How to make sure a loved one is OK over the holidays (and take care of yourself)

Difficult news locally and across the country this week has marred a typically joyous start to the holiday season.

If you spend time with loved ones and notice that someone is not well, what is the best thing to say? How can our words and actions extend beyond the festive gathering?

“For many, this is the first holiday season that has felt normal again, so expectations are very high. But the holidays are never perfect, as much as we wish they were, so we need to think about how we can help ourselves and others when we all eventually need it,” said Dr. Robin Gurwitch, Director of the Center for Help for Children and Families in Chapel Hill and Professor in the Department of Psychiatry and Behavioral Sciences at Duke University.

The News & Observer spoke to gurwitch Y Dr. Crystal Schiller, clinical psychologist at the UNC Department of Psychiatryfor more information on how to best handle these situations this holiday season.

Common signs of mental health problems

In general, you can identify signs of a mental health struggle by noticeable changes in someone’s behavior, which can include:

• Withdraw from social interactions and not be as talkative.

• Or the other way around, talking much more than usual.

• Drinking much more alcohol than they normally do.

• Eating much less or much more.

“When I see these things, I don’t make comments about the behavior itself, like ‘Oh, I see you’re not talking to anyone.’ But instead, I would start by asking some broad questions, like how are you doing? How are you feeling today?” Schiller said.

“See what the person brings up, and if they’re open to a discussion, then you can ask more follow-up questions and understand what this difficult time is like for them.”

If they’re not receptive to a conversation, you shouldn’t push it any further, he said: “There’s nothing worse than feeling really bad and someone intruding on your business. You can check with them later.”

How to help someone who is struggling over the holidays

Here’s how Schiller suggests you help a loved one who is struggling during the holiday season:

• Find a quiet place to talk.: Don’t have this conversation at the Christmas table. Find a quiet moment and ask them “How are you doing today?” questions to see if your loved one is interested in a conversation.

• Listen actively: Ask questions to paint a picture. If something difficult has happened in your loved one’s life, you can ask the right questions to learn more about the difficulties they are facing.

• Ask for an action step: Instead of saying “Is there anything I can do to help?” you can ask “What can I do to support you?” Be sure to listen to your request and move on.

If you are not in a position to help them, but you notice that they are having difficulties, you can talk with them to find out who else can be a source of support for them.

• Call the next day: You should do this whether or not your loved one was open to talk. Let them know that he is thinking of them and that you are happy to spend time with them during the holidays.

“We don’t always know the little moments that make a difference in someone’s life,” Gurwitch said. “Just knowing that someone cares about them and was thinking about them at the time.”

If You’re Struggling This Holiday Season, Do These Things

As we think of ways to help our loved ones who are having a difficult time this holiday season, we should take some time to consider how we are feeling and ways we can feel supported. Here are some ways that Gurwitch recommends checking in with yourself ahead of these important days:

• Know that vacations are never perfect.: “We have all seen Christmas movies. We know people don’t get along, food burns… that’s what makes us laugh. That is the conflict of those movies that we see every year,” he said. “Let go of your expectations that the vacation will be perfect. It will not.

By managing expectations ahead of time, you won’t feel disappointed or guilty when the holidays don’t go perfectly as planned, or if you recognize in advance that the holidays will be difficult for you this year.

• Establish a trusted friend: Take some time before the holiday events to identify a trusted friend or family member who you can contact if things get tough. It might help to set a check-in time – if dinner is scheduled for 4:00 PM, maybe you can text your trusted friend at 6:00 PM

“It doesn’t even have to be a long phone call or text with updates about the day. You can send an emoji to update how you feel. Or a number on a scale of 1-10. But if you need to talk on the phone or FaceTime, make sure ahead of time that your friend will be around to help you.”

• Make room for mourning, but know that experiencing holiday cheer is perfectly fine, too.

“It is okay to feel joy to be together and at the same time to be in mourning. Both emotions can be there at the same time. Don’t feel guilty about having a good time when you thought the holidays would be hard,” she said.

You can excuse yourself to go to a separate room or walk around the block if you start to feel overwhelmed.

• Help someone else if you want: Sometimes, if you are feeling stressed or have hard feelings to deal with, you can help yourself by helping someone else. You can offer to do something for the holiday gathering, or you can find an organization to volunteer with.

If lending a helping hand is too overwhelming and you need some mental health resources to help you through your difficult time, that’s more than okay.

How to offer mental health support to friends, family

If a loved one shows signs of a mental health problem or asks for your help, here’s how MentalHealth.gov “For Friends and Family” Guide suggests that you can offer your support:

• Are they getting help? Find out if the person is getting the care they need or want. If not, connect them to resources for help.

• show compassion: Express your concern and support.

• help is available: Remind your loved one that help is available and mental health issues can be treated.

• actively listen: Ask questions, listen to ideas, and respond when the topic of mental health issues comes up.

• tell them you care: Assure your loved one that you care about them.

• Help: Offer to help your loved one with daily tasks.

• extend an invitation: Include your loved one in your plans. Continue to invite them without being overbearing, even if they resist your invitations.

• Talk openly about mental health: Educate others to understand mental health issues and treat those who struggle with dignity and compassion.

• be respectful: Treat people with mental health problems with respect, compassion and empathy.

(Font: mentalhealth.gov/talk/friends-family-members)

Topics to start conversations about mental health with friends and family

If you need help starting a conversation about mental health challenges, you can try these leading questions from MentalHealth.gov “For Friends and Family” Guide. Be sure to actively listen to your loved one’s responses.

• I’ve been worried about you. Can we talk about what you are experiencing? If not, who do you feel comfortable talking to?

• What can I do to help you talk about the problems with your parents or with someone else who is responsible and concerned about you?

• What else can I help you with?

• I am someone who cares and wants to listen. What do you want me to know about how you feel?

• Who or what has helped you deal with similar problems in the past?

• Sometimes it helps to talk to someone who has had a similar experience. Do you know of other people who have experienced these kinds of problems that you could talk to?

• Sounds like you’re going through a tough time. How can I help you find help?

• How can I help you find more information about mental health problems?

• I’m concerned about your safety. Have you thought about hurting yourself or others?

When talking about mental health problems:

• Learn how to connect people to help.

• Communicate in a direct way.

• Speak at a level appropriate for a person’s age and level of development.

• Discuss the issue when and where the person feels safe and comfortable.

• Watch for reactions during the discussion, and slow down or back off if the person becomes confused or seems upset.

(Font: mentalhealth.gov/talk/friends-family-members)

MentalHealth.gov has a long list of resources available to anyone who needs them. They have guides for parents, family members, children, and more hoping to open conversations about mental health. Find those guides at MentalHealth.gov/talk.

Mental Health Resources in North Carolina

Mental health resources, especially in the midst of the pandemic, and even more so as we approach the holiday season, have been limited. The N&O prepared a list in advance for anyone who needs help.

Find resources for immediate help and groups specific to people in and around the Triangle at newsobserver.com/news.