QTPOC-friendly guide on how to help a friend who struggles with (depression/anxiety/other mental health issue)
Recently, my long time friend came to me about their partner, who they worry is ignoring their worsening depression. After a long facetime call, I put together a list of things to keep in mind, in tandem with my own partner. Thank you, Alixx! These are based on things I have read online and in my neuroscience background, learned from my therapist, and personal experience from both myself and Alixx. This focuses mostly on depression/anxiety, but can also be useful for other disorders such as PTSD, bipolar disorder, or borderline personality disorder.
Mental health treatment has a nasty history of racism, homophobia, transphobia, and misogyny. It can be especially difficult to access help/avoid mistreatment by medical professionals for people of color, low-income people, queer/trans folks, and femmes. Keep in mind the power dynamics of your own relationship and tread carefully, so as not to replicate historical traumas!
1. Center their own experience. This includes their words choices (don’t use the word depressed if they use the word sad) so you are not putting words in their mouth. Pay attention to their patterns of behavior, and ask them if they have any triggers/helpful coping techniques that they know of. Keep triggers in mind, especially if they are going through a difficult time. If they want to talk about what is bothering them, really try and listen. Give feedback or your own thoughts, but ask if they want to hear them first. They are the experts of their mind, and even if you can be of help, you won’t truly comprehend the full scope of how their mental health affects them.
2. Avoid judgemental language and be as specific as possible. Anyone can develop mood disorders at any point in their life, even if they seem to have things together. Don’t say things like “But, you are on your ideal career path” or “you have less problems than other people” because if they are having a hard time getting help it might seem to them that their problems are insurmountable and you don’t want to add to that. Distorted thinking and irrational thoughts can be a part of the disease. While there might a time and place to talk about the positives, only try and engage once you can be confident that the language you are using is the kind they want to hear. Ask for feedback on this if possible. Point to specific behaviors and actions and don’t use blanket statements like “there’s nothing to be sad about” or “everyone gets upset sometimes.”
3. Try to guide them to help and resources. This can be difficult for some people and it may not be successful, despite your own good intentions. The person may or may not have considered that anything is wrong, or they could diminish the importance of their struggles. “I” statements are your bestfriend. If you feel comfortable bringing it up, cite specific behaviors you have noticed (for example, I have noticed that have been skipping your job responsibilities) and explain your own worry as a friend/loved one. Remind them that are resources that they can access (therapists, psychiatrists, behavioral/pharmacological treatments, online chats, support groups, workbooks, hotlines) that may help. Emphasis that they are not alone and that many people struggle with mood disorders. Also, emphasis that they is nothing “wrong” with them, and that they are worthy of love and support. Offering different kinds of resources (therapist links, phone numbers, chatrooms) are useful because they can provide long term support (i.e. a trained professional) or quick relief that they can access alone (chatrooms, hotlines). If they are suffering, they might be avoiding their feelings, or diminishing the importance of them, so gentle listening can go a long way. Offer to help them find these resources. If they have health insurance and/or financial means, look for therapists that take their insurance on psychology today, or someone sliding scale.
Note: Just because someone has a counseling or medical license, doesn’t make them immune to racist, homophobic, transphobic, language/treatment. Look for q/t/poc friendly providers, and ask around for providers that your friends have good experiences with. There are practitioners/clinics/practices that center q/t/poc patients. Navigating the medical-industrial complex is DIFFICULT, so be patient! help them out! Offer them help with transportation, send a link, or lend an ear about the therapist who doesn’t understand queer culture. If you are unable to help, point them to someone who can.
4. Everyone is different and science doesn’t always have the answers. Mood disorders are special kind of monster, that are not entirely understood by scientific research. Someone’s mood changes, responsive tendencies, aggressiveness or passiveness, is unique to their own situation. From an epidemiological perspective, there are trends, such as onset after traumatic event, or onset at puberty, early 20s, and old age. There are are evidence-based treatments that have been proven to help. These include rational emotive behavior therapy, cognitive behavioral therapy, medications like SSRIs, SSNRIs, electroconvulsive therapy, and others. Other lifestyle modifications like healthy eating, regular exercise, and regular sleep can also help. Just as there is no “one” kind of depression, there is no “one” kind of treatment, and a good treatment can take time to develop, and can change over time.
5. Take care of yourself. This is the final and perhaps most important piece of advice. Even though it is great to lend support to a friend or loved one, you will not be able to cure anyone’s mental health issue. Be there for them as much as you are able. If it comes to a point where there is destructive/disruptive behavior (such as yelling, constant conflict, avoidance) is too much, and they aren’t holding themselves accountable, then it is okay to distance yourself from the relationship. There is only so much to do, and prioritizing your own mental health is important. Seek advice from other friends or a trained professional if necessary.
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