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.

5 techniques for the moment you are overwhelmed

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

1. Use breathing techniques

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

  

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2. Accept the situation

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

3. Take a break

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

4. Ask for help

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

5. Express yourself

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

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

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.

5 dating tips for those with a mental illness

  

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Last week, we talked about dating someone with a mental illness. Today, we’re taking a look from the other side. Dating can be overwhelming and confusing, and having a mental illness just adds to that. But it is possible to have a successful, happy and healthy relationship even if you are struggling with your mental health. It took me quite a while, but finding that balance is possible. Here are my suggestions to speed up your process.

1. Don’t expect her to read your mind.

This is a good tip in general, but especially important when mental illness is involved. Other people don’t know what you’re thinking or feeling if you don’t tell them. For instance, you can’t expect someone to cheer you up if he doesn’t even know you’re feeling depressed. Assert your needs. Be as open about what you’re experiencing as you are comfortable with (and as is appropriate at your stage of the relationship). This will help your partner get a better picture of what you’re dealing with, which makes it easier for both of you.

2. Take responsibility.

Mental illness pushes us to do things we would not otherwise do. There are times when we legitimately can’t help it, but you can’t blame everything on your illness. It is not a crutch and it is not an excuse. You have choices, no matter how much you feel the odds are stacked against you. When you really, truly tried your best and your illness got in the way, say that and explain what happened. But you still need to own up to your faults because you are not possessed. You made a decision. You are still you and we all
                                                                             make mistakes sometimes.

3. Respect his needs.

It can be easy to get caught up in our own needs when we are struggling with our mental health. It feels like too much is going on and a lot of energy goes to managing our symptoms. But your partner has needs, too. Respect that she can’t always answer your call at three in the morning. Be okay with him taking the night off to see his buddies. See how you can be helpful as well. Even if you can’t do everything you’d like to, you can make an effort to show that you respect and value her.

4. Work on your recovery.

Your biggest gift to your partner is yourself. That is one motivation to work on improving. You want to be fully present and available, which can be hard when you are struggling with yourself. Dating someone with a mental illness can be stressful, so the improvements you make help it be more manageable for your partner. A healthy you is more able to meet his needs as well. Just be careful that your partner doesn’t become your only motivation.

5. Love yourself.

Have you ever heard someone complain about herself and thought, “I don’t see that at all”? No matter how unlovable you think you are, there are reasons others like and care about you. Pushing away this love to wallow in self-pity not only is unhealthy for you, but can be hurtful to your partner. Self-image is a huge part of mental health. Focus on what you do appreciate about yourself. You should be doing something to show that you care for yourself every single day. Besides, the more you healthily love yourself, the more you can healthily love others.

What has your experience been with dating while struggling with a mental illness? Talk about it in the comments.

5 tips for dating someone with a mental illness

  

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

1. Ask appropriate questions.

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

2. Give him space – or don’t.

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

3. Focus on her strengths.

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

4. Be accommodating and flexible.

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

5. Set your own boundaries.

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

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

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

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

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 ways to manage change

Like the saying goes, change is the only constant in life. Sometimes it’s for the better, other times it’s not. But no matter what, it will come at you every day of your life. With some transitions, it might be hard to adjust. Fortunately, there are things you can do to make change more manageable.

  

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1. Try something new

Prepare for future changes by getting used to the process. Try new things on a regular basis so that variety become a natural part of your life. Take chances and open yourself up to what’s outside your comfort zone. New foods, sports, friends, classes, hobbies and so on make you more able to adapt to the changes you will later encounter. Besides, novel forms of stimulation are great for your brain!

2. Prepare

Not all change is foreseeable, but you can make life a lot easier if you prepare when you can. Make decisions that are consistent with what you will be facing. If you need a new outfit in the winter, you’re not going to buy shorts (unless you’re lucky enough to live somewhere warm). Now is a good time to look at the year ahead. What changes are you making and what challenges do you face? If you take the time to examine those things, you can make a plan to better handle the changes.

3. Establish comfort

When you are faced with something new and unknown, find something familiar to hold on to. There is always a way to bring in something you treasure. Often, it’s the little things. You might have a new job, but you can put the same pictures on your desk and listen to the same radio station on your drive to work. Not only is this a chance for you to make things more comfortable, but you might find that your old experiences can add something valuable to your new ones. 

4. Learn to both hold on and let go

When faced with change, we are given the question of what to keep and when to let go. Take some time to consciously think about this. What lets you progress and what is holding you back? You might also find that some things can remain, but in a different form. For instance, you might move somewhere new. You can’t go to your favorite restaurant anymore, but you can find other similar ones. Alternately, you could adapt skills you used in one setting to fit another. 

5. Be flexible and resilient

In terms of psychological health, flexibility and resilience are essential. When you are flexible, you can roll with the punches and take things as they come. This makes change less difficult and upsetting. Resilience helps you get back on track when things don’t go your way, which cuts out a lot of confusion and wasted time. Practice using these qualities in your everyday life. When things don’t go as expected, don’t let it get to you and find ways to adapt.

6. Ask for help and advice

You don’t have to go through change alone. Other people can be a great resource. Seek out both people you trust and people who have gone through changes similar to yours. If you are having trouble adjusting to a pregnancy, talk to other moms and see what helped them. If you are switching schools, see if there’s another new student you can befriend. If nothing else, it can be great to have someone to vent to and use as a sounding board.

7. Find opportunities

You can look at change either as taking something away from you or as something giving you a chance to grow. As they say, when one door closes, another opens. If the change is not one you enjoy, there can be good things that come out of it, even if it’s simply personal growth. You always have a choice in how you react to the changes in your life and if you seek out the best parts, negativity won’t get to you as easily.

What has helped you during times of change? Sound off 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!

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.

Make a 5-step safety plan right now

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

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

 

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Who can I talk to?

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

What can I do to feel better?

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

When do I need to seek help?

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

Where can I go?

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

Why should I not do this?

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

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

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

15 ways to improve your mood in 15 minutes or less

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

10-question assessment on recovery progress

Every once in a while, it’s good to check in with ourselves and see where we’re at. Recovery is a long process and it’s not always possible to see progress from day to day. But over time, all the effort you put in does add up. Sometimes, it is nice to be able to look back and say, “Wow, I’ve come a long way!”

I recommend writing down your answers to these questions and then doing it over again in a few months. You can keep doing this and have a record of your progress. The insights gained over time can be shared with your therapist, who can give you additional feedback on how you’re doing. He or she can also give you standardized assessments, such as ones measuring depression or anxiety, to use in addition to this self-assessment.

    

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1. What did I use to be like?

Think back a year, six months or since you last answered these questions. Describe what you were doing and what your struggles were.

2. What am I like now? 

Describe your daily functioning, both where you excel and where you could do better. Note any major changes that have happened, such as starting a new relationship or quitting a job. 

3. What coping mechanisms did I use in the past?

Make note of what you did when you were symptomatic. Point out which strategies worked, which ones didn’t and whether or not you now believe they were healthy ways of handling things.

4. What coping mechanisms do I use now?

State what helps you cope right now. Consider whether you have found healthier and more effective ways of handling your symptoms. If you haven’t, what might you do to improve?

5. Where am I at with my goals?

Think about any goals you have made and whether or not you’re making progress on them. Also make plans for the next step in each one and feel free to set new ones.

6. What areas can I improve in?

Consider all facets of your life and pick one or two areas you feel like aren’t quite up to par. Think of ways to make progress with those things.

7. What makes me proud?

Go through all the changes you have made and identify what makes you the most proud. Staying positive and acknowledging the good can give you motivation to keep doing the things that work.

8. Am I getting the support I need?

Take inventory of the people in your life and ask yourself if they are helping or hindering your progress. Also note if there is anything that specific individuals can do and don’t be afraid to ask for help.

9. Is my treatment working?

List the different components of your treatment (therapy, medications, self-care, etc.) and consider if they are actually helpful. If one isn’t, can it be changed or should it be replaced by something else?

10. Where would I like to be by the next time I self-assess? 

Envision what you would like to see happen in the coming months. Be realistic, but don’t underestimate yourself either.

How do you measure your progress? Make suggestions in the comments.