Hi there!  So, my blog has been running for about a month now, and I would love to get some reader feedback.  A lot of you have been commenting on Facebook about your enjoyment of the blog, which I so appreciate.   I would love your comments on the actual blog.  Let me know what you like so far.  What of the categories that I've written about would you like to hear more about?  What new ideas do you have?  This blog exists solely for the purpose of educating my readers on mental health, especially for children, so if you have any new ideas, questions, or would like to contribute in any way, let me know.  Remember, the more we talk about mental health, the more the stigma goes away, which is why I'd love to open up the conversation to include my readers as well. 

Thanks for your continued support, and looking forward to your comments. 

Be Well

~Emily

It is so critical that when a child is diagnosed with a mind disorder, they realize that they are not alone.  Half of Us is MTV's campaign to educate children and adults about mental illness.  It features celebrities and non-celebrities telling their stories about their experience with mental illness.  Celebrities such as Brittnay Snow and Mary J. Blige are joined with others to share their experiences.  There is truly a story that everyone can relate to on this site.  I totally recommend that you give the site a visit and hear others speaking out on their experiences. 

I'm a bit later with my post today than usual, which I apologize about.  However, I've been really reflecting on what I want to say today.  I have been surfing the web all day for stories and other interesting tidbits, but I think that I will stick with mostly my own experience today. 

Although the media has begun to address children's mental health in some profound ways, as I showed in yesterday's post, I really feel that schools (at least the ones that I've worked in/ been educated in) are not doing a good enough job of addressing these issues. 

I'll give you some examples:

Flash back to 1996 and before.  I was in high school.  Upon reflecting back, I was in the throws of my mental illness long before it was diagnosed.  I had an undiagnosed eating disorder, I was extremely anxious and depressed, however, I really didn't know a thing about mental disorders.  Why wasn't there education in my school on this subject?

Jump ahead a decade.  What my student teaching taught me was that not much has changed.  While working in a school in NYC, I asked the guidance counselor what the middle school's philosophy was on suicide prevention.  She looked at me and said: "We believe that if we talk about it, we will give the kids ideas, so we don't talk about it."  Now there's a solution.

The next couple of years during my teaching experience in New Jersey, I saw even more of this.  I remember when one of my sixth grader's older brothers committed suicide.  Not a word of it was discussed, and the kids were left to wonder and try to figure out what happened on their own.  How confusing for them.  How sad that a real conversation wasn't had in our school about suicide. 

I once had a discussion in my class about the word "emo."  The kids were obsessed with calling each other this.  For those of you who don't know, "emo" is short for emotional.  Kids label other kids this for all kinds of reasons- what they wear, how they act, etc.  I explained to my students about the stigmatizing nature of such a label.  I told them that if they ever were truly struggling with their emotions, they should see a guidance counselor and speak to them about it.  Well, guess what?  Kids actually went to see the counselors.  Amazing, isn't it?  And then, I got called down to the principal's office and reprimanded for having such a conversation.  Kids actually went to the guidance counselors, and they were not prepared for this.  What?  Prepared to do their job?

Is it ironic that in three separate schools, in two different states, there was such a lack of insight and education about children and adolescent mental health?  I really don't think so.  Administrators, teachers, and guidance counselors are on the front lines in terms of dealing with these issues.  Yet, no one wants to talk about it.  If we don't educate children about their mental health, how are they going to know how to help themselves?  How are they going to know that there is hope, that they can get better?

I'll give you one more scenario.  One of the adults that I treat at my mental health center abuses his wife.  When I gave him new skills on how to handle conflicts with her, he was amazed because no one had ever taught him this before.  He spent his whole life abusing and being abused because he didn't have the skills to handle conflict without his fists.  Why don't schools educate children about how to manage their emotions, so that they don't end up hurting themselves or each other?  It's a conversation that needs to happen. 

Be Well~
Emily

In mental health, there has lately been a lot of buzz around treatment using mindfulness.  What is mindfulness?  Well, mindfulness was brought to the West by practitioners such as Dr. Jon Kabat-Zinn and Dr. Jack Kornfield.  The book Wherever You Go, There You Are by Dr. Kabat-Zinn describes mindfulness meditation in extreme detail.  Mindfulness is originally a Buddhist term, which refers becoming acutely aware of the present moment.  Mindfulness practitioners often do mindfulness meditations in which they focus on their breathing and quiet the mind by staying in the present.  The theory here is that if one focuses on the past, one will be full of regret, and if one focuses on the future, one will be full of anxiety.  The present is where there is peace.  

What is so powerful about mindfulness is that mindfulness techniques are now being used by mental health clinicians to soothe clients with symptoms ranging from anxiety to addiction.  In one very powerful article by Dr. Elisha Goldstein    entitled "Cravings- How Using Mindfulness and Urge Surfing Can Help Now!", Dr. Goldstein discusses that even with cravings as strong as addictions, mindfulness can help.  She coins the term "Urge Surfing," which is an extremely powerful idea that when you are feeling a strong urge to use, this urge rises and falls like a wave, and comes with a physical sensation as well.  By being aware of these intense physical sensations and breathing, you can "surf the wave" of this urge, and watch it pass. 

If mindfulness and "urge surfing" are powerful enough to work with addictions, imagine how powerful it can be on anxiety, depression, and other emotions that overcome one like a wave!  I have tried so many different techniques to get a hold on my anxiety and depression, and I must say that mindfulness is one of the very best when practiced regularly.

Now, imagine if we taught this technique to our children at a young age?  By the time they were adults, they would be able to manage urges that most adults currently struggle with, whether these urges are to overeat, yell at someone, or even steal.  If we could create a critical mass of people using mindfulness techniques, imagine how much more peaceful the next generation could become.  Start with your child.  Start today.

Be Well
~Emily

There is another article in The New York Times entitled Off to College Alone; Shadowed by Mental Illness.      I found that this article may be helpful for parents of children already diagnosed with mind disorders who are heading off to college.  It is a tough transition, and the article goes into great detail about the way a child with a mind disorder can feel with the changes that college brings. 

However, as one who was diagnosed with Bipolar disorder after I went to college, I found this article to be slightly incomplete.  It does touch upon the challenges for students diagnosed in college by telling the story of a personal friend of mine, Stacy Hollingsworth, a wonderfully talented young woman who was diagnosed after going to college, but it does not go into great detail.  It does, however, include a link to a video about Stacy's life experience, which is definitely a redeeming quality. 

As one who was diagnosed during college in my first semester and then whisked off campus for treatment, I can certainly speak of the trials and tribulations of my experience.  I remember not wanting any of my friends or dormmates to know, although I felt like I had "mental illness" stamped on my forehead.  I remember feeling very out of place at treatment facilities because I was placed with the adults, but I was only 18, so my concerns were very different from theirs.  I remember trying to return to Emory University with all my heart, but just being unable to continue my education there.  Emory was in Atlanta, and I live much closer to New York City, and needed to be near my family during this hard time.  Finally, I remember the heartbreak of having to transfer schools after working my butt off to get into Emory in the first place.  I blamed myself, beat myself up, and punished myself for this for years.  I also remember starting at Rutgers University the next year with freshman all over again, which was not easy.  It did get better, but I had a lot of the concerns that many of the children highlighted in this article had: the drinking combined with my medications, getting into stormy relationships as my judgement was skewed, and debating whether or not to tell friends about my illness. 

Overall, college ended up being a good experience, and even though I contemplated dropping out, I realize now that living away from home and getting my degree were some of the most important first steps towards my wellness.  I don't think I would be truly well now had it not been for my college experience. 

Be Well
~ Emily

This topic is very important for parents to read and take to heart.  An enabler is someone who through their actions creates a scenario in which another person’s destructive behaviors are more likely to continue.  If, for example, your son or daughter is a drug addict, and you are not requiring them to get a job, seek treatment, etc, and you are giving them a place to live, this is enabling. 

 

How does enabling apply to mental illness and the treatment of it?  Well, at certain points, a child or young adult with mental illness may need some tough love, and you have to be prepared to give it to them, knowing that ultimately, it will help their growth. 

 

I credit my parent’s tough love with getting me well.  When I first got sick, my parents had the normal reaction of trying to nurture me back to health.  The soft environment that they created was actually not conducive to my recovery.  I needed structure and boundaries.  However, as my illness went on over the years, my parents learned to provide me with these boundaries.  For example, when I was in college, I really wanted to go home and drop out.  In response, my parents told me that I wasn’t allowed to come home.  College was where I lived, and even if I couldn’t go to class, they said it was important for me to stay up there, even while receiving treatment.  This was a hard thing for me, and very hard for them to do, but as a result, I received a college degree.  Had they allowed me to come home, this would have been enabling. 

 

I see this sort of behavior in the parents of my clients as well.  Today, the mother of a nearly 40 year old man who lives at home and has had no job for a number of years called to inquire about our services.  What is wrong with that picture?  First of all, allowing your mentally ill adult son to live at home at that age is pure enabling.  Adults need to be independent, for their health as well as the health of the family.  Next, the parents are supporting this person financially rather than forcing their son to get a job by leaving him no choice.  If they were to cut their son off financially, he would have to find a way to support himself.  Finally, why was the mother calling to inquire about treatment?  If the son was truly invested in getting better, he would have called himself. 

 

Giving tough love is very difficult.  However, sometimes a taking a firm stance and creating boundaries is just what a child or young adult needs to get better.  In the long run, you are giving them the gift of mental health, and ensuring that you have a happy, healthy family. 

 

Be well

~Emily

I consider myself a Consumer in recovery.  What does that mean?  Well Consumer is the PC name given to those who are/ have experienced mental illness.  I consider myself “in recovery” mainly because I am able to function and live independently, but also I am able to live without my symptoms most days. 

 

Before I recovered, none of this was the case.  I struggled with horrible panic attacks, suicidal thoughts and depression, and sometimes delusions and hypo-mania.  Having such a plethora of symptoms left me virtually unable to get out of bed in the morning even to shower and go out. 

 

So, how did I get from there to where I am now?  Proper treatment.  For me, that means that my doctor finally found a cocktail of medicines that worked for me.  Also, I finally found a therapist that was able to help me.  Her name is Sherrie Schwab, and I highly recommend her if you live in the New Brunswick, NJ/ Highland Park, NJ area. 

 

What did Sherrie do with me?  It was a type of therapy known as DBT.  This is short for Dialectical Behavioral Therapy, which was developed by an ingenious woman named Dr. Marsha Linehan.  At the time, however, she was not a doctor, but a Consumer herself looking to find a way to recover.  So, what she figured out was that the best way to recover is to learn a set of coping skills to use when a person is experiencing symptoms. 

 

The best way to learn more about DBT is to look at www.dbtselfhelp.com.  This is a comprehensive resource about all of the ins-and-outs of DBT.  However, I will go over it just a bit in this post.  DBT is divided into four sections, and is usually taught in a group format, with individual therapy used to reinforce what clients are learning in groups.  The sections or modules are:  1) Mindfulness 2) Interpersonal Relationships 3) Emotional Regulation and 4) Distress Tolerance.  Each module focuses on different coping techniques to help someone get out of a psychiatric crisis, and build a life worth living. 

 

DBT is a more advanced form of Cognitive Behavioral Therapy.  The theory behind CBT is that when you are triggered by an event, you then have thoughts about this event, which lead to feelings, and finally behaviors.  In order to change your behavior, then, you must change the thoughts about events that trigger you.  And, surprise, surprise, it actually works. 

 

I thrived with DBT because of the structure, and the thoroughness of the program.   I treated it as a fifth class when I was in school, and directly saw results.  I was able to finish my degree the semester that I took this class.  I took it several times, and each time learned something new.  It is truly like a class in which you learn how to handle intense emotions, with homework and all.  I highly recommend it to anyone who is looking for this kind of help.  They now even have it for adolescents. 

 

Be Well

~Emily

There may come a time in life when you meet someone in the throws of their mental illness symptoms. By this, I mean, someone that is either deeply depressed, highly manic, hearing voices, or having a panic attack.  I know it is hard to talk about these subjects, but there is really not enough advice out there about what to do when someone is in the middle of symptoms.  So, here I'm going to give you the down-and-dirty, honest advice about how to handle the situation.

1.If your friend is deeply depressed:  First, you need to assess the situation, and find out if they are safe.  By this, I mean, are they deeply depressed, but not thinking of hurting themselves, or are they, in fact suicidal?  There are many ways to assess this.  The easiest way is to ask them.  Chances are, if they are coming to you for help, they don't truly want to kill themselves.  However, if you do find that they are contemplating harming themselves, DO NOT TRY TO HANDLE THIS SITUATION ALONE.  You really want the professionals to assess your friend.  There are people trained to know if someone is really safe or not.  So, if you are in any way unsure what to do, call 911, and tell them what is going on.  Chances are, they will call the police, who will come and escort your friend to the emergency room.  It is not a good idea to leave the person while you make the phone call.  Let them know that you are going to do it.  They may say that they don't want you to call, but it is important to call anyway.  It is in their best interest.  I don't recommend trying to hide the call from your friend because this situation of having the police come can be a bit traumatic, and it's better to let your friend know ahead of time.  If you have the numbers for any close family of this person, alert them too, but wait until the police come to do this.  The police will then come with an ambulance as well, and the friend will be escorted to the nearest emergency room, where a trained professional (screener, psychiatrist, therapist, or all of the above), will ask questions and assess the situation further.  If they determine that your friend is a danger to himself, they may admit him to the hospital for further psychiatric care.  Hospitals are there to keep someone safe, so don't feel bad if this friend has to go there.  It is for the best.  You are saving a life.  

2.  If your friend is having a panic attack:    Panic attacks are distressing, but not dangerous.  It is important to reassure your friend of this.  They may be convinced that they are dying, but if there are no other medical complications, they usually aren't, it just feels that way.  Still it is important that you help them get to the hospital if they report chest pains, shortness of breath, dizziness, etc.  If they aren't having those symptoms, it is usually a panic attack.  Take them to a quite place, and tell them that they ARE NOT IN DANGER.  Panic attacks happen because the nervous system is sending out signals that the person is in danger, when actually they are not.  It is kind of like if you pulled a fire alarm when there was no fire.  The alarm would sound, but in actuality, there would be no danger.  Help your friend by making them aware of their breath.  Tell them to say in their mind "IN" on the inbreath and "OUT" on the outbreath.  This will bring them back to the moment, and help them to overcome this anxiety.  It is most important to know that panic attacks do not last forever.  They are temporary, and they will run their course faster when the person having them realizes that they are not in danger.  

3. If your friend is hearing voices:  This is not a situation that you should try to handle alone.  Usually, if your friend is hearing voices, it is a sign that their medication is not right.  It is important that you get them to a doctor right away, or to the emergency room.  Again, your best bet is to call 911.  While you are waiting for the police and ambulance to come, ask your friend what the voices are saying.  Make sure that the voices are not telling them to harm themselves or another person.  If they are, you need to give that info to the police/ambulance immediately, even if the person tells you that it is a secret.  Let the professionals handle this potentially dangerous situation themselves.  If you sense that you yourself are in danger, it is important that you leave, but stay close enough to direct the authorities there once they get there.  

4.  If your friend is highly manic:  How will you know this?  Usually you can tell this by their behavior.  Are they trying to do risky things?  Are they on an uncontrollable shopping spree?  Are they talking faster than usual, and not making much sense?  All of these are signs.  Again, this is an important reason to call 911.  Your friend may take a risk that could hurt them or someone else.  It is a sign that their medication is not right, and they need to have it adjusted.  Stay with them until the authorities come, unless you feel that you yourself are at risk.  

Although it is not easy to talk about these things, it is important to know what to do.  You can save a life that way.  The most important thing is, DON'T try to handle these situations alone.  Involve the professionals right away.  It is a hard thing to do, but it can be the difference between life and death.  Thank you for your careful attention to this entry.  

Much love, and Be Well.
~Emily