Supporting someone over the long term

Ask what they miss or would like more of: seeing a friend, cooking, getting outside, a hobby, work or study. Find out what makes it difficult and whether there is a part they would like your help with. A quieter time, company or a lift may make a difference. They can also say no.

Support does not have to be about getting back to how things were. Their interests, priorities or energy may have changed. Follow what matters to them now.

Make the next step possible

• Find the obstacle. Is it deciding, getting started, travelling, cost, pain, fear of seeing people, or feeling wiped out afterwards? Each needs different help.
• Make the offer concrete. If they miss cooking, choose one meal and bring the ingredients. If they miss a friend, arrange a short visit with an agreed finish. If paperwork is piling up, sit alongside them for one letter.
• Agree when, and your part in it. A reminder, a lift or company may be useful. Repeated prompting after they have declined may not be.
• Review the attempt. Was it manageable? What got in the way? Adjust the size or support before adding more. Completing it without enjoying it does not make the effort pointless.

If even basic tasks remain out of reach, or things are getting worse, help them seek a review. That is information for their GP or team, not evidence that they need more pushing.

Choose something they have a reason to do

A shared interest can give you something to return to each week. There are concrete games and puzzles, making and gardening ideas, and groups and courses in the resource list. A Recovery College may welcome both of you; check local eligibility and book separate places if needed.

Movement is another option if they want it and it suits their health: for example, walking together to somewhere they want to go. With an eating disorder, get advice from their treating team before suggesting exercise or changes to food.

If depression has taken away their interest or energy

Behavioural activation is a treatment that helps people rebuild activity and reduce avoidance with a trained practitioner. If it is part of their treatment, ask how they would like you to help with their agreed plan. They may not enjoy an activity straight away. You do not need to take on the therapist’s role.

Support that was right during a bad spell can become a routine neither of you has revisited. Doing their shopping may still be essential years later. Or they may now want to choose the food, go with you, or manage some of it themselves. How long you have been helping does not tell you which. Look at whether the arrangement still fits their needs and wishes.

By now, you may both have assumptions about what the other wants. Make room for them to say what has become unhelpful: “I've been doing this the same way for a long time. What's actually useful, and what would you rather I stopped?”

Choose one regular task to review, rather than trying to change everything. Agree what stays, what they want to do differently and when to check how it is going. They may need ongoing help, or more support again after a steadier spell.

When they cannot tell you

There will be times when they do not know what helps, or say nothing does. You do not need to keep pressing for an answer. Offer familiar, practical help they have previously welcomed, leaving room for them to decline, and return to bigger questions when they feel able. If their health is getting worse, contact their care team or GP; use urgent help if it cannot wait.

Use what you have learnt

You may have noticed what tends to happen before a difficult period, what helped last time and what made it worse. Write this down together when you can, including where you see things differently. Use it to make or update a plan, so neither of you has to remember everything when things become difficult.

If they have a diagnosis, the condition guides cover more specific ways to help alongside what you have learnt from their own experience.^[1]

Treat persistent sleep problems as something worth help in their own right. A changed sleep pattern can reflect illness, medication, pain or a sleep disorder. It is not always a habit someone can fix through willpower.

If they want your help with routine, agree something you can do alongside them: a regular morning visit, a quieter evening, or arranging daytime appointments at a time they can manage. Work with their treatment plan and daily responsibilities. Keeping an agreed routine is different from checking up on their bedtime.

If poor sleep is making daily life hard or simple changes have not helped, ask the GP or team about assessment and treatment for insomnia, including cognitive behavioural therapy for insomnia (CBT-I). If they have bipolar disorder, check with their team before starting a sleep programme that reduces time in bed.

Less sleep with more energy needs a different response

Sleeping much less without feeling tired, alongside unusual energy, agitation, fast speech or impulsive behaviour, can be a warning sign of a high. Contact their team promptly and use urgent mental-health help if you suspect mania or cannot get timely help. Do not wait for a new routine to settle it. The bipolar guide explains what to do.

If they are tired, in pain or struggling with side effects, raising this with a clinician may do more than another suggestion to be active. Help them describe the impact: what has changed, when it started and what it stops them doing. New physical symptoms deserve assessment rather than automatically being put down to mental illness.

In England, adults with schizophrenia, bipolar disorder or psychosis should be offered an annual physical health check. If an invitation has not arrived, they or someone helping them can ask the GP surgery. Their mental health team may do the check instead. Elsewhere in the UK, ask the GP or team how their regular physical health review is arranged.

You can help book it, ask for a longer appointment or quieter waiting area, or go with them if they want. Ask who will explain results and arrange follow-up. It is also a chance to discuss medicine side effects; changes to prescribed medication need advice from the prescriber.^[2]

See medicines for supporters for appointment questions and important lithium and clozapine precautions.

Check which parts of a task they want help with. Separate the task into parts: choosing what happens, getting ready, doing it and dealing with anything afterwards. They may want help with just one.

For an appointment, that could mean they choose what to raise, you help write it down and drive them there, and they decide whether you come into the room. For money, it might mean sorting letters together while they keep control of decisions and accounts.

If they want to take something back on, agree a trial and a way to ask for help again. Do not quietly withdraw essential support to see whether they cope. More independence might mean choosing their own help, rather than doing everything alone.

When helping has become part of a ritual

With OCD, repeatedly checking, answering the same reassurance question or helping someone avoid a feared situation can become part of the problem. Ask their therapist to agree how you should respond and how to reduce your involvement gradually and supportively. Do not use a general rule to stop reassuring them suddenly, or apply it to food, medication or other essential care.

Supporting someone with OCD covers this in more detail. If your concern is about their ability to make a particular decision, use the capacity guide.^[3]

If everyday life is becoming difficult

Describe the tasks they are struggling with: getting food, eating and drinking, washing, taking prescribed medicines or leaving the house. Ask what help they would accept. If living alone is becoming difficult, ask their GP or team and local social-care service about an assessment; do not assume you must fill every gap yourself.

Help with the part that is difficult

• Meals: ask whether shopping, choosing food or preparing it is the problem. Offer help with that part, such as ordering their usual groceries together or making lunch during a visit.
• Appointments: ask whether booking, transport or remembering what to say is getting in the way. Offer a lift, help with a call or a written list of questions, if they want it.
• Between visits: agree when you will next be in touch and what you will do if you cannot reach them. Involve someone nearby only with their agreement, unless safety concerns mean you need help.

Leave them in charge of choices they can make. Helping with a task does not mean taking over every part of it. Keep some time for ordinary company as well.

For ongoing practical arrangements, use helping with daily tasks and care and carer’s assessments. If they seem physically unwell or help cannot wait, use urgent help.

Sources for the depression treatment and care-needs advice checked: 2 October 2026. NHS depression treatment, NHS England Talking Therapies and NHS care needs assessments (England). The assessment guide covers all four UK nations.

Over time, a conversation can become a round of checks: sleep, tablets, appointments, food. Some of those questions may be necessary. But if they take up every visit, there is little room left for being partners, friends or family.

If they are willing, agree a time for practical updates and leave some of your contact for other things. A shared game, a programme you both follow or an ordinary story from your day gives them a way to join in without reporting on their health. Offer something familiar without making every activity a recovery exercise.

If the same argument keeps happening

Choose one concrete difficulty to discuss at a calmer time. Describe what happened and what needs sorting out, rather than judging their character or effort. Being late to an appointment is a problem you can plan around; calling someone lazy closes that conversation down.

You can acknowledge what was hard for them and still explain the effect on you. If you snapped, a direct apology helps you return to the issue without abandoning it. If conversations repeatedly end in conflict, ask about family intervention rather than expecting either of you to find the right words every time.

Research about family communication is not evidence that you caused an illness or can prevent every relapse. It is also not a reason to accept threats or abuse. See when they are angry with you and setting limits.^[4]

Use what happened last time to make the next difficult period less improvised. When they feel able, make or revisit a plan together. If they already have one with a care team, start there.

• Early changes: what they notice themselves, what you notice, and how they would like you to raise concerns.
• What helps and what does not: include practical support they want and things they would prefer you to avoid.
• Who does what: who can offer each kind of help, and who will contact services if needed.
• When and how to get help: ask their care team or GP what changes should prompt contact. Record the numbers, opening hours and out-of-hours route.

Agree who keeps a copy. Review it after a difficult period, when they are ready, and when contacts or support arrangements change. It should reflect their wishes as well as your observations.

Make or update a crisis plan. If things are getting worse now and cannot wait, use the urgent-help help for their UK nation.^[5]