Why Nobody Brings You a Casserole for Depression (And How We Can Change That)

On January 2nd 2018, I got hit by a car. I was riding my bike and got t-boned by an SUV. I broke my tibia and a finger, requiring surgery on both. For months, I wore two casts and hobbled around on crutches.

I look happy, but it hurt a lot.

The support I received from family and friends was overwhelming. I got dozens of calls, texts, and social media posts, each expressing sympathy and encouragement. Friends came over with gifts. A neighbor I’d barely met brought me a book of crossword puzzles. My coworkers made me a get-well card full of lewd jokes.

My friends and coworkers are the best.
The card I received from my coworkers. They know I like kettlebells, so they 3D-printed some.

I was touched by this outpouring of support. But it made me wonder: why don’t we treat mental illness the same way?

In the past I’ve suffered from depression and anxiety. Family members and friends have struggled with mental illness, with dark periods lasting months, or even years. Nobody brought them cards or crossword puzzles. Nobody came to visit.

In a 2013 article in Slate, Messiah College professor Larry M. Lake wrote that when his wife was diagnosed with breast cancer, neighbors brought casseroles, lasagna, and pies. But when his daughter was admitted to a psychiatric facility for bipolar disorder and drug abuse, his family received “No warm casseroles. No scalloped potatoes in tin foil pans. No soup, no homemade loaves of bread.”

Why did I get such wonderful support when I broke a few bones, but others are left to fight their mental battles alone? More importantly, how can we change this situation? How can we make depression (or any mental health issue) into a “casserole illness”?

I didn’t have the answers. But I knew a few people who might. I work in advertising and recently partnered with Bring Change to Mind, a nonprofit dedicated to mental health. Through them, I interviewed three people far more knowledgable than I am:

Annie Blaine, Marketing & Development Manager of Bring Change to Mind, a nonprofit organization dedicated to ending the stigma and discrimination around mental illness.
Bernice Pescosolido, PhD, Distinguished Professor of Sociology at Indiana University and Director of the Indiana Consortium for Mental Health Services Research. Dr. Pescosolido is one of the foremost sociologists studying stigma, and her research focuses on health, illness, and healing.
David Haggerty, MSc, neuroscience graduate student at the Indiana University School of Medicine. David lives with bipolar disorder, so has the perspective of both “trained researcher” and “regular guy with a problem.”

I interviewed Annie, Bernice and David via phone and quickly learned that my questions went a lot deeper than broken bones.

Why Don’t We Support Mental Illnesses the Same Way We Support Physical Ones?

Sometimes the Disease is Invisible

Anyone can look at me and see I have a broken ankle. But mental health issues are more difficult to spot. Bernice explains:

“Often the way the sufferer will respond to the onset of mental health problems is to hide it. Or disguise it. Or to isolate themselves. Sometimes they put themselves in a position where they can’t reach out. So it’s up to the people who surround them to reach in. — Dr. Bernice Pescosolido

Mental Health is Scary

Even if you understand that someone is suffering from a mental illness, it can be hard to know exactly what that means. And where there’s lack of understanding, there’s fear.

“In the neuroscience and medical field, we don’t really know a lot about what mental health disorders are. And that trickles down, creating an illusion of mysticism. How many horror movies have you seen about people with mental health issues? They’re not making those movies about things like cancer, or kidney failure.” — David Haggerty

“People feel uncomfortable about mental health. It scares them and they don’t know what to say. So they say nothing, and they feel anxious about saying nothing, so they just keep saying nothing.” — Annie Blaine

It’s Hard to Know What You Can Do

For physical ailments, most of us have a go-to remedy. Not so for mental issues. Bernice likens it to getting a rash:

“If somebody has a rash, the old timers will reach for calamine lotion. The new agers will reach for an aloe plant or some home remedy. People know what to do. But people don’t know what to do when loved ones have mental health symptoms.” — Dr. Bernice Pescosolido

Of course, most people don’t have the knowledge to treat something like cancer, or even a broken bone. But mental health adds an extra layer of confusion and uncertainty.

People Still Aren’t Sure it’s “Real”

As injuries go, broken bones are entirely stigma-free. Nobody said, “Maybe your ankle’s not really broken.” I’ve got the x-rays to prove it.

Nobody told me my broken ankle wasn’t real.

But when someone’s behavior changes as a result of mental illness, it can be hard to keep in mind that this is a disease, not a character flaw. I consider myself an advocate for mental health, and even I’ve had trouble remembering this when supporting those around me.

“There’s still that lingering doubt that maybe [someone’s mental health issue] is not real. Even though our studies show very clearly that Americans understand that these are diseases of the brain… when they see it in a real person they may go, ‘Hey, get up out of bed.’” — Dr. Bernice Pescosolido

People DO respond… then disappear.

Bernice revealed that when someone is diagnosed with a mental illness, people around them do show up with support. But they don’t stay.

“[Family and friends] do respond, but everybody but the core family — and only certain people in the core family — stay. Over time, the network shrank. And it shrunk significantly to only people who provided really core needs for the person. — Dr. Bernice Pescosolido

If your friend is on crutches, you can’t really forget they have a problem. But when the problem is mental, it can be hard to remember it’s still there.

At this point, I had a pretty good idea of why we don’t support mental issues the way we support physical ones. So, what can we do about it?

How Can We Better Support Friends and Family Suffering from Mental Illness?

Here’s the hopeful part. There are many, many things we can do to support loved ones with mental health issues. Here are a few ways to start:

Educate Yourself

When someone you love is going through a mental health crisis, a good first step is to learn about the disease they’re dealing with. You don’t have to become an expert, but a little googling can go a long way.

“You can help a lot by just being educated about people’s experiences. If we take the information produced by mental health nonprofits, or personal stories, and actually work to understand them, people will start to have better outcomes.” — David Haggerty

Bring Change to Mind has some great resources for learning more about mental health issues. You should check them out.

Just Show Up

Ok, so you’re not a doctor or a psychologist. You can’t actually fix what’s going on with your friend. But you can call, text, or visit, and just let them know you’re there.

“You don’t even have to do that much. You can just text, “Hey, I feel like maybe you’re struggling right now. I’m here if you need anything.” That’s literally it. Follow up in a couple days. “Hey, just want to check in.” And if the person needs help, they’ll call you. — Annie Blaine

As a recent campaign from the Ad Council puts it, “You don’t have to be an expert. Just a friend.”

Use Your Superpowers

Some people are good listeners. Others make funny greeting cards. Some people solve every problem with food. It all helps. So when you’re trying to support someone, think, “Ok, what am I good at?”

“ADHD runs in my family, so I can’t go and sit in a hospital for hours [to support a friend]. I just can’t do it. But what I can always do is bring meals. Like sandwich boxes for the people who are sitting there for 24 hours.”— Dr. Bernice Pescosolido

My sister, who lives in Minnesota, wanted to help me when I got injured, but couldn’t make the trip. So she sent me a box of frozen meals to put in the crock pot for easy dinners. Perfect.

When I got injured, my sister sent me ready-made meals to throw in a crock pot.

Focus on the Person, Not the Disease

You may not know much about mental illness. But you do know your friend. What do they like? What would help that person feel better?

“Let’s say it’s somebody who reads a lot, but their depression or schizophrenia is affecting their ability to read. You could get them an audiobook. It’s important to think about what you know about them as a person, not a disease.” — Dr. Bernice Pescosolido.

So what does your friend like? Massages? Movies? Casseroles? A friend of mine knows I like weird crafts, so when I got hit, she brought me a cut-out pattern to make a foam gladiator helmet. Hours of non-mobile fun.

Care for the Caregivers

Let’s say you have a friend with depression. You don’t see this person every day, so your ability to help is limited. But that friend has a partner (or a parent, child, or relative) who is with them much more. That person is doing the bulk of the caregiving. And caregiving is very hard.

“Caregiving can be a really isolating process. You’re doing all this work to make one person feel better. It can be hard and draining.” — Annie Blaine

“It’s very stressful to be a caregiver. So if you’re not comfortable calling the person [living with the mental health issue], call one of the people who is doing the major caregiving. Do something for them. And that in turn, does something for the person.” —Dr. Bernice Pescosolido

One of my best caregivers.

At this point in my interviews, I had a pretty good idea why we have trouble supporting friends with mental illness. And I had some suggestions for addressing the issue. But I also discovered challenges I hadn’t anticipated.

A Few Things to Keep in Mind

You’re Not Going to Cure Them

None of my friends thought they could cure my broken ankle. So you shouldn’t approach mental health situations by trying to “fix” the problem.

“People are uncomfortable and want to fix things. That’s just human nature. But I’ve never met someone who has responded well to that. A lot of times it is just literally sitting there and listening to the person.” — Annie Blaine

And remember that it’s not about you. You’re there to help them.

“They don’t look like they’re feeling better by the time you leave? So what? That’s not the point. Their job isn’t to make you feel better. Your job is to make sure they know that there are people who care.” — Dr. Bernice Pescosolido

Don’t Treat Them Like They’re Fragile

In speaking with David, I learned about a problem on the opposite side of the spectrum. Sometimes, by trying too hard to be supportive, you can make a person with a mental health issue feel infantilized.

“Some people think that because I have a mental health diagnosis, I’m always in a state of crisis. They treat me like I’m fragile. And that’s tough to deal with. It becomes dehumanizing. You feel like an infant, like you need your diaper changed. And that can hurt even more than when people don’t show up.” — David Haggerty

It’s a fine line to walk. I don’t want to discourage anyone from reaching out. But make sure you’re treating someone like a friend, not a burden.

Know That It Might Happen Again

Hopefully I won’t break my ankle again any time soon. But mental illness is often a recurring issue.

“When someone has a physical injury, you think ‘I just have to send a card and it’ll be over once I’ve done it.’ When it comes to mental health it’s probably a recurring thing.— Annie Blaine

“I hate to make this comparison, but it’s sort of like dealing with someone who has an addiction. I went through a really rough patch recently, and I’m feeling better now. But I know that I’m gonna fall off the wagon again.” — David Haggerty

They’re Struggling. But You Can Help Them Struggle Less.

At one point in our interview, David said this:

“I always tell people, if I’m struggling, I can’t ‘pull my self up by my bootstraps’ right now. But if you can help me struggle less, I’ll get to the point where I can.”

I asked David how you could help a friend “struggle less.” Here’s what he said:

“It’s friends being positive. Cutting you slack. A coworker saying, ‘Yes, I understand you missed this deadline,’ but instead of reprimanding, saying, ‘I’ll give you a week extension. Take a day off and focus on your health.’

These little things are concessions people can make because they truly believe that your illness is real. And getting that time to focus on yourself and your disease—like seeing a therapist or eating right or going for a run — all these things allow you to feel a little bit better, and eventually recover from those difficult places.” — David Haggerty

I started this project by comparing mental health to my broken ankle. But now I think the parallel doesn’t really work. Mental illness isn’t a cracked bone with a simple, time-tested remedy. It’s not binary either. My ankle’s either broken or it isn’t; someone with a mental health diagnosis may deal with many shades of difficulty, over a long period of time.

And comparing mental health to physical may be part of the problem. These aren’t issues that will just heal themselves, and we need to have realistic expectations about the outcomes.

What I do know is this. The friends and family who supported me through my ankle injury made the process easier, allowing me to keep my spirits up, get to my doctor and PT appointments, and eventually ride a bike again.

We may not be able to fix the problems going on inside our loved ones’ heads. But we can give them the support they need to get back in the saddle.

Back on the bike, thanks to many, many folks.

Writer, creative director, and fan of breakfast.

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