MDD
Someone with depression reports feeling sad and unmotivated. This is the most appropriate response.
What is validating their feelings and listening supportively
When discussing intrusive thoughts, the safest approach is to:
Explaining that these thoughts are part of the disorder and do not define the person
Why should peers avoid expressing disbelief or doubt about someone’s trauma story?
It can feel invalidating and may worsen trust or emotional safety.
During mania, people may experience this symptom where they rapidly jump between ideas and topics while speaking.
What is flight of ideas?
What is Borderline Personality Disorder (BPD)?
BPD is a mental health condition characterized by intense emotions, unstable relationships, and difficulty regulating moods and impulses.
Key features include:
Fear of abandonment and unstable relationships
Rapid mood swings and emotional instability
Impulsive or self‑destructive behaviors (e.g., self-harm, risky actions)
Chronic feelings of emptiness and difficulty maintaining identity
What is an effective style of therapy that helps people identify and change negative thought patterns and behaviors that contribute to depression.
Cognitive Behavioral Therapy (CBT) is a therapy that helps people identify and change negative thought patterns and behaviors that contribute to depression.
It teaches skills to challenge unhelpful thoughts and replace them with more realistic ones.
CBT also encourages behavioral activation, meaning doing positive or meaningful activities even when motivation is low.
It works for Major Depressive Disorder because changing thoughts and behaviors can improve mood and break the cycle of depression.
Best treatment for OCD
Exposure and Response Prevention (ERP), a form of CBT that helps patients face fears without performing compulsions. Medications include SSRIs as Fluoxetine (Prozac), Sertraline (Zoloft), or Fluvoxamine (Luvox) to reduce obsessive thoughts and compulsive behaviors and may need to be augmented with an antipsychotic.
Best treatment for PTSD
The most effective treatment for PTSD is trauma-focused psychotherapy such as Cognitive Processing Therapy (Type of CBT), Prolonged Exposure Therapy, or Eye Movement Desensitization and Reprocessing. Medications such as Sertraline (Zoloft) or Paroxetine (Paxil) may also be used to help reduce symptoms like anxiety, depression, and intrusive memories.
What is Grandiosity
Grandiosity is when someone may truly feel that they have special abilities, talents, or importance that are bigger than usual. People with bipolar disorder may experience this during manic or hypomanic episodes, and it is not them lying or exaggerating—it reflects how their mind is experiencing the moment. This can sometimes lead to risky or unrealistic decisions, even though the person genuinely believes what they feel.
People with BPD often experience intense emotions that shift within hours, what is this called?
What is emotional dysregulation?
A peer shares they feel hopeless. This is a therapeutic way to respond.
Acknowledging their feelings and encouraging them to seek support or speak to a clinician if needed
These intrusive thoughts or mental images are unwanted, persistent, and cause distress, often driving repetitive behaviors.
How can you respond supportively if a peer shares they feel hypervigilant or easily startled?
Acknowledging their experience and understanding it as a common PTSD symptom
This term describes when symptoms of mania and depression occur at the same time.
What are mixed features (or a mixed episode)?
What is the most effective therapy for BPD developed by Marsha Linehan.
What is Dialectical Behavior Therapy? DBT - teaches mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
1. Mindfulness 🧘 Learning to stay present in the moment instead of getting overwhelmed by thoughts or emotions.
Skills include: Observing thoughts without judging them, Focusing attention, Grounding yourself during emotional spikes Distress Tolerance
How to survive emotional crises without making things worse. Skills include: Distraction techniques, Self-soothing, Radical acceptance, Crisis coping strategies These help prevent impulsive actions like self-harm or destructive behaviors. Emotion Regulation 🌊
Learning how to understand and manage strong emotions. Skills include: Identifying emotions, Reducing emotional vulnerability, Changing emotional reactions, Building positive experiences
4. Interpersonal Effectiveness, How to communicate needs and maintain relationships. Skills include: Asking for what you need. Setting boundaries. Saying no without guilt. Managing conflict
What are helpful things you can say to someone with MDD?
“I hear you, and I’m here for you.”
“That sounds really hard; thank you for sharing.”
“It makes sense that you’re feeling this way.”
“Would you like to talk about what helps you cope?”
Best things to say to someone experiencing OCD
“I understand that these behaviors help you cope, even if temporarily.”
“Thank you for sharing your experience; it helps me understand.”
“It’s okay to have these thoughts—they don’t define you.”
“Would you like to share how you manage your anxiety?”
“I respect your process and the strategies you use.”
Best things to say to someone experiencing PTSD
“I believe you and I’m glad you’re sharing what you’re comfortable with.”
“That sounds like it was really difficult.”
“You’re safe here, and it’s okay to share only what you feel ready to.”
“What coping strategies help you when memories or triggers come up?”
“It makes sense that this still affects you; your response is valid.”
Best things to say to a patient experiencing mania or mood episode
“I hear that you’re experiencing intense moods right now.”
Acknowledges their emotional state and shows you are listening without judgment.
“Your experience is real and valid.”
Confirms that their feelings and behaviors are genuine and not attention-seeking or exaggerated.
“Would you like to share what helps you manage these moods?”
Encourages self-reflection and collaboration in managing their condition.
“It’s okay to talk about your highs and lows safely.”
Creates a safe environment for sharing, reducing fear of judgment.
“I appreciate your honesty in sharing your experiences.”
Reinforces trust and validates their willingness to participate in discussion.
Worst things to say to person diagnosed with BPD
“You’re just being dramatic”
Dismisses the person’s genuine feelings and can make them feel ashamed or invalidated.
“You’re too emotional”
Suggests their emotions are wrong or excessive, which can increase self-criticism and shame.
“Stop overreacting”
Minimizes their experience and implies they should have control over emotions that are intense or overwhelming.
“You’re manipulating me”
Accuses the person of bad intent, which can damage trust and make them feel judged.
“Why can’t you just calm down?”
Ignores that regulating intense emotions can be very difficult and may worsen distress.
Comparing their emotions to others
Invalidates their unique experience and can make them feel misunderstood or less worthy.
What are the worst things to say that can make a person feel judged, misunderstood, or invalidated?
“Just cheer up” / “Snap out of it”
-Minimizes the seriousness of depression and implies it’s a choice.
“Everyone gets sad sometimes”
-Invalidates the severity and persistence of depressive symptoms.
“You don’t have it that bad” / “It could be worse”
-Dismisses their experience and can increase feelings of guilt or shame.
“Why are you so lazy?” / “Just get motivated”
-Misinterprets fatigue, lack of energy, and low motivation as character flaws.
“You need to think positively”
-Oversimplifies depression and ignores the biological and psychological factors.
“You’re overreacting” / “Stop feeling sorry for yourself”
-Suggests their emotions are invalid or exaggerated, increasing isolation.
“It’s all in your head”
-Can feel dismissive and stigmatizing, even though depression has real neurobiological components.
“I know how you feel” (if you haven’t experienced it personally)
-Can come across as minimizing; better to say, “I’m here to listen and support you.”
“You should just exercise/eat better/sleep more” (without sensitivity)
-While lifestyle factors can help, framing them as a cure can feel judgmental or like blame.
“Others have it worse than you”
-Comparison invalidates personal suffering and can increase shame.
Worst things say to someone experiencing OCD
“Your rituals are silly” / “Why do you even do that?”
This shames the person for behaviors they feel compelled to do. It can increase anxiety, make them feel judged, and discourage them from sharing their experiences or seeking support.
“Just stop worrying”
Worrying in OCD is involuntary and part of the disorder. Telling someone to stop minimizes their struggle and can make them feel misunderstood and frustrated.
“You’re overthinking it”
This implies the person should be able to control their thoughts, which is not realistic in OCD. It can increase guilt and self-blame, making symptoms worse.
“That’s ridiculous”
Labeling thoughts or compulsions as ridiculous is invalidating and dismissive. It can make the person feel ashamed and reluctant to share their experiences in the future.
Dismissing intrusive thoughts or compulsions as fake
Intrusive thoughts and compulsions are real experiences for the person, even if they seem irrational to others. Saying they are fake invalidates the distress they feel and may increase isolation and anxiety.
Worst Things to say to someone experiencing PTSD
“Just get over it” / “Move on already”
“Why do you still think about it?”
Pressuring someone to share details of trauma
“It wasn’t that bad” / “It’s in the past, why care?”
Expressing disbelief or doubt about their trauma
Worst things to say to someone with a Bipolar Diagnosis
“You’re just exaggerating your moods”
Minimizes the reality of their emotional experience and can make them feel dismissed.
“You’re lying about being manic”
Accuses them of dishonesty, which damages trust and invalidates their symptoms.
“Stop being so dramatic”
Labels their natural mood fluctuations as attention-seeking rather than part of the disorder.
“You’re out of control”
Increases shame and fear, making them feel judged rather than supported.
“Why can’t you just calm down?”
Ignores that regulating intense emotions can be very difficult for someone with bipolar disorder.
Minimizing hypomania or mania as attention-seeking
Invalidates genuine experiences and can discourage sharing or seeking help.
Best Things to Say to someone with a BPD diagnosis
“I hear that you’re feeling intense emotions right now.”
Shows that you are listening and acknowledging their experience without judgment.
“It makes sense to feel this way given what you’re experiencing.”
Validates their emotions and normalizes that strong feelings are understandable.
“I’m here to listen without judgment.”
Offers a safe space for them to share, promoting trust and openness.
“Let’s focus on coping strategies together.”
Shifts toward problem-solving and skill-building in a supportive way.
“Your feelings are valid even if they feel overwhelming.”
Confirms that their emotions are real and acceptable, reducing shame and self-criticism.