Part 3 of a three part blog series
Content warning: These blogs share personal experiences of depression, anxiety, suicidal thoughts, and medication side effects. Please consider your own wellbeing before reading.
This is the blog I never expected to write for this Movember series.
After sharing my first two blogs with some team members to ensure this was hitting the right balance, I was asked another question: When someone is in the middle of a mental health crisis, how can friends, family and colleagues help? The truth is, from my perspective, I don’t know. In my darkest moments, I could barely comprehend how to help myself, let alone explain to somebody else how I wanted to be helped.
What I can share is what helped me given the benefit of hindsight.
When I asked my wife how she felt during that time, she often said, “I don’t know how to help you in this moment but know that I love you no matter what.” These were the words I held onto. She could not take away what I was experiencing, but knowing that her love was there, even when neither of us knew what to do, mattered enormously. The kids would just come for a hug (which they always do) and they knew I was ‘sad’ but they just loved me like they always have done in their way.
“It is not so much our friends’ help that helps us as the confidence of their help.”
(Epicurus, 1926, Vatican Saying 34)
So what does this mean? Epicurus is saying that knowing we can count on someone can itself be a source of comfort, even before they do anything to help. This was actually helping me more than anything…
The ordinary things mattered
My family kept doing our normal household routine. Getting the kids ready for school. Doing the washing. Cleaning the dishes. On better days, I participated where I could, as I could, without judgement. I love to cook, so making dinner as I normally would helped things feel familiar. It was our routine, and that familiarity helped. Friends and colleagues knew I was experiencing poor mental health, but I felt I had to continue working. Owning a small business doesn’t always make it possible to step away fully. It felt as though I had a mask on. I could not explain what was happening because I didn’t understand it myself.
The American Psychological Association (2024) explains that depression can leave people exhausted, overwhelmed and withdrawn from everyday activities and relationships. What looks like disinterest may reflect how difficult participation has become. This matters when supporting someone whose ability to connect or contribute changes from day to day.
Checking in, without pressure
Some colleagues later said, “I just didn’t know what to say. I wanted to reach out, but I didn’t want to make things worse.” What helped me was ordinary contact. Messages without an expectation of a reply. Familiar conversations without having to explain my mental health each time. People checked in, rather than checked on me. Others may welcome questions about their feelings. I appreciated being able to talk without providing an update.
What did not help were comments such as, “Just pick yourself up”, or “You need some sunshine and vitamin D.” I live in Australia. Sunlight is not in short supply. I am also a redhead. Have we forgotten “Slip, Slop, Slap”? We are not living in polar darkness here.
These comments were often well intended but added to my sense of failure. Mental Health First Aid guidance advises against dismissing depression or suggesting someone can simply pull themselves together (Mental Health First Aid International, 2022).
What can friends, family and colleagues do?
Mental Health First Aid recommendations draw on research and agreement between professionals, carers and people with lived experience. They emphasise listening, acceptance and practical support, adapted to the individual (Bond et al., 2019). The Similar advice comes from across the countries where MCM works.
- Singapore’s MindSG guidance emphasises listening, accepting silences and avoiding unsolicited advice (HealthHub, n.d.).
- The Mental Health Commission of Canada (2021) recommends listening without judgement and helping people access appropriate support.
- Ireland’s Health Service Executive (2025) encourages staying connected, being patient and accepting the person as they are. These messages reflect much of what helped me.
Across Australia, Canada, the UK, Ireland and Singapore, where MCM works, we need to consider language, culture, faith, relationships and attitudes towards mental health. We should ask whom the person wants involved and avoid assumptions about what their background means for their needs.
Small things that can help
Supporting someone experiencing mental health problems, living with dementia, or both will look different for each person. These are some practical places to begin:
- Make contact without creating an obligation. Send a message saying, “Thinking of you. No need to reply.” For someone who finds messages difficult, offer a familiar voice or a quiet visit.
- Offer something specific. “Could I bring dinner?” or “Would you like company? Or Would you like me to go with you to your appointment?” can be easier to answer than “Let me know if you need anything.” Give the person time and respect their answer.
- Keep familiar life within reach. Offer their usual favourite drink, favourite music or an opportunity to help with an everyday task. Invite participation without pressure, adapting to what they can manage that day.
- Listen, notice and respond. Speak respectfully, using their preferred language and allowing time to respond. When words are difficult, notice expressions and changes in comfort or engagement. Seek professional advice about new or worsening distress rather than assuming it is simply part of dementia.
These suggestions bring together Mental Health First Aid guidance and dementia care guidance, with examples drawn from my experience and reflection (Alzheimer’s Society, n.d.; Mental Health First Aid International, 2022; NICE, 2018).
Giving someone space does not mean overlooking safety. If concerned about suicide, ask directly. Asking does not put the idea into someone’s head. In immediate danger, contact local emergency services and stay with the person if safe to do so (Lifeline Australia, 2022).
Families, friends and colleagues need support too. Nobody should have to carry this responsibility alone.
Whose routine are we supporting?
My family knew what normal life looked, sounded and felt like for me. How well do we know this about people supported through health and social care? Alzheimer’s Society guidance highlights familiar surroundings, routines, connection and opportunities to contribute. Different care workers bringing different routines can be confusing for someone living with dementia (Alzheimer’s Society, n.d.).
Knowing someone enjoys music is a beginning. Knowing they start their morning quietly, enjoy folding washing (although this is a very debated topic in our house, my wife folds laundry incorrectly yet she has not been receptive of this feedback consistently for the last 23 years!) or prefer company without conversation gives us something more personal. Familiarity is also cultural. Language, food, faith, humour and family customs may shape what feels comforting. Their importance differs between people, including those from the same community. Nationality alone cannot tell us what matters. Whose routine are we supporting: theirs, or the service’s?
UK guidance recommends exploring causes of distress, including pain, delirium and inappropriate care, alongside psychological, social and environmental support (National Institute for Health and Care Excellence [NICE], 2018). It also recommends considering psychological treatments for mild to moderate depression or anxiety in people with mild to moderate dementia. These principles offer useful reflection across our work. Their application must respect individual preferences, local professional guidance and available services. Familiarity and acceptance matter alongside appropriate assessment and treatment.
How we speak matters too
Our communication is part of that support. Elderspeak is a patronising way of speaking to older adults that can include exaggerated intonation, childish language or terms such as “love”, “pet”, “sweetie” or “darl”. These terms may be familiar and welcome to some people, but can feel infantilising to others, particularly when used without knowing the person or their preferences.
Williams et al. (2017) found that an intervention reduced elderspeak, and reductions in elderspeak were associated with reductions in resistance during care. This does not establish exactly how each person felt but challenges us to consider how our approach contributes to their response. Patronising communication can also affect people experiencing mental health problems. Speaking as though someone cannot understand, offering simplistic reassurance or talking about them rather than including them can undermine their sense of being heard and respected. Needing support does not take away someone’s adulthood or right to participate in decisions about their life.
Across both dementia and mental health support, knowing the person matters. Clear, respectful language, attention to individual and cultural preferences, and time to respond help us make room for their voice. When someone becomes distressed, our words, tone and actions deserve consideration alongside their other needs. My experience has reminded me how much acceptance matters when you cannot explain yourself. People living with dementia and other mental health problems deserve that same patience, alongside support that responds to their individual needs. I remember the ordinary conversations, familiar routines and participation without judgement. And my wife’s words: “I don’t know how to help you in this moment but know that I love you no matter what.”
We may not always know what to say. We can still show someone that they matter.
Managing Director, MCM
References
American Psychological Association. (2024, March 28). Depression and how psychotherapy and other treatments can help people recover. https://www.apa.org/topics/depression/recover
Alzheimer’s Society. (n.d.). What causes changes in behaviour in people with dementia? https://www.alzheimers.org.uk/about-dementia/stages-and-symptoms/dementia-symptoms/what-causes-behaviour-changes
Bond, K. S., Cottrill, F. A., Blee, F. L., Kelly, C. M., Kitchener, B. A., & Jorm, A. F. (2019). Offering mental health first aid to a person with depression: A Delphi study to re-develop the guidelines published in 2008. BMC Psychology, 7, Article 37.
Epicurus. (1926). Epicurus: The extant remains (C. Bailey, Trans.). Clarendon Press.
HealthHub. (n.d.). How to better support others? https://www.healthhub.sg/programmes/mindsg/caring-for-others/how-to-better-support-others/
Health Service Executive. (2025, June 20). How to help someone with depression. https://www2.hse.ie/mental-health/helping-someone-else/depression/
Lifeline Australia. (2022). Helping someone at risk of suicide [Fact sheet]. https://www.lifeline.org.au/sites/default/files/2025-11/lifeline-australia-fact-sheet-help-someone-at-risk-of-suicide.pdf
Mental Health Commission of Canada. (2021, November 1). How can I help someone in mental distress? https://mentalhealthcommission.ca/resource/how-can-i-help-someone-in-mental-distress/
Mental Health First Aid International. (2022). Depression: Mental health first aid guidelines (Version 2.3).
National Institute for Health and Care Excellence. (2018). Dementia: Assessment, management and support for people living with dementia and their carers (NICE Guideline NG97).
Williams, K. N., Perkhounkova, Y., Herman, R., & Bossen, A. (2017). A communication intervention to reduce resistiveness in dementia care: A cluster randomized controlled trial. The Gerontologist, 57(4), 707–718.
If this blog brings up difficult feelings, support is available. You do not have to face them alone.
- UK: Samaritans offers emotional support, 24 hours a day. Call 116 123, free.
- Ireland: Samaritans Ireland offers emotional support, 24 hours a day. Call 116 123, free.
- Canada: 9-8-8: Suicide Crisis Helpline provides support if you are experiencing suicidal thoughts or worried about someone else. Call or text 988, free, 24 hours a day.
- Australia: Lifeline provides crisis and emotional support, 24 hours a day. Call 13 11 14 or text 0477 13 11 14.
- Singapore: Samaritans of Singapore provides emotional and crisis support, 24 hours a day. Call 1767 or WhatsApp 9151 1767.
- Movember: Visit movember.com for information about men’s health, mental health and suicide prevention, and to select your country’s website.