I appreciate people who ask questions about mental health struggles – it shows that they care enough to dig a little deeper and are trying to understand. I should clarify here that I know some people ask questions because they are fed up or at their wit’s end. I would argue that as long as they have the patience to listen to the answers, those are still valuable questions.
Why is it important to ask questions? Because mental illness affects everyone. It affects those on the inside, as well as those on the outside looking in. In 2017, 43.7 million adults in the US suffered from some sort of mental illness (MHA, 2018), which means that chances are pretty high that if you don’t suffer from one, you know someone who does. According to a journal article from World Psychology, “Many people with serious mental illness are challenged doubly. On one hand, they struggle with the symptoms and disabilities that result from the disease. On the other, they are challenged by the stereotypes and prejudice that result from misconceptions about mental illness” (Corrigan & Watson, 2002).
Misconception: “A conclusion that’s wrong because it’s based on faulty thinking or facts that are wrong” (n.d.)
You might argue that a journal article from 17 years ago isn’t relevant anymore. Coming from someone who suffers from depression and anxiety, I can tell you that statement is still incredibly relevant. Stigma is a toxic byproduct of misconception, which is the direct result of lack of education. The National Alliance on Mental Illness reports that “stigma and misunderstandings about mental illness prevent families from facing the problem and seeking help” (NAMI, 2019). On the other hand, “education provides information so that the public can make more informed decisions about mental illness” (Corrigan & Watson, 2002). How does education happen? By asking questions.
Question: “A sentence or phrase used to find out information” (2019).
With all this in mind, I thought I would share some of the questions that get asked of me. Some I hear on a regular basis…some I’ve only heard once or twice. All are welcome. I urge you, though, to always consider how you pose your questions. You know the old adage – it’s not what you say, but how you say it. Due to the stigma that surrounds mental illness, it’s easy for some people to get defensive. This is due to the fact that they have likely been bullied growing up or have experienced less than compassionate interactions with the public and health providers as adults. The uneducated masses can be horribly unkind. If someone doesn’t seem comfortable answering questions, don’t push the matter. It might be a trigger for them. I would like to think, though, that open minded people would be willing to share their experiences for the sake of education. As mentioned before…that is the only way to end the stigma. It can all start with one person asking one question and waiting to hear the answer.
These FAQs are in no particular order. I am typing them as they come to mind. Bear with my stream of consciousness.
Is it okay that I don’t know what to say?
This was asked of me very recently by two different women who mean the world to me (my mom and my aunt). It was striking to me how similar and genuine the sentiment was in each separate conversation. The answer is quite simple: Yes, it’s okay that you don’t know what to say. No, it does not add to my anxiety that you don’t know what to say.
One of the difficult lessons I have learned over the last few years is that if someone has never experience anxiety or depression (or any other mental illness, for that matter), they will never truly understand. By this I mean truly empathize. You can still try to understand what I’m going through from an education standpoint, without actually knowing how it feels to be depressed or so anxious you don’t even want to leave the house.
It’s okay to not fully empathize or understand exactly what I’m going through on an emotional level, which means it’s okay to not know what to say. Most of the time I don’t even know what to say, so how could I place different expectations on anyone around me? Compassion and a little grace are all I ask for when words fail. Don’t put pressure on yourself to come up with some Hallmark greeting card sentiment. And certainly don’t put pressure on yourself to say something that will make this whole thing better – that’s what medication and therapy are for!
Is it okay for me to laugh while reading your blog or is that insensitive?
Please laugh! I deal with stress, pain, and general unease with humor. I’m sure it’s hard sometimes to know exactly how to take some things I pen, especially if you don’t know me on a personal level. But if I’m making fun of myself, I am doing so to show the world that life is too short and too important to be taken seriously. Some days, poking fun at my own depression is all that gets me through the day. Laugh with me…just don’t laugh at me. There’s a difference.
Have you thought about seeing someone for this?
I get this one ALL. THE. TIME. Here’s the thing: therapy is expensive. If I could sit down and talk to a professional once a day, I would. We live in a society that doesn’t take mental health coverage seriously. We live in a society where 3 therapy sessions are considered adequate for many Employee Assistance Programs. For someone with chronic mental health, routine therapy sessions can be very unkind to the pocket book. Although I just started seeing a new therapist a month ago, I realized it’s not a financially viable option for me long term. This is the world that we live in. When therapists charge $100/hour (as they should…they have so much expertise and education backing them up), but insurance waves my high deductible in my face, guess who doesn’t go to therapy?
That was a long, somewhat bitter way of saying that yes…I have thought about seeing someone. I’ve thought about it a lot throughout some of my emotionally traumatic experiences in the last few years. When you think about bringing this up to someone, do so with sensitivity and keep in mind that it’s not as easy as finding a therapist you mesh with and having coffee with them. Oh how I wish it were that easy. Remember that there are often extenuating circumstances that prevent ongoing therapy. If someone isn’t going, don’t assume it is because they are lazy or in denial. Maybe someday mental health benefits will be where they need to be. Until that day, I fight my battles without the help of a professional counselor.
What do you do when you are stuck obsessing over something?
When I begin to experience obsessive anxiety, it can quickly spirals out of control. It sometimes gets to the point that I can’t focus on any task at hand. My mind goes into hyper-analysis mode and starts exploring all the worst possible outcomes to whatever situation has caught my eye so thoroughly. Often I know that I am being irrational, but by then it’s too late. Usually, the key for me is to pull someone I trust aside, explain to them what I’m worrying over, and let them talk me off the proverbial cliff. Sometimes it takes talking to a “normal” person (i.e. someone who doesn’t have irrational, obsessive anxiety) to realize that everything will be okay.
I’d like to quickly draw your attention back to the phrase someone I trust. I have learned over the years that not everyone is willing to talk you down. Not everyone is capable of understanding what obsessive anxiety is. They don’t want to acknowledge that, while I know my fears are unfounded and irrational, I can’t stop the invasive thoughts that interfere with just about everything except breathing. Sometimes even breathing is threatened! The trusted people in our lives are often family members, significant others, or close friends. It becomes easy to go to these people over and over, which can unfortunately become frustrating for them. In my experience, my significant others are the ones who become most hard on me and tell me to “just stop worrying” or that “obviously that won’t happen…forget about it.”
In those moment of blind panic, having someone say “you worry too much” is the most defeating answer to my cry for help. What I need is this: don’t point out how crazy I am. Instead, walk me through the reasons that the expired macaroni and cheese I just ate isn’t going to kill me. Walk me through the reasons why driving up over a curb unintentionally isn’t going to cause Armageddon to fall down upon us. Although my extreme anxieties may seem silly and irrational to you, please acknowledge that for me, they are very, very real. When everything is out to get me, a patient person who is willing to talk me off the ledge is the most helpful thing I can ask for.
Does it help to talk about it?
See above. For me, it helps for a number of reasons. 1) It gives someone the opportunity to talk me down, 2) it helps me feel like I am spreading education, and 3) it is an outlet when I have been bottling up emotions and fears.
One thing I will add here is that I am a much better communicator through the written word. Talking in person can be incredibly difficult for me. I fumble for the correct words, forget what I am saying mid-sentence, and trip over my own tongue. This generally triggers my social anxiety and things just go downhill from there. If I struggle to express my feelings to you verbally, don’t think it’s because I don’t know what I want to say. It’s usually because I need to write it down first.
Is all that medication really necessary?
For some people, medication works better than any other forms of treatment. If you remember that mental illnesses are due to genetic makeup and chemical imbalance in the brain, you have to view it as a physical disease, not just an emotional disorder. Would you go up to someone with cancer and say, “Do you really feel that chemo is necessary? Have you tried meditation instead?”
So my educational takeaway is this: I wouldn’t put chemicals into my body – chemicals that have almost certain side effects – if I didn’t feel it was necessary for my sanity and survival. My psychiatrist started me on a mood stabilizer a couple months ago. I can quite confidently say that it saved my life. I take antianxiety/antidepressants so that I can go out in public and function on a daily basis. I take sleeping medication so that I can get a decent night’s sleep, which raises my threshold for both anxiety and depression. There is a method to the madness. Instead of asking someone if all that medication is necessary, it might be better to ask what the medication is for. You might be amazed by how much you learn!
Are text messages an impersonal way to check in on you?
I hate talking on the phone. The awkward silences (most often caused by my verbal constipation) generate an insane amount of anxiety and distress for me. I most certainly do not consider it impersonal to reach out to me via text. Just the fact that you are reaching out is enough to bring some light to a potentially very dark day.
Can’t you just stop worrying?
Let’s talk about this one. I get it a lot. I mentioned earlier that it is usually the people who are closest to me – who live with me on a daily basis – who start to push this question to me. My very first serious boyfriend gave me a book on my birthday about how to stop worrying. Each significant other after him proceeded to tell me to just stop worrying so often that it got to the point that I felt I couldn’t talk to them about anything. I felt shut down inside a relationship that should be a safe place.
That being said, this can still be a valuable question…but only if you listen the first time or two it is answered. Try to keep in mind that I don’t choose anxiety for the sheer joy I get out of it. No. It is a devastating illness that spreads into every area of my life. If I could just flip a switch and turn it off, I would do that. As you seek to further educate yourself and ask more questions about your loved one’s mental illness, this question should answer itself. It is not a choice.
Does being around other people help?
It depends on my mental state, so that answer may change from one hour to the next. Sometimes I want to be in the company of people I care about for an afternoon or evening. Sometimes I want to barricade myself in my apartment and not come out for days. If you ask someone with anxiety or depression to come out with you and they say they aren’t feeling up for it, it doesn’t often help to say something like “Oh come on…it will make you feel better.” I can tell you that in my experience, depression and chronic anxiety are EXHAUSTING. There are times where the mere thought of going out in public brings me near to tears because I don’t have the energy. I’m not saying no simply because I’m feeling antisocial or don’t like you anymore. I’m saying no because my very sanity depends on it. The same applies if I come over and end up leaving after only an hour or so. I get overstimulated and anxious, even when I’m with people I know and love. If I suddenly stand up and say I need to get going, don’t try to change my mind. Instead, acknowledge that I know my limit and I have reached it. The only thing more exhausting than facing the world is feeling guilty for not having the energy to face the world.
How are you today?
I can never actually tell if people ask this because they genuinely want to know or if it’s just to be polite. I fall into the category of people who tends to say “Fine, how are you?” instead of being honest. It causes me a lot of anxiety to think about opening up to someone in the elevator when all they were doing was acknowledging my presence.
When it’s obvious that someone is asking because they genuinely want to know, sometimes it’s enough to make me cry. If you are honestly worried about someone and are concerned that they are a danger to themselves or others, try to press a little bit when they only want to give you the standard “I’m okay” answer. Don’t be bossy. Just encourage them that you are there for them. It may be the tree root that that person is able to grab as they plummet off the cliff.
Have you considered [insert diet or health trend here]?
I think even the most sane and mentally healthy people would tell you that diets are difficult to follow. They would also tell you that if you stick to it, they can be wonderful stepping stones to a healthier you. I’ve considered a couple different diets recently, based on the positive results people experience on a physical, mental, and emotional level. While I am of average build and don’t necessarily need to lose a lot of weight, it’s the lifestyle change that appeals to me. So why didn’t I do it? I realized that the diet plans I was looking at involved strict self-control, a ton of meal planning, and denying myself some of life’s simple comforts. Pretty much describes any diet, right? Exactly.
What I realized is this: my perception is that I have failed at so much leading up to this point, so why would I set myself up to fail something else? One of the diets allows no alcohol, but I’ve learned that every now and then a glass of wine is exactly what I need to take the edge off. I am not an emotional eater, so why should I put so much added pressure on myself when I am in such a delicate emotional state? It was an important lesson is acknowledging and respecting the fact that there is a time and a place for everything. Maybe in a year or two I can say goodbye to alcohol and carbs for 30 days. Until then, my self-care inner voice is telling me to enjoy a piece of cheese, savor a Dr. Pepper, or nibble on an Almond Joy if I need to. All good things in moderation, right?
You know you can call anytime, right?
Depression does not foster a proactive mentality. I understand that I am surrounded by people who are only a phone call away. However, usually when I am in a bad enough place that I truly need to talk to someone, I have become numb to that option. If I am in a bad place, I don’t deny that I can call people. What my mind and body deny me is the energy to do so. The idea of explaining my mental state seems like too much to bear. Just picking up the phone seems exhausting.
On top of that, I don’t want to be a burden. I know that everyone has their own struggles. I often don’t feel that I am worthy of placing more to their list of worries. That does nothing but make me feel guilty, which pushes me deeper in depression and higher into anxiety. Sometimes it is easier to just curl up in a ball and cry my way through it.
Thank you to everyone who remains just a phone call away, though. I hear you.
How do you put yourself out there like you do in your blog?
It’s all for the sake of education for every player in this elaborate story that is mental health. I don’t do it for attention or pity or accolades. One of my new favorite quotes is this: “I hope that if you read yourself in my story, it will hold up a mirror for you” (Hollis, 2018, p. 53). If putting myself out there for all the world to see – the good, the bad, and the ugly – helps one person realize that they have worth because of their unique struggles (not in spite of them!) or helps one family member better understand what their loved one is experiencing, then it is worth it. Ending stigma and misconceptions are worth it.
Corrigan, P. & Watson, A. (2002). Understanding the impact of stigma on people with mental illness. World Psychiatry. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489832/
Hollis, Rachel. (2018). Girl, Wash Your Face. Nashville, TN: Nelson Books.
MHA. (2018). 2017 State of Mental Health in America – Prevalence Data. Mental Health America. Retrieved from http://www.mentalhealthamerica.net/issues/2017-state-mental-health-america-prevalence-data?gclid=EAIaIQobChMIyvvR-I-A4AIVj8DACh0BhAzkEAAYASAAEgILffD_BwE
Misconception. (n.d.). Vocabulary.com. Retrieved from https://www.vocabulary.com/dictionary/misconception
NAMI. (2019). Family Education and Support. National Alliance on Mental Illness. Retrieved from https://www.nami.org/Learn-More/Mental-Health-Public-Policy/Family-Education-and-Support
Question. (2019). In online Cambridge Dictionary. Retrieved from https://dictionary.cambridge.org/dictionary/english/question