When the answer to “Are you OK?” is “No”.

Mental illness is a scary, unnerving and confusing time for not just the patient, but the circle that surrounds them.  For those in that circle who don’t understand what’s happening or want to help, this article is for you.  It is no way designed to replace professional advice, it is simply here to provide insight and understanding. Links to professional resources have been provided at the end of this article.

1. This is Normal.

The statistics demonstrate that it is almost certain you will be directly affected by mental illness at some point in your life.

It’s as common as the everyday head cold and just like a head cold you’ll note;

  •  no-one is immune
  •  everyone is affected differently
  •  it can be treated but not prevented
  •  it makes the patient sick (symptoms are real).

It’s simply an illness that needs to be treated. No connotations required.

2. Starting the conversation.

The biggest revelations can come from the smallest moments. Maybe you heard a sob in the bathroom, maybe you watched them return three times searching for what they’ve forgotten or maybe they no longer share with you the important things and only provide superficial conversation now.  Changes will be there if you’re attentive enough to notice them. Mental health illness can be hidden, ignored or deflected but if you’ve noticed anything that concerns you don’t be afraid to initiate the conversation.  If you need a starting point consider the following openers:

  •  “I just noticed  (observation), is everything OK?”
  •  “If there’s ever something you want to talk about,  I’m always here.”
  •  “That was a pretty big thing with (event).  How are you coping with it?”
  •  “You just said you’ve been feeling (emotion). What did you mean by that?”

3. Understanding their position

This is not about understanding their condition,  rather gaining a perspective on the paradigm they are now existing in.

Society has gone a ways to normalise mental disorders but remember this is not normal for them. Their internal world has changed and just as they may seem unfamiliar to you they are also unfamiliar with themselves. This will likely bring with it a swag of negative emotions which exacerbates the condition:  guilt, shame, regret, disappointment, fear, failure, grief, loss, frustration, anger, impatience.

Be patient and withhold judgement.

4. Consider your response

Your response when someone shares their mental illness with you inevitably sets the dynamic and tone of the conversation going forward. Consider the table below:

Emotion Response Emotional Translation
Pity “You poor thing!”
“You’ve had a hard time of it”
I can see what’s happened and I’m glad it’s you not me.
Sympathy “I’m so sorry this happened to you.”
“I hope it gets better soon”
I feel bad for what you’re going through.
Empathy “I can only imagine…”
“It must be so  difficult to …”
I’m thinking how I’d feel in this position.
Compassion “How can I help?”
“What can I do?”
I want to help ease the pain and suffering you are going through.

Whilst all the responses are caring in nature the emotional translation could have you seen as condescending, uncommitted or lacking understanding.

If you’ve felt like your loved one shut off or pull away after the initial conversation have a think about your dialogue and how this may have been interpreted.

If you’re unsure of what to say ask them how they are feeling physically, emotionally and mentally. It’ll help improve your understanding of their situation whilst providing you both with a safe baseline for future conversations.

5.  You can’t fix this

In the case of the common cold example discussed above,  you wouldn’t expect yourself to be able to fix their dripping nose so why would you expect you’re capable of fixing their mind? Your role isn’t the fixer, leave that to a professional. Your role is to continue to be who and what you were to them before this happened (friend, sister, spouse, employee etc.).

Whilst you can’t fix the situation, you can help.  Life goes on and there are always practical things that need to be done (eg. housework, babysitting, shopping, work tasks etc). Providing them with additional time in their day so they can heal is a genuine help.

6.  Nothing is predictable

Mental illnesses are unpredictable. There is no fixed period for recovery. They’ll have good days and bad days as well as good periods and bad periods.

Medication is unpredictable. What works for some, won’t work for others. Doctors may need to try different dosages and prescriptions before they get it right. Your loved one may not understand what are the symptoms of their illness and what are the effects of the medication. It is worth knowing that medication doesn’t take effect immediately. Anti-depressants take 6-8 weeks before they take effect and after this point dosages may need to be further adjusted.

Your loved one will be unpredictable too. They may be constantly running late when they were always punctual or sloppy when typically tidy.  It will be different for each person and also different for each person during each stage of recovery. Drugs and alcohol will add another level of unpredictably as they impact medication and illnesses in different ways.

Memory loss, confusion, fatigue, emotional outbursts …the range of symptoms is huge and there are no definites. This is the nature of mental illness.

7. Look After You.

Whilst our awareness of mental health is greater than ever before, when it’s close to home it’s still a difficult topic to raise and discuss.

Your concern will be a weight and a worry but you don’t have to bear it alone.  Find a trustworthy confidante and support person(s) that you can share thoughts, fears, emotions and experiences with. You don’t have to name names, in fact, maintain the trust that’s been shared with you.

This isn’t about sharing what your loved one is going through – it’s about what you are going through.

As you share your story you’re also inviting others to share their story with you.  The more we discuss mental health, the more we normalise it. The magnitude and impact of the issue also becomes more apparent.

It’s critical through this period that you take time for you. Your inner resources will be drained by the support you’re providing so make time regularly to top yourself up with activities you enjoy (eg. exercise, socialising, etc). This is not being selfish or uncaring to your loved ones needs. This is self-care and essential for your own mental health.

Finally, don’t forget they are still the person you loved or cared for. Remind them of this…  especially if they are struggling to love themselves right now. This period will end but what won’t end is the bond you’ve strengthened by simply being there during this difficult time.

If you feel this article has been helpful, please share and continue the open dialogue of mental health.

If you require further information or professional assistance please contact one of the support organisations listed here.


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