Tag Archive for: CARE Counseling

How Schools Can Help Students Respond To Suicide

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

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

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

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

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

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

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

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

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

Addressing Mental Health Needs

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

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

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

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

 

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

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

The 7 Thought-Habits of Highly Self-Confident People

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Are there mental habits that will increase your self-confidence?  Most definitely. You’ll read about 7 such powerful thinking habits below.

My last blog revealed the very best mental habit I know for building self-confidence: “The Daily Success Review.” This short and simple 3-minute procedure nudges you to tune into the little things you do right every day instead of over-focusing on what you think you did wrong. I have nicknamed this daily technique, “The Small-Success Review,” to counter the destructive mindset of thinking that only huge and dramatic successes and accomplishments really “count” when it comes to bolstering self-esteem.

In addition to the Small-Successes method, there are other ways to increase your self-confidence just by altering your mindset slightly.  Of course, it is also important to practice behaviors that will increase your confidence and to learn to project self-confidence to others, and those will be the topics of upcoming blogs.  This blog will spotlight the thinking activities you can do right now to build a self-esteem mindset.  Below are 7 of my favorites:

1. Don’t worry if you don’t feel confident all the time.  It sounds counter-intuitive, doesn’t it? But Dr. Alice Boyes, in her useful new book, The Healthy Mind Toolkit, describes her realization that she needs both self-confidence and self-doubt to do her best work.  A little self-doubt can keep you humble enough to realize you may need to learn more or work harder at something.  It may even give you the dogged determination to keep going and “show people what you’re made of.” Doubt, according to Boyes, “causes us to question what we’re doing, mentally prepares us to accept change, propels us to work harder or differently, and can lead to us taking more cooperative approaches in dealing with people who disagree with us.”

I love this reminder that your feelings of confidence will ebb and flow during the course of a day–or a lifetime—and that this fluctuation is normal. Not to worry!

2. Show compassion toward your Future Self.  Caring for your Future Self could involve actions as small as filling up your gas tank this afternoon because you have a busy morning tomorrow and as far-sighted as exercising now for better health as you age.  “I may not want to exercise,” you could say to yourself, “But my Future Self sure would appreciate it.”  Inthis blog(link is external), habits guru Leo Babauta points out that people who don’t procrastinate are also likely to be people who want their Future Selves to be happy.   Can you decide to be one of them?

3. Practice compassionate and realistic self-talk.  Being able to realize when you are suffering, to comfort yourself, and to tell yourself that “tomorrow is another day,” will help you accept yourself even when you haven’t been able to handle yourself the way you would have preferred. Being supportive and kind to yourself when you have made mistakes will not only boost self-esteem; it will also boost your motivation and self-control, according to research cited by psychologist Kelly McGonigal in her book, The Willpower Instinct.

Some examples of compassionate self-talk:

  • “It’s true that you didn’t do as well as you wanted on the talk, but given that you didn’t feel well, you were a hero just to get through it.”
  • “Yes, you feel bad that you didn’t say NO to your friend’s request.  Think of what you could say next time and put it in your mental file.”
  • “You don’t have to be perfect.”
  • “Don’t let it get you down. This too shall pass.”

4. Relabel “failures” as setbacks, challenges, opportunities, or learning experiences.  Relabeling “failures” as “challenges,” for example, will immediately lower the level of stress hormones in your body.  How could you meet this latest “challenge?”  Changing one word can initiate a cascade of problem-solving thoughts. Analyzing past mistakes and setbacks may also improve your future performance, according to this research(link is external).  Strike the ugly f-word “failure” from your mental vocabulary list!  Practice enough, and you will develop a “growth mindset,” as psychologist Carol Dweck calls it.

"Idea." Image by Tumisu. Pixabay, CC0.
Source: “Idea.” Image by Tumisu. Pixabay, CC0.

5. Don’t assume that other people know what you know. Own your expertise! This reminder is also from The Healthy Mind Toolkit by Alice Boyes.  Do you know…the best places to find inexpensive clothing? Your city’s ordinances about trash, permits, and large-item pickups? The best restaurants for any occasion? Think about the times when people turn to you for information; your friends realize that you have numerous areas of expertise, both career-related and life-related.

6. Know your strengths.  Think back on compliments and positive feedback from others. Notice how much you enjoy or dislike certain kinds of tasks. Take in the way you contributed to a situation and made it better. When you’ve had a success, mentally replay it again and again.  Remembering and savoring positive feedback from others will help you internalize your strengths. Likewise, remembering other positive experiences will ingrain your special qualities into your brain. (Many readers have found this blog on “knowing yourself” a helpful way to focus on strengths.)

7. Remember your higher purpose and your meaningful values and goals.  Reminding yourself of your most important values, goals, and life mission can give you more willpower, persistence, and self-confidence, according to considerable research.  Your values keep you oriented to your “true north,” pointing to the core of who you are.

If nothing is working, and you feel prey to constant feelings of worthlessness or self-hatred, find a good therapist. Your therapist will help you challenge any deep-seated negative beliefs about yourself.  Yes, therapy involves time, money, and work, but it’s worth it to improve your self-confidence. There’s a lot of truth in this quote by Maxwell Maltz: “Low self-esteem is like driving through life with your hand-brake on.”

References

McGonigal, K. (2012). The Willpower Instinct. (NY: Avery), p. 148.

Boyes, A. (2018) The Healthy Mind Toolkit. (NY: Tarcher), p. 66, 205, 206.

Babauta, L. “Two Simple Habits of Non-Procrastinators.”

By Meg Selig

https://www.psychologytoday.com/us/blog/changepower/201805/the-7-thought-habits-highly-self-confident-people

Ensuring Your Child Is Supported At School

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

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

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

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

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

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

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

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

 

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

 

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

 

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

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

 

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

https://www.nami.org/Blogs/NAMI-Blog/May-2018/Ensuring-Your-Child-is-Supported-at-School

Learning To Change In Order To Heal

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Preventing A Generation From Struggling In Silence

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

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

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

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

What We Learn Becomes Who We Are

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

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

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

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

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

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

Proving Why Students Need NAMI ETS

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

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

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

Making An Impact

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

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

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

By Laura Greenstein

https://www.nami.org/Blogs/NAMI-Blog/May-2018/Preventing-a-Generation-from-Struggling-in-Silence

Are You A Chronic Self-Abandoner?

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Self-abandonment is a strange concept. How can you abandon yourself when you are always with you? If you’re well-schooled in the world of self-development, you may have an educated guess at what self-abandonment is: It’s when you don’t support yourself, right? Kind of.

Essentially, self-abandonment is when you reject, suppress or ignore part of yourself in real-time. In other words, you have a need or desire you want to meet, and (often on the spot) you make the decision not to meet it.

Example A: Jen comes home from a long, exhausting work week and is looking forward to resting. A friend calls, asking if she can come over to vent about her difficult relationship. While Jen knows what she wants, she still reluctantly tells her friend to come over.

Example B: Kyle is interested in studying a particular style of art that has excited him for years. But his friends poke fun at him, saying it’s a waste of time. Kyle despondently never enrolls in art class, despite his genuine interest.

In both cases, these individuals value the needs and opinions of others more than they value their own. They have an initial trajectory they are fairly certain about, but they abandon it as soon as they are “pressured” by others.

In a self-abandoner’s mind, the belief that their needs and desires either cannot be met or should not be met is a strong one. This belief leads to a continuous process of detachment, as the self-abandoner repeatedly makes decisions to ignore, repress or condemn their personal needs. Over time, they might even forget or lose the ability to identify their own needs.

This is a tough pattern that can lead in many negative directions. It can take us so far away from who we are that we find ourselves in a pattern of people-pleasing, settling or neglecting ourselves. Before long, our personal identities might even feel hazy. So, how can we move out of this pattern?

At its core, self-abandonment typically arises from a lack of self-trust. So, the fundamental solution to self-abandonment is self-trust and making a commitment to yourself. Anything that involves self-care, self-exploration or asserting yourself is a step in the right direction. Another part might be learning to handle peer pressure (yes, just like in high school!).

Here are two questions you can apply to any situation to determine if you are operating from self-abandonment:

  1. “For what reason am I making this decision?” If the answer involves guilt, shame, fear, timidity or generally negative emotions, you might be in abandonment mode.
  2. “If I were the only person on earth, would I still want to do ___?” This removes other people’s influence from your decision-making and frees you up to determine how you actually feel.

Remember: There’s no quick-and-easy solution. We don’t become self-abandoners from one decision, so we won’t change after one positive experience. Eventually, you’ll create a reservoir of experiences in which you trusted yourself and things worked out. With those in mind, you won’t default to self-abandonment. With those in mind, self-trust will come more naturally.

 

A mental health counseling grad student, Brianna runs ExistBetter.co, a blog that explores the nitty gritty of mental illness and self-development.

https://www.nami.org/Blogs/NAMI-Blog/April-2018/Are-You-a-Chronic-Self-Abandoner

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

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

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

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

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

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

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

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

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

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

The Double Standard Of Mental Illness

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

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

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

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

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

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

 

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

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

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

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

 

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

https://www.nami.org/Blogs/NAMI-Blog/April-2018/The-Double-Standard-of-Mental-Illness

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

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

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

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

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

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

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

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

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

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

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

By Alexander Leon

https://www.theguardian.com/commentisfree/2017/may/12/lgbt-mental-health-sexuality-gender-identity

How I Healed Myself Of Shame

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I can’t remember a time when I didn’t feel shame. But I do have evidence that there was once a time when I was shame free. I have a photograph of me as a little baby, smiling with a twinkle in my eye. I look radiant and filled with joy. I have another photo of me at four years old, in which I am frowning, and I look defiant and lost. The twinkle in my eye has been replaced with a dark, empty look.

What had occurred that had taken away the joyous smile on my face and replaced it with darkness, emptiness and hatred?

The answer: shame. Shame replaced my innocence, my joy, my exuberance for life. Shame caused me to build a wall of protection and defiance. Who was I defending myself against? My mother, a woman who was so full of shame herself that she couldn’t help but project it onto me.

After being neglected and emotionally abused by my mother, sexually abused at nine and raped at twelve, I found myself riddled with shame and the belief that I was unlovable and rotten inside. I began acting out by shoplifting. I was angry at my mother, the men who had abused me and at all authority figures. I wanted to get back at everyone who had taken advantage of me. After I was finally caught and brought home in a cop car, my mother gave up on me.

Fortunately, I didn’t give up on myself. I knew there was goodness in me and I fought to find it. I turned to solitude and introspection and began to find the pieces of myself I discarded when trying to shield myself from further harm.

Here’s how I worked to heal myself and combat my feelings of shame—and how you can, too:

    1. Stop blaming yourself for the abuse. There is absolutely nothing a child can do that warrants a parent emotionally or physically abusing them, and there is absolutely nothing a child can do to cause someone to sexually abuse them. You did not cause your abuser to mistreat you.

 

    1. Give your shame back to your abusers. Parents often project their own shame onto their children, as was the case with my mother, who had me out of wedlock and felt horrible shame because of it. The following exercise will help you give your shame back to your abuser:
      • Imagine “going inside your body” to look for shame. Some see shame as a cloud of blackness. Others, as an ache in their stomach or a pain in their heart. Wherever you sense shame, imagine taking it and throwing it back at your abuser(s).

 

    1. Gain an understanding as to why you behaved as you did. Instead of viewing yourself as “bad” for acting out (if you did), begin to view your negative behaviors as attempts to cope with the abuse. The following behaviors are some of the most common coping mechanisms in former victims of childhood abuse:
      • Eating disorders: bingeing, compulsive overeating and emotional eating.
      • Self-injury: cutting, burning, head banging or any other form of self-harm.
      • Difficulties with sexual adjustment: sexualizing relationships, becoming hypersexual, avoiding sexual contact or alternating between these two extremes.

 

    1. Show self-compassion. Compassion is the antidote to shame. It acts to neutralize the poison of shame, to remove the toxins created by shame. The goal is to treat yourself in a loving, kind and supportive way. Think of a phrase to soothe and encourage yourself, look at yourself in the mirror, make eye contact and say this phrase with certainty.

 

  1. Provide yourself with forgiveness. Self-forgiveness is different from letting yourself off the hook or making excuses for negative behavior. The more shame you heal, the more clearly you’ll be able to see yourself. Instead of hardening your heart and pushing people away, you’ll become more receptive to others. It’s important to work towards forgiving yourself for: the abuse itself, the ways you hurt others because of your own abusive experiences, and the ways you have harmed yourself.

Don’t let shame take over your life. It took me many years to rid myself of the shame that followed me nearly all my life. The important thing is that you just begin to heal your shame, so it doesn’t dictate your life.

 

Beverly Engel has been a practicing psychologist for 35 years and is an internationally recognized psychotherapist and acclaimed advocate for victims of sexual, physical, and emotional abuse. She is the author of twenty-two self-help books and Raising Myself: A Memoir of Neglect, Shame, and Growing Up Too Soon. In addition to her professional work, Engel frequently lends her expertise to national television talk shows.

https://www.nami.org/Blogs/NAMI-Blog/April-2018/How-I-Healed-Myself-of-Shame