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Podcast: Self-Help Cliches Have a Peculiar Value

Take the bull by the horns! Pick yourself up by your bootstraps! Are these cliches condescending for people with mental illness? Or is there a grain of truth to them? Today, Gabe and Lisa debate the pros and cons of the all too common “taking your life back” advice we all get from well-meaning people. Gabe shares his personal story of gaining back control of his life a day at a time while healing from depression.

When you struggle with mental illness, how much of your behavior, thoughts and emotions do you actually have control over? Is it helpful to feel in control of your life, even when it screws you over?

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations , available from Amazon; signed copies are also available directly from Gabe Howard. To learn more, please visit his website, gabehoward.com.

Lisa is the producer of the Psych Central podcast, Not Crazy. She is the recipient of The National Alliance on Mental Illness’s “Above and Beyond” award, has worked extensively with the Ohio Peer Supporter Certification program, and is a workplace suicide prevention trainer. Lisa has battled depression her entire life and has worked alongside Gabe in mental health advocacy for over a decade. She lives in Columbus, Ohio, with her husband; enjoys international travel; and orders 12 pairs of shoes online, picks the best one, and sends the other 11 back.

What to Say to Someone Who Is Sick: Expert Advice on Showing Up When It Counts

Someone you know is sick, and you aren’t sure how to approach the subject. Should you wait for them to bring it up? Avoid it altogether so you don’t make them uncomfortable? What if you accidentally say the wrong thing and damage your relationship in a moment of crisis?

Questions like these are important. They’re a sign that you care. While no one has all the answers, there are some guidelines, borne out of experience and supported by research, that may help you be present for someone who matters to you.

A serious illness can take up a lot of space in a person’s life, whether a full recovery is just a few days away or the condition is chronic. For that reason, it’s especially important to be sensitive to whether someone wants to talk about sickness or something else entirely.

As Chaplain Resident at Mayo Clinic, Natasha Dachos, LMSW, is often in conversation with people coping with illness. “The most important thing to remember,” she says, “is that this is a whole person in front of you. Whether they are a mother, a father, a child, a teacher, a person who likes to run — they are a whole person, with all the complexities that go with it.”

It’s easy, Dachos explains, to focus exclusively on the illness — losing sight of other aspects of their lives. “Sometimes they feel quite ill, and sometimes they feel less sick. But being sick is just one part of the whole person.”

Academic, medical, organizational, and work environments all have complex hierarchies. If you’re in a position of power or influence in someone’s life, it’s important to be aware of the ways the imbalance of power can shape your conversations during a time of illness.

For example, asking an employee about their diagnosis or treatment might make them feel pressured to talk about a condition they’d rather not discuss at work — even if the question is well-meaning.

What to say at work

If you’re able to speak privately, you could say something along these lines: “I know you were out for a while recently. I hope you’re OK, but if you’re not, I’m here if you need help or you’d like to talk.”

In one 2018 study, 50 to 70 percent of patients in the intensive care unit wouldn’t speak up about their concerns out of fear their caregivers would consider them a troublemaker. Gender, age, race, and economic status can make it even more important to listen with care, speak sensitively, and respect boundaries.

If you’re having conversations with a long-time friend, power differentials probably won’t be a big factor in your conversations. But if your friend has developed a condition that’s considered a disability, if medical expenses have changed their economic position, or if they have an illness that’s often stigmatized, the dynamics of your friendship may have shifted a little.

If you’re communicating by email or text, be prepared for a delayed response. If someone wants to respond honestly to your message, they may need to wait for a time when they can answer fully.

Both of you deserve ample time to share, to process, and to respond without rushing. Setting aside a distraction-free time to talk could make the experience much more gratifying for both of you.

If you’re talking to someone you know very well, you’re probably aware of their cultural background, personal beliefs, and faith tradition. If you’re not certain, it might not be wise to assume that someone else would be encouraged or comforted by the same ideas that inspire you.

Rev. Caila Rinker, MDiv, a chaplain in Mayo Clinic’s Department of Spiritual Care, is often called upon to support people of different cultures and faith traditions. She maintains what she calls “a posture of compassionate curiosity.”

It’s also important to understand that someone’s personality, family background, and culture may influence how open they are to discussing their illness with you. Finding other ways to offer support may be easier to accept for people who don’t feel comfortable conversing about their health concerns.

Over the course of an illness, especially one with a long recovery period or a chronic condition, someone who’s sick is going to go through a wide range of emotions and states of mind. Each time you show up for a conversation, it could be a totally different kind of experience.

“People may be angry that they’re sick, or angry that their bodies are diminishing, or angry that they can no longer do something that’s important to them. You may be a very safe target for that anger.”

See if you can remain open to what your friend or family member is feeling right now. If you can provide a safe space for someone to be open and authentic, you’ll have given them a gift of enormous value.

Tip 5: Deal with anxiety and depression

When you have a serious illness, it’s normal to feel sad about your health and grieve the hopes and dreams you may have lost as a result of your medical condition. It’s also natural to worry about what the future may hold or be apprehensive about certain treatments, for example. But if such feelings persist and start to interfere with your daily life, you may be suffering from depression or anxiety.

While mood disorders like anxiety and depression are common among patients dealing with a serious illness, they can create a vicious circle. Your illness triggers anxiety or depression, which then erodes your overall health, which in turn negatively impacts the treatment of your illness. This then worsens your mood disorder, and so on.

Manage debilitating symptoms such as pain. Left untreated, pain can have a detrimental effect on your mood and increase anxious thoughts and feelings of hopelessness. Talk to your medical team about ways to better manage pain and other distressing symptoms.

Ease up on the worrying. We all worry, especially when we’re sick. But if you’re constantly overestimating the possibility that things will turn out badly or immediately jumping to worst-case scenarios, it’s time to take action. There are steps you can take to challenge your anxious thoughts, distinguish between solvable and unsolvable worries, and develop a more balanced way of looking at your situation.

Cut down on sugar in your diet. By reducing the amount of soft drinks, sweets, and sugary snacks in your diet, you’ll feel less anxious and avoid the mood crashes that usually follow a sugar high.

Be smart about caffeine, alcohol, and nicotine. Reducing or cutting out your caffeine intake can help with anxiety. Similarly, alcohol can worsen both anxiety and depression symptoms. And while it may seem like cigarettes are calming, nicotine is actually a powerful stimulant that leads to higher, not lower, levels of anxiety and stress.

Countering your “what if’s…?”

It’s hard to imagine that anyone who’s faced a life-threatening illness hasn’t worried about “what if” scenarios at some point. When you’re fighting for your life and faced with great uncertainty, worrying can even seem like it’s giving you some control over your situation. But as with all anxious thoughts, there are ways to calm your worrying mind and take a more balanced view:

Tell someone what you’re thinking. Saying your “what if” out loud can help you put things in perspective. If your fear is unwarranted, verbalizing it can often help you expose it for what it is—an unhelpful worry.

Challenge the thought. What’s the probability that what you’re scared of will actually happen? What are some other likely outcomes? What would you say to a friend in your situation who had the same worry?

Accept the uncertainty. Much of dealing with a serious illness is about learning to come to terms with the uncertainty of your future. Worrying about all the things that could go wrong won’t make your life any more predictable. It will only keep you from enjoying the good things you are still able to experience in the present.

How to help someone cope with a serious illness

When someone you care about has suffered a serious health event or is dealing with a life-threatening illness, it can be difficult to know what to say or do. You loved one is likely experiencing some painful emotions and that can make even those closest to them feel uncertain about how to best offer your support. These tips can help:

Offer your support. Your friend or loved one may be reluctant to ask for help, but it’s support from people like you that can make all the difference in their recovery. Offer to help with a specific task, even if it’s simply to sit with them during or after treatment. Sometimes, the most important thing you can do for someone is to be there.

Listen. When you talk to someone with a serious illness, it’s natural to feel awkward or not know what to say. But often the most important thing is to listen to the person. Allow them to express what they’re going through without judging them, telling them how they should feel, or trying to put a positive spin on everything.

Educate yourself about the illness but don’t give advice unless you’re asked. The more you know about your loved one’s diagnosis and treatment, the better prepared you’ll be to help. But that doesn’t mean you should tell the person what they should or shouldn’t do, unless they specifically ask for your opinion or want to know what you’ve researched. Treatment decisions are ultimately always up to your loved one, so be supportive even if you don’t always agree.

Stay connected. Some illnesses can involve lengthy treatment, so it’s important not to just provide support at the time of diagnosis and then let your attention lapse. Your support can be just as important after treatment as it is before.

  • Let the person know you’re available to listen whenever they want to talk.
  • Admit if you feel awkward. It’s better to be honest rather than trying to pretend nothing’s wrong.
  • If you struggle knowing what to say, remember that a warm hug or a tender touch can say a lot.
  • When you can’t visit in-person, let your loved know you’re thinking of them with a call or text, or by sending a card.
  • Try to keep your relationship as normal as possible. That can mean sharing a joke or a laugh when appropriate.
  • Tell the person you know how they feel or compare their situation to someone else’s. Everyone’s circumstances are unique.
  • Tell them that “everything will be fine.” Such platitudes can just make it harder for them to talk to you about the challenges of their situation.
  • Say that your loved one needs to “stay positive” or “look on the bright side.” Rather than pressuring them to behave in a certain way, make it clear that they’re free to express how they really feel.
  • Take things personally if the person doesn’t want to talk or is angry or upset.

Hack, Thomas F., and Lesley F. Degner. “Coping Responses Following Breast Cancer Diagnosis Predict Psychological Adjustment Three Years Later.” Psycho-Oncology 13, no. 4 (April 2004): 235–47. https://doi.org/10.1002/pon.739

Jim, Heather S., Susan A. Richardson, Deanna M. Golden-Kreutz, and Barbara L. Andersen. “Strategies Used in Coping With a Cancer Diagnosis Predict Meaning in Life for Survivors.” Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association 25, no. 6 (November 2006): 753–61. https://doi.org/10.1037/0278-6133.25.6.753

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