Mental Illness: Communicating When We Don’t Have The Words

When we’re struggling with our mental health, there’s often a message to communicate. To talk about it. But when we’re struggling to find the words we need to describe our thoughts and feelings, talking feels immensely difficult.

Mental illness: Communicating when we don't have the wordsStruggling with words

It’s often tricky to put thoughts and feelings into words. It becomes even harder when brain fog strikes or anxiety creates such a buzz in our brain that we lose sentences halfway through. Even if we can put sentences together, limitations of language mean that sometimes, the ‘right’ words simply aren’t available to us. None seem to adequately describe how we feel.

Our brain might race so fast that we can’t catch the words we need. Alternatively, it could have gone completely blank. Sometimes we get so caught up in trying to make sense of the complex web of interactions in our head, that we stumble and trip over an attempt at explaining it all. When talking to others, we might be so concerned that they understand our explanation, that we over-explain and confuse things further.

Producing speech can add another hurdle. We might struggle to talk when distressed, be situationally mute, minimally speaking, or unable to speak at all. Being unable to speak, and being non-verbal isn’t the same thing. Often, we can still understand and produce language, just not through speech. This could be for psychological or physical reasons.

Over-reliance on words

When accessing mental health support, it can sometimes feel like there’s an over-reliance on words. To arrange a GP appointment, we’ll often have to speak to a receptionist, then a triage nurse. Once in an appointment, we’re usually expected to verbalise our reason for visiting.

When people discuss mental health in the media, they often talk about ringing a helpline. Different numbers flash up on our phones or run along the bottom of our TV screen. Helplines are fantastic and undoubtedly save lives, but can be inaccessible if we’re struggling with words.

If we receive support from a mental health team, they’ll often talk to us by phone or in-person but, either way, words are usually expected. We might be encouraged to write down our thoughts – something which can be really helpful, but not when we don’t have the words needed to write.

Most practitioners and loved ones are more concerned about understanding our communication than they are about the way we communicate. They aren’t usually concerned about us producing “perfect” sentences, and might accept alternative forms of communication, such as artwork, lists of words, mood trackers, writing, or journaling. Unfortunately, although the answer is often “of course!”, in many instances we will need to ask about, or suggest, communicating in this way.

Talking but not communicating

At times, we can talk and talk, but feel like we’re not communicating. It’s almost like the really tricky stuff is shut behind a wall. We can’t open up a line of communication from there to the outside world. We can try hard to explain things but can feel like we’re screaming from behind a soundproof wall.

Struggling to communicate the extent of our thoughts and feelings can prevent us from accessing the help we need. From our perspective, we might think we’ve explained how utterly awful and unsafe we feel, but the depth of these feelings may not reach the person we’re speaking to. This can be exhausting, and feel totally invalidating.

Taking time to regroup and then trying to address this with the person might be helpful. Sometimes, we don’t feel able to do that, but there might be someone we are able to confide in who could help to advocate for us. Alternatively, we might be able to write it down (even if it takes us a few weeks of editing!).

Open or Closed Questions

Different questions come with different difficulty levels when we’re struggling with word-finding. An open question, such as “how are you?” requires much more word-finding than “how did you sleep last night?”, “are you managing to clean your teeth at the moment?” or “did you take your medication this morning?”.

If closed questions are easier, then we could explain that. When someone starts a conversation with an open question, we could reply with “that’s very broad, I don’t know how to answer that right now – please could you break it down?“, or similar.

Alternative communication

Speaking is not the only way to communicate.

Art, AAC, body language, sign language, Makaton, dance, emojis, hugs, music and writing are all ways to share feelings. None of these things has to be a masterpiece. They don’t have to be “good” or “perfect”; there isn’t a perfect way to express ourselves because we’re all different.

Though some of these communication methods still require finding words, they don’t hold the same pressure that a conversation might. We have more time to think, look words up, or go back and edit things. We might find it helpful to mix and match words with images or sounds.

There’s also no rule to say that we have to come up with words ourselves. Sharing poems, lyrics, books, quotes, or blogs that resonate with us are ways of sharing feelings without the pressure to put words or sentences together. As long as we credit others, it’s okay to express ourselves through borrowed words.

Sometimes words are too hard, and we don’t really want or need them. A hug can tell us as much, if not more than, a conversation about how the day has been. With loved ones, we might be able to pick up body language cues, tone of voice, and tiny changes in behaviour. Equally, they might notice these things in us.

Advanced planning

If we know that communication is difficult, whether that be all the time or just when we’re in distress, advanced planning can help.

Playing with different forms of communication to find those things that work best for us can take trial and error. When we find a communication method that we like, practising it can help to improve our confidence in using it. For example, if we’ve discovered that doodling is our thing, then we might find that a doodle a day helps us to feel more able when using it to express ourselves.

Communication cards can be immensely helpful. These cards are written in advance and allow us to communicate at times when language and/or speaking abilities are dampened. Sometimes, reducing the pressure to find words can make word-finding easier.

If we’re under a mental health team, we might find it helpful to include our preferred communication style(s) in our crisis plan. If an unfamiliar member of staff is working with us, then they’ll then have this information available to them.

With friends or family, codes can work brilliantly. For example, a specific emoji that means “I’m struggling and don’t have words right now but I really need [thing]”. It takes the pressure off having to try and explain things during difficult times.


Sometimes, we do have the words, but we don’t feel able to use them. This can be a conscious or unconscious thing. We might not realise how much we can describe, or want to share because those words are hidden behind a wall of fear, anxiety, and shame.

Although we might know that we don’t need to be ashamed, we’re not alone, and people care, it’s still hard. The truth is, talking about our thoughts and feelings is vulnerable. It isn’t easy. Sometimes we spend a long time building trust with someone before we’re able to find the words we need, and that’s okay.

In the meantime, it can help to find a way to process everything, just for ourselves, whether it’s scribbling furiously in a notepad, dolloping some paint on a page, or nurturing a growing garden as we turn things over in our mind.

We might find, especially if our brain is feeling slower than normal, that we think of words days after a conversation took place. Writing these words down while we remember them, either as a note to bring up the next time we see someone, or in a message to send to them, can be hugely helpful.

Accessing help when words are tricky.

Struggling with words can create a barrier when accessing help.

Thankfully, many helplines now offer text-based options, and some even offer sign language. Though this might be easier than talking these options can still be tricky when words are hard to come by.

Email or messaging options, might allow us to include GIFs, images, music, or quotes. We might find it useful to think of some stock phrases at a time when we’re feeling okay, then pull them out when needed. It won’t be possible to think of a stock phrase for every single situation we might ever face, but a slightly imperfect call for help is better than struggling alone. By saving these phrases to somewhere like the notes app on our phone, they can act as a foundation to build upon, and edit them slightly before sending them.

Perfect words do not exist

However we choose to move forward, it’s important to remember that there’s no such thing as a perfect combination of words. In fact, there’s no such thing as perfect communication with or without words. The way we choose to express ourselves has to be right for us. That’s something that will be different for different people.

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