Not everyone enjoys the holiday season as much as Snoopy and friends.

We have all likely walked through a shopping mall or grocery store this time of year and hearing the familiar jingle “Tis the season to be jolly, fa la la la la, la la la la” piping through overhead speakers. If we are excited about the holidays and their promise of time spent with loved ones, such melodies can lift our spirits and kindle warm memories. Sadly, not all share such fondness for the holiday season.

Many who struggle with mental illness feel left out of the advertised frivolity, thus exacerbating the stigma they already feel. One of the difficulties they wrestle with is the discrepancy between the ubiquitous external symbols of joy, peace and happiness—such as the peppy holiday jingles found on TV commercials and in grocery stores—and the internal experience of melancholy. For many, especially those who do not find comfort in their connections with family, the holidays are yet again another reminder of an aching gap between lived experience and the pleasures commonly associated with the winter holiday season.

What patients have taught me

In my work with patients, I have learned well the struggles of the season. The fault lines of broken or strained relationships are revealed more clearly with the increased attention paid to families. Those who have lost parents, siblings or who are otherwise estranged from families or spouses can feel the heart wrenching awareness of loss and absence.

From this I have learned two valuable lessons. First, the emotional pain stirred up is not only painful—it is harder to bear in isolation. Alone with painful experience, it is harder to gain perspective. We can feel like the only ones struggling and that no one can relate. This sense of disconnection can fuel shame—the painful sense that we are defective and do not belong—and once caught in a shame spiral, we are prone to retreat further, becoming more depressed in the process.

The second lesson closely follows the first. If isolation and aloneness, coupled with nearly unbearable pain, makes matters worse during the holidays, there is a way out. It is through finding connection and understanding. It is through learning to be vulnerable enough, with the right people, to let them know of our struggle. The number one healing influence I hear from patients every day is the power of connection, usually with peers they can relate to and who understand their plight. Individuals who felt utterly alone and unable to relate discover that their pain is not so uncommon and that there are others who have felt like them. Sharing the burden helps lift its crushing effects and rekindles a sense of belonging.

Getting through

Not everyone reading this post is in a hospital with peers who might be able to offer support this holiday season. Can anything be learned from those currently hospitalized that might apply to you? Yes, I believe so. Find a source of connection. Look in your newspaper for support groups, or talk to your psychiatrist, your therapist, your sponsor, a friend, or a spiritual leader about what the holiday season is really like for you.

There is no need to try and pass off the holiday season as something it isn’t, but at the same time, you don’t need to go through it and only experience misery. It is okay to struggle and find parts of it painful, while being out in the world and living your life anyway—but make sure to do it by relating with others who can understand and empathize with what you are up against. This will help buffer you through a season that is perhaps not so jolly … but can be lived with dignity and supportive connections with others.

In the event you run into someone you know has mental illness, do you whisper to him because you think people with mental illness are violent and easily excitable, or do you speak slowly because people with mental illness are probably not as smart as the rest of us?

Consider this: With one in four individuals experiencing mental illness every year, you are likely already interacting with someone who has a mental illness, according to Mental Health America. Think about that the next time you’re in line at the grocery store, checking a book out of the library or taking the bus to work.

Here’s my first rule of thumb: Treat someone with mental illness as a person, not as an illness. After all, all humans have vulnerabilities as well as strengths and our humanity is found in the sum of our parts, not just in one or two.

Secondly, people should be treated based on your experience with them. Snap judgments can be faulty and may deprive us of true understanding of others.

You can’t know that your butcher, mechanic or co-worker is dealing with a mental illness, just as you can’t know they are dealing with diabetes, cancer or high blood pressure unless they tell you.

Here are some tips–rules of the road, if you will–adapted from the National Center on Workforce and Disability that may help you treat fairly the people you may know who are struggling with mental illness:

1. The terms mental illness and psychiatric disorder are essentially interchangeable. Derogatory labels demean those people suffering from mental illness.
2. People with psychiatric disorders are not more likely to be violent.
3. Do not assume that people with psychiatric disorders also have cognitive disabilities or are less intelligent than the general population.
4. Do not assume that people with psychiatric disorders are not capable of working in a wide variety of jobs that require a wide range of skills and abilities.
5. Do not assume that people with psychiatric disorders do not know what is best for them, or have poor judgment.
6. If someone with a psychiatric disorder gets upset, ask calmly if there is anything you can do to help and then respect their wishes.
7. Do not assume that a person with a psychiatric disability is unable to cope with stress.

These tips point to a basic attitude of understanding and compassion for individuals who have a mental illness, and recognition of the competencies each person demonstrates. Open mindedness, curiosity and a willingness to get to know people without preformed judgments goes a long way in showing basic human courtesy and a respect for human dignity.

According to A Guide to Disability Rights Law, a publication from the U.S. Department of Justice, people with mental illness should receive fair treatment and should be afforded certain protections. These include the right to:

• be treated with respect and dignity
• have their privacy
• receive age- and culturally-appropriate services
• understand available treatment options and alternatives
• receive care that does not discriminate on the basis of age, race or type of illness

Not only is that good etiquette, it happens to be the law.

Fewer than half of the 54 million Americans who suffer from mental illness get treated and those who do wait on average more than a decade before seeking treatment. They fear becoming victimized by stigma or have doubts about the validity of mental disorders or treatment effectiveness.

Unfortunately, mental illness is real. Fortunately, people can and do get better. The treatment success rates for disorders such as depression (more than 80 percent), panic disorder (70-90 percent) and schizophrenia (60 percent) surpass those of heart disease (45-50 percent) and other medical conditions, according to the National Institute of Mental Health (NIMH).

To combat stigma, we must debunk the myths that surround mental illness:

Myth 1:  People with mental illness are weak.

Winston Churchill struggled with depression.

Some of the world’s most powerful and influential people have struggled with mental illness. Abraham Lincoln and Winston Churchill battled depression. Star athletes, CEOs of major corporations, doctors, lawyers and other professionals also deal with mental illness. Making the decision to seek help and participate in treatment takes strength in itself.

Myth 2:  Medication cures mental illness.

New medications made available over the past few decades have helped countless people manage the symptoms of their mental illness. However, taking a pill is not a cure-all for everyone with severe mental illness. Individual and/or group therapy with a qualified mental health professional can help patients gain greater understanding of the factors that contribute to their illness, learn skills to manage their symptoms and improve their self-esteem.

Myth 3:  People with mental illness could just “snap out of it” if they wanted to.

Telling someone with depression or other form of psychiatric illness to “just snap out of it” minimizes a person’s struggle with mental illness. Can you imagine telling someone with diabetes or hypertension to snap out of it? That’s because, just like mental illness, these are chronic diseases that need to be managed daily so they don’t interfere with daily living.

Myth 4: Children don’t have mental illness.

Childhood is often thought of as a carefree, idyllic time, but for many children, the reality is quite different.

Ten percent of children and adolescents in the United States suffer from serious emotional and mental disorders that negatively impact their experiences at home, in school and with peers, according to the NIMH. Children can and do recover from psychiatric illnesses.

Myth 5:   People with mental illness don’t get well.

People who get the appropriate treatment frequently improve and go on to live healthy, productive lives. According to the National Alliance on Mental Illness, between 70 and 90 percent of individuals with psychiatric illness have significant reduction of symptoms and improved quality of life with a combination of medication, psychological treatment and support.

These are a few myths that I think contribute to a lack of understanding and compassion for those with mental illness, but I’m sure there are more.  What are some others that you think make it so challenging to rid the world of stigma?