Nicola Morgan

Author, Speaker, Supporter

Understanding and Supporting Your Teenagers – few spaces left and I’m not doing it again!

How can teenagers help a friend with mental illness?

A parent emailed me about this the other day on behalf of a son whose friend suffers from depression and anxiety. First, it’s wonderful that the son cares enough about his friend that he’s asking for advice about how to help. He should feel proud.

Whatever one’s age, it is never easy to know how to help someone with mental illness. Being a good friend in that situation can be frightening, frustrating and worrying and it can make you feel powerless. You sense that it’s important not to say the wrong thing but sometimes everything seems like the wrong thing. You will probably worry that your friend might do something really serious – I’m obviously referring to suicide here, though even using the word is terrifying. People with depression and other disorders can behave in a very difficult way, not through their own fault but because their illness takes control. The ill person may feel terrified that their friend will stop helping them and they may behave in ways that seem manipulative and clingy.

This is completely normal and it’s really important not to blame yourself or the ill person. Blame the illness.

But, what to do? My advice is not aimed only at the teenager whose mother contacted me, but at young people in any situation where they are trying to support a friend with mental illness such as depression or major anxiety disorder.

  1. Understand that mental illness is not something the patient can simply snap out of or overcome without medical help. The medical help is the most important starting point. This is an illness, not a personality trait or a choice. Make sure your friend is receiving medical treatment.

2. Understand that mental illness warps a person’s viewpoint, muddies how they see the world. They are not in control and are not always rational, consistent or sensible. They are, effectively, “not in their right mind”. So, do not blame them (or yourself) if they behave in a way that seems unreasonable to you. They are not fully in control. Note, too, that anger is a common symptom of depression.

3. On the other hand, you don’t have to accept being badly treated. Let it pass a few times and be patient but if your friend keeps doing something that hurts you, it’s OK to say, “That’s not fair. I really care about you but I also have some things of my own to deal with. I totally understand that you’re suffering and that you don’t mean to make me feel bad – it’s not really you, it’s your illness – but I need to be able to [do whatever it is.]” BUT, if your friend is in a really bad state, your message won’t get through and you need to be very patient at that point. Wait till things are a little calmer and then explain. Throughout all this, keep reminding yourself that it is not your friend’s fault.

4. If your friend is receiving medical help, responsibility is with the medical profession. Also, your friend’s parents have responsibility above you. Do not carry the burden on yourself more than you can manage. It is NOT your responsibility. Just be a friend, not a doctor.

Let me tell you a quick story. When my daughter was at school, in GCSE year, a girl in the year above tragically committed suicide. Obviously, this affected everyone badly, and not only the girls’ friends. In my daughter’s year there were already several students with depression and every time one of them seemed lower than usual, my daughter’s year group wold become incredibly worried. In the end, a teacher gave them a talk. Basically, she said, “You are not responsible for your friends’ mental health and happiness. You have to look after yourselves. Do not take the burden on yourself because it is not your burden.”

I think that was a very important message.

5. Here’s another one that links to it: You cannot look after someone else if you don’t look after yourself. If you are in a bad state of mind, you are not able to help other people. So, do not sacrifice your own health and wellbeing for anyone else. If you look after yourself, then you can look after your friends. Everyone wins. If you don’t, you can’t, and everyone loses.

6. If you are worried about your friend possibly trying to take their own life: first, most people with clinical depression are not suicidal. Suicidal tendencies are a specific symptom which only some depressed people have. However, any comment or hint about suicide should always be taken seriously. See the point below under “I’m worried my friend might harm himself.”

HOW TO HELP

You want to be there for your friend and you will feel, rightly, that spending some time with them is a good thing to do. But it’s so hard to know what to say – and what not to say.

All these are appropriate things to say, depending on the situation:

  • I am so sorry you are hurting / feeling so bad.
  • I can see you’re feeling really low today – I’m so sorry.
  • It is your illness talking – it’s making you see things in a negative, unreal way. It’s not how the world really is but it is how it feels for you.
  • I really want to help but I feel out of my depth. It’s really hard for me to know what to say so please don’t be cross if I say the wrong thing. Tell me if I say the wrong thing or if I’m not helping.
  • Everything – including depression –  goes in stages and at some point you will feel better, especially if you get the right medical help. But it does take time.
  • I know this feels as though it will be with you forever, but it will change. You will have good times in the future. But I’m here for you while it’s tough.
  • I know you don’t want to [go for a walk/run/come to the cinema/come for coffee] but you might enjoy it, so let’s do it? And I’d like to do it so please come with me!
  • Look, I’m really sorry you don’t want to [come to the party/cinema/whatever] but I really want to and I really want you to come with me. Please come. Or, if you really don’t want to come, are you OK with me going anyway? We can do something together tomorrow?

Here are some things that are usually NOT good things to say:

  • You can’t sit around like this – you have to take control
  • Yes, we went through this yesterday – I thought you said you were going to [do xxx]
  • It’s just in your mind
  • Come on, of course you can do it
  • Yes, I understand exactly how you feel. (NB: Unless you’ve actually suffered the same problem, you don’t really know how they feel. It’s good to say that you can see that they’re hurting, but not to seem as though you feel or have felt the same.)

Basically, to support a friend with mental illness we need to avoid trivialising it, avoid making it sound as though there’s an easy cure and avoid sounding as though we’ve had this, too. “Yeah, I was feeling really low last week, too” is not helpful to someone who feels that a heavy black cloud is surrounding them and taking all the joy and light from their world.

“How can I manage my phone/social media when my friend is in contact with me too much?”

This is a very modern problem. Your friend is at home, feeling down, and likely to be messaging you over and over again. You want a break, or just to chat to someone else for a while. You could – in theory – say that you’re busy doing homework or whatever and you can’t talk to them, but if you’re on social media at any point with your other friends, he will know and may well then have a go at you for not being there for him. People who are ill can seem very selfish but, again, it’s not their fault as they just aren’t seeing things in a healthy way.

So, you could say, “Hey, you know I’m your friend and I’m there for you but I’ve got other people I need to talk to as well. It doesn’t mean I’m not your friend.” It’s OK to be firm – just keep emphasising that you are their friend, even when you’re doing other things or with other people.

“I’m worried my friend may harm himself.”

This could either be in the sense of self-harm or in the sense of making a suicide attempt. If you think your friend might be about to harm himself in any way, you need to talk to another adult if your friend won’t do that himself. Ideally, talk to your own parents.

Should you tell your friend you are speaking to someone else? If you can, yes. “I’m so worried and I don’t have the knowledge to know how to help you so we have to get an adult involved. Will you tell [whatever adult] or can I tell [eg my parents]? I don’t have to give details but I just have to say I’m worried about you.” An adult will know what to do. You should not feel that you have to take this responsibility yourself.

If your friend has mentioned taking his own life, don’t wonder about whether he means it or not: tell him that he needs to get help straightaway and, if he won’t, that you will have to tell someone. Although talking about suicide doesn’t necessarily lead to an attempt, it’s not your job to judge the seriousness: treat it as serious.

“My friend hasn’t been diagnosed with anything yet but I’m worried about him/her” 

The key is to get your friend to talk to any relevant adult. They may not want to talk to their parents – that’s OK as long as they talk to someone, and not just you. So, they might go to a teacher, their own GP, a school counsellor, or an adult friend of the family. It is essential that they do tell someone, because help is out there and can be very effective (especially if the help is found early) and, remember, it is not your expertise or responsibility.

Sometimes, a person may not recognise the possibility of an illness such as depression. If your friend has lost interest in things, is behaving differently from usual, is withdrawing from normal activities, never seems to enjoy things, and if this has been going on for more than a couple of weeks, it is likely that there’s a problem that requires help. Try to find a way of encouraging your friend to talk to you first and then an adult. Emphasise that there are good treatments, especially if the problem is caught early. And if they won’t, tell an adult you trust yourself that you are worried about a friend. At first, if you’re not sure if there is a problem, you could avoid mentioning your friend’s name. List the things you’re worried about and get the adult’s opinion.

 

Practical tips

One of the things about depression is that the person doesn’t feel like doing anything. Everything is a huge effort. But there are things which, if they can do them, may well raise their spirits at least for a short while (though not actually cure the illness). So, one thing you could do is suggest and arrange things that you know your friend used to like doing.

Suggestions:

  • Anything involving fresh air and exercise – even just a walk in the sunshine or snow
  • Anything which can take the mind off negative thoughts – such as watching a film or comedy show
  • Something that involves concentration, such as baking
  • Something that involves helping others
  • Anything new – a new hobby or activity

Now, I’m NOT suggesting you drag your friend to do something they really don’t want to do, as it would be really annoying to be pushed into things. Also, don’t make the mistake of saying, “This will make you feel better.” It’s just that it might be fun, not that it’s a cure. Try to be sensitive to what sort of activities your friend would actually like, rather than things you think would be good for him. But, if you can manage to inject some positive activity into your friend’s day, it will not be a bad thing. If the depression is mild or if your friend is not in the depths of a bad episode, doing these positive activities could sometimes make an important difference. (Just don’t make out that going for a lovely walk is going to cure anything. It’s far too complex for that.)

Resources:

Young Minds – will help you understand mental illness.

The Samaritans have five tips for being a better listener, here.

And, of course, the Samaritans or Childline are there to help your friend with an expert listening ear – and they would advise you, too, if you were really worried about how to help.

YouthBeyondBlue have good advice here, including how to help your friend get medical support if they haven’t yet.

If anyone has any other relevant resources, do put them in the comments below!

Be strong, be steady, be open

I think openness is the key to your relationship with your ill friend. The message you want to get across goes like this: “I am your friend and I really care about you. I can see that you’re suffering. You have an illness that is making you feel terrible and making you see the world and your life in a wrongly negative way. But I’m not an expert in the illness and I don’t always know how to help you. I worry I’m saying the wrong thing sometimes. I will not leave you but I do have other things going on in my life which I have to deal with, and other friends I need and want to talk to. You are part of my life but I do have the other parts of my life, too. Sometimes, you need help that I can’t give and so sometimes I will need to get advice from another adult. That’s the best way for me to help you. And that is my main aim: to be there for you and help you. But I can’t do it on my own.”

Finally, well done for being a good person and doing your best to help your friend in need. No one can ask more. Feel good about yourself. And take care.

 

9 Responses

  1. Thank you so much for this post/text. It helped me be a better listener for my best friend. We have been best friends since pre k and she now has been diagnosed with depression about 3 weeks ago and, i felt useless cause, i did’nt know what to do. No that i know about the ilness more, i feel like i can actually help more and, i also feel like i can be a way better listener. I really would like to thank the writer Nicola Morgan so much…

    -Sorry for the bad spelling sometimes, im Canadian french so, there might be gramatical/spelling mistakes in there…

    1. Thank you, Kim. I’m sorry about your friend. Don’t worry if you don’t always know how to help: just being there and listening and reminding her that feelings change and that she can control small bits of her life – that will help.

  2. This is a very helpful article. I have questions though. My daughter is showing signs of depression she is 16. She lost about all her friends because of her behavior how do I get them to really understand the situation and how do I get them on my side to help her. She refuses to accept she has a illnes and there is no support from her father at all. I am at a total loss here and I don’t know what to do anymore.

    1. Dear Bonita, I am so sorry you have these huge worries. It is awful when we watch someone we love suffer and especially when they don’t want to accept help. It’s very difficult at a distance for me to advise, because I don’t know your situation enough, but here are some thoughts:
      1. It’s relatively unusual for a young person suffering from depression to deny that she’s suffering depression: can you think about why this is? It’s *possible* that she isn’t and that you’re misreading the signs.
      2. What are the “behaviours” that have driven her friends away? (Think about this yourself rather than telling me, as I’m not in a position to do more than ask questions.) Are they caused by depression or could it be something else? Maybe they weren’t the best friends anyway. Maybe she is just different from the people she’s at school with.
      3. Have you talked to teachers? They will usually have a good insight into her behaviour at school.

      Other than thinking about all the above, i can only suggest:
      1. Open up to a friend about it.
      2. I don’t think you can “get her friends on your side” to help – I think it has to start with her and you or her and a doctor or counsellor (which can only happen if she agrees)
      3. Meanwhile, I think your best option is to carry on showing you love her, be there for her, have discussions about *other* things: holidays, hobbies, the environment, health, and, especially, whatever she is most interested in. Let her know you’re on her side and that you’re worried but you won’t interfere. Do fun stuff together. Cook, walk, cinema, laugh.
      4. I think you need someone to talk to yourself, to help work through what’s going on – friend, counsellor?

      I hope this will turn out to be a short phase. It’s a tricky age and one when teenagers often put up barriers. Your task is to work out whether she is really depressed or it’s something else. If she definitely is depressed, it’s really important that she sees a doctor but I don’t think pushing her will be the way to make that happen.

      My main tip is this: listen, really listen carefully. See if you can create a time when she’ll talk: tell her that you won’t interrupt and you just want her to be able to talk freely so that you can see whether there’s anything you can do to make her life better.

      Good luck! Parenting is tough sometimes!

  3. Why in the world would you label depression as a mental illness. It is not! It is depressed ( suppressed ) feelings that need to be hear without judgment or labels
    Shame on you for labeling it as a mental illness

  4. The more I read this article the worse it gets …
    It’s not you
    It’s your illness???!!!
    Really??!!!
    Way to make
    A person feel isolated, bad, wrong, and basically damaged

    You have no business writing blogs like this.
    You have no idea what you are talking about obviously!!!!

  5. great article and just what we needed this week! All your points echo what my daughters therapist has advised when managing the emerging friendships in high school. I don’t think adults realize how difficult it is to HAVE to see friends going through these things EVERY day, and multiple times a day/without choice, and the pressure they have to keep the drama from escalating. One wrong comment can end up all over the school in 1 post. And you hit the nail on the head with the “if your friend sees you online with others” because that is happening. The kids even use Life 360 to keep up with each other. When there is a rift, in an attempt to put some space between the depressed person and themselves, they “unfriend” or “remove” a friend, which always causes some kind of reaction. This is an area no one over 25 gets. I know it exists, but I don’t have to deal with it! I can Choose who I eat with, who I work with, where I go. These kids are in a huge population and have no control at a time every move is recorded and shared. They are learning to hate social media. which is fine with me.

Do comment but please remember that this site is for all ages.

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