The blindspot in our discourse around mental health is that we cannot encourage vulnerable people to reach out and ask for help, without teaching a society how to effectively and empathetically reach back
Thursday, October 10 was World Mental Health Day. As someone who has lived through an eating disorder and self harm, and who currently lives with depression and PTSD, this awareness raising day has always been important to me.
It’s an opportunity for people to speak openly about their mental health struggles, to dismantle some of the damaging myths about mental illness, to let people who are struggling know that they are not alone.
As always, this year World Mental Health Day included a lot of rhetoric telling people who are struggling with their mental health to “Reach out”, to “Talk to friends”, to “Ask for help if you need it.” But this year, these messages weren’t landing for me like they used to. They hold struggling people responsible for asking for help, and also indicate that the second you utter “I need help”, help will magically arrive.
“We live in a society where most people receive no education about mental health, where mental health is still stigmatised, where the average person is not willing or able to provide help to someone struggling”
Except, these phrases don’t explain how this help will arrive. Or what it will look like. Or how the people offering help learned how to give it.
There’s a blindspot in the “reach out” rhetoric. It overlooks the fact that we live in a society where most people receive no education about mental health, where mental health is still stigmatised, where the average person is not willing or able to provide help to someone struggling. But yet we tell mentally unwell people to reach out anyway, to people who may end up doing more damage than good. We’re telling vulnerable people to reach out to a society that has not yet learned how to reach back.
Last year, I had a severe mental health crisis. A “I don’t know if I’ll survive this” crisis. It built, incrementally but quickly: a few huge life changes, some health problems, a couple of intense traumas, and suddenly I could no longer function like a human being. I was having so many panic attacks a day that they began to roll together; feeling like I couldn’t breathe and that my heart was about to explode became my new normal.
“My nightmares were so intense that I wouldn’t let myself to more than nap… I had a flashback so consuming I nearly crashed my car on the motorway, so I stopped driving”
My nightmares were so intense that I wouldn’t let myself to more than nap, leaving me in constant state of physical and emotional exhaustion, and making me sick. I had a flashback so consuming I nearly crashed my car on the motorway, so I stopped driving.
My concentration skills and memory simply evaporated, like my brain was in emergency mode and incapable of doing anything beyond surviving. I couldn’t focus, couldn’t read, couldn’t follow the thread of a story, a TV show, the news, the reason I had come into the supermarket.
I lost jobs, had to take a break from my PhD. The panic attacks, social anxiety and overwhelming force of it all meant I completely stopped leaving my house, stopped socialising.
‘I’m falling apart’
Small talk isn’t really an option when the simple question “How are you?” makes you want to hysterically cry and laugh at the same time. How am I? I’m falling apart, how are you?
But I knew what I needed. I needed to remind myself of who I was, and how life could be good – and I needed to ask for help. So I did. I spoke up. I went to therapy and sought out specialists, some of whom were helpful, some of whom were not and just drained my bank account. I told my family what was happening. I told my friends what was happening. I told Twitter what was happening.
I reached out, I spoke openly, I said I needed help and I asked for it. I was doing what I had been told to do.
And people were… not great.
When no-one reaches back
My family were endlessly supportive. Two friends were fantastic. Others were not. People disappeared. People shamed me. People made offers they had no intention of following up on. And it made it worse.
I was very open about the fact that for months, I wasn’t able to leave my house. I got some nice text messages. But literally no-one offered to come to visit me in my house.
I received text messages from people reciting the script we give people when a loved one is struggling. “I’m here for you. I support you. If you need anything, I’m here.” It sounded lovely. Except it wasn’t true. They weren’t really listening to me, weren’t willing to do anything to actually support me.
One basic example? I was very open about the fact that for months, I wasn’t able to leave my house. I got some nice text messages. But literally no-one offered to come to visit me in my house. That’s the difference between the rhetoric of support and actual support: one is physically hearing to the words. The other is emotionally hearing what those words need in response.
Hearing the rhetoric of support from people but getting no actual support from them had a tangibly negative effect on my mental health. It felt like gaslighting. It felt like being silenced with soundbites. It made me feel crazy.
I felt like I was visibly drowning in a room full of people, screaming for help while they looked on, doing nothing, but saying “That looks very difficult. I support you” – and having the world tell them that they were excellent friends, they were mental health allies, they were Being Supportive.
After a few instances of this happening, I stopped asking for help. I stopped telling people how I was. I no longer trusted offers of support, because too many empty promises had been made.
Why we need actionable education
I sound angry. And I am. Not at the people who let me down, but the system that fails to educate us about mental health, yet repeatedly insists we’re all capable of supporting each other.
A few people who I reached out to were outright terrible. But most of them just did not know what to do, did not know how to help. Because we don’t teach people. We tell people to listen, to say they support friends who are struggling – but don’t explain what support can look like.
We don’t explain the day-to-day effects of mental health struggles, what it feels like for people who are struggling, how others can help. We don’t give people detailed instructions on what to do, how to offer help, how to turn the rhetoric of support into action.
I needed someone to ask if I wanted empathy and commiseration to feel validated, or a pep talk to remind me that the world is wonderful and I should stick around to see it.
I needed action. I needed people to offer come to my house when I couldn’t leave it. I needed people to say that I could text them the word “panic” and they would call me, talking nonsense to distract me or doing breathing exercises down the phone until I stopped feeling like my heart was going to explode. I needed someone to ask what would make me comfortable socialising, to say “If this event is too much, tug on your earlobe and we can leave immediately, go home, and watch Drag Race.”
I needed someone to offer to help me research therapists when my brain couldn’t retain names and specialities. I needed someone to ask if I wanted empathy and commiseration to feel validated, or a pep talk to remind me that the world is wonderful and I should stick around to see it.
Knowing how to reach back
I probably wouldn’t have taken them up on a lot of it. But having real, tangible, offers, knowing that I had an actual support system available, knowing that if I fell apart someone would actually do something to pick me up would have made all the difference in the world.
When it comes to mental health, we need to stop trading catchphrases and start implementing education; talking openly and specifically about how mental health struggles affect people, and giving clear instructions on what support can look like. People who don’t know what to do, can do damage. And we cannot let vulnerable people in the throes of mental health crises fall victim to that damage.
Mental health education needs to be universal; for the healthy as well as the sick. It cannot just focus on people who are having a mental health crisis, or teaching struggling people how to cope. It needs to also focus on creating a society that actually knows how to support those struggling.
We cannot stop at telling people “Reach out! Talk to friends!” Because I did. Some of them made my problems worse. Not intentionally, but they did. For reaching out to be a positive experience, we need a society that knows how to reach back.
Read more: Dealing with panic attacks
Read more: Emma Stone on panic attacks
Read more: Social anxiety – a survival guide