Stop Telling Mentally Ill People That It’s All in Their Head

Their perspective, however crazy it seems, is their reality.

One day, my grandmother saw her husband walk into the room with a beautiful young woman — his mistress — on his arm.

Or at least that’s what she thought.

In reality, my mom and grandfather were visiting her in the Dementia Care wing of an assisted living facility that had been her home for the past year.

When my mother came home from that visit and told me that Grandma had thought that she, her own daughter, was The Other Woman, I laughed. At first.

Aww, poor Grandma. That’s sweet.

But that was quickly replaced by concern. And then sadness. And then shame for thinking for even half a second that my grandmother’s distress was remotely “cute.”

This was Grandma’s reality. This was what she believed. From her perspective, her husband of over 50 years came in with a much younger woman, and she thought she had been replaced.

Thankfully, Mom told me, her mother’s distress only lasted a short while. Her unpredictable mind temporarily stopped betraying her, and she saw that it was only her daughter, Christine, who had walked in with her husband Johnny.

Mom is a clinical social worker who at the time specialized — ironically — in counseling families of patients with Alzheimer’s. It wasn’t until she talked to me that I really understood the importance of acknowledging the views of people who are cursed with mental illnesses such as Alzheimer’s Disease.

A couple of years later, my own reality shifted and my family, friends, and most of the people in our small Southern town thought that I’d lost my mind.

They were right.

Everyone’s perspective: In August of 2007 I suddenly left my husband. I felt like I wasn’t a good enough mother to raise our two children, so I left them, too. Then I started dating a slew of younger and decreasingly responsible guys until I finally settled on the worst one I could possibly find. I was selfish, immature, irresponsible, stupid, unloving, and reckless. I was completely crazy.

My perspective: I was unlovable, a failure, stupid, a bad mother, a bad daughter, a bad friend, and a bad person. I was confused, freaked out, and terrified to be alone. I couldn’t function normally. I forgot how to be an adult and didn’t know how to manage anything. No one believed me. No one loved me. No one understood me.

Reality: I was running wild because I had PTSD and Bipolar Disorder, neither of which had been diagnosed, and the added stress of my marriage and family falling apart drove me out of my mind.

For two years.

I remember trying to talk to people, mainly family members, who didn’t understand what was going on. They kept telling me that I was insane. This was true, in the sense that I was full-blown manic and could not control my anxiety. But I wasn’t hallucinating. I was trying to cope with a fragmented, unfamiliar mind. It was like suddenly being made to fly a plane into a storm with zero flight experience. But by all accounts, I was mad as a March hare, the people I loved most in this world told me that my feelings didn’t count. They were invalid.

“That’s just your perspective.”

“That’s not the way anybody else sees it.”

and the classic:

“All of this is in your head.”

Every time I tried to explain anything, I was dismissed. And I went to great lengths to be heard. I would write long, detailed emails to my father — who could not believe that things were that bad — begging him to believe me, to hear me. And each time, he’d reply with equally long emails and pick my words apart, using them as further proof that I was nuts, that I didn’t make sense. He’d take my words and turn them around on me.

In his defense, my behavior was alarming, and he could not understand why I did not want to care for my children. He could not have known that I had been convinced that I was an unfit mother and that my husband was the better parent, and that our last fight had started because of our son’s behavior problems. Also, I had not told anyone about what else had been going on behind closed doors that had slowly been causing me to spin out of control for the past couple of years. I didn’t know how to tell him that every time I was around the children, I would have flashbacks from the PTSD I’d never asked for, and I could not function. I couldn’t articulate my severe anxiety into words or even thoughts.

There was no way that Dad could guess that my mind had corrupted files. All he — and everybody else — had to go on was my outward behavior.

By the end of 2007, I had settled in an abusive relationship because I honestly didn’t think I could do any better. I moved into a single wide trailer with holes in the floor, sold all of my china and silver for pennies on the dollar, sold my washing machine, dryer, and even my bed, and then when there was no money for rent, gas, or car payments, I got rides from people and slept on their couches. My children were over 500 miles away. I was a laughingstock of my little town.

I was pretty much in the bell jar.

I can’t help but wonder what might have happened if someone had initially listened to me and not brushed things off. My husband at the time had been more believable than I had been. After all, he wasn’t the one with the mental problems who had dropped all responsibilities and was running around like a 13-year-old. My parents did get me in to see a psychiatrist, but because they thought I was nuts and reminded me of my own undoing every chance they got, I was convinced that I was a lost cause and eventually gave up.

It took many years for things to improve, but things did eventually turn around. In 2010 I left my abusive boyfriend and moved home. Several months later, my now-husband helped me get my children back. My family was finally able to understand what I had been trying to tell them all along, but it took a long time — and a more recent bipolar diagnosis — for them to be able to put the pieces together and be able to hear me.

And my feelings were finally valid. They believed me. They saw how tortured I had been because of my own mind. Finally, my views were no longer dismissed. Because I had always been close to my family, I was not able to really start healing until they made it clear that my words were important and that I was worth listening to.

I know firsthand that for many who struggle with anxiety, depression, bipolar disorder, and other mental illnesses that are often debilitating, the added component of being told that their perspective is garbage can drive them to despair. People naturally want to be heard, but in my opinion, people who are mentally ill really need to know that they are heard. If, God forbid, one day I become the one who thinks that my husband is walking in the door with his side chick, when it’s really my own daughter, I don’t need a pat on the arm and a chuckle. I need them to understand that in my world, this is my reality, and that I need someone to at least listen to me and try to offer reassurance.

If we could try to see through the lens of someone we care about who seems to be highly anxious or depressed or paranoid over nothing, or who is not making sense, we could be that sympathetic ear they desperately need.

Even if we really do think that it’s all in their head, we don’t need to antagonize them by letting them know about our opinion. Even if their behavior is strange or self-destructive, now is not the time to make it all about us.

This is about their feelings, not ours.

This is about a person who can’t just walk away from the trap in their mind.

Someone needs to be their ally and their advocate instead of their critic and accuser. They need to be heard — even if it’s just for a short time because their needs are out of your scope of experience. If you’re willing to hear them, you could then offer them some options for getting help. Even the smallest bit of compassion may just be the lifeline that person needs.