It would be easier to be a supportive friend if everyone felt comfortable opening up and asking for help when they were having a hard time. However, some people may prefer to keep to themselves or act like everything is fine, even when they are in a crisis.
It can be difficult to stand by and watch someone you care about struggle, but it’s often difficult to support someone who isn’t asking for help. We asked some top therapists for their advice on how to approach someone you care about when they are having a hard time, even if they don’t want to talk about what’s going on.
How can you tell if someone needs help?
Sometimes, it may be obvious that someone needs help. However, not everyone will break down crying or ask for support. Because it can be hard to spot the signs that someone is struggling, it helps to know what to look for.
According to Pamela Orren, Ph.D., a clinical psychologist at Kaiser Permanente, there are six common warning signs that someone needs help:
- They may lose interest in activities they normally enjoy or stop spending time with friends.
- The person may “become more irritable or emotional.”
- They may experience “changes in sleeping or appetite” by sleeping or eating too little or too much.
- Someone struggling may also “show a decline in personal care” and “no longer care about how they look.”
- The individual may have a “negative or hopeless outlook.”
- They may start to abuse alcohol or drugs.
However, signs that someone is struggling may be more subtle, says Attiya Awadallah, a licensed and board-certified creative arts therapist at Lenora Art Therapy and Counseling who specializes in treating depression, anxiety and complex trauma. For example, Awadallah once suspected that her friend was having a hard time when the friend’s responses to her texts became uncharacteristically “brief and infrequent.” Since her friend was usually “very engaged,” Awadallah sensed that something was wrong. After a little prodding, Awadallah’s friend “admitted that she was feeling stressed but didn’t want to bother anyone with it,” she says.
Other subtle signs may include a drop in productivity or sudden mood changes.
Why don’t some people ask for help when they need it?
In a perfect world, everyone would feel comfortable asking for help when they need it. However, people in need may not reach out for several reasons.
Some may not want to disclose personal information about themselves or a family member, even to close friends, Orren says. “They may feel too proud or embarrassed, or [they may] be afraid of looking weak and incompetent,” she explains. “[Or] if they’re used to being an independent person, they don’t want to look vulnerable.”
Others may feel they are a burden if they ask for or accept help, she adds. “Understanding these reasons can help you approach the situation with more tact.”
What can you do if someone needs support but isn’t asking for help?
Anyone can have a bad day, but if you think someone is struggling and may need help, it’s perfectly OK to ask them what’s going on.
“Let them know that you’ve been noticing changes in their behavior and that you’re concerned and there to listen,” Orren recommends. “Just listening with an open mind without judgment can help someone feel understood and supported. [Taking] the time to truly listen and not offer solutions may be the best way to support an individual who does not ask for help.”
Although simply listening may not feel like enough, “we don’t need to take action” to help someone feel better, Orren stresses. “They may just need someone who will listen.”
Awadallah adds that focusing on “giving them a safe space to express their feelings rather than trying to fix the problem immediately” may be more helpful than anything else.
If you sense that someone needs more help, Orren suggests asking, “‘What can I do to support you?’” Awadallah also recommends trying to get the person to focus on the here and now instead of fixing a larger problem. For example, asking, “What would be most helpful for you right now?” can help the person focus on small steps or how they can feel better in the short term. This can be helpful even if they still need to deal with the underlying problem.
If the person wants more support but can’t tell you what would be helpful, “do not ask open-ended questions,” Orren says. “This can often feel overwhelming.” Instead, she recommends providing concrete suggestions. For example, asking, “Can I set up a meal train for you or watch your kids for a few hours to give you a break?” takes the pressure off them and may spark some ideas.
When Awadallah’s friend finally opened up and confided that she was struggling, Awadallah suggested that they sit together virtually while her friend worked through her to-do list. “It wasn’t something [she] would have asked for, but it ended up being exactly what [she] needed to feel supported without feeling like she had to tackle everything alone,” Awadallah says.
What if they still don’t want to talk?
Not everyone will feel like talking. If that’s the case, simply saying, “‘I’m here for you. Whenever you want to talk, I’ll listen. I’m just a call or a text away,’” shows them that you care, Orren explains. Then, “check in on them frequently. Provide them with a text, card or note just reminding them that you are there and willing and able to help. Let them know that you are thinking about them.
“Small tokens of appreciation for the person may help” as well, she adds. “Bring them a cup of coffee or tea or something to brighten up their day like a plant or flowers.” Orren also recommends encouraging them to engage in self-care, such as going for a walk.
It can also be helpful to let your friend know that “talking about problems is not easy,” that “they’re not alone” and “that asking for help is actually a sign of strength,” she recommends.
Orren also emphasizes that even if someone doesn’t feel comfortable talking to you, they may open up to someone else. You can suggest that they reach out to someone they trust, such as a family member or another friend, or ask them if “they’ve talked with their doctor about how they’re feeling.” If they are open to it, you can sit with them to show your support while they make a call to a family member or doctor’s office. Giving them the number for mental health hotlines such as the 988 Lifeline and the 741741 Crisis Text Line “are great options,” Orren adds.
What shouldn’t you say to someone who is struggling?
As well-meaning as you may be, some phrases are not helpful and may make the situation worse. While it’s impossible to make an exhaustive list of what not to say, there are some common phrases you should avoid.
Saying, “I know exactly how you feel,” may ring hollow because “no one knows exactly how anyone else feels,” Orren says. She also adds that it sounds dismissive to say something along the lines of “everyone gets depressed.” It’s also “not helpful [and] may not be true [to say that] ‘this will pass,’” especially if the person has been struggling for a while, she explains. Similarly, telling someone, “‘You have no reason to feel depressed,’” can make someone “feel guilty or ashamed or as though their feelings don’t count.”
Orren stresses that everyone should be cautious before taking action without someone’s consent. Even the most well-meaning friend should not reach out to an adult’s family members without their permission. Some people may have “complicated family dynamics” and may not want to share that they are struggling with their family. Orren also cautions against setting up a GoFundMe page without someone’s permission. They may not feel comfortable accepting financial donations or may not want their story shared widely.
In addition, Awadallah cautions against “offering unsolicited advice without being asked.” She recalls a time that she overheard a co-worker offering a colleague unsolicited financial advice. “Although well-intentioned, it came across as intrusive because it wasn’t what she needed at that moment,” she says. “Instead of feeling supported, [the co-worker] felt judged and overwhelmed.” She adds that “even with the best intentions, it’s crucial to wait until someone asks for advice or help before stepping in with suggestions or actions.”
What if they still refuse to accept help?
Although it can be hard to see a friend struggling, it’s crucial to know when to step back. There will come a point where “it will not help to continue to push them” to ask for help, Orren says. If this happens, “it can be very beneficial to let them know that you have tried to get them help and that you hear that they are not quite ready to get the help at this time,” she adds. “Let them know that you understand and will be there and will be ready to help should they change their mind in the future.”
This article originally appeared in the January 2025 issue of SUCCESS+ digital magazine.
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