Mental Health First Aid After A Breakup

‘Mental health first aid’ is a term that is most often used in workplaces and it’s also a form of training you can take: like all first aid it is about recognising signs that someone needs help, stabilising if any immediate risk involved and getting professional support to the person as soon as possible. In the context of a breakup, it’s likely that a friend or indeed a colleague at work of the identified patient (you if you are going through the breakup) will be the first aider. It’s often difficult for the person affected to recognise they need help as a part of mental illness is lack of insight into being ill. So, the first step for anyone is to alert their network to the fact they are going through this. This can be difficult as you may be experiencing shame or embarrassment about the ending of the relationship and not want to talk about it, but it’s crucial to alert folk to your situation.

Thinking of the first aid analogy, going through a break can be seen as analogous to organising a major event where one of the first things you would do is ensure you have first aid, ambulances etc on standby as you know it’s much more likely for people to hurt themselves in these situations. A breakup is of the three major life transitions that can lead to what is known as transition shock. The others are:

• Moving home
• Changing job/change in economics
• Changing intimate relationships

Depending on what the circumstances you are in, it maybe that a breakup involves a number of these transitions simultaneously. All of which is to say that just like medical attention, first aid is more likely to be at a public event, it is part of the risk planning, so you should be realistic that your psychological distress may move into mental health needs. So, the first tip is risk assessment and risk management just in case you need help alert others to what is happening.

If you have a previous history of mental health problems, you need to realistic about the higher risk of a relapse in the condition during the transition, whatever that condition such as anxiety, depression, addiction, eating disorder etc, especially in this context as major life transitions produce significant stress reactions which are triggers of mental health problems. As part of your risk management, you may want to think about prophylactic interventions such as medication before you become symptomatic, or increasing your attendance at support groups if you are in recovery or restarting some evidence base therapy.

As a possible patient ensuring you engage in general good health and wellbeing practice is crucial. Start with the insights from Lifestyle Medicine ensuring you have the 4 corners of health and wellbeing in place:

1. Exercise/active life.The single biggest health improvement you can make is to have regular exercise, ideally 3 times a week for 20 minutes, raising your heartbeat is what you want to aim for, anymore and that’s a bonus!
2. Stress management.Relaxation and stress management are crucial to physical and psychological health. Stress is implicated in all major lifestyle illnesses and every manifestation of psychological distress. Learning to spot and reduce stress reactions is central to living a healthy life.
3. Diet.Having a heathy balanced diet contributes massively to a healthy mind and body. Try to reduce processed foods, eat a mix of 80-20 vegetable and fruit to meat, control portion size and reduce sugar.
4. Sleep.Good sleep hygiene is essential to healthy living. Sleep deprivation is a form of torture due to the psychological consequences of missing REM sleep cycles. So, practice good hygiene in your sleep habits; don’t drink alcohol or other stimulants at night, exercise, have a simple and regular bedtime routine, reduce blue screen activity at night and don’t use your phone in bed!

If you are the possible ‘first aider’ it’s important to feel confident in being a little nosier than you normally would. Don’t be afraid to ask your ‘patient’ about their symptoms, at worst you will get a grumpy response to leave them alone, but mostly you will get thanks for being solicitous. What are the types of symptoms that might indicate the need for signposting or referral to professional help?

• major sleep disturbances
• significant changes in outlook
• significant changes in appetite or eating patterns
• increase in alcohol use
• dysregulation (anger aggression etc)
• low mood
• thoughts of being a failure and a burden on others
• lack of concentration, stopping and forgetting tasks
• emotional lability

Any one of them at low levels is to be expected, but it’s about poly symptom, intensity, and duration. If there are several at the same time and they hang around for more than a few days or if they are very intense it’s time to ring the alarm bell. So, what can you do?

• Give your patient a good listening to. Learning to actively listen to someone without judgement is more often than not the most helpful thing you can do. Unburdening ourselves reduces our isolation and improves our mood, allowing us to make better real-world decisions to improve our circumstances.
• Signpost and follow up. Know what the services are available in your setting. If you are work colleagues have a chat with your line manager and ask what EAP exists and how that can be accessed for example. If you are a friend, maybe scope out support groups and offer to chaperone? Maybe ask if you friend has talked to their GP?
• Why don’t you get mental health first aid training?
• If you have very serious immediate concerns for the safety of your friend/colleague or someone they care for, then contact emergency services who can intervene to take them to a place of safety for assessment and treatment if needed (for example of you ask them how they feel and they say they want to kill themselves and they have it planned out/methodology/timescale dial 999)

Mostly what we all need is to know someone has got our back and is willing to be a buddy in times of stress, and that doesn’t need loads of training, it just needs a big heart, open ears, and mostly closed mouths that murmur support.

About Noel McDermott

Mental health expert Noel McDermott is a psychotherapist and dramatherapist with over 30 years’ work within the health, social care, education, and criminal justice fields. His company Mental Health Works provides unique mental health services for the public and other organisations. Mental Health Works offers in situ health care and will source, identify and co-ordinate personalised teams to meet your needs – https://www.mentalhealthworks.net/