What does sustainable mental health support from friends look like?
30 July 2020CW: Brief mention of crisis and emergency services
After a challenging situation which left a close friendship changed I started to reassess how I share my experiences of mental health conditions, crises, and day-to-day difficulties with friends.
In the UK, 1.6 million people were referred to talking therapy in 2019, 11.4% more than the previous year. The more educated we become on our wellbeing, the more we look to access support. When we can’t find the professional help we might need, we generally turn to close friends and family for guidance.
"It’s important to remember that our friends aren’t always qualified to take care of our complex difficulties, just like therapists aren’t there to come round for dinner or go for a walk on the beach".
It’s important to understand how we can safely share information with the people around us, and what it means to be considerate and thoughtful when we discuss distress.
It can be helpful to identify and establish boundaries for ourselves and others - what do these look like and how can we communicate them efficiently?
I have learnt to ask whether or not people are okay if I share potentially challenging information with them. It’s less about permission and more about consent - I begin with: “Would you be in a place for me to discuss some difficult feelings I’ve been experiencing? I’m not in crisis or distress, I would just like a space to talk things through".
This is often met with appreciation or confusion - maybe they haven’t been given this option before, or they think it’s a bit unnecessary. In both cases, content warnings and filtering triggering terminology is a way of giving the other person an opportunity to back out guilt-free if they feel like it might be overwhelming. It’s a free and simple way of giving people an easy exit.
But what happens when I am really upset and need an immediate response?
Crisis and emergency are, by nature, chaotic and distressing for everyone involved. For anyone unfamiliar with urgent A&E visits and late night calls to the Mental Health Rapid Response Service, doing it alone can be incredibly isolating. The professional duty is to breach confidentiality if you’re at risk to yourself or other people. Friends are quite often held in a quandary of privacy here - “don’t tell my mum” becomes a sensitive request. Secrecy and disorder are often associated and it becomes very challenging for friends to decide when it’s necessary to reach out to people of influence.
Where does “challenging information” begin and end?
If someone asks me “how are you?”, to what extent can I be honest with them when I am not well that day?
Whilst everyone has bad days, people experiencing complex mental health problems often go through significant daily distress. Their “bad day” might involve harmful behaviour or damaging actions that can be difficult to hear about. Is it okay to share that with your friends?
Friends are perfectly entitled to say no, to establish their boundaries and limits on their care to you to protect their own sense of wellbeing.
It’s very hard to hear that the people around you aren’t in a place to immediately support you. It’s important to accept, but means you can be left in the lurch with overwhelming feelings and situations. When someone asks for help or discloses sensitive information, friends will often respond in spite of their own difficulties, often to their own detriment.
When boundaries are crossed without warning, friends can be left feeling concerned or hurt without being asked permission to carry the weight of other people’s problems. Whose care is prioritised here? These situations can generate a co-dependency, or a need for mutual support. This is common and understandable; the question is how we make this exchange healthy.
What happens when you can’t afford or access therapy and the people around you become your support system? It comes down to a labour that people are trained and paid for - is this a role that friends should fall into?
We find friends through common interests and shared spaces like school, work, and clubs or societies. We find therapists through the NHS or online directories. There is a history of conflating therapists with friends and vice versa and these close and confiding relationships have a lot of similarities. But one is a professional and often involves a business transaction and the other is a natural and organic connection.
It’s important to remember that our friends aren’t always qualified to take care of our complex difficulties, just like therapists aren’t there to come round for dinner or go for a walk on the beach.
How can we create a balanced support system in our friendships and relationships?
It’s a case of honest, transparent, and considered communication. Friendships are designed to support and uplift, a system of mutual benefit and progress that we all look to pursue and maintain. These complex relationships don’t always look like that; they involve negotiation and compromise and sometimes falter or break down.
- See more: Where do people draw the line in supporting others with their mental health?
- See more: I need urgent help, I'm feeling suicidal
- See more: I have experienced or witnessed something traumatic
Ultimately, our friends aren’t our therapists. Whilst we can lean on them for support, advice, and guidance, we shouldn’t rely or depend on them unreservedly. We don’t know what their capacity or capability is at that moment - maybe they need support too.
The answer lies in opening up a dialogue to identify what you and the people around you can handle. Take some time to think about what your own boundaries are - what you are comfortable hearing, if you have an “out of office” time, and whether or not you can cope with a friend in crisis, and let that guide you in conversation with those around you.
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