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with Tarra Bates-Duford, Ph.D., MFT

Should You Tell a Loved One You Suspect They May Have a Mental Illness?

Too often, when someone appears to be struggling with mental health related issues it can be very difficult for them to acknowledge symptoms and accept a diagnosis. Unfortunately, unlike illnesses and impairments that are visible mental illness can be difficult to recognize. We all experience periods of depressed mood, anxiety, anger, euphoria, etc., however, what sets mental illness a part from natural responses to challenges/issues consist of the impact it has on normal functioning, such as, interruptions in sleeping/eating patterns, cognition issues, dysregulation of mood, increased systems without intervention, decrease in energy, periods of mania, racing thoughts, suicidal thoughts/ideations, etc. Unfortunately, many people are often so wrapped up in the symptoms that they are unable to see that the symptoms they are experiencing is more than just a response to a “bad day” or difficult months. It is not uncommon for persons struggling with mental health symptoms to deny or minimize symptoms, pretending symptoms and concerns do not exist. When someone rejects a diagnosis of mental illness, it’s tempting to jump to the conclusion that he/she is “in denial.” However, someone with acute mental illness may not be thinking clearly enough to consciously choose denial. They may instead be experiencing “lack of insight” or “lack of awareness.” The formal medical term for this medical condition is anosognosia, from the Greek meaning “to not know a disease.”

Persons that struggle with mental health symptoms are often so overwhelmed and preoccupied with both positive and negative symptoms related to mental illness that they often fail to recognize that the challenges they are experiencing will not resolve themselves without intervention (therapeutic, mental health, or medicinal). Sometimes, individual’s closest to those struggling with mental health symptoms can see he/she may be experiencing more than just “normal issues”, i.e., there may be something more significant involved. Hence, persons on the outside looking in may see that a loved one is struggling with more than just a bad day, he/she is probably struggling with an undiagnosed mental illness. Often, it is our loved ones that can identify a pattern of behavior that goes beyond unusual into pathological.

It should be noted, having an assumption that someone may suffer from a mental illness may not be correct, the assumption could be wrong. Mental illness symptoms and diagnosis may not look the same in all individual suffers, some symptoms can mimic more than one illness, can look like one illness but be another, may be a response to medication, intoxication, interaction between medication and alcohol, etc. Although, a loved one may be right about his/her suspicions of a mental illness do not expect for the individual sufferer to readily agree with you. Unfortunately, even if you are right you can likely expect the person you suspect of having a mental illness to become defensive or even deny mental illness is a concern. Many of us deny mental health concerns because of the fear and stigma associated with mental illness. Some people still view persons with mental illness as dangerous or violent, therefore, acknowledging or disclosing mental health issues can become a very distressing though for individual sufferers. Persons with mental illness often experience fear of discrimination at the thought of acknowledging and disclosing a mental a diagnosis. Fear of being stigmatized and discriminated against can create barriers to treatment resulting in those with mental health concerns suffering in silence.

Things A Loved One Should Consider Before Expressing Concerns of Mental Illness:

  • Why do you believe your loved one has a mental illness?
  • Could there be another reason for your loved ones behavior?
  • Be specific and concrete surrounding your concerns, i.e., I noticed that your have appeared really sad for the last few weeks, it does not appear to be improving.
  • Have specific examples of the behaviors that are concerning.
  • Have you done your research on mental illness?
  • Do you have basic knowledge of what may be concerning about your loved ones behavior, what that behavior may suggest.
  • Obtain informational pamphlets about the various mental health disorders
  • Do your research on the types of resources, help, and treatment available to individuals suffering from mental illness.

Having a conversation about mental illness with someone you suspect may be mentally ill can be a very difficult conversation to have. Many people when confronted with suspicions of mental illness often become angry, hurt, and defensive about the other persons perception that he or she may be mentally ill, “unstable”, or flawed in some way. Before having a conversation about suspicions of mental illness make sure it is conducted in a calm, accepting, nonjudgmental environment. If you choose to have more than one person participate in the conversation make sure the person you believe to be mentally ill does not feel ganged up on and has the opportunity to express himself/herself.

Helpful Tips to Guide Conversations about Mental Illness Include:

  • Remain calm
  • Be specific about the behaviors that are concerning
  • Remind the person you love them
  • Avoid making diagnosis, simply specify concerns
  • Remind them they have done nothing wrong, they have not caused the disorder
  • Assure them that mental illness is a disease, it is treatable
  • Allow the person suspected of being mentally ill the opportunity to speak
  • Do not assume the person suspected of being mentally ill to agree with you
  • You may need to verbalize your concerns several times to the person suspected of being mentally ill
  • Try to understand that it can take time for the person to process the information and sink in.
  • Don’t be surprised if the person you suspect of being mentally ill becomes angry during the conversation. Becoming angry is a natural response to things that are unpleasant or distressing

Fear is often the reason persons suspected of being mentally ill do not seek mental health treatment. For some, by avoiding a formal diagnosis they can pretend the illness does not exist, he or she can pretend nothing is wrong. Persons with a familial history of mental illness are more likely than those without a familial history of illness to refrain from seeing a doctor in an attempt to avoid one of their worst fears being confirmed. Early diagnosis and appropriate treatment is the best way to stabilize symptoms and manage the disorder. For many mental illnesses treatment can include one or more of the following approaches; medication, individual psychotherapy, group therapy, etc., or a combination of all three.

Should You Tell a Loved One You Suspect They May Have a Mental Illness?

Tarra Bates-Duford, Ph.D., MFT

My name is Dr. Tarra Bates-Duford PhD, MFT, CRS, CMFSW, BCPC I have a PhD in forensic Psychology specializing in familial dysfunctions and traumatic experience. I work with individuals and families struggling with familial dysfunctions, trauma, rape, and incest. I also have a masters in Marriage, Couples, & Family therapy. I am a certified relationship specialist with American Psychotherapy Association (#15221). I have more than 15 years in the field of mental health, relationships, and behavioral sciences.

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APA Reference
Bates-Duford, T. (2017). Should You Tell a Loved One You Suspect They May Have a Mental Illness?. Psych Central. Retrieved on June 4, 2020, from


Last updated: 15 May 2017
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