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!

Organizational Fragmentation is Hurting Us

Mental health professionals are like cats. We are hard to herd. Perhaps this is due to our independent and autonomous nature, at which most of us seem to arrive after years of study and work as strong advocates of the individual. Perhaps this is an example of western philosophy taken to an extreme.

Whatever the source this has resulted in an unfortunate situation in which we have created a seemingly endless array of professional organizations with which we affiliate. These organizations appeal to narrow sensibilities or professional pursuits. Here are a few examples from the college mental health profession alone:

• AUCCCD
• ACCA
• ACCTA
• ACCCCS
• AUCCCO
• APA's Division 17 and its Commission on College Counseling
• NASPA and its programs on mental health
• ACPA and its programs on mental health
• And professional organizations representing several disciplines within college mental health, such as APA, ACA, NASW, AMFTA, and those for psychiatry.

This is just a partial list. Other professions may have multiple associations as well, but often rely on a single one to speak on their behalf, such as ACHA or AMA for those in medical fields.

This degree of fragmentation is a major obstacle to advancing our specialty, which I believe it is. Due to all the voices, all the principles and customs on which these organizations were founded, it is next to impossible to form meaningful and potent alliances, position statements, and agenda for advocacy at any level. Attempts have been made, such as through HEMHA, but these may be limited in scope due to funding and staffing realities. Without appropriate funds and executive staff to carry out its goals, such efforts will always be quite limited in spite of the very best intentions behind them.

It is past time for us to correct this situation. Due to forces in the economics and politics of health care in the United States, some organizations are pursuing an agenda which often does not incorporate respect for other professions or their core philosophies, especially regarding youth and young adults. Trends toward pathologizing normal life experiences, such as bereavement, so that intrusive interventions may be deployed are but one example. Take note of the buzzwords associated with these efforts: evidence-based care, best practices, integrated care, and so on. As I covered in a previous post, these buzzwords mask another reality, which is integration without true integration, and selective review of research to support whatever may be called a best practice.

The professional organizations representing college mental health need to be consolidated in order to form a more active and potent and focused association. It is an irony that in our appreciation for diversity, we may have neglected the greatest diversity of all: the full range of our professional philosophies and service models. Without such a consolidation and re-calibrating of our efforts, this diversity will continue to suffer and may disappear altogether.

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. 

Some thoughts on recovery

Today I’m going to get a little more personal than I normally do. I’ve been thinking about where I’m at in my recovery, where I’m heading and what I’ve learned. From this, I have a few things I’d like to say.

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We all know life isn’t fair. Mental illness is one of those unfair things. Whether it’s caused by nature, nurture or something else, mental illness infringes on our lives in a way that is disruptive and even paralyzing. The things we want to experience and accomplish can seem so far out of reach. Hope can be elusive, but it’s important to believe it’s there.

There are times when I’ve spent months in bed. Other times, I only spent long mornings in bed. Now, I can get up just fine most days. What changed? A million little things. I have had a lot of therapy. I got on the right medications. I have done work on trauma I’ve experienced. I regulated my sleep cycle. I make sure to eat enough. I actively seek out things that keep my interest. I slowed down with school. I cut out negative influences in my life. I’ve worked to better my
relationships. I even got cats. 

So is recovery easy? By no means. All that had to happen simply for me to get out of bed before lunch. If that much and more was required to make that one change, how long is it going to take to do other things? 

The truth is, my whole life. Mental illness can and does go into remission, but you still have to work to stay as healthy as you can. I could say that things are “good enough,” but I think that would be selling myself short. To be honest, I’m not happy with myself unless I am working to heal and become a better person. 

And that is one thing I think mental illness can do: It can make you more motivated to grow and become strong. Recovery teaches you the skills to be healthier, which can be applied beyond reaching a baseline “okay.” As much as not having mental illness would have changed my life for the better in many ways, it would also rob me of some of my strengths. I wouldn’t be as resilient. I wouldn’t place such a high value on good relationships. I wouldn’t know how to handle a crisis. I wouldn’t be as grateful. I wouldn’t be able to run this blog and try to make treatment easier for someone else. 

I wish I knew a better way to express how much each and every good choice you make is significant progress. I don’t know that I’d listen to myself a few years ago. But it ended up adding up. It took a long time, but my life is on track to be what I want it to be. Not all my aspirations will come true, but I’ve made new ones that are realistic to me and my condition. 

I’ve been reflecting about why I run this blog at all. I really, really want my readers to believe that recovery is possible. Not only is it possible, but it’s something you can do. There will come a day when you’ll say, “It was worth it to keep trying.” It might even happen when you least expect it. You are meant to live a good and happy life. You have a right to achieve that. If you do ten things wrong today, the one thing you did right still matters. Those “one thing”s add up eventually.

Have you made progress? Do you have hope you will? Give us your thoughts in the comments.

Wants and Needs

As higher education institutions have adopted business models a customer service orientation toward students has taken root. This is not always a bad thing. It helps faculty and staff stay on their toes and work hard to address legitimate needs of our consumers. It can serve to market the school well and also to advance its image and brand.

As with most things, however, there is a pernicious shadow to these trends, one that is anathema to college mental health which is all about addressing the needs of students. But customer service many times becomes more about satisfying wants. This in turn has created a phenomenon in which those around a student, such as parents, faculty, staff, administrators, and other stakeholders, have taken on a positively entitled, demanding posture concerning something they think should be done for a student. Sometimes there may be a positive basis for the expressed want, sometimes not.

Counseling and psychotherapy is about an individual's need to change something about themselves, something that is contributing to their own unhappiness. The things which need changing are determined by a trained professional, working collaboratively, who evaluates the individual's needs. Many times, early in therapy, clients focus on their wants and not their needs, but this is what may have led to the cultivation of life problems in the first place. Wants are often about being comfortable, while counseling, at least in the beginning, will entail a degree of discomfort. Lasting change is rarely if ever a comfortable process.

So we may face scenarios in which insisting on wants may actually lead to harm for a student, and therefore represent an abuse of counseling services. This we are obligated to prevent or stop altogether. Just as no one can dictate how a physician treats your ailing kidney, no one can dictate how psychotherapy is to be conducted (though insurance companies try to do this all the time). It is unhealthy for anyone to attempt to control what ought to be a collaborative working relationship between client and therapist. Counselors are obligated to uphold standards around this issue, so don't be surprised when they say "No." Of course, folks can seek other opinions elsewhere, where it it will be less convenient and more costly, if they like. Or they could give it several sessions first, say five or six, and then make judgements about the effectiveness of therapy after the discomfort begins to wane.

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.