The open conversations around mental health in society today represent huge progress in comparison to even ten or twenty years ago. I am especially in awe of the academics who present their struggles publicly (such as in blog posts here) and find this absolutely crucial for the health of our field. Reading their stories has made a difference to me and helped me feel less alone.

In this blog post though, I want to offer some support for those who can’t or don’t want to talk about their mental health. An important message should be: That’s okay too. As long as we’re talking to someone, we don’t have to talk to everyone. Based on my personal experience, this is an even more important message for people trying to support someone who is struggling. Public health initiatives encourage us to ask “Are you okay?”. The idea is to give people an opening to talk, but for a person in distress, it can feel like the burden is being put on them to reassure others. This was my experience during an event I wasn’t able to talk about and instead of helping me, it forced me into isolation. Sometimes, asking others if they are okay can be problematic—even unhelpful—and we need to be aware that we might have to adjust our strategy if someone is not responding.

 My Experience: Remembering Trauma

Like a lot of us, starting postgraduate studies for me meant moving internationally. Something about being so far from “home” seemed to offer safety to something inside of me that needed to come out. It’s hard to explain the feeling at the time – I didn’t know what was coming but also I sort of did – but I couldn’t have put it into words for myself or anyone else. I tried to distract myself from bouts of anxiety by working extremely long hours. I remember working seven days a week on my Master’s thesis, sometimes late into the night with tears streaming down my face. I knew it was completely unnecessary but it was better than the alternative. I was afraid of slowing down, because if I did, I’d have to face how I was feeling.

Eventually I cracked. For two weeks I lay on the sofa sobbing uncontrollably, without any idea why, unable to work or move much. Here’s where today’s openness around mental health did help me: I didn’t feel shy about getting help. With unbelievable luck, I found the perfect therapist on the first attempt. She saw almost immediately that the situation was more complex than what I had described (which was basically, “I don’t know why I’m here”). And, after about a year of work, a trickle of fragmented childhood memories came back to me, then the trickle became a flood. The horror was so intense I withdrew from friends and eventually from work. I was 18 months into my PhD at this point and spent weeks at a time not leaving my apartment, not bathing or cleaning or eating properly, only able to watch Friends re-runs because they were light and fluffy and safe. I had terrible insomnia and when I did sleep, it was all nightmares. My close friends were on the other side of the world, and no-one here knew what had happened. I was completely alone. 

The Inevitable Questions

It’s been 4 or 5 years and I am still not physically able to talk about what happened. At the time, since something was clearly wrong, I was asked constantly “Are you okay?”. This happened everywhere from one-on-one meetings to crowded trains, social situations, and work meetings. Friends double-, triple-, quadruple-texted me before I (sometimes) answered, demanding to know what was wrong and suggesting I join them for various outings they had already planned. Telling people I was going through something without giving details only made it worse. The lying about being fine became so exhausting on top of everything else that I started blocking numbers and stopped going to the office. I understood and appreciated that people were looking out for me, but the unintended effect was that I became even more isolated.

Looking back, this was a shame because my PhD was my life raft. I’ve always loved my job and it gave me something to cling onto when the rest of my life had fallen apart. It wasn’t just the physical and mental effects of the trauma – it was also dealing with the fact that everything I thought I knew about myself and my family and the world was a lie. I lost any notion of having a family and was grieving for the parts of a normal life that had been taken away from me. I no longer knew who I was, but the one solid thing was my work. Focusing on that, using the emotional skills I learned from being an academic to fight for my life – this is what I needed. So, it was a shame that part of the reason I felt unable to go to work was because I couldn’t face the inevitable questions about my health.

Supporting someone who doesn’t want to talk

Public messaging on mental health focuses on talking, which is great, but it gives the impression that the only way to help someone is to get them to talk about what’s bothering them. I can’t speak for others, but here are some things I wished for from people who wanted to support me: 

1. Firstly, I wish we could have talked about anything other than what was bothering me. I felt like every interaction I had became about “How I was doing”, even with people I wasn’t close to. What I was going through made me feel exposed and vulnerable and I wasn’t comfortable feeling like everyone was watching me. It also made me feel like my whole life had just become this one thing—it would have been a relief to talk some science or listen to other peoples’ problems.
   
2. I wished people had put some thought into what our relationship was before asking me if I was okay, as well as when and where they asked: It was often a person with whom I’d never had a personal conversation before, who was suddenly asking me to talk about my problems in a crowded public place.
   
3. I also wished that people who genuinely wanted to help would have just asked me what I needed. It feels a bit like cheating to ask someone directly what they need, but it shows you care.
   
4. Most importantly, I wished people would have accepted “I’m fine” as an answer. Or no answer at all. It wasn’t anything personal. Sometimes saying “I’m fine” was as much about holding myself together as reassuring others.

Conclusion

Knowing what to do when a friend or colleague is in distress is hard, and in my experience very few people are good at it, including me. In this post I’ve tried to highlight the downside of what is otherwise a very positive development in academia and society generally. Accepting that a colleague doesn’t want to talk is part of supporting them. Sometimes just the opportunity to be around you and talk about something other than what they’re going through is enough.

In addition, while my reasons for not wanting to share my struggle were personal, there are all sorts of reasons someone might not want to talk. Unfortunately, mental health stigma is still very real and concerns about professional or personal consequences—real or perceived—need to be respected. 

Finally, if you are the one struggling, it can be helpful to be open about what’s happening, but it’s equally fine not to be. As long as you’re getting support from somewhere—for me it was a therapist and my closest friends—it’s perfectly valid to tell everyone else you’re fine, or not respond, or not give the full story. You do not owe your story to anyone and not sharing it doesn’t mean you don’t value the people around you or that you don’t want to make a difference. 

This blog is kindly sponsored by G-Research