'I was shocked by the reaction': Why we struggle to say are you OK?

But, new RUOK? statistics reveal that one in three people don't feel comfortable asking the question.

"When we drilled down to the reasons people are holding back, it was things like 'I don't know what to say, I don't want to make it worse, I don't want to pry'," explains clinical psychologist Rachel Clements.

"To have a conversation with someone whom you suspect is not travelling so well, you don't have to know exactly what to say ... you can give a tremendous amount of support by asking the question and listening."

It was the lack of questions and lack of listening that struck RUOK? ambassador, actor and vegan caterer, Annalise Braakensiek when she was "immobilised" by the "dark cloud" of depression.

"Very few people asked me 'was I OK?' And when I did say [I wasn't], they ran," the 44-year-old says. "I was so shocked by the reaction of so-called friends – the aggression, the lack of support. That's when I really realised the negative stigma with mental illness is rampant. People have that real 'what have you got to be depressed about?' [attitude]"

In reality of course, as Braakensiek says: "Suicide and feeling you're on the edge; success doesn't come into it."

Our culture of downplaying or dismissing pain has "got us into trouble", Clements says. 

"We have an incredibly high suicide rate in Australia – there are eight deaths a day by suicide."

While not everyone is willing to open up when they are struggling, even when they have a strong support network, we cannot underestimate the potency of letting others know that we're there and we care. 

The first time Braakensiek fell into depression was about 15 years ago. She had met her biological father only three years before he died from cancer.

"Seeing him pass away was the most hideously painful thing because I'd just found him," she recalls. Her grief was compounded by the unexpected death of her best friend three days later.

"I didn't know what depression was," Braakensiek says, but she found herself overwhelmed and unable to get out of bed. 

After a friend reached out and suggested she might be suffering from depression, she started cognitive behavioural therapy (CBT), a meditation practice and prioritised rest and exercise.  

"I got out of it quickly, all things considered, and was super well for many, many years until two years ago," she recalls.

Then, in the space of four months she lost three family members as well as two friends who died of suicide.

"It was an incredible amount of grief in a short space of time which left me incapacitated again," Braakensiek says.

Although she "immediately" recognised the feelings, they once again overpowered her. 

"I couldn't get out of bed," she says. "I think I spent about six weeks in bed. I couldn't do anything but cry my heart out – it was a very frightening feeling."

The reaction of those around her didn't help. 

"What surprised me and really disappointed me was I had people actually being aggressive 'what have you got to be depressed about? You live this charmed life, you're famous, you're beautiful'," Braakensiek says.

"People seem to run away from it like 'how can you be like that'? I'm usually this innately positive person and very energetic... for me to be bedridden and immobilised, they didn't know how to deal with it ... One person literally said 'ugh, here she goes again'."

Just as a negative response can exacerbate the way someone is feeling, a positive, empathetic response can be instrumental in that person feeling supported.

"Talking to my grandfather was so wonderful, he made everything make sense and took away me feeling like I was being indulgent for feeling this way," Braakensiek says. "When you hear 'what have you got to worry about' or 'get on with it' you feel guilty ... he helped me to get on the right track."

She began CBT again and now sees a kinesiologist, meditates, does yoga and exercise and focuses on eating well and sleeping. 

"I've lost more people than I can count on two hands. I would be a robot if I wasn't brought down by this," says Braakensiek who is touring Australia with other ambassadors for the RUOK? Conversation Convoy.

"You need people to care and be there but self-care is imperative as well ... I tackle it every single way I can, but I also honour the fact that I loved these people so so much and they've left and it's OK to not be OK."

ALEC: Ask, Listen, Encourage action (which may simply mean assisting someone towards support), Check in (stay in touch and be there for them)

Trust your gut: "Expect people to minimise and say they're OK when they're not," Clements says. "Our psyche is to minimise, deny and avoid in the space of mental health. Trust your gut reaction – if you know someone well, be gently persistent."

Don't assume: "We see someone in a high-performing role or doing well at work or they might have a great family and we do make assumptions," Clements says. "It doesn't discriminate and it can affect anyone. How someone is presenting on the outside is often very different to how they're presenting on the inside."

Real-time conversations and connections matter: "A text doesn't cut it if someone is really struggling. It's effectiveness versus efficiency: it might be more efficient to send a text message but is it more effective?"

Take initiative: Don't wait for someone to come to you before you ask how they are. "We're not relying on the person who's not travelling so well to come to us," Clements explains. "We're taking the burden off them to invite them into that conversation and that's what makes a tremendous difference in connecting people when they feel disconnected."

The RUOK? Conversation Convoy is currently in WA and will be in Sydney on 1 September before heading north to Cairns. To donate or track the Conversation Convoy they can head to www.ruok.org.au

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