R U OK? Day is for starting conversations about mental health, but what do you do if someone says "No"? Here are some tips to help you have those difficult conversations about depression or suicide.

Mental health: How to talk about it with someone who needs help

Her social media accounts are littered with glamorous photos but life for Paige Spiranac has never been breezy.

The former golfer, a college star who had a short career in the pros, has spent her adult life copping accusations she’s only famous (she has more than two million Instagram followers) because of her looks rather than her efforts on the fairway.

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But what the radiant image she portrays on social media doesn’t show is the lifelong struggle with anxiety, bullying and suicidal thoughts.

‘I’M NEVER GOOD ENOUGH’

A sheltered child, Spiranac was homeschooled from fourth grade.

As an elite gymnast her dream was to go to the Olympics. But after quitting and developing terrible anxiety, her parents decided to bypass the mainstream education route and keep her at home for fear she would be “eaten alive” at school, Spiranac said in the latest episode of her podcast Playing-A-Round.

She didn’t have many friends her age and as she progressed into her teenage years was still naive to the realities of sex and alcohol. She only went to one school dance and asked the boy she was with to leave the after-party because she saw someone was drunk.

Spiranac was so determined to succeed at sport, be it gymnastics or later on golf, her social skills fell behind as she spent more time alone at the driving range than with friends.

She loves her parents but admitted there was a time she was scared of them. They instilled in her the notion of always striving to be your absolute best, and Spiranac took that advice to heart as she pushed herself to the limit at the expense of enjoying normal childhood experiences.

It started her on a dark path towards neglecting her own interests. “I always seek people’s approval and I’m always never good enough,” Spiranac said. “I’m always wanting to do everything I can for them.”

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‘TOXIC’ INFLUENCE MADE LIFE MISERABLE

The pressure of being a gun child gymnast exacerbated Spiranac’s self-esteem issues.

She went to the renowned USA Gymnastics training facility, the Karolyi Ranch in Texas — the same place where disgraced Olympic doctor Larry Nassar worked before being convicted of sexually abusing athletes.

But instead of finding common ground with her peers, Spiranac became even more isolated as bullying and a gruelling schedule that put her in the gym for seven hours a day, six days a week took its toll.

She encountered “mean girl issues” where other gymnasts spit in her drink, threw away birthday cakes and excluded her from activities.

It was after that traumatic experience Spiranac’s parents decided to home school her.

“The gymnastics community is toxic. You just do what they say no matter what. It’s really scary,” Spiranac said on her podcast. “I never felt like I fit in. I didn’t have a group of friends.”

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Going to golf didn’t change things because although Spiranac played with girls as she honed her craft, once again she felt like an outcast as she had trouble forming bonds in the fiercely competitive environment.

It was an issue that plagued Spiranac before she took up sport, but became worse later in life.

“I’ve never felt like I fit in. I always feel like I’m walking in the wrong direction or swimming upstream,” Spiranac said.

“It’s really hard for me to connect with a lot of people.

“I always feel like an outcast … it’s just always been very different to everyone else.”

HOW SPIRANAC LOST HER INNOCENCE

From the straight-laced child who grew up in Colorado, Spiranac learnt a lot more about the world when she hit college.

On her first weekend at the University of Arizona, a sober Spiranac was driving friends around when they were pulled over by police. Asked if she’d been drinking, she burst into tears and said she had — even though she hadn’t touched a drop of alcohol that night.

After acing the tests and returning a zero reading on a breathalyser, an officer asked Spiranac again if she’d been drinking.

“Yes officer, I’ve been drinking water,” she said, oblivious at the time as to what she was really being asked as everyone around her laughed.

That innocence was quickly shattered though as Spiranac learnt what she had been missing out on, embracing the college lifestyle. She loves her mum and dad now but that wasn’t always the case.

“Once I went to college and experienced life, I was like, ‘What were you guys doing? How did you never teach me this and how did I never have a normal life?’” Spiranac said. “I resented them.”

The sporting prodigy became “a bit promiscuous” and turned into a “crazy party girl” who drank all the time and became depressed.

“I hated myself because that was everything I was not supposed to be,” she said.

She hated herself and she was a target for others too. Spiranac moved colleges after one year to attend San Diego State because, among a variety of reasons, wild rumours were being spread about her sex life, including claims she had sexually transmitted infections.

PAIGE THOUGHT ABOUT TAKING HER OWN LIFE

Spiranac says she hardly goes out at night because of her social anxiety. She gets incredibly nervous before any social occasion and something as simple as going to the movies can spark panic attempts.

Being in large groups of people is Spiranac’s worst nightmare. She can get overwhelmed to the point where she’ll start crying.

The worst bout of depression Spiranac ever suffered was during her senior year of college. She couldn’t get out of bed and “just didn’t want to deal with life anymore”.

Taking anti-depressants only messed her up more because she was continuing to drink and it got to the stage where Spiranac contemplated taking her own life.

Having climbed to the top of a building at a carpark, Spiranac looked down and told herself she was going to jump.

She didn’t follow through but it wasn’t the only time suicidal thoughts entered her mind. The day before her first golf tournament as a pro in Dubai — the same event where someone threatened to release a nude photo of her on the internet — it all became too much.

“I locked myself in the bathroom, just trying to find anything I could to not deal with tomorrow,” Spiranac said.

SPIRANAC FIGHTS BACK

The combined stresses of her mental health struggles reached breaking point and eventually Spiranac decided she needed to make a change, altering her diet and channelling her energy into working out.

She went off anti-depressants and gave up her partying ways in an effort to become the person she was before going to college.

“Now with my anxiety and my depression I just try to handle it head-on,” she said.

It’s worked, to a point. While Spiranac is coping better than she did during her darkest days in college, she knows the mental health battle is never truly won.

Panic attacks remain common and she still suffers bouts of depression, but it’s no longer a daily fight.