May is Mental Health Awareness Month, and I’m passionate about breaking down stigmas, shining a light of compassion on those who have a mental illness and treating them with grace, dignity and love. My dad had bipolar disorder, and it impacted our family in a huge way. You can read more here and here.
According to the National Alliance on Mental Illness (NAMI), one in five Americans experience mental illness in a given year. I have friends and loved ones with depression, anxiety, OCD, PTSD, borderline personality disorder, bipolar, psychosis and more. When someone close to us is suffering, we want to let them know we care. How can we best encourage them?
“Words do matter,” said Dr. Philip R. Muskin, professor of psychiatry at Columbia University Medical Center and secretary of the American Psychiatric Association, in a story in U.S. News & World Report. “By avoiding stigmatizing statements, you can help stop the shame and fear that is often associated with mental illness.”
After doing a little research and thinking about my own experiences, I came up with five things not to say to someone with a mental illness.
Five things not to say (and what to say instead)
- “It’s all in your head.” When you tell someone this, you’re telling them to think rationally. News flash: sometimes people with mental illness think and behave in illogical ways. Hearing it’s all in their heads doesn’t stop the way they think. They may get even more overwhelmed by their thoughts and feelings. Talking may provide stress relief or help them process what they’re experiencing. Try saying, “If you want, you can tell me what you’re going through. I’ll listen.”
- “It could be worse.” Of course you can always find someone who is in a worse situation than you are. But that doesn’t take away the pain you’re feeling now. It usually just adds a dose of guilt on top. I’ve made the mistake of reminding loved ones about some folks who have bigger problems. I realize that’s not the most helpful approach. A better statement is, “I’m sorry you’re going through this, but you’re not alone. I’m here for you.”
- “Go treat yourself and take your mind off it.” Many a person with mental illness made a bad situation worse by self-medicating with alcohol, recreational drugs, gambling, shopping… My dad was a high functioning alcoholic until the combination of liquor and medications for his bipolar disorder wrecked his life almost beyond repair. We shouldn’t encourage loved ones to seek relief through an outlet that could turn into an addiction. Instead, say, “Do you want to do something together?” or “How can I help?”
- “Why do you take all that medicine?” When a mental illness impairs a person’s ability to function, medication can make a tremendous difference. A loved one may need anti-depressants or anti-psychotic drugs (or both) to enable them to work or go to school or just get out of bed in the morning. It may take many months for the psychiatrist to find the right drugs and dosages. Sometimes a doctor will work with the patient to wean them off drugs, but we shouldn’t encourage our friend or family member to seek alternatives for medication. In the right moments and without pressuring them, we can share what we find helpful, as long as it doesn’t interfere with the doctor’s orders. Every individual with mental illness is unique. They need to work with medical professionals to find their best options. We can say, “I’m glad you’re taking positive steps for your health.”
- “Just focus on the positive.” Again, I’ve made mistakes here. I’ve urged loved ones to focus on the good around them, but a depressed person might not be able to experience positive emotion. One symptom of depression is anhedonia: the inability to feel pleasure. Sometimes a loved one is in such a bad place mentally that we need to focus on their safety and on just being present. “I know it’s hard now, but I believe it will get better. There is hope. Don’t give up.”
It’s okay to tell someone, “I don’t know what to say, but I’m here to listen.” You also can apologize for saying something insensitive. Just showing up for your loved one, even if you don’t have anything to say, can help them.
