What can you do for someone who’s having a mental breakdown? Recognize the signs. Make them comfortable. Call the HR rep, a family member, or emergency services to come handle the situation. (Extra step if you’re British: Make tea.)
That’s mental health first aid: the equivalent of getting a blanket and summnooning an ambulance for Dad’s slip-and-fall in the driveway. Anything beyond these basic measures, you might think, is for the professionals to worry about.
Actually, there’s a lot more we can do.
Yes, professional help is best left to professionals, but in matters of mental health—with its complex mix of physical, emotional, social, and even spiritual elements—support from family and friends can be crucial. In my own journey through Madland, homegrown second aid was just as important to recovery as anything I got in a medical office.
Three fears may keep us from leaning in to provide second aid. First, fear of the mysterious: Another person’s mental illness seems scary, like a haunted house we’d rather stay out of. Second, fear of contagion: What if the crazy rubs off on you? What if getting involved risks your own mental health? Finally, there’s the fear of saying or doing the wrong thing and making the problem worse.
Rest assured, these fears are unfounded. Mental breakdowns are incredibly common and quite relatable. They definitely aren’t contagious. And even clumsy attempts to help, if sincere, are almost guaranteed to make things better, not worse.
What we need are a few guidelines to steady us. Here are four simple don’ts and do’s for providing second aid to a loved one in mental collapse.
Don’ts
Feeling down, huh? Try getting outside more. Snap out of it! … Fifty years of hearing about “mood disorders” has led many of us to think of mental illnesses as intensified versions of unpleasant emotional states. Because most psychiatric conditions lack biomarkers, lab tests and brain scans will often come up blank. “Nothing’s really wrong,” we think. But mental illness is a real illness, and telling someone with depression to cheer up is no more helpful than telling a person with cancer to look on the bright side. DON’T equate mental illness with low mood.
It’s that job of yours. Take a break. Have you tried mindfulness meditation? …“Stress” has become a standard explanation for mental health complaints. When a clinician doesn’t know what’s wrong, blaming stress—i.e., whatever you are doing to be so uptight—throws responsibility back on you and gets you out of their office. “Trauma” is another handy explanation: Off you go, the therapist will unpack it for you. In most cases, the story is far more complex. DON’T assume stress is the sole cause of their illness.
Everyone’s overmedicated. You sure you need all those drugs? Docs just push pills. …I suppose some doctors overprescribe. Mine mostly wanted to run a bunch of tests, flash the must-be-a-drug-seeker side-eye at my medication questions, and suggest I exercise more. Meds aren’t everything, but they are often necessary. And finding the right regimen can be a long, hard process—one that requires support, not tsk-tsking or second-guessing. DON’T equate medication with weakness or failure.
Let’s do lunch. Talk to me. Feeling better? Hey, you look great! …Yes, empathy is good. No, empathy won’t solve the problem. If a friend has pneumonia, we treat them kindly of course, but we don’t imagine our kindness is a golden ticket back to health. Similarly, while a mentally ill person needs and appreciates emotional support, empathy won’t cure their disease. And our expectation that it will—that’s another burden laid upon a person with too many. DON’T make them perform wellness so you can feel you’re helping.
Do’s
BELIEVE them when they say something’s wrong. Think how you’d react if a friend told you they have cystic fibrosis. You might say, “Wow, that sounds terrible!” Then you’d ask questions: “How are you doing—no, really? What is cystic fibrosis? What type of treatment are you getting?” You can ask the exact same questions of someone who says, “I have generalized anxiety disorder.” Your willingness to talk and listen conveys respect. It’s also a relief to someone whose complaints probably haven’t been taken seriously enough.
SUPPORT their efforts to get medical treatment. The medical system is hard to navigate at the best of times, and a mental collapse is not the best of times. So: Go with them to the doctor. Ask the questions they aren’t strong enough to ask. Help them manage their medication. When I was sick, the biggest mistake my husband made was to discourage me from going to hospital. Totally understandable! Who wants to stick his wife in the loony bin? But I needed to be there, and here’s an inside tip: the intake process is brutal. If he hadn’t sat with me through the seven-hour process from ER to ward, I couldn’t have done it.
SHOW FAITH that their illness is treatable. So they’ve been hospitalized. Game over, right? Wrong. Even when mental illness is “severe” or “treatment resistant,” there are still treatments, and—this is key—you never know which one will finally work. The search is often an exhausting slog; for me it took four months, for others it might take four years or four decades. Staying present (as you’re able) with someone through that slog, expressing your belief in them and their future, is one of the greatest gifts you can give.
JUST BE THERE. Don’t know what to say? Truth is, it doesn’t matter what you say, it matters that you said it. Some of my people gave advice, some sent me funny memes, some simply asked how I was or said, “I love you.” One friend offered to take me on a spa vacation; I didn’t go, but I appreciated the offer. My daughter texted me an animal-face emoji every morning. Matt brought me lots and lots and lots(!) of tea. The specific approach made no difference. What made a difference was: They were there.
For more on second aid and being there, check out this week’s excerpt.
To find this and other books by Jocelyn, visit JocelynRDavis.com.