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.

7 alternatives to harmful behavior

Mental illness does not just affect our minds and our thoughts. It affects our behavior. There are things that people struggling with mental health will do that helps them feel better, but are actually more damaging in the long run. These include self-injury, substance abuse, eating disordered behaviors, acting out obsessions, lashing out at others and more.

 

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It can be difficult to stay away from harmful behaviors, especially during times of great distress. This is why it is important to have alternate ways of coping. It can take a long time to change harmful behaviors, as they do serve a purpose. As a starting point, though, here are some ideas of what you could do instead of engaging in harmful behavior.

1. Replacement behaviors
If you don't want to engage in a destructive behavior, replace it with something else. People use this strategy all the time to quit smoking by sucking on hard candy, chewing gum or playing with putty to give their hands something to do. In other cases, this could mean drawing on yourself with a red marker instead of cutting or drinking tasty non-alcoholic beverages when you feel the urge to drink. The point is to put something less harmful in the place of the old behavior.

2. Creative expression
You can engage the emotions you are feeling without engaging in the behavior that usually
accompanies it. Try to take that energy that is pushing you towards self-destruction and let it live out another way through using it as fuel for creativity. What does your drug use look like when painted as an animal? What would your eating disorder say if it were a character in a novel about your life? Looking at your behavior from a creative perspective can also help you see things differently, which is a good start for more permanent change.

3. Talk to someone
You don't have to go through tough times alone. If you are worried that you'll engage in harmful behavior, see if you can spend time with someone else. You can talk about what is triggering your desire to engage in the behavior or you can just try to focus on something else now that you're not alone. If you don't have someone to spend time with, see if you can call someone. If there's no one to call, try writing an email to someone you trust. Involving another person can make it easier to resist.

4. Write it out
Written expression can help calm down feelings that surround destructive behaviors. There are many ways you can do this. You can try to process what you are feeling through journaling. You can vent out everything that's causing you distress and tear the paper into as many pieces as you'd like. You can write a letter to bring to your therapist the next session. The point is to communicate instead of act.

5. Distraction
Sometimes, it is better to get your mind on something else. My mother would say that if you're feeling miserable, you might as well clean. If you're able to, you can use the stress you are under to accomplish another task. Not all of us can do that, though, and self-care is an excellent way of distracting. You can use this activity in advance to come up with things to do.

6. Take out your frustration on something inanimate
At times, people feel so much tension, pain, anger and frustration that they can't slow down and do something else. In this case, let the damage be something inanimate, not your body or another person. Sit in your parked car with loud music on and yell at whoever or whatever is causing you problems. Punch a pillow or even your whole mattress. Destry things that won't harm you in a disassembled state (yes on tearing up a pillow; no on breaking glass). Redirecting your emotions allows you to feel catharsis without causing any actual harm.

7. Reward yourself
For some people, having a reward system helps keep dangerous behaviors in check. This can have as much or as little structure as you'd like. It might be a system set up in advance where you have a list of rewards for making it X amount of days without engaging in harmful behavior. It could also be having a secret snack stash or video game that you gain access to only when you are actively controlling your impulses. Some people like having a visual reminder of how long they've made it without those behaviors. You know yourself best, so find what motivates you and use it to stop yourself from doing further harm.


What do you find helps when you feel like engaging in harmful behaviors? Trade tips in the comments.

25 safety tips

Being the victim of a crime or accident can be traumatizing and, as we know, trauma is bad for your mental health. This is why it’s very important to protect yourself at all times. Following are 25 ways you can be safer in your everyday life.

     

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1. Let someone you trust know where you are going and when you will be back.
2. When walking, be aware of your surroundings at all times. You can check your phone later.
3. Keep your car doors locked both while parked and driving.
4. Do not “check in” on social media when you are out of town. It will alert potential burglars that you are gone.
5. Have your keys out when walking to your car or home so you can enter more quickly.
6. Walk on the side of the street that is facing traffic.
7. Keep any entrances to your home well-lit.
8. Always secure your windows and lock your doors.
9. Never tell anyone that you are home alone.
10. If you receive a call from someone about a problem with your credit card, hang up and call the number on the back of your card to make sure it’s actually them. 
11. Never accept drinks that have already been opened or are given to you by strangers.
12. Do not leave valuable items visible in your car. Store them in the trunk.
13. If someone calls and has the wrong number, do not give them your name or repeat the number back to them.
14. Stay on well-lit streets. If it takes you longer to get somewhere, so be it.
15. Get a copy of your credit report once a year (it’s free) and check for inconsistencies. 
16. When out of town for an extended period, have someone check on your home regularly.
17. Shred all papers that contain personal information.
18. Stay away from bushes and other overgrown areas.
19. Use a headset while driving or, better yet, stay off the phone while on the road.
20. Don’t leave a spare key near your front door. Consider leaving it with a trusted neighbor or family member.
21. Hang up immediately if you receive an obscene or harassing call. If the problem persists, contact law enforcement.
22. Memorize important PINs and passwords; do not write them down.
23. Get sufficient sleep so you are alert, especially if you are driving long distances.
24. If you have a GPS, set “home” as somewhere near where you live, but not your exact location.
25. If you are being followed, don’t stop. Keep walking or driving to the nearest public place.

How do you keep yourself safe? Share your most helpful tips in the comments.

10 signs of mental illness you should never ignore

   

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There are a lot of symptoms of mental illness, more than anyone can list off the top of their heads. But some are more severe than others. Here are a few of the ones where you should immediately seek advice from a mental health professional. 

1. Hallucinations

Hallucinations are experiencing the presence of something that is actually not there. Visual and auditory hallucinations are the most well-known, but they can also be smells, tastes, tactile stimulation and more. Hallucinations are a symptom of several serious mental illnesses, so they should always be taken seriously. It is possible that there is a more benign explanation – it could be a lack of sleep or the side effect of a medication. But it can be difficult to judge what the  cause of a hallucination is,
                                                                                                                   meaning that a professional evaluation is called for.

2. Antisocial behavior

Antisocial behavior is not a reference to being introverted and liking alone time; rather, it’s deviating from the norms and laws of society. This often is expressed through aggressiveness, dishonesty, disregard for safety and criminal behavior. Antisocial actions can have long-lasting consequences for both the person performing them and for others, so it’s important to get it under control. When there’s a pattern of these types of behaviors, it’s important to seek help in order to prevent more permanent damage.

3. Identity confusion

There are times when people start questioning who they really are and what they want their lives to look like. Adolescence and mid-life crises are a couple examples. But if taken too far, this uncertainty is potentially dangerous. If someone suddenly abandons what was previously loved and don’t know what to replace them with, it could be a sign that something more serious is going on. At the extreme, there might be complete blank on who one is, which can be indicative of amnesia. It’s important to talk to a mental health professional to identify the cause of losing one’s sense of self.

4. Mania

Everyone gets worked up and excited sometimes, leading to increased activity in one’s life. But sometimes, it becomes out of control. If someone has persistent and abnormal elevated or irritable moods for over a week, it might be a manic episode. These episodes, a hallmark of bipolar disorder, might present with an inflated sense of self-esteem, a decreased need for sleep, racing thoughts, distractibility, being unusually productive or engaging in behaviors that will have serious negative consequences. Because of the lasting impact these episodes can have on one’s life, professional help is warranted.

5. Learning difficulties

It’s normal to struggle with learning sometimes. We are all better at some things than others. But when someone is, in at least one area, several grade levels below where one should be, it could be a learning disability. This doesn’t mean that someone’s stupid, but rather indicates a lack of the ability to learn in certain areas. Learning difficulties could also be indicative of a high level of distress, which needs to come down before one can resume regular patterns of learning. A sharp change in one’s ability, like suddenly being unable to perform tasks one could do before, should also be looked into.

6. Self-injury

Self-injury is indicative of severe distress. It often means that someone is in a lot of pain and is unable to cope with it in a healthy way. Self-injurious behaviors include cutting, burning, bruising, interfering with wound healing and intentionally sustaining injuries. While most of the time there is no intent to cause lasting damage, it might happen anyway. This is one reason why, when someone engages in self-injury, it’s important to intervene. Talking with a therapist can help in terms of finding healthier alternatives and in understanding what caused the behavior in the first place.

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7. Delusions

Delusions are beliefs that are unique to oneself and that contradict the generally accepted reality. Some examples include believing that one is under surveillance by the government without sufficient reason; thinking a song was written about oneself despite never even having met the artist; and insistence that a partner is cheating despite a complete lack of evidence. Something like believing in alien visitations or prevalent conspiracy theories are not delusions, as they are beliefs shared by lots of people. Delusions can seriously impact quality of life and might even lead to people making dangerous decisions, so talking to a professional is important.

8. Substance abuse

As discussed in an earlier post, substance abuse is highly correlated with mental illness. The two can feed off of each other, with substances being used to mask symptoms which in turn become worse due to the substances. While not all substance abuse is indicative of mental illness, it is a serious problem that should be addressed either way. It can also cause physical health problems or lead to acting impulsively in a risky way. There are lots of professionals that specialize in treating substance abuse, so find someone with experience.

9. Major shifts in personality/goals

People are generally pretty consistent in how they act and what they want. While some variations are normal, like deciding to end a relationship or to take up a new hobby, there are times when changes can be a cause for alarm. These changes are more notable when they occur rapidly. A consistently cheery person might abruptly become frequently cynical or someone may suddenly drop out of school despite indications that things were going well. It is important to take a good look at what caused these types of change, as they can be a sign of distress or mental illness. 

10. Suicidal thoughts

Thoughts of suicide should always be addressed. The risks that come with brushing it off or not seeking help are not worth it. Suicides have permanent impacts on both those who commit them and their loved ones. It’s not a decision that happens and stays in a vacuum. Surviving a suicide attempt can also lead to lasting health problems. If you feel like ending your life or suspect someone else might, talk to a professional. The earlier one gets help, the easier treatment will likely be. To learn about what suicidal people talk about, read this. I have also put together a list of hotlines, which can be found here. 

What symptoms made you seek help? Have you seen these signs in a loved one and encouraged him or her to get help? Let us know in the comments.

Are you in (too much) control?

The issue of control is highly related to mental health. Having control makes us feel safe in the world. A lack of it leads to fear and a sense of helplessness. Mental illness can sometimes be traced back to a need to feel more in control, whether it’s in a rational way or not. Here are just a few examples:

   
• Someone with obsessive-compulsive disorder might engage in unusual behaviors because she is under the belief that this will lead to certain outcomes. 
• An eating disorder can be a response to a lack of control of one’s environment, making the body a battleground instead.
• Sometimes, certain personality disorders include attempts to control other people through manipulation or harmful actions, which may or may not be a conscious decision.
• Self-injury can be a way of decreasing distress or other symptoms through taking charge of the pain.
• Depression can worsen when a                                                                                                                                               person believes he has no control  
                                                                                                                                    over his future. 

The question is, how do you learn to control your control? There are no easy answers to that. Trying to do so can create a cycle that can spiral out of control, so to speak, and make things worse. 

So instead of trying to use one controlling action to stop another, look at the original issue. Let’s imagine, for instance, that the root of your control issues is that someone you love has a dangerous physical illness. It’s scary, but you can’t change it. You can’t even really help with the treatment because you’re not her medical team. Lacking control might cause you to attempt to regain it in another area. You might become obsessed about your own health in an attempt to avoid getting ill as well. This can lead into dangerous territory with problems like a severely restricted diet, excessive exercise or taking a large amount of supplements without a doctor’s supervision. 

But the truth is, you can’t control your body completely. You can’t guarantee you will never get sick. Sometimes, it’s unavoidable. So step back and look at what you actually can control. You can decrease your risk of illness by living a healthy lifestyle. This should, however, be done with moderation and a regimen set up with the help of a health care professional.

You might also want to look even further back and think of your loved one. While you can’t provide a cure, you can find other ways of being of assistance. Ask him if he needs someone to drive him to medical appointments. Offer to clean her house. Keep him company while he is bedridden. This is a much healthier and more productive way of managing the emotions her illness have brought up for you. It’s important to recognize that this is actually helping him, whereas you going down a dangerous path with a health obsession does not. 

Sometimes, the best answer is to give the issue some space. Work with your therapist to find ways to manage the anxieties that uncertainty and lacking control bring up. You don’t have to act upon them. Some people find mindfulness and meditation helpful in this regard. Others might think through the situation logically and find some peace that way. Whatever you need to do, decrease the importance of having control. Accept what you cannot change and focus on the things you can do. Again, your therapist can be very helpful in this process.

You don’t have to let your need for control end up controlling you. It’s easier said than done, but gradually working at it one issue at a time will lead to progress. As time passes, it will become easier. You will master the skills you need to respond appropriately to uncertainty. This will lead to a reduction in symptoms and, more importantly, help you become a happier and healthier person.

Have you learned to let go of the need for control? What helped you? Share what worked in the comments.

7 signs you need a new therapist

Not every therapist is a good match for every client. This means that sometimes, finding someone else is the best thing to do to progress in your recovery. There are, of course, reasons to stay with the one you have. By working through your differences, you develop a stronger bond and learn how to manage relationships outside the therapy room. But if any of the following points are a problem, then it might be time to find someone new.

1. You are not being respected.

One of the great tasks in life is learning to get along and grow with those who are different than us. The variety of people in the world should be celebrated, as it allows humanity to reach its highest potential. But these differences can also be a source of prejudice and unkind behavior. If your therapist is devaluing your experiences, not honoring your belief system, asking you to change culturally appropriate behavior or making you feel inferior in any way, it’s time to switch therapists.

2. You can’t establish trust.

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Sometimes, we just don’t trust people. Maybe they remind us of someone that hurt us in the past or appear similar to a stereotype we have problems with. If this is the case, the first thing you should do is talk to your therapist about it. Working through that mistrust can be huge in terms of personal growth. But if you’ve tried your best and just can’t make yourself trust her, find someone that makes you feel more secure.

3. Your therapist is crossing boundaries.

Your therapist should be your therapist and nothing else. He is not a potential business partner. She is not someone you’ll hang out with at social events. He is not the friend you call at 3:00 a.m. Most importantly, she is not a romantic or sexual partner. If your relationship with your therapist is expanding into these areas, that needs to stop immediately. It’s highly unethical and could even have legal implications for your therapist. If he can’t stick to his job, find someone who can. 

4. Your therapist doesn’t respect your time.

When you go into a session, that is your hour. Your therapist should not be focusing her attention on anything but you. He should not, for example, answer calls when with you. She should also be more or less on time and not frequently canceling sessions. Be understanding that occasionally, something major might be going on. But if you see a pattern of these behaviors, you might want to look into finding someone else.

5. Your therapist breaks confidentiality.

Your therapist has to keep all information about you private. He can’t give your information to anyone, even another therapist or healthcare provider, without your permission in written form. If someone asks, she can’t even acknowledge whether or not she’s seeing you for therapy. The only exceptions are related to major safety concerns and rare legal orders, which can be read about here. But if your therapist is, for instance, chatting with your significant other about your progress without your express permission, that’s an ethical violation and a legitimate reason to dump the therapist. 

6. Your personalities clash. 

We all have certain types of people we just don’t get along with. If your therapist has a personality that is particularly irritating or difficult for you, don’t give up right away. You can become a more open and accepting person by working through those issues with your therapist. If it doesn’t work, though, it doesn’t work. On the other hand, sometimes self-improvement is secondary to an immediate concern, in which case, find someone you get along with.

7. Nothing is happening.

Progress in therapy is not as simple as a line gradually moving upwards. You’ll be all over the place. Sometimes, you’ll have a huge change for the better, while other times you’ll take a few steps back. There is some truth to the “getting worse before it gets better” concept, so don’t jump ship just because you become a bit more symptomatic. It’s part of the healing process. But if everything just stays the same, then something’s wrong and you could be better off working with someone else. 

Have you ever switched therapists? Why did you do so and how did it go? Report your experiences in the comments.

5 things suicidal people talk about

    

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Being suicidal can come with a wide range of symptoms and behaviors. It will manifest in as many different ways as there are people. But there are commonalities that tend to appear. One of those is what they talk about. If the following topics come up, you may want to pry further to check on the wellbeing of the person in question.

1. Wanting to die

The idea that suicidal people don’t talk about suicide is definitely a myth. They frequently give indications of their desire to die, sometimes even flat out saying that they want to commit suicide. Saying it does not mean that they won’t do it. Sometimes it’s more indirect, with statements like, “I wish I’d just get hit by a bus.” If someone says anything at all that indicates a desire to be dead, it should be pried
                                                                                                                    into.

2. Feeling stuck, hopeless and having no reason to live

Suicide sometimes happens because there seem to be no other options. Talking about hopelessness or entrapment can therefore be a warning that the person is headed in that direction. There are always options. We may not like them, but they are there. When suicidal, though, those options can seem to disappear. This topic is an indicator that should be taken seriously.

3. Being a burden

Being suicidal can make one feel like a waste of space. Suicidal individuals might feel like they are simply a problem in the lives of others. They might think that others would be better off without them. This can be especially true when illness is present that requires assistance. If the person can’t contribute in the same way others are contributing, it can set off thoughts about the lives of loved ones being better without him or her.

4. Suddenly making big improvements

Sometimes, suicide is preceded by a significant increase in mood. The person might be a lot happier and more positive. This can come from feeling at peace with the decision to actually end ones life. Talking about how something “won’t be a problem any longer” or “doesn’t matter anymore” can stem from the decision to not be around at all. The more rapid and extreme the change is, the more you should ask questions to see what’s really going on.

5. Saying goodbye

It is normal to want a sense of closure. That’s why suicidal people sometimes go around and say goodbye to or make amends with others. It might be in an indirect way, such as, “I value our friendship and would miss it if we were away from each other,” or, “If anything happens to me, I want you to know…” The hypotheticals might not be so hypothetical after all, so it’s important to look out for these statements.

In combination with other warning signs, especially, it is important to take action. Always make sure that the person you care about has resources. There are suicide hotlines, doctors, therapists and community mental health organizations. If you aren’t sure of what to do, you can reach out to these resources as well and ask for appropriate advice. If you believe suicide is imminent or there is an actual attempt, call 911 or take the person to the emergency room. It may cause some upset in the short term, but having an angry loved one is better than having a dead one.

Have you talked to someone and worried about suicidality? How did you know that you needed to reach out?

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.

Mental health myths: children and mental illness

I am taking some time to discuss issues related to childhood and adolescent mental health. Let’s start with a very basic mental health myth.

Myth: Children cannot develop mental illnesses.

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Fact: A significant number of children and teens struggle with mental health issues. 

Sadly, being a minor does not eliminate the possibility of having mental health issues. According to the National Institute of Mental Health, 13 percent of kids and teens between the ages of 8 and 15 struggle with a severe mental health condition. For teens between 13 and 18, that number increases to 20 percent. And those are just severe conditions – there are even more that are struggling with mild and moderate mental health issues.

There are dozens of diagnoses that are considered childhood disorders. These include learning disorders, but also conditions related to development, attachment, behavior, and more. In addition, mental illnesses that adults get can have separate diagnostic criteria for childhood versions of the same condition.

By some estimates, there are more children suffering from mental illnesses than physical ones in North America. These conditions can be devastating not only to children, but to entire families. When one family member struggles with mental illness, it affects the whole family. The family dynamic is disrupted and other family members can experience stress, anger, guilt, shame or denial. It is therefore important for everyone’s needs to be considered, not just those of the one struggling with mental health issues.

By being young, kids and teens won't always have the perspective of knowing what is and isn't normal in terms of their psychological health. We assume that others are like us, so until someone points out that, no, most people don't have to wash their hands repetitively, they might think it's the standard. Some children have never really had a chance to not struggle with mental health, so they don’t know that there is something wrong. That’s why it’s so important for adults to look for signs of mental illness in children.

Some symptoms to watch out for in children and teens include:

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• Being unable to cope with everyday problems.

• Not doing well at school (especially if the child is really trying).

• Difficulty concentrating.

• Loss of interest in activities and friends.

• Persistent negative moods.

• Sleep problems, including disrupted sleep, nightmares and sleepwalking.

• Frequent physical symptoms, such as headaches and stomachaches.

• Changes in eating habits.

• Unwarranted amounts of worry and anxiety.

• Regressing to behaviors of a younger age, such as becoming clingy or bedwetting.

• Risk-taking behavior.

• Repeated anger outbursts.

• Frequent disobedience and aggressive behavior.

• Self-injury.
• Substance abuse.

• Unusual amounts of time spent alone.

• Disproportionately intense feelings.

• Seeing or hearing things that aren’t there.

Take these symptoms seriously. On Saturday, there will be a post detailing how to get help when children and teens experience mental health concerns.

Do you have an experience with childhood or adolescent mental illness that you’d like to share? Please post in the comments.

Who do I call?

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Sometimes, it’s hard to know where to turn to for help. Loved ones may not always be available or you might not be ready to share some of your concerns with them. That’s why hotlines exist. 

Below is a list of hotlines that can be used within the U.S. My blog stats show that my readership is currently almost exclusively here, so that’s who I kept in mind when I made the list. If you are wondering about getting help in another country, feel free to leave a comment and I will see what I can find.

Even if you think you’re okay, read through the list of numbers. They are very varied and you might find something helpful you didn’t know was out there. All numbers are listed in alphabetical order and available 24/7 unless otherwise stated.

Boys Town National Hotline (at-risk teens and kids): 800-448-3000

Bulimia and Self-Help Hotline: 314-588-1683

Childhelp National Child Abuse Hotline: 800-422-4453

Crisis Call Center: 800-273-8255 or text ANSWER to 839863

Crisis Text Line (teens): Text SUPPORT to 741741

Defense Centers of Excellence for Psychological Health & Traumatic Brain Injury (military and others affected): 866-966-1020

Depression and Bipolar Support: 800-273-8255
IMAlive chat support: www.imalive.org
Lifeline Crisis Chat: www.crisischat.org

National Alcohol and Substance Abuse Information Center: 800-784-6776

National Association of Anorexia Nervosa and Eating Disorders: 630-577-1330 (10 a.m. to 6 p.m. EST, Monday to Friday)

National Center for Posttraumatic Stress Disorder: 802-296-6300

National Council on Alcoholism and Drug Dependence: 800-622-2255

National Domestic Violence Hotline: 800-799-7233

National Eating Disorders Association: 800-931-2237 (9 a.m. to 5 p.m. EST, Monday to Friday)

National Institute on Alcohol Abuse & Alcoholism: 800-662-4357

National Institute of Mental Health Information Center: 866-615-6464 (8 a.m. to 8 p.m. EST, Monday to Friday)

National Mental Health Association Hotline: 800-273-8255

National Runaway Safeline: 800-786-2929

National Safe Place: Text SAFE and your current location to 69866

National Suicide Hotline: 800-784-2433

National Suicide Prevention Lifeline: 800-442-4673

National Teen Dating Abuse Helpline: 866-331-9474

Postpartum Support International: 800-944-4773

Rape, Abuse, and Incest National Network: 800-656-4673

Safe Horizon’s Crime Victims Hotline: 866-689-4357

Safe Horizon’s Rape Sexual Assault & Incest Hotline: 212-227-3000

Substance Abuse and Mental Health Services Administration: 800-662-4357

Suicide Prevention Services Depression Hotline: 630-482-9696

The Trevor Lifeline (LGBTQ): 866-488-7386

Thursday’s Child National Youth Advocacy Hotline: 800-872-5437

Veteran Combat Call Center: 877-927-8387

Veterans Crisis Line: 800-273-8255

Update: Here is a link to international suicide hotlines.

If you have any corrections or additional hotlines for the list, please leave a comment. I have not personally called each number to verify the information, so I don’t make any guarantees about them. This list is not intended to be comprehensive. 

Mental health myths: violence

When it comes to mental illness, most people are not as well-informed as we'd like to think they are. This is true of both those who have and have not struggled with it. What is thought of as matter-of-fact might not actually be supported by research and common sense doesn't always apply. This is why it's important to reconsider our assumptions.

From time to time, I'll cover different mental health myths and show the facts behind the truth. Today's topic is violence.

Myth: Mentally ill individuals are violent.

Fact: The mentally ill are generally no more violent than anyone else.

  

Ambro / FreeDigitalPhotos.net

Despite what Hollywood movies and the news would have you believe, mental illness does not account for a much violence at all. Only 3-5% of all violent acts are caused by individuals with serious mental illnesses. This isn't much, especially since 6% of the population qualifies as seriously mentally ill. This means that they are actually doing less than their expected share of violent acts.

In addition, mentally ill individuals are at a higher risk for being on the receiving end of violence. This same group of seriously mentally ill individuals are ten times as likely to be the victim of a violent crime than the general population. That is a very significant increase.

When mentally ill individuals do become violent, it is most likely towards themselves. Over 90% of those who lose their lives to suicide can be diagnosed with a mental illness. It's hard to find exact numbers, but it is generally accepted that suicide is far more common than homicide. Self-injury is also a serious mental health concern and another way that the mentally ill turn on themselves.

While the messages we get from the media suggest mental illness as a predecessor to violence, the concern should be more along the lines of protecting the mentally ill from the violence of others. If you are experiencing violence in your interpersonal life – whether related to mental illness or not – visit the National Domestic Violence Hotline at www.thehotline.org or call 1-800-799-7233.


Sources:
http://www.mentalhealth.gov/
http://www.nimh.nih.gov/
http://www.nami.org/

Can you keep a secret?

One of the reasons that people seek out professional counseling instead of just talking to people already in their lives is that the conversations are confidential. While some people find talking to strangers uncomfortable, others find it liberating to be able to disclose details of their lives without the knowledge and involvement of other parties.

While an ethical mental health professional can be trusted with sensitive information, it's important to know the limits. The nature of their work means that they will encounter sensitive information that occasionally must be acted upon. Each therapist should provide information on when confidentiality must be broken before treatment begins. If this is not done (or if it's been a while and you've forgotten), ask your therapist to give you a copy of her policies. 

In general, the exceptions apply in these four situations:

1. Danger to self or others

If you threaten to hurt yourself or another person, your therapist will have to evaluate what actions are appropriate to keep all parties safe. Factors such as the the presence of an exact plan, directness of the threat, severity and the ability to follow through with it are all taken into consideration.

Don't hold me to these, as this is not an exact science, but here are some examples:

Should not report: 

"I'm so mad at my husband that I wish he'd get hit by a bus." 

"I wish I had a gun so I could shoot myself."

"If I catch my wife cheating again, I'll kill them both." (Contingent on followup questions suggesting it's a sentiment, not a plan.)

Should report:

"I bought a bunch of pills and alcohol so that when I go to bed tonight, I'll never wake up."

"I carry a knife so that when I see him, I can stab him repeatedly."

"After this, I'm gonna head over to my uncle's house and take care of him for good."

A threat of harm to self can be responded to as needed in the situation, ranging from calling a friend to come over for the night to forced hospitalization. As far as threats to others, law enforcement will usually be contacted, although the potential victim(s) may as well. Past crimes aren't held to the same standard as imminent threats, with a couple of exceptions.

2. Child or elder abuse

Because children and elders are considered vulnerable populations, reporting abuse and neglect of these groups is an obligation by law. Some states require everyone to be mandated reporters while others limit the duty to both therapists and some other groups, which may include teachers, health care professionals and law enforcement. 

The appropriate course of action is that when there is a reasonable suspicion of abuse, a report is made. The reporter gives relevant information to another agency, which then decides what the appropriate course of action is. Information leading to a report does not necessarily have to come from the victim or even be a verbal confession. A child with cuts and bruises of different ages with no compelling explanation, a mother who mentions her boyfriend's mistreatment of her son and a teenager mentioning that her underaged friend is a victim of incest are all cases that will most likely be reported. An adult discussing abuse from his childhood, however, will probably not require further action unless, for instance, he has a younger brother who is in the same environment and is likely to be abused as well. A therapist is also not forced to report situations between adults, such as domestic violence in the home of a childless couple. 

The same standards will often transfer to elders and possibly disabled individuals. 

If you have questions about reporting abuse, receiving support or available services, call 1-800-4-A-CHILD (1-800-422-4453). This will not create an official report, but the people on the line can help you find out the next steps. If you are unsure about a situation, please call. It's not a commitment and it's okay to just ask a question.

3. Court order

Occasionally, mental health professionals are asked by the courts to provide information about their clients. This does not mean that any time someone is arrested, the therapist is called to confirm the offense. The principle of confidentiality is so important to therapy that mental health professionals will only reveal the least amount of information required of them and only when presented with official orders. There are also limitations on what can be asked of them, as it has to be relevant. In a murder trial, your therapist can be asked to confirm that you confessed to being at the crime scene, but probably won't answer about whether or not you're having an affair (unless it's directly related to the case). 

This exception rarely comes into play, but it has to be mentioned. The point of therapy is to help you get better, so that should take precedence over the possibility that some day five years from now your therapist will be called upon to answer if you smoked some weed. (She won't.)

4. Medical records

A limited amount of information is given to your insurance company in order to qualify you for treatment. This usually is a diagnostic code showing what you are receiving treatment for. It's not comprehensive and it doesn't involve details; it's just a way of indicating what you are receiving treatment for so that they can cover you. This is a current issue, though, and if this is a concern, learn more about what is required in your area and by your insurance company.

Outside of this, your information may be disclosed to other health care providers with your permission. This will require you signing forms and you get to specify what, exactly can and can't be released and for how long. This applies to the medical field in general, so if you want your wife to be able to get your test results for you when you aren't at home next week, ask for the paperwork!

The topic of mandatory reporting is not without controversy, but these are general descriptions of the current standards. Please don't be afraid of opening up because the information may get out. Breaking confidentiality unless it's absolutely necessary would ruin the whole point of the entire field, so it's an ethical (and legal) obligation that is taken very seriously. 

If confidentiality is a concern, talk to your mental health professional. He'll be able to give you more information on local laws and his own stance on these issues.