Disclosing a Mental Health Condition to Others

From Jill Palmer: Mental Wellness Center
Disclosing to Others
Ideally, the people around you will understand your illness and encourage you. But the important people in your life might not know much about mental illness. They may want to help you, but not know how to help. You can give friends and family a better chance to help by thinking ahead about how to tell them about your mental illness.
Reasons to Talk with Others
One reason to tell family and friends about your mental illness is to receive encouragement. Simply talking to someone sympathetic can reduce your stress level and improve your mood. You may also want to ask for concrete support, like help finding treatment or rides to appointments. Or maybe you want to share your crisis plan with a trusted family member.
Maybe you have mixed feelings. You might be afraid loved ones will judge you or feel uncomfortable around you. It can be very stressful if you're afraid to tell people but feel pressure to do so.
There's no right or wrong number of people to tell. Some people will benefit from telling many family and friends. Others may benefit by telling a couple of close friends and waiting to tell others. You are an expert on your own mental illness and can decide for yourself.
If you're stressed about whether to tell other people, you might feel better if you write down a list of pros and cons. Maybe some people won't understand. But maybe you can also see benefits to telling the people who will understand. If you're afraid, the list of pros can remind you of the rewards of overcoming your fear.
Joining a support group such as NAMI Connection can help you understand your own experiences through hearing others' stories. This support can also provide you with insights and tips for relationships of your own.
When to Tell
If you are compelled to disclose during a period where you are unwell, try to locate the most supportive person in your life. This person can help you through telling everyone else. Otherwise, the time to tell someone is going to depend on several things:

• When you're well. This helps provide a calm environment to introduce whomever you speak with to adjust to the idea, especially if they don't know a lot about mental illness.
• When it serves a purpose. People disclose for different reasons, often depending on whom they're telling. You may tell a loved one because they've worried about your behavior or thinking. You may tell a friend so that they understand why you sometimes can't hang out with them, or if you worry they think you're growing distant. You may tell your employer in order to receive accommodations at work. There are nearly as many reasons to disclose as there are to stay silent. Different people have to decide when and if the risk is right.
• When you're ready. Telling people is a very personal decision. It might help to be able to practice disclosure with a professional, such as a therapist. You can discuss any worries you may have about issues, questions, and comments that might arise. Practicing might also help you clarify your own thinking about mental illness as well as help determine who to tell.
  

Who to Tell
Talking about mental illness can be risky. When thinking over the pros and cons of telling someone, also consider the pros and cons of not telling them. The positives and negatives are different for everyone and thinking them through can help you decide what's right for you.
Being able to offer emotional support is not something that everyone knows how to do. It's a skill that takes practice. Some people may not be able to offer emotional support. If you have relatives or friends who lack this skill, that doesn't mean they don't love you.
You might want to make a list of the people you're considering telling. Include the people you feel closest to. Also list the most emotionally skilled people you know, even if you don't know them as well.
Consider the names. Which of your close friends and family are most skillful at offering understanding? Which ones are best at listening or giving a hug when you're down? What about the people who are good listeners? Which of these "A grade" people could you talk to?
At Work
In a job, you have to weigh the advantages against the disadvantages of being open. Consider the potential negative impact on things like stigma from coworkers against your need for special accommodations, which are considered part of your civil rights. Before you share information about your condition, you should learn about your legal rights and also take into consideration your work environment.
In Personal Relationships
In friendships or romantic relationships, generally, the consequences of being open about mental illness take one of three paths:

• The person is genuinely comfortable with your disclosure and things stay the same
  
• The person is very uncomfortable and ends the relationship
• The person says he or she is fine with it, and then does a fast or slow fade from your life

Once you've told someone, you'll understandably be concerned about their reaction. One sign they can handle it is if they treat you the same during or after the disclosure. Friends stay friends. Colleagues stay polite and interested. If you continue to get the same "vibes" from people, you can be pretty sure that your disclosure has not changed the relationship for worse. And that is the best outcome of all.
Knowing that certain people are aware of an important part of your life and that they accept you and support you can be incredibly helpful and liberating. While some people may disappear, it's better to have strong social supports around you.
How and What to Talk About
You can get the best support possible by planning the conversation. Consider including three items:

1. "Process" talk
2. Specific problem
3. Suggestions for how loved ones can help

"Process" talk means "talking about talking," rather than talking to share information. Prepare your listener for an important conversation by using "process" talk. Here are some ways to begin a process talk:

• "I want to talk to you about something important. I'm not sure how to talk about it, though. Can you just listen to me and try to understand? I'm hoping I'll feel better after talking about it with someone, but I need you to be patient."
• "There's something going on in my life that's bothering me. I think I need to talk to someone about it. I feel embarrassed about it, though, so please don't laugh it off or make a joke out of it."
• "I'm not sure if this will make sense. I feel uncomfortable talking about it, but I want to tell someone. Because you're an RA, I hope you'll be able to give me advice on what to do next for help."

Concrete examples of what you mean by "mental illness." Every case of mental illness is different. To get the best support possible, share one or two examples of what's causing you stress:

• "I think something's wrong because I can't sleep more than a couple hours at night. It's hurting my work and I feel out of control."
• "I've started skipping classes sometimes. I'm worried I'll stop leaving the apartment if I don't get help."
• "The doctor said I have bipolar disorder. Sometimes I feel like things are getting out of control and I’m not sure how to keep myself together."

Suggest ways to support you. Family and friends may not know what they can do to help. You can get the best support by asking for specific types of help:
I'm scared to make an appointment because that's like admitting there's something wrong. But I need to see a doctor. Can you help me find one and follow through?"

• "I'm not thinking clearly these days. I'm getting treatment for a mental illness, but it might take a while to feel right. Until then, when I do something that makes you uncomfortable, can you please tell me what I'm doing instead of getting freaked out?"
• "I'm not supposed to drink alcohol with my medications. I'm going to try not to drink at parties, but I need my close friends to encourage me and help me keep my social life."
• "I'm feeling better. But once in a while, can you tell me you're there for me and give me a hug?"

By telling the right people and suggesting ways for loved ones to help, you can start building a strong social support network. At first, you might be afraid to talk about your experiences. But don't give up looking for support and encouragement from others. You'll discover that many people want to help you.

• You don't have to share everything. Decide in advance what parts of your experience you'll talk about and what parts you won't. Stand by your decision. It's perfectly understandable to answer a question with a statement like “I'd rather not talk about that right now.”
• Make sure to share the good things. Explain how your illness has taught you new things, or about experiences you were able to have in spite or, or because of, your illness.
• Set boundaries. Be clear with people about when you want their advice and when you just want them to listen. Also realize that people come with their own opinions, informed and otherwise, so be patient when explaining. If they try to discredit you, gently remind them that you are the one living with the illness, and you know yourself best.
• Let them know how they can support you. Everyone has different needs, and different people respond in different ways. Think about your needs ahead of time, and about whether this person can support you, if there are resources that would help her or him understand what you're going through, or if she or he says no. Some people may not be able to handle disclosure, so it may be difficult to expect support from them. However, there are many people who will probably feel honored that you shared this with them, and whom will be happy to do what they can.
• Provide them information after you talk to them. Pamphlets and books are a good place to start. NAMI is an excellent web resource, and is home to a number of programs that are great places for people to meet and socialize while learning about mental illness.