How to Talk About Mental Health Without Offending Everyone: Dan Berstein (Transcript)

Full text of mediator Dan Berstein’s talk: How to talk about mental health without offending everyone at TEDxCooperUnion conference.

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Dan Berstein – Mediator, Trainer, and Mental Health Communication Expert

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. 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.

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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.

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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.

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