What You Can Ask to Help a Friend Struggling With Mental Illness

I had a conversation with some good friends the other day about how it can be hard to ask people who are struggling how they are doing, more than just a short, “How ya doin? Good,” exchange, at least. Generally, what I have found is many people, perhaps even the majority, wish they could better care for others. But often we are finding ourselves in an awkward middle-ground of wanting to help, but unsure of how to ask for specifics of what we can help with.

• What is Bipolar disorder?

There are a lot of things I am not great at, but expressing myself and how I feel is perhaps a muscle I’ve learned to flex quite well, especially in the last couple of years.

So, in lieu of this and many other conversations I have had, I thought I would throw this out there to help, even if just a little bit. At least when it comes to helping, or even better understanding, friends who struggle with mental illness.

I struggle specifically with bipolar 2, but in my case, it presents itself most often as depression (the down). When things got really bad three years ago, I think it triggered the manic (the up) side of things, but I can see traces of it way back into high school if I look hard enough. People who struggle with bipolar 2 typically do not struggle with pure manic episodes (though really people vary so much on this spectrum), but can get really, really low.

My mania generally looks more like hypomania, which just means when I am up, I don’t have as many manic symptoms of those with full mania, but I have trouble slowing down, even to eat or sleep, and if you know me well enough, you will hear it in how I talk. It’s usually faster, and I tend to make comments I think are funny in my head, but end up being awkward, and usually regrettable. I normally end up cleaning most of my house, moving furniture around, painting walls, perhaps spending too much money on Amazon or at Target. Nothing dangerous, but it can be detrimental when it lingers, due to lack of sleep and the need to just keep going. And even if it feels good getting a lot of things done, I know that usually waiting right around the corner, is a “down.” What goes up, must come down, as they say.

The downs are harder for me. Instead of not being able to stop and sleep, that’s all I can manage to do. Doing simple things like making dinner, picking up kids from bus stops, showering, talking to anyone outside of my house become excruciatingly difficult. I explained it to a friend once that it feels like you are trying to swim against a fast moving current, but with a huge boulder resting on top of you. Every inch costs you dearly. It’s a mental struggle, yes, but it can feel very, very physical.

There have been times where I have been truly astonished people were able to look at me and weren’t immediately trying to provide life support. I know they just see me as I normally am, perhaps with more bags under my eyes than usual. But to me, what I feel  like, is as if I have been in a ring with a prize fighter, who is currently sitting on my chest and just hitting me, blow after blow after blow. And for a while, you struggle. But eventually, you just lie there. You take the hits. You stare straight ahead, bleeding and bruised, and you just take it. And then you marvel when other people don’t see it.

I think that may be one of the harder parts. You go about your day, but you feel like you are in a completely different universe than everyone around you. You put groceries in your cart, hoping what has become reflexive at this point is enough to carry you home, because all you hear is static, all you see is pain and people just walk by unaware. That’s the double-edge of mental illness. Our bodies can feel like they are pulling themselves apart, or perhaps being ripped apart, but sometimes there are no real physical symptoms to treat. You can’t stop the flow of blood that is still, in reality, tucked safely away in your body, even though it feels otherwise. You won’t get panicked bystanders offering to help in any way they can, because to them you are just walking too slowly because you are daydreaming, or stayed out too late, or some other mundane thing.

I think that is part of why it’s so hard to ask for help sometimes. It seems so obvious to us we are past the point of just casually asking for a little help like you would ask for a Band-Aid. To us, we are already coding on the table. Who can ask for help then?

Don’t think of it in terms of them isolating themselves. Isolation is a symptom … something that happens to  us. It’s like … it’s like you’re walking around in a giant, invisible, sound-proof bubble. And as badly as you want to, you can’t engage like you used to, because everything is muffled. It becomes confusing, then crushing, when you see people you normally enjoy being around doing the same things, but now there’s this distance between you. Laughs get farther from the surface. It becomes harder to pay attention. And either consciously or unconsciously, you start pulling away from each other. It’s good to acknowledge it might be happening on your end as well, even if you don’t mean it. We gravitate toward people who maintain a sense of normalcy for us. It’s natural. But it’s kind of like a frog in boiling water situation. It happens slowly, except everyone else gradually crawls out of the pot and you’re left alone wondering what happened and why everything feels like it’s on fire.

So, for those who don’t struggle with mental illness, I won’t say you are blessed because we all have our mountains. But I do hope this helps you understand our side, even if just a little bit. And if you do want to help, a good question to start with is, “Do you mind if I ask you about your depression (or whatever it is they struggle with)?”

If they say no, respect their space, but assure them if they ever do want to talk about it, you are there. And then, if you are able, make it a point to just interact with them regularly, even if it’s just texting every once in a while. Even if you don’t talk about it, it will help.

And if they say yes, ask away. Use the words … depression, suicide, self-harm, therapy, medicine. If they say yes, they are inviting you into their reality. Don’t be shy. It will be a huge weight off of their shoulders to know you can hear those words, say those words and not walk away. You can wince. That’s allowed. Especially if they are someone dear to you. But stay. Listen. Use the words. Don’t expect to fix it with one conversation, or a million for that matter.

Therapy, medicine, healthy routines — those things can start to mend it. But we cannot get there without someone looking us in the eye and telling us it’s real, we aren’t making it up and there is help. Don’t feel like you need to be that help, there is a reason there are a whole lot of trained professionals specifically for mental illness. It’s a beast. But you can be a bridge. And if even that is overwhelming, ask them if you can help them tell a trusted friend, pastor, counselor or their spouse if they haven’t yet, which happens more than you realize.

Look us in the eye. Please. Help us lift our head above the water, if even for a second. Remind us that there is life outside of this silent, awful cage. It might take a while to break out, but we won’t even put up a fight if we forget there is something to fight for.