Off to College

It is very important to me that adults better understand how important it is to pay attention to their children’s journey into adulthood.  It is a long journey with many different stages and many different challenges along the way. 

September is a good time to remember the part of the journey that can be one of the most challenging stages of the process, namely leaving home and starting college.  For many, it is the first time a child will have spent any significant time away from home. Independent from parents.  Independent from rules.  Thrown into a huge bucket of peer pressure.  It is a time fraught with new challenges, adventures, transitions, ideas, and influences.  Many students do fine, but a significant number of students struggle with all this new stimulation coming at one time.  They are presented with a “perfect storm” of challenges and the new experience of independent decision-making.  It is not unusual that by November the number of new challenges and a student’s inability to balance these challenges can be overwhelming to a college freshman (as well as upper-class students as well), who then begin to fall apart and need help coping with depression and anxiety.  

From a distance (remember that most of these kids are away at college), we, the adults in their lives, need to be vigilant and listen to the tone of our children’s voices and words that they use. If we hear anything that causes concern, we need to encourage our kids to seek help.  If there is the slightest concern about their mental health., we need to encourage our kids to seek help.  

If, after listening to and having conversations one-on-one with your child, you are still concerned about his/her/their well-being, then you need to take a next step. For me that would be to find out more about the school’s mental health resources, and reach out to the people connected to those resources for guidance.  For many students, as with the population in general, the stigma of seeking mental health treatment from a counseling center is intimidating. It is important to emphasize that seeking help is a sign of strength, not weakness.

However, if going to the college mental health center is uncomfortable for your child, there are other resources that are available today outside of that brick-and-mortar health center.  One that is gaining momentum is telemedicine (you can simply google online mental health resources and you will find a whole list of resources).  Or you can connect with a therapist who you may know or has been recommended to you and see if that therapist will meet with your child by Zoom or FaceTime.

We want our kids to be happy, and reaching that goal is not often easy.  We need to use all available resources in order to help our kids during the times that are so difficult. 

 Below is a list that I found on a website called “timely MD.“   I would like to share it with you, and perhaps you can share it with your child  before he/she/they leaves for school.  Hand it to them, slip it into their suitcase, sit down and discuss it.  Whatever works.

Ways that college students can manage mental health

1. Take care of health and well-being. … 
2. Time management. … 
3. Keep track of mental health concerns. … 
4. Surround yourself with good people (even if it’s virtually) … 
5. Practice mindfulness. … 
6. Avoid drug and alcohol use. … 
7. Find ways to get involved. … 
8. Utilize mental health services.

(If you go to the website, each of these points is discussed further.)

Resources:

These are a few resources that are in United States and Britain. There are resources around the world

National Alliance of Mental Illness

National Institute of Mental Health

Heads Together

Society for the Prevention of Teen Suicide

Advertisement

Mental Health Crisis for Children and Adolescents

Child and adolescent mental health concerns are at a crisis level. According to the World Health Organization, the number of children and adolescents who suffer from a treatable mental health disorder such as depression, anxiety, or attention deficit/hyper activity disorder (ADHD) is 1 in 6, and the number is definitely on the rise. This mental health situation is not confined to any geographic area or social status, although children from poorer families seem to be at greater risk, with hospital after hospital reporting they are experiencing huge increases in the number of children and adolescents seeking treatment for mental health disorders.

Many journalists and health organizations are writing about the pandemic and how that has impacted kids. The pandemic alone would have presented serious challenges for any human being, but it has taken a particularly large toll on the development of our children. To go a step further, add in the myriad of events taking place around the world, and we find a Tsunami of challenges tugging at everyone’s mental health. However, I find a silver lining in this awful consequence, because I believe that it has pushed the conversation about mental health issues right through the roof. There are so many individuals being affected by mental health challenges that society can no longer ignore the importance of mental health. Today’s world is simply fraught with events that are difficult to intellectually and emotionally process.

Having to quarantine, wear a mask, knowing that large numbers of people are getting very sick from Covid-19, and that huge numbers of people are dying from Covid-19 are all reasons for precipitating anxiety, panic attacks, and depression. But at the same time our world has been overwhelmed by so many more events happening all around us. Hateful speech, racism, mean-spirited politics, and wars surround us, including our children, every day. We, as adults, can barely protect ourselves from the mental traumas we see and hear, which makes it even harder to protect our children from all the negative events. It is simply not possible to put a bubble around our kids to make sure they never hear a troubling conversation or comment, or a news report on television, or a radio broadcast, or read a newspaper article, or see the horrible pictures of a war scene. And all these words and pictures take away from the safety that should be childhood.

So, more children and adolescents are in the throes of a different kind of pandemic, a mental health pandemic. The need for help is rising, and there are simply not enough pediatric psychologists available for the number of children and adolescents who need them. Although the number of children and adolescents who have needed health care has been rising for some time, the pandemic threw the whole balance of need versus supply of pediatric therapists out of kilter. The American Academy of Pediatrics, Children’s Hospital Association, and the American Academy of Child and Adolescent Psychiatry have together declared an emergency in child and adolescent mental health.

Many children who have been forced to quarantine at home for long periods of time were exposed to excessive quarreling, abuse, and violence, and witnessed more substance misuse by adults. They were prevented from interaction with their peers, which caused many children and adolescents to forget how to interact with their peers and also prevented them from having a needed social setting in which to grow their social skills. Now that children are returning to in-person school settings, there is more than the usual “acting out” in class, and teachers, acting as ‘first responders,” are asking for and receiving more guidance from outside professionals regarding how to recognize signs of trauma and other negative psychological behavior in children and adolescents. Hopefully, with this guidance, the educational staff will be able to help their students find help for emotional or mental health problems. We are also seeing greater government funding that enables our schools to hire temporary health professionals, including mental health professionals. But we need these health care professionals to be permanent additions to the staff caring for our children. Healthy children make healthy adults, which makes for a healthier society. To that end, the United States Congress is working on passing new funding legislation that would make those temporary positions in our health care system permanent, as well as continuing to fund the Student Mental Health Helpline Act. That Act, first introduced in September 2021, needs to be renewed. When that hopefully occurs, the law will authorize grants to agencies that are primarily responsible for public health or education to develop and maintain student mental health and safety helplines for children who are facing challenges with abuse, bullying, depression, anxiety, self-harm, and related issues.
The federal government is addressing the mental health crisis, but it needs to move faster in getting the allocated money out to the people who will use it to make a difference in the mental health of our children and teens.

Resources:

National Alliance on Mental Illness

National Institute of Mental Health

Heads Together

Erode the Stigma

I have been writing a blog about mental health illness for over three years, with a primary emphasis on the stigma that is attached to having a mental illness, measures that can be taken in order to help ourselves get past the stigma and get help, and encouraging those suffering from mental illness to acknowledge their situation.  I have chosen this direction because the stigma is real and it is pervasive.  The stigma is slowly receding with the advent of well-known people speaking up about their own challenges with mental illness, but we do have a long way to go and I will continue to write and promote mental well-being.

My words have reached people in far away places, not only throughout the United States, where I reside, but as far away as Australia, Japan, the Philippines, Russia, England, Iran, and India.  Hopefully, these people have found some support from reading the blogs, but I feel a bit uncomfortable standing on a soapbox and shouting that we should all talk about our mental health challenges and not be shy or embarrassed about telling our stories.  I am acknowledging that I am still affected by this stigma of having a mental health illness.  At times, I find myself silent when it comes to talking about my own situation in public.  I wonder how people will respond to me after I divulge my secret? On the computer, protected by cyberspace, I speak out.  But in person, I always question if I really want to mention that I have an anxiety disorder.  More often than not, I do speak up about this challenge with which I have struggled , and I am able to speak out proactively, but I am still a bit gun-shy about the subject.  I can only imagine what a challenge it must be for other people with a mental illness who are not writing about this topic to openly speak up.

I read an article that appeared in the September 2019 edition of Men’s Health magazine written by a man who is studying to become a psychiatrist.  He states that during his interview for his residency, he was asked why he really wanted to become a psychiatrist. He danced all around the answer, but never admitted to his interviewer that he had battled depression and knew what it was like from the other side.  What he wanted to say was, “ I have been depressed, and I have recovered.  And my experience gave me an empathetic understanding of the patients we’re commonly devoted to.”  He goes on to say that stating that fact would have been his most relevant qualification, not the rather impressive resume of past education.  He also acknowledged that making that statement would have been his “greatest achievement.”  The article ended with these words, “Every time you talk about depression, you erode the stigma – yours and everyone else’s.”

 

Resources:

National Alliance On Mental Health

National Institute On Mental Health

Heads Together Mental Health

Stop Being Selfish

This morning I had a long and wonderful conversation with one of my dearest friends. We chatted about so many things concerning our families.  We wandered from the cute things our grandkids say, to the challenge of so many personalities spending quality time together on summer vacations, and of course we covered the picky eating habits of just about everyone, which make large family dinners very challenging.  The topic that took over the end of our conversation was the different strains of mental illness in both of our families, including, at one time or another, anxiety, depression, bipolar disorder, ADD, and ADHD.  Almost all of those within these two families who are living with mental illness have reached out for and gotten the help that he/she needed, and all those people are living good, productive, happy lives.  Little thought is given to these illnesses from day to day.   However, two family members will not admit that they need help, and therefore are suffering in unnecessary ways, and they are depriving themselves of the happier lives they could lead.  There is absolutely no reason that anyone should suffer with depression, or anxiety, or bipolar disorder.  There are so many medications and therapies available.

I don’t know why these two people are in denial.  Family members have tried to talk to both of them to encourage them to seek help.  But nothing has worked to get these two people moving in the right direction.  The saddest part is that not only do these people continue to suffer, but the whole family around them suffers as well.  It is very difficult to be around someone who is always sad.  It is very difficult to be around someone who is always anxious.  It is really difficult to be around someone who is manic.  It is really selfish for someone to refuse to get help for him/herself, because that person is impacting more lives than just their own by staying in a place of disfunction, pain, and sadness.

Please do not join the rank of sufferers.  Stop being selfish.  Find a doctor that specializes in mental health illness.  Make an appointment with that doctor.  Go to that appointment. Talk to your doctor about a plan of action that can bring you to a fuller, happier, richer life – for both you and your family.

Below is a list of organizations that can help you start helping yourself.

National Alliance On Mental Illness

National Institute on Mental Health

Heads Together Mental Health

Your child is suffering !

As painful as it is to consider, abundant data tells us that childhood suicide is a reality. My heart aches as I process this information.  Children should be immune to the kind of pain that would prompt a suicide solution.  Unfortunately for us all, children are not immune to extreme bouts of mental and emotional pain.  Most of the data and research deals with preteen and teenage children, who are being bullied or are having relationship problems of one sort or another, often with their peers.  Almost all of these preteen and teenage children suffer from depression and/or anxiety as well.   More recently, studies have begun of children 5-11 years of age who commit suicide. Can you even begin to imagine that a five year old could be in that much pain, let alone know how to carry out the action of taking his/her own life?

Yes, there is a lot of data on childhood suicides, but more important for this writing is the information about how to detect and treat the causes that lead to thoughts and acts of suicide by very young children.  It is critical for parents to understand the signs that appear when a child is having extreme emotional problems and considering suicide, and to know how to support them and get help for them.

According to an article in Psychology Today, if you notice changes in a child’s behavior such as in sleeping patterns, eating habits, or socialization patterns, take action to delve deeper to find out what is going on with your child.  Experts in this field say that parents should not be afraid to talk to their children about suicide.  According to the experts, ask direct questions about your child’s thoughts regarding suicide, and talk openly about whether or not your child is considering this as a solution to his/her emotional pain. Parents should not hesitate to discuss the permanency of suicide with their children. Some young children do not understand that it is a permanent solution to a temporary problem.  Contact the child’s physician and let them know what is going on.  Contact a child psychologist and make an appointment for the child.  Spend enjoyable time with the child.  Reassure your child that he/she is very precious to you and you are always there to help them work out a positive solution to their issues.

It is very important to take any expression by your child about suicide absolutely seriously.  Your child is suffering and needs help.

 

Resource

Center For Suicide Prevention

ESA

We are all familiar with service animals that are trained to provide help for their owners in a variety of different ways.  Service animals can be trained to lead a blind person, support the head of someone having a seizure, or detect an imminent panic attack, among other tasks.  However, new on the scene are emotional-support animals (ESA) that provide emotional support to students on a college campus suffering with a mental illness, i.e., depression or anxiety.  The animal is not specifically trained (as would be a service animal) to give emotional support, which can lead to such an animal being indistinguishable from a regular pet.  Inasmuch as the number of college students with clinical depression or anxiety is today rising, ESAs are becoming more common on campuses.

As a result of the Americans With Disabilities Act, which describes a service animal as one that is trained to perform a task its owner can’t, schools have formulated and implemented a clear policy pertaining to the use and housing of service animals on college campuses.  However, the use of ESAs (as reported in a January 23, 2019 Philadelphia Inquirer article in The Region section) is a more recent development, and there is less of a clear-cut policy defining the use of an emotional-support animal.  At the moment, permission for having an ESA in campus housing is granted based on a letter from a medical provider explaining that the person requesting an ESA has a diagnosed mental illness and that an animal is necessary to help this person cope.  Unfortunately, a problem arises when students feign mental health issues in order to obtain permission to have their favorite pet accompany them to college.  This is a kink that needs to be worked out, and may prevent a doctor from writing the necessary letter.  This all being said, there are other avenues to take in order to get the needed letter that will allow someone with a mental illness to bring an ESA to campus.  If you can not get your doctor to write the required letter, there is an organization called CertaPet (that is but one of a number of such organizations) that is able to certify the need for an ESA after conducting a clinical assessment by phone with a person who is requesting emotional support.

There is plenty of research that has been conducted in the field of ESAs, but little of this research proves the if, how, or why an ESA works.  There were a number of students who were interviewed for the Inquirer article giving glowing reports on the benefits of having an ESA, but all the data received was anecdotal information.  Molly Crossman, a researcher at Yale who focuses on human-animal interaction, is cited in the Inquirer article as noting that research has been limited to short-term interactions which does not give a full picture of the benefits of an ESA.  It seems as though the final chapter has yet to be written on the benefits of an ESA, but nothing appears to suggest that ESAs do not serve a helpful purpose.

 

References:

National Alliance On Mental Illness

National Institute On Mental Health

Heads Together Mental Health

the mood changed

“ We talk about mental-health in a reactive way, after a Kate Spade or an Anthony Bourdain commits suicide.  Part of me wonders, if we were to normalize talking about mental health, how many people could we keep from that kind of suffering?” (This sentence appeared at the end of an article that I read recently.)

Most people just do not want to talk about mental-health illness.  The topic of mental-health illness is not found on any list of acceptable subjects for polite conversation.  If the topic creeps in during an evening gathering, the tone of the conversation changes.  People get quiet.  A hush comes over the room.  Eye contact ceases.  People begin to look down into their laps or off to the side.  They squirm in their seats, and sit counting the minutes until the conversation can be changed.

Just the other evening I was with a group of wonderful, bright, witty women, all of whom happen to have partaken in therapy at one time or another.  They are no strangers to the concept of seeking help, and of knowing the benefits of that help.  However, only one of these women knew that I had actually suffered from depression and anxiety.  We were all laughing, drinking, eating, and sharing personal stories.  After awhile, each person had made an off-handed reference to their experience with therapy, leading me to feel safe enough that I could share my story with these wonderful, bright, witty women.  At a moment in the conversation that seemed apt for an appropriate segue, I shared that I write a blog about mental health, and in particluar about the stigma that is so unfortunately attached to it.  I was immediately aware of the change in the mood around me.  Everyone got quiet.  No one knew what to say.  Wonderful, bright, witty, women, all of whom had some experience with a mental health issue, and perhaps even the medications that often accompany a mental health problem, were embarassed by my acknowledging my own battle with mental illness.  To this moment, I do not remember how the conversation moved forward.  I became self-concious, and I know I stopped talking.  The evening continued on, but this incident will certainly make me think carefully before sharing that information again.

If this can happen to me, someone who writes a blog about mental health, someone who can speak about it a bit more freely than many others, how can we expect the average joe to find this topic comfortable?  If the people who understand it are uncomfortable, then how can we expect those who have no idea about mental health illness begin to gain a level of comfort in a conversation dealing with this topic?

The solution to getting rid of the stigma that accompanies mental illness needs to start with us – the people who have a mental illness.  We need to be the ones to speak up and out about our own experiences.  Let people know that we are normal, wonderful, bright, witty, people with a health issue.

Resources

National Alliance on Mental Illness

National Institute on Mental Health

Heads Together Mental Health

Inch by Inch

Inch by inch and step by step we are making progress in the battle against the stigma related to mental-health illness.  The progress has been slow for sure, and comes primarily in the form of articles being written about the existence of this stigma.  The stigma is definitely still a factor in the mental-health conversation, but at least people are talking about that stigma.  Does that sound like progress?  Yes, it does, certainly to me, because we are talking about and acknowledging the existence of mental-health issues.  We are not ignoring the topic hoping it will go away.

Each of these articles to which I referred above talks about people, famous and not-so-famous, admitting that they have mental-health challenges.  Carson Daly, host of The Voice and a contributor on the Today Show, admits battling a panic and anxiety disorder since childhood.  Charlamagne Tha God, a radio host and best-selling author of Shook One: Anxiety Playing Tricks on Me, admits that even though he talks and writes about having mental-health issues, he is still not totally comfortable with this persona.  Allison Schmitt, a gold medal Olympic swimmer, Kevin Love, a professional basketball player, Jason Kander, a politician, and so many more well-known people have come forward and raised their hands and said, “Yes, I have a mental-health challenge.” But even with so many people confessing to having mental-health issues, we unfortunately are still not free of the stigma.

Our society has a long way to go to get up to speed on accepting mental-health illness and treating it like any other illness.  Until that happens, people will remain wary and reticent in seeking help for their mental-health issue. Depression will go untreated.  Anxiety will go untreated.  Panic disorders will go untreated.  Bi-polar disorders will remain in the closet.  And this result is so unfortunate, because there are so many ways to get help and lead a healthy, productive, and normal life.

For resources for help please refer to the list below.

 

Resources:

National Alliance on Mental Illness

National Institute on Mental Health

Heads Together Mental Health

Treatable Maladies

I remember the pain of suffering from depression and anxiety.  I hated that pain.  It was emotionally crippling, just like having arthritis can be physically crippling.  I don’t want others to feel that kind of pain.  I know that I am not able to eliminate mental health illnesses from our list of worldly challenges, but what I can do is encourage those who need treatment for a mental illness to get the help they need.  There are now many ways to treat the depression or anxiety that is the cause of the pain, and there is no reason to continue to suffer.  Mental illnesses are treatable maladies.

When I suspect that someone is feeling the discomfort of anxiety, I want to reach out with my arms and my words.  I want to encircle them with a hug that will protect them from the reality of their pain.  I want to squeeze them so tight, that there is no room left for their pain.  I want to say something that will magically lift away the weight of their mental illness.  I want to let them know and feel that everything will be all right.  But, this goal is not based in any reality, for I know that healing comes from the within, and each person must do his/her own work to heal.  However, that desire to protect others from the pain of an untreated mental illness is the reason I write this blog.  I believe a productive approach through which I can assist others is to help erase the stigma surrounding mental illness, and hopefully once that stigma is gone, mental health sufferers will be more comfortable seeking treatment.  Treatment will help them eliminate their own pain.

New Medications For Depression

People have suffered from depression forever. In the 5th century BC it was called melancholia. Treatment was offered through lifestyle changes, i.e., diet, exercise, sleep, massage, bathing, bloodletting, and vomiting. In the Middle Ages it was believed to be a disease of the spirit – demonic possession – and sufferers were simply burned at the stake. It was not until the 17th century, when a neurologist named Thomas Willis declared that melancholia was “a complicated Distemper of the Brain and Heart,” that medical practitioners were able to place the disease on the correct path. The treatment at that time was still similar to that of the 5th century, but at least they had begun to think of it as an illness. Along the way to modern times, treatments such as electroconvulsive therapy, chemical cocktails, herbal remedies, and a few unsuccessful experimental drugs were tried and discarded. It was not until 1957 that scientists began experimenting with some promising drugs. None were long-lived because of terrible side effects, but the process of trial and error allowed the researchers to begin to understand how the drugs worked, and ultimately provided scientists with information that enabled them to flush out what caused depression. They discovered the cause to be depleted levels of the brain’s neurotransmitters, namely serotonin, norepinephrine, and dopamine. That finding led to the discovery of Prozac in 1987. It was our first SSRI (selective serotonin reuptake inhibitor). Today we have many drugs from which to choose, but still 30% of all people with depression or depression-related illnesses are treatment-resistant.

There is an FDA approved drug presently being used by anesthesiologists called ketamine hydrochloride, which is administered to people who are having surgery in order to put them to sleep. It is unfortunately also being abused recreationally to “trip and hallucinate.” In light of its mood-altering characteristics, it is the basis for experimentation in the search for new psychopharmacological medications. Several clinical tests are taking place showing excellent results for treatment-resistant patients, which further encourages drug companies to continue financing research into ketamine’s curative possibilities. One of its major characteristics is that it apparently works quickly. Unlike the currently available selection of medications for depression and depression-related illnesses, which take from one to two months to begin to kick in, the ketamine-based drugs can have an effect in just a few hours. So progress is plainly being made in addressing the need for more effective medicinal remedies. This is great news for all of us.