How to Talk About Your Mental Illness With Loved Ones in an Honest, Healthy Way

Health Journey with my loved ones

Two weeks ago, I was suicidal from the ongoing pain of back spasms exacerbating everything else that had gone wrong this year, and my isolation from loved ones in my city’s sixth lockdown. I was chatting on Messenger with my sister and one of my best friends, as I do daily, when I suddenly dropped it into the conversation:

“Today, I haven’t felt like making it to my birthday [later in the month], if I’m revealing all.”

My sister and friend encouraged me to “hang in there,” but my honesty wasn’t done. I shared a longer piece I had just written about the reasons I had to go on versus the reasons not to go on, in which the nots were greater. My friend reacted with sadness to my feeling and asked if there was anything she could do to help. I told her:

“Thank you, but I shield this from both of you to be honest.”

This shielding type of honesty was further tested when my sister returned from putting my nephew to bed, a task that had understandably taken her attention. When she returned to the group chat she wrote:

“Soz, had to endure Pinocchio. I’ll call you tomorrow dear Pandy (childhood nickname). So sorry for your pain.”

As soon as I saw this, I began to split on (devalue) my sister, the person I regard as part of my soul; growing up, we had clung to each other for comfort at times as if our lives depended on it. This rapid shift from idealization to devaluation (splitting) is one of the most relationally devastating symptoms of borderline personality disorder (BPD). Here, my need for connection felt downgraded to the needs of a 10-year-old boy. Ugly feelings (I was jealous of my own nephew!! Very aware of my own lack of a family). At that point, I had a choice to either lash out at my sister, admit these feelings, or silently regulate them using the dialectical behavior therapy STOP skill, where I stop, take a moment to observe, and proceed mindfully. I was only partially successful at the regulation.

“Don’t worry about it,” I replied, wounded to my sister’s promise to call me tomorrow. My honesty then became unfiltered, “I feel less important. Less connected. And not tethered to anything today (classic suicidal feeling).”

Since then, I haven’t brought up the issue with my sister (until she approved this article to be written). My suicidal thoughts stopped the next day as my back began to mend. And my sister, my friend, and I continued our frequent daily messages on more enjoyable topics. But this Messenger interaction made me think about the issue of honesty regarding how we share our mental health struggles and experiences with our closest loved ones. What type of honesty is indeed the most effective or the wisest?

For most of my life, I have prided myself on being honest. I think mostly because unfiltered honesty was modeled to me by my incredible late aunt who struggled with bipolar disorder. My aunt was uncompromisingly honest as if the ability to lie or the self-censorship mechanism that most people hide behind was permanently broken. She was steadfastly brave, not afraid to admit and talk openly about the most devastating aspects of her illness. She still is my inspiration here (she was also a writer) as I push myself to write about things that are excruciatingly painful (grief), or have been shameful to admit (identity disturbance), or that make people uncomfortable to read (self-harm). In the end, unflinching honesty about my mental illness journey has saved me many times by connecting with people deeply and bringing them into my pain. The honesty has effectively given me connections and support worth staying alive for.

However, my aunt’s honesty could also get people offside and lose her many relationships because she often had to be right, and could not tolerate opposition. While this was often when she was most unwell, this is a type of honesty that is a distorted one perspective only. I have tried to scrupulously avoid this “take no prisoners” approach, especially at my most unwell in the greatest pain. As a result, I’ve molded my own version of discerning honesty with a bit from Jesus and a fair bit from dialectical behavior therapy. I have found this brand of discerning, or wise honesty, has been as important to me as uncompromising honesty in survival and recovery. The trick is knowing, or discerning, when to apply which type of honesty to which situation.

In my discerning honesty, I have learnt not to forget the person I’m speaking to and the need to be loving toward them even in the midst of overwhelming pain. I have worked really hard not to make everything about me while avoiding making nothing about me. Keeping a genuine interest in the lives and struggles of your loved ones can allow them to help you better by making them feel less drained. The ability to take your eyes off yourself, even just for a moment by asking reciprocal questions after you’re done honestly detailing your struggles is really crucial both for the relationship and for perspective. There can even be healing in such a mutual affirmation. I’m definitely not advocating for hiding your pain, but just making the love reciprocal like the other centered love for your friend or neighbor Jesus taught.

Discerning honesty can become very difficult when we are at our worst, and I have mentioned using DBT skills with splitting, but also this type of wise honesty can help with frantic attempts to avoid abandonment. I experienced the big bad wolf of BPD recently when I was on the receiving end of a breakup. In my experience, there is little to stem the horror of the abandonment feeling, but there are things you can do to stem the relational bleeding and many of these are around discerning honesty toward the object of your abandonment.

The trick is not to use the extreme pain I’m in as a weapon to get them to stay. Recently, when we had the breakup chat, I felt my anger soar a few times like I was going to throw something against the wall. Instead, I affirmed my ex (DBT skill of interpersonal effectiveness), hoped he would be OK, and ended the call. Of course, I’m sure I didn’t do things perfectly and it didn’t stop the overwhelming pain, but a few months later, I can say I no longer feel abandoned (one suicidal night aside).

This is a combination of opposite action, holding back what I really want to say, and also a radical acceptance my relationship is over. Discerning honesty is crucial to interact with your perceived “abandoner.”

I hope that in writing about the discerning honesty I use with my loved ones, I also was appropriately honest in writing about it. I would like to finish with how my friend responded to my frank suicidal admission as she reached me with her own honesty:

“We do worry Andy. We love you. Please look after yourself, you are a precious person. Your friends and family love you and need you.”