How to Walk with a Friend Through Their Mental Health Journey

Written By Adiemus Seah, Australia

Adiemus (BBSC, BACC, MGPC, MAPP) is passionate about helping people achieve goals and enhance wellbeing. He is the founder and director of Strengths Optimizer, and has worked as a registered counsellor, certified strengths coach, and accredited mental health first aid instructor for twenty years. He is the host and producer of the YouTube series, Science UP Your Wellbeing, where he interviews experts in wellbeing science and shares nuggets of wisdom on helping people flourish. He currently lives in Melbourne.

As a registered Christian counsellor in a private practice, I have seen and heard words and actions that are unhelpful for people battling anxiety.

I remember meeting Gary—a 25-year-old young adult leader in a church. He was experiencing disrupted sleep, restlessness, heart palpitations, and tremors. He also worried excessively, found it hard to concentrate and to remember things, and was easily irritated. As a result, he started avoiding church. He said the loud and happy-clappy music in the church heightened his anxiety and made him feel dizzy. And whenever he needed to lead the youth and young adult services, he’d start experiencing a dry mouth, nausea, and tremors.

He also shared his struggles with his youth pastor, and had requested to take a break from the ministry. While his youth pastor was sympathetic and acknowledged his challenges, he strongly believed Gary’s anxiety would go away through prayers and petitions. He was told “not to be anxious about anything”, and he should keep “pressing on” by leading the youth and young adult services because God will honour his faith if he trusts Him, and will deliver Gary from his anxiety.

Indeed, Gary tried very hard. He put up a brave front, showed up for services, prayed harder and sang louder than before, cared unceasingly for his young people, and believed fervently in God’s healing and deliverance.

But these were only temporary fixes to Gary’s anxiety.

When Gary recounted his experience to me, he blamed himself for being weak, for being a hypocrite, and for not being able to “take captive every thought to make it obedient to Christ”(2 Corinthians 10:5), between huge sobs. He felt lonely, ashamed, and defeated.

I worked with Gary, his family, doctor, and youth pastor to address his anxiety illness. We’d look at Biblical teachings on anxiety, mental health, faith, healing, suffering, God’s sovereign power, and purpose. The psychological aspects of anxiety were also discussed. His family was given tips on how to best support Gary during this time, and we worked with his doctor in developing a mental health care plan for him.

Over time, Gary learned to manage the ebbs and flows of his anxiety, which has enabled him to go back to doing what mattered to him: loving God, caring for his youth and young adults, making an impact in the market-place as a financial advisor, and most importantly.

I have met quite a few individuals who share Gary’s experience.

It is not uncommon to hear that anxiety is primarily, if not wholly, viewed as spiritual in nature in many Christian circles. Leaders sincerely believe that a person would not and should not experience anxiety disorders if they just have enough faith and trust in God. Out-of-context Bible verses are often quoted to judge and condemn people, resulting in feelings of guilt and shame. Christians battling mental health challenges such as anxiety and depression are sometimes perceived as having a lack of faith, viewed as spiritual failures, or even worse, labelled as bad Christians.

But the fact that the Bible talks about fear 365 times demonstrates that anxiety is a common and normal human experience. In the most recent National Survey of Mental Health and Wellbeing, it was found that one in five (20%) Australians, aged 16-85 years have had a common mental illness (with anxiety being the highest) at some point during the previous 12 months. Yet, only 35% of people who have a common mental illness seek professional help. One of the common barriers for help-seeking behaviours is stigma, discrimination, and prejudice, and they exist in both the Christian and non-Christian circles.

Christians or not, we all fall short of the glory of God (Romans 3:23). Therefore, we will experience pain, trials, and tribulations in this world. In other words, Christians are not immune to physical and mental illness.

To encourage people to seek help, we need to develop an informed, compassionate, and accepting approach to mental illness, especially in Christian circles where mental illness is perceived as sin, weakness, and failure. We need to acquire the basic knowledge, skills, and confidence when helping someone with mental illness, to be able to listen and communicate with them in a non-judgemental way, offer support and information, and encourage them to get appropriate professional help and other support.

These practical steps form the framework of the Mental Health First Aid Action Plan, which I will elaborate further.

If you’re struggling with mental health challenges . . .

If you are a Christian who is experiencing and battling anxiety or mental illness, speak up and get help. Tell God about your anxiety, for “God is our refuge and strength, always ready to help in times of trouble” (Psalm 46:1), and “nothing can separate us from God’s love” (Romans 8:31-39).

But God has also given us a community, so tell others about your anxiety. They could be your doctor, pastor, family or friends. Yes, I know it takes risk and courage. I have been there before. If you are struggling to tell someone, especially if you are experiencing mental health struggles for the first time, think of your struggles as the same as physical health issues. If you have a sore throat, migraine, chest pain, or a broken limb, wouldn’t you tell someone and seek help because you want to get better and continue to do what you are supposed to be doing, for instance, studying, working, caring for the kids, and so on?

Similarly, mental illness is like physical illness. It needs your attention. Once you share your challenges and vulnerabilities with someone you trust, God will bring the right people to help and support you. If people judge you, help them to understand what you are going through, tell them what you need from them, and move on to find the right people who will help and support you.

If you have a friend who is struggling with mental health challenges . . .

If you want to walk with a friend, family, colleague or a loved one through their mental health struggles, I encourage you to develop your knowledge, skills and confidence in mental health literacy.

You could do so by participating in the Mental Health First Aid (MHFA) training course accredited by the MHFA Australia. The MHFA course does not teach people to provide a diagnosis or therapy but equips people with the knowledge and the skills to recognise the signs and symptoms of common mental health problems, to be able to offer and provide initial help, and to guide a person towards appropriate treatments and other supportive help.

As a MHFA instructor, I teach organisations, communities, and churches on how to apply the MHFA Action Plan using a mnemonic—ALGEE.

Action 1 – Approach the person, Assess and Assist with any crisis

When you notice a friend struggling with mental health problems, the first task is to approach him/her, look out for any crises, and assist the person in dealing with them. You can let your friend know that you are concerned about his/her mental health. It is important that you find a suitable time and space where both of you feel comfortable, and make sure you respect your friend’s privacy and confidentiality.

Action 2 – Listen and communicate in a non-judgemental way

When listening and communicating, it is important to set aside any judgements made about your friend or his/her situation and avoid expressing those judgements. You need to adopt certain attitudes such as acceptance, genuineness, and empathy, and to use verbal and non-verbal communication skills that facilitate understanding and build trust.

Action 3 – Give support and information

Once your friend has felt listened to, it is easier to offer support and information. This includes emotional support, such as empathising with how they feel and giving them the hope of recovery, and practical help with tasks that may seem overwhelming at the moment. You can also ask your friends whether they would like some information about mental health challenges.

Action 4 – Encourage the person to get appropriate professional help

Tell your friend about the options available to them for help and support. For example, medication, counselling or psychological therapy, support for family members, assistance with vocational and educational goals, and assistance with income and accommodation.

Action 5 – Encourage other support structures

You can also encourage your friend to use self-help strategies and to seek the support of family, friends and others. For example, resources from Beyond Blue, Black Dog Institute, MoodGYM, and Lifeline.

But don’t forget . . . Self-Care

Caring and supporting someone who is wrestling with a mental health illness can be distressing, frustrating, and exhausting. Therefore, it is important that you take time to look after your health and wellbeing. For example, you may want to debrief (not gossip) with someone else about what you heard while remembering to respect the other person’s right to privacy.

It can also be good to do things which improve your own mood or mental health after helping someone who is distressed. These comprise eating well, keeping regular sleep habits, practicing mindfulness, being physically active, talking to supportive people, letting people know how you are feeling, scheduling enjoyable activities, and doing other things you know have been helpful in the past.

The five actions from ALGEE are helpful ways to walk with a friend or family through mental health struggles, whether they are Christians or non-Christians. Christians who are helping other Christians through mental health challenges, in addition to applying ALGEE, can also support them by focusing on RIPE—Reality, Identity, Power, and Eternity.

Reality

Acknowledge their pains, frustrations, and lived mental illness experiences. Just as Jesus said in this broken world, we will have trials, troubles, and sorrows. But Jesus also said we can take courage because He has overcome the world (John 16:33).

Identity

Remind them that mental illness is not their identity, but their identity is rooted in Christ, and nothing can separate them from the love of God (Romans 8:31-39; Psalm 139:17-18).

Power

Encourage them to engage in spiritual disciplines (e.g., Scripture meditation, prayer, fasting, worship, service, solitude) to ask and claim God’s power for healing. However, it is paramount that we ask and claim from a posture of surrender rather than a position of demand (Luke 22:42; 2 Corinthians 12:7-9; 2 Samuel 12:15-25; Daniel 3:16-18)

Eternity

Focus on eternity. The Bible shows us that God is still a miracle working God who heals and restores. But the Scripture also teaches us that God is sovereign and in His infinite wisdom, not all people receive healing and recovery in the here-and-now. But God promises that as His children, we will experience eternal life with Christ where there will be no more pain and suffering (Revelation 21:4).