Stress is something we can never escape from, be it good (eustress) or bad (distress). From the small, tedious daily hassles to long-term occurrences that weigh on your mind, stress can impact us in different ways, and the experience varies for everyone. Just as how different individuals have differing levels of pain tolerance, the same applies for stress.
Stress comes in many forms, but they can be largely categorised under ‘environmental’ (e.g noise), ‘social’ (e.g family demands, friendship conflicts), ‘physiological’ (e.g sleep disturbance) and ‘cognitive’ stressors (e.g low self-esteem, high expectations of oneself). While a certain level of stress may be necessary to provide motivation and encourage positive growth, excessive and unhealthy levels of stress especially in the long-term may cause undesirable mental and physical health consequences:
Disrupted sleep patterns / insomnia
Undue anxiety or fear
Difficulty concentrating / forgetfulness
High blood pressure
Nervous behaviours such as teeth grinding or nail biting
Increased frustration and irritability
A racing mind / constant worrying
Poor eating / digestive upsets
Poor decision-making processes
Increased heart rate / rapid breathing
Sweating / sweaty palms
Sense of helplessness
Restlessness / fatigue
When stress becomes chronic, physical health consequences can definitely worsen, and an individual may also develop depression or anxiety disorders. As such, while there is no one-size-fits-all, this article aims to provide useful tips and suggestions on how you can better manage your stress levels, and to avoid being overwhelmed and giving in to chronic stress.
To guide us along, there are two main types of stress-coping mechanisms – ‘Problem-focused’ and ‘Emotion-focused’ coping. These are possibly the most basic approaches to healthy stress-coping, and aim to reduce or eliminate the causes of stress, apart from merely alleviating its symptoms.
Problem-focused coping is where action is taken to clarify and resolve the stressor directly, and hence addresses the demands of a given situation. An example of this method of coping is when a student who is worried over an upcoming examination copes by attending more review sessions and reading up on her course materials diligently. This serves to reduce her anxiety and increase her confidence to excel in her examination. A problem-focused mechanism is primarily used when one appraises a stressor to be within his capacity to change, and hence makes the appropriate adjustments and alterations to cope with the impending demands. As such, it is also important to learn how to identify the root cause of the direct stressor before responding to it accordingly.
Emotion-focused coping may be a concept that you find familiar. Unlike problem-focused coping, emotion-focused coping involves making efforts to regulate your emotional response to a stressor. This means identifying your feelings, focusing and working through them. According to Folkman and Lazarus (1980), such a mechanism can be extremely helpful especially when you need to work through your emotions before you can think clearly enough to act rationally. Emotion-focused coping can be done in various forms such as:
Venting or talking to a friend / close oneWhenever you feel stressed or overwhelmed, bottling up may not be the best way around. Talking to others about what’s bothering you could bring great relief, and perhaps they could also provide you with the constructive feedback or encouragement that you need. Physical affection, such as hand-holding and hugs can help combat stress too. Just as how others may come to you whenever they need support, don’t be afraid to lean into your social circle and find comfort in your friends. Of course, do also remember to be mindful of your friends’ emotions and needs while you’re busy venting!
Journaling In this digital age, perhaps Journaling may come across as a rather old-fashioned way of coping with your emotions. Many a time, people would rather distract themselves and destress by playing mobile games or browsing through social media as and when they are feeling stressed. Although those can be a possible methods of destressing, the beauty of journaling shines through when you give yourself some time to reflect and balance yourself by creating your very own safe space. Writing in a journal can help you clear your mind by releasing any pent-up feelings, to let go of negative thoughts, as well as to enhance your self-awareness as you write about your progress.
Meditation Practising mindful meditation is an effective strategy to combat stress, for it can help you eliminate the stream of jumbled thoughts that are contributing to your heightened stress levels. Studies have shown that training in mindfulness can potentially increase your awareness of your thoughts, emotions, and maladaptive ways of responding to stress, therefore allowing one to cope with stress in a healthier and more effective way (Bishop et al, 2004, in Shapiro et al, 2005). With guided meditations that can easily be found online, all you need to do is to set aside some time for some mental self-care.
Reframing the situation and finding meaning in it When we are stressed, we often only focus on the bad and how much we dread a particular situation. However, it can be helpful to look on the bright side and to find the benefit and meaning in a stressful event. By doing so, we can make these experiences a little more tolerable, as well as to grow and build resilience as we go along.
Other Means of Coping with Stress
Last but not least, pay more attention to your diet and nutrition intake. For some of you, caffeine is a must-have on a daily basis, with some people having four to five cups of coffee per day. However, when you combine stress with the artificial boost in stress hormones from caffeine, this creates a significantly compounded effect. While caffeine can be particularly effective in providing you with the short-term energy boost and increased alertness, it can potentially heighten stress levels in the long-term. As such, it is always good to consume it in moderation and to be mindful of your caffeine intake. In addition, you may want to consume foods rich in vitamin B, which can help to reduce stress responses in your body.
As previously mentioned, everyone experiences life events in their own unique way, and a strategy that works for you may not for others. With that said, we hope this article has helped you to understand the various ways to combat stress better, and that you find the strategy best suited for you. However, if you ever find yourself struggling to cope with stressful life events, do reach out to one of our psychotherapists or counsellors for help.
Zimbardo, P. G., Johnson, R. L., & McCann, V. (2017). Psychology: Core Concepts (8th ed.). Pearson. (Accessed 25/11/2020)
Shapiro, S.L., Astin, J.A., Bishop, S.R., & Cordova, M. (2005). Mindfulness-based stress reduction for health care professionals: results from a randomised trial. International Journal of Stress Management, 12 (2), 164-176. (Accessed 25/11/2020)
For individuals that are taking the first step to seek help from mental health professionals, it is natural that they may be concerned with the possibility of a misdiagnosis, or perhaps an overdiagnosis. With the pre-existing stigmatisation of mental health disorders, clients would have needed to pluck up their courage to seek treatment in the first place. A misdiagnosis could not only hinder them from receiving the appropriate treatment for their affliction, but also allows for their distress to grow unchecked as their hope for recovery diminishes. In other words, accuracy in evidence-based mental health diagnosis is crucial, and this article aims to help you better understand how the diagnostic process works.
As the term “Evidence-Based Diagnosis” implies, psychiatrists or clinical psychologists take extra care to ensure that any diagnosis made is accurate, objective, and not subject to any form of personal bias. In some sense, this also means allowing for a safe, non-judgemental and compassionate environment. Primarily, clinicians would have to understand the client’s suffering and situation, before thinking about how that might relate to a possible mental disorder. Perhaps you may be unaware of this – clinicians do not simply jump straight into tying the client down with a specific diagnosis of a mental disorder. Before all else, clinicians have to consider if the client’s symptoms meet the definitions of a mental disorder in the first place. As per the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the definition of a mental disorder considers these five factors:
A behavioral or psychological syndrome or pattern that occurs in an individual
Reflects an underlying psychobiological dysfunction
The consequences of which are clinically significant distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning)
Must not be merely an expected response to common stressors and losses (i.e.. the loss of a loved one) or a culturally sanctioned response to a particular event (i.e. trance states in religious rituals)
Primarily a result of social deviance or conflicts with society
With reference to the definition of a mental disorder, it is particularly important to note that the consequences of a mental disorder is clinically significant, and causes a weighty amount of disruption to one’s lifestyle and day-to-day activities. For example, it is completely natural for one to feel upset over certain situations, and this does not necessarily mean that you have a case of depression. However, you might need to get it checked out if you find yourself unable to cope with prolonged feelings of sadness which start to interfere with your daily activities, or are causing you to have suicidal thoughts.
Of course, clinicians then assess the syndrome one displays. By “syndrome”, we mean a collection of signs or observable aspects of the client’s suffering (i.e outward expression or behaviour). The main point of this is to identify if the syndrome is clustered in an identifiable pattern that is noted to be severe or pervasive. During the assessment phase, clinicians also try to understand the internal experiences of the client. Besides their outward display of distress, their thoughts and feelings are also important information which counts towards the diagnosis of certain disorders. Upon identifying that the client is indeed suffering from a mental condition, clinicians then try “assigning” the client to a particular category. You can think of it as, “can the syndrome be broadly identified?” There are certain broad categories of disorders, such as anxiety disorders, or psychotic disorders. Needless to say, clinicians have to consider which category the client best fits in.
The last step of the diagnosis process concerns the further narrowing and identification of the specific disorder – branching out from the broader, generalised category and into the specific details. For example, a client could be diagnosed with Obsessive-Compulsive Disorder (OCD), a form of an anxiety disorder. Ideally, a specific disorder is identified during the diagnosis process for various reasons – for the sake of the clients themselves, but also for clearer communication with other mental health professionals (in the case of continuity of care), and even for legal or court matters. Under rare circumstances, some clinicians are able to identify the broad category of the mental disorder, yet are unable to specify the exact condition that the client is suffering from. In cases like these, their disorders will be labelled as “unspecified”, as per the 10th version of the International Classification of Diseases.
As mentioned, evidence-based mental disorder diagnosis is all about diagnosing clients accurately and objectively. To enhance objectivity, some clinicians go the extra mile, stopping to consider if the diagnosis given was biased, or influenced by his or her own culture and history. “Is the syndrome maladaptive?”, “Did I take cultural variables into account?” An objective diagnosis will certainly go a long way in ensuring that the client receives the most appropriate treatment, which will in turn enhance his or her recovery journey.
Overall, it is safe to say that it takes two hands to clap in every treatment process. Clients and clinicians should try as much as possible to work together, be it in the assessment or treatment phase. For an effective treatment, clinicians will do their best to assess the severity and pervasiveness of any syndrome using understandable language such that clients are well aware of their condition. However, clients also need to understand that transparency on their side is pivotal and that it will drastically impact the treatment process, for better or for worse, depending on their cooperativity and how much they choose to reveal.
Dr Robert Shwartz, Ph.D., PCC-S, Evidence-Based Mental Disorder Diagnosis: How to Increase Accountability, Efficiency and Objectivity, video recording, Mental Health Academy
For many individuals, therapy is a rather intense and personal topic, and it could have taken them a lot of courage to finally seek the help that they need. Keeping this in mind, it is exceptionally crucial that one finds the right therapist, for there’s a pre-existing implicit clinical belief that the level of treatment effectiveness is greatly dependent on the therapist-client fit. Of course, every client would love to be able to – ideally – find that one therapist whom they can fully open up to from the very beginning, but in reality, that may not be the case. At times, it is necessary to assess your relationship with your therapist and evaluate if there’s the good rapport you need for your sessions to be a success. Ultimately, it boils down to whether you feel a steady, reliable and safe connection with the therapist, and whether you are making the progress you hope for.
To give you some background, studies over the years have shown that the more similar the therapist and the client, the higher the rate of recovery. As an example, an assessment instrument entitled the “Structural Profile Inventory(SPI)”, which measures seven “independent yet interactive” variables (behaviours, affects, sensory imagery, cognition, interpersonal, drugs/biological factors or BASIC-ID), showed that client-therapist similarity on the SPI predicted a better psychotherapy outcome for the client as measured by differences pre- and post-treatment on the Brief Symptom Inventory. Moreover, the demographic similarity between therapist and client facilitates positive perceptions of the relationship in the beginning stages of treatment, enhances commitment to remaining in treatment, and at times can accelerate the amount of improvement experienced by clients. More precisely, it can be said that age, ethnicity, and gender similarity have been associated with positive client perceptions of the treatment relationship. With gender and cultural similarities appearing the most strongly preferred among clients, these domains generally enhance clients’ perceptions of their therapists’ level of understanding and empathy, and as a result, sessions are judged to be more advantageous and worthwhile. However, besides these, there are also other means to assess your “fit” with your therapist, and we’re here to discuss just that.
First and foremost, consider if you are seeking help in the right place. Does the therapist you are looking at specialise in the area you are seeking help for? Before we can even touch on the topic of interpersonal therapist-client fit, it is important for you to take the time to do some research on various therapists’ profiles – in other words, to sift through and read up on their respective areas of expertise. Typically, therapists would have their area(s) of specialisation up on their online profile directories. It would be clearly indicated if they specialise in areas such as substance abuse, family therapy, or even anger management. It goes without saying that, for example, it would be inappropriate to consult a psychologist who specialises in child psychology when you’re clearly looking for someone who can help you with your substance-use addiction. With that said, it is to no one’s benefit for you to rush into therapy blindly.
Once you have chosen the potential therapist that you are most likely to want to have see you through your road to recovery, another essential question you should ask yourself is whether you are comfortable with their suggested mode of therapy. During consultations, you will have the opportunity to enquire about their recommended techniques or treatment methods that will be explored during your subsequent sessions. If you are uncomfortable with any particular process, giving honest feedback and exploring other methods is always an option. However, at any point, you also have the right to seek other therapists who may be able to help you in other ways that don’t put you in a tight spot. After all, therapy is all about having a safe and comfortable space for you to sort out your difficulties.
When assessing your interpersonal connection with your therapist, make sure to trust your gut. This way, you’ll also be able to track your progress better and to seek alternative help if required. Some questions you can ask yourself are:
Am I satisfied with the current balance of talking and listening with my therapist?
Is my overall therapy experience safe, warm, and validating?
Am I fully assured that I’m in a non-judgemental space where I can be fully honest?
How much has the therapist helped me to gain greater insight into my own behaviour and thoughts so far?
Am I becoming more capable of coping (independently) with stressful or triggering situations over time?
Am I noticing more positive changes in myself, as compared to when I first started therapy?
As mentioned, a major deciding factor should also be on whether you find yourself noticing positive changes in your thought cycles and behaviour after a couple of sessions. At the end of the day, therapy should be about working towards achieving your desired outcome, and should definitely not be limited to weekly venting sessions. Although venting and letting out hard feelings can provide temporary relief, it fosters a client’s dependence on the therapist over time and further reinforces the client’s problems. Therapy should instead help you to feel more confident that you’ve developed the relevant skill sets in order to cope with whatever emotional challenges that brought you to seek therapy in the first place.
Naturally, there’s no guarantee that we will find chemistry with the first therapist we meet. The chemistry between people varies, and sometimes it’s just not possible for us to force it. Thus, it is important to remember that a lack of fit between therapist and client is no one’s fault. However, remember that the ball is in our court, and it is within our control to start looking in the right place for the sake of our own well-being.
1 Herman, S.M. (1998). The relationship between therapist-client modality similarity and psychotherapy outcome. Journal of Psychotherapy Practice and Research, 1998 Winter; 7(1): 56-64.
2 Luborksky, L., Crits-Christoph, P., Alexander, L., Margolis, M., & Cohen, M. (1983). Two Helping alliance methods for predicting outcomes of psychotherapy: A counting signs vs. a global rating method. Journal of Nervous and Mental Disease, 171, 480-491.
3 Jones, E. E., (1978). Effects of race on psychotherapy process and outcome: An exploratory investigation. Psychotherapy: Theory, Research and Practice, 15, 226-236.
4 Blase, J. J. (1979). A study of the effects of sec of the client and sex of the therapist on clients’ satisfaction with psychotherapy. Dissertation Abstracts International, 39, 6107B-6108B.
Beutler, L.E., Clarkin, J., Crago, M. and Bergan, J., 1991. Client-therapist matching. Pergamon general psychology series, 162, pp.699-716. (Accessed 30/08/2020)
With the recent revelation of American rapper, Kanye West, being diagnosed with Bipolar Disorder, the condition has been brought into the spotlight. The term ‘Bipolar’ (meaning “two poles”) signifies the polar opposites of emotional highs and lows. As the name suggests, Bipolar Disorder is characterised by episodic, extreme mood swings in which the individual experiences intense mania and severe depression. Formerly known as ‘Manic-depressive Illness’, the disorder is a fairly common, yet serious mental health condition.
For individuals struggling with the disorder, manic episodes can last days to weeks and are often associated with hyperactivity, an irritable mood, rapid thoughts, increased recklessness, or an exaggerated sense of self-esteem and power. On the other hand, a depressive episode can last weeks to months. In this phase, individuals may experience increased restlessness, a loss of interest in activities (including those that they usually enjoy), poor concentration or disrupted sleep patterns. In more severe cases, these people may also possess suicidal thoughts and behaviours.
In order to help us better understand the condition, we interviewed Deborah Seah, a peer support specialist at Psaltcare.
Deborah started experiencing extreme mood swings in her early primary school years. Having known that her paternal family had a history of mental illness, she identified that her condition was most likely to be genetic. However, she had chosen to suffer in silence until 2 decades later, when she sought psychiatric help for postnatal depression and work-related burnout. At that point, she was diagnosed with Bipolar Disorder as well as Generalised Anxiety Disorder. For Deborah, the disorder reigned control over her life – straining her relationships with her loved ones. Before her diagnosis, others could not understand why she was being so unpredictable, and her erratic behaviour had unfortunately caused numerous misunderstandings.
“It was very challenging to manage my mood swings at the tender age of 8,” she shared. “When I was experiencing my highs, I would talk very fast, have tremendous amounts of energy, get very excited, or become easily irritable and agitated. On the other hand, when I was experiencing my lows, I would feel very sad and experience low energy levels. I could cry for hours or days over trivial matters and be even suicidal at times. The experience of dealing with bipolar disorder consisted of feelings of helplessness, hopelessness and loneliness as I could not predict or control my emotions and energy.” Deborah’s experience with bipolar disorder led her to face an identity crisis – being confused over her contrasting “personalities”, and not knowing which was the real her.
Just like any other mental condition, there are bound to be misconceptions of the Bipolar Disorder, especially if people don’t open up and address it. One such misconception is that individuals struggling with Bipolar Disorder are incapable of managing their mood swings. However, Deborah takes this as an opportunity to debunk such a sentiment: “After a certain point in time, I’ve arrived at a higher level of self-awareness towards my early warning signs, and it has enabled me to gain self-mastery over my condition. When my mood or energy level starts to dip, I’m aware of what could effectively help me to increase my mood and energy. When my mood or energy level is overly high, I know that I need to be extra mindful of not going into overdrive.”
While on the road to recovery, Deborah made a commendable effort in helping herself cope with the disorder. This included reading up on the condition proactively to ensure that she could better achieve self-mastery. Of course, finding a silver lining and staying positive is essential over the course of recovery. Keeping up with articles on others’ success stories and breakthroughs helped her to stay hopeful and confident that recovery is not impossible.
Being highly motivated to make headway towards recovery, Deborah knew that she needed to make changes to her lifestyle. For starters, Deborah:
ensures that she keeps to a good sleep routine and to have sufficient rest
adopts a healthy lifestyle by having a balanced diet and staying active through exercise
stays in a conducive environment for recovery where all potential triggers are removed as much as possible.
She also notes that her Christian faith has played an essential part. Daily prayer and spiritual devotion helped her to calm her mind and provided her with the much-needed inner peace. However, Deborah stresses that one should not brush aside the idea of peer support or psychiatric intervention. The active use of medications coupled with peer support contributed to the turning point in her recovery, and restored any lost hope when the future was seemingly bleak. Connecting to like-minded peers can help one explore new coping strategies and stay on a personal wellness plan.
“Upon knowing my diagnosis, my family took the initiative to purchase books on Bipolar Disorder to understand my condition better,” Deborah recounted. “My family gave me space when I needed it and continually held hope for me even when I gave up on myself. They didn’t pressurise me to make quick progress on my recovery but assured me that they genuinely only wanted me to be happy and that is all that mattered to them. I was deeply touched by their love and concern for me and felt motivated to work hard on my recovery because I realised that they would always be affected whenever I’m suffering.” Through her experience, Deborah holds a strong belief that the hope and support from her loved ones had an immeasurable, significant impact on her, and encourages those who are also supporting their loved ones with mental conditions to stay hopeful.
As of today, Deborah has made promising progress and is well on her way towards achieving mental wellness. After consistently attending a Recovery and Wellness Sustenance (RWS) Workshop at IMH, Deborah graduated with a certificate of participation. Recognising that she benefited much from the workshop, she returned as a Mentor to co-train the subsequent class of peers. In addition, Deborah also completed a module conducted by the National Council of Social Services (NCSS) and was involved in the facilitation for the 3rd and current 5th batch of Peer Support Specialist (PSS) training. She said, “It gave me confidence and reinforced my own recovery as I pay it forward and encourage my peers in their recovery journey. Moreover, it has equipped me with effective coping skills to deal with my mental health condition and it brought my recovery to a higher level.”
To end off, Deborah hopes to pass on an important message to the readers: “To me, there is no shame to be on psychiatric medication or seeking psychiatric help. Just like how people with diabetic conditions need to be on insulin while some people who are asthmatic need to be on Ventolin, people with psychiatric conditions need to take psychiatric medication too. Resilience in Recovery requires these 3 things: Courage – to embrace the past, Gratitude – for the gifts of the present, and Hope – to make the most of the future. I believe that everyone can recover from a mental health challenge, as long as he or she does not give up hope because I am the Evidence of Recovery myself! Everyone recovers at their own pace, just like every flower blooms in its season – let us hold the hope for our loved ones and for those who are battling mental health challenges by cheering them on and being their source of support to believe that recovery is indeed possible.”
“I’m depressed”, “I need help”. How do you react when a friend of yours approaches you, hoping to seek help and comfort? In a society that unfortunately stigmatises mental health issues, many of us are most likely incapable of tackling such situations appropriately. Sadly, people would feel a sense of awkwardness, then attempt to shrug it off by changing the topic. Worse still, some may distance themselves from their troubled peers – being unsure as to how they can help and would rather stay away. To date, mental health issues are considered taboo, and many would prefer to avoid talking about it.
Unsurprisingly, it has come to light in recent times that mental health is ranked second in a study conducted on concerns among Singaporean youths, amid others such as employment opportunities. At the fundamental level, we’ll need to be more informed on how we can assist those around us to seek help from mental health professionals when things get hard, and how we can better support them to cope with their condition. The reason behind this is that many would favour talking to their friends before all else instead of consulting a counsellor or a therapist. Besides the stigma of having to seek therapy, the trust and bond between friends nudges them to find comfort in their peers, allowing them to express themselves more easily. To a certain extent, we are at the frontline and act as the safety net for our troubled friends, thus exponentially increasing the need for us to be more mindful of how we respond and act.
What are some good steps to take if you know that your friend needs help? The most helpful thing you can do if they choose to open up to you is to simply listen. When someone approaches you to tell you their problems, it is extremely important that you lend them a listening ear and to hear them out. This will mean the world to them, for it probably took them quite some time to gather the courage to speak up. Set aside some time to provide an open and non-judgemental space for them to be fully transparent with you. It is vital that any distractions are limited, so that they are assured they have your full attention. Revealing their deepest, private thoughts to someone else is never easy, and when they choose to, it will be greatly beneficial in knowing that the other party truly cares for them.
With that said, let your friend take the lead in the conversation. Let them take control over what they’re willing to share, and what they’re not willing to. We have to understand that ultimately, they have the right to guard their personal feelings and privacy, and we should never, under any circumstance, force them to reveal matters that they aren’t ready to talk about. Don’t put unnecessary pressure on them and let them talk at their preferred pace. You could very well be the first person that they have been able to open up to, and it is crucial that you do not break the trust and confidence they have in you.
Oftentimes, people may tend to get overly-absorbed in the conversation, and take on the role of a “therapist”. Unknowingly, they may start to second guess or make assumptions as to what is wrong, and subsequently jump into conclusions with a possible diagnosis or solution. However, hold your horses – bear in mind that you are neither a trained therapist nor a psychologist. Don’t label them with what you think is going on. Focus on providing them with a reliable listening ear or a shoulder to cry on instead.
Providing words of comfort may seem easy enough – but there are pitfalls in which we often walk into unintentionally. “Things will be better tomorrow”, “I felt the same when I…” Such words are rarely made out of malice, but rather because it is easier to fall back on such overused expressions whenever we struggle to find the right words. However, this could backfire, as the underlying tone may come off as dismissive, unhelpful or even judgemental. Instead, validate their feelings and thoughts. Assure them that you will be there whenever they need someone to talk to, and that it is okay for them to feel what they feel. Moreover, avoid making comparisons between their experiences and yours. Every individual’s journey is personal and unique to them – try to make the conversation less about you and give them a space to express themselves freely.
Focus on how your friend is coping as the conversation carries on, and be alert to any red flags. If it becomes obvious that your friend needs help dealing with emotional issues or a mental health problem, talk to them about receiving proper treatment from a mental health professional. It may be tough to start such a conversation as a person’s culture, family background and experiences may influence their perception about seeking help, which makes such a topic about therapy an intense and personal one. Initially, you may expect some resistance, as they might feel a sense of shame and failure. Remember to reassure them that receiving therapy is not a sign of weakness, but rather a sensible way to deal with their troubles. If possible, simple gestures like offering to accompany them to their first session can also be comforting, for they will be less likely to feel abandoned.
Being patient with them is key, even if your friend is rejecting professional help. Your conversation may have started getting them to consider it, even if it doesn’t mean seeking help immediately. Try to see things from your friend’s perspective and just be there to support and encourage them. Doing this will help facilitate on-going deep and meaningful conversations, and can make your friend more receptive to reaching out to you and for professional help in the future when they are ready.