Common Signs of Someone Who May Be Suicidal

This is an interesting article I found on: www.psychcentral.com

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About 70 percent of people who commit suicide give some sort of verbal or nonverbal clue about their intention to end their life. That means you could be in a position to guide someone to get help before they commit the one action that can never be taken back.

While 30,000 Americans die each year due to suicide, more than 800,000 Americans attempt suicide. Although women attempt suicide three times as often as men, men are four times more likely to be successful in their attempt.

Warning signs of suicide are not difficult to spot, but professionals differentiate between someone who simply has a passing thought of suicide or ending his or her own life, and someone who has persistent thoughts and has a definite plan. However you don’t have to know how serious a person is in order to help them.

Possible Suicide Warning Signs

Have you ever heard someone say two or more of the following?

  • Life isn’t worth living.
  • My family (or friends or girlfriend/boyfriend) would be better off without me.
  • Next time I’ll take enough pills to do the job right.
  • Take my prized collection or valuables — I don’t need this stuff anymore.
  • Don’t worry, I won’t be around to deal with that.
  • You’ll be sorry when I’m gone.
  • I won’t be in your way much longer.
  • I just can’t deal with everything — life’s too hard.
  • Soon I won’t be a burden anymore.
  • Nobody understands me — nobody feels the way I do.
  • There’s nothing I can do to make it better.
  • I’d be better off dead.
  • I feel like there is no way out.
  • You’d be better off without me.

Have you noticed them doing one or more of the following activities?

  • Getting their affairs in order (paying off debts, changing a will)
  • Giving away their personal possessions
  • Signs of planning a suicide, such as obtaining a weapon or writing a suicide note

Friends and family who are close to an individual are in the best position to spot warning signs. Often times people feel helpless in dealing with someone who is depressed or suicidal. Usually it is helpful to encourage the person to seek professional help from a therapist, psychiatrist, school counselor, or even telling their family doctor about their feelings. The National Suicide Prevention Lifeline (1-800-273-8255) offers free and confidential support for people in distress as well as prevention and crisis resources for you and your loved ones.

Remember, depression is a treatable mental disorder, it’s not something you can “catch” or a sign of personal weakness. Your friend or loved one needs to know you’re there for them, that you care and you will support them no matter what.

Suicide is one of the most serious symptoms of someone who is suffering from severe depression. Common signs of depression include:

  • Depressed or sad mood (e.g., feeling “blue” or “down in the dumps”)
  • A change in the person’s sleeping patterns (e.g., sleeping too much or too little, or having difficulty sleeping the night through)
  • A significant change in the person’s weight or appetite
  • Speaking and/or moving with unusual speed or slowness
  • Loss of interest or pleasure in usual activities (e.g., hobbies, outdoor activities, hanging around with friends)
  • Withdrawal from family and friends
  • Fatigue or loss of energy
  • Diminished ability to think or concentrate, slowed thinking or indecisiveness
  • Feelings of worthlessness, self-reproach, or guilt
  • Thoughts of death, suicide, or wishes to be dead

Sometimes someone who is trying to cope with depression on their own might turn to substances like alcohol or drugs to help ward away the depressive feelings. Others might eat more, watch television for hours on end, and not want to leave their home or even their bed. Sometimes a person who is depressed may stop caring about their physical appearance on a regular basis, or whether they shower or brush their teeth.

It’s important to realize that people who suffer from serious, clinical depression feel depressed for weeks or months on end. Someone who’s just having a particularly rough or stressful week (because of school or work demands, relationship problems, money issues, etc.) may not be suffering from clinical depression.

Common Signs of Someone Who May Be Suicidal

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Dying for the Ultimate Selfie: We’re Really Bad at Accurately Assessing Risk

This is an interesting article I found on: www.psychcentral.com

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Selfies are the journaling of our time. We take them everywhere we go, not only to remind our future selves of things we’ve done, but to also broadcast to the world what a fun, exciting, and carefully-curated life we lead.

But in a story that’s becoming as commonplace as school shootings in America, more and more people are either dying or putting themselves in extreme physical danger to take the ultimate selfie. And for what? Fame in the form of more likes and followers on social media.

Why are we so bad at rationally assessing risk in situations such as this?

It’s hard to believe we’ve come to a point in humanity where a simple act of photography could be life-threatening. But combine narcissism, the desire for popularity that extends beyond high school, and the human psychology of risk assessment, and you get a dangerous combination.

Reasons People Put Their Life at Risk for a Selfie

Humans fundamentally underestimate risk. Our minds have developed evolutionary shortcuts in order to make decisions more quickly — especially decisions about risk. This quick shortcut reaction in our brains evolved because it provided us an advantage in our fight-or-flight response, allowing us to decide whether we needed to get away from a potential predator or fight it. It served humanity well for thousands of years.

But over time, the risks changed from natural predators and dangers in the wild to less obvious risks in a mechanical and technologically-driven world. Our brains aren’t naturally wired to take into account these new man-made risks, and so the brain engages in a faulty and biased risk assessment.

Rewards can obscure the risk. When a person becomes so focused on the reward of attaining a goal they’ve worked hard to get — such as taking that ultimate selfie — their brains put aside risk or downplay it in such a way as to make the risk seem significantly less than it actually is. The amount of new follows and likes a person believes they are likely to receive from an amazing selfie simply outweigh their own personal safety.

Sunk costs may come into play as well. If a person has spent the past two hours trying to get to a specific remote rock outcropping to take the ultimate selfie, most people can’t imagine spending all that time and effort — and then not take the selfie. At that point, the person already has so much sunk cost — a cost that has already been expended in time, money, and effort that cannot be recovered. Turning back doesn’t seem like a reasonable option to most people’s brains. The supposed benefits gained from the once-in-a-lifetime selfie simply outweigh the risk.

Risks that we have control over — such as standing on a dangerous ledge — are perceived as lesser and more acceptable than risks we don’t have control over. This is why flying in an airplane is so scary to some — they aren’t the ones driving it; they have no control over the minimal risk they’re taking. This is also why nobody thinks about injury or death when getting into their car. Even though the statistical chances are infinitely higher in getting into an automobile accident rather than an airplane accident, we have control over the car we drive. In our brain, such control provides more acceptable risk — even when the data show that our brain is biased and wrong.

Memory also gets us into trouble when it comes to accurate risk assessment. If we’ve taken dozens of selfies in potentially-dangerous situations in the past without issue, our mind remembers and emphasizes that datapoint. So if 100 percent of the previous times we’ve taken a risky selfie, we’ve had no problem, our brain says, “Why would this time be any different?”

Humans regularly overestimate the odds of unlikely or rare events occurring, while simultaneously underestimating how dangerous or risky commonplace events can be. For instance, we believe that catastrophes, like a school shooting, happen far more frequently than they do. Some people even have a fear of going to school because of them. It’s splashed all over the news when it happens. Statistically, however, school shootings are still relatively rare events.

Everyday risks, on the other hand, we take for granted. They never get any news coverage. Auto accidents, for instance, occur far more frequently and are just as traumatizing to those involved. But you rarely see one in the news, or hear about it from friends — unless it affects someone you personally know.

That’s why people driving an automobile feel safer and believe they’ll never get into an accident — that sort of thing happens to other people. This false belief completely obscures the truth — that most people will be involved in an auto accident in their lifetime. And some people will even lose their lives from one.

Add all these reasons up, and you have a perfect equation for why people take extreme risks to take a selfie. Their brains have miscalculated the risks involved and decided that the rewards, sunk costs, and sense of control outweigh any possible downside.

Sadly, some people are paying for it with their lives. No selfie is worth a person’s life. But saying that won’t magically make a person reassess their selfie choices, because fame and popularity are the virtual drug of choice these days. Sometimes common sense just won’t win out until the fad has faded.

Dying for the Ultimate Selfie: We’re Really Bad at Accurately Assessing Risk

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When Your Anxiety Doesn’t Have a Trigger

This is an interesting article I found on: www.psychcentral.com

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It’s very common for Kristin Bianchi’s clients to tell her that they’re feeling anxious, but they’re not sure why. They say they recently haven’t experienced anything particularly stressful or anxiety provoking, so it doesn’t make much sense.

Consequently, “they frequently become worried about the meaning behind these seemingly random feelings of anxiety,” said Bianchi, a licensed clinical psychologist who specializes in treating OCD, anxiety disorders, PTSD, and depression at the Center for Anxiety & Behavioral Change in Rockville, M.d.

In other words, she noted, “they become worried about worrying, or frightened of fear.”

When many of Regine Galanti’s clients initially start working with her, they, too, describe their anxiety as just happening. Galanti is a licensed psychologist and director of Long Island Behavioral Psychology, where she specializes in using evidence-based treatments for anxiety and related disorders in children, teens, and adults.

Many of us believe our anxiety comes out of the blue. It just feels so random and sudden—startling us like the siren of a smoke alarm, or a squirrel jumping out of the bushes.

But this is rarely the case. Rather, we simply don’t notice our triggers. What we do notice is our anxiety, because it tends to be blaringly, glaringly loud. “When we feel something strongly, we often zero in on it and discount all the information leading up to and surrounding it,” Galanti said.

And the information that leads up to your blaringly, glaringly loud anxiety might be a thought, feeling, or behavior. Galanti noted that anxiety, and really all emotions, consist of those three parts. For instance, you might feel horribly anxious the morning after going to sleep past midnight, she said. You might become anxious as you notice your heart beating faster, she said.

Bianchi noted that it’s very common not to recognize that our thoughts are a significant trigger. “Thinking happens so quickly and automatically that we often don’t realize that we’re having stressful dialogues or creating catastrophic narratives in our own heads.”

For instance, she said, you might not even realize that you’re revisiting a recent conversation that caused you some stress. Maybe you’re replaying how your coworker was gossiping about your boss, which made you very uncomfortable. Maybe earlier this morning you and your spouse fought over your monthly budget (or lack thereof). Maybe your mind drifted to the sarcastic remarks your date was making (and how annoying they were).

The catastrophic narratives your head is spinning might include: “wondering whether or not you turned off certain household appliances, then imagining your house burning down if you forgot to do so; worrying that something bad will happen to a loved one, then imagining your reaction if that type of personal tragedy were to occur; creating ‘worst-case scenarios’ involving academic, career, or financial ruin when thinking about a recent disappointment or setback in any of those domains,” according to Bianchi.

Panic attacks also are a prime example. They seem sudden, but there are usually specific triggers, Galanti said. It might be a thought, “I can’t easily escape this situation,” or a physical sensation, such as your heart rate speeding up, she said.

And then there’s our digital culture. “We reflexively hop from tab to tab, app to app, and website to website, generally giving very little thought to the process,” Bianchi said. But while we might not notice that we’re doing all this hopping and scrolling, we’re still responding emotionally to what we’re consuming, she said.

That means that we are responding emotionally to sensationalist news headlines, flawless Instagram images, and emails from colleagues and clients, all of which can trigger anxiety. However, we’re too hyper-focused on these stimuli to notice what’s brewing inside our bodies.

“Even low-level anxiety reflects that we’re experiencing a fight-or-fight response,” Bianchi said. “When we finally notice it, it can come as a surprise to us, as we hadn’t been paying attention to it up until that point.”

So what can you do? What are your options when your anxiety seems to arise out of the blue?

Below, you’ll find a few tips on identifying your triggers—even the subtle ones—and reducing anxiety when it starts. It’s especially helpful to practice the relaxation strategies when you’re not anxious. This way you’re familiar with them, and maybe even created a habit.

  • Act like a scientist. Galanti tells clients that the goal is to help them treat their anxiety like a scientist: to “take an outsider perspective on their insides.” To do this, she suggested readers use a journal or the notes section on your phone to record your anxiety. That is, whenever you feel anxiety coming on, she said, ask yourself, “What just happened?” “literally, what happened immediately before and then try and pinpoint [your] thoughts, physical feelings, and what [you] do.” Maybe you downed a huge cup of coffee. Maybe you thought about your to-do list. Maybe your thoughts shifted to your child’s first big presentation. Maybe you read an email from your boss. Maybe you said yes to an invitation (that you really, really didn’t want to accept). Maybe you started sweating because it’s so hot. Tracking what triggers your anxiety helps you to spot patterns, and “those patterns can help people come up with solutions,” Galanti added.
  • Slow down your breathing. Bianchi suggested “breathing in slowly through your nose to a count of 4 to 6 seconds, holding your in-breath for 1 to 2 seconds, then slowly breathing out through your mouth to a count of 4 to 6 seconds.” When you’re breathing out, it helps to “imagine that you’re blowing fuzz off a dandelion or blowing a stream of bubbles,” she said.
  • Practice this grounding technique. According to Bianchi, find five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. “This shifts our focus away from the anxiety and helps us to reconnect to the present moment using our five senses.”
  • Practice progressive muscle relaxation. This involves scanning your body for muscle tension, and then “unclenching” tight muscles to release that tension, Bianchi said. “When doing this, it’s important to remember to relax your jaw, open your mouth slightly, and make sure that your tongue is positioned at the bottom of your mouth (versus flexed against the roof of your mouth).” You also can use an app that offers a guided practice, such as Headspace; Stop, Breathe, and Think; and Pacifica, Bianchi said.
  • Face your fears. Avoidance only amplifies and strengthens our anxiety. Facing your fears, a skill known as “exposure” in cognitive behavioral therapy (CBT), is incredibly effective in reducing anxiety. Galanti suggested devising a list of small steps to help you face your triggers. For instance, she said, if caffeine triggers your anxiety, you might “start drinking a little bit of coffee a day, and see what happens. Even if you do feel anxious, maybe you can handle it better than you think you can.” Another option is to work with a therapist who specializes in treating anxiety with CBT or other successful treatments. Bianchi suggested starting your search at a professional organization, such as https://adaa.org, and http://www.abct.org.

Anxiety can sometimes feel like it has zero rhyme or reason, which can be exceptionally frustrating. It can feel like you’re going about your business, and BAM! an object falls from the sky and smacks you on your head.

But when you delve deeper, you realize that there’s a thought, feeling, or behavior that sparked that bam! And that’s valuable information. Because now you can focus on the root of the issue and try to resolve it, whether that’s a conflict with a loved one, difficulty saying no, the fear of fear, not enough sleep, or something else altogether.

When Your Anxiety Doesn’t Have a Trigger

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Mental Health Awareness Month: How Can Therapists Participate?

This is an interesting article I found on: www.goodtherapy.org

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Mental health is a person’s condition regarding their psychological and emotional well-being.

Webster defines mental health as “The condition of being sound mentally and emotionally that is characterized by the absence of mental illness and by adequate adjustment, especially as reflected in feeling comfortable about oneself, positive feelings about others, and the ability to meet demands of daily life.” Additionally, according to The World Health Organization, mental health includes “Subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one’s intellectual and emotional potential.”

In these definitions, the message is largely about stress, which directly impacts how we feel about ourselves and the world around us. Stress can refer to big traumas or even small traumas that disrupt our daily activity and ability to function. It creates a lens, or filter, for how we deal and cope with various situations.

The Importance of Addressing Mental Health

We are told to achieve, to obtain; but if we do not care for ourselves, how do we maintain motivation or momentum to do so?

Often, our coping mechanisms become skewed, and we find ourselves even more overwhelmed, with a warped sense of self as a result. People can slip into a mindset of being inadequate, bad, or invisible. How often do we allow these mindsets to linger and settle in our psyche? What is the normal response to talking about and managing our stress? “Just deal with it;” “I don’t have time to think about that stuff;“ or “I have to keep moving”: Society, media, and even our families may tell us how we should be and what we should be doing. But we may rarely be instructed in the intricate steps for achieving these goals.

We are told to achieve, to obtain; but if we do not care for ourselves, how do we maintain motivation or momentum to do so?

How Professionals Can Help

During Mental Health Awareness Month, it is our duty as professionals to get the word out about how self-care, which leads to self-actualization (the top tier in Maslow’s hierarchy of needs to be healthy and happy) is a priority, and it is necessary!

We can do this by highlighting various concerns that arise when mental health is not addressed. We can use social media as a vehicle and platform to promote ways in which people can implement positive coping skills and learn how to identify when they may need to implement them.

Social media can also be used to advertise when and where support groups may occur or agencies that may be able to support a person who might need help addressing their mental health.

Taking care of ourselves allows us to understand our roles within our families, communities, and more importantly, within the community of the Self. How do we get the word out that it is okay to acknowledge, accept, and make agreements with Self and others to work on improving our state of existence? Mental Health Awareness Month is one way! It is about just that: making it acceptable to breathe. Making it acceptable to stop and address all those stressors that impact our self-worth and allow us to doubt our abilities.

Where do people go to “breathe” or catch a break from reality? Churches and other religious or community centers are a few places! Professionals could speak at local community centers through holding a seminar once a week or handing out pamphlets. They might even place a flyer on community bulletin boards to bring attention and awareness to mental health.

Barber shops and hair salons can serve the community in the same way. Many people come to these spaces to gain insight and gain acceptance. They may often engage in banter that promotes thought and facilitates change. People in these places could be more likely to pick up a pamphlet that’s left around.

Fighting Mental Health Stigma During Awareness Month

If we do not address our mental health, it can decline into mental illness. Most people do not understand or know the difference between mental health and mental illness. Part of what we can do as professionals is educate the public on these differences and how one can be related to the other. During this month, we can highlight the difference!

We can speak to people about how to address both mental health and mental illness. As people may often try to avoid these topics, in such a forum as Mental Health Awareness Month, they can gain information without “outing” themselves.

As identified previously, if people do not address their mental health or stress, the symptoms can become harder to control, hide, or contain. They may slip out in ways that can be embarrassing, harmful to self and others, and detrimental to employment, relationships, and even physical health. These are the pitfalls of allowing stress to grow without being managed or supported.

No matter what stage of change (pre-contemplation, contemplation, preparation, action, maintenance, relapse) you may be in, having better understanding can help! The more we put the word out there and dispel the stigma associated with mental health, the better we can aid people in propelling themselves into possibly and the next phase of change.

Mental health is still, in some communities, seen as an excuse or as not real. Other times, it is misunderstood or not even acknowledged. Our job, not just in the month of May, but every day, is to increase the general understanding of how mental health is a real thing that people struggle to cope with and gain control of.

We are here to help individuals through the process of coping and creating change. Here’s hoping that these ideas and tips will help you spread the word!

References:

  1. Mental health. (2019, April 27). Merriam-Webster. Retrieved from https://www.merriam-webster.com/dictionary/mental%20health
  2. Mental health: A state of well-being. (2014). World Health Organization (WHO). Retrieved from https://www.who.int/features/factfiles/mental_health/en

© Copyright 2019 GoodTherapy.org. All rights reserved. Permission to publish granted by Maia A Delmoor, MS, LPC, CAADC, therapist in Jenkintown, Pennsylvania

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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Small Things I Do Every Day to Manage My Depression

This is an interesting article I found on: www.psychcentral.com

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Some days you feel well, and other days, darkness envelopes you. You feel achingly sad, or you feel absolutely nothing. You’re exhausted, and every task feels too big to start. You feel weighed down, as though there are sandbags attached to your shoulders.

Managing the symptoms of depression can be hard. But even the smallest steps taken every day (or on most days) can make a significant difference.

Below, you’ll learn how five different women live with depression on a daily basis, and the small, yet pivotal actions they take.

Having a daily routine. “Having a daily routine helps me push through the days when I’m not feeling my best,” said Denita Stevens, a writer and author of the recently released poetry collection Invisible Veils, which delves into her experiences with depression, anxiety, and post-traumatic stress disorder (PTSD).

Stevens’s routine starts at night with two morning alarms: one alarm is optional, the second one, which rings around 7 a.m., is not. “I take a moment to gauge how I’m feeling before deciding which one I wake up to.  Sometimes I don’t always have a good night’s sleep and an extra hour of rest helps.”

When she’s up, she drinks coffee and reads. Then she focuses on work. The evenings are dedicated to personal time. This “gives me motivation to accomplish what I need to do during the workday in a timely manner and allows me to end the day investing my time in myself,” Stevens said. This me-time might mean socializing, exercising, relaxing, or working on a writing project—right now she’s working on a memoir about what it was like to live with undiagnosed PTSD and how she recovered.

On weekends, Stevens doesn’t have a schedule. “A balance between scheduled and unscheduled time every week seems to work best for me,” she said.

Setting boundaries. “Setting boundaries is extremely important to my mental and emotional well-being,” said T-Kea Blackman, a mental health advocate who hosts a weekly podcast called Fireflies Unite With Kea.

For instance, Blackman has set her phone to go into “Do Not Disturb” mode every night at 9 p.m., because she wakes up at 4:45 a.m. to exercise. “Working out has been beneficial as it helps to improve my mood and I sleep much better.” Going to bed around the same time and waking up around the same time helps her get consistent rest. “When I am not well rested, I am unable to function throughout the day.”

Exercising. “I make myself exercise even if I don’t feel like it,” said Mary Cregan, author of the memoir The Scar: A Personal History of Depression and Recovery. “If my mind is troubling me, I’ll try using my body instead.”

If Cregan’s energy is really low, she goes for a walk. And these walks have a powerful benefit: She gets to see other people—“little kids in playgrounds, old people walking with their shopping bags, teenage girls all dressed alike. People can be interesting or amusing, and help me get out of my own head.”

Cregan, who lives in New York City, also likes to walk along the Hudson or around the reservoir in Central Park, and admire the water. She likes to look at the plants and trees, too. “If the sun is out, I’ll sit on a bench with the sun on my face.”

Tidying up. Cregan also regularly makes her bed and cleans up the kitchen. This way, she said, “things don’t feel messy or ugly, because that would be depressing in itself.” Sometimes, she buys flowers for her home, since looking at them cheers her up.

Having downtime. Blackman prioritizes downtime to help her unplug and recharge. Sometimes, this looks like listening to water sounds—waves crashing onto the shore, water hitting the rocks—and putting on her essential oil diffuser as she listens to a podcast or reads a book. Other times, it looks like lying in bed and letting her mind wander, as she listens to the water sounds and breathes in the essential oils.

Wearing comfortable clothes. Fiona Thomas, author of the book Depression in a Digital Age: The Highs and Lows of Perfectionism, regularly tunes into her inner dialogue. When she notices the chatter is negative—“you’re so lazy”—she decides to actively challenge the voice and be kind to herself instead.

“One small way that I’m kind to myself every day is by wearing clothes that I feel comfortable in as opposed to what I think people expect me to wear. If I want to wear leggings and a baggy jumper to the supermarket, then I do it.”

Creating small moments of self-care. Another way that Thomas is kind to herself is by going out for coffee, or taking several minutes to stand by a canal and watch the ducks go by.

Practicing self-compassion. In addition to depression, Leah Beth Carrier, a mental health advocate working on her master’s in public health, also has obsessive-compulsive disorder and PTSD. When her brain tells her that she isn’t worthy, doesn’t deserve to take up space, and won’t ever amount to anything, she gives herself grace. “This grace I give myself allows me to be able to hear these old tapes, acknowledge that they are fear based and my fear has a purpose, and then continue to go about my day.”

Taking a shower. “I try my hardest to take a shower every day even though I find this really difficult with depression,” Thomas said. “Even if [showering is the] last thing [I do] at night, I know it helps me feel healthier in the long run.”

Looking in the mirror. “I have also found that the simple act of looking at myself in the mirror, eye to eye, each morning and making a point to say hello to myself—as silly as it sounds—keeps me grounded,” Carrier said. “It is also a little reminder that my existence here on earth is allowed and OK, maybe even something to be celebrated.”

Of course, the specific small actions you take will depend on the severity of your depression, and how you’re feeling that day. The above actions are examples that speak to the power of small. Of course, it’s also vital to get treatment, which might include working with a therapist and/or taking medication.

Ultimately, it’s important to remember that the pain isn’t permanent, even though it absolutely feels permanent in the moment. You won’t feel this way forever. “Having lived with depression since I was a teenager, I’ve discovered that even at my lowest points, I can still survive and it will get better,” Stevens said. “It always gets better. May not seem like it at the moment, but those feelings are only temporary.”

“I never believed it when people told me it would get better when I was in my darkest days and attempted suicide, but I remained committed to my recovery…,” Blackman said. She’s made various changes, and has seen a huge improvement in her mental health.

Don’t discount the power of small daily acts and steps. After all, before you know it, those small steps have helped you walk several miles—a lot more than had you been standing still. And if you do stand still on some days, remember that this is OK, too. Try to treat yourself gently on those days, to sit down, and extend yourself some compassion.

Small Things I Do Every Day to Manage My Depression

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What I Want Someone Who’s Overwhelmed with Their Mood Disorder to Know

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You have depression, or bipolar disorder. And on some days, you feel like you’re treading water—at best. You’re tired of struggling. You’re tired of regularly feeling tired. You’re angry that your to-do list just keeps getting longer and longer. You’re angry that you have to deal with so much darkness day in and day out.

Some days are just hard. Some days you feel so overwhelmed.

It is on these days that you probably feel like the only person on the planet who’s struggling with persistent symptoms.

Thankfully, you’re not. And thankfully, it will get better.

We asked individuals who live with depression or bipolar disorder to share what they’d like others who are feeling overwhelmed with these same conditions to know. Most of the individuals are speakers from This Is My Brave, a fantastic nonprofit organization that hosts live events and aims to “end the stigma surrounding mental illness through storytelling.”

Get treatment. T-Kea Blackman, a mental health advocate and speaker who lives with depression and anxiety, stressed the importance of seeing a therapist who can help you identify triggers, learn healthy coping tools, and set boundaries, along with a psychiatrist if you need to take medication. (For bipolar disorder, both medication and therapy are vital.)

Blackman emphasized not getting discouraged if the first or third medication you try doesn’t work, or the first or third therapist you see isn’t a good fit. “It can take time to find the right dosage and medication, and therapist for you.” This can be frustrating, but it’s common—and you will find the right help.

Focus on small victories. Sivaquoi Laughlin, a writer, blogger, and mental health advocate with bipolar II disorder, has good days, bad days, and sometimes great days. She underscored the importance of realizing that it’s OK not to be OK, and acknowledging small victories, which are actually “huge.”

Some days, those small victories might be getting out of bed and taking a shower, she said. Other days, they might be excelling at work and going to dinner with friends. Either way, it’s all important and worthwhile.

Forgive yourself. Fiona Thomas, a writer who has depression and anxiety, stressed the importance of not beating yourself up when you don’t do everything on your list, or when you have bad days. One of her friends always says: “Remember that your best changes when you’re not feeling well.”

Thomas, author of the book Depression in a Digital Age: The Highs and Lows of Perfectionism, suggested not comparing today’s output to your output from last year or last week. “It all depends on how you’re feeling mentally, and if you’re not 100 percent, then just do what you can—the rest will come later.”

Thomas also suggested doing one small thing every day that makes you feel better. This might be anything from drinking a few glasses of water to walking around the block to talking to a friend, she said. “There are so many ways to boost your mood little by little, and over time, they become habits and make you feel better without even really having to try.”

Do one enjoyable thing every day. Similarly, Laughlin encouraged readers to find one thing that brings you happiness, and try to incorporate that into your daily routine.

For Laughlin, it’s many “one things.” That is, she loves being with her grandson and her dogs, meditating, hiking, reading, and writing. “Start small and build upon it. Forgive yourself if you miss a day or days.”

Remember you are not broken. Suzanne Garverich is a public health advocate who is passionate about fighting mental health stigma through her work on suicide prevention as well as telling her story of living with bipolar II disorder. She wants readers to know that you “are not damaged, but [instead] so courageous and strong to live through and fight through this illness.”

Document your OK days. This way, “when you are having an off day or month or series of months, you can go back and remind yourself that you have felt differently,” said Leah Beth Carrier, a mental health advocate working on her master’s in public health, who has depression, obsessive-compulsive disorder, and PTSD. “You are capable of experiencing emotions other than the numb, black hole you reside in at the moment. There is hope.”

Surround yourself with support. “Surround yourself with people who can support you and find an online community who can relate to you, such as the Buddy Project or my community, Fireflies Unite,” Blackman said. She also noted that the National Alliance on Mental Illness offers free support groups.

Other online supports include: Psych Central’s forums, and Project Hope & Beyond and Group Beyond Blue–both of which were started by one of our associate editors, Therese Borchard.

Teresa Boardman, who has treatment-resistant bipolar disorder, attends weekly therapy sessions, but sometimes, she said, she needs more. “It’s OK to talk frankly with someone. I like to use the crisis text line because I do not have to break my cone of silence. Expressing yourself truly makes you feel less alone.”

Living with a mental illness can be hard. Acknowledge this. Acknowledge your overwhelmed, exasperated, angry feelings. Remind yourself that you’re not alone. And remind yourself that you are doing an incredible job, even on the days it doesn’t feel like it.

What I Want Someone Who’s Overwhelmed with Their Mood Disorder to Know

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Small Things I Do Every Day to Manage My Bipolar Disorder

This is an interesting article I found on: www.psychcentral.com

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Living with bipolar disorder can feel overwhelming. Maybe you’re tired of the ups and downs of different episodes—the soaring energy, the debilitating fatigue, the racing I-need-to-do-everything-and-I-need-to-do-it-now thoughts, and the dark, decelerated, bleak thoughts.

Maybe you’re exhausted from struggling with an especially stubborn and deep depression, which makes it tough to concentrate on anything, and feels like you’re walking through a river of waist-high molasses in a fog.

Managing bipolar disorder can feel overwhelming, too. What can make it much easier is getting effective treatment. Bipolar disorder is highly treatable—but a lot of people with the illness don’t get professional help.

Author Charita Cole Brown pointed out that “Of the estimated 5.7 million Americans living with the disorder, over 50 percent won’t seek treatment.” She wrote the memoir Defying the Verdict: My Bipolar Life “to reduce the stigma surrounding mental illness in general and bipolar disorder in particular. People need to understand how important it is to seek appropriate treatment.”

“My recovery is no anomaly,” Brown said. “By sharing my story, I want people to understand that mental illness is physical illness, therefore we must seek treatment as we would for diabetes or a broken arm.”

In addition to seeking treatment, there are small things you can do every day. Below, alumni from This Is My Brave share the small and significant ways they manage their bipolar disorder. This Is My Brave is an international nonprofit organization that hosts live events and publishes essays on their website written by people who are living with mental illness and living well.

Checking in. Amy Gamble is a speaker, executive director of NAMI Greater Wheeling, and a former Olympian. Every day and throughout the day, Gamble checks in with how she’s doing: “’Are my thoughts racing a little or do I just have a lot of creativity going right now?’ If I find I’m a little charged up or anxious, maybe even hypomanic, I take extra precautions not to make a lot of decisions.”

Gamble monitors her behavior, too. “I think about what is typical for me when I’m balanced. I am a very deep thinker and don’t typically make impulsive decisions. If I start acting on impulse, I reel myself back in. I don’t always notice a change in my behavior right away, but I monitor with hypervigilance.”

Suzanne Garverich also carves out time to pause and do a “self-inventory.” “I assess quickly how I am doing emotionally, physically, mentally, and spiritually,” said Garverich, a public health advocate who is passionate about fighting mental health stigma through her work on suicide prevention as well as telling her story. This helps her identify her needs—“before I go too far down the rabbit hole”—and meet them.

For instance, if Garverich determines that she’s feeling emotionally low and having dark thoughts, she figures out what she needs to do to “help me not go deeper into the dark thinking and depressive feelings.” She might call a friend or take a 10 to 15-minute walk. “It could be as simple as walking to the water fountain and drinking some water—just moving a muscle to change a thought. It could also be that I need to do some redirection of my thinking using my CBT and DBT skills…”

Having an effective bedtime routine. “The major thing I do is to make sure I get 8 hours of sleep a night,” Garverich said. “This really helps in keeping me balanced—sleep has a huge effect on my bipolar.”

To help herself get restful sleep, Garverich maintains a routine. Two to 3 hours before her bedtime, she stops doing anything work-related. She usually watches 30 minutes to an hour of TV. Then about an hour before her bedtime, she takes her nighttime medication, and gets into bed to read. Some nights she also takes a shower or bath.

“I also spend time before I go to bed breathing on my back and reviewing my day—seeing what I have done well, what I would like to improve, and if there is anything I need to share with anyone.”

She sets her alarm for the same time every morning. After she wakes up, she meditates in bed for 30 minutes. (More on meditation below.)

Practicing mindfulness and meditation. Gamble, also author of the book Bipolar Disorder, My Biggest Competitor: An Olympian’s Journey with Mental Illness, practices meditation, deep breathing, and mindfulness. “Staying in the present moment keeps me from getting down about how my illness has limited me.” (She also reminds herself that “everyone has something they are dealing with.”)

Every day Gamble listens to a playlist of her favorite meditation songs. “I put on my headphones and attempt to quiet my thoughts. I focus on slowing my mind down and paying attention to my breathing.”

Garverich also finds it helpful to practice deep breathing throughout the day, especially if she’s overwhelmed. For instance, at work, she usually takes a break and goes to the bathroom to take deep, slow breaths.

Connecting with others. “For me what is really important to achieve daily, to manage my illness and nourish my well-being, is feeling connected and not alone in my thoughts,” said Susie Burklew, who shared her story at the 2018 This Is My Brave show in Arlington, and co-produced the fall 2018 show. Eight years ago, for the first time, Burklew told her therapist that she thought she had a problem with alcohol. Her therapist suggested Alcoholics Anonymous (AA).

“I went to my first meeting that evening and I haven’t had a drink since. For the first time in my life I felt like I wasn’t alone. I connected and was inspired by people who had been through the same struggles and were living a happy life in recovery. I formed a strong network of people in AA and became comfortable opening up about my addiction to alcohol.”

For the past 6 years, Burklew has worked as a behavior specialist and counselor at a government residential rehab that specializes in co-occurring disorders.

Today, reaching out to someone on a regular basis—such as someone from her recovery network—helps her to stay in the moment, instead of getting “caught up in the stress of something that’s happened in the past or the fear of what’s ahead.”

Garverich connects with at least one person in her support system every single day. She might talk to this person over the phone, or they might simply text. Either way, this helps her know she’s not alone—something her illness wants her to feel, she said.

Sivaquoi Laughlin, a writer, blogger, and mental health advocate with bipolar II disorder, makes sure she spends time with her grandson and her dogs every day. “The energy from both provide me with a level of joy that I’m constantly yearning for.”

At the end of the day, Laughlin also sits down with her “16-year-old daughter and [we] discuss our day and name something good/great that happened. Even if it’s been a hard day or we haven’t had time to really connect, I make sure she knows that every day has a highlight.”

Engaging in art projects. “I undertake artistic projects daily. I am no good at it, but I can feel like I can breathe,” said Teresa Boardman, who has treatment-resistant bipolar I disorder with PTSD, OCD, suicidal ideation, and hypersomnia. Her latest project is a birdbath. “It is quite discombobulated that I decided to go with a steampunk theme. Now it is beautiful because I changed how I see it.”

Reducing the to-do list. Every morning, Laughlin lets her dogs out, and immediately makes a cup of tea. Next, she looks at the day ahead and jots down three things she’d like to accomplish. “They could be simple, such as returning a library book or dropping off dry-cleaning to bigger projects like organizing my closet or mowing the lawn. I’ve found that by committing to only three things, it keeps me from being overwhelmed and being triggered by ‘voices’ telling me I can’t do something.”

Boardman makes notes on her bathroom mirror of things she needs to do. For instance, she might list her exercise routine (e.g., 20 minutes of cardio, 20 minutes of yoga), and that she needs to take her morning medication and her evening medication. Boardman noted that she tries to work with her illness and its varying moods. After having over 20 electroconvulsive treatments (ECT), she realized she needed to take a different approach and embrace her illness.

It’s understandable that living with bipolar disorder can feel overwhelming and frustrating. But remember that there are 5.7 million Americans struggling alongside you. Remember that this illness, though difficult, is also highly treatable.

“Don’t give up hope,” Gamble said. “Things will get better, and you can learn how to manage the symptoms. They might not go away completely, but you can learn how it affects you. You can learn how to beat bipolar disorder.”

Small Things I Do Every Day to Manage My Bipolar Disorder

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Free Webinar: Narcissistic Personality Disorder: Everything You Wanted to Know

This is an interesting article I found on: www.psychcentral.com

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(Please note: This free live webinar will be recorded and a copy made available to all who register.)

“Narcissistic personality disorder — one of several types of personality disorders — is a mental condition in which people have an inflated sense of their own importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others. But behind this mask of extreme confidence lies a fragile self-esteem that’s vulnerable to the slightest criticism.” (By Mayo Clinic Staff)

However, as people, we are not as “transparent” as we like to believe. We are complicated. We are triggered by different events. We wear masks. We can be brilliantly malevolent and one is none the wiser. Our reactions to situations and people are dictated by our upbringing, experiences… The combination of environment, genetics and neurobiology makes this disorder particularly difficult to treat.

It isn’t easy to spot narcissists in ordinary interactions with them. They are not “conceited” in the sense that it is one behavior that is so evident we can retreat. As adults, they are well-rehearsed in seduction in order to hide what they have learned (not realized as a self-reflection) is unacceptable. Many times, a person involved with narcissists will realize who they are dealing with later in the relationship, when the narcissist is sure that they have secured your trust and feel they have enough control over you to satisfy their needs.

Three Take-A-Ways From Narcissism Webinar:

1. Viewers will learn about narcissistic traits.

2. Viewers will learn how narcissistic traits manifest themselves in someone and in relationships.

3. Viewers will learn about what it means to partner with a narcissist.

PRESENTER BIO:

Nancy Kalina Gomez Edelstein, NBCC, LPC completed her graduate doctoral course requirements in Psychodynamic Psychology at The George Washington University and received a Master’s in Clinical and Counseling Psychology at Columbia University.

Nancy is a bilingual (Spanish/English) licensed and certified (New Jersey) clinician with over two decades of experience treating and assessing patients/clients for services. She has worked as Clinical Director managing staff, case direction, grant guidelines and agency policy. She has worked in both the United States and South America with the following populations: Triply diagnosed (HIV+/Substance Abuse and mentally ill), gang members, abused/neglected children and their families, domestic violence (victims and perpetrators), severely mentally ill, transgender/transitioning, LGBTQ.

This webinar is a live, 45-minute seminar with a PowerPoint presentation followed by a Q&A moderated by Gabe Howard, host of The Psych Central Show podcast. There is no charge for the webinar, but registration is required. All registrants will receive a link to the recording.

Tuesday, April 30, 2019 6:00 PM – 7:00 PM EDT

Signup hereSpace is limited,
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Space is limited so please register early. Thank you.

Free Webinar: Narcissistic Personality Disorder: Everything You Wanted to Know

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What Is Mandated Treatment and When Does It Apply?

This is an interesting article I found on: www.goodtherapy.org

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When mental health conditions contribute to violent or dangerous behavior, affect the way a person treats their children, or increase the risk of recidivism, a court may order treatment. A court may also compel treatment if a person is deemed a risk to themselves or others. State laws governing court-mandated treatment vary, as do the programs a person might complete as part of court-ordered treatment.

Research on the value of court-ordered treatment is mixed. Mandated treatment offers access to mental health care that a person might not otherwise have. Some studies suggest that people pursuing court-ordered treatment may be less motivated in treatment or less likely to be honest with clinicians. Because treatment is mandatory, however, court-mandated treatments improve treatment completion rates.

The benefits and risks of court-ordered treatment depend on the type of treatment, the client’s commitment to treatment, the skill of the treating clinician, and numerous other factors.

The benefits and risks of court-ordered treatment depend on the type of treatment, the client’s commitment to treatment, the skill of the treating clinician, and numerous other factors.

What Is Mandated Treatment?

Mandated treatment is treatment ordered by a court. A person might have to undergo treatment for a set period of time, receive an evaluation from an approved mental health expert, pursue treatment at a specific facility, or agree to treatment as a condition of probation or parole. A person might also have to receive treatment before receiving visitation with or custody of their child.

Some examples of mandated treatment include:

Emergency mental health holds

When a person is a danger to themselves or to others, a therapist, doctor, or other clinician may pursue an emergency hold. These emergency holds require a person to seek evaluation at a mental health facility—usually a psychiatric hospital. In most cases, the hold lasts 72 hours. After the initial hold period, state laws vary. States generally have some form of judicial oversight, which means that a judge must approve the hold after a set period of time. A person can also fight a mental health hold, usually by filing an emergency petition with the assistance of a lawyer. A person cannot be indefinitely held against their will without a court order.

Treatment in lieu of incarceration

In some states, a person who is found not guilty by reason of mental disease or defect may be ordered to stay in a psychiatric hospital. In this scenario, the person cannot leave until they have either stayed for a period predetermined by the court or the facility has determined the person may be released.

Drug and mental health courts

Many states now offer diversion programs through drug and mental health courts. These programs require a person to complete treatment and other requirements. Those who finish the program can avoid jail or prison time. In many of these programs, jail time is used as a way to induce treatment compliance. For example, a drug court participant who doesn’t show up for a treatment session or who is accused of drinking might be forced to spend a weekend in jail before continuing the program.

Mental health treatment as a condition of some other benefit

Courts often make mental health treatment a precondition to receiving some other benefit. For example, a person being released early from prison via parole may have to seek treatment to avoid being re-incarcerated. Likewise, probation agreements that keep people out of prison sometimes require specific treatment. In these scenarios, a person typically meets with a probation or parole officer on a regular basis to show they are meeting court-ordered treatment requirements.

A person might also have to seek treatment to gain custody of their children. For example, if child protective services removes a child from a parent’s home because of the parent’s addiction, the parent may have to seek treatment and remain sober for a set period of time before regaining custody.

Legal principles of informed consent and informed refusal mean that a person cannot be forced into treatment without a court order. Some states offer a brief exception for 72 hour evaluation holds. In this scenario, however, a mental health professional must believe the person is a threat to themselves or others.

A therapist cannot force a client to stay in therapy or demand that a client undergo certain treatment. Even when a person receives court-mandated treatment, they retain basic rights such as the right to be free of physical abuse. People who have been ordered to undergo treatment may want to consult a lawyer. A lawyer can offer advice about your state’s laws as well as your specific rights.

History of Mandated Treatment for Mental Health

Mandated treatment allows clinicians, judicial systems, and treatment facilities significant control over a client’s life. Historically, mandated treatment was rife with abuse. People sent to mental health facilities might spend years in those facilities, receiving a wide range of unsupported and potentially traumatic treatments. Patients might be forced to undergo electroconvulsive therapy, be restrained for hours or days, or be subjected to violent abuse.

State licensing boards now regulate mental health facilities and prosecute abuse. Abuse can and does still happen. In 2009, a report detailed numerous abuses at Kings County Hospital Center’s psychiatric unit. New stories often feature tales of abuse in prison psychiatric facilities.

People undergoing mandated treatment should review all of their options, especially if they are permitted to choose among several therapists or facilities. When court-mandated treatment requires a person to seek treatment from a specific person or organization, advocates such as lawyers and family members can be key. Loved ones and paid advocates should educate themselves about the reputation of the treatment facility and remain in communication with the person undergoing treatment.

Common Reasons for Court-Ordered Therapy

Some of the most common reasons a court might order treatment include:

  • The person has been convicted of a sex crime. Some states’ sex offender registries require participation in sex offender treatment.
  • The person has lost custody of their child because of abuse, neglect, or addiction.
  • The person is involved in a child custody dispute, and the court thinks one or both parents need either a psychiatric evaluation or mental health treatment.
  • The person has a mental health condition or addiction and the court offers treatment as an alternative to jail or prison time.
  • The person is incarcerated, and the parole board offers treatment as a condition of early release.
  • The person is a threat to themselves or others. A person with intense suicidal ideation may be ordered to get a psychiatric evaluation or be held in a mental health facility for a set period of time. People with homicidal or violent thoughts may also undergo coerced treatment.

Does Court-Mandated Treatment Work?

Like any other treatment, the effectiveness of court-mandated treatment depends on several factors, including the skill of the clinician and the willingness of the client to actively engage in the treatment process. Court-mandated treatment can and does work.

Drug courts, for example, may lower recidivism. One study found that, over 2 years, drug court participation was correlated with a drop in recidivism from 40% to 12%.

Court-mandated treatment may also offer indirect mental health benefits. Researchers have repeatedly documented the harmful effects of incarceration on mental health. When court-mandated treatment helps a person avoid jail or prison time, it may prevent their mental health from deteriorating.

Mandated programs also have some shortcomings. When clients sign confidentiality waivers, they may be less likely to share openly with their providers. When a provider has the power to incarcerate a client by reporting noncompliance to the court, this can compromise the integrity of the therapeutic alliance.

Mandated treatment can feel scary and intimidating, especially if you have never sought mental health treatment before. Mental health workers offering court-mandated treatment are licensed professionals just like any other mental health worker. They have a duty to protect their clients and to offer compassionate care.

In many cases, a person compelled to undergo mental health treatment can still choose their own clinician. Click here for help finding the right mental health professional and here to find a treatment center near you.

References:

  1. Coviello, D. M., Zanis, D. A., Wesnoski, S. A., Palman, N., Gur, A., Lynch, K. G., & Mckay, J. R. (2013). Does mandating offenders to treatment improve completion rates? Journal of Substance Abuse Treatment, 44(4), 417-425. doi: 10.1016/j.jsat.2012.10.003
  2. Do drug courts work? Findings from drug court research. (2018, May 1). Retrieved from https://www.nij.gov/topics/courts/drug-courts/pages/work.aspx
  3. Hartocollis, A. (2009, February 06). Abuse is found at a psychiatric unit run by the city. The New York Times. Retrieved from https://www.nytimes.com/2009/02/06/nyregion/06kings.html
  4. Hedman, L. C., Petrila, J., Fisher, W. H., Swanson, J. W., Dingman, D. A., & Burris, S. (2016). State laws on emergency holds for mental health stabilization. Psychiatric Services, 67(5), 529-535. Retrieved from https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201500205
  5. Yasgur, B. (2018, May 29). Court-mandated substance abuse treatment: Exploring the ethics and efficacy. Retrieved from https://www.psychiatryadvisor.com/home/topics/addiction/court-mandated-substance-abuse-treatment-exploring-the-ethics-and-efficacy

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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The Dangers of Cyberchondria

This is an interesting article I found on: www.psychcentral.com

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We’ve all done it, or at least most of us have. I know I’m certainly guilty of it. I’m talking about turning to the internet for answers to our health concerns.

Just type in our (or our loved ones) symptoms and away we go. That rash we have? Turns out it could be anything from contact dermatitis to cancer. Which is it? Not sure? Well, search some more. There is always another website to check. And as many of us know, these searches can be never-ending.

Excessively scouring the internet for answers to our health concerns is known as cyberchondria. One in three people, among the millions who seek health information in this manner, report feeling more anxious after searching for answers than before. Yet they keep searching even as their worry escalates. Cyberchondria has the potential to disrupt many aspects of a person’s life and studies have even linked it to depression. Those with cyberchondria tend to either avoid going to their doctor, or go too much — both out of fear.

What drives people to engage in a behavior that often makes them feel worse than before?

Thomas Fergus, a psychology professor at Baylor University, links cyberchondria to a dysfunctional web of metacognitive beliefs, which are really just thoughts about thinking. We all have these types of belief systems. For example, it is considered normal to believe that deliberating over a challenging problem will lead to a satisfying solution. In cyberchondria, however, metacognitive beliefs morph into a mental trap — people search online health content incessantly.

Dr. Fergus and Marcantonio Spada, an academic psychologist at London South Bank University, have shown that these metacognitive beliefs in cyberchondria overlap somewhat with those of anxiety disorders. People with health anxiety, for example, hold maladjusted views about the role worry plays in maintaining their emotional and physical well-being. It is these same sorts of dysfunctional belief systems, Fergus says, “that send people with cyberchondria back for long sessions at the computer.”

In 2018, Fergus and Spada published research that, not surprisingly, links cyberchondria with features of obsessive-compulsive disorder (OCD). People with OCD perform compulsions to ease their anxiety, and those with cyberchondria engage in ritualistic searches for health information to dispel their anxiety. In both cases, people will only stop when they feel certain that all is well. As many of us know, online health content is too vast to allow us to be certain about anything. In fact, certainty is not actually attainable when it comes to most aspects of our lives.

So how can we escape the vicious cycle of cyberchondria? Appropriate therapies for anxiety disorders such as Cognitive Behavioral Therapy (CBT), mindfulness, and even antidepressants might be helpful. In addition, metacognitive approaches that encourage people to question the value of going online to relieve their anxiety can be beneficial.

There is another solution to spending countless hours on the internet trying to figure out your latest ailment. Go see your doctor for a proper diagnosis — once. Then you can use the other therapies mentioned to learn how to not only stop searching for answers, but to also learn to accept the feelings of uncertainty that are inevitably connected to our health.

The Dangers of Cyberchondria

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