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Published November 30, 2013, 11:30 PM

What to say when someone's struggling with mental illness

MOORHEAD – Even Marian Olson’s children didn’t know how to talk to her when she was in the depths of her depression and anxiety. Instead, the Moorhead woman’s son and daughter would go to her husband and ask what was wrong with Mom.

By: Sherri Richards, INFORUM

MOORHEAD – Even Marian Olson’s children didn’t know how to talk to her when she was in the depths of her depression and anxiety. Instead, the Moorhead woman’s son and daughter would go to her husband and ask what was wrong with Mom.

“I think the avoidance is the hardest on me, personally,” says Olson, 58. “People just don’t want to talk about it at all.”

Had people been more open to talking about mental illness, Olson says she would have known of her family’s history with the disease and learned about mechanisms to cope with her depression and anxiety.

“It is so real and can be so debilitating,” says Olson, president of the National Alliance on Mental Illness’ Moorhead affiliate. “But also there is recovery possible, so that’s all the more importance for being willing to talk about it.”

More awareness is being brought to mental illness, such as depression, bipolar disorder, anxiety disorders and schizophrenia. Those who struggle are told not to be ashamed or hide their disorders. They’re encouraged to talk about them.

But how do we as friends and families talk about a topic long hushed?

It’s an issue being addressed in the “Make It OK” campaign, sponsored by several Minnesota-based health organizations, including NAMI Minnesota.

One component of the campaign is fliers and print ads that depict silence as a wrecking ball looming over friends and spouses. “Learn what to say to make it OK,” one flier reads, with do and don’t suggestions.

Sue Abderholden, executive director of NAMI Minnesota, says the goal of the campaign is to teach the public to respond in a thoughtful, caring way.

She says the best words express concern and empathy and offer support.

“Can I drive you to the doctor or therapist? Can I bring you a meal? Can I take care of the kids for the afternoon? Just being there,” Abderholden says.


Rachel Blumhardt, clinical supervisor with The Village Family Service Center in Fargo, says not talking about mental illness creates the perception that it is something to hide.

“Being open takes away the element of shame,” she says.

She suggests family and friends educate themselves about the particular diagnosis, recognizing the experience can be a little different for everyone.

They should avoid making assumptions, she says, including any “should” phrases, like “you should be happy.”

Similar to when someone experiences grief, even if you don’t know what to say, simply asking how someone is doing is helpful.

“In my experience, I’ve never had someone say, ‘I wish they wouldn’t ask about how I’m doing,’ ” Blumhardt says. “If they don’t want to talk about it, they’ll say so.”

Blumhardt says body language and tone of voice are also important when tackling this conversation.

“To a certain degree, you have to be OK yourself. You have to mentally have processed this and thought about it and be in a good place yourself emotionally before you go and talk to them about it,” she says.


Part of the reason people may struggle in talking with people about their mental illness is a lingering negative image of people who have these sorts of disorders, Abderholden says. She notes our language is full of slang words for mental illness that are used widely as insults.

“I’m not trying to be the word police, but I think we really have to think about it,” Abderholden says.

Susan Helgeland, executive director of Mental Health America of North Dakota, notes that the stigma about mental illness is deeply pervasive in our culture.

“There is a comfort level we haven’t reached yet,” she says.

Lack of parity in services and insurance reimbursement feeds into the stigma, Helgeland says.

Helgeland says family and friends need to validate the person’s feelings and ask what they can do to help. They shouldn’t lecture and need to be careful not to “rescue” the person, she says.

Helgeland is known for saying “the brain is part of body” and compares mental illness to heart disease or diabetes.

When Helgeland counsels families, she tells them they have to get it out in the open, like they would any other disease resulting from a genetic predisposition.

Abderholden says in talking to people who have been hospitalized for mental illness, very few say they received get-well cards.

“No one makes it through a serious illness by themselves,” she says. “We don’t want people to become mini therapists, but we do want them to offer their friendship and their community’s support.”


Stop the silence. If someone admits to having a mental illness, they are opening up to you in a big way. Ask questions, show concern, but keep the awkward silence at bay.

Be nice. It sounds simple enough, but try to say the right things with openness, warmth and caring. Language and tone of voice are more important than you think.

Listen. The fact that you are there can make a world of difference, so in your conversation, try to err more on the side of listening.

Keep in contact. Offer availability by phone, text, email, or time to meet up. Just be there.

Don’t ignore it. Don’t be afraid to ask about the well-being of another if you think they might be hurting. Trust your senses.

• Offer help. Everyone is different. They may want very specific help or no help at all. Either way, you can always ask and be open to the answer.

Keep the conversation moving. It’s OK to talk about other things to keep silent lulls out of conversation; as long as they know you’re completely open to revisiting the topic later.

Source: makeitok.org/speak-up