“It’s like a messed-up game of Twister or something.”
The young guy sitting in the chair across from me broke a small smile then, laughing softly and wiping his eyes as he said it. It was 3am and we sat wedged into a small room off a busy ER. An infinite drone of beeping machines, rattling wheelchairs and ringing pagers slid under the gap between the floor and door in that moment. We’d just finished talking for an hour, ending on how hard he’d found it to reach out before this point. Before things really started to feel too much. And before the Twister comment we’d diffused the tears with a joke. Reach out, they say. Reach in. Hell, reach just about anywhere you can right? Spin that arrow, man. Right foot red, left hand green. I was a psychiatry doctor in my second year, half way through another dreaded stint of night shifts. And that’s a conversation (and a one liner about Twister) that’s stuck with me all these years since. Because it might have been 3am. Because sure, it might have been some powerful stuff in its own way. But also, so much more because of what had come before it. Because little more than a few hours before we’d wedged ourselves into that tiny room off that droning corridor, the young man sheepishly joking about Twister and wiping his tears on a sleeve had come close to ending his life.
Reaching out can be one of the toughest things we’ll ever do, but it’s (get ready for the cliches) one of the most important we’ll ever do too. In the grips of the pandemic we’ve been talking a lot about mental health and in many ways this is a tiny glint of a silver lining. Reach out, they say. Speak up. We’ve been hearing how vital it is to talk about the mental side to our health right now, and to let those around us know we need help when we need it. The kicker? Even as a doctor I know spinning that arrow is easier said than done.
Whether we’re the one reaching out, or the person across the room reaching in, questions around how and when and why when it comes to talking mental health are some of the most common I get day to day. And sure, that’s because this stuff is hard. But I’d like to think it’s also because, in this game of Twister we call life, we know it’s vitally important too.
One of the most common things that tends to block us from reaching out to talk about mental struggles is the pressure, on both sides, to feel we need to say, solve or do. Whether you’re the person wanting to open up, or the receiver reaching in, it’s important to remind yourself that your ‘job’ here is to be just as you are. As the person struggling, it’s important to take away the fear of having to have answers or clean explanations. It’s ok to just say what’s there, and to say it however you can. As the support person, it’s equally vital to stand in your own shoes too. Keeping this in mind not only helps ease the pressure when we’re trying to be there for someone, but studies show not pushing to “fix” helps the other person feel heard and open up more.
Another common sticking point is finding the right time or place. If we’re struggling, we’ll often put things off as it’s “not the right time” or “he/she seemed busy”. This stuff is tough to talk about, and so it’s normal to feel it’s hard to nail down the right moment. When it comes to this stuff there’s not going to be a right time or moment, and so going with your gut and broaching the conversation when it feels right is always the smart move. Pick a quiet moment when things feel safe and private. A solid tip, especially if either party find it hard, can be to add a ‘diffuser’ in between; broach the subject while you’re walking, doing the dishes, listening to music or taking a drive. Science shows that having something to do or a diffuser in the background can make talking about emotional and tricky stuff easier.
Just listening and allowing yourself to talk is the foundation to mental health chat. Before any worries about what to say or what to do, if all you do as the one needing help is talk and all you do as the one supporting is listen then you’re both already well ahead of the game. Worrying about how the broach the topic is common and normal, and if you’re the one reaching out a ‘smoke signal’ can often be enough to get the ball rolling. Lead in by just letting them know you’re not ok, and flag to them that it’s hard to talk about. From there, communication opens much easier than we’d think. On the receiving end, start with broad questions that allow the other person to move the chat where they’d like. “How you doing?”, “Are you ok?”, “Mate, I’m glad you said something – tell me more”. Then just let the other person talk.
Even professionally, talking mental health and helping others through tough times is all too often more about equations than answers. Taking away the pressure to have say the right thing or explain what/how/why can be empowering for those moving through depression and anxiety in particular. As the supporter, knowing that science backs benefits from just listening and allowing the other person to get things out is helpful. Reflect, summarise how you’re both feeling and explore it to make sure you understand. The rules here are that there are no rules, and studies back the fact that even a muddled convo can significantly improve things and reduce risk – as long as what’s in is coming out.
Talking through and helping each other identify what might help right now is a good place to start when times are tough. Strip it back to the basics as even simple every day health hacks make a huge difference. Locking in the basics like regular sleep, routine meals, daily exercise, or doing something together that’s enjoyable sound cliché for a reason – they work. Agree on a bit of a plan together and keep the communication lines open. It’s incredibly important to reach out for professional support early, so broaching ideas around a crisis line call like LifeLine, making a GP appointment or calling the psychologist is key. As a support person, we can offer to make the call for them or even go to the first appointment. If things are really in a tough spot or any risks are there at all, then emergency services are the right move. Don’t delay.
From either side of the playing board, reaching out and in when it comes to mental health is more important than ever right now. It’s true that it’s often easier said than done. Knowing what to say, how to help and where to start when it comes to getting or giving support can be tough. But whether we’re a mate, a running buddy, a parent, a sibling or a partner – struggling and supporting can change, and save, a life. All these years later I guess I know now that throw away joke at 3am wasn’t in the end a joke at all. Reach out, he’d said. Reach in. Reach anywhere you can right? Like some messed up game of mental Twister. And in the end, I think he was right. Because it’s the reaching that’s the key – in whatever direction. So spin that arrow and take that step. Right hand red, left foot blue.