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Mental Health

Psychologist Alison Melley: How to be There for Your Friends with Mental Illness

This is Alison Melley’s second year teaching at George Mason University, and she teaches undergrad psychology courses as well as doctoral-level practicum in the Teaching of Psychology. She is trained as a clinical psychologist but hasn’t practiced as a clinician since 2005 when she took some time off to focus on her family. She entered the field 10 years later in teaching and loved it so much that she stayed. Psychological science is everywhere and can be applied to just about any situation, and that’s why she loves it.

TW: depression, anxiety, self-harm

What are some signs that a friend might be struggling?

AM: Things like a dramatic change in their behavior and personality is something that typically would make you think that something was going on. For example, somebody who normally gets up and has a routine for their day is instead staying in their pajamas all day, or they’re missing class when they normally wouldn’t miss class. They aren’t responding to your texts when they normally would. Or even vice versa- if they’re going out way more than they usually do. Any kind of obvious changes in behavior is the first thing in terms of signs. The problem is what doesn’t get noticed; someone who is just doing fine. They’re going to class, doing their work, in their routine. They’re trying to control everything by “just being fine.” That person you should also be concerned about because it can be less obvious.

What are the best ways to reach out to them without overwhelming them or crossing a line?

AM: Sometimes when it’s an acquaintance or someone you don’t know as well, you can feel like you’re being intrusive when you ask them if they’re okay. But in reality, that’s probably the best thing you could do- asking them how they are and actually meaning it. For someone that’s a better friend, it can be easier to just tell them what you’ve noticed and ask if there’s anything you can do. A great strategy for having someone feel more comfortable to open up to you is you opening up to them. Not necessarily pouring everything out, but if they ask you how you are, actually tell them. We all want to say we’re fine, but especially this year, we’re not all fine. Being comfortable saying that you aren’t fine can help others realize that they aren’t alone.

What are the best ways to support them and what tools can you offer them?

AM: One of the best things you can do for someone is to realize that you aren’t going to become their therapist, and you don’t want to take on the burden of trying to solve all of their problems. Yet at the same time, you’re worried and you want to help them. Something that’s becoming more of a buzz word these days is psychological first aid or mental health first aid. A lot of us learn things like CPR or how to handle a cut, and we all have our “toolboxes” of what to do or we have our people to call, like 911, our parents, or the doctor. But who do you call when you’re in a bad mood, feel like you might hurt yourself, or you’re really anxious? So, finding a “toolbox” of what helps you when you feel really sad or anxious instead of doing something that makes you feel worse is really important. Figure out which friends you can call when you’re feeling bad. Have your list of things you can do, which is different for everybody, and you can help your friend make that list. What can happen is, when someone is spiraling down into depression or panic, once they start to get worse, they can’t think straight anymore. It’s important that they catch themselves before they get all the way down, and then try to do something to help. You don’t always have to call a person, it can be getting in bed, or working out. The final tool in every single toolbox should be the National Suicide Hotline (800-273-8255).

How should you take care of yourself so that you can help take care of others?

AM: In general, I think the whole “self-care” thing has gotten a little bit out of control because it becomes another to-do list. You do need to take care of yourself to take care of other people, but it shouldn’t be something else to do. It should just be what you do when you have free time. Not to counteract myself, but one way you can do that is fit it into your routine each day. If the thing you really enjoy doing is something like exercising or reading a book, make sure that you are doing that thing that you love every day. But on your downtime, make sure you have time that’s blank, and you don’t have a to-do list. It’s okay to just veg or do nothing, and that’s self-care. People feel guilty, and think they should be painting their nails or doing something that is “taking care of themselves,” but sometimes you need to just not do anything. But the other important thing when you’re helping someone is to listen to your gut and ask yourself if it’s too much, or if you’re too in over your head. You should ask yourself if you’re actually helping the person when you aren’t reaching out to someone else to tell them that your friend needs help. Sometimes, your friend just needs help that you can give them. It’s important to know your boundaries.

How can you know your limits of helping someone through a crisis before it starts affecting you?

AM: If you become the main support for someone dealing with mental illness, they need more support than just your friendship or relationship. Look out for things like if they quit their therapist, or they stop taking their medication and just rely on you; that’s never good. Listen to yourself and know when it feels like too much. For example, when you’re spending more time worrying and caring for this other person than you feel like you want to, or if you’re making sacrifices that cause you to miss your class or lose sleep.

Do you have any advice for navigating this during COVID?

AM: Loneliness is probably the biggest problem right now mental health-wise, and it’s affecting everybody. To navigate it during this time when everyone is so shut off and tired of being on virtual things, make sure you have some regular connections. Even the people that are anxious being in class in person or enjoy being by themselves need to have that personal connection. Finding ways to do that could be meeting somebody outside all bundled up, or just dealing with the virtual environment. Even if it’s just one or two people that you’re connecting to, that’s perfectly fine, it doesn’t have to be that huge social network that we’re used to having in college. If you notice somebody that isn’t connecting, it can be really important to reach out to them. It can go a long way to just send a text to someone, and it can help you feel good too. That little bit of connection can go a long way, and it just takes 15 seconds out of your day. 

Do you have any other advice?

AM: The National Suicide Hotline is something that people don’t really like to talk about, but it’s so important. A lot of people worry that if you say the word, or you ask somebody if they’re thinking about hurting themselves, that you’ll give them ideas, but the reality is that you won’t give them any ideas that they didn’t already have. It’s better to ask, and then to have some backup (like the suicide hotline). Counselors often tell their patients to make the hotline one of their toolbox things- even if you aren’t actually thinking about hurting yourself, just test it out one day if you want somebody to talk to. Then, if you do that, you know what it’s like and you have it in your back pocket. Regarding the psychological toolbox, it’s important to know your own warning signs of when things are about to spiral, and it’s important for friends to know what those are. Knowing that if they do a certain thing, that’s when they need you to step in or ask if they’re okay. It can be hard to be supporting someone with serious mental health issues, but it’s totally doable if you’re willing to talk about it. If it becomes something you don’t want to talk about, that person becomes lonely, people feel like they aren’t connected, and nothing good comes out of it.

It’s important that we all look out for each other and help where we can, especially during these difficult times. Take care of your friends, but take care of yourself, too!

Madison Hoad

George Mason University '23

Madison is currently a junior on the Pre-Nursing track, minoring in both Psychology and Forensic Science. Her goal is to become either a surgical or forensic nurse. When Madison isn't studying, you can find her running, watching Netflix, grabbing Chipotle with friends, or exploring DC!
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