"Reaching Out for Support When You Have a Mental Illness" article
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After having written tons of posts about supporting people with mental illness, I realized that there was a gap–I’ve seen few articles about how to reach out for support when you’re the one with the mental illness. Specifically, how to do so in a way that’s respectful of people’s boundaries.
This is a difficult topic, for reasons that I think are obvious. I don’t want to discourage anyone from reaching out for help, ever. I also want to encourage people to be mindful of others’ needs and boundaries, even when everything hurts so much that that feels impossible to do. Especially then.
Why do these two goals feel like they stand opposed to each other? They shouldn’t. Getting affirmative consent before sharing difficult and potentially-triggering things with people isn’t just good for them, it’s also good for you. Most of us who struggle with mental illness have our moments of panic about imposing on others or being a burden on them. Making sure that we’re actually getting their consent before leaning on them for support can help us with those feelings.
I’ve been on both sides of this. I’ve been the depressed and suicidal person who had to reach out for help, sometimes in ways that didn’t really allow people to say no. I’ve also had people reach out to me in ways that made me feel trapped and coerced. So I think I have a lot of empathy for everyone in both of these situations.
This is a huge topic and this post is very long, but it still doesn’t cover all the nuances. This post is focused on the issue of consent and boundaries specifically, so please don’t be too disappointed if it doesn’t cover everything you thought it would. Suggestions for future posts are welcome as always.
Consent, Consent, Consent
The most important thing about reaching out to someone for support with a mental health issue is to explicitly ask for their consent to have this conversation. This means that, rather than sending them a sudden wall ‘o’ text on Facebook, you might first say, “Hey, can I vent to you about depression for a bit? You can respond whenever you have a moment.” Or in person, if the topic hasn’t come up organically in a way that suggests that they’re ready to hear about it, you might say, “Can we talk about some ED stuff I’m going through right now?”
If you want to talk to someone about things that are fairly likely to be triggering–examples include self-harm, suicidal ideation, eating disorders, homicidal ideation, and so on–it’s a good idea to include a content note. In a message or text, that can just look like “TW: anorexia”; in person, you might say, “Can I talk to you about some eating disorder issues I’m having. I might get into detail.” This is important because 1) the person you’re talking to might have their own issues, which you may not necessarily know about; 2) they may be in a space right now where seeing a sudden wall of text about a very serious topic might really stress them out; and 3) regardless, people can often help you better if they have some idea of what you’re going to talk to them about, especially when it’s something pretty serious like that. When I see “Hey, can I talk to you about anorexia?”, I put myself in a different headspace than when I just see “Hey, can I talk to you about some stuff?”.
When you message someone to talk to them about Heavy Stuff and do not give them a warning about the content or an opportunity to politely bow out, understand that you are making it very difficult for them to say no to you, especially if they’re not someone who feels comfortable asserting boundaries (and most people aren’t). You may not intend to make them feel this way, but that’s the effect it often has when you don’t check in to see if it’s okay first.
I’ve gotten sudden walls ‘o’ text while in class, while on dates, when I was just about to fall asleep in bed, while finishing an assignment on deadline, and all sorts of other inopportune times. It put me in a serious bind, because on the one hand I had a really serious message demanding my attention, and on the other hand, I had things that I needed to be doing. When someone suddenly sends me five paragraphs about having an eating disorder and being suicidal, it feels incredibly wrong to say, “I’m really sorry, but I’m busy right now and can’t talk.” I usually do it, but that’s only because I’ve developed very strong boundaries over the years. Most people haven’t.
Another way that you may unintentionally make it difficult for people to set boundaries is by getting their consent for a certain type of conversation (“Hey, got a minute to chat?”) and then, once they agree, making it clearly way more than a minute and more than just a “chat” (“So I’m really really depressed and I think I’m about to lose my job and I just don’t know what to do, I’m almost out of savings and–“). Phrases like “got a minute to chat” and “hey what’s up” are vague, sometimes intentionally so. Once someone gets into a conversation with you, it’s almost impossible to then be like, “Um, actually, I thought this would just be a casual chat; I’m not really available for a conversation like this right now.”
If someone tells you that no, they cannot talk/listen right now, respect that answer, even if it feels unfair or unreasonable. They may in fact be lazy. They may in fact be selfish and callous. They may in fact completely not understand what you’re going through and if they did then they’d listen. They may in fact just be shallow people who want everything to be sunshine and daisies all the time. They may be all of those things, but they still deserve to have their boundaries respected.
The Importance of Being Specific
Consent is one reason why, when you’re reaching out to someone for support, it can be helpful to be as specific and clear as possible about what you need from them. (I say “as possible” because that can be really difficult when you’re in a moment of crisis.) If they know what they’re being asked to do, then they can actually consent to it. But taking a moment to think about what you need from others right now will help you, too–it’s easier to get what you need if you know what that is and ask for it:
“Hey, I need to just vent at someone about some depression stuff. Would you be able to listen for a bit?”
“I’m feeling down and it would be helpful to distract myself. Could you come over and play video games with me?”
“I’m feeling unsafe tonight. Is it ok if I spend the night at your place and just do my own thing with someone else in the room?”
You may, like me, be concerned that if you let people know you’re having a hard time, they’ll try to offer you types of help that you don’t need. In that case, it can be a good idea to be clear about what you’re not looking for, too:
“I’m going through a really rough time. I don’t really want to talk about it, but could we just chat for a while about something else?”
“I’m having a really bad day. I’m not really up for talking to anyone, but could you send me some cute animal videos?”
What if you want support but have no idea what would help? In that case, being specific is clearly impossible. I think it’s better to be transparent and say something like, “I’m feeling really bad and to be honest I don’t know what would help right now. I just wanted to reach out to someone.” Hopefully, your support person might have some ideas about how to help or what to say.
The reason this sort of transparency is helpful is because otherwise, the person might assume that you do need something specific and you know what that is, but that they need to somehow intuit it. Or they may ask you what they should do, which can be stressful for you to have to respond to.
As a more long-term strategy, though, it might be helpful to try to figure out what other people can do that would help you feel better, so that you know what specifically to ask for from them. If you have a therapist, they can help with that project. If not, you can ask others who struggle with similar issues (maybe on a support forum if you don’t know anyone personally) what works for them. Just because you have similar issues doesn’t necessarily mean the same things will work for you, but there’s a good chance you’ll find something.
Why This Can Be So Hard
Back to the issue of boundaries. For many of us, the pain of mental illness is so strong that it’s hard to empathize with someone who says it’s too much for them to hear about. Resentment can build. You think: “They can walk away from this conversation, but I have to live with this my whole life.” When someone is unable to listen to us talk about how awful we’re feeling, that can kick up those feelings of resentment.
But just as we ask our friends, partners, and family members not to take it personally that we have a mental illness, we should try not to take it personally when they have their own feelings and limits.
There’s a reason psychologists have a concept called “vicarious traumatization,” and a reason why therapists and social workers have such high burn-out rates. Of course, you may not be asking them to do anything close to what a therapist does, and they may not experience it as “traumatization,” but the point is that being very close to someone’s pain can have an impact. In addition, your support people may be dealing with their own mental health issues, which you may or may not know about. They may want to listen to you, but may be unable to because of what it brings up for them.
One last thing I want to say about this is that for me personally, depression made it really difficult to see how my own pain was hurting others. I don’t mean in that awful way that we talk about, where people take our pain as a personal insult or expect us to be happy all the time. I mean that seeing someone you love in pain hurts. Legitimately. But when I’m depressed, I think I’m so awful that I don’t understand how anyone could possibly care that I’m hurting–even though I reach out to them with the hope that they’ll listen. (Mental illness causes many such contradictions.) And when they say that they care so much that it’s really difficult for them to hear about it, it sounds like they’re insulting and patronizing me, presumably to “get out” of having to listen to me. That this perception is often wrong is something that I had to recover from the worst of it before I could understand.
Reading this, you may realize that you have overstepped boundaries in the past. (Or maybe you already knew this.) Mental illness can make people feel like they’re horrible and deserve to die, and realizing that you have overstepped boundaries may exacerbate this.
Try to be gentle with yourself. Mental illness can provoke boundary-crossing behavior, and while it’s important not to use this as an excuse not to work on it, it also means that you’re not a terrible person, and you can get better–both in terms of boundaries and in terms of your symptoms themselves.
Talking about this issues presents what The Unit of Caring refers to as a competing access needs problem. Some people will really benefit from this advice. Some people may already be so terrified of violating boundaries that they almost never ask for the help they need. (This may be surprising given that I wrote this post, but I’m squarely in the latter group.) Mental illness also complicates matters in that people may simultaneously be excessively terrified of crossing boundaries, while also sometimes crossing boundaries!
If you feel that implementing this advice will do harm to you, then don’t implement it. However, I would posit that it would actually be helpful for most people, because my core message here isn’t “You should be Very Very Careful about not violating anyone’s boundaries,” but rather “Hey, here’s how to reach out for help in a way that respects people’s boundaries.”
Supportive People Who Aren’t Really
One reason you may be terrified of crossing boundaries is because you may have done your due diligence and followed all this advice and then still had people tell you that you’ve overwhelmed and burdened them and they never wanted to help you this much but felt obligated to. There’s a lot going on here, such as:
Poor boundaries on the part of those people
People being used to passive communication and reading unspoken messages into your words that you never put there (such as, “If you don’t help me I will hate you/hurt myself/etc”)
A duty-centered view of relationships (believing that being your friend/partner/family member obligates them to help you whether or not they want to or can safely do so)
Simple ableism: believing, however implicitly, that your mental illness makes you so weak and helpless that they are ethically obligated to help you, no matter at what cost to them
The plentiful existence of people who act in these ways makes it difficult to talk about boundaries and mental illness. If we’re constantly accused of being burdensome and asking for too much no matter how careful we are, that can easily obscure the fact that sometimes we really do reach out to people in ways that make them feel like they can’t say no. But remember: both of these things can be true, and are true. They sound contradictory but are not.
There’s no simple way to fix this problem. If you’re not sure whether or not you’re being mindful of boundaries, it might be worthwhile to consult a friend that you trust to be honest and ask them for feedback. And if you notice that there are people in your life who keep telling you that it’s okay to vent about your feelings or to ask them to take you out for ice cream but then it turns out that they never wanted to help you and only did it out of a sense of obligation, it might be time to downgrade these people from “friend that I ask for mental health support” to “acquaintance that I talk about Marvel films with.”
Whatever their reasoning for not being honest (or not being aware enough of their own needs to be able to be honest), it’s not a healthy dynamic. It’s the sort of dynamic that leads many of us to feel like such awful burdens all the time. It’s the sort of dynamic that can make it really difficult to take this blog post seriously, because if people are constantly calling you a burden when you’re not, you may not be able to recognize the ways in which you might actually be crossing boundaries.
Of course, supportive people are difficult to come by and it can feel counterintuitive to stop going to these people for support when they seem to be acquiescing. (And if you ever feel like it’s a matter of life or death, please, do whatever you need to do to keep yourself safe.) But they’re not, in fact, supportive people. If they were, they would properly set boundaries with you in a way that’s compassionate but still assertive. Pretending to consent and then blaming you for believing them is an unkind and unsupportive thing to do.
If you are in crisis and do not feel safe, and none of your support people are available to talk to, please call 911, go to the ER, or call this hotlines if you don’t feel safe doing the first two things:
National Suicide Prevention Lifeline
1 (800) 273-8255