How to Start A Conversation About Mental Illness

Written by Dylan Brethour

Dylan Brethour is a journalist and editor working in London. She writes about pop culture, mental health, and the occasional cult. Her short fiction has been published in print and online.

You can follow Dylan on Twitter.

One of the most common pieces of advice when it comes to mental illness is ‘just talk to someone.’ While the advice is well-meaning it makes it sound as though talking were easy. I take part in a peer support group for people living with OCD and have seen first-hand that one of the hardest things anyone can do is just start talking.

There are so many reasons why telling friends and family about mental illness can be a challenge. It means wading through the labyrinth of misinformation about mental illness. It also means exposing a part of your life that you may have spent decades hiding. Even in the best scenario, the whole topic can still feel a little bit weird and personal. 

So, to mark Mental Health Awareness Week, here’s what I’ve learned about starting a conversation about mental illness with friends and family.

1. Understand what you want to get out of it

There are so many different reasons to talk to other people about mental illness. Do you need practical support accessing treatment or do you just want to explain an important part of your life? 

Of course, you don’t need to choose one single reason why starting a conversation feels important. But approaching the topic of mental illness can feel overwhelming and it’s helpful to have something to focus on. You can also use your decision to narrow down what details of your experience you feel comfortable sharing.

2. Come armed with examples

It gets overlooked how incredibly difficult it can be for people with a mental illness to describe our symptoms. One of my favourite all-time quotes from a psychiatrist is that there’s no way to keep mental illness from being messy. This isn’t ‘mess’ in any pejorative sense, it just means that symptoms can’t always be parcelled into neat little packages that everyone can understand. 

However, because mental illness is messy, it’s also hard to explain. This is especially true if you’re in the grip of a bad episode where just getting out of bed can be a challenge. Mental illness has a tendency to make otherwise simple tasks complicated and explaining symptoms isn’t straightforward to begin with.

Still, people will want to know what’s happening to you and will almost certainly ask questions – not all of them tactful. Being put on the spot and getting flustered makes explaining an already difficult topic harder. Having a plan in place will make expressing yourself much easier. But…

3. You don’t need to explain everything 

Talking about mental illness becomes even more daunting when you feel obligated to try and cover every single detail. It’s easy to imagine the conversation will be a failure if the other person doesn’t completely understand your experience. But the reality is that the first conversation is exactly that, the beginning of a process, not the final product. 

It’s also worth noting that the inverse of openness isn’t necessarily shame. You get to maintain your privacy in the same way someone without a mental illness does. Tell people just as much as you’re comfortable with and share more later if you’d like to. And if, despite all of your careful planning, it still doesn’t go as you’d hoped…

4. Give yourself room to get away

Claustrophobic family holidays and long flights are probably not the best place to start a conversation about mental illness. Ask yourself: would you break up with someone there? If the answer is no, it may not be the ideal spot for a potentially emotional exchange.

While sharing your experience of mental illness can be incredibly rewarding, it doesn’t always go to plan. Words like ‘depression’ and ‘OCD’ get bandied around so often that they’re liable to be misunderstood. It’s terrible and unfair, but sometimes even the people that you love will screw this up. 

If your conversation does go badly and someone doesn’t understand give them your best ‘it’s not me, it’s you’ look and leave. Go pet your cat or watch that weird ASMR cooking thing on YouTube. Whatever works. And remember…

5. You’re allowed to be angry and disappointed 

People with mental illnesses are trained to expect so little from society that it’s tempting to blame yourself when someone doesn’t understand. Seriously, just give yourself permission to be mad instead, it’s cleansing. 

It’s been said ad nauseum but still bears repeating that mental illness isn’t a question of fault or moral failing, it’s just an illness, full stop. Your mental illness doesn’t become any less legitimate when someone you love and otherwise respect doesn’t get it.

At this point, it’s entirely reasonable to just focus your efforts on speaking to someone more receptive. But regardless of who you share your experience with, once you’ve decided to keep talking…

6. Give it time 

There’s no possible way that you’re going to explain everything about your mental illness in a single conversation. Mental illness is complicated, and the way it effects people isn’t always predictable. You’re not just explaining what the illness is but what it looks like in the context of your life. 

The good news is that the initial conversation will almost certainly be the hardest. If you’d like to take the conversation one step further, consider bringing your family member or friend to a peer support group. Therapists are also often open to family members participating in some sessions. 

7. And finally…

In the end, there really is no ‘right’ way to do this. Life is unpredictable and maybe it will turn out that a spontaneous conversation on a 10-hour flight surrounded by tiny chardonnay bottles will be the best decision you’ve ever made. So much of managing mental illness is about learning to trust your own judgement. You know your friends and family best, you call the shots. 

For me, making the conscious decision to tell people about living with OCD has been one of the hardest things I’ve ever done. It has, without question, also been one of the most liberating. Whatever the outcome of your own conversation, it’s worth remembering that you’re doing something difficult and that is something to be proud of.