Transcriber: Leonardo Silva
Reviewer: Tanya Cushman When I was first diagnosed
with bipolar disorder, I was told that the best way
to talk about mental health was to say nothing. My psychiatrist in the hospital warned me that I had so much to lose
if I told anyone about my experiences. He said, "Dan, the stigma against mental illness
is different from the rest. It cuts across race, gender
and sexual orientation. It is unbeatable." Ooh! What a scary introduction
to mental illness. I was 19, and out of nowhere, I had just been hospitalized
for my first mania. I hadn't slept for four straight days. Over that time,
I became filled with energy. First, I was the life of the party. Then, I became obnoxious and irritable. And finally, after having not slept for so long, I was detached from reality. By the time my parents came
to take me for help, I actually thought I was going
to travel back in time to fix it so they never got divorced. When I was in the hospital,
I was coming back down to earth, and I was also starting to realize that my life was going to be
very different with my new bipolar diagnosis. My psychiatrist wasn't the only one
scaring the heck out of me. My family warned me that if I spoke
about my mental illness, I would lose all of my friends. So, I did what I was told,
and I kept it secret. Now, this surprised everybody
because I'm actually a chronic oversharer. (Laughter) But I kept that secret for almost a year, until the stress became unbearable and I got sick again. I had felt so much shame from hiding. I realized then, that for me,
saying nothing wasn't the best approach, and from then on, I was open. Now I'm a pro when it comes
to talking about mental health. I travel the country teaching people
and organizations how to do it. Wherever I go, I tell everyone,
"I have bipolar disorder." I put it in my bio, I share it at cocktail parties, I've told people on first dates ... I'll probably tell you
I have bipolar disorder at least a dozen times
by the end of this talk. But even after over a decade
of doing this, it's still hard to figure out the best way
to talk about mental health. It's a very sensitive topic, and there are so many ways
that we can accidentally offend people. Our conversations get loaded
with assumptions and paternalism and stigma. Assumptions - Assumptions happen when we think
we understand something but we actually don't. People make all sorts of assumptions
when it comes to mental health. It happens when supportive friends
say things like "I've been there" or "I know what you're going through," or if I told someone that I knew what it was like for them
to have bipolar disorder just because I also have bipolar disorder. But the truth is everyone is unique. Two people can have
the same exact diagnosis but very different experiences,
beliefs and values. We may think that we're empathizing
when we say things like "I understand," but we might be inadvertently
offending people by assuming we know their story. And then, there's paternalism. Paternalism happens when we tell someone
what's best for them. We may think we're being helpful when we're suggesting
a treatment option or a resource, but it can become very disempowering
if we do it in a way that treats someone like they can't manage their
mental health condition on their own. An example is when a college student
takes a medical leave of absence so they can take care
of their mental health. A lot of times, they have to seek approval
to return back to school, and many universities actually require that they share their medical records
and the treatment files and possibly periodic updates
about how their treatment is going. Now, the reason that schools do this
is they want to be able to be supportive and welcome the person back to school and make sure they'll be able to do well
when they get back to school. But this process of monitoring
can actually become very disempowering if the student feels like they're not
in a position to manage their own care. So, even when we try to be supportive, this inadvertent paternalism
can push us apart. And what about stigma? Stigma happens when people have
negative attitudes toward mental health. I have seen faces sink and attitudes shift the moment people learn
I have bipolar disorder. "Incompetent." "Dangerous." "Unreliable." These are some of the first thoughts
that people associate with mental illness. One memorable time
that I experienced stigma happened before I ever got sick
with bipolar disorder, when I took an abnormal psychology class. And I actually took that class
the semester before I first got sick. One person in my group of friends made fun of every single
mental health diagnosis that came up and mocked every single treatment, and that person was actually me. I made those comments just before my mental health
problem first emerged. And I'll never forget what it felt like
to be sitting in a hospital, just a few months later, wondering if people were saying
the same things about me. I share that story now for the same reason
that I share it in my trainings: because I want you to feel comfortable when you see me here
talking about my mental illness. When people hear me say
that I have a mental illness, they often get worried that they're going to say the wrong thing
or they're going to offend me. And I want you to know I'm not going to judge you
for anything you say. Even when we have the best intentions, the assumptions and
the paternalism and the stigma can make us say offensive things, and the reality is no matter
what upsetting things we say, we are all in this together. Over 40 million Americans have a diagnosable
mental health problem each year, and close to half of us
will experience one at some point in our lives. Even if we don't ever qualify
for a clinical mental health diagnosis, we still all know what it's like
to feel sad or worried or overwhelmed. Our bad days don't all end
in hospitalizations, but we still all know
what it's like to have a bad day. We have to learn how to connect and have important conversations
about mental health without offending each other. Families need to talk with each other about treatment plans
and living arrangements and lifestyle choices. Companies need to engage their employees so they can accommodate their needs,
maximize their productivity, and build resilient cultures
that are ready for their bad days. Colleges need to know how to refer
their students to mental health services, place them on leaves of absence
and welcome them back to school while empowering those students
during every step of their journey to take care of their mental health. These are just a few of the many
important conversations we have to have, but we can't have them
if we're afraid to broach the subject. And that's where
conflict resolution comes in. I spent years searching for tools to help people communicate
about mental health before I finally discovered mediation. Mediation is a type
of conflict resolution. When I trained to become a mediator, I learned how to support people
in working out their own agreements to resolve a conflict. Mediators don't give advice. We don't make suggestions,
and we don't tell people what to do. Mediators don't take sides. Instead, we just listen
and validate people's perspectives and ask open-ended questions. Mediators provide a structure - a place and a time
to have the conversation. Mediators help people
get past their barriers so they can have a dialogue. So, how do we apply the skills
of conflict resolution to talking about mental health? We have to make room for the other story. That is the biggest lesson
from conflict resolution and the key takeaway from this talk. We have to make room
to listen to other people's perspectives. When we make room for the other story, we can overcome the obstacles
of assumptions and paternalism and stigma. Making room means that we stop assuming we know what's going on
when it comes to mental health and we start asking questions. When I was in grad school,
I had a roommate who was very supportive and wanted to help me
with my mental health problem, but the only problem
was he didn't tell me. He never told me he was doing
anything to try to help me. So I met him, and I told him
I have bipolar disorder and I worked very hard
to protect my sleep. And unbeknownst to me, he would brush his teeth at night
but wouldn't run the water, even though he needed to, because he didn't want to wake me up with the noise
from the faucet and the sink. And the truth is
I didn't need him to do this. So this went on for months and months, until finally, you know,
he built up some resentment and actually felt like
I owed him something because he had been sacrificing
the running water from the sink at night. And we finally had
a confrontation about it, and we worked it out. But, you know, you've got to wonder: What if he'd just asked me
when I told him I had bipolar disorder? What if he asked me, "What does it mean
that you have bipolar disorder? Do you want my help
in protecting your sleep? And how can I help you
protect your sleep?" When we ask questions
instead of making assumptions, then we make room for the other story. Now, making room
for the other story also means that we have to replace our paternalism
with respect for people's choices. Whether you are
a mental health professional or a person living
with a mental health condition or a supporter or all of the above, we all have our own answers
when it comes to mental health. Too often, we spend our time
telling people our answers instead of trying to learn from theirs. We tell people what we believe
is the right treatment or the right resource because we're trying to help, but we forget that even the experts
debate everything, from diagnosis to treatment. There are no perfect answers
in mental health that work for everybody. And without those universal answers,
what we're left with are personal choices. We have to learn to embrace the fact
that there are all these choices and respect the choices that people make. That means we have to say things like, "I know this is your choice. Can you help me understand
what's important to you when you're making that choice?" Or, "You're making
a different choice than I would. Can you help me understand
why this is the right choice for you?" When we frame our conversations as discussions about
people's personal choices, well, then we empower people. We make room for their story. The last thing I'm going to talk about
in making room for the other story is we have to face the stigma head-on. We have to acknowledge that some people do have
negative attitudes about mental health, and this makes it hard for us
to have conversations about it. When I train managers
to talk to employees about mental health, we can't pretend that it's an easy
or simple thing for those employees to go to their human resources department and tell them that they have
a mental health need or to use their employee assistance plan
to access short-term therapy. The scary reality is that it can be hard
to disclose a mental health condition, and people get worried that their boss or their coworker
might see them differently. We can't afford to dismiss the stigma
or ignore the fact that it exists. When we make room for the fact
that there really is the stigma, then we're making room for the stories
of people working to overcome that stigma. Everyone has a story
when it comes to mental health. I started this talk
by sharing a scary statement from my psychiatrist in the hospital, warning me about the stigma
of mental illness and encouraging me to hide. Now let me try to make room
for what might have been his other story. Maybe he had spent years
working with lots of patients who had been open
about their mental illness and experienced a lot of problems
because of the stigma. Or maybe he was one
of the countless professionals who are thriving at their jobs but also privately managing
a mental health condition. Maybe he was telling me
the same advice he follows every day. And what about the people
who make fun of mental illness? What might be their other story? Well, maybe they're like I was when I took
that abnormal psychology class. Maybe they don't even realize it yet, but they're fighting every day to resist the pull
into their own internal instability, and maybe one day they'll even be
on a stage like this one, telling their story. We have to make room
for all of these stories when we're talking about mental health. We have to ask questions
instead of making assumptions, we have to respect choices
instead of being paternalistic, and we have to face the stigma head-on. When we do all these things, we can connect
without offending each other. And we definitely
have it in us to connect. No matter how different we are,
we all have bad days, and if we make room
for everyone's unique story, then we can take a step back together and see that we're all part
of a single big picture, one community of people
trying their best to have less bad days. Thank you. (Applause)
