I don’t remember much from my brief hospital stay in the summer of 2007, but a few things remain with me:
Waking up in an ambulance after an overdose of lamotrigine. An ER doctor abruptly insisting I have bipolar disorder (I don’t). Struggling to walk to the bathroom, my body like goo. The curt send-off of a resident, who told me I needed to take more responsibility for my life.
And after, the secrecy and shame. A relative telling me how much I was hurting the people I loved. The tacit understanding among family and friends that this wasn’t something to be shared or talked about.
These memories have mostly served to reify my fear of reaching out, because even those in the medical community — those meant to be healers — can truly miss the mark.
As someone living with major depressive and obsessive-compulsive disorder, I see firsthand how people struggle to make things better for me: how hard they try, how they trip over their thoughts and intentions, and how often they get it wrong.
I know it can be daunting to interact with someone who lives under the weight of mental illness, even (or especially) when they’re near and dear to you. People usually try their best, but some ideas and behaviors are actively harmful, even when they are (or seem) well intended.
Speaking mostly from my lived experience (and not as Supreme Leader of the Depressed), here are some thoughts on common mistakes to avoid.
1. Giving uninformed or unsolicited medical advice
A few years ago, I saw this meme floating around the internet concerning nature and mental health.
It was made up of two images: a group of trees (which all depressed people hate! We hate them!) with the words “This is an antidepressant,” and another photo of some loose pills with the words “This is shit.”
You know what’s shit? That entire mindset.
Treatment is often more complex than people realize. Therapy, medication, and self-care all have a place in recovery. And for some of us, that medication can be life-giving and even lifesaving.
We take medication to help us get out of bed in the morning, empower us to make better decisions, and to be able to enjoy our lives, our relationships, and yes, even trees!
It’s not, as some have suggested, a “cop-out.”
Our brains need different things at different times. It’s damaging to suggest we’re failures for using a form of care you personally don’t need. It’s a little like saying, “Oh, you’re depressed? Well I cured my depression with air, ever heard of it?”
There’s often a sense that needing this kind of support is a sign of weakness, or that it makes us lose touch with who we are. Medications come with side effects, yes, but they can also be a crucial part of mental health treatment.
It’s hard to advocate for ourselves, however, when loved ones and strangers engage in pill shaming.
And by the way? People with depression aren’t completely unaware of nature. We’re not, like, “Sorry, what in the sweet hell is that?” when we see a plant. We’re also not ignorant of the benefits of nourishing food and moving our bodies.
But sometimes, that’s too much to expect of someone with a mental illness, and it often just intensifies our existing feelings of guilt and shame. It’s insulting to imply that if we went for a walk and downed a glass of celery juice, we’d be alright. (Besides, many of us have already tried these things.)
Healthy behaviors can certainly help us. But using language that pressures or insists it will cure us isn’t the way to go. Instead, if you want to be of service, ask what we need from you. And be gentle with your suggestions and encouragement.
2. Contributing to public discourse on suicide
In her article for Time, journalist Jamie Ducharme unpacks research done in 2018 about how media professionals report on high-profile suicides.
“Exposure to suicide,” she writes, “either directly or through media and entertainment, may make people more likely to resort to suicidal behaviors themselves. The phenomenon even has a name: suicide contagion.”
Ducharme states that suicide contagion occurs when headlines include “information about how suicide was completed and statements that [make] suicide seem inevitable.”
All social media users (not only journalists) have a human responsibility to consider what they’re adding to the conversation.
The World Health Organization website offers a list of
For social media users, this could mean retweeting or sharing news stories that don’t follow these suggestions. Many of us have quickly clicked “share” without considering the impact — even those of us who are advocates.
The Recommendations for Reporting on Suicide also has an excellent resource for this. Instead of using photos of grieving loved ones, for example, they recommend using a school or work photo, alongside a suicide hotline logo. Instead of using words like “epidemic,” we should carefully study recent statistics and use proper terminology. Instead of using quotes from police, we should seek advice from suicide prevention experts.
When we talk about suicide on social media, we need to be sensitive to those on the other side, who are receiving and trying to process our words. So, when you post, share, or comment, try to remember that those who are struggling may read your words, too.
3. Too much talk, not enough action
Each January in Canada, we have Bell Let’s Talk, a campaign from the telecommunications company to raise awareness and reduce stigma around mental illness.
Bell has committed to raising $100 million for Canadian mental healthcare. It’s the first corporate campaign to do this work in Canada. While the company’s efforts might be benevolent, it’s important to acknowledge it’s still a corporation that benefits greatly from this publicity.
Truthfully, movements like this can feel like they’re designed more for neurotypical people who have “bad days too.” Mental illness isn’t often pretty, inspiring, or Instagrammable in the ways these campaigns would have you believe.
The whole idea of encouraging people to talk, to end the stigma around discussing mental health, does little if there isn’t a system in place for us when we do start talking.
It took me about a year to get in to see my current psychiatrist in 2011. While my home province of Nova Scotia is working to improve wait times, this is a very common experience for a lot of people in crisis.
This leaves us relying on people, including general practitioners, who aren’t equipped to help us or able to prescribe necessary medications.
When encouraging people to open up, there needs to be someone on the other end who’s capable of listening and helping to secure timely, competent treatment. This shouldn’t fall on friends and family, as even the most compassionate layperson isn’t trained to assess these situations and react appropriately.
With only 41 percent of American adults accessing mental health services for their illnesses, and 40 percent of Canadian adults in a similar boat, it’s clear there’s more work to be done. People with mental illnesses need more than your awareness and your permission to talk. We need real change. We need a system that doesn’t retraumatize us.
4. Telling us to ‘put things in perspective’
“It could be much worse!”
“Look at everything you have!”
“How could someone like you be depressed?”
Dwelling on someone else’s more severe and unfathomable pain doesn’t alleviate our own. Instead, it can come across as invalidating. Having a strong appreciation for the positive elements of our lives doesn’t erase the pain we’re going through; it doesn’t mean we’re not allowed to want things to be better, both for ourselves and others.
In-flight safety videos instruct you to secure your own oxygen mask before helping anyone else (usually a child). Shockingly, this isn’t because flight attendants hate your children and want to turn you against them, too. It’s because you can’t help someone else if you’re dead. You have to tend to your own garden before showing up at a neighbor’s house with a hoe.
It’s not that those of us with mental illnesses aren’t altruistic, compassionate, and helpful. But we need to take special care of ourselves. This requires a lot of energy.
A more effective approach might be to remind us that feelings come and go. There were better times before, and there will be good times ahead. Behavioral scientist Nick Hobson refers to this as “pulling yourself out of the present,” meaning instead of trying to compare our struggles with those of someone else, we try to contrast how we feel now with how we might feel in the future.
How are things likely to change? How might we be better equipped to deal with these emotions later on?
Practicing gratitude can be helpful. It actually affects our brains in a positive way by releasing dopamine and serotonin, which is cool. However, bluntly telling us to be thankful for our situation is not cool, for the same reason.
Instead, try reminding us of the positive contributions we make and the people who love us. These affirmations won’t cure us, but they can contribute to positive self-regard, and gratitude might follow.
5. Not checking your performative empathy
I understand what it’s like to see someone in pain and to not know what to say or do. I know it can feel jarring and uncomfortable.
No one is asking you to completely relate, though, because not everyone can. Saying something like “I know how you feel. I get down sometimes, too. Everyone does!” tells me you don’t really understand clinical depression. It also tells me you don’t see me, or the chasm that exists between my experience and yours.
This makes me feel even more alone.
A more useful approach would be to say something along the lines of: “That sounds really hard. Thank you for trusting me to talk about this. I can’t fully understand, but I’m here for you. Please let me know if there’s anything I can do to help.”
So, what can you do instead?
Help can look a lot of different ways. It might be listening as we talk through it or simply holding space for us and sitting in silence. It might be a hug, a nourishing meal, or watching a funny TV show together.
The most important thing I’ve learned about being present for someone ill or grieving is that it isn’t about me. The more I get caught up in my own ego, the less helpful I am.
So, I try instead to be a calming influence, to not insist or project. To allow someone to experience the weight of it all and to bear some of that weight with them, even if I can’t take it from them entirely.
You don’t have to have a solution. No one expects that of you. We just want to feel seen and heard, for our suffering to be validated.
Supporting someone with a mental illness isn’t about “fixing” them. It’s about showing up. And sometimes, the simplest gestures can make all the difference.
JK Murphy is a feminist writer who is passionate about body acceptance and mental health. With a background in filmmaking and photography, she has a keen love of storytelling, and she values conversations on difficult topics explored through a comedic perspective. She holds a degree in journalism from the University of King’s College and an increasingly useless encyclopedic knowledge of Buffy the Vampire Slayer. Follow her on Twitter and Instagram.