You Can't Pour From an Empty Cup: Support for Partners, Family and Friends of Those with Mental Illness

Love can be tough, at times it can take it's toll on all of us.

Supporting someone with a mental illness or chronic mental health challenges is an act of profound love and dedication—whether you're a partner, family member, or close friend. Yet, this role can also be one of the most emotionally exhausting experiences a person can face. Whilst you may not see yourself as a "carer", you are often providing ongoing support and care for this loved one.

Many such carers feel the need to remain stoic—suppressing their own emotions to appear strong and resilient for the person they support. While this may seem necessary at times, it often leads to dismissing their own distress, thinking:

• "I can't complain because it's not as bad for me as it is for the person I care for."

• "If I speak up, I'll burden others or make the person I support feel guilty."

This self-silencing can be especially intense during crises—such as when the person being cared for is suicidal, aggressive, or experiencing severe emotional distress. Over time, ignoring your own needs doesn't make them disappear. Instead, suppressed emotions and stress can manifest in harmful ways, including:

• Heightened anxiety or depression

• Burnout and compassion fatigue (feeling emotionally drained and less able to empathise)

• Resentment of the person, adding a wedge in your relationship

• Physical health problems, such as muscle pain, digestive issues, or a weakened immune system due to chronic stress

Compassion fatigue is particularly distressing because carers may notice themselves speaking or acting in ways that feel impatient or unkind—leading to guilt and shame, which only worsen their emotional strain.

How Can Carers Protect Their Mental Health?

"It is always worthwhile trying some new strategies to cope, to reduce compassion fatigue, and to feel recharged with renewed energy and motivation. Try some self-help strategies, but don't hesitate to reach out for support from friends or professionals when needing something more."— Dr. Michelle Darragh, Senior Psychologist at Unburden Psychology

Some Self-Help Strategies to Try at Home

Mindfulness-Based Stress Reduction (MBSR)

The focus of this approach is to allow the racing, sometimes overwhelmed brain and nervous system some "time-out". You could try this for just 5 minutes a few times a day, or for 20 minutes when you feel you really need it. Try not to overthink it, in fact, we're trying to do the opposite!

How to practice:

1. Breath awareness meditation:

   • Sit comfortably and focus on your natural breathing rhythm

   • When distracted (which is normal!), gently return focus to your breath

   • Start with 5 minutes daily, gradually increasing to 20 minutes

2. Body scan practice:

   • Lie down and mentally scan from toes to head

   • Notice areas of tension without judgment

   • Imagine breathing into tense spots to release tightness

3. Mindful daily activities:

   • Choose routine tasks (washing up, showering) to do with full attention

   • Notice sensory details: smells, textures, temperatures

   • When your mind wanders to worries, gently return to the present task

Why it helps scientifically:

• Reduces amygdala (fear center) activation by 19% (Harvard Medical School)

• Increases gray matter in brain regions regulating emotions (NeuroImage Journal)

• Lowers inflammatory markers linked to stress-related illnesses

• Breaks rumination cycles that maintain depression (Journal of Abnormal Psychology)

Cognitive Behavioural Therapy (CBT) Techniques

It is well known from our practice and clients, as well as extensive research, that people have a tendency when under pressure to have some irrational and unhelpful thoughts and behaviours. Did you know that changing a way of thinking can help change behaviour, and vice-versa? CBT can be a challenge if you haven't tried this before, however it is the most well researched psychology therapy and has shown these strategies to be effective.

How to practice in detail:

1. Thought challenging:

   • Identify stressful thoughts ("I'm a terrible carer")

   • Ask: What evidence supports this? What contradicts it?

   • Develop balanced alternative thoughts ("I'm doing my best in difficult circumstances")

2. Behavioural activation:

   • Create a weekly activity schedule including:

     • Necessary tasks (appointments, chores)

     • Pleasant activities (reading, calling a friend)

     • Achievement activities (small goals like a 10-minute walk)

   • Rate mood before/after activities to identify what helps most

3. Problem-solving steps:

   • Clearly define the problem (specific, not vague)

   • Brainstorm all possible solutions without judging

   • Evaluate pros/cons of each

   • Choose one to implement

   • Review results and adjust

Why it helps scientifically:

• Changes neural pathways through neuroplasticity (Frontiers in Psychology)

• Reduces depressive symptoms by 50-75% in clinical trials (American Journal of Psychiatry)

• Particularly effective for carers' guilt and negative self-evaluations

• Provides concrete tools rather than just insight

Acceptance and Commitment Therapy (ACT)

This approach is intended to help you stay present and grounded, even during emotionally challenging times with a loved one. The strategies help to accept difficult feelings—like frustration, helplessness, or guilt—without acting on them in harmful ways. By focusing on values like compassion and connection, ACT encourages actions that support both your loved one’s wellbeing and your own emotional health.

How to practice in detail:

1. Cognitive defusion:

   • Notice thoughts as mental events ("I'm having the thought that I can't cope")

   • Say thoughts in silly voices or write them down to create distance

   • Thank your mind for its (unhelpful) suggestions

2. Values clarification:

   • Identify what truly matters (e.g., being loving, reliable, kind)

   • Rate how aligned your actions are with these values

   • Choose small actions toward valued living daily

3. Expansion technique:

   • Notice physical sensations of distress

   • Imagine making space for them instead of fighting

   • Breathe into the discomfort with curiosity

Why it helps scientifically:

• Reduces experiential avoidance that maintains suffering (Behaviour Research and Therapy)

• Increases psychological flexibility - key for carer resilience

• Effective for chronic stress and burnout symptoms

• Complements mindfulness practices beautifully

Self-Help Books

Sometimes a good book can do wonders. We love to get lost in a good narrative. The books below are a small sample of good self-help books relevant to those who love people struggling with mental health challenges. Unburden Psychology's website also has a page of book recommendations, click here to see the list.

1. "Stop Walking On Eggshells (2nd Edition): Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder" by Paul Mason and Randi Kreger

   • For those who, at times, feel like they are navigating a rollercoaster of intense closeness and sudden emotional distance

   • Useful insights into the challenges and practical strategies

2. "The Compassion Fatigue Workbook" by Françoise Mathieu

   • Practical exercises specifically for carers experiencing burnout

   • Includes self-assessment tools and recovery plans

3. "When the Body Says No" by Gabor Maté

   • Explores the mind-body connection in carers

   • Particularly helpful for understanding stress-related physical symptoms

4. "The Dialectical Behavior Therapy Skills Workbook" by Matthew McKay

   • Excellent for emotion regulation techniques

   • Includes crisis survival strategies for tough moments

When & How to Seek Professional Help

You might think: “I don’t have time,” "I don't have the money," or “I don’t deserve help when someone else is suffering more.”

But consider:

• You can’t pour from an empty cup. Supporting someone long-term requires you to also care for yourself.

• Your mental health impacts the person you care for. Burnout or resentment can strain your relationship.

• You deserve support too. Caring for others doesn’t mean your needs are less important.

Signs you need professional support:

• Persistent sleep disturbances

• Irritability affecting relationships

• Using unhealthy coping mechanisms

• Feeling emotionally numb

• Physical symptoms without medical cause

Why a Registered Psychologist is ideal for carers:

• Specialised training in evidence-based therapies

• Understanding of carer-specific stress points such as guilt, compassion fatigue, and burnout

• Knowledge of mental health conditions and the challenges that would face the carer, whatever their relationship may be

• Objective perspective outside your personal network

• Confidential space just for you

What Support Can Unburden Psychology Offer:

• Individual Therapy

• Group Support - a more cost effective way to access therapy

Interested in Joining Our Supportive Therapy Group for Carers at Unburden Psychology?

If you're seeking connection with others who truly understand the challenges of caring for someone with mental health difficulties, we invite you to register your interest in our therapy-based support group at Unburden Psychology. Designed specifically for carers, this small group (4-6 participants) offers a safe, confidential space to share experiences, learn practical coping strategies, and receive professional psychological support at a more affordable cost than individual sessions. Facilitated by our experienced psychologists, the group combines evidence-based techniques with peer support—helping you feel less isolated while developing skills to manage stress, compassion fatigue, and emotional overwhelm.

Groups are established based on demand, that is, when we have 4+ people on the waitlist, we will try to find a suitable time. Please email or phone the team at Unburden Psychology to express your interest or ask questions. You don’t have to navigate this journey alone—let’s grow stronger together.

Of course, if what your facing is an emergency, never hesitate to contact Lifeline: 131114

Final Thoughts: Partners, Family and Friends deserve Support

Loving someone with a mental illness can be both highly rewarding as well as requiring, at times, tremendous emotional labour that often goes unrecognised. The strategies outlined here aren't intended as quick fixes—they're skills that develop with consistent practice, much like physical exercise strengthens the body over time.

Remember that seeking help isn't a sign of weakness, but rather an intelligent recognition that caring for yourself enables you to care for others more sustainably. Just as you encourage your loved one to prioritise their mental health, you deserve that same compassion. You may not need to have ongoing sessions, or sessions too regularly, but checking in with your own personal therapist will help you be the best partner, friend or family member you can be.