What do you do when you know that your friend is sick? You know that they have had surgery? They have been to the doctor, and have just found out that they have a life-altering illness that will require years of treatment—how do you react? My guess is you would give them a call? Send flowers? Get together and sign a card? Offer to bring over a bottle of wine or a meal? Depending on the illness, we may call a week or two after to see how they are, or just assume our job is done and move on.
This is what we do in our culture. There is a whole section of cards devoted to getting well. We understand the way that illness impacts our bodies. Our bodies are infected, we get treatment, and hopefully the outcome is that we become well.
But what happens when we are diagnosed with Borderline Personality Disorder, Postpartum Depression, Anorexia? What happens if we come to the realization that our dependency on alcohol and drugs has become too much and we need to get help? Do we send those people a card? Do we congratulate them in a phone call and ask them how their thoughts are? And what kind of voices are they hearing? Do they need some help keeping safe? I don't think people do that. I would like to hold onto some faith in humanity that there are SOME people that would, but by and large this is not a thing that happens. It is not a thing we talk about. We whisper about it, we call around to find out what is happening—and then most people find it easier to just step back.
Having a friend or family member go through this type of diagnosis comes with an equally confusing and terrifying burden of emotions. I have worked with so many individuals that have had to go through the gamut of different experiences with friends because of their mental illness or addiction. The purpose of this blog post is to try to bring some attention to the fact that we as a society need to open our minds to the harsh reality that a lot of your friends and family members are likely struggling in complete silence. We need to try and erase the stigma and get people talking.
How do you help a friend with something that is harder to understand? Potentially harder to fix? The nature of mental illness itself makes it such that the individual struggling may not even want the help; may be angry, in denial, isolated. How hard is it to support the person in that case? The first thing to consider, really, is where your friend is at. Look at this chart below. You can see here that there are several other steps before the "action" stage. Individuals are generally not interested in talking about their experience until the "contemplation" or "preparation" stages.
Let me let you in on a bit of a secret: IN ANY OF THESE STAGES, the one thing that people need the most is quite simple. They just need you to be there. All you need to do is stand by, show up, and let them know how you feel. You do not need to fix them, you do not need to call them everyday, you do not need to understand what they are going through. Now, anyone who has tried to do this for someone who is struggling will say—this is not that easy. I know that it is not easy. It is not easy to hear or support your friend through any type of illness, whether it be watching them go through chemotherapy or watching them slowly isolate from their peers and begin to decline mentally. What I am trying to do is open the lines of communication to make it a bit easier to talk about.
A lot of people are afraid to make things worse. "I don't want to make them mad," or, "it is not my business." I also hear things like, "I tried and I don't know what else to do, I thought they would be better by now." Mental illness can be a lifelong battle for some people. It has its ups and its downs, and this can be taxing on a friendship. It can be hard to know what to expect and it can be emotionally difficult to watch someone you love hurting. What I am trying to ask of you is to be patient with those who are struggling and please don't be afraid to reach out.
Part of blogging, I suppose, means letting you into a piece of my life—a piece of not only my insight as a therapist, but also my personal experience. I have been blessed to have a wonderful group of friends all my life. I have truly tested the limits of both my family and my friends throughout my life and my struggles. I have a difficult time opening up, and throughout my illness I was the type to just go with the flow and always brush my illness aside and became a master of excuses. I was lucky enough to have some people in my life who truly did what I mentioned above. They showed up and were there. My best friend is my husband. I have known him since I was 16 years old and we have been through hell and back together—both of us. He is not a man of many words and definitely does not understand what it is like to be depressed or anxious, not to mention struggling with Anorexia. But one thing for certain is he was there. There were times in my own recovery that I was angry that he didn't do more than "just be there"—that he didn't push me to get help and just let me get sick—but I realize now that that was the best thing he could have done for me at the time.
I recently went through some of my very old writing and found a letter that one of my best friends wrote me. I vividly remember receiving this letter one day and being so sad, so angry that she had written such a long and detailed letter explaining how my illness impacted her and our friendship. Who was she to say that this was impacting her?! I was the one struggling. Looking back and reading this letter honestly made me so thankful for the friendship that I have with this person. She was and is truly someone who saw me through some really terrible times, and although we were not very good at confronting the demon in the room at the time, she always managed to let me know how she felt through an email or a letter. In this letter I had recently relapsed and she was pleading with me to see how much this illness had taken from me.
This is just a small excerpt from that letter:
"It is really difficult for me to watch you continue to make decisions that are harming you physically, psychologically and spiritually. It kills me to see you cause physical damage to your body – to your heart, your bones, your hair, your hormones, potentially to your ability to have children. It also hurts to see you emotionally harm yourself – to struggle with anxiety, depression, the ability to have healthy relationships with other people. Over the past few years, you’ve lost your entire life. You’ve lost the ability to do almost everything: to hang out with friends and family, to walk your dog, to make new friends, to go out in the world and communicate with others, to have a romantic or physical connection with a guy, to do any sort of physical activity, to be independent, to be carefree, to be happy. And over the past few years, I’ve lost my best friend. I’ve lost the person I cared about and trusted more than anyone in the world. I’ve lost a person to do things with, to talk to about personal stuff, to have fun with, to laugh with, to be open with, to dance with, to rollerblade with, to gossip with, to hang out socially with, to have dinner with, to share a drink with, to stay out late with, just to name a few things that we used to do on a regular basis. And I feel really selfish saying these things, because I know that you’ve struggled with far more difficult things than I have, but this is something I’ve really been struggling with lately. I try so hard to not let it affect me, but sometimes I am way too consumed with it."
The email went on so eloquently talking about how proud she was, and how she just wants me to be well. I hold this close to my heart now and am thankful that I had a friend that was brave enough to tell me straight.
What I am asking you to do is consider saying what you are afraid to say. Reach out when you are not sure if you are doing the right thing. If you are not comfortable taking that step, then find a professional to help you through. Mental illness is incredibly isolating and, as we know, can be fatal. I can say with great confidence that a simple hello text, a card saying that you are thinking of them, or a phone call asking what you can do can go a lot further then you think.