We Acknowledge Mental Illness, But We Don’t Accept It

Don’t drop your ice coffee and say that you’re going to kill yourself.

Fleurine Tideman
Jun 22 · 10 min read
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Photo: Mar Bustos / Unsplash

We like to think we’ve come far, that progress has been made and so the job is done. We applaud ourselves, smug about the small steps that we’ve completed. This goes for sexism, racism, and also how we consider mental illness. One hundred years ago we didn’t even recognise mental illnesses, fifty years ago depression would lead you to electro-shock therapy or an over-prescription to medication. But that doesn’t mean we’re far enough, that doesn’t mean the work is done.

Because while we will now acknowledge mental illness, we still do not accept it.


Mental illness is permitted when you have a clear reason for it, a cause and effect. We’ll recognise PTSD in people who went to war or experienced a highly traumatic event. We’ll allow depression if someone died. But if you don’t have that reason to circle, to point to and say “This is why!”, then you’re undermined in your mental illness. You’re made to believe that you don’t deserve it, that you should feel ashamed for claiming to have something that people who really struggle have.

We refuse to accept that mental illness can be an accumulation of things, can be buried in our DNA. But then, why can one twin have it and another not? Why are you so messed up when your sister isn’t? I don’t know what to tell you, but sometimes something in DNA interacts with something else, traits in the right temperature produce dysfunction.

You don’t need to have had an abusive childhood to have maladaptive coping mechanisms from it. And by placing so much emphasis on the cause of mental illness, we are instilling shame in many that are still struggling, but now feel guilty for feeling so crap.

It isn’t a bandwagon people jump on, no one would choose to feel like this, so why do we cast such suspicion over them?


We’re allowing diagnoses, but only in certain terms, when that cause is present. But we stay rigid, focused on one diagnosis. We refuse to acknowledge that these disorders can co-exist, can form off each other and link within our psyche.

But you can have an anxiety disorder as well as depression, because the low self-esteem of depression could be leading to anxiety of not being good enough, self-conscious in all social situations. You can have an eating disorder and depression, because your purging may be another form of self-harm, your food restriction could be the only control you have left, your only way to grasp joy.

Georgie Lucy called it a “mental cocktail”, and captured it perfectly, as they can all blend together. Once you mix the tequila with lime juice and triple sec, you can’t remove them, you can’t separate them into different glasses again. They’re all different, but they’re all complimenting one another, you can’t pinpoint that one taste anymore. My different mental illnesses feel like that, and so I don’t want to approach them one by one, but that doesn’t make them any less real to me.

But also when someone doesn’t have a diagnosis. I felt like I couldn’t share my depression with anyone until I had a therapist confirm it to me. No matter the self-harm, dark thoughts, or daily pain. I needed evidence of it, I needed a professional, and until that point, I couldn’t ask for help. We can fixate on a diagnosis when poor mental health can often go without a label and still be highly damaging.


We will acknowledge mental illness in people who look like they have one. Only them. You can have anorexia or bulimia if you’re painfully skinny, otherwise, it is considered almost laughable, a joke to too many.

You can have depression if you refuse to leave your bed every day. If you hurt yourself. But don’t let other people see your self-harm, that’s attention-seeking, that’s wrong too. We only let the people who are on their last verge gain the acknowledgment of mental illness, even though others are calling for help in their own way.

I still have people tell me that they’re so surprised to hear about my mental illnesses, that they never would’ve known, that I seemed so fine. Maybe they mean it as a compliment, but to me it is an insult. It confirms every dark thought that I’m overreacting, that I don’t deserve to say I have a mental illness.

Five years, five therapists and a new diagnosis of a personality disorder, and I still feel like I’m waiting for someone to call imposter. Because I wasn’t lying in bed. I was going to the gym for almost two hours a day, I was excelling in all of my classes, I was organising prom or directing a musical, I was hanging out with multiple friends, I was cooking all of my own meals.

Just because I looked happy, doesn’t mean that I was. My coping mechanism was to never stop, but that doesn’t mean it isn’t just as damaging.

You can be overweight and have an eating disorder, you can be thin and have an eating disorder, you can be any size and have one. You can have the biggest smile in a photo, and be hiding so much pain within it. You can be the most popular person, and also the loneliest.


We’re getting better in our conversation around therapy, slowly but surely. But we still create these limits on it. It’s okay for someone to go therapy, but to be going more than a few months? Suddenly we find it problematic, or excessive, not understanding that it isn’t a quick fix doctors visit. It is reworking everything you’ve learned, rebuilding your schemas and sense of self.

We still joke about therapy, we consider it to be ‘hippy’, never showing it accurately in the media. Therapists in series or films are always shown as either pushy or airy.

We also have the weirdest relationship with medication. We’re either overly in favour of it, pushing it too quickly with little regard, or we completely shun it, and consider only the devastating possibilities. There is no between, and people always feel like they have the right to discuss our treatment with us. Offer perhaps, but only give when asked.


We say that we’re okay with mental illness now, but why is it so taboo for anyone else to know then? Why do we feel the need to write under pen names? Why do people tell us to be careful what we say online, as a future employer might see?

I can post a photo of myself in a bikini, or holding a huge margarita, but the minute I share a blog post about my struggles with a personality disorder, I have family and friends warning me about coworkers or a potential hirer seeing it.

Imagine if I could go into my office, and when someone asks how I am, I could respond honestly and say “My anxiety was so strong this morning that I almost didn’t come in.”. Imagine if I could call in and say I need the day off, not because I have cold, but because my depression feels like a truckload of bricks weighing me down today, and I will not be of any use in the office.

Why is it okay for me to have a mental illness, as long as no one else knows? Why does the fact that I recognise my struggles make me someone you wouldn’t hire? Why are we a liability when physical illnesses are less so?


And the same goes socially. I can admit that I have a mental illness to a select few people. But unspoken rules gravitate around this. You must know them extremely well, deeply well. You can’t ever let it slip into a conversation, we judge those who go to therapy for the most part, and don’t allow it into our social spheres. It can’t be something raised lightly, entered into the atmosphere at a party.

We also are unconsciously taught to not ‘ruin the mood’ or ‘burden others’. I can tell people about my mental health when it is a thing of the past, and I must do the work to never scare them. Because people with positive mental health shouldn’t be dragged down by us dark souls. They get to stay in the light, and we must stew within our pain.

Your mental health cannot impact your friendships. And while I agree you should aim to never excuse your behaviour with it, I feel like it can be relevant in explaining behaviour. But as soon as you bring it up in a discussion or argument, you’ll receive a flippant response. Be told that you’re being unfair, putting them in a difficult position.

It can be relevant. If you feel I don’t respond quickly enough to messages, you might benefit from knowing that my depression has been really bad this week, that I’ve been stuck in bed and stayed away from my phone for bare survival. If you’re angry that I never come to parties with you, knowing that my social anxiety has been extremely damaging at the moment could help you to know that it isn’t about you.

Exactly that, it isn’t about you. We acknowledge mental illness but don’t accept it as a reason, we think that you have it, and so you should deal with it. But it doesn’t work that way. If I have diabetes and can’t drink on nights out because of it, why is that more valid than I can’t drink on nights out because my depression soars and it gets scary within my mind?

The fact that we still don’t accept them as valid reasons, that we insist on removing them from discussions, shows that no, we don’t accept mental illness. As while we can’t blame it for shitty things we do, and shouldn’t, it should be taken into the context of us. I’m an introvert, I’m a writer, and I have BPD. It makes up who I am as your friend, it dictates how I respond in social situations.

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Photo: Taylor Hernandez / Unsplash


This extends past friendships, into relationships. We’re taught that you can have a mental illness, but that it shouldn’t affect your partner. But that isn’t the case in deep, committed relationships.

Because when you are low, I am there with you, it is part of me too. When I need help, you help me how you can. And while this can be dangerous, lead to toxic relationships or the complete bottling of feelings, it can also produce the most loving, understood connections ever.

For me personally, once my partner started to understand my BPD, the fear of abandonment and insecurities that accompany it, then he could accommodate them in how we interacted. It doesn’t mean complete sacrifice, staying home so I feel loved.

It means those small things, texting me a reminder that you love me, considering me, being open, and talking through my fears with me. You can’t date someone with a mental illness and expect it to remain ‘their problem’, if you are with them, it is part of your problem too. It is something you work on together.

And you’ll grow from it too because your perfect partner went to therapy.

Also, we need to stop believing that we can’t share our mental illness until it’s ‘appropriate’. Wait till the fifth date? Wait till you move in together? No, because then they don’t really know you. They can’t decide to love you without knowing all the parts of you they need to love.

My mental illness does not make up my best traits, but it is a part of me, the experiences that shaped me and continue to mould me. My mental illness made me a fighter, it made me empathetic for others, it made me open to other experiences. And you can’t just love those good parts of me and put the rest away. So with new love interests, I’ll be honest, because I would rather know that you can’t handle it now, before I get too invested.


The main way that I know that we don’t accept mental illness, is through the jokes that remain in our culture. It is still acceptable for people to joke that they “want to kill themselves”. Let me tell you, the minute you lose someone to suicide, the minute you know someone who has tried, or try yourself, that joke isn’t funny. It isn’t funny that you dropping your ice coffee makes you want to die, because you don’t, you’re lucky that you don’t have suicidal thoughts, so don’t joke about it.

And we use mental disorders to jokingly label someones normal behaviours. When someone seems to change their opinion or mood quickly, we think it’s okay to call them “bipolar”. It isn’t okay. Thats a real disorder that people struggle with.

Your ‘mood swings’ are not the same as extended periods of depression and manic elevation, nor is it accompanied by life-threatening symptoms and struggles. You’re not ‘depressed’ because your favourite series got cancelled, someone is depressed because they cannot leave their bed, because they have lost the will to keep going.

I urge you to call out these jokes when they happen. You can do it kindly. I simply mention when it happens, that those labels make me uncomfortable when used as a joke, and that I think it’s better that they say “I’m so sad” instead.

People can be understanding, or they might think you’re overreacting, but one day they’ll know. It’s like in Dutch, there is a horrible aged swear word of saying “cancer” as an insult. Many of us have deemed it inappropriate, but others continue to use it, almost to rile people up. But when they sadly have someone in their life affected by this illness, they’ll realise, and they’ll regret it.

As with all things in life, we allow it when it suits us. We can see mental illness in a TV show, but only if she stills look cute, a glamorised depression like Effy in Skins. Mental illness is welcomed to jokes, or discussions when you want to look woke. But mental illness doesn’t stop in those spheres for a lot of us, it invades every corner of our existence.

Understand the difference between mental health and mental illness. So don’t acknowledge mental illness, accept it. Accept that it truly damages lives, that it will impact your friendship or relationship, and you need to find a way to be okay with it. That you can’t choose when to care, you have to turn up day after day, and be there for them. I know it isn’t easy, it’s difficult and feels uncomfortable. But as hard as it is for you, it is so much harder for them to experience these symptoms first hand.

And never joke that someone is suicidal, depressed, bipolar, anorexic, or any other disorder/illness. Make jokes that are actually funny.

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Invisible Illness

We don't talk enough about mental health.

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