One of the most awful memories I have from my teenage years is sitting in front of a doctor, watching her features twist in disgust as I tried to explain the horrifying thoughts I was experiencing, and how much they were upsetting me. I was 15 years old.
Speaking up about mental health issues can be extremely difficult, so I strongly agree that we should be asking our friends and family if they are OK. And then asking again. But with one in four people in the UK suffering from mental health issues every year, it feels like it’s time for us to take a collective step further. To learn more about how to help beyond asking that first question, so that people who are in pain don’t feel as if they are a burden, or worse, a drain.
I first struggled with my mental health during the late 90s. At the ages of 15, 18 and 22, I experienced increasingly severe bouts of ‘Pure O’ OCD. This is a type of OCD with no physical compulsions, but disturbing, shocking thoughts that would cloud my brain relentlessly.
During my second OCD episode, I became so paralysed with anxiety and depression that I could barely eat or sleep, and would periodically call Samaritans in floods of tears, convinced that I didn’t deserve to be alive. I was lucky to have a supportive family who I could talk to, but I still felt desperately lonely.
Once, I took the bus into the centre of Ipswich, the town I grew up in, and visited Samaritans in person. I didn’t feel remotely brave at the time, I just felt desperate. When I was a teenager there was little internet, I wasn’t aware of Mind, and OCD UK didn’t yet exist. All I could do was sob to the kind volunteer, and ask him whether or not he thought I was “evil”.
I barely had the tools to cope as a teenager, so I told my friends the bare minimum, assuming that they wouldn’t understand, since they were ‘normal’. But over subsequent decades, I have learned that many of us struggle, and that I can talk openly to my friends. Which is fortunate, because mental health issues are something that I have had to grapple with again, and again.
In 2014 I had my first non-OCD experience of severe depression and anxiety, and in 2017 I was diagnosed with Premenstrual Dysphoric Disorder (PMDD) – a severe form of PMS that affects 3-8% of menstruating women. I am lucky to have a network of loving friends and family who support each other.
So it was painful when, in the midst of an argument several years ago, a friend blurted out, “I know you have issues with depression, but sometimes you drain me”. In my friend’s defence, it was said in anger, and I had definitely asked more of them than they had ever asked of me. But it was hard to hear, and it remains tucked in the back of my mind.
I was reminded of that moment when I read that Caroline Flack, before her death, had written a post on Instagram about struggling with her mental health in October 2019. In the post, Flack wrote that “when I actually reached out to someone they said I was draining”.
When you feel low, you are already inclined to believe that you’re a burden, so it’s hard to have that suspicion confirmed.
To be clear, I don’t think my friends should be expected to give up their time to me endlessly, or that they should automatically understand what it’s like for me, or replace professional help. And I recognise that they may be struggling, too, and need my support.
Because a quarter of us will experience mental health issues this year, but research from 2014 showed that only 39% of adults aged between 16-74 with conditions such as anxiety or depression were receiving treatment. And a huge 70-75% of people with diagnosable mental illness receive no treatment at all. It may be uncomfortable to think about, but 2018 saw more than 6,000 suicides in the UK, the first year-on-year rise since 2013.
Writer and activist Gina Martin recently shared a touching message on Instagram about supporting her friends and family with mental health issues. It read, in part:
“You will never ‘be draining’ to me. You will always be human. And that is why I love you”
Thanks to my friends and family, I have learned that there are simple ways to offer ongoing support. Once, as I sobbed to my Dad during a bout of depression, he enveloped me in a huge hug and said, “tell me what you need from me”. It was a simple, powerful expression of love and support, and one that I try to repeat to friends.
What has helped me, and my friends, is consistency. If a friend tells you they aren’t OK, being there can be as simple as checking in via text once a week after the initial chat. Or really listening when your friend explains their needs, and helping them access the tools they need. I learned this from my best friend, who has nudged me to the doctors countless times over the years.
Katerina Georgiou, a BACP-registered Gestalt counsellor and psychotherapist, agrees that it’s important to be realistic about what you’re capable of.
“Don’t say ‘I’m here whenever you need’ if you can’t be,” Georgiou advises. “Manage expectations and don’t make promises you can’t keep. It’s absolutely OK to have boundaries, if delivered respectfully.”
Other people’s boundaries, I can acknowledge now, are something I have struggled with when I feel desperate. But I’m learning, and taking guidance from others.
My mum tells me that she is always happy to talk, but that she may not always be able to return my call or message immediately. It’s kind, but fair.
I don’t pretend to have all the answers, and I’m learning how to better support my friends, too. But I believe we are all capable of deeper compassion and understanding. It may start with asking if a friend is OK, but it doesn’t need to end there.
Mental health support: how to help a friend who is struggling
Katerina Georgiou shares expert tips for helping your friends with their mental health issues.
- Manage expectations: Be aware of what you can and can’t manage alone.
- Ask the experts: Mind charity has lots of experts on hand to guide and help you. Call their helpline or contact a local branch.
- You don’t always have to DO something: Alternate talking with quick texts that simply check in or offer a nice thought. Try “Just making myself a cuppa/pouring a drink and I’m raising a glass to you. Much love”.
- Simple gestures go a long way: The Blurt Foundation, for a small subscription fee, can send out packages and regular emails to a loved one struggling with their mental health. They let your friend know you care while alleviating some of the pressure to be the only one offering support.
- Help your friend help themselves: Samaritans has a service where you can ask them to call your friend, as long as you tell your loved one you are doing this, and they give consent to you to do so.
- Take the pressure off yourself: You’re not the cause of, or cure for, a person’s struggles. This can be a helpful mantra you remember.
- Don’t go it alone: People can feel guilty or resentful in scenarios like these, and it’s important to recognise that you don’t have to shoulder the responsibility alone.
- Ask for help yourself: Helplines like Samaritans are not just for the people you’re concerned about, but also for you to talk about how things are affecting you.
Samaritans (116 123) operates a 24-hour service available every day of the year. If you prefer to write down how you’re feeling, or if you’re worried about being overheard on the phone, you can email Samaritans at firstname.lastname@example.org
Mind also provide advice and support to empower anyone experiencing a mental health problem. You can find more information at mind.org.uk