On Help, Getting and Giving

[Content Note: Disablism; self-harm.]

One of the things I've been seeing a lot in the wake of Robin Williams' death is the thought that perhaps discussion around his taking his own life after living with depression will encourage other people to seek help.

And that is a true thing.

For people who need help, and have access to mental healthcare, being motivated to seek out help will be a very good thing.

Of course, not all people have access to mental healthcare. And not all people who need help, in the throes of depression and/or related anxiety disorders, have the capacity to seek out that help for themselves.

So another thing I've been seeing a lot is reminders to reach out to people who may need and want assistance accessing mental healthcare.

And that is also a true thing.

It can be invaluable to people whose mental illness makes it nigh impossible to even contemplate the task of navigating insurance networks and finding covered providers who specialize in their needs and making an appointment and getting to that appointment and filling prescriptions and all the other bits and pieces of the process of participating in their own care.

It can be helpful to have a friend who offers to walk through that process with you.

So another thing I've been seeing is the suggestion to be present for people who have mental illness, to ask them what they need and offer what help you can, whether that's researching options or driving someone to an appointment or picking up groceries or doing laundry for them.

I don't want to diminish any of this—the need for accessible comprehensive mental healthcare; the importance of having the support of friends (or family members, or whomever) to help begin (or restart) that journey; the meaningful difference it can make to have someone who's willing to just do the chores one doesn't have the energy to do oneself.

These are all good things.

But I also want to say this: There is a strong narrative around "fixing" people with mental illness. And I don't mean just helping someone with a mental illness be as functional and healthy as they can be. I mean the idea that someone can "get over" being chronically mentally ill, and how offering "help," or advising them to "get help," often acts in service to that narrative.

Partly this narrative exists because some people do experience temporary, or situational, depression and/or anxiety, and so there exist a lot of bad assumptions about how everyone is capable of "getting over" depression and/or anxiety. Individual people experience mental illness in individual ways, and chronic mental illness is not indicative of "weakness," of a person's inability to bootstrap themselves out of their disorder.

(Which is why, for the love of Maude, if you have an anecdote about a person who jogged their way or meditated their way or special dieted their way out of depression and/or anxiety, keep it to your fucking self, unless and until someone with mental illness solicits your advice.)

And partly this narrative exists because most of us don't have good practice at allowing people to be in pain. We want to be able to fix people we love who are hurting.

Sometimes to the point where we ignore all evidence that trying to "fix" someone is only hurting them even more.

One of the things we all have to get okay with is the reality that even people with chronic mental illness who seek help, all the help available to them, are still going to hurt, sometimes or all the time.

That "help" often means getting the tools to navigate mental illness, not to "fix" it.

One of the best things anyone can do for someone with chronic depression and/or anxiety is simply let us be ill.

I don't mean abandon us. I don't mean accept all manner of behavior with mental illness invoked as an excuse for harm, of self or others. What I mean is: Don't oblige us to mask our illness for your comfort, because you can't sit with the fact that we've got an illness that makes us hurt, sometimes or all the time.

Let us be fully present, even when we feel bad.

This is a cultural thing. There are, for example, way more people who want to read me write about my resiliency in the face of fat hatred than write about how it hurts. There are way more people who will show up for a party than for a support session. There are people who love to laugh with you, who would recoil to see you cry.

And that's because crying needs "fixed." Instead of being viewed as just another expression of emotion. Which some people may need to express more than others.

Some people with mental illness need interventions, not a space to cry without judgment. Some people need both. Some neither. And crying is just shorthand for any number of possible manifestations (short of harming others) of depression and/or anxiety that someone might show, which could make someone else uncomfortable when there's no easy "fix," that don't necessarily need fixing.

The point is that it has to be okay to be a person with mental illness. Before anything else—before "help," before supportive offers, before listening—it just has to be okay to be who we are.

It is tough to be expected to be someone other than yourself, at the same time you're clawing your way out of an abyss. Or clinging to the edge of one, trying to avoid falling in.

I am not suggesting indulgence; I am suggesting validation.

There are people who resist this approach to people with mental illness about whom they care. They mistakenly believe that accepting us as who we are is accepting, and thus giving power to, the very darkest parts of our disease.

That is exactly wrong. Being allowed to acknowledge those dark places is our only chance to successfully navigate them.

And, besides, they are not outside of us. They are inside of us.

To ask us to abandon these parts of ourselves at the door is to ask us to tear our very selves in two, as if that could ever make us whole.

Let us be unbroken, and then you will see that we don't need to be fixed.

That is certainly the help I need myself, and the help I endeavor to offer to my loved ones with diseases like mine.