20 things not to say to someone with a mental illness

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

100 ways to improve your mental health

We’ve reached a milestone today – this is my 100th post! To celebrate, I decided to make a list of 100 things. The most helpful idea that came to mind was ways to improve mental health, so here it is. I have broken the list down into categories so that you can find the ones that are the most relevant for what you are working on. (Another milestone: Happy birthday, A. You’re my favorite.)

  

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Emotionally

1. Honor your emotions for what they are and accept them fully.

2. Do something that makes you happy every day.

3. Remember that feelings are temporary; they will always change.

4. Express your emotions creatively.

5. Ask for help when you feel overwhelmed.

6. Know when to back out of a situation.

7. Stop your thinking and ask yourself what you are actually feeling and why.

8. Use a feelings chart to identify what you are experiencing.

9. Surround yourself with little things that make you happy – flowers, art, scented candles, etc.

10. Find positive and uplifting entertainment.

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Mentally

11. Stay in the present.

12. Deal with stress as it comes up.

13. Eliminate bad habits. 

14. Set realistic goals and work towards them.

15. Stop using negative words to describe yourself.

16. Reward yourself for doing difficult things.

17. Take a break when you need it.

18. Find new ways to do things.

19. Stop and consider other perspectives on what you’re experiencing.

20. Use good common sense.

                                                                                              Physically

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21. Exercise regularly.

22. Take time to relax.

23. Eat three meals a day.

24. Take your medication as prescribed.

25. Stay at a healthy weight. 

26. Get enough sleep.

27. See a doctor when you need to.

28. Choose healthy food.

29. Stay away from harmful substances.

30. Love your body as best you can.

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Socially

31. Rely on your support system.

32. Spend time with other people regularly.

33. Be a helpful friend.

34. Respect the needs of others and expect that they do the same.

35. Engage in volunteer work.

36. Eliminate negative influences in your life.

37. Set and keep healthy boundaries.

38. Make time for yourself.

39. Be clear in your communication.

40. Be considerate.

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Intellectually

41. Be educated about your disorder(s).

42. Learn something new every day.

43. Study things you genuinely find interesting.

44. Study something you know absolutely nothing about.

45. Do mind exercises like sudoku, crossword puzzles and word games.

46. Talk to other people about what they do.

47. Take an evening or community course.

48. Think up funny jokes and witty responses.

49. Take notes when you are learning about something. Refer to them later.

50. Do calculations in your head instead of using your phone.

Spiritually

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51. Practice mindfulness

52. Meditate and/or pray.

53. Eliminate unhealthy beliefs.

54. Rely on a higher power.

55. Learn about the beliefs of others.

56. Journal about your spiritual experiences.

57. Share your spiritual experiences with open-minded loved ones.

58. Forgive.

59. Find or decide on your life’s purpose and live it.

60. Stay true to what you believe.

                                                             Environmentally

                                                             61. Surround yourself with beautiful things.

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62. Hang up motivational posters.

63. Spend time in nature.

64. Keep your home clean.

65. Use sticky notes to post affirmations where you’ll see them frequently.

66. Support any environmental causes you believe in.

67. Use your resources well.

68. Take basic safety precautions.

69. Repair broken things so they don’t continue to frustrate you.

70. Stay organized.

Occupationally

71. Do things you love.

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72. Know your limits when it comes to work.

73. Develop schedules and routines.

74. Simplify your work.

75. Get support from colleagues when necessary.

76. Keep good boundaries between your personal and professional lives.

77. Compliment coworkers on a job well done.

78. If you are unhappy in your job, look for a new one.

79. Multitask less.

80. Take a day off when you need to.

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Self-care

81. Journal regularly. 

82. Go for a walk.

83. Make your favorite meal.

84. Use grounding techniques.

85. Have a list of coping skills.

86. Be patient.

87. Keep a gratitude journal.

88. Go easy on yourself.

89. Respect yourself.

Other

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91. Stand up for yourself.

92. Believe you can get better.

93. Keep a beginner’s mindset.

94. Learn from every experience.

95. Keep some money in savings.

96. Have alternatives for self-destructive behaviors.

97. Be prepared for change.

98. Have a safety plan.

99. Stay progress-oriented.

100. Make a list of personal reasons to recover.

Do you have any tips to add? Please do so in the comments!

A case for family treatment

We cannot escape family. Their presence or absence will always impact us on some level because family is interconnected in a way that nothing else is. It’s foundational to who we are. A family can be composed in many ways – with blood being only one possible tie – and we will all have different “families” throughout our lifetimes. Sometimes we may be more alone than others, but we all started in a family and that is paramount to the people we become.

There’s an analogy that compares a family to a mobile or a wind chime. There are independent units, but you can’t move one without moving the others. Everything we do impacts our families – and everything they do impacts us. For instance, if a child graduates high school and moves out to go to college, the family has to readjust to the environment without that person. This can mean practical changes, such as redistributing chores, or emotional ones, like when the sibling closest to the one who moved feels left out and has to form new bonds with the remaining family.

  

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There’s a concept in psychology called the “identified patient” (IP). The IP is the family member who has a “problem.” This could be an alcoholic parent, a child failing out of school or someone struggling with physical or mental illness. Everyone else in the family can convince themselves that they are okay because they are not the IP. In this way, all the problems of the entire family get shifted on to one person. 

This isn’t done with bad intentions. Often, the family has benevolent or fond feelings for the IP. A wife will make excuses for her partner’s absences due to a drug problem in order to save face or get him off the hook. A parent gives a child lots of attention because she’s acting out at school. A teenager is happy to have an ill brother because he distracts the parents so she can rebel. This isn’t the family being mean. It’s the family adjusting.

These adjustments that are made for the IP do, however, have consequences. The wife is saving the husband from the repercussions of his drug problem, enabling him to continue to use. The siblings of the “problem child” feel like their parents don’t care about them. The sister gets in trouble because the parents were busy caring for the sick brother. Trying to cover up the problem is just creating more problems, but because they aren’t the IP, the other family members eschew their own troubles in favor of those of the IP.

Remember that mobile? One person “moves” by having a problem and everyone else shifts their problems somewhere else. 

This brings up the question of where the real problem lies. Is the identified patient of concern, or is it the family as a whole? What starts out as an obstacle for one family member can set off a chain reaction wherein everyone becomes involved.

So what happens when the IP gets better? First of all, the family often stands in the way of the IP improving. If her problems are resolved, then theirs become real again. While the family wants what’s best for the IP, they also want to retain the balance they have established. They might even fear becoming the next IP because the family doesn’t know how to function without one. 

This is why family treatment is so important. It allows all the cards to be put on the table, making it easier to notice connections between family members and their various problems. Sometimes, having a mental health professional take a look at your family unit as a whole can help all of the family better understand what is going on and how to make the family healthier. Everyone’s problems get a chance to be addressed, not just the IP. A good therapist will know not to blame the IP for everything.

   

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Family treatment can cause upset, though. It’s a time of change as new habits and coping skills need to be put in place. It will bring out all sorts of things that no one knew were there and things might even feel worse for a while. But having the family unit heal both individually and as a whole is worth it. There is no price for having stronger, healthier bonds and better problem management. 

When each family member learns to see what he contributes to the problem, he can learn valuable information about how he relates to others, which will be useful in any type of relationship. As she examines her real issues and how she displaces them, she can learn to take more responsibility and thereby have more control over her life. None of us exist in isolation and none of us can heal that way.
                                                                                                                   Individual and common concerns are intricately
                                                                                                                   interwoven.

Even if all the family members aren’t struggling, consider getting treatment together anyway. If nothing else, the love and support shown by joining the treatment is irreplaceable. There is work that simply cannot be done in individual therapy. Besides, by learning healthier patterns, you can improve the lives of the generations to come by having and teaching the skills necessary to have a healthy and happy family.

Have you had any experiences with family treatment? Post your experience in the comments.

15 mental health resolutions for 2015

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Happy New Year! As we all know, this is the time of year when people take stock of their lives and find ways to improve. So in the spirit of goal-setting, here are 15 resolutions to keep you mentally healthy in 2015. I encourage you to adopt at least one of them!

1. I will set and maintain healthy boundaries.

2. I will say no to negativity. 

3. I will make time for myself.

4. I will love and accept my body the way it is.

5. I will continue to learn new things.

6. I will practice mindfulness and self-care.

7. I will ask for help when I need it.

8. I will find healthy ways of dealing with stress.

9. I will not indulge in excess.

10. I will surround myself with supportive people.

11. I will take medications as instructed. 

12. I will physically take care of my body (exercise, nutrition, sleep, etc.).  

13. I will only speak positively about myself, in or out of my head.

14. I will shrug off unhealthy guilt. 

15. I will be proud of myself for each step towards recovery.

What mental health resolutions are you making? Post yours 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.

Lapse, relapse and recovery

Part of recovery is relapse. It's almost expected. At some point, after things have gotten better, they'll probably get worse again. The truth is, though, that your attitude towards relapses will have a big impact on how you handle them and whether you can use them to grow.

   

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First of all, a relapse can be many things. It might be returning to substance abuse or self-injurious behaviors. It can also be falling into another depressive episode or having obsessive thoughts again. It is an increase in symptoms that you have previously managed to reduce.

Then there's the definition of relapse. Some people think that any step backwards is a "relapse." The thing is, there is a difference between a lapse and a relapse. A lapse is engaging in a behavior or experiencing an increase in symptoms. Lapses happen to the best of us. They are not the same as a relapse, which is a series of lapses that put you back into the state of illness you were in before.


Some mindsets, such as that of Alcoholics Anonymous and other groups in that tradition, say that a lapse means you're back at day one. This can be very discouraging. But it's not the only way to view it. A lapse can be a learning experience. It tells you about what triggers your symptoms and what your areas of weakness are. This allows you to become stronger in your recovery.

If you experience a lapse, don't give up and give in. Messing up once or having a bad day doesn't mean you have to start over. It doesn't mean you're having a relapse. It just means that you now know what you need to work on. Resist the urge to fall back into old patterns. Take the time to think and maybe journal about what happened and why. Share these thoughts with your therapist, who can help you come up with strategies to avoid similar pitfalls in the future.

Sometimes lapses do add up, though, and become a relapse. While not ideal, this is perfectly normal. But if you could become better once, you can do it again. Stay open and honest with your therapist and support system. If you are struggling, let someone know. It is easier to get back on track with someone cheering you on. Keeping secrets is a sign of trouble.

Every day you spend free of destructive behaviors or symptoms of illness should be celebrated. Whether or not all of those days are in a row is secondary. Each time you make the choice to be healthy, you are right to be proud of yourself. Whether you had a single lapse or are in a full relapse, recovery is still an option. Life has lots of ups and downs. It's what you do with them that matters.


What has your experience been with lapses and relapses? What keeps you on track towards recovery? Share your thoughts in the comments. 

10 journal prompts to improve relationships

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In the past, we have looked at journal prompts to increase self-reflection. It is a very powerful way to explore yourself and come to a better understanding of who you are. Because this is currently my most popular post of all time, I thought we’d look at some other ideas to write about. This time, we’ll take a look at questions that can help you improve your relationships.

Remember, journaling can also be done visually through drawing, painting, collage and so on. For some examples of art therapy exercises, check this out. You can modify them to fit these prompts.

1. Make a list of the most important people in your life. What do you admire about each of them? 
2. What are nice things that others have done for you? Can you do any of these things for someone else?
3. Pick a relationship you cherish. Write a letter to this person explaining why this relationship is especially important to you. (Sending it is optional.)
4. Think about couple you feel have a loving relationship. What have you observed them doing that you’d like to see in your own relationships?
5. Write about childhood friendships. What positive things did you do as a child that you have lost over the years? 
6. Make a list of traits you have. Next to each of them, list who else in your life has those traits. You might find some new common ground.
7. Who has had the greatest influence on you? Why have these people mattered so much?
8. How can the examples of others help you improve yourself?
9. Have you had a special relationship with a pet? What have you learned from this that can help you be better in your human relationships?
10. What kind of person do you want to be in the context of your relationships (sister, boyfriend, student, etc.)?

What did you discover using these prompts? Do you have any other ones you’d like to share? The comments are open!

7 reasons to enter individual therapy

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Therapy can be helpful for lots of different concerns. While we have discussed when it is appropriate to enter treatment, we haven’t had a good look at the reasons for doing so. If you or someone you love is having problems in any of these areas, you should consider contacting a therapist to commence treatment.

1. Relationship problems

Relationships are, perhaps, the most important aspect of life. While there are a few hermits out there, people aren’t generally meant to go it on their own. We need others, whether that means a farmer who grows your food or a friend that offers a shoulder to cry on. Relationship impairment is, therefore, very significant. If you are having a hard time with your relationships in general or are struggling with an important relationship, a therapist might be able to help you figure
out your part in it and how you can improve those bonds.

2. Support during transitions

Change can be hard. Change is even harder if you go it alone. As well-meaning as friends and family may be, they are not always enough to guide you through major adjustments. For instance, if you have been diagnosed with a major illness, are going through a divorce or can’t quite get in the groove with a new job, it might be a good idea to talk to a therapist. He is removed from the situation and doesn’t have anything but your best interest in mind, whereas others – while wanting to help – might have their own agendas. 

3. Impulsive behaviors 

Everyone does something on impulse from time to time. Whether it’s as simple as trying a new place for lunch or as complex as quitting school to travel the world, sometimes we just want to do something. At times, however, impulses can get the best of us. Doing things without thinking can damage the lives of us and the people around us. It is especially important to get professional support if you are having problems with addiction or sudden aggression. If you wake up the next day regretting your decisions, consider contacting a therapist.

4. Difficulties in school

Education is a very important part of life. Struggling with it is definitely a cause for concern. You could have a learning disability, or something might just be in the way of you completing your work efficiently. Therapists are trained to identify what is causing your problems and can even offer assessments to see where your challenges lie in order to help you get through them. They can also make recommendations to your school about accommodations for any conditions you might have.

5. Vocational issues

What you do for work is one of the most important life decisions you will make. Whether you are struggling to find out what you want to do or not doing well in your current occupation, therapists are a great resource for working through work issues. Because employment is essential to supporting oneself and one’s family, entering therapy when you are struggling is a good investment. As with school, therapists can sometimes make recommendations for accommodations in your workplace to help you succeed in your job.

6. Sexual concerns

Sex is a significant part of intimacy; therefore, difficulties in that area of life can be particularly distressing. Luckily, therapists are not there to judge you and can help you work through any concerns you have in this area. Whether you are struggling with people accepting your sexual orientation, learning to be intimate after sexual assault or curious whether your sexual quirks and kinks are healthy, a therapist is a good sounding board to help you work through such personal and important questions.

7. Self-improvement

Therapy isn’t only for those who are unhealthy. Sometimes, people go to therapy just to become better people. You might have some meaning-of-life questions, or you might just want to be a better friend or more comfortable in your own skin. Therapy is a great setting to explore your strengths and weaknesses and find out how to make the most of your life. Therapists can teach you useful skills and techniques, help you work through “the big questions” and explore how you can add more meaning to your life. 

Why did you decide to enter therapy? Tell us 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.

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.

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.

25 reasons to recover

On tough days, it’s important to remember why you are working on your recovery at all. When steeped in negativity, it’s hard to think of what you have to gain. But it is important that you do. Motivation and hope can get people through a lot. 

So what keeps you going? I suggest that you make a list of reasons why you want to recover. There is always something. Even if your list has a single item, you can turn to that one reason you have when you are feeling discouraged. You can do your list all at once and add to it as you think of new ones, or you can decide to write down one a day for as long as you can. To get started, here are 25 examples.

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1. So you can feel confident in your own skin.
2. To truly be there for your loved ones.
3. To understand yourself better.
4. So you don’t have to worry about keeping up appearances. 
5. To think more clearly.
6. So you don’t have to be scared of going outside.
7. To be a more empathetic person.
8. So you can get out of bed in the morning with a smile on your face.
9. So you’re not afraid of food.
10. Because you deserve the best life you can live.
11. To be honest when you say, “Fine,” when others ask how you are.
12. So you can wear whatever you want without being uncomfortable.
13. To show your loved ones that you care about them.
14. So you don’t always compare yourself to others.
15. To concentrate better.
16. So you can actually enjoy celebrations. 
17. To feel motivated and inspired.
18. To improve your physical health.
19. To become a more accepting person.
20. So your dreams can become realities.
21. To show others that it is possible.
22. To feel like life is worthwhile.
23. Because you believe in second chances.
24. To show that you love yourself.
25. Simply do it because you can.

What are your reasons? Add to the list 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?

9 things you need to believe in order to heal

Healing from mental illness is one of the most difficult things you will ever do. It’s a scary process and you never know if you’re going to relapse. But a lot of it is about attitude and belief. Here are some of the things you need to believe if you want to recover from mental illness.

1. It is possible to heal.

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There is very little point in trying to recover if you do not believe it is possible. Not believing it sets up a major barrier that makes progress in treatment minimal at best. Belief in the method of healing is essential to recovery. Take the placebo effect. If a pill that does nothing can make some people better because they believe it is something else, then believing in your actual treatment is going to be fruitful.

2. It is okay for it to take time.

At the start of therapy, people usually want to know how long it is going to take. Some people even expect everything to be solved in a single session. The truth is, it’s going to take however long it’s going to take. The average is 8-12 sessions, but that number is, in a lot of ways, completely meaningless. Whatever you need is how long it’s going to take and that’s okay.

3. It is normal to take a step back.

Recovery isn’t a straightforward trajectory towards wellness. There are ups and downs. You will get worse before you get better. And even when you do get better, you’ll still have bad days/weeks/months. The thing with setbacks is that they actually make you stronger than you were before. You may feel like you overcome it to end up in the same place, but you’ll have grown even more.

4. You are worthy of love no matter where you’re at.

Measuring our self-worth is often done by looking at our output. How well do we do in school? How much money do we make? What kind of significant other have we won over? Mental illness can affect one’s ability to produce, but it doesn’t affect self-worth. You’re just dealing with a different set of characteristics. Now your courage in facing your disorder, determination to get better and willingness to comply with treatment set you apart.

5. Others will support you if you let them.

There are others who will want to help you. And if they’re not already in your life, you will be able to find them. I spent so many years trying to recover without letting others really be there for me. I thought I had to do it myself. You don’t. Once I started letting other people in, I’ve made tremendous progress. I don’t have a big social network, but even one person supporting you makes a difference.

6. Your treatment team can help you.

Research has shown that believing in the ability of your therapist to help you improves therapy outcomes. That’s why sending someone to therapy who doesn’t believe in it or who isn’t ready is pretty useless. If you don’t entirely trust your specific therapist, look for someone else. It is critical that you have faith in those who are helping you. (Here’s a list of questions to ask potential therapists.)

7. Things are always changing.

Don’t give up on yourself because you believe you’ve exhausted every option. The world is in constant flux and your circumstances are changing all the time. There are always new treatments, new research, new therapists, new medications, new friendships, new hobbies, new everything. The belief in change is also helpful when you’re having a setback because you know it won’t last forever.

8. You are not an exception.

I spent a lot of years thinking that there was something so terribly wrong with me that I wasn’t going to get better. I put forth all my best effort with minimal results. I just thought that I was someone who couldn’t get better and that the most we could do is not make things worse. It took six and a half years of therapy to find a crucial component that turned things around. But we found it. You will find it, too, eventually.

9. It will be worth it.

Mental illness changes the way you view the future. It can be very hard to see yourself living the life you want. The truth is, things might not work out the way you’d like. I’ve worked on my undergraduate degree for eight years and still don’t know if or when I’ll get it. But I’m learning to appreciate any progress. I don’t have a lot of relationships in my life, but the ones I do have really matter. There are a few things I enjoy doing that I didn’t know about before. You have to believe that you’ll find something worthwhile, even if it isn’t exactly what you planned.

What beliefs have helped you in your recovery? Add your thoughts in the comments.

7 signs of abuse in children

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

1. Problems regulating emotions

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

 

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2. Excessive fear of doing something wrong

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

3. Unexplained physical injuries

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

4. Extremes in behavior

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

5. Age-inappropriate sexual knowledge

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

6. Avoiding someone specific

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

7. Regressing to earlier behaviors

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

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

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