“How are you?” 

Those three words crop up at the start of so many of our conversations, whether they’re face to face or typed out on WhatsApp, and they’re so commonplace that our knee-jerk reaction is often to respond with some variation of “Oh, you know, fine,” without really answering the question. And it’s just as common for us to simply accept that answer at face value without really probing what’s going on.

With a new scary headline about the economy cropping up every few hours (skyrocketing bills? Tick. The highest leap in inflation on record? Yep. A huge drop in real-terms wages? That too), many of us are feeling anxious and uncertain about the months to come. This is why speaking honestly to our friends about our mental health has never been more important. Yet even with those that we’re closest to, it’s often easier to default to vague questions like “How’s work?” that often prompt equally vague answers and circle around the real problems you’re both trying to share. 

Admitting that you’re not OK isn’t easy (not least when our Instagram feeds are filled with acquaintances boasting about how many miles they ran before breakfast and all the other various ways that they’re smashing the whole self-care thing), and often, asking someone whether they genuinely are “fine, actually” can be just as hard. No one wants to say the wrong thing, and of course they could well be just fine and you risk looking like a bit of a twit. 

But delving a little further is crucial because often, when the need for self-care is really desperate, you’re then oblivious to it or feel so undeserving of it that you couldn’t begin to pinpoint that need, never mind talk about it. And often it takes someone other than you to spot that.

When your brain starts wandering off path, into a place it feels hard to get back from or when it’s spiralling and foggy, there’s rarely a green juice or bowl of chia seeds in the world that could pull it back on track. If your mind is intent on destroying its ‘self’, it cannot fall on you to take care of yourself. 

One in four people will experience some kind of mental health problem every year, meaning someone you know, right now, is likely on the verge of going under. It’s not just friends, it’s colleagues too. Opening our eyes to everyone around us and, just as we’d notice a bleeding leg or a giant bruise, looking to see if we can spot how that person is doing on the inside is crucial – even if at first glance they’re firing on all cylinders, bossing it at work and looking like they’ve got a personal stylist.

Take a few extra minutes to really look and listen: notice that the colleague sitting opposite you hasn’t eaten lunch in weeks because she’s “too busy”, think twice about your sister’s flippant comment that “she can’t sleep at the minute” or ponder why your friend keeps cancelling plans, rather than just being offended when she does. Then asking them if they’re OK. Really OK. 

To take the conversation away from the usual top-line pleasantries, Jill Attree, grief specialist and founder of When Life Wobbles, suggests narrowing down the time scale when checking in and ask: “Tell me how you are feeling right now… not how are you today?” Slowing things down and not cutting in or talking over them with examples of your own experiences (even if they’re well-intended) is important too. “Stop talking and actually listen when they start sharing their story without interrupting them or comparing to your own experiences,” Attree adds.

One of the hardest things about mental health problems is how many years they can steal. How many years you can spend pretending you’re “just fine” when you’re at best treading water and at worst being dragged along the seabed, tangled in a big old clump of seaweed. Because you can’t often see a mental health issue, but you can hide them from others and from yourself. But if you’re asked outright if you’re OK, it might be the reminder you need that it’s not your responsibility alone to manage it. And it might just halt that cycle before it goes on too long. Or gets too deep. 

For more pointers, we asked Jo Loughran, formerly director of Time to Change, the mental health anti-stigma movement led by Mind and Rethink Mental Illness, how to broach the subject if you think your friend, colleague or family member is suffering from a mental health issue. Here is what she advised:

1. Starting a conversation. If you’re worried about a friend or colleague, then simply asking them how they are feeling is a good start. You don’t have to set aside hours to chat and it doesn’t need to be formal or even face-to-face. Often people find it easier to talk while doing something else – for example on a walk, while cooking or watching TV.

2. What should I say? The most important thing to remember is that you don’t need to be an expert. Your friend doesn’t expect you to solve their problems: just being there will mean a lot. Take the lead and ask questions – don’t be afraid to ask how they’ve been.

3. What shouldn’t I say? If someone has opened up to you, try not to brush their problems under the carpet and avoid clichés like ‘It’ll pass’ or ‘What have you got to be depressed about.’

4. Listen. Listening without judging can be as important and significant as talking. The fear of being judged is a huge barrier for many people speaking out about mental health. You might not understand what they’re going through, but that’s OK.

5. Support. There are professional support options out there. Reassure your friend that it’s OK to ask for help.

If you, or someone you know, is struggling with their mental health, you can find support and resources on the mental health charity Mind’s website and NHS Every Mind Matters or access the NHS’s list of mental health helplines and services.

If you are struggling with your mental health, you can also ask your GP for a referral to NHS Talking Therapies, or you can self-refer.

For confidential support, you can also call the Samaritans in the UK on 116 123 or email jo@samaritans.org. In a crisis, call 999.

This feature was originally published in May 2018

Images: Getty; Hian Oliveira, Soragrit Wongsa, Brian Agua