The bravest thing you can do this year is say it out loud

## Introduction: We praise openness — but punish vulnerability Every year "World Mental Health Day" arrives as a reminder that we *actually* have become better at talking. Campaigns roll across screens, employers put up posters, and celebrities talk about anxiety, depression and breakdowns. We applaud. We share. We comment with hearts and support. Yet **shame mental health** remains strong in Norway. It's a paradox: the more we say "it's okay to talk," the more it can feel like a personal failure when we actually need help. We've created a culture where openness often works best as a *retrospective story* — preferably when things turned out well, with a clear turning point and a moral that fits an inspirational narrative. That's when the story feels safe for an audience. But mental health problems are rarely tidy. They are not linear, not aesthetic, not always "learning experiences." They can be monotonous, shameful, annoying to others and hard to explain. And that's precisely why the stigma persists — not because we lack information, but because we still lack a social space where it's okay to be in the middle of it. I believe the new "openness" about mental health is often too superficial, too individual-focused and too dependent on the celebrity format. If we truly want to challenge **taboo mental disorders**, we must do more than clap for the brave. We must change what we reward, what we tolerate, and what systems we expect people to navigate when they have no energy left. ## The celebrity story: A door-opener that can also become a trap Celebrity stories about mental health have obvious benefits. They normalize. They put language to feelings many otherwise can't name. They create recognition and can lower the threshold for seeking help. When people with power and visibility talk about depression, it can grant the public a kind of social permission: If *they* can struggle, I can too. At the same time, the celebrity narrative can become a trap — not because it's dishonest, but because the format rarely withstands complexity. Media and social platforms reward narratives with dramaturgy: crisis, turning point, victory. The person telling the story is often turned into "proof" that it's possible to get out of the darkness with the right attitude, the right help, the right routine. The problem is that many do not find "the right help" accessible. Many face queues, rejections, or a system that demands more energy than they have. When the celebrity story is presented as a universal model, it can unintentionally reinforce shame: *If they managed it, why can't I?* Thus **openness about depression** isn't always comforting — it can become a new yardstick. This is where we should distinguish between openness as *inspirational content* and openness as *social practice*. The former is about identification and hope. The latter is about structure: low-threshold services, accessibility, working life, finances, and a language that accepts that some people never get "well" in a way that looks tidy. ## Shame is not just a feeling — it's a social regulatory mechanism When we talk about shame, we often treat it as individual: "You shouldn't be ashamed." But shame is largely social. It arises when we believe others will think less of us — or when we have experience that they actually do. Shame around mental health has a special form because it ties into morality. Many don't just feel that they are struggling; they feel that they *are* difficult. There's a difference between saying "I have a broken arm" and "I couldn't get out of bed for three days." The latter can trigger a cultural reflex: lazy? weak? incompetent? dramatic? That's why well-meaning slogans are not enough. Stigma lives in small situations: - when a colleague says "we all have a bit of anxiety" in a way that trivializes - when a manager supports in words but rewards those who never are absent - when friends go silent because they don't know what to say - when social security language and health care assessments make people feel like suspects Shame becomes a governance system: it makes people hide, perform, grit their teeth — and often delay seeking help. Those who wait too long may end up needing more extensive treatment. Thus shame is not just an emotional burden, but a public health problem. And here's the political part: It's cheaper to talk about "openness" than to fund robust support. It's easier to host an event than to build a system that can tolerate people falling without stripping them of dignity. ## Friendship as health care: The most underrated low-threshold offer In Aftenposten there's a story about how a new friend in adulthood made a big difference for a doctor's health, and how a regular monthly meet-up at a café became a kind of "life review ritual" (see sources). It's interesting precisely because it shifts the focus away from the spectacular and toward the everyday. We talk a lot about therapy, medication and diagnoses — and all of that is important. But it's easy to overlook how much mental health is actually supported by relationships without professional labels. A friendship can be a **low-threshold service** in practice: a place to be without performing, a place to put words to the chaos, a place to be met before it becomes a crisis. I think we've underestimated this, both culturally and politically. Culturally because we cultivate individualism: "I have to manage myself." Politically because we often think of health as something that happens in institutions — not in interpersonal networks. The point is not that friendships should replace treatment. The point is that friendships can be what makes people able to ask for help at all. They can also be what keeps life together while a person waits in line. Still, there's stigma here too: many find it embarrassing to *need others*. We've turned dependency into something shameful, even though humans are, by nature, social animals. ## "It's okay to talk" — yes, but where? And with whom? Openness is often presented as a universal good. But openness is not neutral. There are risks: - Openness can cost job opportunities if the workplace doesn't actually tolerate it. - Openness can change friends' perceptions — not out of malice, but out of uncertainty. - Openness can become "content" that others consume, without you receiving support. Therefore the call to be open easily becomes moralizing. It places responsibility on the person who struggles: *If you just say it out loud, it will get better.* But what if it doesn't get better? What if you're met with unsolicited advice? What if you're reduced to "the one with depression"? What if you're met with silence? Then we must be honest: openness is not only a personal choice — it's a social contract. It only works if those around you have the competence and capacity to handle what comes. At a time when "World Mental Health Day" often aims to get more people to share, we should talk more about recipient responsibility. That should be part of public education: - How do you listen without trying to fix? - How do you tolerate that it takes time? - How do you follow up without surveilling? - How do you ask in a way that doesn't feel like an interrogation? If we don't train for this, openness becomes a stage, not a community. ## The modern form of taboo: Don't place too great a burden Many think taboo means silence. But today taboo often looks different: You may talk — as long as you do it in a way that doesn't demand too much from others. The modern taboo is tied to burden. You can say you've been struggling, but preferably finish by saying you've "learned a lot." You can say you go to a psychologist, but present it as self-improvement. You can say you're tired, but still deliver. This is where **taboo mental disorders** become visible in practice: not in the prohibition of mentioning them, but in the prohibition against letting them *affect the relationships and systems around you*. We tolerate the story — but not the consequences. This creates a double burden: 1) You are in pain. 2) You must also ensure others don't feel uncomfortable. Shame is the glue that holds this duality together. ## Working life: The big test of whether we mean it If we want to measure society's real attitude toward mental health, we should look at the workplace. That's where a lot is decided: economic security, identity, social belonging. Workplaces love to say "people are our most important resource." But in practice it is often productivity that's the resource, not the person. This becomes clear when an employee struggles mentally: How flexible is the employer, really? How safe is it to say you have depression without being seen as a risk? I believe much of the stigma lives in the expectation of stability. Mental health problems can fluctuate. They can create unpredictability. And unpredictability fits poorly into streamlined systems. If we are to reduce **shame mental health**, we must make it legitimate to have fluctuations without them automatically being read as lack of will. That means concrete measures: - more graded positions and real accommodation options - managers trained in mental health and conversation skills - routines that make it safe to ask for help early, not only when you're exhausted It also means we must stop pretending everything can be solved with a "one therapy hour." Sometimes the problem isn't the individual but work pressure, unclear demands and constant availability. ## Low-threshold services: A word we love — but rarely deliver on Politicians and municipalities like to use the term **low-threshold services**. It sounds good: quick help, little bureaucracy, proximity. But for many the threshold remains high. Barriers can be: - practical (opening hours, travel, queues) - financial (co-payments, private treatment) - psychological (fear of judgment, fear of diagnoses) - social (what will family, colleagues, friends say?) We don't have a robust enough safety net for the "ordinary" person who is sliding into depression, or who has anxiety that gradually shrinks life. Many get help only when they're sick enough to fit the system's categories. That's a bad model, both humanly and economically. If low-threshold is to be more than a slogan, there must be more doors in: adult health centers, drop-in conversations, quality digital low-threshold services, and better collaboration between GPs, municipalities and specialist health services. And not least: information must be easy to find when you can't orient yourself. ## World Mental Health Day: Commemoration or redistribution of responsibility? "World Mental Health Day" has a clear strength: it gives a common moment for conversation. But it also has a weakness: it can make us feel like we've done something, without anything changing. We often mark mental health with messages about individual courage: be open, ask for help, talk about it. These are important calls, but they have a bias. They can become a transfer of responsibility where the person who struggles must do the work: articulate themselves, raise their hand, be brave. I think we should use the day differently: as an annual check of structures. - How long did people in our municipality wait for help this year? - How many dropped out of school or work without follow-up? - How many were denied because they were "not sick enough"? - How many workplaces have concrete routines for mental health — not just posters? It's less Instagram-friendly, but more effective. ## Openness about depression: What if we lower the expectations for the story? There is a kind of openness that's easy to like: well-worded, wise, a little sad but not too dark. The kind that ends in hope. But depression can make you quiet. It can make you irritable. It can make you not reply to messages. It can make you disappear from your own life. If we are to normalize **openness about depression**, we must tolerate that the story is not always pedagogical. That it doesn't always come with insight. That it doesn't always have a "point." The most important thing we can do as a society may be to reduce the demands on how pain must be presented to be believed. Sometimes the most valuable openness is not an op-ed, a TV interview or a stage show. It's a sentence in the kitchen: *I can't manage anymore right now.* And if the recipient answers with advice, trivialization or panic, the speaker learns that it was a mistake to say it. That's how stigma is reproduced in small ways. ## What we should learn from the story about friendship and health What makes the Aftenposten story about adult friendship and regular meeting points interesting is that it points to something fundamental: mental health is often built in rhythm, not miracles. A monthly coffee can act as a lifeline because it creates predictability and invites reflection without becoming therapy. In a culture where we are increasingly efficiency-driven, it's radical to set aside time to "review life." Not just work, not just achievements — but life. And here is my clear opinion: we need a new status for relational maintenance. Calling a friend, arranging a walk, sending a message that doesn't demand a clever answer — that's not trivial. It's prevention. Maybe we should talk less about "fixing yourself" and more about keeping each other going. ## Conclusion: Openness without infrastructure is just another pressure We won't eliminate stigma around mental health simply by talking more. We'll get rid of it when we change what it costs to be honest. As long as openness can mean loss of status, opportunities or security, shame will persist. As long as people must be "sick enough" to get help, many will pretend they're fine until they can't anymore. As long as we celebrate a celebrity's comeback but can't tolerate a neighbor's long-term struggle, **taboo mental disorders** will continue to change shape. My claim is simple: we must shift focus from stories to structures. From "be brave" to "make it safe." From "share more" to "respond better." From campaign days to everyday practice. And perhaps the most radical thing we can do right now is not to post, but to build a culture where a monthly coffee, an honest phone call and a real low-threshold service are actually available before life falls apart. That's when openness stops being an ideal — and becomes reality. ## Sources - *Unknown author*, "Doctor: – This is one of the most important things you can do for your health", **Aftenposten**, 2025-08-03.