Demi Lovato is once again talking about her mental health, and her candor ― as usual ― is crucial in confronting stigma. But her latest comments also underscore the important role loved ones play in someone’s life when they have a mental health condition.
The singer discussed an unhealthy relationship with exercise and how it exacerbated her eating disorder on the podcast “Pretty Big Deal With Ashley Graham.” She told host Ashley Graham that her habits ― which included working out multiple times a day ― weren’t red flags to most, but they were definitely part of a bigger mental health issue.
“I thought the past few years was recovery from an eating disorder, when it actually was just completely falling into it,” she said. “I realized that ... maybe my symptoms weren’t as obvious as before, but it was definitely an eating issue.”
She told Graham she wished that someone around her had recognized the signs of a disorder and intervened.
“I was just running myself into the ground, and I honestly think that that’s kind of what led to everything happening over the past year,” she said. “It was just me thinking I found recovery when I didn’t and then living this kind of lie and trying to tell the world I was happy with myself when I really wasn’t.”
The wish that someone would check in or reach out is also the premise of Lovato’s new song, “Anyone,” which she debuted at the Grammy Awards last month. In the lyrics, Lovato sings about feeling like nobody’s listening to her and experiencing empty conversations.
“I almost listen back and hear these lyrics as a cry for help,” Lovato told Apple Music’s Beats 1. “And you kind of listen back to it and you kind of think, how did nobody listen to this song and think, ‘Let’s help this girl’?”
Lovato’s words are a heartbreaking reminder that we all need to do more than just encourage people to “reach out” when they’re struggling. We need to recognize unhealthy behaviors and compassionately show up for loved ones ― even if they say they’re fine or generally appear OK.
When you’re in the thick of a mental health issue, you often don’t feel like you can reach out. Some of the major symptoms of mental health conditions are isolation, shame and guilt. The very nature of the illness makes it hard to reach out or speak up.
“It’s hard to reach out when you’re struggling and not feeling like yourself,” Racine Henry, a therapist and owner of Sankofa Marriage and Family Therapy in New York, told HuffPost. “Mental health disorders are very consuming. ... Sometimes you’re not conscious enough to think, ‘I should tell my friends’ or ‘I should call my sister.’ You’re just trying so hard to survive and stay above water.”
This isn’t to say that the onus is solely on loved ones to pull someone out of a mental health matter. But there are efforts you can make aside from a nice platitude. Here are just a few actionable ways you can help someone in your life who either has a history of mental health struggles or is currently dealing with one:
Know the warning signs
The first thing you can do right now is talk to your loved one about mental health and their healthy behaviors. How do they normally sleep or eat? What does a regular routine look like for them? Knowing this information can help you recognize when something isn’t right on your own.
“People don’t always know how to ask for help or they feel like they’re being a burden. They may feel embarrassed they’re having another mental health episode,” Henry said. “If the people around them are aware of what their baseline is, they can then intuitively pick up on when they need help.”
Be an active listener
If someone does disclose that they’re having a difficult time, make sure to fully immerse yourself in that dialogue. Active listening ― a technique where you concentrate on what the other person is saying and reply in a way that shows them you understood ― is crucial in these tough conversations.
“Active listening skills are something none of us are really taught,” Christine Moutier, chief medical officer of the American Foundation for Suicide Prevention, previously told HuffPost. “It’s less about what you say and more about how you encourage them to talk more and give them a response that’s nonjudgmental and really supportive.”
Get specific in your texts
This goes for someone who opens up to you or not. Tell them you are there to talk about what happened. Invite them to get tea or say you’ll come over and watch a movie. Offer to call their therapist or family members.
“It doesn’t have to be a long, drawn-out conversation and it shouldn’t ask anything of them,” Henry said. Make it an offer.
Reach out repeatedly
Consistency matters. There’s some evidence that shows occasional, repeated communication can make a difference for those who are at risk for suicide or struggling with their mental health.
“I think one of the best things you can do is continually remind someone that you’re there as a resource,” Henry said, adding that you should try to check in every two or three days (even if you don’t get a response). The gentle persistence part is key.
“They could be rejecting your help a lot,” Henry continued. “I always tell family members or support systems that you should want a person to be angry with you for helping rather than have them no longer be here. If you have to constantly call or text or stop by, do that. Often when the person is better, they’ll be thankful for your help rather than listening to the rejection.”
If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HOME to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.
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This article originally appeared on HuffPost.