With an estimated 1 in 5 adults having a diagnosable mental health condition in any given year, chances are you will know someone in your lifetime who is struggling with mental health.
Do you know what to do?
Supporting someone with mental health challenges requires compassion, understanding, and resilience. 
In this fifth installment of our blog series, Foundations of Mental Health: A Beginner’s Guide, Rogers’ Emily Jonesberg, MSW, LCSW, program manager for Community Learning and Engagement and WISE shares strategies to help you be an active participant in a loved one’s treatment and recovery by:
- Showing up in a caring and compassionate way
- Knowing what to say and what not to say
- Staying strong while offering support
Emily, what challenges might someone face while supporting someone with a mental health challenge?
Naturally, we want to be as present as we possibly can, giving love and support because we care so deeply. Oftentimes, it can feel almost physically painful to see our loved one struggling. It’s the perfect situation for someone to start to experience feelings of compassion fatigue or burnout. Feeling overwhelmed is a natural part of the support process, particularly when you pour yourself into someone without perhaps knowing what realistic expectations should be and how to set the appropriate boundaries.
One challenge that someone may experience is feeling an overwhelming amount of heaviness. Sleep, appetites, or engagement with your own support systems could be impacted because you become consumed with trying to help your loved one with a mental health challenge. Be mindful of these behavior changes. If you start to notice them, try to take a step back, reconsider what is within your locus of control within this situation, and realistically focus your energy on that. Try to not put too much energy toward things that ultimately are up to your loved one and you’re not going to be able to change.
Remember that your well-being and self-care are paramount. You are not going to be able to show up for that loved one the way that you want to if you’re not caring for yourself first. Self-care is not selfish, and by engaging in it, you’re going to be a better person for the people that you care so much about.
Emily, what are ways people typically try to support someone who is struggling that may not be the most helpful?
People jump to problem solving and say things like, “Have you tried this?” “This is what’s helped me in the past.” Or sometimes people downplay what a person is feeling by saying something like, “Just don’t worry about it.”
I think oftentimes it’s rooted in this idea of just wanting to be able to help when you see someone in so much pain and wanting to take that pain away. But offering advice like, “Make sure you get your 10,000 steps.” “Meditate.” “Read this book.” “Eat a balanced diet, and naturally, everything’s just going to be better,” isn’t helpful because it’s just not that simple.
When we jump to giving advice, we are missing an opportunity for deeper connection and understanding of what the person is actually going through.
Instead, try the following:
- Listen and support someone with compassion, curiosity, and empathy.
- Set aside your own biases.
- Connect to what resonates with you so that you feel motivated to support the person.
- Validate their feelings.
- Ask questions like, “What would be helpful right now?” or “What worked for you when you felt this way in the past?”
Oftentimes, people have their own wisdom on what may be helpful to do next. They just need someone to help them get there.
As you think about supporting someone who’s struggling with substance use, a common desire, because you care so deeply, is to shield them from any sort of consequences of their negative behavior. Let’s say someone damages relationships or has a negative outcome with their work or in other spaces in their life. It can be very tempting as a loved one to say things like, “I’ll clean it up.” “It’ll pass.” “We’ll forget about it.” Or not even talk about what happened and avoid it. But by getting rid of the natural consequence, that can sometimes further fuel the substance use. Your loved one may need to see the fallout from their behavior in order to motivate themselves into another stage of change. So as tempting as that is, do your best to allow some of those natural consequences to occur for that individual in hopes that it helps motivate them to see how severe the problem may be and seek help.
Emily, how can someone show up in a compassionate way?
We like to use a model called the “Compassionate Action Steps” when we think about how we show up for someone in need. Compassionate action takes practice and often occurs over multiple interactions. If you feel you skipped a step, take time to reconnect with this person to provide the support you missed.
The 6 steps are:
1. Notice – Be present in the moment and able to recognize signs of distress.
The first step is to be mentally and physically present enough to notice that someone is struggling. Admittedly, because we’re human, no one can be fully present all the time. There’s going to be occasions when we have to set some boundaries, or we need to admit that we can’t be that supportive person in a particular moment because we have too many other things going on.
2. Self-check − Be aware of your initial thoughts and feelings.
If we’re able to be present enough to notice someone’s pain and respond to it, the second step is to self-check. As someone is sharing their story, most likely we’re going to have thoughts pop up in our heads. They may be biases. They may be previous experiences that we’ve had that are similar to what we’re hearing. They may be advice or judgments. All those thoughts distract us from being fully present with that individual and can potentially skew how we provide support. This is also a time for you to check in with your own body. Do you feel settled enough to support someone in this moment? Do you need to ground yourself first before proceeding?
3. Seek understanding – Listen with curiosity to comprehend the other’s perspective.
After you’ve completed self-checking, seek to understand. Don’t worry about the finer details that the person is sharing. You really want to focus on the strengths and feelings that are being communicated.
4. Cultivate empathy – Genuine concern based on what you have come to understand.
Next, do your best to connect to the feelings you perceive the person is experiencing so that you’re coming alongside the person in a supportive way. You don’t want to connect so deeply that that you get consumed with those feelings. That can cause you to no longer be mentally present because you’re distracted by thoughts of the last time you may have experienced a similar emotion.
5. Discern best action – Co-plan with the person to figure out what would be helpful to them.
When you move into discerning best action, you’re going to reflect back some of the strengths that you heard in that third step of seeking to understand. Also, ask open-ended questions to help the person plan their next steps. This is when we can pause, check in, and ask if they want advice if they seem stuck. Say something along the lines of you, “I’ve experienced something similar in the past. Would you like me to share how I handled it?” That gives the other person the opportunity to decide if that’s what’s most helpful for them in that moment.
6. Take action – Be aware that intention alone is not compassionate action.
After you’ve asked opening questions and supported this person in deciding what they want to do, the last step is to take action. If you made any commitment in the discern best action step, make sure you follow through, otherwise you risk erasing all the other support you put in place in the previous steps.
Here’s another chance for boundary setting. If they’ve asked for some sort of support and you know you’re not going to be able to provide it for whatever reason, offer alternatives.
Helping others can bring stress to the helper as well. It’s important to allow yourself to complete your own stress cycle, which is the process your body goes through to respond to and recover from stress, so you can tend to your own well-being.
Emily, any suggestions for what a person should say or not say?
Well-meaning words and good intentions can sometimes have unintended consequences, leaving a person feeling hurt and even more alone. Click here for a downloadable PDF of what to say and what not to say to someone who is struggling with their mental health.
Emily, what is compassion resilience and how does that help a person stay strong while supporting others?
We define compassion resilience as the ability to maintain empathy, strength, and hope, despite the challenges that come up every single day that may pull you away from those things. It could be your typical day-to-day tasks that might be feeling a little heavier today, or for the sake of what we’re discussing, it could be caring for someone with a mental health challenge.
Compassion resilience is the ability to remain optimistic in an imperfect world. And our world is always going to be imperfect. The ability to get back to that position of compassion resilience is really helpful and can be quite grounding. This, too, takes practice. Compassion resilience requires us to have realistic expectations for ourselves and others and set boundaries to back up those expectations.
Just because you’re caring for someone else doesn’t mean that you pause in caring for yourself or don’t show up for yourself in the same way that you would for a loved one.
We have a lot more information in our compassion resilience toolkit for parents and caregivers on how to care for yourself while caring for others.
* We created the following guidelines to help foster genuinely supportive and caring conversations. These steps are from the combined works of Monica Worline, Awakening Compassion at Work, 2017, and Beth Lown, The Schwartz Center for Compassionate Healthcare, 2014.)
Next in Foundations of Mental Health: A Beginner’s Guide: Strategies to support your own mental health
