20 things not to say to someone with a mental illness

Mental illness is hard enough to handle on its own. Having other people make insensitive comments just make it even worse. It is, however, important to acknowledge that these remarks are generally not meant to be hurtful. They often reflect a lack of understanding mixed with a desire to seem helpful or comforting. Still, words can hurt. Here are 20 things to avoid saying when speaking with someone about their mental illness (and what I’m thinking when you say it).

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“Just snap out of it.” If I could, I would.

“Stop feeling sorry for yourself.” Mental illness is a legitimate problem and it’s okay to have feelings about it.

“I promise it will be okay.” You have no way of knowing that.

“Why are you like that?” That’s for me and my therapist to figure out.

“Can’t you just try to be different?” I’m pretty sure I have.

“Yeah, my brother has depression, too.” Everyone experiences mental illness differently, so I don’t want to be compared to someone else.

“That’s weird.” I know. I don’t need to hear you saying it, though.

“You’ve been doing it long enough now. Stop.” There would be no need for therapy if we could go in and out of mental illness at will.

“There are others who have it worse.” I know, but suffering is not a contest.

“At least it’s only depression/anxiety.” Even the most common mental illnesses can be extremely difficult to handle.

“That’s just how you are.” Mental illness is not a character flaw.

“You brought this on yourself.” Even if I did contribute to the problem, I did not ask for this. 

“I know how you feel.” No, you don’t, and I’m offended that you think you do.

“Things will change soon.” Timing is always a big question mark with mental illness.

“It’s all in your head.” That’s why it’s called mental illness. But it affects physical health, too.

“Do something to distract yourself.” This is not nervous anticipation. It won’t just get better if I wait.

“Don’t be so negative.” I am entitled to my feelings. Besides, I’m pretty sure you would be “negative,” too, if you were in my shoes.

“It could be worse.” Yes, it could, but that doesn’t mean this isn’t difficult.

“But you have so many things to make you happy.” That doesn’t change that I’m also struggling.

“You don’t seem to have a mental illness.” Mental illness is not always apparent on the outside.

Sassy remarks aside, feel free to share this post with someone who might need a little perspective. For things you can do that are actually helpful, read this post.

What have people said to you about mental illness that you have found hurtful? How do you respond? Tell us in the comments.

Dating violence and your mental health

One of the saddest situations is hurting someone under the disguise of love. Unfortunately, abuse in the dating setting happens much too often. A third of adolescents are victims of abuse by a dating partner, while 43% of college women experience violent or abusive dating behaviors. Clearly, things can go sour long before moving in together or saying, “I do.”

Dating violence happens in many ways. Most commonly, there can be physical, sexual, verbal or emotional abuse. This doesn’t have to be extreme behavior in order for it to be legitimately abusive. You don’t have to break bones – a slap or a shove is physical violence, too. Rape is one form of sexual assault, but unwanted touching is as well. Verbal abuse may escalate to threats, but can start out with name calling or simply making you feel bad about yourself. Before controlling everything you do, an emotional abuser may start with something seemingly minor, like insisting you dress a certain way or constantly asking about where you are and what you’re doing. Abuse is abuse, no matter the degree, and abuse is wrong.

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There is a high emotional and psychological toll to dating violence. It sets up a pattern that allows for future abuse. It increases the risk of drug and alcohol abuse, as well as risky sexual behaviors. These things, if unchecked, can lead to a lifetime of pain. It gets so bad that half of all young people who experience both dating violence and rape attempt suicide. 

You can also experience mental illness as a result of dating violence. Depression, anxiety, phobias, posttraumatic stress disorder and sexual concerns are but a few of the potential results. Even if no specific disorder manifests, therapy may be necessary due to the stress and distortion resulting from being in a violent relationship. 

Unfortunately, leaving these types of relationships can be risky. If someone can hurt you while claiming to love you, you bet (s)he can retaliate if you try to end the relationship. Timing and safety are very important when leaving abusive relationships. This is one reason professional help is important. Creating a safety plan can honestly be a life-saver. If you are experiencing dating violence, talk to your therapist. If you feel you are in immediate danger, call 911. Otherwise, a list of some additional resources are below.

Loveisrespect

www.loveisrespect.com

1-866-331-9474

Text loveis to 22522

Chat available on website

National Domestic Violence Hotline 

www.thehotline.org

1-800-787-3224

Chat available on website

Rape, Abuse & Incest National Network (RAINN)

www.rainn.org

1-800-656-4673

Chat available on website

Have you experienced dating violence? Share your stories and advice in the comments.

Taking risks in therapy

   

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We all have something that we don’t like to talk about. While therapy is an appropriate setting to explore these issues, we sometimes hold back on certain things — even in that context — out of fear. “Will I sound crazy?” “Will I be believed?” “What will my therapist think of me?” “What are the consequences of saying this?” “Will my therapist think less of me?“ These questions and more prevent us from being completely open in our treatment. 

But if you never take risks, you won’t progress when it comes to those issues. In fact, they may become worse as feelings of shame, embarrassment, guilt, hostility and unworthiness fester inside of you. The fact that you won’t talk about the topic becomes an issue in and of itself. 

The first obstacle you need to pass is trusting your therapist. You can read more about that here. In short, developing a strong therapeutic alliance in a safe relationship allow you to be more open. Keep in mind the ways in which your therapist has been trustworthy in the past. If you remind yourself of these things, opening up might not seem quite as impossible.

Still, even with trust, it can be hard to explore certain topics. I spent a lot of time trying to figure out how to talk about a series of events that happened a few years ago. I had been seeing the same therapist I’m seeing now at the time these things happened and my irrational fear was that I’d remember things wrong and become discredited. But I have yet to find a way around those fears. So what could I do?

It got to a point where my only options seemed to be to keep quiet and never heal or to take a risk and see what happened. After years of deliberation, I decided to just go for it and see what would happen. For me, that meant telling the story regardless of my fears. So I did. 

I was not prepared for how well that went. At first, I addressed my concerns about how he might remember things differently than I did. I asked my therapist to not go back and read his notes from the time in question and he agreed to follow my request. This removed a lot of pressure. 

It’s going to take a while to get through everything. And that’s okay. Breaking the larger story into smaller segments allows me to do a little each week. This way I get insight into each part, which helps me understand the larger context at play. While the content is very difficult and, at times, triggering, I’m feeling better about myself and am more realistic about my role in those events.

Jumping in is not always the solution, but I’m pretty sure that at this point in the post, you have a specific issue or situation in mind. Test the waters. See what happens. Be honest about your concerns. You can discuss them before you get to the actual content. But when you’re ready, opening up despite fear can be extremely healing. I know it has been for me.

What risks have you taken in therapy? How did it work out? Tell us about it in the comments.

5 techniques for the moment you are overwhelmed

We all have those moments where we are hit with something overwhelming. Whether it be an argument, a panic attack or a piece of bad news, our gut reactions aren’t always the most helpful. That’s why it’s important to have coping strategies for those first few moments. Try one of these techniques the next time you need to stay calm while dealing with a big emotion.

1. Use breathing techniques

There’s a breathing trick I have been using lately to help calm down and refocus. First, you close your eyes. Feel everything that’s inside you and pick a word that best describes your emotions. Now, forget about that while you breathe in for four counts, hold for four counts and breathe out for eight counts, thinking only of your breath (or, if you’re like me, the counting). Do this three times, then check inside again and label your emotion. You should be seeing at least some improvement. Keep doing this as many times as you feel necessary.

  

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2. Accept the situation

There are things we simply cannot change. They happen and we have to deal with them. Instead of thinking thoughts like, “This can’t be happening!” or “That’s completely wrong!”, try just accepting it. Your outrage is not going to change the situation. Accepting is not the same as agreeing. Accepting means facing reality for what it is instead of delving into your own pathology. By trying to make something different than what it is, you are wasting your time and mental resources. Make the decision to accept whatever happened and then see how you can have a helpful reaction.

3. Take a break

There are some situations that have to be dealt with immediately, but often you don’t actually have to respond at once. When you are overwhelmed, step aside from the incident until you can gather yourself. You can tell the others involved that you need a moment, but you can also take a timeout without letting on why. Just go to the bathroom or say that you need to check that you turned off the stove. Anything is helpful. Another trick for smaller breaks is to have a drink with you. When you need a moment, just take a sip. It’s amazing how big of a difference a few seconds can make.

4. Ask for help

If someone else is in a position to be helpful, just ask. If it’s difficult for you, it’s often difficult for someone else, too. They’ll understand and do what they can. You can call a sister and vent, go out on the town with a friend or simply ask your therapist to hand you a tissue. Feeling alone in a situation can make it so much worse, so showing yourself that you are loved and cared for can be very calming.

5. Express yourself

Sometimes, feelings demand action. Some of the options that occur to us are healthy; some are not. Pause to make sure your action is appropriate before you act. Punching a wall might sound therapeutic, but you can hurt yourself and/or the wall.  You could hit a pillow a few times instead. If appropriate, you could also respectfully state out loud what you are feeling and experiencing. If you don’t have the option of expressing yourself in the moment, make a mental note of how you will do it later. This could be journaling, exercising or talking to your therapist, for instance. Knowing that you have an outlet later can help you better focus in the moment.

What do you do in the moments you are overwhelmed? Give your own tips in the comments.

5 tips for dating someone with a mental illness

  

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It’s February, so romance is on everyone’s minds. Love is such an important emotion. It can change lives in a way that nothing else can. We all need love, and that includes those of us with mental health issues. Here are some suggestions to help you if you are dating someone with a mental illness.

1. Ask appropriate questions.

You need to be reasonably respectful of your partner’s privacy, but don’t be afraid to ask questions. Preface them with, “You don’t have to answer this, but I’d like to know…” so that he doesn’t feel like he is being pressured. Focus on what pertains to you. “What do you want me to know about your condition and how it makes you feel?” “How can I be helpful?” “What are signs that your symptoms are worsening and what do you need when that happens?” It matters a lot when someone takes the time to find out how she can be supportive.

2. Give him space – or don’t.

At a time when your partner is doing reasonably well, talk about how much space she needs and when she needs it. Also talk about when he should not be alone. For instance, someone with PTSD might not want to be touched while experiencing flashbacks. Discuss those boundaries. Alternately, depressed people tend to shy away from others, but it isn’t always healthy. Asking in advance, is it okay to take initiative when these times come? If serious suicidal thoughts are an issue, make sure that your partner has someone to be around at all times. Support and space are equally important and it’s helpful to know when each is needed.

3. Focus on her strengths.

Mental illness can make you feel vulnerable, inferior – even useless. Some people feel like they aren’t contributing enough to the relationship or that they are being a burden. This is why it’s very important to make note of when he does something positive. Notice specific actions and comment on them. Things as simple as “Thank you for making me dinner,” “You look nice today,” and “I appreciate that you spent time with me today,” can boost self-confidence and foster positive emotions. A lot of people with mental illness need reassurance, so knowing they did something right can bring peace of mind.

4. Be accommodating and flexible.

Part of the challenge of mental illness is that it’s unpredictable. Sometimes there’s a reason that symptoms flare up, such as stress or failure, but other times random little things can set off an episode. Work with what you have at any given time. If you had a dinner and movie date planned, but your partner is too anxious to leave the house, order takeout and watch something on Netflix. If physical intimacy is difficult, go slowly and let him take the lead. If she has a hard time being around strangers, don’t drag her to big social events. 

5. Set your own boundaries.

Having a partner with a mental illness can be stressful. At times, you might find yourself in a caretaker role and it can be draining. This is why it’s important that you set boundaries. For instance, make sure you have enough time to take care of yourself. You might need to state that when he starts yelling at you, you will leave until he has calmed down. It might be helpful to make clear that there are some things she can’t blame on her illness (and what they are). It’s important to be understanding, but if you are struggling, you need to have the space to take a break and gather your strength. You can’t be as helpful if you aren’t doing well yourself.

Mental illness is hard on both partners, but it isn’t an impossible barrier to a happy relationship. While your partner might have some challenges, he also has gifts to offer. Living with a mental illness can make you empathetic, brave, considerate, grateful, persistent, thoughtful, strong and any other number of positive qualities. It encourages deep feelings and that includes love. In the end, both of you are just people. You have frustrating qualities as well. But love is beautiful in that it can make everything else disappear, if only for a moment at a time. Love is worth whatever it takes.

Check back on Tuesday to hear about dating from the other side.

What have you found helpful in dating someone with a mental illness? Tell us in the comments.

Depression May Be Linked to Inflammation in the Brain

New research in Canada reveals that inflammation deep in the brain may be linked to depression.  Specifically, the Centre for Addiction and Mental Health (CAMH) studied the brain scans of patients with depression and those without.  Results showed 30% more inflammation in the brains of patients with clinical depression.  In addition, symptoms worsened with the degree of inflammation.  Keeping in mind that researchers only studied the scans of 40 patients, concrete conclusions are a tad premature.

Nevertheless, this research does offer new ideas for investigation, which could uncover other possible causes for the illness as well as potential new treatments for depression.  In other words, perhaps reducing inflammation in the brain may alleviate or eliminate the symptoms.  This is exciting news for the individuals that do not respond to medication, which, according to this research, consists of 30 to 50 per cent of patients!

“Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants.

[…] The purpose of inflammation is to eliminate the initial cause of cell injury, clear out necrotic cells and tissues damaged from the original insult and the inflammatory process, and to initiate tissue repair.

[…] Too little inflammation could lead to progressive tissue destruction by the harmful stimulus (eg. bacteria) and compromise the survival of the organism. In contrast, chronic inflammation may lead to a host of diseases, such as hay fever, periodontitis, atherosclerosis, rheumatoid arthritis, and even cancer (e.g., gallbladder carcinoma).”

According to Dr. Jeffrey Meyer of CAMH, it is theorized that the body of patients that have suffered some type of infection or trauma may have healed, however the brain has not had the opportunity to recover.  This may explain why patients with certain types of inflammatory disease, such as lupus, are several times more likely to develop clinical depression.

Of course, it is still unclear whether the inflammation in the brain occurs before depression sets in or as a result of the illness.

_______________________________________________
Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depression, major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and depression may make you feel as if life isn't worth living.

During these episodes, symptoms occur most of the day, nearly every day and may include:

• Feelings of sadness, emptiness or unhappiness
  
• Angry outbursts, irritability or frustration, even over small matters
  
• Loss of interest or pleasure in normal activities, such as sex
  
• Sleep disturbances, including insomnia or sleeping too much
  
• Tiredness and lack of energy, so that even small tasks take extra effort
  
• Changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people
  
• Anxiety, agitation or restlessness — for example, excessive worrying, pacing, hand-wringing or an inability to sit still
  
• Slowed thinking, speaking or body movements
  
• Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that are not your responsibility
  
• Trouble thinking, concentrating, making decisions and remembering things
  
• Frequent thoughts of death, suicidal thoughts, suicide attempts or suicide
  
• Unexplained physical problems, such as back pain or headaches

Facts: 

• Depression is a common mental disorder. Globally, more than 350 million people of all ages suffer from depression.
  
• Depression is the leading cause of disability worldwide, and is a major contributor to the global burden of disease.
  
• More women are affected by depression than men.
  
• At its worst, depression can lead to suicide.
  
• There are effective treatments for depression.

Study finds link between depression, brain inflammation
Inflammation
Depression (major depressive disorder)
Depression

© www.mentalhealthblog.com

Past vs. present

   

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When in the middle of a stressful or triggering situation, it can be easy to let emotions get the best of you. The thing is, those feelings aren’t always connected to the present circumstances. Luckily, there’s a quick way to calm down and see what’s really going on. It’s called past vs. present.

This technique is pretty much what the name suggests: comparing the past and the present. When you are feeling emotionally overwhelmed, take a minute to look back and consider other times you have felt similarly. Then you can tell yourself what is currently different than the past situation. Here are some examples to help you get the point.

You ask out someone that you met at a party and get rejected. This might make you feel upset or confused and lower your self-esteem. When you think of where you’ve felt those feelings before, you realize that it’s how you felt when your ex left you. But in the present, we’re not talking about someone you had made a commitment with. This concerns a relative stranger. Someone you just met should not be allowed to have the same emotional sway as someone you were deeply connected to. You recognize that the current situation does not carry as much weight as the one in the past, so while it’s not fun being let down, it doesn’t have to ruin your day.

You have to give a presentation at work. No matter how much you prepare, you feel anxious and like you are going to mess up. You are afraid you’re going to be made fun of, so you think back and see if you can remember a time that it actually happened. You remember that in junior high, you had to do a presentation, but forgot and had to go in front of the class unprepared. As you stumbled around a topic you didn’t know much about, you could hear snickering and whispers in the room. In the present, however, you are prepared. You know the material and have been practicing what you will say. You don’t have to feel as nervous as you did back then.

Someone you encounter seems to upset you for no reason. You don’t know why you dislike him; others around you might think he’s great. She may never have said or done a single offensive thing to you, but you can’t get rid of your dislike for her. That is when you look back and see who this person reminds you of. Maybe he looks like a mean coach you once had. Maybe she has the same tone of voice your mom had when she was angry. It can also be a matter of position, such as having a bad experience with a doctor and projecting that onto future doctors. Once you can recognize that the person who upset you is actually in the past, you can move forward with the present person.

It can sometimes be a little tricky to find out who or what you are actually dealing with emotionally, but a little reflection can go a long way. Even if you can’t find a person or reason in your past, looking for it might help you realize that the situation is not as bad as it might feel. 

Do you think this technique could be helpful for you? Try it out and come back to tell us how it went.

Make a 5-step safety plan right now

In the midst of a crisis, it’s hard to think clearly and make good decisions. That’s why it’s important to know ahead of times what to do when the going gets tough. A safety plan gives you a template for action when you are feeling suicidal, tempted to self-harm, drawn into addictions, engaging in unhealthy behaviors or feeling self-destructive. 

Having a written safety plan can be a huge help when you’re symptomatic, so let’s make one. One way of doing this is by looking at all the questions surrounding the issue. By using those five Ws, you can pretty quickly explore the many facets of staying safe. Grab a piece of paper or copy the questions into your word processor and finish this post with a safety plan in hand. 

 

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Who can I talk to?

You don’t have to go through tough times alone. Write down the people in your support system who are good listeners and who know how to make you feel better. Include their addresses, phone numbers and/or email addresses just in case you don’t have access to that information. Put a suggestion by each name stating what this person can be helpful for, like “Call my boyfriend to hear why I am loved,” or “Visit my mom to get advice.” 

What can I do to feel better?

Think about difficult times in the past and try to identify what, exactly, you were feeling and maybe even what caused those feelings. By identifying what’s setting you off, you can better find ways to manage it. Write a list of your most common triggers and a healthy way to deal with each one. This might look like “When I feel scared to go outside, I can have someone come with me,” or “When I am disappointed, I can create a gratitude list.”

When do I need to seek help?

Know your limits. Create a guide showing what to do at the different stages you might escalate through. This takes away the decision making element that can be overwhelming when you are upset. It could look something like this: “Feeling sad: Go for a walk. Wanting to hurt myself: Spend time around friends. Engaged in self-injury: Care for my wounds, then do something nice for myself. Feeling suicidal: E-mail my therapist. Actively suicidal: Call a suicide hotline or 911.”

Where can I go?

Sometimes a change of scenery can make all the difference. Make a list of places that you enjoy or that are helpful to you. While still being safe, make sure you have options for both day and night, even if it’s just a different room in the house. Some places you might want to consider are the homes of loved ones, support groups, your favorite park, a local coffee shop, the library, a scenic route for driving or even your own backyard.

Why should I not do this?

Make a list of all the reasons acting on your impulses aren’t a good idea. Acknowledge the negative consequences, but make sure to also stay positive. Having something worth not giving in for is really helpful. This could range from “I want to keep my body healthy,” to “I want to reach three months without this behavior,” or simply, “I deserve to be happy.” If you need help getting started, a list of reasons to recover can be found here.

Keep copies of your safety plan in accessible places, like in your purse, wallet, backpack, car, nightstand, comfort box and on your phone. You can also give them to people you trust who will notice when you are having a tough time so that they’ll have a guide for how to best help you. If you haven’t already been following along, I really suggest you do this. Having a safety plan is invaluable when you are in the midst of being symptomatic. It’s a lot easier to think of things now than in the moment.

What did you include in your safety plans? Is something important missing? Make suggestions in the comments.

15 ways to improve your mood in 15 minutes or less

Recovery is a long-term process, but that doesn’t mean that there aren’t quick fixes along the way. Sometimes, a few minutes is all that’s needed to clear up some anxiety or get rid of the blues. So the next time you are feeling out of sorts, try one of these suggestions. With time, you’ll have your own list of what works best for you.

1. Meditate. Taking a few minutes to slow down, focus on your breathing and clear your mind relaxes both your body and mind.

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2. Laugh. They don’t say that laughter is the best medicine for no reason. Bookmark funny YouTube videos and silly cat pictures that make you giggle.

3. Move around. Whether it’s jumping around and dancing or taking a walk around the block, getting a little exercise makes your body release endorphins, which in turn boost your mood.

4. Do something nice. By performing a random act of kindness, you take your focus off yourself and your problems, which means both the receiver and you benefit.  

5. Take a nap. Close your eyes and drift away for a while. Taking long naps can mess with your sleep cycle, though, so keep it short and sweet.

6. Pull out your journal. The nice thing about journaling is that it takes what’s in your head and places it somewhere else. If needed, here are some journaling prompts.

7. Talk to someone. Call that friend who always knows how to cheer you up. A little human contact can go a long way.

8. Snack. At times, we get grumpy or irritable because we haven’t eaten. Eat a healthy snack or indulge in something you love.

9. Listen to music. Create a playlist of songs that make you feel better. Keep it on your phone, your work computer, in your car – wherever you might need it.

10. Get some sunlight. Soaking in some sunlight increases your vitamin D levels. This, in turn, boosts your serotonin levels, which keeps you happy.

11. Look at pictures. Take a walk down memory lane. Seeing good times and people you love will make you smile and remind you that things aren’t so bad. 

12. Spend time with a pet. A little time with your cat, dog, hamster, bird or whatever you have reduces stress. Besides, they’re just so cute. 

13. Aromatherapy. Scents impact people’s moods. Use your favorite smell or try citrus, lavender, basil, cinnamon or peppermint. 

14. Learn something new. There’s that little high that comes with finding out something really cool. Click on a few Wikipedia pages and see what comes up.

15. Make a gratitude list. A tried and true method for improving your mood is to make a list of things you are grateful for. It’s hard to be unhappy when you are thinking about what you appreciate.

What helps you feel better in 15 minutes? Share your tips in the comments.

Don’t put a timetable on recovery

Like most people, I entered therapy not knowing what to expect. I had dealt with depression and other mental health symptoms for years, but thought that I could take charge of my problems in a matter of weeks – a few months at the most. Almost eight years later, I’m still at it.

Assuming when I would “get better” was a mistake. The thing is, you never know. You may ask a therapist for an estimate, and they’ll often give you one. 8-12 sessions is a frequently used figure. But really, there are so many factors that influence this. There is no way to calculate how long treatment will take. 

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It is unfair to both yourself and your therapist to set a timetable on recovery. There is nothing wrong with setting goals, but don’t make hard deadlines. The mind is very complex and what’s masquerading as a relatively simple concern might actually be liked to a much larger underlying problem. You just might not see it before you examine the presenting concern. 

On the other hand, sometimes it’s faster than you’d think. I’ve heard of people benefiting from a single session. All your life problems won’t be solved in an hour, but sometimes you luck out and get the insight you need a lot quicker than expected. Really, don’t go in expecting one session to fix everything, but know that what you think might take many months or years may actually not require that much time. 

Unfortunately, insurance companies aren’t nice about letting you take as long as you need. There are often limits on how many sessions they will pay for. This means that you will want to try to make the most of your time with your therapist. Talk to her about what to do. Seeing him every other week instead of weekly can give you slower progress, but it stretches out over a longer period of time. Together you can find out what’s best for you. Also, don’t be afraid to call your insurance company if you have questions. 

Even when therapy is over, it does not mean that your progress ends there. You should not expect to be completely “fixed.” Recovery is a journey, not a destination. For many people, managing one’s mental health is a life-long endeavor. Improving your mental health is a long-term commitment. However long it takes to feel better is how long it takes. Just don’t stop trying. The “do it at home” tag is a great source for exercises to keep up your progress independently of therapy.

I know it’s hard, but don’t stress about how long your recovery will take. That only creates more anxiety and concern. Accept yourself for where you are at and be proud of yourself for any progress, no matter how small. It’s heading in the right direction that matters. Maybe you’ll feel better soon and maybe you won’t. The persistence you put in to your recovery will, however, eventually pay off. 

Are you able to be patient with yourself about the rate you’re progressing at? How did you come to peace with it?  Let us know with a comment.

5 paths to self-discovery

One of the primary purposes of therapy is to learn more about yourself. This process of self-discovery allows you to understand what’s going on with you, which then leads to better decisions that create a happier life. But finding out who you are doesn’t have to be limited to an hour a week. There are other ways to discover new things about yourself.

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1. Make a timeline

Using a poster board (or just lots of paper taped together), create a timeline of your life. Include major events (starting kindergarten, first boy/girlfriend, death of grandparent), but also changes in who you are (depressive episodes, discovering hobbies, learning the importance of self-care). Alternately, you can have a sheet of paper for every year of your life. If you put this in a binder, you can add to it as time goes on. You can even use pictures. As you look through your timeline, you can discover patterns in your life or connections you would not otherwise have made. For instance, did your anxiety start at the same time you switched schools? This, and the rest of your timeline, is useful information to share with your therapist.

2. Meditation/spiritual practice

We all try to get a sense of how we, as individuals, connect to the larger “whole” of humanity and the universe. Many people find this meaning in spiritual practices. No matter what your belief system is, it can help you discover purpose within your life. Meditation is one practice that can be applied across religions (or the lack thereof). The concentration required for meditation opens your mind up to new insights and ideas. Other spiritual practices – such as prayer, worship or talking to a religious leader – can also be profound ways to learn about yourself.

3. Trying new things

Remember when you were a kid and something on your plate looked gross and you didn’t want to eat it? A parent probably told you that you don’t know you don’t like it until you try it. This principle can be very widely applied. You don’t know how you’ll feel about new activities and experiences until you have actually attempted them. Finding new interests through exploration and experimentation lets you discover parts of you that you didn’t even know were there. Alternately, if something doesn’t resonate with you, that says something about you, too. Do something you would not normally do. Go see a play in the park, try your hand at tennis or go to a foreign restaurant to see if, yes, you like it because you tried it. 

4. Journaling

Writing can be a very powerful tool of self-discovery. The process of putting words on paper brings up things you didn’t know were there, allowing new information about yourself to surface. It also gives you a record throughout time, allowing you to see how you’ve progressed in your thinking and your recovery. It is a mindful and in-depth form of looking at things. Journaling can be done in many ways. You can do it freestyle where you just go with whatever comes along or you can work with prompts. A list of them can be found here. 

5. Ask questions

Children learn more content in a shorter amount of time than adults do. That is, in part, because kids ask so many questions. As we get older, we like to think we have things figured out, but embracing that you don’t know everything will ultimately make you wiser. Ask yourself questions about yourself, the people around you and larger issues. Why is your favorite color the one it is? Why do people tend to cut conversations short with you? How do you feel about sending people to prison? By actually examining yourself and the world around you, you get a fuller understanding of who you are, what matters to you, what you believe in, what your priorities are, who you want to become and so on. 

How do you learn more about yourself? Tell your self-discovery stories in the comments.

Diagnosis spotlight: depersonalization/derealization disorder

We all experience dissociation in some way or another. It can be as simple as highway hypnosis, where you suddenly realize you’ve driven for miles without noticing, and as complicated as dissociative identity disorder, formerly known as multiple personality disorder. Somewhere in-between, there is depersonalization/derealization disorder.

First of all, what are depersonalization and derealization?

Depersonalization refers to a distortion in self-awareness. You are, in a sense, unfamiliar with yourself. One typically experiences detachment from the body or the sense that it is unreal. It can even mean watching yourself from outside your body. The self just doesn’t feel real and things might seem like a part of a dream. It can also be watching yourself go about your day and making decisions, but not really feeling in control. Time might also be distorted and there can be physical and/or emotional numbing. 

Derealization is when everything else doesn’t feel real. Your surroundings might feel foggy, distorted, unreal or, again, like a dream. People, places and things that may be familiar seem strange or surreal. It’s hard to fully perceive the world around yourself and it might seem like you are watching everything through a filter of sorts. It can be like living in a bubble. What is around you is very separate from you and it can be hard to fully engage in life. 

Depersonalization/derealization disorder means having episodes of one or both of these. It can be accompanied with a feeling that you’re “going crazy.” There might also be vague physical symptoms, like tingling or lightheadedness. It is often associated with anxiety and/or depression. 

Approximately one-half of adults have had an episode of depersonalization or derealization. It happens. But when it is recurring or even constant, it can become pathological. Onset is almost always before age 25, so it’s something that can be experienced from a very young age. Childhood trauma is considered one of the causes of depersonalization and derealization, but it can happen without it. Symptoms can also be caused by physical conditions or substance use, so those need to be ruled out. Episodes are often preceded by high levels of stress, anxiety, depression, traumatic events (or reminders of them) and/or drug use.

Both therapy and medication are used to treat depersonalization/derealization disorder. In particular, cognitive behavioral therapy allows people to reinterpret the symptoms and psychodynamic therapy can look at unresolved and suppressed internal conflicts. Medication-wise, nothing has been approved specifically for the treatment of this disorder, but anxiety medication and anti-depressants have shown some success. There is also research supporting the use of lamotrigine, an anti-convulsant typically used to treat epilepsy. Using grounding techniques can also be very helpful.

Having the experiences of depersonalization and derealization can be very frightening. But it is a recognized mental health condition and a notable amount of people experience it. If you feel like the symptoms described apply to you, please talk to a doctor or therapist. It is possible to gain control over it enough to where it is not interfering with your life, if it doesn’t go away altogether. 

Have you experienced depersonalization or derealization? What was it like for you? Share your experience in the comments.

5 habits that promote mental health

Mental health is not something you are born with or without. It is something that can be impacted by as many different things as your physical health can. We might take vitamins and get flu shots to protect our bodies, but do we offer the same level of care to our mind? Here are some habits that can help your mental and emotional health.

1. Take care of your body

Your mind and your body interact on a constant basis. What you do to one will surely affect the other. That’s why taking care of your body is essential. Consult your doctor to find out what is best for you, but here are some general guidelines. Eat appropriate amounts of healthy food on a regular basis. Ideally, you should do moderate exercise for half an hour five times a week. But anything helps, even five minutes of stretching. Work your way up to it. And make sure you get enough sleep. Every body is different, but some research indicates that 7 hours is optimal.

    

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2. Learn new things

If you don’t stretch your mind, how do you expect to keep it in shape? Your brain needs the occasional challenge and learning is a great way to do this. Learning new things promotes qualities such as confidence, happiness, self-efficacy, independence and wisdom. Keeping the mind active can stave off some of the effects of age-related cognitive problems. While it’s fun and comforting to do things you already enjoy, learning something new has an even greater effect on your mind. Learn to cook Thai food, paint with watercolors, restore cars, woodwork or take on a new language. This last one is especially great for mental growth.

3. Reduce stress

Stress is unavoidable. Some amount of it is healthy because it helps us get things done, but having too much can have negative consequences for your mental health. There are many studies supporting this. So find ways to reduce the load. If your child is having a birthday party and you’re trying to clean the house, decorate, make treat bags and bake a cake, maybe you should just buy a cake at the store. If you have overwhelming work responsibilities, see if you can delegate some duties to someone else. For some tips on managing stress, read this.

4. Engage in self-care

Life is so full of demands that sometimes we forget to just slow down and assess what we actually need. When you feel scared, overwhelmed, frustrated, in pain or otherwise having a difficult time, stop and ask yourself what you actually need. Commit to act on it. If you need to slow things down, try some grounding techniques. If you are hungry, grab a snack. If you feel lonely, call up a friend. Something inside of you always knows what you need and you need to learn to listen to that part of you. It’s best to take care of how you’re feeling before it develops into something bigger.

5. Ask for help

Sometimes we think that we should be able to handle everything life throws at us. But the truth is, humans are social creatures for a reason. We need each other. So when you are depressed, overwhelmed, anxious, distracted or otherwise having problems, it’s okay to ask for help. This can involve anything from going to therapy to having a neighborhood kid mow your lawn for you. What matters is that you’re not going through your struggles alone. Besides, connecting with other people is good in and of itself. And you never know when you might be helping someone else simply by being in touch.

What healthy mental health habits do you have? Leave other suggestions in the comments.

7 signs of abuse in children

Child abuse is one of the greater evils in society. It can be incredibly damaging to children and affect them for the rest of their lives. This is why it’s so important to catch abuse as often or early as possible. Here are some signs to look out for. (This list is by no means comprehensive.) 

1. Problems regulating emotions

It’s hard for abused children to safely express emotions, so they might have outbursts of strong feelings. This can manifest in their behavior as well. When the child does something somewhat explosive, try to find out what feelings were behind it. This trouble regulating emotions can continue into adulthood.

 

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2. Excessive fear of doing something wrong

When a child has a strong fear of doing something wrong, it might be because she is used to being punished for her mistakes and shortcomings. Even trivial decisions might be difficult due to fear of making the wrong choice. This fear might also manifest as being withdrawn or anxious. It might be a fear related to a certain type of choices or a generalized fear.

3. Unexplained physical injuries

Look for bruises, cuts and other injuries. If the child has no explanation – or provides an unconvincing one – monitor it. If there is abuse in the home, it may be continuous, leading the child to have frequent injuries. Accident proneness is one thing, but that will have more credible explanations (though it might still indicate neglect). 

4. Extremes in behavior

Another sign of abuse in children is that they are very extreme in their behaviors. This can go either way. They might be very rigid or they might be disorganized. They can be excessively obedient or completely rebellious. If a child is “too much” of anything and completely lacks the ability to navigate a middle ground, it’s a bad sign.

5. Age-inappropriate sexual knowledge

If a child seems to know a lot more about sex than he should, it might be a sign of sexual abuse. This can manifest both verbally and in behaviors. They might have a lack of appropriate physical boundaries with others or even be overtly seductive. This can, however, also swing to the other extreme, where the child is wary of touch in general.

6. Avoiding someone specific

A child may be trying to escape abuse by avoiding the abuser as much as she can. If there is no obvious reason for the child to avoid this person, it’s worth looking into. This is more than just going to his room because he doesn’t feel like being around someone. The child might hide when the person is nearby or even run away from home.

7. Regressing to earlier behaviors

An abused child might use coping skills from a younger age. This might include wetting the bed, fear of the dark, thumb-sucking, needing a comfort object and clinginess. It can even extend to the child being less skilled in language usage, talking like someone who is younger. It is especially worrying if the child has quit the behavior before, but is returning to it.

If you suspect that a child is being abused, you need to contact someone. A good starting point is a child abuse hotline. In the U.S., the national number is 1-800-4-A-CHILD (1-800-422-4453). If you live elsewhere, search online for a number or contact local authorities. It is better to be safe than sorry when it comes to children who might continue to be hurt if you don't seek help.

Do you feel like you could notice if a child is being abused? Talk about what helps identify these children in the comments.

15 grounding techniques

Grounding is a very useful tool when you are feeling symptomatic. It is finding a way to stay in the present moment instead of giving in to what your mental illness is causing you to experience. It can be used to decrease anxiety, help with reality testing, stop flashbacks, reduce dissociation, end panic attacks and more. 

There are lots of different grounding techniques. Having strategies in mind ahead of time can help reduce distress in the moment. Knowing which ones work are a matter of trial and error, so here is a list of 15 that you can try out.

     

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1. Name five things you can see, three things you can hear and one thing you can smell. 
2. Describe your environment (“The carpet is beige and soft. The chair I’m sitting in is made of wood. The walls are painted green,” etc.).
3. Focus on your breathing. Breathe in through your nose for four counts, hold your breath for seven and exhale through your mouth for eight.
4. Carry something small that you can play with (bracelet, stress ball, putty, etc.). Focus while you use it.
5. Go through the alphabet and think of something for each letter (names of bands, movies, cities, etc.).
6. Get a hot or icy drink and focus on the sensation of drinking it.
7. Smell something you find calming. You can put on lotion or carry a handkerchief with perfume or essential oils on it.
8. Take a shower or a bath. Notice how the water feels on your skin and imagine that all of your stress is being washed away.
9. Say reassuring things to yourself out loud. (“I am in my apartment and it’s safe here. I am loved. I can call a friend if I need to,” etc.)
10. Move. Go for a walk, wiggle your toes; do whatever works for the situation you’re in.
11. Mentally go through everything you did today. (“My alarm went off at 8:00. I got up and took a shower. I ate breakfast,” etc.)
12. Listen to music you find comforting. Pick out all the different instruments                                                                          and notice how each of them sounds.
13. Engage in a hobby you enjoy. Let everything else go while you focus on doing what you love.
14. Write down exactly what you’re thinking and feeling. Imagine it disappearing into the paper. You can tear it up when you’re done, if you’d like, and throw those thoughts and feelings away.
15. Put your feet on the floor. Keep your eyes open. Engage all five of your senses. Force yourself to stay in the present.

What grounding techniques work for you? Let’s make a list in the comments.

Eliminating negative self-talk

     

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Your mental illness can be a very powerful voice in your head. It doesn’t literally have to be a voice, though sometimes it is. It is whatever is inside of you that tells you things that make your symptoms worse and hinder your recovery. It might be saying something like this:

• You are worthless.
• The world is dangerous.
• You don’t deserve love and attention.
• Others are laughing at you.
• Your body is flawed.
• There’s no point in trying.
• You have to engage in unhealthy behaviors.

It can be hard to challenge these thoughts because they are coming from within. They appear to be your truth. But just because it’s in your head doesn’t mean it’s actually you. These thoughts might actually be from someone else or they might be a result of psychopathology.

Thoughts can be left over from what others have said or implied by their actions. We all have those things someone said to us once that we believed and of which we never let go. I haven’t felt confident singing since my junior high choir teacher told me I couldn’t. I’ve also never looked at my body the same way since someone I once dated told me to lose weight. That doesn’t mean those things are true. I can probably sing well enough to not seriously embarrass myself. What
                                                                                     someone else thinks my body should look like is actually irrelevant. 

But at some point, these people held credibility for us. What they thought mattered because we gave them that power. With effort, we can take it back. Recognize that these original messages might have been off-hand and not really meant. Other times, people might have been deliberately cruel. There can even be some level of truth to what was said. What matters is how you choose to respond. I can tell myself that how I sound doesn’t really matter because I’m not a professional singer. I can also tell myself that my ex was just plain wrong for criticizing my body. Challenging these thoughts can be hard, but the more you do it, the more you believe it. It might take years, but that’s better than giving these people space in our heads.

Other negative thoughts are not the voices of others, but a result of a mental illness. No one knows how mental illnesses work. But they do affect our thoughts. Depression might tell us that life isn’t worth living. Obsessive-compulsive disorder can tell us to engage in ritualistic behavior to prevent bad things from happening. Anxiety tells us that it’s safer to be scared. 

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These thoughts are invasions in our heads. They are foreign to who we really are. That’s why we call their speakers illnesses. They do not belong in us any more than cancerous cells do. You have to believe that what your mental illness says is not what you actually are. You can choose who you are.

That is not an easy task. It takes a lot of effort and it won’t get better overnight. One thing you might want to do is incorporate affirmations into your life. You can read about how to do that here. You can also ask yourself if the thoughts actually make sense. By challenging them, you lessen their power. Even if you don’t believe the challenge, the fact that you are doing it means that you are at least willing to consider that the thoughts might not be true. That’s somewhere to start.

Sometimes, we can’t work through these thoughts on our own. If they are causing you distress or interfering with your life, talk to a therapist. They know strategies to help you change. It might be helpful if, between sessions, you write down all the negative self-talk you catch. Bring your list to therapy, as this will give your therapist an idea of where you’re at and how you can be helped.

You don’t have to be a victim to your own mind. Remember, considering that you might be wrong is the first step. Fill your life with positive things to give the negative thoughts some competition. Recognize that the harmful self-talk is not a part of who you truly are. You are a strong, capable person who can take back your mind from negativity, no matter how long it takes.

How do you reduce negative self-talk? Share your tips in the comments.

5 ways nature can heal

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Nature has been helping people heal long before the inventions of therapy and medication. Humans were developed to survive without any modern conveniences, so it only makes sense that the natural world holds things that can help us in recovering. 

Consider what nature can do for you, even if you don’t want to leave the house. Inspired by the (hopefully) nice spring weather, here are five suggestions for how nature can help in your healing process.

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1. Sounds and scents

Nature can be very soothing and calming. It’s simple to bring nature inside through your senses. If you are lucky, you live somewhere you can simply open your window to hear and smell a forest or brook. But for the rest of us, turning on some nature sounds and lighting a flower-scented candle will have to do the trick. 

There are websites that let you blend and customize different sounds, such as this one. It is also said that certain scents will alter your mood, filling you with calmness, energy or concentration. Here is an example of a list of how certain scents might benefit you. Google will give you plenty more.

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2. Gardening

While some of us hate weeding (guilty), some people find gardening to be a soothing and stress-relieving hobby. It gives you the satisfaction of seeing your hard work bloom, which can do wonders for your confidence and self-efficacy. 

Even city-dwellers holed up in apartments can reap the benefits of caring for plants. A flower box can be used to make a beautiful display or to be used to grow herbs and small vegetables. For those who are interested in growing their own food in cities, look up urban gardening. It’s a real thing.

  

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3. Food and supplements

What you eat determines a large part of your health. It is, after all, what makes up your body. Good nutrition in general is beneficial to physical and mental health, but specific foods can serve individual purposes. Supposedly, blueberries should make you less stressed while walnuts make you happier.

In addition to providing food, nature also gives us plants and herbs that hold healing properties. The scientific backing on these varies, so do your research. But from what I’ve heard, some places use St. John’s wort as a first line of treatment for depression, preceding anti-depressants. But if you do want to try a supplement, talk to your doctor. Some can interfere with medications or make certain health conditions worse.

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4. Pets

The creatures we share this world with can become healing as friends, or even part of the family. My cat can tell when I am anxious or depressed and will cuddle up with me extra much. Having a pet also gives you a daily responsibility, forcing you to have interaction and get out of bed.

Sometimes, people have specially trained service or therapy animals. Dogs, for instance, can be trained to help with PTSD symptoms. I have also heard of ones that will bring your medication to you if you are bedridden, so it’s pretty incredible what animals can do.

  

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5. Spending time outdoors

Then, of course, there is simply going out into nature. Take advantage of whatever is nearby – forests, mountains, beaches or city parks. If you want more variety, plan vacations and road trips around the environments you’d like to spend more time in.

While outside, do activities that you enjoy. There’s more to do than hikes or walks. Some options include riding bikes, swimming, picnics, sketching or painting, picking flowers, snow activities, bird watching, playing children’s games and just sitting down and enjoying your surroundings.  Sometimes a breath of fresh air is exactly what’s needed to feel better.

What gifts of nature do you use in your recovery? Exchange ideas in the comments.

Living with physical and mental illness

Health is a complex concept. A holistic view of health allows for multiple aspects to be examined, including physical, mental, social and spiritual health. These different facets interconnect and feed into each other, creating an intricate person as a whole. 

   

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Physical and mental health are highly related. According to the Canadian Mental Health Association, people with a mental illness are at a higher risk for a chronic physical illness. It works the other way, too: If you have a chronic physical condition, your mental health is at risk. Some disorders concern both the body and the mind, including hypochondria, eating disorders and insomnia. 

A combination of mental and physical symptoms can be more debilitating than either on its own. It creates a double struggle. If you are having mental health issues, it might be difficult to attend to physical symptoms. Physical conditions can also increase psychological symptoms such as depression and anxiety.

If you are in this situation, it is possible that you have an extended medical treatment team. You might, for instance, have a primary care physician, a psychiatrist and a specialist for your physical condition. In order to receive the best possible treatment, it becomes extremely important to be open and honest with all of them. If one doctor puts you on a medication that is contraindicated with one you are on from another, you can have very bad reactions. Your primary care physician, especially, should get documentation from everyone you visit. It can be hard to talk about mental illness with someone who doesn’t specialize in it, but do it anyway. She can always consult with colleagues if she is stumped. 

Self-care can help mediate the barrage of symptoms. Taking time to let go of everything else and do something that feels good for you is important. Try to think of things that make you feel better mentally and physically. Listening to and focusing on music can be cathartic emotionally while distracting you from your pain. Exercise is very effective in improving depression and can be part of healing some physical illnesses as well (talk to your doctor about what is safe if you have a physical condition). Getting a massage gives you a nice, relaxing break while relieving muscle tension.

Don’t be afraid to ask for help. It can reduce stress, which negatively impacts both physical and mental health. If you can’t do heavy lifting, call your brother. If you are struggling in school because of a condition, talk to your school’s accessibility services. If a work task becomes difficult, ask a colleague to help or talk to your boss about possibly changing your responsibilities. If you can’t get out of bed, ask a friend to drop off dinner and maybe have a chat. If you would be willing to do it for someone else, there is probably someone willing to do it for you, too.

Having limitations due to illness can be discouraging. It might mean giving up your favorite hobby. It could exclude you from having certain careers. It means you may have to be more dependent on your loved ones. But there are still ways you can contribute. Just find the things you can do, no matter how small. It adds up and you never know how much something will matter to someone else. We are all interdependent and your contributions, while maybe not as obvious or notable as those of others, are part of what makes your relationships work. 

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As someone living with multiple physical and mental health conditions, I have found that attitude is essential in this situation. When I give in to feeling discouraged, I become more dysfunctional. I lay in bed all day thinking negatively about how I am laying in bed, then I keep doing that. When I focus on how I made my brother happy by spending time with him, had all of my studying pay off at the end of the semester or wrote four blog posts in one day (it happened once), it’s a lot easier to be healthier. When I concentrate on enjoying the things I am doing, it gives me more motivation to keep doing those and other things. 

It’s a special kind of burden to struggle with illnesses of both the mind and the body. Don’t do it alone. Let those around you help you, whether it’s your medical team or your neighbor. When everyone does what they can, things tend to fall into place eventually.

Do you struggle with both physical and mental health? Tell us what you find helpful in the comments.

5 steps to finding your best coping skills

I experience one type of distress when I have interpersonal problems and another when I am anxious about school. What helps with one will not always help with the other. That’s why it can be useful to map out what will help when you are feeling certain ways. Today I’ll lead you through an exercise to make a list of what will help you when you are feeling certain types of distress. 

I encourage you to grab a pen and some paper. You can also type on your computer (be prepared to copy and paste), but I’ll be creating a hypothetical sample by hand. If you write this up as you go along, you’ll have a very helpful tool at your disposal by the time you have finished reading this blog post. Really, you should do it. You’ll thank yourself later.

1. Identify what situations create strong emotional reactions in you. Write them out on a page. If you get stuck, consider the last month and identify situations that caused you distress. Write as many as you’d like. You can include things that are positive, but still potentially stressful. It might look something like this:

When you’re finished, you might find that you can combine similar items. In this case, I will combine “I feel rejected” and “I feel alone” to create “I feel rejected and lonely.” I will also make “I have a headache” and “my back hurts” become “I have physical pain.” If you don’t want to list specific situations, this exercise also works well if you make a list of emotions (angry, scared, nervous, overwhelmed, panicked, etc.).

2. Identify your coping tools. Create a list on a new piece of paper of what you have found helpful in the past when you are dealing with stress or strong emotions. You might also want to add things that you haven’t tried yet, but that might be helpful. There are lots of lists of coping skills at your disposal through Google. Give yourself as many options as possible. Include both items that improve the situations and ones that distract you from it, as each has its own uses. Here are some examples:

3. Take a third (and maybe fourth) piece of paper and use lines to make boxes for each of your identified trigger situations or emotions. Label each one. 

4. Think about what strategies from the second list help the most with the situations or emotions from the first. Try to find at least three strategies for each section.You can repeat your items. If you think of something that isn’t on the second list, that’s great! Add it anyway. You don’t have to include every coping mechanism you listed. What’s important is filling up those boxes with whatever is helpful.

5. Make your list accessible. Take a picture of it and put it on your phone. Keep a copy in your purse. Hang it on your bathroom mirror. Give copies to your support system so they know how to help you. Share it with your therapist. Just get your list out there so that when you do need to cope, you’ll already know how. It’s hard to think of things in the moment, but that will be less of a problem with this list on hand.

Did you try this exercise? What are some helpful matchings you found? Help each other out by sharing ideas in the comments.