From the June 2018 issue

Disclosing a Mental Illness: Who Should You Tell?

When to tell others if you or your child has a mental health condition can be a difficult decision. A local expert weighs in.

Brought to you by Flinn Foundation

Dealing with a mental illness can be challenging enough on its own. Adding in the weight of other people’s reaction to your condition? It might not seem worth the risk.

But disclosing a mental illness to others is something many people consider for various reasons and at different times throughout their life, struggling with the idea of whether friends, family members and even your boss or coworkers should know.

“It’s still a hidden illness,” says Dr. Katherine J. Gold, M.D., MSW, a family physician, obstetrics and mental health researcher and assistant professor at the University of Michigan Department of Family Medicine in Ann Arbor. “People are more likely to share with supportive friends and sometimes with family, but not employers.”

When it comes to telling friends, “there are few cons to sharing,” Gold notes.

“If people don’t accept someone because of mental illness, it’s probably worth knowing that earlier rather than later,” she says.

Before disclosing a mental illness in the workplace, adults and young people should familiarize themselves with the law. The Americans with Disabilities Act, or ADA, a federal civil rights law protecting people with disabilities including mental health conditions, specifically prohibits discrimination in all aspects of employment. As long as you’re qualified to do the job – even if you require “reasonable accommodations” to do it, which most employers must provide – you can’t face unfair treatment in hiring, compensation or termination because of your disability.

“For some professions, such as those of us in medicine or law, many state licensing boards still ask about mental health diagnosis or treatment, so sharing can have professional implications,” Gold explains. “For other jobs, I think it depends on the climate in your workplace and how supportive your supervisor is. The ADA has strong workplace protections for disabilities including mental health, but that doesn’t mean that everyone will be supportive at work.”

One of the major benefits of sharing about a stigmatized illness is that it can reduce stigma and increase acceptance.

“Letting people know may make it easier if someone needs to attend ongoing appointments for treatment. When Brooke Shields went public with her postpartum depression, it made a tremendous impact in reducing barriers for other moms who had similar struggles and needed help,” says Gold, who also serves at the U-M Depression Center.

Other examples of celebrities talking about their mental illness – like Mariah Carey’s recent discussion of her bipolar disorder – have made it easier to share, too. And with the rise of social media, many decide to share online.

The National Alliance on Mental Illness suggests telling people when you’re well, “when it serves a purpose,” and when you’re ready. Plan the conversation in advance, focusing on “process talk” to prepare the listener, being specific about the problem and offering suggestions for how loved ones can help.

Parents of children with mental health conditions face a challenging decision too, since disclosing their child’s condition may be needed in some cases.

“Parents should focus on doing what they think is in the child’s best interest,” Gold advises. “Parents don’t need to share every embarrassing detail, but if a kid is struggling, it helps to let other adults know who can help. It’s really important for young people to have adults they trust whom they can turn to in a crisis; that might be parents or family members or it might be a teacher or coach or counselor.”

If trusted adults know a young person is struggling, she adds, “they can step in to help and can communicate with parents.”

“The idea of ‘it takes a village’ is really important in helping kids through stress and mental illness,” Gold says.

People should also be prepared for how to appropriately respond when someone discloses a mental illness to them.

“Although the instinct might be to give advice or say something that starts with ‘well, at least…’ don’t do it,” Gold emphasizes. “People who are struggling need someone who will listen without judging them. It’s OK to ask questions to try to understand what’s going on and to acknowledge how hard this must be. With kids, I often talk with them about who else they might be able to share these struggles with and encourage them to talk to important adults they can trust.”

And be sure to respect the person’s privacy – unless the person is considering suicide, in which case professional intervention is needed.

There’s hope that talking about mental illness will be easier in the future. It can start with how each individual person talks about mental illness and reacts to others who have it.

“Friends and colleagues who can listen and not judge goes a long way,” Gold says. “Depression is not a weakness or personal failing; research clearly shows it a biological brain disorder and we should talk about it and treat it as such, just as we do with diabetes or high blood pressure. You wouldn’t treat someone in a hypertensive crisis by telling them to just relax to drop their blood pressure, and we can’t treat severe depression by advising someone to ‘cheer up’ or ‘just look on the bright side.’ This is a medical illness and is very treatable.”

Brought to you by the Ethel & James Flinn Foundation. Find more information at flinnfoundation.org.

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