It usually presents itself with a furrowed brow. Maybe the eye contact isn’t the same as it used to be. Jokes don’t come easy and the conversation is hard. There’s something wrong and you just want things to be the way they used to.
I can remember a time when I was lost. I wasn’t there. I had sunk into heavy drug use as a way to cope and if I hadn’t outright insulted my closest friends, I had alienated them. Most of it was a downward shifting demeanor but part of it was the fact that I had been diagnosed with a serious mental illness.
There’s truth in the notion that something like that scares people, they don’t know what to do or how to help and for those suffering, it seems to be an endless haze of confusion about how to act or just generally how to be a human being.
Anybody who has a friend or family member with mental issues most definitely has a good share of horror stories and looking back on that time for myself, now that I’m amidst a relative stability, it doesn’t seem real.
To say that I’ve separated myself from the person I was in the early stages would be an understatement but I’ve also embraced it and in my recovery I’ve come to recognize what exactly it takes to help somebody in those types of situations; especially if you’re a friend.
The first thing a friend needs to know is that their buddy is still in there somewhere. They’re just lost somewhere in the frightening thoughts. Imagine if every waking moment you were afraid that people’s main motivations were at best, to make a fool out of you, or at worst hurt or kill you. Of course you’d be different. At that point the notion of even leaving one’s house is too daunting to imagine, let alone going out to get a beer. Still, the fun loving friend that seemed to devolve into this fearful shell of fear and security is still in there and they desperately want to come out, they’re just too afraid of what you’ll think if they do.
The next thing a friend needs to know to help is what exactly their friend is experiencing. The best way to do that? Ask. What’s their diagnosis? What’s going on? What’s it like? Don’t be afraid to sit down and have a good talk with your friend to figure out what they’re thinking or what’s going on in their head. Your friend will be happy to unload because, if you do ask, it’s likely the first time anybody has done so and everyone needs to take a load off at some point.
Don’t be alarmed if what your friend says scares you or seems completely irrational, I can pretty much guarantee it will. In that vein, don’t try to tell them what’s real or argue with them, because what’s real to them may be completely out of the realm of rational thought. Just fucking listen. Let them unload. Then, if you feel so inclined, educate yourself. Learn about the illness and understand that this behavior is not isolated to your friend; millions experience mental illness.
Just be a good friend. That is, be there for them.
Understand that your friend who may have been a different person in high school, is going through, to put it in the simplest terms, a rough time. This rough time may last for years or it may never end but it doesn’t mean that your friend is gone. They’re just different now. There may come a day, if your friend is diligent with their recovery, when things will seem closer to normal and you feel like things are better. Understand though, that there is no cure for mental illness, it is chronic and it will be a part of your friend from here on out.
Really though, the best thing you can do for them is to just keep being their friend. Don’t treat them differently than you ever would have, because they will know and that will make them feel worse. Don’t gossip to your other friends that you’re friend is insane because gossip and speculation is the last thing that a paranoid schizophrenic needs to experience. It only serves to reinforce the irrational fear that people are out to get them.
A concern among mental health professionals is the fact that many people who are suffering isolate themselves and forego human contact. When you’re afraid and panicking every minute of the day about what others are thinking, or doing to you it’s completely understandable that you’d want to isolate yourself, and get away from the evils of society. That’s why it’s more important than ever to be a friend. Let them know they’re not alone and that you have their back.
Out of all that though, just be there for them. That’s pretty much the only thing that they really truly need.
Your friend may do something that scares you but it’s important to know that they’re only doing it because their thoughts have convinced them that there’s no other choice. It may be hard to remain friends after that but if you do, you’ll be rewarded with some of the best conversations, the richest experiences, and the deepest level of friendship that might ever possible, because you stuck around and no one else did. 
