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.  

Semicolon – Continue Living

                  The other day was World Semicolon Day.  Let’s look at what the semicolon represents.  In grammar a semi-colon represents a sentence an author could have ended but chose not to.  From a mental health perspective, the semicolon represents a continuation of life, a decision to keep moving forward and not giving up.  

                  The use of the semicolon in association with mental health was started in 2013 by Amy Bleuel.  She selected the semicolon as a symbol of hope.  She intended for it to be a symbol of hope after her father died by suicide.  The semicolon is a representation of persevering in the face of mental illness. She founded Project Semicolon. Bleuel stated, “In literature, an author uses a semicolon to not end a sentence but to continue on.  We see it as you are the author, and your life is the sentence.  You are choosing to keep going.”  Bleuel battled mental illness herself and died by suicide in 2017.  She left the legacy of the semicolon to help others.  

                  The idea behind the semicolon is that your story isn’t over.  That is Project Semicolon’s reminder to people struggling with mental illness.  Even when you struggle with self-harm and suicidal thoughts, your story isn’t over.  Many people get the semicolon tattooed on their wrist as a reminder that their life isn’t over, that it is worth fighting for.  

                  As someone who has lived with self-harm and suicidal thoughts since my teenage years, the semicolon has become significant for me.  It is a reminder to keep fighting the thoughts.  It is a reminder that my life is worth living.  As a writer I understand the use of the semicolon.  That strengthens its significance for me.  When I see a semicolon whether on a tattoo or on a social media post, I am reminded that I can fight mental illness.  I can pause and then keep going.  

I am not trying to trivialize the mental illness fight.  The semicolon itself is not enough to stop a person from dying by suicide.  Rather, it serves as a reminder that continuing your story is possible.  The semicolon can provide a pause that allows a person to receive help.  

                  I have thought about having the semicolon tattooed on my wrist.  I am too much of a chicken to sit for the tattooist needle, though.  I do have a bracelet with a semicolon on it.  Maybe someday I will go through with the tattoo. 

                  Symbols are powerful.  The semicolon is a symbol of hope.  When a person is living with suicidal or self-harm thoughts, it is difficult to break that train of thought.  Sometimes words are too much.  A symbol, such as the semi-colon, can be the image that interrupts the thoughts even if just long enough to get help or step away from whatever was going to be used for self-harm.  The reminder to keep living is vital.  Mental illness is powerful.  We need reminders that we can live with mental illness.  

                  The semicolon also serves to raise awareness about mental health.  It can be a discussion starter.  I have seen it frequently on social media.  Every time it sparks discussion.  For every person that learns about the semicolon, awareness about the seriousness of mental illness is raised.  That is what we need, increased awareness.  Bringing mental illness into discussions will lead to normalizing treatment for mental health disorders. It will make it easier for a person to choose to get help. 

                  The next time you see a semicolon, take a moment to think about its meaning.  Think about how difficult it can be for some people to keep their story moving forward.  That will help you understand that self-harm and suicidal thoughts are symptoms of an illness.  The semicolon is a reminder that we each have a story to live.  The story needs to keep going.  Use a semicolon to pause, when necessary, but then continue your story.  

                  

Things You Can Do to Support Your Mental Health

                  Living with mental illness is not easy.  Often, even the simplest of tasks weigh heavy.  Getting out of bed can seem to be a Herculean task.  The darkness of depression can shroud your world.  So, what can we do to ease this heaviness?

                  One thing I think is important is to practice coping strategies when the darkness of depression is not as heavy. This will make it easier to engage in these strategies when the depression is bad.  I have tried to develop several coping strategies for myself.  I am not always good at turning to my coping strategies. That is part of the nature of depression.  When it has you down, it is difficult to engage.  That is why it is important to practice coping strategies.  In a sense they need to be somewhat automatic at times.  The more automatic strategies are, the easier they are to turn to when they are needed.

                  Coping strategies are supports that can help a person deal with depression in a healing way.  Here are some coping strategies you can try:

 

·      Listening to music

·      Writing/Journaling

·      Drawing

·      Walking

·      Exercising

·      Yoga

·      Painting

·      Meditation

·      Playing with a pet

·      Sitting with a friend or family member

·      Taking a shower

·      Sitting on the beach

·      Getting out in nature

·      Gardening

·      Deep breathing or other breathing exercise

·      Playing a musical instrument

·      Going to a support group

 

These are just some examples.  Coping strategies can be unique to each individual.

What works for one individual may not work for another. That is okay.  The important part is finding what works for you.  Try different things out.  Don’t get discouraged if something doesn’t work.  I know that is a difficult task when you are depressed.  That is why I think it is important to try coping strategies out when you are feeling a little better.  Then you know what you can turn to when the depression is worse.  

                  I have learned that writing, listening to music, walking, and painting work best for me.  I do want to try other things.  One thing I am considering is learning to play a musical instrument.  It may or may not work, but I can try.  The important thing is trying.  If we don’t try out different coping strategies, there is no chance we will find what works for us and we will be trapped in our depression.  

                  Coping strategies are not the only answer to depression.  Rather, they are a part of our toolkit.  Our depression toolkit might include medication and therapy.  It might include non-traditional treatments such as TMS, ketamine, or ECT.  Depression is an illness.  It requires treatment.  We can help that treatment be more effective by engaging in coping strategies.  

                  You may find it helpful to share your coping strategies with people who support you.  My mental health team knows my coping strategies.  The friends and family members I am closest to also know them.  By knowing my coping strategies, they can encourage me to try one when I am struggling with my depression.  I have found this to be very helpful.  Sometimes it is difficult to turn to a coping strategy on my own.  Having someone gently remind me helps.  

                  I encourage you to discover your own coping strategies.  Maybe it is something from the list above. Maybe it is something totally different.  Share your coping strategies in the comments section below.  You might have a strategy that will help someone else.  

 

An Invisible Illness

            I was thinking about how often people with depression get overlooked.  Their illness is not seen.  It happens to me.  Most people don’t realize I struggle with depression because I usually hold the illness inside of me.  With few outward signs, depression is not always viewed as the real illness that it is.  Sometimes we feel the need to hide our depression because people don’t understand that it is not just sadness. Depression is a real illness. It is painful and requires treatment.  

            Today I would like to share a poem I wrote that explains what it is like to live with an invisible illness.  If you have had similar experiences, I encourage you to comment.  If this poem makes you think of someone, share it with them so they know they are not alone.  The only way we are going to make depression visible is by normalizing it.  That requires discussions about depression.  There are many people living with this invisible illness.  My hope is that we can bring more visibility to depression and in doing so bring more healing. 

 

 

An Invisible Illness

 

I see it in the eyes of others.

They wonder how I can have an illness

When I seem to function so well.

My illness is invisible at times,

But it is always there.

Plaguing my mind;

Hindering my life.

I hold so much of the pain inside;

Pretend the physical symptoms are not real.

Mental illness is often silent on the outside.

Others do not understand what I go through each day.

They assume that I am okay.

Sometimes I even tell them that I am.

It is my attempt to normalize how I really feel,

But it is a lie.

Mental illness hurts.

Invisible at first glance.

Devasting when truly seen.

If others could see the torment

Maybe they would understand and

Life might be a little easier for me.

The pain of an invisible illness is hard to explain.

So, I do my best to hide it.

When really, I should explain it to anyone who will listen.

Let others know what it is like.

Raise awareness

And allow myself a chance to heal.

 

Succeeding with Mental Illness

                  I just saw a post on NAMI San Fernando’s social media.  It struck me as something that really needs to be discussed.  The post simply said, “You can have a mental illness and still succeed.”  That is a powerful statement.  It is true. Mental illness often tells us that we are worthless or that we are not good enough, but the reality is there are people living their best lives with mental illness.  

                  People with mental illness have jobs, raise families, and are successful in the arts and on the playing field.  People with mental illness contribute to society often without anyone knowing they struggle with mental illness.  A simple Google search would yield tons of people living with mental illness.  We will look at some of those people later in this post.  

                  Let’s start with what it means to succeed with mental illness.  Each person defines success differently.  That definition is often fluid.  Success can be defined differently at various points in life.  On some days just getting out of bed can be defined as success.  I have had many of those days.  For me depression can at times prevent me from having the energy and the desire to function.  If I can manage to get up and do something as simple as brushing my teeth or showering, I have been successful.  This may seem like a simplified description of success, but the weight of mental illness is heavy and little steps take a lot of effort. 

                  As I mentioned people with mental illness have jobs.  Mental illness is an invisible illness.  You never know when you are interacting with someone who is living with mental illness.  The barista who made your coffee may be dealing with depression.  Your accountant may live with a paralyzing anxiety.  The teacher instilling knowledge in your children may fight bipolar disorder.  These are just a few examples.  People are often able to hide their mental illness from those who do not know them and maintain successful jobs.

                  I was a special education teacher for over 26 years.  I lived with depression and anxiety that whole time.  Still, I functioned.  My students never knew how much I struggled.  I hid my illness from most of my colleagues and administrators.  They did not need to know.  I was successful as a teacher despite fighting a mental illness.  I am proud of that fact.  Were there days when I couldn’t be in the classroom?  Of course.  But isn’t that true of any illness?  Most people take a day off when they have the flu.  Mental illness is no different.  There were days when I was in the classroom when I probably should have taken the day.  I persevered.  On the outside I was just like any other special education teacher.  Inside, my mind was telling me to give in, to go home and hide in bed.  Overall, I was a successful teacher.  I worked despite my mental illness.  I knew other teachers who did as well.  

                  Back to that Google search I mentioned.  I just did a search for successful people with mental illness.  Let’s look at some of the names that popped up.  

                  Carrie Fisher: actress with bipolar disorder

                  Jim Carrey: actor with depression

                  Buzz Aldrin: astronaut with depression and substance abuse disorder

                  Michael Phelps: attention-deficit hyperactivity disorder

                  Demi Lovato: actress with bipolar disorder and bulimia

                  Billy Joel: musician with depression and substance abuse disorder

                  Britney Spears: musician with bipolar disorder and postnatal depression

                  Ludwig van Beethoven: composer with bipolar disorder

                  Charles Schultz: cartoonist with clinical depression

                  Dolly Parton: musician with clinical depression

                  Ernest Hemingway: author with clinical depression

                  Georgia O’Keefe: artist with clinical depression

                  Sylvia Plath: poet and author with clinical depression

                  Herschel Walker: athlete with dissociative identity disorder

                  Abraham Lincoln: US president with depression

                  Winston Churchill: world leader with bipolar disorder

                  Michelle Obama: US First Lady with low-grade depression

                  

 

                  This is just a sampling of the names I found.  Every day people go to work with mental illness.  People do hard things with mental illness.  People wake up and function despite the pain of their illness.  They do not let their mental illness define them.  Notice in my list I used the word “with”. People are not their diagnosis.  Mental illness is something we have.  It is not who we are.  It does not define us.  

                  As a society we need to do a better job of reducing the stigma surrounding mental illness.  We need to recognize that mental illness can strike anyone.  When we live with mental illness, we have our struggles, but we also have our successes.  

                  I have described success in the workforce, arts, and playing field.  Those are not the only measures of success.  As I mentioned just getting out of bed can be a success at times.  Talking back to negative thoughts, fighting back against suicidal thoughts are both successes.  They are not easy to do.  I can attest to the difficulty of these two.  It takes strength.  Anyone who has ever fought these thoughts knows it is not easy.  These individuals are success stories.  Fighting anxiety is another difficult task.  People can be paralyzed by their anxiety.  When they interact with world, even if it is just with one person, they are being successful.

                  Success should be defined in individual terms.  No one else knows what knows the struggle that a person with mental illness lives with on a daily basis.  What is deemed a success by one person might seem routine to another person.  That is okay.  What matters is that we try to do our best even as mental illness impacts us.  Define success in your own terms.  You can discuss what success looks like for you with a trusted loved one or a mental health professional.  It can be helpful to share your successes with one of these people. Celebrate your successes no matter what that success is.  Living with mental illness is a success.  Remember, you determine your own successes, and your mental illness does not define you.

 

                  

 

Myths Surrounding Mental Health

                  Mental health is frequently misunderstood.  Often, mental illness does not receive the same empathy as physical illness.  People have false beliefs about mental health, which are hurtful to people who live with mental illness.  Society perpetuates these myths.  We see it in the media, hear it in conversations, and feel it in the workplace. Let’s look at some of these myths.  

                  One myth about mental health that exists is that mental illness is a result of a personality weakness or a character flaw.  This could not be further from the truth.  Mental health issues are a result of illness.  A person does not choose to have a mental illness.  A person with a mental illness is not weak.  They have an illness just like a person with heart disease or cancer has an illness.

                  Another myth about mental illness is that it won’t affect you.  Mental illness can affect anyone.  According to SAMHSA (Substance Abuse and Mental Health Services Administration) in 2020 approximately 1 in 5 American adults experienced a mental health condition and 1 in 20 Americans lived with a serious mental illness.  Suicide is a leading cause of death in America.   According to SAMHSA more lives were lost to suicide in 2020 than to homicide.

                  People often falsely believe that people with mental illness are violent.  The truth is people with mental illness are no more likely to be violent than anyone else.  Sadly, people with mental illness are more likely to be a victim of violence than they are to be violent.  

                  Another myth is that people with mental illness cannot hold down a job.  I can personally attest to the falseness of this statement.  I have worked my entire adult life.  I have an advanced degree and I was a teacher for 26 plus years.  It was actually a physical illness, cancer, that has resulted in me not being able to work.  Most of the time an employer does not even know when an employee has a mental illness.  

                  It is also a myth that children don’t develop mental illness.  In the case of nearly half of all mental illnesses there are signs before age 14.  Young people can suffer from depression and anxiety.  They can experience mental illness. The myth that children don’t experience mental illness results in many children not receiving the treatment they need.  

                  It is also a myth that there is no hope for individuals with a mental illness.  People with mental illness can recover.  They can experience healing.  This doesn’t mean that the mental illness disappears.  With treatment a person can live a full and productive life with mental illness. 

                  Another myth is that loved ones and friends can’t do anything to help a person with mental illness.  There are many ways loved ones and friends can support a person with mental illness. For more information on ways this can be done read my article on the topic at this link: https://namiglendale.org/support-a-loved-one-living-with-mental-illness/

                  Overcoming the myths surrounding mental illness is a difficult task, but a necessary one.  These myths make it difficult for people with mental illness.  Our illnesses are difficult enough without the stigma caused by these myths.  We need to raise awareness and start conversations about mental health.  Treatment for mental health needs to be normalized.  People with mental illness have an illness.  They are not weak or lazy.  They need treatment and understanding.  Mental and emotional health is just as important as physical health.  We need to rise above the myths and support people with mental illness.  

                  

                  

Benefits of Therapy for Depression

         Depression is a real illness.  It requires treatment. Therapy is an important part of that treatment.  There are different types of therapy.  Some of types of therapy include cognitive behavioral therapy, dialectical behavior therapy, humanistic therapy, integrative therapy, and interpersonal psychotherapy. In this post I will speak about therapy in general terms.  I will be referring to forms of psychotherapy or talk therapy.

The purpose of psychotherapy is to help a person identify and change troubling emotions, thoughts, and behaviors.  This is usually done in a one-on-one setting.  The provider is a licensed mental health provider such as a therapist or psychologist.  Therapy can take place in group settings as well.

I have engaged in therapy most of my adult life.  Psychotherapy has helped me develop coping skills and allowed me to better understand the shifts in my mood that are beyond my control.  I find that my mood improves when I am able to discuss the events and emotions that lead to my depression.  In therapy I am guided to understandings of my thoughts.  When I have a better understanding of what my thoughts are telling me, I can cope better.  I find that just having an open and safe space to talk is beneficial.  

So, what are the benefits of psychotherapy?  There are many benefits.  These benefits depend on the person and what he, she, or they need.  Some common benefits include:

·      Improving overall mental health

·      Increasing self-awareness

·      Developing coping strategies

·      Developing healthier communication strategies

·      Confronting anxiety

·      Getting through a crisis

·      Developing healthy relationships

·      Navigating trauma

·      Easing of symptoms

 

All these benefits are important.  Improved overall mental health will lead to

improved quality of life and easing of symptoms. When we increase our self-awareness, we better understand what triggers us and what leads to changes in our mood.  Developing coping strategies is important because it teaches us how to function when our mood is trying to drag us down.  Healthy communication strategies allow us to express what we are going through, which can help loved ones understand us and offer help.  Developing healthy relationships is tied to this communication skills.  When we experience depression, it is difficult to maintain relationships.   Therapy can help in this area by providing us with communication skills and self-awareness. 

                  Therapy is especially important when we are in crisis or trying to navigate trauma.  Having a psychologist or therapist gives a person someone to reach out to in times of crisis.  In therapy we can learn strategies to take when we are in crisis.  For example, I have learned how identify that I am crisis and how to contact my psychologist in moments of crisis.  I have also learned that resources such as 988 are available as well.  Being in therapy has allowed me to develop an understanding that reaching out for help, whether it be from my mental health team or 988 is not only important, but it is okay.

The benefits of therapy can be instrumental when living with depression.  We cannot overcome depression on our own.  Therapy is a key part of healing.  Some people benefit from short-term therapy.  Others need it throughout their lives.  For me therapy is as necessary as my blood pressure medication.  I need therapy as a routine part of my life.  It is a part of my healthcare.  I don’t miss my therapy sessions because I know it affects my healing. 

                  People often say just deal with it, buck up and be strong.  There are social media posts that encourage people to just push through.  We are told to smile or just get through it.  Depression does not respond to that mentality.  It is not possible to just grin and bear it.  People with depression need treatment and part of that treatment is therapy.  Going to therapy needs to be normalized.  We go to the doctor when we have the flu or other illness.  In the same way that going to the doctor is normal, we need to make it normal to go therapy.  The stigma that exists around going to therapy needs to be lifted.  It is okay to go to therapy.  Therapy is necessary treatment for people with mental illnesses such as depression.  

                  Today there are avenues to therapy that didn’t exist a few years ago. Many therapists are available for online sessions.  There are therapists’ groups who advertise on social media.  In addition, primary care providers can refer you to a therapist.  If you are affected by depression, therapy can provide you with many benefits. There is no shame in going to therapy. I wouldn’t be able to write posts or maintain this blog if it were not for therapy.  Therapy has improved my quality of life.  I encourage anyone who is struggling or even just needs some help to seek out therapy.