Let’s Talk, Don’t Stop!

January 28th is Bell Let’s Talk Day. Kudos to Bell and all the people who participate in this event for the work they’re doing to help reduce the stigma of mental illness.

Working up the courage to step forward and admit to someone else that you’re worried you may have a mental health problem is one of the toughest things to do for many people. With continued efforts to reduce stigma, hopefully asking for help will be easier.

But what if you work up the nerve and ask for help, and get completely shut down?

Too often, that is exactly what happens. And if your concerns get dismissed out of hand, what then? It’s likely going to be a long time before you try to ask for help anywhere again. And that is a tragedy.

Things you Don’t Want to Hear

Below are some of the many things that have been said to people worried about their mental health, looking for help for the first time. And these are all coming from health providers, mostly physicians or in some cases mental health professionals.

“Don’t be silly, you’re fine”

This is likely to come from friends and family members, often parents, worried about the stigma of mental health and how being labelled might affect you (and them). But it can come from health providers too, whether they’re too busy, think you just worry about everything (helloooo…), or are themselves stigmatized or biased against dealing with mental health issues.

Of course, some times it is true that you’re fine. Most people aren’t experts at differentiating between emotions that are a normal part of human experience and those suggestive of mental illness. You’re asking for their expertise, and at the very least a conversation about whether or not your feelings are causing you problems is warranted. In fact, using that opening to probe deeper is prudent, as many people have a hard time talking about these things, and will downplay or minimize their symptoms.

If you’re approaching someone for the first time about mental health concerns, they should at the very least take you seriously. Most people don’t do this as a joke.

(Ok, some people may do it in a humorous manner, but that’s usually nervousness. And people who have been receiving mental health treatment for some time often develop a very biting sense of humour. But it’s certainly not there at first.)

“Psychiatrists are only for people with schizophrenia”

Yes, a family doctor actually said that to someone asking if it would make sense to speak with someone about a problem they were having.

Yes, many family doctors treat mental health issues, as do many other professionals. And yes, some psychiatrists are very specialized, and may see only people with certain types of disorders. But to suggest that psychiatrists in general don’t see people with more common mood and anxiety disorders is ludicrous.

“Here’s a prescription”

You unburden yourself after feeling for months that your life is falling apart, and that’s your doctor’s answer? Take a pill?

This is worth exploring in more detail another time, but that’s no way to respond to someone. Medications may well be the right answer, but they definitely need to be placed in a larger context. If that’s all you heard, you’re certainly not going to feel like you were taken seriously or listened to. And most people, rightly so, are probably hesitant to jump into mind-altering drugs without some education.

Yes, family doctors are busy. But really? You deserve better than that kind of response.

“Go see a counsellor”

Again, this needs to be put in context. As I’ve talked about before, there are lots of different types of mental health professionals, but knowing which one is right for you, and being able to financially or otherwise access them is often difficult or impossible.

Without any context, and some pointers in a particular direction, you’re probably going to get stuck, and feel about as good as you did if a prescription was shoved in your face.

“Well at least you don’t have cancer”

Possibly one of the most ignorant and dismissive things you could say to someone struggling with mental health issues.

“Get some more exercise and you’ll feel better”

This may well be true for some people, but certainly not for most. If that (or any other “quick fix”) is the answer given when you first approach someone, they haven’t been listening to you.

It’s true that exercise can be helpful for many people with mild-moderate depression. I know personally it delayed me needing to start antidepressants for a year or two, and keeps the dose I need lower than I would need without exercise.  But that’s several steps down the road, after some basic things like investigating the exact nature of your problems, and perhaps trying to find out what may be causing them.

“You should go to church”

Yes, some people take comfort in religion (for the record, I’m not one of them). And while I won’t downplay that, it has its limitations. Mental illness is a health issue. And to turn a previous question around, “would you go pray as the only thing you do if you have cancer?” And yet, some people still do.

Speaking to a religious or spiritual leader may be helpful, but like any other type of counsellor, you have to understand their background and training. While many clergy are getting better at recognizing legitimate mental health concerns and redirecting people appropriately, many have absolutely no knowledge or training in this area whatsoever. I’d rather not take my health on faith. And if the words “sometimes exorcisms are appropriate…” cross their lips, run.

“You must have done something wrong”

Otherwise known as “it’s all your fault.”

It’s truly amazing how often people get confronted with this, again often from family and friends, but there are even some health providers who will respond to certain types of mental health issues (e.g. some personality disorders) in this way.

Blaming people is not the answer, and shows just how far we still need to go in terms of education. Or how many people make themselves feel good by putting other people down. Mental health blogger Natasha Tracy describes this far better than I could.

“It’s all just in your head”

Technically, this may be mostly true (though you’d be amazed how much serotonin you can find in the intestines). But what people are really saying is that you’re imagining things, and that you don’t have a real health issue.

This is an obstacle for a lot of people, in the sense that there’s no blood test or diagnostic imaging investigation that will provide a mental health diagnosis. Without such “objective” evidence, it can’t be real, can it?

Yes it can. Very, very real.

“Just suck it up, you’re not even trying”

This often comes from people (including some doctors) who think that you’re consciously choosing to feel the way you’re feeling, and that if you just decided to, you could “snap out of it.” Again, this is one of the things that separates normal fluctuations in mood from mental illness.

In lieu of rebutting this, I’ll share one of my favourite cartoons on the matter (see original source):

Don’t Stop Talking

Talking about your mental health concerns is the first step.

But sadly, you’re not always going to get a respectful and helpful response.

If that is the case, remember that you’re not alone. There are still too many barriers to accessing good mental health advice and care, and it’s too easy to get discouraged. It may not be easy, but try again. Keep asking for help.

You may or may not have a diagnosable mental illness. But there are trained professionals out there that can help you determine that, and what to do next.

Remember, whatever your mental health symptoms get labelled, if they are affecting your quality of life, it’s a problem.

Keep talking.

Don’t stop.