“My computer is three feet from my bed. When I can’t make it that far I take my laptop to bed with me. If I can’t sit up I use my phone. I guess connection is important to me.” (Fran Houston.)

Connection is important to us all, but those who live with mental illness can find good connections in short supply. Changes in mood and behaviour can put relationships under strain, leaving people feeling vulnerable and alone precisely when they need help the most. If you have a friend who lives with mental illness you have the choice to buck the trend. Be the one who doesn’t back away. With the internet, distance needn’t be the obstacle it might appear. I am caregiver for my best friend Fran who lives with bipolar disorder three thousand miles away in the United States. Here are ten ways you can be there for your friend. You really can make a difference.

1. Do what you can

Distance means there are things you can’t do. You can’t give your friend a ride to appointments, fetch groceries or call round with a hot meal. You can’t hold your friend’s hand or give them a hug. Focus on what you can do. Play to your strengths and what your friend needs. (Hint: if you’re not sure what your friend needs - ask!) If you’re good with the internet perhaps you could help your friend find information online. That might include researching your friend’s condition (see #7, “Get educated”) but think outside the box. I’ve helped Fran plan trips abroad, book hotels when she’s traveling with limited internet access, and even acted as an emergency GPS service to help her catch a flight! Are you good at organising? We share “to do” lists and keep Fran’s appointments, trips and meetings on a shared calendar so we’re both aware of what’s coming up. I also remind her to take her medication each morning but not everyone appreciates being prompted like this, so ask first. Illness can get in the way of communicating effectively. When Fran is manic her writing tends to become rambling, “poetic”, and hard for others to follow. I act as a safe audience, proof-reading important letters and emails and helping Fran present as clearly as possible.

2. Be there

Practical help is important but your presence and commitment are the most valuable gifts of all. As a caring “internet friend” you can be there when it might be inconvenient for local friends and family. I may not always be free to chat or talk immediately but Fran knows I will never ignore her call or turn her away. Such trust is powerfully reassuring, valuable and stabilising.

3. Be vigilant

Being in regular contact puts you in a great position to detect changes in your friend’s behaviour or symptoms which might suggest things are moving in an unhealthy direction. Your friend is allowed to have a bad day - or a good one - without that necessarily implying anything dangerous so don’t leap to conclusions. Share what you’ve noticed, though, so your friend is aware too. Vigilance is a team sport!

4. Be a team player

You have a unique and valuable role to play but you can’t do everything. Allow others in your friend’s support team to do what they can do best. That includes other friends and family, professional and clinical specialists. With your friend’s permission consider introducing yourself and exchanging contact details. I carry details of Fran’s doctor, psychiatrist and care manager at all times, as well as some of her close friends. I’ve never needed to call them but it is good to know that I can.

5. Use all the tech

There is more to being supportive than picking up the phone when your friend is in crisis. Technology is wonderful! Use it creatively to grow a relationship rich in shared experience. Email, social media, instant messaging, SMS (text) messages, voice calls and webcam - each has its place and unique flavour. Mix things up a bit. If you normally hang out on social media try emailing for a change. If you always webcam from your study at home, try calling from your phone next time you’re in town or at the beach. Invite your friend to do the same. Share your worlds as well as your words. And don’t ignore “snail mail”! A handwritten letter or greeting card is a tangible token of your caring relationship. (Steer clear of “Get Well Soon” cards unless you are sure how that message resonates for your friend.)

6. Have a plan B

The thing with technology is… it doesn’t always work! Have a backup plan for when either of you lose your internet connection. Phone calls and SMS (text) messages can be expensive, especially if you live in different countries or are traveling. However, they can be reassuring. In 2013 Fran crossed the Atlantic from New York to Southampton on the RMS Queen Mary 2. The ship’s internet service was too expensive for Fran to use but I sent a text message each morning and night (normal international rates on my tariff) which let her know I was thinking of her.

7. Get educated!

Be the person who takes time to learn what your friend is going through. Research your friend’s illness or situation online, check out “friends and family” books if you can find them, and read books and blogs by people with lived experience. Look for online courses, and workshops such as the excellent Mental Health First Aid (MHFA) course which is taught around the world. No book or course will tell you what it’s actually like to live with illness but they help you appreciate what your friend has to deal with. Fran is the expert on how bipolar disorder affects her personally but I probably know more about the disorder in a wider context. Together, we make a formidable team!

8. Listen up

Try to resist the temptation to leap in with suggestions and “fixes”. There are occasions when practical help is appropriate (see #1 “Do what you can”) but sometimes what your friend needs is a safe space to share and explore what is going on for them. Treat such trust with respect and make sure you both understand what is happening. You are called on to withhold judgment while your friend talks openly about their thoughts, feelings and situation. You don’t get to judge them and it is down to you to handle whatever you hear. It’s not about you. Worry helps no one but if you are concerned for your friend’s welfare or safety discuss that with them, and engage other help if you feel it is necessary (see #4, “Be a team player”).

9. Don’t forget yourself

Being a friend to someone who lives with mental illness is deeply rewarding but it’s not all “sunshine and rainbows” so give thought to your own support needs. Don’t be a martyr! If you are struggling be honest about it so your friend knows what is going on. That might be all you need - a caring relationship works in both directions - but your wellness plan might also include extra time with family and other friends, hobbies, a visit to your doctor… whatever works for you. You might feel a bit guilty. After all, you’re the “well one” and your friend has far more to deal with than you do. But well or ill, we all wobble. We all need to take care of ourselves, and we all need help sometimes.

10. Enjoy yourselves!

Remember to make time for life’s simple pleasures. Not everything has to be about illness. You may be far apart geographically but with a little imagination there are lots of ways to share quality time. Take turns choosing a book and read to each other over the phone or webcam. Have a private music concert or get some popcorn in and watch a movie together online. Fran and I recently watched the Preakness horse race using a combination of my PC and her phone, laptop and TV. It was a great race and lots of fun!

I’ve shared some of the ways we’ve have found to bridge the geographic distance between us. Whether your friend lives on the other side of town or the other side of the Atlantic, you can help them best by keeping in touch. Keep talking. Keep sharing. Use technology as creatively as you can, because ultimately miles cannot separate us if we dare to care.

About the author

Martin Baker (“Call me Marty”) graduated with a First Class Honours degree in Pharmacy from the University of Bradford in 1983 and completed three years postgraduate research at the Parkinson’s Disease Society Research Centre, King’s College London. Certified in Mental Health First Aid, he is committed to developing his skill set in the mental health arena. He took the internationally recognised Applied Suicide Intervention Skills Training (ASIST) course in July 2014. Recent training includes ‘Beating Bipolar’, a web-based course developed by Cardiff University, and eSuicideTALK, part of the most used and widely recognized suicide prevention-intervention training in the world.

Marty is a current member of the National Alliance on Mental Illness (NAMI), The National Association for Mental Health (Mind), and Bipolar UK. He is a registered Champion of the Time to Change anti-stigma campaign and a member of Stigma Fighters and the NoStigmas Project. Marty has family experience of bipolar disorder and depression and is primary support and caregiver to his best friend Fran Houston.  With Fran he is writing a book about how to be a good friend when your friend lives with mental illness. Marty lives in England and has worked in the computing industry since 1993.

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