How to Support Someone Struggling with Their Mental Health

When someone we love is struggling with their mental health, we want to help — but we often don’t know how. We say the wrong thing and wish we’d said nothing. We say nothing and feel guilty for it. We offer advice when what’s needed is silence, or we give space when what’s needed is presence. It’s one of the hardest interpersonal challenges we face.

The stakes are real. According to NAMI (National Alliance on Mental Illness), more than 60 million Americans are affected by mental health conditions each year. Most of them have family members, partners, or friends who are trying to figure out the same question you might be asking: How do I help?

This guide offers concrete, evidence-backed answers.

Start with Listening — Really Listening

The single most important thing you can do for someone struggling with their mental health is to listen to them — fully, without agenda.

This sounds simple. It is not. Real listening means:

Putting your phone down and giving them your undivided attention
Resisting the urge to fix — at least at first. Many people in emotional pain don’t want solutions; they want to feel understood.
Not redirecting the conversation to your own experiences or others’ worse situations (“At least you don’t have it as bad as…”)
Tolerating silence without rushing to fill it
Reflecting back what you hear: “It sounds like you’re feeling really overwhelmed and alone.”

Research on therapeutic alliance — the relationship between a therapist and client — consistently finds that feeling heard and understood is itself one of the most healing experiences a person can have. You don’t have to be a therapist to offer this gift. You just have to be present.

What to Say — and What Not to Say

Helpful things to say:

“I’m here. You don’t have to go through this alone.”
“I’m not going anywhere.”
“I don’t fully understand what you’re going through, but I want to.”
“What do you need right now — do you want me to listen, or are you looking for ideas?”
“I’m so glad you told me.”
“This isn’t your fault.”
“You matter to me.”

Phrases to avoid:

“Just think positive.” (Dismisses the reality of their experience)
“Other people have it worse.” (Implies their pain is unwarranted)
“You have so much to be grateful for.” (Creates guilt, not relief)
“I know how you feel.” (Even if well-meaning, it can feel invalidating)
“Have you tried exercise/meditation/journaling?” (Unless they’ve asked for suggestions)
“You just need to snap out of it.” (Shows a misunderstanding of mental illness)
“You don’t seem depressed/anxious to me.” (Mental illness is often invisible)

The NIMH recommends validating emotional experiences without necessarily agreeing with every thought — for example, you can say “I hear that you feel like a burden to everyone” without agreeing that they are actually a burden.

Understand What They’re Going Through

You don’t need a psychology degree to be a supportive presence — but learning about what your loved one is experiencing can make a significant difference. If they’ve been diagnosed with depression, anxiety, PTSD, bipolar disorder, or another condition, take the time to read credible information from NIMH, SAMHSA, or NAMI.

Understanding, for example, that depression involves changes in brain chemistry — not laziness or weakness — can help you respond with patience rather than frustration when your loved one can’t get out of bed or lacks motivation. Understanding that anxiety disorders involve a hyperactive threat-response system can help you see their avoidance as a symptom rather than a choice.

Knowledge also helps you avoid inadvertently saying things that, while well-intentioned, increase shame or isolation.

Encourage Professional Help — Gently

You can be the most loving, present support person in the world and still not be sufficient to treat a serious mental illness. Therapy, medication, and professional support are often essential — and encouraging your loved one to seek them is one of the most important things you can do.

That said, pushing too hard can backfire. People in depression often lack the energy and motivation to take action, and pressure can feel like judgment. Some approaches that work better:

Offer to help with logistics. “Would it help if I sat with you while you looked for a therapist?” or “I can drive you to your first appointment if you’d like.”
Normalize help-seeking. Share stories of people you respect who have been to therapy, or acknowledge that you’ve considered it yourself.
Provide specific resources. Rather than saying “you should get help,” you might say “I found a resource called SAMHSA’s helpline — it’s free and confidential, and they can help you find someone local.”
Follow up. After the initial conversation, check in. “Have you had a chance to look into any of those options?”

If your loved one is resistant, try to understand why. Common barriers include cost, stigma, fear of being judged, previous bad experiences with treatment, or simply not believing treatment can help. Each barrier has potential responses.

Recognize the Signs of a Crisis

Knowing when a situation has moved from “struggling” to “crisis” is critical. Watch for:

Talking about wanting to die or suicide — directly or indirectly (“Everyone would be better off without me”)
Giving away possessions
Saying goodbye as if they won’t see you again
A sudden calm after a period of deep depression (which can indicate a decision has been made)
Increased substance use
Reckless behavior

If you notice these signs, take them seriously. According to the CDC, nearly 50,000 Americans die by suicide each year — and many more attempt it. Do not leave the person alone. Do not promise to keep it secret. Ask them directly: “Are you thinking about suicide?”

Research consistently shows that asking someone about suicide does not plant the idea — it creates an opening for them to talk about something they may have been carrying alone.

If there is immediate danger, call 911 or take them to the nearest emergency room. The 988 Suicide and Crisis Lifeline (call or text 988) is also available 24/7 for both people in crisis and those supporting them.

Support That Lasts

Mental health struggles are often not one-time crises — they are long journeys. Sustaining your support over time requires some intentional practices:

Check in regularly, even when things seem okay. Depression and anxiety can look fine from the outside. Consistent, low-pressure check-ins (“Just thinking about you — no pressure to respond”) let someone know they’re not forgotten.

Don’t make mental health the only topic. People struggling with mental illness still want to laugh, talk about movies, share ordinary life. Don’t let every interaction become a mental health check-in. Treat your loved one as a full person.

Follow through on what you offer. If you say “call me anytime,” answer when they call. Broken commitments are particularly painful for people who already feel they’re a burden.

Respect their autonomy. Ultimately, a person makes their own choices about their mental health care. You can encourage, advocate, and support — but you cannot force recovery.

Taking Care of Yourself

Supporting someone with a serious mental illness can be emotionally exhausting and psychologically taxing. Caregiver burnout is real. If you don’t protect your own mental health, you will eventually have nothing left to offer.

NAMI’s Family Support Group program offers free peer-led support groups for family members of people with mental illness — this is an often-underused resource. The SAMHSA National Helpline (1-800-662-4357) is also available to family members, not just people in crisis themselves.

Boundaries are not selfish. They are necessary. You can care deeply about someone and still have limits on what you can do and how much you can absorb. Communicating those limits honestly, and getting support for yourself, is part of being a sustainable presence in your loved one’s life.

Get Help Now

If someone you love is struggling — or if you yourself are finding it hard to cope — our mental health hotline is here for you too.

Call our hotline today. You’ll speak with a trained counselor who can help you navigate a difficult conversation, find resources for your loved one, or simply talk through the weight you’ve been carrying. Supporting someone with a mental illness can be one of the hardest things you’ll ever do. You don’t have to do it alone.