For millions of people, having a solid support system is essential for recovery from a mental and/or substance use disorder. People of all ages who have behavioral health conditions are just like those with other treatable conditions – deserving of empathy, compassion, and respect.1 Encouragement from peers, loved ones, colleagues, and the community where they live can have a significant impact on people’s overall health and well-being in recovery.
The 23rd annual National Recovery Month (Recovery Month) observance this September will celebrate the effectiveness of treatment services and the reality of recovery. Recovery Month is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), within the U.S. Department of Health and Human Services (HHS).
This year’s theme, “Join the Voices for Recovery: It’s Worth It,” emphasizes that while the road to recovery is sometimes difficult, the benefits of preventing and overcoming mental and/or substance use disorders are significant and valuable to individuals, families, and communities. People in recovery achieve healthy lifestyles, both physically and emotionally, and contribute in positive ways to their communities. They also prove to family members, friends, and others that prevention works, treatment is effective, and people recover.
Recovery Month aligns with SAMHSA’s Recovery Support Strategic Initiative, which partners with people in recovery as well as family members to promote individual, program, and system approaches to building recovery and resilience. Family and friends make a difference by offering support, reassurance, companionship, and emotional strength. They share the message that treatment and recovery support services are available and help their loved ones find a recovery program that meets their individual needs.
This document provides tips for recognizing the signs of a behavioral health condition and encouraging a positive change in the life of someone you know, while learning ways you can cope with your loved one’s condition.
Recognize Mental Health Problems
While most people believe that mental health problems are rare,2 these conditions are, in fact, common.
In 2010, 1.9 million youths aged 12 through 17 (8 percent of the youth population) in the United States experienced a major depressive episode in 2010.3 Furthermore, the Centers for Disease Control and Prevention (CDC) recently projected that nearly half of Americans will develop at least one mental health problem during their lifetime.4
Remember that you are not responsible for and did not cause the mental or substance use disorder of a family member or friend. However, it is important to learn about the recovery process so you can help your loved one. It's also valuable to be able to recognize the signs of mental health problems, which vary by age group, so you can be alert to any new changes:5, 6
Young children: Changes in school performance; poor grades despite strong efforts; excessive worry or anxiety; hyperactivity; persistent nightmares; persistent disobedience or aggression; and frequent temper tantrums.
Older children and pre-adolescents: Substance use; inability to cope with problems and daily activities; changes in sleeping and/or eating habits; excessive complaints of physical ailments; defiance of authority; truancy, theft, and/or vandalism; intense fear of weight gain; prolonged negative mood, often accompanied by poor appetite or thoughts of death; and frequent outbursts of anger.
Adolescents: Feelings of sadness, hopelessness, or worthlessness; prolonged grief after a loss or death; excessive feelings of anger or worry; alcohol or drug use; exercising, dieting, or binge-eating obsessively; hurting others or destroying property; doing reckless things that may result in self-harm or harm to others.
Adults: Confused thinking; prolonged depression (sadness or irritability); feelings of extreme highs and lows; excessive fears, worries, and anxieties; social withdrawal; dramatic changes in eating or sleeping habits; strong feelings of anger; delusions or hallucinations; growing inability to cope with daily problems and activities; suicidal thoughts; denial of obvious problems; numerous unexplained physical ailments; and substance use.
If your friend or family member tells you that he or she has a mental health condition, the following tips can help you offer support:7
- Express your concern and support;
- Ask about how he or she is managing and really listen to the answers to show an interest in continuing the conversation;
- Ask what you can do to help. You can leave this open-ended or help the person create options for addressing his or her needs;
- Offer to help your loved one with errands or everyday tasks. However, be careful not to make the person feel powerless or incapable of managing his or her life;
- Reassure your loved one that you care about him/her, and include him or her in your everyday plans, such as going out to lunch, seeing a movie, or exercising; and
- Find out if the person is getting the care that he or she needs and wants. If not, offer your help in identifying and getting the necessary support.
Some friends or family members may not share that they have a mental health condition, but you can still offer support and encouragement. For example, if you suspect a loved one is suffering from depression, consider the following:8
- Start by learning about their condition – in fact, sometimes you may notice the signs of a behavioral health condition before your loved one does.
- Although it may be difficult to figure out where to begin, think about ways you can start the conversation. It's important to remember to talk to loved ones in language they will understand, even if they are in a depressed state of mind. For instance, you can say, "You are not alone in this. I'm here for you" or "I have been feeling concerned about you lately."
- Encourage loved ones to admit they have a condition, an essential step to recovery, and help them understand the necessity of seeking treatment.
- If a loved one resists treatment, suggest scheduling a check-up with a general physician, or offer to accompany the person to an appointment.
You can also visit SAMHSA's What a Difference a Friend Makes website to watch an interactive video that shares tips on how to support a friend who is living with a mental illness. The website also provides additional resources that emphasize the positive impact a friend's caring and understanding can have on a person with a mental health problem.
Recognize Substance Use Disorders
Like mental health conditions, substance use disorders affect families of every race, ethnicity, socio-economic status, and location.
Learn the signs of substance use and misuse to help recognize the problem, so you can encourage your loved one to seek treatment and recovery support services. The following are signs that a friend or family member may be abusing drugs:9
Physical signs: Bloodshot eyes or pupils larger or smaller than usual; changes in appetite or sleep patterns; sudden weight loss or weight gain; deterioration of physical appearance or personal grooming habits; unusual smells on the breath, body, or clothing; and tremors, slurred speech, or impaired coordination.
Behavioral signs: Drop in attendance and performance at work or school; unexplained need for money or financial problems; engaging in secretive or suspicious behaviors; sudden change in friends, favorite hangouts, and hobbies; and frequently getting into trouble (fights, accidents, illegal activities).
Psychological signs: Unexplained change in personality or attitude; sudden mood swings, irritability or angry outbursts; periods of unusual hyperactivity, agitation, or giddiness; lack of motivation; appearing lethargic; and appearing fearful, anxious, or paranoid, with no reason.
In adolescents, specific signs of substance use include:
- Bloodshot eyes or dilated pupils, and use of eye drops to try to mask these signs;
- Absenteeism from class and poor classroom performance;
- Trouble/misconduct at school;
- Missing money, valuables, or prescriptions from the home;
- Uncharacteristic behaviors, including isolation, withdrawal, anger, or depression;
- Secrecy about a new peer group;
- Lost interest in old hobbies;
- Dishonesty about new interests and activities; and
- Demands for more privacy and sneaking around.
If you are a parent who suspects your child or teen is using drugs or alcohol, it's important to take action right away. Casual drug use can quickly turn into a long-term problem. There are ways you and other family members can intervene:10
- Set tighter limits with clear consequences;
- Get outside help and support if necessary;
- Have productive conversations by remaining calm, sharing your concerns, and listening; and
- Monitor behavior and activities.
When offering support to someone with a substance use disorder, refer to the following tips to guide the conversation with your family member or friend.11
- Express your concern and provide examples of ways in which the person's substance use has caused problems – be sure to include the most recent incident;
- Don't cover up or make excuses for substance use-related accidents or occurrences;
- Intervene as soon as possible after a substance use-related argument, incident, or accident, when the individual is no longer under the influence;
- Gather information on treatment options and offer to accompany the person to the first appointment or meeting; and
- Recruit other friends, family members, or people in recovery to deliver the message that help is available and treatment is effective.
Most importantly, remind these individuals that recovery is possible, and that millions of people just like them were able to regain their lives and live healthy, rewarding lives in recovery.
Learn the Facts
Misconceptions about mental and/or substance use disorders exist. If you learn the facts, you can correct these misconceptions and support your family members or friends in their recovery journeys.
Myths and Facts: Mental Health Problems
In 2010, 31.3 million adults received mental health services.12 Despite the prevalence of mental health problems, myths and misconceptions about these diseases exist. Inform your family members and friends of the correct information:13
Myth: People with mental health problems are violent and unpredictable.
Fact: The vast majority of people with mental health problems are no more violent than anyone else. People who suffer from these conditions are much more likely to be the victims of a crime than people without these conditions.
Myth: Once people develop a mental health condition, they will never recover.
Fact: Studies show that most people with a mental health condition get better, and many recover completely. Recovery refers to the process in which people are able to live, work, learn, and participate fully in their communities. For some individuals, recovery is the ability to live a fulfilling and productive life. For others, recovery implies the reduction or complete remission of symptoms. Having hope plays an integral role in an individual's recovery.
Myth: Mental illness is the same as intellectual disability.
Fact: Mental illness is completely unrelated to intellectual disability. Intellectual disabilities are characterized by limitations in learning, reasoning, and problem-solving, as well as in conceptual, social, and practical skills. In contrast, people with mental health problems — which cause changes in a person's thinking, mood, and behavior – have varied levels of intellectual functioning, similar to the general population.
Myths and Facts: Substance Use Disorders
In 2010, 4.1 million people aged 12 or older (1.6 percent of the population) received
treatment for a problem related to the use of alcohol or illicit drugs. Learn the facts and dispel the myths about substance use disorders so you can encourage your family or friend to acknowledge a problem and seek help:16
Myth: Overcoming substance misuse is simply a matter of willpower. You can stop using drugs and alcohol if you really want to.
Fact: Prolonged exposure to drugs alters the brain in ways that result in powerful cravings and a compulsion to use the substance again and again. These brain changes make it extremely difficult to quit by sheer force of will.
Myth: Substance dependence isn't a disease; there's nothing you can do about it.
Fact: Substance dependence is a brain disease. The brain changes associated with dependence can be treated and reversed through therapy, medication, exercise, and other treatments.
Myth: Someone with a substance use disorder has to hit rock bottom before he or she can get better.
Fact: Recovery can begin at any point in the process — and the earlier, the better.
Myth: You can't force someone into treatment; a person has to want help.
Fact: Treatment doesn't have to be voluntary to be successful. People who are urged into treatment by their family, friends, employer, or the legal system are just as likely to benefit as those who choose to enter treatment on their own. As they become engaged in treatment and their thinking clears, many formerly resistant individuals decide they want to change.
Myth: Treatment didn't work before, so there's no point trying again.
Fact: Recovery from substance misuse and dependence is a long process that often involves setbacks. Relapse doesn't mean that treatment has failed or the cause is lost. Rather, it's a signal to get back on track, either by going back to treatment or adjusting the approach.
Mental and/or Substance Use Disorders Affect the Whole Family
Individuals with mental and/or substance use disorders aren't the only ones whose lives are impacted by these conditions. These disorders affect family members and friends emotionally, physically, spiritually, and economically.
If someone in your life is suffering from a mental illness, you may wonder what caused your loved one to become ill or worry what others think. These are normal feelings, and it is important to remember that there is hope.17 The following tips will help you cope with changes in your life:18, 19
Set limits, roles, and boundaries. It may be tempting to help your loved one in what are actually counterproductive ways. For instance, calling in sick for someone or bailing someone out of jail can make things worse by delaying the person from getting help. Setting personal limits instead can encourage people with behavioral health conditions to take action themselves, empowering them on their road to recovery.
Develop a coping strategy. Change is difficult, both for you and your loved one. As you develop new ways of dealing with your loved one's behavioral health condition, that person may respond to you with anger, hostility, or unusual behavior. Preparing in advance how you will deal with these behaviors and being consistent in your response will help the affected person see that you are serious about helping him or her. Consistency is essential.
Accept your feelings. You may find yourself denying warning signs, worrying that your family will be exposed to prejudices, or unable to understand how a loved one's behavioral health condition developed. These feelings are normal and common among families going through similar situations. Find out all you can about mental and/or substance use disorders by researching them and talking with health professionals. Seek your own support network and share what you have learned with others.
Support recovery. There are many ways to support recovery. Clearly let the affected individual know that you are there for him or her throughout the recovery process. Offer praise about positive change, attend support group meetings, and participate in family therapy. Ask the person about his or her progress and celebrate even small successes.
Simplify your approach by setting small goals. People with mental and/or substance use disorders must set small goals, such as "one day at a time." The same is true for families and friends who care about them. It is easy to become overwhelmed, so it is important to step back and set one small goal for yourself at a time.
Sustain your own physical, mental, and spiritual health. All three of these can decline for the person who suffers from substance use or a mental health condition, and the same often happens to those around them. Eating properly, getting exercise, taking breaks, and addressing spiritual needs are very important for family members. Taking time to focus on yourself is essential and will ultimately help you keep things in perspective and improve your patience and compassion for helping your loved one.
When family members and friends are involved and supportive of a person seeking treatment for substance misuse, the likelihood of success is improved.20 You can work toward making things better for yourself and also increase the chances of your loved one reaching and maintaining recovery.
Make a Difference During Recovery Month and Throughout the Year
This September and throughout the year, SAMHSA encourages all friends and family members to become involved in Recovery Month and support people with behavioral health conditions. You can:
Share your story. Whether you are in recovery yourself or supporting someone you know who is in recovery, your story will inspire others to seek help. Consider talking to youth through school or community programs and spreading the message that prevention works, treatment is effective, and people recover.
Offer encouragement to others. Let your friend or family member know how much he or she means to you and that you love him or her. Remind your loved ones that life in recovery is possible, and that professionals can help to manage a mental health and/or substance use condition.
Join in the celebration. If your friend or loved one is in recovery, join that person this September to recognize his or her accomplishment. Whether it’s going to dinner together, going on a group run, or attending a Recovery Month event – remind your loved one that his or her achievement is great and that you are proud!
The support of others is crucial to achieving recovery. SAMHSA supports a number of programs designed to provide opportunities for people with behavioral health conditions and their families and friends to work together. These programs can help people address mental and/or substance use disorders, support recovery, and become actively engaged with policy reforms to promote health and wellness.
- SAMHSA’s What a Difference a Friend Makes initiative encourages, educates, and inspires people between ages 18 and 25 to support their friends who are experiencing mental health problems.
- SAMHSA’s Family Centered Substance Abuse Treatment Grants support the implementation of evidence-based procedures, and were developed to provide substance abuse resources to adolescents and their families, or other primary caregivers, in areas with unmet needs.
- SAMHSA’s Children’s and Family’s Health Transitions program uses a system of care approach to provide an easy transition to adulthood for youth and young adults with mental health issues, as well as to support their families.
- SAMHSA’s Consumer and Family Network grant encourages participation from families, individuals, and youth in mental health system reforms, including leadership development, policymaking, and coalition building.
- SAMHSA’s Bringing Recovery Supports to Scale Technical Assistance Center Strategy provides policy and practice analysis, as well as training and technical assistance, to States, providers, and systems to increase the adoption and implementation of recovery support services.
Additional Recovery Resources
A variety of resources provide additional information on Recovery Month, mental and/or substance use disorders, and prevention, treatment, and recovery support services. Use the toll-free numbers and websites below to share your experiences, learn from others, and seek help from professionals. Through these resources, individuals can interact with others and find support on an as-needed, confidential basis.
SAMHSA’s Website – Leads efforts to reduce the impact of mental and/or substance use disorders on communities nationwide.
SAMHSA’s National Helpline, 1-800-662-HELP (4357) or 1-800-487-4889 (TDD) – Provides 24-hour, free and confidential treatment referral and information about mental and/or substance use disorders, prevention, and recovery in English or Spanish.
SAMHSA’s “Find Substance Abuse and Mental Health Treatment” Website – Contains information about treatment options and special services located in your area.
SAMHSA’s “Considerations for the Provision of E-Therapy” Report – Shares extensive information on the benefits, issues, and successes of e-therapy.
SAMHSA’s ADS Center – Provides information and assistance to develop successful efforts to reduce prejudice and discrimination and promote social inclusion.
National Suicide Prevention Lifeline, 1-800-273-TALK (8255) – Provides a free, 24-hour helpline available to anyone in suicidal crisis or emotional distress.
National Association for Children of Alcoholics – Advocates for the public awareness, education, and support of children whose parents suffer from substance use disorders.
National Council on Alcoholism and Drug Dependence, Inc. (NCADD) – Offers assistance to individuals, parents, youth, and friends and family who are fighting alcoholism and drug addiction.
Teen Challenge International – Provides youth, adults, and families with effective and comprehensive faith-based solutions to life-controlling alcohol and drug problems.
Inclusion of websites and resources in this document and on the Recovery Month website does not constitute official endorsement by the U.S. Department of Health and Human Services or the Substance Abuse and Mental Health Services Administration.