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Supporting someone with mental health difficulties

February 15, 2021

If we have a friend or family member who’s having problems with their mental health, it isn’t our duty or responsibility to provide support – but we’ll normally want to do whatever we can. It can be hard to know the right thing to say or do, however. Here are six practical steps we can take to help someone who’s experiencing anxiety or low mood to cope with how they feel.

1. Find out how they want to be supported.

Instead of making assumptions about what the person needs from us, we could ask them what would be most helpful. Do they just need us to listen? To suggest solutions to problems? To provide practical assistance in some way?

2. Know what not to say!

Sometimes – with the best of intentions – we’ll say something that’s meant to be constructive, but which can actually have the opposite effect. We might aim to help someone get things in perspective by saying ‘You just need to get on with it’, ‘There’s no reason to worry’ or ‘There are people worse off’, for example. People’s feelings are often rooted in how they interpret and react to a situation, however, so this is unlikely to make them feel any better.

People with anxiety-related conditions such as obsessive compulsive disorder (OCD) and health anxiety will often seek reassurance. Giving it can feel like the right thing to do; for instance, ‘Don’t worry, the kitchen is spotless’ or ‘I don’t think the pain is anything serious’. This only puts a sticking plaster over the problem; the relief will be short-lived, and tomorrow they’ll need reassuring again. In the long term this can actually keep the problem going.

It can help if you encourage the person to recognise that reassurance has a negative effect. Ask them – is it really helpful when I say that things are ok? And for how long does that feeling last? Agree together what you’ll do instead: this could be making them a cup of tea, or pointing out ‘That’s an intrusive thought!

3. Recognise that you can’t ‘fix’ them.

Unless they’re extremely unwell, it’s their choice whether to seek therapy or treatment – and you won’t necessarily be able to change that, even if you know it’s the right thing to do. It has to be their decision, but you can plant the seed.

If you believe someone would benefit from getting treatment, try to elicit their thoughts about doing so. Ask if they’re aware of the support that might be available, and what their feelings are about it.

4. Understand that you can’t fully understand.

Whether or not you’ve experienced similar difficulties yourself, it may be hard to understand what the other person is feeling. It’s all bound up in the context of their world, and what they’re experiencing won’t exactly reflect what you know.

Try to see it from their perspective, imagining what unseen symptoms and thoughts might be underneath what you’re witnessing. For instance, if your friend just wants to stay in bed, you might find that frustrating because you know it isn’t helping, but they might not be able to see the point in getting up. Even if you can’t understand, you can still be empathetic. Be aware that there are other things going on, and let them know you can see it’s tough for them.

5. Look after yourself too.

It’s hard to watch someone you care about suffer. Talking about someone else’s difficulties can also affect our own thoughts and feelings. We might find it sad, frustrating, frightening or stressful. It’s really important that we’re aware of the impact supporting someone is having on us, and seek support ourselves if we start to struggle.

6. Agree to be a co-therapist.

Sometimes, a friend or family member of someone who’s having cognitive behavioural therapy (CBT) will be asked to be a co-therapist. This means helping them to reinforce and maintain the behaviours they’ve learned in between appointments, which is what makes CBT effective. The co-therapist will be invited to join one or two sessions, and have the patient’s problem, the treatment plan, and their specific role explained.

If the patient has a spider phobia, for example, if may be the co-therapist’s job to look online for photos to use during exposure therapy! If someone has OCD, it might be down to the co-therapist to point out ‘That’s an OCD thought you’re having’ when the person becomes anxious. If you’re asked to be a co-therapist, it’s totally up to you whether you want to say yes.

CBT is an action-based therapy which equips people to manage mental health difficulties by making changes to their behaviours and how they relate to their thoughts and feelings. Find out more.

ieso Online Therapy
This blog has been written by a member of the clinical team at ieso.
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