Mental health

Normalizing Mental Illness Symptoms – the Good Way and the Bad Way

Normalization of mental illness - the good way: symptom Y is common in illness X; the bad way: symptom Y happens to everybody

I got thinking about this recently because my best friend is a normalizer, and it really doesn’t feel very good sometimes.  But there are other times when normalizing aspects of mental illness can be helpful.  So what’s the difference?

The invalidating way

A little while back, I told my best friend that I was heading out do some shopping despite being smelly from not having showered for several days.  He said it was no big deal, and added “I don’t shower every day.  Sometimes the effort isn’t worth it.”

With good intentions, he was trying to convey that it’s okay to not be okay.  However, the message that came through to me from his words was that the effects of my illness were so minor that they were just part of normal experience.  That, with undertones of “you’re not actually ill right now.  This is just normal you.”

Because I know him very well and know that normalization is an automatic, default response for him, I can talk myself out of that message that I perceive that he’s sending without too much effort.  It still annoys the hell out of me, though.

The problem with minimizing or normalizing the effect(s) someone has due to their illness is that it invalidates that it is an illness experience.  Even if something like not showering could be within the realm of normal experience, if I’m only experiencing it because of my illness, then that’s not “normal”; it’s an illness symptom.  No matter how well-intentioned, this kind of invalidation can be really damaging.  Rather than alleviating distress, which is probably what was intended, it sends the message to the person that what they’re experiencing is them, not their illness.  For me, at least, that separation of what’s me and what’s illness is a very important coping mechanism.

The helpful way

Mental illness can produce some weird effects.  It can be easy to start feeling like a freaktastic weirdo with whatever strange symptom it might be that you’re experiencing.  But if you hear from your healthcare provider or from someone else with a similar diagnosis that what you’re experiencing is normal for people who have your illness, all of a sudden you’re a lot less freaktastic.

This is different from the other kind of normalizing in that it acknowledges the distress and frames it within the context of illness.  That then opens up the potential to connect with other people with the same illness to talk freely about that same freaktastic symptom that they may also be experiencing.

This kind of normalization is hard, if not impossible, to do for people who neither have mental illness nor are health professionals.  Someone saying that their cousin’s dog’s best friend experienced the same kind of thing when he was ill is probably not going to be that helpful.

When in doubt, validate

It’s not always clear what approach someone is going to respond best to.  My take on it is that validation will always be a good option.  That conveys acceptance of the distress that the person is in without evaluating it.  Validation makes people feel heard.

As for my best friend, he’s working on the validation.  And I’m trying to keep a lid on my reactions when normalization slips out.  It’s a work in progress.

Have you had experiences with people normalizing mental illness, either in a positive or negative way?

 

 

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72 thoughts on “Normalizing Mental Illness Symptoms – the Good Way and the Bad Way”

  1. Have you had experiences with people normalizing mental illness, either in a positive or negative way?

    No, I can’t say that I’ve NOTICED it. I’m fairly certain it has occurred though. My immediate family is a ‘bury your head in the sand and ignore the illness’ kinda group. They also don’t believe mental illness is “real” – they tend to think one can heal oneself of ‘bad behavior’. Given that there are now three documented generations of folks with mental illness (scratch that. FOUR generations), to have someone minimize or disregard what is a true illness can be frustrating and discouraging. I’ve learnt over the many years I’ve been around how to cope with those people who are the most hurtful. Now I usually walk away if too hard a hit is taken on my ‘tender’ nerves. But the children of those people I mentioned have still to learn how to deal with their parent who doesn’t see the child’s pain. (the children are all 20, save one who is 19. Two or three of that set (8 in all) have some form of mental illness. Or I’m projecting, but I see similar behaviors to what I had when I was their age. Depression is the most prevalent. With the suicide of these children’s uncle last summer, it appears depression is on both sides of the tree.

    I will have to pay closer attention because now I’m intrigued. I know of one person that perhaps normalizes my mental illness (a friend). I’m not sure if that’s good or bad.

    1. It’s fascinating how families respond to it when there’s mental illness scattered throughout the family tree. I would think the bury your head in the sand approach is probably pretty common.

    2. Almost makes me wonder if “bury head in sand” mechanism is even more prevalent in families with mental illness scattered about. What came first…?

  2. I find that most people in my “circle” just worry about me. They reach out a little more, but they know better than to suffocate me as I will disappear on them if that happens. My Bestie said she’s been praying for a meaningful undertaking during the pandemic lol made me laugh, it’s a sweet thought, but I’m not a charity case

  3. Oh ‘I’m also tired at the end of the day’ yes that is normal but you don’t run empty; full stop. Feeling thàt tired and empty that you fall asleep onto the couch at 9 am after a full night ‘rest’ is not normal in the ‘normal’ range. When talking about mental health, yes, it can be ‘normal’ maybe even good to have a rest.
    I don’t like it when people normalize too much because it’s not the symptom in itself that is hard to deal with but the whole underlying thinking, worrying, insufficient sleep that is hard to deal with. And sleep and feeling tired is just one small example as ‘showering’ is too. I understand where you’re friend is coming from but he maybe doesn’t always fully understands what the task of showering means when dealing with mental health struggles.

    1. It’s definitely a lot more complex than just oh, that’s normal. I think with my friend doesn’t fully understand the illness, but he’s got this weird rule that he was taught by his dad that only 20% of the time should be spending talking about problems, and the other 80% should be focused on finding solutions and looking for the positive. So his first instinct is to look for what’s positive, and it’s rather annoying 😉

  4. First off, I’m constantly amazed and impressed by your ability to see that someone’s undesirable behavior is “just the way that person is,” because I know you’ve done it with me too and my cheerful Pollyanna ways. It’s great that you have the objectivity to not take it personally, and it’s great that you don’t just shun the person from your life over it. I’ve been able to become more tolerant of that sort of thing myself, but when I was younger, I just couldn’t cope with it. (I think, though, that when I was younger, everyone I knew just happened to be a bad person. Go figure.)

    Anyway, onto the actual topic rather than the topic within the topic! I totally agree. It’s probably well-intentioned, but it sort of invalidates the fact that–in his case, he’s too lazy to bother taking a shower every day. In your case, you can’t get yourself into the shower to save your life. It’s not the same thing. Yeah, it’s a normal behavior to skip a daily shower, but it’s not normal to have severe difficulty getting it done.

    I too struggle with shower time. I don’t think I’ve taken one in a week. I have a mental block that makes it hard to get myself into the shower. It’s not depression like in your case; I’m not sure what it is.

      1. Oh thank you for asking!! I feel great! The symptoms came back last night when the Ibuprofen wore off. It freaked me out, but I didn’t take anymore Ibuprofen. Instead, I took some extra Seroquel (allowed), but before it could knock me out, I got a freakin’ attack of restless leg syndrome. Oh my gosh. [Rolling my eyes at the memory.] My legs can take someone out when that happens! And then I was afraid to wake up today, fearful I’d feel poorly, but I’ve been up for a few hours and feel great!! YAY!!

  5. Thank you so much for this post. It just shows to me that I am still learning appropriate responses after 30 plus years with bipolar illness. I have not been familiar with the term minimalized in this context. If I have minimalized anyone with my comments, I rescind them! They were not intentional.

  6. Wonderful post! Some of my family members make comments like this, and I’ve never been able to articulate why their comments bothered me, but now I know that it’s because they were (probably unintentionally) minimizing my experience 😮

  7. Fascinating post. I guess I’ve looked at my mental illness as somewhat of another personality trait. I’m creative and eccentric, which puts me outside the box of what a lot of people except, and then toss manic behavior and sometimes irrational anxiety and I think people just see me as an unpredictable person. When I used to get a “It’s just Josh being Josh” it never really bothered me. While I hid my addictions from people, I never hid the mental illness. Hell, I wrote about my bipolar at length in my magazine and became the poster boy for it. I guess normal has never been something I concerned myself with, so maybe by default that, too, makes me a normalizer. I think about people who have disabilities and get pissy when you point it out…like you’re supposed to treat it as if it’s normal. When I worked in pro wrestling, I knew a handful of midgets. They are not happy people and really lose their shit when you make reference to their height. I think normalizing is often just a way to assure others that you’re OK with them and that you’re not going or not sure how to address what makes them different.

    1. That’s an interesting perspective on it. I guess I was thinking more along the lines of a situation where the midget says their height bothered them, and someone responded to them that their height was normal.

      1. But, isn’t their height normal in their world? It may not be normal across the population as a whole, but if I’m friends with the midget, should I always commiserate with them that it sucks when things are on the top shelf?

        1. I guess the midget was a bad example. But basically if I’m experiencing a symptom of my illness that’s challenging, and someone is dismissing that, that’s a problem for me.

  8. Therapists try to normalize in the healthy sense. We don’t feel a lot of common humanity so the normalizing is useful practice for us. When we told T-2 we didn’t want any more teletherapy together, T-2 said many colleagues have clients with CPTSD and DID who also would rather have no therapy than teletherapy, and it’s a choice we can make. So we did! Stopped seeing T-4 permanently. Paused T-2. Cut T-3 to once per week and kept T-1 to once per week because T-1 declined our attempt to pause.

    We don’t share our symptoms with friends we had before our current mental health odyssey. All our newer friends admit/understand/allow their mental health status, so it feels safe

  9. Thanks for sharing it is nice to get to know you a little bit better and to discover the way your mind works. I totally agree with you that normalizing is annoying 🙂

  10. I think we’d all had the comments trying to ‘normalise’ your behaviour or responses that relate solely to your mental illness – “everybody feels like that sometimes”. Yeah, right!

    I think you’ve spoken of Spoon ‘theory’ before Ashley. And with my physical disability, I might use 5 or six spoons throughout the act of showering and putting clean pj’s back on lol. Then I’m literally fatigued to the point I can pass out. I’ve got four spoons to last the rest of the day.

    One of hubby’s sisters says “She don’t look sick, she can move around” aarrgghhh! There’s no point trying to put her right cos she’s got a bad back 😉

  11. I have found both positive and negative normalisation as you described. When I meet someone who has experienced similar feelings and emotions it’s been a huge relief and very supportive. I have a ‘friend’ though who has experienced moments of anxiety in stressful situations but not depression. She frequently tells me that positive thinking is the way forward and that we all feel down but it’s about not letting it get to you and getting on with stuff. I’ve had to distance myself from her for obvious reasons!

  12. This has just become my life now and is why I disconnect so often. My bounce back is better and not always great and I’m not always strong enough to get through or over “others”. But I try too still!
    Another issue I face is that I made to feel like I had no real feelings or issues but of my illness. If I’m upset or stressed or even confused about anything it easily can be put back in my face. “ Have you taken your meds?” “Maybe you’re having a day?”
    This becomes really frustrating to me. It’s like I’m nothing but a sick person on meds or I’m just fine and need to “get over it”.

  13. Really great post, thank you for sharing.

    Yes I have experienced normalization and probably I have even exercised it with others. I understand why people do it in some contexts. For example, people who tell me my anxiety over a situation is okay, it makes sense, are likely just trying to help me calm down.

    What bothers me however is the annoying kind. What gets me the most is “just stop thinking about it” or “don’t think about it”. I have heard such phrases my whole life. On the one hand that is exactly what I need to do IN PRACTICE. On the other hand, when someone says this all it does is make me feel frustrated/angry/annoyed and invalidated. I immediately think, you don’t get it, I can’t. I can’t JUST STOP! And when I think that it’s like it becomes reality. But then when I can exercise JUST NOT obsessing I feel like I don’t want to tell some people because I don’t want to hear any kind of I told you so when it was never really what you told me. Make sense?

    Other things people like to hand me in thoughts is the idea that maybe I’ve got too much time on my hands. Like my mind is too idle and I just need to go do something. Let me tell you, I wish that were the case. Often I could be very busy and get hit with a fear (doctor’s office says call us, results are in, OH NO OH NO they didn’t say you’re all good see you next time! SHIT!). All that stuff I was doing? Yeah, it needs to wait for me to pull myself back together.

    Another normalization for me comes when I worry about something physical, like this pain or this wound etc, and the person says “oh you’re fine, it’s okay. Just call your doctor.” Again, it’s a case of: on the one hand, on the other. On the one hand, they’re right that I need to call my doctor. That’s an action to deal with my fear IF calling my doctor is appropriate. In my case, it’s not always appropriate. On the other hand, the demeanor of said person is dismissive, “oh you’re fine”, just do XYZ. I need to be able to quiet my mind in that moment. When you dismiss a person, they might likely just dismiss you so your attempt to help actually makes them just go inside further. IMHO.

    I do think that some people, like your friend, just don’t know any better but they want to help.

    1. Ah yes, the good old “just stop thinking about it.” Kind of like if you tell someone to just not think about a white bear, all of a sudden white bears are going to be dancing around all over the place.

  14. Your posts never fail to expand my understanding of mental illness. I hadn’t even considered the difference between normalizing and validating. Prior to this post, I would never have thought there could be a invalidating way to normalize symptoms.

    Saving some cake for you.

  15. I used to have a lot of problems with motivation due to depression / ADHD. My partner pointed out that he also ‘doesn’t feel like doing things’ sometimes. Hmf. You can imagine how that convo went down! People are usually well meaning but they don’t realize that comments like that can make a person feel distraught, misunderstood, and alone in what they are experiencing. Thanks for another interesting post – every time I come here you’re giving me more food for thought. 🙂

  16. I always feel a little weird because, on the one hand, yeah if you don’t admit you have/experienced/dealt with the same thing, you can’t normalize. But, if you then *do* say, “yeah, I have X and experience Y, too!” there’s that fear you are making it “all about you.”

    1. Yeah that can be hard to navigate. I guess it makes a difference if you frame it as “I have X and Y and it’s hard” rather than “I have X and Y and it’s not that big a deal.”

  17. Happens all the time. You know the latest is that “Raina you are getting old, hence you WILL feel tired”. A doctor n a therapist said to me, when I said I told them I get tired. Wtf. I refuse to believe them. For the longest time I would not brush my teeth everyday and then as my healing began last year, I do now! You are right A, validation for whatever we are in the moment is the key! Hugs..

  18. Yes yes yes….I have experienced this all throughout my life. This is such a good post Ashley. You’ve hit the nail on the head.

    Normalising is almost another person’s way to make a person feel better about their perception of something either they are unfamiliar with or uncomfortable.

    People love to generalise too. Because if everyone does something then it is more accepted. If hardly anyone does it, it is not accepted so much. And we all prefer quick-fixes and solutions. But those with many long-term type illness whether physical, mental, emotional, they cannot be fixed and sometimes there is no solution. The person themselves are the solution usually.

    Example is:
    You say that you feel empty and sad today
    A person thinks, what can I say to help this person depending on their mood and how much they know you.
    They then come out with phrase such as:
    “It’s ok, we all get sad sometimes, it’s just a feeling, keep smiling.”

    Perhaps its said with all good intentions and the facts the person is saying may well be also correct. But its normalising and invalidating. It is limited sympathy at best.

    But here is the important point. People do not care about what you know. They care about how you feel about them.

    There is the difference also from sympathy and empathy.

    And sympathy is similar to the response above. However empathy is more like:
    “I’m really sorry you are feeling like that.” (Acknowledgement and validation) What has made you feel that way? (Interest in the person) I’m here if you need to talk.” (Giving that person some reassurance that you are there)
    Or something like that.

    People are often afraid to ask questions because they feel it’s being too private in their business, or they do not wish to know, do not have time, or they want to fix it straight away with a phrase.

    Others no matter how well intentioned cannot fix these types of of situations, feelings or even symptoms within a person, but what another person can do is acknowledge, validate, listen, show interest, empathise if you can and reassure.

    I hope that made some sense?!

      1. Thank you Ashley, sometimes I cannot explain things very well because of mind fog, and cannot think of the right words to use. It is the meds that do that, but I need them. 🙂

  19. This was a great read! I can totally relate to this. My family has a heard time understand what’s going on with me, and I have learned to accept it. I have therapy once a week and that helps me a lot. Thank you for posting this.

  20. Sorry, people (like me) can be ignorant. But what would YOU say to somebody letting themselves decompose for no apparent reason, somebody who can not or will not vocalize anything sensible? Is silence preferred to saccharine platitudes? We can’t all be psychotherapists, so how do we support depressed or psychotic or self-destructive loved ones? Everything we say, or even do, can easily be criticized for being insensitive or ignorant or worse, but not saying anything seems…cold-hearted and callously inhuman, and is harmful to our own psyches.

    1. One place to start is by asking questions about what’s going on for the person, and if there’s anything you can do to make things easier. If someone is ill enough that they’re unable to care for themselves, then more proactive attempts to get them connected with professional help are probably called for.

  21. I think there’s healthy vs non-healthy normalisation, and healthy normalisation includes validation, I feel.

    For me, it helped to hear “It’s normal to have these feelings” (anger bordering on rage, which I felt guilty about) from my therapist because she knows my history of abuse. Maybe tone and phrasing also matters, how it’s delivered. 🙂

  22. When I talk about my anxiety, panic attacks, OCD or depression, I get called crazy or made fun of. At times, I can take it and even laugh at the jokes. But some days, it takes me to a dark place of deep rage. I don’t know how to handle those types of situations. I try to be open about my mental health to the people I surround myself with on a regular basis in the event something happens. I didn’t expect them to use it against me for their punch line.

    1. That’s so uncalled for. People would never think of doing that for a serious physical illness, and there’s really no excuse for doing it with a mental illness.

  23. For those people that suffer disorders as depression, it’s not helpful the normalization of such aspects. They don’t understand or maybe they’re just trying to help, but it isn’t helpful. Anyways, I’m still trying by other ways and treatment to move on with my life and get better. One of these treatments is Transcranial magnetic stimulation therapy (TMS). It’s getting big results for me. I’ll keep you updated about my progress. Wish me good luck!

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