How to Support Your Loved One Through a Mental Health Crisis

I’ve been blown away by all the positive responses I’ve received for the blog post I published about my depression. I haven’t been able to respond to all the messages and comments scattered around, but thank you so much to everyone who read it, shared it, and took the time to tell me how much they care about me. Knowing that someone you love is struggling is extremely hard, and sometimes you might think that the little gestures you make don’t make a difference, but they do. They really do.

In my Facebook post linking to the blog entry, I mentioned how I’ve never called a suicide hotline. Of course I was speaking only of my own experiences, not anyone else’s, so I want to emphasize, again, that it IS important to publicize information for hotlines and organizations when high-profile people die by suicide, because there are many people who have been saved by them. My point wasn’t that these resources are useless — rather that they aren’t one-fits-all solutions and they aren’t effective at all if they’re not supported by action. You can’t constantly write things full of triggers, victim blaming, and ignorance and then wait until someone dies to put a phone number on your page, thinking that will absolve you of all responsibility because “well, I gave them the information, so if they don’t get help, that’s on them.” This is why the media often have strict guidelines for covering suicides, especially in the social media era. But that doesn’t stop ignorant laypeople from vomiting their ill-advised, unwanted opinions into the void. “Coward.” “Selfish.” “Burning in hell.”

Many people have anxiety about talking to anyone on the phone, especially a stranger. For them calling a suicide hotline would likely make their symptoms worse, not better. Other people, once they’ve called, have been patched through to counselors who are poorly trained, hostile, or incompetent. Some people have had the cops called on them, and if not, just the threat of police involvement is traumatic enough, because up to 50 percent of people murdered by police are mentally ill or otherwise disabled.

It’s not the existence of these organizations that is problematic; it’s the people who often operate or support them. Understand and respect that for many people a suicide hotline is not a viable option, or if it is, that calling one probably won’t do much more than minimize the immediate danger, not the long-term symptoms.

So in those cases, what can you do?

  1. Check in. Haven’t heard from your depressed friend in a long time? Send them a quick text to let them know you’re thinking about them. Sometimes the world is too overwhelming and we have to withdraw; that doesn’t necessarily mean you did anything wrong. Something as simple as a, “Just wanted to say hi! Hope you’re doing OK” or a funny cat GIF can tell your friend that they’re important to you and make them more receptive to reaching out once they feel up to it.
  2. Know that flakiness =/= disinterest. I dread leaving my apartment about 99 percent of the time. It might be for something I really want to do or to hang with someone I really like, but sometimes I’m low on energy and social events make me anxious, irritated, or sad. And my mood can change on a dime, too, which means sometimes I’ll express interest in going somewhere and then not show up or cancel at the last minute. Sometimes depression and stress causes physical pain — headaches, nausea, etc. — that can also be a factor. So if your friend says they’re sick, or they show up but seem distant or leave early, try to keep an open mind, and please don’t stop inviting them. Leave the door open for them to interact when and how they’re ready.
  3. Offer to help them in material ways. When my depression is bad, my hygiene suffers. My laundry and dirty dishes will pile up, I’ll lose my appetite, and I’ll skip showers some days. If you’re a roommate or romantic partner, take some time to make your loved one a snack or encourage them to take a shower (without suggesting their funk is singeing your eyebrows off). Showers always make me feel better! I just don’t like getting out of bed sometimes. And I love food, but cooking is a chore. If you make a mean lasagna you know your friend likes, offer to bring them some. The food + the company might help more than you think.
  4.  Watch your language. About 20 percent of adults in the U.S. currently have a chronic mental illness. That means you likely encounter people everyday that are depressed, anxious, bipolar, schizophrenic, autistic (autism spectrum disorders are not mental illnesses, but they are commonly put in the same category), or have a personality disorder. Many of us hide our conditions because of stigma, so ask yourself: Are you contributing to it? Do you call yourself “OCD” because you like to keep your house neat? Do you use slurs like r*tarded or insane to talk about things or people you don’t like? Do you go on rants about how mental illnesses are a conspiracy by Big Pharma and all we need to do is drink more water and think positively? Do you think any and every affliction can be cured by just “praying about it”?
    We notice these things, and we make note of who is “safe” and who isn’t. Assume there is always a mentally ill person present, because there likely is. And if not, you’re probably insulting someone’s friend, brother, sister, etc. Plus it’s just dickish, ya’ll.
  5. Guilt doesn’t work. And it’ll make us want to punch you. I suppose if you need to literally talk someone down from a ledge, guilt is a reasonable emotion to exploit, but that is not something I would suggest doing in any other circumstance. It just makes us feel shitty, because we already know how our deaths would affect people and yet we still want to die anyway. Guilt doesn’t make those feelings go away; it just keeps us alive for the moment, maybe. But it also fosters resentment and marks you as someone who is “unsafe,” which is why I say it should be a last-ditch resort. Instead, if someone admits to you that they’re in a bad spot or actively suicidal, ask them questions and keep them talking. Don’t judge, don’t offer advice — just listen. It may be trite but it’s totally fine to offer “I’m sorry” in response; we understand the sentiment. Ask them if there’s anything you can do to help or distract them, then follow through. Tell corny jokes, whatever. Give them a hug if you know they appreciate them.
  6. Give them space to rant. I complain a lot, and I’m a cynical bastard. These are facts. Part of it is just my stellar personality, but many times I complain about trivial shit because there’s something much deeper worrying me that I can’t express. Society makes plenty of space for us to talk about how crummy the weather is or how we hate our jobs or how the rent is TOO DAMN HIGH — not so much when it comes to talking about fighting the urge to hurt yourself, go on a bender, or make reckless decisions with your money because of mood swings. Listening to someone complain about trivial nonsense can be frustrating, but things aren’t always how they appear. Complaining can be a small but necessary outlet for much darker feelings. Same goes for macabre humor. It may be disturbing to hear someone joke about death or dying, but believe it or not, sometimes that keeps us from actually harming ourselves. If you’re not sure about intent, ask. If you’re not close enough to the person to expect that level of honesty, however, it’s better to just keep your distance if they’re making you uncomfortable. Just because someone you vaguely know may be mentally ill does not give them the right to traumatize you in response.
  7. Do NOT call the police. The expression of suicidal ideation or intent alone is not enough to warrant involving the authorities. There should be an immediate danger to the individual or someone else before involuntary hospitalization or police restraint is considered. It’s important to realize that a mentally ill person, regardless of the level of threat they realistically pose, will put authorities on high alert and there’s a high chance the person will be injured or killed, especially if they are Black, Native, and/or Latino.
    Caveat: If someone in a mental health crisis is putting you or someone else in danger, you are under no obligation to prioritize their safety. But absent an immediate danger to others, such as possession of a weapon or threat/execution of physical assault, it might be more helpful to try to reason with the person yourself or call a therapist, social worker, or other mental health advocate for advice or assistance. If the person does have a weapon, do NOT attempt to fight or wrestle it away. You are not acceptable collateral damage. Get to a safe space and call 911.
  8. It’s not about you. No offense, but it’s not. A big reason why guilt doesn’t work? Because it centers the feelings of other people over the person who’s actually hurting. Saying, “If you died, I’d be devastated” seems innocuous enough, but when you say that to someone in a mental health crisis, what they hear is, “My comfort is more important than anything you’re feeling right now.” It’s dismissive. If all you can offer a suicidal person is platitudes without any concrete support backing it up, it’s not only ineffective, it can be downright dangerous. The goal should never be to convince a mentally ill person to live for someone else. We do not “owe” the world our brilliance; it is not a “tragedy” if our disease or deaths mean we can’t make other people happy anymore. The priority should be to make us healthy and happy for our own sakes, and I’m sure that’s what allies and loved ones want, but that meaning is lost when you start a conversation with how a death would affect you.

And sadly, the harsh reality is sometimes you can do everything right and it’s not enough. But that’s true of life in general. Compassion and mindfulness go a long way, and they’re things you can practice 24/7, 365 — not just after it’s already too late.

Obligatory Resources for More Information

National Suicide Prevention Lifeline offers both phone and online chat options for accessing help 24/7, 365 days a year. 1-800-273-8255.

Crisis Text Line provides text message-based support. You can get in contact with a counselor by texting “HOME” to 741741 anywhere in the U.S. and get support for any kind of crisis, not just those involving suicide. Available 24/7. If your phone carrier does not recognize shortcodes, you can also access the text line through Facebook by sending a message.

American Foundation for Suicide Prevention provides support and educational resources and advocates for public policy and research initiatives that help mentally ill or otherwise at-risk individuals get the treatment they need.

NoStigmas is an organization dedicated to providing community, support, and action steps to mentally ill people.


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