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Supporting Someone with Mental Health Struggles

It can be difficult to support a loved one with mental illness. These tips and strategies from a therapist will help.

There is no one size fits all

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.

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 of 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 was 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 love 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. It is generally beneficial to acknowledge reality as it actually is. 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 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 a safe, supportive ally. 

Be a pushy cheerleader

Encourage your loved one to do things that are healthy for them. Broadly speaking, most people need to move, socialize, do enjoyable things, accomplish tasks, and 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. 

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Your (Obligatory) Holiday Survival Guide

Christmas and Kwanzaa are right around the corner (and Hanukkah snuck right past me). Maybe you love this time of year…and maybe you don’t. Maybe you’re like a lot of folks who find it quite challenging. Personally, I don’t holiday like a lot of my fellow Americans, but I think it would be an oversight not to address the topic, even if it’s a bit late in the game.

In 2006, I was an intern at Children’s Mercy Hospital, and I had the bad luck of being on call for Christmas. That meant I was stuck in a city where I knew very few people, all of whom would be going home to their families for the holidays. My parents came to visit but headed home on Christmas Eve. I bawled the next day, alone in my studio apartment, missing everyone and everything.

The next year, I was in a different city at a different hospital but, again, stuck with the Christmas call. That year was easier. I had a friend in Omaha, and we did our own thing to celebrate.

The following years saw some holidays with friends in California, some with my family, and some with my partners’ families. I’ve gotten very unattached to any specific vision of what the holidays must be like, and, honestly, it’s been pretty freeing. My holiday stress level tends to be pretty low, but that’s not the case for many people.

The holidays bring with them changes in routines and schedules. Our self-care goes out the window. We hit the end of the year crunch time. Many people have the added task of holiday shopping, decorating, cooking,  hosting, traveling, planning, and juggling 9 million things. Others have salient reminders of what or who they’ve lost. Couple all of that with the pressure of meeting expectations (yours and others’) or not feeling as joyous as you think you should. While you’re at it, throw in (what’s typically) a cold and dark time of year and a pandemic we’re all tired of, and it’s no wonder that many people experience heightened stress, anxiety, or depression!

Fortunately, there are some things you can do to not just survive but thrive through this season. Now, I’m not advocating that you abandon your holiday traditions as I have, but I will encourage you to do ALL of the things on this list.

1. Let your values be your guide.

Get really clear on who and what is important to you, particularly when it comes to the holidays. Tune out the noise, the expectations, the perceived obligations, and put your time, energy, and attention into what truly matters.

2.  Don’t sweat the small stuff.

When something less than desired happens, put it in perspective. Ask yourself, “On the scale of bad things, is this a paper cut or a nuclear disaster?” and react accordingly.

3. Make time for self-care.

Prioritize the basics like sleep, eating nutritious food, drinking water, and moving your body. Make time for whatever other self-care practices help you feel like you at your best.

4. Move with ease.

When we feel stressed, our movements get frantic, rushed, and hectic. Instead, intentionally relax your shoulders and move gently, smoothly, and a little more slowly than you might want to. This will help tell your nervous system that it’s all good. There’s no crisis. Relax.

5. Channel compassion – for yourself and everyone else.

You don’t have to be merry. In fact, there may be lots of reasons why you aren’t, and I bet the way you’re feeling makes sense when you consider those reasons and put them in context. So be kind to yourself! Offer that same compassion (empathy + kindness) to others, too. Adopt the attitude that everyone is doing the best they can at that moment. Try to understand what their perspective might be, how it might make sense when you consider the context, and offer them kindness, too, even if it’s just in your own thoughts.

6. Speaking of kindness, do one for someone in need.

Not only does this help someone out and add just a little bit of goodness into the world, but altruism is good for us, too. It gets us out of our own heads and our own problems and, frankly, it feels good to do good.

To be honest, I think this is pretty solid advice for any stressful time, not just the holidays, but I sincerely hope you thrive through this holiday season.

“You can tell a lot about a person by the way they handle three things: a rainy day, lost luggage, and tangled Christmas tree lights.”
 – (often attributed to) Maya Angelou
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Your Election Week Survival Guide

Let me get straight to the point. It’s election week in the US, and tensions are HIGH. So many people are feeling anxious and angry as we await the results and anticipate the next 4 years.

I suspect that wait is going to extend well past Tuesday night if the predictions I’ve heard are correct. It could take days or weeks to get the final tally from all of the ballots. That means that those tensions, that anxiety and anger, are likely to stay…and maybe even escalate. Here are 5 tips for surviving election week.

1.     Learn the difference between News and Noise.

There’s going to be a lot of the latter coming at you. News is factual, unbiased information whereas Noise is a distraction. It’s loud and unpleasant and causes a disturbance. It’s irrelevant though it can sound important.

Noise includes the speculations, predictions, assumptions, and opinions coming at you from news broadcasts and TV programming, articles, your social feeds, your neighbors, your family, even your own mind.

So much of human suffering comes from the “extra” we add to situations, from our minds’ commentary. Remember, that’s just Noise. And over the upcoming week(s), other people may get loud with their Noise and project it onto you.  Noise commands your attention, but you don’t have to give it. TUNE IT OUT.

2.     Compassion is the antidote to hate and anger. 

Regardless of which side of the political spectrum you fall on, you may have some strong feelings toward the other side. While the right kind of anger can be motivating, some anger is unnecessary and unhelpful, meaning that it can detract from your wellbeing and that of others. Compassion is the key.

To tap into your compassion this week, keep in mind that we have FAR more in common than it might seem. A recent study looked at the similarities among people across the globe and found that we’re overwhelming similar – on average upwards of 90% similar in attitudes on a range of things like human values (e.g., independence, achievement, conformity, tradition, benevolence, power), moral attitudes (e.g., dishonesty, domestic violence, purity), and trust (in other people, science, and the government).

More than 90% similar. Let that sink in. 

At our core, we all value the same things like education, security, and morality. Our current political system, among other contributing factors, amplifies differences, and our brains, with their information processing glitches, run wild with them. We fall prey to the Us/Them bias, black-or-white thinking, mind reading, name calling, and judgements, just to name a few. It’s your job to keep your mind in check, and this week is going to be a real psych strength challenge (If you need to shore up your own psych strength skills, our Ascend program can help).

Try to put yourself in others’ shoes and see the world from their perspective. Try to understand rather than judge. Try to find some common ground that can be a unifying force. Try to let your values guide you, not your fear or anger.

3.     Play nice.

I get that you may be passionate about the issues that speak to you, and you may feel compelled toward action. You may want to bring others to your side, and you may find yourself in heated discussions, in real life or online. Before you react, though, take a pause. Ask yourself what you really want from this interaction. While it may feel satisfying to unleash on someone else, to tell them how and why they’re wrong, that’s unlikely to end with them changing their mind. In fact, they’ll likely dig in more, and you will have actually just helped to strengthen their resolve. Think about it. When was the last time someone came at you, telling you that you’re wrong, perhaps tossing out a name or two, and you said, “You’re right! Thanks for helping me see the error of my ways”?

Exactly.

Changing someone’s mind starts with understanding their mind first. Starting at that common ground and operating from a place of compassion and respect, you may be able to guide them to a new way of thinking. Shouting, arguing, name calling…that’s all just Noise.

4.     Practice gratitude.

No matter what happens Tuesday or in the following weeks, there is a lot to be grateful for. Don’t lose sight of that. When you find yourself feeling anxious or angry or overwhelmed or disillusioned, take 60 seconds to find something IN THAT VERY MOMENT to be grateful for. Tapping into gratitude – really feeling it – can be a powerful way to tame internal Noise and find some calm in the chaos.

5.     Finally, be sure that you are taking some time to unplug, to breathe deeply to calm your nervous system, and to take care of yourself.

If you missed it, our Tips to Survive and THRIVE Through the Political Season podcast episode may be worth a listen.

“We are far more united and have far more in common with each other than things that divide us.”
-Jo Cox
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A Quick Technique to Develop Compassion for Anyone

Last week, Ashley wrote a post about judgements. And, we’ve talked extensively about the importance of avoiding judgement and accepting (not necessarily approving of) other people’s behavior.

We simply can’t force others to do something, think something, or be a certain way. Even when, if we’re being absolutely honest, we believe they’re WRONG.

But sometimes we have to be taught how to be compassionate for certain situations. This can be incredibly hard, which is why I want to introduce a technique that can help you build compassion for nearly anyone, even if they’re the person you disagree with most in the world.

You are not your thoughts.

Let’s begin on solid footing. You’ve heard us say the phrase, “You are not your thoughts” many times.

What we mean by this is:

  • Your mind is a thought-generating machine.
  • It subconsciously learned a number of automatic, involuntary, and habitual thought patterns over the years.
  • It constantly spews these thoughts, resulting emotions, urges, beliefs at us, every waking moment of the day.
  • Most of these thoughts aren’t useful, helpful, or even accurate.
  • YOU are not generating them. It’s the involuntary part of your mind.

They are not you. To have a meaningful life, we must spend time cultivating compassion. To truly improve our mental health we must also form a daily practice of self-compassion.

Breaking that down even further, it means that, through the process of neuroplasticity, your mind has taken in subtle and overt information from people, the environment, the media, and other places over the years, and it has ‘learned’ to react in a certain way. Forming these thoughts is part of our common humanity.

Through no intention of your own.

Your mind is like your blabber-mouth roommate who talks constantly and has an opinion about everything. 

It feeds you the self-criticism it has learned. The self-limiting beliefs it has learned. The knee-jerk reactions about the world and other people that it has learned. When it was and was not showed compassion.

And, although it feels “authentic” and as if it is our “own voice” in there. It’s not. You are separate from that involuntary voice.

You are the person who is observing that voice, but man can that voice have a powerful influence over each and every one of us!

THEY are not THEIR thoughts

This knowledge, if applied to other people, can be used to help you develop compassion for nearly anyone else in the world. 

Stay with me.

Imagine someone you really disagree with. Someone, dare I say it, who you really dislike. Someone whose beliefs and repeated behaviors make it very difficult to have compassion for them.

Now…imagine what that person must have involuntarily and unfortunately learned throughout their life to get them to believe those things and behave that way.

You see, no one is immune from neuroplasticity. And thankfully so! It is the reason why we can reinvent our sense of self, learn new things, and build psychological strength!

But, it’s also the reason why we….all of us….learn unhelpfully and sabotage beliefs, behaviors, thoughts, and habits. It’s why we treat some strangers better than some family members.

What must that other person have learned about themselves, their limitations, the world, what to fear, who not to trust, what they can and can’t count on, and so much more?

Now, think about that person as a newborn baby. A baby who has their whole life ahead of them. A baby who has not yet learned these things.

Think about directly telling that baby the things that person must have learned in order to be that way.

Then, sink into the compassion you feel for that innocent version of that person. That innocent baby is still in there. It’s still inside all of us. But, it can be covered and silenced by decades of unhelpful “lessons” we’ve learned.

Compassion

Compassion is one of the easiest ways to avoid making a judgment about yourself and about another person. 

It’s a quick way to soften the edges and begin to repair a connection, have a more effective conversation, and find common ground.

I hope this exercise gave you one more way to do that.