I’m going to say two statements.
“I have asthma”
“I have depression”
I want you to think about what your inner responses were to each of those. Not your adjusted, socially acceptable responses. Your first gut reaction.
Were your thoughts slightly different from me saying I have asthma, to me saying I have depression?
If so, you will very much be in the majority. Since the first proper differentiation's were made between causes of physical and mental illness in the late 18th century, we have been conditioned into viewing them as quite separate things, and so our responses to them also changed.
The usual response to statement one is- “Ok”. Someone might ask how often it affects me, how bad it is. On the whole, what I say is taken at face value.
The usual response to statement two is mixed. I feel like peoples' responses split them loosely into two categories.
Category one- “oh dear”, “how awful” *generally acts uncomfortable and unsure how to react*. Category two- distrust. “Well you seem fine”, “everyone has hard times in their lives, no need to make a disorder out of it”, “people are just jumping on the bandwagon”. There is inherent doubt and the weighing up of validity.
It's interesting, as someone who has both asthma and depression, witnessing these different responses. I have no issue discussing my respiratory health with people, but I definitely notice I am much more cautious about what I discuss regarding my mental health. I do try actively to be more open about my experience of mental illness to try and do my bit to reduce the stigma, but even so there is definitely an uncomfortableness, a worry about how the other person will react, a worry which never crosses my mind when discussing asthma.
In October, I spent a total of three weeks in hospital. I have realised on a couple of occasions when people ask why I was in hospital, I have said it was because of covid. Now, this isn't entirely untrue. I did spend a couple of days in hospital due to covid. But it isn't exactly an accurate representation of the truth. The reality is I spent a week on a psych ward, followed by a week at home under the Intensive Home Treatment Team, during which I had the covid admission, followed by a readmission to the psych ward, where I stayed for another two weeks.
Despite the fact that my respiratory and mental health have caused significant and potentially life threatening issues within the last couple of months, it feels like a taboo to discuss one of those causes. And so a lot of the time, it's easier to just go with the acceptable ailment- the physical one.
I am very lucky in my life, that most of the people who I spend my time with either have first hand experience of mental illness, work with vulnerable people or go out of their way to understand what helps and what doesn't. This means that with a lot of people, I have been able to be open about the past couple of months. But I still worry about the reactions. Will they think I'm being overly dramatic? Do they think I just can't cope? Will they be convinced that I’m unstable or have less capacity than I did 30 seconds before I told them about my struggles with mental illness?
So, if I’m worried about people's responses, then why am I writing this? Because I wish there isn't such an obvious difference in responses between statement one, and statement two.
There needs to be a better understanding that this discomfort of mental illness comes from two things. Firstly, the stereotypical image of a mentally ill person, and secondly, not knowing how to respond when someone does open up.
The idea of a stereotypical mentally ill person is outdated and dangerous. It has certainly prevented me from accessing support in the past because I felt like I wasn't ill enough, I didn't fit the stereotype well enough. I have got better at fighting my own views on this, and it has benefited me hugely. Spending this recent time as an inpatient allowed me to be safe and start to get better. I wasn't dragged kicking and screaming, I didn't refuse treatment. A discussion was made between me and my care team, we came up with a plan, and we did what was needed to help me through this depressive episode. It was calm and organised, not the image of chaos that can often come to mind when you think of someone going to a psych ward.
I do feel like the fact that most people don't know how to react when someone says they have a mental illness is one of the biggest issues at the moment. This comes from a lack of knowledge, not a lack of care.
Obviously, each person's needs are individual and will vary. It can feel like such a hard topic to discuss, but that discomfort isn't going to start to ease until we, as a society, start having more of these conversations. With time, it will get easier. I have made a brief list of things that might help ease that discomfort, based off my own experience and those of people I know:
Think how you would respond if someone had told you about a physical illness. This might include:
Asking if there is anything you can do to help
Asking if there are any factors that could help or make things worse
Taking them at face value. If you aren't going to question the validity of a physical illness, you shouldn't need to question their mental illness either. You're not the gatekeeper of who does and does not have “real issues”. If someone is saying they need support, regardless of what the actual reason behind it is, then they need support. Full stop.
Be less worried that the person doesn't want to discuss it. The likelihood is, if they have disclosed their issues to you then they don't mind talking about it. In fact, that might be their way of trying to open up conversation. Mental illnesses can be so isolating, and the difficulties society has about discussing it can amplify that. Give someone the opportunity to talk.
Be open with what you don't know. Personally, I find this one of the most important points. Some of the most helpful conversations I’ve had have been when the person asks questions, does not judge the answers, and is actively trying to increase their awareness. If you’re worried about upsetting them, then say that. Most people will let you know their own boundaries, but staying quiet can be misinterpreted.
Remember that someone doesn't always need an answer or a suggestion on how to fix it. If you have advice to give, ask if they want advice or if they want to talk about it instead. Giving someone the opportunity to vent can be just as helpful at times as providing solutions.
Try not to critically question. Feeling like you are having to justify yourself can be exhausting and invalidating. If you are just genuinely asking a question to better your knowledge but are worried that it could sound critical, then be clear of your intentions. It will put the person at ease.
Be compassionate. Remember that as hard and uncomfortable as it is for you to discuss the topics and watch someone you love struggling, don't forget that for the person themselves, it can be all consuming. Battling your own mind is exhausting. It's constant. It's isolating. What you see on the surface is likely the tip of the iceberg. This is a point that should be applied to most things in life- be kind.
On the whole, any discomfort I have regarding discussing my mental health with others stems from my concerns about what their response will be, not my unwillingness to discuss it.
Yes, the first few conversations will be hard. But it will get easier. And you might, without knowing it, be providing that person with an opportunity to feel less isolated. And that can make a world of difference.
No change in behaviour is easy, but changing the way you view someone opening up about mental illness can be quite literally life saving.
And that's an amazing super power we all have.
-Lis