This post is a follow-on to this from early 2017: Three Things Not to Say to Someone with a Mental Illness.
Saying you have a mental illness is like coming out. You have to assess that person and work out how they’re likely to react. You need to decide how detailed you want to go. And you need to prepare to bid a hasty retreat if the conversation grinds to an awkward halt.
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.
Christmas and New Year is famously a difficult mental health time of year, and in recent weeks a few things have been said to me or people close to me that have hindered far more than they’ve helped. Here they are – as well as some better things to say if you are thinking of saying any of these things to anyone you know.
1. Have you tried reframing the narrative / thinking yourself out of it / just not letting yourself be unhappy?
This is one of the least helpful pieces of advice you can give to someone who’s mentally ill.
Mental illness makes sufferers feel all kinds of things – frustrated, anxious, irritable, sleepy, manic, spiteful, guilty, and obsessive are just a few off the top of my head. It’s certainly not all about feeling sad, any more than physical illness is all about having a temperature.
What links all the above emotions is that they’re destabilising. They all have their place in a healthy person’s psyche, but a mentally ill person will feel them at inappropriate times or to an unhelpful extent. If it’s not a choice to feel this way, it’s impossible to choose not to have them.
To emphasise: mental illness is not something anyone chooses. No one gets pleasure from being unhappy, or prefers it to being content. Emotional suffering is not a lifestyle choice. There’s a reason it’s called an anxiety attack – in the same class as an asthma attack.
A better alternative: Tell me if you feel bad, and let me know what you need, or what I can do, to help.
2. Don’t antidepressants turn you into a zombie / give you seizures / change you into a different person?
TL;DR: antidepressants don’t do any of those things. The classic analogy, which I’m going to explain now, is that mental illness is like diabetes. Both are chronic conditions that aren’t the sufferer’s fault. Both require the sufferer to be careful about their lifestyle, and recognise the triggers that set off an attack. Both use medication to regulate the inner workings of their bodies to manage their condition.
Diabetics’ bodies can’t produce insulin, or can’t recognise it. The brains of the mentally ill produce incorrect levels of neurotransmitters, which affects brain function. In both cases, sufferers might need to take drugs to regulate this.
The worst times in my life in the last few years have been when I’ve been without antidepressants. Ideally one day I will come off them, but if I have strange levels of neurotransmitters in my brain, I’d rather have that corrected than not. They don’t make you artificially happy, or give you difficult side effects – unless you have the wrong kind, or the wrong dose. They help damp down the worst aspects of the condition and bring you closer to your real, healthy self.
A better alternative: Just say nothing. It’s none of your business.
3. How are you? … Okay, but you’re basically alright, aren’t you? Oh, good.
This ties in to one of the things I said in my last post, which is that ‘I know how you feel; I get anxious too.’ It’s amazing having someone listen to you, but it can feel so belittling when they don’t take in what you’re saying.
I imagine it must be tough to ask people with mental illnesses how they’re doing if you don’t understand – maybe you think they’ll start crying, or start talking about some horrible trauma. But really? We probably just want to talk about our day. It just might have some phrases like ‘It set me off a bit.’
The inverse of this of course is that if you’re going through a tough time, it can feel hard to talk to someone about it – you think you’re being a burden or self-pitying or selfish. And if you manage to, it feels horrible to have someone recoil in horror or ignore the things you’re saying because they’re scared of your illness.
A better alternative: If you want to talk, I’m here. I’ve got your back.
I hope these make sense and that they are useful for someone. Feel free to share this with others if you think they might benefit from it. And remember you can always email if you need help or support: firstname.lastname@example.org.