Why Is It So Hard to Explain Mental Illness?

October 25, 2012 Natasha Tracy

Explaining mental illness is a hard task. It's hard for others to understand and it's hard for us to say. Language itself is partly to blame. Breaking Bipolar blog.

I’ve been writing about bipolar disorder and mental illness for nine years. Nine long years of pain and depression and episodes and hyperreality and desperation and description and explanation and exploration. And people still don’t get it. Even if you look at the past year – over 200 articles, there still seems to be nothing but a chasm between the mentally ill and so many of the mentally well.

And I think this is because language is insufficient to express emotional pain and turmoil. We have good words for describing physical pain: radiating, hot, throbbing, sharp, achy and so on. But when it comes to emotional pain we’re “sad.” The same word applies when you drop your ice cream cone on the ground as when you’re so depressed that you can’t get out of bed. It’s not surprising that people don’t get what we’re talking about.

Pain is a Matter of Degree

But emotional pain, like physical pain, is a matter of degree. Everyone experiences sadness – which is the problem. An average person who experiences sadness thinks they know what it is. And they do. They know sadness of a level 2. Or 4. Or maybe even 5 when a loved one dies. But they don’t know the sadness that is so big that it destroys your world.

Similarly, people can get upset and get anxious before a test or a job interview and think they know anxiety. But that isn’t the grating, jagged, writhing beast that eats you from the inside of your flesh.

People seem to think they understand severity – thinking that their pain must be the worst pain, and if they got over it then so should everyone else. No one would compare a twisted ankle to a shattered femur and expect the shattered one to “walk it off” but with emotion, that’s exactly what we do.

The Language of Emotion

Essentially, language is the problem. No one, euphemistically, says, “Gosh, I feel so cancer-ridden today,” but they will say, “I’m so depressed the [insert sports team] lost last night.” People take even the word “cancer” very seriously, as they should, but the same isn’t true for words like “depressed.”

And this isn’t anyone’s fault, exactly, it’s just language and the way we use it. Anxiety can be normal or it can be pathological. Sadness can be normal or it can be pathological. Sex drive can be normal or it can be pathological.

Unfortunately, people misunderstand all those normal emotions for the ones that a person who’s sick experiences because they’re called the same thing. And all the explaining in the world seems to run up against a brick wall in some people.

I guess all I can say is that understanding comes when the reality of what a pathological emotion does is faced. Understanding comes when you see someone not be able to get out of bed. Realization arrives when you know someone who is too anxious to leave his or her house.

And talking about these real experiences and real consequences of illness can contribute to greater understanding for all. Because the words themselves can’t set us free but using them to tell the honest and open truth just might.

You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter.

APA Reference
Tracy, N. (2012, October 25). Why Is It So Hard to Explain Mental Illness?, HealthyPlace. Retrieved on 2024, July 19 from

Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate, and author of Lost Marbles: Insights into My Life with Depression & Bipolar. She's also the host of the podcast Snap Out of It! The Mental Illness in the Workplace Podcast.

Find Natasha Tracy on her blog, Bipolar BurbleTwitter, InstagramFacebook, and YouTube.

October, 25 2012 at 12:13 pm

Nice work, Natasha.
When we're at the doctor's office, we're asked to describe the pain in the terms you mentioned as well as the severity.
"How much does it hurt from one to ten, ten being the worst you've ever experienced?"
Well, hell. How do you explain mental illness in those terms? It's impossible.
"It's an acute, searing depression that radiates from my soul outward. I'd put it about an eight."
You just can't quantify it like that.

October, 25 2012 at 12:50 pm

I think very few people can understand the involuntary tears that won't stop,the experience of white-knuckling your way through a suicidal depression, the pathological feeling that there is absolutely nothing good in the world. Also the tremendous grief that you have lost yourself, that person who was bright and cheery does not exist anymore.
Many years back a friend of my sister's was shocked when she learned about my struggles with depression. She said that I did not seem like that type of person at all. She was right, I was well at the time. My illness is not me.
People with bipolar are not crybabies. When I am well I do not cry over every little thing. Why do people insist on judging us based on our behavior when we are sick,rather than we are well?

October, 25 2012 at 12:55 pm

Hi Natasha. Glad to hear this message illuminated by you. I made a vlog on the topic called, "Words Fail Us" Take a look at: YouTube/UpDownJunkie. Thanks again for all your great work.

DJ Jaffe
October, 25 2012 at 2:18 pm

Kind of think the opposite. Think the problem is we don't use scientific language. Therefore mental illness merges into mental health merges into Yoga a 'me time'. Until we develop language to differentiate, it all gets tangled. "Neurobiological Disorders" would be one such term. The second reason is we need more people like you. As long as people with serious mental illness fail to speak out, and advocates for mentally ill continue to teach that their is 'stigma' (rather than discrimination), not likely to see much progress. Another great post

October, 25 2012 at 4:03 pm

Your article brought back memories in the doctors (GP) surgery and my trying to articulate how I was 'feeling'. In those earlier days (before diagnosis) a lot of crying through the process, with the Dr saying 'don't cry, stop crying'.Looking back at those times I was not only dealing with depression/mania (rapid cycling) I was expected to be able to describe my condition which for me, in and of itself was frankly almost if not impossible.
Later when I was in therapy, and the meds were helping, I was able to find words which enabled me to describe some of the pain I was experiencing, and I did notice at the time that a lot of what I said was described as 'feeling this or feeling that'.
As therapy went along I found my voice and was amazed at times how my explanations sounded so strange, even to me, language that I have shared only with my psychologist.
So even though I feel I had somewhat found my voice, it sounded at times quite crazy.
Quad Erat Demonstratum...

October, 25 2012 at 4:09 pm

I loved this article so much, thank you! Funnily enough, this came up in therapy just today. Last year was a very bad year (and ended with a diagnosis of DID), made worse by horrible reactions from supposedly close friends. These past few months I have had a problem feeling anything (which is quite a nice break, honestly!), but something clicked in our session today, and I was describing what the pain was like last year, pain so intense you can't stand up, so that it feels like your blood is on fire, when even self harm doesn't help,n all you can do is lie on your bed, and plan to die. And I think my therapist was really shocked. She asked me why I didn't tell her that last year, and I told her I tried, but didn't have the language. And there's the problem. People hear you're depressed and think they know because they've been sad too. And then think you're crazy because you self harm and attempt suicide, and thy didnt. I wouldn't wish these feelings on anyone, but it's kind of ashame there's no way of letting people experience it for 5 minutes. I think that would promote some understanding pretty quickly!

October, 25 2012 at 4:36 pm

I often think the problem starts with the term 'mental illness' itself. It seems to translate instantly into 'thinking problem' and most mentally well people believe that their (obviously superior) thinking is responsible for their wellness, and not the other way around. ::Sigh::

October, 25 2012 at 6:49 pm

The only phrase I have ever been able to use to convey the severity of my feelings and pain are to tell people it's like being buried alive.

October, 26 2012 at 4:37 am

And when you reach out for help family says "suck it up," and doctors want to lock you up disregard mental and physical pain. Then the doctors and nurse's beging to use you as a test animal for all the medications, the "treatments." And the cycle remains... it's like the Neverending Story... the Great Nothingness.. a pit of great nothing but crap. So I continue to try and suck it up or be locked up like a criminal... :(

October, 26 2012 at 6:53 am

I appreciate your blogs so much. I think you (and all the other articles) explain mental illness very well... I just don't think that "normal" people care or even really try to understand. "It's all in your head.." well DUH! All we can do is try our best every day. For me, the low cycling when I can't get out of bed manifests in physical ways too... migraines, nausea, etc. So the physical pain is understood, never the mental. it's beyond frustrating but so good to share with people that understand. when I'm at my very lowest, wishing I wasn't in this world, I take Natasha's advice and think of the things I haven't done that I want. I want to go to Scotland, I want to get married... and then of course the mess your loved ones would have to deal with if suicide happened. Too bad they wouldn't get WHY it happened.

October, 26 2012 at 10:01 am

It is always difficult to judge and relativate something of high social meaning. I think the stigma can be huge and identification stays an automatic thing we do. There's always some kind of reaction to this and only the experience in itself seems to be a reliable way of judging. I think it is wrong to become cynical in the way like, they can't understand. Like there's some special right about this. It is another way of reactance to identification. I think there needs to be consciousness that most things in mind happen unconsciously. Some things might happen pathologically. But this does not mean that healthy and ill stays a relative concept. Because the big differences I ask myself questions about the natural kind value. Some people are more powerful than other people. I place myself on the weak side, and believe I would do much better if I had the power to do so. This makes me resistant and full of doubt. You may say, it places me on the "other" side. In any way, it is true that I give higher ratings of truth to the things a read about people who talk out of "real" experience. What I try to say: limits count also and they are not pathological. Some limits can become better, most not. Fact is: there's no manual but there's a point to say stop. Even if conclusions go along. My position is in a way more vulnerable. It goes to the essence of being, and I am not a different person. I would say.

October, 26 2012 at 11:31 am

Just Wed., I was asked by the ECT dr. before he did the treatment how I would rate the last 2 wks. in terms of depression, and I said, well, almost every day is different (rapid cycling) so he said on a scale of 1 to 10 when it's the worst. Eight, I said, and he was quite surprised. I should have said ten if it was surprising that someone getting ECT had depression rated 8! Ratings = useless efforts at quantification.

October, 26 2012 at 1:59 pm

When people ask, “How do you feel?” they probably mean ‘as compared to everyone else.’ But I’m really only able to answer as compared to how *I* usually feel. And my ‘OK’ is probably south of most people’s.

Kevin Owen
October, 27 2012 at 10:44 am

"Because the words themselves can’t set us free but using them to tell the honest and open truth just might."
I practise Advanced Psychotherapy [Not Psych Psychotherapy, now obsolete.]and have an understanding of the beast and how it can criple a person. Telling someone about it has some benefit, sometimes but one would have to keep doing it for the rest of his/her days to get relief from it, all the while it continues to worsen or the medication one takes has to be strengthened to help one suppress it. Maybe its time to look for another solution outside of the roller coaster journey your've had over the past 9 yrs?
Kevin Owen
Psychosomatic Healing
Handling Trauma With Advanced Psychotherapy
Handling the stress related to all illness.
With a reduction in Mental and Physical Stress comes an improvement in health.

Anne Purnell
October, 27 2012 at 6:47 pm

I have thought for years that the disease or illness we call depression should be given a real name. Give it a person's name. Other conditions that cause brain pain and are so desperately in need of cure have names like Parkinson's, Alzheimer's. Offhand I can't think if another illness that is medically referred to by one of its symptoms in this way. The word implies choice. Bipolar, probably similar. I used to wonder if Dr. Kay R Jameson would want to lend her name. Or somebody! I don't think this is a small thing at all.
When I used to say it aloud once in awhile, I had just become acquainted with some people from NAMI. ( who are wonderful). But when I heard myself say it aloud, I realized the reason I felt like it was brushed off as trivial, was probably because, sadly, my new friends had been in the thick "trees" of dealing with crises for so long-- changing the name of this thing Did sound trivial. I was just coming in from the "outside world". So I could see the proverbial "forest." It seemed so obvious-- the sign at the path into this place sounds like something that reads "depressing" to anyone who might want to learn more about it. And like a place that if you just turn around and go back, you will be fine. That doesn't sound like something that needs medical attention to me. That sounds like a bad name for a devastating thing. That's it for now. Thanks for this article. Very much.

Paul Winkler
October, 28 2012 at 9:31 am

As long as our treatment experts are clueless, how can we ever explain properly? When I had set out to kill myself one day, I felt obligated to leave off a note of thanks to the hospital staff for their efforts, telling them my suicide was not their fault. After the police caught me and brought me back to hospital, my therapist was extremely angry that when she had asked how I was I answered "fine". I was supposed to say "I am suicidal and off to kill myself today" What idiots. If I wanted to die, why would I tell her that!? So she could stop me?

October, 30 2012 at 4:18 am

Perhaps the problem is not so much the explanation as that some people just don't want to listen.

Dr Musli Ferati
October, 31 2012 at 10:02 pm

Among many impediments on clarification of any mental disorder the deficit of verbal expression exhibit a crucial matter. It is our poor fund of words through which ones we may express our emotional experiences and difficulties as well. However, by me as clinical psychiatrist, it should to undertakes some practical steps on understanding the real emotional suffering of psychiatric patients. Between them is the ability to understand the emotional language of someone with mental illness. This language is expressing by body speaking through our pertain gesture and our mimicry, which one we should to understood in adequate manner. Even this way is implicit one, it enable us to embrace the great mosaic of psychic suffering of psychiatric patient. Without this model of approaching in daily work-out in mental health service, the performances of current psychiatric treatment would be insufficient ones. The feeling of misunderstanding of patient has got great negative impact in the process of healing of any person with mental illness. In consequence, it ought to practice a careful way of listening to any psychiatric patient in order to understand its said and non-said emotional discern.

June, 10 2013 at 7:31 am

This is a good article. I liked that you mentioned that the words we use to describe the bipolar experience can also be used to describe everyday annoyances and frustrations (i.e., I am SAD because I am depressed vs. I am SAD because I dropped my ice cream cone). Luckily for me, the pdocs I talked to actually did ask me to describe my feelings on a scale. One in particular suffered from depression himself so I think he is much more attuned to the nuances of depression than others. For anyone who cares to read a good description of depression in all its subtleties and nuances, check out William Styron's Visible Darkness. I never had an easy time describing the experience myself. Maybe I was too busy trying to figure out a causal factor. I really needed to know where this was coming from because I always had the sense that it was not normal. This article helps one to know that describing it is difficult, and understanding even more so.

July, 2 2014 at 6:53 pm

Having bipolar myself, is so frustrating, the depression part is perhaps a little easier to relate to but the manic part has been most hard for me to get others to understand . Plus for me just to deal with, myself. I'm so ex tactically happy that I literally repelled people . I love people and all ways craved being close to people , drawing me closer to them . Instead I scarred people, really! They literally was afraid of me . I overwhelmed them with my exuberance! How I hated that! Then I would have self hate, and go through extreme depression , over and over again! Still like that,but not as bad, medicine helps .But life is so hard. People just don't understand!!!

July, 2 2014 at 8:12 pm

I wrote a metaphorical story that helped me explain a little of what I was going through in a visual way. It helped my parents get a little more understanding of me. But the truth is words can never fully describe the pain and emotions of mental illness

November, 3 2014 at 9:46 pm

It was very interesting to read both the original blog post and the comments. I have had a mild depression for a few years and have finally decided to go to both CBT and a psychiatrist on my doctors ordination. Little by little have I puzzled together my life during recent years, but still the depression remains with the suicidal thoughts. No matter how fun or great my day may had been, I still could not feel anything more than a slight lamina of emotion. So I came to fully comprehend that something is out of tune in my body.
It is so frustrating because I used to have a great range and depth of feelings. Now I have went from painful sorrow to emotional fatigue and numbness. I remember how I had absolutely no idea what depression was. I used to think that if it ever happened to me I would just muster will power, think about good things and be healthy again. As being the positive man I am. How wrong was I!
All of a sudden my favourite music sucked and was bland. My earlier happy memories no longer carried any emotional impact on me besides perhaps feelings of sorrow or bitterness. My wish to travel was completely numbed by complete lack of feelings of curiosity. Food barely tastes anything or has any impact emotionally, hence my reluctance to cook more advanced dishes. I used to be able to study and remember a lot, but now I can barely remember or appreciate what I read ten seconds ago.
I nowadays feel like I'm in a row boat and I see all of these other people sailing along with great speed and joy. People with no experience of depression should start with two things:
1. Realize that you most likely don't have the slightest idea of what impact depression has, even if you feel sad sometimes. Start from there and read up on it with a clear mind.
2. Respect the person suffering and try to muster an understanding that a depressed person is going through something enormous. I have great respect for everyone who has a mental illness, but particularly for a person who struggles with severe or chronic depression.
Right now I have started to feel a glimmer of hope after many hard years of fighting and trying to improve my life. Perhaps I will start to feel better the coming months, or maybe in a few years. I don't know. But for the first time in a very long time I have began to respect myself and realize what kind of disease depression is, and why professional help is so important.
Good luck to you all! Remember that even if people around you don't comprehend what you are going through, there is at least one dude, with a poor sense of humour and horrible cooking skills, who understands pretty good and feels great respect.

May, 31 2015 at 1:37 pm

All day today the tears have been flowing and I just can't seem to stop. I self harmed to release some of the pressure that has been building up inside. I'm not suicidal exactly I just needed some sort of distraction or release to feel 'better'. I know that sounds crazy but I actually do feel better. I am tired though from all this crying and all I wanna do now is sleep.
Tomorrow I'll get up again and put on my happy face to go to work so I can pay my bills, well at least most of them...

April, 22 2017 at 12:07 am

I find it hard to describe the kind of pain I feel. I only can say with certainty that the "k
Living" do not have a clue. For this I find I am all alone and will inevitably kill myself. I am only waiting for my mother to pass. I know this sounds sick, but this is what I'm driven to. There are no words to describe the pain. I failed at life. Jr

In reply to by Anonymous (not verified)

Natasha Tracy
April, 24 2017 at 6:17 pm

Hi Jack,
I'm sorry you are feeling this pain right now. I know how bad pain can be. I know how bad it can get. And I know how hard it can be to describe it to someone else.
I also know, however, that things do get better. With help from others, pain can pass.
Please see our suicide section for a lot of information on what you may be feeling:…
And please reach out and get help. You are not alone. People want to help you, but you have to reach out in order for them to do that.
- Natasha Tracy

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