Many people feel uncomfortable or unprepared starting a conversation about mental health and this may mean that they avoid the conversation altogether.
Are you currently worried about the mental health of a friend, family member or co-worker?
You may have been asking yourself, how can I approach someone with depression? Maybe you are worried about a friend who is struggling with anxiety and you are not sure how you can be supportive? Or perhaps you've been thinking, what should I do if my family member has an alcohol or drug problem, and should I encourage the person to seek professional help?
At some point in our life, most of us will be confronted with such a situation and wonder, "how do I know if someone is experiencing a mental health problem?" or "what if the person doesn’t want help?". When someone you know and love is not well or experiencing a mental health crisis, you want to be there for that person.
We've put together some simple advice based on the Mental Health First Aid Guidelines, so you can take supportive action and help someone you are concerned about.
Here's how you can help a friend, family member or co-worker with a mental health problem or experiencing a mental health crisis.
HideIs it a bad idea to ask someone about suicide?
Many people fear that asking someone if they are thinking about suicide could put the idea in their head. This isn’t true. Instead, it can make the person feel less alone with their thoughts, and more able to accept help.
It’s important that the question is direct and unambiguous, and delivered without judgement. “Are you having thoughts of suicide?” or “Are you thinking about killing yourself?” are both good ways to ask. This lets the person know that you are not afraid to talk about suicide and they don’t need to be either.
If the person doesn’t feel judged, they will almost always tell the truth. This is because most people don’t want to die. They want their pain to end and they can’t see another way out. You can help them find one.
HideI think my friend is harming themselves – what should I do?
If you are concerned that someone you care about is deliberately injuring themselves, you need to discuss it with them. You could say something simple yet direct, expressing your concerns that the person may be injuring themselves, for example “Sometimes, when people are in a lot of emotional pain, they injure themselves on purpose. Is that how your injury happened?”.
Try to maintain a calm and caring tone of voice and avoid expressing anger or disgust. Tell the person that you want to help and let them know the ways in which you are willing to help them. Don’t focus on stopping the self-injury. Instead, ask about what is causing the distress and discuss how professional support might help the person feel more in control.
Contact emergency services if a wound or injury is serious, or if the person has harmed themselves by self-poisoning or overdose.
HideHow can I make my friend’s panic attack stop?
Panic attacks are very frightening, but not life-threatening. The good news is they always pass. Helping your friend to sit down somewhere quiet and waiting for it to pass is the best thing to do. If panic attacks recur and the person is upset by them, encourage them to speak to their GP.
Only a health professional can say for sure if what they are experiencing is a panic attack or something more serious. If it’s never happened before or the person thinks they are having a heart attack, it’s better to call an ambulance to be safe.
Sometimes during a panic attack the person might feel the urge to run away. While you shouldn’t stop them, it’s good to discourage them from doing this. Avoidance as a strategy can lead to greater problems later on. In the past, some people suggested that counting breaths or breathing into a paper bag would help. We now know that even if these methods feel helpful in the short term, they can become a kind of emotional crutch, leading to difficulty with treatments later on.
HideDoes my child have an eating disorder?
It’s not possible to tell if someone has an eating disorder just by looking at them. However, dieting, weight changes, excessive exercise, and focus on weight and appearance are warning signs.
Talk to your child about what you’ve noticed. It’s important to be non-judgemental and caring. Telling the person they look good just the way they are isn’t helpful as eating disorders are about far more than just weight or appearance. They are often about trying to assert control.
An important prevention strategy for eating disorders is media literacy. Talk to young people about unrealistic images in the media (including social media), photo manipulation and curated social media images. Encourage them to focus on health and happiness instead of weight and appearance.
HideWhy won’t my friend just cheer up?
If a person with depression could cheer up, they would. It’s not that simple. Depression affects thinking, feeling and behaviour as well as physical health and it’s not possible to just ‘snap out of it’. Untreated, depression can last for years.
Encourage the person you care about to seek professional support. Most people respond well to psychological therapy and learn skills that can help to keep them well. Others may need medical treatments such as antidepressant medication. Encourage your friend to talk to their GP about how they’ve been feeling.
HideWhy is my friend such an attention-seeker? (teen)
When it seems like someone is ‘seeking attention’, it means they need help, and they may not know how to ask for it. Instead of ignoring the behaviour, ask them what’s happening and offer to support them to get help. It would be good for your friend to talk to an adult in their life – a parent is best, but if they’re not ready for that, there might be someone at school who can help.
If your friend is engaging in non-suicidal self-injury (also called ‘self-harm’ and sometimes ‘cutting’), or talking about suicide, it’s really important that an adult knows about it. Talk to your friend about who they would be comfortable talking to. You can’t keep a secret about something that big. Remember that if they are talking to you about what’s happening it means that they want things to change.
If your friend tells you that you’re not allowed to tell anyone what’s happening with them, explain gently that you care too much about them to keep it a secret.
HideWhy won’t my partner quit drinking?
Some people drink alcohol to cope with unpleasant emotions or underlying mental health problems. It can be very difficult to make a change without learning new coping strategies or seeking treatment for the mental health problems.
If they are dependent on alcohol, they will need the help of a doctor to change their use. Quitting alcohol suddenly can lead to a medical emergency.
Talk to your partner about your concerns, focusing on what you have noticed rather than on the drinking, using non-judgemental language and ‘I’ statements. You might say “I’m concerned about how alcohol is affecting your behaviour” rather than “You drink too much and it needs to stop”.
Not everyone who recovers from alcohol use problems quits drinking completely. Although this can be a good goal, focusing on abstinence can make the person reluctant to make changes at all. Instead encourage them to talk to a doctor or call a helpline to seek advice.
HideIs it normal to be unhappy in old age?
Feeling unhappy shouldn’t be seen as a normal part of ageing, though there are many risk factors in older age that can increase the risk of depression. These include poor physical health, disability or low mobility, major life events such as moving out of home or losing some measure of independence, and bereavement. However, mental health problems are less common in older adults than young people.
No matter the person’s age, there are treatments that can help. Approach the person in a caring and calm way and let them know that you’re concerned. Offer to help them visit a doctor to talk about what has been happening. Some physical illnesses and medications can cause symptoms of depression as well, so asking for a full medication review might help as well.
HideIs there effective self help for depression?
There are many effective self-help strategies for depression. They include moderate regular exercise, massage therapy, meditation and mindfulness, and self-help books based on cognitive behaviour therapy. Self-help strategies tend to work best when their use is guided by a clinician such as a psychologist.
However, when a person is experiencing depression, it can be very hard for them to have the motivation to engage in self-help strategies. Depression makes it hard to concentrate and focus. If someone is depressed, being forceful about self-help strategies can make them feel worse, because they can feel as if they have failed. Instead, support any efforts the person makes to feel better.
Self-help strategies are best used when depression is mild or moderate in conjunction with following the advice of a mental health professional. They can be good for maintaining wellness as well. If depression worsens, it’s best to seek the advice of a professional.
HideHow can I calm someone who is experiencing mania?
Mania is a state where a person is very excited and full of energy and may have a lot of new ideas. It is usually a feature of bipolar disorder, a mental illness where a person experiences episodes of both mania and depression, generally with periods of wellness between episodes.
The person may need medication. It’s important to seek the help of a mental health professional as soon as possible, whether they have experienced mania in the past or not. It can be helpful for the person to try to rest until help can be sought.
Mania can be a very pleasant state where the person feels capable of achieving anything they put their mind to. This can mean the person is not motivated to seek help. However, mania can cause impulsive behaviour and put people in situations where they are at risk of harm. Always be respectful and non-judgemental when talking to the person and focus on your concerns rather than your behaviour.
HideDoes cannabis cause schizophrenia?
Cannabis can bring on an episode of psychosis and increases the risk of schizophrenia in people with other risk factors. Frequent use of cannabis has been linked to the development of schizophrenia. If someone experiences an episode of psychosis immediately after using cannabis, it may be drug-induced psychosis which is unlikely to return if the person doesn’t use cannabis again.
Many people believe that as cannabis comes from a plant rather than being a manufactured drug it is safe to use. This is not true. All drugs – illegal drugs such as cannabis and legal drugs such as alcohol – do carry risks and it’s important to be aware of those risks and how to minimise them.
HideIs this a problem, or normal teenage mood swings?
Mood changes during adolescence are normal, and most changes are related to bone development, the pressures of adolescence and the importance of increased independence. Some parents and other adults may find themselves worrying about something that is very normal. Others may dismiss or not notice something that indicates a mental health problem, thinking that all changes are to be expected in this age group.
It’s not always easy to tell the difference. Look for changes which prevent a young person from doing the things they want and need to do, negative emotions that are present most of the time (maybe even when something good has happened) and changes that persist for more than two weeks. Withdrawing from family is often a normal part of gaining independence but withdrawing from friends may be a sign that they are struggling to enjoy life.
HideIs the COVID-19 pandemic a traumatic event?
Different people respond in different ways to negative events. Some people are likely to experience lasting distress from the pandemic while others will not. People who are already anxious or have other mental health problems are more likely to experience the pandemic as a traumatic event.
This may also be influenced by the degree of exposure. Those who get the virus may be afraid for their lives or of passing it on to someone else. Those who know someone who has died from the virus are bereaved in addition to the other stresses. It might be especially hard for those unable to travel to attend a funeral. Other people will find this to be a time to feel more connected to their communities. Isolation due to stay-at-home orders can make it hard for some to use their usual coping strategies. There’s no right way to feel about stressful events.
If someone you care about is feeling distressed and struggling to cope, you can be supportive. Don’t judge their reactions. Ask how they are feeling and if there is anything you can do to help them feel better. If symptoms persist, encourage them to seek professional help.
HideWhat are the most commonly used drugs?
The most commonly used drug in Australia and the rest of the world is alcohol. Many people don’t think of alcohol as a drug, but it is. Using too much alcohol can cause serious mental and physical health problems and dependence. People who drink a lot of alcohol can engage in behaviour that they otherwise would not. Nicotine is another legal drug which is widely used, though the use of tobacco has declined over time. Cannabis is the most commonly used illicit drug in Australia.
Use of alcohol and other drugs can be a sign that a person is struggling to cope with negative emotions. It can be very difficult to make changes without professional help. Other people begin using alcohol or other drugs because they enjoy the effects, leading to more frequent use over time.
HideHow can I stop my partner from gambling too much?
Gambling is a very popular activity in Australia and most people who gamble do not have problems. Signs that your partner may have a problem include lying about or hiding their gambling behaviour, spending more time or money than planned on gambling, and concealing financial statements.
If you think your partner may have a gambling problem, it’s important to talk directly with them about it. Try to be calm and non-judgemental. Your partner might feel guilt and shame about their behaviour and might be struggling to maintain control or win back their losses.
There is effective help for gambling problems. Psychological therapies can help the person to overcome false beliefs about their gambling and make changes to their behaviour. If your partner has incurred debts from gambling a financial counsellor can help your family to negotiate with banks and other creditors.
HideWhy is my colleague acting so different?
Mental health problems can make it hard to concentrate and focus. Making mistakes, absenteeism, reduced ability to manage a workload are all possible symptoms. Talk to your colleague non-judgementally and ask how they’re feeling.
Work can be very good for mental health, as long as the workplace is supportive and healthy. If workplace culture (including bullying, unfair treatment and expectations of long work hours) is contributing to poor mental health in employees, it’s important to address the problems head-on and make changes.