There is so much stigma and misinformation around mental ill health, it can be difficult to know what to say or do when someone you know is struggling. Of course, the best thing you can do is make yourself available to listen and be supportive, but it can be easy to stumble into saying something that's well-intentioned but actually quite unhelpful. If you're at a loss for words or worried about putting your foot in it, help is at hand. We asked RSCPP therapists to help us put together a guide to what NOT to say and why.
This is unhelpful as it does not really acknowledge how the person is feeling and may prevent them from talking about their concerns. They might withdraw further, thinking their needs are not important.
This insinuates that they shouldn't seek help and whatever mental health/emotional difficulties they are experiencing will resolve themselves without any professional intervention. This is often wrong and unhelpful. When someone is going through a mental health crisis, it is best to seek help before the problems escalate to a point where their day to day functioning is impaired and they have a complete breakdown. Mental health problems should be viewed in the same light as physical health problems.
Comments like 'don't mention this to anyone else in case it opens up a can of worms' can add to the shame and isolation that person may be experiencing and may put them off seeking help where appropriate.
The assumption that seeing a mental health professional equates to being mentally ill is one of the reasons why a lot of people shy away from seeking professional help when they need it the most. The stigma attached to mental illness is very damaging and is the underlying reason why a lot of people suffer in silence without seeking essential help. Seeing a psychotherapist or a mental health professional should never be viewed as a weakness; in actual fact, it is a strength because it signifies that you take your health seriously.
Of course things could be worse. But how does that help how this person is feeling right now? Think about how you would feel hearing something before you say it.
Such messages - often followed by 'There are lots of people in this world far worse off than you, and they carry on', or 'We all feel down sometimes, but we carry on!' - are usually well-meaning, but they are patronising and dismissive of genuine suffering. When someone is inwardly struggling, and very likely feel isolated and unsupported already, these kinds of messages will only worsen their present state of being - when actually they need to feel acknowledged and cared about, and that their struggle is validated.
This can create fear about seeking medical help and, if they do and are offered any forms of medication, this may create acute anxiety.
People with eating disorders may commonly hear things like: 'you are being selfish; there are people in third world countries who don't have a choice about whether to eat or not.' People with anorexia usually feel every conceivable horrible emotion about themselves and yet can't find another way to cope with life. They don't choose not to eat, it's an illness that tells them having control over food is the way to cope and, if they don't follow the illness's rules, they are failures, which leads to a viscous circle of self loathing.
I think one of the worst things to say is anything that begins with 'You just have to...' For someone with mental health problems, 'just...' could seem insurmountable. It's also a very patronising message and blames the person for their problems.
It may be that night time is actually when this person feels worse, and the idea that a good night's sleep is all that is needed trivialises their feelings.
Although you maybe trying to normalise their feelings and help them feel less alone, this can sometimes make someone feel more alone, as their unique experience is not being heard or understood.
Maybe you feel like you know how to resolve someone else's difficulties, even when you aren't too sure how to handle your own. To offer advice might feel like what is required, helpful and supportive of you. However, you are not the person who is struggling and what might be right for you, may be far from right for someone else.
Depression carries what is known in the field as a cognitive bias. This means that people who are depressed have a strong and uncontrollable tendency towards negative thinking. This also applies to memory in that they struggle to remember specific events from the past, especially if they were of positive or happy times. Depressed people also tend to think negatively about themselves, which affects their sense of self worth, and also have a tendency towards rumination and focusing on discrepant thinking (i.e. on the gap between how things are and how they 'should' be.) This cognitive bias is a symptom and also a maintaining factor of depression. Telling a depressed person to 'look on the bright side' only makes them feel even more inadequate and hopeless as they simply cannot do that because of the depression.
Some people may actually be suffering from feelings removed from reality, and telling them it's in their imagination will be both frightening and confusing.
You might try to reassure an insecure friend who thinks they're unattractive by telling them you think they look great, and that 'beauty is only skin deep'. Whilst these platitudes are delivered with the best of intentions, at best they don't even register with the person because they don't ‘fit' with the way they see themselves, but at worst they're passively critical, telling the person that they're wrong to think the way that they do. For someone who's already experiencing pain, this can easily fuel the distress further and can even cause them to doubt the validity of their own experiences.
You may be trying to give them strength or recognition but this can make people feel worse.
For more information and advice from our therapists, check out 'How to help someone you think may need therapy'.