Mental health

Three Things Not To Say To Someone With a Mental Illness (And Some Alternatives)

Telling someone that you have a mental illness is a little bit like coming out. You have to assess that person and work out whether they’re likely to react positively or negatively. You need to decide how detailed you want to go. And you need to be prepared to bid a hasty retreat to easier topics if the conversation grinds to an awkward halt.

If I say that nerve-wracking sentence “I’ve been struggling with my mental health recently”, especially if I say it to someone’s face, a lot of thought has gone into that decision. But most of that thought won’t have been about me and how I feel, but about the context, about our relationship, and about them and how they might handle it.

Is it really worth it, you ask? Often it’s not, and I lie. For all society’s progress about decreasing mental health stigma, telling people you’re one of the one in four is still about as cringe-worthy as telling them you’ve had explosive diarrhoea for the last week.

Of course, my fear is partly unfounded: unlike coming out, there’s a minimal chance of anyone saying anything hateful to my face. By and large, people don’t hate on people who are mentally ill. Although here’s a lovely counter-example.

But just as the whole situation is confused and frustrating and worrisome on my side, the people I do open up to can be sympathetic but have no idea what to say — or end up saying things that make me feel ten times worse. Here are three examples.

1. “You just seem to be acting so normally. You just seem so on top of it. I almost forgot that you have that mental illness!”

Sometimes, it’s hard work not to break down and weep in public. Going to a work do or a birthday party can be exhausting for days afterwards. As I say above, sometimes being honest about mental health is impossible. How does the prospect of approaching someone you’ve met a few times and saying “Sorry, I just need to go to the bathroom and cry my eyes out for five minutes for no reason. Brb!” sound?

Keeping it together and appearing cheerful and professional and coherent in public is laudable. When someone says that you’re hiding your illness so well that you don’t seem to be suffering at all, it undermines that hard work and invalidates your true feelings.

It doesn’t matter what’s going on inside, because you’ve got such a nice smile.

A better thing to say: “You’re really strong. Do you need anything? I’m impressed and I’m proud of you.”

2. “I don’t blame you. You know what? I feel a bit miserable today, too.”

If someone tells you their symptoms are particularly acute today — for example, that they’re really anxious and have been struggling to concentrate — please do not say that you feel bad too. It’s nice to know that people understand where you’re coming from, but it can be also be a way of shutting you down.

One of the aspects of mental illness that I struggle with most is the distinction between my thoughts / feelings and the thoughts / feelings from my mental illness. If I want to curl up under my duvet today instead of going to work, is it because I’ve not slept well or have PMT, or is it because I’m about to have a tough few days of depression or anxiety? Who knows. There is no way of knowing. And that conflict — the back-and-forth as I try to work out how I feel and whether to trust it — can be just as bad as the original thought.

When people say they feel lousy too, they make it about them — and they make you feel like you’re just making a fuss. As thought what you’re calling the mentally ill ‘voice’ is actually just another bit of you, and which is making a totally valid point. Yeah, it’s fine to burst into tears at work for no reason whatsoever. I’ve had a rough day too. Let’s just chill.

A better thing to say: “I can empathise with that. What’s up?”

3. “You’re so organised. At least your compulsions mean that you get loads of things done, and you’re really productive.”

If anyone else says this to me, I will scream and then I will vomit-cry all over them. (Yep. I will cry and I will also vomit. On them.)

Some people exhibit compulsive behaviour. This might be ‘well-known’ things like cleaning or counting, or it might be writing, lists, or jigsaws. If someone has a compulsion to do something that’s generally considered to be a chore, such as cleaning or organising, they are not lucky. Those compulsive thoughts are not a blessing. People with these compulsions do not do them because they enjoy it. They do it because there is an air strike going off in their mind, and this is the only way to make the mortars stop dropping and to feel calm.

Anxiety and compulsive behaviour mean that you’re locked in a constant battle against the never-ending niggling in your mind that you aren’t doing enough, you aren’t doing enough, you aren’t doing enough.

If you tell someone about this and they say “At least you’re really productive and you always get things done“, this implies that the mental illness is worth more than your attempts to quash it. That the niggling voice that you desperately try to quieten is more important — and better — than you.

A better thing to say: “That sounds exhausting. Is there anything I can do to help?”

I often internally compare being mentally ill to having a broken leg. Telling someone you have a broken leg is often either unnecessary or can be done in a throwaway comment — because, well, there’s the leg and there’s the cast. Mental health problems can be just as painful, problematic, isolating, and awkward as a broken leg — but unlike something so simple, they’re a minefield to navigate for all involved. I’m keen to do my bit to help make things easier.

By the way, if anyone has recently come off or is planning to come off Duloxetine as an SSRI antidepressant and is wondering what withdrawal is like, I just went through it — and it was totally horrible. I’m here if anyone would like advice or support!

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