As I walked around the track listening to her fragile heart trying to make sense of her son’s mental illness, I couldn’t help but wonder why she would choose to suffer in silence. But before I even asked the question, I totally knew the answer.
Nobody else really knows? I asked her.
No, not really, she replied before adding with a melancholy lilt, it’s just too painful to talk about.
It’s too painful.
I can’t shut off the echo of those three words. Probably because of their familiarity.
And because of the fact that there seems to be a tenuous tightrope between mental health and mental illness just as there is between physical health and physical illness.
Only difference is, when we get bronchitis, the flu, shingles, even something that could be life-threatening like pneumonia or worse, like kidney failure or cancer, it isn’t shrouded in the same deafening silence as is the diagnosis of a mental illness. In fact, people rush to care for those who are physically embattled, offering to bring some chicken soup to an ailing friend, to run to the pharmacy to pick up a prescription, to provide transportation to a doctor, clinic, or hospital appointment.
So why is it so painful to talk about, much less to accept care for, mental illness?
Perhaps it’s because of the stigma attached, one that says mental illness is about being weak instead of strong, vulnerable and ashamed rather than confident or proud. It’s quite possibly also because of some fear, that crazy, irrational fear that engulfs us with thoughts that if we talk about it, it’ll become more prevalent, like it’s contagious somehow. Or maybe even the fear of rejection if we share too much, by people who just don’t understand or, worse, who simply choose not to walk alongside of us but instead, to turn and walk the other way.
As a school counselor, in my family of origin, and in my personal life, I’ve had many close encounters with mental illness. Early in my college years, for example, I struggled with disordered eating following a dramatic weight drop after enrolling in a quick weight-loss program. It started innocently enough, with me wanting to shed a few unwanted pounds. I would couple my exercise regimen with intentionally cutting back on calories until voila, there would emerge a thinner, happier me.
What I didn’t see coming next was this: The more weight I lost, the more euphoric I felt. The more euphoria I felt, the more weight I wanted to lose. If I could get the scale to read 130, then wasn’t 120 a possibility? Remember that tightrope walk between mental wellness and mental illness? I was running and running and running, physically and emotionally, until I started running on empty, running away from a dysfunctional past and running to avoid an uncertain future. Thankfully my mom was a nurse and was able to intervene before my eating disorder was too far advanced; I landed in a behavior intervention program at the University hospital. After a few weeks as an inpatient, I continued with outpatient resources and therapy for the remainder of my college years. And beyond, if I’m honest.
Throughout all of those years, nobody beyond immediate family knew what I was going through, how much it hurt. How much I hurt. How much my heart hurt.
Because I was too ashamed to talk about how sick I’d gotten. And it was too painful.
So, to my friend whose son is struggling right now, I say these three words: I get it.
But then I add that we must never give up. We must never stop offering our help, support, and love. We must never stop trying to intervene. We must never stop fighting for mental health and wellbeing. It’s a battle we cannot ever afford to lose.
Think of mental health as a three-tiered process: Prevention, Intervention, Post-vention.
As the wise adage goes: An ounce of prevention is worth a pound of cure. And self-care is not selfish. One way to try to prevent mental illness from taking hold and not letting go is to take good care of our whole selves, mind, body, and spirit. Learning about our feelings, recognizing them, naming them, claiming them, accepting them as a part of who we are and what we have to offer is key to emotional regulation. Learning how to respond to our feelings, big or small, easy or hard, comfortable or uncomfortable so that we can effectively communicate our needs is critical for our emotional (and physical!) health and wellbeing.
With children, it’s important to give them the vocabulary to express themselves, then invite them to practice using their words to get their needs met proactively, so that when it really counts, they’re able to respond appropriately. Encourage them to keep a Feelings Journal so that they can express in pictures or in writing what they can’t quite eek out in words. Validate and normalize their feelings with expressions like: It’s okay to feel that way. Tell me about it. That must feel scary, sad, etc. I’m right here for you. I hear you. I understand. And don’t forget that all behavior is communication, so you must also listen closely to what they’re not saying.
With the first sign that prevention alone isn’t enough, early intervention is critical. Are there changes or disturbances in sleeping patterns, eating habits, or physical hygiene routines? Is your child irritable or isolating? Have friends stopped coming around? Has his or her mood or attitude changed dramatically? Is s/he shutting down or withdrawing? Have they stopped talking? Or do you see mania or delusions you’ve not seen before? If you suspect that something isn’t quite right, seek help immediately from a mental-health professional like a school counselor, your primary physician, a child psychologist. Do not leave navigating these unchartered waters to chance; it’s not likely they will calm on their own. Let me add that sometimes interventions are messy and not pretty; do them anyway. Your child’s mental health is way too important to do nothing.
Treatment doesn’t typically end just because we have successfully intervened. It’s crucial to mental health and wellbeing that patients continue to seek help and rely on people in the medical field as well as on family and friends for assistance, validation, encouragement and support. If treatment involves medical intervention, complete routine med checks and be alert and cautious about side effects. If long-term therapy is warranted, keep those scheduled appointments faithfully. Find an accountability buddy if need be. If a support group is an option, don’t see it as optional. Step out in faith and give it a try. Trust the recommendations of your mental health professionals to optimize your care and maximize your chances at a full recovery.
Know that there is always hope for a better tomorrow; if you or someone you know is struggling with mental health issues, please contact your doctor, a trusted adult, or a hotline immediately. Help is always just a phone call or a click away.
Finally, there is a certain strength that comes with allowing yourself to be vulnerable, transparent, and authentic. If you have struggled with mental illness, regardless of where you are in your journey, please be willing to share your story. Together, we can shatter the shroud of silence that overshadows our hopes for restorative healing and mental wellbeing and health.