation on these platforms, the advice you offer could be unhelpful or even harmful.

Keep communication open

It’s easy to allow your assumptions and beliefs to take over when someone you care about is experiencing mental health problems, but this can leave them feeling misunderstood and isolated. Avoid focusing on your own experience or using examples from your life. Instead, ask them to talk about their experiences.

Avoid closed questions, which are any questions that can be answered by a single word, such as yes or no. Instead, encourage them to talk more freely with questions such as “How does that feel?”

Listen closely

People who are experiencing a mental health crisis need to feel heard. Try to focus on listening to their experience, rather than giving advice or telling them what you think.

Check whether you’ve understood them correctly using phrases such as “It sounds like you’re feeling … Have I understood that correctly?”

Help them find professional help, if they’re ready

As a friend, you can do a lot to help someone who is struggling with their mental health, but you’re not a trained professional. If your friend is ready, you can help them find a mental health professional, such as a therapist or a counselor. This can be important, especially if your friend is overwhelmed or struggling with daily tasks, as they might not have the energy to look for this support themselves.

Remember that you can’t (and shouldn’t) push someone else into treatment, though. Your friend is more likely to go through with treatment, and it is more likely to be successful, if they decided for themselves.

Offer practical support

Life doesn’t stop just because someone is facing mental health struggles. If your friend is finding life difficult, it can be helpful to offer them practical as well as emotional support. This could be helping them to clean their house, offering childcare, or going with them to medical appointments.

Practical help needs to meet your friend’s needs, but they may find it difficult to ask for the things that would make the most difference for them. Try saying, “I’d really like to help you out. I was wondering if it would be helpful for me to …, or whether there’s something else that would make more of a difference for you?”

Be able to sit in silence

Someone else’s mental health issues aren’t something you can solve, and they’re probably not expecting you to. Rather than offering platitudes or solutions, sometimes the most helpful thing to do is to just sit with them and show them that they’re not alone.

It’s especially important to avoid “toxic positivity”, where you try to cheer them up by reminding them of the good things in their lives. Avoid phrases such as “At least you have …” or “You should be grateful for …”

Crisis intervention for a friend

Experiencing a mental health crisis in a friend can be scary and difficult. It’s important to protect yourself and ask for help in supporting them.

A mental health crisis can include

• Suicidal thoughts and feelings.

• Psychosis, hallucinations, or paranoia.

• Being unable to carry out basic self-care tasks, such as eating or bathing.

• Feeling disconnected from themselves or as if the world isn’t real.

• Making extreme, harmful choices, such as risky sex, excessive spending, or reckless gambling.

• Feeling compelled to harm others.

• Severe anxiety and panic attacks.

A mental health crisis is an emergency, and you need to seek professional support. Try to stay calm and assess the situation. Consider

• Whether there are any potential hazards, such as knives or medication, that you can remove.

• What mental health services is your friend already working with, if any? Contact them if possible.

• What mental health services are available in your area.

Don’t

• Tell your friend that they’re imagining things.

• Wait or assume it will all blow over.

• Put yourself at risk.

Do

• Listen to your friend, even if they seem to be making no sense.

• Offer reassurance.

• Let others know what is happening.

• Call 911 if there is immediate danger to your friend or others.

• Be honest with professionals about any illegal substances your friend may have taken.

• Seek support and reassurance once the immediate crisis is over.

What to do if they are suicidal

Suicidal feelings are an emergency, and it’s important to reach out for support if someone you are close to is considering harming themselves. If they are not at immediate risk, it might be helpful to call the 988 Suicide and Crisis Lifeline. They can call this helpline to talk through their feelings, but you can also use it to seek extra advice and support for yourself.

If in doubt, call 911. Be clear that you are asking for help with someone who is experiencing a mental health crisis, and ask for support designed for their needs. In many areas, it is possible to receive 911 help from someone trained in mental health crises.

Additional resources and organizations

To offer support to your loved ones, you need to know where to turn for help and advice. You might need information on different mental health conditions, how treatment works, and how to look after your own mental health.

Other reliable sources of information and support include

• National Alliance on Mental Illness (NAMI)

• Anxiety and Depression Association of America (ADAA)

• Centers for Disease Control and Prevention (CDC)

• American Psychiatric Association (APA)