What Not to Say to Someone with a Mental Illness

                  In previous posts I have discussed how to support someone with a mental illness.  One question I often hear is “what do I say?” There is a more difficult question to answer. “What shouldn’t I say?”  Well-intentioned words can be hurtful at times.  It is important to understand what is not helpful for a person with mental illness.  

                  Throughout my life I have heard phrases such as “cheer up.”  These two words seem harmless, but when I don’t have the capacity to just cheer up, the words have the opposite effect.  If I could just cheer up, I would. I don’t choose to be depressed.  It is not a conscious choice to feel consumed by the darkness of depression.  I understand that “cheer up” is often said with good intent, but it doesn’t help.

                  Let’s look at some comments that while well-intentioned, actually hurt more than they help:

 

·      “You have so much to be happy about.”

·      “Things could be worse.”

·      “Just smile.”

·      “This too shall pass.” 

·      “Everyone gets a little down sometimes.  It’s normal.”

·      “Have you tried chamomile tea (or insert other self-care action)?”

·      “Just try to be positive.”

·      “You wouldn’t feel this way if…” 

·      “When I am sad, I go shopping.”

·      “You have so much to live for.”

 

 

On the surface these comments seem harmless.  Maybe in some cases they are.  When a person is just having a bad day, these might be helpful.  However, if a person is living with a mental illness, comments like these are likely to do more harm than good. For example, saying something like “this too shall pass” or “you will get through it” trivialize what the person is going through.  Depression, anxiety, and other symptoms of mental illness do not just pass.  Medication, therapy, and other treatments can help, but there is always that underlying knowledge that the illness is still there.  You can’t wait out depression.  

Telling someone with depression that they have so much to be happy about is a slap in the face.  Depression isn’t about being happy or sad.  Rather, it is a debilitating mood disorder.  The effects on mood are much deeper than just being sad.  I can smile while being depressed.  At times I can even laugh as if nothing is wrong.  I can feel happy about something while being depressed.  For example, yesterday I heard that my niece hit a double in her college softball game.  I was happy and I smiled at the news.  I was still depressed.  My mood was still strangled by the arms of depression.  I was happy about something outside of myself.  I reacted to a moment.  Inside, I was still feeling the depression. The happiness I felt for my niece didn’t stop the depression.  Moments like this do help.  It gave me something positive to focus on for a few minutes.  However, it was the moment, the experience that I was responding to, not mere words.  

People are full of suggestions to make depression go away.  It used to annoy me.  To be honest, sometimes it still does.  Fortunately, I have learned that people mean well.  They just don’t understand.  “Have you tried…” is a common response.  The other person wants to help, and they are offering a suggestion of something that has made them happy or something they have heard helps.  If those things helped, I would be doing them.  While a cup of chamomile tea can be soothing, it is not going to ease my anxiety or lift my mood.  Telling me to drink a cup of tea or go for a walk are not going to help me.  Those words actually only tell me that the person does not understand that I have an illness.  Depression, anxiety, and other mood disorders are mental illnesses.  The key is the word illness. Would you tell a person with heart disease to try chamomile tea?  Would you tell a person with cancer to focus on the positive?  Actually, since my cancer diagnosis, I have heard that one. So, maybe people really just don’t understand any illness.  

When you are talking to someone with a mental illness it is important to remember that they know their illness best.  They are not just sad.  Their mood is impacted by an illness that requires professional treatment. Instead of telling someone that have so much to be happy about, ask them what you can do to help. Ask them what they need from you.  Then when the situation arises again, offer one of those as a strategy to help.  Have conversations about what helps when the person is not in difficult place.  That way you will have a better idea of what helps the person.  

These conversations can be a tough.  When a person lives with mental illness, there is a lot of emotional pain that others cannot understand.  There is a darkness that is difficult to understand if you have never experienced it.  Perhaps the best thing someone else can say to a person living with mental illness is “I am here.  I can listen if you want me to” or simply, “what can I do?”  Never pretend to have the answers.  Never assume you know what the person is going through.  Being there and offering to help in whatever way the person needs will go a long way.  However, if you say something that is not helpful, a lot of us will understand.  We know you are trying.  Remember that we know our illness.  If you don’t know what to say, ask us.