The chances are, if you’re not struggling, someone close to you is

Susan GriffinWHETHER it’s a pep talk, a bottle of fizz or a shoulder to cry on, it’s comforting to know your friends are there for you through life’s ups and downs.It can feel like there are no topics off limits, but even the closest of mates can find it tough to talk about their mental health.Whether it’s a pep talk, a bottle of fizz or a shoulder to cry on, it’s comforting to know your friends are there for you through life’s ups and downs.The chances are, if you’re not struggling, someone close to you is.According to NHS England, one in four adults experience at least one diagnosable mental health problem in any given year.While there are some risk factors for mental health conditions, no one is immune to the pressures of life, especially during a cost of living crisis, and we all have bad days – or weeks.“The winter months can be difficult,” says Susan Cummins, mental health practitioner at Islington GP Federation.“It’s important to make sure people don’t fall under the radar and that we provide a safe space for them to open up about any struggles they may be experiencing.”Some signs a friend might be struggling include being quieter than usual, or less active on group chats.You may feel like you know a person inside out, but it can still be difficult to know whether they are struggling.“There is no set way people with depression, anxiety or other mental health conditions act,” says Dr David McLaughlan, consultant psychiatrist at the Priory Hospital Group and co-founder of Curb Health.“Everyone manifests mental health difficulties in their own way. Often they mask their symptoms, doing their best to protect others or hide the challenges they’re facing,” he adds.“The key is changes in their behavior. Be observant and pay attention to any differences in someone’s normal baseline."Are they acting differently from usual?”Some signs a friend might be struggling include being quieter than usual, less active on group chats, a change in appearance, being more negative, eating less, and experiencing sleep difficulties.

BROACH THE SUBJECT CAREFULLYIf you suspect someone is having mental health problems, raise it with them, but don’t have expectations about how they will respond.“Everyone experiences mental health differently, so how you bring up your concerns will be different from person to person,” says Simon Blake, chief executive of Mental Health First Aid England.“Just make sure your friend feels comfortable and not confronted or attacked. They need to know you are on their side and want to help.”He suggests broaching the subject face-to-face if you can, or if you’re talking to them over the phone, encourage them to have their camera on, if they’re comfortable.Seeing each other will help you feel more connected. Make sure you can both talk freely.When speaking in person, reduce distractions by putting your phone on silent and turning off notifications, and be sure to set aside plenty of time, so neither of you feel rushed.Use changes in your friend’s behavior to start a conversation. For example, say: “I’ve noticed you’ve stopped coming out with us and replying on the WhatsApp group. It made me wonder if you are OK?”Or try: “I wanted to check in and see if there was anything I can do to help?”'Listen without interrupting and pay attention to their words, how they talk and their body language.Regardless of who started the conversation, it is crucial to give the person your undivided attention.“Listen without interrupting and pay attention to their words, how they talk and their body language,” advises Simon.“These will give you clues as to how they’re feeling. It’s important not to criticize or use phrases that minimize their experiences, such as: ‘Pull yourself together.’Always respect their experiences, even if they differ from yours. Using phrases like: ‘I understand how difficult this must be,’ and: ‘I’m so glad you’re telling me about this,’ can show you are listening in a non-judgemental way.”

YOU'RE NOT ALONEEVERY 90 minutes in the UK a life is lost to suicide.It doesn't discriminate, touching the lives of people in every corner of society - from the homeless and unemployed to builders and doctors, reality stars and footballers.It's the biggest killer of people under the age of 35, more deadly than cancer and car crashes.Yet it's rarely spoken of, a taboo that threatens to continue its deadly rampage unless we all stop and take notice, now.That is why The Sun launched the You're Not Alone campaign.The aim is that by sharing practical advice, raising awareness and breaking down the barriers people face when talking about their mental health, we can all do our bit to help save lives.Let's all vow to ask for help when we need it, and listen out for others... You're Not Alone.If you, or anyone you know, needs help dealing with mental health problems, the following organizations provide support:

DON’T SHY AWAY FROM THE SUBJECT OF SUICIDEA third of people incorrectly believe that asking about suicide can put the idea into someone’s head, according to Mental Health First Aid. But, in fact, it could save their life, says Simon.“If you are worried that someone is having suicidal thoughts, you should ask important questions, like: ‘Are you having suicidal thoughts and do you have a plan to end your life?’” he says.It may feel uncomfortable – after all, it’s so rarely spoken about. “I have heard time and again that people fear being too direct or saying the wrong thing,” says Simon.“But the opposite is true. With the right support, we can all be brave enough to ask the question that could save a life.”Rosie Weatherley, a spokesperson for mental health charity Mind, adds: “Encourage your friend to talk about their feelings. Asking open questions and seeing how long they have been feeling this way can help you figure out the next best step.”Encourage your friend to seek professional treatment and support from their GP, Mind, Samaritans or the National Suicide Prevention Helpline UK. “If you’re worried someone is at immediate risk of taking their own life, stay with them and get emergency help,” says Rosie.

TRY NOT TO FORCE A CHATSend a card or a small gift, or perhaps cook them a meal, it's an easy way to show you care.Be aware not everyone is ready to share their feelings, so don’t force your friend to talk if they don’t want to. “Instead, be explicit that you’re worried about them and that you care,” says Simon.“Even if they say they don’t want to talk, let them know your door is always open. Keep checking in on them, even if it’s just a message to say you’ve been thinking about them."If they don’t respond, don’t be afraid to do it again. Send a card or a small gift, or perhaps cook them a meal, so they don’t have to think about preparing dinner. Small gestures go a long way to show you care without them having to say they’re not OK.”

CHECK ON THE ‘STRONG’ PALIt’s also worthwhile just hanging out and having fun more often to see if your friend opens up naturally when they are more relaxed.

Don’t presume that your friend who always seems put-together doesn’t struggle. While there are many reasons why they might shut down a conversation about mental health, we shouldn’t give up trying to help if we suspect there is an issue.Continue checking in and reminding them you are there. “A ‘strong’ friend may not ask for help, but they may benefit from a chat,” says Susan.It’s also worthwhile just hanging out and having fun more often to see if your friend opens up naturally when they are more relaxed, rather than always making it a serious conversation.

LOOK AFTER YOURSELFSupporting someone through their toughest times is a wonderful thing to do, but it can be demanding and draining.Mind advises setting boundaries and being realistic about what you can do. “Always remember, you are not a replacement for medical support or advice,” adds Simon.
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