How to support a friend who is struggling: what to say and what to avoid

You have noticed that a friend has gone quiet, snaps more, or says things like "I am just tired of everything." You want to help, but you are afraid of saying the wrong thing. That worry is normal. Samaritans notes that reaching out can help someone know that someone cares.

Signs that a friend may be struggling

Everyone shows distress differently. Samaritans lists general signs, and one or two may be all you see:

• Not replying to messages, or becoming distant.
• Not wanting to do things they usually enjoy.
• Feeling tearful, restless, angry or very tired.
• Sleeping or eating much more or less than usual.
• Using alcohol or drugs to cope.
• Talking about feeling hopeless, worthless or trapped.

Stressful events can raise the risk too: a loss, family problems, money worries, job or study pressure, loneliness, or a painful illness. None of this is proof. It is a reason to check in.

How to start the conversation

Pick a quiet, private moment. A walk or a chai together can feel easier than sitting face to face. Put your phone away. Samaritans suggests open questions that need more than a yes or no answer, such as "How are you feeling today?" or "What has been going on for you this week?"

Here are some openers in everyday Indian English:

• "I have noticed you have been quiet lately. I am here if you want to talk."
• "You do not seem like yourself. How are you really doing?"
• "No pressure to explain. Do you want company, or do you want to talk?"

If they do not want to open up, that is fine. You have still let them know you care. Try again another day.

Listening is the main job

Samaritans gives listening tips under the word SHUSH: show you care, have patience, use open questions, say it back, have courage. Focus on the other person, make eye contact and put your phone away. You do not have to fill every silence. Check you have understood by repeating back what you heard, without interrupting or offering a solution.

Helpful things to say

• "That sounds really heavy. Thank you for telling me."
• "I may not fully understand, but I would like to."
• "You are not a burden to me."
• "What would help most right now?"
• "Would you like me to sit with you, or help you find someone to talk to?"

Things that usually do not help

Rethink Mental Illness lists responses that are unlikely to help. These include telling them to "cheer up", "pull themselves together", "man up" or "snap out of it", giving unsolicited advice, changing the subject, downplaying their feelings, comparing their situation to someone else's, and telling them to be grateful. In an Indian setting you may also hear lines like the ones below, which follow the same pattern. Try to avoid them:

• "Log kya kahenge? Just stay positive."
• "You have a good job and a family. What is there to be sad about?"
• "Everyone goes through this. Be strong."
• "Do not tell your parents, it will only worry them."

Advice like this can feel kind when you say it. To the person hearing it, it can sound as if their pain is a mistake.

If you are worried about suicide, ask directly

Many people fear that asking will put the idea in someone's head. The US National Institute of Mental Health says the opposite: studies show that asking people if they are suicidal does not increase suicidal behaviour or thoughts. Samaritans says evidence shows asking someone if they are suicidal can protect them, because it gives them permission to tell you how they feel and lets them know they are not a burden.

Use clear words. For example:

• "Are you thinking about suicide?"
• "Sometimes when people feel this bad, they think about ending their life. Is that something you are going through?"

Then listen. Do not argue, shout or promise to fix everything. If they say yes, stay calm and take it seriously. You do not have to solve their problems. Thank them for trusting you.

Keeping them safe

The NIMH says that reducing access to highly lethal items or places can help prevent suicide. Rethink advises not leaving them on their own if they may act on suicidal feelings soon, and making a crisis plan, ideally before a crisis, covering who to contact and which helplines to use. If you are unsure what to do, a professional or Tele MANAS (14416) can advise you.

If they are in immediate danger, call Tele MANAS on 14416 or 112. Samaritans advises, if you can, calling for help and, if you are not with the person, trying to arrange for someone to be there. Ask them simple questions to help them stay present. If it is safe to do so, move them away from a dangerous place.

Helping them link to care

You cannot force someone to get help, but you can make it easier. Offer to find a number, make the call together, or go along to the appointment. Samaritans says you can mention services and offer to accompany them.

In India, Tele-MANAS (14416 or 1-800-891-4416) is a toll-free helpline run by the Government of India. The government says it aims to provide free tele-mental health services, 24 hours a day, in 20 languages depending on the languages states opted for. Your friend can call it themselves, or you can call for advice. Our guide to therapy in India explains the other options.

Supporting them over time

Distress does not end after one good talk. The NIMH lists following up as a key step: staying in touch after a crisis or discharge from care can make a difference. Samaritans suggests agreeing with the person how often to check in, not forcing them to open up, and still letting them know you are there. A short message works: "Thinking of you. No need to reply."

• Offer practical help, such as a meal, a walk, or sitting with them while they make a call.
• Keep inviting them, even if they often say no.
• Help them build a wider circle: other friends, family, and professionals.
• Make a safety plan together when they feel able, so they know who to contact in a crisis.

Family and community: how they can help and hinder

In India, family is often the first place people turn. That can be a great strength. In a small 2020 study of 20 distressed urban adults in southern India, family or friend support helped some people seek treatment. The same study found some people held back through fear of being labelled or judged by family, friends or colleagues. It was a small study, so treat it as a window, not a rule.

A few practical ideas:

• If your friend wants family to know, offer to be there when they tell them.
• If they do not, respect that where you can, unless there is a risk to life.
• Avoid gossip. Do not discuss their situation with mutual friends without their say.
• Share the load. Samaritans quotes one person who cared for her mother and learned that one person cannot be everything, and that a family can take turns.

Phrases about family honour, "what will people say", or marriage as a cure can add shame. Gentle replies such as "Needing help is not a weakness" can make space for a different conversation.

Look after yourself too

Supporting someone can be draining. Samaritans notes it is okay to decide you are no longer able to help someone and to let them know you will not be contactable for a while. Talk to a trusted person yourself. If you feel low or overwhelmed, Tele MANAS (14416) is there for you too.