For Family & Friends

"The illness turned my once proud, strong, loving husband of 29 years into a stranger"

 "I never cry, I'm usually a positive person and quite strong.

But watching my mother struggle so much totally consumed me"

"The hardest part was accepting my son needed medical help"

"Her daughter was diagnosed two years ago, but it wasn't until recently that she learnt how to cope and more importantly how to live with her child's illness"

Family and friends play a very important role in supporting and caring for people with mental health conditions. Although every personal relationship is unique, there are aspects of supporting a person with a mental illness to get help and recover that are common to many people. It is common for people not to discuss mental health conditions with family members or friends because of fear, lack of knowledge and stigma.

Family and friends may be involved in different stages of the person's experience with mental illness from helping them to recognize the early signs to accessing treatment, working towards recovery and managing emergency situations. Caring for, living and working with or being friends with a person who experiences mental health issues is sometimes not easy and it can be hard to know what to say and what to do.

• Confirming that someone has a mental health condition may be difficult. Unlike physical illnesses, which have obvious symptoms that can be observed easily, symptoms of mental health conditions may be hidden and a person may not also openly share their symptoms due to fear of stigma. You may sense changes in a person's behavior but attribute symptoms to other causes. For example, it can be difficult to know whether lack of sleep and weight loss are the result of work-related stress or whether they may be symptoms of anxiety, depression or another health matter. The best advice is to familiarize yourself with the signs and symptoms of mental health conditions and trust your instincts if things are not quite right. For specific information about the signs and symptoms in Children and Adolescents click here. 

• Raising the subject with the person you care about may take some planning and thought. It can be helpful to have this discussion as early as possible, before symptoms start dominating day-to-day life. It is important to let the person you support know that you are concerned. Talk sensitively, in a non-accusing and non-blaming manner, about the changes you have noticed – even though you may feel tired and frustrated with the person. The person may insist they do not have a problem. In these circumstances, try to keep calm, but be firm in your approach.​

• Encouraging the person to seek help is a key step and you could suggest that you help them by making an appointment to get professional support from a health provider or take them there. Sometimes the person may refuse to get help. If the person will not listen to you, think about asking someone else to talk to him or her like another trusted friend or family member. 

• Educate yourself with good quality health information so you feel more informed and in control of what is happening if you know about treatment options and any side effects of medications. 

• Ongoing support from family and friends will play a major role in a person's recovery.  A daily or weekly plan at home that includes you encouraging the person to follow their treatment plan, attend medical appointments and take part in stress-reducing, enjoyable activities may be helpful. 

• Dealing with setbacks in recovery can be frustrating and disappointing for both the person and their family and friends. Encourage them to speak with their health professional about ways of moving through an episode or relapse. 

• Emergency situations may arise when a person has severe mental health issues or the person's condition deteriorates rapidly. It is frightening and distressing when someone you care about wants to harm him or herself, but discussions about suicide or self-harm should be taken seriously and urgent action taken.

Additionally, below is a list of practical day-to-day ways you can support someone who may be experiencing mental illness:

• Show that you care just by listening and without being judgmental
• Offer emotional support, patience, affection and encouragement. Remember, people affected by mental illness, like any other illness cannot just 'pull themselves together' or 'get over it easily' and need both professional and family support.
• At any stage of their symptoms or illness, encourage them to discuss how they are feeling and seek help from a trained health professional. Encourage them to talk about what they are experiencing and get them to work out what they can do, or what they need to change.
• Invite them out on walks, social outings and gentle activities. Encourage them to take part in activities that once gave them pleasure. However, try not to put too much pressure on them as not feeling able to engage in activities they used to enjoy can be a source of further unhappiness.
• Help them feel good about themselves by praising daily achievements, even if small.
• Encourage them to help themselves through self-help techniques and further treatments if appropriate.
• Someone affected by mental illness may get irritable and be more likely to misunderstand others, or feel misunderstood than usual. They may need reassurance in some situations, and you may need to be patient with them. If they get angry, it is best to give them some time and space to calm down and when the person is calm, talk about the triggers that cause them to become angry and what you should do if this happens again.
• If the person has repeated episodes, you may be able to learn what their triggers are, or spot when an episode might be starting, and encourage them to take action before it gets any worse and develop their own 'Stay Well Plan' .
• Remember, even after someone has started treatment it may take some time before they really start to feel better. If the illness is severe, you may be faced with some hard decisions and it will help if you can find someone you can discuss these with and seek assistance if you noticed unusual patterns.
• Discourage them from using alcohol or other drugs to feel better.
• Encourage the person to try to get enough sleep, exercise and eat healthy food.

It would be unhelpful to:

• Put pressure on the person by telling them to 'snap out of it' or 'get their act together'
• Stay away or avoid them
• Tell them they just need to stay busy or get out more
• Pressure them to socialize more or to cover up how they are feeling by taking substances.

You can visit Mental Health in Women for special advice for spouse of women with postpartum depression or psychosis, which relates to mental health conditions during pregnancy and after childbirth.

It is important for people who are caring for someone experiencing mental illness to look after themselves, both physically and emotionally and ensure that they get support for themselves by talking to a family physician or spiritual leader.

For more information you can download resources which provide:

​

• A guide for people caring for a family member or friend living with a mental illness
• Advice on how to have a conversation about mental health with a child or friend you are worried about

Support and acceptance from family and friends is essential to the recovery of people experiencing mental health conditions. 

Below are some reflections from people in Qatar on family and friend relationships in relation to their journey with mental illness.

"I started telling my husband and parents about how I feel. They thought that I am just being sensitive and I should think positively. I tried, but I couldn't control my fear"

***

​

"My sister is all the time in her room, I wouldn't say that she's crazy, don't talk to her, we try resolving the issue… I don't think that people would neglect any person if he/she needs medical support… they would encourage them… there is more awareness than before

***

"I got an anxiety problem and my family didn't know how to treat me and help me…"

"Friends wish you luck and to be healthy soon and leave you… I needed friends at that time"

***

"My family called me lazy and my friends stopped hanging out with me,they told me I depress them'"