I wonder what the world would be like if we could talk about mental illness the same way we talk about physical illness. Not that I’m convinced that these are neatly separated categories, but it is a useful basic distinction.
Imagine if you could walk into a party and say, “don’t hug me, I’ve been suffering from traumatic flashbacks all day & I can’t take being that close to another person right now.” Like you would if you had a cold — you’d say “don’t hug me, I have a cold & don’t want to pass it along.”
If you say you have a cold, the other person might mostly ignore it & move on, saying that they hope you feel better. Or they might be moved to offer some sort of sympathy or help — “oh no, that sucks — let me give you some tissues & soup and a get well soon card.”
But what would they say if you tell them you are sorry for missing their party, but you couldn’t leave the house because the panic attack was too intense? What would they say the tenth time you tell them that?
The lack of ability to talk about mental illness is an extremely isolating phenomenon. Mental illness is just as prevalent as physical illness, but we have to hide it. We have to make excuses for missing events & reacting to things in less-typical ways because to tell the truth is considered shameful. We are not supposed to reveal that our parents tortured us, or that we’re not over the horrors we saw in war, or that our genes are messed up & we can’t be happy. We are not supposed to be vulnerable to abuse, or admit that it happened, or that it had an effect on us.
I don’t believe people are bad. I have an almost endless supply of faith in the potential redemption of every person. I am almost always willing to believe that someone does not mean to do harm. And yet I don’t see the kind of compassion in the world that I think we need to have for other people. Mental illness does not always manifest as a diagnosis in the DSM. Sometimes it’s temporary or situational — something terrible happens that overwhelms our sense of self & our capacity to relate to others. That seems like something we should be able to see & recognize in other people, not something we should punish & sweep under the rug. Even when these situations arise out of events that are societally acceptable, such as losing a spouse or other close person, we still struggle with extending compassion & understanding. We don’t even have a system for letting people know that we’re grieving a loved one, and once we’ve named our grief, others feel awkward & don’t know how to respond.
I wish we could talk about mental illness as easily as we talk about physical illness. I wish that there were better ways to incorporate the reality of mental illness into our public lives, instead of hiding it away because we are supposed to feel ashamed.
Freedomgirl 
It seems like a vicious cycle, we don’t talk about mental illness which makes it more difficult to actually talk about mental illness. I think if someone came up to me and said “don’t hug me, I’ve been suffering from traumatic flashbacks all day & I can’t take being that close to another person right now.” I would end up having “sure no problem” but a the same time I would end up with a host of questions that I am not sure I would be able to prevent myself from asking. Starting with “is there anything I can do?” and “what triggers them?” Then I’d be stuck wondering if I was an asshole for asking
yeah CAB you have a good point — once we have a framework where we can say ‘i’m suffering from mental illness right now and need A, B, and C,” then we don’t have a good framework for what the person is supposed to reply back to them. when is it appropriate to ask more about the illness? I think it wouldn’t be asshole-ish of you at all to ask if you could do anything — but it might be a lot for the person to try to explain what triggers them. it would certainly be too much to ask where their symptoms came from. and i know that for someone living with PTSD the triggers can sometimes be as simple&obvious as watching a war movie or receiving a phone call from an abusive relative, but are sometimes as humdrum as the light & time of day or presence of dishes on the stove.
but I can’t imagine any scenario in which asking if you can help would be taken the wrong way. i think there is a lot of fear & shame around mental illness, fear that once people know there won’t be any patience or compassion. fear that it will cause people to not want to be around you. i see people posting ads on CL all the time that specify various requirements of no mental illness in their target mates. and yet, who among us has never experienced it? i suppose they mean no chronic mental illness.
so to try to focus this response, i think the best way to respond to someone who has shared the existence of their mental illness with you is to be there for them in the same way you would if they said they were sick with the flu, or diabetes. make adjustments in the way you interact with them to accommodate their illness. ask them how to do that. you wouldn’t serve a diabetic loads of sugar, but you’d still invite them over for dinner. maybe war movies are triggering to your hypothetical friend — so you make sure not to have a war movie on in the background of your party. maybe if war comes up in a table discussion you’d gently steer the conversation toward something else. or maybe you wouldn’t, but you’d go up to your friend afterward & share that you thought of them & wondered if that conversation was difficult for them & ask if there’s a way you could have handled it better.
ultimately, i wish that the disability community were better integrated with the chronic mental illness community. i think PTSD or chronic depression or schizophrenia are disabilities, but mostly invisible ones that have no recognition or way of addressing them in our current policy system.
and now this comment is as long as my post! thanks for still reading, CAB! i think you are my most faithful reader 🙂
I appreciate your writing this post – and especially your response to CAB. Both were spot on.
What I don’t understand is when people knows someone else is struggling, and then say something like “just snap out ot if” or worse, they get annoyed and pile on more stress.
I do think that the general public is becoming more educated about mental health issues. And the more we talk about it, the better we will all be.
i’m not sure i have much to say, but i feel i ought to say something, if only that i’m glad you wrote this.
it is strange for me to even consider, because i don’t have the words to describe my own state other than “crazy” (or “sprinkles”…that’s what jamie calls my crazy), and also because i am a chronic under-sharer (in my non-anonymous, non-internet life), so shame aside (though that is *definitely* a factor) i don’t see myself divulging – in much the same way that i am liable to say i am “fine” or perhaps “under the weather” as code for the particulars of physical illness.
please excuse the excessive use of parentheses, and i would love to hear your further thoughts on the subject.
I simply want people to be more aware of body language. Just look at how I’m moving around so that you are not blocking my only exit or how I’m positioning this chair between us. I am subtle, yes, but it would be nice if people paid some attention to the comfort level of others…and try not to take it personally. Tall order.
But, that said, I would never feel comfortable enough to explain my movements to a stranger. The whys of it are too personal.
I love your observation about the subject. Discussing it takes some of the stigma away, even if only for a handful of us.
I appreciate this post so much.
I’ve found that I have to cultivate the compassion that I want, where I can. My tell that something is wrong is that I disappear. I stop making plans with friends, I stop showing up to group events, etc. Two of my closest friends here told me the other day that sometimes I’m secretive and a little flaky (their perception of me after I cancel plans), and for a moment it kind of hurt to hear that; I pride myself on being a good friend.
I was really honest about how my depression manifests itself, and I apologized for my “flakiness.” I also told them that sometimes, I just need a little bit of a nudge for social interaction. At that point either I’ll make plans and feel good about it, or I’ll confirm that it just feels like too much at the moment. They were amazing about it, and one of my friends actually opened up about some struggles she’s been experiencing. We discussed how we’d like to be handled in various situations – including if we are out in public together, and something comes up – and it felt great.
As for strangers, I don’t know that I would ever feel completely comfortable disclosing all of that. But again, that’s why I opened up to my friends. I’m old enough to know now that I need their help.
Thanks again. I think society is gaining awareness of mental illness, and it just takes more of us talking about it.
sending hugs and thinking of you.
thank you for this. i really wish we could get there as a society. i think one part of the problem is that we see mind and body as so fragmented. the model of care/medicine/healing is so compartmentalized: mental health is covered under different insurance than physical health, which is different still than dental and vision care… yet it’s all part of one human being.
I agree mental illness still continues to have a sort of stigma associated with it. But why not stop being afraid. Why not openly talk about it without being afraid of what others may think. A part of society is social influence, once a few of us start talking about it then a few more and more will talk about it. I know a few people who suffer from mental illness and let others know about, it’s sort of liberating for them to not be ashamed and let others know and maybe educate them. Because the truth is people are afraid of ‘the unknown of what they have no knowledge of’. Nice post want to check out my new blog http://www.myownpsychblog.com