What to say when someone tells you no, they’re not ok

by | Mental Health, Videos, What We're Talking About

Knowing how to respond when someone says they’re struggling with their mental health or even suicidal thoughts can be daunting. Here’s how to help someone with depression or psychological distress

The stigma around mental illnesses like depression and anxiety has reduced considerably in recent years. While we’re all getting more comfortable with asking, “Are you ok?” knowing how to respond when someone answers, “No, I’m not,” can be challenging. But learning to become comfortable with having tough conversations might be the most useful skill you can acquire. 

“Research has shown that conversations can make a difference when someone is struggling,” Annabel Bowman, a spokesperson for R U OK says. “Of those who have recently talked to someone about what’s troubling them 80 per cent agreed the conversation was meaningful and helpful.”

This could get awkward

Putting aside our own feelings of awkwardness can make all the difference to someone else, Dr Tim Jones, a Hobart-based GP affirms. “It’s good to recognise that however uncomfortable we might be, the other person is probably doing it tougher,” Dr Jones says. “To be authentic, non-judgemental and clear about our intentions to understand, care and explore are the qualities to cultivate. If we achieve this we’ve been a good support person even if it’s been uncomfortable.”

Instead of worrying about saying the wrong thing, remember that simply being there and being aware of someone else’s needs is the best way to show you care. “Harnessing our shared humanity to see the needs around us and respond to them with thoughtfulness and compassion is the central step we can take to bring positive change,” explains Dr Jones, who is also a Senior Medical Educator for The Royal Australian College of General Practitioners.

Reserve judgement

It’s not uncommon to compare a person’s emotional response to your own experience, but rather than judge their feelings, simply making them feel heard makes all the difference. “We live in challenging times where financial pressures, high workloads, health concerns and social isolation are all impacting our society,” Dr Jones says. “Showing a genuine interest in someone’s wellbeing and making some specific time to actively listen and explore their feelings will be a safe first step to building a strong foundation for recovery.”

Compassionate listening is a powerful tool. “If someone opens up to you that they’re not doing ok, it’s important to listen to them with an open mind and to engage in the conversation in a genuine authentic manner. Care and concern can make a real difference,” says Annabel.

Listening vs fixing

When someone shares what’s wrong, it’s natural to want to swoop in and resolve whatever problem your friend, family member or colleague is facing. But that’s not really the point. It’s more about being there for them. “It can be tempting to try to fix the immediate issue but we will achieve better outcomes if we listen and support rather than try to step in too much,” he says. 

“You don’t need to be an expert to ask. Listening and giving someone your time might be just what they need to help them through. You don’t have to have the answers or be able to solve their problems, but you can help them consider the next steps and actions they can take to manage their situation.” 

Signs someone needs professional help for depression

When it comes to knowing when someone might need professional help, gauge how long they’ve been feeling low. “If someone has opened up to you that they have been finding life tough for more than two weeks, they may need some extra support,” she says. “Please encourage them to speak with their doctor, local health centre or one of the services listed at ruok.org.au/findhelp. Family and friends can also call upon these services for advice and assistance on how to support someone who is struggling.”

From there, you can shine a light on ways to make getting help happen: It can be helpful to share stories of others you know in similar situations and what help they did receive and what it achieved,” Dr Jones says. “It can also be helpful to identify any barriers (transport, cost, privacy) to seeking help to see if solutions to these can be found. Ask if a support person booking and/or attending the appointment is useful too.” 

Is it ok to ask about suicide?

As for knowing what to do when you’re worried someone is thinking about hurting themselves, it’s far more helpful to ask outright than avoid the conversation. “It is emphatically okay to ask about suicide,” Dr Jones says. “It doesn’t increase the chance of any harm coming to a vulnerable person. If people are never asked there can be a deep sense of shame that will prevent any volunteering of this information.” 

What do I do if someone is talking about suicide?

If you believe your friend is at risk of suicide, suggest they call for immediate crisis counselling or offer to call on their behalf. “If you are worried someone is having suicidal thoughts, contact Lifeline for crisis support on 13 11 14. If life is in danger, call 000,” Annabel says.

When talking with someone who is struggling, making a plan to follow up is crucial. “Try to be specific about when and how would be most beneficial and make plans before the conversation ends,” Dr Jones says. “It’s great to follow up how people are feeling into the future with gentle and non-prying questions. ‘How are things since we spoke’ is an example of this.”

How a GP can help with mental health concerns

Speaking to a GP is the first step to getting support. “The GP will explore the contributing factors and provide a safe and compassionate space to speak openly about them,” Dr Jones says. “They will assist in accurately identifying the key issues involved and developing realistic initial goals to address these. Mental health concerns, addiction and loneliness are major challenges to navigate. A comprehensive management plan involving all appropriate supports can be developed over a few consultations and regular follow up can be arranged.”

Need more information?

If you do want to skill up in knowing how to be an effective supporter of someone in need, there’s help for that too. 

“The free resources from R U OK? provide tips to help you lend support to the people in your world every day of the year,” Annabel says. “Because when we genuinely ask, ‘are you ok?’ and are prepared to talk to them about how they’re feeling and what’s going on in their life, we can help the people who might be struggling feel connected and supported, long before they’re in crisis.”

For more information, support or to talk to someone

RU OK

Lifeline or call 13 11 14 (24 hours/7 days)

Beyond Blue or call 1300 224 636 or chat to a counsellor online (hotline and online chat 24 hours/7 days)