Not long ago, if someone mentioned the phrase “mental illness”, we’d think of people with obvious symptoms of psychological distress.Or, it might be used as the punchline in an inappropriate, but still somewhat socially-acceptable joke.
Chances are, someone close to you is experiencing mental illness in one form or another, and the symptoms might be so subtle, they’d go unnoticed. Either way, they’re no laughing matter, especially if that person is you.
Has someone in your life shared with you that they’ve recently been diagnosed with a psychological condition? Do you know someone who might need help, but you don’t know what to do? As a friend, family member, or co-worker, you might feel awkward addressing their condition, but with the right approach, your support can make a huge difference.
Diagnosing Mental Illness
Mental illness covers a broad spectrum of acute and chronic challenges to our psychological and emotional well-being, each with its own variances and degrees. In the age of the internet and sensational daytime talk shows featuring medical doctors and psychologists, it’s easy to fall prey to the role of “armchair shrink” when we suspect someone we know “has issues”.
In reality—and we don’t mean reality TV—properly diagnosing psychological issues is often extremely difficult, for a number of reasons. These are only a few:
- Many disorders and illnesses have overlapping symptoms.
- Patients in short-term, emergency hospitalization situations often don’t get thorough evaluations or aren’t cooperating. These situations are about ensuring the immediate safety of the patient, not long-term care.
- People seeking care are often afraid to disclose many of their symptoms, due to social stigmas or feelings of shame.
- People avoid seeking care for fear of being “found out” by employers, family, and friends.
- People often don’t seek care from the right type of mental health professional.
- Medical plans often don’t adequately cover mental health treatment.
If therapists, psychologists, and psychiatrists have a tough time diagnosing a client with a specific mental health issue, laypersons don’t stand a chance. The only professionals truly trained and qualified to evaluate and diagnose mental disorders are psychiatrists, particularly those with a Psy.D rather than a Ph.D. The former is generally focused on research, while the latter is oriented towards applied clinical practice. And even then, it might take several evaluations to get on the right track.
But the process is worth it because, with the right mental wellness program, people do get better.
For example, a woman who struggled with depression had been seeing a licensed therapist for several years, but it wasn’t until her primary physician insisted that she see a psychiatrist that she was diagnosed with Bipolar II. This disorder differs from Bipolar I in that the clients usually experience depression more deeply, but without extreme mania or psychosis. She’d been taking antidepressants, but those on the Bipolar spectrum require specific types, as well as additional mood stabilizers to avoid erratic mood swings.
Within two months of her new regimen, which included monthly “med checks” with her Psy.D. and weekly visits to her therapist, who specialized in Cognitive Behavioral Therapy (CBT), she reported feeling mentally healthy and hopeful for the first time in nearly a decade.
A Better Understanding of Mental Illness
How do you know when it’s appropriate to intrude in someone’s personal business? If you’re a parent with an underage child, it’s relatively easy to get referrals and take your child to the right mental health professional, but if you’re a friend or the relative of an adult, it can be a little awkward to raise the subject. Unless that person has made threats of suicide, or of harming another individual (in which case you should call 911 and explain the situation in detail, noting to the dispatcher that it’s a mental health issue) there isn’t much you can do to actively intervene.
Following are only some of the general symptoms of mental distress:
- Sudden changes in mood, or wide mood swings
- Sudden changes in energy levels
- Irritability, or outbursts of anger or sadness
- Disrupted sleep patterns
- Lack of ability to concentrate
- Impaired speech patterns
- Compulsive behavior or unhealthy coping mechanisms
Often, people who are dealing with depression or stress are good at “holding it in”. As a society, we’re expected to bootstrap our way through conflicts, a cultural attitude that reinforces the stigmas set upon mental illness. We don’t want to be thought of as “weak” or “whiny”, or somehow less credible in the eyes of our family and peers.
Mental health issues are very real, and painful.
In most cases, direct intervention isn’t the appropriate response. Non-judgmental compassion always is. You wouldn’t tell a cancer patient to just “get over it”, would you? Insisting that a person with a broken leg just “walk it off” would be highly inappropriate. But people suffering depression or other mental illnesses often feel that because their symptoms aren’t physically obvious, they’re not taken seriously.
- When someone can’t get out of bed in the morning, it doesn’t mean they’re lazy.
- If someone is anxious or exhibits compulsive behavior, telling them to “chill out” won’t work. They can’t.
- If someone is suicidal, they’re not selfish or spiteful; they’re simply in so much psychological pain that they can’t think beyond getting relief.
Those who are dealing with mental distress deserve the same support and empathy granted upon a person dealing with serious physical illnesses. Mental illness is physical; when our brain chemistry is off, it’s no different than when any of our other organs are affected by disease.
Words make a difference.
Whether you’re trying to broach the subject of a person’s behavior or mood, or someone you care about has just confided in you that they’ve been diagnosed, what you say can have more of a positive impact than what you do. Avoid any “you should” statements or guilt trips.
Here are a few suggestions for expressing your support in a positive way:
Don’t say: “We stopped asking you to join us because you always said no.”
Do say: “I know you haven’t been feeling like getting out, but if it’s okay, we’re going to keep asking in case you do,” or “I know you don’t feel like going out, but would it be okay if I came over sometime? We can just hang out. No pressure; we can just watch a movie or something.”
Don’t say: “You should get help.”
Do say: “You’re obviously in a great deal of pain right now. You deserve to see a psychiatrist or therapist. Do you want me to help you find someone (with or without a sliding scale fee system)”
Don’t say: “I can’t help you if you don’t tell me what the heck is going on!”
Do say: “It seems like you’re dealing with a lot right now. When you’re ready, I’m here if you need someone to talk to.”
Most people living with mental illness know, on some level, that they need help, and that they’re not functioning at 100 percent capacity. They know their behavior is affecting those around them. But guilt, overwhelm, finances and fear are often holding them back. Seriously depressed people might not believe there’s a point to seeking help, so addressing their deservedness is important.
Supporting Yourself Through Healthy Boundaries
When someone we care about is in a crisis, we want to do whatever we can to ease their suffering. Setting limits on what you can and cannot do for your loved one is important for both of you.
- If you become overwhelmed, you’re of no use to anyone.
- When you’re clear about what you’re willing and able to do, they’ll be less anxious about being a burden.
- People in psychological distress might have difficulty recognizing their own or others’ boundaries, so being firm in setting your own helps protect both of your well-being.
For example, Trish’s adult son is severely depressed and anxious. It’s clear that he wants validation for his pain, but he has a difficult time asking for it, and therefore, he can come off as “passive-aggressive” or manipulative.
Trish would identify the manipulative behavior when speaking to her son and request clarification. “I want you to feel you can be direct and trust me with the truth. If there’s something you need, please ask; if I can help, I will. If I can’t, I’ll let you know.”
David, whose best friend is exhibiting erratic spending behavior and mood swings after a nasty divorce, is tired of bailing him out: “I can’t loan you any money, John, but I’m here if you want to talk. I’m concerned that you’re focusing on the painful aspects of your divorce; maybe we can put our heads together and figure out what good stuff is ahead?”
Resources for Mental Health Sufferers and Their Loved Ones
Reach out to National Alliance on Mental Illness for guidance on all sorts of topics, from handling an immediate crisis to getting support for yourself as a family member as well as for the person dealing with the illness. You can even find support groups near you and referrals for local mental health professionals.
PsychCentral is a popular forum and information website for those dealing with mental illness in their lives, directly or indirectly. They also have a directory for locating a qualified professional near you.
Do you want a little bit of a lighter perspective on mental illness? Comedian (and diagnosed depressive) Paul Gilmartin has a popular podcast, The Mental Illness Happy Hour, featuring interviews with mental health professionals and people dealing with mental health issues. The purpose of the website is to reduce the stigma of mental illness, help sufferers realize they’re not alone, and allow “normal” people to better understand what it’s like to live with a diverse range of disorders.
If You’re Suffering Right Now
It’s true. There are stigmas about mental illness. It is scary to reach out to professionals, peers, family, and co-workers. But there is no shame in being sick, and you deserve every chance to get better.
Medications have been given a bad rap, but they do work, especially when prescribed under the right supervision. With the right combination of medications and talk therapy, that sense of overwhelm and dread you may be feeling right now will be lessened.
You might feel like a burden, or unworthy of your loved ones’ help. You might feel that they don’t understand what you’re going through. That feeling is normal for those dealing with mental health issues. But you don’t know how they feel, and they deserve the opportunity to stand by you and lend you the support you need to get better.
You’re not alone.