Working towards recovery through affirmations

  

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Thinking positive thoughts does not make mental illness disappear. It is far too complex for that. But what we think does influence how we feel and how we act. So if you can improve your thinking, you might see positive changes in many areas of your life.

One way of doing this is affirmations. An affirmation is a statement that you are presenting to yourself as a fact. You repeatedly expose yourself to these statements and thereby change the way you think and feel about yourself. 

Sometimes, it’s hard to believe these statements. That’s okay. But for them to work, you need to believe them, so modify them to fit your truth. Instead of “I am brave,” you might say, “I can be brave.” If “I am worthy of love” seems too farfetched for you, try “It is possible that I am worthy of love.” Using smaller, modified statements that you can actually believe is going be more effective than grandiose statements that you just blow off.

There are several ways of using affirmations. Some people look in the mirror in the morning and state to themselves whatever mottos they are using. Others might meditate and use an affirmation as the focus. Another way to do it is by writing it somewhere you will see it often. I tried this last one recently. I wrote up several statements on post-it notes and placed them around my bedroom, bathroom, the door out of the house – anywhere I’d pass daily. I even had one by my light switch. I also had my boyfriend write up a few for me.

Looking back at the last several weeks since I did this, I have become more assertive and confident. I am proud of my accomplishments instead of minimizing them. That was probably the biggest change for me. I learned that it is okay to love yourself and that showing off your self-esteem is not a bad thing. I feel like my relationships with those around me are more open and communicative. I’m also getting my needs met better in those relationships because I know what to ask for and how to set boundaries. 

I’m not saying that all of that can come from hanging up some post-it notes. It can’t. I’ve been working really hard in therapy, in my relationships and by myself. But I think that those positive reminders gave me the push I needed to believe that I was worth those changes. 

So it doesn’t hurt to try. It was actually really nice to have the notes from my boyfriend, so I highly encourage you to ask your loved ones to help you out. You can offer to do the same for them, too. But the most important part is still what you say to yourself. You can have all the love and support in the world, but it won’t matter if you don’t internalize it and only you can do that for yourself.

If you don’t know where to start, I will post a list of some suggestions tomorrow. I also regularly post affirmations on Twitter, Facebook, Pinterest and Tumblr. Follow me on those if you would like an occasional boost. I use a combination of quotes, graphics and thoughts I have personally written with my readers in mind. All of you matter to me and I really hope I can offer something to give you hope.

Have you found affirmations to be helpful? Share what you do in the comments.

Mental health myths: Is mental illness a choice?

I am taking on another mental health myth. Today I want to debunk that mental illness is a choice and that there are easy ways out of it. I am going to label this as an opinionated piece, so if you’d rather not read it, go ahead and stop now. I’ll see you next time.

Myth: You can just snap out of mental illnesses.

Fact: Mental illness is not a choice.

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I have a way of knowing that my mental illnesses are real. If they weren’t, I would change them. I have been trying for years, but I still have disorders that I am gradually recovering from. I have some physical health conditions as well. If I could stop those symptoms, they would be gone, too. But no one expects me to do that. And I have put way more effort into stopping my mental health issues than my physical ones. If I could make them go away, they would have been gone years ago.

Trust me, if you could just make it stop, mental illness would not exist. It’s miserable. It damages your relationships and your ability to function. It can make you your own greatest enemy. Sometimes it causes you to do damage to yourself physically, socially or emotionally. It can be insidious, or symptoms might get unmanageable in an instant. You never know.

If mental illness were not real, the United States would have been $57.5 billion richer in 2006 (The Agency for Healthcare Research and Quality). This was equivalent to the cost of cancer. Thousands of health care professionals would be out of work. The American Psychological Association estimates that there are close to 100,000 licensed psychologists in the U.S. alone. And that number is not considering other types of therapists, psychiatrists, social workers, psychiatric nurses, substance abuse counselors and others who work in the mental health field. There would be no need for such a large industry if people were simply being grumpy or nervous and blowing it out of proportion. 

One in four Americans suffers from a mental illness in any give year (National Institute of Mental Health). If mental illness had quick fixes, the only logical conclusion is that this number would be a lot lower. 

It can be very harmful to treat people with mental illnesses as if it is a choice. Gender is not a choice. Race is not a choice. Sexuality is not a choice. Physical illness is not a choice. And mental illness is certainly not a choice either. Biological bases for certain mental illnesses are considered scientific facts. There are high correlations between environmental and developmental difficulties and mental illness. 

By treating someone as if she is being weak or lazy, you are invalidating a very real struggle that you should be so thankful that you aren’t the one dealing with. Having others reject, mock or belittle mental health issues can make symptoms worse. You will never help someone with a mental illness by encouraging him to snap out of it. Instead, focus on how you can help. Be someone family, friends and colleagues can turn to for understanding and kindness. For ideas about how to do this, read the post about helping loved ones with mental illnesses.

Vignette 4: What Would You Do?

James, an angry student

Background: James is hostile and belligerent.  He frequently appears angry and disrespectful, addressing others with profanity and aggressive gestures.

Scene: James asks to meet with you about his grades.

Ms. Forney: So, James I understand you wanted to see me about your grades.  How can I help you?

James: (Loudly) You can help me by getting rid of all the jerks in my life!  These grades here (hands her some papers) are unfair.  Those damn idiots gave them to me because they don’t like what I have to say.

Ms. Forney: Calm down, James.  Start from the beginning so I know how to help you.

James: (Even louder) Don’t freakin’ tell me to calm down!  I am sick and tired of being treated this way!  And by people who don’t know anything!!  (Gestures with fists in the air) If they don’t stop, I swear I’ll…

Ms. Forney: (Anxious, exasperated) James, you seem angry at me too.  What have I done that upset…

James: You’ve been OK, I guess.  It’s the others that jack me up.  (Slams fist on table)  Talk to them and tell them to leave me alone!

Ms. Forney: I can’t do that James.  But maybe I can help you arrange a meeting with the people you need to talk to about this.

James: Yeah, right, another meeting.  You go ahead and do that.  But it won’t matter tomorrow… (gets up and leaves the office abruptly)

Ms. Forney gets a call from her secretary, Gail, who says:

Gail: Are you OK?  James just stormed out of here and threw a folder at me on his way out!!  I’ve never seen such anger in all my life!

Ms. Forney looks down at one of the papers James handed her.  In the margins James has written: Moron.  You will pay for this.  I will see to it.

Suggestions: Because there are strong indications of threat, as well as objective evidence of aggressiveness, a call to your campus police and behavior intervention or similar team is warranted.  Attorneys have said there is no FERPA impediment to this action, as the information involved represents observable behavior.  It is important to move swiftly so that James gets the help he needs.

When you're upset with your therapist

When it comes down to it, the process of therapy is a relationship. It is being able to open up to someone and finding acceptance, care, empathy, hope and help. But like any other relationship, there can be times when things aren’t going so well. No relationship is perfect.

 

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That doesn’t mean that when you get upset, you should go and replace your therapist. You don’t just switch out family members or close friends. There are certainly circumstances in which changing practitioners is warranted, but you should always try to work things out with your current mental health provider. 

Part of why it’s important to work on repairing ruptures in your therapeutic relationship is because therapy is not entirely unique. You have probably had someone else similarly hurt you. You might have had someone react negatively to you in that particular way. But the great thing about therapy is that you have a chance to work through those problems. You have a captive audience, so to speak, where you can play out the difficulty to its full extent. This can give you incredible
                                                                                                                 insight into your other relationships.

But that doesn’t mean it isn’t hard when something upsetting happens with your therapist. Try hard to see what is actually going on. Was something she said offensive to you? Are you maybe working towards separate goals? Do you disagree with your current treatment plan? Was there a misunderstanding? You need to know what has gone wrong in order to fix it.

And if you want to know what it is, the only way you can find out for sure is through talking about it. Don’t be afraid to say something to your therapist. Some phrases you might try using include:

• “I feel like there is something off in our relationship and I want to work through it. What do you think about that?”
• “I’m not sure we’re heading in the same direction. Could you explain to me why you are choosing the interventions you are using?”
• “I’ve noticed that whenever I ______, you ______. Can you tell me why that is?”
• “It offended me when you said ______, which made me feel ______.”
• “I’m not sure if I/you understood what you/I meant when you/I said ______. How did you interpret that?”

The most important part is getting the conversation going. Therapists know to expect these ruptures. They are trained in how to deal with them. It happens all the time. You are just two people talking and that won’t always work out ideally. It can be a great learning experience. If handled properly, it can help both you and your therapist make progress.

It’s not easy, though, to negotiate when there’s been a breech. At one point my therapist used an intervention that ended up causing me some distress. This caused me to become hesitant to talk about the topic that lead to the intervention. We talked about why he did what he did and why it upset me. We then discussed how that situation could be handled should it arise again. It took me some time to be comfortable discussing that particular topic. I am still very careful about what I say when I talk about it. But we both have a better understanding of how to work with that issue now. I learned to trust him in a new way. He now knows more about what that topic means to me and can act accordingly. 

All in all, you can either look at ruptures in the therapeutic alliance as personal insults that causes resentment and mistrust or you can look at them as a genuine aspect of relationships being played out in the therapy room. I don’t think I have to tell you which is the most helpful when it comes to progressing in your healing. The skill of repairing ruptures is important to all relationships and therapy is an excellent venue to practice doing so.

Have you and your therapist ever not seen eye to eye? Tell us what you learned from it in the comments.

15 journal prompts to increase self-reflection

Journaling can be a great way of expressing what is going on inside of you. Writing forces you to slow down your thinking and be more mindful of your words, leading you to reach a deeper understanding of what you are going through. This can help you gain insights that let you progress on your journey towards healing.

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Engaging in journaling can take different forms. You can write a well-thought out piece or you can put the pen to the page (or fingers to the keyboard) and write without stopping about whatever comes to mind, no matter how trivial or silly it might seem. Journaling can also be done with images, whether you are drawing or collaging. A combination of words and images can be very powerful and express your experiences in a new way. 

Sometimes the words just flow, but other times a prompt can be helpful. Following are 15 ideas to get you started.

1. What relationships matter the most to you? How can you maintain and improve them?
2. How have you changed and grown in the last year?
3. Make a list of how to manage your depression/anxiety/stress/other symptoms. 
4. What is one thing you can do to improve yourself today? This week? This month? This year?
5. Write about someone whose life you have changed for the better. Explore how you can use that experience to help others.
6. What healthy habits do you have? What areas can you improve in?
7. What are things you can do in 15 minutes or less that improve your mood?
8. When was a time you felt content? What made you feel that way and how can you regain that feeling?
9. What do you want your life to look like next year? In five years? In ten years?
10. How do you handle rejection/fear/grief/other negative emotions? How can you be more prepared for those times in the future?
11. Write about an accomplishment you are proud of and what you did to get there. How can you use those skills in accomplishing other goals?
12. What memory do you cherish the most? How did that time impact your life?
13. Write a list of things that make you happy.
14. Who is someone you trust and can confide in? How can you be like this person for someone else?
15. What do you uniquely offer to this world? How can you use this to improve your surroundings?

Do you have any journal prompts to share? The comments are open!

Books about mental illness and recovery

Books are an invaluable source of information. When it comes to mental health, they can be a great resource in helping you understand what you are going through. Following is a list of some of the top-selling books on various mental illnesses. I have not read all of them and I do not endorse any of them. I am simply going by what the most popular titles in the field are. I recommend reading reviews before purchasing a book, as that will give you a better idea of the content. The list is not comprehensive in any way. I hope you find something useful!

Anxiety

The Anxiety and Phobia Workbook by Edmund J. Bourne, Ph.D.

The 10 Best-Ever Anxiety Management Techniques by Margaret Wehrenberg, Psy.D.

The Mindful Way through Anxiety by Susan M. Orsillo, Ph.D. and Lizabeth Roemer, Ph.D.

Attention deficit hyperactivity disorder (ADHD)

Parenting Children with ADHD by Vincent J. Monastra, Ph.D.

Your Life Can Be Better by Douglas A. Puryear, M.D.

Driven to Distraction by Edward M. Hallowell, M.D. and John J. Ratey, M.D.

Autism spectrum disorders

Autism: A Practical Guide for Parents by Alan Yau

Autism by Dr. Robert Melillo

The Complete Guide to Asperger’s Syndrome by Tony Attwood, M.A., Ph.D.

Bipolar disorder

The Bipolar Disorder Survival Guide by David J. Miklowitz, Ph.D.

The Bipolar Workbook by Monica Ramirez Basco, Ph.D.

Living with Someone Who’s Living with Bipolar Disorder by Chelsea Lowe and Bruce M. Cohen, M.D., Ph.D.

Depression

The Depression Cure by Stephen S. Ilardi, Ph.D. 

The Mindful Way through Depression by Mark Williams, Ph.D., John Teasdale, Ph.D., Zinder Segal, Ph.D. and Jon Kabat-Zinn, Ph.D.

Feeling Good by David D. Burns, M.D.

Dissociative disorders

Coping with Trauma-Related Dissociation by Suzette Boon, Ph.D., Kathy Steele, M.N., C.S. and Onno van der Hart, Ph.D.

The Dissociative Identity Disorder Sourcebook by Deborah Bray Haddock, M.Ed., M.A., L.P. 

Rebuilding Shattered Lives by James A. Chu, M.D.

Eating disorders

8 Keys to Recovery from an Eating Disorder by Carolyn Costin, M.A., M.Ed., MFT and Gwen Schubert Grabb, MFT

Life Without Ed by Jenni Schaefer

Healing Your Hungry Heart by Joanna Poppink, MFT

Insomnia

Say Good Night to Insomnia by Gregg D. Jacobs, Ph.D.

The Effortless Sleep Method by Sasha Stephens

The Insomnia Workbook by Stephanie A. Silberman, Ph.D., DABSM

Obsessive-compulsive disorder 

The OCD Workbook by Bruce M. Hyman, Ph.D. and Cherry Pedrick, RN

The Mindfulness Workbook for OCD by Jon Hershfield, MFT and Tom Corboy, MFT

Obsessive-Compulsive Disorders by Fred Penzel, Ph.D.

Panic disorders

When Panic Attacks by David D. Burns, M.D.

Panic Attacks Workbook by David Carbonell, Ph.D.

From Panic to Power by Lucinda Bassett

Personality disorders

Understanding Personality Disorders by Duane L. Dobbert, Ph.D.

The Cognitive Behavioral Therapy Workbook for Personality Disorders by Jeffrey Wood, Psy.D.

Difficult Personalities by Helen McGrath, Ph.D. and Hazel Edwards, M.Ed.

Posttraumatic stress disorder

The PTSD Workbook by Mary Beth Williams, Ph.D., LCSW, CTS and Soili Poijula, Ph.D.

The Post-Traumatic Stress Disorder Sourcebook by Glenn R. Schiraldi, Ph.D.

When Someone You Love Suffers from Posttraumatic Stress by Claudia Zayfert, Ph.D. and Jason C. DeViva, Ph.D.

Schizophrenia

Surviving Schizophrenia by E. Fuller Torrey, M.D.

Schizophrenia: A Blueprint for Recovery by Milt Greek

The Complete Family Guide to Schizophrenia  by Kim T. Mueser, Ph.D. and Susan Gingerich, MSW

Substance abuse

The Mindfulness Workbook for Addiction by Rebecca E. Williams, Ph.D. and Julie S. Kraft, M.A.

Clean by David Sheff

Beyond Addiction by Jeffrey Foote, Ph.D., Carrie Wilkens, Ph.D. and Nicole Kosanke, Ph.D. with Stephanie Higgs

For loved ones

The Family Guide To Mental Health Care by Lloyd I. Sederer, M.D.

When Someone You Love Has a Mental Illness by Rebecca Woolis, M.F.C.C.

You Need Help! by Mark S. Komrad, M.D.

Memoirs

Broken Glass: A Family’s Journey Through Mental Illness by Robert V. Hine

Just Like Someone Without Mental Illness Only More So by Mark Vonnegut, M.D.

Crazy: A Father’s Search Through America’s Mental Health Madness by Pete Earley

Share your favorite books on mental illness and recovery in the comments.

Learning about your diagnosis

It can be overwhelming to be diagnosed with a mental illness. Your diagnosis could be something you have lots of preconceived notions about or something you have never heard of before. Either way, it's normal to have a desire to learn more about your now-named condition.

The go-to source these days is the Internet. You can certainly get a lot of information this way, but not all of it is good information. Start with reputable sites like WebMD or The Mayo Clinic. These will give you a general idea of what you are dealing with. For more in-depth information, look up organizations and foundations associated with your condition. For example, for mood disorders, there’s the Depression and Bipolar Support Alliance and for trauma survivors there’s the International Society for Traumatic Stress Studies. For information on mental illness in general, visit the National Alliance on Mental Illness.

  

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If you are looking for support online, try joining a forum either specific to your disorder or that caters to those with mental illness in general. Two examples are HealthyPlace and PsychCentral. Social networking sites like Tumblr are a bit more disorganized, but have communities that discuss recovery and give support. Be cautious when it comes to seeking support online, though. You are not talking with professionals. People aren’t always who they claim to be, either. If you have any serious concerns, talk to a professional. But if you are simply looking for people who can relate to what you’re struggling with and offer suggestions of what symptom management skills work for them, then the Internet is a great place to find that.

Books can offer more in-depth information than you will find online. Because books have to be accepted by publishers and go through an extensive editing process, they tend to be more reliable than a random website. Look for works written by experts in the field. If anything strikes you while reading – whether positive or negative – bring it up with your therapist. It might turn out to be either something that does not apply to you or a great starting point for a productive conversation. I will post a list of books relating to various conditions tomorrow.

One of the most important sources for information, however, is your therapist. She not only knows about your condition, but knows how it manifests in you specifically. This is invaluable. Ask as many questions as you need to about your diagnosis. You’re not bothering your therapist; in fact, he might appreciate that you are taking an interest in your mental health and are willing to engage in treatment. Therapists can also offer other resources like books or local support groups.

Being proactive in your treatment will help you get better faster. Learning about your diagnosis is one way to do this. It will give you a better grasp on what your are dealing with. Knowing that what you have is not unique and that there are others who are dealing with similar struggles can be very comforting. Just take it at your own pace.

What have you found helpful in learning about your diagnosis? Tell us in the comments.

20 questions to ask a potential therapist

First sessions with therapists can be kind of like first dates or job interviews. You want to find someone who is a good fit for you, so you ask a lot of questions. Figuring out what to ask, however, might not be the easiest thing to do while you’re in the moment. Pick whichever of the following questions are the most important to you and bring a list to your fist session. It’s better to know sooner rather than later if your therapist is the right person for you to be working with.

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1. Are you currently licensed? (In the U.S., this can be verified by searching “license lookup [state]”.)

2. How long have you been practicing? 

3, What is your educational background? 

4. Are you affiliated with any professional organizations? 

5. How do you believe people change? 

6. Have you ever treated anyone with my symptoms? 

7. What did you do? 

8. Did it work? 

9. What did you learn from it?

10. Why are you working in this field? 

11. What do you consider your strengths as a therapist? 

12. What are some areas in which you would like to improve in your practice? 

13. What do you consider the most important factor for healing and improvement? 

14. What are your expectations of a client? 

15. If something comes up between sessions, what would the best thing for me to do? 

16. Have you ever had any disciplinary procedures? (In the U.S., this can be verified by searching “license lookup [state].”)

17. If yes, do you believe you were in the wrong? 

18. What have you done to rehabilitate from disciplinary procedures?

19. Would you be able to recommend additional resources (books, support groups, physicians, complimentary treatments, etc.)?

20. Do you believe you can help me?

Don’t be afraid to ask for any information relevant to your treatment. You have a right to ask questions. Any therapist unwilling to answer such questions should probably not be in practice.

What questions have you had about starting therapy? Let us know in the comments.

Diagnosis spotlight: trichotillomania

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We all have nervous habits, like biting nails or chewing on pencils. But when taken to an extreme, such repetitive actions can become a serious problem. One case is trichotillomania, a condition of repeated compulsive hair pulling that results in hair loss. While much more than a nervous habit, it can have similar feelings of instinctive impulsivity and a soothing power. It is also difficult to stop, so much that professional help is often needed.

Hair pulling can occur at numerous different sites on the body. Some of the most common ones include the scalp, eyebrows and eyelashes. With the latter two, they may become removed completely. Trichotillomania of the scalp can lead to visible hair thinning and baldness. To be diagnosed with it, efforts to stop must have failed and there must be significant distress and/or impairment in at least one major area of life. This might include avoiding social situations due to embarrassment or shame. It can be exasperated by stress.

Trichotillomania is more common than you may think. According to the DSM (psychiatric diagnostic manual), it affects 1-2% of the adolescent and adult population in any given year. Women are ten times more likely than men to have trichotillomania. In children, the ratio is more even. 

There can also be accompanying behaviors to trichotillomania. Rituals may be established in how the hair pulling is done. This might include looking for certain types of hairs, trying to pull out hair in a specific way (like leaving the root intact), studying the hair, playing with it and chewing the hair. It is not required diagnostically, but other body-focused symptoms (nail biting, lip chewing, skin picking, etc.) can be present. Trichotillomania also often co-occurs other mental illnesses, notably major depressive disorder. These should be assessed for and addressed as part of treatment.

Seeking help for trichotillomania is important. In addition to the psychosocial consequences of this disorder, there are multiple medical concerns that accompany it. It can lead to permanent damage to hair growth and quality. Less commonly, it can cause skin conditions, carpal tunnel syndrome and musculoskeletal pain. If the hair is eaten, it can cause dental damage and very painful digestive problems.

  

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Treating trichotillomania primarily involves psychotherapy. Cognitive, behavior and acceptance and commitment therapy have been found to be particularly effective. Habit reversal training might be a big part of treatment, teaching you how to redirect and lessen your behaviors. There is no FDA approved drug treatment for trichotillomania, but some drugs might help alleviate symptoms. These include SSRI antidepressants, clomipramine (a tricyclic antidepressant), olazopine (an atypical antipsychotic) and naltrexone (used to treat substance dependence).

Relapse is very common with trichotillomania. One thing to remember is that a slip up does not mean you are actually relapsing. You can engage in your behaviors without returning to them fully. Let those times simply be single instances instead of an excuse to return to full-blown pathology. Stick to any treatment plans you have developed and don’t be afraid to reenter treatment. Trichotillomania is not a character flaw. It’s a mental disorder that very well might be partially due to abnormalities in brain chemicals. That’s not your fault.

It might be difficult to seek help for trichotillomania, seeing as those who have it often find it embarrassing. Remember that it’s a real condition and that you have as much of a right to treatment as someone with bipolar disorder or diabetes. Any competent therapist will not judge you or berate you. They are there to offer support and help you learn how to manage the condition. With treatment, trichotillomania can and does get better. 

Have you experienced trichotillomania or another compulsive, body-focused problem? Share your thoughts and experiences in the comments.

3 art therapy exercises to do at home

Art therapy is a form of treatment that allows for expression beyond words. It gives you a chance to look at your problems in a different way and learn more about yourself. Today I thought I'd share three different exercises you can do at home. I've included examples of my own work.

1. Create an image of inside your head.

What does it look like inside of you? Create a piece that represents what is going on internally. This can be as abstract or as concrete as you'd like. Collage words and images or just find colors that represent your feelings. I made this one at a time when I was feeling particularly overwhelmed.

2. Let words inspire you.

Look to words to inspire an image. Find a quote, song lyric, affirmation or other words that speak to you. Create something to represent it. You may or may not want to use the actual words in the piece. I used a quote by Drew Barrymore: "In the end, some of your greatest pains become your greatest strengths."

3. Make an altered book.

Take an old book and create art on the pages inside. You can use words that are on the page as part of your art, or you can just work over them. There are an unlimited number of ways you can do this project. I've found that this visual journaling can be a great way of tracking my progress. For some practical instructions, look here and for inspiration of how your pages can look, go here.

Art therapy can be both relaxing and really hard work. If you start to feel overwhelmed, take a break. You don't have to actually finish a piece if it's bringing up too much. Creating art, especially as a part of your treatment, can be very powerful and informative. Bring your pieces in to therapy to give your therapist a chance to see what you are experiencing in a whole new way.

Want to share what you've made? Link to your images in the comments.

Are antidepressants safe for youth?

Antidepressants are used both as first line and adjunct treatment for depression. The most commonly used type is selective serotonin reuptake inhibitors, or SSRIs. A simplified explanation of how SSRIs work can be found here. These drugs are also used to treat other mental health conditions, mostly anxiety disorders. It does takes several weeks for the positive effects of the medication to manifest, at least with depression.

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All medications come with certain risks and side-effects. SSRIs, however, can be extra hard on children, teens and young adults. The FDA has issued a black box warning on all SSRIs, which is its strongest warning. It states that taking these medications can cause an increase in suicidality in those up to age 25. 

This warning is issued because 4 percent of children treated with SSRI medication experience suicidal thinking and behavior (including attempts). This is twice the rate of those who took a placebo (sugar pill). So while the odds of having this reaction to an anti-depressant are low, it is important to watch for, especially in the first month or two and around dosage changes. 

It is believed that the benefits of taking an SSRI outweighs the risks. And it is true that it is a fairly rare reaction. But without discouraging antidepressant use, I want to stress how real that suicidality can be. I was 20 the first time I took an SSRI and there was a marked difference in my level of suicidality. I went from thinking about dying to planning on it. As soon as I realized this, I contacted my psychiatrist and he reduced the dosage. I had to be watched for a few days, but it got better.

What I learned from that is to not go through medication changes alone. Let important people in your life know about the change. These include family, significant others, therapists and other healthcare providers. When symptoms become worse, it can be hard to reach out for help. If others are looking out for you, it is much safer to go through medication changes. They can notice if you change and help make sure you talk to your healthcare provider.

Suicidality isn’t the only side effect of medications. Even in adults, SSRIs can make you more depressed before you get better. I’m now 26, but I let my mom, boyfriend and therapist know every time I go through a medication change, even if it’s just changing the dosage of something I’m already on. No matter what you are taking – whether it’s for a physical condition or a mental one – I think it’s good to tell those who will be around you the most. 

So are SSRIs safe for those under 25? For the most part. Just monitor any adjustments very closely. If you are thinking of taking or having your child take antidepressants, mention any concerns you have to your prescribing physician. She can help you make a plan for how to handle any side-effects that might come up.

Have you taken antidepressants while under the age of 25? What was your experience? Let us know in the comments.