Maintaining a friendship with someone with a mental health disorder can be rewarding and challenging. While social support is crucial for anyone’s well-being, it becomes even more vital for those grappling with mental health issues. However, such friendships also require a nuanced approach and can be unpredictable in nature.

Let’s face it: A majority of people crave stability and predictability in their interpersonal relationships. Most do not thrive on chaos or appreciate unexpected twists and turns that can leave their head spinning. When your friend has a mental health condition, the friendship often requires more flexibility and patience than one might be used to, and the journey can be anything but smooth sailing.

The complexities multiply depending on the diagnosis and can even defy conventional expectations. I’ve seen this in my own friendships—expecting one reaction and receiving something far more intense or unpredictable. The emotional and behavioral range can be vast, challenging not just social norms but also testing the boundaries of the friendship itself. There’s a real art to knowing when to engage and when it might be healthier to take a step back.

Friendship with someone who has a mental health disorder often exists within a context of heightened emotional intensity. Be prepared for long, emotionally charged discussions and repetitive reassurances. It can be draining, and you may sometimes find yourself at the edge of your patience. This is especially true if you are emotionally or professionally invested in the mental health field, as I am. I have found that my role as a mental health therapist further complicates the dynamics, blurring the lines between friendship and therapeutic interaction.

What does ‘normal’ behavior mean in such friendships? The term is relative and could be seen as a spectrum rather than a rigid set of criteria. The struggle is real when it comes to balancing empathy and patience with the need for mutual respect and kindness. Sometimes, despite your best intentions, these friendships can seem more like emotional minefields than stable sources of support.

For example, a friend with bipolar depression once spent our entire dinner outing projecting her deep sadness and resentment about her condition onto the world at large. While I had looked forward to a pleasant evening catching up, the atmosphere became heavy and morose, rendering the whole experience emotionally taxing.

And this was a relatively mild example. In more extreme situations, I’ve had to abruptly end dinner plans when a friend accused me of sabotage, alleging I had planted roaches in her food to ruin her manuscript deal.

So, if you aim for a lasting friendship with someone dealing with mental health issues, here are some recommendations based on my own experiences:

• Exercise unconditional patience and acceptance regarding your friend’s limitations.
• Cultivate a forgiving attitude.
• Establish clear boundaries to protect your own emotional well-being.
• Be aware of any triggers or traumas that might affect your friend’s behavior.
• Adjust your expectations—don’t compare your friend with those who don’t have mental health challenges.

Despite your best efforts, understand that these friendships are prone to fraying and may collapse. It’s not necessarily a reflection on you or them but rather the complex interplay of mental health and interpersonal dynamics.

At the end of the day, friendships with individuals who have mental health disorders offer an opportunity for deep emotional connection but require a special kind of resilience and ongoing effort. Balancing empathy with self-care is the key to navigating these complex relationships successfully.