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Pressure Points for Anxiety - Psych Central 18 Sep 2024

Anxiety can disrupt your daily life, but pressure points for anxiety can help. Learn more about where these pressure points are and how they help ease your anxiety symptoms.

Anxiety affects most people occasionally, but some experience it more often. It can become severe and impact your daily life due to the long lasting symptoms. Some signs of anxiety include:

frequently feeling panicked, worried, or fearful - having a hard time concentrating - restlessness - feeling nauseous, having headaches, or experiencing digestive issues - trouble sleeping - fatigue or irritability - having muscle tension

Anxiety treatments may include medication and therapy combined, but other options are available, including acupressure. Acupressure for anxiety is a traditional Chinese medicine that involves stimulating pressure points to alleviate symptoms.

What pressure points relieve anxiety? 1. Shou san li point The Shou san li pressure point helps improve:

• general anxiety
• neck tightness
• shoulder pain
• diarrhea It does this by improving the energy flow to your large intestine. You can find this pressure point below your elbow by bending it 90 degrees and measuring two finger widths below the bend.

You can ease stress, headaches, and muscle tension by applying firm but gentle pressure while massaging the area. It’s important to note that this pressure point can induce laborTrusted Source, so consider avoiding it if you’re expecting a baby.

Massaging this spot firmly for around 5 seconds can ease anxiety while also reducing insomnia, menstrual crampsTrusted Source, and pain.

Applying pressure to this area using small circular motions can help reduce anxiety and stress. It can also help ease dizziness and headaches and help stop you from clenching your jaw.

Gently apply firm pressure while rotating your finger in a circular motion for at least 2 minutes.

You’ll know you’ve found the right spot when you find a slight indent. Applying pressure to this point by massaging it in a circular motion can help reduce anxiety symptoms.

• anxiety
• stress
• headaches
• neck pain But applying pressure to the union valley pressure point can also induce labor.

To use the Union Valley pressure point for anxiety, you’ll apply pressure to the webbing using your opposite hand. Then, massage the area for about 5 seconds while breathing deeply and slowly.

Consider focusing on relaxing and paying attention to the sensation as your anxiety symptoms ease.

• pain
• inflammation
• mania
• insomnia When you feel stressed or anxious, massage that spot with your finger and thumb for a couple of minutes.

If you want to try it, you’ll start by sitting in a comfortable position with your eyes closed. Once you’re ready, touch the Hall of Impression pressure point with a finger or thumb.

Breathe slowly and deeply while pressing firmly and gently and moving your finger in a circular motion. Continue moving your finger at the spot between your eyebrows for 5 to 10 minutes.

If you want to use this pressure point for anxiety, you’ll want to rotate your hand so your palm is facing upward. Applying firm but gentle pressure to the area can help ease anxiety, nausea, and pain.

How does acupressure work help relieve anxiety? Acupressure for anxiety relief is a type of massage that can help ease symptoms of anxiety. It eases anxious feelings for patients before a medical procedure or other stressful situation. One study from 2018Trusted Source shows that it also reduces anxiety and stress for those receiving fertility treatments.

Acupressure can help improve your blood flow and relax your muscles. These benefits help reduce anxiety symptoms and also effectively ease stressTrusted Source.

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How to Deal with a Narcissistic Parent 06 Aug 2024

Healing from a parent with narcissistic traits is possible. It can take time to reset the way you view yourself and the world, but you can overcome this type of childhood trauma.

Whether a person has a diagnosis of narcissistic personality disorder (NPD) or only a few narcissistic characteristics, those traits can influence important relationships in their life. It can also affect the way they parent their children.

People with NPD often seem to lack empathy, need admiration, and exhibit grandiose behaviors. Their need for validation is so great that they may be driven to overlook the needs of others, including those of their children.

To receive a diagnosis of NPD, a person needs to meet specific criteria when assessed by a mental health professional.

But a parent can still have narcissistic traits even if they don’t meet the criteria for NPD. These traits can lead to relationship dysfunction, and mental health issues for the child of the narcissist.

If you’re healing from a parent who lives with NPD or has narcissistic traits, there are a few strategies that may help.

1. Finding forgiveness 2023 researchTrusted Source has found that forgiveness:

• reduces anger
• decreases anxiety
• eases depression
• increases self-esteem
• raises hope for the future
• calms stress These mental health benefits can lead to improvements in your physical health.

If you’re experiencing the stress of holding on to anger, this may have adverse physical consequences. It can impact aspects of your health, such as:

• sleep quality
• heart health
• cholesterol
• blood pressure But, forgiveness reduces the chance of these adverse effects.

Forgiving a person for their behavior is not the same thing as defending that behavior. You can forgive your parent while understanding that the way they’ve treated you is wrong.

2. Breaking cycles If you’re the child of a parent diagnosed with NPD or who displays narcissistic traits, you may be part of a legacy of intergenerational trauma. This means that the narcissistic traits your parent exhibits may be from adverse events in their own childhood.

Research has found that NPD symptoms are sometimes linked to childhood neglect or types of abuse, such as:

• verbal abuse
• physical abuse
• sexual abuse
• emotional abuse Household dysfunction may also be a contributing factor. Or your parent may have been raised by someone living with narcissistic traits or NPD themselves.

Recognizing and dismantling this cycle of intergenerational trauma is an integral part of healing.3. Processing grief Grief is a natural response to loss. Loss that’s not as societally recognized is commonly referred to as disenfranchised grief.

You can also self-disenfranchiseTrusted Source by not allowing yourself to grieve the loss of a childhood that was free from narcissistic influence.

For example, as a child, you may not have had:

• the nurturing parenting that you deserved
• the carefree and innocent childhood experienced by your peers
• a stable environment that enabled you to feel secure
• the unconditional acceptance to foster healthy self-esteem
• the freedom to develop your own identity Acknowledging and processing important losses like these can help you move forward with your healing journey.4. Learning about narcissism Educating yourself about narcissism can help you identify toxic behaviors, like gaslighting or emotional abuse.

If you internalize the criticism you receive or blame yourself when your parent is unhappy, this can affect your self-esteem. Educating yourself on the condition may help learn how to deal with narcissistic behaviors.

Analyzing narcissistic behaviors enables you to:

• know when a narcissist is overreacting to a situation
• understand that their behaviors are shouldn’t be taken personally
• identify manipulation attempts
• recognize when their expectations are unfair or inappropriate

5. Setting boundaries Setting boundaries is a way to protect yourself. Internal boundaries reduce your parent’s influence on the way you think about yourself.

This type of boundary involves seeing their unkind behaviors as narcissism symptoms, rather than reflections of your worth. This protects you from internalizing the harm from their behaviors.

External boundaries involve tapering back on the way you’ve learned to over-accommodate your parent. It includes saying no and expressing your own preferences and opinions.

It’s important to note that it may be easier to set external boundaries when you’re an adult and no longer living with the parent in question.

6. Choosing for yourself Changing jobs or college programs to follow your own interests is an example of making choices for yourself.

You may be on a path that pleases the ego of your parent but doesn’t align with your goals.

Changing your path is a way to establish your own identity, work toward your goals, and create some distance between you and the damaging effects of your parent’s manipulation tactics.

7. Finding healthier relationships It can be challenging for the child of a parent living with narcissistic traits to know the characteristics of a healthy relationship.

As you learn more about narcissism and its effects, you’ll become more skilled and confident at identifying beneficial human interactions.

Using your experience and insight to find healthy friendships and romantic relationships is an important part of breaking this mental health cycle.

8. Seeking help Finding a therapist who specializes in narcissistic relationship patterns may help you cope. A trained therapist can help you:

• identify narcissistic behaviors
• change your thought patterns
• set boundaries
• identify healthy relationship characteristics

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10 Signs of Depression in Children - Psych Central 27 May 2024

Childhood is naturally filled with emotional ups and downs. But a loss of interest in things always enjoyed and distancing from friends could be more than just developmental change.

Depression is complex. It’s both a standalone mental health disorder, known as major depressive disorder (MDD), and a feature in other disorders, like bipolar disorder and post-traumatic stress disorder (PTSD).

Symptoms of depression go beyond persistent low mood and energy. They can involve changes in behavior, impaired cognitive function, and somatic, or physical, symptoms.

Symptoms of depression in children In 2021 alone, as many as 20% of children in the United States between the ages of 12 – 17 years of age experienced a major depressive episode.

Depression symptoms can look differently in children compared to adults due to different life stages. For example, children may not demonstrate an obvious loss of interest in chores like an adult who lives on their own might.

Instead, signs will often involve a child’s individual interests and behaviors.

“For example,” says Dr. Louise Metcalf, psychologist and Founder/CEO of Gheorg, “if a child is normally a keen Minecrafter but they stop enjoying it with nothing seeming to replace it, and they are grumpy/irritable and sad, or flat emotionally, these are pretty strong signals of depression in children.”

Other signs your child might be experiencing depression include:

• unexplained drop in grades
• poor behavior reports from school
• crying often
• spending less time with friends
• sleeping more or less than usual
• expressing they’re not good at anything or that everything is their fault
• not caring about school, sports, or other activities they were once passionate about
• engaging in substance misuse and other risky behaviors
• frequent talking, writing, or drawing of death or dying
• running away
• irritability
• eating more or less than usual

According to the American Academy of Child & Adolescent Psychiatry, children are also more likely than adults to have physical complaints like headaches and stomach aches.

Barriers to recognition As challenging as it is to identify depression during the transitionary stage of childhood, there are other reasons childhood depression can go unnoticed.

According to school psychologist Cyrell Roberson, cultural disparities can also play a role in how symptoms of depression are recognized and perceived in children.

“Research shows that irritability in the average white teenager is often labeled as a symptom of depression, which it is,” he says. “However, the same behavior is often perceived as disruptive in Black and Latinx children, which can then lead to hopelessness because they’re misunderstood and the underlying issues aren’t identified and they ultimately go untreated.”

What causes depression in children? Depression is a brain disorder that involves changes to your brain’s function and structure. Its exact causes aren’t fully understood, but genetics, environmental factors, and psychological influences can all play a role in its development.

Literature has documented depression in children as young as 3 years of age, but it’s most commonly seen in teens between the ages of 12 – 17 yearsTrusted Source.

In addition to genetics and other underlying causes, certain factors may increase a child’s chances of experiencing depression.

“Causes can be quite diverse so this is challenging to answer precisely; however, certain events make depression more likely, such as traumatic events in the family,” says Metcalf.

She indicates these events can include:

• a death in the family
• homelessness
• dramatic change in housing, such as asylum-seeking
• domestic violence
• abuse
• bullying by peers

Adverse life events aren’t the only possible contributors to childhood depression. ResearchTrusted Source suggests depression may be more common among children who live with:

• a naturally pessimistic outlook
• sleep problems
• chronic medical illnesses, like diabetes
• other mental health conditions, like anxiety disorders
• substance use
• medication use Children may also be more prone to developing depression if they have an insecure attachment to primary caregivers. According to a multi-level meta-analysis from 2019, insecure attachment to caregivers was seen as a predictor of depression among children.

Insecure attachment is a concept in psychology that refers to relationships between children and caregivers featuring anxiety and uncertainty, often caused by absent, emotionally distant, or abusive caregivers.

Speaking with your child about depression If you’re wondering when to speak with your child about depression, Roberson recommends asking yourself the following questions about your child:

• Have their bad days begun to outweigh their good days?
• Are they having insomnia or excessively sleeping?
• Do they have a hard time waking up for school?
• Is there evidence of poor concentration at home or at school?
• Are they no longer interested or showing enjoyment from their usual activities?
• Have they distanced themselves from family and friends?
• Are there maladaptive coping mechanisms, like substance misuse?

If the answer to any of these questions is “yes,” it may be time to have a conversation about depression.

“Parents can help best by helping children to feel comfortable talking about their thoughts first; don’t shy away if your child’s thoughts are dark like this,” says Metcalf. Tell them it is natural to feel like this sometimes but that all emotions come and go.”

She then suggests building comfort by having the whole family say three good things that happened to them that day, or three things they liked about that day.

For the caregiver, she suggests being sure to include one positive thing about the child experiencing depression.

As it becomes comfortable to talk about thoughts and emotions, it opens up the door for caregivers to have a discussion about depression.

Treatment options for children According to national data, only 60% of children who experienced a major depressive episode in 2021 received treatment.

“If your child has persistent symptoms of depression that feel like [they] just won’t shift then always seek professional help; try not to wait more than a month,” Metcalf recommends. “Also if your child expresses a desire to end their life or is harming themselves, don’t panic, just go and seek professional help as quickly as you can.”

Childhood depression and adult depression are treated using psychotherapy approaches and medication. Psychotherapy, also known as “talk” therapy, utilizes different frameworks to address the underlying causes of depression while teaching children effective ways to cope with negative feelings in daily life.

Cognitive behavioral therapy (CBT) and IPT, interpersonal psychotherapy, are two therapy methods proven to be effective in the treatment of childhood depression.

In addition to psychotherapy, symptoms of depression in children can be treated with medications like antidepressants to help relieve impairing symptoms.

How is depression diagnosed in children? What sets depression apart from the typical childhood experience is the duration of symptoms and how they impact daily life. Unlike day-to-day experiences that cause emotional flux, depression involves impairing changes in thinking and behavior that persist over extended periods of time.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), the diagnosis of depression in children and adults is given after 5 or more of the following symptoms have been present during the same 2-week period:

• constant depressed mood, which may show as irritable mood in children
• constant diminished interest or pleasure in all or almost all activities
• significant weight loss, which may show as inability to make expected weight in children
• sleep disturbances
• restlessness or slowed physical movement
• constant fatigue or low energy
• constant feelings of worthlessness or inappropriate guilt
• impaired concentration and decision-making
• suicide ideation

For a diagnosis, at least one symptom must be depressed mood or diminished interest/pleasure. Symptoms must cause notable impairment in important areas of function and not be attributed to another condition or substance.

If your child is showing signs of depression, consider seeking a referral for a diagnosis from a qualified medical professional such as a therapist, psychologist, or psychiatrist. www.findHelp.co.za

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How to Speak with Your Kid About Anxiety - Psych Central 17 Nov 2023

If you’ve ever felt the tightness in your chest of a worry you can’t seem to escape, you know the reality of anxiety. That pit in your stomach. The shortness of breath. An inability to sleep at night, as your brain whirs and whirs. A sense of dread or uneasiness — sometimes without a clear cause.

It’s a reality I’ve dealt with for most of my life. Only, when I was a kid, I didn’t know there was a word for it.

Even when I was finally given a diagnosis, it was handed to me with nothing more than a prescription for meds. No one took the time to help me understand what was going on or to assure me that I wasn’t as broken as I felt.

Maybe you’ve experienced something similar. Or you have a child who seems to be dealing with anxiety. You want to help the little ones in your life understand what’s going on and provide them with vocabulary that can help them describe their experiences and ask for help when they need it. But you’re unsure of where to begin.

Perhaps you’re anxious just thinking about it.

We’re here to help. Why not start by taking three deep breaths? In through the nose and out through the mouth (smelling the flowers and blowing out the candles, if you will). And then… let’s begin.

What is anxiety?

According to the American Psychological Association (APA), anxiety is “an emotion characterized by feelings of tension, worried thoughts, and physical changes.”

If you have an anxiety disorder, you may experience frequent and recurring intrusive thoughts or worries that can be difficult to control. These thoughts usually don’t go away and may even get worse over time.

People with anxiety often fixate on their worries and have difficulty clearing their heads or focusing on other things to the point that the anxiety may affect their daily life. They may even begin to avoid activities or things they used to do or enjoy.

Anxiety can also manifest in physical symptoms, including:

• restlessness
  • muscle tension
  • upset stomach, or other aches or pains
  • dizziness
  • rapid heart rate
  • sleep disturbances
  • trembling
  • sweating
  • headaches

If any of this sounds familiar to you, you’re not alone. Anxiety is the most common mental health condition in the United States today, according to the Anxiety and Depression Association of America (ADAA). It affects roughly 40 million adults and 4.4 million childrenTrusted Source between the ages of 7 and 17.

Anxiety can also occur alongside other conditions. For example, it’s common for those with depression and attention deficit hyperactivity disorder (ADHD) to also be diagnosed with anxiety.

The good news is that anxiety is highly treatable and the more a person understands about their condition, the easier they can develop tools to help manage it.

This is true for both adults and children.

Talking with your kid about anxiety Given the prevalence of anxiety disorders, it’s likely your child knows someone who has experience with anxiety or they’re dealing with it themselves.

Your child doesn’t even necessarily have to have a personal connection to anxiety for them to have questions about it. The condition often shows up in television and movies, and they may hear celebrities they follow talking openly about their own experiences with anxiety.

This is one of the beautiful things about increased awareness.

The more people who support and speak up about mental health — either from their own personal experience or as an advocate — the easier it becomes for others to understand and talk about it.

Whether you, your child, or someone you love is dealing with anxiety, the conversation with your child can start by getting curious and exploring what they already know. From there, you can dispel potential misinformation and explore how to approach the topic further.

It’s a good idea to explain to them that just like our bodies sometimes get colds, our brains sometimes get sick as well.

Younger kids may already have an understanding of what worries are and that feeling worried or scared can affect people mentally and physically, but it may help them to learn more about the why.

You may want to talk about how anxiety happens when the brain starts working too hard and getting too protective, like a worker bee tasked with keeping the queen safe. It buzzes and buzzes and wears itself out.

For older children, you can talk about how that then impacts the mind and body, and some of the symptoms they or their loved ones may experience as a result of anxiety. You can also discuss different types of anxiety, such as related to school, the future, or other things.

It’s also important to talk to your kids about managing anxiety and to let them know that it’s helpful to share when they’re feeling anxious so they can get the support they need.

For starters, you can share and practice breathing techniques with them (like the one mentioned at the beginning of this article — smelling the flowers and blowing out the candles) that promote relaxation and calm.

Still, depending on the severity of your kid’s anxiety, it’s also a good idea to talk to them about getting help from a mental health professional and to normalize mental health treatment, including therapy and medications.

For younger children, you may want to say something like “Sometimes worries or fears get so big that it’s hard to deal with them on our own. Your anxiety has made it really hard for you to leave the house (or go to school or to the doctor or play with your friends). A therapist can help you and Mommy and Daddy learn how to make our worries a little less big and scary.”

Questions your kids may ask Regardless of your child’s age, they will likely have questions when the topic of anxiety comes up. Here are some common ones you might want to prepare yourself for:

What if my brain isn’t wrong? For a child who’s experiencing anxiety themselves, the worries they’re carrying are very real. It’s important you don’t minimize those worries by brushing them away as unlikely or saying their brain is overreacting.

Instead, you want to let them know that fears and concerns they have stem from real places and are valid. But the extent to which those fears and concerns are taking over their thoughts is where their brain may be struggling.

One helpful way to do this is to talk them through their fears and to point out possible solutions or ways to resolve those fears. Remember: the fear itself isn’t invalid — but the amount of brainpower being taken over by the fear may not be helpful.

Is something wrong with me? Kids who experience persistent anxiety may also have difficulties with self-esteem and confidence. They may assume they’re bad or the “problem” in any given situation, or that they did something to cause their anxiety.

It’s important to remind kids that there’s nothing wrong with them or anyone who has anxiety.

They’re not broken or defective, they just have a health condition — like any common cold or sore throat, except it occurs in the brain. You can also explain that certain events like trauma, stress, or adversity may cause mental health conditions.

Try to make it clear to them that having anxiety isn’t their fault, and more importantly, it’s something they can get help for.

What does treatment involve? When talking about getting help for anxiety, children may want to know what that looks like. Depending on the severity of their anxiety, therapy is often the first step in treatment. Research has found that therapy alone can often be very helpful.

Psych Central has a great child-friendly guide to therapy that may help your child prepare for that step.

You can also talk with your child about medications that may be available in addition to therapy, letting them know that just like taking antibiotics for an illness of the body, anti-anxiety medication can help with anxiety symptoms. Some researchTrusted Source has shown that a combination of psychotherapy and medication is effective for some people.

Will I always feel this way? For a child experiencing difficulties with anxiety, fears about the future can be a large part of their experience. It makes sense that a child with anxiety would be worried about always having those symptoms.

Now may be the right time to remind your child that help in the form of treatment is available and is very effective in helping with anxiety.

You can tell them that many people get treatment for mental health conditions and it’s nothing to be ashamed of. If you’ve had mental health treatment yourself, you can share with them what that experience was like for you and how it helped.

You can also practice deep breathing exercises with them and ask them to pay attention to how they feel before and after those exercises are complete. Chances are, they’ll feel much better after — and you can use this to show them that there are tools available that help.

Still, if they feel like the exercises are not helping, it’s good to acknowledge and validate that things may feel really bad right now, but that doesn’t mean they will feel that way forever.

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Trauma Denial: How to Recognize It and Why It Matters - By Psych Central 16 Oct 2023

Denial of trauma is a defense mechanism that protects you from emotional pain. Sometimes, however, healing is on the other side of it.

Healing from all types of trauma is possible, even if it takes some time.

For some people, the first step toward that recovery may be the most difficult one, though. Confronting the traumatic event and what it meant to you may bring up hurtful memories and sensations.

This is why denial is often a natural trauma response.

Trauma denial may serve as a shield that emotionally and mentally disconnects you from the traumatic event. But it may not aid you in healing the pain.

Understanding why trauma denial happens — and accepting that you may be living with it — can become a powerful healing tool.

What’s trauma denial? Trauma denial is a way to put distance between you and an overwhelming experience.

It can be one of the many ways your brain tries to adaptTrusted Source and mitigate a reality collapse or a system overload, which can often happen after a traumatic event.

As you might imagine, denial can be enormously useful.

“Trauma denial may be helpful in the short term. It allows the trauma survivor to stand up and get back on their feet,” says Sabina Mauro, a psychologist in Yardley, Pennsylvania.

Yet, just like a trusty old pair of shoes, the comforts we learn to rely on may start to fall apart, if given enough time.

“Ongoing trauma denial causes more suffering than there needs to be. Although trauma survivors may learn how to suppress this unpleasant experience from their past, their body and mind will continue to carry it until the trauma is confronted,” says Mauro.

Addressing your trauma symptoms isn’t easy, but it can be rewarding. It can help you grow and integrate the parts of your past so you feel more solid, self-actualized, and whole.

What’s trauma? Trauma is an emotional response to experiencing, or witnessing, a distressing event or series of events, according to the Substance Abuse and Mental Health Services Administration (SAMSHA).

Some experiences linked to trauma include:

accidents childhood abuse domestic violence loss of a loved one natural disaster sexual assault torture war Certain mental health conditions may develop after a traumatic experience: anxiety post-traumatic stress disorder (PTSD) or complex post-traumatic stress disorder (C-PTSD) depression personality disorders schizophrenia substance use disorder

Denial as a defense mechanism Denial is a defense mechanism, aka, an efficient mental process that acts as a protective shield and helps you cope. It can help you minimize the impact an event has had on your life.

“Trauma denial often occurs when the reality of the trauma is so great that it is psychologically safer to bury, deny, suppress, or avoid what happened than to accept that the trauma ever occurred in the first place,” says Maryam Elbalghiti-Williams, a licensed certified social worker in College Park, Maryland.

The psychological function of denial is to push aside overwhelming information to buy you some time and give you room to breathe after a traumatic experience. This may be a conscious or unconscious process.

Denial is not the only psychological process that may happen after the traumatic event, though. You could also experience:

dissociation emotional numbness anosognosia emotional blunting Denial versus emotional avoidance Denial and emotional avoidance both create distance from a traumatic experience, but they’re slightly different:

“Denial distorts facts and events by ignoring the presence of the elephant in the room, so to speak. There is no admission of a problem,” says Lashara Shaw, a licensed professional counselor based in Naperville, Illinois.

Avoidance, on the other hand, can be an attempt to refrain from feeling painful emotions by withdrawing or dissociating from specific experiences, Shaw explains.

It could also involve avoidance of situations or interactions that may become emotional in any way.

For example, denial would be saying, believing, and acting like the traumatic experience didn’t affect you.

Emotional avoidance, on the other hand, could be using alcohol to prevent thinking about the event or feeling detached from friends and family in general.

Denial in unresolved trauma There may be many benefits of denial, which could help explain why people develop this defense mechanism for unresolved trauma.

Denial can help you:

avoid pain get on with your life maintain an illusion of control remain loyal to someone who hurts you stick out a tough situation until you can safely get away protect your self-esteem ResearchersTrusted Source have also found that those who deny or minimize their childhood trauma have a positivity bias that can protect against other mental health conditions in the future, like depression.

And for those who’ve picked up on the fact that trauma may be more difficult to heal without the help of professional support, avoidance can provide yet another respite: a reason to steer clear of a therapist’s office.

“Psychologically, it can help people avoid stigmas that come along with diagnoses such as post-traumatic stress disorder (PTSD),” says Meagan Turner, a licensed therapist in Tucker, Georgia.

“The problem with denying it is that until you acknowledge and recognize trauma for what it is, you deny your own experience. The trauma denial ultimately creates a barrier to the ability to heal from it,” says Turner.

How to tell if you’re in denial If you’re living with trauma or PTSD denial, or you suspect that someone you love is, there are some signs that’ll help you identify this process.

Avoidance is one of them.

If someone brings up the event, you may be the first to change the subject. You may also feel uncomfortable when people around you get emotional or vulnerable.

If someone is asking you questions, you may divert attention away from yourself, preferring to learn more about whoever you’re talking with instead.

You may have symptoms of avoidance, like staying busy in romantic relationships, using work as an escape, or engaging in substance use.

One of the most common signs that someone is in denial is minimization, says Turner. It often comes out in the way you talk about (or, rather, don’t talk about) what happened.

Minimization can sound like:

“It’s fine. I’m OK, really.” “That was then. This is now.” “I’m sure that happens to everyone.” “It wasn’t a big deal. I’ve moved on.” “There’s no use talking about the past.” “It wasn’t bad enough to be called trauma.” “That didn’t happen to me.” “I’m strong. I can deal with it fine.” “I just prefer not thinking about it.”

Everyone’s different, and these examples may not be what you relate to. Maybe you’re handling it in a different way. Self-exploration, ideally with the help of a health professional, may provide you with clearer signs.

How to resolve trauma (and why) Healing from trauma takes time, but it’s possible. When you can work through it, you may feel like taking off a heavy backpack you never even knew was there.

And when you finally reach the other side of trauma, there may be a new range of emotions available to you: relief, completion, lightness, closure, liberation, or joy.

To start your healing path, consider these tips to manage avoidance behaviors:

Professional support While it may be intimidating to think about reaching out for help, trauma-informed therapists are trained to help you process and integrate trauma in a way that is safe and appropriately paced.

“A common myth that keeps many survivors from seeking help is the idea that you have to re-tell every minute detail of what happened to you. That isn’t true,” says Williams.

“You can engage in transformative trauma therapy and never verbally describe the events,” Williams explains. “A good trauma therapist will help you use your body, art, and other expressive modalities to work through your trauma.”

Self-help As you navigate this healing process with a mental health professional, trying to also participate in activities that nurture your mind, body, and spirit can be helpful. These include:

deep breathing regular exercise massage therapy meditation grounding and somatic work yoga You may also find it useful to read about trauma recovery. Some therapist-suggested books include:

“The Body Keeps the Score” by Bessel van der Kolk “Trauma and Memory” by Peter A. Levine “Trauma and Recovery” by Judith Herman There’s no one-size-fits-all approach Trauma impacts everyone differently. Recovery is a process unique to each individual. Allowing yourself to gravitate toward the approach that feels the most authentic for you can he helpful in maximizing your recovery process.

“There are multiple ways to address this; talking to a doctor, a counselor, a psychologist, a trauma-informed minister are all options,” says Shaw.

“Some individuals take great comfort through exercises, stretches, and maintaining relaxation in the body,” Shaw explains. “Not everyone desires to talk to professionals after experiencing a trauma, and that is OK.”

The important thing is going with whatever feels the most supportive. Meet yourself where you’re at. When and if you’re ready, you can always find help from a therapist.

Let’s recap The psychology of denial is simple: It’s your brain’s way of keeping you safe.

It’s a natural process designed to help you get on with your life. But, over the long term, denial may bar you from a sense of inner peace or an intimate connection with others.

While coming out of denial can be difficult, it may be worth it.

“Being in denial gives power to the past,” says Mauro. “Confronting your trauma gives power and control to you, right here and right now.”

We’re going to go with Team You on this one. You’ve got this.

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Inside Bipolar Podcast: Alcohol’s Impact on Bipolar Disorder - Psych Central 06 Oct 2023

In our society, alcoholic beverages are very common, and since people living with bipolar disorder are just like everyone else, they absorb the same messaging surrounding drinking. From the simple wedding toast to “wine o’clock” and “beer thirty” to celebrate the end of a long work day, imbibing a drink is as common as breathing. But is this the best choice for people managing bipolar disorder?

It is a complicated question that depends on a myriad of factors like where you are in your recovery or whether you take medication to treat bipolar. In this episode, we discuss just how big of a deal mixing alcohol and bipolar disorder is, answering questions like “Is it really dangerous?” and “Do you need to quit drinking entirely or can you just have a little bit?”

We also delve into whether it is possible to regulate bipolar disorder with alcohol. Join us as Gabe and Dr. Nicole discuss the ins and outs of alcohol use and staying stable with bipolar disorder.

https://psychcentral.com/blog/inside-bipolar-podcast-alcohols-impact-on-bipolar-disorder

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How to Move Past Regret - Psych Central 12 Apr 2023

Regret is a common feeling that has both negative and positive effects. Knowing how to move past and learn from them is key to your overall well-being.

Regret is a feeling based on the idea that you could have acted differently to produce a more desirable outcome.

Regret can be accompanied by guilt, embarrassment, and self-blame. It can include asking yourself a lot of hypothetical questions: “What if I acted differently? What if I took that opportunity? What if I didn’t say what I said?”

Because you can’t go back in time, you’ll never know the answer to those questions. For that reason, you might ruminate about it — thinking the same thoughts over and over again, wondering what could’ve happened.

You might regret something even when, realistically, there’s nothing you could’ve done, and even if ultimately you believe you made the right choice. The feeling of regret itself isn’t proof that you did the wrong thing — you might simply have complicated feelings about your experience.

Why are regrets harmful? Regret is associated with higher levels of cortisol. Known as the stress hormone, cortisol helps you when you enter flight-or-fight mode. Chronically high levels of cortisol are associated with mental and physical health problems.

According to a 2015 studyTrusted Source, people who are prone to regret are more likely to experience:

depression hopelessness suicidal ideation

Many people ruminate about regrets. Rumination is when you can’t stop thinking about the past, even when you’re having the same thoughts over and over again. With rumination, these thoughts are negative or upsetting in nature.

Although most people ruminate, rumination is associated with certain mental health conditions, including:

depression anxiety post-traumatic stress disorder (PTSD) obsessive-compulsive disorder (OCD)

It’s not possible to avoid regret entirely. But managing regret in a healthy, positive way can help you learn from the experience.

*Can regrets be a positive thing?8 Regret is a healthy, common feeling that most people feel once in a while. In some cases, regret can even be beneficial.

The benefits of regret can include:

Regret can improve your decision-making skills: While you can’t avoid mistakes altogether, regretting past decisions can help you make better, more thoughtful choices in the future. Regret can motivate you: Sometimes, regrets can motivate you to perform better, take healthy risks, and focus your energy on what matters to you. Regret can help you be more self-aware: Your regrets might teach you about your values, strengths, and weaknesses. Regret can inspire gratitude: You can use your regret to fuel a deeper appreciation for the decisions you don’t regret and the positive things you have in your life. With this said, if your regret is excessive or obsessive, it might do more harm than good. This is especially the case if you linger on regretful thoughts for too long or if you find it hard to think of anything other than your regrets.

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Why Change Is the Only Constant and How to Embrace It - Psych Central 20 Feb 2023

‘The only constant is change’ is a statement that portrays how life and everything in it is subject to transformation. Learning how to adapt is key to your overall well-being.

Change is all around us. Some change is fixed, like the shift of one season to another, while other change is evolutionary and progressive, tossing new circumstances our way as time goes on.

It’s natural to dislike change — it often requires you to come out from a zone of comfort and security.

But adaptability, the process of reinventing your behaviors, thoughts, and emotions, can be a key protective feature in mental health.

Change is the only constant: Meaning Ancient Greek philosopher Heraclitus observed that the natural world was in a constant state of movement. People age, develop habits and move environments.

You can’t step into the same river twice — even rocks were subject to changes by the elements over time.

He called this universal law of change “Logos,” and tied it to three central beliefs known as his flux doctrine:

Everything undergoes constant change. There’s unification of opposites (the opposite of something can only exist because of change in the original). Everything exists and doesn’t exist at the same time (matter can change forms so that the object no longer exists, but the original substance does). The irony in all of this, as his statement implies, is that the only thing that will never change is the presence of change itself.

How to embrace change and cultivate adaptability You don’t have to love change to be able to embrace it, and small adjustments can make change less painful in the long term.

1. Finding your people Kate Schroeder, a licensed professional counselor from St. Louis, Missouri, suggests finding and surrounding yourself with people who can support you through change.

“The number one way to improve adaptability is to find a supportive network that you can both learn from and lean on throughout your life and the transitions that are certain to unfold,” she says.

2. Becoming self-aware Have you ever asked yourself why change feels uncomfortable? Getting in tune with why you may resist change can be helpful, says Dr. Jenn Hardy, a licensed psychologist from Maryville, Tennessee.

“When we recognize that it comes from our temperament or difficult experiences earlier in our life, then we can approach ourselves with more compassion.”

3. Acknowledging stress as a sign of change Hardy adds that stress can make you feel as though change is impossible, but it’s often a sign it might be time.

“Maybe you don’t even need to talk to someone [about your stress],” Hardy says. “You may already know the parts of your life that are in need of an adjustment. Let this be your sign to start dealing with them.”

4. Writing out the positives “Consider the ways that change may be beneficial for you or those around you,” advises Halle M. Thomas, a licensed marriage and family therapist associate from Portland, Oregon. “It can be helpful to actually write this out as a list so that you can see it on paper.”

What happens when you can’t adapt to change? Adaptability can be an important predictor of resilience in life.

2022 research shows that during the COVID-19 pandemic, some people were unable to adapt to lockdown. This was linked to higher levels of depression, anxiety, and insomnia.

Being unable to accept change can have serious implications for a person’s relationship to themselves and those around them, as well, Thomas says.

“For those who are unable to accept change, they can find themselves feeling stuck in their life or in their relationships,” Thomas says. “At its worst, this feeling of being stuck can increase anxiety, depression, and substance use.”

Let’s recap Adaptability is how you modify your feelings and behaviors in the face of uncertainty.

While it may not be comfortable to shift out of the known and into the unknown, change isn’t going away just because you’re resistant to it.

As Heraclitus once said, the only constant in life is change.

If you experience difficulty adapting to change, remember that you’re not alone. If you find change overwhelming, you may want to talk with a mental health professional. Check out www.findHelp.co.za and find the help you need.

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12 Steps to Learn to Like Yourself - PSYCH CENTRAL 07 Nov 2022

You might not appreciate who you are right now, but you can learn how to like yourself. Maybe it can even turn into love.

Not liking who you are can interfere with your well-being. It’s a common occurrence that affects many of us, but you deserve to learn how to like yourself.

Not liking yourself can cause a lack of self-confidence. It might interfere with your ability to take risks and enjoy life. You might not like the life you lead if you don’t appreciate who you are.

Learning to like yourself can increase your self-confidence and help you reach your goals. It can help you live a fulfilling life with meaningful relationships. You can make some beneficial changes in your life to help you learn to like yourself and love your life.

Is it normal to not like yourself? Experts indicate that it’s not uncommon for people to dislike themselves. Sometimes people can’t like themselves because of negative thought patterns and feelings. They may feel a sense of shame about who they are, making it extremely challenging to believe anything good about themselves.

Sometimes, people don’t like themselves because they didn’t come from a supportive or nurturing household as a child. They may have low self-esteem and lack compassion for themselves as a result. This lack of self-confidence can lead to people-pleasing for validation and porous boundaries.

How to begin to like yourself more You might not feel love for yourself right now, but you can take steps to get there. Taking steps to find a more neutral place where you don’t dislike yourself but don’t quite love yourself is a good starting point.

Continuing your journey will eventually lead to loving who you are. Experts indicate that some of these steps include:

1. Take care of yourself Research indicatesTrusted Source that regular exercise and a healthy diet can improve overall health and well-being. Consider setting a goal of 12-3 hours of moderate physical activity every week. This can look like going on walks, practicing yoga, joining a workout class, going for a bike ride, etc.

While exercising and eating healthy is essential for your well-being, you also must feel good about who you are on the outside. This could mean taking care of your appearance and dressing in a way that makes you feel comfortable and confident.

2. Identify Your Strengths You might focus on your weaknesses and shortcomings when you don’t like yourself. Shifting your thought process and thinking about your strengths can make you feel better and release some of the negativity.

If this doesn’t come naturally to you, you might want to try journaling about the things you like about yourself and what you are good at so you have something positive to look back on when you’re feeling low. You can also call up a friend and ask them what they think your strengths are.

3. Express gratitude for who you are Practicing gratitude by embracing your gifts, abilities, and life itself can help you learn to appreciate yourself. It allows you to focus on the positive aspects of your life rather than thinking of things you wish were different.

You can think of all the small ways you take care of yourself each day that you may take for granted. Thank yourself for moving your body today, feeding yourself, going to work, watering your plants, making your bed, etc.

You do more than you realize, and it’s worth taking a second to thank yourself for everything you do. You can also take a moment to thank the environment and the people who give meaning to your life.

4. Avoid comparing yourself to others Comparing yourself to others often leads to not liking yourself. Comparing yourself can diminish your self-confidence and cause you to question your worth. You’ll likely notice an improvement in how you feel about yourself if you work to stop the comparisons.

When you do notice you’re comparing yourself, try to remind yourself that other people’s wins are not your losses, and there’s room for everyone to thrive in their lives.

5. Limit Social Media Exposure If you compare yourself to people on social media, you can remember that you’re comparing yourself to their highlight reel. Many photos get edited to look perfect, and comparing yourself is unfair. Consider limiting your social media exposure if it becomes an issue in your life.

Even taking one day out of the week to distance yourself from social media and focus on the real world can help ground you and remind you that what goes on on social media ultimately doesn’t matter.

6. Focus on positive thinking A negative thought process can lead to not liking yourself. You can switch your thought process and focus on positive thinking to help you find neutral territory. Eventually, positive thinking can lead to loving yourself, but take it one step at a time.

You can try replacing negative thoughts with positive ones, promoting an optimistic outlook on life. It can increase self-confidence and help you feel better about who you are.

Studies show that rumination, or analyzing and focusing on trauma or a past event, can lead to self-critical thoughts. Switching your mindset and focusing on positive thinking in these instances is essential, or it could contribute to depression.

This change in thinking may feel forced at first, but that’s okay. Stick with focusing on the positive, and positive thinking will eventually begin happening naturally.

7. Be kind to others Being kind to others can help you like yourself better. Acts of kindness can improve your self-confidence because you’ll feel like a kind and generous person. Without acts of kindness toward others, your self-image might plummet, leading to not liking yourself much.

8. Prepare for upcoming events Taking the time to prepare for upcoming events can help you like yourself. Studying for tests and setting aside the time you need to prepare can help you trust yourself. You’re more likely to feel good about yourself if you know that you did what was necessary to achieve your goals.

Tests aren’t the only thing you can prepare for to feel better about yourself. You can also plan for upcoming meetings, dinner parties, or events. Consider taking the time to think about any experiences coming up in your life so you can do what you can to prepare.

9. Surround yourself with positive people Spending time with critical people who tear you down and make you feel bad about yourself isn’t beneficial. It can interfere with how you view yourself. Letting go of anyone who makes you feel unworthy can help you learn to like yourself.

Consider taking the time to develop a friend group that supports you and your dreams. They might offer constructive criticism because they want to see you do well. You can focus on the people who want what’s best for you and spend less time with negative people.

10. Set goals that are small and achievable Achieving goals will make you feel better about yourself, helping you learn to like who you are. It can also help set you up for future success as you know you can achieve your goals.

You can set small goals that are easily achievable while still challenging yourself. It can help you recognize your strengths and love who you are.

Each time you reach your goal, increase what you wish to achieve next. Progressing in increments is powerful and helps keep you motivated while teaching you to like yourself.

11. Practice self-compassion Practicing self-compassion can prove beneficial to your well-being and thought process. You can experience more positivity in life, contributing to liking yourself more. Experts explain that self-compassion involves being kind to yourself, practicing mindfulness, and focusing on humanity.

12. Try therapy TherapyTrusted Source can help you recognize negative thinking habits that are inaccurate or harmful. It can also help you develop coping methods to alleviate stress and focus on the positive parts of your life. A therapist can help you recognize specific issues in your life that contribute to your disliking yourself.

Let’s recap
It’s common for people to dislike themselves, but you can work toward a more positive lifestyle. You likely won’t quickly go from disliking yourself to loving who you are, but you can find neutral territory. Once you find neutral ground, you can keep building on it to learn to like yourself.

These tips can help you lead a better lifestyle. You deserve self-love and can achieve it by focusing on self-compassion and positive thinking.

You can start with one or two tips before moving on to other ideas. Or, you can implement it all at once. Either way, you can notice a positive change in your life with these helpful steps.

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How to Let Go of Past Hurts: 8 Ways to Move On - Psych Central 21 Oct 2022

Letting go of the past, including people who hurt you, may involve accepting what you can’t control, taking accountability, and focusing on the lessons. Seeking help is also important.

Most people have, at some point, wondered how to let go of a hurtful past. It’s natural to feel that your current emotional pain is forever linked to what you experienced before. But, even if the past caused it, letting go of the pain starts with focusing on today.

How to let go of the past may mean different things to different people. It may also depend on your situation.

Maybe you think letting go is about being able to remember events or people without experiencing the pain. Perhaps you feel it’s about forgetting altogether. Or, it may mean you want to move on despite not having forgotten or forgiven yet.

Whatever it means to you, it’s possible to release what weighs heavy on your heart and mind. You can heal, and these tips may help.

“I am not what happened to me; I am what I choose to become.” ~ Carl Gustav Jung

1. Consider questioning if the pain is comfortable Sometimes when you’ve hurt long enough, you may get used to the emotional pain. Maybe it feels safe and familiar. Maybe you’ve internalized it as part of your identity. Perhaps staying angry at that person is comfortable because you can keep a distance.

Growing pains can be real. Getting away from the things you’ve felt and thought about for a long time may be uncomfortable. But healing, joy, and peace of mind may be on the other side of letting go.

It may not be the case for everyone, but if you ask yourself “why can’t I let go?” these questions may help you start releasing your past:

-Are there any secondary gains from keeping yourself focused on what hurts? -Is thinking about the past keeping you from trying new relationships or situations? -Do you avoid resolving emotional pain because this would mean facing it first? -How would your life be if you left the past in the past? -What would happen if you adopted a different role in the situation?

2. Consider letting it out Sometimes, to heal, you first need to feel it. Bottling up your thoughts and emotions may hurt you more in the long run and make it hard to let go, particularly if you keep thinking about the past and what harmed you.

Ruminating on the same negative thoughts may affect your mood, relationships, and even your ability to be productive and creative.

Try to find ways to express how you feel healthily. Releasing the emotional charge may help you stop ruminating.

Consider engaging in activities that provide a safe space for you to let it all out. For example:

-journaling with prompts -writing a letter to the person who hurt you (sending it is optional) -expressing your pain through art or play if writing or talking is difficult for you -finding a trusted friend, relative, or therapist to share your experiences and feelings

3. Consider taking accountability Taking accountability doesn’t mean you have to blame yourself for things that happened to you in the past. It’s more about realizing how much energy you’re spending on remembering or feeling things that are no longer your present. It’s also choosing to focus your attention elsewhere.

When you hold on to your pain, resentment, or hurtful memories, you’re reliving the painful experience again and again. This may keep you stuck in the past, which is something you can no longer change.

Taking accountability is also about claiming your power and deciding others will not control how you feel or live your life.

Maybe you didn’t have a say in what hurt you in the past, but you have a say now. You can choose where you put your mind and heart today.

It’s natural and valid to feel this is a difficult task. Maybe the pain is so intense that you can’t help but focus on it, or perhaps you have to live with the consequences. But healing is still possible.

Consider reaching out to a mental health professional to explore how you can develop effective coping mechanisms that may make releasing the past easier. You deserve it.

4. Try to make space for the new Focusing on past events may leave little room in your heart and mind for new experiences, including those that may bring you joy.

Not letting go of the past may make you more prone to miss the good in your life.

Consider these steps to make space for the new and to release the past:

-set personal and professional short-term goals -cultivate gratitude so you can focus on the present good -assess the quality of your current relationships and choose those that do you good -commit to a new hobby or activity every month -clean and organize your spaces, so you give away or discard items that no longer serve you -establish new bonds or try to strengthen casual relationships that have the potential to be great friendships -practice mindfulness, so you learn how to return to the moment when your mind wanders to the past -commit to one self-care activity every week -engage in altruistic activities that may boost your mood by helping others -identify positive leaders and role models who lead with empathy and compassion

5. Prioritizing yourself may help Prioritizing yourself is about being intentional with your decisions. This may start with realizing that choosing what’s good for you doesn’t mean you’re being selfish.

Putting yourself first may also mean reclaiming your power by leaving in the past what hurts you and focusing on healing today. It’s about realizing that you matter.

Consider:

-going to therapy to explore how to let go of the past and hurt you’ve experienced -setting boundaries with other people who may want to relive or discuss the past when you’re not ready to -making life decisions that make you feel safe, at peace, or happy, even if others don’t agree -reframing thoughts that may increase your anxiety or sadness to focus on thoughts that may make you feel hopeful -engaging in self-compassion and self-respect -Prioritizing yourself may also be about exploring ways to find forgiveness.

Forgiving yourself and others has been associated with higher psychological well-being, including a higher tolerance to uncertainty and a lower tendency to experience anger.

“The wound is the place where the Light enters you.” ~ Rumi

6. Try to focus on the lessons What have you learned about relationships, love, yourself, and life from your hurtful past experiences?

Your first response to this question may be to think of the negatives you may have learned. It’s natural and valid. But try to pause if this is your first reaction and consider focusing on a few positive lessons. For example:

-how strong and resilient you may be -who showed up for you and proved you can rely on them -the things you now know you don’t want in your life -the coping skills you may have developed to face life challenges -the sense that everything passes and this too shall pass *This isn’t an all-inclusive list and may not necessarily apply to your situation.

The idea is to try to identify whatever strength, skill, knowledge, or clarity you may have gained from a painful event. Focusing on these lessons may make it easier to let go.

7. Accepting what you can’t change may work One reason you may be ruminating about past events could be a need to revisit past choices or what could have been.

Focusing on the “what ifs” may lead you to repeatedly engage in the same inner conversations and scenarios. But thinking about what happened isn’t going to change it.

It may be difficult to accept, but learning to identify those things you have no control over may help you let go of the past.

The “should haves” or “what ifs” will not change what happened. The “what coulds” and “what wills” may help you move forward and be intentional in daily decisions that will affect your present and future.

8. Consider getting professional support Whether you live with trauma, experience anxiety or another mental health disorder, or may be facing relationship resentment, a mental health professional can help you let go and release your emotional pain.

Let’s recap Learning how to let go may depend on your specific situation and understanding of what letting go is about. But it’s possible and healing can be achieved.

Openly expressing how you feel, reclaiming your power, making room for new experiences, and focusing on the lessons are a few ways to let go of emotional pain.

If you’re having a difficult time letting go, consider seeking the help of a mental health professional. They can help you explore the possible causes of your challenges and develop coping skills that work for you.

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WHAT DOES DEPRESSION FEEL LIKE? - Psych Central 21 Sep 2022

The experience of depression isn’t uniform. No two journeys look the same, but symptoms can be managed whatever it looks like for you.

Slogging through a pool of molasses, wearing a heavy trench coat, donning a pair of grey-colored glasses… These are just a few of the ways someone might describe what it feels like to live with depression.

But, in truth, depression is different for everyone.

There are a range of possible experiences you can have if you live with depression — sadness is not the only symptom.

No matter how you feel right now, it’s valid and real. And it doesn’t have to be permanent. Support is available to help you get through it.

Does everyone experience the same depression symptoms? No. Depression is a very personal experience and each person can show their symptoms differently, says Erica Cramer, a licensed clinical social worker in New York City.

“For example, one person can lie in bed all day and cannot gather the motivation to leave their apartment. Meanwhile, another person must be out all the time because they cannot be alone with their thoughts,” she explains.

In general, a healthcare professional may diagnose depression if they identify several “typical” symptoms that have been present for at least 2 weeks. These are outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).

Some of these symptoms of depression include:

• low mood
• loss of interest in activities
• hopelessness
• reduced libido
• fatigue
• changes in cognitive functioning
• sleep disruptions
• eating more or less
• irritability
• thoughts of self-harm

Different types of depression More than 8.4 million people in the United States experience depression every year, but not all depression is the same. The type of depression you experience can affect how your symptoms manifest.

Some types (whether included in the DSM-5 or not) include:

• major depressive disorder (MDD), aka clinical depression
• depression in bipolar disorder
• persistent depressive disorder (formerly known as dysthymia)
• “high-functioning” depression
• postpartum depression
• premenstrual dysphoric disorder (PMDD)
• seasonal depression (aka seasonal affective disorder and formally called MDD with seasonal patterns)
• situational depression
• smiling depression

What does depression feel like? There are many possible ways to experience depression symptoms, depending on your age and particular circumstances.

These are some ways that common symptoms of depression may feel:

Depression feels like there’s nothing to hope for The loss of hope is a common symptom of depression.

You may feel like you’re always taking one step forward and three steps back. This may lead you to wonder, “So why try?”

Or maybe you look at your calendar and see nothing to look forward to.

A sense of hopelessness can also manifest as guilt or shame for something you’ve experienced.

Depression feels like everything is upsetting Irritability and anxiety are commonly seen in people with depression.

Maybe you snap at loved ones for things that didn’t bother you before, like blocking your car in the driveway or eating the last of your favorite comfort food.

You may also find yourself ruminating over social interactions or fearing the worst possible outcome in relationships, work matters, or school.

You might feel overwhelmed — things that didn’t bother you before are now a big deal.

Depression feels like sleeping too much …or too little.

Your sleep is often affected when you have depression, along with your appetite.

You may find yourself wanting to sleep all day, even though you had a full night’s rest.

Or perhaps you lie awake at night with racing thoughts, thinking intensely about the past and future. Your body is tired enough to sleep but you just, well, can’t.

Depression feels like crying all day without a reason Many people with depression can experience intense sadness or crying outbursts.

You may find yourself shedding tears during commercials, songs, or out of the blue while sitting at your desk.

As you navigate this, Cramer says to try to find a way to process your feelings.

“Some people may enjoy listening to a song that identifies with their emotions. Others may find writing in a journal extremely helpful,” she says. “It is important to do some trial and error here to determine what is successful.”

Depression feels like no longer knowing who you are or what you like You might find that you’re no longer interested in things you used to enjoy.

Anhedonia — decreased or absent pleasure in everyday activities — is one of the hallmark symptoms of depression, says Dr. Lindsay Israel, a psychiatrist in Fort Lauderdale, Florida.

This can be experienced differently from person to person, she explains.

“For example, a grandmother might not be able to feel the joy in spending time with her grandchildren playing right in front of her,” she says. “A musician, on the other hand, might not bother picking up a guitar because he does not feel it makes him happy to strum the strings anymore.”

Not finding pleasure in what used to be enjoyable could make you feel off or like you want to return to “your normal.”

Depression feels like not being able to get out of bed It’s not in your head: Fatigue is a common symptom of depression. According to 2018 research, this is possibly due to inflammation and reduced oxygen supply.

From the outside, your low energy and lack of motivation may look similar to “laziness.” However, this isn’t a personal choice.

If you live with depression, little tasks like sorting the mail or brushing your teeth can feel downright overwhelming.

Depression feels like not getting anything done If you feel like your brain is firing differently lately, you’re not imagining things. There are many cognitive symptoms of depression.

“Low energy, lack of sleep, difficulty concentrating, and low motivation can all lead to difficulty in accomplishing tasks for the day, such as going to the gym, grocery shopping, or even balancing your checkbook,” says Israel.

Depression feels like body aches ResearchTrusted Source has shown that physical symptoms like pain are linked to depression, possibly due to an imbalance of chemical messengers (neurotransmitters) in the brain.

The neurotransmitters that play a role in pain perception, such as serotonin and norepinephrine, are the same ones that play a role in mood regulation, explains Israel.

“With depression, the threshold for pain decreases, so you may experience pain in the joints and muscles,” she says. “You may experience more frequent headaches, joint pain, muscle pain, or fibromyalgia.”

Depression feels like considering self-harm Suicidal ideation exists on a spectrum, from thoughts of suicide to suicide attempts.

This may be just a thought, like wishing you wouldn’t wake up tomorrow or feeling at peace with the idea of getting into a fatal car accident.

It may also be more active, like coming up with a plan or setting a date to harm yourself.

Whatever you’re feeling, you can get through this. This is the depression talking. There are resources available to cope with this pain.

You’re not alone Help is available www.findHelp.co.za

Is there a difference between untreated and treated depression? Yes, there is a difference between untreated and treated depression symptoms. You might have more severe symptoms and side effects when you live with untreated depression for a while.

Untreated depression may be difficult to manage on your own. With professional support, it’s possible to improve how you feel and function.

Depression is more common than many people think, and you’re not alone in this, says Cramer.

“The fact that it is often not openly discussed makes some people think they are the only person that feels this way, but it is something that a lot of people experience at some point in their lives,” she says.

In fact, it’s a condition that many folks have learned to manage effectively. A mental health professional may help with this, along with support groups.

“There is no shame in going to therapy and sharing your feelings with a neutral person,” she says. “When you feel as though your depression is too much for you to handle alone, seek professional help.”

Let’s recap The symptoms of depression are as diverse as the folks experiencing them.

You may cry more, sleep fewer hours, or feel detached from what used to be important to you. You may find it hard to get things done or have unexplained aches and pains in your body.

All of this, and any other experience, is valid.

There are several ways to cope with depression and many treatment options available. There are also strategies to care for yourself when you live with depression.

To begin the healing process, you may find it helpful to reach out to a therapist who “gets” depression.

You don’t have to go through this alone anymore. Help is available and recovery is possible.

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WHY IS SELF-ACEEPTANCE SO HARD? - Psych Central 05 Sep 2022

Self-acceptance can be difficult, especially if life experiences taught you to alienate yourself.

Do you accept yourself as you are? Those who do are more likely to experience good mental health than those who do not.

Self-acceptance is about accepting that you are who you are, flaws and all. Accepting your full self might seem simple enough, but it’s easier said than done. In fact, self-acceptance can be difficult for many of us.

Self-acceptance is not the same as self-esteem or self-confidence. While your self-esteem might rise and fall based on the way you perceive your worth, self-acceptance remains consistent no matter how you view yourself.

The good news is that self-acceptance can be learned. Learning to accept yourself can improve your mental well-being and help you cope with life’s ups and downs.

Why is self-acceptance so hard to achieve? Accepting yourself is easier said than done. We often receive messages from the world — the media, family members, teachers, religious teachings, and so on — that imply our inferiority. This can make it hard to accept ourselves.

For instance, your upbringing might make a difference. A 2016 studyTrusted Source based on 236 young adults in Turkey found that participants were more likely to experience self-acceptance if they remembered their parents accepting them in their childhood.

Discrimination can also make a difference: it’s hard to accept yourself when the world tells you you’re inferior. A review published in 2020 found that LGBQ+ individuals had lower levels of self-acceptance compared to heterosexual participants. This could be because they were more likely to experience discrimination.

Self-acceptance can be particularly hard if:

• your parents or caregivers didn’t make you feel accepted
• you’ve experienced trauma that affects the way you see yourself
• you feel guilty about past events
• you’ve been taught to see yourself as inferior because of your race, gender, orientation, or another aspect of your identity

However, it isn’t impossible to practice self-acceptance just because you’ve experienced trauma, neglect, or discrimination. It may take time, but practicing self-acceptance can be helpful to you in the long run.

What’s the connection between self-acceptance and depression? Self-acceptance is linked to mental health. Research from 2019 suggests that people with a negative self-image and low self-esteem may be more likely to experience symptoms of depression.

A 2019 study noted that “unconditional self-acceptance” is a better predictor of mental well-being than self-esteem. Self-esteem is about how you perceive yourself — whether you feel you’re worthy and good, for example — but self-acceptance is about accepting yourself regardless of whether you feel worthy or not.

Why is it so hard to accept yourself when you have depression? It might be because depression can affect the way you view yourself. Feelings of worthlessness and low confidence are common symptoms of depression. These feelings can make it harder for you to feel positive about yourself.

However, it’s possible to learn to accept yourself when you have depression. Self-acceptance is about accepting your flaws, even when your confidence is low and when you feel unproductive, unworthy, or unhappy.

Learn about practicing self-compassion when you have depression.

What does self-acceptance look like? Self-acceptance is when you accept all aspects of yourself, positive and negative. This doesn’t necessarily mean you’re resistant to growth, but rather that you accept yourself instead of fighting against the parts of your personality that you dislike.

Signs of self-acceptance can include the following:

• Even in difficult circumstances, you accept yourself.
• You acknowledge your flaws and weaknesses.
• You feel comfortable being your authentic self.
• You’re able to take (kind) criticism without feeling attacked.
• You feel like you’re on your own side.

Self-acceptance is not about:

• believing you are perfect or flawless
• avoiding growth and self-improvement
• feeling 100% confident all the time
• always believing you’re right

A lack of self-acceptance can look like:

• experiencing self-loathing or self-hate, especially in difficult circumstances
• taking drastic attempts to avoid honest introspection
• feeling ashamed of your flaws and weaknesses
• denying or ignoring your flaws because they make you uncomfortable
• getting defensive whenever someone confronts or criticizes you

What is SELF-LOVE? Self-love is about being compassionate and kind towards yourself. It’s about prioritizing your needs — not in a selfish way, but in a way that acknowledges your humanity.

Positive psychology often focuses on nurturing self-acceptance and self-love. Most approaches to psychology focus on addressing dysfunctional behavior so that people are able to function better. But positive psychology takes it a step further: it focuses on helping people thrive.

Positive psychology suggests that all of us, whether we have a mental health condition or not, can benefit from learning to love ourselves, work on self-improvement, and practice healthy habits. There’s a strong focus on promoting happiness, gratitude, and stress-management skills.

Positive psychology methods for self-love can include:

• trying mindfulness and guided meditations
• engaging in creative hobbies
• practicing gratitude
• journaling free-style or using prompts
• cultivating healthy relationships with others
• identifying harmful patterns and addressing them
• nurturing healthy habits

Let’s recap
Self-acceptance doesn’t come naturally to all of us. If you’ve been exposed to messages that say you’re unworthy or inferior, you might find it harder to accept every aspect of yourself.

However, it’s possible to nurture your self-acceptance and learn to meet yourself with compassion and care. Positive psychology and therapy can help you learn to accept all of your parts — the good, the bad, and the ugly — so that you can have a healthier relationship with yourself.

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https://psychcentral.com/health/tips-for-raising-resilient-kids 16 Aug 2022

Resilient kids are adaptable problem solvers. They face unfamiliar or tough situations and strive to find practical solutions.

While adulthood is filled with serious responsibilities, childhood isn’t exactly stress-free. Kids take tests, learn new information, change schools, change neighborhoods, get sick, get braces, encounter bullies, make new friends and occasionally get hurt by those friends. They also face real-world, unfiltered traumas.

What helps kids in navigating these kinds of challenges is resilience.

Defining resilience for parents Lynn Lyons is a licensed social worker and psychotherapist in Concord, New Hampshire, who co-authored the book “Anxious Kids, Anxious Parents: 7 Ways to Stop the Worry Cycle and Raise Courageous and Independent Children” with psychologist and anxiety expert Dr. Reid Wilson.

Lyons says when resilient kids step into a situation they “have a sense they can figure out what they need to do and can handle what is thrown at them with a sense of confidence.”

She said that this doesn’t mean that kids have to do everything on their own. Rather, they know how to ask for help and can problem-solve their next steps.

Resilience isn’t a birthright. It can be taught. Lyons encourages parents to equip their kids with the skills to handle the unexpected, which contrasts our cultural approach.

“We have become a culture of trying to make sure our kids are comfortable. We as parents are trying to stay one step ahead of everything our kids are going to run into.” The problem? “Life doesn’t work that way.”

Anxious people have an especially hard time helping their kids tolerate uncertainty simply because they have difficulty tolerating it themselves.

“The idea of putting your child through the same pain you went through is intolerable,” Lyons said. So anxious parents try to protect their kids and shield them from worst-case scenarios.

However, she said that a parent’s job isn’t to be there all the time for their kids. It’s to teach them to handle uncertainty and to problem-solve. Below, Lyons shared her valuable suggestions for raising resilient kids.

1. Not accommodating every need According to Lyons, “whenever we try to provide certainty and comfort, we are getting in the way of children being able to develop their own problem-solving and mastery.” (Overprotecting kids only fuels their anxiety.)

She gave a “dramatic but not uncommon example.” Suppose a child gets out of school at 3:15. But they worry about their parent picking them up on time. So the parent arrives an hour earlier and parks by their child’s classroom so they can see the parent is there.

In another example, parents let their 7-year-old sleep on a mattress on the floor in their bedroom because they’re too uncomfortable to sleep in their room.

2. Avoiding eliminating all risk Naturally, parents want to keep their kids safe. But eliminating all risks could rob kids of learning resiliency.

In one family Lyons knows, the kids aren’t allowed to eat when the parents are not home because there’s a risk they might choke on their food. (If the kids are old enough to stay home alone, they’re old enough to eat, she said.)

The key is to allow appropriate risks and teach your kids essential skills. “Start young. The child who’s going to get his driver’s license is going to have started when he’s 5 [years old] learning how to ride his bike and look both ways [slow down and pay attention].”

3. Teaching kids to problem-solve Let’s say your child wants to go to sleep-away camp, but they’re nervous about being away from home. An anxious parent, Lyons said, might say, “Well, then there’s no reason for you to go.”

But a mindful approach is to normalize your child’s nervousness and help them figure out how to navigate being homesick. So you might ask your child how they can practice getting used to being away from home.

When Lyons’s son was anxious about his first final exam, they brainstormed strategies, including how he’d manage his time and schedule to study for the exam.

In other words, engage your child in figuring out how they can handle challenges. Give them the opportunity, over and over, “to figure out what works and what doesn’t.”

4. Teaching your kids concrete skills To paraphrase the adage, ‘If you give a kid a fish, you feed them for a day. If you teach a kid to fish, you feed them for a lifetime.’

When Lyons works with kids, she focuses on the specific skills they’ll need to learn to handle certain situations themselves.

She asks herself, “Where are we going with this [situation]? What skill do they need to get there?” For instance, she might teach a shy child how to greet someone and start a conversation.

Giving kids age-appropriate freedom helps them learn their limits, she said.

5. Avoiding ‘why’ questions “Why” questions don’t help promote problem-solving. If your child left their bike in the rain, and you ask, “why?” “what will they say? I was careless. I’m an 8-year-old,” Lyons said.

Try asking “how” questions instead. “You left your bike out in the rain, and your chain rusted. How will you fix that?” For instance, she said that they might go online to see how to fix the chain or contribute money to a new chain.

Lyons uses “how” questions to teach her clients different skills. “How do you get yourself out of bed when it’s warm and cozy? How do you handle the noisy boys on the bus that bug you?”

6. Not providing all the answers Rather than providing your kids with every answer, start using the phrase “I don’t know,” “followed by promoting problem-solving,” Lyons said. Using this phrase helps empower kids to learn to tolerate uncertainty and think about ways to deal with potential challenges.

Also, starting with small situations when they’re young helps prepare kids to handle bigger trials. She said they won’t like it, but they’ll get used to it.

For instance, if your child asks if they’re getting a shot at the doctor’s office, instead of soothing them, say, “I don’t know. You might be due for a shot. Let’s figure out how you’re going to get through it.”

Similarly, if your child asks, “Am I going to get sick today?” instead of saying, “No, you won’t,” respond with, “You might, so how might you handle that?”

If your child worries they’ll hate their college, instead of saying, “You’ll love it,” you might explain that some freshmen don’t like their school and help them figure out what to do if they feel the same way, she said.

7. Avoiding talking in catastrophic terms Try to pay attention to what you say to your kids and around them. Anxious parents, in particular, tend to “talk very catastrophically around their children,” Lyons said.

For instance, instead of saying, “It’s really important for you to learn how to swim because it’d be devastating to me if you drowned!” you might try just saying, “It’s really important for you to learn how to swim.”

8. Letting your kids make mistakes “Failure is not the end of the world. [It’s the] place you get to when you figure out what to do next,” Lyons says. Letting kids mess up is tough and painful for parents. But it helps kids learn how to fix slip-ups and make informed decisions next time.

According to Lyons, if a child has an assignment, anxious or overprotective parents typically want to ensure the project is perfect, even if their child is not interested in doing it in the first place. But it’s helpful in the long run to let your kids see the consequences of their actions.

Similarly, Lyons said that if your child doesn’t want to go to football practice, you might let them stay home. If next game they sit on the bench, they might also be sitting with the weight of their decision.

9. Help them manage their emotions Emotional intelligence (EQ) and self-regulation are key to resilience.

You can teach your kids that all emotions are OK, Lyons says. It’s OK to feel angry that you lost the game or someone else finished your ice cream. Caregivers can also teach kids that after feeling their feelings, they need to think through what they’re doing next, she said.

“Kids learn very quickly which powerful emotions get them what they want. Parents have to learn how to ride the emotions, too.”

You might tell your child, “I understand that you feel that way. I’d feel the same way if I were in your shoes, but now you have to figure out what the appropriate next step is.”

If your child throws a tantrum, she says, be clear about what behavior is appropriate (and inappropriate). You might say, “I’m sorry we’re not going to get ice cream, but this behavior is unacceptable.”

10. Modeling adaptability Of course, kids also learn from observing their parents’ behavior. Try to be calm and consistent, Lyons said. “You cannot say to a child you want them to control their emotions while you yourself are flipping out.”

“Parenting takes a lot of practice and we all screw up.” When you do make a mistake, admit it. You could say, “I really screwed up. I’m sorry I handled that poorly. Let’s talk about a different way to handle that in the future,” Lyons said.

Resiliency helps kids navigate the inevitable trials, triumphs and tribulations of childhood and adolescence. Resilient kids also become resilient adults, able to survive and thrive in the face of life’s unavoidable stressors.

www.findHelp.co.za

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THE PHYSICAL EFFECTS OF LONG TERM STRESS - PsychCentral 22 Jul 2022

Stress can impact your mental health, but it can also affect your physical well-being.

Whether you experience it occasionally or you face it frequently, stress can creep up on us all at some point. While we often think of how stress affects our mental health, the strain it can put on our bodies is just as important to consider.

Stress can affect every area of our body, from our ability to fight off viruses to how we digest food.

Understanding just what stress does to our bodies can help reduce its effects. By taking intentional steps to reduce stress and its symptoms, we can mitigate stress’s strain on our physical health.

Stress and the body It can often feel as if stress affects only your mental health, but it can also have a significant impact on your physical well-being. When stress occurs, your body reacts.

To defend against stress, your body unleashes hormones that speed up your heart rate, tense your muscles, and boost your immune system. Once stress passes, your body resumes its usual state.

With chronic or prolonged stress, though, your body may remain in a state of stress defense, and you may find yourself experiencing symptoms such as:

• anxiety
• depression
• headaches or migraines
• muscle pain
• insomnia
• irritability

Chronic stress can impact your entire body — from the nervous system to the reproductive system. No area is exempt from the effects of stress.

**How Stress Affects The Body Central nervous and endocrine system Stress can trigger your body’s fight, flight, or freeze response, which is controlled by your central nervous system (CNS).

When stress is perceived, your brain sends signals throughout your body. You’ll likely experience an uptick in adrenaline and cortisol (also known as stress hormones), as well as an increase in your heart rate. This reaction prepares you to face (or flee) the challenge ahead.

Your CNS will likely go back to business as usual once the stress has passed. In cases of chronic stress, however, your body may remain in a defensive response.

This can contribute to behaviors like turning to drugs or alcohol for support, over or under-eating, or feeling anxious or depressed — which can all, in turn, create additional stress.

Respiratory and cardiovascular system The release of stress hormones can put your respiratory and cardiovascular systems into overdrive.

Airways in your lungs will widen to allow more oxygen to flow to your brain, causing your breathing to become quicker. While this is meant to help sharpen your senses and increase alertness, it can also make breathing more difficult — especially for those with conditions such as asthma, emphysema, or chronic bronchitis.

The extra adrenaline released during the stress response also causes an increase in blood flow. Your heart rate and blood pressure rise as your body works to pump blood to your heart, muscles, and other vital organs, preparing them to react.

Experiencing long-term stress puts strain on your heart by forcing it to work harder more often, increasing your risk of developing high blood pressure or experiencing a heart attack or stroke.

Digestive system There are various ways stress can wreak havoc on your digestive system. For some, stress can cause stomach discomfort, including pain, bloating, or nausea. Others may experience diarrhea, constipation, or even irritable bowel syndrome (IBS).

ResearchTrusted Source also suggests a link between physical stress and ulcers. While stress may make existing ulcer pain worse, more studies are needed to determine whether stress can directly cause ulcer formation.

Stress can also trigger an increase in glucose levels, which may increase the risks associated with type 2 diabetes.

According to a 2005 review, stress may not affect only existing cases of diabetes, but it may also contribute to its development. Findings have been mixed, though, and more research is needed in this area.

Muscular system To protect themselves, your muscles tense up when stress occurs but will usually relax once the stress passes. Chronic stress, however, can prolong muscle tension.

This can lead to headaches and migraines, as well as aches and pains in the shoulders, back, and extremities.

Sexuality and reproductive system Long-term stress can have lasting effects on male and female reproductive systems. Stress can also impact a person’s sex drive. Stress can mentally and physically wear you out, and you may find yourself avoiding sexual activity.

Women may experience changes both before and during their menstrual cycles. Premenstrual syndrome (PMS) symptoms may worsen, and periods themselves can become heavier, more painful, or irregular.

Those going through menopause may also notice heightened symptoms when stressed due to increased hormone levels.

Research also shows that stress may also make it difficult to become pregnant or can complicate an existing pregnancy.

In men, chronic stress can cause testosterone levels to drop, impact sperm production, or even lead to issues such as:

• impotence
• erectile dysfunction
• infections in the prostate or testes

Immune system Your immune system is activated by stress, helping you avoid infections and heal faster. But while stress can give your immune system a positive boost in the moment, chronic stress can eventually weaken its effectiveness.

This can make it harder to recover after getting sick or injured. It can also cause you to contract viruses — like a cold or the flu — more easily and leave you more open to other infections or illnesses.

**WAYS TO REDUCE STRESS* Stress isn’t always avoidable, but it is manageable. There are many ways that you can lessen or even eliminate stress when it creeps up.

Try to listen to your body. Learning what triggers stress and how your body reacts to it can help you identify ways to combat your specific stress symptoms.

Consider doing an activity you love. Bingeing your favorite show, writing in your journal, listening to music, or reading a book can soothe stress and make you feel happier and more calm. Try to exercise regularly. Exercise increases your endorphin levels, which can elevate your mood and boost energy. Consider a relaxing activity. Meditation, mindfulness, muscle relaxation, or other soothing activities can help ease symptoms of stress.

Engage with others. While asking for help isn’t always easy (especially when we’re feeling stressed), connecting with others for support can help ease stress. Speaking with a professional. A healthcare or mental health professional can provide you with resources or suggest treatment for managing your stress.

Let’s recap We often associate stress with how it affects our mental health, but its physical effects are just as important to understand.

Our bodies respond to stress by releasing hormones and triggering reactions that help defend and protect our overall well-being.

This includes elevating your heart rate to pump blood to your vital organs, increasing your breathing to spread energy-giving oxygen throughout your body, and boosting your immune system to prevent any infectious attack.

When stress eases, our bodies relax and resume business as usual. But when we experience chronic or prolonged bouts of stress, our bodies may be prevented from returning to a relaxed state.

This can negatively impact your health, from lowering your immune defenses and raising your blood pressure to causing digestive or reproductive issues.

By taking intentional, actionable steps, you can reduce the impact of stress. Engaging in activities you enjoy, regularly exercising, connecting with loved ones, or seeking the guidance of a healthcare or mental health professional can all help you overcome stress.

ALL ABOUT STRESS

Everyone experiences stress at some point in their lives. But what’s stressful to you may not be the same as what’s stressful to others. You might also have your own way of managing that stress.

The intensity and duration of your stress response will depend on many factors that range from your personality to your support system.

And although it may often feel unpleasant, stress is an evolutionary necessity. More importantly, it can be managed. When it isn’t, though, it may develop into an acute or chronic stress disorder.

What is stress? Stress is the body’s natural response to a stressor. A stressor is a trigger that may cause you to experience physical, emotional, or mental distress and pressure.

In other words, stress is a physical sensation and a feeling of being overwhelmed and not able to deal with the pressures caused by a stressor.

Your mental and physical reactions to a stressor serve a purpose.

For example, in a hazardous situation, stress puts your body in “fight or flight” mode. In this heightened state of alert, your body and brain are doing everything possible to increase your chances of surviving that perceived or real threat.

You may also have a stress reaction to events that might not be life-threatening, like job deadlines or school assignments. In these scenarios, when managed well, stress could helpTrusted Source you focus and accomplish your goals at an optimal level.

When stress has this potential for a positive outcome, it’s usually referred to as eustress. When, on the other hand, stress leads you to feel overwhelmed and unable to cope, we refer to it as distress.

In the short and long run, distress may impact your mental health and sense of well-being.

Impact of distress on your mental health Mental health professionals usually consider three main types of negative stress responses. They each have their own signs and symptoms and may vary in duration too.

Acute stress disorder (ASD) To reach a diagnosis of acute stress disorder, symptoms must last between 3 days and 1 month. A trigger is usually a traumatic event that causes an intense reaction.

Symptoms of acute stress disorder include:

• feeling emotionally detached or numb
• dissociative amnesia
• derealization and depersonalization
• flashbacks or recurring images from the traumatic event
• hypervigilance and constant state of alert

• anxiety symptoms For example, after experiencing a jarring car accident, you might start:

• avoiding vehicles altogether

• feeling muscle tension when riding in a car

• having nightmares about the car accident

• experiencing panic attacks with or without an evident cause If symptoms last for more than a month, a diagnosis of post-traumatic stress disorder (PTSD) is possible.

Episodic acute stress disorder Folks with episodic acute stress disorder experience intense and heightened distress from everyday challenges. In other words, if you live with this condition, you periodically experience intense and extreme stress reactions to relatively simple stressors.

Contrary to acute stress disorder, which is caused by one traumatic experience, episodic acute stress is a response to several stressors that might not be considered such by people without the condition.

For example, if you have episodic acute stress disorder, you might have an intense stress response from deciding what to do for lunch today, and again later on from thinking about an important report you need to submit tomorrow.

Some people with type A personality develop this condition.

Symptoms of episodic acute stress disorder may include:

• irritability and poor anger management
• heart palpitations and shortness of breath
• muscular stiffness and pain
• panic attacks and other signs of anxiety
• chronic illnesses
• Chronic stress Left unchecked, stress responses can become a chronic condition such as generalized anxiety disorder.

Ongoing stress keeps your nervous system in overdrive. Your cortisol and adrenaline levels are constantly coursing at higher levels, and your body and mind don’t get the opportunity to wind down.

While acute and episodic stress symptoms will eventually ease, chronic stress holds the sympathetic nervous system hostage in a heightened state for an extended and undefined amount of time.

Triggers for chronic stress can vary from person to person, and they may include chronic illness, abuse, racism, and lack of rest and sleep.

Some signs and symptoms of chronic stress include:

• difficulty sleeping
• frequent headaches
• irritability
• brain fog
• anxiety
• depression
• physical conditions like acid reflux, cardiovascular disease, and cognitive disorders

Causes of stress Maybe you’re late to an appointment because of traffic, or you’re a new parent who hasn’t gotten enough sleep for a while. Life is full of potential stressors, and your threshold for managing these triggers depends on many factors.

What may cause you stress is not necessarily what stresses someone else. We are all unique in our responses and in how we interpret events. While some people get excited by speaking in public, others may experience a panic attack in the same situation.

There are also a few important life events that tend to be more stressful for everyone.

A well-known tool used by health professionals to measure the amount of stress someone’s experiencing is the Holmes-Rahe Life Stress Inventory. According to this scale, the most stressful life events are:

• death of a spouse
• divorce
• marital separation
• incarceration
• death of a close family member
• major injury or illness
• marriage
• being fired from a job
• marital reconciliation
• retirement
• drastic change in the health of a family member
• pregnancy
• Extreme life changes, such as a pandemic, for example, may also trigger intense stress reactions in many people.

Contributing factors Any stimulus you experience throughout the day has the potential to activate a stress response.

Different stimuli may cause different biological stress reactions, resulting in physical, psychological, or psychosocial stress. Sometimes, the same stimulus might cause more than one type of stress reaction.

Hypothetically, if you procrastinated on your work presentation and found yourself standing in front of your bosses unprepared, you may feel all three types of stress simultaneously: the physical stress reaction of a stomach ache from nerves; the psychological stress of worrying that this will end your chances at promotion; and the psychosocial stress of fearing ostracization for failing to perform to an expected standard.

What else can cause specific stress responses?

• Physical stress
• acute or chronic disease
• injury
• poor nutrition
• lack of quality sleep
• Psychological stress
• worry
• guilt
• mental health conditions
• attachment style
• grief
• Psychosocial stress
• relationships
• employment
• isolation
• racism

Not everyone reacts the same way to these potential stressors. Your body may adapt better to fewer hours of sleep, or you may not find isolation as unpleasant as other people. If this is the case, your reaction to these stressors would not be as intense.

Your personality also plays an important role in the emotional narrative you craft around stress stimuli.

Your genetic makeup, past experiences, negative thinking patterns and cognitive distortions, and tendency to catastrophize can contribute to how intensely you react to a given situation.

At the same time, stressors don’t exist in a vacuum. They can become exacerbated or subdued due to other circumstances in your life.

In general, factors like a strong support network may positively impact overall mental wellness and your ability to manage stress.

You might also overcome a stressful obstacle when the stressor only happens occasionally. When faced with the same stressor every day, though, you’re likely to handle it better on day 1 than on day 82, for example.

In other words, the longer you’re exposed to an stressor, the greater the impact it will have on you.

Examples of long-term stressors include:

• a toxic workplace
• a chronic illness
• poverty
• racism and discrimination
• relationship conflict

Symptoms and effects of stress - Acute stress effects When you’re exposed to a stressor, your brain and hormones immediately signal your body to be alert. You can thank the hormone epinephrine, more famously known as adrenaline, for symptoms such as:

• rapid heart rate
• focused vision and alertness
• tensed muscles
• increased lung capacity

If the stressful event is ongoing, your body will release adrenocorticotropic hormone (ACTH), which causes the adrenal glands to release cortisol. Cortisol keeps your body in this high-performance state until the peril has passed.

Sometimes, the body gets so hyped up on cortisol that it can’t switch off its high state of alert, even after the threat is gone.

• Chronic stress effects A body that won’t wind down from ACTH and adrenaline can be impacted psychologically, physically, and emotionally.

Left in high-stress mode, your body may respond by developing more symptoms.

These symptoms may be physiological, emotional, cognitive, and behavioral.

• Physiological effects
• weight fluctuation
• high blood pressure
• increased chance of heart disease due to high blood pressure
• sexual dysfunction
• chronic muscle tension
• higher severity of acneTrusted Source
• insomnia
• fertility interruptions and irregular periods
• low sex drive
• increased risk of type 2 diabetes
• changes in appetite
• diarrhea or constipation
• Emotional and psychological effects
• low energy and motivation
• anxiety
• irritability and anger
• low self-esteem
• changes in mood
• Cognitive effects
• cognitive distortions
• memory challenges
• learning difficulties
• poor concentration
• brain fog
• intrusive thoughts
• Social and behavioral effects
• social withdrawal
• changes in routines
• substance abuse
• relationship conflicts

How to manage stress Stress is inevitable throughout your life, but it can be managed to reduce the chance it affects you in the long term.

Consider these tips to better manage your stress reaction:

1. Take a walk in nature You don’t have to drive to a mountain resort to feel the stress-relieving benefits of nature. To start coping with stress, find any green space, like:

a park a bench under a tree a friend’s backyard A study published in Frontiers in Psychology found that spending just 20 minutes outdoors is associated with the biggest drop in cortisol levels when compared with other stress-reducing initiatives.

Presuming you have to walk to your nature destination, getting outside also has the stress-reducing bonus of some light exercise to help stabilize your sympathetic nervous system.

2. Learn new breathing techniques Perhaps the most accessible stress reliever is built right into your body. Deep breathing and breathing techniques like belly breathing signal to your brain that it’s time to chill out.

Focusing on your breath is a long-held tenet of meditation for stress.

Learning to control your breathing can keep you anchored in the present moment. Sometimes, reminding yourself of what’s real and happening right now calms your nerves about the future and frustrations about the past.

3. Develop routines that work for you Change is part of life. But a large part of life is also under your control. Developing a solid routine that promotes your mental wellness is a healthy way to minimize the potential stressful impact of change.

For example, sticking to a routine might help you maintain better sleep or eating habits.

When you know that certain parts of your day are guaranteed to happen, it prevents last-minute decisions that can result in stress.

Particularly during the pandemic, when the days may seem long and unformed, introducing some structure can help our brains and bodies adjust and reduce stress levels.

4. Power down blue screens Are you using your phone as a tool, or are you addicted to scrolling?

Some studiesTrusted Source have found an association between cell phone overuse and increased levels of stress, as well as symptoms of depression and anxiety.

To curb your phone use, consider setting limits on the time you spend with it, particularly before bedtime.

Shutting the phone down 30 minutes before bedtime has been shownTrusted Source to have the potential to improve quality of sleep, working memory, and positive emotions during the day.

5. Organize your stress triggers You know what may push your buttons. It may be overdue bills or setting up a doctor’s appointment.

Ignoring unpleasant tasks may feel easier than confronting them in the moment. But out of sight doesn’t always mean out of mind, and not resolving things as they arise could clutter your mind with stress.

Consider tackling the junk drawer, making the appointment today, and revamping your important document filing system.

Developing a systematic approach to areas of your life that cause routine stress may leave you feeling lighter and more competent.

When to seek help Even if you know how to manage stress, there are times when stressors have a greater impact and your responses may be more intense.

It’s natural to need extra help once in a while.

If you feel stress is impacting your day-to-day life, it may be time to reach out for professional help.

It is especially important to seek this support if you’re experiencing symptoms of acute stress disorder.

Getting the necessary help can help manage stress before it impacts other aspects of your life.

www.findHelp.co.za

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This Is What Dissociation Feels Like - Psych Central 25 Apr 2022

From daydreaming to altering personalities, dissociation can look different for everyone.

Though a somewhat vague term, disassociation involves cognitive disconnections between your thoughts, memories, and actions.

Disassociation can also affect your sense of identity and alter your perception of the world around you. It’s the hallmark symptom of dissociative disorders, including dissociative identity disorder (DID), previously known as multiple personality disorder.

But people with various mental and physical conditions can experience dissociative events, in addition to other symptoms.

If left untreated, dissociation can lead to significant problems in daily functioning and worsening mental health. But learning coping strategies can help you manage these potentially distressing events.

What is dissociation? According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), dissociation is generally defined as a disruption or discontinuity in:

• consciousness
• identity
• memory
• perception
• emotion
• motor control
• behavior These components of your cognition may not come together as they should during dissociative events, which could last for just a few minutes or years, in extreme cases.

Awareness of yourself and what’s going on around you can be compromised during dissociation, which might feel like an unwelcome and frightening intrusion into your mind.

On a psychological level, dissociating can be an involuntary means of coping with acute stress, such as physical abuse. Disassociation can act as an emergency escape route, preventing your mind from focusing on an overwhelming or traumatizing stimulus.

Approximately 73% of people who endure a traumatic incident experience dissociation during and directly following the event.

But in protecting you from trauma in the short term, dissociation creates negative consequences in the long term, like:

• personality altering
• memory loss
• emotional disfunction

How the experience of dissociation feels Dissociation looks and feels different for each person who experiences it. But what’s typically consistent in most cases is a sense of departing from reality.

A participant in a 2021 study explained their fragile relationship with reality, saying, “It’s kind of like walking on thin ice, it can break at any moment.”

You may suddenly lose your sense of identity or recognition of your surroundings. You could feel as though you’re observing yourself from the outside in — or what some describe as an “out-of-body experience.” Your thoughts and perceptions might be foggy, and you could be confused by what’s going on around you.

In some cases, dissociation can be marked by an altering of your:

• personality
• identity
• behavior You might feel as though you’ve become a different person altogether with different attributes and thoughts.

Dissociation can take place during a traumatic or stressful event and can sometimes continue in the days or weeks after, such that your memories and events recounted to you might not line up.

One first-hand account describes a woman who reported being told that she had said and done things that she had absolutely no memory of. While some people have no recollection of their dissociations, others can remember when it occurred and what it felt like.

Symptoms Symptoms of dissociation are wide-ranging in their type and severity and can be both physical and psychological.

Some of the most common mental signs and symptoms of dissociation include:

• fogginess and confusion
• detachment
• memory loss
• difficulty accessing or retrieving information
• alexithymia (difficulty recognizing or describing your emotions)
• sudden behavioral changes

• significant shifts in mood Some people experience physical symptoms as well, such as:

• dulled senses, including pain

• sense of weightlessness or emptiness

• pounding heart

• lightheadedness or dizziness

Types of dissociation There’s generally a broad spectrum in the severity of dissociation. Most people have experienced dissociation at some point in their lives.

Situations that can be considered dissociative include:

• a wandering mind during class
• closing track of the road as you’re driving

• certain meditative states But the more severe types of dissociation — those typically associated with mental disorders — take many forms, including:

• Dissociative amnesia. The central symptom is loss of memory — forgetting entirely or misremembering details about specific events, periods of time, or your own life history.

• Dissociative fugue. This is a form of amnesia involving physical movement, in which you travel from one place to another with no memory of how you arrived there. Sense of identity is often lost.

• Depersonalization. This is a detachment from your thoughts, emotions, body, or life altogether. It may feel like you’re watching yourself from an outside perspective.

• Derealization. The world around you seems unreal, including other people. This is despite a maintained logical awareness that your surroundings are, in fact, real.

• Identity alteration or confusion. You may adopt a different personality, voice, behavior, and sense of self. In milder forms, this could be a sense that you are or have acted in a way that doesn’t align with your true identity.

Causes and triggers Unlike many other mental health events, genetics likely play little to no role in a person’s tendency to disassociate.

The overwhelming consensus among researchers and mental health experts is that traumatic events — particularly in youth — may be the most common underlying cause of dissociation and many related disorders.

Childhood trauma leading to dissociation could include:

• sexual abuse
• physical abuse
• neglect
• exposure to war or violence
• car accidents
• natural disasters

There are some potential physical causes of dissociation as well, like:

• epilepsy
• head trauma

• brain tumors For those who begin to dissociate once they’ve already reached adulthood, physical conditions are more likely to be responsible, including:

• combat

• torture

• repeated abuse Dissociating might be considered a form of protection in these traumatizing situations, shielding you from unbearable or overwhelming experiences.

But in some cases, dissociation can become your go-to defense mechanism. Possible triggers of dissociation can include:

• alcohol
• substances like phencyclidine (PCP) and ketamine
• depressive episodes
• acute stress or anxiety A 2018 case studyTrusted Source focusing on one 55-year-old woman identified that her dissociative events — in her case, alternating personalities — were triggered by stress and substance use.

Sleep might also play an important role in the frequency of dissociative events, with poorer quality sleep potentially making dissociation more likely.

Related mental health conditions Some 2017 research tells us that dissociation can be a symptom of many mental health conditions.

Of course, dissociative events are most commonly associated with dissociative disorders.

Data suggests that about 7% of the population has met the criteria for a dissociative disorder at some point in their lives. Still, difficulty identifying these conditions could mean this estimate isn’t entirely accurate.

The DSM-5 defines five dissociative disorders:

• dissociative identity disorder (DID)
• dissociative amnesia, including fugue
• depersonalization or derealization disorder
• other specified dissociative disorder
• unspecified dissociative disorder

But dissociation isn’t found only in dissociative disorders — it can also be a symptom of other mental conditions, such as: - post-traumatic stress disorder (PTSD) - substance use disorder - schizophrenia - borderline personality disorder (BPD) - obsessive-compulsive disorder (OCD) It’s also common for people who experience dissociation to have depression or an anxiety disorder, largely due to the psychological stress dissociation can create.

Managing dissociation Even though dissociation can be frustrating and intrusive, there are techniques and strategies to help you manage your symptoms and regain control of your life.

What works for one person may not work for another. You may have to try multiple strategies before discovering the tools that are most beneficial to you.

Therapy Professional guidance with a therapist, such as cognitive behavioral therapy (CBT) or dialectical behavioral therapy (DBT), may be the best option for meaningful, long-term improvements in managing disassociation.

Record your reality Referring back to something you created could help jog your memory and reduce the frustration of forgetfulness associated with disassociation.

If you have difficulties with memory loss and disassociation, try keeping a daily diary or taking pictures to help you record:

• events
• thoughts
• emotions
• Mindfulness Dedication to mindfulness can work wonders for several mental health conditions and symptoms. To mitigate dissociative events, 2022 research suggests that practicing mindfulness and reassuring yourself that you’re safe in the present moment might be helpful.

Grounding techniques Grounding techniques can also firmly connect you back to reality in times of disassociation. This could include exercising all your senses, like:

• smelling essential oils
• reading a poem aloud
• petting your dog
• Lifestyle changes

Lifestyle changes are accessible at home and can make a big impact on mental health. Simple self-care measures for managing disassociation might include:

• keeping a consistent sleep schedule
• exercising regularly
• eating nutritious food
• spending time outdoors

Next steps Those who experience dissociation may face stigma or skepticism from friends, family, and even some doctors who still have misconceptions about this condition.

But as scientific knowledge and exploration grow, so does the understanding of this complicated phenomenon.

If you’re experiencing dissociative events or related symptoms, you’re not alone. Reaching out to your doctor or therapist can be an important first step.

If you’re ready to get help but don’t know where to begin, you can visit Psych Central’s guide to finding mental health care.

Management and even resolution of dissociation are possible with the right strategies and guidance.

For more information about dissociation, you can check out the International Society for the Study of Trauma and Dissociation (ISSTD) “Dissociation FAQs” page.

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Anxiety Can Lead to Irrational Fears: Here Are 5 Ways to Cope - Psych Central 20 Mar 2022

Irrational fears can feed underlying anxiety. Keeping them in check may involve retraining your brain’s response to fear.

Fear is not only natural — it’s important. Fear tells you when you’re in danger physically or emotionally. The brain doesn’t distinguish between real or imagined danger.

Faced with fear, your body jumps into action with a flight, fight, or freeze response that allows you to protect yourself from harm.

In our modern lives, where the threat of saying something embarrassing in a meeting is more prevalent than being eaten by a tiger, our systems can go into overdrive trying to fend off potential, future danger.

Some people might find themselves worrying about speaking in public and get sweaty palms before a presentation but present anyway. For others, intense fear may lead them to avoid meetings or speaking in groups at all.

If you experience an exaggerated response to an irrational fear, like public speaking, it’s possible to calm your nervous system when it warns you of a nonexistent danger.

What makes a fear ”irrational”? Fear is a typical human response to danger. But when your fears are out of proportion to the situation, they are considered irrational.

For example, a rational fear might show up as anxiety on a flight during turbulence. Irrational fear is being terrified of flying or the possibility of a plane crash to the point that you don’t take vacations anywhere that requires a flight.

Irrational fears pop up when no actual threat exists. They can also be fears of fictional future situations. These imagined fears come with intense, frightening thoughts and an outsized reaction, like going out of the way to avoid the possibility of the scenario ever occurring.

For example, dating can make all of us nervous and can be awkward. But there’s no real danger in going out on a date and socializing.

Someone with an irrational fear might worry intensely about a fictional extreme situation, like their date humiliating them. That fear might drive them to avoid dating entirely.

What is the link between anxiety and irrational fears? Irrational fears play a central role in anxiety disorders. Anxiety disorders are characterized by strong feelings of fear or worry. Intense feelings of fear can feel uncontrollable and spark avoidance tactics in people with anxiety.

Many of the fears that are underlying in anxiety conditions are about situations that pose little or no real danger, making them irrational fears. Many people living with anxiety know their fears are irrational, but certain thoughts and situations still set off a flight, fight, or freeze response.

Here are some of the anxiety disorders that involve irrational fears:

Generalized anxiety disorder (GAD) involves irrational fear that isn’t related to anything specific. Social anxiety disorder is tied to an irrational fear of embarrassing yourself publicly and limits you at school, work, social circles. Specific phobias are centered around an intense irrational fear of a specific object or situation, like airplanes, spiders, and public speaking. Panic disorder occurs when intense and possibly irrational fears bring on a panic attack. You may develop an irrational fear of panic attacks themselves. One studyTrusted Source shows a link between specific phobias and the part of the brain where fear is conditioned.

More than 31%Trusted Source of adults will experience anxiety in their lives. Symptoms of anxiety may include:

feeling tense or edgy, both mentally and physically fatigue irritability inability to concentrate or focus difficulty sleeping This anxiety quiz may help you assess whether you have anxiety, and in what form. It should not replace seeing a medical professional.

Here are some tips for managing and treating irrational fears:

Learning to be patient with yourself and accepting your irrational fears for what they are, including the limits they place on your life, can help you begin to retrain yourself to react differently to them.2. Learn to control what you can How can you best feel in control of your life? Anxiety is rooted in irrational fears of what might happen. In other words, a sense of a lack of control.

Add in activities that help you regain a sense of control, like volunteering for an organization you care about or joining a sports league. Exerting this sense of agency over your life can help you overcome a tendency to stew on unknown outcomes.

You may learn new social skillsTrusted Source and techniques that can help you cope in a situation that normally causes fear.

If you fear going to the doctor, you might start by looking at a photo of a doctor’s office. In the next exposure session, you might call and talk to your doctor’s receptionist. You’d continue increasing the significance of the exposure until eventually, you’d work your way up to going to the doctor.

Next steps When you know your fears are irrational, but you cannot see a way to escape the cycle of anxiety, know that help is available. Anxiety disorders are treatable.

You can learn — whether through mindfulness, through therapy or support groups, or with the help of medication as well — to break the cycle of irrational fear.

Consider connecting with people who’ve had similar experiences in anxiety online support groups.

Talk with your doctor about your symptoms and if anti-anxiety medication might help your anxiety disorder. Treatment for specific phobias typically focuses on therapy. But as you’re working on your fears, antidepressants, benzodiazepines, and beta-blockers might reduce anxiety symptoms that get in the way of your everyday life.

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8 Foods to Boost Serotonin and Improve * YOUR* Mental Health - By Psych Central 18 Feb 2022

Low serotonin can impact your well-being. Learn how you can boost your serotonin levels with food and what to add to your diet.

Serotonin is a chemical messenger that your digestive tract and central nervous system produce. This “happy hormone” can directly impact your mood and mental health.

“Neurotransmitters carry out important signaling between the cells of the brain (called neurons) that govern essential brain functions like mood, cognition, focus, and rest,” says Uma Naidoo, MD, a nutritional psychiatrist, professional chef, and author of “This Is Your Brain on Food.”

According to Naidoo, low serotonin levels are typically associated with mental health conditions such as:

• mood disorders (like depression)
• anxiety
• insomnia
• obsessive-compulsive disorder
• post-traumatic stress disorder If you’re low on serotonin, eating certain foods can increase your serotonin production.

You may even get a boost in your mood as a bonus.

How food may boost your mood “While we generally can’t get serotonin directly from whole-food sources (with a few exceptions), there are a variety of nutrients and plant compounds that can promote our body’s ability to produce serotonin and other mood-boosting neurotransmitters in the brain,” Naidoo says.

Foods that may increase serotonin Here are eight types of food that may produce serotonin and could help improve your mental health:

• eggs
• dairy
• tofu
• nuts and seeds
• fermented foods
• spinach
• fruits and vegetables
• turkey

A research review from 2016 mentions that serotonin is synthesized from the amino acid tryptophan. Therefore, eating tryptophan-rich foods may be key to improving your mood and feeling better.

“Aside from boosting serotonin, however, incorporating certain groups of foods into a healthy, balanced diet can drastically improve your mental health,” Naidoo says.

Eggs “Research [from 2015] found that even small amounts of tryptophan-rich egg protein influenced serotonin levels and significantly improved the moods of female participants aged 45 to 65,” Naidoo says.

For the best nutrient sourcing, Naidoo recommends pastured eggs from cage-free chickens. Consider starting your day with:

scrambled eggs an omelet a baked frittata

Dairy “Foods like cow’s milk, cheeses, or plain yogurt are noted to be naturally rich in the protein alpha-lactalbumin, which was shown in [2005] researchTrusted Source to increase blood tryptophan levels and improve sleep quality and mood,” Naidoo says.

Consider trying whole unsweetened Greek yogurt with live cultures to help improve both your gut and mental health. Naidoo suggests adding a handful of wild blueberries for natural sweetness, gut-loving fiber, and mood-boosting antioxidants.

Tofu If you’re vegetarian or vegan or otherwise don’t eat eggs or dairy, soy products such as tofu are a great protein option.

“Organic non-GMO-sourced tofu is an excellent, versatile protein that’s rich in tryptophan [and] soy isoflavones, which have a demonstrated association with [fewer] symptoms of depression,” Naidoo says.

You might try tryptophan-packed tofu as a substitute for meat-based proteins.

Nuts and seeds Certain nuts and seeds may help you produce more serotonin.

Naidoo says that eating a handful of walnuts each day has been associated with a reduced risk of depressive symptoms, according to a 2019 study.

You might consider eating a handful of nuts and seeds as a snack on their own or sprinkling them into a salad or cup of yogurt.

Fermented foods Fermented foods are rich in important bacteria that nourish your natural gut microbiome and may improve your mental health.

You could try adding any of these fermented foods to your diet:

• kimchi
• miso
• sauerkraut
• unsweetened coconut milk
• cashew milk yogurt
• Other prebiotic foods, such as garlic, leeks, and onions, may help too.

Spinach “Rich in iron and folate, spinach packs a powerful dose of key vitamins and minerals that are absolutely necessary for the production of serotonin in the brain,” Naidoo says.

“In fact, folate deficiency shares a significant association with symptoms of depression, and therapy with folic acid has shown to improve these symptoms.”

Consider tossing spinach into:

an omelet a smoothie a salad

Fruits and vegetables Many fruits and vegetables may help increase serotonin. Some tryptophan-rich fruits and veggies you may want to try are:

pineapple bananas kiwis plums beans “For an extra veggie punch, pair spinach with sweet potatoes and cherry tomatoes — shown to be among the richest sources of plant serotonin — for a delicious, mood-boosting breakfast hash,” says Naidoo.

Turkey If you celebrate Thanksgiving, then you may have heard that turkey is high in tryptophan.

Consider sliced turkey on whole-grain bread for an easy sandwich or turkey meatballs instead of beef.

“[Nutritional psychiatry] brings back to the individual the notion that the power to care for your own mental health rests, in large part, in your hands,” says Naidoo. “It’s what’s on your plate and at the tip of your fork.“

The bottom line is that eating nutritious foods may have a positive impact on your mental health — and research can back that up. For instance, research shows that a well-balanced Mediterranean diet may benefit mental well-being.

Changing your diet can feel hard, but healthier eating is possible — even when you’re on a budget

Remember that frozen and canned foods, such as frozen fruits and veggies or canned fish, can be healthy options too.

It’s also important to keep in mind that dietary changes are not the only self-care strategy you can try to boost your serotonin levels. If you want to learn about other things you can do, consider reading this article. https://psychcentral.com/depression/self-help-for-depression

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**NEW LISTING **** - ADDICTION TREATMENT FACILITIES *** THE CEDARS** 25 Jan 2022

The Cedars is a boutique group of addiction & mental health treatment facilities where every client gets the individual help they need. Tranquil, private locations around South Africa are staffed by a leading team of multi-disciplinary specialists, many with a personal journey in recovery and a genuine desire to heal. If you or a loved one is looking for #addiction treatment, you could choose from one of our 3 top-tier treatment facilities.

Cape Manor House, located in the leafy suburb of Plumstead, Cape Town, Midlands Estate, located near Mooi River, Kwazulu-Natal, or The Cedars South Coast Estate, located near Scottburgh, Kwazulu-Natal. Whichever of our facilities you choose, you will experience primary care handed down by highly qualified & motivated specialists who collectively offer decades of experience & a genuine desire to uplift those suffering with addiction. We are contracted to various medical aids & hospital plans & additionally offer different payment options so that our services are accessible.

The Cedars Family Team offers Family Counselling, Family Workshops & Reintegration Programs that help concerned family members learn about more addiction & how to help loved ones return to society, post-treatment.

We fully understand that the entire process can be daunting – & our dedicated and compassionate Family counselling Team is always just a phone call away.

If you’d like to chat to one of our addiction professionals – don’t hesitate to get in touch.

Read inspiring stories of recovery on our website, both from the point of view of people in recovery & their families.

Whatever your journey, #TheCedars is there to walk with you every step of the way.

*Contact us on 0818609578 or [email protected] for info. *

For family or loved one support, contact us on 073 532 1752 or [email protected].

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8 Mental Health Trends to Watch in 2022 - by Psych Central 25 Jan 2022

Keep an eye out for these emerging trends and exciting new research developments in mental health in the new year.

Mental health became an important part of the public conversation in 2021, as Olympic athletes, celebrities, and other public figures came forward about their well-being and helped reduce the stigma.

As we enter the third year of the pandemic, we can expect mental health to continue to be a top priority in 2022.

In fact, a recent poll by the American Psychiatric Association showed that one-quarter of Americans made a new year’s resolution to improve their mental health in 2022.

Although 2021 wasn’t without its challenges, the past year brought growth, understanding, and hopefully, renewed optimism.

New developments in science, such as the COVID-19 vaccines, are a testament to humanity’s commitment to healing.

Other exciting research studies have shown us how we can improve mental health services, address racial and socioeconomic disparities, and ultimately, enhance our overall well-being from the inside out.

Suffice it to say, there’s a lot happening in the mental health space — too much for one article alone. To determine our top mental health trends of 2022, we consulted experts in the field and Psych Central’s Medical Affairs Team.

Note that some of these trends aren’t yet available, but we expect a continued increase in research and accessibility in the months to come.

1. Trauma-informed care Nearly 61% of adults have experienced at least one traumatic event in their lifetimes, according to the Adverse Childhood Experiences (ACES) studyTrusted Source.

Around 1 in 6 adults endure four or more traumatic events during childhood, with women and people from minoritized communities facing a greater risk.

Clinicians, health care practitioners, educators, and mental health professionals are widely embracing a trauma-informed approach to careTrusted Source to address trauma among the broader population.

Trauma-informed care will only continue to be emphasized in 2022, according to Nathaniel Ivers, PhD, department chair and associate professor at Wake Forest University in Winston-Salem, North Carolina.

For trauma-informed care to be effective, Ivers emphasizes the need for a holistic approach that includes treatments and strategies that play to an individual’s strengths versus their weaknesses. In some cases, trauma-informed care could run the risk of hyper-focusing on an individual’s trauma exclusively, rather than homing in on an individual’s strengths to effectively understand and treat them.

2. Blood tests for mental illness Soon, you could have the option to take a blood test to easily detect a mental health condition like depression.

In April 2021Trusted Source, researchers at the Indiana University School of Medicine developed a novel blood test for mental illness, suggesting that biological markers for mood disorders can be found within RNA biomarkers.

The breakthrough study indicated that a blood test can determine the severity of depression and the risk for developing severe depression and bipolar disorder in the future. The blood test may also help tailor an individual’s medication choices.

“This is an exciting prospect for identifying biological markers of depression among researchers, but very preliminary in its understanding and potential for use,” says Matthew Boland, PhD, a clinical psychologist in Reno, Nevada, and a member of Psych Central’s Medical Affairs Team.

Although blood tests for mental illnesses are still in their early development stages, this scientific advancement could change, even improve, how mental health conditions are diagnosed, which is often by trial and error.

“This method will remain an adjunctive to traditional diagnostic tools, as mental illnesses are complex and have biological, psychological, and sociocultural etiologies,” Ivers adds.

3. Advancements in psychedelic research Psychedelics have been used for religious, medical, and ceremonial purposes around the world for centuries, predominantly among Indigenous cultures.

And recent research suggests that psychoactive substances like psilocybin, MDMA, LSD, and ketamine can help treat mental health conditions like depression, anxiety, and more.

Although psychedelics are still classified as controlled substances and illegal in many countries, including the United States, laws, policies, and stigma are starting to ease up.

For instance, the Drug Enforcement Administration (DEA) recently authorized an increase in the production of psychedelics to meet growing research demands.

From Yale to Johns Hopkins to New York University, to the newly minted Center for Psychedelic Research and Therapy at the University of Texas, research scientists are becoming increasingly interested in the therapeutic value of psychedelics and other psychoactive substances.

In addition, emerging research shows the potential mental health benefits of psychedelic-assisted psychotherapy (PAP), a form of therapy combined with ingesting a psychoactive substance.

“Adjunctive therapy is needed to keep old habits [from] solidifying following dosing,” Boland says. “More established methods will be slower to adopt, partially due to legality and awaiting increased research findings for efficacy for many specific conditions.”

While psychedelic therapy is still at least a few years away from being offered at your therapist’s office, we’ll likely continue to see more scientific discoveries on the possible benefits.

4. Setting healthy boundaries with social media If you have a smartphone, you’re probably well aware that limiting your screen time can be a challenge. Not to mention, spending too much time online can negatively affect your well-being.

And if you’ve watched Netflix’s “The Social Dilemma,” you’re familiar that Facebook, Instagram, and Pinterest specifically designed these apps to hold your attention for as long as possible.

You might also recall when a former Facebook employee testified before Congress in October 2021 on the negative effects of Instagram on teens’ mental health, which was dovetailed by a global Facebook outage.

The events sparked an overdue dialogue about the potentially harmful effects of social media platforms and the need for taking an occasional break.

We can expect to hear more conversations about “digital wellness” and establishing healthy boundaries with social media, particularly as research continues to shed light on the negative effects on adolescents and adults alike.

“Larger overall scrutiny of the effects of social media on mental health will likely continue and increase,” Boland says. “Whether or not that translates to definitive action by lawmakers may be a different story.”

What “social media boundaries” might look like will vary based on the individual, and whether they’re effective is still up for debate. While more research is needed, Boland suggests that setting the following boundaries can be helpful:

• Limit screen time.
• Unfollow people.
• Don’t read comments. According to Ivers, the mental health effects of “doom scrolling” and virtual privacy could see more traction in 2022 as well.

“I also believe there will be an increase in discussions about the disproportionate influence of social media on people’s ideas, attitudes, and behaviors, particularly for impressionable youth,” Ivers says.

5. Artificial intelligence in clinical settings Advancements in artificial intelligence (AI) technologies could improve the future of therapy sessions and mental health diagnoses. According to research published in December 2021, AI motion sensors can be used to detect symptoms of anxiety such as:

• nail biting
• knuckle cracking
• hand tapping

Additionally, research from October 2021Trusted Source suggests that AI can help train therapists by evaluating their skills, including whether or not they’re creating an optimal environment for their clients.

Although the use of AI in mental health training and treatment could increase in the new year and beyond, experts say the technology is unlikely to replace traditional mental health services with human beings.

6. Continued expansion in telehealth services Therapy administered via telemental health picked up steam in 2020, sustained in 2021, and is here to stay, according to experts.

“Because of the COVID-19 pandemic, many mental health professionals now have the training, experience, confidence, and technology to conduct telemental health services effectively and ethically,” Ivers says. “It also has the potential to increase mental health treatment access to rural and older adult communities.”

According to Boland, around 60% of mental health practitioners currently have full caseloads solely on telehealth.

“Clients largely appear to enjoy the convenience — only a few clients have requested in-person,” Boland says. “Some mental health and business analysts project that telemental health could expand even more.”

Virtual mental health services can be especially helpful for those who:

• are immunocompromised
• have transportation challenges
• have physical disabilities

7. Increase in transcranial magnetic stimulation Transcranial magnetic stimulation (TMS), a non-invasive method of brain stimulation, has been studied extensively in recent years and is being increasingly used to treat certain mental health conditions.

The safety and efficacy have been so promising that the Food and Drug Administration (FDA)Trusted Source continues to approve innovative TMS technologies like NeuroStar and BrainsWay. TMS stimulates areas of the brain that are known to be underactive in individuals with mental health conditions such as:

mood disorders (i.e., depression and bipolar disorder) attention deficit hyperactivity disorder (ADHD) obsessive-compulsive disorder (OCD) “If depression levels continue to increase, I suspect that TMS will be utilized more frequently in 2022, especially for individuals whose depression is not improving with traditional methods,” Ivers says.

8. Virtual reality for chronic pain and care The FDA recently authorizedTrusted Source marketing for a virtual reality (VR) program for chronic pain reduction as an alternative to opioid prescriptions.

VR treatments could be revolutionary, offering a different type of therapy for folks who wish to avoid pain medication to relieve their symptoms.

“People are put into a virtual world where they conduct movements, learn about the nature of pain sensations in their body, and learn a number of behavioral and cognitive skills on how to effectively respond to pain and cope with the stress associated with it,” Boland says.

“[VR] is meant to work along with medication, physical treatments, and behavioral clinician work,” he adds.

As VR technology becomes more accessible, experts say we’ll see a continued expansion for treatments for different mental health and medical conditions.

“As virtual worlds become more prevalent and useful and as the metaverse evolves, I believe that medical and mental health professionals will find ways to help clients through these technologies,” Ivers says.

Looking ahead 2021 was an innovative year for scientific research in the mental health space — and we’re excited to see what 2022 has in store.

From trauma-informed care to psychedelic research to artificial intelligence and virtual reality, there are many exciting developments to be on the lookout for, especially as we all become a little more comfortable talking about our mental health.

www.findHelp.co.za

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###**CROSSROADS RECOVERY CENTRE -ALCOHOL & DRUG REHAB CENTRES LOCATED IN GAUTENG!! - NEWLY LISTED** 20 Oct 2021

Crossroads Recovery Centre is group of private alcohol and drug rehab centres located in Gauteng in South Africa. Our 12 Step treatment facilities based in Pretoria and Johannesburg offer personalized recovery solutions for individuals suffering under the tremendous weight of their addictions. We offer expert, professional addiction treatment for substance abuse and physical addictions to food, sex and gambling.

An idyllic refuge for recovery…

Crossroads Recovery Centre is situated in the green belt of Boskruin in the north of Johannesburg, near to the beautiful Boschkop Nature Reserve. Offering a tranquil and picturesque environment, it is ideal for those in need of a safe space in which to heal, grow and recover. The residence is nestled peacefully in a lush, leafy garden setting that makes it easy to feel far from the hustle, bustle and worries of Joburg. This exclusion from the triggers and pressures of everyday life provides patients the ideal respite needed to begin their road to recovery. The privacy of the home ensures discretion and a restorative, secluded environment that is so crucial to the rehabilitation process. The double story villa can accommodate 19 patients in comfort with access to lovely recreational spaces and ample counselling and group areas to ensure all therapeutic activities are carried out in bright and functional quarters conducive to the recovery process.

Accommodation includes 7 standard and 5 en-suite bedrooms. Recreational zones allow patients to enjoy their downtime on the patio, in the garden or outside gym area and of course the spacious dining room doubles up as a recreation space in which to unwind. Our staff is on call with facilities that include a nurse’s office and 2 counselling rooms.

Security is important to us and the facility is surrounded by an electric fence linked to armed response, complete with an alarm system and panic buttons. It is also patrolled at night by a security guard with paramedic training.

Find yourself. Find your way. Find us at 71 C.R. Swart Drive Boskruin.

Call for free assessment: 0748951043

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In Case of Anxiety: Male Anxiety - an opinion piece by Jon Patrick Hatcher 11 Oct 2021

I’m not a “man’s man”: I don’t look or sound tough. My only gun is for caulking my shower. Plus I have anxiety, hereto named “manxiety.”

My life is a dichotomy in that I’ve spent years in taekwondo, love football and rodeos, but have an affinity for frozen yogurt, and watching Netflix with merlot and soy vanilla candles next to my cats, Thelma and Louise.

I attribute my temperament to genes and California hippie tap water.

The origins of personal traits, including anxiety, can be genetic, environmental, or inadvertently “seed-planted” by parenting. Male anxiety, or manxiety, can be contagious if you’re around it long enough. I should know.

My dad, a virile victim of indecisiveness, often had me second-guessing my own life choices, or not making one at all. To this day, I’m often paralyzed by an Applebee’s lunch menu or yellow traffic light.

Men are stalwarts of resolve… until we’re not We recognize that our cars and lawnmowers need tune-ups and diagnostic tests, but we rarely wash our feet in the shower, let alone visit a physician for our own checkups — especially for anything regarding the brain.

If you’re a man with anxiety, however, the norms become skewed and irrational.

I grew up a hypochondriac. I visited the hospital countless times per year while my parents spent innumerable sums on deductibles and copays.

What I thought was testicular cancer was an inguinal hernia from doing deadlifts. What I was certain was genital herpes was ingrown hair. What I feared was Lyme disease was an allergic reaction to grass. And what I accepted as a heart attack turned out to be… anxiety.

Only twice did I not go to a hospital when I should have.

The first was at 18 while having intense chest pains and labored breathing because I had unknowingly collapsed a lung. In my defense, I thought it was heartburn.

The second was when I intermittently peed blood over a 10-month stint.

The only thing worse than my fear of potential hospice was the anxiety of a pending appointment to put a camera up my urethra.

Consequently, I settled on platinum-level denial until I landed in surgery and chemo. Ignorance is a prickly muse. With chronic male anxiety, it’s torturous to determine what warrants an ER visit versus antacids.

And when it came to my mental health, I handled it like most men: denial, distraction, and drugs. In that order.

Most men with anxiety don’t accept it as the reason for their angst Denial and distraction might be why so many men walk around with addiction. In the absence of knowing any healthier coping mechanisms to life’s stressors, or a willingness to seek help regarding anxiety, we plug the holes however we can.

But if you treated any other disorder by ignoring or avoiding it, the outcome would be similarly grim. You can ignore asthma and diabetes for a while too. But every disorder has its dues.

My first coping tactic for anxiety was denial, lest I appear weak and vulnerable among my peers.

“While some may consider this a stereotype — that men do not seek help for mental health issues — it is statistically correct… men are much more stigmatized by any admission of a psychiatric illness and are much less likely to seek treatment,” says Dr. Sammie LaMont Moss, a psychiatrist with Kaiser Permanente in Denver, Colorado.

This is particularly troublesome as depression and anxiety in men are more likelyTrusted Source to manifest in substance misuse and suicidal behavior.

“We often see in the clinical setting that an attempt to address anxiety can manifest in different ways. For example, men will turn to substances like alcohol or cannabis for some immediate relief, which can cause long-term, harmful effects,” explains Moss.

How anxiety presents in men

I’m an exceptionally kind and empathetic guy, but anxiety makes me irritable and angry. If I’m forced to socially interact or deal with a rude stranger, I become a chupacabra with a flashpoint of Aqua Net. I try to determine when I’m feeling anxious before it defaults to a villainous persona.

But distinguishing between anxiety and moodiness can be difficult.

“Due to the social pressure that men experience based on the unwritten rule that men are to be strong and in control at all times, anxiety is not easily identifiable in men, even if that man’s anxiety has reached overwhelming levels” says San Diego psychologist and singer-songwriter Dr. Bruce Thiessen.

“Many of the symptoms may express [physically] in the form of medical problems or conditions, such as ulcers, back pain, hypertension, and the like,” Thiessen says.

Chicago-based clinical psychologist and founder of the LEAP Center for Anxiety, Dr. Dustin Siegel, agrees.

“A lot of men have been told their whole lives to ‘man up’ or ‘be tough.’ It’s hard for many men to talk to someone else about their vulnerabilities, and one of the paradoxical truths about mental health is that the more a person — male or female — tries to bottle up their feelings, the more likely they are to develop a problem,” Siegel says.

If I simply ignored my feelings of angst, I could pretend anxiety didn’t exist for me. And when denying anxiety exacerbated problems, I turned to distraction, which also avoids addressing the core issue.

*How does chronic anxiety differ in men? *

“The most obvious signs of male anxiety are the physical ones,” says Dr. Lindsay Israel, psychiatrist and chief medical officer at Success TMS.

“Men might find themselves going to the emergency room or their primary care [doctor] with complaints of chest pain, fearful they’re having a heart attack,” she says.

Israel goes on to say, “Men are more likely to develop severe symptoms of anxiety and possibly develop an additional depressive disorder due to the lack of treatment intervention.”

Thiessen confirms this assertion.

“Men are also more likely to become aggressive and to develop problems in their relationships due to dysfunctional ways of expressing their anxiety,” he adds. “Many men turn to drugs, alcohol, gambling, and personally destructive sexual addictions to relieve chronic stress through escape.”

In my case, I wielded distraction-like artillery over my physical well-being. I overtrained in the gym, overran the trails, and overswam in the lap pool. But I also overimbibed alcohol.

I would later harm-reduce to cannabis edibles, tinctures, and vapes. And on a few occasions, I casually overdid those too.

So, what to do with all this ‘manxiety’? Men are historically hailed as fixers. It’s important to note that the acute stress that prompts us to do our taxes or flee a K-pop mob is healthy. Once anxiety becomes long-term or chronic, however, it can be detrimental to one’s physical and mental health.

“One of the best ways for men to become comfortable with accepting that he has a mental health issue is to speak to other people,” Moss says.

“Quite often a man will be surprised to learn how many other people are [being challenged by] similar difficulties. Finding out that you’re not alone can go a long way to help normalize what you’re experiencing,” Moss adds.

Anxiety doesn’t always love company, but it needs perspective.

Thiessen upholds this tenant.

“Men need to feel accepted, and not judged, for showing both strength and [vulnerability]. Society might judge them, mental health [professionals] will not,” he says.

In almost every instance when I’ve revealed my anxiety challenges to another man, he’s replied in commiseration with his own. It’s indicative of the ratio and cross-section of some men who silently endure anxiety.

You don’t need a panic room; you need a panic plan

There are simple and clinically effective things men can do to lower their anxiety:

• Talk with your primary care physician Your doc could potentially prescribe medication or refer you to other specialists who can help.

“This is also an area where group therapy, segregated by gender, may help — particularly for men who are stigmatized and think they’re being seen as weak or as a victim. Learning what other men experience can help break that stigma,” Moss says.

• Download (and use) mental health apps Apps at the comfort of your palm are helpful for anything from interpreting your cat’s meows and fermenting mead in your man-shed to treating your anxiety while preserving your privacy.

Moss encourages his patients to leverage smartphone apps like Calm, Headspace, and myStrength.

• Therapeutic strategies Noninvasive approaches such as biofeedback and transcranial magnetic stimulation (TMS) are some effective anxiety treatment options.

So are medications typically prescribed for anxiety.

Many people leverage a combination of meds and clinical therapy.

“Typically, it’s not any one modality that targets these symptoms for a person, it’s more often a combination of various modalities that gives the most optimal results,” Israel says.

• Exercise “Exercise prevents an excessive buildup of (the hormone) cortisol in the body, while increasing levels of (chemical brain messengers) epinephrine and norepinephrine, neurotransmitters that modulate anxiety, and regulate mood and emotion, yielding a sense of peace of mind,” Thiessen explains.

Moss suggests also integrating healthy lifestyle choices, nutritious eating, and limiting substances like alcohol and cannabis.

More than just the “greatest hits” to contest manxiety, this is my own triage to maintaining a career, relationships, and a life largely unfettered by the cerebral minesweeper of anxiety.

Because there’s no place like “om.”

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How Social Media, Drugs, and the Changing Landscape of Sexuality Are Challenging Younger Generations’ Mental Health 17 Sep 2021

In an era of expanding sexual norms, legalization of marijuana, and lives lived online, today’s teens and young adults are facing a new set of life questions and stressors compared to previous generations — all amidst a global pandemic. This is how they're dealing.

When Simone Biles withdrew from the Tokyo Olympics gymnastics team finals in July, she catapulted a conversation into the mainstream that had been gaining steam like her run-ups to the vault: Even the most accomplished among us sometimes have to take a step back to take care of our mental health. And for people in the 24-year-old gold medalist’s age group who are living under pressures like no generation before, recognizing when you’re not okay and in need of support and self-care is more important than ever.

“Today’s adolescents and young adults are growing up in an age of anxiety,” says Patrice Harris, MD, a psychiatrist and Everyday Health's medical editor in chief at large. "They're living in an age of active shooter drills at school, bullying, ‘fear of missing out,’ and success measured by the number of likes — along with pressure, often from peers — that comes with social media use. And when your peers are not just your classmates, but millions of people, as with Olympians, there's even greater pressure."

Today’s adolescents and young adults are growing up in an age of anxiety. — Patrice Harris, MD

Indeed while the pressures of being the gymnastics GOAT are largely in a category of their own (Biles told Hota Kotb on Today that the sexual abuse she and hundreds of others suffered under former USA Gymnastics team doctor Larry Nassar may have been a trigger during the Games), today’s teens and young adults ages 16 to 26 don’t have to be in the international spotlight to experience a new set of stressors beyond previous generations’ traditional expectations to succeed in sports, academics, performing arts, and careers.

This group, ranging from the youngest millennials (starting at age 24) to Generation Z (up to age 24), is coming of age in an era of tumultuous sociopolitical issues — including constant pandemic uncertainty, gun violence, climate change, rapidly shifting social norms, and a reckoning with systemic racism and sexual assault — that are proven to take a toll on mental health, according to the American Psychological Association’s (APA) “Stress in America: Generation Z” report. As a result, symptoms of anxiety and depression in this generation are on the rise and have been reported by more than half of 18- to 29-year-olds, as reported in the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report in April 2021.

Particularly with the surge of symptoms in this demographic, it’s important that they get support as soon as they start to struggle. And with Biles and fellow superstar athletes like Naomi Osaka and Michael Phelps sharing their stories on the world stage, understanding of the issues grows. “It is important that we raise the level of awareness around mental health and increase our advocacy for equitable, accessible, available treatment opportunities,” Dr. Harris says. “I am hopeful that the awareness raised by Simone Biles, Naomi Osaka, and others will encourage people to seek help when they need it.”

One of the biggest differences between this and past generations is the ubiquitousness of social media in our lives. While today’s social media culture can provide a source of connection, it can also magnify everyday pressures for young adults.

“Youth are growing up under a microscope in a way that’s never happened before,” says Anne Marie Albano, PhD, a clinical psychologist and director of the Columbia University Clinic for Anxiety and Related Disorders in New York City who specializes in anxiety and mood disorders in children, adolescents, and young adults. “From birth, parents are sharing pictures and videos of their kids on Instagram, YouTube, you name it. Kids’ lives are now public.”

The Pew Research Center reports that 48 percent of young adults ages 18 to 29 are online almost constantly, and a study published in Creative Education in July 2021 showed that gadget addiction among Gen Z can be a contributor to mental health issues. In addition, those who use social media often are more likely to be involved in cyber-bullying, which is linked to depression, self-harm, and suicidal thoughts, according to research published in 2019 by the APA in the Journal of Abnormal Psychology.

RELATED: Could You Be Addicted to the Internet? https://www.everydayhealth.com/internet-addiction/guide/

“There’s tremendous pressure on how kids appear to others on social media,” says Dr. Albano. “On one hand, they’ve got to be the coolest and get the most likes from their friends. At the same time, they have to balance not crossing a line for parents and other adults who are saying, ‘Colleges and future employers will see what you post on TikTok.’” This all adds up to a stressful and confusing picture to navigate for an age group that’s already grappling with other pressures such as exploring their identities.

RELATED: 5 Tips for Kick-Starting a ‘Mindful Tech’ Self-Care Habit https://www.everydayhealth.com/wellness/5-tips-for-kick-starting-a-mindful-tech-self-care-habit/

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Talking to children about their mental health - By SingleCare Team - Medically reviewed by Gerardo Sison, Pharm.D. 02 Jun 2021

As a parent, there are many things you need to help your kids with—and helping children learn to talk about their feelings and emotions is one of them.

Why is my child’s mental health important? Your child’s mental health is important because good mental health will help your child perform better in school, develop strong relationships, and grow into high-functioning adults. The skills children learn to manage their feelings as kids and teenagers will carry with them through their entire life.

What are some examples of mental illness in children? Examples of mental illness in children include anxiety, depression, oppositional defiant disorder (ODD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD).

It can be helpful to think of mental disorders in two categories: internalizing disorders and externalizing disorders.

Internalizing disorders primarily concern thoughts and feelings. Children experiencing internalizing disorders, like anxiety or depression, do not always show obvious symptoms that they are in trouble.

Externalizing disorders express themselves in specific behaviors. For example, children diagnosed with oppositional defiant disorder will become angry, refuse to listen to adult instructions, or act out toward others more often than other children their age. ADHD is another example of a disorder with clear, externalized symptoms.

talking to children about their mental health

What causes mental health issues in children? Among children ages 6 to 17, approximately 1 in 6 will experience at least one mental health disorder. There is no way to predict whether a child will experience mental illness, and no magic formula for preventing it. But experts agree that children who experience certain situations or events are more likely to develop mental problems. These situations or events are called risk factors.

Individual risk factors These risk factors are normal parts of adolescence but when combined with additional risk factors (or when extreme) may lead to mental disorders.

Examples of individual risk factors include:

• Low self-esteem
• Anxiety
• Poor concentration
• Poor social skills
• Insecure attachment
• Early puberty
• Family risk factors
• Family risk factors generally relate to the mental and emotional health of a child’s parents.

Examples of family risk factors include:

• Parental depression
• Parent-child conflict
• Poor parenting
• Negative family environment (may include substance abuse in parents)
• Child abuse/maltreatment

If any of these risk factors apply to you or your caregiving partner, help is available.

School, neighborhood, and community risk factors Events and situations outside of the home can trigger mental illness. Again, these factors aren’t uncommon and can be simply a part of growing up, but in some children, they are among the causes of mental health challenges.

Examples of social, neighborhood, and community risk factors include:

• Peer rejection
• Poor academic achievement
• Poverty
• Violence or stressful events in the community
• Violence or stressful events at school

If you are concerned about your child’s learning environment, speak to their teacher, counselor, or a school administrator.

When should I worry about my child’s mental health? Children’s mental health is as important as their physical health. Stay vigilant about both.

If your children are having mood swings, or changes in behavior that last more than a few weeks and that affect their ability to function, talk to your children’s healthcare provider.

How do I know if my child has mental health issues?

Common warning signs of mental health issues in children include:

• Changes in school performance
• Excessive worry or anxiety, for instance fighting to avoid bed or school
• Hyperactive behavior
• Frequent nightmares
• Frequent disobedience or aggression
• Frequent temper tantrums
• Self-harm
• Outbursts or extreme irritability
• Weight loss or gain
• Frequent stomach aches or headaches None of these issues are necessarily related to mental illness, so before you jump to any conclusion, have your child see a health professional.

How can I improve my child’s mental health? Experts say that an important element of positive mental health is a healthy lifestyle. That includes:

• Eating healthy, including plenty of fruits, vegetables, and lean proteins
• Getting exercise—at least 60 minutes a day
• Getting enough sleep—at least nine hours for kids 6 to 12, and at least eight hours for kids 13 and older
• Practicing meditation, mindfulness, or relaxation techniques
• Talking to your children about their mental health is important, too.

How should I talk to my child about their mental health? Like anything you do in life, talking about your feelings and emotions gets easier with practice. Don’t think of “talking about mental health” as an emergency measure. Make it part of your daily routine.

This effort starts with you. Be open about your own feelings with your children. If you are feeling sad or angry, explain to your child what’s making you feel the way you do. This way, children see that it’s okay to share negative emotions. If you hold all your feelings inside, your child will do the same. That’s not healthy for either of you.

Every day, ask at least one question about your children’s feelings, emotions, relationships, and other factors that play a role in their mental health. Don’t force them to tell you, just give them the chance to share. And pay attention to sudden changes in what they say, or how much they say. Drastic changes could be a warning sign that something is wrong.

Talking points for mental health issues Ask direct questions that invite your child to provide answers.

• Concern: Depression, frequent crying, seeming unusually down

• Question: “Have you been feeling sad lately?”

• Concern: Bullying, irritability, lack of friends

• Question: “Is anyone at school mean to you?”

• Concern: Anxiety, violence at school or in the community

• Question: “Do you ever feel afraid?”

• Concern: School performance

• Question: “What are your favourite classes? Are there any you don’t like?”

• Concern: Frequent nightmares

• Question: “Do you notice familiar places or people in your scary dreams?”

• Concern: Frequent temper tantrums

• Question: “Do you know why [EVENT] made you so angry?”

Here are some additional tips for talking to your children about mental health, especially if you have specific concerns.

Be age appropriate You can help children open up about their emotions by explaining and giving them communication tools that are right for them.

Preschool children are more likely to focus on what they can see. If they see you or a stranger getting angry, they’ll notice and may want to understand why. Similarly, showing an emoji or drawing may give them a way to share with you how they are feeling—rather than making them try to think up the correct word.

School-age children are trying to understand the world around them, and they ask a lot of questions. It is also common for school-age children to have fears about the safety of family and friends. Don’t dismiss their questions or concerns. Treat them seriously.

Teenagers are independent, and are more likely to seek out information on the Internet or from conversation with their friends, than to ask their parents. This is natural, but with something as important as mental health, there’s danger if they get the wrong information. It’s critical that you keep tabs on their feelings and emotions, so you can get them the right information at the right time.

Be honest about your own mental health Whether or not you have a diagnosed mental illness, everyone deals with feelings of anxiety, sadness, and confusion.

What you do to combat those feelings—whether it’s taking prescribed medication, jogging every morning, or doing 15 minutes meditation at bedtime—are actions your child surely knows about. Share the importance of maintaining mental health with your children, the same way you share the importance of brushing their teeth every day.

Make sure your child feels safe and comfortable If you are sensing warning signs from your children, or feel that you need to have a deeper conversation, make sure you have them at ease. Don’t surprise them or spring the conversation on them at an unexpected time (which will be easier if you have made a point to talk about mental health every day, not only when problems arise).

If your children react badly to what you have to say, then it’s time to back up the conversation rather than pushing them and making them feel uncomfortable. Explain why you are asking these questions, and why it’s important to talk.

Listen; don’t diagnose or treat At first, listen. Avoid the urge to label what your children are feeling, or to advance an opinion about what they should do. This could make them less likely to share in the future. And try not to react too strongly to what they say.

The most important thing you can do is get a full understanding of how your child is feeling. Then determine what the best next steps are, perhaps in consultation with your child’s healthcare provider.

If you feel your child needs to talk to a professional right away, or may need to in the future, give them information about the suicide/mental health Lifeline.

Creating a circle of mental health Given that suicide is the second-leading cause of death for children, adolescents, and young adults, it’s normal for a parent to worry about their child’s mental health. In fact, anxiety about your child’s mental health could end up affecting your mental health. Opening up with your child, and giving them a space to share their feelings every day, will ultimately be good for both of you. And it doesn’t have to stop when they turn 18; you can help support each other for the rest of your lives.

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Teenage Depression Facts: All You Need to Know - Psych Central 27 May 2021

Your teen years are full of significant changes. Physically, mentally, and socially — your brain, body, and environment are going through a major evolution.

You might feel bogged down from the demands of high school and college assignments piling up. Or you may feel sadness about transitioning to a more independent and unfamiliar life. Throw in a worldwide pandemic, and it’s no surprise that uneasy feelings are on the rise, as shown by recent teen depression statistics and research.

These changes can easily become overwhelming. Understandably, you might shut down, become irritable, or lose interest in the activities that previously made you light up.

While these responses are valid and usual, depression is a condition that’s much more serious than fleeting teen moodiness.

If negative emotions are keeping keep you from functioning like you usually do, or you’ve experienced a sense of hopelessness for more than 2 weeks, you might want to consider treatment for depression.

8 facts about teen depression

1. It’s more common than you might think Everyone goes through a rough patch or feels listless on occasion. But major depression is a leading cause of disability in the United States, and teens are becoming the most likely group to screen for symptoms of this mental health condition.

Data shows that depression affects high numbers of young people:

Data from the 2016 National Survey of Children’s Health showed that 3.2% of children ages 3 to 17 had a depression diagnosis. The frequency of depression diagnosis tends to increase as children enter their teen years. Around 3.2 million teens ages 12 to 17 had one major depressive episode in 2017. According to a 2021 Mental Health America (MHA) report, severe major depression has increased in youth to 9.7%. This is an increase from 9.2% in 2020. The 2021 MHA report also states that youth ages 11 to 17 were the most likely age group to score in the moderate-to-severe depression categories when screened for mental health conditions.

The symptoms of depression might be a bit different in teens and adults. You can read about the symptoms of depression in teens here.

2. Depression rates are higher in females and gender minority teens While depression can affect teens of any sex and gender identity, a study published by the JAMA NetworkTrusted Source found that by 15 years old, females were twice as likely to have experienced episodic depression than males.

When comparing male and female depression rates, depression continues to present at a higher rate in females than males from the teen years into adulthood.

Also, according to the National Institute of Mental Health, risk factors leading to depression are highest among adolescents and young adults who identify with a gender minority, such as transgender, genderqueer, and nonbinary.

3. Teens with two or more racial or ethnic identities report the highest rates of depression Your teen years are often called the “coming-of-age” era for a reason. You’re discovering, questioning, and deciding many aspects of your identity, including what your cultural, racial, and ethnic identity means in your life.

This, coupled with societal pressures and prejudices, can reasonably leave you feeling stressed and emotionally shaken up.

Teens ages 12 to 17 years old with more than one racial identity are the most at-risk racial or ethnic group to report a major depressive episode, according to data published by Substance Abuse and Mental Health Services in 2017.

4. LGBTQ+ teens are at greater risk for depression Recent research shows that sexual identity can impact rates of depression among teens. The Centers for Disease Control and Prevention (CDC)Trusted Source reports that lesbian, gay, and bisexual youth are at a higher risk for depression, suicide, and substance use.

But factors like supportive parents and an accepting atmosphere at school can also decrease the risk of depression in LGBTQ+ adolescents.

5. Most teens with depression are not receiving treatment Depression is not a weakness, and you should never feel ashamed of a depression diagnosis. While major depression is a widespread mental health condition, it still requires attention and professional treatment.

You may be tempted to ignore your negative feelings and symptoms associated with depression, but a consistent treatment plan is vital for depression management.

Left untreated, depression has a higher chance of recurring throughout your lifetime.

According to the MHA, the majority of adolescents with depression — 60% — did not receive treatment for their major depression from 2017 to 2018. Further, more than two-thirds of adolescents diagnosed with depression did not continue with consistent treatment.

6. COVID has increased depression and uncertainty in teens As if the normal stressors and changes happening during your teen years weren’t enough, for many, the pandemic has upended any remaining sense of normalcy and routine as well.

Quarantine, loss of social interactions, illness, fear of illness, the loss of loved ones, and financial distress are only some of the compounding and life-altering stressors that teens have faced since March 2020.

These changes have had a lasting physical and psychological impact on U.S. society. According to teen depression statistics in the Stress in America 2020 survey, Generation Z teens and young adults ages 13 to 23 years old have reported increased uncertainty and depression symptoms.

For all ages, loneliness and isolation trended as the top reason for uncertainty and mental health conditions during the pandemic.

7. There’s no single cause of depression Depression often brings deeply negative or apathetic feelings, but it’s important to remember that these emotions do not reflect any character flaws.

In fact, depression often stems from events outside of your control, such as:

• early childhood trauma
• genetics
• a major life crisis
• Depression can also accompany or become exacerbated by existing medical conditions.

These include:

• poor sleep
• chronic pain
• anxiety
• attention deficit hyperactivity disorder
• substance use disorder Of course, depression can also develop without a specific triggering event or preexisting condition, just as it can result from numerous sources. Exploring the causes of your depression with a professional can help you determine the most effective treatment plan.

8. There are many types of depression If you feel depressed, it does not automatically mean you have a depressive disorder. Depression may be a symptom of another physical or psychological medical condition.

Depression could also be a natural response to a major stressor and does not indicate that you’ll need to prepare to live with recurring depression.

Some types of depression include:

• major depressive disorder (MDD)
• seasonal depression
• peripartum depression
• postpartum depression
• persistent depressive disorder
• premenstrual dysphoric disorder No matter what form your depression takes, it’s important to work with a medical professional to identify the type of depression you are experiencing and, ultimately, develop a treatment plan tailored to your needs.

Treatment for depression When you’re already managing the challenging emotions associated with depression, acknowledging the condition and opening up to someone can feel difficult. But overcoming this hurdle is the first task to getting proper treatment.

Let a parent or guardian know about the depression symptoms you’ve been experiencing so you can ultimately get an appointment with a medical professional.

A doctor can talk with you about medical conditions that mimic depressive symptoms or refer you to a psychologist, psychiatrist, counselor, or therapist to help with a depressive disorder.

Treatment for depression might include psychotherapy, medications, or a combination of the two, depending on what works best for you.

Want to know more? You can read all about treatments for depression here.

Next steps If you’re having trouble finding the right words to communicate your symptoms, try taking a screening tool, such as this one on the Mental Health America website, or contact SADAG.

A screening tool will help you personally evaluate the severity of your symptoms and provide the terminology to describe your symptoms to a parent or medical professional.

Remember, depression is extremely common and becoming more widespread as the pandemic shakes up our society’s usual structure. But you don’t have to live with depression symptoms without support. Reaching out to an adult for assistance with depression during your teen years can reap a lifetime of benefit.

Medically reviewed by Nicole Washington, DO, MPH — Written by Madelyn Brown on May 9, 2021

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What Are the Signs and Symptoms of Substance Use Disorder? 15 Apr 2021

Symptoms of substance use disorder vary widely from person to person and may include physical, psychological, or behavioral signs.

_ If you feel as if you or someone close is frequently using a substance like alcohol, tobacco, or opioids in a way that affects you or others negatively, you may be worried that you (or they) have developed a substance use disorder (SUD). _

SUD is a complex and challenging condition that affects nearly 21 million people in the United States. That’s more than the number of people with any cancer combined.

While misconceptions surrounding substance use may lead you to believe that the condition is caused by a person’s behavior or lack of willpower, it’s important to keep in mind that that’s untrue. Biological factors beyond a person’s control play a major role.

Activation of the brain’s reward center is the primary reason for most addictions. Whether the SUD is due to alcohol, stimulants, or opioids, the rewarding feeling gained from use — involving an abnormally high dopamine release — is often overpowering.

Continued use of the substance may lead to changes in the brain’s structure and function. This can result in intense cravings, withdrawal symptoms, learning and memory problems, and personality changes.

Learning to recognize the signs and symptoms of substance use disorder can be the first step toward seeking help and receiving treatment.

Types of substance use disorder Substances for which an individual can form a substance use disorder include:

• alcohol
• cannabis
• hallucinogens, including LSD and phencyclidine
• inhalants
• opioids, such as heroin or prescription medications
• sedatives, hypnotics (sleep-inducing medications), or anxiolytics (anti-anxiety medications)
• stimulants like amphetamines or cocaine
• tobacco

Dependence on two or more substances is common. For example, evidence suggests that among people with heroin use disorder: over 66% are also dependent on nicotine nearly 25% have alcohol use disorder over 20% have cocaine use disorder

Similarly, among those with cocaine use disorder: nearly 60% have alcohol use disorder about 48% are dependent on nicotine over 21% have cannabis use disorder

Signs and symptoms of substance use disorder Signs and symptoms of substance use vary widely from person to person and depend on the substance, length and severity of use, and an individual’s personality. Below are some of the general symptoms of substance use.

Physical signs of substance use disorder - sudden weight loss or gain - pupils that are smaller or larger than usual - bloodshot eyes - changes in appetite and sleeping patterns - slurred speech - impaired coordination or tremors - deterioration of physical appearance or changes in grooming practices - runny nose - unusual odors on breath, body, or clothes

Psychological signs of substance use disorder - feeling paranoid, anxious, or fearful - unexplained change in personality - feeling “spaced out” - lack of motivation - feeling excessively tired - periods of excessive energy, mental instability, or restlessness - sudden changes in mood - increased agitation or anger - Behavioral signs of substance use disorder - beginning to act in a secretive or suspicious way - experiencing problems in relationships due to the condition - using more than originally intended (being unable to control the substance use) - neglecting family and friendships, as well as duties at home, school, or work - getting into legal trouble, including driving under the influence, fights, or accidents - suddenly changing hobbies, friends, or activities - using the substance under conditions that may not be safe, such as sex without a condom or other barrier method, driving under the influence, or using syringes that are not sterile - experiencing sudden unexplained financial problems, which may include frequently asking for money or stealing - frequently trying to avoid or relieve withdrawal symptoms - experiencing increased tolerance for the substance, which may cause the person to use more and more of it noticing that life revolves around substance use and recovering from use, e.g., always thinking about using or consumed with how to get more - no longer engaging in previously enjoyed activities due to substance use - continuing to use despite negative health consequences

How is substance use disorder diagnosed? To assess a person’s risk for SUD, a healthcare professional may begin with a short screening. This may then be followed by a comprehensive evaluation and a referral to a licensed alcohol and drug counselor, psychologist, or psychiatrist.

One commonly used short screening for substance use is the UNCOPE questionnaire.

Although it was originally developed based on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-4), research shows that it may also help identify SUD based on the fifth edition (DSM-5).

The UNCOPE screening asks the following questions:

• Have you continued to use alcohol or drugs longer than you originally planned?
• Have you ever neglected some of your usual responsibilities because of your substance use?
• Have you ever wanted to cut back or quit using the substance but could not?
• Has a loved one or anyone else ever told you they objected to your alcohol or drug use?
• Have you ever found yourself preoccupied with the thought of using alcohol or drugs?
• Have you ever used alcohol or drugs to soothe emotional pain, such as sadness, anger, or boredom?

For a more comprehensive evaluation and to diagnose substance use disorder, most clinicians rely on the following 11 criteria published in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):

• feeling as if you have to consume the substance regularly (daily or several times a day) and more than originally planned
• spending a large portion of your time finding, using, and/or recovering from the substance
• craving the substance
• needing more of the substance to get the same effect
• experiencing withdrawal when you stop taking the substance
• being unable to meet obligations at home, work, or school because of using the substance
• recurring thoughts of quitting but not managing to quit successfully
• continuing to use despite the problems it causes in relationships
• continuing to use despite mental or physical health problems caused or worsened by it
• giving up or cutting back on social or recreational activities due to the substance use
• using the substance under situations that may be unsafe, such as driving under the influence or using syringes that are not sterile
• A substance use disorder can be considered mild, moderate, or severe based on the number of symptoms a person exhibits within a 12-month period.

According to the DSM-5, a person must have the following number of symptoms outlined above to be diagnosed with mild, moderate, or severe SUD:

• Mild: 2–3 symptoms
• Moderate: 4–5 symptoms
• Severe: 6 or more symptoms

Dual diagnosis Diagnosis is also more complex for people with both a substance use disorder and a mental health condition — known as a dual diagnosis. That’s because it’s often difficult to disentangle overlapping symptoms, such as withdrawal and mental illness symptoms.

In 2019, 9.5 million adults in the United States lived with both mental illness and a substance use disorder, according to the National Survey on Drug Use and Health.

People with a dual diagnosis often have symptoms that are more severe, persistent, and resistant to treatment than those with an SUD alone.

Next steps Signs and symptoms of substance use disorder vary from person to person. The most noticeable signs include:

• disinterest in school, work, or other activities
• physical health issues like bloodshot eyes, lack of energy, or weight loss or gain
• lack of interest in grooming or keeping clean
• behavioral changes like acting in a secretive manner, increased irritability or changes in mood, or being fearful or - - paranoid
• financial problems Recognizing these signs and symptoms may be the first step toward recovery.

_ If you suspect that you or someone you love has a substance use disorder, consider reaching out to a trusted healthcare professional for an evaluation. Together, you can develop the right treatment plan for you._

If you’re not quite ready to see a healthcare professional yet or you’re looking for more information, maybe check out the organizations below, which offer additional resources and support groups:

SADAG - https://www.sadag.org www.findHelp.co.za The Substance Abuse and Mental Health Services and Administration’s (SAMHSA) national helpline is a free and confidential 24-hour referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders. Alcoholics Anonymous and Narcotics Anonymous are well-known 12-step groups for individuals recovering from alcohol or drug addiction.

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IF WE WANT TO END MENTAL HEALTH STIGMA IT WILL TAKE MORE THEN JUST.. TALKING... 06 Apr 2021

Brave conversations need to happen — but we need to think bigger if we want to end stigma for good.

I remember the first time I expressed a desire to go to therapy. I was 17 years old, unknowingly struggling with obsessive-compulsive disorder (OCD).

The anxiety I was living with tormented me, but I was still terrified to ask for help.

When I finally found the courage to tell my parents I needed support, their response was less than stellar. “That’s family business,” they said, aghast.

The shame was written all over their faces. They rejected the idea that their son might need professional help — and I quickly internalized that shame, too.

It would take another year, tormented by my condition, before I would finally get the help I so badly needed.

Why are mental health issues so stigmatized? Stories like mine are far from unique.

More than half of Americans with a mental health condition still remain untreated, impacted by a deep societal stigma that leaves us reluctant to reach out.

The impact on those already struggling is undeniable.

According to the American Psychiatric Association (APA), stigma results in reduced hope, lower self-esteem, increased symptoms, difficulties at work, and a lower likelihood of maintaining your treatment plan.

So where does this stigma come from? Attitudes around mental illness are still reinforced in our culture and media.

People with mental illnesses — especially those with less understood conditions, like bipolar disorder and schizophrenia — are still widely believed to be dangerous, untrustworthy, and incompetent, despite experience and evidence showing this is rarely the case.

In fact, people with schizophrenia are more likely to be the victim of violence, rather than the perpetrator.

Still, being labeled “crazy” by what feels like much of society can feel like a shameful burden that few are willing to take on.

Even the jokes we make — like calling ourselves “so OCD” when we wash our hands or “bipolar” when our moods shift — lead to others taking these disorders less seriously.

This stigma is intensified further for historically marginalized groups — like people of color, women, and LGBTQIA+ people — who have traditionally been depicted as “crazy” or “unstable” due to prejudice, increasing their mistrust of the mental health system.

This is a system that frequently misdiagnoses vulnerable communities because of these same prejudices.

The consequences of stigma are far-reaching, too. Research has shownTrusted Source that discrimination in the workplace, housing, healthcare, and more can be connected to mental health stigma.

How do we reduce stigma? There’s a far-reaching assumption that simply talking about mental health is enough to reduce stigma. However, recent researchTrusted Source suggests that the effectiveness of these campaigns is actually very limited — more must be done.

To truly break down stigma, it has to be addressed at multiple levels:

Systemic change. Discrimination is still an everyday reality for those with disabilities, including psychiatric disabilities. There’s a high correlation between stigma and structural inequality. To truly address stigma, the rights and dignity of people with disabilities have to be meaningfully addressed in education, housing, the workplace, and healthcare, including increased access to treatment. Research and funding. To better understand mental health and illness, more research is needed to increase our knowledge about these conditions and to improve the effectiveness of our interventions, as well as funding to make treatment more accessible.

Media interventions. Media, including television and film, can be a huge accelerant of stigma. Media must be challenged to handle topics of mental health and illness more responsibly to reduce stigma. Mental health literacy. Simply being “aware” of mental health isn’t enough to address stigma. People must be empowered to take command over their own mental health, like knowing where to access help and how to advocate for themselves.

Increased awareness. For many people, there’s still mystery about what mental healthcare really is or looks like. By becoming more active and visible in their communities, healthcare practitioners can reduce a possible fear of the unknown. For communities with a history of mistrust in the healthcare system, seeing a healthcare professional who looks like them and is from the same community can be beneficial. While talking about mental health is a great starting place, more will be needed to truly better the lives of those with mental health conditions.

Common myths about mental health conditions While stigma won’t change overnight, it’s still true that change begins with us. This starts by addressing our own attitudes about mental health.

Below are some common myths that still exist today:

Mental illness is just an excuse for poor behavior Mental illnesses aren’t chosen — and they certainly aren’t an excuse for someone’s behavior.

They’re complex conditions that result from biological, genetic, and environmental factors.

Only a certain kind of person ends up with a mental illness Mental health conditions touch every single community.

Chances are, you already know someone who lives with a mental health condition. Mental illness doesn’t affect a certain kind of person — it can affect anyone.

You could snap out of it if you tried hard enough If we could snap out of it, most of us would, gladly. These conditions are much more complicated than that, though.

Most people with a mental health condition will benefit immensely from some combination of therapy, medication, and community support. This is why it’s crucial that we support people seeking the help they need.

Mental illness is a private issue that shouldn’t be talked about Everyone will have a different relationship to their health journey. Some will choose to keep their mental health issues private; others will find it empowering to share their story.

There’s no right or wrong way to talk about your mental health.

Mental illness can be completely cured While many people will see improvements in their mental health, and some may make a full recovery, most mental health conditions can’t actually be cured. They’re chronic conditions to be managed with the right support.

What’s next? Since my teen years, I’ve had the privilege of accessing therapy and medication for my OCD. It’s made an enormous difference — as it has for many people living with mental health conditions.

While stigma won’t change overnight, that change begins with brave conversations.

More than just talking about mental health, we need to examine what changes have to happen to make mental health accessible to all.

As I approach my 30th birthday, I’m immensely grateful that so many people are opening their hearts and minds to these conversations.

Far from being “family business” or a personal issue, mental health is our collective business and responsibility. Each and every person deserves mental health. And we deserve to live in a world where people with mental health conditions feel safe, supported, and affirmed.

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What Is a Personality Disorder? - Psych Central 10 Mar 2021

You are unique. And this, no doubt, is mostly to your merit — but it’s also a result of where you’ve been, what you’ve experienced, and who you’ve experienced it with.

This unique character — which comes from a combination of external factors, behaviors, thoughts, and emotions — makes up your personality. It embraces how you, as an individual, see and relate to yourself and others.

Sometimes, some of these behaviors, thoughts, and emotions can cause you a great deal of distress that negatively impacts the way you function in the world. When this happens for a long time — and repeatedly — mental health professionals call it a personality disorder.

What are personality disorders? Your personality helps you function in life, with all the challenges that might usually come up. This means that even if you go through painful or stressful situations, you’ll have a strong chance to overcome them and move on.

How you cope with hardship may be different from how somebody else does. We all have our own ways of getting through, and that depends greatly on our dominant personality traits.

For example, you may be, among other things, patient, resilient, and persistent. These personality traits may help you overcome losing a job and become motivated to find a new and better one.

They’ll help you bounce back from your initial feelings of disappointment and devote time to finding another position. Even if you know it might not happen overnight, you stay motivated.

You may also reflect on the circumstances that led you here, assume responsibility (if any), and take note of the lessons learned.

If you have a personality disorder, though, this isn’t the case.

With a personality disorder, you typically experience emotions and thoughts that diminish your ability to:

-face and adapt to stress

-connect and bond with other people

-effectively solve problems

For example, if you have a personality disorder, your reaction to losing a job might be blaming your co-workers for the dismissal and getting into a fight with your boss. You might not realize how some of your behaviors might have led you to face these difficulties.

Now, it’s true that people who aren’t living with a personality disorder could have this same reaction. We all may feel angry, emotional, and paranoid at times.

But if you cope with stress in a similar way every time, and these traits are causing ongoing problems in your life, a mental health professional may reach the diagnosis of a personality disorder.

In other words, most people might recognize in themselves a few traits from a personality disorder.

But to actually receive the diagnosis, you would have to show all or almost all of the traits that characterize that disorder. Also, these traits would cause you a great deal of distress and problems in your life.

Not all personality disorders have the same symptoms and dominant traits. Something they all have in common, though, is that people with the disorder experience difficulties responding to the demands of life.

These difficulties affect:

-relationships

-work performance

-views of the world

-inner experiences

This isn’t a personal choice. Personality disorders are the result of many factors that have influenced your life, including:

-genetic inheritance

-biological processes

-learning development

-cultural experiences

-traumatic situations

-childhood relationships

There’s no one cause for personality disorders. And it’s not clear why not everyone reacts the same way to the same external and internal factors.

This is why experts believe the cause might be a specific combination of all of the above.

How are personality disorders diagnosed? Personality disorders are mental health conditions. That means only a trained mental health professional can make a proper diagnosis.

To do this, they’ll follow established guidelines for mental health.

The guidelines to diagnose a personality disorder typically come from the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. This handbook contains definitions, symptoms, and diagnostic criteria for most mental health conditions.

To make a diagnosis, a mental health professional will want to learn about your personal and medical history and assess your thoughts, emotions, and behaviors. Then, they will compare these observations to the criteria established by the latest edition of the DSM — currently the fifth edition (DSM-5).

Specifically, the five criteria that must be met to make a personality disorder diagnosis are:

1. Impairments These are difficulties you experience in how you see and relate to yourself (identity and self-esteem) and how you connect to other people (intimacy).

In other words, this refers to recurrent thoughts, emotions, and behaviors that might be hurtful to yourself and others.

2. Pathological personality traits To make a diagnosis, a mental health professional will look for a long-standing pattern of pathological traits.

These are traits that once and again make it difficult for you to interact with others or adapt to change. Or they may be traits that are not expected or accepted in your culture.

3. Duration and flexibility To be considered a personality disorder, these impairments and pathological personality traits must be stable, inflexible, and consistent throughout your life.

In other words, you’ve experienced these difficulties and responses for a long time and repeatedly across different situations.

4. Independent of culture or developmental stage This means that the specific behaviors and thoughts your therapist is looking at can’t be explained by your cultural customs or by the capabilities and needs of your age.

For example, an impulsivity trait in an adolescent is almost expected in some circumstances. But if you’re in your 40s, this same impulsivity might be assessed differently.

5. Not related to external factors A mental health professional will want to make sure that these behaviors, emotions, and thoughts aren’t a result of a substance you may be taking or a general medical condition or injury you’ve sustained.

In sum, if these five requirements are met, a mental health professional will move to diagnose you with a personality disorder.

Since there are 10 of them, that diagnosis will not be the same for everyone. It’ll depend on the specific impairments and personality traits that may be impacting your life the most.

Types of personality disorders The 10 personality disorders are classified into three groups, or clusters. These are based on the most representative emotional responses and behaviors:

-Cluster A: odd and eccentric

-Cluster B: dramatic, emotional, and erratic

-Cluster C: fearful and anxious

This is just an overview of all the types of personality disorders. Much more that goes into making a diagnosis than just observing a few behaviors.

Cluster A personality disorders Those with cluster A personality disorders have difficulty relating to other people and often behave in a way that others might consider odd or eccentric.

Paranoid personality disorder People diagnosed with paranoid personality disorder usually interpret other people’s behaviors as menacing or judgmental, even when this is not the case.

If you have this personality disorder, you’ll tend to perceive others around you as being deceitful, patronizing, or mean toward you. This might make you feel untrusting and angry all the time, leading you to have destructive outbursts and avoid developing close relationships.

Others may also perceive you as emotionally detached.

Schizotypal personality disorder A schizotypal personality disorder may lead you to feel very anxious in social situations and uncomfortable and awkward in close relationships. It may also be that you have an eccentric way of dressing and speaking, and others find you very peculiar.

People with this personality disorder may also have:

-paranoid ideas

-odd beliefs

-distorted thinking

For example, you may feel you can read other people’s minds, see into the future, or have close relationships with beings from another planet.

You may also dislike talking with other people and often talk to yourself.

Schizoid personality disorder Those diagnosed with schizoid personality disorder are usually shy, withdrawn, distant, and not socially responsive. They’re also usually very disinterested in others.

If you’ve been diagnosed with this personality disorder, you may find yourself absorbed in daydreaming and fantasizing a lot. These fantasies might be more interesting to you than what’s actually happening around you.

You may also actively withdraw from and lack interest in intimacy with other people, including close relatives. This might lead others to describe you as cold and detached.

Cluster B personality disorders Cluster B personality disorders usually evidence difficulty in controlling your own emotions and a tendency to act unpredictably.

Narcissistic personality disorder The most typical symptoms of narcissistic personality disorder (NPD) are:

-an inflated sense of self-importance

-a constant need for attention and praise

-a lack of empathy toward others

With NPD, you may feel superior to everyone else and often fantasize about unlimited beauty, power, money, and success. To earn these, you may feel it’s necessary to get other people out of the way by any means, without acknowledging their needs or feelings.

You might also be extremely sensitive to criticism and failure and experience intense variations in your mood.

Antisocial personality disorder Mental health professionals diagnose someone with antisocial personality disorder when there’s a persistent display of impulsive, reckless, and aggressive behaviors and no remorse about them.

These recurrent actions might come from:

-not realizing how your actions affect other people

-blaming others for what happens in your life

-constantly feeling overwhelmed and frustrated

-You may have a history of violent relationships, legal challenges, and even substance abuse if you have this personality disorder.

Borderline personality disorder You may experience constant and intense fluctuations in your mood if you have a borderline personality disorder (BPD). These changes in how you feel may also impact the way you think and feel about yourself.

You may also tend to think of others in black-and-white terms. You might think someone is perfect today, then not want to associate with them at all tomorrow.

This tendency to constantly feel disappointed in people might also lead you to experience feelings of emptiness and despair.

If you’ve developed BPD, you may also hate being alone and fear abandonment — which could lead you to use manipulation tactics such as self-mutilation, silent treatment, or suicidal warnings.

The term “borderline” is considered controversial because it has been misused to judge or discriminate against groups of people. We refer to this term here as a clinical diagnosis established by the DSM-5 and not as a judgment.

Histrionic personality disorder Someone with histrionic personality disorder (HPD) feels they need to be the center of attention in all situations. This may lead to overdramatic behaviors that others might perceive as odd and inappropriate.

If you live with HPD, you may feel anxious and frustrated if others ignore you or give more attention to someone else over you. You may also place a lot of importance on your physical appearance and modify it in a way that you feel will call more attention to you.

Cluster C personality disorders People with cluster C personality disorders usually live with strong feelings of anxiety, doubt, and fear.

Obsessive-compulsive personality disorder Obsessive-compulsive personality disorder is not the same as pbsessive-compulsive disorder (OCD). Someone with the personality disorder is likely not aware of their behavior, while someone with OCD realizes their obsessions and compulsions aren’t rational.

If you live with an obsessive-compulsive personality disorder, you may strive for perfection in all aspects of your life. To accomplish that, you might find yourself taking on way more than you can deal with, and you might feel no achievement is ever enough.

Other people might regard you as very reliable, tidy, and dependable, but also inflexible, stubborn, and strict. This may be because you usually have a hard time adapting to change or changing opinions.

You may also take a long time making any decision and completing tasks daily because you want everything to be perfect. When you can’t control the situation or things change around you, you might feel extremely anxious and vulnerable.

Dependent personality disorder Someone with a dependent personality disorder is usually submissive, letting other people assume control over their lives and decisions. There might also be a strong need for others to take care of you.

If you live with this personality disorder, you might have a hard time making decisions on your own. You’d rather ask for other people’s opinions or go with what they decide in every situation.

You may also find yourself extremely hurt if someone criticizes or rejects you.

You may be perceived as a “people pleaser” and could feel very anxious when you’re alone. You might not feel comfortable doing anything on your own.

You may also rely on your relationships and become depressed if one of them ends.

Avoidant personality disorder A diagnosis of avoidant personality disorder may mean you’re extremely fearful of rejection and abandonment. This could lead you to avoid almost all social activities and events, even when internally you wish you’d go.

With this personality disorder, you may also feel insecure around other people, worrying that you may say something silly or inappropriate. Sometimes, if placed in a situation where you have to interact with others, you may end up blushing, crying, and trembling.

People with this personality disorder feel the need to connect to others and establish close relationships, but they don’t because of their insecurities. This, in turn, makes them very upset.

TREATMENT FOR PERSONALITY DISORDERS Research shows that long-term psychotherapy is the most effective treatment for personality disorders. It may help you explore your thoughts and emotions and how these affect you and other people.

Therapy can also help you manage some of your symptoms so that you can cope with some situations more effectively.

In some instances, some symptoms might be treated with medications such as antidepressants. But this isn’t true for every personality disorder or every individual case.

Sometimes, your doctor might recommend including other health professionals in your treatment. They may also suggest your close relatives join you in a few therapy sessions, if you approve.

Because personality disorders all have different symptoms and triggers, they’re not all treated in the same way. The type of approach your doctor chooses will depend on your symptoms, their intensity, and your personal and medical history.

In general, psychotherapy for personality disorders will aim to:

-increase your ability to adapt to stress

-decrease or manage behaviors that might be causing you problems at work or in your relationships

-increase your ability to manage your moods

-reduce your distress

-help you understand your responsibility in stressful situations

These are just general objectives. When talking with your therapist, you’ll have the opportunity to participate in your treatment and set your own goals.

These are some of the most commonly used types of psychotherapy for personality disorders:

-cognitive behavioral therapy

-psychoanalytic therapy

-dialectical behavioral therapy

-schema therapy

Treatment for personality disorders is typically long term. It requires a strong commitment and persistence on your part. But you may experience relief and learn how to manage some emotions if you continue your treatment.

NEXT STEPS Even though there are five universal criteria to diagnose personality disorders, not all of them have the same symptoms.

More importantly, personality disorders are complex mental health conditions beyond a given set of behaviors and emotions. This is why only a trained professional is equipped to make a proper diagnosis.

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A Story of trying to feel.. your feelings - Margarita Tartakovsky, MS 19 Nov 2020

After my dad’s passing in August of ’09, I’d say that for the most part, I’m OK.

I go about my day just fine. Create a to-do list. Happily check items off. Take breaks. Go work out. Run errands. Hang with loved ones. And live life.

But sometimes the grief breaks through.

And I have to tell myself to save it because I can’t fall apart right now. I have things to do.

We’ve talked before on Weightless about the importance of feeling our feelings. That we emerge liberated, relieved and unstuck. Unburdened. The overwhelming release from your brain and body.

Because gripping on to those feelings can lead to unhealthy consequences, such as emotional eating or even a negative body image. We focus so much on shooing away our feelings that they arise in other ways. Maybe we nitpick at our bodies. Or we feel bloated, gross or unloveable.

But it’s really the tension of the bottled-up feelings, the unexpressed emotions. The body bashing and eating just facades.

We think that not feeling our feelings keeps us unscathed. It keeps the “ugliness” from coming up and doing further damage.

I can’t worry about my dad’s death because I have things to do, I say to myself. I have to interview experts, I have to write up articles, I have to get inspired, I have to catch up on email.

I’m sorry, papa, but I can’t think about your loss right now.

I have things to do. And I can’t fall apart right now. Not even a glimmer, not even a chard of glass can fall from my fortress. Because, then, well, then, the whole thing I’ve built up so diligently, so perfectly, will shatter.

Maya Stein, whose poems I absolutely love, recently wrote about the beauty of grief. To say that her poem is powerful is an understatement. (All her pieces are breathtaking.)

I wanted to share it with you because it illuminates the importance of feeling our feelings. It shows us that we can still be strong when releasing the pain. We can find strength in something so vulnerable.

Sure, this might be something we know. At least, intellectually.

But I know that I, at least, need the reminder from time to time.

(Please check out the entire poem here; I’ve left out a chunk of the first section.)

No one knows she cried her eyes out three days ago, sat in her desk chair and wept, unable to see the screen. No one knows how harshly she spoke to herself, flagellated her already fragile spirit, lay on her bed with her forearms pinching her eyelids flat, and made mad proclamations against her weak, fractured heart. No one knows the hours she’s devoted to circling her sadness like a vulture, the mileage she’s worn into her soles, walking the hills of her city in a series of unsuccessful attempts at forgetting.

…

She had convinced herself of her own ruin, a fault line splitting her body in two. Her lungs felt as thin as moth wings, and she was certain her bones had been worn brittle, stilts of a house helpless against a hurricane.

But this is the beauty of grief.

What she saw in the mirror was not the deep ravine left by loss, The war she was waging had not hollowed her cheeks or made an anarchy of her skin. Her lips had not unpinked from slaughter.

Instead, a pliancy and sheen had birthed from the rubble. The eyes looking back at her were bright as promises and it wasn’t the overhead light or the sudden April sun. Grief had lifted the rawness out of her, clutched at the throat of her darkness and pulled until it lay silent and sleeping at her feet, a feral dog fed and full, and what was left was neither muscle nor wound but horizon line, a ripe nothingness some fresh story beginning, etching her face clean.

I’m not sure I’ll ever come to terms with my dad’s passing. (Do people ever come to terms?)

The grief comes and goes.

Sometimes, it’s raw, just like it happened yesterday.

Sometimes, in the middle of doing something, I realize to my horror that my dad is gone.

Sometimes, I realize the horror of how accustomed to life I’ve gotten without my dad. That he could just be plucked from this earth, and I’ve managed to pick up the pieces.

How scary is that?

That someone so pivotal in my life, such a shining light, is gone, has dimmed – and I haven’t suffered a nervous breakdown. I haven’t fallen to the floor and stayed there, crying for days.

Part of it is my personality. I’ve always been introverted with my feelings. Kept quiet whether I was angry, frustrated, depressed or distraught.

Part of it is worry about the aftermath. I assume that this grief, this heavy, heavy grief, will ruin me. Lungs like moth wings, bones so brittle and a shaky foundation, bending to the weakest of winds.

Because let’s be honest, feeling your feelings is hard work. It’s hard to dig through the rubble, forest, flood and fire of feelings.

But it’s OK if it takes time. It’s OK if you’re not ready.

What I pay attention to are my thoughts and behaviors. Am I letting these feelings spark unhealthy behaviors? Am I eating to soothe my pain? Am I beating myself up as a result of bottling up these feelings? Am I doing something that doesn’t honor me? I ask myself these questions. And the answer has been no.

And for now, I’m OK with stopping there.

For now, that’s good enough.

For now, this is my fresh beginning and my cleansed face.

What helps you process your feelings? Do you think bottled up feelings can lead to unhealthy behaviors?

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Coping when your Child is diagnosed with a Mental Illness. 29 Jul 2020

As someone who has supported children who have mental illnesses, I have always been an advocate for their health and safety. Recently, through speaking with families, I found that many describe the experience of having a child with a mental health diagnosis as complicated and turbulent. Parenting a child with a mental illness can be an experience filled with helplessness, and often leads parents to question if what they are doing is right for their child.

The National Mental Health Association identifies that one in every five young people experiences difficulty with their mental health. And, a study of posts on internet forums found that a child’s mental illness impacts the entire family, with parents often struggling to cope. The most common concerns included feelings of hopelessness, seeking advice on how to cope and questions about their child’s diagnosis and medication.

Sara (name changed for anonymity), a mother adapting to supporting her daughter with generalized anxiety disorder (GAD), depression, and anorexia nervosa, shared her struggles with the Trauma and Mental Health Report (TMHR):

“My daughter was hospitalized for about a week because she couldn’t handle the stress of school, work, losing her boyfriend & her weight. She also had expressed thoughts about committing suicide. I unfortunately, didn’t know there was a problem until she admitted herself into the hospital for stress; she was hysterical and couldn’t stop crying and had trouble speaking. I did notice her being unhappy for weeks before but thought she was just being a normal teenager and was just moody. I thought she just didn’t want to speak with her “mommy”. She also was concerned with her weight and was dieting to lose a lot; I did take her to the doctor, but the doctor thought she was dieting responsibly and also she was eating all the food I was making. However, in hindsight, I didn’t realize she was vomiting afterwards.”

Adjusting to a child’s diagnosis can be difficult for parents as they are challenged with supporting their child through their struggles, while also managing their own mental health. Sara identified the entire process as full of personal confusion, helplessness, and self-doubt:

“I was devastated and confused when I found out. I didn’t understand how much my daughter needed the help, and I was very upset with myself that I didn’t notice sooner. I didn’t understand what was going on and was extremely worried that my daughter would have to be medicated and/or hospitalized in order for her to cope with her issues. I also did blame myself for not seeing the “signs” and thought as her mother I should have noticed there was a problem and should’ve acted earlier on her behalf.”

In an interview with the TMHR, Elizabeth Mazur, a researcher at Pennsylvania State University who studies family stress and coping as it relates to disability, mental health and parenting, described the impact of receiving a diagnosis:

“Parents have to adjust to the child having “good days” and “bad days,” and maybe mostly bad days. However, a diagnosis can also be a relief in that parents have an answer to what might have seemed as intractable problems of a child’s temperament. Also, with a diagnosis one can better seek treatment although the roadmap is not always as clear as parents (and professionals) might like.”

Several factors effect a person’s ability to cope. Counselling, stability, social support, adaptability, individual temperament, knowledge, and positive attachment can all help an individual cope with a stressful or overwhelming situation. Confiding in close others and increasing open communication with your family are also important. Sara stressed the importance of having access to therapy:

“I wanted to be strong for my daughter but felt I wasn’t a good mother and needed a lot of help and counselling too…I couldn’t have helped my daughter if I didn’t understand what was going on with my own mental health. Counselling would have helped us all. The whole family was in need of it and while we did receive some group counselling but afterwards it was just my daughter and myself attending the weekly sessions. I think it helped but I also believe that more should have been done by the doctors to help our family cope.”

Above all, Sara advises parents to reach out for help if needed:

“There are a lot of resources made available to parents and families; do not be afraid to advocate for yourself because your mental health is just as important, even if sometimes as a parent it doesn’t feel that way to you.”

-Jessica Ferrier, Contributing Writer

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The Surprising Intimacy of Therapy Phone Sessions - Daniela Gitlin 30 Jun 2020

I’ve been working remotely since the middle of March. While most of us seem to be using video chat programs such as Zoom, Facetime, or doxy.me, I find video so inferior to phone contact, I’m not using it at all in my practice. Surprisingly, all my clients have refused the video option too. Why?

Obvious reasons include not having access to the internet (common in our rural community); not owning a computer, tablet or smart phone (also common); not having the skills (the elderly, the tech challenged), or simply being too ill to manage being online.

A less obvious reason, but possibly more compelling, could be this. Clients make themselves vulnerable enough when they shower and dress to come in to see me in the neutral space of my office.

Video chat takes away that safe neutrality by visually letting me into their homes, which violates their privacy and arouses a variety of trust-undermining feelings, such as of shame, anxiety, and humiliation.

“It’s a mess! I don’t want you to see it,” one client admitted. Meanwhile, I’m able to work from my office (I’m the only one there), which means my personal privacy is protected while theirs isn’t. Seeing me in my personal space wouldn’t level the emotional playing field, though. It would only be another distraction, yet another challenge to keeping the focus of treatment on them.

Many of my clients don’t have access to a delegated private space in their homes. “I can’t even hide out in the bathroom, we only have the one, and someone will need it once I’m in there,” another said. Clients can’t do their work in session unless they’re assured it’s confidential, without risk of interruption, eavesdroppers, or intruders. I believe the camera asks too much of clients.

From my side, video-chat technology destroys the intimacy required to do our sensitive work. The position of the computer, tablet, or phone camera rarely allows for reliable eye contact, which makes us both feel unsettled and uneasy. The image of myself in the upper corner is distracting: every movement draws my eyes and attention away from the client. The same has to be true for them.

The countless distortions that are a function of the way video images are digitally encoded, decoded, and adjusted cause the image to freeze, blur, and drop, and worst of all, to be out of synch with the audio. These glitches and delays scramble subtle social cues and interfere with perceptual processing. We unceasingly, out of consciousness, strain to fill in the gaps. A full workday of that leaves me exhausted, anxious, and dissatisfied. Rather than feeling connected, I often feel the opposite: isolated and disconnected.

If we must have technology in session with us, the phone approximates live contact better. The rate of speech transmission is closer to live conversation and the fidelity of sound far higher, especially from a landline, which is what I use when calling clients. Because I’m deprived of visual cues, my hearing sharpens and my sensitivity increases to subtle nuances of speech rate, rhythm and tone; pauses; and—this is really helpful—the client’s breathing. There are many more moments during the session where all my available senses are fully engaged, and it’s the same for the client.

It’s true my mind wanders more but I use the usual self-management techniques to rein it back. That said, here’s a silver lining to phone work. Thinking requires looking in. In a live session, when a client is speaking and looking at me, I maintain eye contact unless they break it. If they do, that releases me to gaze inside to think. But I still have to keep my eyes on them so as not to miss their return. Phone work frees my eyes to do what they want (they tend to wander vaguely around the room), which lets me think while continuing to actively listen and engage with the client.

Here’s an example. Betsy, 65, works as the head of social work at a local nursing home. She’s been in treatment with me for over 25 years, initially to recover from her abusive marriage. As the years passed and layers peeled away, it became clear that the source of all her symptoms and interpersonal problems was childhood trauma. Four years ago, she had a disastrous affair with a man from work.

Breaking from him took two years and the struggle ripped away her usual defenses, allowing for new insights. Enter the pandemic and remote phone work.

It took a few sessions for the two of us to establish a working rhythm. In a way, it was like being with a new client. Much more frequently than I would in an in-person session, I mirrored, reviewed, and asked for confirmation that I understood what she was telling me. Then we had a real-time a-ha moment.

“So, wait,” I said into the phone, pausing to think as I glanced around the room without seeing it, “are you saying….” I leaned forward in my chair, my attention closely tuned to her breathing,“… that this boyfriend, and the one before, and your ex-husband, are all the same kind of man?”

“Yes!” she said. A long silence ensued. I waited, listening intently to her deep, regular, slow breaths. Then, a little huff, a pause, and— “Oh my god.” Her silence was so active, it was like hearing her think. “Could it be…?” she whispered.

“…they’re all variations of your father?” I said, feeling the risk run through my body even as I let the words go.

It’s not like we hadn’t discussed this insight before. We had, many times. But there was something going on here that was new, and it was important to not miss the opportunity. How would she react? I couldn’t see her. I couldn’t scan her face or her body language. All I had was the surf-like regularity of her breath in my ear. Then, a creak, and a rustling of cloth against cloth. She started chuckling, at first low and soft at the back of her throat, then building to a full out laugh. I sagged back in my chair with a combination of relief, amazement, and fatigue.

So you see, despite the limitations, it’s possible to do transformative work by phone. I don’t find that to be true for video. Still, it goes without saying (I’ll say it anyway) contact in any form is better than none. No matter how you “see” your clients these days, do it. They need us more than ever.

Daniela Gitlin, MD, is a psychiatrist in private practice for more than 25 years in rural upstate New York. Practice, Practice, Practice: This Psychiatrist’s Life is her first book. Contact: danielagitlin.com.

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