The Things Not To Say And Why

There are certain things not to say if your friend comes to you with and says that they are suffering with their mental health. Your reaction could really help or hinder their progress.

The lines that I would suggest avoiding in this situation are:

‘’Get yourself together.’’
Depression, for example, is not something you can simply put a cast on and a few weeks later it has healed. Mental conditions are not someone’s fault, and this statement implies that it is self-induced. It may also deepen the shame that they have if they’re struggling to come to terms with the fact they might have a mental illness.

‘’I get it, I have bad days too.”
While this seems like an attempt to build a connection and make how they’re feeling more relatable, this type of statement actually minimises the pain that they’re suffering and makes it sound as though their current mental state is trivial.

‘’You need to stop feeling sorry for yourself.’’
If someone is struggling to verbalise any negative or hard to deal with feelings, then this kind of statement will make them feel as though they are complaining and a burden to you. Throw away comments like this suggest that you’re not taking their emotions seriously – as though it is something that they can simply ‘get over’.

“What have you got to be down about, you have everything a person could want, a family, a wife, a job, a home.’’
What’s important to remember here is that mental illness is not a choice. A person can have everything that would make someone else happy, but that’s irregardless – they are still feeling mentally unwell, and this statement is unsupportive. A person may be successful on the outside, but no one knows what is happening on the inside.

“Everything is going to be fine.”
How do you know it is? Aside from the fact that this statement isn’t based on anything tangible, someone who is suffering from a mental health condition may struggle to see past the next hour. Asking them to look ahead is something that they may struggle to perceive.

“We should catch up sometime.”
Connection and consistency are important to someone who is struggling. These throwaway statements should not be used as they suggest that you may not mean it. Instead plan a time and a date and something definitive instead.

The Best Things To Say

“Are you okay?”
Simple but effective. It may be that no one has asked that simple question for a while and if you follow this up with “is there anything I can do to help?”, they may feel safe enough to begin the conversation.

“Let’s have a night in.”
By not suggesting that they need to get out more, it will allow them to approach their mental health in a step-by-step way. Instead, suggest staying in with them and do something that they will enjoy. It’s also a good opportunity to start a conversation and be there to listen while they share their feelings.

“Tell me about how you’re feeling.”
Be empathetic but not patronising. They don’t want to feel like they’re in a therapy session but by encouraging communication, they’ll hopefully feel like you’re a trustworthy ear.

“Give me a call if you ever need to chat – day or night.”
Finish your chat with them by reasserting the fact that you are there to chat whenever they need to. Then, make sure that you are actually available to talk when they do reach out. It will take them a lot of courage to pick up the phone and say that they’re struggling.

“Can I cook you dinner tonight?”
Little things go a long way. A simple gesture such as making them dinner will mean a lot to them and reassure them that you are looking out for their wellbeing.

“You are not in this alone.”
Instead of saying that “there is always someone who is worse off” which will make them feel inferior, try comforting them by saying that you will get through this together. A strong support network is key.

The Best Questions To Ask And Why

Keep Things Normal
Try not to treat them any differently. Ask them normal things such as “Do you want to go for a coffee?” or “Did you see that show last night?”. That way, they feel that their mental illness has not pushed people away and even if they say no, don’t give up on them, he may just need time.

“What Can I Do?”
Most of the time they will not need anything tangible, just someone to listen and not judge.

“How are you feeling today?”
Ask about how they truly feel instead of the generic “how are you?”. Try, “I have noticed you are not yourself and I want to know how you are feeling”, then be prepared to listen to them after without judgement.

“Do you need to talk? I’m here if so.”
Sometimes venting or talking about how and what they are feeling can make it a little bit better, even if just temporarily. However, the long-term positive effects from this question will be that they will know you are there for them and that they will feel supported.

Make sure that your check-ins are genuine and regular. Make sure that you don’t push them too hard, too soon but also don’t let them off the hook when they reply “I am fine”. There’s a fine balance between pushing someone too far, too soon and giving up too easily.

“What was the best part of your day?”
May sound like an odd thing to ask, but by asking them this, you’re essentially asking them to find a positive in each day. It will make them feel like they have achieved something and that they are successful.

“Chat to me about how you’re feeling.”
You can try open-ended questions. Try to keep language neutral and casual and give them plenty of time to answer and to find the right words to truly express their emotions. Likewise, when they do respond, try not to grill them with lots of questions.

“Do you want some space?”
While it’s important to show support by being present in someone’s life and ensure them that they are not alone and also making sure that they are not isolating themselves, often some time alone can be helpful to digest how they are feeling or to simply recharge their batteries.

What Answers Should You Be Worried About

“I can’t do this anymore” or “I can’t go on.”
If you suspect they are thinking of taking their own life, it is very important to encourage them to get help such as contacting their GP or NHS on 111.

“I really need to have a few drinks.”
We’re not saying that having a few drinks is always going to be a warning sign, but if your friend doesn’t usually suggest alcohol as a coping mechanism or you’ve noticed that they are drinking more than normal, then this could be an early indicator of misuse disorders.

“I’ve always got a headache at the moment.”
Headaches, while they are never pleasant, could actually be a sign of stress in this case. Built up stress can cause headaches, migraines and chronic headaches and research has also found they are strongly linked to many anxiety disorders.

“I’m really struggling to sleep at the moment.”
Sleep is closely linked with many mental health conditions and actually sometimes has a chicken and egg effect. A lack of sleep can cause the onset of many conditions whereas restless nights, tossing and turning and even sleeping too much can be a warning sign of insomnia and depression. There’s also a strong link between sleep and some anxiety disorders.

How And When You Should Encourage Them To Seek Further Help

Warning signs such as the above are key things to look out for – many of them are early indicators that their mental health is affecting their physical wellbeing. It is crucial that you try to encourage them to seek help from professionals.

A subtle but equally dangerous warning sign of mental illness is hopelessness. Studies have found that hopelessness is a strong predictor of suicide with some people struggling to talk about unbearable feelings, predicting a bleak future for themselves and stating they have nothing to look forward too.

Do everything you can to help them get the help they need. As a friend, you yourself can call a crisis line for advice about the best way to support your friend or loved one, and you can inquire about referrals. You can try and get help from local charities, such as counselling organisations and support groups. On top of that, encourage them to see a mental health professional or go along to the doctor’s appointment.

Small things like encouraging positive lifestyle changes such as plenty of sleep and going out for a walk on their lunch break. Exercise is extremely important as it releases endorphins, relieves stress and promotes emotional well-being.

Also, there is an innovative, medication-free treatment which is now available which can treat the symptoms of mental health issues. This treatment is called Transcranial Magnetic Stimulation (TMS), this treatment stimulates specific areas of the brain which are affected by mental illnesses (such as depression, anxiety and OCD) using magnetic pulses. The depression treatment has been approved by NICE as being safe and effective. An intensive course of the treatment could potentially reverse the symptoms of depression in two to three weeks.

Chloe Ward is Technician at Smart TMS, the UK’s leading mental health clinic specialising in Transcranial Magnetic Stimulation.