CARE-ing for a Friend/ Family Member with Suicidal Thoughts

The National Suicide Prevention Website lists a number of warning signs that can be helpful in recognizing if one is at risk for suicide. Knowing the warning signs, especially if behaviors are new or have increased as well as signs that seem related to a painful event, loss, or change are tell-tale signs.

Holiday Self Care

Who can relate to at least one of the following?
Stressing out over holiday plans to make everyone “happy”
Making a decision that you don’t agree with in order to “keep the peace”
Running all over the place, driving or traveling long distances when you would rather stay put
Saying “yes” to plans when you’d rather say “no”
Pushing yourself beyond your limits because it is something you “should” be doing
Feeling obligated to do the same yearly activity/ outing that you’ve always done because “others are counting on it”

International Stress Awareness

I find it ironic that National Stress Awareness Day falls on the first Wednesday in November, or the day after Election Day. While the United States is known as a stressed out nation, it was ranked number seven according to the 2018 Gallup survey which found that “more Americans were stressed, angry and worried last year than they have been at most points during the past decade.”

Depression in Youth with T1D

Depression is very common in youth who have T1D, if you are a parent who is concerned that your child may be having a difficult time, there is treatment and resources available.

Depression in Attorneys

Depression can happen when work and life become overwhelming. If you are feeling some of the physical symptoms of depression treatment is available.

How a Toxic Work Environment Affects Your Mental Health

Not only is incivility in the workplace on the rise, but according to a recent study, it is compromising one of our most critical assets—our mental health.

The authors of the study, published in the Journal of Occupational Health Psychology, looked at the correlation between toxicity in the workplace and symptoms of insomnia, a common symptom of clinical depression. They wanted to know how, or via which mechanism, incivility in the workplace negatively affected employees’ sleep quality, as there has been limited research into this factor.

What Is Workplace Incivility?

Workplace civility, as described by McKinsey and Company, is “the accumulation of thoughtless actions that leave employees feeling disrespected—intentionally ignored, undermined by colleagues, or publicly belittled by an insensitive manager.” It has also been defined as “low-intensity deviant behavior with ambiguous intent to harm the target, in violation of workplace norms for mutual respect.”

Why Quality of Sleep Matters

Sleep is a critical factor in our overall well-being, including our work performance. It has long been established that poor quality of sleep has significant implications for both our physical and psychological well-being.

For example, insufficient sleep increases a person’s risk of developing serious medical conditions, including obesity, diabetes, and cardiovascular disease. Additionally, lack of sleep over time has been associated with a shortened lifespan.

Effects of Negative Rumination

In examining the indirect effects of workplace incivility on symptoms of insomnia and thus overall health, the determining mechanism was found to be negative rumination, or the mentally replaying of an event or disturbing interaction with a co-worker long after the workday has ended.

“Workplace toxicity leads to adverse effects in part by stimulating people to ruminate on their negative work experiences.” according to the authors. “Negative rumination represents an active cognitive preoccupation with work events, either in an attempt to solve work problems or anticipate future work problems.”

Given that most of us spend the better part of our days and our energy at work, increasing hostility in the workplace doesn’t bode well for our emotional or physical well-being. Research over the past 20 years has associated toxic work environments with increased depression, substance use, and health issues among employees. Further research has shown that organizations are suffering as well. Some of these adverse effects include decreased productivity, lower levels of employee commitment and increased turnover.

Coping Techniques to Reduce Effects of Workplace Incivility

The good news is that sufficient recovery or coping techniques may be able to mitigate the negative effects of a toxic work environment on employee well-being. In particular, relaxation and psychological detachment. The ability to psychologically detach from work during non-work hours and relaxation were shown to be the two mitigating factors that determined how workers were affected or not by a negative work environment.

Employees who were better able to detach psychologically are able to relax after work and sleep better even in the face of workplace incivility. Below are descriptions of these recovery experiences and how they were shown to reduce the negative effects and enable employees to thrive in the most toxic of work environments.

Psychological Detachment

Psychological detachment represents an avoidance of work-related thoughts, actions or emotions. Some of the items used in the study to measure employees’ levels of psychological detachment in the evenings including the following: “I didn’t think about work at all” and “I distanced myself from my work.” Those who were able to detach themselves mentally from this cycle do not suffer as much sleep disruption as those who are less capable of detachment.

Detachment can be fostered through a variety of specific activities, including exercise. Planning future events such as vacations or weekend outings with family or friends are examples of positive distractions outside of work.

Relaxation

It should come as no surprise that prioritizing work-life balance was shown to be another effective buffer against the detrimental effects of workplace incivility. Relaxation has long been associated with fewer health complaints and less exhaustion and need for recovery.

As hypothesized by the authors of the study, relaxation during non-work time served as an important moderator of the relationship between negative work rumination and insomnia symptoms. Additionally, it has been identified as a moderator between work characteristics and occupational well-being, between time demands and exhaustion, and between job insecurity and need for recovery from work. Relaxation provides an opportunity for individuals to halt work-related demands, which is critical for restoring individuals to their pre-stressor state.

Some activities outside of the office that can foster recovery include volunteering, meditation, taking a walk, listening to music, and spending time with friends and other positive social supports.

How Organizations Can Address Workplace Incivility 

Based on the results of the study, the authors suggest the following interventions that companies can address to reduce workplace incivility.

  • Raise awareness
  • Ensure protection for employees
  • Ensure accountability
  • Train and model appropriate behavior
  • Train supervisors on aggression-prevention behaviors
  •  Improve emotional resilience skills
  • Offer training on recovery from work, mindfulness practices, emotional/social intelligence skills

A Word From Verywell

You may not be able to control certain events during work hours or the characteristics of your workplace environment. However, what you do have control over is how you choose to cope. Most importantly, finding time to relax, spending time with friends and family, and engaging in activities that will shift your focus away from work during non-work hours.

If you find that you are still experiencing distressful symptoms and that they are interfering with your functioning, it may be a good idea to speak to a therapist who can help you learn additional strategies for coping.

If despite having done all you can still nothing has changed, it might be time to consider the possibility of removing yourself from the toxic environment and looking for a new, more fulfilling and less distressful job. Your health may depend on it.

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Smiling Depression: What You Need to Know

What are the symptoms of smiling depression?

Someone experiencing smiling depression would — from the outside —appear happy or content to others. On the inside however, they would be experiencing the distressful symptoms of depression.

Depression affects everyone differently and has a variety of symptoms, the most distinguished being deep, prolonged sadness. Other classic symptoms include:

  • changes in appetite, weight, and sleeping
  • fatigue or lethargy
  • feelings of hopelessness, lack of self-esteem, and low self-worth
  • loss of interest or pleasure in doing things that were once enjoyed

Someone with smiling depression may experience some or all of the above, but in public, these symptoms would be mostly — if not completely — absent. To someone looking from the outside, a person with smiling depression might look like:

  • an active, high-functioning individual
  • someone holding down a steady job, with a healthy family and social life
  • a person appearing to be cheerful, optimistic, and generally happy

If you’re experiencing depression yet continue to smile and put on a façade, you may feel:

  • like showing signs of depression would be a sign of weakness
  • like you would burden anyone by expressing your true feelings
  • that you don’t have depression at all, because you’re “fine”
  • that others have it worse, so what do you have to complain about?
  • that the world would be better off without you

A typical depressive symptom is having incredibly low energy and finding it hard to even make it out of bed in the morning. In smiling depression, energy levels may not be affected (except when a person is alone).

Because of this, the risk of suicide may be higher. People with major depression sometimes feel suicidal but many don’t have the energy to act on these thoughts. But someone with smiling depression might have the energy and motivation to follow through.

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7 Tips for Disciplining a Depressed Child

Depression doesn’t just affect adults, it also affects millions of children and adolescents.

Some of the symptoms that accompany childhood depression include irritability, social withdrawal, and low energy. Children with depression may also struggle to manage their behavior.

In 2013, 11 percent of 12- to 17-year-olds experienced a major depressive episode. Many younger children are also diagnosed with depressive disorders, such as persistent depressive disorder or disruptive mood dysregulation disorder, every year.

Children with depression may require a slightly different approach to discipline. Here are seven tips for disciplining a depressed child.

Work With Your Child’s Treatment Team

If you suspect your child has depression, speak to his pediatrician or a mental health professional. Depression is treatable, but without appropriate intervention, it may get worse. Treatment may include therapy, parent training, or medication.

Work with treatment providers to learn about the steps you can take to best support your child’s mental health. Inquire about the specific strategies you should use to address behavior problems like non-compliance and disrespect.

Establish Healthy Rules

All kids need rules, but children with depression sometimes require specific rules that support a healthy lifestyle. A depressed child may want to stay up late and sleep all day, or he may want to spend all of his time playing video games because he lacks the energy to play outside.

Set limits on electronics and discourage your child from sleeping during the day. You may also need to create rules about personal hygiene as children with depression sometimes don’t want to shower or change their clothes. Keep your household rules simple, and emphasize the importance of being healthy.

Provide Structure to Your Child’s Day

Kids with depression often struggle to fill their time with meaningful activities. For example, a child may sit in his room all day, or he may put off doing his chores as long as possible.

Create a simple schedule that provides structure to your child’s day. Set aside time for homework, chores, and other responsibilities and allow him to have limited electronics time once his work is done. Children with depression sometimes struggle with sleep issues, so it’s important to establish a healthy bedtime routine as well.

Catch Your Child Being Good

Positive discipline is most effective for children with depression. Look for opportunities to praise your child by saying things like, “You did a great job cleaning your room today,” or, “Thank you for helping me clean up after dinner.” Praise will encourage your child to keep up the good work.

Create a Reward System

Rather than focus on taking away privileges for misbehavior, emphasize to your child that he can earn rewards for good behavior. A behavior chart or a token economy system can motivate depressed kids.

Choose one or two behaviors to work on first—like taking a shower before 7 p.m. If he follows through, let him earn a token or sticker that can be exchanged for bigger rewards, like a trip to the park. Or, provide small, immediate rewards for compliance, like 15 minutes to play on the computer.

Separate Your Child’s Emotion from the Behavior

Discipline your child’s child’s behavior, not his emotions. Don’t scold him for being angry or lecture him about being in a bad mood. Instead, send the message that emotions are OK, it’s what he chooses to do with those emotions that matters. Teach him healthy coping strategies so he can deal with uncomfortable feelings, like anger, frustration, embarrassment, or sadness.

Consider the Implications of Negative Consequences

Children with depression need negative consequences for breaking the rules, but you should choose those consequences carefully. Taking away your child’s ability to socialize with friends, for example, could make his depression worse.

Short-term consequences, like time-out, can be very effective for younger children with depression. Consequences that take place over several days, like being grounded for a week, can backfire because children with depression may lose their motivation to earn their privileges back.

Depression and Its Relationship to Type 1

Are depression and diabetes related?

The simple answer: yes.

Research shows that if you have diabetes, your risk of developing depression more than doubles. In fact, some studies show, that it could be as high as four times more likely.

And while this information may seem like just one more thing to worry about, it’s important to address and discuss, because doing so has the potential of improving your quality of life. And who doesn’t want that?

Someone once said, “Diabetes is a full-time job that you didn’t apply for, you can’t quit and there’s no vacation or pay.” (We’re nodding.) Agreed — no one lined up for the diabetes merry-go-round or the diabetes loop-dee-loop, because diabetes isn’t fun. Actually, it’s a royal pain. And you never get a break.

You know the drill: count carbs,  administer insulin, (factor in activity, stress and consider what’s happened before),  monitor blood sugars, rest, eat or compensate.

And no matter how vigilant you are and how meticulously carbs are counted and insulin accordingly dosed, you’ll get the rogue BGL, the unexpected zinger that just makes you feel like chucking that juice box or screaming or crying or crawling into a ball and giving up because sometimes you can’t be perfect — no, you aren’t perfect and this diabetes thing is hard, really hard and just when you think you got it right and you’re really hitting your stride … you’re tested, you’re thrown and have to try again then again and again. It’s no wonder the chronic condition can cause anxiety, feelings of frustration and even hopelessness.

Diabetes isn’t just a physical challenge with serious implications; it’s also emotionally demanding and can be extremely difficult to navigate mentally. That’s why the most effective treatments for Type 1 include medical care as well as psychological care.

Everyone at some stage of their life will experience “feeling down.” It’s important to note though, that depression is more than feeling “bummed out.” It’s a persistent feeling (lasting more than two weeks) of sadness or loss of interest, among other symptoms. It can be debilitating, life-altering and throw you down the rabbit hole of self-doubt. It also can be subtle. Perhaps you hadn’t really noticed, and it’s a loved one who’s mentioned the changes, has noted that things aren’t “okay”. Whichever way, don’t worry; take heed! You’ve made it here and you aren’t the first.

If you’re experiencing symptoms in at least three of the following categories, you may be depressed:

Things you may do …

  • Stop doing things you used to enjoy
  • Have trouble getting things done
  • Are unable to focus
  • Remain in your home for long periods of time
  • Pull away from loved ones
  • Use alcohol or sedatives excessively

Things you may think …

  • “I’m worthless”
  • “I’m not good enough”
  • “I deserve to feel like this”
  • “I will never be happy”
  • “This is my fault”
  • “Life is not worth living”

Things you may feel …

  • Guilt
  • Irritability
  • Anger
  • Frustration
  • Unhappiness
  • Indecisiveness
  • Disappointment
  • Sadness

Things you may experience physically:

  • Lethargy
  • Feeling sick and run down
  • Having headaches and body pains
  • Having an upset stomach
  • Irritabile bowels
  • Insomnia or excessive sleeping
  • Extreme weight changes and appetite changes

Note: This is just a short list of symptoms you may be experiencing if you’re depressed. Consult a mental health professional for proper assessment and treatment.

Did you say, yes to all of them? Say, yes to none? Either way: keep reading.

Your mental health affects how you deal with your physical health, so if you become depressed, you’re less likely to manage your diabetes well, which can lead to complications and poor health in general. Essentially, both aspects of care are paramount and affect your well-being in tandem, so don’t neglect either today or tomorrow!

Dr. Diana Naranjo, Assistant Professor of Psychiatry & Behavioral Studies and Dr. Korey Hood, Professor of Pediatrics at Stanford University, work exclusively with diabetes patients and believe that in terms of having optimal mental health with diabetes, depression prevention is key. If you know you are at a higher risk of developing depression or an anxiety disorder, being proactive can also improve your quality of life in the long run.

Planning ahead is all a part of self-care and can include reaching out to the support sources of friends, family, community groups and your credentialed diabetes educator or therapist.

If you have diabetes, it’s normal to experience a wide range of emotions as well as suffer physical setbacks. Especially right after diagnosis, many people report grieving for their health from before and the life they had previously. This is also true for parents or caregivers of those diagnosed with Type 1 diabetes.

The bottom line is that your mental health matters — early in the game and later on — so talking to a health professional can help. Treating your depression or anxiety may require more than talk therapy though. Some people are genetically predisposed to developing mental illness while life circumstances and stress can bring the onset of symptoms. Treatment could include short-term or long-term medication in conjunction with other forms of therapy.

Be sure to ask your therapist if he or she has had experience with clients who have Type 1. If not — and this is most likely the case — you can provide your mental health caregiver with additional information to help her or him understand what Type 1 is and the difficulties you face daily.

“Remember, you’re interviewing and hiring your therapist,” says Dr. Korey Hood. “And the discussion of mental health should not be separate from the discussion about your diabetes.”

In addition to working with a mental healthcare provider, try implementing the following in terms of self-care to help maintain a healthy mental state:

  • Join a community, reach out to other T1D groups and share your story
  • Ask questions of others, learn more about diabetes and depression
  • Perform moderate physical activity (consult your doctor about what would be a healthy level of exercise)
  • Eat healthy foods
  • Maintain a healthy weight
  • Limit your alcohol use

If you think you or someone you know might be contemplating suicide, reach out for additional help here:

Suicide Prevention Lifeline Or call 1 (800) 273-8255 (United States)

Just as much as blood glucose levels are important information in managing your diabetes successfully, so are feelings. Remember that you aren’t alone and there are people out there who understand and have been there. Reach out. Be proactive. And talk about it. There is a wide range of mental health treatments available, so consult a expert today to learn how you can improve your quality of life.

Verified by Dr. Mark Heyman, Director of the Center for Diabetes and Mental Health (CDMH) in Solana Beach, CA. Mark received his PhD in Clinical Psychology from The George Washington University and completed his clinical training at UCSD School of Medicine.

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