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How to Talk About Mental Health Issues

When teens are struggling, speaking up can be hard, but reaching out is the first step to feeling better. How to get started.

Rae Jacobson

When you’re having emotional problems, the first step to feeling better is finding a way to talk about how you’re feeling. But for a lot of us, it can be hard to speak up, and even harder to know how to approach the conversation — who to talk to and what to say.

Talking about your mental health issues may not be easy but it’s a vital part of getting the help you need. We asked the staff of Project UROK, a website which helps young people share their experiences with mental illness, and Jamie Howard, PhD, a clinical psychologist at the Child Mind Institute, for advice on how to start, and navigate, the conversation.

Stigma and silence

According the National Alliance on Mental Illness (NAMI), one in five young adults is dealing with mental illness, but as many as half are struggling in silence.

“We all have reasons why it’s hard to reach out,” says Jose Rivera, who manages social media for Project UROK. Today, Jose is open about his struggles with anxiety and body dysmorphic disorder, but he knows firsthand how hard it can be to start speaking up about mental health. “Maybe you’ve tried before and been burned by a bad reaction. Maybe you can’t find the words to describe what you’re feeling.” But while the thought of sharing what you’re going through can feel scary and overwhelming, says Jose, the benefits far outweigh the cost.

“You. Are. Not. Alone,” says Jose. “And once you start reaching out you’ll realize that. You’re a member of a community, and there’s real help out there.”

Getting started

There’s no right way or best way to talk about mental health issues, but having a plan can help make the process less overwhelming. “Just acknowledging that you need help is a really powerful thing,” says Project UROK’s Charlie Purdom,”But sometimes going from saying it to yourself to saying it to someone else is hard.” Here are some things to help make the conversation more productive:

  • Write down what you’re feeling. For Charlie, journaling is a good way to help organize his thoughts before having difficult conversations. “Writing it down can help you get a clearer idea of what you want to say,” he says. “You can even try writing a script to help guide you through the conversation, if you think it would be helpful.”
  • Find a symptom checker online. “It helps to have the facts,” says Charlie. “Using an online symptom checker, like the one on childmind.org, can help you make sense of how you’re feeling and give you a place to start when talking to your parents or a therapist.” Keep in mind that it’s just a starting point, not a substitute for a diagnosis from a mental health professional.
  • Give a heads-up. Once you chose someone to talk to, let them know that you’d like to have a serious conversation and ask them to set some time aside. For example you could say, “Hey, there’s something I want to talk to you about. Do you have some time tomorrow to talk, just us?”

Who to talk to

“There’s no ‘right’ first person to talk to,” says Dr. Howard. “What’s important is finding someone you feel comfortable opening up with, and who you know will listen.”

  • Choose your confidants “It might sound boring, but start with people who are nice,” says Dior Vargas, Project UROK’s outreach coordinator and creator of the People of Color and Mental Illness Photo Project. Talking to people who you can rely on to be understanding and supportive early on will help you practice and gain confidence.
  • Go beyond friends Talking to friends, in person or online, is a good way to get started but there’s a limit to how much friends can help. “In the end, friends are part of the process, but they probably can’t connect you with the resources you need,” notes Dr. Howard. The goal should be to eventually find someone who can help you get the ball rolling on treatment.
  • Find an adult you trust “If you can talk to a parent, that’s great,” says Dr. Howard, “but a lot of kids are reluctant to do that for various reasons.”

Other people to talk to could include:

“The important thing is to be persistent, says Dr. Howard. “Don’t stop until you find someone who can help you.” 

Having the conversation

Once you’re ready to talk, here are some things to keep in mind:

  • Go at your own pace. If the thought of telling someone what’s been going on feels overwhelming, remember that it’s okay to take it slow. “It’s up to you how much you want to share,” says Dior. “Talking about mental health is more than one conversation. You don’t have to pressure yourself to get everything out at once, or to one person.”
  • Don’t downplay. As a society we’re trained to make serious things seem lighter than they are but that can make it harder to get the help you need. Everyone feels “sad” or “anxious” sometimes, says Dr. Howard, so it’s important to communicate that what you’re feeling is more serious, and affecting your day-to-day life. For example, instead of saying “I’ve been anxious lately,” Dr. Howard suggests being more explicit. ‘I feel anxious all the time. I don’t even want to go to school, I don’t want to go out or see friends. I think I might have an anxiety disorder. I feel really alone and I need help.’”
  • Don’t worry about messing up. Remember that the plan doesn’t have to be perfect. “Think about what you’d like to say, if you can, but if worst comes to worst it’s okay to just say, ‘I feel awful, and I don’t know what to do,’” says Dr. Howard. “What’s important is that you’re telling people how you feel and asking for help. You’ll know you’ve succeeded when you sit down with someone who can help you.”

What if people don’t respond well?

Most people will respond better than you think, but if someone doesn’t react the way you’re hoping they will, don’t be sidelined. Move on to someone else. “We want to be able to rely on the people we love to be there for us,” says Dior, “but not everyone in your life is going to respond in the right way.” If someone doesn’t seem to understand, it also doesn’t mean that they’ll never understand. Sometimes people just need a little time.

Building your team

A support system means having people you can rely on in different ways. A friend might be a good, accepting listener. A parent might be a good back-up for tough decisions. A mental health professional is key to getting treatment, but “it’s good to have multiple people you can confide in,” says Dr. Howard. “We do well when we have a diverse support system.”

Some other things to consider:

  • Beware of too much commiseration. “Finding people who are going through similar things can be a huge help,” says Dr. Howard, but she warns that surrounding yourself with people who are constantly commiserating can often end up working against your recovery. “You have to be really careful to look for a support system that isn’t encouraging unhealthy behaviors.”
  • Find your safe space. When you’re seeking support, look for communities that can speak to your identity in a holistic way. “Not all communities are safe or beneficial for all people,” “says Dior. “You may find a mental health group that offers one kind of support, but it might not be a positive space if you’re LGBTQ or a person of color.”
  • Avoid people who make you feel worse. Tune in to how you feel after conversations. If you notice that you tend to feel worse after talking with a particular friend or family member, they may not be the right person to confide in next time.

Setting boundaries

Once you start talking about your mental health, it’s important to set some boundaries for yourself. “You don’t want your mental health to define you,” says Dr. Howard, “so it’s important to decide who you want to talk to about it, and how much.”

  • Know your audience. Being selective about who you talk to will help you stay in control of the conversation. “It should be a thoughtful selection that you’ve planned ahead for,” says Dr. Howard. For example, if you wanted to let some of your classmates know what you’re feeling, opening up during a full class discussion might not be appropriate. Instead, try asking the people you want to tell out to lunch.
  • Don’t over-share. Being honest and open about your mental health is important, but it’s not an all-or-nothing situation. “It shouldn’t be the focus of every conversation,” notes Dr. Howard.

Helping others

Just talking about mental health issues, even to one person, helps bust stigma and, Jose notes, you may be surprised to find that you’re actually helping others. “When you speak up you’re not only giving yourself a chance to get better, you may unknowingly be paving the way for someone who’s still waiting to find their voice.”

Safety first

Talking about mental illness is a process, but sometimes there are situations when you need to find help right away. If you are in crisis, don’t wait. Your safety is the most important thing. Tell a parent, counselor or teacher immediately if you are:

You can also reach the Crisis Text Line by texting HOME to 741741 or call the National Suicide Prevention Hotline at 1-800.273.8255. Or go to your local emergency room.