No one should go through mental illness alone, it can be an isolating and scary time for anyone, and one of the best ways to work towards better health is to have a good support system in place, including your nearest and dearest. Friends and family would see you through a physical illness, so why not mental illness?
An open dialogue about any form of illness benefits everyone. Sufferers feel less alone and isolated, they feel less ashamed of something which can be as common as dandruff! They get better access to help, they may feel less exposed and vulnerable when asking for help, it helps families and loved ones to cope better with the difficulties they face in supporting a sick or debilitated person. It means that over all people are better educated when it comes to understanding and recognising mental illness in themselves and others. It means that communities in general can be more inclusive of those with mental health problems. It also means that those experiencing illness within their closed communities, be it cultural, religious or otherwise, can see that there may be better or optional routes to take, outside of their immediate approach, when it comes to getting better.
But with so much ignorance, misinformation and fear surrounding mental illness, it can be a daunting task, and with feelings of low self worth people often don’t want to feel like a burden on their loved ones.
So how should people ‘come out’ about mental illness?
Make sure you feel in a safe environment at the time and only share it with people you need or want to tell around you. It may be easier to break it to family in a group for example, but you will probably need to have a good one to one talk with your spouse before you tell your kids. It might help to have a friend on standby or with you so you can offload to them about it later and they can help you get home or keep you safe if you have a difficult time in talking about it.
Keep open minded about the responses you get. It may come as a shock to some and people’s initial reactions may not be what they really wanted to say. Give them time to let it sink in. Ultimately if they won’t accept you, mental warts and all, then don’t be afraid to keep them at arms length as they may hold you back in your recovery. It’s time to care of your own needs!
Be prepared for questions! There may be none, there may be many. You are not an encyclopaedia or an information point! It’s up to them if they want to further educate themselves about it, just be as honest as you dare. If you do want to point them in the right direction there are many online resources like the NHS website, mental health charities like MIND and you can also get leaflets from your doctor, for the bare bones of what you are dealing with. You are becoming an expert in yourself and your mental health, don’t let prejudices, or limited understanding of mental illness undermine YOUR personal experiences with it. It is not your duty to re-educate people. You may be up against some outdated ideas, and that will be tough, only you can decide how much energy and time you want to dedicate trying to convince people of the state of your health, or how well you are coping or recovering. I have been asked some tricky questions and I can only advise that you be as honest as you can be. If ‘I don’t know,’ is all you’ve got it’s fine, you don’t have to be a spokesperson for everyone with your condition, you can only speak from your experience or research!
You don’t have to disclose anything you don’t want to. If you know what might have triggered or contributed to your ill health (drugs, personal tragedy, childhood abuse) it is entirely up to you how much you share. If it feels too raw or personal to talk about some of the hard stuff then don’t tell anyone that you don’t feel you can trust or people that you wouldn’t normally share personal stuff with ie colleagues, in-laws and your bin man.
Don’t be afraid or keep putting it off or it will become much harder which is just a waste of energy and worry! You will most likely feel a huge sense of relief by letting it out! I have had more people share their own experiences with me or want to give me a big hug and help out than I have reject me, disapprove or dismiss it. In fact every single occasion has been 99% better than I imagined. Worrying is a waste of a good imagination!
In fact when I have held it in and tried to hide it, my actions have ended up costing me friendships, because it was harder to accept me when people didn’t understand what was going on (repeatedly cancelling plans, outrageous behaviour etc). Since I have been open and honest about it, people know that I am just having a bad time and don’t take it personally if they see my mood shift and the chaos that can come with that. It is far easier to explain a symptom, than it is to have to explain your actions when you have let people down and they don’t know that your illness got in the way or caused it.
You don’t have to take anyone’s advice. Peoples’ well meaning advice and ideas may be helpful, they may not be. Only you can become an expert on your own health management (although professional advice is STRONGLY recommended, please take special care when it comes to medication management, pharmaceuticals are controlled for a reason and you should always follow your doctors’ advice when it comes to starting or ending any medication. Always speak to your Doctor/CPN/Psychiatrist before making any changes in lifestyle and don’t stop their recommended treatment without speaking to them first).
However you still have the right to refuse a medication or treatment that does not appeal to you, you have the right to seek alternative therapies. You may also find that resisting certain ideas holds you back so try to be open minded, but not naive, when it comes to people’s suggestions. If something does work, thinking ‘I wish I’d done this years ago’ is pointless, you weren’t ready to take it on for whatever reason, you have right now and your future to make it up to yourself.
Try and specify what your needs are (if any). People might be overwhelmed and scared and feel like they have to fix you, when this is not the case, so if you know what you need or expect from them, (a shoulder to cry on, a decent meal a couple of times a week, a babysitter so you can get some sleep), try and be specific so they know exactly what they can do to help. Sometimes you just want people to know, and that’s fine too, just make that clear.
And if someone ‘comes out’ to you about their mental health problems?
If someone opens up to you about their mental health problems please take the time to listen to them and let them finish what they are saying before interrupting or making any assumptions. It has probably taken them a lot to talk about it and it is important to just listen. They may not need any input from you, a listening ear can be all they need sometimes. It does not mean that they are asking anything from you or that you have to change your behaviour around them. It may just be that they want you to know so you can understand any unusual behaviour or so they don’t have to feel as though they are living in fear about being ‘found out’.
Enquire if they are seeking professional advice or support of some kind. You shouldn’t be expected to be solely responsible for them, especially if they are at risk to themselves or others. Most likely if they are telling you what is wrong they have already sought help and opening up is part of their healing. Sometimes people will have already had a lot of professional help, so it’s not always in their interests or appropriate to be medicated or in therapy, if that is the case don’t assume that they are not working towards their recovery, independently.
Don’t panic, it’s not contagious! Please don’t change the way you are around them, unless they specifically request you do and it is a reasonable request! (ie please stop telling them to ‘smile’ all the time or encouraging them to binge drink their problems away. Or listening to Morrissey in their presence) They are most likely fighting to preserve who they are and although they may not be the same as they were before they certainly aren’t strangers who can’t be trusted.
Do your own research and don’t be afraid to seek out advice or help from the various organisations that offer support for friends and families of those with mental health problems. It is not up to them to know everything, part of supporting them can be learning together.
Don’t feel bad for not realising what was going on! Maybe they have had it all along and just didn’t feel able to share it before. It just goes to show you can’t always spot it. People tend to get good at hiding their vulnerability from others, sometimes because they are ashamed, sometimes because half the struggle was just trying to keep going and wanting to fit in. It is a form of self preservation. How often do people say of suicide victims ‘They seemed so happy, normal, I would never have guessed!’? People do what they feel is necessary to protect themselves. You can help make it easier by forgetting everything you’ve ever learnt about mental health from horror movies and start speaking to the person you know and love right in front of you.
They are not a specimen and are still your friend/brother/neighbour/colleague, first and foremost! By all means ask questions but respect the fact that they may not want to disclose everything and they also don’t need to be prodded or provoked with every meeting purely to convince you that they don’t need emergency treatment. Don’t assume that their illness is a threat to you or your friendship. Chances are they’ve told you because they are either in the process of getting help or they’ve been dealing with it for some time and feel a sense of control over things at the moment. They are not their illness.
If they are asking for your immediate and urgent support to get them professional help the first port of call should always be their GP, or hospital in urgent cases. A quick look in the phone book or online will also reveal a plethora of organisations and mental health charities that can offer support to you whilst you go through the process of helping them through a tough time. Emergency phone lines can be lifesavers, keep their phone numbers handy.
Don’t treat the conversation like gossip! It may well have been a huge deal for them to confide in you, betraying their trust in you can be incredibly hurtful and damaging. Just because they are being open with you doesn’t mean that they are shouting it from the roof tops so please respect their privacy. If you need to offload on someone about it then do so without mentioning any names or details. You wouldn’t expect them to pass on any personal details about any health concerns you may have discussed with them so treat them with the same respect.
Be an advocate for them! If someone makes a cruel joke about mental illness or makes a generalisation about a mental disorder or people on sick pay etc, stand up to them and share what you’ve learned about mental illness. You don’t have to disclose any personal information, this helps to stamp out people’s ignorance on the subject and makes people more inclined to speak openly about it, if they feel they are less likely to be judged.
Above all it is important that we keep talking about mental health, our personal experiences, the articles we read, the ongoing research that is out there, what it is to be human and deal with the strange and sometimes scary world we live in.
I have found that when I have taken a deep breath and opened up to others about my mental health issues or experiences with emotional trauma the response has usually been hugely supportive and not only that, people have shared their own experiences with mental health, be it themselves or their loved ones. I have been hugely humbled by those who have admitted their own struggles, their own shame and even shared their own stories of recovery. I know it’s not always easy.
Not everyone is going to get it. Not everyone is going to tell you the words you want to hear, or react how you want them to, you can’t control how people respond to you, but there are millions of us living with mental illness, and there are people who want to help and are willing to listen.
There is a lot more to me than my madness, although I write about it a lot to keep me stable, and my illness can be all consuming at times, I am still Me first and foremost, and that is the person (I hope) that people love and respect. I hide a lot from people, to protect myself, and them, and don’t we all to some extent, but ultimately if someone wants to be in my life they will put the effort in to understand me and find common ground, and if they can’t handle it, that is not a reflection on them and not me.
“Those who mind don’t matter and those who matter don’t mind!”
Ultimately anyone who gets in the way of your recovery or ongoing fight for wellness needs kept at a safe distance, your health matters so much more than their acceptance of you, that much I know.