Coming Out About Mental Illness

Medically Reviewed by Brunilda Nazario, MD on March 21, 2022
5 min read

The only person who needs to know about your mental illness is you.

For a while, that may be enough. No matter what condition you’re dealing with, a diagnosis can be difficult to acknowledge and accept.

It may feel scary to think about sharing with friends, loved ones, or co-workers. Though mental illness is a bigger part of the conversation today than it’s ever been, the stigma and bias that others may have around it, conscious or unconscious, is real.

On the other hand, there may be situations in which you benefit from sharing with others.

It’s a personal decision about a private matter, and you get to decide if you share, when you share, and with whom. The right time is when you’re ready.

The only situation that would require you to disclose your diagnosis is if you request accommodations at work. This is your legal right as part of the Americans with Disabilities Act.

“Disclosing and asking for accommodations is more than reasonable,” says Dawn Brown, director of the National Alliance on Mental Illness HelpLine Services. “Maybe it’s hard to be up and spot on at 9 a.m. because you’re taking medication that makes you drowsy in the morning. If you know your energy peaks or declines at certain times, a break schedule might help your day. If distractions take you off task, you may be able to work from home or in an area with less noise.”

You may feel uncomfortable asking your boss directly for accommodations. It’s normal to wonder if others will see you as lazy, weak, or less dedicated than others.

“I worried that my boss wouldn’t give me responsibilities out of fear that I wouldn’t be able to handle them,” says Whitney Ball, associate director of marketing and outreach at Mental Health America.

Start with the Human Resources (HR) department. You don’t have to give a lot of details: It’s enough to share your diagnosis and ask for an accommodation. For example, “I’m dealing with depression and anxiety and am most productive when I start work at 10 a.m.”

Accommodation requests usually involve documentation of your mental illness, like forms or paperwork, or a conversation between someone in your HR department and your mental health professional.

To protect yourself, document all conversations, requests and outcomes.

Though you don’t have to tell anyone, you may benefit from opening up to people you trust. Maybe you feel isolated and telling someone will make you less lonely. Maybe you want to ask a friend or loved one for support.

“It comes up if I’m feeling alone, or if I feel like I’m hiding my diagnosis and it’s eating me up not to say something, especially around family and friends," says Ball, who lives with anxiety and depression. “I’m normally a bubbly, outgoing person and if I’m acting differently, I like to explain why I’m not myself.”

If you have schizophrenia or bipolar disorder, having someone you trust develop a crisis plan, or advance directive, can protect your finances, wishes, and treatment plan in the event of a downward spiral.

Before you sit down with a loved one or an employer to tell them about your diagnosis, consider these tips:

Be prepared. This isn’t the time to wing it. Practice what you want to say with someone you trust or a mental health professional like your therapist or one of the volunteers at the National Alliance on Mental Illness HelpLine, all of whom “have some form of mental illness and are down the road in their recovery,” Brown says.

Set the tone. Frame the conversation so your friend, loved one, or co-worker understands that what you’re about to say is different from your usual chitchat. For example, you might say, “I’d like to talk to you about something important. I hope you can be patient and try to understand. It’s hard for me to talk about personal things.”

Keep it short and sweet. That may be the best approach, Ball says. “I try to lay down the facts and remove the emotion from it,” she explains. “If I want to disclose, I'll say something like, ‘For the past 5 years, I’ve struggled on and off with anxiety. I’ve found ways to manage it effectively, and right now it’s under control. I’ll let you know if I’m in a tough spot and need your help.’”

Be specific. If your disclosure includes a request for help, make clear exactly what you need: Can you help me find a therapist? Would you drive me to appointments? Sometimes I get anxious: Can I call you?

When you disclose is just as important as what you say.

“Don’t disclose in the middle of a mental health crisis,” Ball advises. “It’s a lot less alarming to the people you’re speaking with if you’re in a solid state.” When your friend is alarmed, you might not get the reaction you hoped for.

When it comes to disclosure to your employer, don’t wait till you’ve failed to meet expectations to ask for accommodations. For example, if an 8 a.m. arrival is a challenge because of your diagnosis, don’t wait until you get written up for being late to ask for a later start time. Take care of it before it becomes a problem.

Above all, disclose only when you are ready.

“The more we normalize conversations about mental health, the more pressure you may feel to share your story,” Ball says. “Don’t feel pressured by society to share openly.”

Ball suggests that you start small. If you’ve never shared your diagnosis with a co-worker, for example, start by telling just one. This can help you feel less alone.

But, she adds, “If you’re not ready, it’s not the time. Vulnerability takes a lot of strength.”

People aren’t born knowing how to support the mental health recovery of a loved one.

“You may not get the reaction you want,” Ball says. “For me, that reaction came with intense worry about me, or making it about them. They’ll say, ‘Oh, I deal with anxiety, too. You have no idea how bad it is.’ Some people have freaked out and I wound up consoling them, or they feel like they caused my mental illness and want to jump into action mode. I didn’t need that.”

Most people won’t mean to be hurtful, negative, or step on your experience by sharing their own or that of others, but it happens.

Smile more, you’ll be happier -- that’s the classic one,” Brown says. “Get over it. You’ll be fine. Just put your feet on the ground when you get up in the morning and you’ll be fine.”

If you don’t feel heard, be prepared to set a clear boundary. For example, you could say, ‘I’m grateful you feel comfortable sharing your experiences, but I don’t have the emotional capacity to hear it right now. When I can handle this emotionally, I’ll come back for this conversation.”

“It doesn’t have to be long or eloquent,” Ball says. “Just a quick get-out-of-jail-free card for your emotional well-being while having these conversations.”