“Be kind, for everyone you meet is fighting a hard battle.”
Contrary to popular belief Plato probably didn’t coin this phrase. Rather, Rev. John Watson (pen name Ian MacLaren) is believed to have championed the oft-quoted maxim starting in the late 1800s.1
The original wording is slightly different: “Be pitiful, for every man is fighting a hard battle.”
In Watson’s time, pitiful would have meant compassionate—a feeling of showing concern for others. This is the backdrop for our third article. How does one show compassion to those suffering from mental health challenges? And once compassion is shown, to become a champion of their recovery?
This RSA short featuring a talk by Brené Brown, PhD, does a terrific job at visualizing the most noble form of compassion: empathy.
Empathy goes beyond sympathetic feelings for others. It demands that we reach inside our figurative well of emotions and life experiences to show concern for others on their level, not ours.2 It pleads with us to listen and express sorrow before sharing advice (if any advice at all). And if our well isn’t filled with emotions or experiences that connect us to those affected by mental and emotional illness, empathy instructs us to be OK with saying, “I can’t pretend to understand what that must feel like, but I want you to know I care.”
But before we discuss your role supporting others, let’s begin with supporting yourself, the caretaker. After all, becoming a champion of recovery isn’t without its own challenges.
Care for yourself before you care for others
If you’ve flown on commercial aircraft before, surely you’ve heard this: “Be sure to adjust your own oxygen mask before helping others.”
Supporters and caregivers, we’re inviting you—nay, strongly encouraging you—to adjust your own mask before helping others. Whether manager, parent, friend, or other supporter, your mental health is paramount to those you care for.
Volumes have been written about mental health and will continue to be written, yet comparatively very little has been written about the supporter’s role. And what’s been written frequently comes only in the form of how to help the one suffering. The supporter is often an afterthought.
Let’s be honest, caring for someone with mental illness is not for the faint of heart. It will stretch and test you. Supporter or caregiver stress results from “the emotional and physical strain of caregiving. Caregivers report much higher levels of stress than people who are not caregivers,” write the editors of Mental Health Disorders Sourcebook, Sixth Edition. “Many caregivers are providing help or are ‘on call’ almost all day.”3 We might even argue many caregivers are on call 24/7 in light of instant messaging, ongoing concerns about the physical safety of those they care for, and so on.
There are very real physical and emotional burdens that bear down upon the caregiver, just to name just a few:
- Feelings of helplessness
- Feeling overwhelmed
- Sleep issues
- Guilt and feelings of failure
- Elevated stress
- Anger, easily irritable or agitated
- Weight gain or loss
- Pessimistic or negative thinking
So, have we painted too grim a picture? We assure you not all is lost. Far from it, in fact.
Yes, mental illness affects more than the person suffering. But it doesn’t have to define you nor the one you care for. Life can and will still be beautiful and meaningful. There will be ups and downs, but by utilizing the resources we’ve provided in this series the ups will begin to outnumber the downs. The number of days of “just surviving” can and will pale in comparison to those of thriving.
Thriving begins with self-care. As a supporter you too can utilize the resources in our Mental Performance Toolbox. Here are some additional things to consider compiled from personal experience:
- Don’t neglect your own health. Eat healthy and exercise regularly.
- Take time to relax and rejuvenate. You’ve earned it.
- Keep a journal. Track your progress in addition to theirs.
- Make sure you’re getting enough rest. You may need more under stress.
- Give yourself a break! You’re doing way more than you realize, and better than you realize, too.
- Make time for you i.e. for things you enjoy.
- Find support for you. This might be in the form of professional therapy, support groups, friends, literature, a night off, etc.
- Make a list of things people can help you with—and let them (or hire someone).
- Let the little things go. This includes advice you’re tempted to give that may not be helpful but also hurtful comments toward you. “Don’t take your loved one’s anger personally. It’s very common for people to direct their feelings at those who are closest. Their stress, fears, and worries may come out as anger.”4
Lastly, we encourage you to practice compassionate detachment. As described by William Berry, LMHC/CAP, “compassionate detachment is being able to empathize and feel compassion for another, while not getting drawn into their perception of reality. You can do what you can, without attaching an expectation to it.”5
Their burdens needn’t become yours. Their behavior needn’t drive yours.
Is mental illness contagious?
No. But the symptoms may be.
“Have you ever watched a friend laugh so hard that you started laughing? Or listened to a co-worker complain for so long that you started feeling negative, too? In this way, moods—and even depressive symptoms—can be contagious.” The good news, as Jamie Elmer describes, is “this also works for happiness.”6
Anxiety is a common contagion. It’s especially contagious as much of the world wrestles with an uncertain future brought about by COVID-19. Judson Brewer, MD/PhD, argues that uncertainty is like a “virus itself, one that is only adding fuel to the anxious fires burning in many of us.” Fear is a natural instinct that helps us survive, but when blended with extreme uncertainty “it can lead to something even more problematic: panic. Just like walking into a party and suddenly feeling like you’re in a ‘social mood’ when you hadn’t been moments before, fear and anxiety are two emotions that spread easily from one person to another.”
So, how does one combat the potentially ‘contagious’ symptoms of mental illness? Please refer to the previous section. You can find additional recommendations in Brewer’s article, “Anxiety Is Contagious. Here’s How to Contain It.”
Leaders, you might also consider taking up meditation.
Validation is the healing balm of mental & emotional illness
We can’t overstate this. Validation is the healing balm of mental and emotional illness. It engenders empathy in the supporter and conveys acceptance to the sufferer. It is the hinge upon which the doors of understanding swing.
As we mentioned in the first article, because most mental illnesses can only be diagnosed by symptoms rather than medical science, the most reliable analysis for assessing something is ‘wrong’ is often the person themself. To them their suffering is real, not imagined. Many factors contributing to their decline in mental health—environmental, hereditary, circumstantial—are beyond their control. Consider, then, the impact when someone verbalizes their suffering and we respond with the equivalent of “this too shall pass.”
On the other hand, imagine the soothing comfort you offer to those who are suffering with the simple phrases “I’m so sorry,” “I believe you,” or “I can only imagine how painful that must be.” As a supporter you’ve not only demonstrated your capacity to be empathetic, but you’ve also swung wide open the door of understanding. You’ve made an immediate emotional connection.7
But let’s be clear: optimism isn’t without its place in championing others on their path to recovery. On the contrary, we would be remiss not to acknowledge the goodness in finding middle ground between the two ends of the spectrum we just described. This can come as validation is coupled with hope. Some examples:
- “I’m so sorry. I can only imagine how painful that must be. I know things can and will get better, but until that time comes life can be really difficult.”
- “I don’t know how everything is going to work out. But I do know there are a lot of people that can help, and I want to do my best to help.”
Allow validation to become a balm of healing for those you support and love.
Stigmas and misinformation: how to avoid being part of the problem
As a society, we’ve made great progress in the past couple years alone but still have a long way to go in understanding how to help those suffering from mental and emotional illness, without ostracizing them as abnormal, at-risk, inferior, or needing correction.
“For people with mental illness, diminished quality of life and loss of personal goals does not result solely from the symptoms, distress, and disabilities caused by their psychiatric disorder,” write Patrick Corrigan, Amy Kerr, and Lissa Knudsen in their research on mental health stigmas. “Quality of life and personal goals are also hindered by people who embrace the stigma that accompanies mental illness and mental health care.”
Living with mental health issues usually means juggling two competing desires:
- A desire to tell loved ones and close friends exactly what you’re experiencing, how you feel, and why you’re acting differently. You’re not looking for sympathy, you just desperately need an outlet to tell someone what you’re going through, especially if everything appears normal.
- A desire to keep all those things to yourself knowing that every time you share something it’s as though you lose a small part of you that you’ll never get back, and you risk subjecting yourself to undesirable outcomes. You worry others will view you as inferior, weak, or anything less than the “strong” person they’ve always known you as. What you so desperately want to share will probably be a shock to them, so instead you keep to yourself just to be able to hang on to some degree of normalcy. You worry they’ll never view you the same once you share what you desperately want to share.
One of the most powerful antidotes to eliminate the conflict between these competing desires, and thereby reduce the stigma of mental and emotional illness, is to create a safe environment to discuss mental health issues.
Leaders, we encourage you to take time in a meeting (or two or three) to mention that mental health is important to you, just the same as you would for topics like diversity in recruiting, gender equality, design excellence, or whatever facets of holistic team health are important to you.8 And if you’ve experienced mental health issues yourself, you might even consider sharing this with your team. You don’t need to give details. What’s important is they see you’re human, that this is a topic they can discuss with you if they ever need to, and they won’t be misjudged if they do.9
Parents, we encourage you to make time to discuss mental health in ways that are conducive to the maturity of your children. Recognize that good mental health is holistic health inclusive of family relationships and even diet and exercise. “Family is … one of the biggest influencers of our mental health. Healthy family environments promote and strengthen mental health, while unhealthy family systems can provoke or contribute to mental illness.”10
All of us can educate ourselves on the common stigmas and the myth-busting realities behind each. Here are just a few.
“Mental illness is just all in the head.”
Hopefully by now we’ve completely smashed this myth throughout our series. “This phrase captures one of the key problems with the notion that … because [someone’s symptoms] are ‘mental’, they either do not really exist, or they should be able to be controlled or ameliorated by the person if they only tried hard enough.”11
In reality, mental illness is often rooted more in one’s genetics, circumstances, or environment than in one’s head. In a post on Facebook Cameron Moll, editor of this series, observed that if those who are suffering feel the burden of recovery lies mostly on their shoulders, they may never escape the downward spiral they find themselves in. “As their friend or loved one, help shift the burden to the environment. You might work with others to proactively change the environment, or provide ‘aircover’ while they cope, or simply help them recognize some of the factors that may be impairing their well-being—especially factors beyond their control. You might even look inward to understand how you’re contributing to their environment positively and negatively.”
“Mentally ill people are dangerous.”
So are every one of us potentially.12 Historically the media and Hollywood have amplified isolated incidents and reinforced stereotypical behaviors. Thankfully we’re turning a corner and this is becoming much less common in both arenas. Research and data have extensively shown “very few people who have a mental illness are dangerous to society. Most can hold jobs, attend school, and live independently.”13
“You can get over mental illness if you just get on with life. You know, like just get out of bed or do something to cheer you up.”
Wow. There’s a lot to unpack here. The reality is mental illness is often accompanied by serious physical side effects, making it difficult to simply “get on with life.” Here’s how a friend of ours described the physical symptoms they were experiencing from depression:
- Weird pressure in my chest as though it’s being pressed inward from the sides and/or compression in the center similar to asthma attacks.
- Subtle ringing in my ears.
- Shaking, not shaking like I’m cold but more like jittering as if I can’t sit or stand still.
- Strong desire to lie down often.
Other physical symptoms brought on by depression may include decreased pain tolerance, back pain, headaches, eye issues.14 Other forms of mental illness also result in physical pain or side effects. (And we haven’t even mentioned the side effects from medication such as antidepressants—another story for another time.)
“Mental illness affects only a small fraction of the world’s population.”
It depends on what you mean by small fraction. Ten percent of the world’s population or the equivalent of 800 million people?15 Not small to our eyes.
“Mental illness doesn’t affect children or teens.”
Sadly, it does. Globally about 1 in 5 children and teens suffer from mental illness.16 And it’s especially prevalent among those who identify as LGBTQ. For example, high schoolers who identify as lesbian, gay, or bisexual are almost five times as likely to attempt suicide compared to their heterosexual peers.17
The more you know. 💫 Please help dispel these stigmas for others.
In our words: what helps and what doesn’t
Here we lift the curtain a little and share something written by one of us, your authors, at the apex of their mental health struggles. What follows is not a universal guide for what to say and what not to say, but rather one person’s perspective.
Telling me “things will get better” usually isn’t helpful. Recognizing that it will probably take a while until things get better usually is more helpful.
If I’m caught up in my current circumstances and don’t care much about the future, I probably have little interest in waiting for things to change. “Things will get better” doesn’t add much value at the moment. On the other hand, you might think saying “it’s probably going to be tough for a while” would be destructive, but I would welcome hearing this from my support circle. Hearing you recognize that things aren’t going to be fixed overnight and that you’re with me for the long haul can be encouraging.
Acknowledging the factors that have led to how I feel now is helpful. Glossing over these and providing uplifting rebuttal usually isn’t helpful.
Validation can be extremely helpful. When I finally brought myself to visit with a family practitioner to begin assessing my mental health, I shared what I perceived to be the factors that contributed to my decline in mental health. This particular doctor seemed to dismiss these factors and missed a critical opportunity to provide comfort by responding such as “I can imagine that must have been hard for you” or something like that. Granted I was speaking to someone who deals mostly with physical ailments, so maybe this was the first time this doctor had a patient with mental ailments. (Lesson learned: seek the right kind of help such as a psychiatrist or psychologist.)
Telling me you care about me or love me, even when I don’t deserve it, is incredibly helpful. Occasionally letting me know how much of a jerk I’m being and that you don’t deserve to be treated that way can also be incredibly helpful.
The former gives me hope. The latter is a wake-up call and helps me put things in perspective.
Losing myself in the service of others can be super helpful for combatting self-pity.
Please remind me that one of the best ways to alleviate my own problems is to help others alleviate theirs. Help me find or create opportunities to serve.
Help me understand that counseling is not a four letter word.
You telling me to get counseling probably won’t settle well, but you can ask me if I’ve considered counseling or therapy. You can also share that you’ve learned many others have had successful experiences with counseling. And if you’ve gone through counseling yourself and feel comfortable disclosing this to me, please do.
Encourage me not to wait any longer for help.
Chances are by the time I open up to you about my struggles, I’ve already been struggling for a while. As humans our tolerance for suffering is pretty high. On the one hand this is reassuring as it means I can get through this. On the other it means months can pass as I try to combat mental illness by myself before acknowledging I need help.
Ask me how I’m sleeping.
Lack of sleep is probably affecting my health physically, mentally, and emotionally and exacerbating what I’m going through.
Help me remember that we’re often our own worst enemy.
Ask me if I speak with myself (doesn’t matter if it’s verbally or mentally), how often, and what the nature of the dialog is. Chances are it’s not healthy. What might you share with me about what you’ve found helpful to maintain a positive attitude?
In our words: observations from a psychiatric nurse
We’ll wrap up this third article with a few observations from our medical advisor for this series, Eddie Brouse, psychiatric mental health nurse practitioner with nearly 20 years behavioral and mental health experience counseling adults and juveniles impacted by depression, anxiety, personality disorders, and more.
Tell them that you’ll check up on them. And then do.
Phone calls, texts, emails, etc. It’s important to understand that someone in crisis can have a hundred people check up on them and still feel abandoned, alone, and desperate. By checking in you’re not expecting everything to be healed and OK, but rather you’re keeping doors open. When a person is willing and able to reach out for help, it’s important that doors be open to them. So in that sense, call, call again, and again. And be okay with rejection, disrespect and misunderstanding. Recovery isn’t about being polite.
Many times I’ve heard a nurse in the ICU say “I’m not here to be your friend, I’m here to save your life.” I decided to adopt a different mantra.
When angry and occasionally violent patients were suffering and turned their emotions on me, one of the first things out of their mouth would be “you’re not my friend.” I learned that the best reply was “I’m the only friend you’ve got, and just because you don’t like me doesn’t mean I’m not your friend.” The fact is, you can hate me and I’ll still give you the help you need.
We aren’t here to ‘fix’ you or your problems.
This is an important concept to remember as a caregiver, supporter, or friend. What we’re here for is to see that you have the best possible opportunity for help. Too often when we talk to someone with a mental illness, we feel compelled to fix things. Sometimes the best thing a person can say is “I don’t know, but I care.” This approach will relieve the supporter from feeling overwhelmed, and it enables the person suffering to know that their supporter isn’t obliged to do more than they’re able to.
“I will call for help if I’m concerned for your safety” should follow the “I don’t know” statement.
Here’s why it’s important to say “I will call for help”:
- It sets some ground rules which are always best established up front. If you need to call the police or the hospital or a hotline, it isn’t a surprise to anyone.
- It lets those in need know you are an access point to additional help.
- By letting others know upfront that you’ll be proactive and won’t keep secrets or ignore the issues, you give yourself relief by not taking on the burden of carrying around the emotions and stress of others.
Friends, we express profound gratitude for your role as champion of recovery. We understand intimately what it’s like to be in your shoes. Your team members, friends, loved ones need you. The need a healthy you. Take care of yourself as you take care of others.
← Part 2 | Part 4 →
We also offer virtual training for your team on understanding mental health and improving mental performance at work. Please contact us to schedule.