Opinion: Helping, Being Helped & Debt - World Mental Health Day 2020

It is just over a year ago that I put a few words down about what I call my nervous breakdown. As today is World Mental Health day it seems as good as day as any to jot down a few more, because the truth is that mental illness isn’t some nice, clean thing like a broken bone. There’s no clear point when you’re ‘better’. I have spent most of the last year coming to terms with the fact that the healing process is going to take years, some of it may take a lifetime.

In some ways I’m lucky. That was actually the word my therapist used when we started our sessions. I didn’t feel very lucky at the time as my brain and body thrashed against each other, leaving the part in between that constitutes me scared, exhausted and weak. But I think she might have been right. Anxiety is far more treatable than many other conditions, I understand it as a bundle of shitty, learned behaviours and ideas that can be unf*cked with time, whereas many other conditions are rooted in some kink in the brain’s wiring that you’re stuck with. I will forever be smitten with those who live a lifetime with mental illness as my look behind the veil left me fairly sure I wouldn’t be strong enough to take it.

I remember in the early days of my crisis, medicated past the point of being a functional person, making plans a few months out, thinking “I’ll be good then.” Of course, good never came on a schedule and looking back it seems naive to have been making plans a couple of months ahead, assuming things would have blown over. And while I can sit here and tell you honestly that I’m pretty good these days, my life is now ruled by striving to stay that way.

Recently I ran into a friend who I was talking to a lot around my breakdown and he confided in me that he is now facing his own struggles. Over the months I was laid up we chatted at length a few times about the things I saw as detracting from my wellbeing, and the things I was doing that I felt were helping me. Seeing him pale, disheveled and tired it brought back many memories and, if I’m being completely honest, a twinge of frustration. After all, this is someone I had talked through the factors that I saw as triggering my crisis and the steps to avoid them, and he hadn't taken them onboard them and looked to be running down the same road I had. Of course I would probably have done the same thing if roles were reversed.

One of the big things that comes with regular meditation is a bit more space between yourself and your thoughts, so I had a moment longer to consider how to react. I felt the frustration and bit my tongue as a hard as I could. After all, when they are suffering who wants to hear “I told you so”? I wanted to help, nobody wants to see their friend suffering and having gone through all this my next impulse was to tell him all about the things that had helped me. Again I bit my tongue. Re-reading the comments to my last piece, I think this is something that more people need to hear: if someone is struggling, don’t try and offer advice or ideas (unless they are asked for). What you must not do is tell someone how they should cope with their illness. I can tell you from first-hand experience how painful it can be to have someone you love try and dictate how you should be dealing with your problems, and I will probably never have the same relationship with that person ever again.

It’s a weird notion - after all, if something is coming from a place of compassion then why suppress it? The truth is that you don’t know what the person you are talking to is going through. Even if you were there with them physically 24/7, you can’t be there in their head with them, and that is where the real suffering is taking place. In an age of over-sharing on social media, how can you possibly differentiate between someone just having a bad day and someone deep in the throes of a life-changing crisis? You cannot know how that information will affect them and it might as easily exacerbate the suffering as ameliorate it.


Even something you think benign, like pointing them to a new treatment, can backfire. It’s mental illness and confidence in the care you are getting plays a huge part in how effective it will be, so if you dent that confidence it’s not unimaginable that it could begin to unwind the progress they are making. The same goes for telling someone that riding your bike will solve everything. While it riding is undoubtedly a great thing to do you for your mental health, it's on a par with telling someone with depression to "be positive." When you're in crisis the stakes are higher than people who haven't been there can appreciate and just one seemingly insignificant nudge in the wrong direction can send someone spiraling into a dark place. It’s the old alcoholics’ maxim: you cannot help someone unless they ask for help.

What you can do is listen, be there and be patient. It may well be a one-way street, when I am struggling my thoughts wrap around in circles and I lose the mental bandwidth to think about other people as I am so focused on whatever is tormenting me. I’m certain I’m little fun to be around and am very thankful for my family and friends who indulged me as I rambled and rambled, glad of people to talk to to distract me from my suffering. But it’s different for everyone, since I saw my friend and offered him a friendly ear, I haven’t heard from him and as much as I want to help, it’s his call whether he reaches out for that or not.

What is hard to understand if you’ve never been down the rabbithole is that when you’re on the receiving end of help, that can create its own problems. I’ve never been good at asking for help, so to find myself at a point in my life when I was unable to do even basic things on my own was profoundly painful. Aside from my anxiety, the benzodiazapines I was prescribed early on left me too out of it and exhausted to do even the most basic things. Doing something simple like the washing up might take a whole day to accomplish. When you are stripped that raw by illness you need help in a way that is hard to explain nearly two years later, and people who aren’t suffering just don’t need help in the same way. For me that created a situation where I felt I owed people far more than I could ever repay and it has taken me a while to make my peace with that, finding solace in the idea of karma.

I don’t believe in karma in any structured or religious way, but for many years now it has struck me as a good general principle to live by. Or maybe you prefer the Bible’s line about doing unto others as you would have done unto yourself. The help I received created a responsibility, one that I need to spend the rest of my life fulfilling. I need to offer the same help to those I meet who need it, to repay that debt to the wider universe. I believe it’s not a transactional thing, I can’t go out today and search for ten people to relieve myself of the debt, but I need to carry it with me, make it part of me.

So when my friend came to me, I tried to listen. When he asked for something specifically I tried to answer. I offered help but tried not to overburden him. To live by the ideas I am talking about here I had to make my peace with the fact that maybe my friend is not someone I can help, and that trying to force my way into his situation would only make things worse for him. That maybe this isn’t a time to repay more of my debt. I probably made a mess of it all. In the end I left him with these words, and even then I worry I said the wrong thing: It will get better, just not as quickly as you hope it will.

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Stories Mental Health Op Ed