How do I talk to a loved one struggling with mental illness?
One of the hardest things in the world is watching a loved one suffer. It can elicit our pain and sadness, fear for what will happen to them, and even helplessness. Feeling unable to help can quickly turn our sadness into frustration and anger as well. Yet, as emotionally distressing as it can be for us to notice that a loved one is suffering, it can be even more difficult to find the words to begin a conversation with them. We worry that they’ll feel judged, that they’ll think we’re stepping over important boundaries, that they’ll hate us for making them feel weak or vulnerable. All of this is understandable.
I hope that this guide can help empower you on how to approach these difficult conversations. I’ve broken it down into two pieces – listening, and advocating. Listening is pretty straight forward - it is taking the time to sit with your loved one to understand what they’re going through. Advocating is helping connect to resources to start the process of healing. Both are essential, though advocating can feel more important, and I encourage you to understand that doing them together can be the most impactful. To make this more concrete, I’m going to start with a scenario of someone struggling with a possible anxiety disorder, and use it to show you how language can be framed as we work through each tip:
“Aarti is a 26-year-old female. She is married, and has two young children. Lately Aarti has been complaining about being unable to sleep, and has seemed more irritable to her friends and family. Her body is constantly aching, but her primary physician can’t trace a cause for this. She and her husband have been fighting a great deal, and he’s started to make threats about divorce. She’s also been struggling at her job as a computer programmer. She’s very worried she’s going to get fired, but is still struggling to concentrate and work the way she did when she first got the job. She tries to take the advice she’s given to “not take tension” and “stop overthinking things” but it feels impossible to her at times to control her racing mind, as she goes from worrying about work to her kids to her relationship with her husband to politics to climate change and back again.”
Listening:
Be non-judgmental
Use objectively rooted language, sharing what you’re noticing rather than any judgments. You’re starting this conversation because you care, and you want that to come through rather than any semblance of criticism. Avoiding using words like “always” and “never” is important.
With Aarti, you don’t want to tell her that she’s “always snapping” at you. You might want to try, “I noticed that you didn’t eat dinner yesterday and that you mentioned that sleep has been difficult. You also shared that you were feeling tired and that your body has been aching, and I just wanted to check in and ask how you’re feeling, since that sounds really difficult”
Be inviting
Make time and space to listen, understand, and empathize before jumping in. Offering stories of our own experiences can help us feel like we’re offering something, but often pushes people away as they can feel misunderstood in what they’re actually experiencing. Avoid “toxic positivity” in assuring your loved one that everything’s going to be okay, and instead sit with the heaviness of their distress first.
As you start talking with Aarti, try to really listen, and give her a chance to share what she’s going through so she feels open, before you jump in to advise her or tell her more about your own experiences. As much as you want to tell her that date night saved your relationship, that may make her feel like you’re minimizing the depth of the disconnect she’s feeling with her husband, etc. Focus on listening and validating.
Be fearless
Talking about problems doesn’t make them worse. Don’t be afraid of asking if your loved one is dealing with thoughts of death or dying if you notice they’re depressed, so that you can make sure you get them the appropriate help. We’ll talk about resources in a later section, but remember that saying suicide doesn’t make it more likely, it just makes it safer for your loved one to really share how they’re doing.
It is possible Aarti has had suicidal thoughts, and the only way to find out how much she’s struggling is to be okay with asking her directly. If you’re worried about her shutting down, remember that this conversation may happen multiple times, and that your steady non-judgmental and inviting presence will be felt.
Be patient
Know the bounds of your own expertise, and try to avoid giving advice. This can make people defensive, and people with their guards up have a hard time taking anything in.
Again, you probably have a lot of tips that you have used to get through work challenges or frustrations with partners, but if you think Aarti is really struggling, try to frame professional help as an anchor under the support and love you’re generously offering. It doesn’t in any way take away from the support that you can offer or indicate that you don’t have time or energy for your loved one to recognize that therapy is a unique healing space that can be important for people at certain points.
Advocating:
Be compassionate
It may take several conversations and a lot of work to get to a place where your loved one feels comfortable talking. They’re hurting, and resistance to help can be frustrating and hard to see, but your steady presence can make an impact even if the process is slow. Accessing help only works when someone is ready to accept it, and this can’t be forced though it can be encouraged. Remind yourself and your loved one that you’re starting this difficult conversation because you care about them.
Be kind to yourself
As you are trying to be a support to your loved one, it’s very important to engage in healthy behavior yourself. Know your capacity, and honor that you can’t fix everything for your loved one, as much as you want to.
Connect to resources
First and foremost, have access to the national suicide hotline (800-273-8255) as well as any local resources (in Maryland, where I’m a licensed clinical psychologist, you can call or text 211 for support in crisis). Call with your loved one if needed, but remember that it’s important to always reach out to people with expertise when dealing with a crisis.
Make it easier to find a mental health provider. It can be overwhelming and difficult to find a provider. I’ve written a few blogs about how to find the right therapist and how to understand the differences between the types of providers that may be helpful to read before navigating the vast world of resources. This resource from MannMukti that I helped develop is a fantastic overview of the process. PsychologyToday.com is a great source for finding providers, and there are many many more like it that are tailored to different populations. Two of them are:
Inclusive Therapists Network - Inclusive Therapists aims to offer a safer, simpler way to find a culturally responsive, social justice-oriented therapist and prides itself on celebrating all identities and abilities in all bodies.
South Asian Therapist Network - this is the largest South Asian mental health community in the world, and is tailored to helping people find culturally competent South Asian mental health professionals.
