How to talk to family about depression and anxiety (because you know they'll ask)

The holidays are already overwhelming enough. Add a mental health condition to the mix, and you might be feeling extra stressed leading up to all the gatherings this month—especially if your family doesn’t already know about your diagnosis. On the one hand, it would be nice to have some support from relatives, but on the other hand, you don’t want to set yourself up to feel even worse if your family members don’t understand what you’re going through or support your treatment. 

As with any potentially triggering scenario, it can be helpful to have a plan for if, how much, and when you’ll share about your anxiety and depression with the family members you’ll be seeing over the holidays. If you’re dreading holiday conversations about mental health, here’s some advice to consider from mental health experts. 

Weigh the risks and benefits

Before you get together with your family, spend some time thinking through whether it would be helpful to share about your anxiety and depression at all. “You don’t have to tell anyone anything, unless it will benefit your well-being or benefit your relationship,” says Grace Dowd, a therapist based in Austin, Texas. 

Yevgenia Tsveleva, BA, BSN, RN-BC, a psychiatric registered nurse care coordinator, recommends chatting through it with your therapist, if you have one. If you don’t, try journaling about how opening up to your family could go. If you think your anxiety or depression will get worse if you aren’t authentic about your experience, then it might be time to tell them about it. But if you think your mental health will be at risk if you share, then it may be wise to find other support, outside your family. 

Either way, this is your journey, and you get to decide how much you tell and who you share with. “You don’t have to engage in any conversations that don’t feel safe and good to you,” Tsveleva says. 

“‍If this is the first time you’re opening up, it can be helpful to start with someone who’s more in touch with their emotions or who is receptive to the idea of mental health.” — Grace Dowd, therapist

Know your audience 

Before you disclose vulnerable details about a mental condition, definitely think about who you want to tell. Ask yourself: Who has been emotionally safe for you in the past or has demonstrated willingness to support you, without judgment? “If this is the first time you’re opening up, it can be helpful to start with someone who’s more in touch with their emotions or who is receptive to the idea of mental health,” Dowd says. Once you open up to a supportive person, you may feel more confident sharing with others—and perhaps that loved one can even give you insight on how to share. 

But don’t feel down on yourself if you don’t open up to everyone. Maybe you feel more comfortable sharing personal details with your siblings, but not your parents—and that’s OK. The goal is to feel more connected and supported. “Every individual and family structure is different,” says Tsveleva. “So you may want to tell some family members and not others, or wait until next year to open up with someone else.”

You can also decide whether you want to initiate a conversation or wait for it to come up organically. Depending on your comfort level, some conversations may need to be more direct and private. Other discussions will emerge naturally, when someone asks how you’re doing. 

Dip your toes in first

If you’re not sure how someone will respond to you talking about a mental health condition, Dowd suggests a “dip your toes in first” approach. When a loved one asks you how you’ve been, open up a little bit and see how they respond. If they ask for more details, give them as long as you feel comfortable. “It’s helpful to determine how receptive someone is before you tell the whole story,” Dowd says. “It’s important to be authentic, but you also don’t want to end up feeling invalidated or misunderstood.”

When you open up, state the facts rather than spilling your emotions. For example, you could say, “It’s been a really hard year, and I’ve been going to therapy,” or “I was recently diagnosed with depression, so I started taking medication.”

Set boundaries 

If a family member incites conflict or criticizes you when you talk about your anxiety or depression, be prepared to set boundaries. Dowd suggests saying something like, “I can see you’re having a strong reaction, but this isn’t up for discussion.” It may not feel good to repeat yourself, but self-advocacy is key in these scenarios. “You may have to be a broken record about letting family members know that even if something isn’t the right decision for them, it’s what is best for you,” Dowd says.

And remember, how your family members respond to your openness isn’t your responsibility—you can only control how you react. “Some family members may take blame for what’s going on in your life, but it’s important to remind them that it’s not about them, it’s something that you’re going through and seeking support for,” says Tsveleva. 

If things feel tense, don’t feel bad about scaling back your involvement in holiday activities. Your well-being should be top priority, even if it means saying “no” to certain events or festivities. 

‍If you’re anticipating struggling with anxiety or depression more around the holidays, don’t hesitate to ask your mental health care provider for extra help.

‍Have a plan to ask for support 

Ideally, your family will be supportive of whatever you share, and they may have questions about how they can be there for you. Dowd recommends having specific ideas in mind ahead of time. Let your family know what “support” means to you, and what it doesn’t mean. For instance, maybe you’re looking for a listening ear, but not advice or silver linings. Or maybe you really want someone in your family to check in on you more regularly. “Either way, it’s helpful for your family members to know what you’re asking for,” she says.

If your mental health is changing your lifestyle in some way or you need specific support, you may want to tell them. For example, if you can’t drink alcohol because it makes your depression worse or you can’t take it with your medication, it may help to clue in your family so they don’t pour you a glass of wine at dinner. 

“If you’re close to a certain family member, disclose your concern to them and share what you need help with, whether getting to an appointment or remembering to take your medication around the holidays,” Tsveleva says. And if safety is a concern, like if you’re having thoughts about harming yourself or others, it’s always important to tell a trusted loved one. (You also can always text HOME to 741-741 to reach the Crisis Text Line.)

Enlist other support, too

Holidays can be exhausting on their own, even if you’re not having a vulnerable mental health conversation. So before you gather with relatives, take stock of your support system and schedule check-ins with people you can rely on for emotional encouragement. 

Dowd suggests checking in with your therapist, if you have one, before the holidays to come up with a game plan and coping skills for going home. Schedule an appointment as soon as you can after the holidays, too. “Chances are, something vulnerable will be brought up, so it can be helpful to have some after-care already planned,” Dowd says.

And if you’re anticipating struggling with anxiety or depression more around the holidays, don’t hesitate to ask your doctor or psychiatric provider for extra help. There are as-needed medications you can take to deal with panic attacks or anxiety symptoms, or your provider may recommend a higher dose of your existing antidepressant. No matter what route you take, don’t go it alone. “Holidays or not, having support is one of the most important components of getting better,” Dowd says.