What to say and what not to say to someone with a mental illness

Posted on 11/14/19 10:30:am


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When a friend or loved one is dealing with a mental illness, you may be at a loss for what to say. You want to offer comfort and support but may be worried about how your words will be interpreted. Sue McKenzie Dicks, vice president of healthy culture at Rogers, shares some of the most common mistakes of what not to say, as well as supportive things to say to help your loved one feel accepted and appreciated as they navigate their mental health problems.

What to say to someone with a mental illness

1. "Do you want to talk about it? I'm always here for you."

Even if you don't entirely understand what your friend or loved one is going through, you can still be there for them in a healthy, supportive way. Listen to them without judgment and make sure they know they're not alone. It's also important to let your loved one lead the conversation so you're able to talk about topics they feel comfortable discussing. "Follow and support rather than lead and advise," explains Sue.

2. "What can I do to help?"

If your loved one has had depression or anxiety for a while, chances are they probably know what does and does not help them. Even if they just need help with something simple like laundry or grocery shopping, offering help lets them know you care.

3. "That sounds really difficult. How are you coping?"

Acknowledging how they feel is both validating and comforting. It reminds your friend that you are listening to them, that you believe that what they're going through is real, and that you want to help them cope.

4. "Let's go somewhere quiet or take a walk"

In times of extreme anxiety, it can help to try a grounding activity, like going for a walk or finding a peaceful place to talk. Grounding activities can be done alone or with another person and may include listening to music or enjoying a soothing scent.

5. "I'm really sorry you're going through this. I'm here for you if you need me."

Remind them that their feelings are valid and that you want to support them.

6. "Are you looking for my perspective or would you rather I listen?"

Clarify which type of support they would like and let them know that you will not judge them. If they want your insights, it's helpful to begin with something like "I don't know if this applies, but I'm wondering about…"

What not to say to someone with a mental illness

It's just as important to understand what responses may be unhelpful, or worse—damaging to someone who has opened up to you. Try your best to avoid the following responses:

1. "I know what you mean. I had a panic attack when I saw my electric bill!"

This attempt at relating to what your loved one is going through is kind-hearted, but also misguided. Relating their panic attacks to your (probably small) anxiety about a regular expense misses the mark because it implies that those two things are the same or of similar consequence and minimizes their pain. "Even if you have an anxiety disorder, suggesting that they can just do what you did when you were anxious is stigmatizing," says Sue.

2. "Have you tried yoga or meditation?"

One of the most pervasive misconceptions about mental health is that yoga, meditation, and other wellness trends can cure depression and other mental health conditions. While these practices are certainly a helpful supplement to treatment for many people, only your friend knows if it is right for them. Sue recommends instead asking what options they see for themselves. "If the person says they feel like they have no options, you can ask permission to share some ideas you've heard that may make sense to them," says Sue.

3. "Why aren't you seeing a therapist?" or "Why aren't you on medication?"

While it's fine to show concern for a friend, remarks like these can come across as accusatory. Again, if the person says they feel like they have no options, you might say, "I always hear about therapy and medication, what are your thoughts on those?" Remember that this is a decision that is ultimately theirs to make.

4. "Are you OK?!"

This question can make your loved one feel pressured to get better immediately, which is rarely the case for mental health. They may also feel some social pressure to tell you they're fine, even if that is not true.

5. "There are lots of people who have it much worse than you."

Remarks like this encourage your loved one to compare themselves to others, which can cause confusion as to whether their struggle is valid or not. You should encourage them to let go of comparing themselves to others and instead focus on what's best for them.

6. "You wouldn't feel this way if…"

Mental health issues and their causes are complex, and many people wear themselves out emotionally by searching for the causes of their suffering. Placing blame leads to unnecessary distress and takes time from increasing understanding of what is going on.

Learn more about how to talk about mental health with your loved one, for yourself or for them, here.

What to do when someone says something hurtful

For those struggling with mental health, much of what's been discussed will sound familiar. You will probably have heard some of the above well-meaning but unhelpful advice and felt hurt by their implications. Rather than respond with anger when someone makes a hurtful comment, Sue recommends reminding yourself "That person does not know enough for me to allow them to be the source of my hurt." Be sure to let the advocates around you step in to educate those who need it or do it yourself if that feels right and healthy for you.

Call 800-767-4411 or go to rogersbh.org to request a free screening.