Wednesday 8 June 2022

How to Educate Yourself about Your Friend's Mental Health Condition

It’s easier to be there for someone if you understand what they’re going through. But how can you understand if you’ve never been there yourself? That’s the situation I found myself in when I met my best friend Fran for the first time in 2011.

Fran lives with three chronic health conditions I’d never experienced and knew nothing about: bipolar disorder, chronic fatigue syndrome (CFS/ME), and fibromyalgia. Being her friend didn’t mean I had to become an expert in any of these but I wanted to learn as much as I could, so I could be there for her as effectively as possible.

I’m sharing my education journey in the hope it might help someone in a similar position. I’ll focus on bipolar disorder but the principles apply no matter what mental or physical health condition your friend or loved one lives with. It’s also relevant to other lived experience including abuse, bereavement, discrimination, self-harm, stigma, suicidality, or trauma.

Whatever your friend’s situation, approach educating yourself about it as a privileged insight into something you may never fully understand.

Why Bother?

You might wonder why you’d want to take the time and trouble to learn about your friend’s health condition. What’s in it for you? Fran never asked or expected me to educate myself about her situation, but our friendship has benefited enormously in many ways. Yours can too.

  • You’ll be more aware of what your friend is going through.
  • You’ll be more aware of, and better understand, potential treatment options.
  • You’ll be better placed to support your friend in ways that are helpful to them.
  • You’ll find it easier to hold an open and non-judgemental space for your friend to talk about what’s going on for them.

Most important of all, you will demonstrate your commitment to your friendship. Your friend is far more than their illness and symptoms, but by taking time to learn what you can, you’re acknowledging the impact they have in your friend’s life.

Educating yourself isn’t about proving what a great person you are, diagnosing your friend or helping them self-diagnose, showing you know more than they do, telling them what to do, or intervening in their life or treatment. The only exception to that is if you feel they are in urgent need of help or are at immediate risk.

You’re not doing it solely for your friend, however. In Why Do You Do It? I described some of the things I’ve learned about myself and how much I’ve gained personally.

I am a better person for knowing Fran. I have a greater understanding of my strengths, values, weaknesses, and vulnerabilities than ever before. I have learned more about mental and invisible illness, suicidal thinking, stigma, determination, courage, and responsibility since we became friends than in the fifty years before we met. [...] I have greatly expanded my circle of friends, met people who feel safe sharing their stories in response to mine, and learned how it feels to offer my skills and experience in the service of others. I have grown — and continue to grow — as a friend and as a man.

I’ve shared a few further insights in a post titled Three Things I Wish People Knew about Loving Someone with Mental Illness.

How Much Do I Need to Know?

No one is suggesting you enrol with your local school of medicine or train as a counsellor or therapist. Fran doesn’t need me to be an expert. She is the expert in how her illnesses affect her, and has professionals to fulfil those specialist roles. It took a while for me to understand where I fit into that team, what I could usefully learn, and how my unique perspective could benefit her most. As I describe in our book:

At first, I imagined I could discover all I needed to know by talking with Fran and spending time with her. I learned a great deal, but after a while I realised I needed additional sources of information. No book, website, or training course can tell me how illness affects Fran personally, but she does not know everything about mental illness and cannot provide a broader, impartial perspective. I seek to educate myself by talking to people with lived experience, by reading books and online material, by taking relevant courses and training, and by participating in the wider mental health community.

Let’s take a look at my journey in a little more detail.

Start With What You Know Already

It wasn’t just that Fran lived with three illnesses I didn’t understand. More fundamentally, she lived with illness, and I needed to get my head around what that meant before I could move on to the details. It helped that we were able to discuss what wellness and illness meant to each of us, and the very different life experiences that had brought us to those individual understandings. Acknowledging the differences provided a solid foundation for the next stages in my education journey. You can read my experience of illness here.

Talk to People With Lived Experience

There’s no better way to understand what it means to live with illness than by talking with people who actually do. Fran and other friends have encouraged me to learn about their health conditions. It’s important to remember, however, that it’s not their responsibility to educate me. In particular, there are times when they have far too much going on in their lives to help me understand. I recall one friend who found it exhausting having to explain things to me all the time, especially when she was struggling. At such times, she needed friends who understood what she was dealing with because they’d been there themselves.

I learn best by exploring what Fran or other friends are experiencing in the moment, rather than trying to understand everything all at once or treating them like a reference textbook. Relentless questioning is unnecessary and unkind, but asking appropriate questions can help each of you explore what’s going on. My friend and fellow mental health blogger Aimee Wilson expressed this beautifully in an open letter to me on her blog:

I love that you ask me questions when I’m struggling because it’s much more helpful than you just sitting there and nodding along, pretending to understand.

I’ve explored what I mean by appropriate questions in a previous article. Bear in mind there may be things your friend is unwilling or unable to talk about, either at that particular time or at all. If so, respect your friend’s boundaries and don’t push for more than they’re prepared to share with you.

Asking questions implies listening to the answers. Listening is an important skill in itself and harder than it seems. Treat it as part of your education journey. As well as learning about your friend’s health condition, you’re learning to communicate effectively and compassionately. One of the most valuable lessons I learned is that there are different types of caring conversation, depending on a person’s needs at the time.

It’s not all about symptoms and treatments. There are some things you can only learn by talking with someone who has lived experience, such as the determination it takes to keep moving forward despite crippling anxiety, depression, insomnia, or suicidality; how it feels to face stigma and discrimination from people with no interest in understanding; how disheartening it can be to ask for help only to find none available; or the courage it takes to unravel past trauma though counselling and therapy.

Not everything will be easy to hear. I’ve shared a few examples in a post titled Four Things It’s Hard for a Mental Health Ally to Hear (And Why It’s Important to Listen).

Books and Online Resources

I’ve found a wide range of books useful, including memoirs and autobiographies by authors with lived experience, biographies, and books written for partners, carers, and friends. Of these, the final category was by far the least represented. There were books for partners, such as When Someone You Love is Bipolar: Help and Support for You and Your Partner, by Cynthia G. Last, and Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner, by Julie A. Fast and John D. Preston, but nothing specifically for friends. Fran and I wrote High Tide, Low Tide: The Caring Friend’s Guide to Bipolar Disorder to address that need.

I recommend the Stigma Fighters collections of short personal stories by people with experience of a range of mental health conditions. In four volumes, the Stigma Fighters anthologies are available in print and e-book editions. The stories are also available on the Stigma Fighters website. (You can find my contribution here.) The range of diagnoses, symptoms, and situations the authors describe helped me appreciate both the uniqueness of someone’s experience, and certain repeated or common themes.

Blogs, vlogs, and podcasts are another valuable resource, not least because they are usually intensely personal and tend to be updated frequently. For bipolar disorder I recommend Julie A. Fast’s blog Bipolar Happens, and her articles at BP Hope magazine and Health Central. If you want to learn about living with borderline personality disorder (BPD) check out my friend Aimee Wilson’s blog I’m NOT Disordered.

Two podcasts by mental health author and speaker Gabe Howard deserve mention: Inside Mental Health and A Bipolar, a Schizophrenic, and a Podcast. The latter, co-hosted by Michelle Hammer, “looks at life through the unique lens of people living with depression, schizophrenia, and bipolar disorder.”

Courses and Training

There’s a wide range of courses and training material, much of which is online and either free or low-cost. Some more expensive training, such as Mental Health First Aid (MHFA) or Applied Suicide Intervention Skills Training (ASIST) may be free or subsidised depending where you live and your personal circumstances. I’ve taken these and many other courses over the years and found most interesting and informative. You can find a selection on our resources page; we also have a list of online suicide awareness courses and podcasts. I particularly recommend Beating Bipolar and the free suicide awareness training at ZSA.

The Wider Mental Health Community

Fran had good connections with local mental health organisations, including the Maine chapter of the National Alliance on Mental Illness (NAMI) and Family Hope. I learned a lot from these but at a certain point I realised it would help to connect with similar organisations here in the UK. This led to me volunteering with the anti-stigma campaign Time to Change. I learned a great deal about myself in the process, met some amazing people, and made several lasting friendships. Volunteering gave me the confidence to become involved with mental health and wellbeing initiatives in my place of work. This opened opportunities to attend conferences and events, and become part of the wider Mental Health First Aider network.

It’s worth noting that some groups or resources may not be available to you without relevant lived experience. I was privileged to attend a few courses run by my local recovery college, including sessions on self-harm and wellness recovery action planning (WRAP). The college meant a lot to me, but it’s run by people with lived experience for people with lived experience, and I respect the fact I couldn’t continue attending.

I’ve found several mental health organisations helpful. No Stigmas offers excellent online ally training covering self-care, peer support, and advocacy. I joined Mind, Bipolar UK, and Bring Change 2 Mind for a broader awareness of news and issues across the mental health community.

Stay Humble and Open

As valuable as it is to educate yourself, it’s important to remain realistic and humble. No matter how many conversations you have, books you read, or courses you take, you’ll never really know what it’s like for your friend. They’re the experts when it comes to the life they’re living, the issues they deal with, and the support and help they need.

Recognise too that you’ll still get things wrong! This might be because you haven’t learned enough about what your friend is going through, or you’ve made assumptions that are wrong, inappropriate, or unhelpful. Treat each mistake as an opportunity for learning. If you’re honest and open about your mistakes you and your friend can both grow from the experience. I’m reminded of a conversation with Aimee, after I’d messed up badly.

I’m not sure if you agree, Aimee, but I’d say we understand there are times we will get it wrong, and that’s OK. It might not feel OK at the time but it will be when we are able to step back a little.

Definitely! And I think more and more we’re learning not to feel like total failures if we do get it wrong, and not blame one another for it.

It wasn’t the first or last time I’ve got it wrong, but we continue to be honest with each other when problems arise.

Learning About You Too

While you’re learning about what your friend goes through, don’t neglect your needs as a supportive friend. That’s something you’re learning about too. Even if you don’t consider yourself in a caregiver role, check out organisations such as Carers UK, Carers Trust, or government sites such as this UK page on support and benefits for carers.

Many organisations that support people living with illness have information and resources for caregivers, for example Bipolar UK, and Mind. Look for carer groups on social media too. Julie A. Fast runs two Facebook groups: one for partners of people with bipolar or schizoaffective disorder, and one for parents and caregivers. Hearing what other people in supportive roles have learned can add to your understanding.

I began this journey with no personal experience of mental illness, but learning what Fran and other friends live with has given me a much greater understanding of my own mental and physical health. I’ve explored this in such posts as Return to Down, THIS BOY GETS SAD TOO, and How International Men’s Day Inspired My First Doctor’s Appointment in 30 Years.

I’ve found that being open and honest about what I’m going through — both here on our blog and in private with friends — makes it easier to ask for help when I need it. It also helps my friends support me from a place of greater understanding. Aimee expressed this well in a recent conversation: “I’m glad you can be honest with me, Marty. No one can support a person who isn’t honest about how they feel, so you being open enables me to really be there for you.”

Over to You

In this article I’ve shared how I’ve approached educating myself about my friends’ experiences with illness. If you’ve been in a similar situation, what helped you most? What worked or didn’t work? Do you feel your friendship benefited? If you live with illness, what advice would you give a friend who wants to learn more about your situation? Do you want people to know, or does that feel like an imposition? Whose responsibility is it to educate people about what it means to live with illness?

Drop a comment below, or get in touch through our contact page.

 

Image by Tim Mossholder at Unsplash.

 

3 comments:

  1. Hi Martin just wanted to say what a wonderful article you have wrote, it is so enlightening, thoughtful and loving. Keep up the good work, you are a beacon in the dark assisting those who are experiencing issues and assisting good friends to understand.

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  2. Given that we all experience bipolar disorder differently, I would recommend to friends of bipolar patients that they approach directly their bipolar friend in conversation. This way your friend can share with you what matters most to them.

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    1. Thank you for commenting. I agree very much with what you say, and I hope that's reflected in the article, specifically the section on talking to (and listening to!) people with lived experience. That's certainly how I began my journey, talking with Fran and other friends who live with bipolar disorder. It's also the way to discover how much of whatever you may have learned in other ways is applicable to their situation. Thank you again.
      — Marty

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