Tag Archive for: CARE Counseling

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

5 Common Myths About Suicide Debunked

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Suicide affects all people. Within the past year, about 41,000 individuals died by suicide, 1.3 million adults have attempted suicide, 2.7 million adults have had a plan to attempt suicide and 9.3 million adults have had suicidal thoughts.

Unfortunately, our society often paints suicide the way they would a prison sentence—a permanent situation that brands an individual. However, suicidal ideation is not a brand or a label, it is a sign that an individual is suffering deeply and must seek treatment. And it is falsehoods like these that can prevent people from getting the help they need to get better.

Debunking the common myths associated with suicide can help society realize the importance of helping others seek treatment and show individuals the importance of addressing their mental health challenges.

Here are some of the most common myths and facts about suicide.

Myth: Suicide only affects individuals with a mental health condition.

Fact: Many individuals with mental illness are not affected by suicidal thoughts and not all people who attempt or die by suicide have mental illness. Relationship problems and other life stressors such as criminal/legal matters, persecution, eviction/loss of home, death of a loved one, a devastating or debilitating illness, trauma, sexual abuse, rejection, and recent or impending crises are also associated with suicidal thoughts and attempts.

Myth: Once an individual is suicidal, he or she will always remain suicidal.

Fact: Active suicidal ideation is often short-term and situation-specific. Studies have shown that approximately 54% of individuals who have died by suicide did not have a diagnosable mental health disorder. And for those with mental illness, the proper treatment can help to reduce symptoms.

The act of suicide is often an attempt to control deep, painful emotions and thoughts an individual is experiencing. Once these thoughts dissipate, so will the suicidal ideation. While suicidal thoughts can return, they are not permanent. An individual with suicidal thoughts and attempts can live a long, successful life.

Myth: Most suicides happen suddenly without warning.

Fact: Warning signs—verbally or behaviorally—precede most suicides. Therefore, it’s important to learn and understand the warnings signs associated with suicide. Many individuals who are suicidal may only show warning signs to those closest to them. These loved ones may not recognize what’s going on, which is how it may seem like the suicide was sudden or without warning.

Myth: People who die by suicide are selfish and take the easy way out.

Fact: Typically, people do not die by suicide because they do not want to live—people die by suicide because they want to end their suffering. These individuals are suffering so deeply that they feel helpless and hopeless. Individuals who experience suicidal ideations do not do so by choice. They are not simply, “thinking of themselves,” but rather they are going through a very serious mental health symptom due to either mental illness or a difficult life situation.

Myth: Talking about suicide will lead to and encourage suicide.

Fact: There is a widespread stigma associated with suicide and as a result, many people are afraid to speak about it. Talking about suicide not only reduces the stigma, but also allows individuals to seek help, rethink their opinions and share their story with others. We all need to talk more about suicide.

Debunking these common myths about suicide can hopefully allow individuals to look at suicide from a different angle—one of understanding and compassion for an individual who is internally struggling. Maybe they are struggling with a mental illness or maybe they are under extreme pressure and do not have healthy coping skills or a strong support system.

As a society, we should not be afraid to speak up about suicide, to speak up about mental illness or to seek out treatment for an individual who is in need. Eliminating the stigma starts by understanding why suicide occurs and advocating for mental health awareness within our communities. There are suicide hotlines, mental health support groups, online community resources and many mental health professionals who can help any individual who is struggling with unhealthy thoughts and emotions.

 

Kristen Fuller M.D. is a family medicine physician with a passion for mental health. She spends her days writing content for a well-known mental health and eating disorder treatment facility, treating patients in the Emergency Room and managing an outdoor women’s blog. To read more of Dr. Fuller’s work visit her Psychology Today blog and her outdoor blog, GoldenStateofMinds.

Communicating Is More Than Finding The Right Words

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

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

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

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

Feeling Empathy For Those Who Are Trying

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

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

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

Learning Essential Communication Skills

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

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

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

Realizing Mistakes Are Just Learning Opportunities

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

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

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

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

 

Keiko Purnell is a NAMI HelpLine Volunteer.

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

How To Reduce Screen Time In The Digital Age

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Smartphones have transformed modern life in more ways than anyone could have imagined. They enable 24/7 access to infinite information and tools that help us stay organized, track our fitness, express ourselves and be entertained. However, easy access to these digital devices and their habit-forming qualities has led to high screen time for both children and adults and emerging research suggests that such high screen use can have a negative impact on mental health.

Since the rise of the smartphone, indicators of mental “wellness” such as happiness, self-esteem and life satisfaction have decreased while serious mental health issues like anxiety, depression, loneliness and suicide have increased significantly, particularly among young people. A possible reason for this might be that more time on screens, particularly social media, leads to increased risks of stressors like social isolation, cyberbullying, social comparison, decreased life satisfaction, reduced productivity and distraction from personal values and goals.

Increased time on screens also means there’s less time available for positive real world experiences that promote mental health, like exercise, quiet reflection and quality, in-person social connection. With all of this in mind, it’s not surprising that research suggests that less time on social media leads to better well-being.

While more research is needed, it certainly appears that less screen time bodes well for mental health. So, consider the following tips to keep screen time in-check, leaving more room for healthy, positive real-world experiences.

Connect For Real

Despite opportunities for online “connection,” loneliness is at an all-time high. Indeed, quality face-to-face social connection is critical to mental wellness. So, make it a goal to have screen-free, in-person social connections with friends, co-workers and loved ones on a daily basis. Consider making it a standard to power down whenever there is an opportunity for conversation such as in the car, standing in line and during meals or social gatherings.

Commit To A Screen-Free Bedroom

Screen time within an hour of bedtime can negatively impact sleep, which can contribute to physical, mental and cognitive issues. However, the lure of a screen in a quiet bedroom is hard to resist. It’s difficult to ignore texts, resist a Netflix binge or mindlessly scroll through social media. Eliminate the temptation by keeping phones out of the bedroom entirely and reach for a book or magazine instead.

Avoid Multitasking

Put away your phone when you need to focus on a task, particularly related to school or work. Research on multitasking shows that it causes distraction, reduces productivity and increases errors. One study showed that subjects whose phones were in a different room performed better on a cognitive test compared to those whose phones were in front of them—and set on “Silent” mode. In addition to reduced productivity and cognitive impact, media multitasking also has been linked to lower wellbeing.

Notice Motives And Feelings

Ask yourself if being on your phone is what you really want to be doing at that moment. By using mindfulness, you can identify if you’re trying to avoid negative feelings or a necessary task, or whether you’re truly enjoying your digital experience. This exercise can help with getting in touch with your emotions and improve purposeful decision-making around screen use.

Pursue Healthy Interests And Activities

Making time for hobbies or activities that promote health, personal growth or connections with others can help to reduce screen use and provide a sense of meaning and purpose. Some examples are: reading books, hiking in nature, taking mindful walks, prayer or meditation, joining a club, practicing yoga, cooking, volunteering or learning to play an instrument.

Practice Reflection And Gratitude

A daily practice in quieting your mind and counting your blessings can boost positive emotion and improve psychological wellness. Research suggests that gratitude may protect against social comparison and envy—common experiences with social media. Reflect on what is good and right in your life. During quiet, screen-free time, write down five good things from each day. Savor simple pleasures like a sunny day, a good cup of coffee or a friendly exchange with someone.

Clarify Your Values

Take time to mindfully consider what you value most in life. What do you want your life to be about? Quality relationships? Physical and emotional health? Spiritual growth? Professional growth? Regularly consider whether screen use is moving you toward or away from your values. If you notice that your screen use is moving you in an unwanted direction, give yourself grace, hit the figurative “reset” button and get back on track.

 

Nina Schroder, MSW, LCSW is a mental health therapist at Virginia Commonwealth University in Richmond, VA. She specializes in the treatment of anxiety and depression and researches the effects of high screen use on mental health, emotional resilience, and overall wellness. Nina is passionate about helping others increase wellness and emotional resilience in the Digital Age and delivers lectures and workshops both locally and nationally. You can reach her at nina.schroder@yahoo.com.

Traveling With A Mood Disorder

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I was diagnosed with bipolar II disorder when I was 14. It has taken me decades to come to grips with what that means, and to be in a place where I’m comfortable talking openly about it. Nowadays, I’m really open, because I work as a travel blogger, connecting with people and places for a living. I actually started my career at a nonprofit office job, thinking that was what I wanted. But the traditional professional life was something I couldn’t live up to, and I frequently used travel to re-center. I’m very lucky to have turned it into a career, because I’ve learned that travel can be one of the most incredible experiences for those of us struggling with our mental health.

For many of us, myself included, it can be hard to get out of bed some days. Depression comes crashing down, and just the thought of moving becomes overwhelming. Needless to say, the idea of journeying to the other side of the world can seem downright impossible.

But I’ve found that waking up in a new place can be very effective in breaking a downward spiral into an extended depression. My brain becomes too preoccupied with learning about a new place to focus on my mood. That said, traveling with a mood disorder also has its perils. So here are some tips and lessons (some of which I learned the hard way). May they help you, too!

Before You Go

Make Sure You Have Enough Medication. Most of us go month-to-month on our meds. That can be a challenge for an extended trip that overlaps with your refill period. I usually work with my doctor to get a two-month’s supply when I know I have a trip coming up to help with that issue. My pharmacy is also aware that I travel often and works with me to push up refill dates if needed.

Brief Travel Companions on Your Needs. Solo travel is easier for me in many ways because I don’t have to justify my emotional needs to anyone. However, when I travel with others, I try to discuss with them what I need (downtime, alone time, etc.) before we go. That way, we can work out systems that allow me to get what I need within the framework of our trip.

For example, I love taking road trips with my father, and it’s something we’ve been doing since I was a little kid. One of the systems we have in place is that when I feel like I need some alone time, we stay at a hotel with one-bedroom suites. He sleeps in the bedroom, and I sleep on the couch in the living room. Just that one wall and a few feet gives me the precious personal space I need.

Plan. For many of us with mood disorders, our anxiety worsens with the unknown—so having a plan can help with that. This doesn’t mean I have every day planned out, but I go into a trip with at least a rough itinerary. I also try to alternate busy days with lighter days to build in some downtime for myself.

While Traveling

Prioritize Self-Care. I refuse to neglect my self-care when traveling. For me, emotional balance begins with a good night’s sleep (at least eight hours, preferably more). I’ve accepted that this means I will rarely enjoy the nightlife in a new place, and I’m okay with that.If your self-care involves exercise, meditation or something else, structure that into your trip. Try to find hotels with fitness centers, room in your suitcase for your meditation materials, or anything else you may need.

Know Your Triggers. Our illnesses (unfortunately) don’t disappear because we’re on vacation. Our triggers are there as well, so we need to continuously pay attention to situations that can activate them. Knowing what our triggers are ahead of time can help us avoid things that might set them off, but sometimes it still happens. What do we do then?

When I was in Japan, I visited the Fushimi Inari Shrine in Kyoto. It was extremely crowded, and at one point, people were all around me, and I felt like I was trapped. I had a panic attack, and I decided that rather than push

through the rest of my day, I would take care of my needs and leave. I told my travel companion that I would meet him back at our hotel, and I left.

Practice Self-Compassion. This one is still hard for me. After a situation like the one in Kyoto, my natural inclination is to be upset with myself. What I (and my illness) needed that day prevented me from seeing a place I wanted to see. While shame, guilt or disappointment might be our natural first reaction, it’s important to then be compassionate with ourselves. Doing what is necessary to maintain balance is hard, and doing it at the expense of something we were looking forward to is even harder. We make tough choices like that every day, but prioritizing our emotional needs is never the wrong choice.

Keep Your Support Structure Engaged. For some people, this means doctors or therapists. For others, like me, it means certain friends and family members. My friend Ana is one of my first calls when I have panic attacks or depression spirals at home. So even when I was in Kyoto, she was my first call when I got back to the hotel. Hearing her voice, even while on the other side of the world, made me feel like I wasn’t helpless or isolated just because I was gone.I do my best to make sure my support structure is aware of what’s going on with me while I’m gone, and I have emergency procedures in place with my therapist and psychiatrist just in case.

After You Return

Update Your Doctor and Therapist. I find it helpful to do a “debrief” with both my psychiatrist and therapist when I return from a trip. What situations did I handle well? What do I wish I would’ve handled differently? How did my meds work in a completely different environment? I believe that we learn by doing, and keeping the professionals we trust informed of our discoveries along the way is important.

Congratulate Yourself. Regardless of whether or not you handled every situation in a way you consider “perfect,” you were able to travel with a mood disorder. That is an accomplishment that needs to be celebrated! Look through your photos, tell stories to your friends, and know that if you did this, you can do anything.

 

Jonathan Berg is a volunteer facilitator for the Depression and Bipolar Support Alliance and the founder and editor of the travel blog The Royal Tour (www.theroyaltourblog.com). He struggles to keep his bipolar disorder in check and shares his adventures and struggles with his readers.

https://www.nami.org/Blogs/NAMI-Blog/August-2018/Traveling-with-a-Mood-Disorder

Spreading Hope Through Peer Support

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What does it mean to be a peer support specialist?

To me, it means providing a voice for people when they struggle in finding their own. It means advocating for people, encouraging their recoveries and even sometimes standing in courtrooms as a show of support. And it often means educating community members and outside providers about First Episode Psychosis (FEP) programs like the Early Assessment and Support Alliance (EASA)—a program where I transformed from a participant to a peer support specialist.

For many, psychosis is a scary experience, and it can be easy to lose hope. When I received my diagnosis, I felt like all hope was lost. I thought my life was over. I thought I was doomed to serve a life sentence, confined to the four walls that enclosed my bedroom in my mother’s basement. That’s a tough pill to swallow at 20 years old. Due to my fear and paranoia, I often found it difficult to leave not only my house, but even my room. I felt completely alone, hurtling in a downward spiral of despair.

This is typical for a person whose experiencing psychosis—to withdraw from those around them. For that reason, psychosis breeds isolation and loneliness. But what made a huge impact for me during this period of isolation was being able to talk with others who understood what I was experiencing. What I needed at that time is exactly what I work to provide for people now: messages of hope. At its core, I view peer support as the strategic use of telling one’s own lived experience as a tool to work with others through their experience.

What Does A Peer Support Specialist Do?

As a peer support specialist, I can meet people where they are comfortable. If they decide they don’t want to meet in the office, I can travel to them. I’ve met people all throughout my community. Often, we even interact via text message to coordinate meetings or just be in contact. Everyone engages in their own way, and I work hard to build rapport and trust with participants and their families.

As a peer support specialist, I work with program participants to help reduce their social isolation. We may look at a participant’s hobbies and interests and use those passions to help reconnect them to their community. The social support that can be gained through hobbies is an important coping strategy for those experiencing psychosis. I work with participants to create organic social supports, so when they move on from our program they have a natural support system in place.

As a peer support specialist, I act as a model for recovery. In the past year, I met a psychiatrist who didn’t even know recovery from psychosis was possible. After sharing my journey with him and combating the idea that a diagnosis is the end-all for patients, it’s my hope that he has changed his message to the patients he works with, potentially creating a dramatic difference in their recovery process.

As a peer support specialist, I work to help people to see diagnoses for what they are: words. A diagnosis is not a definition. See, a word by itself doesn’t have power—it’s merely a series of letters mashed together. The negative connotations associated with the words “psychosis” and “schizophrenia” are learned, taught to us through sources such as the media. And it’s all too easy to take what the media tells us about these diagnoses and use that information to form beliefs about yourself—but a diagnosis says nothing more about you than the color of your hair. What defines each person is theirs to create and own.

As a peer support specialist, I work with people who need me to hold onto their hope for them until they’re ready to hold it for themselves, just as I once needed.