Author: Hanna Gilley

Discovering life’s joyful moments fuels our creativity, our purpose, and our overall wellbeing. Although it can be challenging to allow ourselves to truly appreciate what brings us joy daily, it’s well worth the effort as all aspects of our lives can benefit.

Be present. Joy is experienced in the present moment. It’s normal to think about the past or plan for the future (and in some cases it’s necessary). Try allowing yourself to soak in smaller moments that resonate with you throughout your day. The smell of coffee brewing, a cherished hug from your child, or the way your body feels after a long stretch. Whatever it is, relish it as it’s happening in the moment.

Search for meaning. We tend to get caught up in our to-dos and responsibilities making us forget or push aside meaning and purpose in our lives. During the 2020 quarantine, people had the opportunity to slow down, recognize what’s truly important to them and re-direct their lives accordingly. Dismiss what you should do and dig deep for what you want to do— and do it!

Make time for a passion. Prioritize time for activities that you love. Joy can be found when pursuing something you’re passionate about and can also help you better understand yourself and what may bring more meaning into your life. Bonus points if you go outside of your comfort zone – for a challenge and personal growth. Both will excite and motivate you.

Seek authenticity. Particularly on social media, we can get lost in comparisons and lose sight of our true selves. Ask yourself: am I living how I genuinely want to live? Am I pleasing others rather than myself? Choose to live in a way that feels right to your authentic self. This includes surrounding yourself with positive people. We subconsciously absorb the energy of those around us so choose carefully who you spend your time with.

Connect with nature. Studies have proven that when we spend more time outdoors, we experience less anxiety and reduce our stress levels. When in nature, we not only gain the benefits of fresh air, but we also tend to slow down, be present, and reconnect with a higher power/our spirituality.

As helpers, we provide this feedback to our clients every day. At the end of a frenzied day, it can be daunting to think about putting to practice our own teachings. However, when we choose to prioritize ourselves by finding joy and relishing in it, we know that these efforts can reduce stress and anxiety, boost our immune system, reconnect with life’s meaning and add significance to our life. If you’re having a difficult time finding the positive in your life, do just one simple thing each day only for you. Even if for five short minutes—you’ve earned it. We all deserve to feel life’s joys!

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Mental health can and should be a daily practice, taken into consideration more often than “when something is wrong” or when going through a particularly difficult time. Taking care of your mental health is a preventative form of care and by incorporating daily rituals and practices into your life, you can give your mental health the attention it deserves.

Here are nine things you can do to take care of yourself so you can take care of others:

Take a mental health day. You know yourself best. If you feel that you need a break, take one. If you don’t have vacation or paid time off, consider taking mini breaks throughout the day to renew your energy and spirit. It’s okay to slow down and not feel rushed to cross everything off the to-do list at once.

Switch up your evening routine. Try winding down in a different way than you typically do if you’re feeling particularly stressed or “off.” Think about what relaxes you and adopt that into your routine: reading a book, taking a long bath, chatting with a friend.

Adopt a vacation mentality. Put your phone setting on do not disturb between 9pm-7am. Go swimming instead of sweating at the gym. Walk in the park with a friend during lunch. Ignore emails after you’ve clocked out for the day/week. Whatever you do on vacation that feels relaxing and rejuvenating, try bringing some of that into your daily life.

Meditate for five minutes every day. Perhaps you’ve heard this advice before, but the science doesn’t lie! Meditation eases stress and anxiety, calms your nervous system, helps with memory and so much more. There’s no need to put pressure on yourself to gain some important insight or enlightenment. Sit quietly, focused on your breathing with no judgment of the thoughts in your head. With regular practice, you’ll begin to feel the benefits.

Be mindful of what you eat and drink. It’s a common coping mechanism to comfort our emotions with food, drink or other substances. We all have different nutritional and lifestyle choices, but we suggest being extra mindful when experiencing stress, anxiety or depression as sugar, junk foods and alcohol will make you feel worse (even if you feel better temporarily).

Consider reaching out for professional help. There is no barometer, specific feeling or event that warrants a person to “need” or want professional counseling. We all have varying life circumstances and coping strategies. If you feel like you “shouldn’t be this upset” or that “others have it worse” we suggest allowing yourself permission to seek help. We all deserve it.

Prioritize rest. Our culture values the “hustle” and though hustle has it’s time and place, we also need rest. You know your body and mind best—if you need a morning off work, take it. If you need a long weekend alone, take it. If you need to sleep in just a little bit longer, sleep in! The to-do list is not going anywhere and you’ll need your physical and emotional health in top shape to do your best.

Write down as many inspiring messages as you can. They can be lyrics, affirmations, reminders to move your body, drink water, have gratitude—any message that uplifts you. Keep them close by, such as in a desk drawer, a large jar or your phone’s notebook app. If you need a pick-me-up, reach for one. Alternatively, download an app that sends positive affirmations to your phone daily. It’s proven that we bring to life the thoughts that we tell ourselves (even unconsciously), so let yourself think positive thoughts!

When we feel that we are in control of our thoughts, feelings and emotions we’re bound to continue the work that allows us to feel that way. However, if you think you may need professional help, reach out. Everyone needs help at some point in life. It takes courage and strength to recognize when help is needed and seek it out.

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As mental health professionals, you may suggest the importance of self-care to your clients, but do you have a difficult time implementing a practice in your own life? During the last year specifically there’s been an increase in demand for mental health services as individuals are navigating the effects of the pandemic. It’s essential as a counselor, therapist or clinician that you recognize any signs of stress or fatigue and implement self-care into your daily routine.

This may differ from person to person, but look for the following:

  • Losing your sense of humor
  • Problems developing at home
  • Having low or no energy
  • Becoming irritated with clients
  • Other physical and mental signs of stress include change of appetite, trouble
    sleeping, feelings of overwhelm or that things can never seem to go right

Consistently as a mental health professional, you give so much of yourself to your clients. This has every potential to leave you feeling emotionally depleted if there is an absence of other forms of support or self-fulfilling activities. Further, the cumulative stressor of an ongoing pandemic has been a shared trauma experienced by both client and clinician concurrently. This has presented us with an environmental parallel process while engaging with our clients. As such, it becomes increasingly more vital for us, as helpers, to ensure that we find ways in which to enrich our lives outside of session as a way of practicing self-care.

Outside of your career, you’ll want to be sure that your relationships are not “one-way streets.” It may be second nature for you to always listen and always give, but your personal relationships need full participation and commitment from all parties.

Why is practicing self-care important for mental health professionals?
When mental health professionals do not consider their emotional, physical and spiritual wellbeing as a priority, their outlook on their careers or the profession itself can change which may lead to severe stress or burnout.

Here are ways to implement talking the talk and walking the walk:

  • Join a peer group
  • Consider attending counseling
  • Create boundaries with clients
  • Set office hours (and stick to them!)
  • Take vacations/holidays

How can mental health professionals incorporate self-care into their daily practice?
Nurturing your wellbeing looks different for everyone and also may differ in the various stages of your life. Look for moments within your day-to-day to reflect and care for yourself. Make it a part of your routine and non-negotiable on your calendar.

Small acts of daily self-care include:

  • Go for a walk
  • Meditate, pray or practice mindfulness
  • Journal or write down thoughts and feelings as they arise
  • Nourish yourself with water, movement/exercise and nutritious foods
  • Set priorities on your to-do list ensuring there’s time for yourself

It may feel difficult or selfish at first to make yourself a priority. However, when you take proper care of your wellbeing, you’ll be able to increase the quality of care, impact more lives, and serve your clients better. That starts with taking care of yourself on a consistent, guilt-free daily basis.

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This article originally appeared in Macaroni Kid on May 13, 2021, by Cindy Mailhot, LCPC, LADC, CCS; Health Affiliates Maine. 

Question: My daughter was touched sexually without consent by a classmate last year. She has not had in-person classes with the student this year due to mostly remote classes. She has lately been expressing a lot of anxiousness about seeing him in person when classes resume to normal. How can she best prepare for seeing him again and feeling safe? (The school is aware and spoke to the boy and his parents when this happened. He received a school suspension.)

Answer: I can just imagine how stressful this situation has been for your daughter and for you as a parent. You are doing an amazing job as a parent in supporting your daughter and working with the school to ensure her safety and sense of safety with the world around her.

Not knowing the age of your daughter, here are some suggestions for a variety of ages:

  • Work with the school to determine a schedule and plan that involves minimal interactions with this other student and a plan for when interaction may happen.
  • Sit down with your daughter and review the potential spaces and places she expects to see this other student in school–in the classroom, in the halls, at lunch. Explore the possible interactions she can imagine (good and bad) and brainstorm how she might manage in different situations–walk away, go to the principal or guidance counselor’s office, find her friend group, calmly but firmly say “leave me alone.”
  • Try to understand her “ideal” situation and brainstorm how that might be able to happen.
  • Remind her that the other student might be feeling awkward and uncomfortable, too, and may also be worried about seeing her.
  • Find out what the return to the classroom will look like and perhaps try a trial run rather than going back full-speed immediately.
  • Find out who her supports would be in the school if she’s having a difficult time and work on familiarizing her with these supports (if she isn’t already familiar with them) so she might feel more comfortable seeking help if needed.
  • Explore who the safe people are to talk to if something were to happen that she is uncomfortable with.
  • Stay hopeful. Try something on this list each day. Dwell on thoughts of when the pandemic ends and of all the things you will want to do and explore with your child. Do not hesitate to reach out for help.
  • Find one friend that can be her “buddy” for the first few days or weeks, so she won’t feel alone as she gets a feel for the situation.
  • A transition object from home that she can keep in her pocket that reminds her of your unconditional love and support throughout her day may ease the transition.
  • Provide plenty of opportunities to discuss her worries and concerns with you and anyone else she might feel comfortable with.

To know if she’s adjusting well, keep the lines of communication open. Check-in with her regularly and ask how she’s feeling, if the plans that were made are working and if anything needs to change. I also recommend that you watch for behavior changes. If you notice anything concerning (you know your daughter best), reach out to a mental health specialist for assistance. Behavior changes could include a change in social activities, isolation, sadness, anger, acting out, or essentially any behavior that is outside the norm for your child.

 

Cindy Mailhot, LCSW, CCS is a clinical social worker and the Assistant Director of Outpatient Therapy at Health Affiliates Maine.

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This article originally appeared in Macaroni Kid on April 29, 2021, by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine.  

Question: I recently found out my 17-year-old is smoking marijuana. He said he does it to help with anxiety and that he finds a lot of relief in it. I don’t love the idea at all, but I also feel powerless to stop him. How can I talk to him about the risks but also be supportive if I lose this battle?

Answer: This is a difficult time for parents. At 17, your son is on the cusp of becoming a legal adult. This can give teens a feeling of not needing guidance or permission. Passing the milestone of 18 will not suddenly make him mature enough to all make decisions that are in his best interest. However, if your son is just starting to use at 17, studies show he is less at risk than a teen who starts at a young age, who smokes/vapes for years. A University of Montreal study says that the more teenagers delay smoking marijuana (cannabis) until they are older, the better it is for their brains, but there may be little ill effect if they start after age 17. That may give you some comfort. However, the human brain takes 26 years to reach full development so introducing substances does have risks when it comes to full potential.

That being said, I find a troubling issue in your question. What is causing the anxiety at age 17 for him to self-medicate with marijuana to relieve it? Many people have found cannabis calming, yet at seventeen or any age really, understanding the underlying cause of the anxiety is key. There are many non-drug ways of treating anxiety worth exploring.

Teens have lots of reasons to feel anxious and the pandemic has increased this anxiety. Life looks uncertain, relationships and future plans may be on hold, decreased social activity can add to general unsettledness and hopelessness. Under normal times, this age is challenging—adult responsibilities and major life decisions loom and teens question themselves. They are also developmentally pulling away from parental influences which can sometimes cause problems at home.

I commend you for wanting to address his marijuana use, but an overall conversation needs to include healthy coping and understanding of what is contributing to his anxiety. Living with anxiety can be a lifelong struggle and he should seek help at an early age to prevent this. Assure him that he does not have to talk to you about it, but a counselor might be a great help to him. Cognitive Behavioral Therapy (CBT) is an evidence-based successful treatment for anxiety which many therapists use in their work.

I urge you to do more research to give you what you need for the discussion. For parents with younger children, talking about marijuana and substance abuse needs to happen before they start using and should be an ongoing conversation. Here are some talking points (taken from the references below) for you and other parents to begin a conversation about marijuana use.

Marijuana can affect driving. It is extremely important that teens who drive understand how dangerous driving under the influence of marijuana can be. Reaction time and judgment can be impaired coupled with inexperience behind the wheel.

Importantly, marijuana is illegal. The fact that many states have legalized recreational marijuana has given a lot of young people the idea that it is legal and okay for them to use. It is not. Recreational marijuana is only legal for adults age 21 and older. Legal trouble can be incurred by a teen for possession and/or dealing.

Marijuana is not good for teen brains. Studies have shown that early marijuana use (16 and younger) causes problems with judgment, planning, and decision-making that may lead to risky behaviors. Some studies show problems with memory, motivation, and academic performance. Not the best situation with which to step into adulthood. The teens who may have a predisposition (possible family history) to mental illness and/or addiction may find themselves struggling with depression, psychosis, or further substance use.

There are very real health reasons not to smoke/vape cannabis. A 2017 study in the American Journal of Respiratory and Critical Care Medicine states that teens who vape are twice as likely to experience respiratory problems along with coughs, bronchitis, congestion, and phlegm than peers who do not vape.

Lastly, I like that you want to have a conversation with your son about marijuana. This is hard for parents who are often confused themselves or have mixed messages on the subject. I also like that you want to be supportive no matter the outcome. It is a conversation worth having and it will show your love for him.

Here is further information about cannabis use in teens and about anxiety:

https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Anxiety-Disorders.aspx
https://www.verywellmind.com/marijuana-use-by-teens-statistics-2610207
https://www.sciencedaily.com/releases/2017/01/170125214606.htm#:~:text=2,Delaying%20marijuana%20smoking%20to%20age%2017%20cuts,teens’%20brains%2C%20new%20study%20suggests&text=Summary%3A,they’re%20less%20at%20risk.

Click to access evidence-brief-youth-13-17-e.pdf

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine.

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If you are asking this question, you are probably not alone. In fact, 18 million Americans struggle with misusing alcohol or with the symptoms of Alcohol Use Disorders (AUD). If you feel as though your relationship with alcohol is a problem or could become a problem, it is important to know that you are not alone. There are resources that can provide help and guide you through a recovery journey. Arming yourself with information is a good first step.

What is Alcohol Use Disorder (alcohol addiction)?

There are hereditary and environmental factors to addiction, but many times the cause is not known. The following are some of the symptoms that characterize AUD.

The individual:

  • drinks more or longer than they initially intended to
  • has tried to moderate or stop drinking in the past, but has been unable to
  • spends a lot of time drinking or recovering from the effects of drinking
  • experiences cravings, or strong desires to drink
  • drinks even though it interferes with home, family, work, or school responsibilities
  • drinks even though it causes trouble in their personal life
  • gives up activities or obligations that were once important, in order to drink
  • gets into situations while drinking that may be risky or cause harm
  • continues to drink even if it causes depression, anxiety, or other health problems
  • has to drink more to produce the desired effects
  • has withdrawal symptoms when not drinking

NOTE: According to the DSM-5 Diagnostic and Statistical Manual for Mental Disorders, showing two-three of these symptoms in the last year may indicate a mild alcohol use disorder, while showing four-five symptoms indicates a moderate AUD. Displaying six or more symptoms signifies a severe alcohol use disorder.

Who is at risk for alcohol use disorders?

Drinking alcohol in moderation can be okay for some people. This means that while they may feel the effects of alcohol consumption, they do not feel compelled to keep drinking. Moderate drinking is classified as no more than one or two drinks per day for men and women.

Using alcohol when bored, stressed, lonely, depressed, or if there is a genetic predisposition to addiction (family members with AUD), can lead to further serious problems. If you or someone you care about is drinking to get through the day, it may be time to reach out for help.

How does alcohol affect physical health?

Like any substance consumed in excess, there will likely be side effects. Alcohol may also interact negatively with prescription medications and make it difficult to diagnose other health concerns.

When drinking to excess there can be problems with:

  • Alcohol poisoning
  • Sexual dysfunction
  • Reduced inhibitions or risky behaviors
  • Inability to focus, impaired memory
  • Affected vision, reflexes, and coordination

Long-term effects of active addiction:

  • Impaired learning and/or brain development
  • Increased depression and anxiety
  • Major organ damage; increased risk for heart disease
  • Cirrhosis (chronic liver disease)
  • Cancer

How does alcohol affect mental health?

Alcohol is a depressant. Therefore, it slows down your brain and alters its chemistry. There are many effects including changes to mood, energy levels, memory, concentration, and sleep patterns.

Alcohol may also impact decision making. While drinking, a person may “do things without thinking” or say or do things they would not do or say while sober such as pushing away or hurting the people who care most about them. It can give a person courage to engage in risky situations like unsafe sexual encounters, trouble with law enforcement or getting into fights. Alcohol can contribute to life falling apart, causing withdrawal from important relationships and social situations, and even self-harm. A combination of factors along with intoxication has led to many dying by suicide.

Where do I go for help with AUD?

Talk with your primary care practitioner. There are multiple treatment options ranging from hospitalization for detox if needed, to outpatient therapy with a counselor or group, to rehabilitation or participation in an intensive outpatient program (IOP). There is also residential treatment. There are even medications that can provide support for building a sober life.

Lastly, there are many recovery communities like AA, Smart Recovery, and Women for Sobriety that provide support and assistance in learning how to live a healthy, sober life.

sources: healthline.com, headspace.org, recoverycentersofamerica.com, cdc.org, apibhs.com

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This article originally appeared in Macaroni Kid on March 25, 2021, by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine.  

Question: I am absolutely fed up with my mother-in-law. She has spent pretty much my entire marriage to her son criticizing me as a wife and mother. My husband used to defend me more but has given up saying his mom won’t change her ways so it’s not worth the fight. Recently she called me a “lazy mom” in front of our ten-year-old. Our daughter cried on the way home and said she doesn’t want to see grandma anymore. My husband brushed it off. I’m furious as my daughter deserves to see him stick up for me (and her) and should not be exposed to that. I want to have a discussion with my husband but see red every time I start to gear up for it. How can I discuss this without making matters worse?

Answer: This is an important question to which so many can relate. You would like to not be criticized by your mother-in-law. You would like to be supported by your husband when there are problems between your mother-in-law and yourself. And you want healthy behavior about relationships and respect, to be modeled for your daughter.

Relationships with in-laws and parents are so significant. When troubled, they can be like a tormenting drip, drip, drip of a faucet or they may be like walking through a field with dangerous mines all around, always waiting for an explosion. The criticism can be at the table for every family gathering. When good, however, they can add richness to your life and the lives of your children. All your family relationships can be impacted by this difficulty with your mother-in-law. It can be helpful to see a counselor, a neutral party, to help you sort it out.

“Seeing red” when you want to talk with your husband is not getting the problem solved. Keep in mind that your goal is to help him understand what you need from him. If you go about this angrily or in an accusatory fashion, he will stop listening. Also, remember that he is in the middle. His mother may have been critical all his life, and he may feel powerless to think she can change. He will need some tools to be able to help and counseling may help the two of you stand together to resolve this.

Learning about setting boundaries is one way of making improvements. I encourage you to get a book or do an internet study on how to set boundaries or ask the counselor to help you with this. Learning to set boundaries helps you know what to do when you are not respected. The result of healthy boundaries is that slowly you will begin to gain respect. One of my favorite sayings about boundaries is “people use the people they can use and respect the people they cannot use.” If your mother-in-law can get you upset, cause you to storm out, and leave you hurting then she is the one who is in control. You can say to your mother-in-law, “I value our relationship and your time with your granddaughter, but I cannot allow you to speak to me in that way especially in front of her. Please speak to me with respect or we will need to leave.” If she continues and you allow it, she remains in control. Instead, quietly gather your things and your daughter and let her know you are leaving. No drama, no tears, just leave.

This learning process also includes evaluating those areas in which you may be contributing to the discord between the two of you. You cannot ask to be spoken to with respect unless you also speak and treat her with respect. Most often in these situations, everyone needs to do better.

Lastly, it may sound odd, but try to ignite feelings of love and kindness towards her. You can do this by looking at her life. Is she lonely, hurt, depressed; does she have needs that are not met, or were never met? People often push away the people they need most by the things they say and the things they do. Creating kind thoughts for her may help you connect with her in a more meaningful way. This takes practice, but modeling this for your daughter can have a big payoff for everyone.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine.

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This article originally appeared in Macaroni Kid on February 23, 2021, by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine.  

Question: My son has battled depression and anxiety since late elementary school. He is 16 now. We have tried multiple medications for him, and he sees a therapist regularly. He seems to have gotten worse in the last six months which is no surprise given the difficulties of the past year. I am frustrated because I don’t feel like the meds he is on do enough. It feels like we have tried them all. Any advice would be appreciated.

Answer: Whatever you do, keep trying. I can just imagine how frustrated and hopeless you and he feel—you are doing the right things, and you are not seeing any change. Do not give up.

I hope I can give you some things to think about that might provide ways to further explore and treat his depression. Some people have what is called “treatment-resistant depression.” It means they are not responding as expected to the usual methods of treatment. That means it is necessary for everyone, both professionals and family, to look at other interventions. These are things which need to be considered:

Is the diagnosis correct? There are different kinds of depression which require different kinds of treatment. Since your son’s depression has gone on for this long, he should be treated by a psychiatrist and not a primary care physician.

Is the dose correct? Many psychiatrists are like artists and chemists, in a sense, adding some of this and tweaking some of that, until they get just the right combination. It can take time to find just the right formula of medications. Every person is unique and responds to medications differently.

Are there other mental health conditions complicating treatment? For example, if your son has Attention Deficit Hyperactivity Disorder (ADHD), he could be having trouble both socially and academically, which may contribute to him feeling bad about himself. Treating the ADHD could help with this.

Are there other medical conditions complicating treatment? Medical conditions such as thyroid disorders, mononucleosis, iron deficiency anemia and other vitamin deficiencies like Vitamin D, B2, B6, or folate (Treatment-Resistant Depression in Adolescents, David Brent, MD) can all contribute to depression. Lab work can help assess for these.

How well is your son sleeping? Adolescents are known to spend late night hours on screens and devices; this can interfere with a normal sleep cycle and greatly impact his mood. Medication is not a substitute for lifestyle deficits. Sleep, exercise, good nutrition, and social interactions make life better.

Is your son taking his medication regularly and as prescribed? Missing doses, for example, greatly reduces a medication’s effectiveness.

Is there depression in the family? Is there a family member’s depression, particularly a parent’s, which is not being treated or fully treated? This has a significant influence on how a child views the world.

Is your son currently experiencing bullying, or does he have a history of trauma or abuse? Medication does not treat these issues; however, they have a profound effect on mood. If he has these issues, is he working on them in therapy? Does he need additional assistance from parents, school officials or other professionals with these situations?

Is your son struggling with his sexuality or gender identity? Sexuality and gender identity are big and confusing to adolescents. Could his sexuality or gender identity lead him to family rejection or bullying by peers?

Is your son using substances like alcohol, marijuana or other drugs? Is there alcohol or drug abuse in the family? Using these substances or being affected by someone else’s use of substances alters normal emotional coping.

Is your son thinking about suicide or self-harm? This is so important. Ask him. Educate him that these choices are sometimes the result of feeling very depressed and hopeless. Help him know that there is hope, that as a family you will keep trying to help him feel better. Do not hesitate to take him to the hospital if he is doing things or saying things that make you think he is suicidal. He may be angry, but it is the safest thing to do. If you need help getting him there, do not hesitate to call 911.

Does he have a good relationship with his therapist? Not every therapist is right for every person. Check-in and make sure that he feels connected with and heard by his therapist.

It is very hard to have a child with prolonged depression. Parents feel hopeless and lost. Sometimes parents of depressed children need to talk to someone about it. Call a counselor to help you. Thank you for asking this question. You are not alone.

This and other helpful information on Treatment-Resistant Depression in Adolescents can be found here.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine.

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Bipolar disorder is thought to be a rare condition consisting of “mood swings” but it’s much more common and complex than that. Bipolar disorder affects 60 million people worldwide and approximately 5.7 million Americans. Of these, an estimated 51% will go untreated or misdiagnosed.

Bipolar disorder, sometimes known as manic-depressive illness or manic depression, is a mental disorder that causes an unusual shift in mood, energy, activity level, concentration, judgement, or ability to perform day-to-day tasks. The “unusual” shifts refer to uncharacteristic changes in an individual lasting days or weeks. This is known as an “episode.” A manic episode is an emotional “high,” while a depressive episode is an emotional “low.”

Manic and hypomanic episodes include three or more of the following signs:

  • Unusually upbeat, jumpy, or wired; increased activity, energy
  • Exaggerated sense of well-being or self-confidence
  • Distractibility, racing thoughts
  • Decreased need for sleep
  • Unusual talkativeness
  • Poor decision making such as excessive shopping, risky sexual behavior, etc.

Depressive episodes include five or more of the following signs:

  • Depressed mood; sad, empty, hopeless, irritable feelings
  • Insomnia or sleeping too much
  • Fatigue/loss of energy
  • Restlessness or slowed actions
  • Apathy
  • Abrupt change in weight and/or appetite
  • Decreased ability to think/concentrate
  • Feelings of worthlessness or excessive guilt
  • Thinking about or attempting suicide

Those with bipolar disorder may not recognize the changes in their behavior. Some may also enjoy the feelings of euphoria that accompany a manic episode, but an emotional crash will always follow. The signs described above are not normal or typical of young children, adolescents or adults, and should be taken seriously.

There are three different types of bipolar disorder diagnoses:

Bipolar I Disorder: Manic episodes lasting at least 7 days or manic episodes so severe that immediate hospitalization is required and depressive episodes lasting at least two weeks. Mixed features may be possible (manic and depressive episodes occurring simultaneously). Bipolar I disorder is the most severe.

Bipolar II Disorder: A pattern of depressive and hypomanic episodes (less severe mania) that last for longer periods but are less severe than bipolar I disorder.

Cyclothymia: Periods of hypomanic and depressive symptoms lasting at least 2 years. Symptoms are less severe than Bipolar I and II disorders and individuals are usually able to function in their daily life.

Bipolar disorder is commonly misdiagnosed, the main reason being that those with the disorder may also have a co-occurring disorder. These can include anxiety disorder, attention-deficit/hyperactivity disorder, substance use disorder, eating disorders, or other mental health disorders. A mental health professional will diagnose bipolar disorder by observing signs and symptoms, life experiences of the individual, and the family health history of the individual. A diagnosis typically occurs in late adolescence with the average age being 25, but those in their later adult years can also be diagnosed.

It’s important that those with bipolar disorder or those with undiagnosed symptoms to attain treatment. If left untreated, an individual’s manic and depressive episodes will not improve. Additionally, they may be at risk for drug and alcohol abuse, legal or financial troubles, impaired performance at work and school, difficulty maintaining relationships and suicide attempts. In fact, 30% of individuals diagnosed with bipolar disorder will attempt suicide at least once in their life. A diagnosis and ongoing treatment are vital.

Individuals with bipolar disorder are at higher risk of thyroid disease, migraine headaches, heart disease, diabetes and more. Treatment is highly individualized, especially when it comes to correct medication, often an antipsychotic and/or anti-depressant. Primary care visits are also important in ongoing treatment.

Treatment can include psychotherapy sessions (talk therapy) and medication taken consistently, regular exercise that benefits brain and heart health, sticking to daily routines, avoiding misuse of substances, as well as journaling for symptom tracking are recommended. Individuals with bipolar disorder can lead wonderfully healthy, functioning lives with the assistance of lifelong treatment.

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Are you feeling busy, distracted and exhausted? Even after the emotionally overwhelming year we’ve all just experienced, we haven’t slowed down and taken time for ourselves. Further, our society doesn’t value the practice of introspection, the observation of one’s own mental and emotional processes. Introspection, or self-reflection, is the willingness to recognize and determine your “old programming” that no longer serves you so that you can build new “programming.” How this can be done? With a calm mind to start.

How do I calm my mind?
Having a calm mind will allow you to concentrate and feel more relaxed. This practice will vary person to person, but here are some suggestions:

  • Take a few deep breaths; practice breath work
  • Stretch your body
  • Go for a walk; move your body
  • Journal, meditate, pray

How do I practice self-reflection?
When your mind is calm, allow yourself to draw inward and think deeply on the issue, emotion or memory at hand. To help, ask yourself:

  • What does this make me think?
  • How does it make me feel?
  • How does it hold me back?

It’s important not to judge yourself. Be honest with yourself so that you’re not tempted to imagine how you should feel. Don’t be afraid to dig deeper! You’re trying to access the root of the issue and you will most likely come across resistance. This is your ego/mind trying to protect you from uncomfortable and harmful emotions.

Additionally, you can ask yourself questions in order to get to know yourself better whether or not you’re currently working through an issue. Start with these:

  • What am I really scared of?
  • Am I holding on to something that I can let go of?
  • When did I last push passed my comfort zone?
  • What do I want most in life?
  • When was the last time I made someone smile?

Why should I practice self-reflection?
With self-reflection comes self-awareness. You’ll begin to see your thoughts, behaviors, emotions and reactions in real time as you experience them. You can determine which ones bother you, don’t serve you or harm you and learn to let them go. By slowing down, calming your mind, and asking yourself substantial questions to draw on old issues, you can then learn to shift your behaviors, thoughts and reactions to ones that better represent you, your values and beliefs.

The more you reflect, the easier you’ll be able to hold yourself accountable. This not only benefits you directly, but it also benefits those you surround yourself with. You may even inspire them to be more introspective!

What are benefits to introspection?
A self-aware person can expect myriad of benefits, but here are some that may be true for you:

  • Clarity
  • Self-control
  • Less stress and anxiety
  • Higher self-esteem and pride
  • Increased emotional intelligence
  • Easier time coping with challenges
  • Appropriate reactions to situations
  • Realize their potential and become more aligned

Remember, slowing down, calming your mind and regular self-reflection may come with resistance­­­­ from your mind, your family, even your job. Stay strong­­–this time is essential for your mental health. It’s okay to start small and always be gracious and patient with yourself. You’re in the process of changing how you think, feel, and behave. You’re changing your life!

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