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

College Students Of Color: Overcoming Mental Health Challenges

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July is Minority Mental Health Month which provides an ideal opportunity to talk about the mental health of young people of color. Our country is becoming more and more diverse—the proportion of children of color are projected to become the majority by 2020 and people of color are expected to make up the majority of the U.S. population by 2045. It’s crucial that we pay attention to the mental health of young people of color as they become the future of our nation.

Mental illness affects young people of color at similar rates as white young adults. However, they are less likely to be diagnosed or seek mental health services. This is largely due to stigma and a cultural mistrust of mental health professionals who lack cultural competence.

Not seeking needed mental health care is problematic for this (and any) population—but especially for college-aged people of color. Because 75% of all lifetime cases of mental illness begin by age 24, college is a time during which many mental illnesses first appear. Coping with an untreated mental illness can affect a student’s social experience and academic performance. And for students of color, there’s often more under the surface working against them.

How Discrimination Affects Mental Health

The social determinants of mental health include factors such as where people are born, live and work as well as their age. They also include things such as discrimination and exclusion, socioeconomic status and access to health care.

Some colleges and universities have recently become settings of discrimination, racial profiling and xenophobia. Universities that create these feelings of marginalization and isolation can be harmful to mental health, and for students of color who have a pre-existing mental illness, such acts of alienation can actually worsen their condition.

Many of us grew up hearing the adage: “Sticks and stones may break my bones, but words can never harm me.” Dr. Altha Stewart, who, in May 2018, became the first African-American President of the American Psychiatric Association, stated recently that “this old saying is incorrect and the truth is that  negative words, can be damaging to mental health, especially for young people.”

Racially hateful expressions broadcasted on social media or communicated face-to-face are harmful to the mental health and well-being of college students of color. This is especially true when cyber-based comments are anonymous. Not knowing if comments are coming from a classmate or someone living next door in the dorm can be frightening and anxiety-provoking.

Colleges and universities should create environments in which young people of color are valued. This can be done by recruiting and retaining a diverse staff and faculty; establishing zero-tolerance policies to racist actions; and developing and maintaining cultural supports, such as culturally-themed clubs, dorms and diverse student identity groups.

Positive actions like these are delineated in the Equity in Mental Health Framework developed by the Steve Fund in collaboration with the Jed Foundation. These resources can help young people of color thrive socially, academically and emotionally.

 

Annelle B. Primm, M.D., MPH is currently senior medical adviser to the Steve Fund, and senior psychiatrist adviser to Hope Health Systems and several other organizations. During her career, Dr. Primm has been Deputy Medical Director of the American Psychiatric Association; Director of the Johns Hopkins Hospital Community Psychiatry Program; an editor of the books, Disparities in Psychiatric Careand Women in Psychiatry: Personal Perspectives; and a lecturer and video producer on the mental health of diverse and underserved populations.

You Can Be Prepared For Crises

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Each year, there are about 5 million visits to emergency departments due to mental illness. Five million people whose symptoms escalate to the point of crisis. Five million people who don’t understand what’s going on or what to do and rush to the ER.

However, this number doesn’t include the people who experience mental health crises without going to the ER—people who are scared and unsure if their situation is a “true emergency.” This number also doesn’t account for the caregivers and loved ones of those experiencing a mental health crisis, standing beside someone they care for, watching them struggle, unsure of how to help.

Mental illness is unpredictable by nature and crises can, do and will happen. Although these crises can’t always be prevented, it is possible to be prepared.

Learn As Much As You Can

The first step in being prepared is gathering any information, resources and support that is available. Start by fully understanding your loved one’s condition: What are the primary symptoms? How can you tell if symptoms are getting more severe? What can you do to support them? And the list goes on. It can be helpful to go with your loved one to see their mental health professional, so you can ask these questions and any others you may have.

Next, learn more about what a mental health crisis is and what to expect when one occurs. NAMI’s new guide: “Navigating a Mental Health Crisis: A NAMI Resource Guide for Those Experiencing a Mental Health Emergency” is a great resource. This free, downloadable guide offers practical strategies on how to deescalate a crisis, information about available resources, tips for advocating for a person in crisis and a sample crisis plan. Details like these are often critical in supporting your loved one during a crisis.

Make A Crisis Plan

Creating a crisis plan should be a collaboration between your loved one and you. The best time to develop this plan is when things are going well. Take the time to ask them questions that will help build a crisis plan, like: What would be most helpful for you? What would you like to do? Who would you like to call? Waiting to ask these important questions can make it difficult to make decisions during a crisis episode.

A crisis plan should include:

  • Your loved one’s general information (date of birth, social security number, insurance information, etc.)
  • Current medications and dosages
  • Current diagnoses
  • History of suicide attempts, drug use or psychosis
  • Addresses and contact information for nearby crisis centers or emergency rooms
  • Contact information for health care professionals
  • A determined behavior/symptom that would prompt going to the hospital or calling 911

Once you create a plane, share it with family members, mental health professionals or anyone else you think should have it. Make sure to update it whenever there is a change in diagnosis, medication, treatment or provider. A crisis plan can be a life-saving resource, so keep it up-to-date and in a safe place.

Notice Behavior Changes

A person with mental illness will typically experience changes in their behavior before a crisis occurs, such as sleeplessness, mood swings or paranoia. These changes are warning signs and shouldn’t be ignored. “Psychiatric illnesses, for the most part, evolve slowly, so there’s going to be a lot of warning,” says Dr. Daniel Lieberman to U.S. News and World Report.

If you notice warning signs, talk to your loved one and encourage them to visit their treating mental health care professional or doctor. “If somebody has a relationship with an outpatient psychiatrist, that’s the first place to go,” Lieberman says.In many cases, there might be enough time to get in contact with a provider before escalating symptoms become a crisis.

Mental health crises can be frightening for everyone involved. However, being prepared can take away some of the fear and uncertainty around what to do and how to help your loved one. Your preparation and support alone can help deescalate a crisis situation—just knowing you’re there, as a stable force, can be an enormous comfort.

By Laura Greenstein

https://www.nami.org/Blogs/NAMI-Blog/June-2018/You-Can-Be-Prepared-for-Crises

A Therapist’s Journey: Learning The Art Of Self-Soothing

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One day, I was standing on the back of my pickup truck and throwing away trash at the town dump when I had an experience that’s hard to describe. My head was swimming, my body felt electrified and I felt detached from the world and myself. A memory then trickled in: I was nine years old, being hit repeatedly by my father one evening because he thought I had lost a 25-cent screwdriver. I remember being scared that he was going to kill me. I remember going numb.

Thirty years later, there I stood, scared and numb again—wondering how or what to do to get out of this state, wondering if I would ever “come back.” I was by myself that day, and not only was nobody home, but I had no one to call. None of my friends had the kind of inclination toward giving me the help I needed, and I also wasn’t in therapy at the time. I was stuck—in more ways than one.

It would take me quite a while before I learned how to soothe myself when I wasn’t doing so well. And I’m still not always the best at it. The old phrase of “physician, heal thyself” rings true for me. Being a therapist, I sometimes think, “Jeez, if my clients knew how difficult it is for me to calm myself down sometimes, I’m not sure they’d keep coming to me.”

Working Through Challenging Symptoms

Therapist or not, learning to self-soothe is hard, but it’s something we all should learn how to do—especially if we have mental health conditions or traumatic pasts. Over the years, I’ve mostly grown past, but I’ve never forgotten, the harshness of my father. That doesn’t mean all my insecurities have gone away, and I don’t expect they ever will; it just means that I’ve concentrated on working toward being independent enough from my experiences. That way, I don’t get so wrapped up in my symptoms of depression and anxiety, and in the fears I still carry around.

Instead of being ruled by these symptoms like I have in the past, I have “worked” psychologically, spiritually and practically to learn and practice the art of self-soothing. I remember when I first started practicing, I latched on to one technique, thinking it would be the answer: breath. I would sit quietly, usually in the morning, and I would breathe in and out, paying attention to the noise of my breath passing through my nostrils. When I became aware of my mind wandering, I would try to refocus. I found this exercise helpful—for a little while.

The sense of peace and calm I once got during the exercise vanished one day, so, I started looking for other ways to self-soothe. This became my pattern. I try a self-soothing exercise, and it either helps me or it doesn’t, then after a stretch of time, I move on to something else.

Over the years, I’ve tried numerous self-soothing techniques. For about a year-and-a-half, I did daily meditations from A Course in Miracles, and once it became too spiritual for me, I stopped. I rode my bicycle for a couple of years. I took up “intentional walking” (a kind of meditation in movement). I tried yoga. I attended spiritual retreats. Jogging was more work than soothing. Walking did not work when I was in my 40s, but was effective in my 50s. Sitting quietly with my legs crossed in meditation was more painful than anything. Qi Gong was not helpful. Tai Chi did not work.

Now, in addition to swimming at the YMCA a few times a week, I meditate while stretching for about 30 minutes in the morning. I also read, at times, from spiritual, poetry or philosophy books, and when I get an “ah-ha” moment, I stop and repeat that saying or sentence or concept throughout the day. I also like to go to the movies and “lose myself” in what’s happening on the screen.

Getting Started

I think one of the most important aspects of self-soothing I’ve discovered is that not every technique works for everyone and it’s unlikely that one technique will be the only technique you ever use. I know that I will likely continue using different techniques, probably for the rest of my life. My initial belief that I would find “one answer” to my anxiety, obsessions and fears was a myth.

I see that a lot in my practice, as well. People want one solution to feel better: one medication, one single action to solve all their problems. The fact is, that’s not how life works. We have to try all kinds of solutions; some will work, some won’t, and some might for a period of time and then stop. Some might not work now, but might later.

That’s a difficult concept to get across to clients and even to myself. I want to feel better right now and forever. But that’s unrealistic. That’s why part of therapy is helping people be realistic in their expectations and to realize that growth, becoming more peaceful and calm as well as happier, is a process that evolves over time. Self-soothing is one of those things as well: It evolves over time. If you’re going to take on learning the art of self-soothing, I have a few pieces of advice.

Realize The Value

Too many of my clients hesitate to take time away from our sessions to practice self-soothing. They have convinced themselves there is little value in learning how to calm themselves when actually, self-soothing can help the recovery process immensely. When you are upset or stressed, it is important to know positive ways to cope on your own—that’s a skill important for our individual growth no matter who we are. Finding ways to self-soothe can help you feel at ease when you are dealing with frustration, excitement or having intense emotions. It can also reduce the amount of worry and fear we carry around with us.

Use Simple, Everyday Experiences

You don’t need to be a guru on the mountaintop raking sand to self-soothe “the right way.” A friend once told me she meditates when she irons. Try to think of something simple you do that you can focus on to relax and find some peace of mind, even if just for a short time.

Adopt A Calming Word Or Phrase

Finding words or phrases that help shift you to a calmer state is like having the right tools for a job. You can find these words, phrases or concepts by reading books or articles or daily meditations, by listening to podcasts or videos, or by making them up yourself. When you find something that makes you feel at ease, stop reading or listening and repeat it a few times to commit it to memory. Repeat the word or phrase periodically throughout the day during stressful and non-stressful times; it will likely bring you a sense of calm.

Practice Makes Perfect

Self-soothing is like any other exercise. The more we do it, the better we get at it. You don’t practice running for a marathon by only running the marathon. You practice by jogging shorter distances and building up stamina. When we practice self-soothing techniques even when we don’t “need” them, we are building a skill and more of an automatic response for when we do need them.

Therapy Can Help

I have used therapists in the past as coaches, supports and idea-generators. My therapists have given me great insight into the kinds of situations that trigger me, and helped me learn how to manage those triggers. Learning to manage my triggers reduces the need to self-soothe in the first place.

As you begin this adventure, remember to be patient. Self-soothing is a skill that develops over time. I’m still learning. But through my learning, self-soothing has helped me be calmer in my day-to-day interactions with people, and I’ve found that I’m more prepared for experiences like the one I had in the back of that pick-up truck.

Learn how to soothe yourself. It could make a difference in your life. I know it did for me.

 

Larry Shushansky has helped thousands of individuals, couples and families over 35 years as a counselor and public speaker. He has developed the concept of Independent Enough and shares this when giving talks to businesses, nonprofit organizations and educational institutions. Learn more about him at www.independentenough.com.

https://www.nami.org/Blogs/NAMI-Blog/June-2018/A-Therapist-s-Journey-Learning-the-Art-of-Self-So

Is It A Mental Health Problem? Or Just Puberty?

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We’re seeing epidemic levels of stress in children and teenagers, with increasing rates of clinical depression, anxiety and other coping problems. Fear, uncertainty and lack of control—factors that power stress—are ramped up in times of rapid, unpredictable change. And puberty is a time of massive change: hormonal, physical, sexual, social, cognitive and neurological.

Puberty brings a level of volatility in attitudes, behavior, responsibility and moods that can look and feel like mental illness. Most parents experience at least some moments of concern for their children’s mental health during the puberty ages of 11 to 14. But, should you? Or is your child experiencing a normal transition into adulthood?

It isn’t always easy to distinguish between the typical moodiness of puberty and mental health conditions that require professional attention. If you’re wondering about your child’s behaviors, here are some questions to ask yourself. They provide a good starting point for understanding how serious the problems might be, and whether you should seek professional help:

  • Does your child have at least one good friend? Although most young teens prefer popularity, one close friend is enough to get through puberty with resilience. If your child has no friends, that’s often a sign of isolation, and a strong reason to consider professional help.
  • Does your child have at least one adult they can talk to? This might be a parent, another relative, a teacher, or someone else—someone who can provide wisdom and support.
  • Does your child have at least one activity that engages them? One productive area of interest can sustain a young person through tough times. It might be a sport, the arts, a school subject, gardening, anything that involves thinking, learning and developing competence.
  • Is your child ever happy? It’s normal for pre-teens and early-teens to express more irritability, annoyance and anger (especially with their parents). But if your child never seems happy or contented, that is cause for concern.
  • Is your child engaging in self-harm? This includes alcohol, drugs and other toxic substances; cutting; sexual promiscuity; and self-sabotage like skipping school. It’s normal for a child to be curious about these things, but it’s time to seek help if you think your child’s well-being is threatened by dependence on any of these activities.

If your child does have an effective network of social support—including at least one friend and one adult they can talk to—is happily engaged in one or more productive activity and is not engaging in self-harming activities, you’re likely dealing with “normal” puberty. However, that doesn’t mean your child doesn’t need your help.

How To Support Resilience In Your Early Adolescent

There has been considerable research done showing that parents can make a difference in their children’s ability to handle stress, thereby minimizing the likelihood of mental health difficulties. Here are some ideas for supporting resilience in your child, whether or not they’re experiencing a mental health condition:

Listen

Being available when your children need you can make the difference between a good decision and a dangerous one. Be fully present when your teen wants to talk and be fully positive. Tweens are painfully aware of others’ perceptions and believe that everyone is looking at them with critical or even mocking eyes. Make sure your teen feels your positive gaze. No criticism, no judgement, no distractions.

Strive For Balance

We all need balance in our lives, but that’s especially true for early adolescents. Make sure your young teenager has opportunities for quiet reflection, ample sleep, regular outdoor exercise and good nutrition. Practice breathing techniques, and other mindfulness skills. You’ll be better at managing your own stress, and you’ll provide your teenager with a good model of coping with their ups-and-downs.

Welcome Conflict

Respect your child’s need to create their own unique blend of mainstream values with your family’s values. If you’re an immigrant, single parent, member of a cultural or religious minority or in a same-sex relationship, your child may feel a conflict between their home values and their peers’ values. A friendly debate is a great way for your teenager to discover what you care about, and why it’s worth caring about. You’re likely doing a good job of parenting if you and your teenager can argue, but there’s still love and warmth in your home.

Own The Parenting Space

Tweens and teens can appear to take pleasure from pushing your buttons. But on a deeper level, they need you to stay strong and calm. Just like a toddler who challenges the rules, teens feel safest when they know they can trust you to be solid no matter what grief they give you. That applies whether or not your child is dealing with a diagnosed mental health condition.

The years from 11 to 14 can be highly stressful for children as well as their parents. Unfortunately, there isn’t an easy or simple template for parents to determine whether or not their child has a diagnosable problem—that’s something only a mental health professional can do. You can, however, support your child’s resilience, and help them get through adolescence as smoothly as possible.

 

 

Dona Matthews, PhD, has been working with children, adolescents, families, and schools since 1990. In addition to running a busy private practice, she was the Executive Director of the Millennium Dialogue on Early Child Development at the University of Toronto, and the founding Director of the Hunter College Center for Gifted Studies and Education, City University of New York. She writes a regular column for PsychologyToday.com, has published dozens of articles and book chapters, and is the co-author of these books: Beyond Intelligence: Secrets of Raising Happily Productive Kids; Being Smart about Gifted Education; The Development of Giftedness and Talent across the Life Span; and The Routledge International Companion to Gifted Education.

How Schools Can Help Students Respond To Suicide

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The rate of teen suicide has steadily increased since 2005. Among youth ages 15-24 years old, suicide is the second leading cause of death. A ripple effect of needs is created when a teenage suicide death occurs. Responding appropriately is critical to ensuring that everyone affected—family, friends and the school community—receives the right type and amount of support.

Grief can have a profound impact on students and may create new mental health issues or worsen existing conditions. Additional factors must also be addressed, including identifying students who may be at risk for taking a similar path (also known as suicidal ideation or suicide contagion).

Professor Ron Avi Astor, who recently spoke with USC’s online MSW program, believes that suicidal ideation is often thought of as just an individual issue treated only in counseling, but schools can help a great deal by addressing possible peer and social dynamics that may contribute to stronger suicidal ideation.

However, many educators feel ill-prepared to help their grieving students, and many school districts aren’t offering the necessary training. The National Center for School Crisis and Bereavement (NCSCB) offers a number of guides for schools, administrators and staff that explain how to respond to crises such as a death in a school. These guides incorporate psychological first aid models, which outline steps to help grieving students through a school crisis, including:

  1. Listen: Pay attention to verbal and nonverbal cues from students that show stress and make yourself available to talk.
  2. Protect: Answer questions honestly and communicate what is being done to keep students safe.
  3. Connect: Keep communication open with other adults, find resources that can offer support and help restore student activities that encourage interaction with friends.
  4. Model: Be aware of your own reactions to crises and demonstrate how to cope in a healthy way.
  5. Teach: Help students identify positive coping mechanisms and celebrate small achievements as they begin to get through each day successfully.

When suicide is involved, more effective and specific interventions are needed to address school environments and peer dynamics. As an example, it’s critical for educators and other adults to be able to identify whether a student is at higher risk for suicide contagion. According to the NCSCB, there are certain signs that indicate risk for extreme emotional distress during this time.

Outlined in its Guidelines on Response for Death by Suicide, those signs include:

  • Presence of a mental health condition, particularly depression;
  • Thoughts or talk about suicide or dying;
  • Changes in behavior, such as extreme acting out or withdrawal from others;
  • Impulsive and high-risk behaviors, such as increased alcohol or substance abuse;
  • Talk of a foreshortened future, with an inability to see their place in it.

As the NCSCB notes, “If school staff and other adults perceive the presence of such risk factors—or if reactions to the death persist without significant improvement, a referral for mental health services may be indicated. Response to a death by suicide should not only include the immediate response, but also long-term follow-up and support.”

Addressing Mental Health Needs

Because suicide is often the result of untreated mental illness, addressing mental health needs is often the best way to try to prevent these tragedies. Many parents and teachers incorrectly believe that school-aged children are incapable of experiencing mental health conditions, but that’s simply not the case.

  • 13% of children ages 8 to 15 experience a mental health condition.
  • 50% of all lifetime cases of mental illness begin by age 14.
  • 50% of children ages 8 to 15 experiencing a mental health condition don’t receive treatment.

In order to teach children about mental illness and encourage them to seek help, NAMI created NAMI Ending the Silence: free presentations available for students, school staff and families. These in-school presentations teach middle and high school students about the signs and symptoms of mental illness, how to recognize the early warning signs and the importance of acknowledging those warning signs. As one teacher noted in response to the program: “It is amazing what just one day, one talk, can do. You never really know what’s going on in the brain of any particular student.”

Although death and grief can have a profound impact on a school community, resources such as these can provide critical guidance and support for teachers and staff to help their students before and after a tragedy. Hopefully, one day, we won’t need these resources anymore.

 

Colleen O’Day is a Digital PR Manager and supports community outreach for 2U Inc.’s social work, mental health, and education programs. Find her on Twitter @ColleenMODay.

https://www.nami.org/Blogs/NAMI-Blog/May-2018/How-Schools-Can-Help-Students-Respond-to-Suicide

Must I Tell My Boss I’m Absent Because of Mental Illness?

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I am in treatment (weekly therapy and a drug regimen) for clinical depression and a panic disorder. They are, for the most part, very well managed. However, even the most well managed mental illness has flare-ups, during which I find it difficult to get out of bed, am plagued with suicidal thoughts or am so panicked that I need to take medication to calm my heart rate. When these symptoms are occurring, the idea of being able to work is laughable.

These symptoms are not readily understood by my high-powered industry colleagues and bosses. There is a general feeling that “we all get anxious and sad; we buck up and push through.” Personal days and sick days are discouraged, and there are few light days. Moreover, although my co-workers are vaguely aware that I have a condition that requires weekly therapy, the existence of flare-ups like this carries, I feel, a heavy stigma that I am not “up to” our fast-paced job. This is not the case; I am an extremely productive and dedicated worker, and I love my job. These flare-ups happen less than once a month, and I am fastidious about ensuring that my work is covered appropriately when I am out.

My work is in law, with regular can’t-miss meetings with clients, such that a “taking a sick day” message to a boss will generally be met with: “Can you come in for this meeting/court date or call in to this or that?”; “Have you tried DayQuil?” etc. On days when I am so preoccupied with my depression symptoms that I cannot go in, I cannot meaningfully participate in “just one thing”; indeed, trying to do so often makes it more difficult for me to recover. I have found that the easiest way to avoid these requests is to lie and explain that I am ill with a particularly nasty symptom, such as a high fever, strep throat or food poisoning. This normally halts questioning, as those conditions are deemed “serious enough” to warrant a day off. Given the stigma associated with mental health issues, is it ethical for me to lie about the specifics of my symptoms to my boss, or is this similar to calling in a “sick day” when in fact you’re taking a personal day, an act I would consider unethical? 

Let’s assume that, over all, your firm has reason to agree that you are, as you say, “an extremely productive and dedicated worker.” Your inclination to be more open about your illness is a good one: When more people like you choose to be open about their struggles, understanding will increase, and the stigma you mention will be reduced. And that’s likely to help people in your situation work productively.

The decision you make will depend on how supportive you think your boss will be, what the culture of your workplace is and how much your contributions are valued. You’ll also want to explain the reality of the disorder — that it’s not a matter of “bucking up and pushing through.” Your employers can accommodate your needs only if you inform them properly of your disability. This would both make your life easier and allow them to plan better; one of the many bad consequences of prejudice is that these win-win outcomes aren’t achieved.

But suppose you decide that your firm would penalize you for being honest and that you can get away with inventing physical illnesses to cover your needs. Would the fact that your employers would respond badly to your being honest justify your continued lying? It would: In general, it’s permissible to mislead people who will do you serious and unwarranted wrong if you tell the truth.

Because you work in the law, you’ll know that the Americans With Disabilities Act requires employers (with 15 or more workers) to make “reasonable accommodations” for conditions that are legally considered disabilities. So if candor proved damaging to your conditions of employment, you might have a remedy. Whether an illness, like depression, is disabling depends, according to the law, on whether it “substantially limits one or more major life activities.” Of course, the law says, as you’d expect, that work is a major life activity. And it was amended in 2008 to define disabilities in a way that explicitly includes conditions like yours that are only episodically disabling, so your clinical depression should meet the test. But in the end, it would be for lawyers to advise you on that question.

A final paradox: If you do go on lying to your employers, they will be justified in penalizing you if they find out. They’re unlikely to be impressed by the argument that you were convinced that they would have behaved badly if you had told them. So I would urge you to consider the harder path of telling the truth. After all, if you’re a terrific worker, they ought to know you’re worth a good deal to them.

Kwame Anthony Appiah teaches philosophy at N.Y.U. He is the author of “Cosmopolitanism” and “The Honor Code: How Moral Revolutions Happen.

How Depression Made Me A Man

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“Be strong!”

“Toughen up!”

“Don’t cry!”

Never did someone stand over me as a kid and yell, “Let it out! It’s okay to cry! It’s human to hurt!” From my football coaches to my own father, it seems as though the social norm for men is to be some kind of impenetrable mountain of muscle that feels no pain and has no emotion. If we’re not hunting or fighting or eating a bloody, rare steak, then we’re not men. As a kid, I idolized the manly behemoths on TV. From Arnold Schwarzenegger to Dwayne “The Rock” Johnson, I wanted to be just like them. And I didn’t only want to mimic their physical appearance, but I wanted to be as happy and carefree as they seemed.

Our culture depicts men as heroes and symbols of strength and popularity, almost to the point of being invincible. Every little boy wants to be invincible. When my parents fought—yelling and breaking things in the house—all I wanted to be was invincible against how sad they made me feel. I wanted to be invincible against the feelings I had when that girl I had a crush on in 5th grade said, “No thanks, you’re too fat for me” after I finally worked up the courage to ask her to be my girlfriend; instead, I ran away and cried in the boy’s bathroom during second period. I wanted to be invincible when my youth football coach called me a “pussy” because I got hit and I said it hurt; instead, I questioned why feeling pain made me less of a man.

All these feelings, emotions and a twisted view of masculinity had a hold on me. Rather than accept and process my emotions, I learned to ignore and compartmentalize them. I kept my issues and pains to myself and tried my hardest to push them down as deep and far away from the surface as I could.

Then, the day came when the flood couldn’t be held back any longer and the levees broke. For so long I had hidden my pain, my confusion, my depression and I had become good at pretending to be “okay” with everything life was throwing at me. But one day it was not “okay” anymore. My mental illness had been ignored for so long and it would not be quieted any longer.

I couldn’t find any more strength or courage or fight just to keep those around me from finding out how bad I truly felt. I was so conditioned to “man up” that when the pain, sorrow and thoughts of suicide ran through my mind, I had no answer. I couldn’t yell or puff my chest at depression. Depression didn’t care how much I could lift or what car I drove or how many girls I had been with. Depression knew the real me. It knew the little boy who could never face his real problems head-on because the society in which he grew up wouldn’t let him. He was too busy pretending to be strong, too busy pretending to be a “man” to admit he lived with depression.

After my attempted suicide and rehabilitation, things started to become clearer. I learned that pain, sorrow, anger and sadness are a part of life—emotions don’t care if you are a man or woman or household pet. For the first time, I could accept and acknowledge my weaknesses and my pain. Finally, I found myself and have never felt stronger or more of a man.

Coming out about my depression was one of the most freeing and courageous things I have ever done. No longer am I silent or fearful about who I really am. I am comfortable and confident enough in myself to accept and face my demons. I’m no longer ashamed of my depression. And being self-aware and brave enough to face my emotions fills me with more manly strength and pride than any action hero ever did.

I can now step in front of my mental illness and accept it as a part of me, instead of always living in its shadow. And I’m here to tell you fellas to be bold and fearless about who you are. Be strong enough to admit your pains. Be courageous to acknowledge your struggles—regardless of how “un-manly” they may seem.

Depression affects 6 million men per year. So, next time you’re in the locker room talking, I hope that the conversation becomes deeper than football plays and girls. For being a man is what we men make it.

 

Rob “Roro” Asmar is a chef and restaurateur in the DC area. He passionately advocates for mental health through his volunteer and awareness raising efforts and seeks to break the stigma surrounding mental health & men. His open and positive attitude are expressed through his social media platform @RoroMeetsWorld where you can find his cooking and refreshing take on life. 

https://www.nami.org/Blogs/NAMI-Blog/March-2018/How-Depression-Made-Me-a-Man