We are routinely asked the question, “how are you?” yet how often do we answer it honestly? An estimated 1 in 4 Americans live with a diagnosable mental health condition each year, and as this number grows, many of us still struggle to know how to initiate conversations that allow us to truly understand what the people in our life are going through. While we do not all experience a diagnosable condition, coping with emotional difficulties is a universal part of life, and talking about our mental health challenges like we do our physical health concerns can help us feel less alone during periods of hardship.
Maintaining strong social support is a key factor to psychological health, and family and friends are often the first ones to notice when something is wrong. You don’t need to be an expert to have an authentic conversation about mental health. Simply showing up with care and compassion can offer someone a sense of refuge during life’s darker moments, and having a space to talk about it can be a significant resource to someone that’s hurting.
Recognize the Warning Signs
Noticing the signs that something is wrong can empower us to reach out and initiate connection. Perhaps you’ve noticed a shift in a friend’s behavior, or someone at work has been more withdrawn lately and you’re concerned about them. Signs of psychological distress include loss of interest in hobbies one used to enjoy, increased or decreased sleep, changes in appetite, social isolation, severe anxiety or stress, increased use of substances, or prolonged feelings of sadness or hopelessness. Though we all have tough days, keep an eye out for a loved one whose behavior is dramatically different for more than several weeks.
Start the Conversation
Deciding whether to have a direct conversation about your concerns depends on your relationship with that person. If it’s someone you don’t know well, consider alerting someone closer to the situation. If you sense someone close to you is going through a hard time, trust your gut and speak to them privately about it.
- Gently inquire, don’t push. Begin by expressing that you care and share what you’ve observed. For instance, “I care about you, and lately, I’ve noticed you seem a little down. I’m wondering how you’re doing.” Respect the person’s choice in deciding to share. Phrases like “I know it can be difficult to talk about this” and “I appreciate you sharing this with me” can feel reassuring.
- Practice active listening. Give your complete attention and ask open-ended questions to allow the person to disclose as much as they are comfortable with. Reflect back on key parts of what was said to convey your understanding and be open to any clarification they offer. Often, this reflection can be very encouraging and further dialogue.
- Resist moving into problem-solving mode. Jumping in with solutions prematurely (“have you tried mindfulness?”) can leave the person feeling unheard or shut down. It might also be a sign of our own discomfort with their emotions. It is important to examine a plan for moving forward, but only after we’ve taken the time to listen to and validate their experience.
Know When to Involve Professionals
It can be overwhelming when someone shares about a mental health challenge, and it’s important to know the limits of what you can offer. If signs of distress persist beyond a few weeks, it’s time to consider involving a mental health professional. Receiving professional help can truly make a big difference. Consider broaching the topic this way: “I’m glad you’ve talked to me about this, and I also want to be sure you’re connected with professionals who can help you feel better. When do you plan to establish care with a therapist?” Offer to support them in finding a provider if needed.
If someone you care about is in immediate danger of harming themselves, seek help by calling 911 or going to the closest emergency room. Trained crisis counselors are available 24/7 by texting “MHA” to 741-741 or calling 1-800-273-TALK (8255).
Remember to Support Yourself
It’s easy to let your own wellness fall through the cracks when putting someone else’s needs first. Maintaining self-care is the key to providing sustained support to others. Be mindful of how much you’re able to give and show up in the ways that work for you.
Learning to have thoughtful conversations about mental health and offering ongoing support enables us to be better allies to our loved ones that are struggling. Humans are hard-wired for connection, yet times of emotional pain can thwart this natural instinct and make it hard to reach out. When we can recognize this pain in others, we can choose to show up with kindness and empathy, and in doing so, help the weight of mental health challenges feel a bit lighter.
The National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
The Crisis Text Line: 741741
Support for Family Members and Caregivers (NAMI)
A Guide for Navigating a Mental Health Crisis (NAMI)
Take a Mental Health Screening