Bruce Johns column mug

Have you ever noticed that when adults are socializing, if someone mentions that they are struggling with a mental health issue, it’s usually greeted with about as much enthusiasm as if the person had offered to show everyone their rash?

We each have about a 55 percent probability of experiencing a psychological disorder within our lifetime. As such, it’s pretty much guaranteed that we’re going to either be that someone or be close to someone struggling with mental health issues.

How can we help someone who is suffering from a mental disorder? First, being compassionate and trying to understand what they are going through can be an enormous help. On the other hand, reassurances of, “I’m sure everything will turn out fine,” or encouragements based on our own experience such as, “Just toughen up and you’ll get over it,” can be more hurtful than helpful.

Educating yourself about the condition can help dispel myths you may have heard and allow you to recognize and respond in a supportive manner. Recognizing the person as an individual first, despite his illness, will help keep a healthy perspective. Just as a person with diabetes is not a diabetic first and a person second, a person with a mental illness is still a person first.

There’s a pretty good chance that someone you know is currently struggling with anxiety, depression or another psychological disorder. Given the interdependence we have on one another, it seems incumbent on us that, like lifeguards at a pool, we remain aware of those around us who may not be yelling for help but may be showing signs of distress.

A person in trouble may appear listless, irritable, agitated, or impatient. He or she may have difficulty concentrating, have difficulty settling down, seem unusually preoccupied, or feel easily overwhelmed. They may come easily to tears, have frequent emotional outbursts, or show increased worry or panic.

They may quit eating or sleeping, or conversely may overeat or oversleep. Another signal might be sudden social withdrawal through avoiding friends or not answering texts, calls, or even knocks on the door.

Taking inordinate risks involving potential self-harm such as driving recklessly, repeatedly missing work despite decent health, or showing up intoxicated or hung over are other red flags, as are statements about life being too hard or not worth it. Like lifeguards, staying aware can help us spot when someone around us may be in over his head.

Is it best to approach a person whom you suspect is struggling psychologically, or will that potentially drive them away? Back to the lifeguard analogy, it may be nothing, but it’s probably worth it to check.

Some will respond well to well-intentioned questions such as, “I’ve noticed you’ve been more on edge lately. Is everything okay?”; “You seem more tired and sad than usual. Is anything going on?”; “As a friend, I’m starting to worry about some of the things I’ve heard you say recently. Is there some way I can help?”

We also have to allow that some people may not be ready to share their innermost demons. If you’re met with a denial, accept it graciously and assure them you probably just misread them. We may then be limited regarding what we can do as they work through their struggles, but we can be ready if and when they decide to let us in.

If we are permitted into their inner sanctum, we must be careful not to try to fix before we understand. Slapping Band-Aids on wounds (i.e. giving advice) before we know what’s causing them can allow lesions to fester.

It helps to be honest about what you don’t know. “I’ve never known that kind of (anxiety, depression, hopelessness) in my own life, but despite my ignorance I’m sure we can figure this out.” With your friend’s permission, gather a posse of people to help. You don’t have to do this on your own. Reach out to others who also know the person and might have some experience dealing with his problems. Consult with people you know who might have some experience or expertise. Most therapists are more than willing to consult to get you pointed in the right direction.

Familiarize yourself with local resources. Crisis services are available through Bear River Mental Health, LDS Social Services, and Logan Regional Hospital. Therapeutic resources can be found by looking up counselors in the yellow pages or online. Support groups can be identified by Googling “Support Groups in Cache Valley.” You can also get counselor recommendations from a family doctor.

Checking in with someone who’s struggling can help ease their sense of isolation. Calling or texting once or twice per week to ask how they’re doing can send a needed message of connection and caring. You can offer to help the person make an appointment with a doctor or therapist and even go with them to the first appointment or group. Afterward, you can ask how it went.

What if someone starts talking about hurting themselves? This can create a thorny dilemma. I want to keep my friend or family member safe, yet fear that if I get someone else or the police involved, my friend may never talk to me again.

Love means doing what is in a person’s best interest, even if it hurts. As a true friend, let it be known that you can be counted on to do the hard thing. “I care about you too much to sit by while you implode,” or “I promise you that if it means risking our relationship to keep you safe, I’ll do it and hope you’ll later forgive me.” If you’re unsure if a person is safe and you can’t reach them, call the police or sheriff and ask for a welfare check.

What if someone uses their condition to control the people who are trying to help? Unfortunately, that sometimes happens. Well-meaning, caring individuals can find themselves overwhelmed by the neediness and demands of people who experience crushing feelings of distress and fears of abandonment combined with inadequate emotional controls.

The ultimate goal of such people is simply to feel loved and accepted. However, they consistently harbor deeply etched beliefs of personal inadequacy based on early experiences. They therefore press others to prove their lovability via increasing sacrifice and attention.

Unfortunately, there’s a hole in the bottom of the person’s self-esteem bucket that no amount of reassurance will ever fill. Ultimately what heals comes from within the person, not from outside. But learning self-support, self-soothing, and self-nurturance is not the solution the person typically wants. Such folks are tricky even for therapists to deal with. Professional involvement is usually crucial to progress.

People carrying such wounds can cycle from clinging to rejection, adulation, and vilification. Family and friends often feel they are walking on eggshells or are the innocent targets of incoming missiles. Many well-intentioned friends or family members do exactly what the person most fears and walk away to protect themselves, validating, in the mind of the one carrying scars, that they were, in fact, as worthless as they feared.

Such conditions used to be thought of as essentially untreatable. Recent evidence has shown, however, that even severely disordered persons can, with a mixture of professional and community supports, be helped to achieve a remission of symptoms and achieve long-term recovery. It requires helpers who set firm interpersonal boundaries and offer support, warmth and acceptance within those boundaries.

Being a friend to someone with mental illness means there are likely to be some difficult times. But there are great satisfactions when you realize that what you’re doing might just be helping someone stay afloat when they couldn’t do so alone.

Dr. Bruce Johns is a clinical psychologist at Mt. Logan Clinic. He can be reached at brucerjohns@gmail.com.

Dr. Bruce Johns is a clinical psychologist at Mt. Logan Clinic. He can be reached at brucerjohns@gmail.com.