How are you? Talking about your mental health

Specialist Nurse Adviser for Mental Health, Bupa UK
06 February 2020

When people ask how you’re doing, how often do you automatically respond with an answer along the lines of: I’m fine, how are you?

But what if you’re not fine? What if you’re struggling with your mental health and keeping it to yourself? Telling someone you’re not feeling okay can feel really hard to do. However, with mental health problems affecting one in four of us every year, no one should feel ashamed or alone.

Here I’ve answered some commonly asked questions about how to start a conversation about your mental health.

Couple sitting by the lake

Q. Why is it so difficult to talk about feeling depressed?

A. Depression can be hard to talk about for a real variety of reasons. By its nature, it isn’t just about feeling sad. It’s more than that, with symptoms including exhaustion, an inability to make decisions, negative thoughts and reduced motivation. So thinking about what to say, and who to say it to, can be confusing and overwhelming.

In addition, we may worry about what other people may think and how they will react. Many people also carry their own internal stigma around depression. People feel they should be able to cope, and often don’t share the same compassion for themselves as they would for a loved one. This doesn’t always leave us in the best frame of mind to open up, or talk about what’s happening internally.

Lots of people also tell me that they don’t want to add to another person’s stress and issues. They can see that their friend or family member already has a lot going on in their life and don’t want to add to this.

Q. Why is important to tell others how I feel – how can it help?

A. As a mental health nurse, I spend a lot of time listening to and supporting people. And the main thing I hear is that it has been a real relief to get things out of their head and into the open. Carrying negative emotions and thoughts around can be lonely and exhausting, but opening up is a way to ease the burden. We can then start a conversation about getting the right help from the right place.

Q. Who should I tell?

A. Go at your own pace and speak to people you trust. Talk to whoever you feel most comfortable with. This could be your partner or a close friend. You might find that they have already noticed that you aren’t yourself. If they ask you if everything’s okay, take the opportunity to say ‘actually, I don’t feel great’ and go from there.

Or, you may find it easier to tell somebody outside of your circle such as your GP, friend at work or even a telephone helpline. Lots of people use telephone helplines - in 2018/19, The Samaritans took over 3.6 million calls. The fact that it’s anonymous can often make it easier to open up. This can also serve as a practice run in helping you feel more confident about speaking to those closer to you. This is something I support others to do at a time that’s right for them.

Q. How should I tell someone I’m not alright?

A. Often, somebody close to you has noticed you are not 100 per cent and may have already asked you if you’re okay. You may have said you’re fine or they may not have asked at a convenient time. Just remember they are asking because they care if you’re okay, and if you aren’t they would like to help. Start slowly, and only say what feels comfortable to begin with.

Q. What phrases might be helpful to say if I get stuck?

A. ‘I’ve not been feeling too great’ or ‘I don’t feel like myself’ are good starting points. This starts a conversation and allows the other person to hear what you’re saying and respond. Be honest, say its hard to talk about if that’s how you feel, or if you don’t know how to explain it, say that too. There are no right or wrongs, so just say what’s on your mind.

Q. Where should I tell them?

A. I would suggest having a conversation somewhere without interruptions if possible. I like to talk to my friends over a cup of tea at home as it’s quiet and uninterrupted, but I know this isn’t the case for everybody with busy homes. Going for a short walk with a friend or loved one could be a good option, if you feel up to it. Walking side by side can help a conversation feel more relaxed and less intense. And being outside also has the benefit of getting you out of the house for some fresh air, which can also help your mood.

Q. What else can help to make it as easy as possible?

A. For some people, speaking to others with experience of depression can be really helpful, as they will understand how you’re feeling. This can help you feel less alone, and lots of people find the mutual support beneficial. Mind offers some information on how to find the right peer support for you.

Making notes of what you would like to say before you talk to anyone can be helpful too. This is something I do at bed time when I need to switch off. Making notes for the following day allows my mind to start slowing down for sleep.

Q. What next – what should I expect or do afterwards?

A. It’s always a good idea to check in with your GP to talk about your symptoms. Your doctor should complete a brief assessment to see if you would benefit from some help. This might be in the form of guided self-help or treatment such as talking therapy and/or medication. Not everybody needs or wants this, so please don’t let this put you off seeking help. If your doctor suggests treatment, it’s because you are likely to benefit from it. But this is your choice, and you can take your time deciding and talking it over with those you have spoken to.

The most important thing to remember is that there is help and support out there.

If you need help now

If you need help now, the following helpline is free for you to call and talk to someone.

  • Samaritans
    116 123 (UK and ROI)

Alternatively, visit Mind's website and click on the yellow ‘I need urgent help’ button at the top left of the page. This is a tool that is designed to help you understand what’s happening to you and how you can help yourself.

If you need immediate help or are worried about someone, call the emergency services.




Bupa health insurance aims to provide you with the specialist care and support you need, as quickly as possible. Find out how you can benefit.

Caroline Harper
Specialist Nurse Adviser for Mental Health, Bupa UK

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Health information

At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care.

    • Mental health facts and statistics. Mind. www.mind.org.uk, published April 2017
    • Depression. NICE clinical Knowledge Summaries. cks.nice.org.uk, last revised October 2015
    • Depression. Mind. www.mind.org.uk, last reviewed March 2019
    • Impact report 2018/19. Samaritans. media.samaritans.org, published 2019
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