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getting to know my depression

i live with depression. sometimes it’s major, sometimes it’s minor and sometimes i can’t tell if i have it at all. but i’ve been clinically diagnosed for over 13 years so i have gotten to know it pretty well. depression presents itself differently in each person. for me, depression feels like a deep, heavy sadness. like a thick fog that slowly rolls in and envelops every part of me. it’s so hard to see my way out and it blocks my vision of a positive future or even a tolerable present. through many years of treatment i have worked hard to understand how i feel when depression comes back and how i can take the best care of myself when i feel sick. a few weeks ago i wrote about getting to know my anxiety. today i am going to talk about getting to know my depression. here are some of my own red flags and what i do to help myself when they come up.

don’t panic. when i feel that first tinge of sadness or when i feel more tired that usual, alarm bells start to go off in my head. NOOOOOOOOOOOOOOOOOOOOOOOO. NOT DEPRESSIONNNNNN!!!!!! for me, depression has been nothing short of devastating. it’s hard not to freak out when i feel it coming on. when i remember how sick i was, the thought of a relapse is absolutely terrifying – especially if i have been having a really good, upbeat streak. i feel my thoughts start to race ahead to the worst case scenario and a panicked feeling grows in my chest. this is a critical moment for me. this is a moment when i do have a choice. i have to stop and take a very deep breath. and then ten more. i talk to myself – sometimes out loud – and tap into my own strength and past experience. the conversation goes something like this: it’s ok to be scared of getting depressed again. it’s natural to feel anxious. you are a survivor. remember how much you have learned. whatever happens next, know that you can handle it.

know my red flags. i have found it necessary to understand what my thoughts and behaviors are like when i start to spiral downwards. this helps me catch myself before i hit the bottom.  my first red flag is catastrophic thinking. nobody understands me. everyone else has it easier than me. i will never get over this.  who cares. it doesn’t matter how hard i try. i’ll never be good enough. once i start thinking or saying things like this, i know that my depression is flaring up. another clue is if my energy is low for several days and i find it hard to complete daily tasks, like cleaning, showering or cooking dinner. when i notice these warning signs, i try to pause and reflect on what might be triggering the thoughts or behaviors. i talk to someone, like my family or my therapist. while it’s tempting to ignore red flags, i have found that it’s super important to acknowledge and explore them. for me, avoiding or denying them only makes depression worse further on down the line.

remember that depression is an illness with symptoms. for a long time, i didn’t think of depression as an illness. it felt more like a personal defect that i needed to try to get over. looking back, i can see that this perspective made the symptoms of my depression feel even more overwhelming. i didn’t view my feelings or experiences as symptoms of an illness. sadness, guilt and isolation loomed large and my panicked reaction magnified their effects. through a lot of reading and conversation, i have come to accept that depression is, in fact, an illness. and for me, one that needs to be treated with both medication and therapy. shifting my perspective has helped me to react with less fear when my symptoms present themselves. they make more sense within the context of depression as a legitimate medical condition. i still feel sad, afraid and lonely, but i am able to recognize those feelings as connected to my illness and as symptoms that i can respond to with self care.

accept that i am in a finite period of depression. one of the hardest features of depression is that it makes you think it will never end. which is what makes the onset so scary. a difficult piece of my work in therapy has been accepting that i have a mental illness and building my ability to tolerate it when it flares up. as much as i wish it would, depression won’t just disappear. and somehow, as counter-intuitive as it seems, allowing myself to feel the depression and accept its presence alleviates some of my suffering. for me, the symptoms don’t last forever. i have made it through depression before and, as gut-wrenching as it was, i can do it again. i tell myself that it is ok to feel sad, or angry, or frustrated. this is a perfect opportunity to…

practice self care. for a long time, i ignored and denied my symptoms. if i felt sad, i hid it. i can’t tell you how many times i cried in my car or in the bathroom stall so nobody else would know. i almost never told others about my depression. if i felt exhausted, i pushed myself harder and if i felt inadequate, i took on even more responsibility. i had a lot of negative coping skills – like drinking, smoking, shopping and over-working. and then one day i crashed. and burned. it took me two years to recover. which is why, today, nothing is more important to me than self care. i had to start from the bottom and rebuild my life in a healthier, more authentic way.

i could write all day on self care so i’ll try to keep it short (for now). for me, self care means being honest about my diagnosis. i don’t lie anymore about having depression or about my dad’s suicide. i honor who i am and what i live with. self care means saying no to others when i am feeling overloaded. it means making time to relax, to exercise, to create and to connect with others. self care is using all my senses to soothe and recharge myself – body, mind and spirit. and i practice coping skills every day, not just when i am at my worst. this is what makes them more effective when i do have an episode of depression – they work because i have been practicing.

know when to ask for help. depression is serious. and for some people, like my dad, depression is fatal. suicidal thoughts are a common symptom of depression. and i know that if and when i have them, they are not to be ignored. if i ever have the thought that i would be better off dead, i know that this is the most serious of red flags.  i tell someone i trust immediately and i reach out for more professional support. i believe that i deserve help in treating my depression and i recognize that i can’t do it on my own. in the past i used a personal safety plan that outlined specific steps i would take in the event of suicidal thoughts – this was a very helpful tool. other red flags that indicate i need to step up my professional help are frequent crying, prolonged withdrawal from family or friends, and lack of desire to go to work. i always keep the national suicide prevention lifeline’s number programmed into my cell phone, so that i have someone to call at any minute of the day or night. while suicidal thoughts don’t mean that suicide is inevitable, it’s so very important to act immediately when they come up.

and finally, i remember that i am not depression. i am not my diagnosis or my mental illness. i am not depression – i have depression. when i am feeling especially blue, this is something i say to myself every day. depression impacts our thinking and makes it difficult to appreciate the whole picture of who we are. remembering that i am not depression puts some of the power back into my hands. i am reminded that i have so much strength, ability and compassion to use in support of myself when depression strikes. while i can’t control my symptoms and while nothing is more difficult for me than experiencing depression, it’s critical for me to remember that i deserve to, and will, feel better. i have become an expert in my own experience. developing awareness, acceptance, self care and support have shifted the way that i cope with depression.

to quote one of my favorite internet memes – i have survived 100% of my worst days. so far i’m doing great.

(check out the full version of the above comic strip at

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Third-Person Self-Talk Can Support Emotional Control

Third-Person Self-Talk Can Support Emotional Control

New research confirms the value of silently talking to yourself in the third person, especially during stressful times.

The first-of-its-kind study discovered third person narrative self-talk helps one to control their emotions, and relatively effortlessly.

That is, the third-person self-talk does not require any additional effort than what one would use for first-person self-talk — the way people normally talk to themselves.

The findings are published online in Scientific Reports, a Nature journal.

Say a man named John is upset about recently being dumped. By simply reflecting on his feelings in the third person (“Why is John upset?”), John is less emotionally reactive than when he addresses himself in the first person (“Why am I upset?”).

“Essentially, we think referring to yourself in the third person leads people to think about themselves more similar to how they think about others, and you can see evidence for this in the brain,” said Dr. Jason Moser, Michigan State University (MSU) associate professor of psychology.

“That helps people gain a tiny bit of psychological distance from their experiences, which can often be useful for regulating emotions.”

The study, partially funded by the National Institutes of Health and the John Temple Foundation, involved two experiments that both significantly reinforced this main conclusion.

In one experiment, participants viewed neutral and disturbing images and reacted to the images in both the first and third person while their brain activity was monitored by an electroencephalograph.

When reacting to the disturbing photos (such as a man holding a gun to their heads), participants’ emotional brain activity decreased very quickly (within one second) when they referred to themselves in the third person.

The MSU researchers also measured participants’ effort-related brain activity and found that using the third person was no more effortful than using first person self-talk.

This discovery supports the use of third-person self-talk as an on-the-spot strategy for regulating one’s emotions, Moser said. The finding is salient as many other forms of emotion regulation require considerable thought and effort.

In the other experiment, led by MSU psychology professor Dr. Ethan Kross, participants reflected on painful experiences from their past using first and third person language while their brain activity was measured using functional magnetic resonance imaging, or FMRI.

Similar to the MSU study, participants’ displayed less activity in a brain region that is commonly implicated in reflecting on painful emotional experiences when using third person self-talk, suggesting better emotional regulation. Further, third person self-talk required no more effort-related brain activity than using first person.

“What’s really exciting here,” Kross said, “is that the brain data from these two complementary experiments suggest that third-person self-talk may constitute a relatively effortless form of emotion regulation.

“If this ends up being true — we won’t know until more research is done — there are lots of important implications these findings have for our basic understanding of how self-control works, and for how to help people control their emotions in daily life.”

Moser and Kross said their teams are continuing to collaborate to explore how third-person self-talk compares to other emotion-regulation strategies.

Source: Michigan State University

I Opened the Window and Influenza

As previously mentioned, I’m really out of practice with blog-writing/ writing in general, so I’ll stick to writing (or attempting to write) fairly short posts over the next few weeks. These will probably be a bit random in terms of subject and chronological order.

I mentioned in a previous post that after coming back from Namibia, I seemed to be coming down with repetitive bouts of the flu. One day at work, at the end of November, this lead to a rather dramatic (and somewhat embarrassing) turn of events.

The weird thing about this particular flu-like illness (other than that it kept coming back over the course of a month or so, after me feeling like I was completely back to normal) is that I would go from feeling completely fine to unable to get out of bed, in the space of only an hour or two. During this particular shift at work, it suddenly hit me like a ton of bricks. I started to feel very run-down and very cold, so I told my manager I that I wasn’t feeling well, put my work fleece on, and had a short break for a few minutes. A couple of my colleagues could see that I was unwell and said that I should probably just go home, but having always been a conscientious person, and not wanting to let my colleagues down, I tried to just keep working.

A short while later, I started to feel very dizzy and like I was about to throw up, so made my way back to my department as quickly as I could. My manager and team support people were busy as I got into the department, and so, feeling awful, but not wanting to be rude, I ended up leaning over one of the trolleys (as I felt like I was about to pass out), hoping that someone would notice me and ask what was wrong. It’s both funny and alarming that even when I’m feeling really unwell, I’m still anxious about interrupting people/ getting the attention of other people. After a few moments, my manager turned around, and I simply lifted my head up from the trolley and casually asked “Is there something that I can be sick in?”, then told my manager and another colleague that I felt like I was about to faint. A look of horror suddenly came over my manager’s face, and she and the other colleague rushed over to try and keep me steady. At the same moment, I felt like I was about to faint there and then (I had tunnel vision, just like I did before I fainted/ nearly fainted in the past), so I immediately sat down right where I was. I actually felt better (in terms of no longer feeling nauseous) once I had regained my vision, but because I’d nearly passed out, had a temperature, and still felt unwell, 3 first aiders were called to my department, and my manager (who seemed really worried about me, especially as I had recently been to Africa) decided that an ambulance should also be called. I started freaking out about my health at this point, as I really didn’t feel that things were serious enough to call an ambulance, but started to worry that something may be seriously wrong with me. This wasn’t helped by one of the first aiders telling me that the rash on my right hand/ arm looked a lot like insect bites. They also pointed out that I was shaking (due to the adrenaline kicking in to keep me conscious), but for a change, I actually wasn’t that bothered about it. Normally, having someone notice my shaking (or other physical symptoms of anxiety) would lead to me getting even more anxious.

The paramedics arrived really quickly and took all my vitals, and my blood sugar. They could find nothing physically wrong with me other than a raised temperature. However, given my recent African adventures, they decided that I should be taken to A&E just to be on the safe side. As I had been sat right at the entrance to our department (thus preventing my colleagues from returning/ processing trolleys), my colleagues all had to wait outside the department until my manager asked that they take an early break. I was taken out of our department in a wheelchair (just in case I fainted or felt faint again), with most of my colleagues looking on, which was rather embarrassing. I sheepishly said hello to one of the colleagues who had advised me to go home as I left, and she basically said “I told you so”>

I ended up sitting in A&E for about 2 hours before (thankfully) being told that there was nothing seriously wrong with me and being discharged. The doctors/ nurses reckoned that the weird rash on my hand/ arm was just some sort of allergic reaction, probably related to my eczema. Although I was much relieved, I felt pretty awful about the whole thing, as my sister had to miss classes at university, and my mum had to take the rest of the day off work, in order for them both to pick me up/ make sure I was okay. The member of staff who told me that it was likely just a flu-like viral infection seemed quite annoyed with me as well, and – even though it wasn’t my decision to call an ambulance – I obviously felt really terrible about wasting the time/ resources of an ambulance that could have gone to someone in a much more serious condition. I just hope that the medical professionals I’ve seen before about my fainting/ near-fainting problem are correct in saying that it’s related to anxiety, rather than a sign that something is physically wrong with me. In the CBT group that I attended, the therapists told us that it was practically impossible to faint when very anxious, due to all the adrenaline, so I do find it all a bit odd. Perhaps I’m just someone who faints easily.

I was sort of the talk of my workplace for days after my near-fainting episode, which was quite embarrassing. It’s nice to know that people care/ were concerned though. Honestly, the lengths I will go to just to skive off work, eh? ? The only good thing about the whole ordeal was that I got to relax, stay in bed, and do nothing but sleep and binge play Oblivion (the Elder Scrolls game) for three days. (Yes, I’m a massive nerd, and this is probably part of the reason why I didn’t have a boyfriend until very recently. ? But I make no apologies for that. It’s an old game but it’s a good game). Unfortunately, playing video games is something that I only get to do once in a blue moon these days, and I do miss the sense of adventure and escapism that they bring. (Again, nerd alert! You’re all free to run away now.)

Anyway…sorry for the word vomit. Life has been crazily busy lately (in a mostly pleasant way), hence the lack of posts. I haven’t forgotten my blog though.

Natural Remedy for Youth Sleeping Problems

Natural Remedy for Youth Sleeping Problems

New research indicates high rates of sleep problems among youth continuing through teenage years and into early adulthood. The study also suggests that although the sleeping issues come from a variety of issues, many can be controlled with early training on maintaining an active lifestyle.

In the study, investigators from James Cook University and the University of Queensland tracked more than 3600 people from the age of 14 until they were 21. Reports of sleep problems were significant as “just over a quarter of the 14-year-olds reported sleep problems, with more than 40 percent of those still having sleep problems at 21,” said lead investigator, Dr. Yaqoot Fatima from JCU’s Mount Isa Centre for Rural and Remote Health.

She said the causes of sleep problems were different at different ages.

“Maternal factors, such as drug abuse, smoking, depression, and anxiety among mothers are the most significant predictors of adolescent sleep problems in their children, at 14-years-old.  

“For all people studied, being female, having experienced early puberty, and being a smoker were the most significant predictors of sleep problems at 21 years.”

She said adolescent depression or anxiety were linking factors for sleep problems between the two ages.

“It’s a vicious circle. Depression and anxiety are well-established risk factors for sleep problems and people with sleep problems are often anxious or depressed,” she said.

Dr. Fatima said that as well as the traditional factors, excessive use of electronic media is emerging as another significant risk.

“In children and adolescents, it’s found to be strongly associated with later bedtime and shorter sleep duration, increasing the risk of developing sleep disturbances,” she said.

Dr. Fatima said the study was worrying as it revealed a high incidence of persistent sleep problems and possible concurrent health problems among young people — but it also strongly suggested an answer to the problem.

“Even allowing for Body Mass Index and other lifestyle factors, we found that an active lifestyle can decrease future incidence and progression of sleep problems in young subjects.

So, early exercise intervention with adolescents might provide a good opportunity to prevent their sleep problems persisting into later life.”

Fatima believes future research should investigate the factors that appear to extend a young adults’ sleep problems into adulthood, and how these may be prevented.

Source: James Cook University

School Suspensions Tied to Poor Mental Health

School Suspensions Tied to Poor Mental Health

Children who are suspended from school are more likely to develop a range of mental disorders, such as depression and anxiety as well as behavioral disturbances, according to a new study published in the journal Psychological Medicine.

Researchers at the University of Exeter in England investigated the impact of exclusion from school among the general population and found that suspension may lead to a new onset mental disorder, and that, separately, poor mental health can lead to suspension from school.

The findings show that consistently poor behavior in the classroom is the primary reason for school exclusion, with many students, particularly those in middle and high school, facing repeated dismissal from school. Relatively few pupils are completely expelled from school, but the researchers warn that even temporary exclusions can exacerbate psychological distress.

The researchers assert that identifying and supporting children who struggle in class could prevent suspension and improve their success at school.

“For children who really struggle at school, exclusion can be a relief as it removes then from an unbearable situation with the result that on their return to school they will behave even more badly to escape again,” said Professor Tamsin Ford, a child and adolescent psychiatrist at the University of Exeter’s Medical School.

“As such, it becomes an entirely counterproductive disciplinary tool as for these children it encourages the very behavior that it intends to punish. By avoiding exclusion and finding other solutions to poor behavior, schools can help children’s mental health in the future as well as their education.”

Suspension is more common among boys, secondary school students and those living in socio-economically deprived circumstances. Poor general health and learning disabilities, as well as having parents with mental illness, is also associated with suspension.

The study involved analyzing the responses of more than 5000 school-aged children, their parents and their teachers in the British Child and Adolescent Mental Health Surveys. The research team omitted children who had a previous mental disorder from this analysis.

The findings show that children with learning difficulties and mental health problems such as depression, anxiety, ADHD, and autism spectrum conditions were more likely to be excluded from the classroom. In addition, during the follow-up, the researchers found more children with mental disorders among those who had been excluded from school, than those who had not been excluded.

The researchers conclude that there is a “bi-directional association” between psychological distress and suspension: Children with psychological distress and mental-health problems are more likely to be suspended in the first place but suspension predicted greater levels of psychological distress three years later.

“Although an exclusion from school may only last for a day or two, the impact and repercussions for the child and parents are much wider. Exclusion often marks a turning point during an ongoing difficult time for the child, parent and those trying to support the child in school,” said Claire Parker, a researcher at the University of Exeter Medical School, who carried out doctoral research on the project.

Source: University of Exeter

More Older Adults Embrace Social Media but Many Still Fearful of Privacy

More Older Adults Embrace Social Media but Many Still Fearful of Privacy

Older adults use social media so that they can keep track of family and friends. Some continue to resist the communication channel, however, because they worried that unsolicited viewers will see their content.

In a new study, Penn State researchers discovered older adults use sites such as Facebook to keep in touch with family and friends, monitor other’s updates, and as a means to share photos.

Nevertheless, some seniors listed privacy, as well as the triviality of some posts, as reasons they stay away from the site.

“The biggest concern is privacy and it’s not about revealing too much, it’s that they assume that too many random people out there can get their hands on their information,” said S. Shyam Sundar, distinguished professor of communications and co-director of the Media Effects Research Laboratory, Penn State.

“Control is really what privacy is all about. It’s about the degree to which you feel that you have control over how your information is shared or circulated.”

The researchers believe Facebook developers should focus on privacy settings to tap into the senior market. The study is available online and will appear in a forthcoming issue of Telematics and Informatics.

“Clear privacy control tools are needed to promote older adults’ Facebook use,” said Eun Hwa Jung, assistant professor of communications and new media, National University of Singapore.

“In particular, we think that privacy settings and alerts need to be highly visible, especially when they [older adults] are sharing information.”

While older adults are leery about who is viewing their posts, they enjoy using the site to look at pictures and read posts from friends and family, according to the researchers.

“I am more of a Facebook voyeur, I just look to see what my friends are putting out there,” one participant told the researchers.

“I haven’t put anything on there in years. I don’t need to say, ‘I’m having a great lunch!’ and things like that, I don’t understand that kind of communication.”

According to Sundar, another issue that keeps seniors from using social media is their concern over the triviality of the conversation found on a site such as Facebook.

“They believe that people reporting on the mundane and unremarkable things that they did — brushing their teeth, or what they had for lunch — is not worth talking about,” said Sundar.

“That’s an issue, especially for this generation.”

Nevertheless, researchers believe older users could be a significant resource to help drive the growth of Facebook and other social media sites.

“The 55-plus folks were slow initially in adopting social media, but now they are one of the largest growing sectors for social media adoption,” explains Sundar.

The researchers suggest that Facebook is helping to serve as a communications bridge between the generations and that young people are prompting their older family members to join the site.

“In particular, unlike younger people, most older adults were encouraged by younger family members to join Facebook so that they could communicate,” said Jung.

“This implies that older adults’ interaction via social networking sites can contribute to effective intergenerational communication.”

In the study, researchers recruited 46 participants who were between 65 and 95 years old to take part in in-depth interviews. The group included 17 male participants and 29 female participants, all of whom had a college degree. The participants also said they used a computer in their daily lives.

A total of 20 Facebook users and 26 non-users participated in the study.

If participants had a Facebook account, researchers asked them about their experience and their motivations for joining. Participants who did not use Facebook were asked why they did not join.

A limitation of the study was the fact that all participants lived in a retirement home. As such, future research efforts should review the perception and use of Facebook by seniors who live alone.

Source: Penn State

when i was diagnosed with depression

my college graduation - five months after my diagnosis with depression

my college graduation – five months after being diagnosed with major depression

as i dashed across campus i breathed in the smell of falling leaves and smoke in the air. it was a bright and windy october day during my senior year in college. i had just finished up a long afternoon class and was looking forward to a night out with my girlfriends and a weekend of fun. i had forgotten my phone in my dorm room so just needed to pop in and pick it up before meeting them for dinner.

i was rushing so didn’t look down at it right away but as i walked down the stairwell i paused for a second to check the screen. i had 10 missed calls from my mom. i froze, knowing immediately that something was wrong. she was supposed to be on a flight overseas so i shouldn’t have been hearing from her at all. i gripped the phone in my hand as i sprinted back up to my room. the excitement i had felt about the weekend had vanished as quickly as the warm summer days and i was left with a cold, panicky feeling inside.

i called and she picked up immediately. “mom – what’s wrong?” she paused and then said, carefully, “i don’t want to scare you. but i have cancer.” i felt a loud rushing sound in my ears and stood as still as a statue while she told me. told me that she had been diagnosed with uterine cancer. that she didn’t know how advanced it was. that she would have major surgery in one month to determine what stage she was in.

as i listened something broke inside of me. the wall that had been holding back the pain and anguish and fear from my father’s suicide cracked. and out flooded the panic and the sadness that i had tried to hide away for so long. while i knew that it was unlikely that her cancer would be life-threatening, this latest crisis rocked my sense of safety and stability. every single night in the years after my dad’s death i would pray an extremely long and elaborate prayer (i defy the catholic church itself to match its complexity), begging god to keep my family safe. not to let anything else bad happen to us. and for eight years it seemed like that had worked. and then one october day it didn’t.

i began to cry. all the time. by myself. i would cry in my car, i would cry in my closet, i would even cry, silently, in the toilet stall. every night i would lay face down in my bed and cry myself to sleep, so quietly that my roommate never knew. i lost my appetite and stopped eating meals. i just wasn’t hungry. i couldn’t stop thinking about my mom being gone. that something outside of our control could take her away. that there was nothing i could do about it. and just like when my dad killed himself, i didn’t feel like i could relate to my friends. none of them had experienced (or shared that they had experienced) family losses and challenges like mine. i began to feel very alone.

i went home for my mom’s surgery in november. i watched her put on a gown, get on a stretcher and wheel away from me down a sterile white hallway. my only parent. i was the adult who spoke with the surgeon when she told me that, thankfully, the cancer had been caught so early that my mom didn’t need chemo or radiation. not so thankfully, my mom began to have complications from the surgery almost as soon as it was over. recovery was going to take a while.

two days after her surgery was thanksgiving. it was one of the worst holidays i can remember. my mom was still in the hospital. i had been awake for over 48 hours. my little sister and i came home to an empty house, got into bed and just slept. grateful for a break from the sadness we were surrounded with. when my mom came home several days later i cared for her, waking up every few hours to give her a barrage of medications. i helped my sister with her college applications, as the deadlines were looming and essays needed to be written, family crisis or no. i was like a terrified little adult, trying to keep everyone else afloat. at one point i was so overwhelmed and sleep deprived that i passed out cold on the kitchen floor. i gave up a scholarship to go to ireland and study traditional celtic religion as part of my senior thesis during my winter break. they needed me there. and i needed to be there too.

in the months after my mom’s surgery i continued to struggle. i felt vulnerable and scared. exhausted and overwhelmed. isolated and uncertain. i was drinking too much. i was smoking too. i was as skinny as i ever was – smaller than a size zero. i was shrinking into myself. a feeling of persistent sadness began to follow me around, enveloping me in its mists. i began to think that maybe i couldn’t handle whatever life threw at me. that maybe i wasn’t as resilient as i thought. for the first time i felt hopeless. i wanted to go my home and lay down in the yard and be absorbed into the ground. or press myself into the walls of the house so that i could never lose it. i wanted to become a part of my landscape of loss. no more changes. not one more – i just couldn’t take it.

one night, just after my 22nd birthday, i was at home. my mom had fallen asleep early – the medication she was taking made her really drowsy, plus she had a horrible cold. my sister was in bed too. i was alone. i went outside and got into my car. i put on my oasis cd, on repeat, and began to drive. i circled the george washington parkway and then the beltway, over and over, for hours. crying, crying crying. crying for myself, crying for the whole world, crying like it would never stop. i felt like i had stepped outside of my body, like i was watching myself drive and cry, drive and cry.

several hours later i went home and, sensing that i needed help, called my therapist. the one i had seen for the first five years after my dad’s suicide. the next day i found myself sitting on her couch. telling her about last night. and the last six months. she listened, nodding as i numbly tried to describe how i felt. when i finished, she leaned forward and said, “honey, i think you have depression.” several phone calls and a psychiatrist’s appointment later i had an official diagnosis: major depression. and a prescription for medication.

“no, oh no,” i thought. “not me. not me too.” on that dark december day i didn’t know about coping. i didn’t know about recovery. i didn’t know about self care. i didn’t know how to talk about, how to feel about my dad’s suicide. all i knew is that i didn’t want to have a mental illness and i was looking down at a piece of paper that said i did.

on my way home from the appointment i listened to this song by alison krauss. over and over. tears streaming down my face. just driving and crying, driving and crying.

in this world i walk alone
with no place to call my home
but there’s one who holds my hand
on rugged road through barren lands

the way is dark, the road is steep
but he’s become my eyes to see
the strength to climb, my griefs to bear
the savior lives inside me there

in your love i find release
a haven from my unbelief
take my life, and let me be
a living prayer, my god, to thee

take my life, and let me be
a living prayer, my god, to thee

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School-Based Mental Health Programs Reach Large Numbers of Kids

School-Based Mental Health Programs Reach Large Numbers of Kids

New findings published in the Harvard Review of Psychiatry show that school-based mental health programs can reach large numbers of children and effectively improve mental health and related outcomes.

Approximately 13 percent of children and teens worldwide have significant mental health problems including anxiety, disruptive behavior disorders, attention-deficit/hyperactivity disorder (ADHD), and depression. If left untreated, these disorders can remain throughout adulthood and have negative effects in many aspects of life.

A large number of interventions have been designed to deliver preventive mental health services in schools, where children and teens spend so much of their time. Now a growing body of evidence shows that school-based mental health programs can be widely implemented and can lead to population-wide improvements in mental health, physical health, educational, and social outcomes.

For the review, Dr. J. Michael Murphy, EdD, of Massachusetts General Hospital and colleagues identified and analyzed school-based mental health programs that have been implemented on a large scale and have collected data on specific mental health outcomes. Their findings show that the eight largest programs have reached at least 27 million children over the last decade.

The programs vary in their focus, methods, and goals. For example, the largest intervention, called “Positive Behavior Interventions and Supports” (PBIS), focuses on positive social culture and behavioral support for all students. The second-largest program, called “FRIENDS,” aims to ease anxiety and teach skills for managing stress and emotions — not only for children, but also for parents and teachers.

While some of the school-based mental health interventions target students at high risk of mental health problems, most are designed to focus on mental health promotion or primary prevention for all students in the school. Most of the programs have been implemented across school districts, while some have been introduced on the state or national level.

Evidence is “moderate to strong” that these interventions are successful in contributing to good mental health and related outcomes. For example, studies of FRIENDS have reported reductions in anxiety, while PBIS has shown improved reading scores and fewer school suspensions.

Other interventions have shown benefits in areas such as bullying and substance abuse.

“This review provides evidence that large-scale, school-based programs can be implemented in a variety of diverse cultures and educational models as well as preliminary evidence that such programs have significant, measurable positive effects on students’ emotional, behavioral, and academic outcomes,” write the researchers.

“Data sets of increasing quality and size are opening up new opportunities to assess the degree to which preventive interventions for child mental health, delivered at scale, can play a role in improving health and other life outcomes,” said Murphy and colleagues.

With ongoing data collection and new evaluation frameworks, they believe that school-based mental health programs have the potential to “improve population-wide health outcomes of the next generation.”

Source: Wolters Klewer Health

Facing Threats, Accenting the Positive May Move Relationships Forward

Facing Threats, Accenting The Positive May Move Relationships Forward

For some couples just staying together is good enough. But others want the relationship to move forward and get better and are willing to put in the effort to get there.

For a new study, researchers at the University of Illinois reviewed more than 1,100 studies on relationships dating back to 1950. They found two primary motives behind a couple’s attempts at staying together: threat mitigation and relationship enhancement.

For the most part, improving a relationship includes both components and requires putting effort into the relationship for the pleasure of it.

“Threats to the relationship come from all kinds of different places,” said Dr. Brian Ogolsky.

“Generally, there are many threats early in relationships that can cause problems, but that is not to say that these disappear later. We know couples cheat in the long-term, people end up in new work places and in new situations where possible alternative partners show up, conflicts arise, or a lack of willingness to sacrifice time for your partner emerges.”

Some threat mitigation tactics can actually become enhancement strategies over time, Ogolsky said, but the reverse is not usually true.

“We get to a place where we are pouring energy into the relationship simply because we want to keep the relationship moving forward rather than just mitigating threats.”

In their integrative model of relationship maintenance, the researchers also illustrate individual versus interactive components of maintenance.

“This question of ‘is this an individual thing or is this a couple-level thing’ often goes unanswered. But as we were doing this review, we started noticing that there are ways to maintain the relationship that we can characterize as ‘more or less in our own heads.’ We are doing something to convince ourselves that this is a good relationship and therefore it’s good for our relationship,” Ogolsky said.

“Things like positive illusions, the idea that we can believe our relationship is better than it is or that our partner is better than he or she is. We can do that without our partner,” he said.

Mitigating conflict, however, is something that partners must do together. “Good conflict management or forgiving our partner for doing something wrong is an interactive process.

“When a threat comes in, we can do one of two things: We can ditch our partner or forgive them over time.”

The same is true of enhancement strategies: Partners can do things individually or interactively.

“Individually, even the act of thinking about our relationship can be enhancing. Whereas engaging in leisure activities together, talking about the state of our relationship, these are all interactive,” Ogolsky said.

While Ogolsky rarely offers direct interventions to couples, he said he tends to study the positive side of relationships because of what can be learned from people going through what is inherently a very turbulent thing.

“Relationships have ups and downs. I never go into my work saying people should stay together or they should break up.

“What we are talking about here are processes that exist across different kinds of couples, some of which work very well for some people, some of which may not work for some people. I am interested in understanding processes that keep relationships moving.”

The study appears in the Journal of Family Theory and Review.

Source: University of Illinois