Mental health awareness month may have passed, but the issues around mental health are still a very relevant topic.

In the past several months, more and more people have been paying attention to the way they cope with life or are able to interact with others and learning how to take better care of themselves, whether they are battling with a mental health illness or not.

While we may be focused on our own self care, the people around us may be struggling without us even realising it.

According to an article in Africa Check.com, it is estimated that 30.3% of adults will have suffered from some form of mental disorder in a lifetime, and though there is a growing number of cases of mental illness, the subject can still be a difficult matter to tackle; especially with regards to the people you're closest to in your life.

Clinical psychologist, Garret Barnwell advises us on how we can be there for friends who are struggling. 

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While you might think that your friend would just reach out and tell you that they're struggling to cope, it's not always as easily done. "People are often concerned about telling people closest to them because of being worried about the reaction," Garret says.

"If they are concerned that someone is not going to hear their feelings or will act negatively towards them, it is less likely that they will feel secure enough in the relationship to speak." 

If your friend hasn't reached out to tell you that they're struggling, it may be because they are not ready to or they don't realise that they're battling with a mental illness. Regardless, you may be able to spot signs that they're not okay, and you can still help them through their battle.

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What are the signs to look out for?

"It is usually through changes that one becomes more aware - changes in what people speak about more frequently or don't speak about, changes in behaviour, or changes in their mood over a period of days or weeks," Garret says. If the changes you notice are not characteristic of your friend, that may suggest that something may be going on, he adds.

Here are some of things that Garret advises you to look out for:

What they do: A person's behaviour might change when they're experiencing mental health issues. Is your friend more withdrawn? Are they drinking more than usual? Are they taking more risks than usual? Are they having more difficulties in their relationships at work, at home or with friends? Are they spending less time caring for themselves? These are behavioural changes that might point to a mental illness. 

What they say: It's also important to listen and pay attention to the things that your friend says, either in person or on social media. Usually, there's more persistent talk abut hopelessness or helplessness, fears, or a sense of losing control.

What they feel: In the same way that a friend could indirectly express their mental health struggles in the way they talk about things, so can they show signs through their moods. Your friend could express that they're feeling more tired or overwhelmed. They could also be or feel more irritable, upset, or generally uninspired and significantly demotivated. 

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What can you do to help?

In my personal experience, I've found that the hardest part about knowing that your friend is struggling with a mental illness is not knowing how to care for and support them in a way that's beneficial to their wellbeing. Often, the first act is to intervene and force your outlook onto theirs, but there better ways to express your support. 

Be sensitive. "For anyone, it is not the easiest to tell someone else when you're in a difficult place. Ask whether there is a way that you could help the person and that you are concerned and value them," says Garret. "Do this when they are comfortable. It is not recommended to go into this detail when someone is overwhelmed." 

Listen to them (without rushing to impart your own two cents). If they do express feelings, take these feelings seriously, explains Garret. "A tendency may be to come up with solutions for them or to think that you can help by telling them 'don't think about it too much' or 'to focus on the positive'," he adds. Avoid doing this. "It is important to show that you acknowledge these feelings that the person is experiencing. It is important that the person feels heard." 

Be practical. While being there for the person and providing them with a space to be heard is important, it is possible that your friend may need professional help. If they are suicidal or you are afraid that they may hurt themselves or others, they may need emergency care and it's important for you to know how to link them to appropriate care.

Organisations like the South African Depression and Anxiety Group provide a mental health hotline and suicide crisis hotline that can assist you, and websites like therapist directory are useful to find a psychologist.

If you feel overwhelmed by depression or anxiety, contact the South African Depression and Anxiety group on 0800 12 13 14.

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