Statistics show that mental health is a bigger women’s issue now than ever. As public understanding of conditions like depression and anxiety improves, some of the long-held stigma around treatment recedes. Employers are increasingly open to conversations about mental health sick days, and communities are more aware of the significance of accessing affordable therapy. But when it comes to personal conversations about mental health, many of us still don’t know where to begin. How do you tell your family that things are not OK?
First, know that you can choose to not tell your family anything at all. “Not everyone comes from a family where they can be open about these kinds of things,” says psychiatrist Dr. Kali Cyrus. Consider factors like how often you’re in touch with your folks, how much you rely on them, and how you expect them to respond.
Dr. Cyrus points out that when you’re already going through something, you need to put your personal well-being first. If you’re worried that your parents’ reaction might be harmful — for example, if they’re staunchly anti-pharmaceutical and you’re finally thriving because of the right prescription — feel free to keep your mental health private and seek support elsewhere.
If you do decide to discuss your diagnosis and treatment with your family, licensed marriage and family therapist Dr. Racine R. Henry suggests that you prepare what to say ahead of time so your emotions don’t take over. “The bottom line is that you should trust your loved ones want you to be okay and want you to be happy,” she says. “A lot of their reaction is going to be out of fear or concern for you, and not really about them not understanding or not being supportive — even though that’s how a negative reaction can feel.”
Planning the conversation
Even with the most supportive family in the world, it’s hard to share news about your health. You probably have some idea of how your parents will react — positively or negatively, quietly or inquisitively — and how those reactions might affect you. If you’re stressed by the idea of your mom asking a million questions about side effects or your dad sitting in silence after the word “depression,” find an approach that limits those possibilities.
1. Pick the setting. As the person initiating the conversation, Dr. Henry points out that you need to find a setting that’s comfortable for you. “So if that means this discussion happens through email, that’s perfectly fine,” she says. Other options might include talking over a meal or even in the car — small distractions can take the pressure off the flow of dialogue.
You might also be able to have the conversation in your therapist’s office. “That can be really nice because you have the support and knowledge of a professional there,” says Dr. Henry. “And you also are allowing this person to be part of your healing process.”
2. Choose your talking points. Dr. Henry suggests plotting out your conversation ahead of time: What do you want your family to understand about what you’re going through, and how can they help you? If you’re seeing a therapist, you might opt to role-play this conversation ahead of time. That way you can figure out exactly what details you’re comfortable sharing.
Having the conversation
Whether your parents are doctors with knowledge of mental health issues or TV buffs who believe everything they hear about “mental illness” in the news, this will likely be your first serious conversation about your own circumstances. Be prepared for a range of possible outcomes and, above all, prioritize your emotional well-being.
1. Use it as an educational opportunity. Your family may not be as up to speed on mental health issues as you are, so be prepared to fill in the blanks as necessary. “A lot of the time… people have this very stigma-informed idea in their minds of what a mental health situation looks like,” says Dr. Henry.
She explains that, as part of your conversation, you need to explain your mental health “brand.” For example, you might tell your family about how you feel day-to-day and if your condition involves physical changes as well as emotional ones. If you feel comfortable doing so, explain the events that led you to see a therapist, and discuss how your family can tell when you’re OK or not OK.
“Education really helps,” says Dr. Cyrus. “It has to be relevant to the intellectual range of the family, because people are, in general, really dismissive of what they don’t know.” If your parents have different intellectual styles, you might consider how to convey information about your condition in different ways. For example, one might prefer to read a brochure or other patient literature from your doctor, while the other might gain greater insight from a book, film, or TV show you identify with.
2. Prepare for unexpected connections. Because mental health issues are often genetic, there’s a chance your conversation will hit closer to home than you expected. “More than likely there’s somebody in the family who experiences it,” says Dr. Cyrus. If a parent is struggling to accept your diagnosis — for example, telling you that your ADHD symptoms are “normal” — understand that they may be coming from a place of familiarity.
This could be based either on their own experiences, or those of another family member. “Maybe they’ve never felt comfortable telling anyone about it,” Dr. Cyrus says. But remember that your conversation is still about you and your health. Just as it’s not your family member’s place to deny your experiences, it’s not your place to pass judgment on theirs.
3. There may be some pushback, but you can also do the same. If your family is struggling to accept the news that you’re seeking help for a mental health condition, Dr. Henry suggests asking questions that allow them to feel heard. “What is it about what I’m saying that’s bothering you so much?” Dr. Henry offers. “What’s your biggest concern? How can I help you understand what it is I need from you and what I’m going through?” Ultimately, the answers to these questions will show you and your family how to support each other going forward.
4. Put time limits as necessary. If the conversation becomes more harmful than helpful, take a break, cautions Dr. Cyrus. For example, if a family member makes an unkind comment about perceived effects of medication, you can choose not to engage. Dr. Cyrus suggests using language like, “This is getting to be a little bit too much for me. I really want to talk to you about this — it’s really important to me — but I don’t want to argue.”
After the conversation
No matter how well or poorly the conversation goes, give yourself some space after it’s over. You’ve probably been carrying some stress leading up to this, so it’s time to switch gears.
1. Practice self-care. If your family’s response isn’t as supportive as you’d hoped, it’s easy to question yourself. “Regardless of how they react, this isn’t about them,” says Dr. Henry. “It’s about you and about you taking care of yourself and being more positive and healthier.”
To maintain that positive direction, Dr. Henry suggests lining up a self-care routine for after the conversation. Depending on where you are and what works for you, that could mean talking to a trustworthy friend, texting a therapist, or doing something else to make yourself feel better. “Absolutely reassure yourself that you’re doing the right thing and taking the right steps,” she says.
2. Set boundaries. If a family member tries to resume the conversation before you’re ready, stand your ground. Dr. Cyrus suggests using language like “right now I prefer not to talk about this,” or “I’m not in a place where I can comfortably talk about this.” You might agree on a new time to talk, or set a time to check in with yourself about whether you’re ready for a second attempt.
3. Reshape your support system. Whether your conversation cements your family as part of your mental health support system or places them somewhere outside it, take a moment to reevaluate. “Get other opinions from people that you trust,” says Dr. Cyrus. Your support network, including professionals, should validate your efforts to do what you think is best for you and your body.
How much do you tell your family about your mental health? Tell us about it @BritandCo!
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