“It’s OK not to be OK” is a well-known phrase in mental health campaigning.
It’s positive as it validates a normal part of human experience and encourages people to share their feelings.
However, hearing someone you care about tell you they are, in fact, “not OK” can be difficult – you don’t want to say the wrong thing, or make the situation worse.
This experience is common, though, says Dr Luke Martin, a psychologist and Beyond Blue clinical spokesperson.
“Everybody has ups and downs in their mental health from time to time,” he says, and sometimes, these fluctuations can indicate a mental health condition.
“Nearly half of Australians will experience a mental health condition in their lifetime, such as depression or anxiety,” says Martin.
“That means their mental health challenges are having a significant impact on their ability to function day to day.”
Without the right support, these conditions can affect people for long periods and across many areas of their lives, including relationships, education, and careers.
Men are affected differently
Mental health conditions can have a significant impact, especially among men, says CEO of the Australian Psychological Society, Dr Zena Burgess.
“Every day, seven Australian men die by suicide, devastating families, friends, and communities, with men accounting for approximately 75 per cent of all suicide deaths in Australia,” she says.
Contributing to this is the stigma surrounding mental health that, although decreasing, can still make it harder for men to speak openly without shame, and seek help when struggling.
“Commonly, men experience fear of being judged and shamed for expressing emotional vulnerability,” Burgess explains.
“Social expectations that men should appear strong, stoic, and unemotional can make help-seeking more difficult and may limit opportunities to form close, supportive relationships, contributing to isolation.”
What can you do if someone tells you they are not OK?
When someone opens up, Burgess says it’s important to validate their feelings and show empathy.
“You might say, ‘Thank you for sharing that with me, I can tell it’s not easy’,” she advises.
Asking open questions is also helpful, as they invite more detailed replies and can provide insight into what’s wrong.
An open question might be something like: “Sounds like you’re going through a hard time – what’s going on for you right now?” Whereas “are you OK?” is a closed question that invites a yes/no response.
For those who are initially struggling to share, Burgess says that you might notice some ambivalence in their response, such as “yeah, nah, I’m doing OK most of the time”.
“It can help to gently comment on the ambivalence,” she says.
“For example, “Glad to hear you’re mostly OK, would you be OK to share about the part that isn’t OK?”
Ensuring you keep the focus on them, rather than shifting the conversation to your own experiences, is also important, as is listening and remaining non-judgmental.
Men may need a different approach
While these approaches can work for both men and women, Ireni Farag, program lead of counselling at Western Sydney University, says there are differences in how men and women respond to support, largely due to social conditioning around emotions, vulnerability, and help-seeking.
“Many men have been socialised to value self-reliance, strength and problem-solving, which can make emotional conversations feel uncomfortable or unfamiliar,” she says.
“Approaches that feel practical, respectful and non-confrontational often work best.”
For example, Farag says it can be more effective to have side-to-side conversations during an activity rather than direct, face-to-face ones.
“Invite them for a walk, gym session, drive, or shared task. Conversations often open more naturally during these moments,” says Farag.
Additionally, some men can find it difficult to articulate how they’re feeling so focussing on what’s been happening rather than labelling emotions can be helpful.
“For example: [you might say] “Work seems like it’s been really intense lately. How are you handling all that?” This can gradually lead into deeper emotional discussion.”
Signs that someone might be struggling without directly telling you
While some people confide about their struggles, at other times, shame, embarrassment, or other factors may make people, especially men, hesitant to do so.
But there are signs to look out for that might indicate someone is struggling, the first being behaviour that differs from their normal.
Others include “significant behavioural changes, such as social withdrawal, persistent sadness, excessive worry, irritability, or an increase in drinking, gambling or other distractions,” says Andrew King, a practice specialist at Relationships Australia, NSW.
“Other indicators are sudden shifts in personality, neglect of hygiene, changes in sleep or appetite, low energy or hyper-energetic behaviour, or reduced enjoyment in hobbies that would have once brought pleasure.”
Supporter not a therapist
While family and friends are an important support network, it is critical to remember that you are not an expert.
“Don’t take on the role of counsellor yourself,” says King.
“If there are things that concern you, work with the person to find the right help, and be there as a support team.”
Martin agrees, saying, “It’s OK to say, ‘I’m not sure what to say or what to do, but I’m sure we can figure it out together’.”
It’s important to encourage them to access mental health support via services such as their GP, Beyond Blue, Relationships Australia, Lifeline and Mensline Australia.
How can you support them in the long term?
When people experience mental health challenges, it’s often not a quick fix, and ongoing help may be needed.
Martin says it’s critical to understand that people’s support needs can be individual, and will change over time, even from day to day.
“Develop a habit of checking in about what would be helpful at the moment. [Ask them whether it would help] to talk about it? To problem-solve? Do you want a distraction? Do you need some space?” He explains.
And finally, remember to put your own oxygen mask on first.
“Ensure you’re getting the time and space you need for yourself so you can continue being there for them over time.“
Support is available from Beyond Blue on 1300 22 4636, Kids Helpline on 1800 55 1800, Lifeline on 13 11 14, Menslife Australia on 1300 78 99 78 and Relationships Australia on 1300 364 277.
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