A: How are you doing?

B: I’m fine. How are you?

A pretty common refrain, right? Talking about mental health can be really tricky. Whether it’s speaking about what you’re going through, or trying to get a loved one or friend to open up, these conversations can be challenging, vulnerable, and scary. What’s more, many of us don’t even know the best way to start these conversations. We spoke to Dr. Kristen English - a licensed psychologist in Pennsylvania with over 18 years of counseling experience - about some conversation openers you can use to open a safe and productive dialogue around mental health with loved ones or friends in your life.

1) Don’t be afraid to bring it up - and don’t keep carrying on as usual.
Ask if something’s up if you notice your close friend or loved one doesn’t seem to be acting like themself.

Example: "Hey, you've seemed a bit (down/anxious/preoccupied) lately, and I was wondering if you're doing okay."

2) Welcome conversation.
If you're attempting to interpret why close friends/family members are not confiding their mental health concerns, despite their apparent struggles, they may be holding off because they don't want to be a "burden." Clients regularly state this as their reason for not reaching out to supportive others in their lives.

Example: "I'm glad to listen if that'd be helpful. I totally know you'd do the same for me if the roles were reversed."

3) Ask direct questions.
Don't hesitate to ask direct questions about friends'/loved ones' specific experiences with their mental illness. So often, the person struggling is grateful for the opportunity to express themselves to a generous listener.

Example: "Oh man, that sounds really tough. What's it been like, feeling that way at (home/school/work)?"


4) Talk about yourself.
It seems counterintuitive, but friends or loved ones might be more inclined to open up if they hear us reference our own or others' experiences with emotional challenges.

Example: "Man, I've been feeling really down on myself lately. Do you ever go through bouts like that?"

Example: "I've been talking to my work friend, and he's having a rough time with anxiety right now. I really feel for him. It can just be really hard sometimes, huh?”

5) Share something!
Friends/loved ones might be more inclined to open up if we share articles, blog posts, or podcasts in a manner that doesn't single them out.

Example: "Hey, I got a ton out of this (article/blog post/podcast), and I've been sharing it around. I've been asking folks for their reactions – if it prompts any."

6) Don’t worry about solutions.
Our role as confidant is not to fix. I often hear from clients that they avoid reaching out to folks whom they anticipate trying to fix their problems with advice or sugar-coating, rather than simply listening to them in the spirit of generous, nourishing witnessing. As you're listening actively, try to maintain a voice that's compassionate and even curious, but not pitying.

Example:"That all sounds really overwhelming...such hard stuff to be carrying."


7) Schedule an activity.
Face-to-face conversations can be intimidating and alienating, especially if you are dealing with anxiety or depression. Sometimes it's easier to open up if we're moving or engaged in activities that don't have us sitting face-to-face.

Example: "Hey, I'd love to catch up! Want to (take a walk / go for a drive / do this puzzle / try out this recipe) together?"

8) Check in and offer help
Once you've opened these conversations with friends and loved ones, periodically check in, allowing them opportunities to talk if they'd like, while also giving them room to decline.

Example: "Hey, I've been thinking about you and just wanted to check-in. How's stuff been going lately?"

As you're having a conversation with someone who's struggling, ask them if there's anything you can do to help. Prompt them with concrete examples of helping tactics and specific time-frames for providing the help. Keep an ear out for their specific directives/preferences (within reason and safety) so that you're helping in the spirit of what they personally need, as opposed to imposing your own lens onto them.

Example: "Hey, I'm just thinking about everything you're juggling right now. If it wouldn't feel overwhelming, would it be okay if I brought over some dinner on Tuesday? While we're at it, do you have a grocery list you could text me? I'll be at the store for my own groceries this afternoon, and I'm happy to pick up your stuff too."

Even though these are hard conversations to have, don’t be afraid to ask your friend or loved one how they’re doing. Creating a line of support and opening a space for dialogue can make a massive impact on someone struggling with mental health issues. Don’t worry about being the solution – an open ear, open mind, and open heart can go a long way.

Sesame content is not intended to be a substitute for professional medical advice, diagnosis or treatment. If you have a medical concern, it is critical to seek the advice of your physician or another qualified health provider with any questions. If you are facing a medical emergency, call 911 or visit the nearest emergency room immediately.

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