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What I Wish People Knew about Mental Illness

Catherine Segars

Twenty years ago, I had a conversation with a sweet, well-meaning relative who explained to me that people who took medication for mental illness didn’t have enough faith. There was no point debating with her. She didn’t even know that I was a pill-popper. Those conversations were so exhausting. Trying to justify your existence and your pain to someone who doesn’t understand—it doesn’t help. 

No, it hurts. 

A lot. 

We’ve come a long way since the early 90’s when I began a 17-year journey with clinical depression. Thankfully, the stigma surrounding mental illness has subsided as awareness has increased. Today over 43 million Americans battle an illness of the mind. Johns Hopkins Medicine estimates that 26% of adults in the U.S. suffer from a diagnosable mental illness annually. These statistics show that every American is affected by mental illness, either personally or from someone they know and love.

As someone who has ministered to countless women who battle some form of mental illness, and as someone who has walked this well-trodden path myself…

This is what I wish people knew about mental illness:

1. Mental illness is a physical illness.

The root cause of mental illness is unknown, at least in the human sphere, and scientists debate the origins. Ten years ago, there was a consensus—bad brain chemistry was to blame. Now a growing number of medical professionals question reducing mental illness to just bad brain chemistry. But they admit that SSRIs, the primary group of anti-depressants, help a significant number of people afflicted with the myriad of conditions that live under this umbrella. 

One thing is certain: our brain chemistry is incredibly complex. When it comes to the mental illness of depression, Harvard Health addresses this intricacy: 

"It's often said that depression results from a chemical imbalance, but that figure of speech doesn't capture how complex the disease is. Research suggests that depression doesn't spring from simply having too much or too little of certain brain chemicals. Rather, there are many possible causes of depression, including faulty mood regulation by the brain, genetic vulnerability, stressful life events, medications, and medical problems."

Challenging brain chemistry may not be the only factor in mental illness, but it is certainly a factor. 

We’re taught as children not to judge someone unless we’ve walked a mile in their shoes. Don’t assume that the way your brain works is the way another person’s brain works. You would never look a person with a heart condition and say, “Well, my heart doesn’t work like that. Why does yours?”

Unless you’ve experienced the downward spiral of toxic thoughts that overwhelm the mind, don’t judge. Offer sympathy and support.

A friend is always loyal, and a brother is born to help in time of need.” (Proverbs 17:17 NLT)

2. Medication doesn’t fix everything.

There is not a magic cure-all pill for mental illness. When medication works correctly, it takes the edge off and makes symptoms manageable, but it doesn’t fix the very complex root issues affecting a person who battles mental illness. SSRIs, the most popular form of medication for mental illnesses like anxiety and depression, do not operate like commonly used drugs. There is no quick high followed by a low. They take weeks to get into your system and have any positive effects.

For some people, like me, the side effects from medication can open a Pandora’s box of new issues. 

After being on medicine for several years with fairly good results, I suddenly noticed that the medication wasn’t working any more. That is when I heard the term “Prozac burnout.” I had developed a tolerance to the medicine, and it stopped working. My doctor upped my dosage, and what had been manageable side effects became debilitating and eventually incapacitating, especially as the medicine became less and less effective at treating my depression. 

There are no easy answers when it comes to mental illness. Thankfully, God is very good at solving problems that don’t have easy answers. He understands what ails us and how to bring relief.

If any of you lacks wisdom, you should ask God, who gives generously to all without finding fault, and it will be given to you.” (James 1:5 NIV)

3. We want you to ask.

I know, it’s hard to support a friend or loved one who is battling a mental illness. The affliction is, by nature, narcissistic. But knowing that you care matters—more than you can possibly know. 

Ask how we are and then listen. Processing our feelings, getting them out of our heads, can relieve pressure and alleviate pain. And listening is the best care you can offer. 


Imagine a pressure cooker: just like the valve on top of the pot lets off steam, a compassionate conversation can relieve pressure in the mind of a person struggling with mental illness. We need to know that you care.

Carry each other's burdens, and in this way you will fulfill the law of Christ.” (Galatians 6:2 NIV)

4. We need a compassionate ear, not a critical tongue.

“But you have a great family and a nice home.” 

“You have an awesome job.” 

“You’re so talented!” 

“You just won an award.” 

“Of all people, why are you so sad?” 

Don't mention all the reasons why someone shouldn't be depressed, anxious, OCD, manic, etc. Don't criticize what you don't understand. 

Just listen. 

And then say things like, “It must be really difficult to struggle with those kinds of thoughts or feelings. It’s amazing that you do so well.” 

Or, “I’m really sorry that you are going through this. I can’t imagine how hard that is. I want you to know that I care. I’ll check in on you on tomorrow. Please call if you need to talk before then.”  

Then call. Often.

In humility value others above yourselves, not looking to your own interests but each of you to the interests of the others.” (Philippians 2:4-5 NIV)

5. It's best to drop the expectations.

She had agreed to meet with me every week, and I relished our time together. She was older and wiser. She was cool and composed. She was who I wanted to be when this nightmare was over. 

But then one day I called, and she couldn’t meet with me—not that day or any other day, ever again. She explained that I hadn’t taken her advice, so we couldn’t meet anymore.

I was crushed. 

No, crushed is far too mild a word. I would walk halfway around the complex to avoid her apartment. I was terrified of seeing her again. Obviously, she had become too important, but she dropped me like a bad date when I didn’t perform the way she expected. 

Don't give someone struggling with mental illness something to do and then move on when they fail to comply. Mental illness will not conform to your expectations or your timeline. You will devastate a person you care about if you require something they aren't capable of giving. 

So don’t.

He will not forget how hard you have worked for him and how you have shown your love to him by caring for other believers.” (Hebrews 6:10 NLT)

A prayer you can pray for someone with mental illness:

Heavenly Father, 

I rebuke the spirit of heaviness that surrounds my friend. I command it to leave. I speak healing over every part of their body, mind, and spirit in Jesus name. Provide answers, provide resources, provide support, and give them peace. Help me to help them. Lead them to a stable place with a firm foundation. Give them a new song of praise. (See Psalm 40:1-3)

If this article blessed you, please see the companion piece, “What I Wish People with Mental Illness Knew” to find hope in the midst of a battle with mental illness and a pathway to healing.

Photo Credit: © Unsplash/Matthew Henry