One of the most common questions I get about mental illnesses is how to help a friend or loved one who has one.  It is terrible to watch a loved one suffer with depression or another mental illness. Yet, it can be particularly difficult to help for a couple of reasons. The first is that suffering from a mental illness is very difficult to understand without having personally experienced it. It is a unique form of suffering. Whilst certain parts are relatable (i.e. fatigue), holistically it seems to be a particular challenge. This means that it is hard to relate to someone struggling or know what is best for them if you haven’t ever been ill with one. Even if you have suffered from a mental illness, each case presents unique challenges

The second reason it can be tough to be a friend to someone struggling with a mental illness is that we tend to have isolating responses as symptoms. Anxiety can make us scared of reaching out for help. Emotional apathy and lack of motivation may make it seem pointless spend time with others. Tiredness may drive us to not want to invest energy in relationships. These scenarios make it unlikely that we will be able to tell others our experiences. Each case with the potential to slip into a terrible cycle.

Whilst these specific challenges can make it difficult to support someone who is ill, it still can be done. All friendships need a lot of hard work and everyone, whether ill or not, brings personal challenges to the relationship. However, the best way to fight a mental illness is with a team. In fact, it is the only reasonable way. We need to be surrounded by friends, family, and professionals.

Does having a bunch of great friends and family make the illness go away? Of course not. I have been fortunate with my circumstances, yet I have still wanted to die. I have still felt isolated, scared, worried, and tired. This isn’t a cure but is the way to fight it. In hesitant trepidation, I think of how much worse my life would have been without these people supporting me.

Here is wee summary of what is to come in the rest of this post. How are we supposed to approach friendships? We need to come forward with love and humility as we seek to serve and be served in the relationship, mental illnesses don’t change this. Just as in any relationship, the individuals will have particular needs and challenges, and everyone needs to be sensitive to those. With depression or other mental illnesses these might be things like we are tired a lot of the time, we struggle in groups or at parties, we might need help with motivation to get things done etc. Each case will be unique. Listen and ask questions. It is one of the best things a friend can do in all relationships.

This post will carry similar themes to a previous post, Depression and Relationships: How to Help.

What Good Friends Look Like
I feel like the best way to talk about how to help someone is to share the story of my friends Maggie and Laura. Neither of them are medical professionals or counselors. They have no training in handling mental illnesses, but you don’t need it. They managed to be incredible friends to me. They have taught me so much about patience, compassion, and friendship.

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What do they do that is so special? The reason they are great friends isn’t because they don’t make mistakes. Without malice, they have inadvertently hurt me more than once (and vice versa!). It turns out they are human. What makes them stand out is trying to care for me and do what is best for me regardless of how annoying I have been, how bad of a friend I have been, or other circumstances. They aren’t perfect, but I am a massive fan and I trust them a lot.
They were the first people I told I have depression. For those of you who haven’t struggled with mental illnesses this is a big deal. It is very difficult to open up. Part of this is stigma. I grew up thinking that mental illnesses were a sign of weakness. When I started struggling from them I didn’t want to be seen as weak so didn’t tell anyone for six months.
Mental illnesses often lead to isolating behaviours. They usually keep people from reaching out for help, particularly where fear and guilt are increased.’. I didn’t want to tell anyone because I felt like I had no real friends and they wouldn’t be of much help anyway. I started to distrust people more because my brain now viewed everything through a lens of frustration and anger. This was difficult.

I didn’t want to tell anyone, but I told Maggie and Laura because they asked. They showed an interest in my life. I wouldn’t have told them otherwise. I would have let it fester for longer, but they asked. I could have blown them off, distracted them, lied, but I didn’t because I trusted them. I felt safe enough to tell them because I knew that they cared for me, even if I couldn’t really feel it at the time.

The first thing to take from their example is to intentionally create a safe and trusting relationship. I ‘knew’ in my head that if I told them what I was struggling with they would accept me and care for me anyway (knowing this doesn’t mean telling someone is easy. It is still horribly difficult, but this is an important step). This helped me ignore the negative thoughts from my brain and tell them anyway. I cannot stress enough how important it is to make this clear.

Creating this environment usually takes the form of a potentially awkward verbal articulation. Something as simple as “I want you to know that I am here for you and want to help whenever I can,” can make a massive difference. It sends a signal that you care and that you can be counted on when things are bad. It can feel like a burden to confide in people about struggling with mental illness, so this affirmation is extremely important. Whilst we didn’t have that conversation at that point, I knew I could trust them because they had shown me that they were committed to being loving friends.

A couple of months earlier I had had a concussion playing football and was a bit dazed. They realised something was wrong and wanted to help. Instead of letting me walk the two miles home to my house they invited me to theirs. They gave me somewhere to sleep and somewhere safe to relax. Their natural amiability had showed me that they were trustworthy and I could confide in them that I was struggling, even though neither of us were cognizant of it at the time.

Importantly, they didn’t let the conversation die there. Over the next 4 years as I learned to talk about my struggles more they kept it going. By being open and talking about mental health they made it so I could keep discussing my struggles and reaching out for help. A fantastic example of this is them saying things like “Let me know if you ever need to talk. Let me know if you ever need a hug. Let us know how we can help you.” A lot of people have this conversation once with me, and it freaks them out. This means that they never talk about it again, which is a shame. This needs to be a constant dialogue. Don’t fear mental illnesses, love the people with them.

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These practical acts of kindness are incredibly powerful and relevant to supporting people with mental illness. During my first year of university I eagerly attended each lecture, loving the learning environment. Yet, when I became ill this changed. I didn’t want to go to lectures and felt that they were pointless, so I started skipping them. Whilst there have been a lot of times when I was too ill to attend lectures, there were a lot I didn’t go to when I should have. I was getting away with the skipping lectures until I had a class with Maggie. Every time she saw me she would make me go to lectures with her. She was persistent and was constantly encouraging me to go to them.
She wasn’t doing this because she enjoyed bugging me (I tend to be the one winding her up), but because she cared for me and wanted me to do well. She saw that I was struggling with something practical because of the depression and stepped in to help. I am not sure if she was aware that depression was the reason I was skipping. I would give any excuse at the time to avoid talking about depression. Yet, she was just seeking to be a good friend like she would to anyone she cared about. She saw a practical need and helped.

In my final year it was Laura who stepped in. At the beginning of the year she said something along the lines of “We are going to get you to your lectures. If you are too ill to go that is fine, but any other time we will make sure you get there.” At times they even let me sleep at their flat to help me get to early morning lectures because they lived a lot closer to town than I did.

They understood that I needed help with some practical stuff. They were persistent in making sure I went to the doctors. It was so annoying, but necessary. They knew I needed help from professionals and encouraged me to seek it. It was both affirming and annoying, but that is what loving someone often looks like.
They were patient with me a lot. When I was a bad friend they didn’t desert me. When my depression was twisting my thoughts, they were still supportive. If I was in a bad mood they didn’t get angry. If I forgot things they had told me they were gracious. As a whole, it was their attitude that set them apart. They were loving and caring, always willing to learn. Then they translated their emotion into action and were deliberate in making that obvious to me.

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They were very patient with me whilst I tried to ruin all our photos together

Whilst I could have put a lot more into the section above, I won’t. Hopefully, in the few things I said above you will be able to recognise a pattern. Everything that applies to someone struggling with depression applies to every single friendship ever. Mental illnesses do add some extra elements, but the formula for friendship never changes.
Maggie and Laura were (and still are!) good friends. They are great friends for someone suffering from a mental illness because they are great friends for anyone to have. They create a safe space for everyone. We should strive to do this in every relationship. We should all actively strive to make our friendships environments where we can share our struggles without fear of condemnation. If you have any friend, be intentional about sharing your own struggles and welcoming others to do the same. These safe spaces are critical for people with mental illnesses reaching out for help.

In a similar way, we all have practical needs. I struggle to listen to people and need people to help me listen better. This has nothing to do with my mental illness. All human being struggle in areas of their life and need help from others. Being a good friend means challenging each other to grow into better people. In Scotland, a lot of people have a bad diet. I have friends who need help to stop living on Irn Bru and deep fried Mars Bars. This has nothing to do with a mental illness (being Scottish does not qualify as a mental illness). But these friends need practical help in this area.

We need to be constantly asking others how we can serve them as a friend. Maggie and Laura did with me in many ways, but attending lectures was just one of them. They gave me lots of tea, fed me a lot, and made sure I was going to the doctors regularly. They were amazing and encouraging. They weren’t helping me because I had a mental illness, but because it was what a good friend would do. If I didn’t have a mental illness they would have helped just as much.
Every relationship will look very different, but they follow the same mold of humility and love. Being a friend to someone with a mental illness is the same. Be vulnerable with us, it is a two-way relationship. This helps create a safe space for opening up about our mental illness.

Please depend on us. It builds trust and creates a much stronger bond. The relationship is always two-way, we need to serve you too

A very underrated, yet necessary part of friendship is dependency on vulnerability. This is no different if one of you has a mental illness. One of the best things that you can do for any relationship is to intentionally rely on the other person. This could be emotionally, physically, or even financially. This might be something as simple as letting them buy you a drink or relying on them for emotional support. Regardless of the method, you need to be doing this with anyone you care about. Don’t hold this crucial part of relationship back because the person is ill. It won’t help the relationship. All healthy relationships are two-way.

Please serve us and let us serve you. We might need help with practical things like the dishes or attending lectures. You will as well.

Lovingly listen to us and understand where we are. Love is unconditional, which means that once you know someone loves you it won’t change, regardless of how much life sucks.

Learn about our particular needs in the same that you would anyone. Our mental illnesses do not define us. We are humans and so we struggle with stuff. In our case the only difference is that it might be related to our illness. We might be very tired or anxious and need help with those things.

Mental illnesses are a terrible challenge. They tend to change all our relationships in some way or another. However, we still need the same things in a relationship that anyone else needs. We need people to love us as any human does. We need help with practical things, just as everyone else. We need our individual nuances, blessings, and challenges acknowledged.

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Follow Maggie and Laura’s example. They are not perfect, but constantly seek to love others. They make it obvious how much they care about others. They articulate this verbally, through hugs, food, and many other ways. We need more people in the world to be like them. Their behaviors and attitudes, as imperfect as they are, are humble and full of love. They have made my struggle with mental illnesses far more enjoyable, survivable, and helped me thrive in the midst of challenge.