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

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.


Is It A Mental Health Problem? Or Just Puberty?

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:


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.

You Can’t Plan For Mental Illness

My 5-year plan after finishing high school was simple: graduate from college in four years, then begin graduate school directly following graduation. It was easy for me to imagine a 5-year plan at 18 years old when my toughest challenge at that point had been taming my frizzy hair.

My first two years of college were very successful. I made close friends, was hired by my college as a writing tutor and connected with teachers and administrators in the school district I wanted to eventually work in. I was right on track with my 5-year plan.

During my third year of college, however, the mass shooting occurred at Sandy Hook Elementary School. I felt a very deep connection to the event and in the following months, I noticed that I was on high-alert in public areas. I worried for my safety.

A few months later, I learned about the Boston Marathon bombing when I was in my college’s library. I immediately looked at the entrance to the library and wondered where I would hide if a shooter came through the door. A habit of making “escape plans” in my head became uncontrollable. I created them for any public place, and I avoided walking in open spaces and going out at night. Each night, I dreamt that I was trying to escape from a mass shooting; even in my sleep, I couldn’t shake this overwhelming fear.

Looking back, I can see the warning signs that I needed help. I didn’t tell anyone about the thoughts and feelings I was having because I didn’t want people to think I was “unstable.” Admitting to myself or to others that something was wrong could jeopardize my 5-year plan. I told myself that all college students felt this kind of stress, and that I’d feel better when the semester ended.

My junior year ended, but instead of feeling better, I felt significantly worse. I experienced severe panic attacks, paranoia and anxietythat made it impossible for me to drive, work or stay home alone. After I sought treatment with a therapist and psychiatrist, they recommended I check myself into a psychiatric hospital, so doctors could balance my medication, and I could learn skills to help manage my anxiety. I would be hospitalized five times, spending nearly three months in the hospital. My worst day was when I had to withdraw from my senior year. It felt like years of hard work just slipped away.

I questioned: Why didn’t I seek help sooner?

After my last hospitalization, I immediately re-enrolled in classes. I didn’t give myself the chance to heal because I wanted so badly to get back on track with my 5-year plan. Because I wasn’t working on my mental health, I struggled through two classes, and I wasn’t enjoying school like I did before.

One day, I finally accepted that if I kept putting my education before my mental health, I could risk having another breakdown. I decided to take medical leave from school; I needed to focus on my mental health and regain my strength and confidence. For the next two years, I attended therapy, worked with my psychiatrist, adopted a psychiatric service dog, discovered skills to help me cope and practiced self-care. Eventually, I felt like myself again.

So, I began college again last year. This time, I felt ready. I will be graduating this December with a B.S. in Community and Human Services. The deadline of my 5-year plan has long passed, and my life has not gone as I planned, but I am happy, healthy and have a mission to end the stigma surrounding mental illness. Battling mental illness and maintaining mental health is an ongoing part of my life, but the struggles I faced have put me on the path I’m meant to be on.

For example, I recently became a young adult speaker for NAMI Ending the Silence. I travel to high schools to share my journey with mental illness and talk to students about mental health and stigma. The experience has been life-changing. For years, my goal has been to help people, and through NAMI Ending the Silence and blogging, I am making a difference. I believe that talking openly about mental health issues will end stigma and lead to more effective treatment for mental illness.

Please, if you’re experiencing symptoms or warning signs of a mental illness, seek help as soon as possible. Your mental health is farmore important than your 5-year plan. I’ve learned that college can wait—treating mental illness cannot.


Allie Quinn is a mental health blogger, public speaker, and young adult presenter with NAMI’s Ending the Silence. She works to educate people about the realities of living with a mental illness and raises awareness about the use of psychiatric service dogs. Allie’s mental health blog is Redefine Mental Health

How Schools Can Help Students Respond To Suicide

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.


Ensuring Your Child Is Supported At School

At least 1 in 5 school-aged children is affected by a mental health condition. The two most common conditions among children and adolescents are anxiety followed by depression, but children can have other difficulties that affect their ability to fully take part in and benefit from their classroom experiences. These include attention deficit-hyperactivity, autism spectrum disorder and eating disorders.

Many children can also suffer from emotional reactions to the strain of learning issues, medical illness, family financial struggles, personal problems or other stressors. While not all mental health problems directly affect students’ academic or school functioning, many do, and schools can help.

If your child’s mental health condition is affecting their functioning at school, your first step should be to identify their condition with either a mental health professional or pediatrician and present this diagnostic information to the school.

With younger children (grades K-5), it may make sense to start with your child’s classroom teacher, while with middle or high school students, it’s usually best to start with the school’s health and wellness specialist. Virtually all public and private schools have at least one person who handles student mental health concerns—generally a guidance counselor, social worker, nurse or psychologist. And keep in mind that by law, schools are required to offer some level of accommodation to students with mental health needs; the nature and extent of that support will depend on your child’s particular condition and the resources at the school’s disposal. Your child’s school may have more resources than you might imagine, depending, of course, on your child’s age, condition and particular school setting.

Your next step will be to call a meeting with that designated specialist—or, if the issues have risen to a significant level, with a broader team that includes teachers and other school personnel.

Most parents get nervous meeting with school officials when their child is having behavioral or emotional problems. To support your best state of mind, consider having your child’s other parent or another close relative accompany you to the meeting. If your child is working with a mental health professional, see whether it’s possible to invite this person to the meeting as well. It can be extremely helpful to have an objective observer/expert/advocate with you!

Your partnership with the school is a key ingredient in ensuring that your child receives the support he or she needs. So, here are some tips for forging an effective alliance:

    1. Be honest, direct and specific. Most school personnel will respond with compassion and eagerness to help if they understand what is happening with your child and feel you are leveling with them. If you are vague, or appear to be holding back information, it will be harder for them to understand, and they may be less sympathetic.


    1. Ask questions about what teachers are seeing at school. Don’t assume they’re seeing what you see at home. Some children hold it together all day and then melt down as soon as they get home. Conversely, some children seem fine at home but can be disruptive, distracted or unhappy in classroom environments. Ask your child’s teachers about how your child presents at school. Don’t assume you know the whole story any more than you would assume they know the whole story.


    1. If you’re not sure where the best resources are within your child’s school, request to attend a staff meeting. Talking in-person with the group of players who can support your child is often more effective than sending long, detailed email messages or chatting over the phone with a single faculty or staff member.


  1. Know the law regarding special education support. If your child’s teachers, counselor and other staff are not able to accommodate your child in a supportive way (or if you want to make sure the school system will continue to do so from year-to-year), request an evaluation to see whether your child qualifies for special education services. Under the Americans with Disabilities Education Act, or IDEA, mental illness is grounds for “special education” needs in public schools systems provided they interfere with your child’s ability to make expected academic progress. Even students whose mental health needs do not meet the criteria for IDEA may be entitled to more modest accommodations under Section 504 of the Rehabilitation Act.

There are few parenting experiences more difficult than seeing your child in emotional distress. It can be hard to think straight, and hard to believe that other adults will understand, care enough or know what to do. But your child’s teacher, guidance counselor or principal has likely encountered other students with similar issues and most educators would be naturally inclined to accommodate, include and support your child. And it’s their job to do so. Your job is to enlist their help.


Deborah Offner is a clinical psychologist, school consultant, and former dean of students at a Boston, Massachusetts high school. In her adolescent psychology practice in Newton, Massachusetts, she works directly with students and their parents. She also consults to school and college counselors as well as faculty, school leadership, and parent groups about student wellness and emotional health. Learn more about Dr. Offner at www.deborahoffnerphd.com.


Learning To Change In Order To Heal

I was 21 years old and living in France. I had just graduated from college and was living near Paris when the symptoms began. I didn’t understand what was happening to me. I had never heard of mental illness; I did not think mental health existed. All I knew was that I couldn’t control what I was feeling.

I couldn’t sleep; yet, I also couldn’t get out of bed. I just wanted to stay in the dark with the covers pulled over my head. I became highly sensitive to light and sound. I thought people who approached me were going to strike me, because I was bad and deserved to be hit. Nothing made sense.

I felt as though I was wearing a lead cloak. The weight of it was crushing, as was the sense of guilt and shame I felt for a failed relationship. Waves of panic would wash over me. I was positive I was being persecuted. This person from my past was going to find me and kill me—I was sure of it. Sometimes I felt as though I was floating above myself, watching myself. I would later learn that this was a severe sign of mental illness called dissociation.

I came back to the U.S. for urgent medical treatment. I was diagnosed with major depression and schizoaffective disorder, a condition characterized by a disconnect from reality which accounted for the paranoid delusions.

The diagnosis of depression caught me by surprise. I never saw it coming because I was completely ignorant about mental illness, as was everyone else in my life. Sure, I had been sad for a long time. I had immigrated to the U.S. at the age of 13. I did not adjust well as I just didn’t know how to make new friends. So I kept to myself, with my nose in the books.

I thought I would go through my entire life like that, feeling lonely and disconnected. For me, this was normal. It never occurred to me to ask for help because I didn’t think I had a problem. I just bottled up my emotions. But after eight years, it all came out in a dramatic implosion while I was in France.

My psychiatrist put me on an antipsychotic and an antidepressant, which worked to relieve my physical symptoms. But the emotional wounds took years to heal.

I went to therapy twice a week. I had a lot to say to my therapist and psychiatrist—things I never thought I could tell anyone else, because I didn’t think there was anyone I could count on. I trusted no one even though I had a support system and a caring family. I didn’t notice my support system, which is a big distinction. I still felt all alone.

Therapy saved my life. My therapist told me that many of the belief systems I had grown up with and internalized were not correct and were, in fact, hurting me. I had to be willing to accept that I may be wrong. I had to change.

For therapy to work, you have to be open to change. You have to accept that your way of thinking may be wrong and that your beliefs may be what is making you sick. You have to change your ways to make healthier choices if you are going to get better. I am proud to say that I changed.

In addition to therapy, I also needed (and still need) to take medication every day (and for the rest of my life). I will always have a chemical imbalance in my brain, and I am grateful for the medicines that exist to correct it. At first, I struggled with this dependency. I didn’t want to be dependent on medications. I didn’t want to depend on anything. But my blind psychologist taught me about dependency.

“Listen,” she told me. “There is nothing wrong with dependency. I cannot even pick out my own clothes or drive myself to work.” She had an assistant who did that. “I have this dog to lead my around.” She had a Seeing Eye Dog.

“I must depend on this dog and my driver to get me to work. Without them, I wouldn’t be able to do much. I depend on them and that is not a bad thing.” I started to see how by accepting her dependencies, my doctor was able to not only work, but be a very effective therapist. And her acceptance of her dependencies helped me accept mine.

I never again want to feel the way I felt in the throes of my depression, so I take my medication religiously and attend to my emotional health diligently. I do the work to take care of myself. But I don’t otherwise think about my mental illness, or, until recently, talk about it.

Even though I have been living with my mental health condition for 20 years, I only recently learned about NAMI and their resources when doing some online research. I signed on to be trained for their presentation programs and have become a speaker in the NAMI Ending the Silence and NAMI In Our Own Voice educational programs.

The more I talk about my mental health conditions, the less I fear other people’s judgement and the more I realize the power my example may offer to others. I feel I am making a meaningful impact. The more visible examples of people living well with mental health conditions, the less the associated stigma will be and the more people will be willing to get help early.

I don’t know if I am unique, but I don’t feel limited in any way by my mental health condition. I lead a full life. So, I have moved on to the next phase of my recovery: advocacy. I’d like to be an example of how a diagnosis of mental illness does not have to be devastating. It can be a turning point to a better, self-examined life.

After recovering from a major mental breakdown at the age of 21, Melisma Cox earned two master’s degrees and served as a Fulbright Scholar.

Preventing A Generation From Struggling In Silence

We all know that education is incredibly important for a child’s development. But did you know that the time between toddlerhood and the teenage years (also known as “middle childhood”) is actually the best period for learning? According to anthropologist Benjamin Campbell, the human brain during this time is “organized enough to attempt mastery, yet still fluid, elastic, neuronally gymnastic. “In other words, the brain is developed enough to understand information and absorbent enough to retain it—often for life.

Some parents capitalize on this time by teaching their child a second language, while schools teach the dangers of drugs and alcohol or the benefits of healthy eating and exercise. Kids in middle childhood are fed a great deal of information in the hopes of teaching them life skills and healthy habits while their brains are ripe for learning.

But a critical piece is missing from all this information, something that many parents don’t know how to teach their kids, something that isn’t part of most school’s curricula: mental health.

We cannot forget about mental health. Parents, teachers, all of us should focus on providing youth with the resources and information they need to get help if they are experiencing mental health issues or having thoughts of suicide. To do that, we need resources like NAMI Ending the Silence.

What We Learn Becomes Who We Are

NAMI Ending the Silence (NAMI ETS) is a free, 50-minute presentation/program that helps middle and high school students understand mental illness. The program teaches them common warning signs and when, where and how to get help for themselves or their friends. “We’re just trying to prepare young people so they know that they can talk to somebody about what they are feeling and reach out to a trusted adult for help,” says NAMI ETS Program Manager Jennifer Rothman. “Educating students about what mental health conditions are, what they look like and what kind of symptoms you might see is the key to prevention and early intervention.”

Early intervention is essential to improving long-term outcomes for young people with serious mental illness. Once a student, administrator or family member viewing this presentation learns how to spot the warning signs of psychosis or other severe symptoms, they will know what it is and how to intervene.

The program also helps young people become more understanding and empathetic toward those who struggle with mental illness. During the presentation, they hear the reality of what having a mental health condition is like directly from a young adult with lived experience. By teaching kids to be more empathetic, we are building a generation wherein stigma will lose its power.

Take, for example, an excerpt from a student’s thank-you letter to her class’s NAMI ETS presenters:

“Your presentation had a huge impact on us, and that’s not something that happens often with high schoolers and guest speakers. Personally, I cannot relate, and I am grateful to currently not have any mental illnesses. But my friend has been dealing with depression and it is usually under control, but she goes through periods of time where it gets worse, and she feels like no one is there for her. I’ve tried to do my best to help her, but I had no idea what it was like to feel that way. Thank you for giving me perspective on how horrible these issues can be, and what to do when these situations arise.”

This is why NAMI Ending the Silence should be more accessible and widespread—so millions of teenagers will know how to help themselves and their loved ones now and in the future. NAMI has been expanding this vital program nationwide with the help of Tipper Gore, a former second lady of the U.S., who gifted NAMI $1 million to support this effort.

Proving Why Students Need NAMI ETS

Getting NAMI Ending the Silence into schools can sometimes be a daunting process, which is why in 2015, NAMI started the research needed to apply to the National Registry of Evidence-Based Programs and Practices (NREPP) with the Substance Abuse and Mental Health Services Administration. Rothman explains that when programs have a designation as an evidence-based practice (EBP), it “shows that the program has validity and actually works.”

To achieve the goal of gaining EBP status, NAMI conducted studies throughout 2016. In the first study, 10 schools from five different areas of the U.S. participated. Altogether, 932 students took a three-part survey measuring their knowledge and attitudes related to mental illness. Half of the students then viewed NAMI ETS, while the other half did not. The results found that knowledge and attitudes improved for the NAMI ETS group and stayed elevated weeks after the presentation. The non-NAMI ETS group stayed the same.

These results were consistent across different studies, different presenters and different schools, and among the diverse populations within those schools. The studies suggest that NAMI ETS is consistently effective in improving students’ knowledge and attitudes about mental health conditions and in recognizing help-seeking behaviors. With these impressive results, NAMI has completed its application to NREPP and is awaiting a reply in 2018.

Making An Impact

If we fail to teach the younger generations about mental health, they may struggle alone rather than talk to people who can help them. They may feel ashamed for what they experience rather than know it’s not their fault. They may even take their lives.

Suicide is the third-leading cause of death for people aged 10–14 and the second leading cause of death for people aged 15–24. We cannot ignore these facts, so we must better equip students with the tools needed to ask for help.

And rather than have a mental health specialist come in and talk to students post-tragedy—as is often the case in communities around the nation—NAMI ETS aims to prevent these tragedies from happening at all. With NAMI Ending the Silence, we are working to prevent a generation from struggling in silence.

By Laura Greenstein


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

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.

The Double Standard Of Mental Illness

Mental health conditions are not the only illnesses to suffer from stigma: AIDS, leprosy and obesity are others. However, Princess Diana shook hands and shook the world at the same time. Antibiotics took care of leprosy and obesity receives a lot of attention from the media. But mental health…it still languishes in the shadows.

It receives occasional celebrity glances, but I feel like these campaigns actually move mental health further away from understanding. The answer is not more exposure to mental health, but more education. First Aid, CPR and sexual education can be found in schools, gyms and offices. Yet CBT could be mistaken for a television channel and mindfulness still invokes eye-rolling.

Everyone should be minding their own mental health, but it’s also important to know the signs in others—which is hard to do if you don’t know what you’re looking for.

If a family member walked into your living room, bent over in pain and screaming for help, what would you do? You would help, of course. And generally, you’d know what to do. If you saw blood, you’d try to stop it. If the person was choking, you’d open their airway. You wouldn’t be performing surgery if that was required, but you could call a doctor or drive them to a hospital or go to a pharmacy and get painkillers.

But with mental health, the picture is so different. We don’t do any of the above. We generally ignore the symptoms, often only seeing them in hindsight. Then we say, “Cheer up!” “Things aren’t that bad!” “Look on the bright side!” In the same way that these phrases will not cure a burst appendix, they can’t cure a bout of depression either.

For the most part, but by no means always, a person experiencing mental illness will present as withdrawn, detached or dissociated from reality. But because they’re not screaming in pain or doubled over, we think (misguidedly) that a few feel-good phrases are the best medicine. But the real best way to help when you see these behavioral changes—no matter how subtle they may be—is to recognize that this is the scream you’re looking for. It’s silent, so you must be on high alert, but just like stroke symptoms, the faster you act, the better the outcome is going to be.


Sympathy and empathy is always with the person experiencing the mental illness. And rightly so. Mental illness often feels like being at the bottom of a well you cannot climb out of. And like any illness, you feel sick. Some days, you feel sick every minute.

But there is an army of people struggling as well because mental illness is one of the hardest, most frustrating, most guilt-inducing illnesses to care for. Every caregiver berates themselves for the time they lost their temper, their patience or their cool. Not to mention the guilt and the unease that travels with them every time they leave the house or if their phone rings unexpectedly—the permanency of being on edge, the constant companion that is worry.

But most of all, every caregiver carries the same gnawing question: What if they could have caught their loved one’s illness sooner? What if they missed something—a clue, a sign?

Caregivers and individuals are somehow both expected to recognize symptoms, understand them and then get ourselves or our loved ones the right kind of help in an area of medicine where even the professionals seem to struggle to diagnose clearly. But how can we do that if we’re not properly educated first?


Michelle Walshe teaches teenagers in a College of Further Education in Dublin. This is a full-time job, inside and outside the classroom. Any spare time she has, she spends reading and writing. Michelle has had a number of articles published in the national media in Ireland. She’d lived in America, Australia, Switzerland, Germany and Morocco but home is where her family is and that is Ireland. Michelle has spent the last year taking care of her mother, who experiences bipolar disorder. Check out her blog at www.thesparklyshell.com.


LGBT people are prone to mental illness. It’s a truth we shouldn’t shy away from

almost didn’t write this. It wasn’t from not wanting to. I cradled my head in my hands, desperate to contribute to the reams of social media positivity I had seen surrounding Mental Health Awareness Week.

I almost didn’t – couldn’t – because I was depressed.

There came a certain point in my experience of being LGBT where I accepted that I had to be strong and uncompromising in the face of disapproving glances and withering remarks. I made a pact to throw myself into my community with zeal, no matter how exhausting, and to make full use of the privileges I was afforded in the tolerant metropolis I’d landed in.

And yet, for some reason, I find this an incredibly difficult attitude to transfer over to my struggle with depression. I will share with my co-workers that I am going on a date with a man or going to an LGBT-themed event with an almost belligerent pride, but am overwhelmed with fear in having to admit to those same people that I’m leaving slightly early to see my therapist or that I need to take some time off due to another episode.

Indeed, the word “depression” still has a bite to it, in the way that the word “gay” did when I first dared to say it to someone else in reference to myself. The tone of my voice takes on an odd quality as I approach it in a sentence, to the point where I sound intolerably meek by the time “depression” tumbles out.

The thing is, in many cases, mental illness and being queer go hand in hand. It’s an uncomfortable but important reality that LGBT youth are four times more likely to kill themselves than their heterosexual counterparts. More than half of individuals who identify as transgender experience depression or anxiety. Even among Stonewall’s own staff, people who dedicate themselves to the betterment and improved health of our community, 86% have experienced mental health issues first-hand. It’s a morbid point to make, but it makes perfect sense that we, as a community, struggle disproportionately.

At a recent event I attended, set up to train LGBT role models to visit schools and teach children about homophobia, no one explicitly mentioned their struggles with mental illness. We told one another stories of how we had come to accept ourselves in the face of adversity, talking in riddles about “dark times” or “feeling down” or being a “bit too much of a party animal”. But these problems have other names – depression, anxiety, addiction – that we consistently avoid, despite being in a community in which a large percentage of us will have undergone similar experiences.

And this phenomenon replays itself over and over. Despite there being a common understanding between me and my queer friends that we’ve probably all been vilified in the same way and made to feel a similar flavour of inadequate, we will rarely acknowledge, even within the safe boundaries of friendship, that this has had a lasting impact on our ability to maintain a healthy self-image.

But part of being proud of who we are as LGBT people is being able to be open about the struggles we’ve faced. It’s in naming and wearing the uncomfortable badges of anxiety, depression and addiction that we take the first step towards fully accepting mental illness as an important part of our collective identity. After all, how can we be true role models to the next generation if we refuse to tell the whole story?

And so, this Mental Health Awareness Week, I’m issuing a challenge to my community. If you are LGBT and suffer from a mental illness, be defiant in your acceptance of it in the same way that you would about your sexuality or gender identity. Bring it up, speak it out and feel sure that your voice, however seemingly small or insignificant, is a valid one. After all, we have been, and will always be, a community of fighters – it’s about time we dared to show our battle scars.

By Alexander Leon