Introduction
We all need people in our lives to share the good times, and to support us in harder times. Without them, life can be a difficult and lonely road. Just like everybody else, people who have a mental illness need a 'support team' of people they can talk to and confide in. Having people to support you is an important part of looking after yourself, and dealing with the ups and downs of your condition, treatment and daily life.
Mental health professionals are valuable sources of support for people who have a mental illness, and it is important to have regular contact with at least one of these professionals, for example, a psychiatrist or clinical psychologist. Your partner, close family members and friends can also be vital sources of support. Sometimes, though, it can be difficult to know who you should talk to about your mental illness, and what you should tell them. The information in this brochure will help you make these decisions.
Who can I talk to?
When someone has been diagnosed with a mental illness, it is very important that they are in regular contact with mental health professionals who understand what they are going through and can provide support and encouragement. Mental health professionals can also help you to monitor symptoms, provide medication and other treatments, and discuss how your treatment is going. Listed below are a number of professionals that you might find helpful to talk to.
- A school psychologist or counsellor. Many young people will have psychologists or counsellors at their school that they can talk to. When symptoms are under control, people often just need to talk to someone who is supportive and understanding. These professionals can provide this support. If symptoms become troubling, then these professionals can also help the individual and the family to decide if they need to seek specialist assistance, and can help to refer them to an appropriate professional.
- The local or family doctor. The local doctor will also be helpful to talk to. The doctor can provide support, and if you are experiencing early warning signs or more obvious symptoms of a mental disorder, he or she can assist by making a referral to a mental health professional (usually a psychiatrist).
- The local mental health clinic or community hospital. These are also valuable resources if the individual or his/her family feel that 'something isn't right' but aren't sure what the problem is, or if they notice signs that they know from past experience indicate that a mental disorder is developing or is being experienced. Phone numbers for these services are available in the phone book and through help-lines.
- Telephone help-lines. The local telephone directory will have some telephone numbers for local telephone help-lines that specialise in mental health or welfare issues. These help-lines can be very useful for talking over how you are feeling, or getting information about appropriate services.
- Mental health professionals such as psychiatrists or clinical psychologists. People who have been diagnosed with a mental disorder will usually already be seeing a mental health professional. These individuals form an important part of the support team for a person with a mental disorder. They understand what you are going though, and can provide support and treatment to help reduce symptoms, prevent symptoms from returning, and promote a return to a regular routine. They are available to talk over how you are feeling, and how your treatment is going. If you notice any troubling symptoms that could mean that you are beginning to re-experience a disorder, then it is important to talk to your mental health professional. They will be able to provide you with the assistance you need, or they will know where to direct you for assistance.
Who else could I talk to?
One of the most common experiences of somebody dealing with a mental illness is the feeling of isolation and sense of not understanding what is going on. This can be extremely frightening and can lead people to feel helpless, hopeless and worried about their future. Speaking to others about how you are feeling and the ups and downs of daily life is a very important part of managing painful feelings, keeping things in perspective, and feeling hopeful about the future. Just like anybody else, people with a mental illness do not need to go through difficult times alone, and one of the best ways of helping yourself is to turn to people in your life for support.
Who you decide to tell about your mental illness is a matter of personal choice. Usually there are two kinds of people that you might tell about your mental illness: those who are closest to you who can be involved in your treatment; and other people who may not be involved in your treatment, but who can offer friendship, and support in difficult times.
In general, people you choose to tell about your mental illness will be those who:
- you feel comfortable with;
- can be trusted to listen without judging; and
- can be trusted with this confidential information.
What could I say to a trusted person?
There is no 'best way' to tell someone about your illness. It is probably best to tell people as little or as much as you think they need to know, and only answer questions that you consider reasonable. If you don't feel like giving as much detail as they would like, just say something like "If it's OK, I'd rather not talk about that". In other words, you are asking the person to respect your privacy. In general, people who are closest to you and who may be involved in your treatment will need the most information.
Once you have made the decision to tell a particular person about your mental illness, it will usually be helpful to provide them with some factual information about your condition. It is difficult for people to be supportive and understanding if they don't have sufficient information about a disorder. You might give them brochures from InfraPsych or pamphlets from your local doctor.
If the person is likely to be involved in your treatment, then it will also be helpful for him/her to meet with the mental health professionals who are assisting you. The mental health professionals can help by providing more information about the mental illness and its treatment, and by answering any questions.
How might people react?
When you tell someone you trust about your mental illness, they may feel grateful that you have trusted them with this information. They may also have noticed that you had appeared stressed and they may now feel relieved that you have sought professional help. However, there is no way of knowing how someone will respond until after you have told him or her. People's responses can be quite varied. People may feel worried, confused, shocked, guilty, sympathetic, alienated, disappointed, angry, relieved (that there is an explanation for what has been happening) or concerned, or any combination of these feelings. Be patient with the people you tell - just as you may have needed time to adjust to your illness, they may also need time to absorb the information and adjust to it.
How might I deal with the stigma about mental illness?
Attitudes towards people with mental health problems have changed, and many people realize that people with a mental illness are no different from anyone else. Unfortunately, however, some people have inaccurate information about mental illness, and there are some unfortunate and unfair stereotypes about people who experience mental illness. As with most stereotypes, these stereotypes are based on a lack of information, or misinformation, about mental illness. Helping to inform people who are close to you about your mental illness can help to counter any misinformation they may have about what it means to experience a mental illness. Some of these stereotypes are addressed below.
Aren't people with a mental illness all potentially violent or dangerous?
No. In general, people with a mental disorder are no more violent or dangerous than anybody else. Like anybody else in society, some mentally ill people do commit crimes, however, most people who commit violent crimes do not have a mental illness.
Don't people with a mental illness just get worse and worse until they are finally 'crazy'?
No. Like many other complex conditions, people who have a mental illness experience periods where symptoms are under control and life goes on as normal, and periods where symptoms are more difficult to manage. Most people with a mental illness can lead productive and happy lives.
Aren't people with a mental illness responsible for their condition?
No. Like some other disorders such as heart disease, most mental disorders arise because of a complex interplay between biological vulnerability and psychosocial factors. This biological vulnerability means that they are more sensitive to experiencing troubling symptoms in response to stressors that may not trigger symptoms in someone who does not have the same biological vulnerability. People are not responsible for their condition, nor do they choose to experience distressing symptoms.
Aren't mental illnesses signs of a character flaw?
No. Having a mental illness is not a sign of a character flaw. A mental illness is also not a sign of weakness or laziness, and symptoms are not a ploy to gain attention. Mental illnesses are genuine disorders that require specialist assistance.
How do I talk about mental illness with my partner?
Having a supportive partner when you are undergoing the stress of a mental illness can be vital. Partners can work with the health professionals who are treating you, and can play an essential role in providing support in the recovery process. When speaking to your partner, a straightforward approach is recommended. Explain to your partner what you think is occurring, emphasizing that you have a mental illness that can be treated in various ways. Many people with a mental illness feel worthless and wish to avoid burdening their partners with their problems. Often a component of shame or embarrassment can be associated with this and men, in particular, may not express their feelings so they appear stoic and strong. These attitudes are unhealthy for both you and your partner, and talking with your partner can lessen the stress for you both.
It is important to try to communicate your experiences and not to shut your partner out. Unless you include your partner, there is a risk that she/he will misinterpret the symptoms of your illness (e.g. loss of enjoyment of life or loss of interest in sex) and take them personally. Make a time when you and your partner will not be interrupted and take the opportunity to explain your feelings and emotions. In many cases, bringing your partner in as part of your support team can be a major relief and benefit for both of you. It is also important that your partner, whether alone or with you, has access to information and education, as well as the opportunity to talk with your GP, psychiatrist, psychologist or counselor.
How do I talk about mental illness to other members of my family?
You may feel hesitant and concerned about how to talk to family members, particularly if you think they see mental illness as a weakness or something to be ashamed of. Talk to the people you feel closest to in the family and who you believe will support you. Speaking openly about what you have been experiencing, and the care and treatment you have been receiving, can be very helpful in alleviating the stress that family members may be feeling. It can be an enormous relief for caring family members to realize that there is an underlying medical condition that can be treated and that there is some explanation for what has been occurring with you.
However, it is also important to be selective and cautious when it comes to large extended families, particularly if there is fragmentation and conflict. A large group of family members all giving their differing opinions as to what your mental illness is, how it was caused, and how it might be 'fixed', may leave you feeling confused and more stressed. The mental illness can also become the focus of conflict and blaming, so care needs to be taken in this situation.
How do I talk about mental illness with my friends?
Good friends can be an important support for a person with mental illness. They can listen to the difficulties you are experiencing and aid in preventing the social isolation that can occur. When speaking to a close friend about your mental illness, you need to be honest and direct about your feelings, explain how the illness is impacting on your life and discuss the treatment you are receiving.
You may not feel that you have the emotional energy to maintain a large number of friends. You must also consider about whether disclosure to friends is helpful or whether it is an exhausting, negative process. A few acquaintances, that might be considered friends, may expect you to talk about your treatment and/or feelings, but really only to satisfy their curiosity and interest. Responding to everyone's questions can be exhausting and inappropriate. The best approach is to tell one or two close, supportive friends who can be trusted to maintain confidentiality and who have your best interests at heart.
If I cut down on my drinking, how do I explain it to my friends?
It is usually recommended that people who have a mental disorder reduce or stop their consumption of alcohol and other drugs. This is because these substances can worsen symptoms, can interfere with the effects of medication, and can even bring on another episode. Especially when the person who is experiencing a mental disorder is a young adult, it can be helpful to think about how you might talk to your friends about cutting down your alcohol consumption. Some tips are below.
- Choose one or two close friends, and let them know that you have decided to minimize your alcohol (and/or other drug) consumption, and ask for their support in this. The responsibility for minimizing your alcohol (or drug) use still rests with you.
- Explain to these close friends that when someone has a mental disorder, it is important that he/she minimize or stop drinking (and/or taking other drugs), because alcohol can make symptoms worse and can interfere with medications.
- Ask your friends not to buy you drinks.
- Don't participate in buying 'rounds'.
- Take non-alcoholic drinks with you to social events.
- Time yourself, e.g. to have one drink per hour, or alternate between one alcoholic drink and one non-alcoholic drink in one hour.
- Avoid drinking on your own.
When you are in social settings, sometimes other friends or acquaintances may put pressure on you to drink (or take drugs). In preparation for times like these, it is useful to work out what you will say in advance. You will probably not want to tell acquaintances about your mental disorder, so instead you might say that you are not drinking (or a drinking only a little) because:
- "I am driving"; or
- "I am cutting down on my drinking"; or
- "I am taking antibiotics"; or
- "I am following doctor's orders"; or
- "I am on a 'health-kick'"; or
- "I want to lose some weight"; or
- another reason that you feel comfortable with providing.
How do I deal with colleagues and employers?
One of the difficult issues of dealing with mental illness in the workplace is confidentiality. It is natural to fear being categorized and treated differently and, in some work situations, this may happen. Some work colleagues may seek information to satisfy their curiosity but this is more about gratifying their own needs than helping you. If a very personal conversation with a colleague is not directly helpful for you it should not be encouraged. In general, it is wise to be selective about which of your colleagues, if any, you inform about your mental illness.
It may be necessary, however, to divulge information to your employer, manager or supervisor when energy, motivation and concentration spans are diminished, affecting productivity, organizational, and business skills. Talking with a manager at this stage can be beneficial because he/she can then understand that these behaviors are related to an illness that is being treated. The informed employer is much more likely to be sympathetic than the employer who has to deal with unexplained absences and diminished work productivity. Employers often provide access to confidential employee assistance programs.
How do I talk about mental illness with my children?
Having a mental illness may affect your ability to deal with the responsibilities and pressures of being a parent. It is natural to feel concerned about how you should talk to your children about your mental illness, or whether you should tell them at all. This concern can result in avoiding communication altogether. The problem with this is the risk, particularly in young children, that they will blame themselves for their parent's low mood, unhappiness or erratic behavior.
Children are quick to sense that something is wrong so it is essential to explain to children in simple terms what you are experiencing, e.g. "I have a illness that makes me sad/angry. I am being helped by a doctor/psychiatrist/psychologist and I will improve." It is important to emphasize to your children that they are not the cause of your condition, and it is because of the illness that you may get upset or angry more easily than usual. How much information to give, and how detailed the information should be will depend on the ages of the children involved. Younger children would need far more simple information than teenagers. It may help to involve other people who are important to your children, such as teachers, school counsellors or neighbours. Other trusted people can talk and listen to your children about what is worrying them and how they are feeling.
Children can be very understanding and supportive when approached honestly, but can feel emotionally isolated when the issue is avoided and problems are denied. Talking with your children can be difficult, but this can help to reduce any painful feelings they may be experiencing.
