How to Support Someone with Mental Illness

Statistically speaking, 20 - 25% of people over 18 have a diagnosable mental illness in any given year, and that's not taking into account the rampant levels of self-reported anxiety, stress, and depression that have skyrocketed over the past two years. When we consider these numbers, it is incredibly likely that someone you know and care about is struggling with their mental health. You may not know what to do or how to best support them, and you might find that your best efforts fall flat, don't seem to help, or maybe even make things worse. That can lead to feeling powerless, confused, frustrated, and sad. Fortunately, there are things you can do.

There Is No One Size Fits All

First, it's important to keep in mind that "mental illness" is a really broad term. Mental illness comes in a variety of flavors and forms. That means that two people with mental illness are likely to be very different, which means they have very different needs. Compare it to this: If your loved one had a health condition, how would you support them? 

Well, it depends.

Do they have severe allergies? Cancer? Diabetes? Chronic pain? The specifics of their condition would heavily influence how you supported them. It's the same thing with mental health. Find out their diagnosis if they have one and/or get a good understanding or their experiences and the symptoms that get in the way for them. Then seek out treatment options. It can be difficult to find the right kind of treatment or the right provider(s). If you can take on some of that research, you might remove a barrier to getting the needed help.

Things to Keep In Mind: Tips from a Therapist 

In the nearly 20 years that I've been practicing psychology, I've talked with a lot of parents, partners, and friends about their desire to help their loved one. These are some conversations I find myself having frequently.

Be Patient: It's a Marathon, Not a Sprint

While effective treatments exist, many mental illnesses are chronic conditions, so it's best to think of management rather than cure (like allergies or diabetes). The long-term, day in and day out nature of symptom management can make it hard to be patient and supportive, especially if it looks like your loved one isn't trying to do what they need to. Keep in mind, that it's human for motivation to wax and wane, so your person may not be fully motivated every single day to use the strategies or interventions that they know work for them.

There's also a really good chance that they're working harder than you realize. A lot of the work to manage anxiety or depression, for example, happens on the inside, which you just can't see. You'll only see the symptoms that break through. Assume that they are sincerely trying and want to get better. 

Know That It Isn't Your Fault

You didn't cause this. Parents, I'm looking at you especially. But, there may be things that you're doing that inadvertently make it worse. I call this feeding the dog. Going down the "If only" path won't change anything. You can only focus on moving forward.  

It's Not Their Fault Either

They didn't ask for anxiety or depression or addiction or neurodivergence or any other label. Remember that when you find yourself feeling angry or frustrated. This what not their choice and not their fault. 

They Are Not Their Disorder

There's a therapeutic technique that I find incredibly helpful called externalization. This means separating the individual from their disorder. Doing so opens the door for you to be on the same team, working to beat the disorder. Think about someone with cancer. We instinctively know that they are not their cancer, that cancer is something that happened to them, and is something that they are working to overcome. Mental illness is no different. 

What Not To Do When Your Loved One Has a Mental Illness

You can't guilt, shame, or criticize someone out of mental illness. While I understand the desire to pour those on at times (Why can't you just...? If you truly loved me, then you'd... No one else...). Deep down we think we can get them to choose to be different. These tactics just don't work that way and, in fact, might actually make things worse. 

Refrain from Unhelpful Advice

"Don't worry" or "Don't be sad" are just not helpful things to hear. If it were as simple as Nike's Just Do It, they would have done it eons ago. 

"You should..." Even if your intentions are positive and your advice is actually helpful, phrasing it as a should often lands as a criticism. Find another way to say it. Better yet, do it with them.

Don't Bury Your Head

Denial also isn't helpful for either of you. In general, acknowledging reality as it actually is is beneficial. Minimizing or downplaying or pretending things don't exist gets in the way of taking effective action. Besides, early intervention is often easier and faster than waiting until things get critically bad. 

Do This Instead: How to Support a Loved One with Mental Illness 

In general, try to operate as a compassionate collaborator - someone who accepts them and understands how hard this is, is willing to work together to come up with game plans and offer accountability, and is accepting of them as a whole person.

Learn About Their Mental Illness

Knowledge is power. Once you have an idea of the condition or symptoms that your loved one is experiencing, learn about it! The better understanding you have of the condition or struggles, the better able you'll be to help.

For example, in my practice, I work mostly with anxiety disorders and OCD. Good Parenting 101 says do whatever you can to make your kid feel healthy, happy, and secure. When it comes to OCD and anxiety, though, that approach completely backfires. When parents provide reassurance that worries will not come true or help the child avoid something they find scary, the child feels better...temporarily. But the worries keep coming back. It's important to have a solid understanding of how anxiety works to feel confident responding to your child's worries by saying, "That's just a worry. Be brave." 

Similarly, if your partner has ADHD, they may have trouble with time management. If you don't understand that ADHD is a brain-based condition that affects executive functioning (planning and carrying out tasks), you might get angry and interpret chronic lateness as a sign of disrespect when it's anything but. 

When it comes to learning about mental illness, the internet can be a wonderful place. It can also be a source of complete junk. Look for reputable sites like these:

www.adaa.org

www.nami.org

www.childmind.org

Go There: Talk About Hard Things

Ask questions and be curious about their experience. And when they answer, listen. Really listen. With the intent of understanding, not fixing or giving unsolicited advice. Don't shy away from difficult topics or asking hard questions (it's a myth that asking someone about suicide will make them have suicidal thoughts). Opening the door for discussions about tough topics is a wonderful gift. Even if they don't want to talk at that moment, you've given the message that you are there, that you care, and that you are not afraid of what they might be thinking/feeling/experiencing. You've just shown yourself to be safe, supportive ally. 

Be A Pushy Cheerleader

Encourage your loved one to do things that are healthy for them. In general, most people need to move, to socialize, to do enjoyable things, to accomplish tasks, and to get outside. And there may be additional things that your loved one needs to do for their own treatment or mental health support. Invite your loved one to do it with you, even if they don't want to. And heap on the praise and positive reinforcement for any effort they make. Sometimes just getting out of bed when depression is strong is a victory that deserves to be celebrated!

Positive Reinforcement Can Help

You call it bribing. I call reinforcing desired behaviors. Make a deal with your loved one. If they will go to treatment appointments, use their strategies, do one thing every day that supports their mental health, or [fill in the blank], then you'll do [fill in the blank]. Kids love working for rewards...and so do adults. Many of the adults I work with set up their own reward plans to support their therapy goals. 

Take Care of Yourself

It's important for you to take care of yourself. It can be really challenging to love someone who is struggling with mental health, especially if their symptoms have a direct impact on you. It does not make you selfish or weak or uncaring to do self-care or set boundaries. Being a compassionate collaborator does not mean that you let your loved one treat you poorly, even if their behavior is driven by mental illness.

Have Hope

Finally, have hope. It can get better. Incredible people do incredible things every day, even with (or perhaps even because of) mental illness.

Written by Dr. Ashley Smith

Peak Mind Co-founder