There is a stereotype that’s often attached to mental illness: Those struggling are seen as dangerous, unpredictable, incompetent, and at fault for a disorder they have no control over. That’s why it was shocking when on June 5th, Kate Spade was found dead from a confirmed suicide in her Park Avenue home. Then, three days later, reports broke that Anthony Bourdain had taken his own life. From the outside looking in, neither Spade, a legendary fashion designer and style icon, nor Bourdain, a celebrated chef, author, television host, and noted #MeToo ally, looked “the part.” They were both powerful, wealthy, successful, and beloved, with millions of adoring fans — fans who had no idea they were suffering.
But the truth is, mental illness does not discriminate. One in five adults in the United States has a mental health condition, and according to a report from the Centers for Disease Control and Prevention, the nation’s suicide rate is on the rise. From 1999 to 2016, the number of Americans who died by suicide increased by 28 percent.
In the wake of Spade and Bourdain’s tragic deaths, countless people have taken to social media to share empathetic messages of love and support for anyone struggling with depression or suicidal thoughts, which is a hopeful reminder of how far the conversation around mental illness has come in the States.
But if a friend has confided in you about their own severe depression or suicidal thoughts, it can be hard to know how to help. That is why HelloGiggles asked experts to share tips for navigating this difficult subject. While there is no one right answer when it comes to mental health, these small things can make a big difference in the lives of your loved ones.
1Don’t wait for your loved one to come to you with their problems.
When it comes to depression and suicide, there is no time to waste. If you are worried about a friend, speak up. Broaching a conversation about mental health with a loved one can only help — if you know the right things to say.
“Depression can affect a person’s ability to act on their own to get help,” explained Dr. Carol Olson, chair of the department of psychiatry at Maricopa Integrated Health System and a professor at the University of Arizona College of Medicine in Phoenix. “Often, the suffering person needs others to assist them to get treatment. One can begin by saying, ‘I notice you just don’t seem to be yourself lately, and I’m worried about you.'”
If you’re worried about crossing a line, don’t be. According to activist and TEDx speaker Ron Blake,”It is better to say something than nothing to a friend who is in need. And that something can be as simple as, ‘I don’t know what to say but I want you to know I am here for you.’ That is incredibly powerful to someone who is in need of help.”
The most common advice from mental health professionals when confronting a friend or loved one who is struggling with depression or suicidal thoughts is to listen to what they have to say, without assumptions and without judgement.
“When a friend confides in you that they are struggling mentally or contemplating suicide, the first and best thing you can do is to remain calm and let them keep talking,” said Dr. Sal Raichbach of the Ambrosia Treatment Center. “For someone who is struggling with these issues, admitting it to another person is very difficult. The fact that they confided in you means that they trust you. It’s important to let them know that you are there to support them and are always available to talk. Your reassurance will provide them with a much-needed sense of relief and hopefully bring them back to a safer place.”
3Ask them questions and spend time with them.
There is no one right thing to say when a friend is depressed or feeling suicidal, but being there — asking questions, making time, showing up, and being physically present — can make all the difference.
“If a friend tells you they are depressed, you should ask them more about it. How bad is it? Are they still functioning — going to school or work, taking care of themselves adequately?” said Dr. Victor Schwartz, JED Foundation chief medical officer and clinical associate professor of psychiatry at NYU. “Spend some time with them talking, going for a walk, or having something to eat with them.”
You can also help your friend take care of themselves by bringing them food that’s easy to heat and eat, driving them to work, school, or doctor’s appointments, or sleeping over if they need company. Offer these things, and then ask if there’s anything else your friend needs that you can provide.
Dr. Urszula Klich, a clinical psychologist and the president of Southeast Biofeedback and Clinical Neuroscience Association, notes that brushing off a friend’s suicidal thoughts or trying to “distract” from them can do more harm than good. “Research shows that attempting to get someone not to think about something makes the brain perseverate on it longer,” she explained to HG.
Rather than trying to take a loved one’s mind off of their feelings, address them and ask them questions. Show them that you are invested in what they have to say, and how they feel.
4Do not pass judgement.
When a loved one admits to having thoughts of suicide, do not judge them for it, minimize it, or try to correct their feelings.
“I’m amazed at how people say ‘maybe go to church’ or ‘maybe there’s something you did last week’ that’s causing these feelings,” said Dr. Soroya Bacchus, a psychiatrist in the greater Los Angeles area. “I see a lot of patients who come in and their loved ones are trying to trivialize it because they’re uncomfortable. Recognize that you’re uncomfortable talking about this, don’t judge, just ask [if they’re okay], and listen.”
5Ask them if, and how, they are planning on taking any suicidal actions.
As difficult as it may be to broach the subject, the more information you have, the better. If a loved one tells you they feel suicidal, ask them if they have plans to act on those feelings. Find out what means they have to act on them, such as pills or a firearm, and help them make arrangements to get rid of those means, suggested Dr. Gelbart.
6Do not promise to keep it a secret.
If someone opens up to you about their suicidal thoughts or depression, it can sometimes feel like you are their only confidant. For your health and theirs, make sure that isn’t the case.
“You want to and should keep the person’s confidence, but there may be times that you may need to reach out for added help,” explained licensed clinical social worker Dr. Judi Cinéas. “Making a promise means that you could risk being in a position that you have to choose between keeping your promise and getting the person help.”
You cannot promise to keep a friend’s suicidal thoughts a secret from professionals who could help them, but if they are concerned about their privacy being violated once they seek help, mental health attorney Carolyn Reinach Wolf has a suggestion.
“Friends should ensure those in crisis understand that the mental health system has robust safeguards designed to protect the privacy of those seeking treatment,” she explained. “As seen in the news coverage of Kate Spade’s suicide, concerns about the lingering stigma associated with mental health care can prevent individuals from accepting help. The fact is that those who wish to keep their treatment completely private can absolutely do so, no questions asked.”
7Encourage your friend to seek help.
If someone is depressed or suicidal, reaffirm their feelings and let them know that you hear what they are saying, and that you understand their struggle. But do not let them think suicide is the only answer.
Dr. Nicole, a board certified psychiatrist and chief medical officer at Elocin Psychiatric Services, said to avoid telling someone contemplating suicide that their feelings aren’t real, or that what they are saying is “crazy” talk.
“You want to be sure that you are acknowledging the seriousness of what they are saying, and you definitely don’t want to minimize that in any way,” she explained to HelloGiggles. Talk to your friend about speaking to a therapist and “make sure that you follow back up with that person to ensure that they have addressed the issue,” said Dr. Nicole.
8 Find the phone number for a therapist, or sit with your friend when they make the first call.
Mental illness, especially depression, can be debilitating, which is why it is important for you step up when your friends are unable to seek help for themselves. Dr. Beatrice Tauber Prior, a clinical psychologist, author, and founder of Harborside Wellbeing, suggests doing a little investigative work for your friend if you know they’re seriously depressed or considering suicide.
“Do a search for qualified professionals that can intervene,” she told HelloGiggles. “The American Psychological Association lists qualified, trained psychologists that can help. If your friend mentions that they do not know where to begin in their search for a therapist, you will be ready with the names of trained professionals that can help.”
Setting up appointments, making phone calls, and reaching out to strangers can be incredibly intimidating, especially during a mental health crisis.
“You can offer them encouragement and assistance with setting up an appointment with a mental health professional, or if it’s a crisis situation, offer to accompany them to the hospital,” said Dr. Raichbach.
If mental health care feels financially out of reach to your friend, let them know they have options. Local colleges and universities with psychology and psychiatry programs often have training centers where graduate students (under the supervision of licensed professionals) provide therapy sessions at a significantly reduced rate.
Also, if your friend has insurance, help them look online or call the provider to find out if mental health services are fully or partially covered, then search together for a doctor who accepts your friend’s insurance.
Finally, if you find a therapist in your friend’s area but think they’re financially out of reach, ask if the therapist offers services on a sliding scale or can recommend another therapist who does.
If you or someone you care about is struggling and experiencing suicidal thoughts, you can call the National Suicide Prevention Lifeline at 1-800-273-8255 to speak with someone who can help. You can also chat with a counselor online here. All services are free and available 24/7. Additionally, here are ways you can help loved ones struggling with depression.