How To Help Someone With Mental Illness

“Depression is a thief, and I will not let it steal my daughter.”

My mother said this to me in her bedroom an October afternoon with a ferocity in her eyes I will never forget. She sat with me on the floor as the thoughts that consumed me gargled, undecipherable, in my mouth as I tried to speak aloud my deep paranoia and fear.

“I’m going to have to leave, mommy, I’m going to have to live in a cave.”

I graduated with a double major in theatre and playwriting. I had taken my first play to Los Angeles and performed it for hundreds of audience members. I moved my life to New York City, I had a survival job, and practiced yoga every day. And yet, there I was, on my mother’s carpet, utterly convinced I was going to be forced to leave my life and stare at the damp walls of a cave for the rest of my life.

Depression is a thief and a nasty bitch, and she stole six months of my young life away from me that year. I became a shell of myself, a concave statue rotting with mold and rust. My bones were showing and my skin a sour color, covered in acne, and my hands and feet an icy cold at all times. I lost my mind, I lost my joy, and life and death seemed no different at all.

And in all that, in all that true and utter suffering, I was still expected to go about my day. Post instagrams, go apple picking, call my grandmother, have sex. I was supposed to be twenty two, in New York City, and bursting with youth. Instead I was sure I was having a spiritual awakening, one that felt like knives in the safest part of me, directionless and without intuition, and the worst of it all - the most heartbreaking of all of it - I could not write.

This, this is what goes on inside the mind of someone who is mentally ill. This is what can’t be explained, no virtual reality to plug into and have you understand, this is who is hiding in the bathroom stall, who is about to break on the subway, who is laying beside you in bed unable to watch your favorite crime show because TV violence feels like they are in the line of fire. This is your coworker, your sibling when they are alone, your favorite pop star, your middle school vice principal. These are your precious ones, your loved ones, the ones you know inside and out and have never doubted. But when mental illness sneaks into their bed and swallows their center, you have no idea how to fill the empty space where their vitality once lived.

This is not laziness. It is not lack of exercise. It is not even horrific sadness. It is the loss of the capacity to function in daily life. It is the unbearable and exhausting act of living.

So what do we do to help someone when their god-given right to exist is ripped away from them? I don’t have a direct answer, but I believe we have to start with the truth. The most important thing we can do when our loved one says they are sick is to believe them. The worst thing you can do to someone who is inside the wreckage of their mental illness is invalidate it as their reality. You would never say to someone who says “I’m bleeding!” and is ~clearly~ profusely bleeding: “But are you sure?”

One of the things that I try to impress upon folks when talking about mental illness is that we have to try and catch it early. It’s like getting a cold: if we don’t take the proper steps to address the early symptoms of a cold, it can turn into a far more dangerous illness like pneumonia or bronchitis. Mental illness has symptoms, too, but they are ones we are uncomfortable naming aloud. That’s often because we don’t have the language to talk about these symptoms if they aren’t dire. We have been told to call 911 if someone is going to die by suicide, but we don’t know how to say “Hey, i’m noticing that it seems hard for you to stay present in our conversations together,” or “I haven’t seen you lately and I’ve really missed spending time with you. I wanted to check in on you to make sure everything’s okay.” We’re scared of assuming that something is “WRONG!” because what if something really is? And if something is wrong, we’ve opened up a discussion often deemed inappropriate or shameful. But when someone sneezes, we say “Bless you! Oh man, are you feeling sick?” This is why we associate mental illness with the worst case scenarios: mental breakdowns, hospitalization, suicide. Yes, those are absolute realities. But it isn’t likely that they happened overnight, just like it isn’t likely that a severe case of bronchitis happened overnight. We don’t talk about the early symptoms because we don’t know how to. We don’t want to shake hands with what feels like a gross imposter in our loved ones brain, but when we shrug it off we are fueling the disease. When we avoid the confrontation, the intervention, the fear of naming the brutal beast, we lose precious time and their healing becomes a lesser option.

If our loved one is in a progressed state of their illness it might be that they cannot see that they are struggling within an altered state. In that case, as hard as it might be, we have to do our best to validate our own intuition when it says something's not right. In my experience, mentally ill people are incredibly good at gaslighting us to believe that they are fine. This is because when people are very ill their conviction is that their state of mind is completely normal, and that everyone else around them is living a lie. It is as if any joy or stability they felt prior to being sick has been eradicated from memory. Often times mental illness demands that we are the only ones who know the “truth,”  and that anyone who argues with us are actually the one living inside a delusion. At this point intrusive thoughts have become the definitive reality.  On the flip side, for people who are ill, there’s shame around admitting we are sick. Because we live in a society that does not show us normalized modalities of healing to treat mental illness, ones that aren’t dramatized by the media or considered “extreme,” people who are beginning to spiral feel that they have to pretend they are okay. The stigma around mental illness, the shame and secrecy, make it so scary to be transparent with our community about what is going on. We can’t say “I’m feeling really low and like something might be wrong,” but it’s perfectly fine to admit we have strep throat, because our loved ones are probably going to be right there saying “Fuck, that sucks, do you need help making a doctor’s appointment?” Just like prioritizing our body health is a human right, getting support and being taken care of when our mental health is suffering is also a right. The latter just hasn’t been normalized. And it is important that we let our community know how much hope there is on the other side of admitting we need help.

People who are ill need tremendous support. They cannot do it on their own. They might be the most capable person you know, but when mental illness rears its head they lose that ability. It is often the most creative, compassionate, strong and mighty people that we lose to diseases like this. This is why my mother calls depression a thief, it steals the vitality of ones we love the most and leaves pain in its place. But there are many ways to help. Here are some tools I have found to support the healing process:

HOW TO HELP:

• If they are in an episode, validate their reality. Do not try and save them, cure them, or bring them to Soul Cycle. Hear them, sit by them, and let them know with your words and behavior that you are not going anywhere. Try and stay calm and present when taking in their admission, even though you might feel panicked in the moment.
• Do not expect them to educate you on their disease or how to help them. They probably can’t even get in the shower, let alone make you a powerpoint on their chemical imbalance. Asking questions like “is there anything I can do for you today that would make your day easier?” and offering low-stakes, relaxing activities to do together are great ways to show your support.
• Remember that mental illness is complex and individual, and your perceptions of how illness manifests might be totally off. This can be frustrating and requires patience. Just like we get to know our loved one in the beginning of our relationship, sometimes we have to get to know their disease, too.
• Help them get professional help. Researching therapists for them is a great idea, and writing a one line summary for each suggestion will make the process simpler and more comforting. If you’re in NYC, MyWellbeing makes this process really easy with our matchmaking system. You can fill out our questionnaire for your loved one, and go over their matches together the next day.
• Sun, sleep, and exercise do help - but only if your person is capable of incorporating these things into their routine. These are only supplements to professional help, but they are basic human needs that help stabilize the brain and body. Eating well, mindfulness practices, and therapy animals are also a good idea, but remember: green juice does not cure clinical depression and it never fucking will.
• Tell other people in their life, who you trust and feel your person is safe around, the truth about what is going on. It takes a village. Your person might become reactive and push you away, but in my opinion it is better to have them hate you and get better than love you and get sicker.
• If we know our loved one has a history of mental illness, but is currently stable, we can ask them how we can help if symptoms start to flare up again. It is important to note that mental illness needs daily maintenance, just like diabetes does. Being present in their maintenance routines, like knowing what day of the week therapy is scheduled for or going to a meditation practice together can be great ways to normalize their illness inside your relationship. That way, if they are triggered, it will be easier to offer help because those tools have been integrated into your relationship. For my neuro-atypical cuties reading this article and are in a stable place: in my opinion it is our responsibility to let our people know the ways they can help us if symptoms arise. Just like someone with severe allergies wears a medical bracelet and teaches those close to them how to use an EpiPen, we can offer our tools too. I recently entered into a new romantic relationship and gave my partner three coping mechanisms they can suggest to me if I am triggered.
• If your loved one is having suicidal ideations and has a plan to die by suicide, this is when professional intervention may be vital. Some options before calling the police are: have them reach out to a lifeline like the National Suicide Prevention Hotline and The Trevor Project lifeline and/or encourage them to check into a mental health facility (offer to help find one nearby, drive them, call, etc). If they refuse these options then, in my opinion, calling the police is the best plan for their safety.
• Remember that you must take care of yourself before taking care of anyone else. We have to honor our boundaries and our needs or we will not be able to be present in helping our loved ones. I want to validate how scary and uncomfortable this process can be, it is no easy feat to stand by and watch someone you love suffer.  But it is not your responsibility to save anyone or rescue them, you can only offer your support and love.

When I was at my worst, my mom called every hour on the hour. She listened to my intrusive thoughts but also reminded me it was okay to tell them “not right now.” She helped me find the right doctors, the right medication, and never made me feel ashamed or burdensome for my illness. My friends showed up with cupcakes, slept over, and promised me they didn’t care that I wasn’t the “normal” Haley - they were just happy to be with me. I feared the cave, was in the cave, but my people pulled me out. I am so grateful for all the help I have gotten and recognize my immense privilege in receiving that care. I am dedicated to educating folks on mental illness and aim to create language and tools in helping people recognize and treat their symptoms as early as the first couple sneezes. The path to universal care mandates the integration of these conversations into our every day lives, this is the only way we can normalize mental illness.

For those of you who are reading this in hopes of helping your loved ones, thank you. We need you. There is no perfect way to help, but showing up anyway saves peoples lives. It saved mine.