Why Reaching Out To Mentally Ill Friends Is Complicated

It’s kind of like telling someone “If you’re hungry, come over for dinner.” It doesn’t matter how generous the offer is, or how sincerely meant, if they don’t have a way of getting to your house in the first place.

In the days since the tragic and much-publicized deaths by suicide of Kate Spade and Anthony Bourdain, the United States has been having one of our all-too-infrequent public conversations about mental health and what to do in a crisis, and especially about depression, self-harm, and suicide. Although our track record of meaningful support for the mentally ill (of whom I am one) is painfully inadequate, I always go into this hoping that we’ll move forward in a tangible way by the time we’ve talked it through. Unfortunately, the conversation tends to move through two distinct phases and then hits a wall.

First, a death by suicide reminds us that we never really know what’s going on in another person’s head, and that even those who seem really together might be suffering terribly in secret. People start posting things like “please reach out if you need help” or “here’s a crisis hotline.” It’s kind and well-meant, but it falls short: It doesn’t really do anything to destigmatize mental illness or remove logistical barriers to accessing support. It’s kind of like telling someone “If you’re hungry, come over for dinner.” It doesn’t matter how generous the offer is, or how sincerely meant, if they don’t have a way of getting to your house in the first place.

So in response to these comments, we get the second round of advice: the people who say “you need to reach in.” These posts are usually more detailed and actionable than the first kind, often because they come from people who have lived through a mental health crisis of their own. They offer specific suggestions of how you can show up for someone who is struggling with not wanting to be alive, from calling to make a doctor’s appointment to sending “thinking of you” texts to helping fold laundry. If you know someone’s hungry, this line of thinking goes, it’s not enough to say “I’m making soup.” You need to put some in a Tupperware and bring it around.

But I also find this advice shortsighted, and in much the same way as the first genre, because it still puts the onus on one individual to save another individual from their illness. This is a responsibility that, in a just and moral society, should be shared. It’s too much to ask one person to handle. Certainly, if you have everything you need and one person you love is starving, it’s a no-brainer that you’d feed them. But more often than not, it seems like no one has quite enough to eat. Most people I know are constantly moving resources around to address the most urgent needs, never feeling fully nourished.

Anecdotally, it seems to me that people with mental illness tend to befriend and form networks with each other. If I had to, I might be able to list five people I’m close to who have never had a psychiatric diagnosis. When my anxiety is bad, I feel so desperate for attention and support that I tend to withdraw completely, afraid of overwhelming people with my neediness. My friends who have mental illness of their own seem to understand this best. Only the real(ly unstable) can relate.

Maybe it’s because people in crisis gravitate toward each other. Maybe we have more patience with each other’s inconsistencies than many neurotypical people can muster. Maybe it’s just that the mentally well are actually in the minority. Whatever the reason, there’s a decent chance that if you have mental illness, some of your friends do too. How many pots of soup can you make? How many can you drop off and still come home with enough energy and time to make dinner for your own family? And can you do all that again next week?

I’m very hesitant to write any of this, because for people who already struggle with feeling like they don’t deserve support – again, I know because I am such a person – it will sound like I’m saying “helping you is a burden, so don’t expect people to do it.” It is incredibly important and brave and necessary for people in crisis to ask for help, and we need to make it much easier to do so. But I think that has to go hand in hand with acknowledging that not everyone will be able to provide all the support needed, all the time. Too much of the prevailing advice carries a whiff of judgment, an implication that if someone does die from their mental illness, it will be all your fault – you, specifically – for not doing more.

In a country with a functioning health care system and some underlying sense of morality, helping someone through a mental health crisis might be as simple as driving them to a doctor. But here in the U.S., just making a therapy appointment can be a labyrinth of stressors that’s hard to navigate under ideal circumstances, much less from the depths of an emotional vortex. What that means is, for mentally ill people, deciding to seek help isn’t an endpoint but the beginning of a hideous obstacle course that only sometimes ends with actual psychiatric assistance. And if your doctor moves away or you switch jobs or your copay increases drastically, you might have to start the whole process over again.

So “protecting” your suffering loved one from their self-harming impulses isn’t a one-time thing – it’s not a question of riding in once to save the day. They might need to be saved monthly, weekly, whenever the weather is bad, whenever they hear a certain song on the radio. And one person just can’t do all that saving.

I understand the absolute dread of reaching out, of expressing vulnerability, of telling anyone how bad the bad days can get. I write about mental illness a lot but there are things I don’t write. There have been times – not many, but enough – when I’ve told someone what was happening, described the ugly shadow puppet shows my brain was performing, and they didn’t text me back. When I’ve said “I really really need your help” and someone has said “I’m sorry, but…”

The shame is overwhelming. Instead of thinking, “This person can’t help me, so I’ll ask someone else,” you think “I must never ask for help again.” It becomes even more torturous to convince yourself to call someone the next time the bad weather rolls in. And the flip side: If you’ve been there, you might find it very, very difficult to say no when someone asks you for help, because you know what a motherfucker it is to hear. So, sometimes, you’ll put up barriers in the hopes that they won’t even ask.

Am I talking about you? Maybe. I’m definitely talking about me. What if everyone you love is trying just as hard as you are to hang onto some semblance of normalcy? What if no one has a hand free to do any kind of reaching?

I don’t have the answers, but we need to be asking these questions. What we can all do to make this a world more of us want to stay alive in? I want us to take care of each other, but I also want us to have the resources we need to take care of each other – and ourselves. I want to be able to reach in without dropping three of the things I’m already juggling, and some days I can’t, and I’m really fucking sorry. I hate that I can’t. I want you to be able to do that too. I want us to all have enough in our pantries to cook good things for each other. I want every day to be a pot luck.

Lindsay King-Miller is a queer femme who does not have an indoor voice. Her writing has appeared in Bitch Magazine, Cosmopolitan.com, Buzzfeed, The Hairpin, and numerous other publications. She lives in Denver with her partner, a really cute baby, and two very spoiled cats. She is the author of Ask A Queer Chick (Plume, 2016).

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