What to do when a friend is struggling with mental health difficulties

At Heads Up Durham we are running ‘Look After Your Mate’ week from the 1st-8th November. Tonight -2nd November- we are holding a social contact event (see event page here) in which students will speak about their own experiences and provide an open and non-judgemental space to discuss their thoughts on supporting a friend and on how they themselves would want to be supported. 

-Megan Stokell

With all the new stresses that come with university, it is highly likely that everyone will know someone who is struggling with their mental health at any given time. However, it can be very difficult to know how to respond to this, especially if you have never experienced these kind of issues before. Although everyone is different and therefore there will be certain things that work for one person and not another, this post aims to give a starting point for initiating an open dialogue about mental health with your friend, ways to be there and ways to look after yourself in the process.

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How to tell if someone  is struggling

This is one of the hardest things about supporting a friend: not knowing if they really need the support! Particularly when you are in the earlier stages of a friendship, it can be really difficult to know whether that person is simply naturally shy or is withdrawing due to severe social anxiety. Although many of the tell-tale signs of struggling with mental health difficulties can be exhibited in mentally healthy ways, here are some things to keep an eye out for:

  • What they say! 

Sometimes they will talk about things as ‘normal’ that you can recognise as a deeper problem. For example, when one of my friends was stressed about exams, as everyone was in third term, she mentioned that this stress was causing panic attacks and vomiting. Another example: a friend continually obsessing over calories in food and the guilt they felt about eating ‘unhealthy food’ could be taken as normal in our modern ‘diet culture’ but could also be a sign of a deeply unhealthy relationship with food and a possible eating disorder.

  • Any noticeable change in how they are

Becoming more withdrawn, any change in weight or sleeping pattern and mood swings can all be signs of mental health difficulties.

  • Difficulty in everyday functioning

Regularly missing academic commitments, difficulty eating or leaving the house, or a change in personal hygiene can all be signs that someone is struggling with mental health difficulties.

How to start the ~mental health discussion~

Particularly with a new friend, it can be very difficult to know how to broach the subject of mental health: it is not uncommon for those struggling to get defensive or deny that there is a problem.

The important thing is not to be confrontational, or tell them that there is something wrong with them. Do not try to force them into telling you what is going on with them; ask how they’re doing in general, let them know that you’re there and a non-judgemental space, that you’ve noticed that they’ve been seeming to have a tough time and if there’s anything you can do.


It can also help to share personal experiences (if you have them) of mental health difficulties first; personally I am one to tell people my deepest darkest secrets the second I get a whiff of alcohol and so after one week, all of my first year flatmates knew my mental health history. While this was a bit scary, it was also very helpful as it meant that we all recognised that our flat was a non-judgemental space and that other people then felt more comfortable to talk if they were struggling.

Ways to look after your mate

  • Just listen! Never judge them, and do not feel like you need to give them advice- a lot of the time, people just need to talk it out and a barrage of advice can be overwhelming.


  • Validate them- even if the way they feel or think seems totally irrational to you, remind them that they aren’t being stupid, that they are feeling the way they are for a reason and that their difficulties need not be compared to anyone else who ‘has it worse’. If they feel the need to talk about their problem then I guarantee it is something worth talking about.


  • Ask them how to help- a lot of time, the answer will probably be that they don’t know how you can help them, but if they do, it pays to ask. If you don’t ask, people often won’t tell as they may feel that they are being too demanding. Something as simple as picking up something for them when you go to the shop or sitting with them while they make a doctor’s appointment can make all the difference.


  • Remind them that not everything they think or feel is the case in reality. Practice statements that both validate and rationalise like ‘you feel like nobody likes you but I can promise you that this is not the case, we all care about you’ or ‘I understand that you feel like you need to lose weight, but try to to recognise that this is not true from a health or aesthetic standpoint- you’re gorgeous as you are’ etc.


  • Keep them involved; if they are struggling with social anxiety for example, then the last thing they need is to feel left out of group activities just because they can’t cope with attending, so hold a small group Netflix night or something else that they feel more comfortable with.


  • Encourage them to seek professional help: as a friend, your support is invaluable but a lot of the time, there is only so much you can do without them seeking help from someone trained to do so.

Remember to look after yourself!

Especially if you’re the only one that your friend has told about what they’re going through, it can be really difficult to focus on yourself instead of investing an unhealthy amount of your own mental energy in supporting them. This is one reason to encourage them to try and be open with others, whether it be other friends or a trained professional.

It’s okay to set boundaries! Let them know that as  much as you care about them, there will be times when you won’t be in a position to be able to support them as much as you want to. No friend will want their struggles to cause you to struggle. Spend time to yourself, either just having a laugh with another group of friends or attending a society, or practising some self care- a pamper night or watching your favourite film with some comfort food, a nice hot shower, etc.


Check out the Student Minds Look After Your Mate Guide! 


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