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.

Diagnosis spotlight: anorexia nervosa

   

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When most people hear the word “anorexia,” they think of really skinny people. There is, however, a lot more to this disorder than ones weight. Anorexia nervosa is a disorder of both the body and the mind. It can have adverse effects in many areas of one’s life and should always be taken seriously.

First of all, it’s important to acknowledge that anorexia can happen to anyone, regardless of gender, age or race. A college boy could develop anorexia in response to athletic pressures, or transitioning out of independent living could instigate it for a senior citizen. The stressors that can lead to eating disorders are in all our lives and while young females are more at risk, it is important to acknowledge that that isn’t the whole population.

A hallmark trait of anorexia is the restriction of food intake. Someone with anorexia might create unhealthy diet plans, not giving the body the calories and nutrients it needs. Certain foods are avoided completely, leading to a very restricted diet of what has been called “safe foods.” 

For anorexia to be diagnosed, as opposed to another eating disorder, this restriction should lead to a low body weight. The DSM-V diagnostic criteria used by mental health professionals defines this as “less than minimally normal” for adults and “less than that minimally expected” for children and adolescents. 

Another criteria for anorexia is an intense fear of gaining weight or interfering with weight gain despite being at a low weight. This is often related to the final criteria. One of the following needs to be present: disturbance in how you perceive your body (thinking you’re fat when you’re not, for instance), your self-esteem being excessively influenced by the way you see your body or a failure to acknowledge the seriousness of the low body weight. 

Furthermore, there are two types of anorexia: binge-eating/purging type and restricting type. The former involves episodes of binge eating and/or purging behavior. Purging refers to expelling food from your body, like self-induced vomiting or misuse of laxatives or diuretics. The restricting type does not binge and/or purge, but loses weight through dieting, fasting and/or excessive exercise.

Anorexia also often accompanies other psychiatric illnesses. Depression, bipolar disorder, obsessive-compulsive disorder, personality disorders and self-injury are some of the more common comorbid conditions. This can make the anorexia even worse, as there is more internal turmoil. Getting treatment for other mental health – and physical – disorders can help in the recovery from anorexia.

If you or someone you love is experiencing these symptoms, it’s imperative that you seek out help from a qualified professional. Anorexia nervosa is the most deadly mental health disorder. It will wreak havoc on your body until it literally eats itself. You cannot survive without nutrition. But it’s not just your body. Suicide causes one in five anorexia deaths. It is so important to get help.

Find someone who specializes in eating disorders. They have their own specific challenges and your best shot at recovery is with someone experienced. There might also be local support groups you could join in addition to therapy. If the anorexia is severe or treatment-resistant, consider finding a treatment center. If serious physical symptoms develop, call 911 or get to an emergency room. Look out for fainting, seizures, irregular pulse and other symptoms that could be considered serious. Recovery from anorexia is essential, so don’t hesitate to get whatever help you need.

To learn more about supporting loved ones with eating disorders, read this.

What has been your experience with anorexia? What helped you or a loved one get better? Share your thoughts in the comments.

5 ways to support a loved one in inpatient treatment

Sometimes, mental illness or substance abuse requires more intensive treatment than can be provided on an outpatient basis. Situations like being suicidal, the inability to get substance abuse under control, going through a medication change or an eating disorder becoming life-threatening call for inpatient treatment. The amount of time someone is gone varies, too – rehab can take months while most stays at the psychiatric ward of a local hospital are only a few days. The uncertainty of how long it will take can make the situation even more distressing.

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While this is a lot to deal with for the patient, it also leaves loved ones not knowing what they can do. Visiting hours are often very restricted and you might not even know if your loved one wants you to come. Besides, these programs are sometimes pretty involved, with individual counseling, doctor’s visits, group therapy, psychoeducational classes and more. You want to help; it’s just hard to know what to do.

In these times, grand actions are not very viable. It’s the simple shows of support that end up being meaningful. Following is a list of suggestions for showing that you care. Keep in mind, however, that the rules and policies of each treatment center varies. If you are uncertain of whether a specific item is permitted, call the unit your loved one is staying at and ask a staff member. 

1. Let him know you are there for him… 

An in-patient stay cuts someone away from the world, leaving most of society’s currently used methods of communication off limits. She likely won’t have access to her cell phone or the Internet. This brings up the question of the best way to show support. Even if your relationship is close, he might not be ready to accept you reaching out. A card or a letter is a non-threatening way to show support that allows her to decide if she wants to give you a call or invite you over to visit. Include your phone number, as he might not have it memorized.

2. …but respect her privacy. 

Because it is closed off, knowledge of what goes on within the program can seem mysterious to outsiders. Your curiosity might naturally be piqued, however. But unless you are the parent of a minor, you most likely don’t have a right to know what is going on. You have to trust that the treatment team has the situation under control and will make good decisions. If your loved one wants to talk about his treatment, he will. Be nonjudgmental and a good listener. Avoid giving advice at this time. Besides, after a long day of processing issues and psychoeducational material, hearing about the latest game or celebrity gossip might actually be relaxing. 

3. Pictures 

Due to risks of patients harming themselves or others, there are a lot of restricted items in the inpatient setting. Pieces of paper, however, are generally considered benign, so bring pictures. Don’t just stick with family portraits. Go to your loved one’s Facebook page and print out a few of her having fun with her friends or on a vacation. A picture of a beloved pet can also be appreciated. If your loved one has a strong attachment to a particular location, a photograph of a place that soothes her can also be calming. If permitted, bring Blu-Tack so he can hang them up. Frames will not be allowed, at least not with the glass in.

4. Entertainment 

Despite intensive treatment, there is downtime. If left with the facility’s resources, however, your loved one might spend a lot of time coloring pictures with crayons or playing checkers. While often highly regulated, entertainment is appreciated. Some books and magazines are restricted based on the content, but you probably won’t know until you get there, as it is very arbitrary. Less frequently, a center might allow an iPod or MP3 player. They may, however, require a small speaker, as headphones can be a safety risk. With this, it’s especially important to talk to the staff before you bring something over.

5. Something from home

It is normal to get homesick when in an inpatient setting, seeing as one is pulled away from all the comforts one is used to. Bringing something meaningful from home can ease some of that feeling. Take over a favorite stuffed animal, pillow or blanket. A small, unbreakable trinket with personal significance can be a lovely connection to home. Avoid brining valuable or irreplaceable items. Not all inpatient stays are planned, so a fresh change of clothes can be much appreciated. If you are allowed to bring food or treats, a comfort food can also mean a lot. A connection to life outside the treatment center can serve as a lifeline when treatment is at its toughest.

Have you spent time in an inpatient unit? What shows of support did you find helpful? Add to the list 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.

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.

Learning to be body positive

   

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Because I have some challenges with my body image, up until recently I was getting some of my clothes the wrong size. I had this idea of looking a certain way and that’s how I thought of myself. Finding out that I was actually not shaped the way I thought was such a weird experience. It made me reexamine my body and how I treat it.

Treating your body right isn’t just a physical thing. Exercise and healthy eating are important, as are taking care of any physical illnesses. But a part of having a healthy body is the way you talk to yourself. If you’re constantly thinking, “My thighs are too fat,” or “My arms aren’t muscular enough,” you start viewing your body in a negative way. This type of thinking will affect your ability to properly take care of yourself. At one extreme, it might be depressing and lead to something like overeating. On the other side is starving yourself or engaging in excessive exercise. Neither of those options is healthy.

It’s important to treat your body with respect. It’s the only thing you will have your whole life, no matter what happens. It is an extremely valuable asset and should be treated as such. When you are feeling down about one part of your body, always think of a positive. Even though it sounds cheesy, find one thing you like about it. I promise you can. I like the way my lips are shaped. It seems trivial, but having something about you that you love makes a difference. Everyone – and I mean everyone – has some attractive aspect. You aren’t an exception to that.

I’ve been trying very hard lately to be body positive. I went to the store and bought an item of clothing that I felt insecure about pulling off with my body. I felt so dumb when I was being checked out. It felt like the clerk was thinking, “Really? You’re gonna wear that?” when I’m sure he didn’t even think anything of it. When I wore it, nothing catastrophic happened. No one said anything. People didn’t stare at me. It was hard, at first, to be comfortable. Then I simply stopped noticing. It was fun to wear something different.

My point is, you are more concerned about your own body than anyone else is. (If someone does care more than you, tell him/her to mind his/her own body). How you treat and talk to yourself is what matters. It’s a really hard thing, but just try to accept your body. No excuses, no exceptions. I haven’t been able to do it perfectly, but it’s already made a huge difference for me. 

Your body deserves all the love you can give it. It’s what’s keeping you alive, so be grateful and kind to it.

What helps you feel more confident in your own skin? Sound off 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.

7 ways to support someone with an eating disorder

Eating disorders have the highest mortality rate of any mental illnesses. Because of this, it is extremely important to work towards recovery. It is easier to get better when friends and family are supportive. But eating disorders are complex both physically and psychologically, so it can be hard to know what to do and say – or what to not do and say. Here are some suggestions on how to be supportive of someone with an eating disorder.

1. Remember that eating disorders don’t discriminate. A person of any age, gender, race or size can have an eating disorder. They’re not all bone-thin, white teenage girls. There are several different kinds of eating disorders and it’s impossible to tell by a glance whether or not someone is struggling with one.

  

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2. Understand that it’s not just about being skinny. Eating disorders are complex. While societal pressure to be thin can be a factor, it’s not the only one. There are usually intricate emotional reasons behind the disorder. Risk factors that can influence the development of an eating disorder include having another mental illness, substance abuse, perfectionism, sexual abuse and being involved in activities focused on weight (sports, dance, modeling, etc.).

3. Focus on positive non-physical traits. Eating disorders are often accompanied by a lot of insecurity. It’s therefore important to help build self-esteem in areas not related to the body. Compliment your loved one for his kindness, intelligence, skills, etc. Encourage participation in hobbies and activities that she excels in.

4. Be a good listener. If you are consistently paying attention and responding appropriately to your loved one, he will find it easier to talk to you about difficult subjects. Don’t push the topic of eating disorders, but if it comes up, be supportive and gently encourage recovery. If she has brought up the topic, you can carefully try to follow up, but follow her lead.

5. Do things together that don’t involve food. Eating disorders can be very isolating. It’s important to still have a social life, but a lot of social activities are centered around food. This can be very difficult. Invite him to do things where food is not the focus. Instead of going out for ice cream, go to the arcade or a concert. She’ll feel a lot more comfortable.

6. Don’t make demands about recovery. You can’t force someone to change. Recovery can only happen at the pace that someone is able to work at, so you need to respect that. Not doing so can damage your relationship and make your loved one feel uncomfortable around you. Trust his treatment team to keep tabs on how he’s doing.

7. Get emergency help if needed. Forcing treatment on someone can be ineffective and potentially counterproductive, but sometimes intervention is necessary. If symptoms get severe enough, call 911 or take her to the emergency room. Fainting, seizures, an irregular pulse and other severe symptoms call for medical intervention.

How do you maintain relationships with someone who has an eating disorder? If you have one, what do you find helpful? Share your thoughts 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.

Books about mental illness and recovery

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

Anxiety

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

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

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

Attention deficit hyperactivity disorder (ADHD)

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

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

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

Autism spectrum disorders

Autism: A Practical Guide for Parents by Alan Yau

Autism by Dr. Robert Melillo

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

Bipolar disorder

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

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

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

Depression

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

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

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

Dissociative disorders

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

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

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

Eating disorders

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

Life Without Ed by Jenni Schaefer

Healing Your Hungry Heart by Joanna Poppink, MFT

Insomnia

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

The Effortless Sleep Method by Sasha Stephens

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

Obsessive-compulsive disorder 

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

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

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

Panic disorders

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

Panic Attacks Workbook by David Carbonell, Ph.D.

From Panic to Power by Lucinda Bassett

Personality disorders

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

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

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

Posttraumatic stress disorder

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

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

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

Schizophrenia

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

Schizophrenia: A Blueprint for Recovery by Milt Greek

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

Substance abuse

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

Clean by David Sheff

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

For loved ones

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

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

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

Memoirs

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

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

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

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

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.

David Castillo Dominici/FreeDigitalPhotos.net

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:

David Castillo Dominici/FreeDigitalPhotos.net

• 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.