Broaching the subject of mental illness

How do you tell a loved one that you think they may have a mental illness? Here are some tips
Broaching the subject of mental illness

Mental illness can be a very sensitive topic, particularly if you are speaking to someone who shows some signs of having one. Very often, concerned family and friends are able to observe the changes in their loved one’s moods and behavior, and struggle to find a way in which they can broach the subject: "How can I talk to my loved one in a way that lets them know I care for them and want to support them? With the stigma around mental illness, how will they take my suggestion to see a psychiatrist or a counselor?"

Concerns such as these are perfectly normal, and most caregivers report having these thoughts before they speak to their loved ones. If you’re in such a situation, here is how you can approach it:

Understand the issue

Understand what they’re going through. Read about mental illness in general, and with specific reference to the symptoms they may be showing. Give yourself some time to assimilate the information you are going through, and speak to someone if you need further support. Understanding that mental illness is not very different from physical illness, that it is treatable, and that it can occur to anyone will help you approach the matter with empathy for your loved one, rather than with a sense of alarm.

It’s important to remember that reading about the problem can help you understand and become aware about what your loved one is going through; and at the same time, it cannot be a substitute for a mental health expert who can offer professional care and support.

Seek support for the conversation

Check with yourself: is there someone who can support you in having this conversation? Or is there someone else who may be more suited for it? It is best that this conversation is initiated by someone who is very close to your loved one, someone who the other person connects well with and trusts, so that they don’t feel intimidated or cornered.

Initiate the conversation with generalities

Speak to them in general terms about the changes in their behavior and try to guage if they are aware of or have insight about their symptoms. Most people with mental illness – barring people with acute illnesses such as schizophrenia – have some awareness that what they are experiencing is different from their own experience from before, or different from others’ experiences. Persons with the anxiety spectrum disorders and depression are very likely to have insight into their illness.

Begin the conversation by asking them how they are feeling. Do they feel different these days? If they confide in you about what has changed, listen to them in a non-judgemental way.

Offer empathy

Empathy is our ability to be able to understand another person's experience, even when we are not in their shoes. Offer them some empathy by acknowledging that it may be exhausting, scary or frustrating for them to experience these changes. Reassure them that mental illness can be treated, and there are professionals who can support them in dealing with it; and that in no way does it reflect on them as an individual. It may also help to communicate to them that you understand that they are not able to control the changes that are occurring, or how they are feeling.

Respect their point of view

Offer them a choice about their next steps. Ask them if they wish to seek help. Give them a choice in the matter: would you like to think about it? Are you ready to seek help?

Respect their point of view. If your loved one is forced to seek help, they may not participate in their treatment and treatment may not be very effective. Mental health professionals recommend that treatment works best when the person is willing to seek help, unless the person has a severe illness where they lack insight about their illness (for instance, persons with schizophrenia) or lack adequate mental faculties (for instance, persons with mental retardation). It is only in these severe cases that it is recommended that the patient need not participate or actively collaborate with the mental health professional treating them.

Offer your support

Assure them of your support, and that you won’t share their information with others unless necessary.

Find a good mental health expert and accompany your loved one to the doctor; you may be able to support your loved one’s diagnosis.

Seek help if you feel overwhelmed

During this process, if you feel confused, overwhelmed or have thoughts of guilt, reach out to a counselor or the consulting mental health professional. Address and identify your feelings. Each of us has our own way of dealing with the challenges posed by mental illness and coming to accept the diagnosis. It’s perfectly okay to feel worried and sad about your loved one. Seek emotional support for yourself so you can identify coping strategies that will help you care for your loved one.

This article has been compiled with inputs from Dr Garima Srivastava, a Delhi-based clinical psychologist with a PhD from the All India Institute of Medical Sciences.

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