Systems advocacy is focused on change of systems. This includes areas such as collecting and using data to influence research, funding, and advocacy that helps serve to be a collective voice, especially for those who are most vulnerable.
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Mental Health Awareness at the State Fair is back in 2021! This event, which features CARE Counseling and about 60 mental health organizations from across the state, is an opportunity for all Minnesotans to raise awareness about mental health, which is more important now than ever before as we continue to recover from negative impacts of the global pandemic.
Eating disorders are some of the most challenging mental illnesses and are serous, life-threatening conditions. Affecting one in 20 people during their lifetime, eating disorders frequently occur in people with other mental illnesses, including depression, anxiety disorders and substance abuse issues and as with other mental illnesses, early identification and early intervention are keys to recovery.
NAMI joins NEDA this week in support of the aim to ultimately prevent eating disorders while reducing the stigma surrounding these conditions and improving access to treatment.
NAMI recently spoke with Andrea Vazzana, Ph.D., a clinical psychologist and eating disorders specialist, to learn more about eating disorders and how to help a friend or loved one living with one of these conditions.
NAMI: What is the current prevalence of eating disorders in America?
Vazzana: Overall, over 10 percent of young women currently meet criteria of one of the eating disorders, anorexia nervosa, bulimia nervosa or eating disorder NOS (not otherwise specified). The new Diagnostic and Statistical Manual (DSM5), set to publish in May this year, includes binge eating disorder as a mental illness. Men can also live with eating disorders. While the prevalence of men to women was previously thought to be a ratio of 1-to-10, it is now believed that the ratio is closer to 1-to-6, meaning that six times more women than men have the condition. Although not as common in men, it is important to recognize that more men are now being treated for these mental illnesses.
Some believe that eating disorders are more prevalent in women because of what is called the “thin-ideal”. Biology and environment are both contributors to this condition, and researchers have found that the cultural pressure to equate thinness with beauty, as well as some sports that encourage low body fat and thinness, are factors. It is not always the ideal cultural “think” to equate thinness in men and therefore that social factor is often removed. Still, there are some sports and cultures where being thin is idealized and therefore a contributor.
What are the types of eating disorders and are there any recent changes in prevalence and conditions?
Vazzana: Eating disorders NOS, will be changing with the new DSM, to be published in May. The criteria and diagnosis will change. Binge eating will be a full-blown disorder all on its own. Binge eating disorder is similar to bulimia in that it includes the binging, but not the purging, aspect of the condition.
What are the most common co-occurring disorders (mental health conditions)?
The most common is depression and dysthymia, what some consider a less-severe but often longer lasting condition than depression. Half to three-fourths of those with eating disorders meet the criteria for depression in their lifetime, and there is a direct relationship to malnourishment and depression.
In addition to depression, the other most common co-occurring conditions are anxiety disorders, specifically social phobias and, with people living with anorexia, OCD, which impacts about 25 percent of individuals with this condition.
Substance abuse, particularly alcohol abuse, is co-occurring in about 5 percent of people living with anorexia and from 25-40 percent of people living with bulimia.
Personality disorders are also common co-occurring conditions, particularly for people living with bulimia.
What are current treatment options available and what are likely outcomes?
Recovery from eating disorders is possible. The right treatment choice depends on the type of eating disorder, but treatment approaches are often similar for the various conditions, and coordination of care between mental health care providers, nutritionists and medical professionals is important, depending on the individual’s treatment plan. Nutritional guidance, as well as individual and family counseling, is an important treatment options to consider.
The best rates of recovery for people living with bulimia involve cognitive behavioral therapy (CBT) where the focus is often on normalizing weight and eating behaviors and challenging distorted thinking patterns that are usually associated with this condition. One of the goals is to interrupt the thought pattern that leads to individuals evaluating themselves in terms of shape and weight. Individual therapy is often another key to recovery.
The best rates of recovery for people living with anorexia include treatment plans that incorporate family-based therapy, often the Maudsley Method, which is often used for adolescents and children with Anorexia still living at home. This intervention involves parent coaching to encourage feeding their children to help restore their weight—eating meals with them and encouraging eating. With anorexia, it is important that the individual restore their weight as soon as possible; the longer they are in a danger zone of thinness and malnutrition, the worse the outcome. Early intervention is key; people living with anorexia (about 5 percent) have the highest probability for mortality, including death by suicide.
In addition to psychotherapies, medications, specifically, selective serotonin reuptake inhibitors, SSRIs, a type of antidepressant medication, are sometimes used in patients that are responding to CBT as an adjunct therapy.
What myths are the most common and what stereotypes exist that create barriers to understanding and treatment?
The myths surrounding eating disorders are vast and include myths primarily around race, age and social economics.
When people think of anorexia, they often mistakenly think of young, white, high social status females. This is not the case. There are 5-10 million people in America who have eating disorders, and one out of 6 are men, who more deeply experience the negative aspects of stereotypes and have unique barriers to treatment and acceptance.
We also know that eating disorders do not just affect white women. The rates are as common in young Hispanic and Native American women as they are in Caucasian women. With African American and Asian American women, however, there does seem to be a lower prevalence, with the exception of pre-adolescent African American girls. With Caucasian girls, the prevalence is lower and rates increase with puberty and continue to increase as into early adulthood.
Age is another myth; eating disorders do not just affect teens and young adults. More and more are being diagnosed for the first time in middle age. And unless effectively treated, eating disorders will last into adulthood for many.
How can someone help a friend or loved one who may have or one who is living with an eating disorder? How should they/could they intervene if needed and how can the provide support?
Regarding intervention, the key to remember is that the earlier the better. In terms of identifying a problem, it is important to know that it is common to have body dissatisfaction. Most women are more critical. However, when they go beyond dissatisfaction and they are harshly critical and disparaging of their bodies, and when there is noticeable evidence of over-thinness and over concern about food and weight, there may be a problem.
Some people mistakenly wait to intervene, thinking that the individual may grow out of their condition. The best thing to do is to let them know about your concern. You have observed behavior—talking poorly about their body, other signs—and you just want to be honest. Saying something like, “I have noticed these things and I am concerned about your health,” without being judgmental, can be the most natural first step. Because individuals living with eating disorders are generally already self-critical, it is important to so separate the illness from the individual. Try not to focus comments on appearance but rather focus comments on health by expressing concerns and the need for further medical evaluation. Recognizing that people with eating disorders often consider being thin with success, being persistent and consistent while avoiding criticism and comments on thinness, is important.
After an individual is in treatment for an eating disorder, one of the best things a family member or parent can do is to get family-based treatment or therapy. During meals, families and friends should try not to be angry even if they see their friend or loved one struggling with eating. Working to avoid impatience can be challenging, but neutral and supportive reassurance offer the best outcomes.
It is important that friends and family strive to avoid commenting on appearance. Avoid comments like, “You’re gaining some weight, that looks great!” Compliment other things, perhaps superficial aspects of clothing, conversations, other activities and contributions, but avoid mentions of size or appearance if possible.
What do you think is the most important thing for people to know about eating disorders?
The importance of intervening early! Treatment works best the earlier you can begin it. The longer the condition persists, the more deadly it becomes with more physical complications to manage.
Andrea Vazzana, Ph.D.,is a clinical assistant professor of child and adolescent psychiatry at the NYU School ofMedicine and a licensed psychologist at the Child Study Center.
You’ve done it! High school is over and it’s time for college. Everyone is just so proud… and you’re alternating between wildly optimistic and sure of certain failure. As a person with a diagnosed mood disorder, you just barely survived high school—and that’s no exaggeration.
Maybe you’ve accumulated a list of experiences that don’t exactly enhance your resume—frequent absences, medication trials, psychiatrist visits (outpatient or in), special schools, therapists, suicide attempts and drinking sprees. But you’ve gotten good enough grades, and you’re off to college away from home. Maybe you’re hoping the geographic and lifestyle change will help you (You can confess! It’s what your Aunt Mildred thinks, too).
You are one of a new and mighty generation, with access to early diagnosis and treatment for your mood disorder. In generations past, a “nervous breakdown” in youth meant years of seclusion, sedatives and broken dreams. Today, though, higher education has never been more accessible for those living with mental illness.
With support from NAMI and resources like “The Mighty” and social media, you certainly won’t be living with mental illness all alone, and you’re about to join an exciting, new college community where stigma is reduced. But only about 56% of students earn degrees within six years—it isn’t easy.
Your success depends partly on how quickly you can get into the driver’s seat of managing your illness. So, here are a few practical tips for the road ahead:
Prepare For Your Trip
Make a mental health plan with your parents and hometown mental health professionals. Assume the year won’t be perfect and set up your supports before you go. NAMI actually has an awesome guide that can help you plan and start all necessary conversations—including what you decide to disclose to college officials about your mental health condition. Planning will help you succeed.
Avoid The Potholes
Sleep! You know you have to. Lack of sleep is both a trigger and a symptom. Even if you’re behind on studying—it’s better to get a C on a quiz than deal with a trip to the ER. Limit your late nights to 1-2 per week, max. If your sleep gets disrupted in a dorm, make a change. Speaking of lost sleep: please party wisely. Your medications probably don’t mix well with alcohol and ignoring this warning will be at your peril.
Put On The Gas
Practice self-care. This is likely to be easier than in high school, because many of your new friends will be going for walks or runs, working out in the campus athletic center, taking classes in dance or fencing, practicing meditation and joining clubs full of likeminded students. College is a great time to develop healthy habits, and exercise and self-care are so important for mental health.
Choose Your Passengers
At home, most people probably knew a lot about you. Be honest and open at college, but be wary. Once you’ve shared your story, you cannot un-share it. The world is not always a fair place. If you tell others you have a mental health condition, you may be known by your personality and your diagnosis. Some will see you through a veil of their own ignorance. If this happens, you can take on the task of educating others. You may choose to become a mental health advocate, but wait until you are ready.
As you head off to college, be happy! And be prepared. You have a disorder that you wouldn’t wish on anyone, but it is part of who you are. You’re already accomplished: You made it to college and that’s a great achievement. Your preparations will help you be even more successful and every class will bring you closer to having an educated mind.
Many of the people you will be reading about in school—Charles Darwin, Winston Churchill, J.K. Rowling, William Styron, Annie Lamott, Kay Redfield Jameson—were once in your shoes. These role models were once young adults facing the adversity of living with a mood disorder, but not letting it define them. When their works are discussed in class, you will have powerful insights about their lives. Mood disorders don’t go away, but with medication, support, lifestyle care and a little luck, they can be managed. You can succeed on your journey.
Sharon Carnahan, Ph.D. is Professor of Psychology at Rollins College in Winter Park, FL and Executive Director of Hume House Child Development & Student Research Center. She has taught first-year college students since 1990 and is an advocate for students with special health care needs. www.rollins.edu/cdc.
Earlier this week, I found a scrap of paper while cleaning that stopped me in my tracks. On it, I had written “take a year off” followed by a short list of commitments in my personal and professional life. The list included things I had entered into with excitement—like training other people in my profession and organizing community events—but didn’t have the time or energy needed to continue.
At the time I wrote the list, exhaustion was my norm. I was living with episodic and unpredictable pain, and my work was suffering. I didn’t have the energy to do all the things I normally do. I was keeping my commitments but performing poorly, which made me feel miserable.
What I didn’t know when I wrote that list was that depression would soon be a part of my life. I missed some of the early signs, but eventually it became clear that I was not well. The first clear sign came when I felt no joy during the Night to Shine Prom, an event my friends and I had spent months planning. It’s something we always consider to be “the happiest night of the year.” I thought something might have been “off” with the event, but as I saw joy on everyone’s face except my own, I realized something was “off” with me.
It was then I realized I needed a period of rest for my mental health. And along the way of implementing that rest, I learned a few helpful tips:
It Can Take A While
Some commitments are easy to take a break from, while others require more planning. After the Night to Shine Prom, I let the planning committee know that I wouldn’t be able to help plan the next prom. It was emotionally difficult, but it was quick. However, some of my other commitments took time to transition away from, as I had to identify and train a replacement before I could step down. It took months to fully cross off everything on my list, but each time, I felt a weight lift.
You May Second-Guess Yourself
Each person will face different challenges when preparing for a period of rest. I felt like I would be judged, I felt guilty for being less involved, I worried that important things would be left undone, and I didn’t want my relationships to suffer. These thoughts were common in the beginning, and I had to keep reminding myself how important it was for me to rest and recover.
People May Not Support You
Your colleagues, friends and family probably aren’t fully aware of the reasons rest is necessary for you. If their initial responses aren’t as supportive as you’d hoped for, it might mean they’re just surprised, or they rely on you and will miss your contributions. You may find it helpful to explain why you need to take a break. In some instances, though, the best thing you may be able to do is to quietly try to understand things from their perspective.
Stepping Away Is A Surprisingly Positive Process
Maybe you realize how important it is for you to cut back and have fewer responsibilities. What you may not realize is how positive it can be for other people. During the process of transitioning my responsibilities, I got to see people step up who were just as passionate about these roles as I had been. Almost immediately, the energy they brought to the roles resulted in growth and improvement I hadn’t been able to fully offer for a long time.
Rest Is Hard…
Rest is not accomplished by simply taking time off and then going back to your busy schedule. Rest occurs when you allow yourself to be fully inactive. A period of stillness and rest may be a necessary precursor to a more active mental health recovery. After a period of rest, you may find that you are more motivated to engage in activities like exercise, reading, crafting, praying, journaling or spending time with loved ones. You will be more likely to benefit from those wellness-promoting activities if you have taken time to rest first.
But The Results Are Worth It
When you’re rested, you’ll have energy to enjoy the things you love again. You’ll know you’re on the right track when your response to your personal and professional opportunities changes from “Oh no” to “Heck yes!” Even before I considered myself fully rested, I found I had more energy to be a mom, to be a wife and to commit to my work. After resting for a month, I was thrilled with the quality of my work. I even had energy left over to spend on myself and the things I enjoy.
You May Not Have All The Resources You Need To Rest
I am blessed to have the support of family and friends—and access to paid sick leave. I know these are not resources everyone has and sometimes paying the bills, getting your kids to school or taking care of your loved ones may not be things you can readily disengage from. My advice if you cannot commit several days—or, dare I say, weeks—to rest is to take advantage of whatever opportunities you can. Do what you absolutely have to do and then rest the remainder of the time. Maybe instead of committing a month to complete rest, you start by committing a month to only doing the things you need to, letting non-essential projects wait and accepting help from others when it’s offered.
I am grateful to have experienced firsthand the profound impact rest can have on mental health and work. Its positive impact has influenced me to incorporate continued rest into my regular schedule. I feel great, and I am proud of the work I am doing. I know if I want things to stay this way, I will need to intentionally make time for rest.
Coming across the slip of paper that started my journey toward rest was a shock. As soon as I saw it, memories of how physically and emotionally exhausted I was rushed in. I cried as I recalled all the moments and days I lost to pain and depression. Then I realized how much better I feel now and the role that rest played in me getting to a better place. Seeing that slip of paper strengthened my resolve to rest when I need it.
Jennifer Adkins is a wife, a mom, and a psychologist. Her professional interests include treatment of anxiety disorders, improving family relationships, and reducing stigma associated with mental illness.
As soon as her baby was born, Anna felt a change. Something wasn’t right. She feared for her baby’s safety to an extreme degree. She would sit awake, staring at her baby through the night, terrified something would go wrong, and her daughter would die. After feeding, Anna wouldn’t allow herself to leave her baby’s side for even a moment, worrying something would happen in her absence.
As her daughter grew older, Anna felt intense anxiety that she was doing everything wrong: she hadn’t read to her daughter enough, she hadn’t cleaned up enough, she hadn’t completed enough puzzles with her child. Like many mothers, Anna held it together at work and with friends—the people who saw her every day didn’t know anything was wrong. But on the inside, she was bubbling over with anxiety.
One day, she found herself screaming into a pillow for release, and she knew then she needed help. As supervisor of the Northwestern Medical Center (NMC) Birthing Center in Vermont, Anna was in a knowledgeable position—she knew where to reach out for help.
Is What I’m Feeling Normal?
Feelings of depression, compulsion or anxiety do not mean a woman is a bad mother; they also do not mean she doesn’t love her baby. Many expectant mothers imagine motherhood will be fulfilling and uplifting. But when the baby is born, they may not feel that way at all. Mothers may experience depression, anxiety, obsessive compulsive disorder or posttraumatic stress disorder (PTSD).
A mother may experience PTSD as a result of a real or perceived trauma during delivery or following delivery. This can happen due to a feeling of powerlessness or a lack of support during delivery, an unplanned C-section or a newborn going to intensive care. Postpartum Support International (PSI) estimates around 9% of women experience PTSD following childbirth.
If you are experiencing anxiety, flashbacks or nightmares, you are not alone and it is not your fault.
What Should I Do If I Have These Feelings?
There are screening tools to help find troubling feelings. The Edinburgh Postnatal Depression Scale (EPDS) is a 10-question screening tool that asks mothers to consider their feelings over the week leading up to the test. In the NMC Birthing Center, the EPDS is conducted after delivery, within the two or three days that a new mother stays in the hospital, two weeks after delivery and six weeks postpartum.
“[These feelings] can be easy to brush off,” Anna says. “But it’s okay to say, ‘Something isn’t right. I’m not okay.’” When a mother doessay this, nurses might follow up with questions like: “Can you tell me more about that? What does it feel like?” Nurses can help attach vocabulary and understanding to certain feelings. A mother experiencing these unsettling and frightening feelings should not push them away.
Everything can feel strange following a birth, so be gentle and honest with yourself about your feelings. If you are experiencing troubling or upsetting feelings, ask your nurse or doctor if they can help you find programs and resources. Many mental health agencies offer programs that can help, or there may be counselors in your area that can offer the right kind of support.
It can be helpful to find a solid support system that encourages open, honest communication—this can make all the difference for expectant and postpartum mothers. For Anna, talking to her family and her doctor provided her with the support she needed.
Anna hopes that by sharing her story she can help more mothers feel comfortable about expressing their feelings. Every mother is on her own journey, but she need not travel alone.
By Meredith Vaughn
When a person experiences two or more illnesses at the same time, those illnesses are considered “comorbid.” This concept has become the rule, not the exception, in many areas of medicine, and certainly in psychiatry. Up to 93% of Medicare dollars are spent on patients with four or more comorbid disorders. The concept of comorbidity is widely realized but unfortunately not well-defined or understood.
In mental health, one of the more common comorbidities is that of depression and anxiety. Some estimates show that 60% of those with anxiety will also have symptoms of depression, and the numbers are similar for those with depression also experiencing anxiety.
While we don’t know for certain why depression and anxiety are so often paired together, there are several theories. One theory is that the two conditions have similar biological mechanisms in the brain, so they are therefore more likely to “show up” together. Another theory is that they have many overlapping symptoms, so people frequently meet the criteria for both diagnoses (an example of this might be the problems with sleep seen in both generalized anxiety and major depressive disorder). Additionally, these conditions often present simultaneously when a person is triggered by an external stressor or stressors.
While clinicians can typically recognize one mental illness relatively easily, it’s much more difficult to recognize comorbid disease. They must pay careful attention to symptoms that could suggest other disorders such as bipolar disorder and look for other factors such as substance abuse. This requires time with the patient, possibly their families and other collateral sources of information. The health care system today makes this level of assessment difficult, but not impossible.
Unfortunately, most research today focuses on patients with one illness, and treatments are then guided by this research. In result, there are many well-researched treatments available for mental illnesses, but not for comorbid mental illnesses. There is a lot that we still need to understand about how we recognize and treat conditions when they present at the same time.
There are several things we do know about comorbid anxiety and depression, however, and they underscore this need for accurate assessment. When anxiety and depression present together, these illnesses can often be harder to treat. This is because both the anxiety and depression symptoms tend to be more persistent and intense when “working” together.
This means that those experiencing both anxiety and depression will need better, more specialized treatments. Professionals and caregivers providing treatment may need to get creative, like adding one treatment onto another to make sure that both underlying disorders are responding. For example, if antidepressants are helping improve a person’s mood, but not their anxiety, a next step would be to add cognitive behavioral therapy to the treatment plan.
More research is needed to fully understand why some patients experience comorbid conditions and others do not. Until then, it is vitally important that those experiencing one, two or multiple mental illnesses engage in treatment early, and find a provider they can work with to reach their goals. While treatment may have more challenges when dealing with comorbidity, success is possible.
By Beth Salcedo, MD
When I worked at a psychiatric hospital, I would wheel my cart full of instruments and musical gadgets down the hallway every morning. Patients lingering in the hall would smile and tap on a drum as I passed by. Some would ask me if I had their favorite band on my iPad. Some would peek their heads out of their rooms, and exclaim, “Molly’s here! It’s time for music therapy group!” Oftentimes, I would hear about patients who were asleep in their rooms when I arrived, but their friends would gently wake them with a reassurance: “You don’t want to miss this.”
Music to My Ears
I’ve been lucky to serve many children and adults in various mental health settings as a music therapist. I’ve heard stories of resilience, strength and adversity. I’ve worked with individuals who have experienced trauma, depression, grief, addiction and more. These individuals have not come to me in their finest hour, but despite feeling lost or broken, music provided them with the opportunity for expression and for experiencing safety, peace and comfort.
Research shows the benefits of music therapy for various mental health conditions, including depression, trauma, and schizophrenia(to name a few). Music acts as a medium for processing emotions, trauma, and grief—but music can also be utilized as a regulating or calming agent for anxiety or for dysregulation.
There are four major interventions involved with music therapy:
- Lyric Analysis
While talk therapy allows a person to speak about topics that may be difficult to discuss, lyric analysis introduces a novel and less-threatening approach to process emotions, thoughts and experiences. A person receiving music therapy is encouraged to offer insight, alternative lyrics and tangible tools or themes from lyrics that can apply to obstacles in their life and their treatment. We all have a song that we deeply connect to and appreciate—lyric analysis provides an opportunity for an individual to identify song lyrics that may correlate with their experience.
- Improvisation Music Playing
Playing instruments can encourage emotional expression, socialization and exploration of various therapeutic themes (i.e. conflict, communication, grief, etc.). For example, a group can create a “storm” by playing drums, rain sticks, thunder tubes and other percussive instruments. The group can note areas of escalation and de-escalation in the improvisation, and the group can correlate the “highs and lows” of the storm to particular feelings they may have. This creates an opportunity for the group to discuss their feelings further.
- Active Music Listening
Music can be utilized to regulate mood. Because of its rhythmic and repetitive aspects, music engages the neocortex of our brain, which calms us and reduces impulsivity. We often utilize music to match or alter our mood. While there are benefits to matching music to our mood, it can potentially keep us stuck in a depressive, angry or anxious state. To alter mood states, a music therapist can play music to match the current mood of the person and then slowly shift to a more positive or calm state.
Songwriting provides opportunities for expression in a positive and rewarding way. Anyone can create lyrics that reflect their own thoughts and experiences, and select instruments and sounds that best reflect the emotion behind the lyrics. This process can be very validating, and can aid in building self-worth. This intervention can also instill a sense of pride, as someone listens to their own creation.
On Another Note
When I worked at a residential treatment center, I was notified that a child refused to continue meeting with his usual therapist. Even though he was initially hesitant to meet with me, he soon became excited for our music therapy sessions.
In our first session, we decided to look at the lyrics of “Carry On” by FUN. I asked him to explain what it means to be a “shining star,” which is mentioned several times in the song. I was expecting this 8-year-old to tell me something simple, like “it means you’re special.” But he surprised me when he stated, matter-of-factly: “It means that you are something others notice. It means you are something to look up to, and you are something that helps others navigate.”
And just like that: This lyric offered the opportunity to discuss self-worth, resilience, and strength. Music provided him with the structure and opportunity to process in an engaging way. Soon, his therapist began attending our sessions to help build a healthier therapeutic relationship. His family and teachers reported improved emotion regulation and social interaction skills. Music therapy had provided countless opportunities for building healthy relationships, just as it has for thousands of others.
By Molly Warren, MM, LPMT, MT-BC
If you’re a mom or dad, you’ve walked through the otherworldly time surrounding pregnancy and childbirth. The time following the birth of a child is incomparable: It brings the gift of life and the fun of seeing your family grow.
Parenthood also brings upheaval. Daily routines become irrelevant, sleep is sporadic and scarce, and guilt can take over in ways it never did before. Our old, familiar lives vanish. Like our babies, we’re born into new way of life, and it can take a while to adjust and adapt.
This happens even if all goes well. When you add in a postpartum condition, it can be debilitating. Nine years ago, I struggled as a new parent. After the traumatic birth of my first child, I developed postpartum depression (PPD).
I needed a roadmap. And with the help of other moms, a therapist and research, I pieced one together. My roadmap turned into a book about my journey called When Postpartum Packs a Punch: Fighting Back and Finding Joy. The key points on my roadmap back to wellness are these:
Mental health conditions typically don’t go away on their own—they get worse when untreated. Treatment is key, so do not wait to seek help; you are in charge of your treatment plan. A combination of psychotherapy and medication are the standard line of intervention for PPD, but it varies by person. Different forms of therapy are available, such as supportive therapy, cognitive-behavioral therapy, and eye movement desensitization and reprocessing (EMDR). Talk to your doctor about what would be best for you.
Know You’re Not Alone
Perinatal mood and anxiety disorders affect many women. While the exact prevalence is unknown, some estimates say as many as 1 million moms face it each year in the U.S. alone. Other moms can be your greatest source of strength. If you have persistent symptoms such as intrusive thoughts, sleeplessness or crying spells, reach out to someone you trust. If you don’t feel comfortable doing that, contact Postpartum Support International. They have an invaluable network of women who are a phone call away. There’s no shame in seeking support.
Remember That This Isn’t A Character Flaw Or Weakness
Psychiatrist and chair of the U.K.’s Maternal Mental Health Alliance, Dr. Alain Gregoire, says: “The reality is that we are all vulnerable to mental illness. Our brains are the most complex structures in the universe and our minds are the uniquely individual products of that structure. It is not surprising then that occasionally things go wrong.” Just because you aren’t feeling well doesn’t mean you’re not meant to be a mother. It’s not a subconscious sign you don’t want your child. If your symptoms seem to be telling you this, don’t believe them.
Cling To Hope
Perinatal mood disorders can turn something already difficult—transition to motherhood—into a seemingly impossible hurdle. Just know that the symptoms don’t last forever. They’re temporary and treatable. Keep asking for help until you find the care you need. There’s an army of people who want to help you get better.
By Kristina Cowan
As a mother of two Millennials, I’ve noticed differences between their generation and mine. Like how they prefer to spend money on travel, amazing food and experiences rather than physical things like homes and cars. These aren’t negative qualities—just different.
There is one difference I’ve noticed that is extremely positive: how they view mental health. I recently had a conversation with my oldest daughter, Mackenzie, who struggles with anxiety.
“Mom, you wouldn’t believe how many people my age talk about mental health,” she said. “It’s not a taboo subject anymore. I know a lot of people at work and friends outside of work who see therapists or take medication for anxiety and depression.”
I couldn’t hide my smile. Obviously, I’m not happy they’re dealing with mental illness, but I’m glad they’re not afraid to bring up the subject. My experience growing up was completely the opposite. I felt totally alone. My panic attacks began when I was 10 and I kept it a secret. I didn’t want to be seen as strange or different. By the time I was in my 20s, I panicked every time I drove or went to the grocery store. I knew my symptoms weren’t normal, but I still said nothing. Stigma and fear kept me quiet.
Meanwhile, Mackenzie was 23 when symptoms of anxiety first started to show. At first, I don’t think she wanted to admit she was having problems. She spent hours at the office, working her way up; she rarely took time to relax, never thinking much about her mental health. She blamed her lack of sleep on her motivation to get ahead, and her lack of appetite on acid reflux. But there was a deeper problem.
Mental health conditions run in our family. My mom had depression. My youngest daughter and I have recovered from panic disorder. Mackenzie was aware of our family history, and maybe that made it easier for her to talk about her symptoms. But I think the main reason she was encouraged to get professional help was that she heard her friends and coworkers openly discuss their mental health issues. Mackenzie didn’t feel ashamed or alone.
Millennials are often referred to as the “anxious generation.” They were the first to grow up with the constant overflow of the Internet and social media. The Internet can make life better, but it can also make life complicated, as Millennials often compare their personal and professional achievements to everyone else’s. This can result in low self-esteem and insecurity.
The world is at Millennials’ fingertips, but they also feel its immense weight. “Everything is so fast-paced and competitive. Part of that is social media,” Mackenzie told me. “The sense of immediacy—everything has to happen right away, at the click of a button. There’s pressure to constantly be ‘on.’ To look and sound perfect, and act like you have it all together. But you don’t.”
She continued, “I’m relieved my friends and I talk about being anxious and depressed. I don’t have to pretend anymore.”
A 2015 study by American University said that Millennials grew up hearing about anxiety, depression, eating disorders, and suicide, and they are more accepting of others with mental illness. Millennials are more likely to talk about mental health than their parents or grandparents. As more people speak out, the stigma surrounding mental illness is beginning to lessen.
Word is spreading through social media that mental health is an important part of overall well-being. Celebrities are openly sharing their struggles. The younger generation is learning about mental illness at an earlier age (thanks to programs like NAMI Ending the Silence).
It’s still difficult for many people to be open about their mental health issues—I’m not saying stigma is completely gone. But at least it’s not a totally taboo subject, like it was when I was growing up. I’m thankful Millennials are helping to break that stigma barrier a little further. I’m so glad my daughter doesn’t feel alone.
Jenny Marie is a mental health advocate and blogger. Jenny is married and has two daughters. Her blog is called Peace from Panic.