There are many reasons why people don’t accept a diagnosis of mental illness.

I received an email the other month from someone whose spouse had psychotic experiences and was later diagnosed with bipolar disorder. However, the spouse believes they had a powerful spiritual experience.

The spouse has agreed to see a psychiatrist, and continues to see their counsellor, but won’t take medication.

I’ve been in that very position, refusing both the diagnosis and medication. Understandably. The experiences I’ve had (two, quite recently) from a science approach typically are called psychosis. I like to call it non-shared reality. Regardless how you describe them, elements of these experiences are profound for me.

I’ve always had difficulty with the ‘either/or’ perspective. Either my experience is an illness as seen through the medical model OR it’s strictly a spiritual experience as seen through alternative perspectives such as the anti-psychiatry movement or transpersonal psychology.

What I experienced was more nuanced. To cavalierly categorize it as either only alienates me from potential help.

But what to do?

In my case, I encountered a brilliant psychiatrist who helped me understand what I experienced could be both. Or, more accurately, they could exist simultaneously.

I had undergone (and continue to undergo) spiritual experiences meaningful to me. While at the same time I have a mental illness that would benefit from some medical assistance.

I’ve come to understand the diagnosis of bipolar disorder, anxiety and psychosis does not diminish the importance of these personally transformative events. Mental illness and spiritual awakening are not mutually exclusive.

This was life-changing for me. It allowed me to embrace the spiritual path I held so dearly while also accepting much needed treatment for psychiatric disorders which were, in no uncertain terms, ravaging my life and relationships.

I am of the belief, for some people, we need to blend both approaches, spiritual and medical. If either one excludes or denigrates the other, it won’t be helpful. For me, the litmus test is this: does the person have the quality of life they want? Is the approach they are using causing them more suffering or less?

I wanted to be someone who didn’t need to take medications. But I’m not that kind of person. Some people don’t need to or can manage without. For me, I needed to be open to the possibility of needing meds and not needing them. I needed my support circle to be on board with that too. Or to be honest with me about any bias they had. That built trust. Trust in the end is the best bridge to help build a life worth living.

Allowing for ‘Both’ rather than forcing an ‘Either/Or’ stance made getting better, well…better. I am able to comfortably hold both my spiritual and medical model perspectives. It’s a fine line, but that’s fine with me.

The following are resources to help those of you grappling with the ‘either/or’ situation. Whether you are supporting someone who identifies only with the spiritual, even to their detriment, or for those of you given a psychiatric diagnosis and trying to reconcile it with your profound experiences, I hope these shed some light and offer insight.

1. Visions Magazine – This edition focuses on spirituality and how it related to mental illness. Visions is an award-winning magazine that brings together many views on mental health and substance use.

https://cmha.bc.ca/wp-content/uploads/2016/07/visions_sprirituality.pdf

The following I wrote or created in partnership with others. Each describe in different ways my journey integrating both a spiritual perspective and medical model approach to help my life come into balance so I could begin to flourish.

2. Bridging Science and Spirit – a 7-minute documentary https://www.youtube.com/watch?v=sXq9B9a3sOI

3. Does God* Have A Place In Psychiatric Treatment Plans? – blog

https://www.psychologytoday.com/ca/blog/crazy-life/200910/does-god-have-place-in-psychiatric-treatment-plans

Note: I use the word ‘God’ but don’t mean it in the strictly religious sense, per say. I use it interchangeably with Love, the Divine, Universe, Spirit, Goodness, what-have-you. Please replace it with what you are most comfortable with.

4. I Went Off my Meds to be More Spiritual: Spiritual Growth and Psychiatric Medication – an oxymoron?  http://victoriamaxwell.com/i-went-off-my-meds-to-be-more-spiritual/

5. Crazy for Life – My theatrical keynote (aka one-person stage show) focusing on my struggle to reconcile the mental illness diagnosis with profound spiritual experiences. In it, I describe how medication, for me at least, needs to be part of my wellness tool box. Not the only one, but one nonetheless. View a clip from the show here (watch at 1min 25sec): https://www.youtube.com/watch?v=z-CU5DaOl74&t=7s  Also available for download purchase. http://victoriamaxwell.com/product/crazy-for-life-a-story-about-accepting-help-for-mental-illness/

Have you had spiritual experiences within your mental illness? Do you think it is one or the other? I’d love to hear from you to learn about how you made sense of it.  

© Victoria Maxwell

I do it. You do it. Even birds do it. No, not that. I’m talking about sleep.

Anyone with depression or bipolar disorder, including loved ones of those with the conditions, knows how important consistent good night sleeps are to staying well1. They cultivate equilibrium in mood, mind and heart. Sleep is important for everybody. But, doubly so for anyone with a mood disorder.

Lack of sleep (or irregular sleep patterns) can both trigger a mania or be a warning sign of one.2

With Spring, worm moons, new moons, time changes, and solar flares, along with everyday ups and downs, good nights rests have been hard to come by for me lately. Not a good thing.

When I’m hypomanic (I prefer my personal term: the “Spazzy-McGuinty”* phase) I sleep only five or six hours a night. and still I wake up all bright eyed and bushy tailed. But if that goes on for too many days (more than three) it’s a red flag. Luckily, Spazzy McGuinty usually calms down on her own accord within a couple days. *The exact origins of “Spazzy McGuinty” remains unknown. However, I do know it is a ‘special’ term of manic endearment created by my husband Gordon and I.

When dank depression hits me, I sleep too much. I easily log (not necessarily sawing logs) 10, 12 even, 13 hours of sleep each night but still awake leaden and lost. It’s awful. Sleeping too much is part of atypical depression, which ironically, isn’t atypical at all. It’s actually very common. For others, insomnia is the beast of burden when their depression descends.

So how can sleep become a balm, instead of a bomb in your life when you’re living with a mood disorder?

Commonly referred to as “sleep hygiene” (good sleep habits), below are some of my tricks for consistently getting a good nights’ rest. For the record, I never thought my sleep was all that dirty. Who knew? Okay, well maybe the occasional dream, but still…

 Tips to change your sleeping from a bomb to a balm:

 1) Go to bed and wake up approximately at the same time every night and morning. I usually turn out my lights at 9:00 or 9:30 P.M.(sometimes even 8:30 P.M.). Yes, I proudly embrace my inner grandma. I wake up around 5 or 6 A.M. 8 – 9 hours is ideal for me. I can manage on 7 hours but only for a few days. This may seem like a luxury to sleep that long. But, trust me, it’s a necessity. I also don’t have kids – so it’s actually realistic.

 2) Create a pre-sleep ritual. As is the nature of rituals, I do mine in much the same order every night. These cues tell the brain that sleep is coming and accordingly, the brain begins to wind down.

 This is my pre-sleep ritual. Around 8:00 P.M.:

I change into my jammies, take out my contacts, take off my make-up (on a good night), put on my glasses, floss then brush my teeth and take my medication (mood stabilizer and anti-depressant). Then I snuggle into bed with my hubby. I write tomorrow’s to do list, jotting down anything I need to remember or do the next day so I don’t have it in my head to prevent me from falling asleep. I read for about an hour. Then I turn out the lights around 9:30 P.M. If I’m lucky, and I usually am, Gord gently strokes my forehead or arm as I fall asleep. My hubby probably doesn’t know this but he’s the most important and best part of my sleep hygiene.

 3) Keep the room cooler than normal. We keep a window open, just a crack, even in winter.

 4) Block out as much light as possible. Even light from under a door or from a clock radio can make going to sleep more difficult.

5) Use ear plugs and/or an eye mask. Put them on before you turn out the lights or if you wake up in the early morning when you need to get back to sleep. In hotels when I travel, I turn the clock away from me so the glare doesn’t disturb me and unplug the bar fridge so it’s as quiet as possible.

 6) Make it a TV/cell phone/computer free bedroom. This is a hard one from some people. But believe me. It works wonders to not have any electronics in the room. Some say even reading in bed is a no-no. But I’ve found it relaxes me.

 7) Don’t drink caffeinated beverages (if you drink them at all) in the evening. This includes black tea, soda like Coke and energy drinks. I rarely drink soda but do drink decaf coffee, rooibus or peppermint tea. I usually have only one cup per day. If I have more, I don’t have it any later than 5:30 P.M.

8) Exercise, even if only for 10 minutes a day. I do some form of movement every day. I practice yoga, go running or walk to the mailbox. Whatever I can muster depending on the day.

Experiment with these suggestions. See if any work for you. Put them into practice and do them consistently. When you do, your mood and energy levels will become more stable. If however, you’ve been struggling with insomnia or hypersomnia for some time without relief, please see your doctor. Remember: Poor sleep can wreak havoc in the life of someone who is trying to manage a mood disorder. More importantly though, is to remember that establishing regular sleep patterns can also be a heavenly balm.

© Victoria Maxwell

1. Kahn D., Printz, D., Ross, R., Sachs, G., Treatment of Bipolar Disorder: A Guide for Patients and Families; p. 6; Postgraduate Medicine Special Report, April 2000

2. Helmer, J. Slumber Solutions (add hyperlink: https://www.bphope.com/slumber-solutions/ ), bp Mag/ bpHope.com, Winter 2011

 

In a previous post, I described the O.A.R.S. framework (Observe, Ask + Actively Listen, Refer + Support).  A simple protocol outlining how to approach someone in the workplace who may be struggling with a mental health condition. The 4-step system along with the ‘do’s and don’ts’ helps make difficult conversations more comfortable and effective. For a copy of a handout click here .

Besides good communication strategies, employers and co-workers need resources – resources beyond your typical EAPs (Employee Assistance Programs). Mental illness, a multi-faceted issue, needs multi-faceted solutions.

These are some workplace resources I recommend. I’ve chosen not to list the well-known and well-respected Mental Health First Aid or the Mental Health Commission of Canada’s workplace webinars. Likely you’re already aware of them. If you’re not, please do check them out.

I’ve decided to highlight ones that may not be on your radar.

Please note: I am not affiliated with any of the following organizations or individuals. I know them as reputable resources offering services and information to effectively help employers and co-workers address difficult mental health issues.

Mind: A UK based non-profit providing advice and support to empower anyone experiencing a mental health problem.  Included is a free download about how to support staff experiencing mental health problems: www.mind.org.uk/media/550657/resource4.pdf  

Visit www.mind.org.uk  to find other good resources.

 

Job Accommodation Network (JAN) is a free on-line resource that offers expert and confidential guidance on workplace accommodations and disability employment issues.

Unique to JAN is their Searchable Online Accommodation Resource (SOAR) system and their A to Z listings by disability, topic, and limitation. The databases lets users search for a specific disability (IE: anxiety disorder, ADHD) and then offers disability-specific accommodations, case studies and questions to consider. https://askjan.org/a-to-z.cfm

 

Not Myself Today: A fee-based program developed by the Canadian Mental Health Association for employers to help create mentally healthy workplaces. It’s evidence-informed, with practical solutions, focused on building understanding, reducing stigma and fostering supportive work cultures. www.NotMyselfToday.ca Visit https://cmha.ca/programs-services for other programs.

 

Mary Ann Baynton & Associates: Mary Ann Baynton and her staff offers various services to improve or resolve workplace issues related to individual or organizational mental health issues. Well-respected across Canada and beyond, she has been a pioneer in workplace mental health consulting since 2008. https://maryannbaynton.com

 

Deborah Connors offers training to develop psychologically healthy workplaces and transform culture. https://deborahconnors.com/

 

 

Hayley Peek Consulting: In partnership with Kim Sunderland, Hayley Peek offers programs that teach people how to have a supportive conversation with someone who may be struggling with a mental health challenge or illness. www.hayleypeek.com

 

Provides various free resources such as tools, training, strategies, assessments for employers, staff, managers to improve workplace mental health. https://www.workplacestrategiesformentalhealth.com/

What workplace mental health resources do you recommend? Send me your go-to websites or resources and I’ll list them in a future blog post with your suggestions.

© Victoria Maxwell

Feeling powerless over symptoms often goes with the territory when you live with mental illness. At least it can for me, particularly with anxiety and depression. This isn’t just the case for those of us diagnosed but also those who love and support us. They can feel at the mercy of these debilitating conditions when they’re at their peak.

Like a ragdoll in a tug-o-war between two kids or one in the washing machine (the ragdoll, not the kids) I can feel like I’m at the whim of my symptoms: negative self-talk, extreme fatigue, racing heartbeat, racing thoughts, incessant worry, rumination, lack of focus, aches and pains, hopelessness, emptiness – and those are just the pleasant ones. Kidding.

I enjoy feeling in charge of my mental health. Most weeks I am. But not always. Not by a long shot.

So what do I do? What can you do if you feel like this?

This is a strategy I’ve set up with my husband. It’s not a miracle solution, but it can help lessen the blows of bipolar disorder, psychosis and anxiety that I live with. It can help my husband better weather them too.

Let your loved ones help you. Enlist them into your wellness journey:

My husband knows me well. He catches signs of things shifting up or down better than (and before) I can sometimes. We all have our blind spots.

He’ll see me filling the Britta jug over the top line, or I’m getting up earlier (much earlier) than usual. Or like today, he’ll catch me making a grocery list and doing laundry at 5:00 in the morning. We’ve created a code word so to speak to signal I might be hypomanic. With kindness and enthusiasm, he’ll say ‘Oh. Spazzy Maginty is visiting us today!’

Another day, I fidget a lot in my favorite chair when we eat breakfast together. Or I won’t look him in the eyes when we talk. He might gently ask me ‘How are you doing?’ or more specifically ‘How’s your anxiety?’.

A different instance, he mentions my complexion looks grey and I’m sleeping longer than usual. Or he might recognize I haven’t run in a couple weeks. He’ll smile, look at me and ask if everything’s ok, knowing that likely it’s not.

His comments aren’t criticism but instead observation. Facts that I’ve changed from my baseline of wellness. It’s meant lovingly and delivered that way. It’s information I can use to my advantage. If I take steps to care for myself, I may prevent the anxiety, depression or hypomania from blossoming further. It’s not guaranteed, but it can reduce the intensity.

I’m not to blame for my conditions, and he’s not saying I am. I am however responsible for my health and reaching out for help when I need to.

My next steps are to be on the alert. Revisit and perhaps double up on my wellness tools. I check to make sure I’ve taken my meds and taken them properly. I’ll review and adjust my sleep patterns. Ask myself if I’m putting too much on my plate and if I need to, take things off. I’ll look at my exercise and aim to do a bit more, or do any if it’s fallen off the radar. I’ll call a friend and spend some quality time with them – phone or in person, doesn’t matter to me. As the incomparable Julie Andrews sings (sort of) these are some of my favorite (‘wellness’) things.

Ideally this will result in the levelling off of my symptoms. This isn’t rocket science. But it’s amazing how if I don’t see my warning signs early enough, and make the needed adjustment, how off course I can really go. And I’ve gone off course. Really off course in recent months. Think psychosis (twice) and major anxiety. But with the help and delicate diplomacy of my husband and my own willingness to accept assistance, getting back on more stable ground is possible.

3 Step to Help Prevent Relapse of Mental Illness

Note: Do these steps with your loved ones while you’re well, not when you’re struggling with acute symptoms.

To set the stage ask yourself:

What are your cues? Be specific. Ask your friends and loved ones to chime in about the warning signs they see. Compare notes.

Who do you want to be your ‘cue companion’? How do you want your loved ones or friends to approach you? Decide who and what’s most comfortable for you. You don’t need a husband, or even someone who lives with you. Just someone who cares.

What will your next steps be when they mention something? Have a list of your most effective wellness tools that you’re willing to commit to. Then pick one and do it. Be honest and clear about what you’re willing to do when warning signs start to rear their heads. Set yourself up for success Think tiny adjustments.

Then:

  1. When warning signs arise, your ‘cue companion’ has permission to mention what they see.
  2. Review your wellness tool list (with your loved one if you like)
  3. Take action: add, adjust said tools as needed.

Sometimes I worry, even feel ashamed at times, how much focus it takes to ‘manage’ my mental illnesses; that I might be a burden with all my mental health problems. But Gord has told me when he’s asking me about them, he wants to know. It’s ok, more than ok to talk about my mental health. Go figure?!

I’ve come to realize that this little 3-step system is as much of a sanity saver for him as it is for me.

Try this out with your loved ones and let me know how it goes. Or, if you have a similar system already in place, let me know how that works for you!

© Victoria Maxwell

Happy 2019! I don’t know about you, but I have mixed emotions about the New Year.

Yes, yes, it’s a chance for redos, starting over, goals, the blank page spread out before us. But I also love the idea of doing absolutely nothing different for the coming year, except for one thing.

This one thing was inspired by  listening to one of my favorite podcasts: CBC Radio’s ‘Now or Never’.

This particular episode was all about New Years and resolutions. Let me be accurate, it was about saying NO to New Year’s resolutions. They posed this question: “January brings with it a lot of pressure to change. But what if the thing you need to do in 2019 is just… Be you?” I loved it immediately.

Just. Be. Me. O.M.G. Yeeeessss! What a relief! Relief. I could use me some of that. I think my husband, Gord, could use some of that. I was up and down and all around in 2018 and he was, well, a rock for me.

Not having to do anything, but be ourselves? What a great forkin’ concept! (TY to the TV show “The Good Place” for my new fave euphemism).

Being in recovery from mental illness (or life for that matter), living with mental illness, and managing my mental health, sometimes feels like I’m supposed to be doing more, better, different. Always growing. Also expanding. How exhausting!

We are inundated by messages from society and the media to focus on growth and personal development.

Whether it’s for a small business you run, a family you take care of, a job you have, a home you keep, a relationship you’re in, your fitness level and health, the quality of your friendships, the hobbies you partake in, your chakras, your yoga practice (ok wait maybe I’m taking this a bit far). But, generally, ours is a culture that has an insidious but pervasive bias on improvement.  

I’m not saying self-improvement is bad. I’ve read my library-sized share of self-help books and gone to counselling for years. And it helps. Most of the time.

What I AM saying is personal growth can backfire and do the exact opposite of what I’m trying to accomplish.

Uhem – like a couple months ago. I was trying so hard to find inner peace. But all the things I was doing, all the things I was trying to change about myself and my life, kept the goalpost of serenity moving further and further down the field. The more I TRIED to find peace, the less I had it. I was constantly seeking with no finding (so to speak).

I ended up feeling less happy, more worthless, really tired and combustibly anxious.

So when I heard the call to arms, or rather the call to lay down the arms, from the hosts I jumped at the chance!

TY CBC Now or Never and you fabulously honest hosts Trevor Dineen + Ify Chiwetelu!

I loved hearing on radio (that’s NATIONAL radio, folks) a host admitting he too has a (sometimes not so) little voice that says “I’m not enough”.

A radio segment that rings in the New Year by celebrating our unique messy lovely selves with a particular partiality on self-acceptance. That’s my kind of resolution.

My no-resolution resolution: the only thing I need to do this year is be me.

Write me and let me know how it relates to you and how it changes how you see this coming year.

© Victoria Maxwell

For all the talking we’re doing, for all the well-meaning campaigns, I still believe we are woefully under-trained (or untrained for that matter) in how to effectively and comfortably talk to someone about their mental health, particularly in the workplace.

This was the focus of a workshop I facilitated at the recent, successful Working Stronger conference hosted by the Canadian Mental Health Association – Alberta provincial branch.

The heart of this annual event is to bring together leaders and staff from various sectors and companies to acquire skills and engage in dialogue to increase the psychological health of their workplaces.

I performed my “Funny, You Don’t Look Crazy” about my lived experience with mental illness and my eventual return to work. Then I led an enthusiastic group of individuals in an interactive breakout entitled: “Ready, Set, Recognize: Detecting Mental Illness and How to Help”.

To be quite frank, I was nervous. I had several years employed in the not-for-profit health sector. But my corporate experience has consisted of a two-year stint in a small company (really small – 6 people including me!). 20 years ago.

I was hired as a marketing-assistant-slash-receptionist. Heavy emphasis on the receptionist part. Well, actually, heavy emphasis on the slash part. It was my first job since getting my “sea legs” back after being in the psych ward several times over the previous 5 years. Handling conversations, let alone their phone system, was going to take courage.

I held jobs both when I was struggling and in denial of my mental illnesses and also after when I was learning to manage them. It wasn’t easy for me. I know it wasn’t easy for my bosses or co-workers either.

4 simple steps to make the conversation easy and effective.

Working with well-meaning but misguided managers, and exceptionally talented ones, I’ve learned some strategies about what works and what doesn’t when it comes to addressing mental illness in the workplace.

The result is the framework I created called: O.A.R.S. (Observe, Ask + Actively Listen, Refer and Support). A simple protocol to support an employee or co-worker who may be facing a mental health issue.

The steps of O.A.R.S. are simple, but not necessarily easy. We aren’t used to having these conversations. The only way we’ll get confident is by practice.

One solution for companies is to offer safe learning opportunities and ‘rehearsal’ time for these dialogues in low-stake/no-stake situations.  We can be as awkward and unsure as we need to be and gain experiences of success that we can take into real-world scenarios.

I call the framework the Wizard of O.A.R.S. because, well, who doesn’t like a nice play on words? (Actually, I do know several people who don’t. But that’s beside the point.) And because oars bring balance, stability and direction to a boat. Just like oars, people can give support and guidance to those around them who may be facing mental health issues.

This is not a quick fix. The steps don’t work instantaneously. They can in rare cases. But they will gradually, over time, make a difference.

Observe – Changes in behaviour, length present + document

Ask + Actively Listen – Discuss concerns in terms of behaviour, its impact + needs

 Ask open-ended questions

 Mirror + validate

 Be patient + wait

 Be curious

 Discuss impact of behavior

 Focus on collaborative problem solving + actions

Refer – To resources in the workplace and/or community

Visit my resource page to download a Mental Health Resource Guide for additional tools.

Support – Continue to communicate and encourage; find agreement + set healthy objectives

Click here to download the detailed step by step O.A.R.S. e-guide with links to a fun video of Everyone Loves Raymond using active listening!

Observe, Ask & Actively Listen, Refer and Support: the Do’s & Don’ts

Before you have a conversation with someone at work about their mental health, here are some do’s and don’ts to keep in mind.

DO…

  • Set the conversation up for success
  • Check in with yourself: is it a good day for YOU to speak to them?
  • Check in: is it a good day for THEM?
  • Play it out: where, why now, how, what will you say, what might they say, how will you respond?
  • Have the facts: make sure the facts you have are correct
  • Determine your objective
  • Focus on building trust, rapport, safety + open dialogue so they feel free to talk
  • Speak to them as early as possible
  • Document behavior changes + note impact
  • Be clear about what you need from them
  • Prepare for own internal emotional reactivity
  • Plan + prepare for resistance
  • Listen without judgement
  • Use an icebreaker

DON’T…

  • Avoid talking about impact of behavior
  • Make assumptions about the behavior or jump to conclusions
  • Interrupt
  • Minimize or dismiss feelings
  • Try to fix or offer advice
  • Enable

Please note: The O.A.R.S. framework is for non-urgent situations. If you feel the individual is at risk of harming themselves or others, immediate care should be sought at the nearest emergency ward. If the individual refuses help and is actively suicidal or at risk for harming others, the police should be called to assist. Please consult your company policies and guidelines.

Do you want to make a positive impact? Have that conversation NOW.

Effectively talking to someone who you think may be struggling with a mental health condition at work can be fiddly and unclear. As a result, managers and supervisors postpone or avoid these conversations, especially if we think the person is going to respond with resistance. Maybe we hope the issue will resolve itself. It almost invariably doesn’t though.

Sometimes individuals dealing with mental health issues aren’t ready to admit it to others or themselves. I certainly wasn’t. It’s not an easy thing to accept. The stigma of mental illness, especially in the workplace, has decreased but it still exists. This can lead people to refuse assistance or refuse to acknowledge the problems directly.

Unfortunately, if left unaddressed, behavior resulting from mental illness may cause difficulties at work and result in discipline, termination or other negative workplace consequences.

As a manager, co-worker or ally you can be proactive and discuss the behavior with the person before it escalates into discipline or termination. The earlier you speak with someone, however uneasy this may be, the higher the chance for optimal outcomes. Early conversations also offer the best opportunity to prevent a condition (if present) from escalating or becoming chronic.

Letting a person who you’re concerned about know you’re willing to listen without judgement, support them and problem solve can open the door for discussion.

This is what Liz, my boss at the marketing company did when I went to her for help. Even before that, she prepped the ground for positive interactions. From the start of my time there, she focused on building a personal rapport with me. One based on trust, respect and active listening. She was frank, firm, fair, kind and honest. When I had difficulties, I knew she was the person I could go to and receive wise counsel and fair treatment.

My experience with Liz gave me confidence that has influenced me to this day. THAT is the kind of impact you can make.

 

 

© Victoria Maxwell

Could your workplace benefit from learning how to comfortably address mental health issues? Contact Victoria to discuss the Workplace Mental Health Awareness package: a performance of ‘Funny, You Don’t Look Crazy’ followed by the ‘Ready, Set, Recognize’ workshop. You’ll learn the simple O.A.R.S. protocol to make those awkward conversations easy and effective. Contact me.

While I sipped coffee and munched on a croissant, a supervisor approached me. I had just finished performing ‘Funny You Don’t Look Crazy’ (my story of mental illness and return to work) for a quiet but wonderfully engaged group of managers at a breakfast training event.

He confessed one of the biggest barriers he, the managers and staff face is being comfortable talking about mental health at the company. “We know how to discuss physical illnesses, but mental health issues? Not really.” It’s one of the most common remarks I hear. We don’t have an accepted vernacular and we’re not practiced at it.

Silence kills

This discomfort can lead people to say nothing, ranging from not intervening when they see someone in distress or not speaking up when they need help for themselves. Enter the deadly (literally) silence.

Results from a University of Oxford study found leaving serious mental illness untreated can shorten an individual’s life by as many as 10 to 20 years, similar to the mortality risk of tobacco smokers. 1

I started performing my one person shows about my experience with bipolar disorder and recovery back in 2001. At that time, other than Margot Kidder and Kay Redfield Jamison, there were few people divulging the personal secret of psychiatric disorder.  

Over the last 15 years though, we’ve made good strides in addressing mental health and making it more common place to discuss. We have the “Bell Let’s Talk” campaign, Mental Illness Awareness Week in October and Mental Health Week in May, to name just three.

However, even with these awareness initiatives, the discomfort of discussing mental illness in the office remains, and silence ensues. Silence breeds fear, drives myths and lets stereotypes remain unchallenged. These then reinforce reasons (though unfounded) for individuals who are struggling to refrain from getting help.

Using data collected from close to 500 university staff and students, a 2014 Australian study found the “silence surrounding mental health problems permeates … environment(s) and impacts on help seeking behaviours… (and the) recovery and well-being of affected individuals.” 2

According to another study out of Toronto, silence has negative implications for relationships and productivity in the workplace as well. 3

Programs that raise awareness and aim to reduce stigma are important. But if people’s discomfort of discussing mental illness is never addressed, these campaigns will be of little long term benefit.

4 steps to create comfortable conversations about mental health

Whatever role you hold in your company, the following are 4 strategies to increase your comfort and effectiveness when discussing mental health.

1. Find Company Mental Health Champions. Share Stories. Get Real.

Safe, inclusive and supportive environments will stop the silence on mental health.

Elio Luongo, Chief Executive Officer and senior partner, KPMG in Canada in a Special to The Globe and Mail agrees. How they went about that was a first in corporate Canada.

In 2017, they created the role of Chief Mental Health Officer (CMHO). They enlisted, Denis Trottier, an audit partner who has “lived through clinical depression while maintaining a successful career”. 4

Having an individual willing to disclose their own experience with mental illness and recovery can open up dialogue, change perceptions and create comfort faster than any other kind of educational program. Patrick Corrigan, one of the foremost experts in stigma research, found in study after study, the most effective method to change attitudes about mental health is what’s called contact-based behavioural health anti-stigma interventions. That is, “people with lived experience of mental illness or substance use disorders interact with the public describing their challenges and stories of success.” In fact, this kind of approach is twice as effective as an educational program alone. 5, 6

At Coast Capital Savings, then CEO Lloyd Craig, shared his devastating story of losing his son to suicide. Craig was a pioneer in workplace wellness initiatives and the Credit Union became a model for workplace mental wellness. In a short time, measures they took, which included Craig sharing his story, produced noticeable results. 7

Discomfort around mental health will only dissolve when people see it’s safe to share stories and ask for help. As Luongo puts it, it’s essential “we walk the talk, right from the C-suite level so that our people can be comfortable sharing their stories and talking openly about mental health at the firm.”

2. Be prepared for and accept the uncomfortable feelings.

Like difficult conversations that are…well…difficult. Uncomfortable topics are… well…uncomfortable. Paradoxically, knowing and accepting that something will be uncomfortable can make the experience easier to bear. Two studies out of Denver found accepting (versus avoiding) negative emotions was shown to be associated with reduced levels of anxiety and stress.8 Prior to talking about mental health, assume unpleasant emotions and sensations will rise within you. Your job is only to tolerate them, be mindful of those awkward feelings and continue the discussion. Preparing for them will make the conversation easier.

3. Practice talking about mental health.

Practice brings experience. Experience brings mastery and mastery brings confidence. 9, 10  Be intentional. Start with low risk situations. Take strategic opportunities to discuss mental health in casual conversation in positive terms. The more you do, the easier it will become. For example: decide that for each day over the next week, you will learn something about mental health and share it with others at work or on social media. Or choose to disclose something personal about how you stay mentally healthy. Let people know what you are doing and encourage them to join. Ask people what do they do to stay mentally well.

4. Make it fun and be curious.

This sounds counter intuitive, even improbable, maybe even insensitive. Make mental health fun? Yes. Even though mental illness can be a heavy subject that doesn’t mean learning about it, or creating a supportive environment, has to be. I consider myself to be an mental health icebreaker of sorts. I use a lot of humour as I share my personal experience with anxiety, depression and psychosis. Yes, I’ve managed to find something pretty funny about running down the street naked while in a psychosis – I think flirting with the ambulance guys has something to do with it.

Self-deprecating humour goes a long way to help people feel like they don’t have to walk on eggshells. A lighthearted and respectful approach opens dialogue up as well as people’s hearts and minds. The more serious we are about a subject, the more cautious we are asking questions and the more difficult it is to discuss.

Start simply. Hold short lunch n’ learns that explore well-being, host interactive workshops that offer strategies for mental wellness and self-care. Focusing on mental wellness first, can prime the pump for mental illness topics.

Silence is not golden. Speak up.

Michael Landsberg, former sports host of TSN’s Off the Record , lives with generalized anxiety disorder and depression and is a staunch mental health activist. He says: “When we talk openly, frankly and honestly about mental health, we’re one step closer to healing.” 11

The silence around mental health will only be broken if we take the risk to speak up. Every time we make a decision to talk about it, and not remain quiet, the more healing is possible. This means healthier companies, stronger communities and more vibrant families.  

How do you speak up about mental health at your work? Comment below and let me know.

For more Mental Health resources, tips & tools, sign up for my newsletter.

© Victoria Maxwell

References

1. University of Oxford. “Many mental illnesses reduce life expectancy more than heavy smoking.” ScienceDaily. ScienceDaily, 23 May 2014.

2. Curtin University. “The silence of mental health issues within university environments: a quantitative study.”: Archives of pychiatric nursing, Vol: 28, Issue: 5, Page: 339-44 Publication Year: 2014

3. University of Toronto. “Mental Health Issues and Work: Institutional Practices of Silence in a Mental Healthcare Organization” by Sandra Moll; Doctoral Thesis, 2010 

4. “Corporate Canada needs to help break the silence on mental health”  by Elio Luongo; Special to The Globe and Mail; January 31, 2018

5. Corrigan, P.W. (2012). Where is the evidence supporting public service announcements to eliminate mental illness stigma? Psychiatric Services, 63(1), 79-82.

6. National Academies of Sciences, Engineering, and Medicine. 2016. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change. Washington, DC: The National Academies Press. 

7. “Employers Who Are Walking the Walk” by Donna Panitow; Reprinted from “Workplaces” issue of Visions Journal, 2009, 5 (3), p. 29-30

8. Let it be: Accepting negative emotional experiences predicts decreased negative affect and depressive symptoms. Shallcross AJ, Troy AS, Boland M, Mauss IB. Behav Res Ther. 2010 Sep;48(9):921-9. doi: 10.1016/j.brat.2010.05.025. Epub 2010 Jun 1.

9.  Conger KJ, Williams ST, Little WM, Masyn KE, Family Research Group B. Development of Mastery during Adolescence: The Role of Family Problem Solving. Journal of health and social behavior. 2009;50(1):99-114.

10. Why a Sense of Mastery is the Key to a Better Confidence?  by Evelyn Marinoff

11.  Michael Landsberg, quote: https://www.thelavinagency.com/speakers/michael-landsberg

When mental illness hits, it can hit hard. It hits the person who has it hard and it hits the family equally hard – though in very different ways.

One of the most common questions I get after my workshops and keynotes is, ‘How can I help my loved one when they don’t think they need help to begin with?’ So common in fact I’ve written two previous posts, one on my Psychology Today Blog: How to Help Your Adult Child if They Have a Mental Illness and another on my own: Families Falling Apart. There are many reasons for not wanting help. Denial, shame, anosognosia (the inability to be aware of one’s illness – a frequent symptom of psychosis itself ). 

Regardless of the reason, as a family member or friend, it can feel powerless. I’ve been on both sides of the path. I was that ‘someone’ with bipolar disorder, anxiety and psychosis who wouldn’t accept the diagnoses for years. I am also the daughter of a mom with bipolar disorder and severe anxiety, who has accepted the diagnosis, but does little more than take medication, which unfortunately succeeds in alleviating only a few of her symptoms. Good treatment involves more than just medicine.

But there are steps you, as a loved one, can take. Here are a few to help you help your family member or friend move forward on the journey to recovery and wellness. Take what you like and leave the rest.

1. Remember the journey to accept that there IS a problem, is theirs alone. You can help prep the ground, by having discussions and listening with an open heart, by setting clear boundaries, by offering information when appropriate. You can help create an environment that increases the chances of the person reaching out for help, but you can’t do it for them.

Anyone who’s been in this position knows, it takes more than one conversation. It takes many. It’s about opening the door of possibility. It’s about voicing your concerns with compassion and clarity and without judgement. Difficult, I know – especially when the struggle has been going on, in some instances, for years. But the rewards of avoiding power struggles, directives and arguments are great. A list of resources follows at the end of this post.

At the same time, it’s about setting boundaries for your own well-being and recognizing you are not responsible for their health and happiness. If you’re a parent of an adult child, this is one that is most heart breaking to learn and understand. Letting go is tough even when the adult child is well and thriving.

2. Rebuild trust and rapport. When family members ask me how to help their loved one, the issue has frequently been going on for quite some time. During that period, entrenched power struggles usually have developed and mistrust on both sides has been established. Your adult son or daughter, brother or parent, may continue to get angry when you suggest anything. The trick is for you to NOT get angry back. Easier said than done. Tools from Dr. Xavier Amador’s LEAP (Listen Empathize Agree Partner) method (below) may guide you how to listen without creating power struggles and rebuild trust essential for healing. Dr. Lloyd Sederer’s TEDx talk offers excellent tips and encouragement.

It was important that my treatment was a shared decision-making process; that those around me, both parents and professionals, didn’t try to convince me to do something. I needed to have people empathize, understand and reflect back my experience. The more I felt respected and heard, the more open to suggestions I became because I felt like I was being empowered not attacked.

3. Evaluate whether you really are the best person to talk to your loved one right now. Be honest. If conversations almost always end with tempers flying, another person who has his/her best interests at heart and can communicate more easily is a better option – at least for now.

4. Invite your loved one to go to the doctor together to address a legitimate physical issue. The problem could be poor sleep, or frequent headaches. You might feel that they stem from a mental health issue, but tending to a physical complaint is often easier to address first.

If mistrust and tension in your relationship is high, this may not be a good option. But, it’s surprising what sometimes works. The goal is to have them be willing to see someone for a general check-up. In that appointment have a mental health check-up too.

Resources:

  • Crisis Lines:  If you need help immediately, please search this list of crisis lines and centers and contact one of them right away.
  • Download this free Mental Health Resources and Tips e-guide I created from my website. It has many of the resources listed here and others for loved ones, individuals living with mental illness and employers and staff.
  • Dr. Lloyd Sederer’s TEDx talk ‘When Mental Illness Enters the Family offers excellent tips for parents, loved ones and others when supporting someone who is struggling with mental health issues but isn’t able to see they need help. In addition to his talk, he has a widely praised book “The Family Guide to Mental Health Care: Advice on Helping Your Loved Ones
  • Dr. Mark Komrad’s video has some good points. I wouldn’t watch the first part but from 49:30 minutes he describes when, how to talk to someone, some do’s and don’ts. Some of his approach is paternalistic, but some of the tips are useful. His book “You Need Help! A Step-by-Step Plan to Convince a Loved One to Get Counseling may be a helpful read. I can’t vouch for the info as I haven’t read it yet, but it comes recommended.
  • Dr. Xavier Amador’s book “I don’t need Help, I’m Not Sick describes his well-known LEAP (listen, empathize, agree, partner) approach. This post gives a concise summary of his LEAP programThis video illustrates a role play contrasting a traditional communication method and his LEAP method: Dr. Amador focuses heavily on anosognosia (when someone lacks the ability to be aware that they are ill). He makes a point to differentiate this from denial. You can find individuals who have been trained in his method on his referrals page.
  • Practical tips for family and friends on the “Living with Mental Illness: A Guide for Family and Friends” website.

I hope these resources help. Let me know if they do. If you have ones not listed here that are especially effective, please mention them in the comment box.

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© Victoria Maxwell