Both depression and anxiety affect people’s relationships with friends. In addition to a deep and prolonged sadness, depression includes a loss of interest or pleasure in activities the person usually enjoys, as well as feelings of fatigue and a loss of motivation. This cluster of symptoms can mean that a person experiencing depression withdraws from their usual activities and friendships which usually bring them joy.
People experiencing anxiety can find being in public or around groups of people triggers anxious thinking and the physical symptoms of anxiety (e.g. heart racing, shaking, difficulty breathing). This is a frightening experience which, understandably, the person wants to avoid.
In both cases, depression and anxiety causes people to withdraw from relationships with family and friends. Unfortunately, these symptoms can set up a cycle for people. Friends may initially try to stay in contact with the person, but will understandably stop contacting them, particularly if they are not aware the person is experiencing mental health difficulties. It then becomes harder for the person to re-establish the friendships and activities which would be so beneficial.
Here are some ideas for helping friends who are struggling with mental health.
What you would do if your friend had some sort of physical illness or injury?
As a starting point, think about what you would do if your friend had a broken leg. Would you send a card to tell them you were thinking about them? Offer to help walk the dog? Or pick the kids up from school? Show up at their place with a home-cooked meal? In many ways mental illness is similar to other health conditions and people benefit and appreciate the same sorts of support.
Encourage your friend to remain connected to activities and relationships.
Encouraging your friend to remain connected to activities and relationships can be key, although it will feel really, really, hard for them. Think about the things you usually do with your friend, things that the two of you typically enjoy. Get in touch and suggest you do those things together. Your friend may not be able to do all the things they are usually able to do and so you may need to adjust everyone’s expectations. So, for example, if together you have loved tramping through a spectacular bit of the country, suggest a short walk somewhere close by. If you usually go to a gig or some other performance together, dial it back by suggesting listening or watching something at home.
Try to avoid alcohol and other substance use.
If what you do together usually involves the consumption of alcohol and other substances, try a suggestion which doesn’t encourage this. Alcohol and drugs can play a significant role in maintaining depression, anxiety and other mental health problems and so is best avoided when people are unwell.
Exercise and having contact with the outdoors has a range of benefits for both mental and physical health.
The benefits of exercise for both mental and physical health are well known. So, if you can incorporate some gentle exercise with your friend, you’ll be helping in a couple of different ways. Likewise, we are beginning to understand the benefits of being outdoors and having contact with nature for mood and anxiety. This offers another option for spending time with your friend.
Not all conversations need to be “deep and meaningfuls”.
Not all conversations with your friend need to be “deep and meaningfuls”. Some people with depression and anxiety can experience massive amounts of over-thinking, worry and rumination, where painful thoughts turn over and over in the person’s mind, leaving them feeling stuck, overwhelmed and out of control. Sometimes people with depression and anxiety will start voicing these painful thoughts aloud and it possible that friends and family get drawn into “co-ruminating” with them. You will know when this happens because you will begin to feel hopeless, sad or fearful as well. As much as possible, try not to get drawn into these cyclical conversations. Instead, try to focus your friend on some shared interest or activity. Sometimes, an analysis of last weekend’s Super Rugby game or your latest Netflix obsession is just the ticket to interrupt the painful thoughts in your friend’s head and get them focused on something else.
Show that you are listening to your friend by paraphrasing or summarising what you friend is saying. Demonstrate empathy and try to validate your friend’s difficulties and emotions.
There are some key communication skills you can use when talking to friends about mental health difficulties. Make sure you are really listening to what your friend has to say, as well as saying your piece. Show that you are listening by paraphrasing or summarising what they have said back to them. Paraphrasing also leads you naturally into demonstrating empathy for your friend and validating their feelings and difficulties. It could look something like this:
It sounds like you are having rough time at work, the project is not going well, and you don’t think your manager is listening to you. I can see how that would be very frustrating.
It sounds like you are spending lots of time in your head worrying about what’s going to happen next. It makes sense that you feel overwhelmed and out of control.
Showing empathy and validating your friends situation and feelings are powerful tools in helping them to open-up about what is happening for them. Your friend will feel that they have been listened to, perhaps the first time, and may be encouraged to say more. Empathy and validation are also necessary steps before you can begin a conversation about seeking help and beginning to make changes.
Good self-care is very important when supporting others.
If you are supporting someone with mental illness, your self-care becomes very important. It is very difficult to be empathic, patient and persistent if you yourself are stressed. Take care of yourself by eating well, getting sufficient sleep and exercise and having time for fun and relaxing activities. Make sure that you share the load of supporting someone with mental illness. See if you can recruit other friends or family members to help.
A family doctor of GP is a good place to start in accessing professional help.
Remember that there are professionals available to assist. A family doctor or GP is always a good place to start when seeking professional help.
I originally wrote this piece in response to a request from Stuff. If you’d like to read the resulting article here is the link.