How to deal with friends with mental illness

Seeing my best friend spiraling into an acute paranoid psychosis left me feeling scared, overwhelmed and helpless. I had no idea what to do, who to talk to, how to behave around her. When you have no idea how to support yourself, how do you support your friend?

According to WHO one in four people in the world will be affected by mental disorders at some point in their lives. That makes it highly probable that you will experience a friend to suffer from a mental illness. Put in numbers, that is quite scary. However, mental illness does not equal mental illness.

What sort of mental illness are they suffering from?

There's a difference between depression, anxiety and psychosis.

As already mentioned above: Mental illness does not equal mental illness. You might have friends with the same diagnosis, but they are all acting differently. There is no one size fits all approach to dealing with mental illnesses.

First, try to get your friend diagnosed. Get together with their families. It might feel weird in the beginning to talk about such an issue with their parents or extended family, but keep in mind that everybody has their best interest at heart. You are not breaking their trust by confiding in their family and/or other friends.

Have they been diagnosed with depression? Continue reaching out to them even if you don't get much of a reply. You don't always have to sweep in with a grand gesture. Drop by with some groceries or cook food for them. Quickly help cleaning up their apartment. Maybe changing the bedding or just open the windows to let in some fresh air. It will make a world of difference if they are not able to do it themselves.

Does your friend suffer from anxiety? Agree on a safe word. If you are out and about and they mention the safe word, you get them out of the situation, no questions asked.

What if your friend is in the midst of a full-blown psychosis or even schizophrenic?

What to do in cases of psychosis

Unfortunately, there is not much you can actually do. They most likely will not agree that they are mentally ill and need help. Remember: what they are experiencing is real to them. The voices they are hearing? The feeling of everybody turning against them? That is their reality.

Keep in mind: Psychosis is a lonely illness.

They will most likely start pushing you away since you won't engage in their reality (because you don't experience it like that). In my friend's case, she cut contact with all her friends and family and returned to an Asian island where she was living before. She's in no-contact with her friends there as well.

How to deal with that? It's still crucial that you take your friend's feelings seriously though. Do not try to argue with them, however. You will loose. Listen to them without judgement. Ask them questions not related to their condition. They are still more than their sickness. It might be a part of them, but it does not define them.

Your boundaries

You are not a bad friend by needing space.

Honour your boundaries. Is it getting too much for you? You are not a bad friend by taking a step back. Dealing with loved ones that are going through mental illness can be very exhausting and might trigger some trauma you went through previously.

When my friend said she doesn't consider us friends anymore, I was hurt. And I was angry.

But on the other hand, I was also relieved. Relieved to not have to deal with her erratic behaviour and her weird ideas any longer.

Does this make me a bad friend? No. I did everything in my power to get her the help she needed and I was there when she needed me. Will I still be there if she ever reaches out to me again? I don't know. All I know is, that this sickness changed her fundamentally. And it will take a lot of work (on both sides) to make this a working friendship again.

It's eady to make excuses for your friend's behaviour, especially when they suffer from psychosis. That still does not mean you have to take on the full load.

Are they abusive towards you? Are they lying to you or trying to manipulate you? Remove yourself from the situation. For your own mental health.

You are their friend, not their therapist

Even if you are a therapist in your everyday life, you are not theirs. Do not try to analyse them, to cure them or hand out unsolicited advice. Your job is to support them and to be there for them and most importantly: To love them in their darkest hour, even if it has to be done at a distance.