When someone has a mental illness it can be very difficult for them to see it. The very nature of a brain illness is such that the brain itself has a hard time recognizing it. We are often so wrapped up in the symptoms that we can’t see that what we’re really suffering from is an illness and not just a bad day, bad week or bad month. This is to say nothing of anosognosia, the clinical condition wherein people don’t possess the insight necessary to understand that they are sick.

Sometimes Others Can See We Have a Mental Illness

So sometimes the people around us are the ones that realize we’re sick before we do. Sometimes it’s our loved ones that can clearly see a pattern of behavior that goes beyond unusual into pathological.

But if you know someone who you suspect has a mental illness, how do you tell them?

Knowing Someone Has a Mental Illness

First of all, realize that you might be wrong. Even I, with more than a decade’s experience with this disease, could incorrectly identify the disease in others. I am not a doctor and certainly not a diagnostician. Also, loved ones don’t generally have the chance to ask the critical questions that indicate a mental illness – the kind of invasive, personal, rather impolite questions that a doctor would ask.

So you might be wrong. That’s doesn’t mean you shouldn’t say anything, but it’s something you might want to keep in mind.

The Person with a Mental Illness

Conversation About Mental Illness

That being said, even if you’re right you can likely expect the person you suspect to have a mental illness to deny it. We all want to deny we’re sick. It’s human nature. No one wants to admit to any illness let alone a mental illness. In fact, even if the person agrees with you they may still exhibit denial as it’s one of the natural stages of grief and grieving is normal if you’ve just found out you have a serious illness.

Also keep in mind that this person isn’t going to be thinking at their best at this time – they have a brain illness – that’s going to affect how they assimilate information. Be prepared to speak slowly and present simple information, at least at first, until the person gets their bearings. (This doesn’t mean that there’s anything wrong with the person’s intelligence, it just means they are temporarily impaired. It happens.)

Planning for the Conversation

First, get your ducks in a row. Consider for a moment why you think this person has a mental illness. Are these reasons reasonable? How do you know? Have you done your research? I would suggest that if you haven’t done your due diligence and at least looked up the diagnostic criteria for the mental illness then you shouldn’t even be having the discussion in the first place. Without that basic knowledge you’re really shooting in the dark.

Secondly, have specific examples of why you think the person has a mental illness. It’s not enough to say, “you seem sad,” you need to actually have examples ready to back up that idea like, “remember last Tuesday when I found you crying for no reason.”  These concrete examples can help the person with the mental illness really get a grip on what you’re seeing and your perspective. I recommend writing these things down so that in the heat of the conversation, with all the emotions running high, you don’t forget what you want to say.

To be continued: How to have the conversation where you tell someone they have a mental illness