We all go through tough times and people help us through them. Other times we have been worried about other people’s mental health. Whether they are a friend, family member or colleague, there are many ways to support somebody you care about.

1 in 6 people experienced a common mental health problem such as anxiety or depression in the past week.

What is mental health and wellbeing?

What are mental health problems?

How do I know if someone has a mental health problem?

Sometimes it will seem obvious when someone is going through a hard time, but there is no simple way of knowing if they have a mental health problem. Sometimes you don’t need to know. It’s more important to respond sensitively to someone who seems troubled than to find out whether or not they have a diagnosis.

Although certain symptoms are common with specific mental health problems, no two people behave in exactly the same way when they are unwell. If you know the person well, you may notice changes in their behaviour or mood.

Below are some signs of common mental health problems. Our A-Z of mental health provides information on a range of mental health problems not covered here.

Signs of depression People who are depressed may: have low confidence

lose interest in activities they normal enjoy

lose their appetite

get tired easily

be tearful, nervous or irritable. At worst they may feel suicidal.

Signs of anxiety People experiencing anxiety may: have difficulty concentrating

be irritable

try to avoid certain situations

appear pale and tense

be easily startled by everyday sounds.

Panic attacks Panic attacks are usually a sign of anxiety. Someone having a panic attack experiences a sudden and intense sensation of fear. They may breathe rapidly, sweat, feel very hot or cold, feel sick or feel faint.

Obsessive compulsive disorder (OCD) OCD is a common form of anxiety involving distressing repetitive thoughts. Compulsions are the actions which people feel they must repeat to feel less anxious or stop their obsessive thoughts.

Some people who are distressed deliberately harm their bodies, usually secretly, using self-harm as a way of dealing with intense emotional pain. They may cut, burn, scald or scratch themselves, injure themselves, pull their hair or swallow poisonous substances.

Some people experience a severe mental health problem, such as bipolar disorder or schizophrenia. They may have periods when they experience their own or a different reality. They may hear voices, see things no-one else sees, hold unusual beliefs, feel exceptionally self-important or read particular meanings into everyday events.

How can I help?

There are a number of ways you can help a friend, relative or colleague who has a mental health problem:

Talking about mental health

If you are worried about someone it can be difficult to know what to do. When you are aware there is an issue, it is important not to wait. Waiting and hoping they will come to you for help might lose valuable time in getting them support.

Talking to someone is often the first step to take when you know they are going through a hard time. This way you can find out what is troubling them and what you can do to help.

Eight tips for talking about mental health 1. Set time aside with no distractions It is important to provide an open and non-judgemental space with no distractions. 2. Let them share as much or as little as they want to Let them lead the discussion at their own pace. Don’t put pressure on them to tell you anything they aren’t ready to talk about. Talking can take a lot of trust and courage. You might be the first person they have been able to talk to about this. 3. Don't try to diagnose or second guess their feelings You probably aren’t a medical expert and, while you may be happy to talk and offer support, you aren’t a trained counsellor. Try not to make assumptions about what is wrong or jump in too quickly with your own diagnosis or solutions. 4. Keep questions open ended Say "Why don’t you tell me how you are feeling?" rather than "I can see you are feeling very low". Try to keep your language neutral. Give the person time to answer and try not to grill them with too many questions. 5. Talk about wellbeing Exercise, having a healthy diet and taking a break can help protect mental health and sustain wellbeing. Talk about ways of de-stressing and ask if they find anything helpful. 6. Listen carefully to what they tell you Repeat what they have said back to them to ensure you have understood it. You don’t have to agree with what they are saying, but by showing you understand how they feel, you are letting them know you respect their feelings. 7. Offer them help in seeking professional support and provide information on ways to do this You might want to offer to go the GP with them, or help them talk to a friend or family member. Try not to take control and allow them to make decisions. 8. Know your limits Ask for help or signpost if the problem is serious. If you believe they are in immediate danger or they have injuries that need medical attention, you need to take action to make sure they are safe. More details on dealing in a crisis can be found below.

If it is a family member or close friend you are concerned about, they might not want to talk to you. Try not to take this personally: talking to someone you love can be difficult as they might be worried they are hurting you. It is important to keep being open and honest and telling them that you care. It may also be helpful to give them information of organisations or people they can reach out to. A list can be found below.

How do I respond in a crisis?

People with mental health problems sometimes experience a crisis, such as breaking down in tears, having a panic attack, feeling suicidal, or experiencing their own or a different reality.

You may feel a sense of crisis too, but it’s important to stay calm yourself.

There are some general strategies that you can use to help:

Listen without making judgements and concentrate on their needs in that moment.

Ask them what would help them.

Reassure and signpost to practical information or resources.

Avoid confrontation.

Ask if there is someone they would like you to contact.

Encourage them to seek appropriate professional help.

If they have hurt themselves, make sure they get the first aid they need.

Seeing, hearing or believing things that no-one else does can be the symptom of a mental health problem. It can be frightening and upsetting. Gently remind the person who you are and why you are there. Don’t reinforce or dismiss their experiences, but acknowledge how the symptoms are making them feel.

How do I respond if someone is suicidal?

If someone tells you they are feeling suicidal or can’t go on, or if you suspect they are thinking of taking their own life, it is very important to encourage them to get help. You or they should contact a GP or NHS 111. They can also contact the Samaritans straight away by calling 116 123 (UK) for free at any time. They could also get help from their friends, family, or mental health services.

You can ask how they are feeling and let them know that you are available to listen. Talking can be a great help to someone who is feeling suicidal, but it may be distressing for you. It is important for you to talk to someone about your own feelings and the Samaritans can help you as well.

Useful organisations and resources

The first person to approach is your family doctor. He or she should be able to give advice about treatment, and may refer you to another local professional. See our guide on How to talk to your GP about your mental health.

Specialist mental health services

There are a number of specialist services that provide various treatments, including counselling and other talking treatments. Often these different services are coordinated by a community mental health team (CMHT), which is usually based either at a hospital or a local community mental health centre. Some teams provide 24-hour services so that you can contact them in a crisis. You should be able to contact your local CMHT through your local social services or social work team.

Samaritans

The Samaritans offer emotional support 24 hours a day, in full confidence. Call 116 123 or email [email protected].

Mind Infoline

Mind provides information on a range of mental health topics to support people in their own area from 9.00am to 6.00pm, Monday to Friday. Call 0300 123 3393 or email [email protected].

Rethink Advice and Information Service

Rethink provide specific solution-based guidance: 0300 5000927 Fax: 020 7820 1149 E-mail: a[email protected].

Anxiety

Anxiety UK runs a helpline staffed by volunteers with personal experience of anxiety from 9:30-5:30, Monday to Friday. Call 08444 775 774.

Citizens Advice

Citizens Advice provides free, independent and confidential advice for a range of problems as well as providing information on your rights and responsibilities.

Step Change

StepChange provides help and information for people dealing with a range of debt problems. Freephone (including from mobiles) 0800 138 1111 or visit the website on www.stepchange.org.

MindEd

MindEd is a free educational resource on children and young people’s mental health for all adults.