Sunday, January 22, 2012

How to Talk to People with Mental Illness

Okay, another soap box post.

A favorite blog of mine has a set of posts entitled "social minefield".  I think this would appropriately be put underneath such a title.  Why does it matter?  Well, at least half of the grad students I have known suffer from mental illness.  I am one of them.  I was diagnosed with unipolar depression at age 19 and OCD shortly after.  I was diagnosed my first year of grad school with bipolar II, which wasn't a surprise.  I have a history of it on my mother's side of the family and while it sucks, I doubt you would really ever notice.  I'm pretty stable.  Copious amount of therapy and the appropriate regimen of meds has led me to lead a pretty normal life.

The other reason that this matters?  Students, just like normal people, have mental illnesses.  Plenty of them do.  They probably won't tell you that they have them, but you should be sensitive to the needs of your students.  In fact, being diagnosed with a mood disorder in your late teens/early 20s is very likely.  This is the time of frontal lobe development and the time when you are most likely to see this occur.  My diagnosis at age 23 and my symptoms, which appeared up to a year earlier, was textbook.  You may see students also exhibiting strange behavior, a  lack of concentration, or saying that they are completely stressed. Tell them that it is normal and refer them to a stress relief center on campus.  Most colleges have these sorts of groups on campus.  Mine has them almost every day of the week - for free.  Others, like my undergrad, charge a nominal fee and have regular meeting times.  You don't have to say, "I think you have a mental illness" because they may just be overwhelmed and lack study skills, but especially if they have had a recent loss or are dealing with other issues and confide in you about this, know the resources.

The thing I stress most, however, is that you don't offend people.  You see, people like myself have mental illnesses.  Yes, normal, productive members of society can suffer.  You may make jokes about "being OCD" or may make fun of me for freaking out over a door not being locked properly.  It's one ritual I may always have.  It's painful for me and I don't need an audience.  I legitimately believe that things will burn down when I don't lock the door properly.  Yes, it sounds crazy - because it really is - but I have no control over these thoughts.  My brain just likes to screw with me sometimes.  Don't make jokes about self-harm, eating disorders, or how you want to kill yourself.  People who have been there or have been personally effected by suicide don't like it.  My sister saw two suicides and one attempt within her first year of college.  She really gets upset by these jokes, despite not suffering from a mental illness.

Why does this matter?  Well, there are several reasons:
1. People who have suffered and are back "on track" and in therapy, taking their meds, exercising, etc to help themselves may find themselves feeling badly about taking their meds and doing the things that help.  Stigma can be a powerful barrier to treatment.
2. People who have a mental illness should feel safe.  They shouldn't be made to feel ashamed.  Part of the problem with mental illness is that it IS stigmatized.  You can work to change that by making every space a safe space.
3. You never know who has been effected by mental illness - either by their own struggles or by those of others.  I am very effected by not only my own contemplation of suicide but also the multiple attempts of people around me which left me reeling.  I never attempted and never ever had a plan, but the thought that there was no hope was all around.  Many people have felt that way once.  Trivializing it doesn't help.  So, be careful always.  You don't know who is listening.

How do I improve the situation?
1. Don't trivialize the struggles of mental illness.  Being OCD is not like an episode of Monk.  Cutting yourself is not just something emo kids do.  Eating disorders are no something you wish you had.  You aren't clinically depressed because you had a shitty day.
2. If someone has a mental illness, be supportive, but don't assume anything.  They will tell you what they are comfortable telling you.  Don't assume that they are somehow "crazy" or "fragile" unless they tell you.  I am a pretty normal human being.  I get A's.  I study just as hard as everyone else.  I deal with some trials and tribulations, but I don't ask for sympathy.  I learned something when I case managed for Medicaid.  You need to give empathy, not sympathy.  This is true here.
3. If a student or colleague comes to you, be aware of the resources available.  Don't say, "I think you need to see someone."  Say instead, "I know stress can be overwhelming.  Have you tried these stress relief workshops?  I hear they really work."  If you are talking to a friend and really care about them, you can offer to go with them to the stress relief thing or agree to hold their hand while they wait for a therapist.  Be aware of what is there, share it in a supportive and non-judgmental manner, and then let the person do what they will with it.  Empathize.  Don't judge.
4. Be aware that mental illness can be crippling and it is time consuming to take care of - just like any other illness.  I work on it all the effing time.  That said, it's not any different than having a physical illness.  I have several other chronic conditions that are pretty bad to deal with and they are very similar to mental illness as far as coping goes.  Most people have dealt with this sort of condition at least once in their life.  Think of how you felt and how you wanted to be treated and do unto others as you wanted to have done to you.

As an academic - hell, as someone who comes into contact with people - you should be aware of mental illness.  People have the ability to change stigma.  Just as was done with diseases like breast cancer and AIDS  in the past, we can help bring this to the forefront.  It's just especially important because of the age of students you deal with and the fact that academics have a higher incidence of mental illness than the general population.

Just some food for thought.


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