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A
I can think of one particular client who was in his 70s and just thinking about over the course of our work together, maybe a couple sessions in, he had tears in his eyes and he said, how have I waited this long to come in? I didn't realize I could feel differently. And even thinking about that person makes me tear up. Because we think about what all can happen when we open the door and kind of move past that initial fear or the stigma we might hold about what it might mean for us to get help.
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Hey, can I talk to you about something? I wish you knew. I wish you knew how lonely menopause felt. I wish you knew why it's so hard for men to share their feelings.
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I wish you knew what it was
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like growing up in a low income family.
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I wish you knew how hard it
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was not having a college degree. I wish you knew what it's like to be me. Welcome back to Mind if We Talk, where you get to be a fly on the wall for mini therapy sessions and learn some mental health tips in the process. I'm your host, Srila Roy Green, a licensed mental health counselor with over 19 years of experience. Today we're talking about a question almost all of us will face at some point. When someone you care about is struggling, how can you help? According to Betterhelp's recent State of Stigma report, 85% of millennials and Gen Z say mental health care is a basic necessity. Yet the majority of both groups say still feel discouraged from seeking help and worry about being judged if they do so. While awareness around mental health care may be growing, knowing how to show up for ourselves and each other isn't always so straightforward. To help break it down, I'm joined today by better health therapist Hannah Heitz. We talk about how to recognize when someone might be struggling, how to support loved ones without trying to fix them, and why stigma still shows up in ways we don't always recognize. Let's get into it. Thank you, Hannah, for joining me on today's episode of Mind if We Talk. It is such a pleasure to have you back again. I'm actually really excited about this episode, I have to say, because the State of Stigma report, I think is just really phenomenal and it provides us with so much information, but it's almost like a lot of information. And I wanted to sit down with you today and really break down some of the really incredible findings from the report and really help our listeners to break it down and how they can apply it to themselves. So, so really excited to have you here today. I wanted to start us off by looking at something very interesting about the report, which is the state of stigma. Found that talking to a therapist or taking care of our mental health is incredibly important. It matters. However, there's a discrepancy and a disconnect there because a lot of those same people that say, yes, therapy is needed, you need to go get help, or everybody should take care of their mental health are also people who are maybe not seeking therapy for themselves. And so what do you think is part of that disconnect or creating that disconnect for folks?
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A
Such a great question, and I'm really glad the state of stigma highlighted this incongruence, right, between what we know to be true and what we say to be true for other people versus what we believe to be true for ourselves. And I think it really touches on this idea of internalized stigma. There are so many of these ideas that can permeate our minds around, like, why it might not be for us or why we might not even feel like we deserve it.
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B
And a lot of people, I think, in general feel like it's not for me, or I don't even know where to begin, or I'm too much, right? And there's almost like a. But there are people who really need help, and I don't want to take away from that. I've definitely heard anecdotally that said to me where it's like, yeah, but I don't. I'm not as sick as somebody else who might need you or need this kind of help. And I'm just like, yeah, but you're
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a human being absolutely feeling, feeling stuck in how to even get started, right? And getting care where to go or who's a good fit, right? All these added layers on top of the internalized stigma make it really hard to actually take that first step 100%.
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B
And with that said, that actually brings me to my next question. Is that, you know, a lot of folks or have loved ones that they want to help, support, or they see the need for, like, I really think that they need help. I need. I think they need therapy. How can I support them? And what would be some, you know, key takeaways for our listeners around how to support someone they feel needs that help.
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So some of the things that I would start with would really just be to acknowledge and just comment on what you're observing and someone say, like, hey, I've noticed things are maybe seeming a bit off for you, or I just wanted to check in with how you're feeling. Right. Just simply observing, acknowledging, checking in, not leading with, hey, I think you need therapy. Not to be obvious about that, but to start really low level and just open the door to a conversation. Right? Open the door for someone to have a space where they can feel heard and maybe let you know that they're not doing well or they might need some support.
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B
Right. I think it sounds really simple, but sometimes it's simply saying, I'm worried about you. Right? I think there's a. I'm really worried about you. I've noticed that you're not yourself lately. Or you seem, you know, fill in the blank, overwhelmed, anxious, you know, whatever, really kind of keeping it simple to say, is there anything I can do? Right. Or if you need. Do you want help getting help, you know, even, you know, because I think that's part of it too, right. It's like, I don't know where to begin. And especially if somebody's in distress emotionally, they may not know where to begin. They're not thinking clearly a lot of times. Right. And so saying, do you want me to help you? Or I have noticed because, you know, outward signs of distress are not always very obvious. They're usually very subtle. And so with that said, are there any signs that people should look out for that signal distress?
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I think of. Not to get like, too semantic about it, but I think of like, signs and then I think of patterns because often there might be a sign and it's something temporary, right. Maybe someone just woke up on the wrong side of the bed. We've all had those days. But when it turns into something you're repeatedly seeing and noticing, that's when it's like, oh, this pattern is starting to make me wonder. Right. And I think they can range in what they look like in terms of a little anecdote. Like growing up, my sign that I was a bit anxious at school was that I would tighten my ponytail and I would tighten it so hard it would move from one side of my head to the other because I was really stressed. I had a rough year with the teacher. But it can look like that. But it could also look like someone being irritable or someone being a bit snappy, right? These things that we might not necessarily think of when we think, oh, maybe they're struggling, but it's really a signal that someone is struggling. Just looking for that pattern over time.
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B
No, I think that's really great. And I think for our listeners, it's especially important to realize that it's any kind of like small pattern of deviation from that person's norm. Their norm, not your norm, but the other person's norm. Right. I think your ponytail example is a great one. You know, for me, it's. I get very quiet and I get very withdrawn. Right. If I'm having a hard time or I'm overwhelmed or I'm feeling anxious, and it's. It's such a quiet, it's such a silence that it's almost like being in, like, a vacuum for other people who are around me. Right. And so when that gets picked up on, there's an immediate, like, is everything okay? Is everything okay? Because that's a deviation from my norm. Right. And I think that's really important for people to recognize, you know, and paying attention to little habits, little signs and signals. Right. And those pattern changes like eating habits, sleeping habits, how they're responding. If this is somebody who's generally outgoing, have they suddenly shut down? Right. If this is somebody who's generally quieter and they're even more quiet, is that a shift for them? You know, what's. What's changed? Hygiene, you know, all those little things. Right. We sometimes overlook them or dismiss it, but I think it's so important to keep those little patterns in mind. I love that you use that difference between signs versus patterns, because sometimes that's the thing is we're waiting for a big sign. There isn't always a big sign. It's usually pretty subtle, and it builds up. Um, so I'm really glad you highlighted that for our listeners. And actually, that segues me into my next piece, which is, you know, it's really interesting because you. You mentioned irritability. And interestingly enough, the patterns that we saw in our search data spoke to irritability. And the actual quote, why am I so angry all the time? And, you know, again, we just spoke about, like, sadness, withdrawal. You mentioned anxiety, but we haven't really touched fully on irritability.
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Anger.
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You know, do you think that irritability can be an early warning sign for people who are struggling?
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Absolutely. I think irritability, even anger, can be a warning sign that we're struggling. And I think for a lot of folks, not everyone, I think it really depends on your identities, how you show up in the world. But anger can feel like a safer emotion to feel than feeling hurt, feeling sad, feeling vulnerable. Right. To feel angry can feel a bit more like armor that you can put on, and you can. You can be angry rather than really acknowledging some of those deeper, maybe more painful emotions to dig into.
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Anger is a little bit more motivating. Right. It's a little bit more protective. Whereas shame, guilt, fear, anxiety, those are the feelings that we're like, ah, you know, would. It could just hide. We don't want to admit it, you know, because those are scary and they're vulnerable. Right. You know, those other emotions can sometimes feel way, way too vulnerable. Like showing our belly. Right. You know, I think of an animal, they don't want to show their belly. Right. Unless they feel safe. Anger is a lot easier.
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Right.
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So I think that that's a great point to bring up for our listeners, for sure. And actually brings me to the next piece, which is, you know, how. How do we help somebody when they are expressing that anger and maybe hiding their shame, guilt, pain, all of the other deeper emotions that they're maybe experiencing and are afraid to talk about? How do we help somebody transition to really getting to the meat and potatoes of it?
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What comes to mind first for me is really just modeling vulnerability in oneself. Right? So showing this. This other person who maybe is really struggling to go beyond that anger or feel comfortable enough or safe enough to go deeper than that anger, showing them that you're willing to do it, you're willing to be that vulnerable and having that conversation, just modeling what that looks like and feels like. And I think that is such a powerful tool that we often forget that how we show up can be a signal for someone else that it's safe for them to show up that way.
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B
Mm. I love that. I love that. The mirroring, right? The modeling, I think also being able to not just mirror it, but offering multiple times. Cause sometimes, you know, it's, you know, first time's not always the charm. Sometimes it's ten times the charm. Right. And just constantly reinforcing. I'm here when you're ready. I'm here when you're ready. I'm here when you're ready. You know, that can be really helpful, too. When somebody's feeling anxious, depressed, overwhelmed, what do you think are some really healthy responses that we can use to help those individuals, you know, and our loved ones, whoever they might be, A friend, close one, you know, relative, you know, they're struggling, they have anxiety, depression going on for them. What are some helpful tips or tricks, so to speak, that we could maybe implement?
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A
You know, when we have someone we care about who's struggling, it's first, those questions we've talked about or kind of actions we've talked about in terms of just checking in with them, simply showing up for them, and also being aware that no matter how much you care about someone who's struggling. You can't fix and solve what they're going through. Right. You can be there as a support, but that there is only so much we can do. Right. And being mindful of that as well. And I think that's a really sticky point because that's really painful when you see someone you love struggling and you want to be there for them, but you can't kind of sacrifice your own wellbeing in that process either.
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B
Right? Absolutely. And I think you brought up a really good point, which is that you can't fix it for them. You know, I think a lot of times that's the. That's the. The point of tension, I think, is the way to put it, where it's like, I just want to rescue them. I just want to fix it for them. And the reality is no one can fix it except for the individual who's going through it.
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Right.
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But you can' do it for them. But you can walk beside them. And I think that's really important for listeners to hear is that we get it right. Even as therapists. There have definitely been times. I know I just want to jump in and fix it for my client. I just want to jump in and fix that problem, but I can't. And it's so overwhelming and frustrating to be a bystander. Right. But we don't have to be a bystander. We can be a support. Right. We can walk beside that person even if we can't walk in their shoes. And I think that's really important for our listeners to understand is like, you may not be able to fix their problems for them, but you can be there as a witness, as a support, as a sounding board, as whatever, and help encourage and listen and, you know, all of those things so that that person feels less alone because they're already feeling so alone. Right.
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Yeah. To keep showing up. Absolutely.
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What are some unhelpful things that people may do? I know that's a. I mean, I have a list.
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I have a list. They don't get me started. I know, I know. We're both laughing, and I think it's. What's. Is that. I think so often the unhelpful comments folks make are. Are coming from a place of love and care. Right. So, like, holding that. I think we often. It's hard to know what to say. So often these kind of maybe wrong things to say. If you've said them, I'm guessing they're coming from a place of love. It's figuring out. Okay, how do I. How do I figure out what's more helpful, what's more useful for me to say? I think some of the ones that come to mind that I hear most from folks are, oh, you'll be fine.
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Yeah.
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Oh, it's no big deal. Everyone goes through this, right? The minimizing comments. Right. It's not that bad. Or be grateful for what you have, the minimization. You can almost hear, you can almost see where it's coming from. This place of trying to help someone keep perspective or reframe their situation.
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Sure.
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But it's not that simple.
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When you're already bogged down and weighed down and you don't have enough over here to help bring in the balance, it can be really hard for somebody to have perspective, to be able to say, this too shall pass. Oh, that's my other favorite. As I said, it is, this too shall pass. It's like, no, really, I didn't know that. You know, and that's like, that's the comeback you almost want to have is to say, I'm aware of the fact that this will pass, but right now, when I'm in the moment, it's really not that simple. I wish it was that simple. We need somebody to be with us in the now when we're going through it. I do want to get to another. A couple more questions, actually. You know, one of the report's biggest takeaways is that, you know, stigma hasn't disappeared, it's just evolved. What it looks like today is like we're feeling like we should handle things more on our own, not burden other people, push through. You know, what do you think modern health stigma looks like today versus, let's say, I don't know, 20 years ago?
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I think it's. What you said is spot on, that it's shifted and it's not gone. And that's not to say we haven't made strides, because I think there has been been so much progress. Right. So kind of name that, hold that, set that over there, and also acknowledge that it's shifted and become something different. I think while the public perception has shifted, the work of changing that kind of internalized perception or how we might understand what it means to need help is still there. And I think it's rooted in something much deeper and something like cultural. Right. That we. It's part of the air we breathe in terms of. Especially when I think of maybe like some cultural norms here in the US around, you know, pull yourself up by your bootstraps or these certain things where it's expected that we can handle everything on our own. When historically as humans we are, we are meant to be in community, we are meant to need help. It's hard to figure out what does that mean for us to need community and be in community while also living in a setting where the expectation is that we should be able to do it on our own.
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Yeah, no, I think that's really important to keep in mind. Yeah. Back in the day, you know, again, I'm gonna go back 20 years, people didn't even know what the heck this was. You know, people didn't even know what therapy really was to a degree. They just thought that mental health spoke to severe mental illness treatment. Right. Like that, you know, people were locked up or people were this or that's what's going to happen to you if you talk about your depression or your anxiety or people are gonna think I'm crazy. It's so funny because now maybe that stigma doesn't exist, but to your point, there' stigma, it's just shifted just slightly. It's just tweaked itself to suit kind of the current narrative, if you will. You know, across the us, the UK and Germany reports there's a similar pattern and it's that most people support mental health, but the stigma is showing up in different ways. It's still there and it's a little bit different. So there's the I don't want to be a burden is a theme that's coming up in the UK and there's a stronger emphasis on wanting to see, stay private or being more self reliant in Germany. But the stigma persists because of those factors. Right. You know, what do these similarities and differences imply when it comes to again, mental health, stigma and how it's evolving in cultures?
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A
Yeah, that's such a great question and such interesting findings in the report. I think stigma is so context dependent and thinking about, okay, then what do we take from those findings? What do we do with that? I think about, okay, if we know this is one of the narratives that's especially true in a certain culture, how do we monitor it within ourselves? How do we acknowledge if this maybe assumption or bias that's really common to our culture, our experience is maybe getting in our way of getting, getting help or maybe getting in the way of a loved one getting help. Right. And I think, you know, we talk about culture in terms of kind of the findings from the country, but culture can also be like some of the stories we tell within our own families around what it might mean to get help.
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Right.
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So those are some of the. The larger cultural narratives that might be presenting barriers or perpetuating stigma. So how do we more mindfully challenge them if we know those things are true?
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How can we support and encourage people to ask for that therapy, to ask for that help without that pressure, without the judgment?
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You know, stigma has shifted and changed shape, but also it's so dependent not just on, like, this culture that we live in, but who you are. Right. What your identities are.
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I think it's important for people to hear that therapy is a safe place. It should be a space where you don't feel judged. It should be a space where you have somebody that's in your corner and has your back. Right. But objectively, and I think if people are able to recognize and. And reconcile that, that like therapy safe, it's a place where you can just be you. It takes time. It's not overnight, but knowing when you find that right fit with a therapist, they're going to just be there for you. And. And the reality is they're going to be days where you're going to walk out of therapy and you're not going to feel maybe great, but you're going to grow. The discomfort is normal because you're being vulnerable, and maybe that's something new for that person. Right. So it's natural to feel that way. The fear is natural. All of the feelings that kind of come along with starting to get that help and seeking help are normal and natural, but they're part of the process.
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A
Exactly like part of that. Opening the door to that vulnerability. I've heard folks describe it as like this fear of opening Pandora's box and therapy being the opening of the box of what's inside, but thinking about the fear of opening that box and what could come from it. And even if you said you're not gonna feel maybe great every time you leave therapy, but thinking in the long game, like, how will this impact me? How will this change things for me? What does this mean for me to maybe not feel anger, but actually feel the hurt underneath and be able to process that and then move forward and show up differently?
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B
Absolutely. Can you think of any good anecdotes or times, Hannah, where you've felt, like, inspired by somebody finally getting the help that they wanted and then being like,
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wow, oh, my God. I can think of so many situations, I think, over the years of clinical practice, I can think of one particular client who was in his 70s and just thinking about over the Course of our work together, maybe a couple sessions in, he had tears in his eyes and he said, how have I waited this long to come in? I didn't realize I could feel differently. Even thinking about that person makes me tear up. Because we think about what all can happen when we open the door and kind of move past that initial, the fear or the stigma we might hold about what it might mean for us to get help and go there and get that help and see what's on the other side.
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B
And when you finally take that peek, you're like, oh, oh, I didn't even realize. Right. And so incredible to watch that, isn't it? Like, it's. I think that is my favorite thing about being a therapist is seeing that aha. Of wow, I figured that out or I got there or I got here. And the reality is, is that you do it when you are ready. And then once you're there, it isn't about looking backwards and say, why did I do this sooner? Either. It's about being able to say, I can move forwards. And I have a totally different mindset. We talked about a lot of stuff today, Hannah, and I'm just thinking out loud here as we wrap up. What are some things that you would want our listeners to take away with them today?
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A
That's a great question. I think some of the takeaways that I'm. I'm holding from today include really showing up for each other. Right. Showing up as curious, as validating as listening to other folks who maybe need us, listening to ourselves and what we need, kind of what those emotions might be signaling to us and really thinking about them as cues or signals as to what might be going on under the surface. The other thing I'm thinking about is that stigma is still around. I think because we've made such strides in terms of how we view mental health societally that we assume that a lot of people don't hold the stigma. But it's still there, and it's still something we need to challenge both within ourselves and encourage other people to challenge, especially when we need help. And then I think lastly, it's really never too late to get help and help is available. Right. And maybe we'll need some. Some tools or strategies to figure out where to find that help, but that it is out there for us.
- [24:05]
B
Absolutely. I think also, you know, again, to highlight that we're. We're a lot less alone than we think we are. Again, you can't necessarily, you know, do the work for somebody else or. Or walk in their shoes specifically, but you can walk alongside them. Right? Those are the pieces. And that's often what therapy is, right? Is, is just being there to be part of that for that individual. You know, making sure that when you are expressing concern for somebody that you care about and you see them struggling, making space for them in small ways just to make sure they know that they're not alone, you know, is really important. And not saying, oh, you'll get over it. It's not about getting over, it's getting through it. And I think that the, that's the piece that we all have to remember. Right? Thank you so much, Hannah. Loved having you here again.
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Yeah, thank you so much for having me. It's been such a, such a pleasure to be on and yeah, thanks for, for bringing on for such a great topic.
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After this conversation with Hannah, a few key themes stand out. Most people agree that mental health support is important, but stigma still shows up in quieter ways, be it delaying seeking help to questioning whether things are serious enough. But support doesn't require perfect language, simple check ins, staying present and listening without judgment can go a long way. And while it's natural to want to fix things, real support is often about helping someone feel less alone, because showing up for each other in small, steady ways can make reaching out feel more possible. This is an ad by BetterHelp. In this episode we're discussing BetterHelp's recent State of Stigma report, which emphasizes the importance of taking our mental health seriously. Because when we support each other and help one another take steps toward care, it can make it easier to find the help we need and feel less alone in the process. Learning how to express what you're feeling or even identify it in the first place takes practice, and therapy can help create a space to do that without judgment. BetterHelp makes it easy to get the support you deserve. Visit betterhelp.commindifwetalk for 10% off your first month. That's betterhelp.com mindifwetalk I want to give a big thank you to BetterHelp for their passion for this project and for giving us a platform to champion the well being in all of us. Mind if We Talk is produced by Acast Creative Studios in collaboration with Better Help and hosted by me, Sri La Green. If you like what you just heard, drop us a review in Spotify or Apple podcasts and share the episode with your friends. Maybe one of our topics will help someone in your life and remember your happiness matters. Mind if We Talk is intended for entertainment and education, not for mental health diagnosis or medical advice.