20 things not to say to someone with a mental illness

Mental illness is hard enough to handle on its own. Having other people make insensitive comments just make it even worse. It is, however, important to acknowledge that these remarks are generally not meant to be hurtful. They often reflect a lack of understanding mixed with a desire to seem helpful or comforting. Still, words can hurt. Here are 20 things to avoid saying when speaking with someone about their mental illness (and what I’m thinking when you say it).

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“Just snap out of it.” If I could, I would.

“Stop feeling sorry for yourself.” Mental illness is a legitimate problem and it’s okay to have feelings about it.

“I promise it will be okay.” You have no way of knowing that.

“Why are you like that?” That’s for me and my therapist to figure out.

“Can’t you just try to be different?” I’m pretty sure I have.

“Yeah, my brother has depression, too.” Everyone experiences mental illness differently, so I don’t want to be compared to someone else.

“That’s weird.” I know. I don’t need to hear you saying it, though.

“You’ve been doing it long enough now. Stop.” There would be no need for therapy if we could go in and out of mental illness at will.

“There are others who have it worse.” I know, but suffering is not a contest.

“At least it’s only depression/anxiety.” Even the most common mental illnesses can be extremely difficult to handle.

“That’s just how you are.” Mental illness is not a character flaw.

“You brought this on yourself.” Even if I did contribute to the problem, I did not ask for this. 

“I know how you feel.” No, you don’t, and I’m offended that you think you do.

“Things will change soon.” Timing is always a big question mark with mental illness.

“It’s all in your head.” That’s why it’s called mental illness. But it affects physical health, too.

“Do something to distract yourself.” This is not nervous anticipation. It won’t just get better if I wait.

“Don’t be so negative.” I am entitled to my feelings. Besides, I’m pretty sure you would be “negative,” too, if you were in my shoes.

“It could be worse.” Yes, it could, but that doesn’t mean this isn’t difficult.

“But you have so many things to make you happy.” That doesn’t change that I’m also struggling.

“You don’t seem to have a mental illness.” Mental illness is not always apparent on the outside.

Sassy remarks aside, feel free to share this post with someone who might need a little perspective. For things you can do that are actually helpful, read this post.

What have people said to you about mental illness that you have found hurtful? How do you respond? Tell us in the comments.

7 reasons I speak up about mental health

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I grew up with a perception of mental health that was skewed in the way I assume it is for a lot of people. I thought you had to be really crazy to see a therapist. I believed that you either did or you didn’t have a mental illness and it didn’t occur to me that it’s really a spectrum that everyone is on. I reckoned that I probably knew a few people with some kind of “mild” mental illness, but didn’t know that one in four Americans struggles with a mental illness in any given year (NAMI). 

Boy, was I wrong about a lot of things. But I didn’t know that until I sought treatment myself and had years of experience in the therapeutic environment. As my progress with mental health increased, I also took classes on psychology in order to better understand what was going on both with myself and with others. And here I am, running a blog about the very topic that I so deeply misunderstood when I was younger.

So what changed for me to go from a stigmatized and uninformed perception to being a voice for the mentally ill? There are a few major factors.

1. I was so confused and even hurt by the mental health system that I didn’t want anyone else to have to navigate it alone and uninformed. I am empathetic and I truly just want to make this process easier for even just one person. 

2. I heard the stories of others. Whether through reading, classes or conversations, I learned about other people with struggles similar to my own. I realized that I am not alone and that when I speak up for myself, I am also standing up for a whole invisible community.

3. I realized that the mentally ill are underrepresented in society at large. Because there is so much stigma, people don’t always speak up. But silence will not change things and I feel like it’s the right path for me to be vocal about this topic. 

4. I was sick of hiding who I am. Trying to keep up a front of everything being okay was exhausting and just made me feel even worse. While I had a lot of fear about being open, everyone who is close to me now knows that I struggle with mental illness and have (eventually) been great in their responses.

5. I want to do my duty as a citizen. They say that when letters and phone calls are being made to politicians, they estimate that each person speaking up represents over 1000 people who feel the same way. I want to bring another 1000 people’s struggles to attention.

6. I want to live in a world where I can say I have a mental illness the same way others can say they have diabetes or a broken leg. I don’t want a negative, judgmental, uninformed and awkward response. I want the same courtesy and sympathy that is given to those with physical illnesses.

7. I don’t want my mental health issues to be meaningless. These are the cards I have been dealt and I choose to play them in a way that can bring hope and healing to others. 

I acknowledge that it’s a difficult topic to speak about and that not everyone wants to do so. I didn’t either, for a long time. That changed and now this is a large part of who I am.

But you don’t have to create a whole blog to be a part of the conversation. Even a single post on your blog draws attention to the topic. Today is Mental Health Month Blog Day, sponsored by the American Psychological Association. If you submit your post about mental health here today, it will be added to a list along with other people’s posts. Even if you don’t submit anything, check it out to see other people’s contributions. The more informed you are, the better you will be able to address the topic of mental health both personally and publicly.

Why do you speak up about mental health? Or what stops you from doing so? Join the discussion in the comments.

Taking risks in therapy

   

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We all have something that we don’t like to talk about. While therapy is an appropriate setting to explore these issues, we sometimes hold back on certain things — even in that context — out of fear. “Will I sound crazy?” “Will I be believed?” “What will my therapist think of me?” “What are the consequences of saying this?” “Will my therapist think less of me?“ These questions and more prevent us from being completely open in our treatment. 

But if you never take risks, you won’t progress when it comes to those issues. In fact, they may become worse as feelings of shame, embarrassment, guilt, hostility and unworthiness fester inside of you. The fact that you won’t talk about the topic becomes an issue in and of itself. 

The first obstacle you need to pass is trusting your therapist. You can read more about that here. In short, developing a strong therapeutic alliance in a safe relationship allow you to be more open. Keep in mind the ways in which your therapist has been trustworthy in the past. If you remind yourself of these things, opening up might not seem quite as impossible.

Still, even with trust, it can be hard to explore certain topics. I spent a lot of time trying to figure out how to talk about a series of events that happened a few years ago. I had been seeing the same therapist I’m seeing now at the time these things happened and my irrational fear was that I’d remember things wrong and become discredited. But I have yet to find a way around those fears. So what could I do?

It got to a point where my only options seemed to be to keep quiet and never heal or to take a risk and see what happened. After years of deliberation, I decided to just go for it and see what would happen. For me, that meant telling the story regardless of my fears. So I did. 

I was not prepared for how well that went. At first, I addressed my concerns about how he might remember things differently than I did. I asked my therapist to not go back and read his notes from the time in question and he agreed to follow my request. This removed a lot of pressure. 

It’s going to take a while to get through everything. And that’s okay. Breaking the larger story into smaller segments allows me to do a little each week. This way I get insight into each part, which helps me understand the larger context at play. While the content is very difficult and, at times, triggering, I’m feeling better about myself and am more realistic about my role in those events.

Jumping in is not always the solution, but I’m pretty sure that at this point in the post, you have a specific issue or situation in mind. Test the waters. See what happens. Be honest about your concerns. You can discuss them before you get to the actual content. But when you’re ready, opening up despite fear can be extremely healing. I know it has been for me.

What risks have you taken in therapy? How did it work out? Tell us about it in the comments.

Why you should see a student therapist

Every therapist has to start somewhere, so there are plenty of student therapists who are practicing under supervision. They can often be found in university counseling centers and in community clinics. This means that college students and those utilizing community resources may well end up working with a student therapist.

   

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Not everyone is entirely comfortable with this. If you’re a senior citizen, how can you put your trust in someone in her twenties? Does a student feel like he is getting appropriate treatment when his therapist only a couple years ahead? It’s an issue that student therapists have to deal with sometimes. The thing is, they shouldn’t have to.

Research shows that student therapists perform just as well as licensed practitioners. Some even suggests that they might actually be better. The reason for this is unknown, but it could have to do with being regularly supervised, the fact that their education is still present or recent, and the initial zeal that old hands lose. No one knows for sure. What matters is that you shouldn’t be worried about having a student therapist – you might actually be better off that way.

Supervision allows students to have a second pair of eyes on their clients. Supervisors often watch tape of students performing therapy, meaning they can give very detailed and relevant feedback. Students also have someone who can help them conceptualize their clients and give suggestions. It’s kind of like having a second therapist behind the scenes.

By virtue of being in school, students are actively learning. They are dealing with the material both theoretically and practically. They spend a lot of time actually thinking about all the things that lie behind therapy, something a seasoned clinician might not do. Students also have multiple professors at their disposal, meaning that experts are on hand.

Students are also enthusiastic about their work. They are at the very beginning of their careers, following their dreams. You don’t commit to graduate school unless the subject has significant meaning to you. They haven’t been jaded by time and they are excited to learn and grow. It’s a unique period in their lives where there is lots of energy on hand. 

So if you are under the care of a student therapist, you shouldn’t worry about her being inexperienced. There are other factors at play that make up for that. Every therapist, no matter how long he has been practicing, has something unique to offer. If you find someone who’s a good fit, it doesn’t matter whether or not she has “Ph.D.” after her name.

Have you seen a student therapist? How did it go for you? Tell us in the comments.

Mental health myths: Am I crazy enough?

Mental health concerns come with a lot of misunderstandings and there is plenty of misinformation out there. That’s why I like to tackle mental health myths from time to time. Today, let’s look at some thoughts about seeking treatment.

Myth: If I see a therapist, I’m crazy.

Fact: There are lots of “non-crazy” reasons to seek help.

   

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Somewhere in their heads, people set an imaginary standard for what the threshold should be for seeking mental health treatment. People come up with an idea of what they think is “bad enough.” One of the unfortunate consequences of this is that it makes people assume that someone who is in treatment meets their criteria for what they believe a mental health patient is. This is often not the case.

An acute crisis or severe symptoms definitely warrant treatment. But these are not the only reasons to seek it. It’s completely normal to go to a therapist if you are experiencing mild or moderate distress. This is, in fact, a good thing. By working on your problems before they get magnified with time saves you a lot of effort in the long run. 

It’s kind of like getting a headache. You notice that you’re hurting, but think that it’ll pass. As the day goes on, it gets worse and worse. Finally, you take some ibuprofen. But because the headache has set in more deeply at this point, it might be that no amount of pills makes it go away. You just may not feel better until after you sleep it off. Ultimately, you prolong your pain by not taking preventative action when your discomfort was tolerable. 

The same goes for staying in treatment after you start feeling better. There is no pressure to terminate until you are ready. You don’t have to stop just because you’re mostly doing better. Maintenance is important. My symptoms are not nearly as bad as they have been in the past, but I’m still in treatment because I don’t want to go back there. You might want to reduce the frequency of your sessions when you have made significant progress, but that is something to discuss with your therapist. Together you can make a decision on that.

Some people feel like they have to “earn” the right to be in therapy. They think that they don’t deserve treatment because they aren’t psychotic, don’t have a history of trauma or can cope reasonably well with their lives. The thing is, you don’t have to be a certain way to deserve help. The only prerequisite is a desire to improve your life. 

Honestly, you don’t even have to have problems to be in therapy. Plenty of people go for self-improvement. Some examples include learning to develop better relationships, finding greater fulfillment in your life, learning more about yourself and so on. You just can’t make assumptions about why people are in therapy.

In short, you don’t have to have hallucinations or be so depressed you can’t get out of bed for months before seeing a therapist. If you feel like therapy is or would be helpful for you, go for it. Likewise, don’t pass judgment on anyone else for seeking help. They don’t know your circumstances and you don’t know theirs. There is no template for what someone in treatment looks like. 

What beliefs have you had about yourself because you’re in treatment? How did you work through them? Talk about it in the comments.

The isolation of mental illness

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Mental illness can be a very lonely experience. It can feel like what applies to the rest of the world gets turned on its head when it comes to you. When others ask questions like, “Why didn’t you come to the party?” or “Why haven’t you finished your assignment?” it can be hard to come up with answers that are both understandable and that protect your dignity. It’s hard to find words to describe what permeates your life and makes you feel separate from everyone else.

I wish I could say that people are generally understanding and that if you just say it how it is, you’ll get an empathetic response and an offer of help. The truth is, people are generally uncomfortable talking about mental illness. This societal silence perpetuates the feelings of isolation that mental illness can create.

Still, mental illness affects everyone, whether through experience or indirectly through others in their lives. With one in four Americans struggling with mental illness in any given year, everyone knows someone. It is, however, for the most part an “invisible illness” and people learn to hide their symptoms so no one knows anything is wrong. But it’s still there. 

The next time you sit in a meeting, classroom or other group situation, start counting off one in four people. Now take that group and expand. Remember, the one in four figure is for any given year. Some people have recovered from a past mental illness and others will experience it in the future. Seeing how common it is in this way can be an eye-opener. It’s a lot more prevalent than it seems when you’re lying in bed at 3:00 p.m. and wondering what’s wrong with you since “everyone else” can move on with their days. 

   

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But knowing you are not alone and feeling isolated are not mutually exclusive. While you might theoretically know that others are struggling, too, it’s not like people show up to work saying, “I didn’t come in yesterday because I had a really bad panic attack,” like they say, “I didn’t show up because I had the flu.” Mental illness is surrounded by so much stigma and perceived shame that it’s hard to talk about.

If you want to change the conversation and help others understand how mental illness impacts everyone, that’s great. Just take care of yourself while you do so. As a starting point, here is an article on how to tell others you have a mental illness. If you’d rather avoid the topic, that’s okay, too. It’s your right to decide how much you want to talk about your condition, if you want to talk about it at all.

One thing that can help you feel less alone is through entertainment. Finding stories of others we can relate to can be cathartic and empowering. There are lots of mental health memoirs that focus on specific conditions, so you can surely find one for yours. For instance, there’s Prozac Nation for depression and Girl, Interrupted about borderline personality disorder. There are so many more if you just search for them. There are also fictional stories of mental illness, as well as more technical books. (I’ve compiled a list of books that help you learn more about your condition.) Movies that address mental health topics abound, too, like these Oscar-winning best picture films.

There are also online communities that can offer support. For instance, HealthyPlace has a variety of forums addressing different conditions. Another cool site is PatientsLikeMe, where in addition to having access to forums, you can track your symptoms. Everyone’s data is used to come up with helpful information. It covers a lot of medical conditions, but there’s a section for mental health concerns. Be aware, though, that these groups are for support only. They are not a replacement for a doctor or a therapist. Simple symptom management tips and sympathetic stories are great, but you should not use forums to resolve more serious issues.

Remember that mental health issues are just as much a part of the human experience as anything else. It can feel isolating, but you are by no means alone. You can choose to seek out others who share your experience, or you can just comfort yourself with the knowledge that what you are experiencing is, in its own way, normal. How you approach your condition is entirely up to you, but always know that you aren’t broken, you aren’t weird, you aren’t crazy and you aren’t alone.

What do you do when your mental illness makes you feel alone? Share feedback in the comments.

You don’t need to justify your mental illness

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You might have certain beliefs that invalidate your mental illness. They might be reasons why you shouldn’t be mentally ill or why your illness is not that serious. You may even feel guilty for seeking treatment. One of the biggest causes for these thoughts is comparison to others.

Everyone has their own idea of what mental illness looks like. This might be influenced by media portrayals, amount of education about mental health and interactions with mentally ill people. You end up comparing your symptoms and situation to that ideal that you have in your head. For instance, you might see obsessive-compulsive disorder as an illness centered around germophobia and strange rituals. Your version could be focused on your productivity and thus cause you to compulsively work. This looks different, and you might even try to justify your situation as adaptive. But it’s still a mental illness. You are dealing with obsessions and compulsions; they just don’t have the same content as the idea in your head.

The truth is, there is no definitive way in which mental illness manifests. Anything that causes distress or interferes with your life is worth looking at. In fact, you don’t even need to qualify as having a mental illness to seek treatment. You might just want support through a difficult situation or work on self-improvement. This is perfectly legitimate. You don’t have to be completely dysfunctional and crippled by your mental illness in order to have a right to get help. 

Another thought you might have is that your past does not justify your illness. This might, again, be about comparison. You might think mental illness is something that comes as a result of something else. This could be trauma, an extraordinarily difficult present situation, childhood abuse, bad relationships, or other circumstances you see as justifying having a mental illness. You might not see your past or your circumstances as “bad enough” and thus invalidate your own experience. You could have posttraumatic stress disorder from a car accident and say to yourself, “Well, it’s not like I went to war or was raped.” You still have PTSD. It doesn’t matter what caused it; it’s there. Looking at worst case scenarios is not going to change that. 

Besides, we don’t actually understand how mental illness develops. Sometimes it just happens. You might have a perfectly healthy life and still develop depression. You could have a nurturing upbringing and still have schizophrenia. You don’t have to have a reason to struggle with your mental health. If you are having difficulties, accept that as enough. 

A decent therapist is not going to look at you and say that you don’t have it bad enough to be worth her time. He’ll understand that it is an act of courage to seek help. Treatment is not easy. It’s not something you’re doing for fun. Your therapist will not think less of you for not having a textbook version of a severe condition. She is there to help you no matter what lead you to her office.

So don’t stress about why you have mental health issues. You might be able to point to some factors or you might not. Either way, what matters is that you are seeking treatment and that you are working on it. That says more about who you are than whatever symptoms you are or are not having.

This post is part of Mental Health Month Blog Day. For a list of other participants writing about mental illness, click here. 

Do you feel a need to justify your illness? Share what helps you accept your situation in the comments.

How do I tell someone I have a mental illness?

It is hard to come to terms with having a mental illness. It can be even harder, at times, to help others understand where you’re at because they are not living it. But the path to recovery is best walked with support, so at some point, you might want to tell someone about your mental health condition. Since May is Mental Health Awareness Month, let’s look at talking about mental illness.

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Remember that you get to decide who does and doesn’t know about what you’re struggling with and how much you want to share. Telling someone one thing does not entitle her to know everything. It’s also important to feel safe with the person you are confiding in. When you have carefully considered telling someone and feel comfortable with it, here are some tips on how to have that initial conversation.

Be aware of your own feelings in advance

Don’t go into the conversation unprepared. You are opening up a whole new box of information and feelings, so know what’s in it. Plan for how you are going to deal with any emotions that come up while you’re explaining yourself. Remember that it’s okay to take breaks or to finish the conversation another time. 

Also attend to how you are feeling before you have “the talk.” Are you anxious? Scared? Relieved? Practice some self-care that is appropriate to how you are feeling. Plan for what could help you during the conversation when you are having strong emotions. Maybe playing with a stress ball would help. Perhaps your anxiety is reduced if you have a bottle of water so you can take a drink to buy time when you’re uncertain about an answer. Find whatever works for you.

Understand your condition

If you want him to be understanding of you, some education might be needed. In order to provide that, you need to learn about your diagnosis and/or symptoms. There will probably be questions and it’s best to have the answers. You can read the post on learning about your diagnosis. The chance of misunderstandings and confusion are decreased if you can use factual information instead of conjecture. 

But it’s okay not to know everything. If you are unsure of the answer to a question asked, say something like, “I don’t actually know the answer to that. I’m still learning, too. Let me see what I can find out and we can talk more about it later.” You don’t have to be an expert on your condition; you just need to be appropriately informed about your mental health concerns.

Set appropriate boundaries

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I once told someone about some of my problems who went on to share them with other people. That was difficult, but I realized that I never set the boundary of who I was comfortable with knowing. I now spell out who I want to know if I am going to say something to an individual who is a part of a group I'm in (family, a circle of friends, support group, etc.). 

If the person you are confiding in can’t promise to respect your privacy, reconsider telling her unless you are ready for everyone to know what you are about to share. If you need to set boundaries about what you are willing to discuss, make sure to do that, too. Think ahead so you can express any limitations and boundaries that you need him to respect in the future as well.

Explain the support you need

People will leave the conversation feeling much more positively about it if they have some answers about how this applies to them. If these people are trusted enough for you to talk with, they are likely the kinds people who will want to help. Think about this in advance and be specific. Ask if it’s okay to call her if you have the urge to self-injure. Request to have lunch with him after your therapy appointments to de-stress. Tell her that you need someone to just ask how you’re doing from time to time.

Also let him know what you want him not to do. Again, be specific. If you have triggers, it might help to give her a list of them. If you feel it would be helpful, you can also refer him to the post about helping loved ones with mental illnesses. 

Be prepared for a variety of responses

As much as I wish there wasn’t, there is a lot of stigma surrounding mental illness. This means that people already have ideas of what mental illness is and those beliefs are going to influence their response to you. Not everyone is going to be completely supportive from the get-go. Instead of blurting out everything at once, pace the conversation. See how she reacts to minor information before revealing major points. If there seems to be a negative response, find a way to end the conversation. 

On the other hand, some people can become overly invested in your situation. If he tries to take control over your treatment or starts coddling you excessively, have a conversation about how this affects you. Tell her that your treatment team is plenty competent to help you make decisions about the hows of recovery. No matter the response, plan on engaging in some self-care after the conversation. It’s stressful and you need to take care of yourself.

Have you told someone about your mental illness? How did it go? Post your own tips and observations in the comments. 

Mental health myths: Is mental illness a choice?

I am taking on another mental health myth. Today I want to debunk that mental illness is a choice and that there are easy ways out of it. I am going to label this as an opinionated piece, so if you’d rather not read it, go ahead and stop now. I’ll see you next time.

Myth: You can just snap out of mental illnesses.

Fact: Mental illness is not a choice.

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I have a way of knowing that my mental illnesses are real. If they weren’t, I would change them. I have been trying for years, but I still have disorders that I am gradually recovering from. I have some physical health conditions as well. If I could stop those symptoms, they would be gone, too. But no one expects me to do that. And I have put way more effort into stopping my mental health issues than my physical ones. If I could make them go away, they would have been gone years ago.

Trust me, if you could just make it stop, mental illness would not exist. It’s miserable. It damages your relationships and your ability to function. It can make you your own greatest enemy. Sometimes it causes you to do damage to yourself physically, socially or emotionally. It can be insidious, or symptoms might get unmanageable in an instant. You never know.

If mental illness were not real, the United States would have been $57.5 billion richer in 2006 (The Agency for Healthcare Research and Quality). This was equivalent to the cost of cancer. Thousands of health care professionals would be out of work. The American Psychological Association estimates that there are close to 100,000 licensed psychologists in the U.S. alone. And that number is not considering other types of therapists, psychiatrists, social workers, psychiatric nurses, substance abuse counselors and others who work in the mental health field. There would be no need for such a large industry if people were simply being grumpy or nervous and blowing it out of proportion. 

One in four Americans suffers from a mental illness in any give year (National Institute of Mental Health). If mental illness had quick fixes, the only logical conclusion is that this number would be a lot lower. 

It can be very harmful to treat people with mental illnesses as if it is a choice. Gender is not a choice. Race is not a choice. Sexuality is not a choice. Physical illness is not a choice. And mental illness is certainly not a choice either. Biological bases for certain mental illnesses are considered scientific facts. There are high correlations between environmental and developmental difficulties and mental illness. 

By treating someone as if she is being weak or lazy, you are invalidating a very real struggle that you should be so thankful that you aren’t the one dealing with. Having others reject, mock or belittle mental health issues can make symptoms worse. You will never help someone with a mental illness by encouraging him to snap out of it. Instead, focus on how you can help. Be someone family, friends and colleagues can turn to for understanding and kindness. For ideas about how to do this, read the post about helping loved ones with mental illnesses.