How to Help a Loved One: Growing our Awareness of Mental Health by Rebecca Pearlstein, PsyD

The emergence of a mental health condition is often accompanied by an aggregation of warning signs. Knowing these markers, or subtle changes in behavior, can make a crucial impact in providing our loved ones professional help when they need it the most. In many cases this is a matter of life or death. These early warning signs may range from the subtle non-verbal cues we observe, to uncharacteristic verbal or physical acting-out behaviors.

Non-verbal expressions make up approximately 90% of our communication to the world, thus it is these communications that give us the earliest signs that our loved one may be struggling with an inner battle. Isolative behavior, dissociation, or noticing if they are “zoning out” may be first signs that they are turning inward. These behaviors are often concurrent with avoidance; is your friend or partner declining to partake in activities in which they previously found joy and excitement? Are you noticing increased fatigue, sleep, or general malaise? Notice how long these behaviors are occurring. While a few hours of alone time is generally normative, isolating for days on end, from four days to a week or more is significant and casts a red flag. These observable behaviors may indicate a struggle in managing their mood and may point to the beginnings of a depressive episode.

Some less-subtle behaviors to be aware of are verbal expressions of hopelessness, or overt acts or expressions of aggression. A sudden change in mood, marked by irritability or agitation, is often a mask for the pain and sadness one struggles with internally. These changes in mood and behavior, in most cases, rarely come out of the blue. It is important to consider any environmental change, in other words, was there a trigger or precipitating event that preceded these changes in behavior? Perhaps there was a recent death, an anniversary of a death, a job change or loss, news of a medical illness, end of a relationship, or changes in the sociopolitical environment.

What then, can be done if we begin to observe these behaviors? First, take a breath, and know that there is help. We often might be frustrated, or hopeless ourselves, when our initial efforts to help are turned away, or the aggression is turned or displaced on us. If we observe the signs or hear expressions of hopelessness, it is okay, and encouraged, to ask if they are having thoughts of hurting themselves. Remind them that they are not alone, because they are not. In the immediate short term, there are 24-hour suicide hotlines to call and text. You can also call 211, a helpline that can assist you in locating available resources in your community. An appointment with your primary care doctor is encouraged to rule-out a medical explanation for the changes, this doctor can then provide you with referrals for a licensed therapist and psychiatrist for therapy and medication management. When we respond to the initial warning signs, ask questions, remind our loved ones that we are there for them and follow up with them, our support and persistence can make all of the difference.

Help is always available, call the National Suicide Prevention Hotline if you or a loved one is struggling with thoughts of suicide: 1-800-273-8255.

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