Sunday, May 28, 2017

how to support someone with a mental illness

Sunday, 05/28/17, 10:22am

Oh blog. Dear dear blog. You dear dear readers and loved ones who have stuck with me through, what I believe was the worst of it, and I think I'm close to finally coming out the other side. I love you all for sticking with me, despite my illness causing me to push people away so much. I now understand, after fighting this illness for so long, what it is that helps me the most.

And I can look back on my behavior all these years and I can see my mistakes but I can also see why I made them and what I was looking for.

I feel amazing. If I didn't know any better I'd wonder if I was manic, but I know that's not it. I can recognize the emotions in myself and I can better label them now. We also think this latest antidepressant might just be starting to kick in.

I should explain. There's so much to explain though. I have to do it right, because this may still be a hard post for all of you to read.

Let's start with a couple things. What I have to say, I think I know a lot about and I want to tell you why I think that and why I think I have the authority to talk about it. You know I have depression and anxiety, right? You may assume some things about my depression and anxiety, and the best thing I can do is share about it and hope that you understand more and assume less. And you may know that I'm an engineer, so you can probably assume that I have a fairly logical and analytical brain, which may or may not give you assumptions about me. I have seen, firsthand, my whole life, how my emotional side and logical side have been in conflict. And I think I finally know how to resolve them.

What I have to talk about is empathy, something I've touched on in this blog, but something I didn't fully understand until now. Many things have led to this "epiphany" I keep talking about. I've been feeling frustrated by my illness and I feel like a burden to everyone around me but part of the reason I feel that way is I see myself rejecting their help as I get worse and worse and I feel awful about that because I want to accept their help but it doesn't feel helpful to me, for some reason I can't figure out. It's been really really hard, but as I understand empathy more, in this last week of epiphanies, I can better empathize that the people helping me have also been scared to death by my illness and my rejection of their help. They see me deteriorating and they don't know what to do about it.

So, quickly let's have a little bit of history. I grew up not understanding mental illness. When I started feeling suicidal when I was about 12 or 13, I had no idea what to do with those feelings. I knew that I shouldn't have these feelings, they certainly felt scary and wrong to me, but I was terrified to tell anyone because I didn't know how they would treat me, because to me, this was me, not an illness. So I didn't tell people. For a really long time. I figured out, enough, how to reject those feelings and be happy and choose to be happy and pretend like all that stuff had never happened. I was happy in high school and college because I chose to be happy and when I was met with people who were depressed at that time, I couldn't understand what they were going through, and I, along with everyone else, couldn't help them either.

Then after having kids, those awful, scary feelings came back. I couldn't seem to choose to be happy anymore, but I kept trying to. I was like, ok, I'll get the minimal help I need and continue to choose to be happy. And I kinda did that, somewhat well, or at least it appeared that way to everyone else. The people who saw me depressed knew I wasn't all the way better, but I was functioning, enough.

My therapist has mentioned several times that I don't seem to accept my illness. All the scary thoughts I have about myself and the reason I usually go down that hole even further is because of this ridiculous belief in me that this is all my fault. And, as it turns out, it's been reiterated to me over and over and over again by the stigma that's out there.

Let's talk more about stigma real quick. I believe that it is something that is so pervasive, even with the improvements in mental health advocacy over the years. It's something that doesn't actually seem to get better because as mental healthcare improves, we also set higher expectations on the patients to "get themselves better". And that's such a ridiculously weird expectation. We see people who are so far gone with their mental illness, and we can't empathize with that situation because we haven't lived their life. We don't actually know what that person has tried and we don't actually understand why they've chosen the care they have.

The reason I call this stigma is we don't treat people with a physical illness the same way. We don't argue with cancer patients about the care they've been getting, usually, if they are seeing the experts. But then experts in mental illness aren't perceived as experts because mental health has to do with human behavior so why do people need experts for that? And suddenly, everybody feels like they need to help but of course most people aren't qualified to do so.

Let's try some empathy on real quick. In the last few days or so, I've been applying it everywhere, I've been practicing it more, and I'm finding it's getting easier and easier to do it as I see how it works. So take for example the young teenager, struggling with bullying and suicidal thoughts. They don't know who to turn to, because despite everyone loving them, very few people are empathizing. Because as this person struggles with these thoughts, they become more and more irritable and they seem to push others away more and more. If they don't understand, like really understand, not just logically, that there is help out there and people are willing to give it, they will turn to suicide. Absolutely.

We keep using this language to describe suicide as "committing" or "choosing to die" or whatever. It turns out, that language blames that person every time. They were "selfish", etc. We refuse to humanize and empathize with what that person was going through to lead them to that act, because it's so scary that someone would hurt us that way by leaving us.

Death by cancer is forgivable. Death by suicide is not.

Because yes, suicide isn't an "option", I'm not trying to claim that it is. It's just, we have to find the right language instead of demonizing the person with the illness.

If I tell you that I'm feeling suicidal, you feel scared. Am I right? You feel like it's all on you to fix this and you don't know the right way to do it. So you do what you know best, you remind the person you love them, and you offer some way to help, by either offering to help when they're willing to take you up on it and/or offering advice. But in the case of mental illness and suicide, etc, we rarely offer empathy, because yes, it is so scary and it's almost impossible to empathize with something that is so foreign and so scary.

I find that the best help I get is when that person offers empathy, first and foremost. Before and throughout any piece of advice they have to offer.

My therapist offers things for me to do and to practice in my life, but she is trained and knows to always give empathy first. I talk about how hard my life is, and she says, "wow, that sounds tough. it sounds like you've been struggling with these thoughts for a long time." And I still don't necessarily respond super well to her advice, because usually it's something I need to change about my life. And of course that's hard. But I respond better to her than I do to someone who doesn't offer empathy.

I started sharing about my mental illness at a point in my illness where it probably wasn't quite what I needed. I didn't know that what I needed and craved was empathy. But after taking data on all the help I've received since sharing openly, I've now seen that empathy is the common thread to helpful help.

I don't think that empathy is the key to eradicating mental illness or something. I do think that empathy is the key to eradicating stigma though, and I think that's going to be my message to the world from now on. If you can empathize with these crazy illogical thoughts that are floating through my head because I have this illness that you can't just fix by telling me the right thing to try, then you can start to offer empathy and give me exactly what I need when I need it the most.

My biggest fear like I mentioned is that I can't get better, either because I won't or because I won't accept help or because I haven't found the right treatment yet. I've been looking for other people to tell me that's not true, but of course they can't tell me that because they're almost too scared to talk around me. I've been looking for other people to remind me that this is an illness, it's not my fault, but then as I refuse to empathize with how hard their situation is in supporting me, I'm not invoking the empathy I want people to show me.

The best thing to say to someone with a horrible mental illness is this:
"I am so so sorry that your illness makes you feel that way. That sounds awful and scary. I wish I could help. Please tell me if there's anything I can do to make it better and I will try to do that thing. In the meantime, I will accept you for who you are and accept that you're trying your hardest to reject these feelings and thoughts."

And the best thing for someone with a horrible mental illness to say to people supporting them is this:
"I am so so sorry that my illness makes you feel helpless and scared for me and I know that you want to help so much. And I know you love me. Please know that when I reject your help, I'm not rejecting you. I am trying so hard and I will continue to try and tell you when I need help and get the help I really need."

I love you all. Really I do. I don't want to hurt anyone by what I have to say and I'm not trying to blame others for suicide or whatever. That's not my message. My message is simply this: try to implement empathy in your life, with your spouse and children, with your parents and your siblings and extended family, with your friends and neighbors and acquaintances, and most especially, with people you find disagreement with. If you try empathy, you can usually start to understand where someone else is coming from. And that is an amazingly powerful tool.

I don't expect I've said everything I wanted to say in this short super long blog post. And I don't expect to get this all figured out real quick because what I want to do is an impossible task. I want every person in this world to put empathy first and foremost in every situation they encounter, but that's not going to happen. It's not how our human brains are wired. When we see a scary situation, we have the "fight or flight" response, and it's really really hard to stop that. I've been working on stopping that, every time I get depressed or anxious, and I haven't been very successful so far. I think, I hope, it's going to get easier, as I get better and better at empathy and asking others for what I need. I think, maybe, I'm getting there.

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