For many years, discussing and admitting mental illness was a taboo, mired in shame. In our community, we denied the existence of mental illness and the necessity for treatment. We distrusted psychologists and their medicines. We attributed our troubles to an ancient supernatural nemesis, and threw ourselves on altars and in the hands of our preachers and church congregations. We thought we could pray away any issues, or merely keep marching until our bodies collapsed and our minds were shattered. In the worst of cases, a person whose issues were too severe found themselves shuffled away into the shadows by their family members, hidden from society.
It is, therefore, beautiful that we have entered an era where we have removed the stigma attached to mental illness and seeking treatment. Those of us with mental illnesses have learned to embrace them as a condition of our humanity, and not as a curse or shameful condemnation. Our family members and friends have learned that they must be present to surround us with love; to build and become powerful support systems.
Yet, despite that great charge, many of our loved ones don’t know precisely what being a support looks like; where it begins and what it entails. As a person who was diagnosed with depression and generalized anxiety disorder, I have learned what the supports I need are. I've also found that many of those supports are shared by those with other of the most common high-functioning mental illnesses. To those of you who wish to be a support system for your family and friends, I offer these ideas:
1. If you’re not ready to sacrifice and work with your loved one, and to walk through the dark night with them, then make it immediately clear that you are not prepared for the task.
This may sound like I am telling you to abandon the person you love. Yet, it is the best thing to do if you are not prepared for the work that comes with being a support. Half-hearted or undependable support can be dangerous. It is incredibly important not to romanticize mental illness, even as we embrace it. Your friend who suffers from depression may call you one day, sobbing uncontrollably, refusing to tell you where he is, expressing that he is fully prepared to commit suicide, and begging you to give him reasons why his life is worth the pain. Your family member who suffers from an anxiety disorder may be having a debilitating panic attack while at work, on the highway, or at a meeting in a town an hour away; she may be literally unable to move, and may need you to drop everything to come get her. Your fiancé with schizophrenia may walk into the bedroom one day yelling to you that the clouds outside have been sent to kill him, that the food in the kitchen has been poisoned by an unknown agent, that the picture on the wall is watching him, and that the news anchor on the television has been insulting him personally for the past half hour. You may get a call from the local police telling you that your friend with bipolar disorder, or any number of mood disorders, has been arrested for getting into a violent fight with her coworkers or her classmates; or for crashing her car into the yard of a neighbor who smart-mouthed her. Even with the strongest medications, many of the most common mental illnesses are only lessened in their intensity, but not erased. You may not discover how taxing and difficult being a support for your loved one is until you’ve had to do it the first few times. However, the moment you realize that it’s too much for you; that your heart isn’t in it; that you can’t do it, tell them. This will allow them to build a support system that is prepared to weather the many violent storms that come before the sun shines.
2. It’s not you, it’s them.
Cliché as this sounds, it’s true and it often needs to be said as a reminder. Last year, my anxiety disorder got so bad that I developed agoraphobia- the fear of going places that trigger my anxiety attacks. I began having debilitating attacks from just leaving the house, so I didn’t go anywhere for two entire months. I used to hang out with my friends multiple times during the week, but they quickly noticed that I was unable to see them for weeks at a time. Some of my friends thought I was avoiding them, or had an issue with them. I had to explain that it was not personal; it was uncontrollable. Your husband or wife with depression may become antisocial, and stop showing signs of affection; they may hide out in the bedroom or in the dark living room for weeks at a time wanting no contact. Your partner with a mood disorder may become physically violent toward you. Your friend with schizophrenia may think you're in on the evil plot that she is hallucinating. In the midst of this, it is important to remember that their behaviors are a condition of their illness, not an indictment against you. If this becomes too much, see number 1.
3. Familiarize yourself with their mental illness.
It is absolutely imperative to study the mental illness your loved one has. It’s important to know the behavioral effects of their illness, the side-effects of their medication, their triggers (the external things that exacerbate their condition), and the warning signs of an episode. It’s also important not to minimize their mental illness and to understand the full scope of it. Depression is not just sadness; it’s a completely inescapable and smothering sense of hopelessness and pain that strips a person of their desire to love, to be loved, and to live. Anxiety disorders are not just a feeling of anxiousness; they cause an irrational fear of everyday situations that trigger debilitating panic attacks marked by hyperventilation, fainting, loss of feeling in the extremities, a sense of imminent doom, a loss of physical control, agoraphobia, elevated heart rate, sweating, nausea, vomiting, and more. Also, there are different types of anxiety disorders such as generalized anxiety disorder, panic disorder, and social anxiety disorder; similar symptoms, but different triggers. Schizophrenia completely disconnects a person from reality and rational thoughts, causes visual and aural hallucinations, triggers self-deprecating projections, creates a breakdown in rational thought, and causes episodes of intense delusions. Although people use the word “bipolar” like an insult, true bipolar disorder is an uncontrollable mood disorder that wildly pitches people between manic happiness, violent anger, uncontrollable sadness, and a full range of radical emotional extremes. You must know the details to help. If this is challenging, see number 1.
4. Support is multi-layered, and cannot be shallow or topical.
Being a support system for your loved one with a mental illness is more than just sending texts, calling over the phone, or chatting on social media. It requires you to be physically present. You’re going to need to hug, hold, and reassure them. You may need to drive across town to help, or randomly accept a facetime call during their panic attack, depressive episode, or hallucination. You will need to visit them at home when you haven’t seen them for a few days because something may be wrong. You need to be extra sensitive and empathetic to their behavior, to look out for their triggers. You may literally need to hold their hand at times during an episode, practicing breathing exercises, or waiting for the uncontrollable tears to stop. You may need to reassure them that there is no one watching them, that the food isn’t poison, that they aren’t worthless, and that no one is coming to get them. You may need to talk them down or physically restrain them during a rage or manic episode. You’ll need to guarantee that they are taking their medication, even when they feel it’s worthless. You'll need to remind them life is worth living, and that they are loved. Again, if this is too much, see number 1.
These four tips should help you support those you love. Remember: a) being a support is hard. If you can’t do it, make it clear. B) Don’t catch feelings. It’s not you, it’s us. C) Don’t romanticize mental illness. It’s real out here, and most of the time it’s terrifying. Be prepared to help us through the storm by knowing what to expect before the clouds arrive. D) Hold our hands, rub our heads, be the shoulder we can cry on, hide the weapons, and talk us through it.
Above all, surround us with love because it is the most powerful, healing, and transformative force of all.