Things to Avoid Saying to People With Mental Health Problems
Recovery from a mental health condition is a complex and difficult journey that can be a full time endeavour. It’s not a a linear process; but full of blips and struggles as well as triumph and success. Recovery can be hard enough without unhelpful (even if well meaning) comments or conversations. Here is a collection of the types of things people in recovery wish you wouldn’t say to them! This list was compiled initially thinking about recovery from an eating disorder, but a lot of the comments apply to other conditions as well.
Aren’t you better now?- Recovery isn’t a simple process with a clear beginning, middle and end. Unfortunately a course of therapy doesn’t mean you’re fixed and it can often be hard to tell where a person is in their journey by just looking at them. Recovery takes time, try not to assume that because someone has been doing better for a while, it doesn’t mean they’re ‘fixed’ now.
You don’t look like you have an eating disorder (insert other condition here too!)- mental health conditions come in a variety of shapes/sizes and presentations. Try not to invalidate someone by telling them they don’t look like they have that condition. It’s just a bit offensive!
You look fine/healthy/well- telling someone they look fine can be a real challenge to someone in recovery who is battling to come to terms with a new recovering body. It can be a really distressing comment that is often used through habit without any real thought or meaning behind it.
OMG my cousin/aunt/hairdresser/a lady down the road had an eating disorder/the same condition as you- a list of all the people you’ve ever know with a mental health condition can feel a little insensitive. It’s human nature to make comparisons and find similarities in conversation but it can also feel a little invalidating to for the person who has felt able to talk about their own experiences.
General morbid curiosity- sometimes there can be a sense of feeling like a bit of a spectacle with some of the types of questions you’re asked about your illness. My personal favourite was being asked what I ate and if I ate anything when I was unwell. The intimate details of eating disorders are kind of like sexy underwear... We all know it’s and it’s great for anyone who needs to know about it and be involved with it.... But at the same time, you don’t need to discuss it/flash it around. There is a time and a place for intimate details... Perhaps leave it to the person with the condition to guide you on their level of comfort when discussing it.
I totally know what you’re going through, I had depression (insert time since/duration)- mental illnesses are really complex. It can be comforting to know that someone has an idea of the type of situation you’re in, but there’s a difference between empathy and complete understanding. People are all really different so try let the person with the condition explain their situation rather than your experiences getting too involved!
I’ve been in hospital 50 million times more than you- perhaps 50 million is a slight exaggeration but mental illness isn’t a competition to see who’s’ been more unwell. Inpatient stays aren’t a badge of honour that demonstrates to the world that you were the most unwell. Often people suffer from eating disorders in the community and lose their lives, demonstrating that those in hospital aren’t always the sickest.
I have a stomach ache... well I have reflux... well I have IBS... well I have gastro paresis... OH well I have had my bowel removed... WELL I was pronounced dead!... Well I AM ACTUALLY DEAD/chronically and severely dead. Did you have a glucose level of 0.00000001 and get resuscitated?!- again perhaps a slight exaggeration... But battles of the sickest can also take place through unhelpful oneupmanship, where it can feel competitive to have received the most dramatic treatment or diagnosis. In reality, it’s probably not helpful for anyone... So could be another good area to avoid!
Start exercising... it’s healthy for you- for people in recovery, diet as well as exercise is normally controlled and managed in terms of what is appropriate for that individual. Diet and exercise advice is probably left for the professionals to deal with. You never know, you might be suggesting exercise to someone who is not physically well enough to take part in it or could make someone in recovery feel really guilty about their exercise regime and potentially trigger them to feel compelled to do more.
Be naughty, have a slice of cake or saying ‘OMG we’re so fat’ whilst eating something ‘unhealthy’- now... Repeat after me... There is NOTHING naughty or bad about cake or foods that are deemed less healthy than others. Thee secret to a health diet is to have a balance of food groups including those that have fat in them. Cake is good and tasty and something to be celebrated, if you think it’s naughty then perhaps you need to think about your own relationship with it!!
People telling you about their diet and then remembering and saying... oh but not you- diet talk is really challenging. In my experience my ability to cope with that conversation depends on how I’m feeling at the time; generally it doesn’t bother me. The thing that does is people following it on with judgements about my body or whether I should or shouldn’t be dieting. When my eating disorder is strong or my perception of my body a little out of whack, the last thing I want to hear is people telling me I don’t need to diet whilst telling me about all the dieting they’re doing. Think about your audience.
People stopping to ask if you’re ok because you look healthy or assumptions that eating=healthy- sometimes the hardest part of recovery is the point where you look a lot more ‘fine’. Recovery starts the moment you’re free in the real world with real world problems and stresses... that’s the point true recovery starts. Just because people look healthier, it doesn’t mean that everything on the inside is hunky dory and it’s quite sad to feel like you got more support when you were the most unwell... it kind of perpetuates some of the underlying issues with different disorders.
Saying ‘you’re fine now right’?- fine is a really tricky word! What even is fine?
People saying ‘I’m glad you eat now’ -I know for a fact, my family were very relieved to see me eating more normally and healthily. But constant reminders that I was eating ‘now’ were excruciatingly difficult and had the potential to make my head go wobbly. It was just easier to change the topic away from the food. Food and eating is just a symptom of an eating disorder, it’s much nicer to talk about normal mundane things around meal times rather than dwelling on the thing I found tricky!
Telling you an ED is just about eating- the above leads on to this suggestion too... in recovery, you are told often, that eating disorders aren’t simply about food or eating. They are complex and challenging mental health conditions and moving the focus away from the food can allow the real psychological work to begin. Reinforcing unhelpful stereotypes of eating disorders isn’t the most helpful way to approach them.
‘Just eat healthily’ or ‘just get over it’ or ‘it’s all in your head’- of course... if recovery was as simple as just getting better or just being healthy, a lot of people wouldn’t get so stuck within the cycles of eating disorders... much the same as pulling yourself together or just getting over it, it’s much easier said than done.
It’s ok to lose a bit of weight as long as you control it/stay within your healthy BMI/just a little- This is another example of leaving the judgements to the professionals. Any form of weight-loss for someone who is in recovery from an eating disorder needs to be managed really carefully as it can be a strong potential relapse trigger.
When you eat in front of someone and they instantly think you’re fine now or you refuse something as you genuinely don’t want it and they act like you’re dying- it’s normal to have a differing appetite at different times, whilst keeping an eye on someone recovering from an eating disorder and supporting them with their intake is really helpful, jumping to conclusions can cause stress and tension in your relationship. Rather than casting a judgement, perhaps be curious about what’s going on and check they’re doing ok.
When you genuinely have allergies and people think its just an excuse to not eat or not being able to eat certain things because of health issues and people think you’re not doing too well at the moment- this kind of statement belongs with other aforementioned comments that should be left to professionals to discuss. It can be easy to jump to conclusions about choices a person is making and whether or not they are eating disordered... but it’s definitely better to be curious and ask rather than assuming.
Saying “no she wont eat this” without even offering- these kind of comments or situations can make it obvious to a group that you have problems around eating; not only can it be embarrassing, it also sets up a perfect opportunity for eating disorders to take advantage of the situation. It’s much better to offer anyway, you never know, ‘she’ might decide to be brave and participate in whatever is being shared and will feel more included at being able to have a choice.
When someone says “I haven’t had an appetite so I haven’t been eating much, but at least I’m losing some weight”- weight-loss conversations are often best avoided with someone who is in recovery, as it can feel quite upsetting. If it does feel ok to talk about weight-loss, it’s perhaps better to stick to healthy methods rather than taking pride in having lost weight through illness.
Pointing out people around you and commenting on how small they are- comparisons are often a big fear of people with issues around body image... if you’re pointing out other people and making judgements about them, imagine how that could be impacting on a friend who assumes everyone does it about their weight or body!
Saying”you’re eating french fries?!” “You should eliminate X from your diet”- whilst fad dieting tips and ideas are common in conversations, it’s not healthy to eliminate entire food groups from your diet. It’s especially unhelpful to suggest this to someone with an eating disorder as it can really give their illness room to get creative!
‘You are useless’ or ‘no wonder your manager doesn’t like you if you act like this’- mental health conditions aren’t a measure of your worth as a person... and it’s really unfair of someone else to comment on you in this way. Telling someone who is struggling with a mental health condition that they’re useless is often reinforcing the way they already see themselves and really isn’t helpful... to then apply these unhelpful judgements to other people... well that just feels pretty out of order regardless of your mental health!
‘Grow up’- Unfortunately eating disorders and other mental health conditions aren’t a sign of immaturity and don’t just disappear as you reach a certain birthday... maybe if you feel like saying this, you could do with a little growing up yourself!
‘Everyone finds things hard, you just give in’- life and being a human is really complicated. Unfortunately combinations of events, feelings and other elements such as illness or even the weather; can impact on our ability to cope with what’s happening. We all have those days where you end up in tears because you dropped a plate and it was just the final straw to a bad patch! Having a mental health condition isn’t a sign of giving in, often it’s a mark of someone trying to stay strong on their own and not asking for support from those around them!
‘Those pills are fake’- generally people don’t take medication without a good reason for it, especially for mental health conditions; it can feel embarrassing or shameful to admit to having medicinal help for a condition... but you wouldn’t question someone with a physical health condition taking prescribed medication for it!
‘It’s sad you need to write things down to realise what’s going on’- if someone has a coping method, try not to destroy it with your words. If it’s working... then does it matter if it seems ‘sad’ or ‘silly’... I like to blow bubbles when I’m stressed. It harms no-one and immediately reduces my anxiety... taking the place of unhelpful eating disorder behaviours. Don’t judge and perhaps give it a go yourself, you never know it might help!!
‘You don’t look anorexic’- If I had a penny for every time someone has said this to me! Coupled with ‘you look fine now’, it probably tops my list of the most unhelpful thing someone can say to someone who is in recovery from an eating disorder. Firstly, eating disorders come in all sorts of shapes and sizes... but secondly, the goal of recovery is to not look skeletal but to restore a healthy weight. Being told you don’t ‘look’ like you have an eating disorder can be highly triggering and stressful, it’s just additional unnecessary fuel for a nasty ED!
‘You’re eating loads’- In recovery, prescriptive meal plans are given for a reason. They’re worked out on the basis of the amount of food the person needs. It’s really hard to have that questioned by other people... it’s the amount it is for a reason!
‘Your problem is that you’re just over-sensitive’- being sensitive is such a positive quality... but over-sensitivity isn’t really a DSM-V criteria for a mental health condition. Often people with eating disorders have very selfless personalities and worry about impacting on others... but it isn’t a single reason for their difficulties.
Sometimes what people do say isn’t the difficulty. Mental illness is complicated enough but often it becomes a barrier meaning people avoid saying something or doing something but the person with the mental illness or difficulty wishes they hadn’t.
One way of tackling difficult conversations is to take a lead from the person with the mental health condition. They can guide you to the right balance and level of discussion. If you are able to promote open conversation that’s respectful and compassionate, they’re more likely to feel more able to be honest with you whilst feeling safe to do so. The moral of the story is... don’t NOT speak to someone with a mental health condition, but perhaps think before you speak and take a little time to judge whether what you’re saying is appropriate.
Thank you so much to all of the wonderful contributors who made this blog possible and not a rambling list of purely my own experiences!
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