By: Tess Brigham
It’s one thing for you to feel down and depressed but when someone we love is struggling; the range of emotions we experience is overwhelming. Some days you feel so angry your friend or family member isn’t taking action to get the help they need. Other days you feel incredibly sad because you wish you could take their pain away. And some days you feel like throwing your hands up and shouting: “Fine. It’s your life. I’m out.”
When you have a friend or family member who is grappling with a mental health issue, the path forward can seem so simple and clear to you but not for your loved one. Which puts you in a tough position - you want to be supportive, but you also want this person to take action and get the help they need.
We all know the saying: “You can only control yourself, not other people.” One of the hardest aspects of being a friend or close relative of someone with a mental health issue is the ultimate fact that it’s up to them if and how and when they choose to get help. Which is super difficult! However, there are some things that you can do to make this easier for everyone.
1) Understand what may or may not be happening
How do you know if your loved one even has a serious problem? Maybe they’re just a little sad or stressed about work?
As a therapist, a big part of our job is identifying and correctly diagnosing mental health disorders. We use something called the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is a HUGE book so I’m not going to bore you to tears going through the whole thing, but I do want to share the symptoms of the two most common disorders people struggle with (not including drug and alcohol issues): depression and anxiety.
First let’s start with the formal diagnosis of depression.
According to the DSM, to be formally diagnosed with Major Depression the individual must show that “five or more of the following symptoms have been present during the same 2-week period and represent a change from previous functioning: at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.”
Here is the list of symptoms:
There are certainly days when we all experience one or more symptoms of depression for various reasons. Life is hard. It can be overwhelming and stressful one day and the next day you wake up feeling more hopeful. Being unemployed, a recent break-up, grief, can all create feelings of worthlessness.
This is why identifying and understanding depression is so difficult. You want to pay close attention to whether your loved one has lost interest and pleasure in activities that they once loved. Also, if their overall mood remains depressed, sad, and they talk about feeling hopeless.
Anxiety can be a tricky one because we all get really anxious and stressed in various ways every single day. There is the stress about the upcoming presentation at work, there’s the stress of whether he or she text me back, and there’s the stress of simply getting to work on time. We need our anxiety in order to function in society.
There are also lots of different kinds of anxiety from just being anxious in social situations (social anxiety) to being fearful of certain things or events (specific phobia) to having what some think is a heart attack but usually turns out to be related to our anxiety (panic attack).
For this article, I’m going to focus on Generalized Anxiety Disorder. GAD is described as excessive anxiety and worry, occurring more days than not for at least six (6) months, about a number of events or activities (such as work or school performance). The individual finds it difficult to control the worry. The anxiety and worry are associated with three (or more) of the following symptoms:
Anxiety may be harder to recognize in a friend or family member because, hey, we’re all super busy and our 24/7 connected world we live in today is tough to manage. Yet, if you notice your friend complaining about not getting good sleep, she/he is snapping at you a lot, complaining about aches and pains in their bodies, or if she/he just seems really erratic, your friend may be struggling with GAD or some other anxiety-related issue.
2) Offer support
If you’ve recognized your loved one is struggling with a mental health issues, start with a simple, nonjudgmental, open conversation. Your timing and tone go a long way when you want to be heard. Pick a time when you and your loved one are alone and have the time and space to talk. You'll want to express what you’ve been seeing in your loved one and also leave the door open to talk more about what you’ve been observing.
Use “I” statements such as:
“I’ve noticed you’ve been cancelling plans a lot lately, is everything OK?”
“I’ve been hearing you say you haven’t been sleeping, how long how this been going on?”
“You’re one of my favorite people so when I hear you say you have nothing to live for I feel sad and scared because it seems like you’re in a lot of pain right now.”
When someone is struggling they don’t want to tell their friends and family what’s really going on because they don’t want to appear weak or to make that person worry. If you’ve gone through something similar, let them know. Admitting to being depressed and/or anxious takes a lot of vulnerability, so if you’re going to talk to a loved one about this issue, you have to be willing to be vulnerable as well.
3) Strategize and help them create a plan of action
The best way to manage both depression and anxiety is by doing the things you don’t really want to do. For someone who is depressed, getting outside, exercising, and seeing friends are honestly the BEST things you can do for yourself, even when it feels like you just want to curl up in bed. Seems a little strange – right? But getting Vitamin D from the sun, connecting with friends which give you a feeling of love and acceptance, and getting a rush of endorphins from exercise are all great (and natural) ways to help manage depression.
Anxiety is about control or the lack of control. Your loved one is feeling anxious because they don’t feel in control of certain situations, events, or people. Strategize a few ways they can better manage their anxiety. Suggest cutting down on caffeine, help identify the people/times when they feel most anxious, help them put together a plan for managing the anxiety, and/or write down everything that is making them anxious to go through the “worst case scenario.” Help them see that what they fear isn’t so scary, and remind them of times when bad things happened and they were able to overcome these situations.
Really important thing to note: alcohol only makes anxiety and depression worse, so try not to invite your loved one out for cocktails and instead do a fun outdoor activity with you and other people he/she loves.
4) Help them get the right help - which may include you also getting help
If you’re overwhelmed on what to do for your friend, don’t do it alone, reach out to someone you know that could help. A mentor, pastor, co-worker, friend of the family, anyone that you feel comfortable sharing this information with and who is always a good sounding board.
If your loved one is ready to get help, then let them know you’re happy to help them find a good therapist and/or psychiatrist. If they make it clear they’re not willing to see a therapist or psychiatrist, ask if they would be willing to see their general doctor instead. Once your loved one is ready to work with a therapist, read my last post and go through those steps with your loved one to help them identify the right therapist for them.
If you’re currently dealing with a loved one who is struggling with a mental health issue, give yourself a huge hug because this is so tough. If you have a loved one whom you’ve tried all of these techniques and they’re still unwilling to get help then you need to find your own therapist to work through these issues.
Tess Brigham is a licensed psychotherapist and Board Certified Coach and specializes in helping 20-Somethings/Millennials navigate this exciting but overwhelming time in their lives. To learn more about Tess go to her website at: www.tessbrigham.com.
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