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Approaching a Friend with a Personal Health Issue

friends talkingApproaching an individual with a personal health-related issue is a process often involving many elements including engaging in dialogue, educating yourself and your friend, and exploring resources, with the eventual goal of them seeking additional help from a health care professional. 

This article discusses general techniques and tips for approaching a friend about a personal health-related issue, and goes into detail on the specific topics of eating disorders, alcohol and drugs, and suicide or depression.

Five important things to do before approaching a friend

  1. Think about your relationship to your friend.  Are you trusted and comfortable talking to your friend about the issue and do you believe they feel the same?  Are you the best person to confront them about this issue?
  2. Educate yourself.  Learn about the specific issue you will be approaching your friend about, issues you think may be related, and available resources. 
  3. Assess your feelings about the situation.  Be aware if you are angry or upset so you can keep these emotions under control during the confrontation.  Assess your motives for approaching your friend, remembering that to preach, punish, or criticize may not be useful in helping your friend.
  4. Practice what you will say. During the confrontation state observable behaviors that have lead you to become concerned.  Be specific about particular actions and incidents that have lead you to talk with them. 
  5. Choose a time and location that will be free of interruptions in a private place.  When confronting a friend, do it in a situation divorced from the problem at hand unless you believe they are in immediate danger to themselves or others.

Additional tips

  • Give your friend your full attention including using positive body language to convey you are willing to listen.  Face your friend, make eye-contact, sit on the same level as them, and turn off possible distractions such as cell phones.
  • Use "I" statements that tell your friend exactly what you have observed and how this makes you feel.
  • Be prepared to listen more than you talk.  If your friend is willing to talk about their situation, listen to them without interrupting.  If your friend is quiet, you can attempt to continue the conversation, but do not be overbearing or demand responses to your questions or concerns.
  • At the end of the confrontation let your friend know that you are open to talk more about the issue.  If they are interested in resources that can help or seeing a health care professional, offer to help them investigate or go with them if they would like.  Let them know that you will support them through this process and are willing to talk about the issue more if it has not been resolved.
  • Be prepared for many different responses ranging from denial to anger to relief. 
  • Recognize that your friend's behaviors or state of mind may make you feel concerned, angry, or helpless and you can contact a health care professional for help.  You can also contact a health care professional for additional help before approaching your friend.

Techniques to avoid

  • Minimizing the issue.  Do not assume the problem will go away on its own, or offer simplistic solutions such as, "just get over it" or "its not that big of a deal" or "you need to get a job" even if it appears this way to you.
  • Going beyond your role as a friend by giving counseling or psychological advice.  You are important in helping your friend, but avoid specific medical advice beyond suggesting they talk to a health care professional that is more qualified.

Example

You suspect your friend has a problem with alcohol.  They go out drinking almost every night and plan to come home, but lately they have not been coming back.  You suspect that either your friend is incapable of returning or is participating in something else they are not willing to discuss with you, even though the two of your are usually open with each other.

"I noticed you have been going out to the bars a lot lately, and you have not been coming back home at night.  This makes me worry about you because before you leave you tell me you will be back later in the night.  How do you feel about this?"

This statement first explains the behavior that has been noticed before further explaining why you are concerned.  It then asks an open-ended question for your friend to answer as they choose.

"You told me you were coming back last night from the bars and you didn't.  Where were you?  I was so worried I was about to call the police.  I think you have been drinking too much lately."

This statement is poor for many reasons.  It judges your friend, demands a specific answer about their whereabouts, and may overwhelm them with the idea of calling the police.  Furthermore, a pattern of their behavior is not established, so they may wonder why you are approaching them about this one incident when this behavior may feel commonplace to them.

Alcohol and drugs

  • Educate yourself on the effects of alcohol or specific drug(s) you are concerned about before confronting your friend.
  • Do not confront your friend while they are under the influence of alcohol or another drug.
  • Explain what you have seen as a result of them being under the influence of alcohol or drugs that has you worried.
  • Encourage and support your friend to seek and find professional help although you cannot force them to do so.

For more information on the signs and symptoms of an alcohol problem, see Helping a Friend Who May Have an Alcohol Use Disorder.

Eating disorders

  • Educate yourself on eating disorders before the confrontation including the three main types of anorexia, bulimia, binge eating. 
  • Remember that eating disorders are often not a problem with food, but stem from other mental health issues.  Ask open-ended questions accordingly so you allow them talk about stressors beyond just food and body image.
  • Do not confront your friend about an eating disorder during mealtime, while exercising, or any other time you feel is directly related to the eating disorder.
  • Focus on your concerns about your friend's health and well-being, not on their weight or appearance.

For more information on eating disorders including signs and symptoms of an eating disorder, see Eating Disorders.

Suicide and depression

If you do not see your friend on a regular basis then keep in touch by calling, writing, or e-mailing.  This can help negate isolation, which can be a major component of depression and suicide.

  • Ask open-ended questions that allow your friend to fully explain their feelings.
  • Ask your friend if they have thought about suicide and if they have a plan.
  • If your friend has told you they are suicidal do not dismiss the statement, swear to secrecy, or leave them alone before getting additional help.

For more information on suicide including signs and symptoms of suicide, see Suicide Prevention: Helping a Friend

Additional resources

University of Washington resources

Hall Health Mental Health Clinic (Hall Health Center)

University of Washington Counseling Center (Schmitz Hall)

Wellness Resource Center (WRC) (Hall Health)

Seattle Area Drug/Alcohol Resources (Alcohol and Drug Abuse Institute, UW)

Committee on Eating Disorder Awareness (ASUW)

 

Authored by:  Peer Health Educator
Reviewed by: Hall Health Center Mental Health Clinic staff, January 2014