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mental health mondays :: speak up

so here, finally, is the post that was supposed to be here last week, but the stupid blogger app ate it. i really hope that someone's new year's resolution was to make a better blogger app.

a while ago, i wrote a post about the things you should never say, or at the very least should stop saying, to people with mental disorders. however something i realised when looking around the internet was that there are precious few of the opposite: suggestions for things that it is both appropriate and helpful to say. i thought to include a few of them in the post linked above, but goodness, what a negative lot we mental health advocates are! so in the interests of trying to balance that overwhelming tide of negativity [of which i'm a part], i present to you a list of things that you should say to people with mental disorders. because positivity.

"how can i help?"
i wanted to make the list as different as possible from my previous suggestions, but i really can't overstate the importance of saying this. no matter what the type or severity of the mental disorder, sufferers have a tendency to forget that other people can do things for them [unless they have narcissistic personality disorder. chances are you're not going to have to ask them what you can do, because they'll have a list ready. but that's a different group that really needs to be treated on its own.]

"i'm not going anywhere"
one of the scariest things for people with mental disorders is the idea that their inner "monsters" will scare everyone they care about away. reassure them that that's not the case whenever you can and more importantly, show that it isn't the case with your actions.

"what kind of resources do you have access to?"
having a mental disorder can be so confusing and overwhelming that hearing that you have one can leave you thinking "great. now what?" the best way to encourage your loved one to think about next steps is to start the conversation about what they can possibly do. the options generally given are medication and therapy. one or both of those may be beyond the financial means of your loved one, which makes it even more important that they start thinking about how they can overcome that. people with mental disorders, especially anything related to depression, are prone to thinking "all is lost", so if they seem bewildered or convinced that there is nothing that can be done to help them, you can push this conversation along further by helping them look at what resources are there. mental health initiatives are chronically underfunded, but that doesn't mean that there aren't some means available.

"what changes have you noticed since you've been on your medication?"
this assumes that the person is on medication, but when they are, it can be helpful to ask them to look at the before/ after picture. "non-compliance" is a huge problem with psychiatric medication and so getting your friend/ family member to think about how their life has changed can help them realise what the meds are actually doing. alternately, it's a good way to identify cases where the meds aren't doing what they're supposed to be doing and might need to be tweaked. third, it's a way of getting someone to think about the side effects of the medications they're taking versus what it's doing to help them.

"how is your therapy going?"
people with mental disorders have a tendency to think of themselves as undeserving of help, or of their condition as being beyond help, so if therapy isn't working for them, they can have a tendency to accept that. having someone who has their best interests at heart who keeps them talking about it, who celebrates their progress and who reminds them that it might be a problem if things aren't moving forward can be an invaluable benefit. it can help make the person aware of their progress, which can seem impossibly slow, but it can also make them aware if the particular therapist or method isn't right for them.

[that said, therapy is a long process, so don't encourage them to think that if it isn't working right away, it's a lost cause. but not every type of therapy is suited to every patient and perpetuating a mismatch is a losing proposition for everyone: your friend would be better served by another therapist and the therapist is likely capable of offering more meaningful help to other patients.]

"do you want to go to the hospital?"
we talked a little bit about this in a previous post, but let me repeat for emphasis: you are not capable of solving a loved one's mental health problems. know your limits and respect them.
if someone is suicidal, or are in the midst of a psychotic break, the place for them to be is a hospital, not at home or at your place. make them understand that their problem is serious and that they are as deserving of attention as anyone in crisis. hospitals were created to help people in medical need and you should never feel shy of using them.

my last post on the subject dealt chiefly with suicide, so i felt it was important to raise some points on dealing with people in psychosis. this isn't a likely scenario for most of us, but for those close to someone with schizophrenia or bipolar disorder, it's always within the realm of possibility. so here are a few precautions for dealing with someone when you can't reason with them:


  • stay calm. if you start to get worked up, angry, or scared, walk away or at least stop talking. you aren't failing your loved one by getting upset, it happens, but your absence is preferable to your overtly anxious presence. 
  • give the person their space. being crowded or touched- even by someone they love- can amplify a psychotic person's response and make the situation much worse. speak to them calmly, act as normal as possible and/ or keep an eye on them from a discrete distance. 
  • contain the situation as best you can. do not physically confront a person in a psychotic state ever. if the person is inside, endeavour to keep them that way, but don't make an obvious point of blocking exits, locking doors or anything else of the sort. keep yourself between the psychotic person and the exit. 
  • call emergency services when you can. make it clear what they can expect to find and make it clear that the person is not a threat, but needs to be taken to the hospital. if you can, request a response from medical personnel rather than the police [since this is neither their job nor their area of expertise] and that any responders should make sure to turn off their lights and alarms as they approach. [bright lights and loud sounds can aggravate psychosis in some people. best not to take the chance.]


in addition, for people suffering from an acute panic attack, there are a couple of things that you can do to help pull them back to reality.


  • remain calm. if you can't do that, be quiet. any level of upset is going to make things worse. 
  • encourage them to breathe deeply. do it yourself and get them to do it with you. breathe in as deeply as possible and as slowly as possible, then exhale in the same way. in through the nose and out through the mouth. breathing deeply and slowly stops the body from being able to manifest the physical symptoms of panic and effectively stops the attack dead in its tracks. even if the brain wants to panic, it can't unless the rest of the body cooperates. 
  • touch them if they're amenable. in this case, touching is good, provided the person isn't resistant. i'm not talking about a bear hug, but try to just put your hand on them in a friendly way. it can help ground the person in the most literal way, tethering them to the rest of the world. 
  • speaking of grounding, try to get them to focus on mundane things- what you're wearing, a few objects in the room, their jewelry. doing this breaks the panic "circuit" and derails the attack. 


a panic attack is not like psychosis, because the person having the attack is usually very aware of what's happening to them, so there's no need to pretend that you're trying to do something other than calm them. tell them about how the breathing works. tell them that you're distracting them with mundane things just to get them calm if you want to.

change the subject, eventually.
this is the last thing i want to suggest as something you should do when talking to a person who has a mental disorder. yes, you want to listen to them and make them feel like their problems are valid and deserving of attention. yes, you want them to know that you are there to listen to them and that you can offer suggestions and encouragement, but remember this: it's not healthy to talk about mental problems all the time.

you're not a psychiatrist [well, maybe you are, but then you really don't need to be reading my advice] and you're not there to solve your loved one's problems. you're there to be the same person in their life as you always were. so do the things that you always did together. go to movies. go to restaurants. talk about books you've read. do sports together. snuggle. go back to building that perpetual motion machine together.

dealing with a mental illness can be a huge task and there's no reason to make it seem worse by talking about it so much that it seems like the only thing someone has in their life. remind them of everything else that they enjoy and of the fact that there's a lot more to them than their disorder.

and because i haven't posted the warning in a while, let me do so:

i am neither a psychiatrist nor a psychologist. i have no training in this field whatsoever. i rely on research and personal experience to create the blog posts you see here and what i say should never, never ever ever ever be considered as medical advice.

if you look at current figures of what percentage of people will likely experience a mental illness in their lifetime, it seems increasingly unlikely that any of us will go through life without knowing someone who has one. that sounds bad, but in the interests of positivity, think of it this way: it is completely normal for someone to have a mental illness for at least some part of their life and it is completely normal to have people in your life who are going through them. this is a skill set that we've all needed to learn for a long time and, congratulations, you're alive at the time when people are finally accepting it. lucky us. 

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