If You See Something, Say Something

Many times people can look back on someone’s behavior and see the signs of emotional struggle, but do you feel confident in your ability to notice struggle as it’s happening? And what you should do about it? This article is meant as a helpful reference to the signs of poor mental health, and how to talk to a loved one about seeking help.

Triggers

Sometimes mental health struggles can be lifelong, but for what we are discussing today, we’ll focus on the change you notice in another person. Triggers for emotional suffering include - but aren’t limited to - major life changes, recent loss, major loss of a loved one that happened some time ago, difficult job, the end of a relationship, becoming a full time care taker, and having many obligations all at once.

Some careers can be a big trigger to emotional suffering. When a person has ongoing stressors, they can experience Vicarious Trauma, or trauma second hand through the stories of someone they work with. Examples of these are: first responders, nurses, doctors, mental health professionals, jail workers, those in the social services, and teachers.

Those who experience a change in their Physical Health, including chronic pain are especially subjected to emotional turmoil. Pain can take a tole on your ability to sleep and function at a normal level. The unknown of test outcomes and living your life with only “what-ifs” add a stress that can prevent you from planning anything in the future, to help yourself or to look forward to.

Signs and symptoms

Hopelessness: hopelessness can look like an I Don’t Care Attitude “Whatever it doesn’t matter” It can be paired with attending work and school less, not going out with friends, or even going out all the time. Hopelessness can also look like self-put downs. If you notice a person with worthlessness, guilty, and hopeless statements, this is a sign of mental struggle.

Depressed mood: A person can look happy on the outside, with small glimpses of sadness that seem to always be there. If it appears someone is working hard to look normal or happy, it could be time to say something.

Weight: A change in someone’s weight can be a sign of both happiness (think beginning a new relationship) or sadness. If the weight change is paired with someone’s loss of hunger or with someone’s ‘I Don’t Care’ attitude is often related to emotional suffering.

Energy/sleep: A slowing down of thought and a reduction of physical movement noticed by others can present itself as confusion, difficulty focusing, stress when making decisions, or an avoidance of making decisions all together. Sometime people will have never ending thoughts that can affect their energy level or ability to sleep, while others will always be tired and sleeping.

Jokes about suicide or wishes to die: Although this is the last sign and symptom on this article, it may be the most important. Please know even if someone jokes about suicide, it is still worth it to say something- even if it’s really funny. Common statements include they want to give up or can’t do it anymore. Even if someone says they don’t want to kill themselves, but wouldn’t mind if something happens that resulted in their death is worth saying something about.

What to say: setting up a safe place

I always encourage people to discuss difficult things when they come up naturally. For instance, if someone is talking about their suffering is considered the best time to bring up getting help. But, it’s not always that convenient and some people deny that they have an issue. In this case, the best way to set yourself up for a successful conversation is to create a Safe Place.

No matter where you physically are you can create a safe place to discuss hard things:

No judgement zone-make sure the person knows you do not see their struggle resulting from something wrong with them. Remember most emotional struggles come from something happening to you or something out of their control.

Respect their freedom of choice- Everyone has the choice of how they live their life and even if you want them to do a certain thing, remember it’s not your life. Studies have shown that people are more likely to follow through if they are doing it because they want to not because they’re forced.

If not now, when? – Not everyone is open to therapy, and there can be many reasons someone is not ready night now. If this happens, encourage them to identify “when is when?” What would show them it’s time for therapy. Suicidal thoughts? Never sleeping? Feeling sick? This way when you follow up you can ask if it’s time.

How to have the discussion about therapy

Despite there being more acceptance in therapy as a whole, it is still hard not to be offended when someone recommends therapy. So be ready for that, but don’t let offense stop you from recommending it. Be curious about their experience. Ask what they think of therapy. Do they know anyone who have been helped? How do they think it could help for them? If they are open to it, discuss how they can get therapy for themselves.

Ways to seek out therapy:

Options: online vs. In person. If you are able to have privacy in your own home/office, online therapy is recommended for those to be in a comfortable place when being vulnerable. Some people do not feel that online therapy is as intimate as in person, but others like the convenience of scheduling and lack of travel expenses/time. If you feel more comfortable being physically at a place and in-person with your therapist, community-based programs and outpatient therapy offices are recommended for you. The in-person experience can come with barriers as well, such as waiting room discomfort and transportation struggles.

Covered by insurance: Be aware of what your coverage is by using the phone number on the back of your insurance card for customer service. Call and ask –

Do I have coverage for online (telehealth) therapy?

How many sessions are covered a year?

Do I have a Copay? (typically, the copay will be whatever a “specialist” amount is)

they say NO to getting help:

It’s important to remember everyone has a choice for what they do with their life. If someone says no, or gives reasons not to, it’s ok to accept that answer. The best response to the answer no is to ask, “What would show you it’s time to get a therapist?” Get them to identify what level of suffering they must feel to show it’s time to get help. Is it daily suicidal thoughts? Crying everyday? Anger outbursts daily? How bad would it have to get that shows you you’d need help to feel better?

If there are barriers to seeking therapy, help them to figure out how to get them out of the way. Common barriers to therapy include; cost, bad experiences, a negative view of getting help, fear, anxiety, and lack of motivation. To help someone with barriers, break them down one by one and offer solutions. Some people will go if they have someone to join them. Sometimes cost isn’t as bad as you think. Some teenagers aren’t aware that in certain states they can seek help without parent consent.

Once barriers have been given solutions, ask again- Can I help you get help?