5 Things You Shouldn't Say to Someone with a Mental Illness

Last week, the Obama administration took action on one of their promises to reduce gun violence: they instituted rules that will require insurance companies to cover mental health and substance abuse to the same extent they do other kinds of illness. With all the hullabaloo about Obamacare, the news was greeted quietly. I had a big smile on my face when I saw the headline announcing the change, though.

I'm one of the 57 million Americans who will experience a mental health challenge this year. I know that I will, because I have a chronic anxiety disorder and have dealt with bouts of depression since I was a child. I've been treated for my anxiety with an anti-depressant for about 15 years. 

I'm telling you this because I'm one of the lucky ones. My company is understanding. My family is understanding. I am helped by a very small dose of medication with no side effects, and I have been more successful at life than I could ever have imagined when I was pulled over on the side of the road crying for no reason all those years ago. I feel a responsibility to declare the fact of my illness because so many people suffer silently, afraid that they won't be accepted or will lose their jobs. Many people with mental illness wait as long as 10 years before getting treatment - for reasons that include the stigma of being thought "crazy."

I once heard mental illness described as a "hidden disability," and I believe that all of us have to help to "un-hide" it. This means that we have to be careful with our words so that we are not perpetuating harmful stereotypes or casting out microaggressions  that subtly belittle others.

I want to name some of the things that I've heard people say that are hurtful to those of us who have mental illnesses, so that we can start to strike these kinds of statements from our speech, and create a world where people feel free from stigma if they take advantage of the treatment that's now made more available by the new insurance rules.

5 Things You Shouldn't Say to Someone With a Mental Illness

Why doesn't she just get treatment?
I've heard this said about people who are struggling in their work or lives because of mental illness, and it's often said with a great deal of judgment, and often said to others who have gotten treatment for their mental health challenges. First off - you don't know that this person isn't being treated. Finding the right treatment for mental illness can be difficult. Doctors often have to try several varieties before something works. And second - the illness itself can keep someone from getting treatment. For example, I have an anxiety disorder, which means that when untreated, I experience paralyzing anxiety about new situations. I couldn't overcome the anxiety of getting treatment until the need became greater than the fear. That took awhile. And finally, the stigma of being thought "crazy" can keep people from facing their illness. Or they may have their own stereotypes of mental illness, and not realize that they don't have to hear voices to be in need of help. It absolutely breaks my heart every time I hear of someone who is struggling but won't see someone; they need our love and understanding, not our judgment.

Have you tried ... (insert: yoga, meditation, therapy, getting a pet, etc.)? That always makes me feel better.
Mental illness is different than a lot of health problems, because the symptoms are often extreme versions of things everyone experiences. We all have anxiety sometimes - it was necessary to keep us alive in the evolutionary environment. But just because you've experienced anxiety, it doesn't mean that you can treat mine. For example, when I'm untreated, I have a crippling fear of talking on the phone. I have literally felt that I would die if I called a pizza place or a store to ask their hours. Even with treatment, I have been known to write out what I'm going to say on the phone. That's an extreme kind of anxiety, and it belittles my experience when you suggest that you know what will fix it.

Have you tried ... (insert those same things) instead of drugs?
Does anyone ever say to someone with the flu, "Have you tried meditation to get rid of that virus?" We don't (most of us, anyway) just say a prayer when someone is having a heart attack. We give the person aspirin and call 911. But for some reason, we think it's OK to suggest to people with mental illnesses that they shouldn't need medication. It's seen as a sign of weakness. 

Most people dealing with mental illness are incredibly strong people. They are going through terrible suffering, and still managing to live their lives, take care of their children, do their jobs. Why would we then suggest they should not have something that will improve their suffering?

You have to just face your fears.
As I mentioned, my fears are completely irrational. For example, I have very little anxiety about: spiders, public speaking, snakes, the dark, and most other things that are considered rational fears. But those things that make me anxious provoke a strongly physical reaction, almost a paralysis. I literally could not face my fears because I couldn't move. I've had students with selective mutism (a kind of anxiety disorder) who wouldn't speak in class, and who were harassed by teachers (even special ed teachers) and other students, urging them to talk. These kids can't just face their fears and start talking. 

There is a point where you can be helped by exposure to things that scare you, but it's usually not something that can just be done through force of will. 

You're just sensitive/special/extra caring/sad/nervous, etc.
Being depressed is not like being sad. Having an anxiety disorder is not like being nervous. Both have physical symptoms (like joint pain, lethargy, sleeplessness or over-sleeping...). This isn't something that's all in your mind. It's all over your body. And even when symptoms are primarily mental, this doesn't mean that someone is just being dramatic or overly-emotional. Depression can be triggered by things that are supposed to make you sad, like the death of a loved one or pet. Doctors can diagnose when someone is having emotional reactions that are proportional to events, and those that aren't.

These are just a few of the things people say that bug me. I hope that by having some open conversation, we can begin to de-stigmatize living with mental illness and come to accept it as we would any other health challenge.