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Ask an Expert: How to Spot the Signs and Support Those Struggling With Their Mental Health

In our latest “Ask an Expert” column, we’re honoring Mental Health Awareness Month by asking a psychotherapist our most frequently asked questions on mental health.

Today, we consulted Sarah Kencel, LMSW, a psychotherapist in a private practice, for her advice on how to spot the signs that someone is in need of help and how to support those who are struggling with their mental health. Read on for her tips on approaching these difficult conversations and for resources to support anyone struggling with their mental wellbeing.

How can we normalize the conversation around mental health?

Sarah Kencel: One easy way to normalize the conversation is to have the conversation more frequently. Check-in with your friends often, ask them how they are doing, especially now. When speaking about mental health, keeping the conversation casual can help normalize it too. You don’t need to have a formal sit-down to ask someone what’s up. 

Almost everyone to some extent knows what it feels like to have symptoms associated with depression or anxiety. If you can relate to what your friend might be going through and how they may feel, even on a small scale, you can empathize with it. This is a crucial step to entering into the conversation from a place of understanding and acceptance. 

Lastly, if you are able, using self-disclosure about your own feelings without overtaking the conversation might allow that person to feel more comfortable. Much of the time, when someone is struggling with their mental health, they can feel isolated and alone. Universalizing the common experience allows that person to recognize that they are not alone.

What are some common signs that someone is struggling with their mental health?

Sarah Kencel: Mental health professionals use a clinical manual, called the DSM-5, to determine if an individual meets the criteria for a diagnosis. This identification helps us determine the appropriate treatment approach. While you don’t need to use this manual, being aware of some of the symptoms associated with disorders (such as depression or anxiety) could be helpful: these include changes in mood states, changes in eating and sleeping behavior, withdrawing, and irritability. Looking at this in today’s context, with many of us sheltering-in-place or social distancing, symptoms can include isolating in the home or reducing an online presence by not engaging in texting, calling, or video chat anymore. Changes in physical appearance or a lack of hygiene maintenance may also be signs that something is up. In addition to looking for concrete signs, trust your gut if you sense that something is off.

 To learn more about signs that someone might be struggling with their mental health, click here.

How can people go about offering support and help to those struggling with their mental health?

Sarah Kencel: Once you have determined it is appropriate to approach someone about their mental health, take a moment to plan beforehand what you’d like to say and how you want to come across. To put it simply, be intentional about how you want to convey your support. Jot down supportive words and phrases you will use to express acceptance and unconditional love. Be mindful of your body language and physical presence, you want to appear approachable and comforting. It might sound silly but practicing in front of the mirror can help. Now, in the world of video chat (if this conversation is occurring on that platform), it is even easier to be sensitive to how you may be coming across to the other person: that little speaker-view window can be a helpful tool if you need to do a little mid-convo self-check-in. 

When talking to your friend, it is important to validate their unique and subjective experience. One of the resources I love to show clients is Brené Brown’s video on empathy. Dr. Brown does a fantastic job of illustrating how you can be a friend to someone in need. I highly recommend watching this video to understand how impactful a simple gesture, such as sitting with someone, can be. This enlightening video illuminates how our human tendencies to problem solve and silver-line situations can actually be invalidating and detrimental to the conversation. 

This next step is almost as meaningful as having the initial conversation: after you approach a friend about their mental health, continue to check-in with them, again and again. Follow-up once someone shares something with you. If your friend is not receptive to your initial attempts, keep checking in and stay available. 

Most importantly, do not take whatever information your friend might have disclosed to you and share it with others for any reason other than seeking assistance in a crisis or if you feel that it would be appropriate and deemed necessary to share private information (for example, if your friend is in an abusive relationship, if their condition is worsening, or if they are harming themselves). A true mark of friendship is the ability to hold the trust and consideration of another human being in our hearts. It is a gift to cherish and respect. 

Speaking of support, it’s important to remember that your primary job as a friend is to offer just that, not fix the problem. The most impactful, meaningful way to show up for them is to tell them you accept them and show you care. If you can accomplish these two goals, I promise you will have made a world of difference. 

If necessary, encourage your friend to seek additional help from a parent, counselor or other relevant professional. If you have serious concerns about your friend’s wellbeing, tell an adult, such as a guidance counselor at school. As a New Yorker, I air on the side of caution and apply the famous subway motto “If you see something, say something” when deciding if an observation warrants conversation.

What are the common barriers people encounter when seeking help for their mental health?

Sarah Kencel: Recognizing what may prevent someone from seeking help for their mental health can aid in understanding how to approach them. Culture may play a role in someone’s comfortability in speaking about mental health. Other individuals may have fear-based assumptions around social-rejection or negative consequences if they disclose mental health issues. These beliefs determine if and how someone will seek help. Furthermore, if an individual is struggling with their mental health, their experience of reality may lack self-awareness, or they feel helpless in seeking out help. Being aware of these and other barriers can help you to approach the conversation with sensitivity, acceptance and consideration. 

Do you have a go-to resource to help someone on how to talk to a friend?

Sarah Kencel: Seize The Awkward is a wonderful resource filled with material on how to spot the signs someone is struggling with their mental health, including instructions and suggestions on how to approach and structure the conversation, and relevant resources for both you and the person in need. If you’re specifically concerned about your own or a loved one’s mental health during COVID-19, Seize The Awkward has a coronavirus landing page.

This story is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on

By Maggie Maloney

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