What to Say to Someone Struggling with Mental Illness

I talk all the time about my struggle with postpartum depression/OCD/anxiety. Not only is it NOT a secret, but I kinda fly that flag everywhere I go. A lot of people find this odd or even inappropriate, which is fine. I stopped caring about what people think about my illness a long time ago. I'm open about my PPD for several reasons, but mostly,

1) It helps me deal. The more I talk about it, the less pain and shame I feel about it. My dad has this saying, "The only things in life that go away if you ignore them are teeth and girlfriends". And it's true of mental illness. So instead of locking the memories and the pain away and letting them slowly eat away at me, I throw them into the light.

2) It helps raise awareness. The more people that talk about it out in the open, the less it's stigmatized.

And perhaps most importantly,

3) By being open about my struggles, maybe I can help someone else who is suffering.

It's because of #3 that a friend came to me the other day asking for help. Someone she loved was exhibiting signs of anxiety (with a hint of depression thrown in there because the two are basically BFFs from Hell). And she asked me, "What do I say to her?"

She caught me off guard because I was standing in the backyard playing referee to two very physical little boys, but as I started talking through my experiences, I started to work out some concrete advice. 

Weirdly, in the 6 years since I was hit with PPD, no one has ever asked me what to say to someone struggling with mental illness.

And it occurred to me that maybe this is something we should be talking about. Maybe people could really benefit from knowing how to talk to someone with depression.

So I put these thoughts into a concise little essay. Let me clarify that I mostly use the word "depression" because that's the most common form of mental illness, but the advice remains the same regardless of whatever particular disease your friend/loved one is facing. 

Here you go:

"Talking to Someone with Mental Illness"

****Ok first I think it's my duty to put in a disclaimer: if you think someone is having a MENTAL HEALTH CRISIS call 911 IMMEDIATELY. Do not pass Go, do not collect $200. Call 911. Please. Seriously.****

Sorry, y'all. This is dark stuff. I had to go there. But moving on...

Insomuch as you're even bothering to read this, give yourself a high-five, because you're a pretty awesome friend/loved one/human being. If you care enough to WANT to help someone, you're cool. I like you. And despite how helpless you may feel when dealing with a loved one in pain, you DO make a huge difference in their healing process.

This blog might get pretty wordy, so in case I'm already starting to lose you, I'll lead with the most important part:

Listen. Listen more than you speak. Listen as much as you possibly can before you talk. Ask questions. Listen to the answers. If you're talking more than you're listening, you're doing it wrong. If you're talking more than they're talking, you're doing it wrong. Shut up, eyes forward, listen. When you do speak, try to encourage them to verbalize their thoughts. "How does that make you feel?" "What are you most afraid of?" "When do these thoughts/feelings affect you the most?" Stuff like that. Help them throw their pain into the light. I've spend a lot of time on a therapists couch. And the main thing I've realized is that therapy is 90% getting you to put your feelings out there so you can begin to understand them. Be that conduit for your friend.

Honestly, it's probably good advice just to listen to anyone struggling with anything. Mental illness, crisis, death of a loved one, whatever. Truly listening to someone has great healing power.

For the most part, don't offer advice, and NEVER offer advice based on YOUR life. If you've never had depression, I promise you, you will not be able to relate. Even I, as a card-carrying mental illness survivor, am very hesitant to dispense advice. And when I do it's only ever, "This is what I did" and NEVER, "You should do this".

Think of it this way. Let's say your best friend is a Quantum Physicist having a crisis because she can't make a particular equation work out. If you yourself are not also a Quantum Physicist, you wouldn't walk up to her and say, "Did you try using PEMDAS? Because man, when I was taking Algebra I, I used to get so messed up if I forgot to do the parentheses first..." They'd be like, "YES I F***ING USED PEMDAS ARE YOU F***ING KIDDING ME DO YOU HAVE ANY IDEA HOW INSANELY COMPLICATED THIS IS NO YOU DON'T BECAUSE YOU HAVE NEVER EVEN REMOTELY DEALT WITH THIS".

Same goes for when you tell your friend with depression, "Have you tried thinking about all the happy stuff in your life? That always helps me..."

Empathize and Affirm. As I thought back to the things people said to me that truly helped, my dad jumps to the front of the list. This might be surprising if you know my dad, because he has the emotional sensitivity of a feral cat, but weirdly enough, he always said the EXACT right things to me. And all he did was empathize with my pain and affirm me. Example:

"I'm so sorry you have to go through this. I wish I could take it from you and carry it myself. I'm here for you. Just please know how much you mean to me, and how much you mean to this family. You bring us more joy that you can ever know. We love you SO MUCH. And I know I can't take this from you; I can't make it better for you, but my heart aches for you."

No advice. No "have you tried?"s. No "but look how great your life is". Just love.

Sometimes in the depth of our suffering, we forget that we have value. Remind us.

Don't judge. Do you think maybe taking anti-depressants is excessive? Are they trying weird alternate therapies like acupressure or probiotics? Yeah, sorry, but it doesn't really matter what you think.

The exception to that rule: if you see self-destructive behaviors, speak up or call for back-up. I'm talking like, alcoholism, drug use, cutting themselves, etc. But if it's just like, "Wow, you're running a lot. Are you sure that's necessary?"* then maybe just kind of don't. 

*Someone actually said that to me.

Offer them anything they need, and really mean it. Offer to take them to see a doctor if they want to. Tell them to call you any time, day or night, if they need anything. Make sure they know you're there for them, and you always will be. Our lives feel very uncertain and terrifying, and a great thing you can do for us is to assure us that you will be a rock for us. Cry with us. Hold our hands. Bring over a tiara for us to wear.*

*Someone actually did this for me.

Just because you don't have mental illness yourself doesn't mean you can't be a pillar of strength for someone who does. Maybe you don't know what you say. Maybe there's nothing you CAN say. You can't carry our burden, but you can walk beside us and give us strength by your love. And that is wonderful. And powerful. And valuable.

We need you. We love you. From the bottom of all of our hearts, thank you. Good luck!