How to Help a Friend Who’s Struggling with Their Mental Health

Young adults have felt the impact of pandemic-related stressors more than any other age group. Interruptions to work and school, increased political strife, and limited social interaction have added to the burden of uncertainty and pressure this generation was already carrying. At one point during 2020, three-quarters of young adults were experiencing symptoms of anxiety and depression—and for many of those young people, these issues haven’t gone away. 

The silver lining is that more young adults than ever before are talking openly about mental health, in person and on social media, at home and in the workplace. “Young people are advocating for their needs and for the needs of others who are suffering,” says Newport Executive Director Leigh McInnis, LPC. “They’re speaking their feelings out loud, telling others that’s it’s okay to feel these feelings, and advocating to make space for them.”

But sometimes reminding a friend who’s struggling that “it’s okay to not be okay” isn’t enough. It isn’t easy to know how to help a friend with depression or another mental health concern—or what to do if you’re worried about a friend who seems to be having a hard time but hasn’t opened up to you about it.

How to Tell Someone You’re Worried About Them

First, find the right time and place to have a private discussion that won’t be rushed. Then share your concerns with compassion and without judgment. One of the most important aspects of how to help a friend is the attitude you bring to the initial conversation.

You might mention examples of your friend’s behavior that have you worried, such as their withdrawal from social activities, seeming sad or negative most of the time, signs of self-harm, or excessive use of drugs or alcohol. Once you’ve expressed your concerns, let your friend talk.

Here a few tips to help make the conversation more productive:

• Practice active listening—focus fully on what they’re saying rather than formulating your next response while they’re talking
• Validate their emotions without belittling or minimizing them; you might use a phrase like “That sounds really hard”
• Ask open-ended questions like “Can you tell me more about how you’ve been feeling?”
• Resist the temptation to suggest a diagnosis or offer advice
• Assure your friend that you care about them and you’re there for them
• Find out if there’s anything they would like you to do, such as helping them to access professional support
• Don’t pressure them to share more information than they willingly offer.

If you have experienced a similar struggle, it’s okay to talk a little bit about what you went through, as a way to show empathy and share hope for the future. But be careful not to turn the conversation into a monologue about your own experience. 

What a Concerned Friend Can Do

Once you’ve approached a friend to express your concerns, what’s the next step to take? If they’ve asked you for concrete support, such as researching therapy options or having a daily check-in call or text, be sure to follow up on that right away.

But what if you left the conversation without any actions to take? If that’s the case, then the best approach for how to help a friend with depression, anxiety, social anxiety, or other mental health issues is to keep reaching out. Invite them to take a walk, come to a gathering, or go out for coffee—and don’t be deterred if they say no more often than not. Keep asking, and let them know how much you value them and their company.

When you do get together, ask questions and listen—but also share what’s new in your life. Just because you’re worried about a friend doesn’t mean that every conversation should focus on what they’re going through. That won’t be helpful to them or to you. Be open about your own challenges, so they know that they’re not alone in dealing with hard things.

5 Steps for How to Help a Friend with Substance Abuse Issues

One of the most common worries young adults have is, “Is my friend an addict?” But the real question to ask is whether a friend is struggling with their mental health. It’s important for a concerned friend to understand that substance abuse is a symptom of an underlying mental health issue, such as trauma, depression, anxiety, bipolar disorder, or another mental health issue.

1. Make sure that your friend is sober when you share your concerns.
2. Include specific examples of their behavior that is concerning you.
3. Let them know how these behaviors are affecting your relationship.
4. Come prepared with information about local treatment options or support groups.
5. Continue to express how much you care about your friend and how much you want them to get help.

Figuring out how to help a friend with addiction issues can be very difficult, particularly if they are in denial about their substance abuse or alcohol abuse. Remember to tap into compassion and to think about the larger issues your friend is going through that may be manifesting as substance abuse. Blaming or shaming them for their behavior is not how to help a friend. And if they continue to resist the ideas that they need support, let the conversation go, at least for now. It might have planted a seed that they will think about and act on later.

How Far Should You Go to Help a Friend with Depression or Substance Use Disorder?

No matter how much you care about your friend, there is only so much you can do. It’s not healthy for either person if the concerned friend makes themselves constantly available around the clock for calls or crises. Moreover, if the friendship has become toxic, don’t keep it going just because you’re afraid something bad will happen if you’re not there. And don’t expose yourself to potential danger in an attempt to keep a friend safe.

If you’re the only person your friend has opened up to about their struggles, encourage them to talk to other friends or family members. If you see that they’re getting worse and not seeking help or confiding in others, you might need to tell someone else what’s going on—a mutual friend, someone in your friend’s family, a shared mentor, etc. Although your friend may be angry that you shared this information, eventually they will understand why you made that choice, and may even be grateful that you did.

Ultimately, if your friend is over 18, it is their decision whether or not to seek help. As painful as it may be to witness their struggle, all you can do is continue to offer your support and caring.

Take Care of Yourself First

When considering how to help a friend, don’t forget that taking care of yourself comes first. It’s stressful to be worried about a friend, especially if you feel helpless or if they have shut you out, so you need to take care of yourself as well as trying to help them. “Young adults need to love and care for themselves in order to care for others,” Leigh says.

Moreover, attending to your own mental and physical health is a way to model positive behavior for your friend who is struggling. You can even invite them to join you in this effort if you wish: You could both go to a weekly yoga class or you could join a support group together. But don’t let your self-care revolve around their needs; prioritize your schedule and your own well-being.

Read “6 Daily Self-Care Practices for Young Adults.”

What to Do in a Mental Health Emergency

If you believe a friend is in immediate danger due to mental health or substance abuse issues, take action to make sure they are safe.

• Call 1-800-273-TALK (8255) to reach a 24-hour crisis center through the National Suicide Prevention Lifeline.
• Text MHA to 741741 to connect with a trained Crisis Counselor from the Crisis Text Line.
• Call 911 or take them to the nearest emergency room.

Mental Health America also provides free, confidential “warmlines” that you or a friend can call if you need support but there is no immediate danger. Find a warmline at mhanational.org/warmlines.

Treatment for Depression, Anxiety, and Substance Abuse at Newport Institute

At Newport Institute, our mission is to help young adults build self-worth, authentic connections with others, and a sense of purpose and hope. We address the trauma and attachment wounds underlying mental health issues like depression, anxiety, substance abuse, and other co-occurring disorders. Our team of clinicians, medical experts, and experiential therapists guide young adults to navigate the internal and external challenges they face during this pivotal stage of life.

Contact us today to find out more about our specialized care for young adults. Even if Newport isn’t the right fit for you, we’ll help you access resources to support you or your loved ones.

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