By Rebecca Ruiz
It wasn’t long ago that the stigma of talking about one’s mental health forced many people to stay silent. Now though, messages encouraging people to share their struggles and seek help are widespread, including on Instagram, in public service announcements, and in celebrity interviews. Even Burger King launched a campaign to raise awareness and mark last May’s Mental Health Awareness Month.
Yet it’s one thing to notice and appreciate this newfound acceptance and another to acknowledge to someone else that you’re experiencing a mental health condition or illness. People typically avoid disclosing that information for several reasons, including internalized stigma and shame, fear of rejection, worry about discrimination at work, and uncertainty about whether they need treatment.
Indeed, mental health experts say it’s critical for people to weigh their concerns and disclose their experiences with others if and when it feels necessary and right.
“It’s really on a need-to-know basis,” says Quinn Anderson, manager for the HelpLine operated by for the National Alliance on Mental Illness (NAMI). Run by staff and volunteers, the HelpLine is designed to answer callers’ questions about symptoms of mental health conditions, how to help family members get treatment, where to find local support groups and services, and more.
If you’ve decided it’s important to tell someone about your mental health, try following these tips so that you’re prepared to have the conversation — and have a plan for handling what may come next:
1. Weigh the pros and cons.
Patrick Corrigan, a distinguished professor of psychology at the Illinois Institute of Technology, helped develop a program called Honest, Open, Proud that provides guidance for those who want to disclose a mental health condition. The first step in this process is considering the potential risks and benefits.
In Corrigan’s research on the positive aspects of “coming out,” he’s found that people who are fed up with having to keep a secret feel freer once they’ve shared what they’re experiencing. But that sense of liberation may be elusive if the other person in the conversation responds with shame or judgment.
For those who take the risk of telling a supervisor, the pay-off can be certain workplace accommodations, which employers are required to offer per the Americans with Disabilities Act. An employee with a psychiatric disability may receive a flexible schedule, sick leave, and a tailored break schedule, in addition to accommodations like work space with reduced exposure to noise, various types of equipment and technology, and modified job duties. Even though employers are not permitted to discriminate against workers based on a psychiatric disability, an employee may worry that disclosing a condition puts their job prospects or security at risk.
“We do not have an agenda to talk people into coming out,” says Corrigan, noting the potential downsides. “Once you’re out, it’s not easy to go back in.”
2. Arm yourself with information about your experiences or condition.
When discussing a sensitive topic, you’re likely to have done some research in advance in order to feel confident. Talking about your mental health is no different. If you’ve been diagnosed by a medical professional, or simply noticed worrisome symptoms that seem associated with a mental health condition, familiarize yourself with the relevant language that can help you communicate what you’re experiencing to others.
Such education can inform your understanding of what you’re going through — as can learning about others’ experiences — and thereby reduce your own sense of shame or stigma.
3. Decide who needs to know and what you want from them.
If you’re already seeing a mental health provider, that person may be able to help determine who — if anyone — you should tell. Anderson says a provider can help you develop a plan, and in some cases, offer to invite a loved one to a joint appointment so you’ll have backup and the therapist can explain your treatment.
When deciding on your own whether to disclose, consider if it’s important, or even critical, for certain people to know. While you might hope to explain recent behavior to a loved one, ask for support, or perhaps seek acceptance, telling someone who isn’t capable of recognizing your needs and reacting with compassion or empathy could be devastating.
Anderson says it’s also helpful to prepare responses if someone asks how they can help. Answering that question can be as simple as describing what it looks like when you’re really struggling, along with guidance about how they can best support you.
The Honest, Open, Proud programs sometimes recommends against telling people who are generally bigoted, people who use disrespectful language (think “crazies” or “wackos”), people who attribute social problems to mental illness, and people who oppose giving fair or new chances to those who’ve experienced a mental illness.
Before opening up about your mental health, be clear about why you’ve chosen to tell a certain person, what you hope to gain, and how you’ll proceed if they can’t emotionally handle the information.
4. Choose an ideal time to talk, and keep it simple.
Dawn Brown, director of community engagement for NAMI, recommends choosing a time where you’re alone, relaxed, and have enough time to explore the subject.
“I wouldn’t wait ’till you have a fight with your spouse to bring it up,” she says.
Similarly, sticking to the basic facts of what you’ve experienced and why you’re sharing that information can provide necessary guardrails for the conversation. If you feel ready to delve deeper, consider how that might affect the discussion if the person you’re talking to isn’t prepared to do the same.
5. Seek additional support and resources.
No matter how your conversation goes, it can be essential to seek additional support from groups and likeminded peers who will help you feel more empowered. Disclosing, whether to a medical professional or loved one, may be one step in a long recovery journey. NAMI provides resources like contact information for local support groups to those who call the HelpLine, and Honest, Open, Proud provides similar referrals at the program’s end.
Feeling connected to the right support can be particularly important for people who can’t find culturally competent mental health providers, or those whose family members and friends have vastly different views of mental health as a result of cultural attitudes or beliefs.
Anderson says it’s important to stay hopeful and remember that help is out there.
“There will be individuals who don’t get it, who will always have a discriminatory perspective, and individuals who don’t know but want to help, and then those who really get it,” she says.
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