Ask the Bitches: “How Do I Protect My Own Mental Health While Still Helping Others?”

We’re going to cap off our series on mental health with a question from one of our Patreon donors! This question comes to us from Patron Zoë. And it is SO GOOD and SO IMPORTANT! I am thrilled that she allowed me to share my response.

Here’s Zoë’s question:

In a recent article, Kitty recommends peers as an alternative to therapy. Philosophically, I think it’s a great recommendation. US culture seems increasingly dependent on monetary fixes rather than social fixes.

Here’s my problem: as a friend of some people with severe mental hurdles who can’t afford/don’t want therapy, sometimes it’s just… too much.

I feel stuck. I want to love them and assuage their anxiety, depression, or suicidal thoughts. But I also find myself hitting a wall where they aren’t getting well or coping any better than they did before I tried to help.

It’s not fair to expect someone to just suddenly overcome a mental health issue just because I talked them through one incident. It’s also not okay to treat a friendship as a transaction. (“One breakdown for you; one breakdown for me: that’s the deal!”) But it also starts to become a pretty huge emotional burden and an unbalanced relationship for a while. In my case, the friends most reliant on my care are on the internet, which means they have fairly unlimited access to me.

I don’t think it’s selfish to want to draw a line… but it feels selfish. And I don’t know what to do.

I really can’t understate what a powerful and difficult question this is. Whether your mental health seascape is placid or stormy, being a constant source of support for other people’s struggles takes tremendous psychic energy. Here are my suggestions on how to manage this incredibly tricky situation.

Intimacy Versus Isolation

<flips over chalkboard> Let’s talk about Erik Erikson’s theories on psychosocial development, shall we?

Erikson (one of the most prominent psychologists of the 20th century) believed that as we age, we enter eight distinct psychological crises. As we explore and conquer these life stages, we gain a basic virtue to help us resolve future crises.

For example, the first stage for infants under age two is trust versus mistrust. When my parent leaves my sight, will they return? If I cry out, will someone come for me? Am I safe? If the infant receives consistent support from their primary caregiver(s), they learn the virtue of hope.

Most of our readers are probably in the sixth stage, which lasts from around age eighteen to forty. It is at this age that we grapple with our longest psychosocial crisis: that of intimacy versus isolation. We are fully autonomous adults who have formed a sense of personal identity, and now we want to be seen, accepted, and loved by others. The virtue we learn at this stage is love.

During your early adulthood, you can expect that many interpersonal disappointments and conflicts will center on these themes. So the good news is, you will not necessarily be in this position forever. As you and your peers age, their needs will shift into other kinds of conflicts. The bad news is: young adulthood is the longest stage. Whoops.

Boundaries

Communicating the right amount of intimacy you’re comfortable sharing with another person is the most formative lesson we learn in young adulthood.

In my observation, the biggest difference between a twenty-year-old and a thirty-year-old is the experience they’ve gained in defining, erecting, and defending their personal boundaries. It’s a hard lesson to learn, but one with incredibly rich rewards.

Setting mental illness aside for a moment, a big portion of question-asker Zoë’s dilemma rests here. You can tell that both Zoë and her peers are new to this stage of development. She wants intimacy with her peers, but they are giving her far too much, and she’s struggling to gently push back without shoving. They (her peers) are not clued in to the appropriate amount of intimacy to give, and are heaping too much upon someone with limited ability to help them.

Honestly, most of that is likely due to their age and stage of development. Mental illness exacerbates the disconnect. It diminishes the intimacy-seeker’s ability to show discretion, and the intimacy-recipient’s ability to cope.

And obviously, it heightens the stakes across the board. When you are afraid that rejection may lead to suicide or self-harm, it’s a hundred times harder and more complicated to push back.

Do you have consent?

Thinking around sexual consent has evolved greatly in the last ten years, and I’m encouraged by how quickly affirmative consent is being adopted into the mainstream.

I think it’s useful to apply that framework to talking about mental health issues.

There is nothing shameful or gross about sex—but it is intimate. There is also nothing shameful or gross about mental illness—but it, too, is intimate. And intimacies of all kinds deserve active, affirmative consent. As what is intimacy without consent, but a violation?

I believe that people with bad big brains (myself included) have a duty to ask for consent before firing off on their struggles. This should consist of three parts: “Here’s where I’m at. Here’s what I need from you. Can you provide that right now?” Even better if you couple it with a reminder that no is an okay answer.

For example:

“I’m feeling really anxious right now, and I think I just need to say what’s bothering me out loud and get some positive vibes from a friend. Are you in a place where you could do that right now?” (And remember, if that person says no, it doesn’t mean they don’t love you or don’t care. It means they trust you enough to be honest.)

For example:

“I’m in a rough place right now, and I don’t want to overburden you. Can I trust you to let me know if you need space?” (Taken verbatim from this article, with all compliments for the perfect phrasing.)

Insist on affirmative consent

That’s my general PSA to people who are seeking peer help. Now the flip-side: you deserve to insist on it.

For example:

“Hey, I love you, but I can’t jump into this stuff without a heads-up. I don’t want to engage with you on mental health topics unless I know I’m in a place where I’m ready to listen and be helpful.”

For example:

“I am a flawed and vulnerable human too. And that means I have limitations. I really need you to hear the love and the honesty in my intentions when I say you are not a burden, and you are loved, but I can’t follow you into this dark place right now.”

Ask what they want you to do

Sometimes you can get sucked into a dynamic where the other person doesn’t even know what they want from you. It’s just a habit to reach out and blast their feelings at you.

Try reframing it with a request for specific action. This will help establish a baseline of expectations, and put the other person in an action-oriented state of mind. Refer them to real things they can do immediately to care for themselves. Be their shoulder angel, encouraging healthy habits.

For example:

“That sounds awful. How can I help?”

For example:

“You sound really stressed out right now. When’s the last time you ate / slept / showered / took a day off / talked to a professional?”

Address the issue before it’s a crisis

So let’s say you make a new friend. You start having some Real Talk™, and the topic of mental health struggles comes up. This is the perfect time to set expectations around your availability. Waiting until the other person is at a total crisis point is not ideal.

For example:

“I’m so glad to know we can talk about these issues. To be honest, I’m pretty sensitive to hearing about other people’s struggles. I would always like a heads-up before the topic comes up, and sometimes I may need to step back. I’m letting you know that now so that when it happens, you know it’s not a reflection of how much I care for you.”

Set specific parameters that work for you

I think blanket boundaries are best, but if it helps you to set defined parameters, you can certainly do so.

You can request to initiate all conversations. Or set boundaries around certain days or times. You can also send cues with how quickly you respond to messages. There is nothing wrong with waiting a few days to respond to emails or social media messages, especially if there isn’t a credible fear of self-harm. Constant availability is horrifically draining. Don’t do it professionally, and certainly don’t do it emotionally.

For example:

“In order to be helpful to you, I need to be in a good place myself. When I’m feeling strong enough for conversations like these, I’ll reach out to you preemptively.”

For example:

“The weekend is my time to recharge. For my own mental health, I’m not going to respond to these messages until Monday.”

Radio for backup

If you know someone going through an acute crisis, enlist others to proactively reach out and help you.

For example:

“So-and-so is in a pretty dark place, and I’m going on vacation next week. Can you look in on them? I need to relax, but I want to make sure they have someone to talk to while I’m gone.”

Be honest

How do you tell someone feeling-hurting information they need to know, without actually hurting their feelings?

You can’t.

This is the core of boundary-setting, and why it’s so damn hard. It’s prioritizing your own needs first, which means the needs of another will come second, or third, or fiftieth.

Sometimes you just need to just let the facts be the facts, and let the other person be responsible for their own reaction. You need to mentally prepare for the reality that you can, and will, disappoint other people.

For example:

“I wish I could help you more, but I need to rest and have some time to myself now.”

For example:

“I’m sympathetic, but I don’t know what more I can say than that. I wish you well.”

For example:

“I’m not a professional mental healthcare provider. I have to ask you not to use me as if I were. That’s just too much pressure for one person alone.”

For example:

“You are scaring me. I’m sending you the number for a hotline, I beg you to continue this conversation with them.”

Be consistent

Sadly, a boundary is like an invisible fence for a dog. It may only work after they’ve hit the barrier at top speed two or three times. You owe it to them to be consistent. Once you’ve articulated a boundary, enforce it. And get comfortable with saying no.

For example:

“Hey, I’m sorry to hear about that, but remember how I said I can’t always be available to talk about these issues at a moment’s notice? I really need to you to respect that.”

Lose the savior mentality

I once opened my home to a person I did not know well. All I knew is that she was on the brink of homelessness, and had talked openly about suicide to her coworker, a friend of mine. I had a spare room, so I offered to let her move in with me. She accepted, and… it kinda sucked. She was a difficult person to live with, and after two months I asked her to move out.

I was awash with fear on her behalf. Where would she go? Who would take care of her? How would she find a place to live? Would she kill herself? Would I forever live my life with the stain of someone’s death on my conscious?

Nope. She’s alive and well. She found someone else to live with for a few more months, and now has a place of her own again. I eventually came to feel that her talk of suicide was more of an expression of her frustration and despair than a sincere threat of actual self-harm. But I had absolutely no way of safely judging that at the time. Feeling like another person’s life rested on my shoulders was incredibly stressful. I had my first and only panic attack during this time, and only asked her to leave because I felt I was slipping into a very unhealthy place.

Sometimes empathetic people with high ideals feel great pressure to act. We want to leap into the fire and try to make things better. But this is a foolish and dangerous thing to do, for everyone but the absolute closest of confidants. Being inside the fire makes it impossible to put it out—you’re just one more person who now needs to be saved.

Ask yourself why you feel compelled to “save” people. It’s almost certainly because deep down, you yourself wish someone would help you with the same abandon. You must be that person for yourself first.

Don’t accept abuse

Some people are emotional vampires. They aren’t necessarily bad or evil people. They just cannot stop themselves from taking everything you have to give.

It is incumbent on you to protect yourself. You can be sympathetic and understanding of the mental health struggles of someone else, without allowing yourself to be victimized by it. Such a cycle is deeply unhelpful to both parties.

Please remember that mental illness is not a blanket license to be a jerk. You aren’t an intolerant person if you refuse to excuse assholery from a mentally ill person.

Many abusers have been abused themselves. And many symptoms of mental illness make social interactions difficult. Acts of abuse are often signs of serious internal anguish. You can intellectually appreciate those facts without forgiving that person or allowing them continued access to yourself.

Processing rejection is a basic life skill

You should never, ever be cruel to someone to “toughen them up” or “make them grow.” Especially a mentally ill person. Geez.

But the reality is that processing rejection is a normal part of human development. Leaving a toddler to cry in their crib feels cruel. Driving away from a child on their first day at a new school feels awful. Punishing a teenager for age-appropriate missteps feels mean. Turning someone down who asks you out feels rude.

But that doesn’t mean they are. It’s far more cruel, awful, mean, and rude to try to sustain an unsustainable dynamic. No one has infinite patience, and eventually you’re gonna buckle in on yourself—or blow up on them. People who reach adulthood with no ability to accept rejection are frightening individuals. Resist the urge to “fix,” coddle, or defer your own needs beyond a point that is helpful.

Accept reality as it is

Finally, I have a specific recommendation to listen to the Invisibilia episode “The Problem with the Solution.” This is an excellent podcast for people who aren’t mentally ill and want to understand the best way to help those who are. Spoiler alert: getting deeply, personally invested in another person’s mental health is a great way to worsen their condition.

One of the hardest aspects of caring for others is the fear that you’re doing it wrong, or making them worse. If you aren’t a professional, there is a possibility this is true. It’s easy to let fear and worry lead us into enabling behaviors that harm both parties. So follow that clichéd-but-true advice, and put your own oxygen mask on first.

Zoë, thank you for asking this incredibly important question. I hope some of the ideas here will be of help to you and others.

If you’re concerned that a loved one might harm themselves, here are some more resources…

• National Suicide Prevention Lifeline
• Suicide Prevention: How to Help Someone who is Suicidal and Save a Life
• LoveIsRespect.org: When Your Partner Threatens Suicide
• How to Set Boundaries to Protect Your Mental Health
• Setting Boundaries With Those Living With Mental Illness
• How to Deal With a Mentally Ill Person: Setting Boundaries

And here are more from our recent series on mental health…

• Our Master List of 100% Free Mental Health Self-Care Tactics (this has many more resources at the bottom, including “warmlines” for less-urgent health emergencies)
• Everything Is Stressful and I’m Dying: How to Survive a Panic Attack
• Econ Nerd Review: Kurt Vonnegut’s Galapagos and Your Big Brain
• How Mental Health Affects Your Finances