How to talk about mental health in a way that’s actually helpful


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Sometimes, when I know I’m going to have to talk about my mental health with loved ones, I prepare like I’m heading into battle. I load myself up with mantras for calm, consider the facts I need to know, and affix it all like armor to deflect from well-meaning but destructive utterances. So many people don’t have the language for how to talk about this stuff, and it often results in everyone feeling a little bit more terrible than they did before.

This year, for instance, I worked through one of the worst depressions of my life—it lasted a year, and I felt as though I was drowning, constantly. Living across the country from most of the people I love means their understanding of my mental space hinges almost entirely on my ability to communicate it in a way they’ll understand—a way that doesn’t make them worry or feel as though they need to say the “right” thing.

So, I consulted with my family, friends, and New York-based behavior analyst Makenzie Sandler to figure out how to avoid the seemingly innocuous conversational pitfalls that stop mental health discussions in their tracks.

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Don’t: Offer unsolicited advice

This one can be hard, as it feels almost hard-wired into how we as people communicate. But sometimes it does more harm than good. “Most times, the person does not want your advice,” Sandler cautions. “Pause and reflect before you spew out your well-meaning recommendations. Did the other person specifically ask you what they should do? If not, keep it inside, or if you feel so compelled, at least ask before you offer.”

But why? To be frank, it often makes people feel as if they are incapable or dumb. “Unfortunately, this sort of situation is going to happen, regularly,” Sandler warns. To circumnavigate it, she suggests coming up with a few responses that acknowledge their words but don’t infringe upon your own boundaries (more on those later). Think of ways to thank the person for trying, without obligation yourself to do what they’re suggesting, she says. “For example, ‘Thanks for your thoughtful recommendations,’ or ‘I’m so glad that worked for you and you feel comfortable sharing with me. I’m not ready to take others’ advice, but I will ask you when I’m ready.’”

Don’t: Tell them “everyone feels this way”

Similar to unsolicited advice, the phrase “everyone feels this way” seems like a positive—but it can backfire, spectacularly. Sometimes this is absolutely the way to go: Lots of people just don’t want to feel alone. But what feels like a very supportive phrase—You’re not alone! So many people are dealing with stuff just like you! And if they can do it, so can you!—can sound like, “Everyone feels this way and they’re surviving. Why aren’t you? What’s wrong with you?” to someone living with mental illness.

Sandler suggests considering the situation and your relationship to the person first: “Often, it is recommended to avoid the motivational ending to the supportive phrase. Stop while you’re ahead. ‘You’re not alone’ is enough most of the time.” And it’s important, she reasserts, to constantly assess how the person you are talking to is reacting to your words. “Did they smile and say I know, thank you. Or did they bow their head with no indication of lifting their spirits?”

“‘You’re not alone’ is enough most of the time.” —Makenzie Sadler

So how do we make someone feel less alone in their grief without making them feel incompetent? A supportive personal and relatable statement such as “I’m always here to talk,” “You’re not alone,” or “This sucks, I’m here for you” is often the way to go, she says. However: “Avoid the phrase, ‘I hate to see you this way, what can I do?’ If the person didn’t already ask you for something specific, then they don’t know what you can do for them.”

Don’t: Ask too many questions

When someone is struggling with their mental health, they’re often in a fog they don’t understand, and knowing what they want or need can be tricky. Sandler suggests offering things rather than asking, since “decision-making and problem-solving [in this state] are not easy.” Instead, she suggests being specific: “Like, ‘I’m coming to pick you up tomorrow night and we’re going to the diner,’ or ‘I’m going to call you after dinner tonight just to say hi.’ This gives the person the opportunity to say no thanks, but also reminds them they have someone there for them.”

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Do: Set healthy boundaries

Sometimes, you’ve just reached your limit on discussing big, heavy topics, and you need a time out. So how do you set boundaries without hurting the other person’s feelings? “Try to evaluate which boundaries are permanent for your well-being and which are temporary,” Sandler told us. “This will help you frame them when communicating with others. Sometimes you need a hiatus from an emotionally difficult or effortful relationship, but you know you’ll come back to them. Other times, you need to permanently remove yourself from a toxic environment or relationship.”

This can be hard to accomplish when you constantly feel as though you are a burden (as mental illness so often does). Sandler suggests compassion for yourself in these moments especially.

“It’s a process and mistakes will be made. Setting boundaries temporarily or permanently is hard! Take it one step at a time and be proud that you’re respecting yourself,” she says, adding: “Remember, you are not a burden.”

Do: Be as clear as possible about expectations

Words matter, and how you’re speaking matters, regardless of what side of the conversation you’re on. This is, perhaps, where the most unintentional slip-ups happen: People feel as though “real” feelings are being transmitted through subtle actions, words, or even body language.

“It’s important to take frank stock of the situation both you and the people you’re talking with are in, emotionally and personally,” explains Sandler. “Find out what’s important for the other person, and see if this a good time both literally and emotionally. If you know the intent and main interest of the conversation, it removes guessing, awkward interactions, and feelings of not being heard. A kind and thoughtful example may be to say something like, ‘I want to hear you and not misinterpret your feelings or needs. Do you want me to just listen or are you hoping for something specific from me?’”

Checking in with the person to see if they have the mental energy or capacity to have the conversation in the first place does wonders.

Checking in with the person to see if they have the mental energy or capacity to have the conversation in the first place does wonders, too. Don’t go overboard with it—that can be patronizing, put people on the defensive, or just plain make ‘em nervous. But simply recognizing the other person in this way makes everyone feel considered, and provides context for you and the person you’re talking with, meaning everyone communicates better.

Do: Steer clear of comparisons

It’s easy to try and equate two situations in order to provide perspective. But sometimes these sort of comparisons do more harm than good. Sandler suggests avoiding them—or at least understand where you’re coming from. “The further you are from truly feeling or experiencing what the person is feeling, the more likely your comparison will backfire. Do not force a story to attempt to relate or share compassion,” she says. “The more you listen and imagine what they experienced, or how they are feeling, the less compelled you will be to share your experiences. Strive for compassion, move away from pity.”

But how do you try to relate to people living with mental illness without sounding like you’re minimizing their pain? This is difficult, Sandler admits. “Stigma runs rampant in our society and mental illness education is severely lacking. People living with mental illness are often treated differently. This is not always bad or negative, and sometimes is just avoidance. The two best ways to try to relate to people living with mental illness is to first see them as a person and second educate yourself…If you see them as a person first, you’ll be able to relate more naturally to experiences rather than attempting to figure out what is going on internally that they are most likely also struggling to understand.”

Something that’s stuck with me recently is an idea I read in Brene Brown’s book, Rising Strong, about approaching every situation in life with the mindset that “everyone is just doing their best.” It’s a perspective shifter that isn’t all that original (I’m sure I heard something similar on Mister Rogers’ Neighborhood as a child)—but it’s no less important.

Talking with your loved ones about mental health doesn’t have to be as hard as it currently is: with grace and patience as we look towards shared understanding, things can get better.

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