Helping Loved Ones Heal

It’s a real heartbreak when a loved one suffers from depression or anxiety. In searching for ways to help, you may feel unsure if your efforts will be taken as an act of love or a painful intrusion. Broaching the subject can be met with anger, embarrassment, denial, shame, and frustration from the person of concern. Mental health concerns are often unaddressed for months, even years after the problems start. Unfortunately, the time never seems right for such a personal and sensitive discussion. That’s one reason why mental health issues are one of the more common and serious medical issues. 

Studies conducted by National Alliance on Mental Illness, Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Disease Control and Prevention (CDC) and the U.S. Department of Justice, find real cause for concern with the prevalence, and unaddressed nature regarding mental health conditions:

• Prevalence: 
  • 1 in 5 U.S. adults experience mental illness
  • 1 in 20 U.S. adults experience serious mental illness
  • 17% of youth of youth (6-17 years) experience a mental health disorder
• Unaddressed: 
  • The average delay between symptom onset and treatment is 11 years
  • 45% of adults with mental illness are treated in a given year
  • 66% with serious mental illness are treated in a given year
  • 51% of youth (6-17) with a mental health condition are treated in a given year. 

For those that suffer from mental health issues, help often begins with a friend or family member who provides the support and encouragement to seek professional help. It’s imperative for those offering help to do so with compassion and a persistence appropriate to the severity of the situation. 

Knowledge

A first step in offering assistance is having a baseline knowledge of anxiety and depression, particularly because the symptoms can vary from one person to another – some might become irritable and aggressive, others lethargic and withdrawn. There may be basic care issues such as poor eating and sleeping habits, and there may be performance problems, such as trouble concentrating or difficulty in remembering. One might express hopelessness, low self-esteem, and guilt. In more serious situations one may talk of, or act towards suicide or harm to others. 

In addition to varying symptoms, it’s important to recognize the severity of one’s illness, to determine the appropriate level of intervention and assistance required. Mental Health America suggests the following Stages of Mental Health Conditions:

• Stage 1, Mild symptoms and warning signs: A person begins to show symptoms, but is able to function at home, work, or school. A sense of “something not right.”
• Stage 2, Increased frequency and severity of symptoms: Something is obviously wrong. Performance at home, work, and school become more difficult.
• Stage 3, Serious disruption of life activities and roles: Many symptoms taking place at the same time. A feeling of losing control.
• Stage 4, Severe enough to jeopardize one’s life: Serious enough to create a crisis event such as unemployment, hospitalization, homelessness, incarceration, or death.

Compassion

Having to face one’s mental health issues and their associated treatments would be difficult for anyone, but is a much greater challenge for someone who may already struggling with the sadness, irritability, frustration, agitation, lack of energy, and feelings of hopelessness that comes along with depression and anxiety. They don’t need a ‘shove’ or a ‘wake-up call’. Chances are they are already struggling.  What they need more than anything else is compassion:

• Compassionate listening: Addressing the topic of one’s mental health is best approached with a calm, open, and non-threatening discussion. Offer your complete attention, ask open-ended questions to uncover more details, and take moments to summarize what you’ve heard. Avoid phrases that minimize (e.g. ‘it’s just a phase’, ‘think of all the good things in your life’), or compare (e.g. ‘when I feel that way I just…’). 
• De-stressing: Making life easier for your friend or loved one not only helps them get through their days, it may also give them the energy and hope they will need to address their situation and seek help. Offer to help with daily chores (shopping, help around the house cooking a meal), with companionship (going for walks, watching a movie), and with moving ahead with treatment (making appointments, driving to appointments).
• Earn one’s trust: It’s a leap of faith for someone to open the doors to something as personal as one’s mental health. Ways to earn and maintain one’s trust include keeping things confidential, keeping promises, and not judging. 

Appropriate Persistence 

As a loved one helping a person address mental health issues, it’s important to make sure your persistence is commensurate with the severity of the situation – being careful not to over react, or to allow a serious situation to go untreated. For the severity stages identified above, we suggest the following levels of persistence:

• Stage 1, Mild symptoms and warning signs: To bring the subject of mental illness up and offer help may be appropriately persistent for a person who is just starting to show symptoms. It may encourage the loved one to seek help. If not, it opens the door for further assistance later.
• Stage 2, Increased frequency and severity of symptoms: for this stage, persistence may come in the form of multiple instances of compassionate listening. It continues to be a soft, gentle approach, happening a number of times.
• Stage 3: Serious disruption to life activities and roles: With family, work and/or schooling at risk, the downside of not addressing mental health issues becomes more apparent. A caregiver might be persistent up to the point where communications shuts down, hopefully easing up before the caregiver’s help is no longer welcomed.
• Stage 4, potential for a crisis event: 
  • If your loved one’s trajectory is leading to a crisis such as unemployment, homelessness, or incarceration, and if more gentle encouragement hasn’t yielded results, a more direct intervention approach might be in order, where a larger group of family and friends works to convince the individual to seek help. The disadvantage of this approach is it may come across as confrontational. The advantage is it emphasizes the severity of the situation and forces the patient to confront their illness. 
  • If you believe your loved one is considering suicide, don’t leave him or her alone. Stay with them and dial 911.

Helping a friend or loved one through mental health issues is often thankless and never easy. But knowledge, compassion, and the right level of persistence can bring about a positive change that can truly improve one’s quality of life.