This week is Mental Health Awareness Week (MHAW). Some 1 in 4 people in the UK will be affected by a mental health issue each year, with anxiety and depression being the most common problems. The theme of this year's MHAW is relationships, because your relationships - with family, friends, partners, co-workers - are the cornerstone of good mental health.
Suicide is the single largest cause of death in men aged under 45 in Britain today.
It's a statistic you may have heard before, but it doesn't get any less shocking. When you're feeling sad, lonely, anxious or depressed - emotions that absolutely everybody experiences at some point in their lives - the best way to address the problem is by talking about it. Thrashing things out with a relative, a partner, a mate or even just a stranger will always be better than fighting that battle alone.
The chances are that one day you might need to be that person; the person that takes it upon themselves to pick somebody up when they fall down. That's not easy either.
Luckily, charities such as the
Campaign Against Living Miserably, or CALM, are there to offer guidance to men of any age who are feeling down. They want to challenge the age-old concept of masculinity that prevents so many men from opening up about their feelings, knowing that doing so could prevent thousands of deaths.
https://www.youtube.com/watch?v=Z1K8RffVOtk
JOE sat down with CALM's CEO, Jane Powell, to talk hypothetically about what you should do if someone you know is depressed, and she was adamant that there is nothing more valuable having a mate.
JOE: Your flatmate has started spending a lot of time in their room, only really surfacing for the occasional meal. Is it invasive to knock on their door and try and get them to talk about it? Should you let them have their space?
Jane: I would suggest knocking on their door and asking them for some help. Say, for example, that you’d like some company cooking dinner, and see if they’d be up for that. Rather than going to them and saying something like “do you need some help?", look more at some kind of activity engagement. It might be that you’re going to start doing a 10k activity and you’d appreciate a running mate or a cycling mate. Whilst you’re cooking or cycling or running, or whatever, you can then start to chat about stuff. That’s a good time, shoulder to shoulder, while you’re doing something, to start asking some of those questions.
JOE: How persistent should you be with trying to get them help? You obviously want to be there without being overbearing.
Jane: Quite often you will get rebuffed by someone who feels that they’re so rubbish inside of themselves that it’s embarrassing and they don’t want to think about it; they don’t want to think about anything at all. But do carry on, sit down and encourage them to talk. Share with them and let them know that we’ve all been there; we’ve all had those times when we’ve felt really bad. Don’t rush it. Take time with this kind of thing.
Ask them if they're alright, definitely, as it shows concern. But try and take it to other places. Ask
for help rather than offering it. Ask them to help you. Let them feel that they’re valued, rather than just pitied. And that you do care. When their self-esteem is low it’s about trying to build that up again. You would like them to be in your life.
JOE: A typical response from a man who thinks his mate is depressed might be to suggest going to the pub. Is this always a good idea?
Jane: Alcohol will very often exacerbate problems, and when guys are down or depressed, because it’s quite hard to share, they’ll drink. They might also feel quite impulsive and irritable - quite angry. So if you add all those things up together what you get is alcohol followed by some risk-taking: behaviour which isn’t brilliant and may even land a guy up in trouble with the police. It’s not a brilliant idea.
Sometimes it can be nice to chill out and have a drink after a particularly stressful day, but if that becomes the prop that gets you through every day, apart from the fact that its going to damage your liver it may well exacerbate the problems that you already have. It’s a good idea to look at other ways of relieving stress, so running, sports - any activity which takes you out of your head. Even just a walk in the park can be good. Something where you look outside of yourself and get some perspective back on life.
JOE: A lot of people with depression bottle up their feelings and do everything to appear okay on the surface. Are there any signs you should look out for?
Jane: I think the signs to look for with other people and within yourself would be drinking large amounts of alcohol or taking lots of drugs. I would be worried about somebody who is absolutely the life and soul of the party, who is drinking more than ever and who’s being funnier than ever. People who are taking more risks and behaving really prattishly. They’re someone who’s probably struggling a lot.
Other signs are sleeping a lot or not sleeping at all. Withdrawing completely isn't great sign. But the opposite – being really hyper – is another sign you would worry. Quite often what we hear is that when men are down or depressed they don’t even recognise that that’s the case. They’re just feeling very angry, very frustrated or that there is nothing they can do that is right. They feel that they’re worthless and the only thing that they’re doing is messing up all the time. Everything about them is a waste of space. That’s depressed. We can help get past that.
JOE: As much as the situation is improving, so many men still find it next to impossible to talk openly about their feelings. Are there any man-to-man approaches that you would recommend from experience?
Jane: We’ve got a society which is very much predicated on the idea that a man is strong and absolutely silent, so this is an uphill task for all guys out there. But we can see from the demand on our helpline - which always increases - and the support that we get at CALM, that guys want to be able to talk. They want to be able to have these conversations. We’ve done some research asking men how they'd respond if one of their friends told them they were feeling suicidal. 69 percent of guys said they would like to sit down with their mate and talk about it. We have a willing audience, but the audience is still plucking up the courage to have that conversation with their best mate. We would always say go for it.
Don’t go for it in a big open group of people, though. These are conversations to have one-to-one, ideally while you’re both doing something. Do it somewhere with privacy and with some time to spend.
JOE: How do I get my mate to talk to a professional?
Jane: Very often we see that the best thing for them to do is reach the point where they're able to talk about it with someone and then they can start to feel in control of it. I wouldn’t necessarily say, “right you’re depressed, you need to see a GP now", because that kind of discounts the value that there is in enabling them to have that conversation at the time.
On our helpline, if someone wants to find some therapy then we will talk through finding a therapist with them over the phone. You can also do that yourself directly through our website. Ask them what they would like to happen. Try and be that supportive mate, rather than someone wagging a finger at them saying “this is what you should do”.
Being depressed and suicidal is a terrible place to be in, and that person is quite scared because suddenly the world is totally out of control. I would try to give them some control back.
JOE: What should you do if your mate tells you they’re having suicidal thoughts?
Jane: If someone was having a suicidal thought right now I’d make sure you’re in a safe place – not near windows - and stay with them. Talk with them and see whether or not it would be helpful for them to see a crisis team there and then. You can ring 111 with them, tell them your friend is actively suicidal and he would like some help. You should be able to call a crisis team from wherever you are.
Talk to them about where they would like to be and what can happen next. Come up with a plan. You can ring the helpline between 5 and 12 and they can talk to someone, or you can talk to the helpline yourself and come up with a plan about how you or he is going to get past this particular moment.
It’s about getting through that difficult moment and coming up with a plan about how he's going to get through the next hour, the next days and the next few weeks. Get through that panicked moment where he’s overwhelmed by an urge to get away from life.
Think about the moment when you hit your funny bone and suddenly you’re overcome with pain. It radiates through your body, but you know it’s going to end. What you need to enable your mate to do is to is understand that this will pass. It’s hard to see at the time, but it will.
If he starts to feel like he’s a burden on everyone, or that people are trying to help because they feel like they should, rather than because they’ve got any great liking for them, then he’s going to think “ok, I don’t want to do this anymore. I don’t want to be a burden anymore". That’s when he might start to think about taking his own life.
JOE: Is it okay to confront the issue directly?
Jane: You can open a conversation with him about suicide, but see what else you can make that friendship to be about. What other things can you share? Make sure your relationship isn’t just about him feeling depressed and suicidal. Make it about more than that.
He will be really relieved that he can talk to you about it. Point out that 42 percent of men have thought about it. Talking about suicide won’t make somebody kill themselves - it may well prevent them from killing themselves. It’s scary but it can also be a release.
JOE: What do you do if you notice they’ve been self-harming?
Jane: Tell them that you see they’re self-harming and that when they get the urge and things get really bad to come and knock on your door and you’ll go for a really fast and intense game of table tennis. It’s about getting through that moment when he's trying to push away the pain.
Say that when they have that feeling you can go and do something really intense and overwhelming. Get a punchbag in the flat, anything to just whack it out when it happens. The more he can find ways of getting through that, the better. Pretending it’s not happened won’t help. Try and be relaxed about it. Not all help needs to be medical intervention. The nicest form of help is a mate.
JOE: How much investment from your side is worthwhile before it actually becomes an issue for your own mental health? Are you enough to help your best mate with his sadness?
Jane: If it’s too much ask for help. Be there for them, but sometimes you’ll need more help, so ask them where you should go. Don’t be afraid of telling them you need more help. We’ve all got to look after our own mental health as well. Sometimes we’re fine, sometimes we can’t cope. Get them to feel comfortable with ringing the CALM helpline or another helpline. Or ring it yourself. It’s there for any guy. If we only had it for people with very serious, certified mental health conditions then that would be rubbish. It’s there for guys - period.
It’s not weak people who get depressed and feel suicidal while everybody else is fine. Things can go wrong for anyone. None of us have got full control over our lives. Whether it’s work, health or relationships: any of those things can and do go wrong, so these issues will and do effect everyone, male and female. They are hard to get through and can leave us feeling wretched and totally suicidal. Relationships are what life is all about. That and our own health - that’s really all there is. That’s what keeps us going.
The CALM helpline is open 5pm - midnight, 365 days a year. London: 0808 802 58 58 Nationwide: 0800 58 58 58
