Thoughts / friends

We get by with a lot of help from our friends

Friendships are not always easy. When we have a friend who is experiencing a mental illness it can be tough going. In reality, it can be bloody hard work.

The reality is though that when we have a mental illness we can get by with a little help from our friends. I know this, because I’ve been really lucky. My friends have been exceptional during my episodes of mental illness. I also know that the research is in – positive social support and friendship has a positive effect on an individual’s recovery and prognosis following a mental illness episode.  

If you’re lucky enough not to have experienced a mental illness of some form, then you probably don’t understand what all the fuss is about. “Why does everyone seem to have mental health problems all of a sudden? Depression? Anxiety? All the things?” You might wonder, as you go about your daily life, eating yoghurts and paying bills, generally living in ignorant bliss. And fair enough.

If you haven’t experienced a mental health condition, it can be difficult to comprehend and why would you want to? Take depression, for example. Depression is like an awful houseguest that you definitely didn’t invite to stay. But, here they are anyway, eating up your energy and making a huge mess. Depression doesn’t care that you have work to do. It doesn’t care that there are dishes in the sink and the bins need to go out. It devours your time and strength and will to continue.

Depression can leave you with crumbs. Crumbs are useless. You can’t do anything good with crumbs except make a delicious picnic for insects. Do ants even need picnics? Depression can feel like your head is full of cotton wool and static electricity. It’s not a good time. Well, it wasn’t fun for me. I guess that’s why it got called it depression and not Happy Party Fun Brain.

The point of this is: how can you help someone you love when they’re experiencing a mental health condition that you pretty much have no idea about?

LEARN ABOUT IT

In general, I find that the more I know about something, the easier it is to comprehend and the less difficult it becomes to deal with. (Unless the thing is climate change. The more I seem to find out about climate change, the more panicked I become.) If we’ve got a loved one with a mental health condition, we can value the friendship by learning more about the illness to understand how it might make them feel and maybe increasing our confidence in providing love and support to them.

PRACTICAL HELP GOES A LONG WAY

People experiencing an episode of mental illness need all the things other people need. Food, water, a billion dollars in unmarked bills – the usual. But it can often be a bit harder for us to gain access to those things at this time, on account of having our brain being hijacked by a piece of meatloaf. Yes, empathy and solidarity are wonderful things, as are flowers and little notes. Sometimes though, a little bit of help with the washing, or the cooking, or tidying away some of the clutter that builds up during a phase of mental illness would be the stuff of splendid dreams.

BE PATIENT

Unfortunately, it’s really, really, really difficult to predict how long it might take for a person’s mental health to show improvements. When I experienced depression and anxiety, not knowing how long it would take to get out of the slump, and perceiving exasperation (whether real or imagined) from my loved ones only heightened the anxiety and pressure. If you can, relax. Remember that no one invites their mental illness in, to fester in their brains, and you can’t send it scurrying back to wherever it usually lives. Please relax. Just being there is good enough. Your friend will no doubt be working harder than you can imagine to stay alive and get through each day, so don’t try and rush them, or question what's going on inside their head. Just look at the outside of their head (where their face might be) and say “You’re strong. I’m here with you through this. You are going to feel better.”

TRY NOT TO SAY DUMB SHIT

Dumb shit would include: “you should eat healthier and exercise more”, “my friend Penelope had depression once and she got better by going to a psychic”, “but you don’t have anything to be sad about” “[Invitation to do something self-destructive and dangerous]”. If your friend is acting in a way you really can't get your head around, the thing to remember is that they are still your friend. So being genuine and caring is your best option here.  

Try not to nag your friend to describe what their mental illness is or convince you that it is a real and serious condition that has very little to do with being sad/nervous/weird. Your friend probably doesn’t have time for this as they are busy being unwell. Treating mental illness like it’s an indulgence or an embarrassment is validating the very real shame that we already feel. Trust me. The world asks us to be ashamed. It asks us to be quiet. What we need from our friends is for them to say “you don’t need to hide this. You don’t need to be ashamed. This is happening, it’s real, and it’s not your fault. Also you want a delicious biscuit that looks like a button? Here you go. Here is a button biscuit. It’s so small, right? And tasty. Wow. Amazing.”

LOOK AFTER YOURSELF

There is really no need to martyr yourself for our emotional health. That’s not how any of this works. Do what you can do. Don’t do more. Don’t make yourself weak to try and make someone else strong. Your wellbeing is important, and I promise you you’ll only exhaust yourself, and end up resenting us if you make it your job to nurse us through the whole ordeal. So don’t. When we have a mental illness we can really struggle to be good or engaged friends at times and you’re allowed to feel frustrated about that. Take time off from it all if and when you need to. You aren’t failing us by looking after yourself. We love you. We might just be a bit weighed down by the univited house guest to express our appreciation right now. Also, don’t take our shit. Unacceptable behaviours don’t get a pass just because I’m unwell. You don’t deserve cruelty or abuse so please tell us if we're out of order; if not immediately then when our episode has passed.

AND … KNOW YOUR OWN LIMITS

I’ve been on the other side of this friendship too and had friends who have been struggling with their mental health. Despite receiving treatment, their reliance on me has at times become emotionally draining and some days it has taken a toll on our friendship. While we may feel an obligation to care and ease the pain for those closest to us, at the end of the day we must understand our limits and look out for ourselves too.

HELP US STICK TO GOOD BEHAVIOURS / A HEALTHY ROUTINE

What were once ‘easy’ or ‘normal’ routines can become really difficult during mental illness. Breakfast needs to be eaten everyday. A walk in the afternoon is a good idea. Green tea can help. Everyone needs water. Taking medicine has to happen as prescribed. Whatever. These things seem simple but are often monumentally hard tasks when a particularly bad spell of depression comes around. When nothing matters, these things happen less.

Gentle reminders are good, or an all-caps text message that says “YO! DID YOU DRINK WATER TODAY? ALSO LOOK AT THIS PICTURE OF A FRENCH BULLDOG DANCING IN A SOMBERO. SO CUTE.” These sorts of gestures go a long way. Gently nudge us into behaving like humans. That way when the fog lifts and we can look around at our lives again, we won’t feel horrified at all the things we let slide. Maybe we'll give you a little kiss on the head, too – for being a pal. Thanks.

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The purpose of friendship

In the previous post, we looked at the joys and benefits of friendships. It can be one of the high points of our existence.

Yet, in reality it can sometimes be routinely disappointing. We might be at dinner at someone’s house. The host has evidently gone to a lot of trouble, with an impressive spread of food and drink. But the conversation might be meandering. Devoid of any real interest. Maybe the discussion flits from an over-long description of the failings of a local restaurant to a strangely heated discussion about crypto currency (again). We might go home, incredibly touched by the intentions and efforts of the host, but we may still wonder what the whole performance was about.

Let’s consider if we didn’t engage in such performances. What might happen if we avoided human contact?

Alone in an unchanging environment, the sensory information available to us, and the ways in which we process it, can change in unpredictable ways. For example, we normally spend most of our time attending to and processing external stimuli from the physical world around us. However, monotonous stimulation from our surroundings may cause us to turn our attention inward, which most of us have much less experience handling all that well.

No, or limited, human contact can lead to a profoundly altered state of consciousness. We may begin to question what’s going on in our surroundings: Is that creaking sound upstairs just your old house pushing back against the wind, or something more sinister? This ambivalence leaves us frozen in place and wallowing in unease—especially if we’re alone. When we’re uncertain, the first thing we usually do is to look to the reactions of others to figure out what is going on. Without others with whom to share information and reactions, ambiguity becomes very hard to resolve. When this happens, our mind can quickly race to the darkest possible conclusions.

Unpleasant things can also happen when small groups of people experience isolation together. Much of what we know about this phenomenon has been gathered from observing the experiences of volunteers at research stations in Antarctica, especially during the “wintering-over” period. Antarctica's extreme temperatures, long periods of darkness, alien landscapes, and severely reduced sensory input create a perfect natural laboratory for studying the effects of isolation and confinement. Volunteers in these studies experience changes in appetite and sleep patterns. Some stop being able to accurately track the passage of time and lose the ability to concentrate. The boredom that results from being around the same people, with limited sources of entertainment, causes a lot of stress—and everyone else’s mannerisms become a grating, annoying, and inescapable source of torment.

What does this say about the way we’re wired? It’s clear that meaningful connection to other people is as essential to our health as the air we breathe. Given that prolonged periods of social isolation can crack even the hardiest of individuals, it’s probably best we continue to engage in our performances with our friends.

It's been proposed that one of the issues with friendship is that these relationships lack a sense of purpose. Our attempts at friendship tend to go adrift, because we collectively resist the task of developing a clear picture of what friendship is really for. The problem is that we are unfairly uncomfortable with the idea of friendship having any declared purpose, because we associate purpose with the least attractive and most cynical motives. Yet purpose doesn’t have to ruin friendship and in fact, the more we define what a friendship might be for, the more we can focus in on what we should be doing with every person in our lives – or indeed the more we can helpfully conclude that we shouldn’t be with them at all.

It's been suggested that there are at least five things we might be trying to do with the people we meet:

  1. Networking. Before you sigh a collective sigh, consider this, we are all pretty small, fragile creatures in a vast world. Our individual capacities are entirely insufficient to realise the demands of our imaginations. So, of course, we need collaborators: accomplices who can align their abilities and energies with ours.
  2. Reassurance. The human condition can be full of terror. At times we can be on the verge of disgrace, danger and disappointment. And yet such are the rules of polite conduct that we are permanently in danger of imagining that we are the only ones to be as crazy as we know we are. We badly need friends because, with the people we know only superficially, there are few confessions of regret, rage and confusion. The reassuring friend gives us access to a very necessary and accurate sense of their own humiliations and follies; an insight with which we can begin to judge ourselves and our sad and compulsive sides more compassionately.
  3. Fun. Despite talk of hedonism and immediate gratification, life gives us constant lessons in the need to be serious. We have to guard our dignity, avoid looking like a fool and pass as a mature adult. The pressure becomes onerous, and in the end even dangerous. That is why we constantly need access to people we can trust enough to be silly with them. They might most of the time be training to be a neurosurgeon or advising middle sized companies about their tax liabilities but when we are together, we can be therapeutically daft. We can put on accents, dance our hearts out or share our weird fantasies. The fun friend solves the problem of shame around important but unprestigious sides of ourselves.
  4. Clarifying our Minds. To a surprising degree, it can be pretty hard to think on our own. The mind is a bit skittish and squeamish. As a result, many issues lie confused within us. We feel angry but are not sure why. Something is wrong with our job but we can’t pin it down. The thinking friend holds us to the task. They ask gentle but probing questions which act as a mirror that assists us with the task of knowing ourselves.
  5. Holding on to the past. A number of friends have little to do with who we are now, but we keep seeing them. Perhaps we knew them from school or university, or we once spent a very significant holiday with them twenty years ago or we became friendly when our children were at kindergarten together. They embody a past version of ourselves from which we’re now distant and yet remain loyal. They help us to understand where we have come from and what once mattered. They may not be totally relevant to whom we are today, but not all of our identity is ever contemporary, as our continued commitment to them attests.

Even Aristotle attempted to figure out the purpose of these social relationships we keep. He postulated that there were three types of friendship:

1. A friendship of utility: Similar to networking, where we derive a relationship based on the benefit we receive from each other. We may share certain interests, hobbies or work.
2. A friendship of pleasure: Normally built between young people and based on our pleasures and passions. We might be seeking something that is pleasant to us presently, and as a result these friendships can be fleeting and easily change.
3. A friendship of goodness: The pinnacle of the friendship chain. When we only wish the best for each other. We love each other for who we are. And I'd agree with Aristotle, that as humans, it may be near impossible for us to maintain a really large number of these friendships. 

If we’re a bit more precise about what we’re trying to do with our social lives, we can bring a greater awareness and understanding to the process of friendship. Bringing more meaning and celebration to the experiences that both enrich our lives and keep us emotionally healthy.

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Sending empathy, love and hope

Feedback from the ground (that’s you guys!) is that, buying a card for someone who is experiencing a mental illness is one thing. That perhaps is the easy bit. But writing and sending a card for someone experiencing a mental illness is a whole other story. This perhaps is the not so easy part.

Totally agree my friends. I still get a bit nervous or worried when someone I really like in my life is unwell. What can I say? Will I say the wrong thing? Will I be unhelpful? All valid points, thank you critical voice in my head. But do you know what’s probably worse? Knowing someone is unwell and not doing anything at all. Just pretending it’s not there and ignoring it all together.

Whilst everyone is unique and ultimately you know your loved one much better than me, here is a list of my general tips to fill in the blank spaces of your cards with compassion, empathy and hope.

  1. Try and use statements that show you recognize that your loved one is unwell. This is called validation. Validating someone’s feelings and their illness rather than shaming, questioning or trying to analyse it can make a difference. Statements such as “That must be very hard for you”, or “You are important to me. You matter to me and so do your feelings”, can be very comforting for the person experiencing a mental illness and has the potential to relieve them from some of the shame they may be experiencing regarding their experience.
  2. Often when people are experiencing a mental illness their brain is being a total bitch. In a nutshell it can really attack the person from the inside, skewing their perception of themselves and the world around them. This is an excellent opportunity to bring them back to reality. Or try anyway. Pay your loved one some compliments. Remind them why you really, really like them. For example, “Please don’t forget that I think you are a kind/ generous/beautiful/insert-nice-adjective-here person to be around.” If you’re loved one is very unwell they might not believe it 100%, but it’s never harmful to hear these things. 
  3. Let your loved one know that you’re not going anywhere. And then don’t go anywhere. Everyone fears abandonment on some level, but often the experience of mental illness can be particularly isolating and lonely. As someone who has had a mental illness, or three, the fear that people are not going to stay around for much longer as a result of being so unwell was a real and significant fear. Who would want to hang around someone who hasn’t been able to wear anything but tracksuits and leave the house in a week? If you can say “I am here for you and I’ll be hanging around too”, this might just bring a massive sense of relief to your loved one.
  4. Ask your loved one what you can do to help. The key word here is ‘ask’. This is important because it shows your loved one that you’re ready to assist them in their way. When they’re ready.
  5. Remind your loved one that what they’re going through is really tough and they are doing an excellent job. Something along the lines of “Be kind and gentle with yourself. You are doing the best you can”, is realistic and factual, but probably the kind of feedback that your loved one is not giving them self right now.
  6. Provide some statements of hope. Unfortunately mental illness often comes with other friends attached. Friends like hopelessness and helplessness. If you can provide some realistic words of encouragement and hope it might slightly lessen the impact these friends are having. Statements like “You can get through this experience. I believe in you”, can let your loved one know that you are hopeful for them, even if they are unable to be right at this minute.
  7. Write about a ridiculously silly and incredibly funny story. Sometimes when people are experiencing psychological pain they need something to laugh about. And just because they have a mental illness does not mean they have lost their sense of humour. When I was in hospital my sister used to send me ridiculous photos, texts, emails and updates about her day. Like how many biscuits she’d eaten. The sheer ridiculous of these frequent daily updates (and the phenomenal number of biscuits she could consume in a work day) eventually bought me to belly laughs.
  8. Tell them you love them. Do this repeatedly. This is probably the simplest, best and most important thing you can do.

These things can all be hard to say – or write – but if you can find something that comes from love, acceptance and empathy I think you’ll be right. Remember, they’re still just that person you really, really like. And if they’re experiencing a mental illness they’d probably really love to hear that from you.

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Chatting and dreamin'

I had the most beautiful conversation today.

It came from the pleasure of lunching with two of my favourite human beings. Whilst this is a reasonably regular occurrence, special shit went down today.

These two friends have been having some difficult times of late. One is experiencing symptoms of a mental illness and undertakes outpatient therapy and has begun taking prescribed psychiatric medication. The other has started seeing a psychologist for support with managing the effects of someone close to her experiencing a mental illness.

Now there’s nothing beautiful about the situations my friends are in. Both of their experiences have been difficult to watch. It’s so incredibly hard to see your loved ones in distress. And unfortunately neither of these situations is uncommon. Nor are these things are easily fixed. It’s a continual adventure of gains and setbacks.

But at lunch today, I took a moment just to observe what was happening. And it was divine.

We were all discussing aspects of our emotional health with vulnerability and honesty and openness. And there didn’t appear to be any shame involved. We didn’t feel the need to lower the volume of our voices, in order to hide our experiences from those around us. We offered each other advice and support with compassion, empathy and love. We felt safe. We discussed our own experiences of therapy and referred to each other’s therapists by first name. We came up with hypothetical conceptualisations and formulations of our own and other people’s behaviour. And my non-mental-health-professional friends used psychological terms fluently, sporadically AND correctly. Terms like “co-rumination” and “validation”. As I mentioned – divine.

There’s so many things that are special about this. Firstly, and most importantly, these two loved ones have acknowledged that they value their mental health and have been brave and courageous in asking for help and professional support. And my hypothesis on this, is that with time, they’ll reap the rewards. Secondly, I didn’t feel one little bit guilty. Guilty about burdening others with my emotional issues. Thirdly, it was so very, very easy to talk about these things. We switched between the achievements of potty training to our mental health to illegal internet browsing at work without any hesitation at all. And I think it was easy because we came from a place of love. We were open and honest and discussing these things in a place of no judgment.

Even though I reasonably regularly have conversations about my mental health with my loved ones, the frequency of these conversations is still rare. I’m so glad I took that moment to observe this experience in all its beauty, because otherwise it might have just passed us by. We’ve probably had other lunches just like this and I've probably had other conversations on par with this, but just not noticed how special it was at all.

So my dream is that all – okay, I’ll go with most – conversations about mental health are like this. Filled with honesty, love and empathy. Devoid of shame, judgment and fear. My dream is that conversations like this don’t just occur between three really close friends. But occur between friends, colleagues, acquaintances even.

Imagine if you could run into a distant relative down the street and when they asked how you were, you could explain that actually you’ve been experiencing some panic attacks and they’ve been quite horrific and you’re really struggling, but you’re seeking some assistance from a professional. And you’re not scared or ashamed to do that. Because the basic human reaction that you’re expecting is compassion and love and support.

Wouldn’t that be divine? I hope it happens in my lifetime. I’m so glad the conversation I had today did.

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