How not to say the wrong thing

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By: Susan Silk and Barry Goldman

 

When Susan had breast cancer, we heard a lot of lame remarks, but our favorite came from one of Susan’s colleagues. She wanted, she needed, to visit Susan after the surgery, but Susan didn’t feel like having visitors, and she said so. Her colleague’s response? “This isn’t just about you.”

“It’s not?” Susan wondered. “My breast cancer is not about me? It’s about you?”

The same theme came up again when our friend Katie had a brain aneurysm. She was in intensive care for a long time and finally got out and into a step-down unit. She was no longer covered with tubes and lines and monitors, but she was still in rough shape. A friend came and saw her and then stepped into the hall with Katie’s husband, Pat. “I wasn’t prepared for this,” she told him. “I don’t know if I can handle it.”

This woman loves Katie, and she said what she did because the sight of Katie in this condition moved her so deeply. But it was the wrong thing to say. And it was wrong in the same way Susan’s colleague’s remark was wrong.

Susan has since developed a simple technique to help people avoid this mistake. It works for all kinds of crises: medical, legal, financial, romantic, even existential. She calls it the Ring Theory.

Draw a circle. This is the center ring. In it, put the name of the person at the center of the current trauma. For Katie’s aneurysm, that’s Katie. Now draw a larger circle around the first one. In that ring put the name of the person next closest to the trauma. In the case of Katie’s aneurysm, that was Katie’s husband, Pat. Repeat the process as many times as you need to. In each larger ring put the next closest people. Parents and children before more distant relatives. Intimate friends in smaller rings, less intimate friends in larger ones. When you are done you have a Kvetching Order. One of Susan’s patients found it useful to tape it to her refrigerator.

Here are the rules. The person in the center ring can say anything she wants to anyone, anywhere. She can kvetch and complain and whine and moan and curse the heavens and say, “Life is unfair” and “Why me?” That’s the one payoff for being in the center ring.

Everyone else can say those things too, but only to people in larger rings.

When you are talking to a person in a ring smaller than yours, someone closer to the center of the crisis, the goal is to help. Listening is often more helpful than talking. But if you’re going to open your mouth, ask yourself if what you are about to say is likely to provide comfort and support. If it isn’t, don’t say it. Don’t, for example, give advice. People who are suffering from trauma don’t need advice. They need comfort and support. So say, “I’m sorry” or “This must really be hard for you” or “Can I bring you a pot roast?” Don’t say, “You should hear what happened to me” or “Here’s what I would do if I were you.” And don’t say, “This is really bringing me down.”

If you want to scream or cry or complain, if you want to tell someone how shocked you are or how icky you feel, or whine about how it reminds you of all the terrible things that have happened to you lately, that’s fine. It’s a perfectly normal response. Just do it to someone in a bigger ring.

Comfort IN, dump OUT.

There was nothing wrong with Katie’s friend saying she was not prepared for how horrible Katie looked, or even that she didn’t think she could handle it. The mistake was that she said those things to Pat. She dumped IN.

Complaining to someone in a smaller ring than yours doesn’t do either of you any good. On the other hand, being supportive to her principal caregiver may be the best thing you can do for the patient.

Most of us know this. Almost nobody would complain to the patient about how rotten she looks. Almost no one would say that looking at her makes them think of the fragility of life and their own closeness to death. In other words, we know enough not to dump into the center ring. Ring Theory merely expands that intuition and makes it more concrete: Don’t just avoid dumping into the center ring, avoid dumping into any ring smaller than your own.

Remember, you can say whatever you want if you just wait until you’re talking to someone in a larger ring than yours.

And don’t worry. You’ll get your turn in the center ring. You can count on that.

Susan Silk is a clinical psychologist. Barry Goldman is an arbitrator and mediator and the author of “The Science of Settlement: Ideas for Negotiators.”

http://articles.latimes.com/2013/apr/07/opinion/la-oe-0407-silk-ring-theory-20130407

What Really Happens in a Therapy Session

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When you take your car to the car mechanic, you know what’s going to happen: Your car will get repaired.

When you break a bone and visit your doctor, you know what’s going to happen: Your bone will be set in a splint or cast and eventually heal.

But when you make an appointment to see a therapist, do you know what’s going to happen? Many people aren’t quite certain. Will you just talk? Will you have to discuss your childhood? Will you be “hypnotized?” And what’s the “point” of seeing a therapist, anyway? Why not just talk to a friend?

There is a great deal of uncertainty in our society about what actually happens during a therapy session, what types of issues and problems are suitable for therapy, and what benefits a therapy session can provide. I’d like to address a few typical questions—and misconceptions—about what therapy is, what it isn’t, and how it really works.

Q: Do I have to be “sick” or “disturbed” to go see a therapist?
A: No. Thinking that one has to be “seriously disturbed” in order to see a therapist is a myth.

While some therapists do specialize in severe emotional disturbances—including schizophrenia or suicidal thoughts—many focus on simply helping clients work through far more typical, everyday challenges like mapping out a career change, improving parenting skills, strengthening stressmanagement skills, or navigating a divorce. Just as some physicians specialize in curing life-threatening illnesses, while others treat “everyday” illnesses like flus, coughs, and colds, psychotherapists can serve a wide range of clients with a range of needs and goals, too.

In fact, most of my clients are successful, high-achieving people who are quite healthy, overall. Most are challenged by a specific, personal goal—like losing weight, creating more work-life balance, finding ways to parent more effectively, or feeling anxious about dating again after a rough break up.

Q: How can I choose the right therapist for my goal/situation?
A: Choosing a therapist is like choosing any other service provider—it’s a good idea to visit the practitioner’s website, and read client testimonials or reviews (if they have any—many do not, for confidentiality reasons). It’s also good to ask friends and family members, or your physician, for referrals (and of course, check to see who is covered in your health insurance network).

If you are hoping to work on a specific issue—overeating, smoking, making a career change—try to find a therapist with expertise in that area. Many list their specialties or areas of focus on their websites. There are therapists who specialize in relationship issues, parenting issues, anger management, weight issues, or sexuality—pretty much any issue, goal, or situation you can imagine. If you’re not sure about someone’s expertise, just call them and ask. If they can’t be of assistance with your issue, they may be able to refer you to someone who can.

Q: What actually happens during a therapy session?
A: Each session is, essentially, a problem-solving session. You describe your current situation, and your feelings about it, and then the therapist uses their expertise to assist you in trying to resolve that problem so you can move closer to having the life you wish to have.

At the beginning of a session, the therapist typically invites you to share what’s been going on in your life, what’s on your mind, what’s bothering you, or whether there are any goals you’d like to discuss. You’ll be invited to speak openly. The therapist will listen and may take notes as you speak; some, like myself, take notes after a session. You won’t be criticized, interrupted or judged as you speak. Your conversation will be kept in the strictest confidentiality. This is a special, unique type of conversation in which you can say exactly what you feel—total honesty—without worrying that you’re going to hurt someone’s feelings, damage a relationship, or be penalized in any way. Anything you want—or need—to say is OK.

Some therapists (like myself) may give clients some homework to complete after a session. That homework might be to set up an online dating profile and reach out for a first date, or to exercise three times a week. It may be to spend some time each day pounding a pillow to safely release pent-up emotions, make a nightly journal entry, or any number of “steps” and “challenges” relevant to your goals. During your next session, you might share your progress and address any areas where you got frustrated, stuck, or off-track.

Of course, every therapist is different, every client is unique, and every therapist-client relationship is distinct as well—which means that there is nouniversal description of a therapy session. Some therapists employ dream interpretation in their work. Others bring music or art therapy into their work. Others incorporate hypnotherapy, life coaching, meditation, visualization, or role-playing exercises to “rehearse” challenging conversations. The list goes on and on. Ultimately, regardless of their approach, a therapist will listen without judgment and help clients try to find solutions to the challenges they face.

Q: Will I have to talk about my childhood?
A: Not necessarily. Many people think that visiting a therapist means digging up old skeletons from your childhood, or talking about how awful your mother was, etc. That is a myth. What you talk about during a therapy session will largely depend on your unique situation and goals. And depending on your goals, you may not actually talk about your past that much. The focus of your therapy is as likely to be your present-day reality and the future that you wish to create.

That being said, if you REALLY do NOT want to discuss your childhood, the intensity of your desire NOT to talk about it might suggest that you should! When people have strong negative emotions—about their childhood or any other topic—it’s typically worth doing some excavating to figure out why that is. Whatever is causing them to feel such strong emotions about the past is more than likely impacting their present-day life in some way, too.

Q: How long will I have to go to therapy?
A: This varies from person to person. I’ve had clients who booked one session, we worked out their issue(s), and they were all set: They marched out and didn’t need a follow-up session. Sometimes, one brave, honest conversation is really all you need.

Other clients have booked sessions with me over a period of several weeks or months, focusing on one issue, resolving that issue, then perhaps moving on to a different challenge. Then there are other clients who I’ve been working with for some time—they appreciate having a weekly, bi-weekly, or monthly “check-in.” They may share their feelings, sharpen their life skills as needed, or perhaps enjoy a deeply nourishing guided meditation or hypnotherapy experience to de-stress. As one client put it, “Every two weeks when I meet with you, I leave your office feeling like you pressed my reset button.”

Therapy is really about whatever a client needs—a one-time conversation, a temporary source of support during a life transition, or an ongoing experience to optimize health physically, mentally, emotionally and spiritually.


Q: Is meeting with a therapist over the phone—or through video chat—just as effective as meeting in person?
A: That depends on your personality and preferences. In the state of Hawaii, where I live, at least one insurer that I know of covers doing therapy virtually via video chat (like Skype or Facetime). This makes it a convenient option for people. Many of my clients do enjoy having some, or all, of their sessions via video chat because it means they don’t have to take time out of their busy schedules to drive, park, and so on. They can just close their bedroom or office door, pick up the phone or log in, and away we go—very convenient.

Where feasible, I suggest trying out both ways—do a traditional, in-person therapy session and then try a video session—and see which format is the best fit for you.

Q: Why see a therapist? Why not just talk to a friend or someone in my family?
A: If you are blessed with caring, supportive family members and friends, by all means, share your feelings, goals, and dreams with those people. They are a big part of your support network, and their insights and encouragement can be very helpful. However, people who already know you might not always be completely objective when listening to you. For example, you may want to change your career, and you confess this dream to your wife. She may want to support you 100%, and try her very best to do so, but she may also be dealing with emotions of her own—such as anxietyabout how a career shift will change your lives, not to mention your income. These emotions could make it difficult for her to listen and support you objectively.

This is why working with a therapist can be so valuable. It’s a unique opportunity to share everything you’re feeling, and everything you want to create, without anyone interrupting you, imposing his or her own anxieties onto the conversation, or telling you that you’re “wrong” or that you “can’t.”

A therapy session is a space where you don’t have to worry about hurting anyone else’s feelings—you can be totally honest. It also means you have the potential to solve problems faster and with greater success. In the long run, that’s better for you and everyone else involved in your life, too.

To sum it up:
Therapy is a valuable tool that can help you to solve problems, set and achieve goals, improve your communication skills, or teach you new ways to track your emotions and keep your stress levels in check. It can help you to build the life, career, and relationship that you want. Does everybody needit? No. But if you are curious about working with a therapist, that curiosity is worth pursuing. Consider setting up one or two sessions, keep an open mind, and see how things unfold. You have very little to lose and, potentially, a lot of clarity, self-understanding, and long-lasting happiness to gain.

Suzanne Gelb, Ph.D., J.D, is a clinical psychologist and life coach. She believes that it is never too late to become the person you want to be: Strong. Confident. Calm. Creative. Free of all of the burdens that have held you back—no matter what has happened in the past. Her insights on personal growth have been featured on more than 200 radio programs, 200 TV interviews and online at Time, Forbes, Newsweek, The Huffington Post, NBC‘s Today, The Daily Love, Positively Positive, and much more. Step into her virtual office, explore her blog, book a session, or sign up to receive a free meditation and her writings on health, happiness and self-respect.

We Want You Here

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By Laura Greenstein | Sep. 24, 2018

 

Sometimes life can feel like a burden. It can feel like each day is a challenge. As if making it to your bed at the end of the day is like reaching the finish line of a long race. It can feel as if each interaction is a struggle. As if you only have a limited amount of oxygen, and each word you speak is a drain on your supply.

For those of you who have ever thought about suicide, you know this feeling all too well.

But you should know that you are so strong.

You’re strong for still being here even when your thoughts tell you that being alive isn’t worth the pain. You are strong for carrying the weight of it all on your shoulders for so long. For carrying it by yourself even while thinking you were alone in the way you feel—even while believing that no one and nothing out there could take off some of the weight.

But you should know that you are not alone.

We are a whole community of people who understand what you’re facing. And more than anything, we want to help you. You don’t have to go through this alone. We want you to ask us for help. We want to help you carry that heavy weight because we understand what it’s like to burden it alone. We may not know exactly what you’re facing, but we understand what it’s like to feel hopeless.

But you should know that there is hope.

There are resources. There is help. There is support. There is time. Time that forces everything to change. You may not feel okay today, but that is okay. The awful way you feel is not permanent. You may feel like you can’t bear the pain any longer, you may feel like you don’t have it in you to reach out for help, but you are stronger than you know, and we believe in you.

And you should know that you are worth it.

You are worthy. You are important. Your life is important. You deserve a place on this planet, and we deserve to have you with us.

And you should know that you are an inspiration. 

You have faced more than many can fathom and yet here you stand. Your strength is a source of hope for those who feel the same as you do. Not only should you feel comfortable telling us about your darkest moments, but we want to hear it.

And you should know there is no shame in your story.

To feel shame is, unfortunately, part of our experience. But it is not fair. It is not fair to yourself. Because the way you feel is not your fault. You should never blame yourself for your darkness. Your darkness if a part of your story, and we accept you.

More than anything, you should know that we want you here.

 

Laura Greenstein is communications manager at NAMI. 

 

https://www.nami.org/Blogs/NAMI-Blog/September-2018/We-Want-You-Here

The Power To Create Change Comes From Within

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By Katherine Ponte, BA, JD, MBA, NYCPS-P, CPRP | Oct. 24, 2018

 

Stigma is a shield created by society, made up of misunderstanding and fear of mental illness. When we look away from someone behaving erratically or “strangely” on the street, that’s the fear society ingrains in us. Perhaps we’re scared to consider the possibility that the same could happen to us; that we might be shunned by society, too.

The shield of stigma also stops us from seeking help for our own mental health. When faced with a stressful life event or emotional challenges, we might carry the hurt or confusion inside. Perhaps we avoid facing a potential diagnosis, so our illness only grows worse. Stigma facilitates mental illness turning into the “monster” it doesn’t have to be.

Social perceptions need to change. However, stigma is so deeply rooted in societal norms that it can take a long time to eradicate. And people like me, people living with mental illness, can’t wait on society to change. We need to live now. In fact, we need to be pioneers.

Our Experience Combats Stigma

First, we need to overcome our own belief in society’s fears. This requires finding hope, and specifically recognizing the possibility of recovery. Recovery from mental illness is living a full and productive life with mental illness. With this mindset, we can take ownership of our condition and live a fulfilling life. This can be one of the most powerful forces for change.

Stories of living fully with mental illness can help reshape society’s bias. They also provide inspiration and guidance for other people living with mental illness. This is the power of peer support and sharing lived experience. It creates a cycle of more people finding recovery, and then in turn, society seeing more positive examples of people living well with mental illness. Society needs to see what life with mental illness can and should be—a life of possibility, not a life sentence.

Our Experience Inspires Others

When people share their mental health journeys, it also helps set our own expectations. Recovery is hard and there is no smooth path to get there. It’s also not a cure, it requires continuous patience, discipline and determination. There will be stumbles and uncertainties along the way. This is the reality of mental illness. That’s why relatable, real-life examples are so valuable.

Knowing that others are going through similar challenges can help us build resilience. The result is self-empowerment by the example of others. We, the mental health community, rely less on the image society projects upon us, and instead focus on the image reflected to us by our peers. This is the power from within ourselves and our community.

I believe that this type of person-driven recovery has been overlooked as a way to combat social stigma. It’s become so ingrained that not even people with mental illness think recovery is possible. Too many of us allow society’s fears to become our own. Together, we can reverse the vicious cycle of stigma and instead, power the virtuous cycle of hope and recovery.

 

Katherine Ponte is a Mental Health Advocate and Entrepreneur. She is the founder of ForLikeMinds, the first online peer-based support community dedicated to people living with or supporting someone with mental illness and is in recovery from Bipolar I Disorder. She is on the NAMI New York City Board of Directors.

https://www.nami.org/Blogs/NAMI-Blog/October-2018/The-Power-to-Create-Change-Comes-from-Within

Avoiding Holiday Stressors: Tips For A Stress-Free Season

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By: Jessica Maharaj

The “most wonderful time of the year” can quickly turn into the most stressful time of the year for many. When compounded by a mental illness, common holiday pressures can create a perfect storm of exacerbated stressors, symptoms and setbacks if not proactively addressed.

The reality is that potential hazards exist at every turn during the holidays. These situations can trigger heightened difficulties for people suffering from depression, anxiety, PTSD and other mental illnesses. The holidays can also introduce additional stressors such as complicated relationship dynamics at family gatherings, grief over losing a loved one or simply trying to live up to the unattainable expectations of the “perfect holiday.”

While it’s important that all people consider the impact of the holidays on emotional well-being, it is crucial that those with mental illness consider tactics for avoiding pitfalls. Of all the things on your holiday preparation to-do list, the most critical one is maintaining your mental health and practicing self-care.

Major Depressive Disorder With A Seasonal Pattern

Major Depressive Disorder with a Seasonal Pattern (formerly known as seasonal affective disorder, or SAD), is a form of depression that often accompanies changes in seasons. This disorder results from chemical changes in the brain and body and is best controlled with the help of a mental health professional who understands the nuances of treating this condition. Whether through online, remote care options such as telepsychiatry or in-person treatments, seeking professional support is truly beneficial in proactively managing this condition leading up to, during and following the holiday season.

Symptoms of SAD can become more pronounced as the holidays approach. These tips can help you manage your symptoms during the holidays.

  • Stay hydrated. Drink plenty of water and herbal teas, and don’t forget to hydrate your skin with lotions and lip balms. Hydration nourishes the brain and its physical effects can improve your overall mood.
  • Find time to exercise. The holiday season is a great time to ice skate, ski or hike. If you don’t have access to these outdoor activities, any form of exercise will release endorphins, which can lessen the symptoms of depression.
  • Spend time with loved ones. This offers an opportunity for social interaction, which can help lessen the feelings of loneliness that may come around this time of year.
  • Pamper yourself. Taking a bath, having a warm drink or getting a massage can create a sense of calm and happiness, especially during the stress of the holidays.
  • Indulge without overconsuming. Treating yourself can make you happy, but over-indulging in unhealthy food around the holidays can negatively impact symptoms.

Grief Over The Holidays

One of the greatest holiday stresses is the absence of a loved one who passed away. The empty seat where they would have sat can fill families with a sense of grief, loss and emptiness, as well as worsen symptoms for individuals with mental illness. The following recommendations can help you and your family cope:

  • It’s not all sad. Know that some parts of the holiday will be wonderful, and some parts will be sad. The anticipation of sadness may be stressful, but the holidays provide an opportunity for healing. You can still take joy in the relatives that are present and remember fond memories of holidays past.
  • It is okay to feel the way you feel. It is healthy to acknowledge your feelings and work through them, rather than suppressing them.
  • Take care of yourself. Find healthy ways to cope, such as exercising. Organizing family walks is a great way to get fresh air and enjoy the company of others. Don’t search for solace in unhealthy foods or alcohol. If alcohol is present, drink responsibly.
  • Don’t feel pressured to uphold family traditions. While they might be a comforting way to remember a loved one, sometimes family traditions are too painful to bear. Your family will find new ways to celebrate, and your traditions will adjust with time.

Keep in mind that the loved ones you lost would want you to remember them fondly, to enjoy the holiday season, and to find comfort in having the family come together.

Managing Holiday Expectations

The holiday season only comes once a year, and while it’s understandable to aspire for perfection, it’s important to set realistic, attainable goals. The following are a few key tips for avoiding the stress of perfection.

  • Make a budget. While the average American household spent nearly $1,000 on holiday gifts in 2017, it’s important not to go overboard. Do your best to stick to a budget while still leaving a small amount extra for wiggle room; the holidays tend to bring out the generosity in us.
  • Come up with a plan. Spread out your errands, so you don’t become overwhelmed with too many tasks at once, and don’t forget to schedule some relaxation time!
  • Find the best time to shop. Malls are less crowded on weekdays and weeknights. If you can manage, try to go during the day and park farther away from the stores. Your time in the sunlight walking to or from your car can boost your serotonin levels. Practicing mindful activities while you wait in line can also help you stay calm among the holiday shopping chaos.
  • Be kind to yourself. All you can do is your best and your best is good enough. It’s impossible to please everyone, but we are often our own harshest critics.

Keep in mind that the holidays are about spending time with loved ones, not gifts. Your friends and family will be happy to create memories with you, so don’t worry about finding an expensive gift or if they will like it; they will appreciate your efforts and affection regardless of what you give them.

The holidays bring joy and happiness as well as frustration and stress. This holiday season, you may have many things to take care of, but the most important one is yourself.

Jessica Maharaj, a Certified Nursing Assistant, is currently pursuing a master’s degree in Clinical Mental Health Counseling at George Washington University while also working at InSight Telepsychiatry. She earned a Bachelor of Science degree in Psychology with a second major in Biology and a concentration in Human Services from the University of Maryland, Baltimore County (UMBC). Jessica was the President of UMBC’s campus chapter of NAMI during her undergraduate career. 
https://www.nami.org/Blogs/NAMI-Blog/December-2018/Avoiding-Holiday-Stressors-Tips-for-a-Stress-Free-Season

Shutting Down Five Misconceptions About Depression

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When I first started opening up about my struggle with depression, I was fortunately met with a lot of support from friends and family. However, there were certain reactions that brought to my attention just how deep the misconceptions are about mental illness.

I found myself defending my experience and struggle to the people I loved. Even though they meant well, their misconceptions of mental illness ended up having a negative impact on my recovery and made me feel more alone and misunderstood. And that is not an uncommon experience.

When I was struggling, it was easy for simple misinformation to work its way into my brain and make me doubt myself. But now that I am further along into my recovery, I can recognize stigma for what it is and shut it down. So, here are the most common unhelpful responses I’ve received about my depression, and why they are nothing more than misconceptions.

  1. “But you have such a great life!”

This is by far the most common reaction I receive when I tell people I have depression. And it stems from the belief that depression is an external condition—if you have a sad life, then you will be sad. What hurt the most about this statement was that I knew I had a nice life. And the fact that I could still experience depression, even when so many people were worse off, just made me feel ashamed and ungrateful. And while it’s true that traumatic events can contribute to the onset of depression, so can your genetics and brain chemistry. So, someone who may seem to have a “perfect” life can still develop a mental illness.

  1. “Are you sure?”

While this one may seem harmless, here’s why it’s not: No, I’m not sure. I used to wake up every day scared that I was faking my mental illness. I told myself I was sad, but it wasn’t “bad enough” to be considered depression. I was months into therapy, on medication, working with multiple doctors, and I still didn’t think it was enough validation. So being asked if I was completely sure I was struggling from mental illness just poked at the fact that after all I had been through—all the therapy sessions, medication trials, self-harm relapses and diagnoses—there was still a voice in the back of my mind telling me I was faking it.

  1. “Have you tried yoga?”

The amount of people I talked to who suggested I do yoga, go gluten free, or try yet another health or self-care tip is alarming. Especially because these people were not suggesting diets and exercises as a side dish to a main course of cognitive behavioral therapy and antidepressants—they were suggesting them as the full meal. I had people tell me that I shouldn’t take medication because it might “change my personality” (spoiler alert: I wanted it to! Depression had become my only personality trait!), and instead, I should just stick to cycling and/or going vegan. This response completely undermines the reality and severity of mental illness. Because, yes, there are plenty of activities or hobbies that can help someone through recovery (for me it was writing), but depression is an illness and deserves to be treated as such. No amount of yoga is going to completely cure a clinical illness.

  1. “Oh, I don’t believe in mental illness.”

This one’s simple. Some people think the earth is flat. That doesn’t change the fact that the earth is, surprisingly, very round. And you not believing in depression doesn’t change the fact that I have it. Next.

  1. “But you don’t seem depressed to me!”

I’ve had a lot of people tell me I don’t “look” or “seem” depressed to them. A big misconception surrounding depression is that it’s for attention, which means people suffering would have to be very open and vocal about their struggles for others to notice it and give them that attention. But, often it’s exactly the opposite. I hid my mental illness from everyone I knew. I put on a smile, laughed at jokes, did my homework and hid my scars because I was scared and ashamed of what people would think of me. And it’s not uncommon for people struggling with depression to hide behind a mask of happiness. So it doesn’t matter whether or not someone “seems” depressed—they may still be suffering.

I know from personal experience that opening up to someone about having mental illness can be extremely difficult and scary. And if people overcome that fear only to have their struggle questioned and invalidated, eventually they’re going to stop being open. If someone opens up about their mental illness, they are looking for hope and support. And they deserve it. In many cases, they need it. I know I did. And often, the widespread misconceptions surrounding depression prevented me from getting the support I needed. So, I think it’s about time we stop asking people with depression if they’ve tried yoga. Because I have tried yoga. And I’ve found that my therapy sessions work a whole lot better.

 

Caroline Kaufman is the author of LIGHT FILTERS IN: Poems (HarperCollins). Known as @poeticpoison on Instagram (202k followers), she writes about giving up too much of yourself to someone else, not fitting in, endlessly Googling “how to be happy,” and ultimately figuring out who you are. She grew up in Westchester County, NY and will return to Harvard University this Fall for her sophomore year. In the future, she hopes to attend medical school and continue growing as a writer.

Communicating Is More Than Finding The Right Words

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My last depressive episode left me completely isolated. I didn’t respond to messages for months. Since I didn’t know how long I would be depressed, answering the question “how are you?” became emotionally draining. Actually, that one question was why I stopped talking to people entirely.

“How are you?” is such a knee-jerk opening line to a conversation; most of us don’t even realize we’re saying it, or pay much attention to the typical response of, “I’m good.” But I wasn’t good, or even okay, and saying it just to get past that question felt like a lie I didn’t want to explain.

I never would’ve guessed that I could go such a long period of time without talking to anyone. I know now how painful it was for those who cared about me not to hear anything despite their repeated attempts to reach out.

Peer support—“peer” defined both as friends and as those who identify as having mental illness—can be profoundly helpful to the recovery process and to help keep symptoms at bay. I could’ve really benefited from this kind of support during my depression, but my lack of communication with my friends and family led me to struggle in silence.

Feeling Empathy For Those Who Are Trying

When that dark cloud finally lifted, I was intrigued by how difficult it was for me to communicate with the people I cared about during my episode. I didn’t want to go through that again. I wanted to learn how to be better at communicating, especially in the thick of a depressive episode.

So I read the book, “There Is No Good Card for This: What to Say and Do When Life Is Scary, Awful, and Unfair to People You Love.” It includes many wonderful examples of how and when to say or do something, and when it’s best to say nothing at all and just listen. It’s a relatively short, easy read considering the depth of knowledge it contains about difficult conversations. Some of the scenarios included made me cringe as I reflected on things I’ve said that were less than ideal.

This book was immensely helpful in learning empathy for those trying to make a connection with me during my episode. I learned that my negative reaction to my friends asking me how I was doing was because depression had changed my perception. The book helped me understand that people might say uncomfortable or insensitive things—“how are you doing?”—when they are genuinely trying to connect but don’t know what to say or what may negatively impact someone.

Learning Essential Communication Skills

I also learned how I could be a better support system for my friends facing adversities, because we all end up being the supportive friend at one time or another. Conversations are a two-way street, even if one person is doing most of the talking. How you listen and respond can change the tone and outcome of a conversation. In “There is No Good Card for This,” you can find out what type of listener you are and what you can do to improve or change the way you respond. This can help build confidence during a difficult conversation.

Here are a few tips from the book to start working on:

  • Don’t judge or assume. People deal with life’s hurts in various ways. It’s easy to say how we would behave in a friend’s situation, but trust that your friend is doing what’s best for him/her, even if you don’t agree with it.
  • Listening speaks volume about how much you care. It can be much easier to listen than to find the perfect thing to say. Try to avoid asking clarifying questions or offering suggestions and anecdotal stories in an attempt to connect unless you know this is what your friend wants. If unsure, ask if he or she would prefer for you to listen for support or brainstorm helpful next steps.
  • Small gestures make a big difference: Some people are better at showing they care than expressing it in words. Clipping coupons for everyday essentials, preparing and delivering their favorite meal, or gifting a massage are just a few examples.

Realizing Mistakes Are Just Learning Opportunities

At the end of the day, just knowing my friends cared enough to reach out meant the world to me. I isolated myself because I felt emotionally fragile and didn’t want to be asked how I was doing. I still wanted to cheer and root for them, and to tell them how proud I was of them despite my depression; I just didn’t want them to ask how I was because I was still trying to figure that out. I now know that I could have expressed that sentiment, and my friends would have understood. It sounds so easy in hindsight, but I couldn’t even get past “how are you?” to tell them.

Please know that you are not alone if you’ve ever felt like this, and if you would like to talk to someone without fear of judgment, please call the NAMI HelpLine for references to mental health resources—including support groups—in your area or online. If you’d like to speak with a trained peer support specialist, the NAMI HelpLine can also give you a local number that you can call 24/7.

Traditional classrooms do not include courses with the sole purpose of teaching emotional intelligence, sensitivity and empathy, so those lessons tend to come from life experience. It’s important to remember to be kind to yourself and others as you navigate through difficult situations. Look back on mistakes as learning opportunities.

I have learned through this experience that if someone is reaching out to you, their heart is probably in the right place, even if they can’t find the “right” words.

 

Keiko Purnell is a NAMI HelpLine Volunteer.

https://www.nami.org/Blogs/NAMI-Blog/August-2018-/Communicating-is-More-than-Finding-the-Right-Words

Mental illness may be a common life experience

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Abnormal is the new normal — at least for mental health. Only a small share of the population stays mentally healthy from age 11 to 38. Everyone else experiences a mental illness at some point, a new study finds.

“For many, an episode of mental disorder is like influenza, bronchitis, kidney stones, a broken bone or other [common] conditions,” says Jonathan Schaefer. He is a psychologist at Duke University. A coauthor of the study, he notes that “Sufferers experience impaired functioning. Many seek medical care, but most recover.”

The study looked at 988 people who lived in New Zealand. Only 171 — or about one in six people —experienced no anxiety disorders, depression or other mental ailments from late childhood to middle age. Of the rest, half experienced a mental disorder that lasted a short time. This was typically just a bout of depression, anxiety or substance abuse. The person then recovered.

The remaining 408 people — roughly two out of every five — experienced one or more mental disorders that lasted at least several years. Their diagnoses included more severe conditions. These may have included bipolar and psychotic disorders.

Schaefer and his colleagues shared their findings in the February Journal of Abnormal Psychology.

By the numbers…

The researchers analyzed data on people born between April 1972 and March 1973 in Dunedin, New Zealand. Each person’s general health and behavior was assessed 13 times from birth to age 38. Mental health was assessed eight times from age 11 onward.

Previous studies had linked several traits with a lower chance of developing mental disorders. These included growing up in an unusually well-off family and enjoying really good physical health. Scoring very high on intelligence tests also has been linked to good mental health. Surprisingly, however, the New Zealanders who stayed mentally healthy scored no better of those qualities than anyone else.

Instead, people with good mental health tended to have personality traits that gave them some sort of advantage. Those traits started emerging in childhood, the surveys showed. These people rarely expressed strongly negative emotions. They also tended to have lots of friends and very good self-control. Those with lasting mental health also had relatively few family members with mental disorders, compared with their peers.

There were some benefits in adulthood for those who always had good mental health. These people had, on average, more education, better jobs and higher-quality relationships. They also reported more satisfaction with their lives than the others did. But lasting mental health doesn’t guarantee an exceptional sense of well-being, Schaefer points out. Nearly one-in-four people never diagnosed with mental illness scored below the entire group’s average score for life satisfaction.

Less surprising was the 83 percent overall rate of mental disorders. That matches recent estimates from four other long-term projects. Two had focused on Americans. One looked at people in Switzerland. The last was another study from New Zealand. These studies followed people for 12 to 30 years. And over that follow-up, between 61 percent and 85 percent of the participants reported having at least some mental disorders.

Such high rates also were reported in an earlier study, from 1962. It had surveyed a random mix of people living on the island of Manhattan in New York City. Many researchers had doubted that study’s findings, however. Why? It had relied on a diagnostic system that was less strict than the ones used to evaluate the people in New Zealand, explains William Eaton. In fact, he says, the Manhattan study now appears to have been on the right track. Eaton is an epidemiologist at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Md.

There is often a stigma attached to mental illness. But if more people realize that most will eventually develop some mental disorder, at least briefly, that stigma might fall, Eaton suspects.

Ronald Kessler is also an epidemiologist. He works at Harvard Medical School in Boston, Mass. Kessler directs U.S. surveys of mental disorders. He suspects the numbers of people who experience a mental disorder may be even higher than what was reported in these studies.

Many people that seemed to have enduring mental health in these studies may not have. They may have developed brief mental disorders that got overlooked, he says. It might have been something such as a couple of weeks of serious depression after a romantic breakup.

Focusing on those rare cases of lasting mental health may not be the best idea, he says. “The more interesting thing is to compare people with persistent mental illness to those with temporary disorders.”

By Bruce Bower

https://www.sciencenewsforstudents.org/article/mental-illness-may-be-common-life-experience

Sour mood getting you down? Get back to nature

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Looking for a simple way to help reduce stress, anxiety, and depression, and maybe even improve your memory? Take a walk in the woods.

“Many men are at higher risk for mood disorders as they age, from dealing with sudden life changes like health issues, the loss of loved ones, and even the new world of retirement,” says Dr. Jason Strauss, director of geriatric psychiatry at Harvard-affiliated Cambridge Health Alliance. “They may not want to turn to medication or therapy for help, and for many, interacting with nature is one of the best self-improvement tools they can use.”

Your brain and nature

Research in a growing scientific field called ecotherapy has shown a strong connection between time spent in nature and reduced stress, anxiety, and depression.

It’s not clear exactly why outdoor excursions have such a positive mental effect. Yet, in a 2015 study, researchers compared the brain activity of healthy people after they walked for 90 minutes in either a natural setting or an urban one. They found that those who did a nature walk had lower activity in the prefrontal cortex, a brain region that is active during rumination — defined as repetitive thoughts that focus on negative emotions.

“When people are depressed or under high levels of stress, this part of the brain malfunctions, and people experience a continuous loop of negative thoughts,” says Dr. Strauss.

Digging a bit deeper, it appears that interacting with natural spaces offers other therapeutic benefits. For instance, calming nature sounds and even outdoor silence can lower blood pressure and levels of the stress hormone cortisol, which calms the body’s fight-or-flight response.

The visual aspects of nature can also have a soothing effect, according to Dr. Strauss. “Having something pleasant to focus on like trees and greenery helps distract your mind from negative thinking, so your thoughts become less filled with worry.”

Bringing the outdoors inside

If you can’t make it outside, listening to nature sounds can have a similar effect, suggests a report published online March 27, 2017, by Scientific Reports. Researchers used an MRI scanner to measure brain activity in people as they listened to sounds recorded from either natural or artificial environments.

Listening to natural sounds caused the listeners’ brain connectivity to reflect an outward-directed focus of attention, a process that occurs during wakeful rest periods like daydreaming. Listening to artificial sounds created an inward-directed focus, which occurs during states of anxiety, post-traumatic stress disorder, and depression. Even looking at pictures of nature settings, your favorite spot, or a place you want to visit can help.

Find your space

How much time with nature is enough? “Anything from 20 to 30 minutes, three days a week, to regular three-day weekends in the woods is helpful,” says Dr. Strauss. “The point is to make your interactions a part of your normal lifestyle.”

Your time with nature could be something as simple as a daily walk in a park or a Saturday afternoon on a local trail. “You can even try to combine your nature outings with your regular exercise by power walking or cycling outdoors,” says Dr. Strauss.

The type of nature setting doesn’t matter, either. “Focus on places you find the most pleasing,” says Dr. Strauss. “The goal is to get away from stimulating urban settings and surround yourself with a natural environment.”

And don’t feel you have to go it alone. A 2014 study found that group nature walks were just as effective as solo treks in terms of lowering depression and stress and improving overall mental outlook.

In fact, the researchers noted that people who had recently experienced stressful life events like a serious illness, death of a loved one, or unemployment had the greatest mental boost from a group nature outing. “Nature can have a powerful effect on our mental state,” says Dr. Strauss, “and there are many ways to tap into it.”

By https://www.health.harvard.edu/mind-and-mood/sour-mood-getting-you-down-get-back-to-nature

An Important Conversation With My Mom

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July is Minority Mental Health Awareness Month, and I wanted to take this opportunity to explore a particularly difficult season in my life: the years my mom served time.

As a quick background, my mom has always been as much of a friend as a mother, and before this period we spoke every day. The years she spent incarcerated were intensified by my severe depression and overeating disorder, but we’ve never fully talked about how they impacted one another. I thought now would be the right time to have that conversation:

DeWanda: Let’s start with logistics because my memory is the worst. What were the dates of your incarceration?

Mom: I was sentenced on July 2, 2008 and went straight to first Howard County Detention Center. I was transferred to the MCIW (MD Correctional Institute for Women) on July 20 and was there until April 20, 2010.

D: It felt so much longer in my head. Do you remember your first day? How did you feel?

M: The very first day was when I went to court for the sentencing. I was told that I needed to be prepared that they might not allow me to return home that day. The lawyer was right because I was told I was being given seven years out of a 15-year maximum. At that moment, I was silent, I felt numb, nauseated and like I was going to faint. They took me out of the courtroom in handcuffs after the judge spoke and to a cold room with cement floors, a single steel commode and a sink. There was also a cot. I felt dizzy and like I had just lost a loved one to death so I lied on the cot in the fetal position, pulled a blanket over me and immediately cried myself to sleep.

D: I can’t believe I never asked you that before. I think I must have been somewhere doing the same. I was in-between living situations then, couch-hopping with my friends, but I never felt more alone in my life.What would you say was your main coping mechanism during your time at MCIM? I mentioned mine was food. (Spoiler alert: It did not make me feel better.)

M: My coping mechanism became an obsession with reading lots of books. I would isolate myself during times when I could’ve been out mingling and talking to other people in the recreation area. I instead would hide in my room and read. I read and slept all the time. The other ways to cope was that I volunteered to clean up the entire tier of our living quarters as many nights as I possibly could. I cleaned the hallways, the main area and the shower stalls. I was constantly cleaning my cell (which all my cellmates loved). That went on until one day I finally decided to volunteer to help in the Chaplains office in which I ended up directing the choir, teaching people how to sing properly in a choir and helping to teach the new believers classes.

I basically spent the first month feeling sorry for myself and tried to do nothing but sit there and read. When I got over that phase I substituted it with being constantly busy so I’d be too tired to do anything but sleep when I did lay down. It also made the time go so much faster being busy.

D: So, it seems safe to say that faith played a significant part of how you spent your time. Me too, I was attending Redeemer then, and praying with my Bible study group about everything. I also worked on that play, “In the Continuum” down in North Carolina. My character, Abigail, was a woman of great faith too. It was the first time you had ever missed a performance. What else do you feel like you missed out on during your time?

M: I was worried about you because I didn’t know if you had jobs enough to have sufficient income. I didn’t really feel like I was missing anything because life {outside} had become so hectic and stressful that I just needed to lay down somewhere. It probably helped me to get to the point where I don’t have to go places as much as I used to.

D: You’ve always been the glass-half-full type. Yeah, I was miraculously fine. I remember coming to get you for Great-Grandma’s funeral and making sure they released you. That was a little light in the midst of things. I still feel bad about getting married while you were away, but I guess I thought you wouldn’t want me to stop living.

M: I was in no way offended about you getting married cause look at what a great husband you got. We ain’t want Alano to get away.

D: You’re too funny! This conversation is good. I’m over here crying.

M: Don’t cry! It’s over now and I actually got to help others which also helped me get through it. I saw other people who had to be on depression medication all the time while I was there. I have never been diagnosed as depressed but I supposed OCD is a problem.

D: Statistics regarding incarcerated women and mental health are pretty staggering.

M: Oh, wow!

D: OCD is definitely a thing—under-eating makes people feel like they’re in control, even if the food is gross.

M: I never really knew what that was; I just know I have to do something when I’m stressed.

D: Any lasting thoughts you’d like to leave with the NAMI community?

M: Yes. Get up every day and write a list of all the good things and blessings that you have. It helps to create a more positive mood for the rest of the day. The more we focus on the good things and also remember that someone else may have a harder time than we are experiencing, it keeps it all in perspective. Also, don’t be afraid to tell others how you are really feeling the next time someone asks, “How are you?” It makes all the difference in the world if you have someone who you know genuinely cares. Try to be that person for someone else and see what a difference it will make in your life.

 

DeWanda Wise is an actress whose work includes roles on Fox event series, Shots Fired, and the critically acclaimed series, Underground. She resides in California with her husband and the best cat in the world, Rascal.

https://www.nami.org/Blogs/NAMI-Blog/July-2017/An-Important-Conversation-with-My-Mom