A Tale of Two Pals: on friendship & mental health

Content note: self-harm, eating disorders, suicide, hospitalisation.

It was the best of times; it was the clinically depressed of times.

Mental illness can fracture friendships. Friends may struggle to find the right words to say. They may feel helpless or frustrated. This week is a celebration of friendship blossoming through mental illness. Too often, those with mental health problems are imagined as isolated figures, head in their hands as they sit alone.

Mental health is a continuum in which we all participate. Most people with experiences of mental illness have regular ol’ friendships like anybody else. Sitting on the sunny side of recovery, I’m able to reflect with gratitude on each of my friendships which strengthened through adversity and helped me get to where I am now.

There’s someone without whom my tale would be incomplete. As the first of G4RL’s collaborative posts, allow me to introduce my true pal, Sarah. She’s another successful gal with a realistic belief in love. Friendship needs more air-time, both when it goes right and when it goes wrong. Whatever our gender, we need to celebrate platonic intimacy and counteract the idea that affection is reserved for romantic relationships. We need to assert the value of friendship and romance in equal measure. We need to share the stories which demonstrate that recovery is achievable with the right support.

Here we are in conversation about difficult memories, boundaries and the best advice we’ve given each other. Find out how to support someone with a mental health problem and earn their trust.



  • How did you become friends?

Sarah: We became friends at university. Initially we were unlucky: we fell on opposite sides of the impermeable social boundary which ran through college. I had a preconceived idea of you. I judged you as being this wild, party girl and assumed we’d have nothing in common. Luckily one of your most outstanding characteristics is your openness and warmth of character. When our paths crossed, you had no preconceptions about me and approached me as a potential friend. I was immediately drawn to you because you’re really charismatic and magnetic. What I value most is your loyalty as a friend, your empathy, your integrity, your steadfast commitment to your values and your capacity for love.

Nikki: For me, it’s your sense of humour, your strength, your insight and your grace. You’re also infinitely cooler than me.

Sarah: It’s interesting that all these qualities are at odds with stereotypes of mental illness. Society tells you that if you’re mentally ill, you must be insecure, reactive or needy. You get painted as a cast-off or an outsider. All those stereotypes also have a positive flip-side. Loyalty and commitment can be mistaken for neediness. As a society, I wish we would celebrate the optimistic qualities which accompany mental illness, rather than making a caricature of the difficulties aspects.



  • How did you first open up to each other about your mental health?

N: My mental health problems were out in the open at university. My negative relationship with alcohol was very visible, as was my then eating disorder. But I was drowning at the time and couldn’t yet talk about what was going on. The first time I asked for your support was when I moved to London after university. I was struggling with a relapse of depression. From then onwards, you made me feel totally safe. I could trust you entirely and I felt you wanted to be there for me. It wasn’t just one conversation that unlocked those feelings, but the continued building of an atmosphere where I felt comfortable and respected.

S: I had this deep respect for you and all you’d been through. It’s really easy to see that someone has issues and quickly think “Oh, she’s crazy”. Beneath the immediate veneer of appearances, it was extraordinary what you’d overcome, the incredible strength you’d demonstrated and how you’d managed your emotions.

S (cont’d): The first time I opened up to you was after you’d visited A&E when you’d been suffering from suicidal feelings. On the train home, I wanted to show you I understood how you were feeling. I told you about my previous problems with self-harm and eating disorders. I remember feeling embarrassed, because I hadn’t spoken to a friend in depth about it before. This couldn’t be more different to how I feel now, which is a testament to the intimacy of our friendship.



  • What has been the hardest moment in supporting the other person?

N: It was last Halloween, at your house party. Your eating disorder had really taken hold. Some of our mutual friends came to me crying, asking me what we should do to help you or what was going to happen to you now. I felt so powerless. I felt like there was nothing I could do to help you see your worth and value. Your eating disorder had hidden that from you. I remember sitting on your bedroom floor with your head in my lap and just holding you. I was terrified at the prospect of your illness getting worse. I felt fiercely protective of you. It also made me reflect on how difficult it had been for other people who had supported me in the past. I became even more grateful for my friends and family. It really shifted how I looked at the effects of mental illness on loved ones.

S: The hardest moment was taking you to the psychiatric ward in 2016. You voluntarily admitted yourself as an inpatient. Something inside you knew that’s where you needed to be and it was the only feasible way for you to stay safe in the short term. It was just horrible to see you panicking once we’d walked through the doors.  I saw you suddenly realise you couldn’t undo what was happening to you. I recognise that feeling now: when you hit rock bottom, something out of your control happens and the situation is taken out of your hands. I’ve always felt that you should be in charge of your mental health and I’ve never wanted to take your agency away from you. The circumstances surrounding your admission were really hard, because at that time, you needed to be looked after in a different way for a little while, which challenged my view.



  • What is your most precious memory during a difficult time together?

S: The most precious memory was also when you were in the ward! It was just such a peaceful, close time between us, despite the circumstances. We were mistaken for sisters by the staff and just went along with the lie. Before you were admitted, it was really difficult for me to support you as a friend. You were in such a painfully unhappy place. I visited you at home and I’d often feel quite anxious about how you’d be feeling when I first opened the door. When I arrived, you were usually just in bed or initially really sad and flat. But within the first five minutes, I totally relaxed again, because it was so obvious that it was you underneath your illness. You were absolutely yourself, you still made me laugh, you still gave me advice like any other friend would and we always had fun. It’s so easy to be frightened by the facade of mental illness and just bolt. But the person underneath is always still there. If you love them, then you continue to be there for them without question, because it’s what you want to do. You know that they are worth it and can see that they are still there inside.



  • What’s the most useful advice the other person has given you?

N: There would be no G4RL without you. All the conversations we’ve had about relationships, love and mental health have fed into the blog. You told me to never let someone else dictate my worth, which helped me develop a strong sense of self-worth and independence. Everything else grew from that. You’ve always reminded me that the bad times are temporary and that even in the depths of depression, those feelings will pass. You showed me that self-kindness is worth prioritising. By believing this, I was able to take the small steps which built the foundations of recovery and got me to where I am now.

S: The best advice you ever gave me was to be utterly self-accepting in the face of my mental illness. I spent so long hiding what was going on. I didn’t seek help until my self-destructive behaviours had become really entrenched. To watch you take ownership of your mental health in a really positive way has been so inspiring to watch. It’s been so helpful for me to see that it’s not something to hide and that mental illness can and does get better in time. Seeing you treat yourself with kindness and watching your mental health dramatically improve has been so remarkable.

S (cont’d): You also really helped me when I was in a new relationship last year. I was vulnerable as my eating disorder and self-harm had started becoming serious issues for me. The relationship was playing havoc with my self-esteem and the bottom line was I had no reason to trust this guy. I’d just reached a horrible place of paranoia and you reminded me to be kind to myself and my brain. You reminded me not to minimise my worries and to trust my instincts. You told me that true love stands up to criticism and difficult conversations. You helped me navigate the maze that is social media and showed me how to avoid comparing myself to the other girls I was worried about. You reminded me that those girls are never the enemy and that all the suspicion, anxiety and self-loathing I was feeling should have been directed at and addressed with my boyfriend.



  • How do you keep your boundaries when supporting the other person?

N: I accept you exactly as you are. I don’t try to change you or ask you to be anything more than you’re capable of being on difficult days. I have no expectation of an immediate response when we’re texting. We’re always honest with each other when we need to be offline for a day or two. It’s better to be upfront and say that you need space, rather than lying or disappearing without an explanation. It shows respect towards the other person, your commitment to them and avoids misunderstandings. I don’t discuss any current triggering issues with you, so I avoid talking about food or sending selfies with my full body visible. With an eating disorder, it’s hard to avoid those reminders on a day-to-day basis, but as your pal, I don’t want to add to this in our interactions.

S: It’s never easy supporting a friend with a mental health problem. You never want to see someone you love struggling and it can be hard to find the right words to say. The actual illness can throw up obstacles too, so the person might not trust you or might try to push you away. You have to make a concerted effort and really build their trust. It can be hard, but is the basis for a really strong relationship. If you stand strong through the difficulties, then you’re made for life. When you’re helping someone with a mental illness, it’s important to look after your own wellbeing too. It’s ok to tag out sometimes and you don’t have to be there 24 hours a day. If you’re not being your best self, you can’t be a help to the other person anyway.

S (cont’d): The most important thing is to separate the person from their mental illness. It’s easy to fall into the trap of thinking that someone has become their mental illness. The language we use really shows this. We say “they are anorexic, rather than they have anorexia”. If you set yourself the task of resolving a mental illness, you are going to fail. You can’t sit yourself down next to depression or anxiety and expect to be able to make it better. You will never win. It’s not about trying to engage with the illness itself; it’s about trying to support the person, so that they become strong enough to fight it. This helps you avoid negative spirals and stops you from getting frustrated. If you try to resolve their illness, you will just become resentful and frustrated, because it’s not possible. Instead it’s important to focus on being really constructive and positive with the person you’re supporting, so you can work with them towards recovery.

Next week sees a return to our regularly scheduled programming. The topic is busily being determined on Twitter dot com @G4RL_blog. I’ll be teaching y’all how to become diamonds in the sack unless you act now. Head over to that wicked website, follow the account and exercise your democratic right. You can also find the funnies on my personal account @NikkiS4. See you next Monday!


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