Tag Archive for: CARE Counseling

Talking To Kids About Mental Illness

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By Kathleen Boros | Nov. 16, 2018

 

In my children’s book about mental health awareness, Binky Bunny Wants to Know about Bipolar, Binky Bunny sees Mama Bunny sleeping a lot and wonders why she won’t wake up and play with him. When he asks his mom what’s wrong, he learns about bipolar disorder.

Binky learns that Mama Bunny loves him very much, but she needs her naps to function from day to day. It’s not that she’s avoiding Binky, or the chores that need to be done around the house; she wants to work and play, but she was born with an invisible illness in her brain that slows her hop.

Binky learns that he needs to work with his father to help Mama Bunny feel better. He doesn’t want bipolar disorder and its symptoms to keep her from experiencing life’s everyday gifts. Now educated and engaged, Binky is determined to help his mom live in an environment where she can heal.

This book is my way of showing how important it is to talk with our children about all aspects of mental health—including mental illness. As a parent with a diagnosis of bipolar disorder, I’ve already started a dialogue with my 8-year-old son to help him get a better grasp of what’s going on with me. I believe I was given my illness for a reason, and I’m not going to keep quiet about it, especially with my son.

I don’t believe in hiding behind stigma and just telling him I’m tired. I’m upfront and honest, because I believe if we want to live in a society free of stigma, we have a moral obligation to educate our children.

Keep Your Kids In The Loop

As soon as children are old enough to understand that mommy or daddy isn’t “like the other mommies or daddies,” it’s time to have a talk. It’s OK if they don’t understand right away. Every day is another opportunity for more education. Have a recurring family meeting or a set, consistent time when you all sit down and have a candid conversation about mental health. This will provide repeated opportunities for discussion and for your children to ask questions.

My family does this pretty informally. When my husband and I are together at the end of each day, we ask my son how his day was. This is a perfect opportunity to let your child know if you’re having a good day or if you need a little extra help. For example, on a day when loud noises might be bothering me, I might ask my son to keep it down for me and explain why.

Also use this time to explain how your mental illness is currently affecting your daily routine. If you’re a parent with a mental health condition who needs to be alone or take naps to recharge (like Mama Bunny and me), kids might be worried there’s something wrong with you, or worse, that you don’t want to spend time with them. Make sure they know nothing could be further from the truth. It might not be every day you have to sleep in or take naps, but if you have a particularly sleepy week, reassure your children it’s not something you’re doing to avoid them. Taking a nap is sometimes like taking a shower—just a part of daily hygiene.

Answer Their Questions

I know I don’t have all the answers, so if my son asks me something I’m unsure about during our talks, I’ll seek resources from my doctor or local library. If I need to explain something about mood, depression, mania or hospitalization, I’ll try to find something age-appropriate I can read to my son. But there really isn’t a lot of reading material about mental illness for children. So, I’ll often write down his questions and bring them to my next appointment so my doctor can give detailed, kid-friendly explanations I can bring home.

A few times, I’ve set up appointments for the two of us or our whole family to visit my doctor. My family finds this very helpful because no matter how much research we might do on our own time, bipolar disorder is different for everyone who experiences it. No two people with the same diagnosis have identical symptoms or express their illness in the same way. So, it’s great when my family can get together to talk to my mental health professional, who helps me with my illness, about how we can all cope together as a family. When we leave, we feel like we’re all on the same page.

Be Honest About Medication

This might not be a popular opinion, but I think children should also be informed of the medications their parents are taking. Medications for depression cause certain side effects, while medications for psychosis cause other side effects and medications for anxiety cause different side effects still. I think it’s important for children to know what to expect.

And it’s OK to tell children that having to take medication for your illness is something not under your control. Just like how they need shots to stay healthy or take antibiotics when they get sick—with mental illness comes medication. We might not like it, but we need it.

Keep The Conversation Going

Teaching kids about mental health should not stop once they leave the house. School is an important place for them to learn more, and school counselors and teachers should have resources about mental illness and suicide. It’s also beneficial for a child to have a non-biased counselor to talk to if they have questions they don’t feel comfortable asking you, or if they’re having mental health concerns about themselves.

A great resource for schools is NAMI Ending the Silence, an in-class presentation in which students learn about mental illness from someone with lived experience. Having conversations and learning about mental health in school will only reinforce the information you share with your child at home. The more education your child receives about mental health, the more important it will seem.

As parents, we’re not mind-readers, and we can’t afford to pretend we are. That’s why it’s so important to communicate with our children about mental illness—even if it’s difficult to talk about or explain. We never know what they might be thinking, and it’s only fair to you and your children to be honest about your mental health.

I wrote my children’s books about bipolar disorder because my son was starting to ask questions, and I’d rather he learn from me about mental illness than the callous things he might learn from those who aren’t educated.

I’ve seen amazing ripple effects since starting our talks: My son now educates others on the topic. He has tools in his toolbox to use if someone says something about mental illness he knows isn’t true.

To help end stigma, we need to start with our own children. So if you’re a parent living with mental illness, fill your house with love and mental health awareness. Don’t procrastinate, educate. And feel free to use Binky Bunny. Together, we can all hop to stop stigma!

 

Kathleen Boros is originally from Massachusetts and was brought up in Florida. She’s been married for 15 years and has an 8-yearold son. She was diagnosed with bipolar disorder at 19 and is now 41. She received a bachelor’s in behavioral science and a master’s in special education. She enjoys writing to educate children and their families about mental illness. Join her efforts to educate children on mental health with Binky Bunny.

https://www.nami.org/Blogs/NAMI-Blog/November-2018/Talking-to-Kids-About-Mental-Illness

Avoiding Holiday Stressors: Tips For A Stress-Free Season

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By: Jessica Maharaj

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

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

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

Major Depressive Disorder With A Seasonal Pattern

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

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

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

Grief Over The Holidays

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

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

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

Managing Holiday Expectations

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

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

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

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

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

Tips For Successful Family Therapy

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For most my life, my mom and I have had a turbulent relationship. Vague reassurances from others that “everyone has family problems” never helped with our nonsensical fighting or how I felt. I never knew what to do, but I knew it had to stop.

Family relationships are sometimes responsible for life’s biggest conflicts. They’re often complicated and can span decades. For many, it’s the steady drip of unresolved arguments and personality clashes that leave lasting feelings of resentment and bitterness. But there is a way to work through this. There is a hopeful course of action—it’s called family therapy.

Giving It A Chance

Family therapy is a collaborative and inclusive process which focuses on the family as a unit. Family therapists are skilled in dealing with a variety of conflicts whether it involves communication issues, estrangement, financial problems, divorce, a death in the family and more.

There might be a time before starting therapy when you won’t want to go. I certainly didn’t. My mom certainly didn’t. The pains of having to sift through years of battles wasn’t appealing. But without confronting the past, we are bound to repeat the same mistakes. Therapy may lead to the resolution you’ve been searching for. It’s important to give it a chance.

Finding The Right Therapist

I knew that the family therapist I chose was effective because within our first few sessions, I felt comfortable. I knew I would be able to open up to her. And I never dreaded talking in session. She also brought up Narcissistic and Borderline Personality Disorder in regards to my mother. This helped me to trust my therapist and her expertise even more, because she was able to spot that early on.

If you feel that a therapist is not effective, it’s okay to keep looking. In my experience, most therapists don’t take it personally. In fact, they encouraged my family to find the right fit for us. Your comfort level and ability to open up are essential in a therapeutic relationship.

Over time, your therapist will learn your family’s communication style. Some families are louder than others, while some fill the minutes with silence. Certain family members may be withdrawn at tense moments, while others might be aggressive. Your therapist will be see these differences and guide each of you accordingly.

How To Have Effective Therapy Sessions

A typical therapy session is 50 minutes, once a week. It’s a short amount of time to work through a lot of issues among multiple people. In order to best use your time with your therapist, here are a few tips to have effective sessions.

  • Prepare prior to therapy. Each family member should jot down questions or issues they would like to discuss.
  • If there is one family member you don’t get along with, carefully decide what you’ll say to them when you have your chance to speak.
  • Remain strong and respectful.
  • Speak calmly.
  • Try not to argue.

You may feel as though your family will never resolve long-standing conflicts. But it is possible. With listening and restraint, your family can reaffirm its bond and clear up old disagreements and hurt. Or you may decide it’s time to move on. For me, the decision to lessen contact with my mother, while controversial to some, was the right choice. I am no longer consumed with guilt about not being able to get along. Without therapy, I know I would still have an extremely close and volatile relationship with her.

Because it was such a positive and powerful experience for me, I always recommend family therapy to others. Even the more exhausting and uncomfortable sessions were necessary. Without them, I wouldn’t have been able to identify toxic patterns of behavior, understand my depression, or take control and realize what I needed to do in order to change my life.

There is nothing to fear about family therapy—it’s a safe place to work through negative feelings and move forward. Any decisions you make with your family will be based off careful discussion and thought. When I look back now, I know I wouldn’t have made the same choices without the support of my therapist.
Amanda C. Dacquel is a mental health writer and advocate. In 2014, she started TheCurrentCollective.com to share mental health experiences, resources and news. You can connect with her at AmandaDacquel.com.

Holiday Magic Is Made By Women. And It’s Killing Us.

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I have yet to send out my Christmas cards this year, but the various steps necessary to complete this task have been weaving through my mind for months. I booked a session with a photographer at the end of August. I picked out and shopped for outfits for the entire family in October. In November, the actual photoshoot took place, but not before a flurry of back-and-forth emails deciding on time and place while factoring in the weather.

The photos will be in soon. Perhaps there will be a clear winner, but the most likely scenario is that I will spend hours deciding which child’s “weird face” picture is the most palatable to send to grandparents. They can never just smile, no matter how much coaxing and bribing is involved. Then I will spend time carefully picking out the right photo card and figuring out just the right holiday message before ordering. I’ll have to check my address book, contact a handful of people for updates, decide who is getting a card, order stamps, hand-write addresses until I have carpal tunnel and lick envelopes until my tongue is swollen.

Of course, I could forgo this emotional labor and take the cards off my list entirely. It would free up a little mental space in an already hectic time, but it would also come with the consequence of disappointed relatives. I know because I actually did skip the holiday cards one year. My elderly aunt was heartbroken not to receive one. My husband’s grandparents were left without a set of great-grandchildren pictures to hang on the mantle. I had failed not only in the emotional labor of orchestrating the Christmas card, but also in considering the expectations and feelings of others.

“Women already perform the bulk of emotional labor … but during the holidays, this work ramps up.”

Women already perform the bulk of emotional labor ― the psychological phenomenon of unpaid, often unnoticed labor that goes into keeping everyone around you comfortable and happy. But during the holidays, this work ramps up. There are more mental lists to juggle, more commitments on the calendar to keep track of, more tasks to delegate. There is more pressure to make things magical for those around you. It takes a lot of unseen and underappreciated effort to keep everything humming along smoothly.

Melody Wilding, a licensed social worker and coach who helps clients overcome challenges like emotional labor, says that a tendency to put too much on our plates and let self-care slip is often par for the course during the holidays.

“Putting pressure on yourself to have or create the ‘perfect holiday’ can send your stress skyrocketing, and overcommitment can quickly lead to exhaustion and burnout,” she told HuffPost.

How to manage the stress of emotional labor this time of year

I certainly try to keep self-care in mind during the holidays, usually taking on a yoga routine and drinking lots of decaf green tea to combat the stress. But the overwhelm still gets me. While it’s up to my husband to put up the lights and trim the tree, the vast majority of the holiday planning falls to me.

It’s me who puts the parties and potluck dishes on the calendar, keeps track of the winter coat drive, plans the get-togethers with both sides of the family, expends the mental energy of figuring out gifts for everyone. It’s exhausting, and seems unending (at least until after the new year rolls in). Normally this level of productivity would make me feel like a rockstar, but during this time of year, it simply feels like I’m falling short.

Experts say that this type of intense pressure can lead to perfectionism ― and in its most extreme form, perfectionism can be associated with mental health issues. Research has linked perfectionism with anxiety, depression and even thoughts of self-harm.

“Question the voice of your inner critic that says you’re not good enough.”

– MELODY WILDING, LICENSED THERAPIST

I’m not one to strive for perfection, but during the holidays it’s so easy to point out those spots where it would be feasible for me to do more. We could go chop down our own Christmas tree, but I’ve never actually gone ahead and planned a trip. I could learn to use my sewing machine and make a festive table runner and napkins. I could make a beautiful gingerbread house from scratch if I really tried hard. I find myself thinking I’m probably doing enough, but I feel like I could be doing more.

Wilding says a solution to that irrational feeling might be stepping slowly away from Instagram. It’s advice that makes sense: Studies show excessive social media use is linked with increased feelings of loneliness, anxiety and depressive symptoms.

“Social media makes it seem like everyone else’s life is perfect and enchanted … except yours,” she said.

Wilding recommends taking the time you’d otherwise spend surfing Facebook and use it for more restorative activities (so probably not baking gingerbread houses from scratch, unless you’re really, truly into that sort of thing). There is plenty of emotional labor to be done without seeking out more. It may be best to reevaluate what you do, drop some commitments and choose to only do the emotional labor that you genuinely value.

“Question the voice of your inner critic that says you’re not good enough,” Wilding said.

That voice is usually wrong, Wilding stressed. So when it crops up, head in the opposite direction.

“Don’t be afraid to drop a ball, or two,” Wilding said. “You’ll discover the world won’t end, and in fact, will encourage other people to start picking up their share of responsibility.”

By Gemma Hartley

https://www.huffpost.com/entry/emotional-labor-holidays_n_5a1ec905e4b0d724fed5588a?utm_campaign=hp_fb_pages&ncid=fcbklnkushpmg00000063&utm_medium=facebook&utm_source=main_fb&fbclid=IwAR0czvI9P_3Khih3_59bBKT1m8_1ob_yazA93IyMpU68ws80BHaSYGyalpw

Getting Older Veterans Proper Care

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In an era of ongoing armed conflict, the impact of posttraumatic stress disorder (PTSD) is more widely recognized than it was 40 years ago when veterans were knee-deep in the atrocities of the Vietnam War. In fact, PTSD wasn’t even recognized as a mental illness until 1980.

While the disorder is more visible today, we usually only see young, male veterans representing all veterans experiencing PTSD. But there’s still a large population of Vietnam veterans who have been struggling with PTSD symptoms for over four decades, often with little support.

A recent article by The Family Institute at Northwestern University highlighted the ongoing impact of PTSD in older veterans, and how we can ensure they receive the unique types of support and interventions they need.

What Older Veterans Need

Diagnosis has typically been delayed in older veterans, which means some have been struggling for decades. These heroes face age-related events that could trigger an exacerbation of symptoms—like retirement, the loss of a loved one or changes in health.

Due to their unique needs, some experts suggest older veterans might benefit from a counseling approach that integrates the following:

  • An approach that embraces the veteran’s story and affirms their feelings
  • Technology that increases access and decreases isolation (such as telehealth)
  • An affirmation of the realities of both the trauma and the resulting symptoms of PTSD
  • Peer support

Encouraging older veterans to embrace the benefits of therapy and counseling can be a challenge, so they may prefer to work with professionals who were/are also a member of the military in order to feel a sense of camaraderie.

Delayed-Onset PTSD In Older Veterans

About 31% of male American veterans who served in Vietnam experienced PTSD at some point in their lifetime, according to the National Vietnam Veterans Readjustment Study. A 2013 study on the long-term effects of the conflict found that approximately 1 in 10 veterans who served in Vietnam experienced PTSD 40 years later.

This is called delayed-onset PTSD. Although most people experience symptoms of PTSD within a few months after a traumatic event, sometimes it can be years before someone experiences the full spectrum of their symptoms.

Dr. Dawn M. Wirick, daughter of a Vietnam veteran and a veteran herself, counsels older combat veterans and has seen the effects of delayed trauma: “What they end up telling me is down the road, when they retire, once they aren’t so busy, they start having recurring nightmares.”

There are a variety of complex factors that can lead to delayed-onset PTSD. Some of the main reasons why it was so prevalent among Vietnam veterans were:

  • They were drafted
  • The conflict itself was highly unpopular (so they were reluctant to talk about it)
  • The troops were often treated poorly when they returned home

Additionally, as is the case for most men, they were told to “man up” and be strong, so expressing sadness was viewed as a sign of weakness. In result, many veterans repressed their feelings. This created more complex psychological reactions to their time in combat, andrepressed feelings often find their way to the surface much later.

Older veterans need proper treatment to overcome these long-term effects of living with PTSD. Coming to terms with events that occurred decades ago is no easy task, but access to effective counseling can help validate what they are feeling, eliminate the sense of isolation and begin the healing process. Coming to terms with events that occurred decades ago is no easy task, but access to effective counseling can help validate what they are feeling, eliminate the sense of isolation and begin the healing process.

 

If you are a veteran in need of help or are concerned about a veteran in your life, visit the Veterans Crisis Line website or call their 24/7 hotline at 1-800-273-8255.

 

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

https://www.nami.org/Blogs/NAMI-Blog/November-2018/Getting-Older-Veterans-Proper-Care

Making The 2018 Mid-Term Elections About Mental Health

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Throughout NAMI’s history, mental health advocates have shaped laws, increased funding and promoted research to address the inequalities and injustices facing people with mental illness in our country. In the last two years alone, NAMI advocates sent hundreds of thousands of emails to Capitol Hill and made countless phone calls and visits to their representatives in nationwide efforts to pass mental health reform (the 21st Century Cures Act) and to stop dangerous health reform proposals that would have hurt people with mental illness.

We’ve made progress, but we still have further to go. NAMI’s members have an opportunity in the 2018 mid-term elections to vote more mental health champions into office. From district attorneys to county officials to governors to members of Congress, every elected official plays a role in determining what services and supports are available to people with mental illness—and there’s never been a better time to cultivate mental health champions.

NAMI members are instrumental in helping raise policymakers’ and candidates’ awareness of mental health issues by sharing stories that help make those issues real. The goal in talking with candidates is not to convert them—it’s to converse with them. As a nonpartisan, nonprofit organization, NAMI seeks only to educate politicians. This is how we develop trusting, invaluable relationships on both sides of the aisle, rather than being just another special interest group.

When speaking with a candidate, share a fact or two and let the person know how important mental health care is to you. Asking open-ended questions gives candidates a great opportunity to reveal their thoughts and share their visions for improving mental health care. Here are some policy positions that might help you identify whether a candidate is a mental health champion.

What Policies Should A Mental Health Champion Support?

1. Increasing The Availability Of Mental Health Services And Supports

Approximately 1 in 5 adults in the U.S. experiences a mental health condition, yet more than 60% of those adults go without treatment. We need more access to quality mental health services and supports, especially for underserved groups like our nation’s veterans and people living in rural and frontier areas.

How do you know if a candidate is committed to increasing the availability of mental health services and supports? Ask them how they would improve mental health care. A mental health champion would invest in:

• Expanding access to mental health care, including for veterans and people living in rural and frontier areas;

• Supporting health insurance protections that cover mental health care at the same level as other health care;

• Ensuring Medicaid coverage for people with mental illness based on income to make sure people can afford the care they need;

• Increasing supported housing programs that offer stable, safe and affordable housing for people with mental illness; and

• Growing supported employment programs that help people with mental illness get training, search for jobs and be successful in the workplace.

2. Promoting Early Intervention For Mental Illness

Approximately half of all mental health conditions begin by age 14, and 75% begin by age 24. Every young person who experiences a mental illness deserves to realize the promise of hope and recovery. And the quicker a young person gets quality services and supports, such as first episode psychosis (FEP) programs, the better their recovery outcomes.

Ask candidates how they would increase early intervention for mental health conditions. A mental health champion would support:

• Increasing FEP programs, which provide recovery-focused therapy, medication management, supported education and employment, family support and education, case management and peer support;

• Promoting school-linked mental health services for youth, which bring mental health professionals into schools to provide mental health care to students; and

• Integrating mental health care into primary care settings to increase early identification and treatment of mental health conditions.

3. Ending The Jailing Of People With Mental Illness

About 2 million Americans living with mental illness are jailed each year—mostly for non-violent offenses. Unfortunately, a person experiencing a mental health crisis is often more likely to land in jail than in a hospital. Mental illness should not be treated like a crime. Instead, people with mental illness who are in crisis should be diverted into effective treatment options.

Ask candidates how they would address the jailing of people with mental illness. A mental health champion would support:

• Expanding Crisis Intervention Teams (CIT), a community policing model that helps law enforcement divert people to mental health treatment instead of jail;

• Ensuring that mobile crisis response teams can intervene and effectively de-escalate mental health crises; and

• Increasing Assertive Community Treatment (ACT) teams that provide intensive, wraparound treatment and support to people with serious mental illness.

When candidates hear from NAMI members about the importance of mental health care, they listen. We need more elected officials like this who understand and support mental health issues—officials who are committed to funding the services and supports people with mental illness need to be safe, stable and on a path toward recovery. You can do your part by engaging in a dialogue with candidates and voting for people who will become tomorrow’s mental health champions.

Overcoming Stigma

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I was sitting alone in the hallway of the Carter Center conference area in Atlanta during the 2012 Rosalynn Carter Symposium on Mental Health Policy. I had just finished being a panelist and talking about how employment and education helped me overcome the stigma associated with my depression. The conference was still in session, so I had the hallway to myself. I sat quietly, reflecting on the fact that I had been invited to speak here as both a clinician working in community mental health and a person living with depression.

Two scenes flashed through my mind highlighting two very different points in my life: getting offered a job as a therapist at the mental health center where I completed my internship for my Master’s in social work, and sitting in a psych ward on the eve of my 18thbirthday, wondering if I would graduate from high school.

Persevering Through Depression

It took many years of perseverance for me to become that professional sitting on a panel at a national conference. Though I managed to graduate from high school, I dropped out of college at 19 as my depression worsened. I was unemployed, and my only income was Social Security disability. Years of failed depression treatments included medication and talk therapy.

I spent most of my time alone doing what I refer to as “stewing in my own depressive juices.” This lasted for 10 years. During that time, I was challenged by the symptoms of mental illness— insomnia, loss of appetite, lack of concentration, suicidal thoughts. After a decade of being unemployed and living on Social Security, I decided that for my own survival, I had to return to school and complete my social work degree. Of course, my depression was against this:

“You can’t go back to school; you will fail.”

“You won’t be able to concentrate enough to complete your assignments.”

“You’re too stupid to get a college degree.”

Somehow, I decided to talk back to these negative thoughts. My response was simple: “I’m just going to do the best I can.”

And I did. I got myself back to school and finished my degree in social work. Around that time, I also tried a different treatment for my depression, and it worked. Things got easier.

Today, I feel incredibly lucky to say that I am doing exactly what I want to be doing. But really, luck had little to do with it. Besides my symptoms of depression, I faced an additional barrier to school, employment and inclusion in general: unhelpful attitudes from well intentionedhealth professionals—in other words, stigma.

Learning To Reject Stigma

One mental health professional once told me, “Maybe you’re not getting better because you’re not trying hard enough.” Another warned me, “You might not be ready to go back to school full time. Shouldn’t you just take one class and see how that goes?” A psychiatrist decided, without asking for my opinion, that I should be sent to live in a group home for people with mental illness. (That did not happen, and that treatment relationship ended that day.)

These scenarios were fueled by the stigma associated with mental illness—stigma that ultimately serves to limit and exclude rather than encourage and include. Had I listened to those professionals, I might never have returned to school or entered the workforce.

So how did I overcome the stigma that I faced? I rejected it. Rejecting—or overcoming—stigma, whether it be self-stigma, public stigma or structural stigma, is one of the keys for those of us living with mental illness. This is not an easy task, to be sure, but it is becoming more possible and a bit easier as more and more of us of speak out about our mental health conditions.

 

After working as a therapist and witnessing the negative effects of stigma on clients and their family members, I decided to develop a stigma-reduction training curriculum called “Overcoming Stigma.” I spent several months reading every scientific article I could find about stigma research. Most of it simply documented that stigma exists (in hospitals, in psychiatry, in substanceusetreatment centers, in pharmacies, universities, employment, housing, etc.) and that levels of stigma have not changed over the last decade.

According to many studies, effectively reducing stigma pointed to one intervention: contact with someone successfully managing a mental illness. One shining example of this is NAMI’s In Our Own Voice (IOOV) program. People with mental health conditions share their powerful personal stories in this free 60- or 90-minute presentation. I decided to integrate elements of IOOV into the beginning of my trainings by briefly disclosing my own depression and giving a few examples of my experiences with stigma. The rest of the training includes a description of the seven most common types of stigma experienced by people with mental illness and substance-use disorders, research about the effects of these stigmas, ways to reduce stigma, and the clinical and agency assessment tools I developed.

I have presented Overcoming Stigma trainings in many different health care settings, and the curriculum continues to evolve, always guided by the latest stigma research. Recent research shows that stigma training needs to be ongoing instead of a one-time thing and, it likely needs to address many stigmas all at once.

My trainings get everyone involved in the discussion; I like to ask for anecdotes from attendees. Here are some real-life examples of stigma shared by health care professionals who have attended my trainings over the past several years:

• A cardiac surgeon said he would not do surgery on a person with schizophrenia because he didn’t think the person would be able to do the required follow-up care.

• A therapist shared that as a Ph.D. student, he was told he would lose his scholarship if he left for “depression” treatment but could keep it if he left for “medical” treatment.

• A mother puts off making an appointment for her daughter to see a therapist despite her daughter experiencing severe symptoms of anxiety because she doesn’t want her daughter to be labeled as “crazy.”

• A physician attendee said it was well known in her neighborhood that her son had been hospitalized with bipolar disorder and no one acknowledged this fact (much less offered any type of support).

• A mental health clinician working in an emergency room said doctors and nurses often referred to patients in the ER with mental illness as “her patients,” rather than “our patients.”

If I do my job well, attendees leave with the understanding that we all have a role to play in reducing these harmful kinds of stigma. Personally, I still experience stigma, but I am no longer limited by it. I sometimes even chuckle when I hear someone say something particularly stigmatizing because I immediately think, “Well, that’s going to be part of my next training.” That’s not to say it isn’t still discouraging to see or hear things that continue to perpetuate stigma, but for me, there is a feeling of freedom and power in being able to turn a potential lost opportunity into one that is gained.

 

Gretchen Grappone, LICSW is a trainer and consultant with Atlas Research in Washington, D.C. Her work includes projects with VA medical centers, community mental health centers and other health care settings around the country. She lives in New York City.

https://www.nami.org/Blogs/NAMI-Blog/October-2018/Overcoming-Stigma

Shutting Down Five Misconceptions About Depression

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

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

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

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

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

  1. “Are you sure?”

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

  1. “Have you tried yoga?”

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

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

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

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

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

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

 

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

Reflections On Medicine, Shame And Stigma

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As I was entering medical school, I found out that my mother had made a postpartum suicide attempt. I did not find out from her; it was shared with me in hushed tones by another family member who thought I should know, “now that I was going to be a doctor.” I was quite surprised by this information. And it made me sad to think that this wasn’t a topic she felt she could openly discuss.

Suicide is a challenging issue for all of us. Secrecy surrounds the topic, with shame as a common co-traveler. That’s why it’s an honor for me to be a small part of NAMI’s movement to make seeking help and support more acceptable. I’ve met many resilient people in the NAMI community who have overcome suicidal thoughts or actions. Often because there was a person who stood by them during a crisis or a new treatment approach that made a difference in their life. Some found sobriety for a co-occurring substance use disorder. Others found clozapine or lithium, which have been shown to reduce suicidal thinking. Some learned coping skills through a psychotherapy like cognitive behavioral therapy or dialectical behavioral therapy. Many found relief in the community of NAMI. Regardless of how, their suicidal thoughts or actions were talked about and changed.

My field sorely needs similar conversation and change. Doctors also have high rates of suicide and it’s a major issue that some of the doctors we turn to for care are often not taking care of themselves. We need to teach help-seeking behaviors in the medical and psychiatric fields. Doctors need the same support and encouragement to get help as their patients.

I lost a patient to suicide early in my psychiatric residency. This was a person with many strengths, who was also in tremendous psychological pain. I worried about him during off-hours and felt powerless to help at times. After I learned of his tragic outcome, I was upset, slept poorly and struggled at work for months. I was worried I had said the wrong thing or had failed in some way as an inexperienced psychiatrist. I seriously considered leaving the field and entering another specialty. I was lucky to receive support and empathy from my colleagues and supervisors as they encouraged me to seek therapy. I did my best to carry on, but I never forgot about this patient and his suffering.

Last year, at an American Psychiatric Association (APA) event, I was impressed that even doctors are wondering if they worry, struggle and stress too much. APA president Anita Everett reviewed the stresses that commonly consume doctors and announced that psychiatric wellness would be a core feature of her leadership. Dr. Everett’s thoughtfulness and openness on the stresses doctors face and her emphasis on help-seeking was powerful; her efforts have started many overdue conversations across the entire field of medicine. Unfortunately, the same shame that led to the secrecy around my mother’s postpartum suicide attempt is alive and well in the medical field.

Doctors don’t have all the answers for stress, mental illness and suicide—our most challenging aspects of being human. Medical culture needs to continually evolve and learn from the remarkable and resilient people like those I have met at NAMI. Facing your mental health challenges head-on and working to get help with a supportive community behind you is a key piece of NAMI culture. It’s a culture we can all learn from.

 

Ken Duckworth is medical director at NAMI.

https://www.nami.org/Blogs/NAMI-Blog/September-2018-(1)/Reflections-on-Medicine-Shame-and-Stigma

How To Have A Healthy Relationship With Social Media

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Social media has allowed society to become more connected than ever. Over three billion people around the world use social media to engage with others, access the news and share information. In the U.S. alone, seven out of ten people are active social media users.

Some would argue that social media is inherently bad for our health. Recent research explores the negative implications of social media, including sleep issues, an overall increase in stress and a rise in mental health conditions and addiction to technology. There are also concerns about cyberbullying and youth and teen safety online. Fortunately, tech companies are proactively addressing these types of concerns. For example, the recently released Parent’s Guide to Instagram helps parents who are “raising the first generation of digital natives, for whom the online world is just as important as the offline world.”

On the other hand, there are many benefits to social media. Young people today consider social media as platforms for sharing their voice and finding a community of like-minded peers. And users of all generations understand that with social media, you can celebrate milestones or reconnect with old friends and relatives.

Regardless of what type of impact we believe these digital platforms can have on us, we must be intentional in how we use social media. For example, as NAMI’s social media manager, I use social media as a tool to spread mental health awareness. Through my experience, I’ve learned several tips and tricks for having a healthy relationship with social media. Here are some you might find helpful.

Unfollow Unhealthy Accounts

It’s important to remember that, often, the images and stories on social media aren’t reflective of real life. Whether you follow friends, influencers, businesses or organizations, social media feeds are filled with carefully crafted, curated posts. Consider the following: Does your feed leave you feeling overwhelmed or less-than? Do you constantly compare your experiences with others? If yes—and you notice an overall decrease in your happiness, self-esteem and life satisfaction, it’s time to make a change. Put an end to the negativity by reviewing the accounts you follow—unfollow, block or delete accounts that don’t bring positivity, motivation or inspiration into your life.

Support And Connect With Others

There are many people you can connect with through social media, even if they’re on the other side of the planet. And that’s a good thing. However, if the interactions you’re having leave you feeling isolated or upset, you should reevaluate why you use social media. Do you want to engage with others who share your interests? If so, search for digital communities of people who you have something in common with. From there, you can be more selective with who you connect and engage with.

Take Note Of What You Share

These days, it can be challenging to determine reputable sources of news and information. That’s why it’s important to play a conscious role before sharing something you see online with your friends or followers. Think about whether the content—be it an article or video—is helpful or harmful to others. Also consider if it truly provides knowledge worth sharing. If it doesn’t contribute something positive to the digital world, it may not be worth sharing on your social media account.

Reduce Your Screen Time

Smartphones are quite everywhere these days. In any public setting, you’ve likely noticed others with their eyes glued to their phones. In fact, recent studies reveal that people spend an average of over two hours a day on social media. If you’re concerned you may be spending too much time social media, try adopting healthier habits. Start by tracking the time you spend on social media; if you’re on Facebook or Instagram, look out for the new tool that helps users manage time spent on their accounts. When you limit your screen time, you’re creating more time for enriching, real-world experiences.

Take A Break

Completely stepping back from social media can be hard, but it’s a good way to help you reconnect to reality. Log out from your accounts for a full day, a week or even a month. Have a friend change your password so you don’t feel tempted to log back in to your account. Then, take notice of how you spend your time. Perhaps you rediscover an old hobby or sport. Or maybe you’re able to schedule more quality time for your family or friends. Either way, it’s more exciting to live life as it’s happening, as opposed to “living” through a screen.

Rather than thinking of social media as something that only hurts our health, we should reevaluate when and how we use our accounts. Social media platforms can be used for good—it all depends on whether you choose to use it for good.

 

Ryann Tanap is manager of social media and digital assets at NAMI. 

https://www.nami.org/Blogs/NAMI-Blog/September-2018-(1)/How-to-Have-a-Healthy-Relationship-with-Social-Med