Mind Matters – How to talk to someone who is really struggling

Again in the news we hear there is a huge increase in people struggling with their wellbeing, with anxiety and depression rates soaring. Services are being expanded but it is getting more and more likely that someone close to you might be needing help.

Being a psychotherapist people often seek my advice when they are concerned about a friend or family member. In response to this I always start by asking “Do you believe you are unable to help – that you can’t think together about a way forward?”

Often I hear the problems appear so big and complicated there is a sense of not being able to help, of feeling overwhelmed and feelings of fear such that they have thoughts that anything they might try to do and say could make things worse. It is natural to experience such a response because it is likely the person you are concerned about is thinking and feeling this way too.

At this point many people become nervous that they are not equipped to help, particularly if powerful feelings are expressed and words come up like suicidal, crazy, murderous, out of control, psychopathic or any of a whole range powerful words or the many psychiatric terms that are becoming so widely used nowadays.

Instead it can be useful to recognise that actually your experience of being with them is potentially helping you to develop a good understanding of what is happening for them and that this means you are already helping.

These thoughts and feelings are most likely coming from a place of isolation, loneliness and desperation and the most effective way to start dealing with things is not to panic but to see if you have understood correctly. Do this by asking something like “I am wondering whether you are thinking the problems are too big and complicated, things can only get worse and you are feeling isolated, lonely and desperate?”

In doing this you will already be helping with the feelings of isolation and loneliness and your willingness to ask questions will already be challenging the feeling of desperation.

Now start to consider whether either of you might be struggling to talk freely. One of the most frequently given reasons people give for choosing to talk to a therapist is they don’t need to worry about what impact sharing their problems will have on either the other person or that relationship. So if you think that the conversation isn’t flowing freely then ask. You can then both think about whether there is someone else who it would be easier to talk to.

If you both decide to carry on talking then the next thing is to ask for as much information as possible. If suicide has been raised or if you find it enters your thinking then ask about it. Where suicide is spoken about then an organisation that offers really great information for helping people speak more easily is zerosuicidealliance.com. You might for example suggest looking at the site together?

Assuming you both feel it’s proving helpful to talk then you can think through together the basis of the concerns. Consider questions like: What is going on? What if anything has changed? Why might the concern have become apparent now? What has been tried to sort things out? What is different that means you are not coping like in the past?

Is this a completely new experience, if not what happened last time? What options have been considered and why have they been ruled out? What would you like to do if you could do anything you wanted? What would you say to your best friend if it was them in this situation? Ultimately think of questions that help the two of you to think through what to do and where to start in making their situation better. Often of course, if isolation is a key factor then talking may in itself be enough.

Remember although you are asking questions it is not for you to answer them. You might have opinions or think your own experiences are relevant – it can be helpful to share these but ask whether the person wants to hear them. Opinions can be really helpful if you know the person well enough, however remember answers are only really answers when we find them for ourselves – to give or be given an answer is rarely the answer! The most important opinions and experiences are the person’s own.

If after having talked things through the other person is still really distressed, ask what they would like to do now and what they want from you? If you are concerned, tell them what you would like to do. If you are struggling with feelings and thoughts because someone close to you is struggling then get support from others. Speak to friends or family you trust or speak to a therapist.

Finally, if you think there is an immediate threat to safety dial 999 or go to your local Accident and Emergency.

Nicholas Rose
Psychotherapist, Counsellor, Couples Counsellor and Coach

UKCP registrant, MBACP (accred), UKRCP
PGDip, MA, Adv Dip Ex Psych

Nicholas Rose & Associates
Counselling, psychotherapy and coaching for children, adults, couples and families.


Read more blogs by Nicholas Rose

Read the next in the series – Venturing out in storm Eunice

Read the previous one – After two years of Covid, how are your relationships?

See all Nicholas’s Mind Matters blogs here

Read a profile of Nicholas here

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