How to help someone struggling with their mental health

Written By leanne Maskell

Please note: this article talks about distressing topics including suicide - but these conversations might save someone's life.

Last week, I finally called my GP and told them I was having severe panic attacks, as I'd been instructed to do by my therapist weeks ago.

They asked me how long I'd had symptoms of anxiety and depression, and I told them the truth: for as long as I can remember.

Until age 25, I lived with a voice in my head that blasted how much it hated me (and life in general), 24 hours a day, every day. Worrying about which people I'd upset that day, what I'd done wrong, what I was going to 'do' with my life, why I was so stupid, why I couldn't just be 'normal', what was wrong with me, why I was so selfish... you get the picture.

It was (and is) excruciatingly painful. Life is hard enough without having a self-hate monster inside your head narrating what a terrible job you're doing at it and how much of a failure you are.

As a teenager, I discovered I could turn this voice off with tequila shots. I was incredibly reckless, getting black-out drunk several times a week, making very bad decisions, and self-sabotaging my life.

Before long, I wanted to end it all, which is a thought that terrified me. I booked an appointment with a therapist, believing I'd hit 'rock bottom', waiting to be inevitably sectioned into hospital. She told me that she couldn't diagnose me with anything, nor give me any advice or drugs, but just listen. I left thinking I might as well pay to talk to a wall, deciding therapy was pointless.

A few months later, I was in Australia, with my life having spiralled out of control and feeling suicidal all day, every day. I got a rash all over my body and was instructed to see a therapist and get a massage by the GP, which I found bizarre - but it got rid of the rash. By chance, I also ended up accidentally going to a mental health meet up on the beach called One Wave Is All It Takes.

It was only here that I heard someone say how they had also felt suicidal, that things changed. That person looked like a normal human being, and if they could experience this invisible torture, that meant there was hope - because at least I wasn't alone. When I heard how their partner had been murdered, it shocked me out of my state, and I decided not to act on my own plan, recognising how we could all die at any point.

The thoughts, anxiety, depression, and chaos continued, though not as intensely. I decided to pay to see a private psychiatrist because I eventually realised it might be possible to live without this constant pain, which is how I was diagnosed with ADHD. My first response was that I had a real problem, to which I was told that I had really bad ADHD.

Taking the medication was the first time I'd ever experienced quiet in my brain. I had no idea other people lived without a constant deafening narrative, without what felt like a million different tv shows blasting at you. I didn't know it was genuinely possible to experience peace from your own thoughts (despite trying every meditation and yoga class out there).

Over the last 6 years, I have still experienced these challenges from time to time, but how I imagine a 'normal' person would - largely in response to external reasons. For example, a bad break up, or stressful work situation. The difference is that my brain could slow down and consider all options during these challenges - it no longer instantly searched for the 'off' button. I experienced a lot of trauma-related challenges, but no longer had the constant droning of anxiety and depression in my brain.

Ironically, in recent months, I have had a lot of disruption to this medication due to national shortages. When I was unable to take it, I was in shock at how loud my brain suddenly was. Although the shortages of Elvanse have been largely resolved, these symptoms have stuck around, and I'm currently facing a 7 month wait for a medication review. (I am extremely lucky. It would have been 7 years if I wasn't literally an ADHD coach & insisted on my right to choose the provider.)

However, this has meant I've experienced what we'd call 'anxiety and depression' more seriously in the last few months.

The line between ADHD and mental health conditions like these is very blurred. When I've previously taken other kinds of medication, it really didn't agree with me, and I stopped after a couple of days. I still have a lot of internalised ableism against my own ability to just 'get on with it'.

However, it is truly horrible to live like this. For me, having depression feels like being Eeyore - I can't enjoy the good things. At a party or social event, it feels like there is an invisible boundary between me and other people. I find myself in awe of how they seem to be so comfortable, and ruminating on why I can't just be 'normal' - or happy.

There is an inability to feel joy and a tendency to self-isolate. There's a narrative of how boring and selfish you are, of how no one wants to hear about your problems, and how you 'should' be fine, because you have nothing to complain about.

Then there's the reactions of the people you do try to tell. Who don't realise what you're saying, or feel uncomfortable due to not knowing what to say, and come out with often very unhelpful comments ('you just need to get over it!') - or ignore it all together. You convince yourself that you are in fact, fine - and it all starts again.

Last week I reached out to a friend I hadn't spoken to in a couple of months asking if I'd done anything to upset her. She said she thought I didn't want to be friends, as I'd shut myself off, which is of course exactly how I felt in reverse. I realised that my external image of being busy and stressed keeps me imprisoned in the self-fulfilling prophecy that nobody really likes me anyway.

As Grayson Murray was confirmed to have taken his own life aged 30 this week, I was hit by the reminder that so many of us out there are struggling in these invisible prisons, no matter how 'fine' things look on the outside. Suicide is one of the leading killers globally, with 1 person taking their own life every 40 seconds.

However, we're all so scared of talking about it. The thought itself is what can scare us into shame-based silence, fear of being confirmed as being selfish and attention seeking and not wanting anyone to worry about us but also being scared of ourselves. Media reporting of celebrity suicides has been linked to increased suicide rates - but this shouldn't close down conversations. It should open them up.

This goes for the rest of mental health challenges, too. It's lovely to share 'it's ok not to be ok' quotes and suicide hotlines and so on, but do you know what they say when people call? They ask if they have anyone to talk to.

Therapy on the NHS is pretty much non-existent, but the many people who are unable to afford this need help as well.

We are living in a highly individualised, lonely society. We see so much talk of mental health awareness, but not so much about mental illness and how to engage with it.

I know this because sharing this post itself feels one of the scariest things I've done in a long time, but I don't see anyone sharing about what living with mental health challenges feels like on here. I have never seen a 'superpowers' of depression post.

I do see a lot in the news about how conditions like anxiety and depression aren't 'real' illnesses from a political perspective, which just increases this stigma more. These conditions may be 'in your head', but they can be life-threatening.

As a business owner working in the mental health industry, I am privileged to be able to share my current challenges and know that my career probably won't be at risk. The people who would avoid working with me for sharing this are the ones that already wouldn't be working with me. I set up ADHD Works for this very reason - because I know how powerful it is to be able to see that we are not alone.

So, here's some things that may help (or not help) if you know someone who's experiencing mental health challenges.

1) Listen without judgement (and avoid giving advice!)

If someone tells you they are going through a hard time, you can simply let them know that you're there for them to listen without judgement. You can tell them that they can always speak to you, and they can tell you anything - that you may not have the answers, but you're there for them.

This can be one of the hardest but most effective things to do for someone else. Very often, we just want to be validated. We don't want advice or to hear about why we shouldn't feel the way we do (please please please do NOT tell them that 'everybody has X' or 'children are starving in Africa') - we just want to hear that we're not aliens for feeling the way we do.

This is tough, because our human instinct is to problem solve - but you can simply ask whether they'd like you to offer advice or to just listen. The majority of advice isn't taken, and it can lead to someone feeling as though they aren't being understood. They may not know what they need, but humans are never going to go too wrong with simply having space held for them.

2) Tell the person you care about them

This is SO SIMPLE but often so bizarrely difficult for people to do (maybe this is just a side effect of being British). Telling people you love them or care about them, or think they are just a great human being who you're glad exists, is a very understated form of reassurance.

Instead of telling someone to 'cheer up', you can tell them 'I care about you, no matter how you're feeling.' A friend of mine used to text me at random points to just say that they cared about me, and it meant so much. You don't need a reason to tell someone you love them (try it out!).

This is often what I need to hear most when I am having a mental health spiral - just to feel that I'm not 'too much' for having emotions. It's easy to take it for granted, but when was the last time you told someone how much you truly cared about them - or heard this in return?

3) Suggest hanging out (regularly!)

When someone is experiencing mental health challenges, they may likely be isolating themselves whilst believing that everybody hates them (remember the self-fulfilling prophecy?). They may also find it very difficult to plan ahead or socialise, especially if they feel like they're living in a grey fog of misery and don't know how to pretend to be happy for their friends who seem to be smashing life.

During these 'mental health awareness' days / weeks, we're often told to 'check in on our loved ones'. Asking someone if they're okay over text isn't the same as asking them to have a real conversation. Offering a phone call, or a walk, or a dinner, are again often understated but highly effective ways of providing support. This is especially so for someone who's convinced themselves that they're a burden and annoying people.

Reminding them that you genuinely enjoy having them in your life (and the reasons why!) can be very helpful. Offering to set up meetings, providing reminders, and sending calendar invites can be extremely useful (especially for those of us with ADHD).

Checking in with the person on their preferred form of socialising and adapting to this is important too. One of my closest friends and I hang out mainly by doing activities like yoga together. Sometimes we don't even manage to have a long conversation, but it's a regular check in point for human contact. Another plays endless games of chess with me when I'm feeling anxious.

Everyone will be different, but for me, an invite to the pub is likely to cause far more anxiety than it would for me not to go! Remember not to give up: if someone says no, you can offer different alternatives for them.

4) Be kind

Having mental health challenges can be very difficult for everyone involved, and it's important to remember that it's no one's fault. It's not the individual's fault (no matter how many times I search for 'meaning' in my depression or anxiety, or how many therapy sessions I go to - it is just what it is), and it's not the people around them's fault. You cannot help someone who doesn't want to be helped, but you can choose not to give up on them.

Although it's commonly said that 1 in 4 people will experience a mental health problem, we all will. We are quite literally all here on this earth with no clear instruction manual on what to do, navigating climate catastrophes and wars, whilst beating ourselves up for not being good enough. We will all experience bereavement and grief, loss and failure, mistakes and fear.

Disability is ironically the one characteristic we will all probably experience at some point, if from old age, if nothing else.

So we might as well give each other a break. If someone forgets or cancels their plans with you at the last minute, or if they're late, or if they say something you don't like, take a deep breath and remind yourself that none of this really matters.

If someone makes a mistake, remind them that it's okay. If someone doesn't reply to your messages, message them again, with kindness. If they annoy you, feel free to go take your anger out by shouting at a wall, for example, before giving the human in front of you a bit of kindness.

If there's one thing I hope you can take from this long over-sharing post, I hope that it's to be kind to others, and yourself. You can only do your best, and if you've read it this far and are thinking about someone in particular, take this as your sign to just send them a text to let them know you're thinking of them. You never know the ripple effect that a simple act of kindness can have.

If you're struggling right now, please remember that things do get better. This isn't the rest of your life. Hold out for the moments of joy, and remember that you are loved, that you are more than your job title or likes on social media (in fact, get off social media as much as possible). You deserve to feel joy.

Resources

leanne Maskell
Next

What happened in my ADHD assessment