Young adults getting help

I was recently interviewed for an article by Nicole Pasulka on takepart.com. She’s done a great job covering the challenges that young adults today face in getting help with mental health concerns. This is an important topic because, as she writes,

“People between the ages of 18 and 30, often known as millennials, are more likely to be diagnosed with mental illnesses like depression, schizophrenia, or bipolar disorder, and less likely to seek treatment. Three quarters of all mental health conditions have emerged by the time the person is 24 years old.”

She touches on a lot of relevant issues concerning seeking treatment, so I recommend checking it out. The article is called “How These Millennials Realized It Was Time to Get Help” and you can read it here.

7 signs you need a new therapist

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

1. You are not being respected.

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

2. You can’t establish trust.

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

3. Your therapist is crossing boundaries.

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

4. Your therapist doesn’t respect your time.

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

5. Your therapist breaks confidentiality.

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

6. Your personalities clash. 

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

7. Nothing is happening.

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

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

Mental health myths: Am I crazy enough?

Mental health concerns come with a lot of misunderstandings and there is plenty of misinformation out there. That’s why I like to tackle mental health myths from time to time. Today, let’s look at some thoughts about seeking treatment.

Myth: If I see a therapist, I’m crazy.

Fact: There are lots of “non-crazy” reasons to seek help.

   

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Somewhere in their heads, people set an imaginary standard for what the threshold should be for seeking mental health treatment. People come up with an idea of what they think is “bad enough.” One of the unfortunate consequences of this is that it makes people assume that someone who is in treatment meets their criteria for what they believe a mental health patient is. This is often not the case.

An acute crisis or severe symptoms definitely warrant treatment. But these are not the only reasons to seek it. It’s completely normal to go to a therapist if you are experiencing mild or moderate distress. This is, in fact, a good thing. By working on your problems before they get magnified with time saves you a lot of effort in the long run. 

It’s kind of like getting a headache. You notice that you’re hurting, but think that it’ll pass. As the day goes on, it gets worse and worse. Finally, you take some ibuprofen. But because the headache has set in more deeply at this point, it might be that no amount of pills makes it go away. You just may not feel better until after you sleep it off. Ultimately, you prolong your pain by not taking preventative action when your discomfort was tolerable. 

The same goes for staying in treatment after you start feeling better. There is no pressure to terminate until you are ready. You don’t have to stop just because you’re mostly doing better. Maintenance is important. My symptoms are not nearly as bad as they have been in the past, but I’m still in treatment because I don’t want to go back there. You might want to reduce the frequency of your sessions when you have made significant progress, but that is something to discuss with your therapist. Together you can make a decision on that.

Some people feel like they have to “earn” the right to be in therapy. They think that they don’t deserve treatment because they aren’t psychotic, don’t have a history of trauma or can cope reasonably well with their lives. The thing is, you don’t have to be a certain way to deserve help. The only prerequisite is a desire to improve your life. 

Honestly, you don’t even have to have problems to be in therapy. Plenty of people go for self-improvement. Some examples include learning to develop better relationships, finding greater fulfillment in your life, learning more about yourself and so on. You just can’t make assumptions about why people are in therapy.

In short, you don’t have to have hallucinations or be so depressed you can’t get out of bed for months before seeing a therapist. If you feel like therapy is or would be helpful for you, go for it. Likewise, don’t pass judgment on anyone else for seeking help. They don’t know your circumstances and you don’t know theirs. There is no template for what someone in treatment looks like. 

What beliefs have you had about yourself because you’re in treatment? How did you work through them? Talk about it 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.

Don’t put a timetable on recovery

Like most people, I entered therapy not knowing what to expect. I had dealt with depression and other mental health symptoms for years, but thought that I could take charge of my problems in a matter of weeks – a few months at the most. Almost eight years later, I’m still at it.

Assuming when I would “get better” was a mistake. The thing is, you never know. You may ask a therapist for an estimate, and they’ll often give you one. 8-12 sessions is a frequently used figure. But really, there are so many factors that influence this. There is no way to calculate how long treatment will take. 

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It is unfair to both yourself and your therapist to set a timetable on recovery. There is nothing wrong with setting goals, but don’t make hard deadlines. The mind is very complex and what’s masquerading as a relatively simple concern might actually be liked to a much larger underlying problem. You just might not see it before you examine the presenting concern. 

On the other hand, sometimes it’s faster than you’d think. I’ve heard of people benefiting from a single session. All your life problems won’t be solved in an hour, but sometimes you luck out and get the insight you need a lot quicker than expected. Really, don’t go in expecting one session to fix everything, but know that what you think might take many months or years may actually not require that much time. 

Unfortunately, insurance companies aren’t nice about letting you take as long as you need. There are often limits on how many sessions they will pay for. This means that you will want to try to make the most of your time with your therapist. Talk to her about what to do. Seeing him every other week instead of weekly can give you slower progress, but it stretches out over a longer period of time. Together you can find out what’s best for you. Also, don’t be afraid to call your insurance company if you have questions. 

Even when therapy is over, it does not mean that your progress ends there. You should not expect to be completely “fixed.” Recovery is a journey, not a destination. For many people, managing one’s mental health is a life-long endeavor. Improving your mental health is a long-term commitment. However long it takes to feel better is how long it takes. Just don’t stop trying. The “do it at home” tag is a great source for exercises to keep up your progress independently of therapy.

I know it’s hard, but don’t stress about how long your recovery will take. That only creates more anxiety and concern. Accept yourself for where you are at and be proud of yourself for any progress, no matter how small. It’s heading in the right direction that matters. Maybe you’ll feel better soon and maybe you won’t. The persistence you put in to your recovery will, however, eventually pay off. 

Are you able to be patient with yourself about the rate you’re progressing at? How did you come to peace with it?  Let us know with a comment.

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.

Honoring large-scale trauma

Trigger warning: This post gives a general overview of a traumatic event and the aftermath.

This will be an opinion post. 

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Today I’d like to talk about something very personal. But first, you need to know a little about me. My mom is American while my dad is Norwegian. We lived in Norway until I was a teenager, when we moved to the U.S. I identify with both cultures and, yes, I still speak Norwegian.

This July 22 is the three-year anniversary of a tragedy in Norway. A man set off a bomb in the government district of Oslo, killing eight. He then proceeded to massacre 69 people at a youth camp on the island of Utøya where escape was near impossible. These attacks severely injured several more. This has been called Norway’s 9/11, though for the sake of this post I will not make comparisons between the two.

One thing that makes this attack particularly heartbreaking is how widespread the effects were. It was a political camp for teenagers and young adults. The average age of those who died there was 19. But they weren’t all locals. There were representatives from all over the country attending the camp. This spread out the effects because every community had young people who either never came home or came back changed for life. This lead to a deep, nation-wide sorrow.

That event, its aftermath and the anniversary every year has been hard on me. There is research that suggests that high levels of media exposure of a traumatic event can cause secondary effects. I have, at times, been glued to my computer reading and watching news about it. Empathizing with those in a tragedy is normal and healthy, but the level of pain I felt was magnified with every detail I learned. I have had to seek help for this. And that’s okay.

Last night, after noting the timezones placed Norway in July 22, I got very upset. I was at my boyfriend’s apartment and he listened to me talk and cry. When I had done this for a while, he had an idea. He is Latino, so cultural differences do come up in our relationship. He asked how Norwegians mourned. The first thing that came to mind was flowers. After the attacks, unbelievable amounts of flowers were placed at sites related to the attacks. Other cities created places to put them, too. And there were gatherings where everyone brought roses.

When I told him this, he suggested I get roses and put them in places that are significant to me. I thought about it overnight and have come up with a small list. After posting this, I am going to go and buy a half-dozen white roses and commence the process of distributing them. This idea is helping me make peace with this day. I am still upset, but it’s a little more tolerable now that I have a way to express my experience.

There are three things I hoped to convey with this post:

1. Even if you aren’t directly involved, traumatic events can legitimately have an effect on you. If they are affecting you, bring it up with your therapist. It’s okay that it’s not about you.

2. When bad things happen, support can be found in communities. The community you’re in might be as small as your family; it’s connection and sharing the impact that’s important.

3. Everyone has different ways of mourning and it is healthy for you to find your own way to handle grief. It can be in line with a culture or uniquely your own. The important thing is that you express your feelings appropriately.

The sad truth is that every day, intense violence affects people all over the world. Some places see it more than others. When something impacts you, whether directly, indirectly or through exposure, you need to find a way to manage your feelings. It’s okay to reach out. It’s also okay to privately and personally do what you need to do to find peace.

I’d like to end with something Stine Renate Håheim, one of the survivors at Utøya, said after the events: 

“If one man can show so much hate, think of how much love we could show together.”