So Robin Williams has died. Suicide. And that’s sad as any death is.

Facebook is full of posts with his picture sharing phone numbers and websites of helplines. Ones telling people that “suicide is a permanent solution to a temporary problem.” And declarations that if you’re feeling down, if you have depression to make sure you tell someone. Friend’s saying that they hope their friends feel capable of telling them. And similar on twitter and other places.

Here’s the thing: I have a depression diagnosis and I have a lot of anxiety at times which has been recognised by medics although it’s never been given a label like GAD (generalised anxiety disorder). It’s more than 11 years since one of my friends finally convinced me to go and see a GP about the way I felt.

I’d told someone. I’d told her. But she couldn’t physically make me go to the doctors and get help. She kept telling me I needed to and encouraging me to for at least six months. I’d probably been depressed to a certain extent I had to do that myself (and unfortunately that meant things deteriorated because I didn’t go until I got scared about what might happen unless I did).

Then I went and told a GP. It wasn’t my GP because my mine was a male and I thought a female doctor would be easier. It was a first step but it wasn’t the solution facebook seems to be suggesting it was. Telling her wasn’t enough. I needed her support but I also needed meds and I needed time.

That first type of antidepressants made me ill so I ended up telling most of my carers although I’d not meant to. Several of them said “me too.” and I was shocked. Telling people might have been easier if I’d known how common it was. I felt less alone.

I went back a few weeks later for review and I did tell my then GP because really I loved my uni GP because he also had CP and he got a lot of what I went through. Over the years he’s been one of the few medics I’ve never had to convince that my depression isn’t caused by my CP. He’d seen me a lot in the months before for UTI and chest infections and I don’t know what else routine stuff. And he apologised to me for missing my mental health problems. It meant a lot to me but I wasn’t surprised and I didn’t blame him. I’d hidden it.

And since then over the last 11 years I’ve been on and off of antidepressants. I’ve told a lot of people about my mental health.

I’ve told friends. Family. Doctors, counsellors, social workers. Carers and some other people too.

Sometimes it helps a lot. Sometimes it helps a little. Sometimes it doesn’t help. And unfortunately sometimes it makes it worse.

I’ve had the response:

That I’m being silly

That I just need to stop taking antidepressants because they “are addictive and bad for you.”

That of course I’m depressed because I’ve got CP, what do I expect?

That things that have triggered bad times are in the past and I need to move on.

That I’m worrying about nothing

This too will pass

“you think you’ve got it bad I’ve blah blah blah” from a friend who kept telling me to tell her when things were bad. She still does that now and she gets annoyed if she ever finds out I’ve not told her stuff. But I’ve never, in more than 11 years since diagnosis been able to have a conversation with her about my mental health problems without it immediately being turned into something all about her.

Offering to listen and encouraging me to tell you about my problems is huge. But I need you to actually listen.

How could you help someone in a mental health crisis:

Don’t use cliches like this too shall pass or the one I keep seeing today “suicide is a permanent solution to a temporary problem”. Robin Williams had been undergoing treatment for various mental health conditions for over twenty years. He had a real, serious illness not a temporary problem. Calling it that belittles his suffering.

If someone tells you don’t try and make them tell you exactly what it is they have to be depressed or anxious about. Mental health conditions can and do defy explanation.

Also, don’t make assumptions about causes. I’m sure some of the counselling I’ve had would have been more effective if I’d not spent so much time trying to get it though the counsellor’s head that the fact I can’t walk had nothing to do with my mental health. The assumptions of a supposed link between my physical disability and my mental health condition make it harder in fact.

Only make offers of support that you genuinely mean. If someone offers me the chance to talk but then tells me all of their problems rather than listening when I try to take them up on it I usually end up feeling worse because I feel alone and I’m worried about my friend.

Support takes different forms for different people. I have issues with medication compliance. Someone demanding to know everyday if I’d taken my meds (something one of my carers tried) didn;t help me. But when I had a friend who was also struggling with med compliance we would tweet each other and check in every day or two sort of “I’ve managed my meds today, how’re you doing?” that really helped.

Don’t try to force a particular therapy or drug on someone. Fluoxetine might be really great for people who have depression that worsens around their period. I was on fluoxetine when I first started raising that issue and it didn’t help. Sertraline did but all I kept being told from medics was “fluoxetine is good for that, perserve” until finally one switched me to sertraline for another reason. Friends told me fluoxetine was good too. It was good for me but it wasn’t the answer.

Just because you recovered doesn’t mean I will. I care about how you’re doing but when I’m really struggling telling me that I only need six months of antidepressants doesn’t help. And actually, the standard treatment isn’t six months of antidepressants. it’s treatment until condition improves and then for another six months to ensure no relapse.

If the person in question is able to lead you in what support they need try to follow them.

But don’t, ever just tell someone to “tell me” if you have a problem and expect that to be the answer. It’s a first step that you can take to helping them. Telling you is a brilliant first step for the person with mental health condition. But living with/treating/recovering from/whatever a mental health condition is a long, long journey. And it needs more than that first step of talking about it.