I love the concept behind ‘R U OK?’ Day. I know more people suffering from mental illness than I do who are free of it. They are wonderful, warm, generous people who fight their own minds every day to complete simple tasks like waking up, getting dressed, even just finding the motivation to feed themselves.
Yet somehow, most of them still hold down steady jobs and complex social lives. These people are my heroes. Some of them will read this and think, ‘Is she talking about me? I struggle with X, but–I’m not that special. She must mean someone else.’
No. I mean you. You, and the others like you who throw yourselves into the rush of every day when your body screams to stop. Who have once, twice, so many times ended up crying in front of doctors, desperately begging for help. Who have sat and wrestled with yourselves while thoughts of hate and self harm sprang up in your mind like unwanted pop-up adverts.
You, who have lost some battles, but won others. You’re everyday heroes.
In light of R U OK? Day, this is my guide for conversations starting with the sentence ‘Are you okay?’
- ‘Are you okay?’
Ask without judgement. Be gentle, it’s a deeply personal question. Be light and casual, as if you’re asking about the weather. Don’t put them on the spot in front of others, try and keep it private.
- If they say yes–accept it.
Even if you know there’s something they’re not telling you, move on. You might not be the person they feel comfortable talking to. If you know them well, you might ask if they’re sure and give them a second chance to speak.
Don’t push if they keep resisting. Say you’re willing to listen if they ever want to talk, and leave it at that. Realising you’re not their preferred confidante sucks, but your interest and concern might be enough to push them to open up to someone else.
- If they say no–don’t freak out.
Four simple words: ‘How can I help?’
Truth is, you probably can’t. Or the ways that you can help out may seem stupid or insignificant. To a depressed person nothing is insignificant. The tiny things like bringing their favourite chocolate bar mean everything, because it demonstrates that they are important enough to not only be remembered, but that someone remembered what chocolate bar they love.
- Don’t try and solve them.
Some people listen with half a brain while the other half is planning solutions. Don’t. Listen to the problem with your whole brain and brainstorm solutions with the person if they invite you to. They may already have a plan in place. Even if they don’t, it’s so important to address the person before the problem.
If the first thing that comes out of your mouth is ‘Have you thought about…’ or similar, the person is likely to feel less like a human being and more like something broken to be fixed. It’s natural to want to help someone out of their hurt, but don’t start there.
- Don’t normalise (invalidate) their experience.
There are some silly things that get said in these conversations that can be unintentionally hurtful. Anything that equates depression to a ‘normal’ feeling like sadness can stop someone from seeking further help. It can lead to them believing what they feel isn’t worthy of medical attention, that everyone suffers the same as they do.
Unless you’re a medical professional trained to identify the difference between regular low mood and diagnosable depression, don’t normalise what they’re feeling. Some phrases that are unfortunately common:
‘Everyone feels like this sometimes.’
‘It’s a rough patch, you’ll get through!’
‘Chin up, it’s not as bad as you think.’
‘You’ve just got to be a bit more positive.’
‘It will pass, just keep trying!’
Though the intention of the words is good, all of these carry the message that how the person feels is either not ‘real’ or just a part of everyday life. I’ve written a bit more below about the difference between depression and sadness.
- Do acknowledge their experience.
There is one thing you can always do when someone expresses their struggles to you. No matter what the subject is or how complex the problem, you can say this: ‘That sounds horrible, I’m sorry you’re struggling with that.’
People wrestling with mental illness frequently doubt the validity of their feelings, so having someone else acknowledge the struggle is powerful. It could be what they need to accept they need proper help and take those first steps. Even if they’ve already sought treatment, that acknowledgement means a lot.
- Accept and respect personal boundaries.
Speaking up can be overwhelming and exhausting, and they may wish to be left alone after. If they seem uncomfortable, ask ‘Would you like me to stay?’ and respect the answer.
If they are happy for you to stay, don’t expect to keep discussing their mental health. A lighter subject change may be in order, or even just sitting in comfortable silence. Conversely, they may wish to continue explaining their feelings to you. The conversation ends when it ends. Don’t push for more.
So what do I know about it?
Mental illness is a subject I feel very strongly about. I began my own mental illness ‘journey’ (I suppose you could call it that?) with an anxiety diagnosis at age 22. I’d always been that way, an extreme level of anxiety to me felt normal. Realising that not everyone lived in the shadow of dread was a revelation for me. I am still a highly anxious person, I probably always will be. Seven years on, I’m far better at managing the more damaging sides of panic disorder, social phobia, and generalised anxiety disorder.
Beneath the anxiety, depression began to make itself known. For the record–depression isn’t a mood, it’s not a sadness. Sadness is a symptom of depression. Sadness happens when you look outside to the things you used to love and feel nothing. Sadness happens when you know there are things you should be doing, but the drive to do anything is gone. Sadness happens when you go to sleep at night and don’t care if you wake up. Sadness happens when you have depression, but depression is not sadness!
Depression is a sense of inescapable emptiness and isolation. You’re a flat battery. The cycle of knowing you have to live –> having no motivation to do it –> self loathing for your inability to do anything is where the negativity comes in. Depression is frustrating. It’s heartbreaking. It feels like you’ve broken up with everything you used to love and now there’s nothing left in your life. Nothing that inspires you.
Depression is not the same as a bad week or a rough day. It’s not something you snap out of overnight. It’s not something that will be better if you just ‘get a good sleep’, or ‘relax and see some friends’. It’s something you fight every day to escape, some days harder than others. It’s feeling helpless and lonely, even when there’s nothing wrong in your life.
It’s not always brought about by big and dramatic events. Sometimes it just is. Sometimes it’s a sudden crash from coping to not coping, sometimes the slide into depression is so subtle that you don’t realise until you’re drowning. It’s waking up one morning and realising: I don’t remember the last time I felt good about something.
Depressed people do have good days. A laugh doesn’t mean they’re lying–about depression or what they see is funny–but it’s one bright distraction in a dark night. Some wear masks to hide the pain and stop dragging others in.
Talking helps, as long as the conversation acknowledges the true weight of the issue. The more we write off depression as ‘being really sad’ or something you can ‘smile through’, the more we turn people who truly need help away from seeking it.
Help them realise they are worthy of a doctor’s time and effort. All you have to do is say, ‘I’m sorry, that sucks’.