When you’re given a diagnosis of a mental illness that is hindering your ability to live – interfering with relationships, keeping you from focusing on your goals or achieving your dreams – you’re obligated to yourself to fight it, to get better. You may not get better all at once, or quickly, or as fast as others – and the road will be more twisted than straight-forward. But the key is that you always move forward when you can, never stopping for longer than you need to.

That’s not the case for everyone, though. There are people who struggle with mental illness, but don’t acknowledge it – or refuse to get better. If you’re family, and you’re taking care of your relatives, then you may feel obliged to help them no matter what – but there’s a fine line between helping someone get better, and letting yourself be dissolved by the struggle.

Remember to Preserve Yourself

If your friend has been diagnosed as mentally ill in some form or fashion and cannot get better because they refuse to, or because they consistently follow habits that worsen their condition despite everyone’s efforts to help, then you must consider that it may be time to make some heavy, important decisions.

It’s hard to leave someone over a mental illness – cutting a friend off because of their behavior can feel like a betrayal, especially with the way we all talk about how mental illness is something we could all be affected by, something we can’t help.

But that’s misleading. It’s not that you can’t do anything about mental illness – it’s that you can’t do anything about the fact that you or someone else has become mentally ill. Zachary Ament of Westwind Recovery said “It’s still up to every single person suffering from a mental disorder to get better, seek treatment, and try what they can to remediate their symptoms. In fact, I’d go so far as to say that it’s a person’s responsibility, a person’s obligation, to do their best to get better – not just for their own sake, which is purely subjective, but for the sake of those around them.”

Then there are cases where someone is unable or fundamentally unwilling to seek help, or where help will be a constant state of existence. That’s when you have to take a step back and ask yourself if you’re mentally and emotionally capable of sustaining this relationship without permanently scarring yourself, as well.

It’s a bit insensitive to tell a depressed person to simply stop being depressed because it’s making an impression on others, though, so it’s important to take this piece of advice with a shred of context.

There’s a difference between a case where someone is doing their best to get better, whatever their best might look like, and a case where someone languishes and leeches and avoids all treatment or suggestion, and cases where your help as a friend comes second to the necessary long-term professional help. Let’s start with scenario number one: denial.

It’s Not Me, It’s the World

There is a line of thinking in certain cases where people suffer a personality disorder, a case of schizophrenia, heavy addiction or any other condition in a long list of self-destructive and dangerous mental diseases, and they refuse to recognize their condition. Instead, every maladaptive habit and every negative event is on the shoulders of someone else, the fault of some other force, an issue that has nothing to do with them and isn’t in their power to stop.

That sort of thinking isn’t just because someone’s being an ass – it’s a lot more complicated than that.

Most people would ask you to put yourself in the shoes of someone with a mental disease diagnosis and imagine what it must be like to swallow the fact that you are “crazy”. But that’s a bit inaccurate.

It’s not about you – this is about them. And there are many reasons why someone might refuse to accept that they need to get better. Perhaps it’s not just that they’re scared, but they’re so narcissistic to the point that the sheer idea of being fundamentally wrong about anything is laughable at best.

When it’s a disorder, it must be treated as one. One wherein a person’s mental issues are coupled with a determination to control and manipulate, and perhaps even hurt those around them. Any respectable doctor will be frank with you in a case like that: “walk away”. In the best-case scenario, you’re playing into the problem and becoming an enabler – worst case, the situation pulls you into your own issues and slowly makes a wreck of your entire life.

Denial is a natural part of the process of discovering a mental illness. Not everyone knows that there’s something medically wrong with them. So, when the time comes that they’re given an official diagnosis, it can come as quite a shock at first. It’s only normal – and as such, it’s normal to resist the idea that it’s real. That the illness is an actual problem and not a misdiagnosis.

It’s most commonly a hallmark of addiction, but other mental illnesses work the same way. Unless a person has a condition that is quite apparent, it may be that they’ve been mislabeling a benign mental illness as a character quirk, until some form of stress got too much and they fall into an episode of more drastic or extreme symptoms.

But all this, of course, doesn’t excuse the simple fact that denial isn’t something to be tolerated. Or rather, it’s not something you have to withstand. It’s okay to step back from someone you used to care about, specifically when they rant and rave and harm those around them. It’s okay to take a step back, shake your head and refuse to be abused a second longer. Mental illness isn’t a license to hurt others, and that should be understood by everyone involved. If they won’t accept treatment but are abuse towards others, then it’s time to disregard their reluctance and focus on an alternative to what they want.

Are You Helping?

You should always be there to extend a helping hand if you feel up for it, and be there to offer support when it’s needed – but that’s still a privilege, something you’re granting out of your own generosity and love for another, and out of loyalty to a friend. If they refuse to get better, or even refuse to accept that they’ve got a problem, or if the situation is draining you to the point where you’re feeling yourself slip into emotional issues, then it might be time to walk away.

Walking away doesn’t have to mean you leave them to their own devices – in truly desperate cases, that’s akin to a death sentence, and not the right thing to do. But if you’re at your wit’s end, it’s time to take a break for yourself. A friend with major depression and serious issues with self-treatment, for example, needs professional help and a distinct treatment plan. You may be integral in the long-term, but you can’t help much when what they need is support from people with a much better, personal grasp of their situation, from support groups for similar clients to regular therapy sessions and alternative treatments.

In fact, saying goodbye may be the best thing you can do. If your friend is suffering from a problematic and destructive mental illness and your relationship has turned into a one-sided show of abuse, then it’s time to accept that your old friend is, for all intents and purposes, gone – and you can’t help bring them back. It’s not your job to bring them back, and it’s your choice to stick around and wait.

It ultimately comes down to whether you think that your addition to your friend’s life is helping both of you. It cannot be a one-sided relationship – you can decide to play the saint and sacrifice your own sanity for your friend’s, but in all honesty, that usually means that whatever friendship you had, to begin with, will be tainted with underlying resentment.

You’re there to help, but not at the expense of yourself. That won’t just damage your own sanity – it’ll produce nothing but guilt in your friend, and leave them angry and ashamed that they can’t do better, or that your issues have become their fault.

See the Fine Line

There’s a difference between abandoning someone and cutting them out of your life for justifiable reasons. When a person is mentally ill, their reality is warped. There’s no use fighting them on it if they can’t choose to reject their condition, and if you’ve truly done what you can to help them, then the only thing you can do is save yourself.

It’s something no one wants to say – but often enough, we’re at a point in our role as caretakers where we desperately want to say it. That doesn’t mean it’s right to give up when there is more left for you to do. You must be able to decide when you’re truly at your limit – yes, being friends and taking care of someone with a mental illness is hard. It’s tough. But is it so emotionally straining that you resent them for it? Has your relationship been entirely shattered? Do you feel that their condition is becoming a problem for you in your life?

If yes, then you’re only making things harder for the both of you. But if you’re not positive that you want to quit, then you shouldn’t – so long as hope exists, it’s worth pursuing.

But be sure not to mistake hope for something else, like emotional entrapment. In other words: be honest with yourself. Brutally honest. Now more than ever. Are you truly helping your friend – or are you just tearing yourself apart? Mental illness, while often treatable, requires one very vital thing to be effectively combatted: will. And this goes for the both of you.

It’s Hard Not to Feel Guilty

We get it. This post tries to address the difficult topic of dealing with mental illness from an involved bystander’s perspective. If your friend has undergone a trauma or through some other means has significantly worsened with their mental health, then you should recognize that the option to jump ship is a viable one – and you must know when it becomes viable. Even then, though, it’s hard to abandon a friend and not feel guilty about it – so don’t abandon them. Part ways in a way that brings both closure to the situation, and leaves you both better off.

Pressure and Support

When you’re playing the role of support, you must know where your support begins and ends. Every case of mental illness is different, and what may count as encouragement and help in one case, could be a source of pressure and stress in another. People have different approaches, they improve at a different pace, they have different perspectives of how much they can handle.

The key? Communication. Many friendships and relationships involving mental illnesses like depression and anxiety fall apart because of a lack of communication. It’s important to talk to one another more than ever – do not ever rely on guesswork or what you think is right, because no one – not even the professionals – can make an educated guess on how any one client feels at any given time.

There’s a reason therapists ask so many questions. They also know when to ask them – and so should you. Arguments can occur because of insensitivity and misunderstanding – don’t resort to impatience or snarky behavior. Instead, try and take all perspectives into account, and ask and clarify.

Helping a mentally ill friend through tough times can sometimes be akin to walking on eggshells. You must tread carefully, and you must learn not to say anything at times. It’s best to just be there in some moments. If that’s too much for you to handle, then you must admit that to both yourself and your friend.