Mental health problems affect one in four of us. While conversations about mental health have been sprouting up more often on social media or even in Netflix series, there is still a strong and persistent resistance to talking about mental health –– especially your own.

Talking about your own mental health after all is scary. You don’t know what other people will think, or what they will say, or even if you are sharing too much (whatever that means).

• Is this the right moment?
• Is this the right person?
• Have we gotten to know each other well enough?

The internal debate goes on and on, and then the moment passes and the opportunity disappears.

The same is true with grief. Like mental illness, grief is often isolating. In many ways, Americans leave their friends and family in the dark when it comes to grief.

• We don’t know how to lean in.
• We don’t know what to say.
• We don’t want to make things worse (as if we could).

Both mental illness and grief make both those experiencing them and those holding space for friends or family talking about them feel … well … awkward. Historically, we’ve taken that awkwardness to mean that we should shy away from it. That we should take that stress signal and just shut it down, bury it, not deal with it.

That couldn’t be further from the truth. That awkwardness we feel is often vulnerability. And vulnerability, we know, is the key to building close relationships. Is it easy to do? No. Holding space for someone else’s vulnerability can be hard.

• It can show us our own scars and triggers.
• It can show us just how hurtful the world can be.
• It can reveal to us truths about the people we know and love that maybe we aren’t comfortable with.

But the above is exactly what every single one of us was created for: to connect, to see, to be seen, to hold space. And that’s why, we want to bring Time to Talk Day to the United States!

What is Time to Talk Day?

Time to Talk Day is an annual day promoted through the UK focused on getting folks to talk about their mental health –– to hold the space.

“Too many people are made to feel isolated, ashamed and worthless because of this. Time to Talk Day encourages everyone to be more open about mental health – to talk, to listen, to change lives. We know that talking about mental health can feel awkward, but it doesn't have to. This year, we're using the popular game 'Would you rather?' to help break the ice and get the conversation flowing.”

The goal is to remove the stigma and the awkwardness, which often comes from inexperience with the conversation. And the only way to reduce inexperience is to actually have the experience!

Why Talking is a Secret Power to Mental Health (and How We Can All Do More of It, Better)

Of course, this can be intimidating! And that’s OK! To help out, we sat down with Alex Maceda, Director of Brand and Client Experience at Two Chairs.

She walks us through:

• What has been happening in the mental health awareness space in the United States
• Why talking about it (often!) is so helpful
• When and why therapy can be used as a tool to help both those wanting to talk about their mental health issues, and for those who have friends and family suffering and want to help.

And so much more –– including diving in on grief of course! Let’s dive in.

Mental health awareness has been on the rise. What are the biggest cultural shifts you’re seeing taking place in our collective understanding of mental health?

While we have a long way to go in our collective understanding, I still feel excited about the progress that’s happening and the increased recognition that mental health affects everyone.

Especially in the past few years, we’ve seen many celebrities -- from actors, musicians, comedians, athletes, business leaders, to politicians -- come out and share their personal journeys with mental health and wellness.

That openness has a trickle down effect on our collective understanding of mental health.

At Two Chairs, for the first time, we’ve seen clients posting on social media about their experiences in therapy and an increased number referring friends or colleagues, which you might not have seen even two years ago.

There is so much power in sharing stories and I believe that the increase of stories out there has contributed to the shift in our collective understanding.

What are continuing cultural myths or misunderstandings about mental health?

As one of the first consumer-facing brands offering psychotherapy, we are constantly confronting cultural myths and misunderstandings about mental health.

For many, mental health and therapy are still a black box.

One of our core values is to bring psychoeducation out of the therapy room and into the world. We create space for discussion and understanding of mental health topics for everyone, whether or not they’re a Two Chairs client.

We particularly see these misunderstandings with those approaching care for the first time - some of the most common below:

1. Having bad days means you have poor mental health.

Not necessarily. Just like physical health, mental health exists on a spectrum (Keyes, 2007).

When you say you’re “sick” that can mean a whole host of things -- on the one hand, a mild cold that might mean you’re sniffling but otherwise able to go about everyday life, on the other hand so sick that you can’t get out of bed.

Mental health is similar; on one end of the spectrum you have mental illness, which is a diagnosable condition that stops you from fulfilling normal everyday tasks.

On the other hand, you have flourishing. For most of us, we exist somewhere in between, and exactly where depends day to day, even hour to hour. This means that regardless of a diagnosis, people can experience both good and bad days.

Another damaging assumption is that if you have a diagnosis, that means you are never happy, and that things are always tough for you. This simply isn’t true. With the right support, a person can learn to manage or fully recover from a mental health problem and experience very good mental wellbeing.

2. Mental health is only something you need to address if you are diagnosed with a mental illness or if you are in crisis.

Mental health is for everyone. We all have mental health, and can make a choice to work towards better mental health through self-care and wellness practices, whether or not we are in crisis mode.

On the therapy side, we’ve had clients who have been in therapy for years who are coming proactively, and treating it as a preventative tool that is a regular part of their life.

3. Mental health issues come from personal shortcomings, and you can “fix” your mental health if you try hard enough.

According to George L. Engel’s biopsychosocial model of health, there are biological, psychological, and social factors that all contribute to our mental health as humans.

• Some of them are within our control, like our careers and peer relationships.
• Some are out of our control, like genetic vulnerabilities, trauma, and family background.

Each aspect can change day to day, hour to hour. Because of this dynamic, it’s problematic to think of mental health as something that can be fixed or resolved.

In any state, there are many ways that therapy can be helpful. Engaging with clinical care can help you understand your own personal mental health and encourage growth and learning.

Why is talking more regularly about mental health so important?

Growing up, I rarely heard stories or discussion about mental health, and certainly never saw someone I identified with come out and talk about it openly. That lack of discussion prevented me from asking for help when I needed it, a story that unfortunately I hear too often from both peers and clients.

At Two Chairs, we believe that same lack of open discussion reinforces stigma, which is one of the main barriers to accessing care.

As part of our work to destigmatize therapy and mental illness, we create opportunities for people to read and see stories around mental health and when comfortable, share their own.

Most notably, we launched #TalkTherapy, a series of reflections about the unique lived mental health backgrounds of people in our community. Each person’s story is a chance to give a face and voice to therapy — a topic that is often faceless, and rarely talked about in social settings.

For those who want to help, what are good ways to begin a conversation about mental health that doesn’t feel forced or awkward?

Before entering into the conversation with a friend or family member for the first time, recognize that they may fear the stigma or generally be uncomfortable with the topic of therapy and mental health.

While it seems simple, it’s important to remember that stigma exists and that it impacts people differently and on different timelines.

As someone who is currently very open about my experience with therapy and mental health, I often have to remind myself that it took me years to get to this place, and that my friend might be earlier on his/her journey.

For this reason, patience, understanding and empathy is key.

These conversations are not easy and while change might not happen during the first conversation, a reassuring, non-judgmental, and supportive presence is almost always appreciated, whether they are able to express appreciation in the moment or not.

First and foremost, if you fear your friend is at risk or harming themself or others, experiencing an emergency or in crisis and in need of immediate help, please call 911 or go to the nearest emergency room. It is important in this case to engage professional support trained in these situations. Additional resources can also be found here. If they are not in danger, a suggested approach, with the caveat that nothing is one-size-fits-all, is below.

To the extent possible, consider having the conversation in person.

There is a lot gained in an in-person interaction: you are able to sense their tone of voice, body language, appearance or other aspects that might help you understand where they’re at.

The power of in-person has been clinically-proven and is something we deeply believe in at Two Chairs. That being said, this may not be right or possible for every situation and in some cases it may be worthwhile to feel it out via text or phone before meeting in-person.

For your discussion, make sure to cultivate a safe, non-judgmental space, physically and emotionally—much like therapy.

Consider your friend’s preferences: would they prefer to talk in a public place with distractions, at home, or while doing another activity? What would make them feel most at ease?

Be present with your friend, listen, and make sure you have time to see the conversation through and will not be cut off abruptly or interrupted.

Use open, rather than leading questions, and try not to make assumptions about their experience.

For instance, “How have you been lately?” “How are you doing?” “Have you been feeling stressed?” “I noticed XYZ, what’s been going on with that?”

Remember that if your friend has never experienced something like this, they might be scared, defensive, or not know how to describe what they’re feeling. It’s natural to get frustrated by these responses, but do your best to approach them with empathy and understanding, and know that they could be coming from a place of pain and are not personal.

For guiding the conversations around mental health, it’s often helpful to share a little bit about your own experience with mental health, if you’re comfortable.

It can help open up the conversation, and vulnerability is often met with vulnerability. Feeling validated amidst your struggles can be extremely powerful for personal healing.

More than anything, use your best judgment and your knowledge of your friendship.

If the topic feels too difficult to broach despite your efforts, try not to get discouraged. I see over and over again that people come to care in their own time, and often, little can convince them if they’re not ready. That being said, while a friend might not engage with you in the first conversation, they often hear you, and even that is powerful and deeply helpful for many as they think about starting a care journey.

What small, thoughtful things can we do to maintain our own mental health?

Self-care is something I think about a lot personally and something I often give presentations on to members of the Two Chairs community.

For me, the key to self-care is the first part of the word -- “self.” As in, it is deeply personal and there is no “silver bullet;” what works for one person may not work for another.

For example, yoga helps me take care of my body and mind, but I know that a few of my coworkers and friends are simply not interested in it. And that’s okay! It’s so important to identify self-care tools and mental wellness technology that can work for you and not have any judgement around those that don’t. Here we’ve compiled some self-kindness examples from our team, with additional examples below.

• Mindfulness and meditation: Mindfulness is paying attention to the present moment in a nonjudgmental way, and there are a variety of ways to practice it including belly breaths, meditation, and visualization exercises. There are countless studies on the benefits of meditation, particularly on calming down the body’s stress response and improving emotional regulation over time.
• Recharging: Recharging looks different for everyone -- some recharge by spending time alone, others recharge by spending time with others. It could look like reading, going on a walk, experiencing nature, spending time with a friend or just taking a night in alone. For me, I like to block 1-2 nights a week as “decompression nights” where I don’t make any plans just to have the space to do whatever I need in that moment.
• Therapy: Therapy is a collaborative process based on a trusting relationship between you and your therapist, and can be beneficial at whatever point on the mental health spectrum you’re at. It can help you improve your relationships with your family and friends, help you overcome fears and insecurities, cope with stress, and communicate effectively.

What about for others –– especially in the workplace?

One effective tool for maintaining mental health in the workplace is creating space for open conversations around stress and burnout and building a culture that encourages mindfulness or self-care during the day.

At Two Chairs, we sit together as a group once per week to do a guided meditation with essential oils and calming music. While not everyone joins each week, it’s a dedicated time on the team’s calendar that signals it’s ok to take a break.

For me, one of the most stressful parts of work is how busy and fast-paced it often is. As such, I try to find little pockets of “recharge” time or integrate mindfulness or meditation into what I’m already doing.

It could be taking 5 minutes to myself at the beginning or in the middle of the day to do a short meditation or taking a couple minutes to walk around the block and do some deep breaths in the fresh air.

Another easy way is to encourage deep breathing as a group to kick-off a meeting, a short exercise for this below:

1. Put one hand on your belly, and one hand on your chest. Take a slow, deep inhale (4 seconds) and try to push the hand on your belly as far out as possible.
2. Exhale (5 seconds or more) and feel your hand flatten against your belly.
3. Continue this 4-second inhale and 5-second-or-longer exhale for 10 breaths.

In your point of view, how does grief play into overall mental health?

Grief can play an all-consuming role in a person’s mental health. It’s a powerful emotional process that can have unpredictable and far-reaching effects on the life of the person grieving and the people around them.

Over time and with the right support, emotions can become less consuming and intense, but the void that a significant loss leaves behind will likely always be felt.

One of our favorite definitions of mental health is, “the capacity to live a full, productive life as well as the flexibility to deal with its ups and downs.”

Loss of a loved one is one of the lowest lows we can experience as humans; one of the most intense ‘downs.’

For me, it has felt like a thick cloud that makes me question the presence of light, or ‘ups.’

Grief is fundamentally intertwined with one’s mental health. In grief, we often face a new life narrative that contains the absence of someone who was there before.

It’s important to let ourselves feel that but to also acknowledge that the existence of a low low does not negate the potential for a future high. Adjustment is no small mental and emotional task and often takes time and is made much easier with social, familial, and professional support.

What are helpful ways to hold space for those who are grieving?

The answer is inside the question: simply hold space for them. This quote by author Brene Brown is one we cite often,

“My mom taught us to never look away from people’s pain. The lesson was simple: Don’t look away. Don’t look down. Don’t pretend not to see hurt. Look people in the eye. Even when their pain is overwhelming.

And, when you’re in pain, find the people who can look you in the eye. We need to know we’re not alone—especially when we’re hurting. This lesson is one of the greatest gifts of my life.”

Grief is painful and uncomfortable and it is our natural inclination to try to end it or stop it or dull it for our loved one.

In the moment, try not to impose your own ideas of or timeline on what a person needs after a loss, and listen to what they’re asking for, verbally or otherwise.

Above all, be patient with yourself while learning how to support someone through their grief, especially if you’re doing it for the first time. It takes courage to be there for someone in their most difficult moments, so showing up and holding space is a huge first step. A few other helpful recommendations are below:

1. Remember there is no right timeline for grief, do not attempt to rush or “fix” their grief by sharing platitudes and offering solutions. Challenge yourself to sit in the discomfort of knowing that you cannot take their pain away.
2. Do not respond to their grief with tales of greater woes. It’s a natural response to try to make a friend feel better by telling them a harder story. While well-intentioned, this often can feel like minimizing what they’re going through. Remember, in this moment, it is about them and their experience.
3. Do be physically present for them, but do not feel pressured to constantly ask how they’re doing. Sometimes it’s helpful to have a reprieve from the weight of their grief by going about normal life without everyone checking in about how difficult things have been. On that note, know that if you want to share a memory or ask about it, you’re not “reminding” them about their loss—they are always aware of it.

Get Involved with Time to Talk Day

Don’t look away. Don’t not talk about it. Use today to spark conversation among friends and family.

And if you don’t know how, then the Time to Talk website offers tons of fun games you can download and play together over a glass of wine, a nice meal, or just in the light of each other’s company.

‍