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. 

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.

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.

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.

Mental health myths: children and mental illness

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

Myth: Children cannot develop mental illnesses.

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

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

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

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

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

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

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• Being unable to cope with everyday problems.

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

• Difficulty concentrating.

• Loss of interest in activities and friends.

• Persistent negative moods.

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

• Frequent physical symptoms, such as headaches and stomachaches.

• Changes in eating habits.

• Unwarranted amounts of worry and anxiety.

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

• Risk-taking behavior.

• Repeated anger outbursts.

• Frequent disobedience and aggressive behavior.

• Self-injury.
• Substance abuse.

• Unusual amounts of time spent alone.

• Disproportionately intense feelings.

• Seeing or hearing things that aren’t there.

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

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

Who do I call?

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

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

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

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

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

Childhelp National Child Abuse Hotline: 800-422-4453

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

Crisis Text Line (teens): Text SUPPORT to 741741

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

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

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

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

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

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

National Domestic Violence Hotline: 800-799-7233

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

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

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

National Mental Health Association Hotline: 800-273-8255

National Runaway Safeline: 800-786-2929

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

National Suicide Hotline: 800-784-2433

National Suicide Prevention Lifeline: 800-442-4673

National Teen Dating Abuse Helpline: 866-331-9474

Postpartum Support International: 800-944-4773

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

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

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

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

Suicide Prevention Services Depression Hotline: 630-482-9696

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

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

Veteran Combat Call Center: 877-927-8387

Veterans Crisis Line: 800-273-8255

Update: Here is a link to international suicide hotlines.

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

Healthy distress management

Life is never completely free of things that bring us sorrow, scare us or make us stressed. There will always be a cause for distress. Finding healthy ways to manage this is essential for mental health. Repressing your distress instead of dealing with it can lead to or exasperate mental illness. This can range from being less productive at work because something is nagging at you to developing PTSD and dissociative symptoms from not confronting a trauma. It is easy to turn to bad habits for comfort. Drinking, overeating or self-injury can temporarily create a sense of peace. They all have negative consequences, though. Following are some healthy ways of managing distress.

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Express yourself through the arts
Art can heal. Since the early days of human existence, people have created art. It is just as powerful today. In fact, there is an entire field of art and movement therapies. Expressing your thoughts and feelings in art is a way of making your experience "real." So write a poem about the heartache you are feeling. Dance to express that feeling of reaching for something you will never have. Paint what the inside of your mind looks like. The possibilities are endless. Even if you don't consider yourself an artist, art is something everyone can participate in. Try different mediums until you find something that works for you.

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Talk about your experience
The brain doesn't like secrets. Research by James W. Pennebaker suggests that keeping secrets can have adverse effects on your physical health, including your blood pressure, sleep, and immune function. Disclosing those secrets, however, reduces stress and improves overall physical health. In other words, bottling up everything you are feeling doesn't work. It will literally make you sick. Confiding in someone is healthy for your mind and your body. Therapy is an excellent outlet, but even talking to family and friends about what is worrying you can have a positive effect. The important part is that you get it out there.

 

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Keep a journal
Pennebaker's research also states that writing in a journal can have similar favorable consequences to those of talking to someone. For some, a journal is less intimidating than a conversation. It is a safe place to say anything. If you are worried about someone reading what you wrote, you can destroy the content after you write it. Tear it into little pieces or burn it. You can also write in a way that others won't understand. Some people like writing in a foreign language. When writing about one particular topic, I use a code that only I know how to solve. This takes more effort, but if it is what makes you feel safe, go for it.




Use entertainment for catharsis

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Sometimes, all we need to feel better is to find a story we relate to. One of the reasons entertainment is so popular is that it allows us to feel less alone. I can't count the number of times I have listened to certain songs to get through the night. Some of my favorite movies contain themes that resonate in my own life. And books can be a more prolonged way of identifying with characters and their circumstances. Finding entertainment that speaks to you and your situation can be incredibly healing. Make playlists for different emotions. Own copies of movies that make you feel better. Read books that deal with what you're going through, either literally or metaphorically. You don't have to be alone.


You can read more about Pennebaker's work here.

What helps you deal with overwhelming thoughts and emotions? Let us know in the comments.