The collage above is something I meticulously pieced together at a time when I was struggling with conflicts at work. It is a composite of many family members and friends; a visual reminder that I was part of a larger community that could offer me support through dark and difficult times. I kept it in a folder at work and took it out often when I was feeling particularly stressed, to remind myself that I was not completely alone. The collage was one of many coping mechanisms I used during that time, to keep myself going when the way ahead sometimes seemed hopeless. The conflicts I was experiencing at work exacerbated my chronic depression and anxiety, resulting in a spiral of darkness that was sometimes difficult to explain to the people around me. Not everyone is well versed in what it means to have a mental health condition, and something so personal isn't a topic that can or should be shared with everyone. I found that it was most helpful to speak with a few close friends and explain not only my external situation at work, but my internal experience of what was happening, and the behaviors they might see from me while I was struggling. With a few people I went into more detail about what depression and anxiety are, and how chronic depression and anxiety are different from brief situationally based experiences of sadness or fear. Sometimes it was like trying to explain how to hear the color blue; some people had a hard time understanding something that was so different from their own experiences. Others understood immediately, and shared their own stories about struggles with mental health issues.
If you have a friend or loved one who you think might be experiencing mental health concerns, ask them how they're doing. Then really listen to what they have to say. They may initially minimize their situation so that they don't appear needy or "weak". They may worry that acknowledging there is even an issue at all makes them appear incompetent or incapable, particularly if they are people you know at work. Find a place where you can talk to them privately, or take them out to lunch, away from prying eyes in the workplace. Reassure them that you don't think any less of them because they are struggling, and offer your support. I find it's best to be specific when offering support, and to ask what would be the most helpful for that person. Some people may find it comforting to have periodic lunch dates set up, so that they know they have times set aside when they can speak openly to someone about how they feel. Ask if they have anyone they are seeing professionally to assist them with maintaining good mental health, like a therapist or psychiatrist. You might be surprised to know how many people around you are quietly making use of those services without anyone knowing about it. In my own situation, I found it helpful to meet with friends regularly outside of work to vent. I also asked some friends to make a small gesture of acknowledgement when they walked by my cube- a friendly word, a smile, a touch; so that I knew they "saw me" and that my pain was not completely invisible to everyone. Some people may appreciate small gestures like the handful of Dove chocolates I found on my desk one day with a thoughtful card; others may prefer verbal acknowledgements or praise about something they are doing well, or something you appreciate about them. Everyone is an individual; ask what works best for them.
Relationships are living things. They grow and change; they need to be fed. I found it both very humbling and very freeing to share my experiences with a few close friends; it changed the relationship I had with the majority of them for the better. They knew more of who I was, and I felt more free to be myself, and not just pretend that everything in my life was fine. They also felt more free to share similar experiences with me; leaving both of us feeling more understood and more whole. There may be some people in your loved one's life who don't fully understand what your loved one is trying to share with them, or who may be uncomfortable with the idea of mental health concerns. I generally start with a small amount of information and see what kind of reaction I get. If the person knows nothing about mental health concerns, I may offer them some resources to read that explains the specific mental health concern I am speaking to them about. If they are not receptive to learning more for whatever reason, I simply seek out someone else. Not everyone is able or willing to be supportive, and it helps to find that out at the beginning instead of "looking for water in the desert" and continuously being disappointed. Reassure your friend or loved one when this happens; a lack of support is seldom about the person asking for support, and more likely to be about the issues of the person being asked. Remind them that you support and care for them; perhaps problem solve other alternative sources of support or stress relief that they could make use of. Our workplace has a massage therapist who comes once a week, for example. Wellness resources such as this can be helpful, along with other personal services like pedicures, or manicures. Find out what activities your friend or loved one finds interesting or relaxing, whether it be a hobby or a visit to the spa, and encourage them to engage in some of these activities regularly. Offer to go with them and share the experience with them.
My biggest concern when sharing my mental health concerns was that I would be seen as fundamentally different from my friends and loved ones; somehow broken and imperfect. That my mental health status would separate me from their affection and respect. One of the most important things you can do for any friend or loved with a mental health concern is to let them know that you love them the way they are, and don't consider them damaged goods. Let them know the qualities you appreciate about them and the gifts they bring to your life. No one wants to think that they are a burden in their relationships, or that they have nothing to offer in their interactions with friends and loved ones. It is sometimes hard for people in the midst of emotional turmoil to see and acknowledge the strengths they bring to the table in their interpersonal relationships. Tell them. Give them specific examples of times when they have been helpful, supportive, or kind. Remind them of their many talents, and how they have shared them with you and other people.
There may be times when someone you love needs more than you can give them, particularly if they are in a severe crisis. If your friend or loved one indicates that they are thinking of hurting themselves or anyone else, seek help for them. Help them call Employee Assistance, a crisis line, or their therapist. Bring them to a crisis counseling appointment or their local emergency room to be assessed if necessary. You may have to involve other support people in their lives, such as their employer, their spouse, or other relatives and friends who are aware of their mental health status. Always take your friend seriously if they tell you they are considering self harm, and seek assistance.
Look again at the collage at the top of this page. There are many people pictured there; some relatives, some friends, some coworkers. There were so many pictures to choose from initially that I ran out of room. It was a good visual reminder to me that I did have people in my life who loved me, even when I felt isolated and alone. It is easy to get fixated on how dark the world seems and how difficult the experience of mental illness is; it is easy to forget the many people who impact our lives. We may not see them every day, and we may share different pieces of our lives with them. But seen as a whole, the image is powerful. It is the combined strength of an entire community of people. Ask your friend or loved one about the people in their community of strength. Have them list these people on a piece of paper, or make a collage. Perhaps carry a picture or two with them at difficult times. Remind them that you are one of the people in their community, and that you love them. Because that's really what it comes down to. Being a part of a community, being accepted, being loved. Knowing that with all of your challenges there are people who still see you as YOURSELF and not just a label saying " a little bit nuts" or "kind of scary due to mental health issues". Knowing you have a place in the world, and in their hearts. Speak the words out loud and tell them.