Today is RU OK Day, a mental health initiative aimed at encouraging people to have difficult conversations about mental health. Many people, however, are totally unprepared when the answer to "are you okay" is "no." Here's a guide to talking to the people in your life who are struggling with mental health, especially for anyone who has never been in that headspace themselves.
Before You Ask
Make sure you're prepared for the possible outcomes this conversation might bring: are you prepared for the answer to be 'no?' Are you okay with discussing potentially distressing topics like suicide?
Make sure you're in the right headspace yourself to deal with an emotional situation, and that you're truly ready to listen. Don't ask just because you want to look like a good person, or even because you feel obliged to on R U OK day.
Also consider the person's relationship to you. If you're not close friends, it may be hard for them to open up to you, and a co-worker might not want to air their mental health problems in their workplace. If you're feeling unsure, try reaching out to someone who's closer to the person and encourage them to start a conversation, or reach out to them but be prepared if they decide they don't want to talk about it with you.
More than 2800 people take their own lives in Australia each year, while as many as 65,000 attempt suicide, and hundreds of thousands more are affected by the ongoing results of these actions. Yet there is little open conversation about suicide, and a lingering stigma makes it hard for those who are struggling to reach out and get help. For the sake of those around you who may be silently suffering, here are five things to know about suicide, and how to help people who struggle with suicidal behaviour.
Starting The Conversation
Make sure you're in a good time and place for a conversation, knowing that it might take a while. There's nothing wrong with starting up a conversation online, and a lot of people even prefer messaging where you can take more time to formulate your words. However depending on the person and their preferences, it may be better to chat over a cup of tea or on the phone.
Be friendly and not too pushy, and if you've noticed specific behaviours that are out of character, mention that in your messages. Often people who are struggling leave hints that they're not okay, and when you're feeling isolated and worthless it can be helpful just to know someone noted your absence. Try something like "you haven't been at class much lately, how are you going?" or "I saw your Facebook post, are you doing okay?"
Don't use wording like "I hope you're okay", as this puts the pressure on them to say yes, and doesn't sound like you're open to listening if they're not actually okay.
If they don't want to talk to you, don't pressure them, just let them know that you're thinking about them and you're always available if they do want to talk. You can also ask them whether there's someone else they would like to talk to, and see if you can help with that.
Let Them Lead The Conversation
If they say no, they're not okay, you need to be ready to listen. Ask open-ended questions but always follow their lead and let them take their time if you need to. "Do you want to talk about it?" is always a good thing to ask if they remain quite closed off, or you're not sure how they feel about the conversation. Again, the answer might be no - take that graciously and remind them that you are available if they do want someone to talk to.
To get them to open up, try questions like "how long have you been feeling this way?" or "have you felt this way before?" If you're talking online or on the phone, you can offer to meet up and talk in person (and share a hug or two), but don't pressure them if they say no.
Know that everyone reacts differently to these conversations, especially when mental health conditions are so varied and are often comorbid in different combinations. Some people might be angry and frustrated with their life circumstances or other people. Some might be self-destructive, guilty and afraid of being a nuisance. Some might be distant, stoic and melancholic.
Don't Try To Fix Their Problems
One of the worst things to do in this situation is to immediately offer a 'solution' to the person. Mental health is a complex thing impacted by a number of factors including neurobiological ones. No matter how much meditation has helped you, it's not going to be a fix-all for someone with depression. Oftentimes people who are looking to reach out to someone aren't looking for answers anyway, they just want someone to understand what they're going through.
Instead of offering your own solutions, ask them if there's anything you can do to help. They might just want someone to listen, they might want someone to chat to about something neutral as a distraction. They could want low-pressure companionship, or a hug, or some help with neglected house chores or cooking dinner. They might indeed want advice, but you should only give it if they ask directly. If they're unsure, then you can gently suggest one of the above (or anything else) as things you would be willing to help them with.
If you do have something genuinely really helpful to offer, say something like "I found this helpful when I was going through a tough time, it might be useful for you too." Just remember not to be pushy if they're not interested.
If it's clear that the person's problems are ongoing or severe, however, do encourage them to seek professional help. You can lead into that point by asking something like "have you ever seen a therapist before?" If they say yes, ask if they have considered going back. If they say no, ask if they would think about starting a mental health plan. If they're open to the idea, see if they need help with the process, and give them information if you can. You can find some information about mental health plans here, but the best thing is to make sure they book in with their GP as soon as possible.
Antidepressants are important, often lifesaving drugs, but there is a cost for their effectiveness. The medications are dispensed with a fact sheet listing a whole host of potential side effects, many of which will probably be experienced at some point.
Don't Make It About Yourself
Don't make this conversation about your own problems, past or present. You can mention them in the way of indicating that the person isn't alone in what they're going through, but don't let it seem like you're using the conversation to talk about your own woes, or even vaguely imply that you've had it worse at some point.
A lot of people who've reached out to me in the past have turned the conversation into a way of talking about their own problems, and I've inadvertently become the support for them instead. I understand it's tempting, when you see someone who is having a similar experience to you, but you also run the risk of belittling their experiences, or putting emotional labour on someone who isn't in a position to carry it.
So try to keep your own stories to a minimum unless they ask directly - you're here to listen, not tell your own stories.
Check In Regularly
Even if you leave the initial conversation having helped your friend onto the right path, your role doesn't end there. Make sure you check in regularly, see if the person is improving or if they need some extra help, and let them know that you're thinking of them. Make an effort to hang out in person, even if you have to go to them most of the time. Physical companionship can be hard to seek out when you're depressed, even though it's incredibly helpful to your mental state. Your friend might also reach out to you if you need to, as by reaching out in the first place you often become a 'safe' person to discuss mental health and difficult times with.
Be ready to make some effort to help your friends out - some of the best emotional support I've gotten over the last few years have been when friends have rallied to help me clean the house when I've been in a particularly deep rut, as well as bringing food and making sure I ate it.
By reading this you've already taken the first step in being a supportive friend to the people you know who are struggling with mental health, and the more you talk to people the easier it will be to have difficult conversations about depression. So if you've noticed someone in your life behaving oddly or putting out warning signs, start a conversation today - you may save a life.