People with mental illness have been accused of using their illness as a crutch. They have been blamed for not trying hard enough to get better. We know so many people who think taking a medication for our illness is "unnatural" that we're amazed we ever talked ourselves into going to the doctor for a prescription. We've been told we just need to think more positively and that will fix our attitude. Our doctors make remarks like "everyone gets stressed in college," and we wonder if we're overreacting. We've heard family and friends talk about mental illness as if they are authorities, assuming that we just need to "deal with it." Some people are willing to offer support to us only on the condition that we are not "using depression/anxiety as an excuse." And last but absolutely not least, there is the classic religious response that anxiety and depression are a spiritual attack straight from the devil himself and that if we were holy enough we could just shake it off.
The people who said these sorts of things to me are for the most part people who care about me and mean well. I believe that they intended to help, comfort, or advise me. The problem is that I have tried to believe almost every one of these perspectives and my anxiety has twisted them even further out of reality. I have convinced myself that all the suffering is my fault, that I am the problem and that I could be getting better faster if I wasn't so selfish and lazy and defective and problematic. These beliefs have had such an unhealthy grip on me (and on others with mental illness) that I am writing this post to explain and defend myself to the world, something no one should really have to do. I am writing this to convince myself just as much as to convince you.
This is what mental illness stigma looks like. In fact, this is a really good example to illustrate that mental illness is not rational. Anxiety and depression are different from stress and sadness and lethargy because they aren't proportionate to the reality of situations and they can't be cured or silenced by factual observations.
But, facts are still important. For example, it's a fact that depression and anxiety are real chemical imbalances in the brain. It is a fact that people can genetically inherit these illnesses, and that they may need treatment- which for some people may be a medication to restore the chemical balance. It's a fact that even though they are mental illnesses, anxiety and depression have physical symptoms like fatigue, loss of sleep, cold hands, panic attacks, muscle tension, and more. It is a fact that more than 15 million adults in the United States struggle with depression and more than 40 million struggle with anxiety disorders. So, by extension, it is also a fact that there is likely someone in your life dealing with one of these illnesses and you don't even know it. It is a fact that that these illnesses are treatable...but there is a difference between "treatable" and"curable." There is a difference between coping effectively with an illness and not having an illness at all, a difference between finding healthy solutions to a problem and not having a problem to begin with.
Finally, it is a fact that these illnesses are serious and need to be taken seriously. It is a fact that depression can be lethal. It is a fact that some people who do not get the help they need die from mental illness. It is not trivial, and it deserves more than a band-aid or a casual anecdote in the way of support. I hope that if you have read this far, it means you care enough to want to help. It can be hard to understand mental illness if you have never experienced it, and you may not know where to start. I am here to help you help us. My suggestions are not exhaustive and they may not apply universally for every person with a mental illness, but they are a good starting point and will hopefully help you to communicate with your friends and relatives about the support they need.
1. Remind us to take care of ourselves.
If we seem to be overextended or just plain hard to put up with, this is the best place to start. Did we get enough sleep? Have we eaten anything healthy recently? Have we eaten at all? Do we need a cup of tea or a hot shower? When was the last time we took our medication? My best friend and I both deal with anxiety and depression on a daily basis and check-ups like these are one of the most important things we do for each other. We can easily get so wrapped up or bogged down in our anxiety that simple self-care slips our minds or at least takes a backseat to our raging internal dialogue. Depression especially can drain us of the motivation we need to complete these care routines. This can make us irritable, numb, and unyielding and we will probably not be able to appreciate any of the other help you may have to offer, however wise it may be, when we are in this burnt-out state. You can show you care by offering that motivational nudge.
2. Be patient with us.
When you know you have a mental illness and you know your thought patterns are not always healthy, it can be very difficult to sort out your thoughts. If you need us to explain why we are upset, why we are making a certain decision, or why we feel the way we do, try not to put us on the spot. It takes time and space for us to sift through our thoughts and weed out the ones that don't make sense so that we can communicate what really matters to us about the situation. We want to open up, but it's challenging when we don't get the room we need to do so.
We also appreciate your patience because we know our moods or outbursts are difficult to handle, and we want them to stop just as much as you do. It's okay to ask us to work on this, but realize we will again need time to develop the strength and the strategies needed for curbing these reactions.
3. When in doubt, ask questions instead of assuming.
It is okay for you to not understand us. We are not offended that you are still learning about what helps and what doesn't. We aren't disappointed if you don't have the answer to improving our health right away. But please, try not to assume you know everything about an illness you've never experienced. If you really want to become an expert, you will need to spend more time reading and listening than you do talking. If you're like the average person and don't have time for that much extensive research, feel free to ask simple questions when you need to care for or understand someone with depression or anxiety. You can start in the comments on this post if you want!
It's also good to ask questions because this both helps us open up and feel a little more in control. We don't want to be spoiled or babied through our illness; in fact, we really like those times when we feel strong and capable. If you assume we need you to do things for us that we actually want or like to do on our own, it can seem like an insult to our competence even if it is well-meant. Try to steer clear of assumptions of all kinds and this will help us immensely.
4. If we confide in you, respect our privacy.
I have been very open about my struggles with mental illness, mostly because I know I have a few understanding people backing me up and because I think I can make a small difference by speaking up and educating others. Not everyone with a mental illness is this comfortable talking about it...honestly, "comfortable" is a strong word even for me. It is very difficult to discuss anything that makes you feel vulnerable. The rushes of thoughts and emotions that come with anxiety and depression are tricky to navigate, and as I mentioned in #2 we don't always understand them ourselves, much less have the ability to explain them to others. If someone talks to you about their anxiety or depression, you should treat that information carefully and respectfully. Except in cases of emergency, don't share what they told you without their permission. You may simply be looking for better understanding or advice about how to help your loved one when you consult others, but first recognize the courage and trust it took for them to approach you at all. If you still can't decide, see #3.
5. Don't joke about mental illness. Seriously, don't be that guy.
Hopefully this one is obvious. Making us laugh, even at ourselves, is good. Very good. Laughter boosts us up against anxiety and depression and we are all for that! Just don't use "humor" that criticizes or misrepresents our illness, even if we're not around. (As we've already discussed, there is probably someone among your family, friends, or acquaintances that has anxiety or depression and just hasn't told you.) So, telling people to "jump off a cliff" as an affectionate joke? Not okay. Asking sarcastically if someone has taken their meds yet when they seem emotional? Also not okay. I think you get the picture.
6. Don't blame yourself. In fact, don't blame anybody.
By this time you may be thinking to yourself, "Crap, I've done some or all of these things wrong!" Honestly, in that case, I'm proud of you. You're reading something to educate yourself on how to do better and you're willing to admit your mistakes. Go, you! You should know that it is not your fault that someone close to you is struggling with anxiety or depression. These illnesses often seem to worsen as a direct result of specific experiences or interactions and that makes people feel guilty that something they did or said made the illness worse. This struggle is often especially difficult for parents of individuals with mental illness. They can feel like they failed to recognize the illness soon enough, failed to get their child the right help, failed to prepare their child for certain challenges or to teach them to cope properly. They may even feel that their child is repeating their mistakes. I am here to tell you that taking your loved ones' mental illness personally will not help anyone. You will be a better support if you focus not on whose fault the illness is but on how best to support your loved one through their treatment. (Besides, science points to anxiety and depression being genetic, not just circumstantial.)
7. Let us experience our healing even if it's not what you expected.
My healing process so far has become very personal, but sometimes I feel as if my solutions and decisions get put under a microscope because all those concerned for my health want to have a say about what I should be doing. It's really hard to heal under a microscope. I want to be able to find the best solutions for me through trial and error and sometimes my own intuition. The more my family and friends allow me to do this while standing by for me to fall back on when I need them, the stronger I will become. Unconditional love and support as a backdrop to a personalized program of professional help and other remedies or coping mechanisms is the help I need.
I hope these thoughts and tips help you.