I was twelve years old when I experienced a Friday night that started out like any other. I was at the skating rink laughing and having fun with my friends, knowing I only had a few minutes before my mother would be there to pick me up. However, an hour passed and my mother never made it. Eventually, an employee requested that I come to the front door. My grandmother was waiting there for me with tear-stained cheeks. She informed me that my mother and three siblings had been in a car accident, and my four-year-old brother was badly injured. After a quietly tearful and emotionally-charged ride to the hospital, we were met at the front doors of the emergency room by three family members who told us, “Nathan didn’t make it.”
Numb. Complete and utter numbness was the only thing I could feel in that moment. Numbness wouldn’t seem so bad compared to what I would feel in the coming months and years following my little brother’s death. We all suffered from the loss over the next few years, but we did so privately. We didn’t act like nothing happened, we just didn’t talk about it because it was too painful. We all suffered in silence. I’m sure, to anyone else, we looked like perfectly normal, happy people. Nevertheless, behind closed doors we were all struggling internally with ourselves; wrestling with the loss we had to overcome and the reality that our family would never be the same again.
Knowing what I know now, I was most certainly dealing with depression and second-hand trauma from the events of that fateful night in November. The sound of my grandmother’s gasp upon hearing the news; my mother’s cries; the look of confusion and sadness on my other brother’s face; and even the way the cool air felt against my skin as I walked into the emergency room … these are all memories that are as vivid now as the night they happened. At the time, I had no way of knowing what I was dealing with, or if it was normal to feel the way I did. We failed to talk to each other about what we were going through. I kept my feelings and emotions to myself, afraid there was something wrong with me. This, in the end, only made me feel more isolated and alone.
I was in college when mental health and counseling services first became available to me. I was finally able to confront my grief, work through it, and ultimately process how it affected my childhood.
I tell this story to say that I understand how unnerving that first conversation can be. Taking that first step—opening up to someone about something I struggled with for so long—was a very scary experience. However, I’m eternally grateful that I did it. I felt validated for the first time, and the feelings I struggled with began to make more sense. This gave me much-needed emotional relief and I learned that one symptom of depression is feeling isolated and alone; as if no one else could possibly understand what you’re going through. I realized that mental illness wants you to believe that you’re alone, even when that’s not the reality.
As a licensed therapist, my goal is to reach out to others, educating them and letting them know that they don’t have to suffer in silence; they’re not alone. Encouraging people to take ownership of their mental health means they must first know that services are readily available and attainable. It is for this reason that I championed the Primary Care Behavioral Health Integration model of care at Carevide. This model integrates behavioral health services into primary care centers where providers address general and routine healthcare needs. This makes services more accessible to people who tend to seek mental health treatment through their family physician. Additionally, by making it a standard part of routine care, it seeks to eliminate the stigma associated with mental health treatment.
At Carevide, our goal is to treat the whole person … mind and body. Your physical health is significantly affected by the state of your mental health, and in turn, your mental health can be impacted by your physical health. Treating one symptom without the other is counterproductive and can potentially leave the door open for your health to deteriorate. Integrating behavioral health with primary care makes sense, because we want to give our patients the best possible chance for a successful outcome.
We recognize that opening up to someone about your mental health is not easy, which is why we want to provide a safe, familiar and confidential environment to do so. Asking for help is the first, small step toward becoming a better version of yourself, and small steps add up to big changes. Even the strongest people need support from time to time, and we all have the right to receive support for our mental health. Fearing judgement, or how others will perceive us, is another symptom of mental illness. Recognizing there is a problem and asking for help is a huge stride toward positive mental health.
Mental illness is not a choice and we’re all susceptible to experiencing negative mental health. We can’t always feel one-hundred percent, and that’s nothing to be ashamed of. If your heart or kidneys weren’t functioning properly, you wouldn’t hesitate to seek medical treatment to fix the problem. Why should it be any different for your brain? Like any other organ in your body, your brain may malfunction from time to time. A healthy brain is integral to your survival, and it is worthy of your investment. At the end of the day, your longest, most-important commitment is to yourself.
If you’re struggling with life stressors, trauma or feelings that hinder your ability to live a happy life—or you know someone who is—everything can change for the better with a single conversation. Here are some ways to begin a conversation about mental health.
5 Tips for Starting a Conversation About Mental Health
- Find a safe space where you feel comfortable opening up and discussing your feelings. This can be within the confidential environment of your primary care provider’s office, with a therapist, at home in your kitchen, or in a secluded corner of a coffee shop with a trusted friend.
- Don’t wait for the perfect moment because that moment may never come. By waiting for it, you are only further indulging yourself in an avoidance tactic, which many people who suffer from mental illness tend to do. Start the conversation at a time when it feels natural. The more typical the setting, the less unusual and uncomfortable it can feel.
- It’s okay to open up. Remember that a symptom of mental illness is feeling isolated, alone, and ashamed of the struggles you’re going through. The reality is that many people live with mental illness of some kind, and it’s very common to struggle with the symptoms—i.e. depression, anxiety, and stress—even if we do not have a disorder. These struggles are a normal part of life. Many people struggling with mental illness need to feel a connection to others, as well as recognition and validation that they’re not alone, and most importantly … that there is hope.
- When sharing your own experience, you might feel nervous, upset, or unsure of what to do next. If speaking with a friend a loved one, ask them if they’re okay with being a listening ear or if they mind accompanying you to future appointments. Remember, you may have been dealing with your feelings for awhile, but this is their first time hearing about it. If they’re not immediately supportive, they may need time to process the information, so be patient. Unfortunately, some people have difficulty comprehending things they don’t understand or haven’t experienced themselves. Nonetheless, no one has the right to make you feel invalidated. Be a good listener. If you are on the receiving end, practice active listening and give the other person a chance to talk. Consider that you may have no idea what they’re going through, and that’s okay! You may feel upset or unsure of what to feel, which is an understandable reaction. Educate yourself before you draw conclusions, and learn how to be a supportive confidante. Remember to check in with yourself about how you are feeling and consult reputable websites to seek support.
- Ask twice. If a friend or loved one seems off—or as though something is bothering them—ask how they’re doing and if everything is alright. Often we tend to provide automatic responses such as “Good, how are you?” In this case, ask them again. “Really? Are you okay?” Even if they’re not comfortable talking at that moment, they will know that you are willing to listen to them when they’re ready to talk.
I’m grateful for your advice about opening up to your close peers about your mental health. My wife is suffering from post-partum depression, and she hasn’t been talking much to her friends since giving birth. I love that you said most people undergoing depression need to feel connected to others and that they need people to validate their feelings and give them hope. I’ll talk to my wife about this, and maybe also schedule a session with a reputable mental health therapist in our area.