How to support a friend struggling with mental health (by someone who recently struggled)

7 min read

A personal account of depression and how to navigate through supporting others in their difficult time with empathy and listening.

7 min read

In February 2019, I ground to a halt. I don't really know how to describe it other than that. I pretty much stopped talking, I found any form of social contact foreign and exhausting, and the work I used to wake up fizzing with excitement for suddenly felt pointless and empty.

I had just turned 30 and moved back in with my parents. And although it was a while before I admitted it to myself, I was depressed.

I took three weeks off work to try and wade my way out of it. To avoid seeing the disappointment in my parents' eyes at having a 30-year-old son who couldn't leave his bed, I would get up every weekday at 7:30am and drag myself onto a train to somewhere an hour or so outside of London. I'd sit on a bench in a town square, or walk up and down hills and along promenades. When the weather was good, I'd lie on pebbly beaches for hours on end. Weekends were my break. I could stay in bed without raising a fuss.

Eventually I got myself to therapy. I started taking antidepressants, got one of those blue SAD lights you shine into your face in the morning, and went on holiday somewhere sunny. I gently re-emerged back into my own body and life.

During that strange time, the people in my life reacted to and interacted with me in various ways. Some of the conversations were helpful and some were not. I've learned through my own experience how important empathy is. Here are the three things I would tell myself next time I'm trying to support someone I know through a low patch of their own.

Listening deserves as much care as speaking

Strangely, given its importance, listening is not something we’re ever taught to do properly. Like many of life’s most crucial skills—resilience, empathy—there’s a prevailing view that we should leave the learning of how to listen up to osmosis (read: chance). As a result, most of us are pretty terrible listeners. A University of Oklahoma study showed that we immediately forget half of what we hear, and only comprehend a quarter of it.

The key to being a good listener is to bring as much active attention to your listening as you do to your words. Here's how:

  1. Try not to think about what to say next: you can’t rehearse and fully listen at the same time.

  2. Start from empathy and be a conversational partner with their needs in mind. Picture what the other person is saying in your mind, either as an image or a diagram, to try and understand it better.

  3. Don’t feel the need to fill silences. Count to three in your head before cutting in, as the other person might be trying to articulate something tricky, and people usually open up more when given enough space.

  4. Check you’ve understood by paraphrasing what they’ve said back to them.

Active listening, as this has often been termed, doesn't come naturally to many of us. It's a bit like meditation: it sounds easy until you actually try it. But with concerted effort, determination, and practice, it's something we can all get better at. And for the other person, the feeling of being listened to—really listened to—is … everything.

Keep the bar of involvement very low

When you're feeling low, even the tiny things can feel like huge tasks. When friends would call me, I wouldn't answer because the idea of holding a conversation seemed too strenuous. When someone sent me a non-fiction book in the post, it made me feel worse because I didn't have the energy to schlep through it, but I felt pressure to tell them my thoughts about it when we next spoke.

“The difference between pestering someone and simply being there for them, in my mind, is the difference between asking and giving.”

A phone call asks someone to participate. A book asks them to comment. I much preferred it when friends would simply leave me voice notes or send me a card in the post. What I found most comforting was when a friend texted to say they were happy to call and monologue at me on the phone, or read me an article they had enjoyed. Or simply, to leave a video call on in the background while they were working or reading. I felt connected even though it didn’t require me to do anything at all.

It works similarly for socializing. Staying connected to others and having some level of human contact when you're depressed can be helpful, but oftentimes it requires so much energy. Being asked to go to a cafe, or to be in large groups, didn't help me. It was far better when friends offered to pick me up and go on a walk. This meant I didn't have to travel anywhere and it also meant I could have periods of silence that wouldn’t be awkward. That's harder to do if you're sitting opposite someone in a cafe.

Another friend offered to cook while I rested in my living room. Later, that same friend offered to come over and work quietly at my kitchen table. I appreciated the physical presence and their not forcing me to interact. Overall I’d say:

“Only ask of someone with depression what you would ask of a new mum in the few weeks following childbirth. In other words, not much.”

Ask to understand, not to solve

Depression isn't something you can fix on behalf of someone. You can't will your way out of poor mental health by sheer force. It's one of the hardest things in life to realize: that our control over the feelings of people we love is pretty limited.

To stick with the analogy of a new mum following childbirth: trying to push someone towards a solution or offer advice if you haven't been through a similar experience yourself, rarely helps.

Asking any question beginning with: “have you tried…” or “why don't you try…” is off-limits. Underneath that question is the implication that they aren't doing enough. No one wants to hear that when they're feeling fragile.

Asking "why do you think this has happened?" or "what might be behind why you're feeling down?" isn't helpful either at the time. It's something to consider months afterwards. If someone has just been in a car crash, you don't immediately ask them why they crashed. You ask them if they're okay, you ask them what they need, you sit with them until the ambulance comes.

Similarly, trying to put their pain into perspective doesn't help either. We all want our pain to be taken seriously. Of course things would be worse if we were homeless, or our country was at war, or if we had a long-term health condition. But every individual's pain is legitimate.

If you’ve been through a similar struggle with your mental health, tentatively sharing things that worked for you can be helpful. Just make sure to keep the focus on you—"when I was feeling low, I really liked going for walks at night"—rather than asking them.

And when it comes to asking questions, legitimize their pain by simply trying to understand it better. Stay in the present moment: don't stray into the past (causes) or the future (solutions).

How does it feel when you're this low: can you describe it? Where in your body do you feel it? What's it like? How does time feel to you? What times of day is it worst? How would you draw your pain in a picture? Ask carefully, only following up with another question if the person is ready to share, and holding silences rather than immediately moving on.

By asking questions like this, in the present, with the simple aim of understanding, we are saying to someone: I see your pain. I care about your pain. And, as best as I can, I am trying to join you in your pain.

Because ultimately, that’s the only true support we can give. In the end, the hopes and dreams and needs and wants and emotional states and mental health of the people we love are — both wonderfully and sadly — theirs and theirs alone. All we can do is knock on the door, ask to come in, and sit with them until it passes.

18th-22nd May 2020 is Mental Health Awareness Week.

Partner at Spill, a startup that lets employees book video therapy sessions through Slack. 

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