What does mental illness look like?

Mental illness carries a real stigma. One way is that people have a clear image of what someone with mental illness looks like thanks to countless films with men in white coats restraining a wild haired patient, stripped of dignity. It’s not helpful and it’s not accurate. But even I am guilty of having an image of someone who is mentally ill. When I picture someone with depression, I think of someone at home, in dirty clothes, surrounded by mess and possibly crying. Sure, that’s sometimes what I look like. More than I would like to admit actually … but I don’t always look like that. When I picture anxiety, I see someone pacing, wringing their hands, talking fast or not talking at all. Again, that’s sometimes me. Add in rapid breathing, clammy pale skin, nails bitten to the quick … it’s quite the look I like to rock. But I don’t wear that look everyday. I don’t always show my feelings. And my feelings aren’t linear – they oscillate far more than I would like!

Often, a sudden change in someones appearance can be a sign that they have stuff going on. Good or bad. It’s easy to presume that someone who is struggling with mental illness will suddenly look worse – less polished. But I don’t think it’s as simple as that. Sometimes when I’m fighting off my anxiety monster I have to fake it till I make it – I have to put on my glad rags, plaster a smile on my face and get out of the house. Passers by don’t know the torment going on in my mind. Some people feel compelled to clean or exercise. Others may try to improve their mood by buying a new wardrobe (sorry credit card). Don’t presume because someone is laughing and joking that they are happy. Sure, it may also be that someone rapidly gains weight, loses weight, looks unkempt or let’s personal hygiene slip – but it won’t always look like that.


People who know I am unwell at the moment have come to expect me being make up free, tubby and with tears in my eyes. I know that I often look a mess. But not always. Sometimes I look like the old me. I walk tall with a smile on my face, wearing an outfit not lounge wear. Sometimes I laugh and joke. I go out and have fun. But that leads to its own worries – do people think I’m suddenly better? Will I now have to be like this everyday? Will people think I am faking how unwell I feel?  Do they realise that I have to force myself to get up and get out. I make myself do the stuff I want to do despite feeling on the verge of a panic attack or tears. I don’t have the mental energy to do this everyday. The days that I do manage to pull myself together and get out really take it out of me. Putting on my social veil takes its toll. It is bloody exhausting pretending to be OK. But I keep doing it because I can’t learn to be happy without practising being happy.

The most helpful way to know if someone is struggling is to talk to them. Ask. Listen. Don’t assume you know what is happening in someone’s mind based on how they look. If you notice changes, ask. Let them know you are there for them. If someone suddenly seems better, don’t presume it’s all over now and they are cured. Mental illness doesn’t have a look. It’s a monster that likes to hide away inside.

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