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

5 Myths That Prevent Men From Fighting Depression

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Depression can be hard to talk about—so hard that a lot of men end up silently struggling for years, only to reach out when they’ve hit rock bottom. Others, sadly, don’t reach out at all. This is one of the reasons why men account for 3.5 times the number of suicides as women.And depression is one of the leading causes of suicide.

Fighting depression is difficult. Not only do you have to fight the illness but you also fight the stigma attached to it. For men, the fear of looking weak or unmanly adds to this strain. Anger, shame and other defenses can kick in as a means of self-protection but may ultimately prevent men from seeking treatment.

Here are some common myths that stand between men and recovery from depression:

Depression = Weakness

It cannot be emphasized enough that depression has nothing to do with personal weakness. It is a serious health condition that millions of men contend with every year. It’s no different than if you develop diabetes or high blood pressure—it can happen to anyone. We show our strength by working and building supports to get better.

A Man Should Be Able To Control His Feelings

Depression is a mood disorder, which means it can make us feel down when there is absolutely nothing to feel down about. We can’t always control what we feel, but we can do our best to control how we react. And that includes choosing whether to ignore our problems or face them before they get out of hand.

Real Men Don’t Ask For Help

Sometimes we need an outside perspective on what might be contributing to our depression. Consulting a professional who has more knowledge of depression and treatment options is the smartest thing to do. Trying to battle a mental health condition on your own is like trying to push a boulder up a mountain by yourself—without a team to back you up, it’s going to be a lot harder.

Talking About Depression Won’t Help

Ignoring depression won’t make it go away. Sometimes we think we know all the answers and that talking can’t help a situation. This couldn’t be further from the truth. Often, things that seem like a huge deal in our minds aren’t as stressful when we talk about them more openly with a friend or mental health professional. Talk therapy (or psychotherapy) is a proven treatment for depression. It’s useful for gaining new perspectives and developing new coping skills.

Depression Will Make You A Burden To Others

Being unhealthy and refusing to seek treatment can put pressure and stress on those that care about you, but asking for help does not make you a burden. It makes people feel good to help a loved one, so don’t try to hide what you’re going through from them. What’s most frustrating is when someone needs help, but they refuse to ask for it.

If you (or a man you know) think you might be living with depression, HeadsUpGuys is a website specifically designed to help men fight depression. The site features practical tips, information about professional services and stories of recovery. It also has a self-check that can help determine whether or not depression may be affecting you. Check it out today.

 

Since recovering from experiences with depression and a suicide attempt in 2010, Joshua R. Beharry has become a passionate advocate for mental health. Josh is currently the project coordinator forHeadsUpGuys, a resource for men in pursuit of better mental health.

https://www.nami.org/Blogs/NAMI-Blog/March-2018/5-Myths-that-Prevent-Men-from-Fighting-Depression

Record Numbers of College Students Are Seeking Treatment for Depression and Anxiety — But Schools Can’t Keep Up

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Not long after Nelly Spigner arrived at the University of Richmond in 2014 as a Division I soccer player and aspiring surgeon, college began to feel like a pressure cooker. Overwhelmed by her busy soccer schedule and heavy course load, she found herself fixating on how each grade would bring her closer to medical school. “I was running myself so thin trying to be the best college student,” she says. “It almost seems like they’re setting you up to fail because of the sheer amount of work and amount of classes you have to take at the same time, and how you’re also expected to do so much.”

At first, Spigner hesitated to seek help at the university’s counseling center, which was conspicuously located in the psychology building, separate from the health center. “No one wanted to be seen going up to that office,” she says. But she began to experience intense mood swings. At times, she found herself crying uncontrollably, unable to leave her room, only to feel normal again in 30 minutes. She started skipping classes and meals, avoiding friends and professors, and holing up in her dorm. In the spring of her freshman year, she saw a psychiatrist on campus, who diagnosed her with bipolar disorder, and her symptoms worsened. The soccer team wouldn’t allow her to play after she missed too many practices, so she left the team. In October of her sophomore year, she withdrew from school on medical leave, feeling defeated. “When you’re going through that and you’re looking around on campus, it doesn’t seem like anyone else is going through what you’re going through,” she says. “It was probably the loneliest experience.”

Spigner is one of a rapidly growing number of college students seeking mental health treatment on campuses facing an unprecedented demand for counseling services. Between 2009 and 2015, the number of students visiting counseling centers increased by about 30% on average, while enrollment grew by less than 6%, the Center for Collegiate Mental Health found in a 2015 report. Students seeking help are increasingly likely to have attempted suicide or engaged in self-harm, the center found. In spring 2017, nearly 40% of college students said they had felt so depressed in the prior year that it was difficult for them to function, and 61% of students said they had “felt overwhelming anxiety” in the same time period, according to an American College Health Association survey of more than 63,000 students at 92 schools.

As midterms begin in March, students’ workload intensifies, the wait time for treatment at counseling centers grows longer, and students who are still struggling to adjust to college consider not returning after the spring or summer breaks. To prevent students from burning out and dropping out, colleges across the country — where health centers might once have left meaningful care to outside providers — are experimenting with new measures. For the first time last fall, UCLA offered all incoming students a free online screening for depression. More than 2,700 students have opted in, and counselors have followed up with more than 250 who were identified as being at risk for severe depression, exhibiting manic behavior or having suicidal thoughts.

Virginia Tech University has opened several satellite counseling clinics to reach students where they already spend time, stationing one above a local Starbucks and embedding others in the athletic department and graduate student center. Ohio State University added a dozen mental health clinicians during the 2016-17 academic year and has also launched a counseling mobile app that allows students to make an appointment, access breathing exercises, listen to a playlist designed to cheer them up, and contact the clinic in case of an emergency. Pennsylvania State University allocated roughly $700,000 in additional funding for counseling and psychological services in 2017, citing a “dramatic increase” in the demand for care over the past 10 years. And student government leaders at several schools have enacted new student fees that direct more funding to counseling centers.

But most counseling centers are working with limited resources. The average university has one professional counselor for every 1,737 students — fewer than the minimum of one therapist for every 1,000 to 1,500 students recommended by the International Association of Counseling Services. Some counselors say they are experiencing “battle fatigue” and are overwhelmed by the increase in students asking for help. “It’s a very different job than it was 10 years ago,” says Lisa Adams Somerlot, president of the American College Counseling Association and director of counseling at the University of West Georgia.

As colleges try to meet the growing demand, some students are slipping through the cracks due to long waits for treatment and a lasting stigma associated with mental health issues. Even if students ask for and receive help, not all cases can be treated on campus. Many private-sector treatment programs are stepping in to fill that gap, at least for families who can afford steep fees that may rise above $10,000 and may not be covered by health insurance. But especially in rural areas, where options for off-campus care are limited, universities are feeling pressure to do more.

‘I needed something the university wasn’t offering’

At the start of every school year, Anne Marie Albano, director of the Columbia University Clinic for Anxiety and Related Disorders (CUCARD), says she’s inundated with texts and phone calls from students who struggle with the transition to college life. “Elementary and high school is so much about right or wrong,” she says. “You get the right answer or you don’t, and there’s lots of rules and lots of structure. Now that [life is] more free-floating, there’s anxiety.”

That’s perhaps why, for many students, mental health issues creep up for the first time when they start college. (The average age of onset for many mental health issues, including depression and bipolar disorder, is the early 20s.)

Dana Hashmonay was a freshman at Rensselaer Polytechnic Institute in Troy, New York in 2014 when she began having anxiety attacks before every class and crew practice, focusing on uncertainties about the future and comparing herself to seemingly well-adjusted classmates. “At that point, I didn’t even know I had anxiety. I didn’t have a name for it. It was just me freaking out about everything, big or small,” she says. When she tried to make an appointment with the counseling center, she was put on a two-week waitlist. When she finally met with a therapist, she wasn’t able to set up a consistent weekly appointment because the center was overbooked. “I felt like they were more concerned with, ‘Let’s get you better and out of here,’” she says, “instead of listening to me. It wasn’t what I was looking for at all.”

During her freshman year, Hashmonay sought out help on campus after she started having anxiety attacks before her classes and crew practices.
Eva O’Leary for TIME

Instead, she started meeting weekly with an off-campus therapist, who her parents helped find and pay for. She later took a leave of absence midway through her sophomore year to get additional help. Hashmonay thinks the university could have done more, but she notes that the school seemed to be facing a lack of resources as more students sought help. “I think I needed something that the university just wasn’t offering,” she says.

A spokesperson for Rensselaer says the university’s counseling center launched a triage model last year in an effort to eliminate long wait times caused by rising demand, assigning a clinician to provide same-day care to students presenting signs of distress and coordinate appropriate follow-up treatment based on the student’s needs.

Some students delay seeing a counselor because they question whether their situation is serious enough to warrant it. Emmanuel Mennesson says he was initially too proud to get help when he started to experience symptoms of anxiety and depression after arriving at McGill University in Montreal in 2013 with plans to study engineering. He became overwhelmed by the workload and felt lost in classes where he was one student out of hundreds, and began ignoring assignments and skipping classes. “I was totally ashamed of what happened. I didn’t want to let my parents down, so I retreated inward,” he says. During his second semester, he didn’t attend a single class, and he withdrew from school that April.

For many students, mental health struggles predated college, but are exacerbated by the pressures of college life. Albano says some of her patients assume their problems were specific to high school. Optimistic that they can leave their issues behind, they stop seeing a therapist or taking antidepressants. “They think that this high school was too big or too competitive and college is going to be different,” Albano says. But that’s often not the case. “If anxiety was there,” she says, “nothing changes with a high school diploma.”

Counselors point out that college students tend to have better access to mental health care than the average adult because counseling centers are close to where they live, and appointments are available at little to no cost. But without enough funding to meet the rising demand, many students are still left without the treatment they need, says Ben Locke, Penn State’s counseling director and head of the Center for Collegiate Mental Health.

The center’s 2016 report found that, on average, universities have increased resources devoted to rapid-access services — including walk-in appointments and crisis treatment for students demonstrating signs of distress — since 2010 in response to rising demand from students. But long-term treatment services, including recurring appointments and specialized counseling, decreased on average during that time period.

“That means that students will be able to get that first appointment when they’re in high distress, but they may not be able to get ongoing treatment after the fact,” Locke says. “And that is a problem.”

‘We’re busier than we’ve ever been’

In response to a growing demand for mental health help, some colleges have allocated more money for counseling programs and are experimenting with new ways of monitoring and treating students. More than 40% of college counseling centers hired more staff members during the 2015-16 school year, according to the most recent annual survey by the Association for University and College Counseling Center Directors.

“A lot of schools charge $68,000 a year,” says Dori Hutchinson, director of services at Boston University’s Center for Psychiatric Rehabilitation, referring to the cost of tuition and room and board at some of the most expensive private schools in the country. “We should be able to figure out how to attend to their whole personhood for that kind of money.”

At the University of Iowa, Counseling Director Barry Schreier increased his staff by nearly 50% during the 2017-18 academic year. Still, he says, even with the increase in counseling service offerings, they can’t keep up with the number of students coming in for help. There is typically a weeklong wait for appointments, which can reach two weeks by mid-semester. “We just added seven full-time staff and we’re busier than we’ve ever been. We’re seeing more students,” Schreier says. “But is there less wait for service? No.”

The university has embedded two counselors in dorms since 2016 and is considering adding more after freshmen said it was a helpful service they would not have sought out on their own. Schreier also added six questions about mental health to a freshman survey that the university sends out several weeks into the fall semester. The counseling center follows up with students who might need help based on their responses to questions about how they’d rate their stress level, whether they’ve previously struggled with mental health symptoms that negatively impacted their academics, and whether they’ve ever had symptoms of depression or anxiety. He says early intervention is a priority because mental health is the number one reason why students take formal leave from the university.

As colleges scramble to meet this demand, off-campus clinics are developing innovative, if expensive, treatment programs that offer a personalized support system and teach students to prioritize mental wellbeing in high-pressure academic settings. Dozens of programs now specialize in preparing high school students for college and college students for adulthood, pairing mental health treatment with life skills classes — offering a hint at the treatments that could be used on campus in the future.

When Spigner took a medical leave from the University of Richmond, she enrolled in College Re-Entry, a 14-week program in New York that costs $10,000 and aims to provide a bridge back to college for students who have withdrawn due to mental health issues. She learned note-taking and time management skills in between classes on healthy cooking and fitness, as well as sessions of yoga and meditation.

Mennesson, the former McGill engineering student, is now studying at Westchester Community College in New York with the goal of becoming a math teacher. During his leave from school, he enrolled in a program called Onward Transitions in Portland, Maine that promises to “get 18- to 20-somethings unstuck and living independently” at a cost of over $20,000 for three months, where he learned to manage his anxiety and depression.

Another treatment model can be found at CUCARD in Manhattan, where patients in their teens and early 20s can slip on a virtual reality headset and come face-to-face with a variety of anxiety-inducing simulations — from a professor unwilling to budge on a deadline to a roommate who has littered their dorm room with stacks of empty pizza boxes and piles of dirty clothes. Virtual reality takes the common treatment of exposure therapy a step further by allowing patients to interact with realistic situations and overcome their anxiety. The center charges $150 per group-therapy session for students who enroll in the four-to-six-week college readiness program but hopes to make the virtual reality simulations available in campus counseling centers or on students’ cell phones in the future.

This virtual reality program — developed by Headset Health in partnership with the Columbia University Clinic for Anxiety and Related Disorders — allows students to confront their anxiety in a simulated college scenario.
Courtesy The Headset Health

 

Hashmonay, who has used the virtual reality software at the center, says the scenarios can be challenging to confront, “but the minute it’s over, it’s like, ‘Wow, OK, I can handle this.’ She still goes weekly to therapy at CUCARD, and she briefly enrolled in a Spanish course at Montclair State University in New Jersey in January. But she withdrew after a few classes, deciding to get a job and focus on her health instead of forcing a return to school before she is ready. “I’m trying to live life right now and see where it takes me,” she says.

Back at the University of Richmond for her senior year, Spigner says the attitude toward mental health on campus seems to have changed dramatically since she was a freshman. Back then, she knew no one else in therapy, but most of her friends now regularly visit the counseling center, which has boosted outreach efforts, started offering group therapy and mindfulness sessions, and moved into a more private space. “It’s not weird to hear someone say, ‘I’m going to a counseling appointment,’ anymore,” she says.

She attended an open mic event on Richmond’s campus earlier this semester, where students publicly shared stories and advice about their struggles with mental health. Spigner, who meets weekly with a counselor on campus, has become a resource to many of her friends because she openly discusses her own mental health, encouraging others not to be ashamed to get help.

“I’m kind of the go-to now for it, to be honest,” she says. “They’ll ask me, ‘Do you think I should go see counseling?’” Her answer is always yes.

By Katie Reilly

http://time.com/5190291/anxiety-depression-college-university-students/

What To Do If Your Workplace Is Anxiety-Inducing

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There are so many aspects a job that can cause anxiety: having tight deadlines, trying to harmonize a work/life balance, dealing with office gossip and politics, meeting your supervisor’s expectations… the list goes on.

Thanks to all this, most people who work will experience some anxiety at some point. But what do you do if your workplace makes you feel that way on a regular basis? When you dread stepping foot into the office day after day. When something about your job makes anxiety your norm. When you have an anxiety disorder and work constantly triggers your symptoms.

Depending on your situation, it might be helpful to evaluate whether your job is right for you. But if you aren’t able or don’t want to change jobs, there are ways to manage workplace anxiety.

Practice Self-Awareness

Before you can improve your situation, it’s important to understand what exactly is creating your anxious feelings or worsening the symptoms of your condition. Even if the root of your anxiety is something you can’t change, like having more work than you can handle, knowing the cause can help you figure out next steps. It’s a lot harder to reach a destination without a map.

Share Your Feelings

It may be helpful to talk to a trusted coworker as they can relate to and sympathize with your anxiety. If you don’t have a coworker you trust, you can talk to a friend, family member or mental health professional. Talking about anxiety with the right person can help you process these intense emotions and it can be validating if the person is supportive and understanding. They might also have ideas or suggestions to help you cope.

Release Your Thoughts

Anxiety feeds off itself and one anxious thought can turn into 100 pretty quickly. There’s no way I will meet this deadline. What if something else comes up? What if Steve thinks the project is terrible? If you’re feeling inundated with this kind of thought-spiral, it can be helpful to release your thoughts.

One of the most effective ways to do this is by writing them all down. Do a brain dump of all your anxious thoughts—not to understand them, but just to get them “out.” If you’re at home (or somewhere you feel comfortable) thinking about work drama, you can also sing your thoughts. The idea of these practices is that you can’t write or sing as fast as you can think, so you’ll actually be slowing down while you release your unhelpful thought patterns.

Know When To Ask For Help

If you’re drowning in work, having a hard day or feeling like you can’t meet your supervisor’s expectations, ask your colleagues for help. While it may feel like everyone handles their own work and stress independently, and you should too, this is often not beneficial to anyone. Asking for help when you need it alleviates your burden and builds trust among coworkers. If you feel guilty for taking up their time, offer your support the next time they need help.

Take Time Off

Every six months or so, take some time off work and disconnect as much as possible. Don’t feel guilty about it. You deserve time to yourself or with your loved ones. There is no shortage of research about how important it is for your mental health to get regular breaks from work to decompress and reset. It gives you something to look forward to, time to reflect and practice gratitude. Time off also helps build resilience.

Accept Anxiety

The more you fear anxiety, the more powerful it can become. Part of reducing anxiety is accepting that sometimes work is going to make you feel that way. This is a lot easier said than done, but it comes with practice. So, next time you feel your thoughts and heartbeat start to race, take a moment, sit at your desk and tell yourself: “I feel anxious right now and that’s okay. I’m uncomfortable with this feeling and that’s okay. I don’t know how long this will last, and I’m okay with that.” Tell yourself these things and mean them. It can be surprising how much this small act can help.

Workplace anxiety happens to everyone. But for those who experience it regularly, it’s not something you should push aside or ignore. Even if you feel stressed out and under pressure, it’s important to take time to manage your anxiety. Work is important, but it’s not worth your mental health.

 

By Laura Greenstein 

https://www.nami.org/Blogs/NAMI-Blog/February-2018/What-To-Do-if-Your-Workplace-is-Anxiety-Inducing