How to Help a Friend

My teenage daughter has had a rough few years. She has struggled with depression and severe anxiety since her father died back in 2013. 

There have been many panic attacks, months of school ‘refusal’ and challenges caused by low self-esteem. The good news is that she is now coping so much better and is moving her life forward in hugely positive ways. Unfortunately we’re not quite at the ‘happy ending’ stage… one of her best friends’ is struggling with her own demons and it’s proving challenging.

Clearly, it’s wonderful that my daughter cares enough about her friend that she wants to help. She should feel proud. It’s never easy to know how to help someone with mental illness. Being a good friend in that situation can be frightening, frustrating and worrying and it can make you feel powerless. I know that she worries that her friend might do something really serious. People with depression can behave in a very difficult way, not through their own fault but because their illness takes control. That person may feel terrified that their friend will stop helping them and they may behave in ways that seem manipulative and clingy.

So, what is the best way to handle this? The advice from our Spurgeons’ counsellors is not just aimed at my daughter who is familiar with mental illness, but at all young people trying to support a friend with depression or major anxiety disorder.

Understand that mental illness is not something the patient can simply snap out of or overcome without medical help. This is an illness, not a personality trait or a choice. Make sure your friend is receiving medical treatment.

Understand that mental illness warps a person’s viewpoint. They are not in control and are not always rational, consistent or sensible. They are, effectively, “not in their right mind”. So, do not blame them (or yourself) if they behave in a way that seems unreasonable to you. Remember also that anger is a common symptom of depression.

On the other hand, you don’t have to accept being badly treated. Let it pass a few times and be patient but if your friend keeps doing something that hurts you, it’s ok to say, “That’s not fair. I really care about you but I also have some things of my own to deal with.” Unfortunately, if your friend is in a really bad state, your message won’t get through and you will need to be very patient. 

If your friend is receiving medical help, responsibility is with the medical profession. Also, your friend’s parents have responsibility above you. Do not carry the burden, it is not your responsibility. Be a friend, not a doctor.

You cannot look after someone else if you don’t look after yourself. If you are in a bad state of mind, you are not able to help other people. Never sacrifice your own health and wellbeing for anyone else.

If you are worried about your friend possibly trying to take their own life: first, most people with clinical depression are not suicidal. Suicidal tendencies are a specific symptom which only some depressed people have. However, any comment or hint about suicide should always be taken seriously. 

How to help – Things to say, depending on the situation:

• I am so sorry you are hurting / feeling so bad.
• I can see you’re feeling really low today – I’m so sorry.
• I really want to help but I feel out of my depth. It’s really hard for me to know what to say so please don’t be cross if I say the wrong thing. 
• I know this feels as though it will be with you forever, but it will change. You will have good times in the future. But I’m here for you while it’s tough.
• I know you don’t want to [go for a walk/run/come to the cinema] but you might enjoy it, so let’s do it? And I’d like to do it so please come with me!

Here are some things that are usually not good things to say:

• You can’t sit around like this – you have to take control
• It’s just in your mind
• Come on, of course you can do it
• Yes, I understand exactly how you feel. (*Unless you’ve actually suffered the same problem, you don’t know how they feel. It’s good to say that you can see that they’re hurting, but not to seem as though you feel or have felt the same.)

To support a friend with mental illness, you’ll need to avoid trivialising it, so avoid making it sound as though there’s an easy cure. “Yeah, I was feeling really low last week, too” is also not helpful to someone who feels that a heavy black cloud is surrounding them and sucking all the joy from their life.

"How can I manage my social media when my friend is in contact with me too much?"

This is a very modern problem. Your friend is at home, feeling down, and likely to be messaging you over and over. You want a break. You could say that you’re busy doing homework or whatever and you can’t talk to them, but if you’re on social media at any point with your other friends, they will know. People who are ill can seem very selfish but, again, it’s not their fault as they just aren’t seeing things in a healthy way.

So, you could say, “Hey, you know I’m your friend and I’m there for you but I’ve have things to deal with myself.” It’s ok to be firm.

"I’m worried my friend may harm themselves."

This could either be in the sense of self-harm or in the sense of making a suicide attempt. If you think your friend might be about to harm themselves in any way, you need to talk to another adult. Ideally, talk to your own parents.

Should you tell your friend you are speaking to someone else? If you can, yes. “I’m so worried and I don’t have the knowledge to know how to help you so we have to get an adult involved. Will you tell [whatever adult] or can I tell my parents?” An adult will know what to do. 

If your friend has mentioned taking their own life, don’t wonder about whether they mean it or not: tell them to get help straightaway and, if they won’t, that you will have to tell someone.

My friend hasn’t been diagnosed with anything yet but I’m worried about him/her

The key is to get your friend to talk to an adult. They may not want to talk to their parents – that’s ok as they could go to a teacher, their own GP, a school counsellor, or an adult friend of the family. It is essential that they do tell someone, because help is out there and can be very effective.

Practical tips

One of the things about depression is that the person doesn’t feel like doing anything. Everything is a huge effort. But there are things which, if they do them, may well raise their spirits at least for a short while (though not actually cure the illness). You could suggest things that you know your friend used to like doing:

• Anything involving fresh air and exercise 
• Anything which can take the mind off negative thoughts – such as watching a comedy show
• Something that involves concentration, such as baking
• Anything new – a new hobby or activity

Try to be sensitive to what sort of activities your friend would actually like, rather than things you think would be good for them.

Finally, well done for being a good person and doing your best to help a friend in need. No one can ask more.