7 Things Not to Say to Someone Experiencing a Mental Health Crisis

Nov 30

If you are in a trusting relationship where someone has disclosed to you that they are struggling with their mental health, it can feel hard to know what to say next.

Sometimes, people fall silent because of the fear that they will say something wrong. To begin, here is a list of seven things not to say (and why).

“Look on the bright side!”

While well intended, this response is a classic form of toxic positivity. Whitney Goodman defines toxic positivity as, “...the unrelenting pressure to be happy or be pursuing happiness, no matter what the circumstances”. Toxic positivity often leads to negative feelings for the recipient of these messages, especially when someone is weighed down by symptoms of depression or worry.

As I sometimes say to my clients, it can lead to “layering feelings on top of feelings” - meaning, now the individual might feel guilty about the fact that they’re feeling depressed. “Layering feelings” distracts from our core emotions and makes it even more difficult to make progress.

Remember, it is ok for someone to have negative emotions. If you are unable to tolerate their feelings, they likely won’t feel safe continuing to come to you with their concerns. It is difficult to struggle with depressive feelings, but it is even harder to do so alone.

“My Aunt Judy struggled with that - she was so crazy!”

There are a couple of problems with this response, the first of which is comparing. Mental illnesses are highly individual; comparing two people’s depression and probably as effective as comparing two people’s sedans. Yes, they both have one… but one is a twenty year old toyota and the other is a brand new BMW 3 series. They likely don’t have a whole lot in common. Their maintenance, appearance, and interiors are very different from one another, even though they both are under the same definitive “class”. Comparison can make it difficult for the person in your life to feel truly understood.

Additionally, this response utilizes judgmental and potentially triggering language. Terms like crazy, insane, OCD, bi-polar, anorexic, and psycho are often used in flippant and hurtful ways. You might feel they are benign, but someone who is struggling may find these words incredibly painful and offensive. Opt for non-stigmatizing terms, especially with people who you know are actively suffering.

“I heard that getting enough sleep, exercise, and eating right gets rid of those types of symptoms”

As a social rule, it is best not to give advice unless someone has asked for it. This is true of people suffering from mental health concerns as well. The first reason not to do this is because it often comes from a place of assuming you know something that the other person doesn’t. When in reality, that person has likely thought about their concerns and researched them much more deeply and intensely than you have.

Secondly, while alternative treatments and focus on holistic care absolutely can have positive impacts on people, insisting that all mental illness can be “cured” by such methods leaves the sufferer feeling as though you don’t believe their ailment is legitimate.

And third, some vulnerable people may avoid medication or therapy because they believe they just need to be “healthier” - thus leading them to not get the treatment that they need. This can lead to dangerous consequences due to “advice” given by non-professionals. Be careful and mindful of the messages you’re sending when someone confides in you - your words can have a significant impact.

“It seems like everyone has a mental illness these days”

Not only is this response incredibly invalidating, it’s also irrelevant. Whether other people are or are not suffering with more or less mental illnesses has no impact on whether or not the person confiding in you is struggling. This statement can also send an underlying message of “I’m not sure I believe you”. Be careful about these generalizing statements, and instead focus on what their experiences are like for them, without judgment.

“Things could be worse!”

Yes, but they also could be better. Have you ever said, “I really shouldn’t feel happy because other people have it better”? Probably not… so don’t do it in reverse. Comparative suffering doesn’t take away the emotions people are having, it only tells them that whatever they’re feeling isn’t ok to you. Comparative suffering comes from the belief that there is a finite amount of empathy and compassion we can give people - but that simply isn’t true. Someone feeling their hurt doesn’t take away the pain of people suffering from starvation in another part of the world. It is ok to seek to maintain perspective within our struggle, but allowing people to feel their feelings actually teaches them how to extend more empathy to themselves and others.

“Oh everyone has those symptoms sometimes - that’s totally normal”

This comment can be very minimizing for someone who is in the middle of a mental health crisis. It is likely that if someone has told you some small part of their story, there is much more going on under the surface. Taking one part of their symptomology and saying it is “normal” is not seeing the entire picture. Consider that if they are coming to you with a diagnosis or set of symptoms, there is likely a lot more that is left unsaid.

“Suicide is so selfish”

A comment such as this shows a deep misunderstanding of what suicidal ideation is and how it functions. Thoughts of suicide, death, and dying are a common symptom of depression and not a reflection of moral character. Furthermore, telling someone that suicide is selfish is not at all helpful in preventing suicide. It is likely to lead to feelings of shame, which only increases their negative emotions and low self worth. Consider instead, letting them know how much you care for them and would miss them if they were gone.

[Avoid the subject / Change the subject / Not bringing it up again]

While avoidance is an understandable reaction when you don’t know what to do, it inherently communicates that you are made uncomfortable hearing about their mental health status and therefore a not a safe person for them to confide in. If you wish to have them communicate with you more regularly, don’t be afraid to check in and follow up. Don’t leave your friend or family member feeling unseen in their pain. You don’t have to fix anything, you just need to be present with them.

If you’ve said any of these things in the past and you’re finding yourself worried about the impact- take a deep breath - it is impossible for us to show up perfectly for the people we care for.

Start by extending the same compassion to yourself that you are now going to practice for the person in your life who is in crisis. We all make mistakes, we are all human. And when we know better, we do better. I invite you to rethink these common responses and increase your compassion for those struggling with mental health crisis and suicidal thoughts.

In the next blog post, I will cover what to say to someone instead so that you can feel prepared to better support your loved one.

If you are finding that you need more support in your care for someone struggling with their mental health, therapy might be useful. Contact me for a free 15 minute phone consultation to see if I can be of help, or I can help you get connected to someone who is the right fit for your needs.

Rachel Van Wickle