Many friends and family members don’t understand mental illness

Lately, I’ve been working as an independent psychiatric assessor, interviewing people who are off work for reasons of mental health. I’ve been learning a lot from the experience, including some telling details about the reactions of friends and family to people who are experiencing mental health conditions.

The majority of the people I assess are doing quite poorly. They’re unable to function, both at home and in the workplace. They want to get on with their lives but without the proper diagnosis and treatment, they just can’t. Many of them have a history of childhood trauma which has made them more vulnerable to stress in their adult lives. Some have a family history of mental health conditions.

Many of the people I speak to have more than one mental health condition, including major depression, generalized anxiety disorder, post-traumatic stress disorder, obsessive-compulsive disorder, personality disorder, and/or an eating disorder. Many have severe insomnia and/or problems with addiction.

Sadly, I’ve found that a significant number of loved ones have a limited understanding of mental illness and minimal awareness of the signs and symptoms of mental health conditions. They often lack patience or tolerance toward the person who is suffering, which only increases the person’s shame and guilt about having a problem.

People who are suffering think they should be able to “shake it off”

I have found that many people who experience mental health challenges feel like they should be able to talk themselves out of their condition. Many think that they’re “weak” or “stupid” for failing to do so. The truth is that they’re failing because it’s not possible to talk themselves out of a mental health condition.

In fact, one of the ways we know that someone has a mental illness is that they can’t talk themselves out of it. When the person can’t force themselves to “cheer up” or to “calm down,” or to “think positive” or to “get some sleep;” when they can’t “just stop” their dysfunctional behaviours, that’s when we know it’s about more than simply having a really bad day.

Pretty much anyone can shake off a bad day. No-one can shake off a mental health condition, once it has set in.

People with mental health challenges need support and understanding

The people I assess have told me that their spouse has complained that they’re not attending to the household chores when they don’t even have the energy to take a shower or make themselves a meal. Some people have told me that their parents were angry at them for spending the whole day in bed, while they’re lying there, overwhelmed by thoughts of death or paralyzing fears.

People who are dealing with mental health conditions need our support and our understanding. Friends and family members need to educate themselves about what mental illness looks like and how it affects a person in the short term and in the long run. They need to resist criticizing the individual who is suffering for not doing the things that their mental illness has prevented them from doing.

As I mentioned in a previous article about how to talk to someone with depression, things that friends and family members shouldn’t say include “snap out of it,” “you brought this on yourself,” “it’s not so bad,” and “it’s going to be okay.” They also shouldn’t call the other person “lazy” or “unreasonable” for being unable to cope with the normal stresses and responsibilities of life.

The problem with mental illness is that the affected individual doesn’t necessarily look “sick.” The condition is in their brain, not their body, so they don’t necessarily manifest the signs of illness that we expect to see in someone who is unwell. That doesn’t mean that they’re not suffering from a real condition—one that is not going away on its own.

Offering someone a diagnosis is an acknowledgment of their suffering

My role as an independent assessor is to provide a diagnosis and make treatment recommendations to the person’s primary care provider. Once a diagnosis is established, it is much easier to gear the treatment to the specific condition (or conditions) affecting the individual. I will often recommend a combination of medication and talk therapy, and sometimes I’ll suggest a rehabilitation program as well.

Even though these are diagnostic interviews as opposed to psychotherapy sessions, many of the people I speak with feel a profound sense of relief by the end of our conversation. This is because I’m taking their problems seriously. Usually, I’m telling the person “yes, you do have a real problem. No, you’re not imagining things. And FYI, it won’t go away on its own.”

This is reassuring to the other person because it enables them to let go of some of the guilt and shame they’ve been carrying, and it empowers them to ask for more respect, tolerance, and understanding from their loved ones.

We can all do better in our dealings with people who experience mental illness. Bell’s Let’s Talk Day is coming up, so I invite everyone to inform themselves and to become better allies to the people in their lives who struggle with mental health conditions. I invite you to sit down and talk to the person who is suffering and to ask them how you can better support them, now and in the future.

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