Saying You're Fine When You're Not: When And How To Communicate Your Mental Health Struggles

Medically reviewed by Andrea Brant, LMHC
Updated October 10, 2024by BetterHelp Editorial Team

For many readers, an honest answer would be something like “I’m feeling anxious,” “I’m feeling pretty sad right now,” or “Things have been tough lately.” Why is it so difficult to be honest about your difficulties with mental health? And could you benefit from opening up about it?

It can be intimidating for many people to admit they might have a mental health condition or even acknowledge their negative feelings. You may worry that the people in your life may look at you differently or that they won’t want to be around you if you “complain too much.” But there may be good reasons to let people close to you know how you feel.

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Do you need to impart how you feel with someone who will understand?

The difficulties with opening up about mental health

For some, it’s part of a broader feeling that talking about what’s bothering them is a bad idea. They may have been taught early on that it’s inconsiderate to “dump problems” on others. Some people may have had relatives, teachers, or other authority figures who punished or criticized them for “complaining,” leading them to conclude that there’s no point in speaking up when they are having trouble.

There is also a worry about being perceived negatively by others. According to a UK study, approximately 40% of adult men have never discussed their mental health with anyone. Among the main reasons were embarrassment and stigma. Some may also worry they’ll be disbelieved and seen as faking their condition.

It’s also possible for people to develop self-stigma, meaning that they’ve internalized negative attitudes about mental illness. People with self-stigma accept unhelpful things they’ve heard about people with mental illness and believe these things are true about themselves. This can prevent them from opening up about their conditions and seeking help.

In the face of these difficulties, it can seem easier to keep problems to yourself. That may lead you to say, “I’m fine,” when you’re not.

Public attitudes toward mental health are changing

Unfortunately, it’s true that some people still hold negative attitudes toward those with mental illness. People living with psychological disorders are more likely to experience problems including:

  • Housing discrimination
  • Employment discrimination
  • Coercive treatment
  • Negative views of their competence

On the other hand, things do appear to be changing for the better. In 2019, the American Psychological Association reported survey results showing that more than 80% of Americans agreed with statements like:

  • “Having a mental health disorder is nothing to be ashamed of.”
  • “People with mental health disorders can get better.”
  • “People with mental health disorders can live normal lives.”

There has been an increased social acceptance of discussing mental health and wellness openly. 

Why should you let others know if you’re not fine?

Some readers may still feel that opening up to others about their mental health is more trouble than it’s worth. But there can be important benefits to letting the people in your life know about your difficulties. 

For instance, if others know about your psychological challenges, they may help encourage you to get help from a professional. More than 70% of people worldwide who experience mental illness never receive treatment, which may make day-to-day life much more difficult for them. However, encouragement from the people you care about can help motivate you to seek mental health resources.

Also, discussing symptoms you’re experiencing can be beneficial. Talking through your concerns may be part of what makes psychotherapy helpful for mental health conditions, and there’s evidence that support from your peers can have similar effects. You might be surprised by how much it helps to discuss your mental health openly with the people in your life. 

They might also be able to help you with related challenges. If you’re experiencing a manic episode, loved ones aware of your condition could recognize the signs and help to give you support.  

There’s even a chance that speaking up about your difficulties could save your life. 

If you’re having thoughts of suicide, you can find help through the National Suicide Prevention Lifeline, either online or by dialing 988.

iStock/LumiNola

How to tell others when you’re not feeling okay

Planning ahead may make it easier to let people know when you’re experiencing hardships related to your mental health. Here are a few strategies that can help when preparing to open up about your difficulties:

Decide who needs to know

Telling co-workers may never be necessary, though some research suggests that it can benefit those whose work environment is supportive.

Gauge their attitudes on mental health

It may be helpful to learn how the people in your life feel about mental health in general. You could try bringing it up by discussing recent research on psychological topics or tell them you heard from a friend dealing with similar challenges and ask for advice. If they seem understanding and empathetic about people with mental health disorders, it may make it easier to talk to them about what you’re going through.

Choose the right time

If the person you’re talking with isn’t aware you struggle with mental health, it may be best to wait until you’re not in a serious crisis to talk about it. This doesn’t necessarily mean you should only talk about mental health in a good mood. However, if you’re experiencing severe symptoms, it may be difficult to talk about it objectively and calmly.

Rehearse in advance

You may feel more confident and comfortable opening up if you’ve practiced what you want to say. If you have a therapist, they’ll likely be happy to role-play a conversation to help you prepare. And mental health support groups may enable you to find people who’ve already had these kinds of discussions with people in their life. They can likely help you rehearse and offer you advice.

Be direct, specific, and brief

There’s often no need to get into a detailed explanation of your condition, especially in the very first conversation. In many cases, it may be enough to state the basic facts of your situation and how you’re doing currently. You can let the person you’re talking with know that you appreciate them asking how you’re doing. If there’s something specific they can do to help right now, you could let them know; otherwise, you can tell them you’ll reach out if necessary.

Give them time to take it in

If you’ve spent a long time saying “I’m fine” when you’re not, the people in your life may be surprised to learn you’re having mental health struggles. They may need time to process this new information, so consider moving on to other topics and let them absorb what you’ve told them in their own time.

iStock/SDI Productions
Do you need to impart how you feel with someone who will understand?

Talking with a therapist first may help

Opening up about your mental health may be much easier with a trained professional than with someone close to you. Engaging in psychotherapy for at least a few sessions could help you get more comfortable talking about your feelings and experiences. Finding a therapist with internet-based tools is often faster than going through primary care physicians or searching independently.

Online therapy has demonstrated success rates very similar to in-person sessions. Researchers reviewing the existing research found no difference in effectiveness between traditional therapy and online counseling. Clients experienced similar reductions in symptoms, life outcomes, and satisfaction with the process. If you’re ready to discuss your mental health difficulties, you can find a therapist quickly through BetterHelp’s online platform. 

"Diana has been my therapist for a couple of years now. She can’t cure my recurrent depressions, but she is so wise and comforting to talk to. Through the years I have had many therapists, some better than others, but Diana is the best by far. I referred a friend to her, and she seconds my high opinion of this warm and wonderful woman."
— BetterHelp member’s review of their therapist

Takeaway

It’s common to worry that people may think less of you if they know you’re struggling with your mental health. But letting people know when you’re not okay can be an important part of working toward recovery. This process is often easier with help from an experienced therapist.
Depression is treatable, and you're not alone
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