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A Safe Place to Chat Anonymously, Get Support & Feel Better | ReachOut Australia

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Connect with other young people and find support that works for you. ReachOut helps you deal with stress, anxiety, depression, and whenever life doesn't go as planned.

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Find a therapist - Specifically for those searching for help with PTSD

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Find a Therapist

Available en Español

Good treatments for PTSD are available. Here are some suggestions for finding a therapist, counselor, or mental health care provider who can help your recovery.

Things to Consider

If you are a Veteran, see Help for Veterans.

Make sure the provider has experience treating people who have been through a trauma.

Try to find a provider who focuses on evidence-based medications for PTSD or effective talk therapy for PTSD, such as Cognitive Processing Therapy (CPT), Prolonged Exposure (PE) or Eye Movement Desensitization and Reprocessing (EMDR).

Find out what type(s) of insurance the provider accepts and what you will have to pay (out-of-pocket costs) for care.

You may find more than one therapist. Learn about Types of Therapists.

First steps

Contact your family doctor to ask for a recommendation. Or, ask friends and family if they can recommend a therapist.

If you have health insurance, call to find out which mental health providers your insurance company will cover. Your insurance company may require that you choose a provider from among a list they maintain.

Finding a Provider Using the Internet

These resources can help you locate a therapist, counselor, or mental health provider who is right for you. Note: These resources can be used by anyone, and if you are a Veteran, see the "Help for Veterans" section below.

Finding a Provider by Phone

In addition to the numbers listed above. you can also find a therapist, counselor, or mental health provider in the following ways:

Some mental health services are listed in the phone book. In the Government pages, look in the "County Government Offices" section, and find "Health Services (Dept. of)" or "Department of Health Services." "Mental Health" or "Behavioral Health" will be listed.

In the yellow pages, mental health providers are listed under "counseling," "psychologists," "social workers," "psychotherapists," "social and human services," "mental health" or "behavioral health."

You can also call the psychology department of a local college or university.

Help for Veterans

All VA Medical Centers and many VA clinics provide PTSD care.

Some VA centers have specialty programs for PTSD. Use the VA PTSD Program Locator to find a VA PTSD program.

Vet Centers provide readjustment counseling to Veterans and their families after war. Find a Vet Center near you.

VA Medical Centers and Vet Centers are also listed in the phone book. In the Government pages, look under "United States Government Offices." Then look for "Veterans Affairs, Dept of." In that section, look under "Medical Care" and "Vet Centers - Counseling and Guidance."

If you are a Veteran looking for a community care provider, learn about VA's MISSION Act.

Find more information on Help for Veterans.

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Available en Español Good treatments for PTSD are available. Here are some suggestions for finding a therapist, counselor, or mental health care provider who can help your recovery. If you are a Veteran, see Help for Veterans. Make sure the provider has experience treating people who have been through a trauma.

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A group that “helps people with disabilities become full participants in the community; choosing for themselves how to live, learn, work, socialize, and play.”

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Easterseals Crossroads featured Northeast Arc's assistive technology lending library during a recent episode of the Assistive Technology Update podcast. Stacey Villani, division director, Family Services, at Northeast Arc, and Jeff Boucher, assistive technology...

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Easterseals Crossroads featured Northeast Arc's assistive technology lending library during a recent episode of the Assistive Technology Update podcast. Stacey Villani, division director, Family Services, at Northeast Arc, and Jeff Boucher, assistive technology...

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Call 800-273-8255
Text 838255

A helpline for veterans, service members, national guard and reserves, as well as friends and family members

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Call 877-565-8860

A helpline for Trans and questioning callers run by Trans identifying people.

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Call 1-866-488-7386
Text START to 678-678

A helpline for LGBTQ+ Youth

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Text HOME to 741741

A 24/7 crisis text line for people in need of emotional relief during a suicidal crisis who do not wish to talk over the phone but find text easier.

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National Alliance on Mental Illness HelpLine

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National Alliance on Mental Illness HelpLine

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Call 1-800-950-6264

A Free service that provides information, referrals and support to people living with mental health conditions, family members and caregivers, mental health providers and the public. *NOT a crisis line*

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Call 1-800-273-8255

A 24/7 crisis line for people in suicidal crisis or emotional distress.

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An app with free guided mindfulness meditations

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An app for meditation and sleep help.

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An app to help primarily with anxiety and depression, this app has free mindfulness meditations and mood trackers. Some things require premium service.

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A website and app to help with all sorts of Mental Health issues. While there is a free version, many meditations and articles require premium service.

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Managing Stress Associated with the COVID-19 Virus Outbreak

Available en Español

Impact of the COVID-19 Outbreak on Individuals and Communities

The COVID-19 (coronavirus) outbreak has the potential to increase stress and anxiety, both because of the fear of catching the virus and also because of uncertainty about how the outbreak will affect us socially and economically. There are practical steps you can take to improve your wellbeing.

Coping with the Stress of COVID-19

Dealing with stress reactions caused by the COVID-19 virus outbreak can improve your health, quality of life, and wellbeing. The following evidence-informed principles have been shown to be related to better outcomes in many adverse situations (2). There are key actions within each element that might be especially helpful for those affected by the COVID-19 outbreak (1, 3). It's not necessary to have all elements in place but implementing some of the following suggestions may help you deal with the stress caused by the COVID-19 virus.

Increase Sense of Safety

Reduce anxiety with healthy actions that make you feel safer. The Centers for Disease Control and Prevention (CDC) and other experts suggest the following good hygiene habits to limit the risk of infection:

Wash hands frequently with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer.

Cover your mouth and nose with a tissue when you cough or sneeze.

Properly dispose of used tissues.

Cough or sneeze into your upper sleeve, arm, or elbow if you don't have a tissue.

Clean your hands after coughing or sneezing.

Stay at home if you are sick.

Avoid contact with those who are sick.

Clean and disinfect objects or surfaces that may have come into contact with germs.

Make plans for what will happen if someone in the home becomes ill or if quarantine or shelter-in-place measures are ordered.

Read more about prevention on the CDC website.

Stay Connected

Seek support from family, friends, mentors, clergy, and those who are in similar circumstances.

Be flexible and creative in accessing support via phone, email, text messaging, and video calls.

Talk to your supervisor about the possibility of working from home temporarily.

Cultivate Ways to be More Calm

Realize that it is understandable to feel anxious and worried about what may happen, especially when many aspects of life are being affected.

If you find that you are getting more stressed by watching the news, reduce your exposure, particularly prior to sleep.

While circumstances may be stressful and beyond your control, you can try to offset them with positive calming activities. Practice slow, steady breathing and muscle relaxation, as well as any other actions that are calming for you (yoga, exercise, music, keeping the mind occupied).

Preparing for a range of possible scenarios and having adequate supplies should sheltering at home be necessary can help you feel more calm. For instance, you can put together a kit with supplies to last you and your family 3 - 5 days. Include supplies such as:

Water and food, vitamins, fluids with electrolytes, and food preparation items such as a manual can opener.

Prescribed medical supplies or equipment, such as glucose or blood pressure monitoring equipment; thermometer; medicines for fever, such as acetaminophen or ibuprofen; anti-diarrheal medication.

Hygiene supplies such as soap and water, alcohol-based hand wash, soap, tissues, toilet paper, and disposable diapers if necessary.

General supplies such as a flashlight and batteries, portable radio, and garbage bags.

Read more about pandemic preparedness on the CDC website.

Improve Your Sense of Control and Ability to Endure

Accept circumstances that cannot be changed and focus on what you can alter.

Modify your definition of a "good day" to meet the current reality of the situation.

Problem-solve and set achievable goals within the new circumstances in your life.

Evaluate the absolute risk of contracting the virus and recognize the benefits of accepting a certain level of risk in order to maintain as much of your normal routine as possible.

Those who have been faced with life-threatening situations recommended the following strategies:

Quickly recognize, acknowledge, and accept the reality of the situation.

Make a plan for dealing with feelings of being overwhelmed or overly distressed. Preparation can make you feel more in control if these feelings arise and help you move through them quickly.

Combat unhelpful emotions by using distraction or staying busy-both mentally and physically.

Avoid impulsive behavior.

Get organized.

Increase positive coping behaviors that have worked in the past.

Shift negative self-statements to statements that allow you to function with less distress. Try changing "this is a terrible time" to "this is a terrible time, but I can get through this."

Rather than getting discouraged, focus on what you can accomplish or control.

Seek out mentoring or information to improve your ability to make decisions and take actions when necessary.

Try to engage in the situation as a challenge to be met, which can increase your ability to act both creatively and decisively (1).

Remain Hopeful

Consider the stressful situation in a broader context and keep a long-term perspective.

Look for opportunities to practice being more patient or kind with yourself, or to see the situation as an opportunity to learn or build strengths.

Celebrate successes, find things to be grateful about, and take satisfaction in completing tasks, even small ones.

Give yourself small breaks from the stress of the situation by doing something you enjoy.

Draw upon your spirituality, those who inspire you, or your personal beliefs and values.

Printable Handout

Resources

References

Gonzales, G. (2003). Deep survival. Who lives, who dies, and why. True stories of miraculous endurance and sudden death. W.W. Norton & Company. New York.

Hobfoll, S. E., Watson, P. J., Bell, C. C., Bryant, R. A., Brymer, M. J., Friedman, M. J., et al. (2007). Five essential elements of immediate and mid-term mass trauma intervention: Empirical evidence. Psychiatry, 70(4), 283-315.

Reissman, D. B., Watson, P. J., Klomp, R. W., Tanielian, T. L., & Prior, S. D. (2006). Pandemic influenza preparedness: adaptive responses to an evolving challenge. Journal of Homeland Security and Emergency Management, 3(2).

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managing stress associated with the covid-19 virus

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Available en Español The COVID-19 (coronavirus) outbreak has the potential to increase stress and anxiety, both because of the fear of catching the virus and also because of uncertainty about how the outbreak will affect us socially and economically. There are practical steps you can take to improve your wellbeing.

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Please read the entire Privacy Policy of the American Psychiatric Association (APA). As described, this website utilizes cookies. By closing this message, continuing the navigation or otherwise continuing to view the APA's websites, you confirm that you understand and accept the terms of the APA's Privacy Policy, including the use of cookies.

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With nationwide school closures in effect, many parents are now monitoring homeschooling while at the same time trying to make a living in the midst of a terrible economic crisis. In this environment of broken routine and uncertainty, chances are your child is showing big feelings and challenging behaviors.

In my work as a school psychologist, I've been hearing from parents that despite their best efforts, their children are struggling with meeting homeschool expectations. Kids who never showed behavioral or emotional challenges are experiencing issues, and kids who had some struggles before are showing an uptick of challenges. Here are three ways to support your child (and manage your own stress) during school closures that parents I work with have found helpful.

1. Simplify: Relax your homeschooling and productivity standards to a level appropriate for a worldwide pandemic

If you're a parent suddenly trying to balance remote work and homeschooling, your household might look a bit like mine right now. As I am writing this, I am also toggling back and forth between helping my third-grader with Google Classroom, trying to set up my kindergartener for some independent writing work, and fielding questions every few seconds (wait, what is the difference between scalene and isosceles triangles again?!?).

I've come to realize in these past few weeks that being super productive with my work as a school psychologist AND giving full attention to homeschooling my children is not possible right now. Turns out, being a parent, teacher, and school psychologist are three different jobs that cannot all be done well at the same time.

Spending time wishing things were otherwise is an exercise in frustration. And since research shows that acceptance is an important trait in positive well-being, here are a few mantras about simplification you might want to try:

I am not homeschooling. I am doing my best to help my kids learn at home during a crisis.

I am not "working from home." I am doing my best to work at home during a crisis.

I cannot be as productive as normal because these are not normal times. I will focus on what I can accomplish in just the next 24 hours and let go of what I cannot accomplish right now.

Research shows that gratitude is another way to cultivate well-being. Even in challenging times, there is an opportunity to be grateful and to be accepting of what you can and cannot accomplish in a crisis.

Here's one simple strategy for you and your family members to start your day: Say, write, or draw (if your child is young) one thing you're grateful for, one thing to do, and one thing to let go of or accept. Putting gratitude at the front of your day will set a positive tone for the day. And while you undoubtedly have more than one thing to do, focusing on ONE important task and letting go of impossible standards will keep you from feeling like you are falling short every day.

2. Structure: Keep calm and structure on

If you Google "How to support my child during COVID-19," the top advice is to stick to a regular schedule, even when you're all at home all day. There's good reason for this. For adults and kids alike, routine and predictability are calming during times of stress. If you've tried to set a schedule and your children are resisting it, here are some reminders:

Now is not the time to clamp down and control your child's day. Now is the time to collaborate with your child on a schedule that works for the whole family.

It is okay if your schedule does not go to plan every day. Every day is an opportunity to fine-tune what is working and eliminate what is not working.

Your job as a parent is not to recreate an eight-hour school day. Your job is to help your child feel safe and do their best with the distance learning plan the teachers have provided.

It's worth reiterating that you do not have to recreate a full school-day schedule! Your family schedule may look more like what you would create over a summer break, including opportunities for fun, exercise, hands-on learning activities, and family connection. It is also important to build in "emotional checkpoints" during the day and involve your child in the schedule.

3. Support: Get ahead of the meltdowns (and teach critical social-emotional skills, too!)

When our children are experiencing big feelings, they may communicate them through behavior. If your child is melting down over something that seems small to you, it may be a sign they are overwhelmed or flooded with emotions.

For instance, when my kindergartner fell into a puddle of tears and screamed at me because she didn't like the word-sorting activity that her teacher gave her to do, it wasn't really about the sorting activity. After she calmed down using her "Calming Menu" we had created earlier (hugging the dog is her go-to), she ended up sharing that she was sad because she missed her friends. Had I clamped down on compliance on the assignment, it would have been a missed opportunity for her to practice calming down and expressing her emotions.

The important takeaway message here is that children (and, indeed, adults!) do not have access to their thinking and reasoning skills when they are flooded with emotions. If your child cannot focus on school tasks, or you are seeing them melt down, tantrum, or withdraw, it's likely because they are having a hard time meeting an expectation while under stress.

The antidote? Empathy. Research shows that empathy can calm the nervous system and re-engage the thinking and reasoning side of the brain. When you are in the middle of a meltdown, you might remind yourself of this using the following mantras:

My child is not giving me a hard time; they are having a hard time.

Behavior is communication, and my child is "telling" me they need support.

The teachable moment about behavioral expectations is never in the "hot" moment. I must calm my child through empathy first.

The reality is, your job right now as a homeschooling parent is less about academics, and more about creating safety, belonging, and acceptance. Your kids can learn about academics from teachers. The most important skill you can teach is how to manage big feelings under stress. Here are some techniques that may be helpful in teaching critical emotional-regulation skills:

Develop a list of calming strategies BEFORE you and your children need them. Post them on your fridge where all family members can readily use them.

For research-based and easy-to-do connection activities that teach social-emotional skills, visit Greater Good in Education and pick a few to try with your family.

Get support yourself by picking one self-care practice on the Greater Good in Action website so you can parent from a place of calm and model for your child how to solve problems together. Kids learn by watching us, so taking care of yourself is teaching your child how to cope.

We are living in unusual times, but we also have a real opportunity. Being in close quarters during times of stress is a chance to step back and focus on connection. In stressful times, children will be protected if they are connected. When all this is done and our kids go back to their schools, we can have given them the gift of connection and some new social-emotional and problem-solving skills.

Greater Good wants to know: Do you think this article will influence your opinions or behavior?

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How to Reduce the Stress of Homeschooling on Everyone

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With nationwide school closures in effect, many parents are now monitoring homeschooling while at the same time trying to make a living in the midst of a terrible economic crisis. In this environment of broken routine and uncertainty, chances are your child is showing big feelings and challenging behaviors.

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In the early days of COVID-19, we faced many difficult decisions in everyday life: trying to weigh risk and decide whether to meet up or stay home, send kids to school or visit the gym. Now that my home state of California has its "shelter in place" order-and many other cities and states are in various stages of lockdown-a waiting period has taken shape.

In some ways, this is a relief-our minds get decision fatigue in the face of so many choices. Now we have our instructions, which are restrictive but useful to our brains. But many other types of uncertainty still remain, about things like our jobs, whether we will get sick even while taking precautions, or when we will see our loved ones and return to some normal routines.

We do not do well with uncertainty, and it drives much of the anxiety in the world, even when we're not facing a pandemic. In fact, I define anxiety loosely as "an unrealized fear that thrives in uncertainty and other vague circumstances." In the face of the unknown, we speculate, we avoid, we try to control. We "research" and confirm what we are afraid of.

This is not a good place for our thoughts. As a psychotherapist, I know that getting through this time will involve getting a grip on our minds. We need to focus on what is reassuring and positive, and what we can control. We can control our minds, at least to some extent. We can start small. Here are some things to work on.

Try: Structure your time

Reason: Routines are calming for everyone. Whether for children or adults, our minds need to know what to expect next. Anxiety thrives in vast amounts of unstructured time.

My sister-in-law Bonnie ran a daycare, and I am convinced that part of the reason she survived is because she gave each week a theme. We are all now running daycares of actual human gremlins or just the gremlins of our mind. Make a theme to your day, or a specific focus to your work. Bugs. Harry Potter. Ending emails as positively as possible. Walking or stretching during all phone calls. The focus doesn't really matter, but it will help you make sense of the day. Remember, your mind wants to put order to things and when you don't provide enough structure, it will spiral out on you.

Make a bucket list of things you will do during this time, and prioritize those that lead to a measurable result. Start with a morning routine. Keep it simple. Weed a corner of the yard. Cook a new recipe. Make a meal plan with all the groceries you just stocked up on. (I know I saw you at Trader Joe's today!) Meal plans are great for uncertainty; even if you are just microwaving something, it is one more thing you can count on to go as planned.

Include essential tasks for your job and schoolwork when appropriate, but keep your expectations low. Even with extra time at home, we are cramming in work and usually more cooking and child care. At the very least, we have more interruptions and more temptations to procrastinate.

If you are working from home, don't forget to make time to take a walk around the block, and plan to catch a sliver of the news and know when you will stop. Schedule news check-ins as if they are meals; no snacking.

Try: A news break

Reason: Our brains need to return to baseline functioning without constant stimulation from a fear-inducing topic.

Constantly taking in news headlines about infection, risk, and death stokes our fear engine, and we have to work hard to keep our worries in check due to our brain's negativity bias: our tendency to pay more attention to the bad rather than the good. Consuming lots of news is not tolerable long-term for most people. Most of us could use a break for an afternoon, or even a full 24 hours to reset ourselves in the world and show up calmer.

Avoiding the news for a day makes our " wise mind " available when we do tune back into news. "Wise mind" is a term from dialectical behavioral therapy that refers to a way of looking at things with perspective and acceptance, or "peace in the truth."

Instead of checking the news, notice what happens if you take a walk in nature. Nature has huge stress-relieving effects. The birds aren't worried. The trees are growing. Your body is working. You can remind yourself that some basic things are still in place.

When you do need to tune back in, you want to be able to do this from a calm place. Wise mind gets chipped away by too much news and stimulation.

Try: Thought charts

Reason: Thought charts help you see a choice in what you focus on, and try to shift your perspective to a plan of action instead of worry.

It doesn't do us any good to ruminate ("when your thoughts go in a circle," as my son says). Ruminating thoughts feel like the devil on your shoulder, the worry cloud, or the buzz of anxiety.

Cognitive behavioral therapy (CBT) is the most evidence-based way to address fear and ruminating thoughts, including issues like depression, anxiety, and insomnia. CBT is used for specific phobias, as well as widespread unease. With practice, it teaches you to reframe your thoughts in a way that generates less reactivity and more measured responses. CBT also happens to be the best treatment for those on the obsessive-compulsive spectrum, which recently has come to include many of us. (Who isn't having recurring thoughts on coronavirus?)

One helpful technique from CBT is to create a thought chart: This includes three steps: identifying the thought that creates concern, sometimes called an "event," followed by the actual worried thoughts, and finally a challenge to them. The challenge to these worried thoughts should include self-compassionate phrases ("It's normal to be worried right now"), as well as plan-of-action phrases ("Listening to the worried thoughts aren't helping me so I will take a walk and play a non-news podcast").

Thought charts help you look at the thoughts you have about yourself, your future, and the world around you-and see what messaging you're giving yourself based on these thoughts. For example, at this time many of us are looking at the world around us and telling ourselves we ought to be afraid, and speculating on worst-case scenarios.

However, we can't know the future, and with practice we can learn that this repetitive messaging is not productive for our lives. We can acknowledge the truth of our thoughts (if evidence supports it) and then add our own choice of response that includes two things: self-compassion and a plan of action.

We might respond to these worried thoughts by saying, "It's true that coronavirus is out there, and that is scary [self-compassion]. What steps can I take so that I can still do what I need to do while following public health recommendations [plan of action]? When I let fear run my life, I don't feel any better protected, so I'm not going to listen to this thought any more today."

With practice, thought charts validate our anxious thoughts without letting us become trapped in them. We can see a clear choice and practice giving power to the self-compassionate and action-oriented thoughts.

Especially since we are all in this same situation together, we owe it to ourselves to figure out how to not let that terrified little part of us run our lives. The world needs us to bring our wise minds to action.

Greater Good wants to know: Do you think this article will influence your opinions or behavior?

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Three Tips from a Therapist for Calming Your Coronavirus Anxiety

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In the early days of COVID-19, we faced many difficult decisions in everyday life: trying to weigh risk and decide whether to meet up or stay home, send kids to school or visit the gym. Now that my home state of California has its "shelter in place" order-and many other cities and states are in various stages of lockdown-a waiting period has taken shape.

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Epidemiologists and virologists around the world are scrambling to understand and prevent the spread of the novel coronavirus. There is another group of researchers who are concerned about a slightly different foe: the mental health pandemic.

Facing an infectious disease, we have been forced to maintain distance from each other, all while going through levels of fear, uncertainty, job loss, and grief that are unprecedented for many people.

"In an ironic twist, many of the strategies that are critical to ensuring our collective public health during this pandemic may put people at greater risk for . . . mental health issues," write Frederick Buttell and Regardt J. Ferreira at Tulane University in a recent, special issue of the journal Psychological Trauma.

In brand-new studies coming out of China, Spain, the United States, and other countries, researchers are discovering in real time how we are collectively coping with this worldwide event. The results are not uplifting, but they aren't surprising either. We are suffering, some of us worse than others. You don't have to have lost a job or a loved one to be affected. Humans are complex, and so are emotional responses to the pandemic.

When this all started, we learned how viruses spread and how to wash our hands like pros. Now we have lessons to learn about what happens to mental health in a crisis like this, so we can find ways to address it.

1. We're anxious, depressed, and traumatized

As COVID-19 spread through China in January and February, researchers were already sending out questionnaires to citizens locked down in their homes. In half a dozen studies with over 10,000 respondents, they found that people were experiencing worse mental health problems than before the pandemic-high symptoms of stress, anxiety, depression, and post-traumatic stress disorder (PTSD). Up to half showed serious signs of depression (depending on the study), while up to 35 percent showed serious anxiety.

One survey followed over 1,700 people in 190 Chinese cities from late January to late February. During the height of the pandemic, their stress, anxiety, and depression didn't change. Their symptoms of PTSD declined slightly-but they were still high enough to be worrisome. People weren't getting worse, but they also didn't seem to be getting used to pandemic life.

2. Some of us are lonely, but not all

All the phone calls and video chats with family and friends may be helping, write Martina Luchetti and her coauthors from Florida State University, as well as a new sense of togetherness. "Many people have felt part of community-wide efforts to slow the spread of the virus. The feeling of . . . being in this together may increase resilience."

However, this hasn't been true for everyone. People who are younger or living alone, or who have a chronic health condition, are lonelier than other groups. In fact, one study in the U.S. in April and May (before any restrictions were lifted) found that almost two thirds of people under 30 had high levels of loneliness, and 37 percent felt they had low support from their family.

"Feeling cut off from social groups may lead one to feel vulnerable and pessimistic about one's circumstances," write Cindy H. Liu and her coauthors.

3. Domestic violence has increased

In early April, the United Nations called for immediate global action to combat the increasing violence against women and girls during the pandemic.

Scientific surveys are only just beginning, but some preliminary results confirm these trends. Among people who were already experiencing domestic violence, the violence has gotten worse in nearly 60 percent of cases, report Buttell and Ferreira.

In their view, this comes down to a variety of factors: people spending more time at home with abusive partners, unemployment and other financial stressors causing conflict, shelters shutting their doors, and police being discouraged from making arrests.

Needless to say, the threat of abuse is compounding the stress, anxiety, and fear that many people are already experiencing during the pandemic.

4. The effects depend on your personality, lifestyle, and demographics

While older people have greater health risks from COVID-19, it seems to be younger people who are struggling emotionally. According to studies from Spain, China, and Slovenia, younger people tend to be more depressed, anxious, stressed, and traumatized in the era of COVID-19. The same is true for women, who may also be more lonely.

There's no clear explanation for why this might be true, but researchers have some speculations. Women tend to have worse mental health in general, and certain stressors right now-like the added burden of caregiving and the risk of losing jobs-may fall more heavily on women.

Personality also influences how we fare in tough times. Two related traits that seem to matter during the pandemic are our ability to tolerate uncertainty and our ability to tolerate distress. While it's hard for anyone to struggle or face the unknown, some people are less comfortable with it than others. And right now, it's those people who seem to be ruminating more, feeling more afraid, and experiencing more depression, anxiety, and PTSD.

5. It's worse for disadvantaged groups

In studies across the world, researchers investigated what else might make people vulnerable to mental health problems during the pandemic. They found a few key factors that put people at risk.

For one, people with poor health or chronic diseases tend to have higher symptoms of stress, anxiety, depression, and PTSD, several studies found. Of course, this might be because these are also the people with greater health risks from COVID-19.

Your income and education matter, too. The less stable your income and the less educated you are, studies suggest, the more anxiety, depression, and stress you will experience. The pandemic is threatening the economy, affecting everyone's financial future, but the situation is worse for people who were already struggling. In a very real sense, we're not all in the same boat.

"It is an inescapable fact that people lower on the socioeconomic ladder are struggling more"

―David Sbarra, Ph.D.

A Pew survey of nearly 5,000 Americans in April found that the lowest-income people were most afraid of getting COVID-19, too. "[While] Americans may be struggling with the emotional challenges of the pandemic, it is an inescapable fact that people lower on the socioeconomic ladder are struggling more," says psychologist David Sbarra.

6. The effects are compounded by racism

Those unequal effects extend all the way to who lives and who dies.

In fact, Black people are more likely to be infected, less likely to be tested and treated, and less likely to survive if they get COVID-19. According to Andrea King Collier in an article for Greater Good, a history of racism means the Black community is confronting the pandemic with worse health, less access to care, and more distrust of the medical system.

That means they have more reason to be fearful for their own lives, and they are more likely to experience loss. In fact, Pew research suggests that more than a quarter of Black Americans know someone who was hospitalized or died from COVID-19, compared to 1 in 10 white Americans.

These hardships worsened after the police killing of George Floyd, a Black man in Minnesota. His death catalyzed nationwide protests for racial justice-but at the same time, many observers say, it made the pandemic even harder for many Black Americans.

"Black people have been hit on all sides with the threat of loss of life," says Riana Anderson, assistant professor at the University of Michigan's School of Public Health. "It is exhausting. Depleting. Depressing. And absolutely an additional stressor." She argues that family and community support is a strength of the Black community, but physical distancing restrictions have made it more difficult to access that power.

All of these inequities create mental health problems that are even more aggravated by reduced and unequal access to mental health services.

7. Your work situation matters

One of the biggest disruptions to our daily lives today is how the pandemic has affected our work.

Doctors, nurses, and paramedics are taking on the urgent task of caring for COVID-19 patients, while other essential workers are putting themselves at risk to sell food, deliver mail, and pick up trash. Many office jobs have transitioned to remote work, asking employees to isolate at home, with many precariously juggling work and care for children or elders.

Other people have been unable to continue work during the pandemic, waiting for the time when they'll be called back, while some have been laid off entirely. Unemployment in the U.S. more than quadrupled from February to April, leveling off in July at 10 percent.

A Chinese survey in mid-February examined some of these work situations, though not all. What was clear is that people who are unable to work temporarily-even if they don't get laid off-have worse mental health. And while working in an office might seem risky, it was the people working from home who were actually more distressed and less satisfied with their lives.

Caring for yourself and others

There's a lot we don't have control over in this situation, which is stressful in and of itself. You may have some of the risk factors mentioned above, and there's nothing you can do about it.

But what can you control? That's the first question to ask.

For example, research from 28 countries conducted in mid-March found that the more people used social media, the more fearful they were. Frequent social media users in China were more likely to feel both depressed and anxious at the same time. Part of the reason may be because, particularly when the pandemic was ramping up, it was the main topic of discussion online. If being on Facebook doesn't feel good, consider putting limits on social media time.

Does that mean ignorance is bliss? No. Finding the right sources of information is key. In fact, Chinese people who were highly satisfied with the health information they got about COVID-19 tended to have lower stress, anxiety, depression, and PTSD. Being informed helps reduce uncertainty and anxiety-but overloading ourselves with information can also be unsettling. Online or offline, reading news or imagining worst-case scenarios with family, the people who spent three or more hours a day focusing on COVID-19 were more anxious.

Besides taking breaks from news and social media, practicing basic safety and hygiene could go a long way for your mental health. In Chinese studies in January and February, people who engaged in proper hand washing, wore masks, and avoided sharing utensils tended to experience less depression, anxiety, stress, and PTSD.

Since March, Greater Good has been sharing tips for well-being during COVID-19. For the most part, these are nothing new. In normal life and in a pandemic, we fare better when we try to stay connected in our relationships, cope with stress in healthy ways, and find a sense of agency.

But we can't self-improve our way out of the pain and difficulty. What we're going through right now is a trauma, or at least a major stressor on a global scale. This is one of those times when life really is harder by a little bit or a lot, depending on your situation. Feeling bad is part of being human-and right now, that's something many of us need to face, even as we work to feel better, stay connected, and help others.

Greater Good wants to know: Do you think this article will influence your opinions or behavior?

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Seven Ways the Pandemic Is Affecting Our Mental Health

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Epidemiologists and virologists around the world are scrambling to understand and prevent the spread of the novel coronavirus. There is another group of researchers who are concerned about a slightly different foe: the mental health pandemic.

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Coronavirus: Mental Health Coping Strategies | NAMI: National Alliance on Mental Illness

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The coronavirus can significantly affect mental health for everyone, but especially for those with mental illness. Both the anxiety of contracting the disease as well as the increase in loneliness and isolation can worsen and trigger symptoms. Acknowledging, recognizing and acting on mental distress in these uncertain times is key to lessening the impact.

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Self-care includes all the things we do to tend to our physical, mental, and emotional health needs. Here are just some of the many ways you can do it.

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COVID-19: How to manage your mental health during the pandemic

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Anxiety about COVID-19 can be overwhelming. You may worry about getting the virus, the length of the pandemic and the future. Learn how to cope.

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The Safety.com Guide to Teen Health and Safety | Safety.com

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It's a trying time to be the parent of a teenager. After months of being cooped up at home away from friends, unable to attend school or go out, most kids are chomping at the bit to get back to the lives they had before the pandemic. Getting teens to take safety seriously is a struggle at the best of times, and as the nation moves towards reopening, it's never been more important to ensure kids are following the rules.

How can parents respect their teens' needs while still helping them (and everyone else) stay safe? Even if reopening hasn't started in your area, it's never too early to start talking about what your family's approach will be. Discussing what's coming can help teenagers feel more prepared and increase the odds of smart, safe behavior when the time comes.

Hear your teenager out

"The first thing is always to try to understand where your teen is coming from," says Lindsey Giller, PsyD, a clinical psychologist at the Child Mind Institute. To adults, teenage worries ("I'd look stupid in a mask!") or priorities ("I need to go to the park with my friends on Saturday.") can seem a little ridiculous. But taking them seriously is key to establishing open lines of communication.

"Don't dismiss their concerns, even if they seem trivial to you," says Dr. Giller. "Their friends are their lives, and that's where their social development is supposed to be right now. Being 16 or 17 and not being able to see your friends or boyfriend or girlfriend for two months is a big deal."

Instead of handing down mandates (which, let's be real, teens aren't likely to follow), having a clear sense of what they want and need will make it easier to come up with rules that they can reasonably follow.

Empathize and validate

"It's not fair!" is a sentiment we're all familiar with. Most of us have felt it more than once since this started. But few feel it more exquisitely than teenagers, whose lives have been disrupted right when establishing their own identities and pushing for independence are most important.

Teenagers are likely to feel the unfairness deeply, says Lindsay Macchia, PhD, a clinical psychologist at the Child Mind Institute: It's unfair that this happened at all, that it's still happening after months of quarantine, and that, even though they're not the people most at risk, they can't just go back to doing things the way they used to.

The more you validate your teen's feelings, Dr. Macchia says, the more you give them space to be open and expressive. In this case, you can explicitly agree with them. You might say: "You're totally right. It is unfair. I feel it too. It's boring and it sucks. But it's what we need to do to keep everyone safe."

That validation, adds Dr. Giller, "can get them to a place where they're more accepting of whatever you say next."

Create perspective

The quarantine has been a long slog. So long, in fact, that it can be hard to remember that it's really only been two months. "Those two months can feel like forever, especially in the minds of teens," says Dr. Giller. "But you can remind them that it really isn't forever." It might not be over soon, but it's not going to last the rest of their lives. Helping your teen remember that the restrictions really are temporary can make it easier for them to follow rules in the meantime.

Stick to the facts

Having seen the impact of the pandemic, we know how important it is to take precautions and we want our children to take them seriously, too. So it can be upsetting when the response to your urging safety is a deadpan "Okay, Mom" (without looking up from the phone) or the dreaded "Uh-huh." It's tempting to want to keep explaining until they seem to get it, or to "scare" them into compliance, but that can backfire.

"It's not so much what you say as how you say it," explains Dr. Macchia. Teenagers, she explains, are likely to push back against lecturing or overanxious behavior. Avoid catastrophizing, or focusing on worst-case scenarios, to make an impact. Saying something like, "If you don't take this seriously people will die " can just make your teen more likely to brush you off.

Instead, focus on being transparent and grounded with them, says Dr. Macchia. Emphasize that this affects everyone, that they have their role to play, and that you have faith that they're up to the challenge.

Use trusted sources

If teens are skeptical about the risks posed by the coronavirus, don't hesitate to turn to trusted, fact-based sources like the CDC, the World Health Organization, or NPR. You could even arrange a call with your doctor or your child's pediatrician, if they have a good relationship. "Enlisting others to say, 'This is real, this isn't just parental worry,' can help," says Dr. Macchia.

Teens may also be reading or hearing information that runs counter to what the scientific community is saying. To head off misinformation, ask your teenager about what they're reading and help them make sure information is coming from a trustworthy source.

Personalize the situation

If your child hasn't been personally impacted by the virus, it may seem abstract, unreal and unlikely to affect them. They also know that fewer young people have gotten seriously ill, which can make it seem even less relevant to their lives.

Click here to see all resources related to the coronavirus crisis.

Help teens make the connection by citing the danger for older family and friends. You can also emphasize that what we do now can have a big impact on what our lives look like down the road. If we don't all use caution as we open up, we might end up with more outbreaks, which means more lockdowns and more disruptions in things like school, college and being able to see friends. The point is to help teens see that your fears aren't far-fetched, and that social distancing is important in ways that do affect them directly.

Link independence with safety

Sooner or later, your teens will be going out and seeing their friends, one way or another. "Parents really want to be able to trust their teens," says Dr. Macchia. "and teens want to get some of their freedom back."

When they do got out, Dr. Macchia recommends tying independence to compliance with safety measures. The more willing they are to take seriously safety precautions like distancing, wearing a mask or socializing only outdoors, the more freedom they'll be able to have. Work together to brainstorm ways they can safely hang out with friends. For example:

Measure 6 feet of distance and practice staying that far apart. ("It's farther than you think!" says Dr. Giller.)

Make a list of outdoor places where your teen could safely meet with friends, like a nearby park (if it's not too crowded), the beach or even the back yard for a socially distant picnic.

Make or buy cool-looking masks your teen is more likely to actually wear. You could even suggest they get matching ones for their friends.

Prepare for tricky situations

For even the most cooperative teens, challenges will come up. They may have friends who aren't (or whose families aren't) taking safety practices seriously. One way to prepare kids to stick to your plan is to emphasize your family's values - and acknowledge that not everyone shares them. "Just like you would with a kid whose friends are engaging in other dangerous behaviors, like substance use, you want to validate how hard this is for your child to navigate," says Dr. Macchia.

It can also be helpful to give your child practice dealing with difficult situations before they come up. Dr. Giller recommends being open with your teen about the fact that some of their friends might not follow the rules - and might pressure your teen to do the same. You might ask: What would you do in that situation? What are a few things you could say to your friend? "They can start to consider how they would stay true to their values even if there's this new element of peer pressure or fitting in," says Dr. Giller. Failing that, you can also offer yourself up as a catch-all excuse to deflect peer pressure: "I can't. My mom is really strict." Whatever strategy you use, preparation will make it easier for kids to find their voice when an awkward moment arises.

Address lying head-on

Teenagers lie. It's annoying at best, dangerous at worst, and definitely something parents are concerned about, especially now. It's never been more vital for kids to tell the truth about what they're doing - and to be honest if they've made a mistake, so that you can be sure the rest of the family (especially older or more vulnerable relatives) stay safe.

"When kids are lying, they're often just trying to escape the consequences," notes Dr. Macchia. Parents, she suggests, can head this off by offering kids a kind of get-out-of-jail-free card for mistakes.

Make an agreement that if they'll be totally truthful, you'll put any kind of punishment or lecturing to the side. "What's most important is that they tell you if they've slipped up and potentially been exposed," Dr. Macchia says. Help your teenager understand that these are extraordinary circumstances, and that the consequences of lying could be much more serious than getting yelled at or grounded.

Above all, remind your teen (and yourself!) that though we're in the middle of a very difficult time, this crisis, like so many others, will pass. We're all on the same team and what we do now will decide what happens next.

You're in the right place for your child's social, emotional and behavioral health. Request a telehealth appointment.

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Teenagers and Reopening | Child Mind Institute

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It's a trying time to be the parent of a teenager. After months of being cooped up at home away from friends, unable to attend school or go out, most kids are chomping at the bit to get back to the lives they had before the pandemic.

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Quaranteenagers: Strategies for Parenting in Close Quarters (Published 2020)

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Because of coronavirus, teenagers are missing out on major rites of passage. Offering compassion paves their way toward feeling better.

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< Back to UNICEF COVID-19 portal

Being a teenager is difficult no matter what, and the coronavirus disease (COVID-19) is making it even harder. With school closures and cancelled events, many teens are missing out on some of the biggest moments of their young lives - as well as everyday moments like chatting with friends and participating in class.

For teenagers facing life changes due to the outbreak who are feeling anxious, isolated and disappointed, know this: you are not alone. We spoke with expert adolescent psychologist, best-selling author and monthly New York Times columnist Dr. Lisa Damour about what you can do to practice self-care and look after your mental health.

1. Recognize that your anxiety is completely normal

If school closures and alarming headlines are making you feel anxious, you are not the only one. In fact, that's how you're supposed to feel. "Psychologists have long recognized that anxiety is a normal and healthy function that alerts us to threats and helps us take measures to protect ourselves," says Dr. Damour. "Your anxiety is going to help you make the decisions that you need to be making right now - not spending time with other people or in large groups, washing your hands and not touching your face." Those feelings are helping to keep not only you safe, but others too. This is "also how we take care of members of our community. We think about the people around us, too."

While anxiety around COVID-19 is completely understandable, make sure that you are using "reliable sources [such as the UNICEF and the World Health Organization's sites] to get information, or to check any information you might be getting through less reliable channels," recommends Dr. Damour.

If you are worried that you are experiencing symptoms, it is important to speak to your parents about it. "Keep in mind that illness due to COVID-19 infection is generally mild, especially for children and young adults," says Dr. Damour. It's also important to remember, that many of the symptoms of COVID-19 can be treated. She recommends letting your parents or a trusted adult know if you're not feeling well, or if you're feeling worried about the virus, so they can help.

And remember: "There are many effective things we can do to keep ourselves and others safe and to feel in better control of our circumstances: frequently wash our hands, don't touch our faces and engage in physical distancing."
>> Read our handwashing tips
2. Create distractions

"What psychologists know is that when we are under chronically difficult conditions, it's very helpful to divide the problem into two categories: things I can do something about, and then things I can do nothing about," says Dr. Damour.

There is a lot that falls under that second category right now, and that's okay, but one thing that helps us to deal with that is creating distractions for ourselves. Dr. Damour suggests doing homework, watching a favourite movie or getting in bed with a novel as ways to seek relief and find balance in the day-to-day.

3. Find new ways to connect with your friends

If you want to spend time with friends while you're practicing physical distancing, social media is a great way to connect. "I would never underestimate the creativity of teenagers," says Dr. Damour, "My hunch is that they will find ways to [connect] with one another online that are different from how they've been doing it before."

"[But] it's not going to be a good idea to have unfettered access to screens and or social media. That's not healthy, that's not smart, it may amplify your anxiety," says Dr. Damour, recommending you work out a screen-time schedule with your parents.

4. Focus on you

Have you been wanting to learn how to do something new, start a new book or spend time practicing a musical instrument? Now is the time to do that. Focusing on yourself and finding ways to use your new-found time is a productive way to look after your mental health. "I have been making a list of all of the books I want to read and the things that I've been meaning to do," says Dr. Damour.

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How teenagers can protect their mental health during COVID-19

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6 strategies for teens facing a new (temporary) normal

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Dream Diary is a series exploring dreams, nightmares, and what happens when they bleed into real life. Here we look at bad dreams during the pandemic.

While isolation may be among the many feelings you've experienced while hunkered down at home during COVID-19, when it comes to having bad dreams at night, you aren't alone.

If you search the hashtag #pandemicdreams you'll find no shortage of tweets shared by those whose dreams seem to be wackier than usual. But as an anxious sleeper who rarely has a night of uninterrupted sleep, I've found my own dreams have increasingly taken a violent, disturbing turn over the past few months. Turns out, I'm not the only one.

"After I came home from college, I noticed that I was having weird dreams and nightmares," says Isabella Goodman, 22, of Houston, Texas. "I usually have at least one a week, but the peak was probably at the beginning of April." She says her dreams range from getting married to a stranger to more distressing ones like being chased by a murderer or having someone try to break into her home.

"I wake up feeling anxious and jittery and then I'm really alert for the next hour or so," says Goodman. "I haven't had any dreams that have anything to do with the coronavirus but it's been really stressful and I'm having stress dreams so I don't think it's a reach to say there's a correlation."

According to Meir Kryger, MD, FRCPC, a world-renowned sleep expert at the Yale School of Medicine, that's exactly what's happening - and it might be more common than you think.

Kryger says that since COVID-19, many of his patients report that they're experiencing more bad dreams than usual or are experiencing them for the very first time.

"My personal belief is that it's related to an underlying anxiety about sheltering in place, being worried about your family and friends," he says. "And what happens when you're worried about something or you're stressed or anxious, your sleep becomes unstable."

This instability can contribute to the intensity of your dreams, which occur three to five times a night. Kryger says that most of the time, people will remember none of these dreams or maybe just one. And while we still don't know the precise reason why humans dream, we do know that's when REM (rapid eye movement) occurs, which is important for brain learning and creating memories. We also know that if your dream has distressing content, you're more likely to remember it, says Kryger.

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Dream Diary is a series exploring dreams, nightmares, and what happens when they bleed into real life. Here we look at bad dreams during the pandemic. While isolation may be among the many feelings you've experienced while hunkered down at home during COVID-19, when it comes to having bad dreams at night, you aren't alone.

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The University of Vermont Health Network

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Helping Your Teenager Cope with the Quarantine

At a time in life when it's both developmentally appropriate and culturally expected to seek independence from parents or guardians, teenagers have suddenly been brought back to the nest, their wings clipped for the foreseeable future while families stay home to prevent the spread of COVID-19 respiratory illness. Living in close quarters may be especially tough for this age group, and helping them cope will involve listening, empathy and patience, says Peter Jackson, MD, a child and adolescent psychiatrist at the University of Vermont Medical Center and Champlain Valley Physicians Hospital, as well as an assistant professor at the Larner College of Medicine at UVM. Here, he shares some guidance for parents and caregivers.

Validate Feelings

This is the time in their growing up when teens want to go their own way and explore the world outside the family's circle, to find their own identity. I think there's a strong stereotype that teenagers only want to be connected on social media nowadays, but that's not the case - they're missing real-life interactions with their peers. And so teenagers may be especially frustrated about being restricted in their movements and having to stay home under the same roof with their family all day, every day. That's a pretty normal response. Having the adults in their life acknowledge and validate what they're feeling will go a long way in helping them cope.

Find and Keep a Routine

Even though teenagers sometimes fight against the routine more than little kids do, they still need some structure in regards to sleep, mealtimes, daily responsibilities and fresh air. It's not a time to abandon all previously established expectations and limits. This might also be a good time to support them in the pursuit of a new goal or hands-on project that they wouldn't otherwise have time to pursue.

Make Sense of Invincibility

Many teens feel invincible. That tendency is also developmentally normal. Evolutionarily, we know that there's a reason why at a certain stage in life you need to be more risk-taking and you need to be willing to branch out from your family group. This group may be less accepting of being told to follow precautions that to them might seem over the top or burdensome. Understanding this may help parents find ways to reach teens where they are.

Tap Into the Desire to Help Others

Scare tactics towards fear or trying to instill guilt aren't going to work that well with adolescents. Teenagers are more empathetic than we give them credit for. They can be really conscientious, and it's not uncommon for them to be motivated by causes around social justice. Remind your teen that this is a chance to help the common good. We can empower them to be a part of something bigger, and to think outside of themselves. They are doing their part by staying home.

Grant Some Autonomy

The teen years are a time when kids need to take more ownership and demonstrate autonomy. It's good to let them be independent in their remote learning. Parents should continue to check in and provide support but don't need to take over their schooling. From middle school onwards teachers are gradually letting adolescents take more ownership and become more accountable. Parents can do the same.

Promote Optimism Without Sugarcoating

Teenagers are going to be wondering about the future. They will want to know when sports will start back up, when they will be able to return to part-time jobs, if they will be able to keep their summer plans. It's OK to say, "We don't know. But as we do our part, I think we can have some optimism. It looks like areas that have committed to taking the necessary precautions are seeing improvement." Be truthful. Teenagers are mature enough that they don't need it sugarcoated. It's much easier for teens to just hear it as it is than to be falsely reassured. And they can deal with uncertainty too. We can say what we do know and then say, "We're going to have to wait and see."

Define, Record and Learn From the Experience

This is going to be a defining experience in your teen's formative years. It has the potential to be incredibly and unforgettably informative. You may suggest that your teen keep a journal, reflecting on these changes. Consider prompting them to think about the things that they may have taken for granted, and talk about it too. There is also an opportunity for all of us to ask, "What really matters the most to me? What do I miss a lot? What do I want to bring back into my life? And what do I realize I'm really fine without?" I think that is a meaningful conversation for families to have.

Reach Out to Teens Who Need Encouragement

While for some families this may be a bonding, almost nostalgic experience, many are extremely taxed right now. Our government mandates have wisely been attentive to socioeconomically challenged families and children with special education needs. There are so many additional adolescents who need to be on our minds as a community. Consider adolescents with depression or anxiety, adolescents for whom home has unfortunately not represented the center of their support system. Sadly, for some, home has been the opposite. They don't have some of the more caring adults in their life right now. If I could say something to our entire community, think about the families you know for whom this experience will be nothing like Little House on the Prairie. Who needs a phone call from you? If you're a coach, which kid on your team needs an outreach? For a music teacher, which of your students could use a "Hello, how's your practice going?" Offer some words of encouragement: "I care about you and I hope you're doing well and I look forward to seeing you again."

Give this guidance a try at home, but remember to be patient and kind to yourself, too. You are navigating this new and unchartered way of life alongside your teenager. Together, as a family, you might just find a new rhythm and grace that works for the personalities, feelings and shared experiences that live under your roof.
Peter Jackson, MD, is a child and adolescent psychiatrist at the University of Vermont Medical Center and assistant professor at the Larner College of Medicine at UVM.

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Helping Your Teenager Cope with the Quarantine

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At a time in life when it's both developmentally appropriate and culturally expected to seek independence from parents or guardians, teenagers have suddenly been brought back to the nest, their wings clipped for the foreseeable future while families stay home to prevent the spread of COVID-19 respiratory illness.

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Stay informed about what's really happening by tuning into trusted sources such as the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), or your state health department. However, do your best to limit your news consumption to a few specific times during the day (e.g. about 15 minutes a day in the morning and 15 minutes a day in the evening) for key practical information. Avoid watching or reading news on social media where information can be exaggerated or incorrect.
When you have a job that requires you to be there in person
If you work at a business that is considered "essential", you may still be required to report to work during this time. While you may be grateful for the continued paycheck, you may also be fearful that you will become ill and spread the virus to your family members or roommates. Individuals who are staying home and are not required to go into work may not fully understand what you're going through. Share your concerns with your supervisors or your coworkers who are in the same situation. Also, when possible, participate in relaxing activities when you're home from work, such as yoga, watching a movie or funny videos, or going on a walk outside.
Create and follow a new routine that includes boundaries

During this time, you may be working remotely for the first time or you've found yourself in a different working situation than before the pandemic. Whatever the case, it isn't just "work as usual"-your daily living routine has most certainly been disrupted. Creating a new daily routine that you follow will help you cope with this new, unpredictable situation and make you feel more in control of everything. A routine can help you stick to healthy habits and prioritize needed self-care even during the workday, since you will be able to carve out blocks of time for activities such as breakfast, stretching, exercise, and relaxing.

When working from home, there is not a natural start and stop time for working hours. Instead, there can be a blurring of boundaries between your work and home lives. Setting a schedule that you maintain each day will encourage you to work reasonable hours and stop working or checking email when your workday ends.
Stay connected with your coworkers and colleagues when working remotely
Many people spend the majority of their waking hours at work, meaning their coworkers are their main source of social interaction each day. When working from home, it's important to find new ways of staying connected with your colleagues to discuss both work and personal matters.

Your coworkers should serve as a social and professional support system. For example, coworkers can be a helpful outlet to talk through coronavirus-related fears such as job security, worries about your health and well-being, or the safety of your loved ones. You and your coworkers may also find it helpful to share strategies for adjusting to a new way of working and living. Some teams and organizations have organized daily or weekly video check-ins or virtual "happy hours" to do this. You may consider suggesting one of these ideas to your manager or team. It would also be a nice idea to call up a coworker that you normally see to ask how they're doing. Reaching out to others is mutually beneficial.
Be patient with yourself and your coworkers

This is an overwhelming situation that has forced us to make significant changes in the way we live and work. Take comfort in the fact that everyone around you (your co-workers, your supervisors, and your friends and family) is going through this together. You may need to adjust your schedule for childcare or caregiving responsibilities or other priorities that come up during this time. If you have kids or pets (fondly known as coworkers) at home, you may be interrupted on work-related phone or videoconference calls. That's okay! Share these challenges with colleagues and supervisors so they are aware. Or consider introducing your children or pets to your colleagues to make light of the situation.

To minimize distractions, it can be helpful to work during specific periods of time, such as early mornings or evenings. Again, sticking to this particular routine (whatever it may be) is important for staying mentally well. You may also find it harder to focus on your job when you are constantly receiving coronavirus-related emails or seeing distressing articles about the pandemic online. Try to set aside time to read updates about the pandemic, but also allocate specific times to limit distractions and disconnect from the news.

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Maintaining Your Mental Health When Working during the COVID-19 Pandemic | Psychiatry | Michigan Medicine

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Stay informed about what's really happening by tuning into trusted sources such as the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), or your state health department. However, do your best to limit your news consumption to a few specific times during the day (e.g.

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National Association of School Psychologists (NASP)

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Families across the country are adapting to the evolving changes in daily life caused by the COVID-19 pandemic. Most schools, places of public gathering, and nonessential businesses are closed, and parents and other caregivers are faced with helping their families adjust to the new normal. This includes trying to keep children occupied, feeling safe, and attempting to keep up with schoolwork as best as possible. None of this is easy, but it helps to stay focused on what is possible in order to reinforce a sense of control and to reassure children that they are okay, and that the situation will get better.

It is very important to remember that children look to adults for guidance on how to react to stressful events. Acknowledging some level of concern, without panicking, is appropriate and can result in taking the necessary actions that reduce the risk of illness. Teaching children positive preventive measures, talking with them about their fears, and giving them a sense of some control over their risk of infection can help reduce anxiety. This is also a tremendous opportunity for adults to model for children problem-solving, flexibility, and compassion as we all work through adjustting daily schedules, balancing work and other activities, getting creative about how we spend time, processing new information from authorities, and connecting and supporting friends and family members in new ways. The following tips can help.

STAY CALM, LISTEN, AND OFFER REASSURANCE

Be a role model. Children will react to and follow your reactions. They learn from your example.

Be aware of how you talk about COVID-19. Your discussion about COVID-19 can increase or decrease your child's fear. If true, remind your child that your family is healthy, and you are going to do everything within your power to keep loved ones safe and well. Carefully listen or have them draw or write out their thoughts and feelings and respond with truth and reassurance.

Explain social distancing. Children probably don't fully understand why parents/guardians aren't allowing them to be with friends. Tell your child that your family is following the guidelines of the Centers for Disease Control and Prevention (CDC), which include social distancing. Social distancing means staying away from others until the risk of contracting COVID-19 is under control. Showing older children the "flatten the curve" charts will help them grasp the significance of social distancing. Explain that while we don't know how long it will take to "flatten the curve" to reduce the number of those infected, we do know that this is a critical time-we must follow the guidelines of health experts to do our part.

Demonstrate deep breathing. Deep breathing is a valuable tool for calming the nervous system. Do breathing exercises with your children.

Focus on the positive. Celebrate having more time to spend as a family. Make it as fun as possible. Do family projects. Organize belongings, create masterpieces. Sing, laugh, and go outside, if possible, to connect with nature and get needed exercise. Allow older children to connect with their friends virtually.

Establish and maintain a daily routine. Keeping a regular schedule provides a sense of control, predictability, calm, and well-being. It also helps children and other family members respect others' need for quiet or uninterrupted time and when they can connect with friends virtually.

Identify projects that might help others. This could include: writing letters to the neighbors or others who might be stuck at home alone or to healthcare workers; sending positive messages over social media; or reading a favorite children's book on a social media platform for younger children to hear.

Offer lots of love and affection.

MONITOR TELEVISION VIEWING AND SOCIAL MEDIA

Parents/guardians should monitor television, internet, and social media viewing-both for themselves and their children. Watching continual updates on COVID-19 may increase fear and anxiety. Developmentally inappropriate information, or information designed for adults, can also cause anxiety or confusion, particularly in young children.

Dispel rumors and inaccurate information. Explain to your child that many stories about COVID-19 on the internet may include rumors and inaccurate information. Older children, in particular, may be accessing a great deal of information online and from friends that contains inaccuracies. Talk to your child about factual disease information.

Provide alternatives. Engage your child in games or other exciting activities instead.

TAKE TIME TO TALK

Let your children's questions guide you. Answer their questions truthfully, but don't offer unnecessary details or facts. Don't avoid giving them the information that experts indicate as crucial to your children's well-being. Often, children and youth do not talk about their concerns because they are confused or don't want to worry loved ones. Younger children absorb scary information in waves. They ask questions, listen, play, and then repeat the cycle. Children always feel empowered if they can control some aspects of their life. A sense of control reduces fear.

BE HONEST AND ACCURATE

Correct misinformation. Children often imagine situations worse than reality; therefore, offering developmentally appropriate facts can reduce fears.

Explain simple safety steps. Tell your child this disease spreads between people who are in close contact with one another, when an infected person coughs or sneezes, or when one touches infected objects or surfaces.

Stay up-to-date on the facts. Go to https://www.cdc.gov/coronavirus/2019-ncov/index.htmlfor additional factual information.

KEEP EXPLANATIONS AGE-APPROPRIATE

Early elementary school children. Provide brief, simple information that balances COVID-19 facts with appropriate reassurances that adults are there to help keep them healthy and to take care of them if they do get sick. Give simple examples of the steps people make every day to stop germs and stay healthy, such as washing hands. Use language such as "adults are working hard to keep you safe."

Upper elementary and early middle school children. This age group often is more vocal in asking questions about whether they indeed are safe and what will happen if COVID-19 spreads in their area. They may need assistance separating reality from rumor and fantasy. Discuss the efforts national, state, and community leaders are doing to prevent germs from spreading.

Upper middle and high school students. Issues can be discussed in more depth. Refer them to appropriate sources of COVID-19 facts. Provide honest, accurate, and factual information about the current status of COVID-19. Engage them in decision-making about family plans, scheduling, and helping with chores at home.

For all children, encourage them to verbalize their thoughts and feelings. Be a good listener!

STAY CONNECTED TO SCHOOL

Locate learning resources. Schools' capacity to conduct virtual learning experiences will vary greatly, but most schools are providing lessons and learning activities for children to do. Take advantage of the many companies and online platforms currently offering free learning opportunities.

Identify additional resources. Know if your school or district is providing additional resources, such meals, or technology, such as a laptop or tablet.

Stay in touch. Find out how the school is communicating with families and students. Be sure to read any communications you receive. Check with you children, particularly older ones, as they may be receiving information directly that would be helpful for you to know.

Connect with school staff. Reach out to your child's teacher and other relevant school staff if you have concerns about their coping and keeping up with assignments or activities.

KNOW THE SYMPTOMS OF COVID-19

According to the CDC, symptoms of fever, cough, and/or shortness of breath appear within 14 days after being exposed to the disease.

For some people, the symptoms are similar to having a cold; for others, they are more severe or even life threatening.

MODEL BASIC HYGIENE AND HEALTHY LIFESTYLE PRACTICES

Practice daily good hygiene. Encourage your child to practice these simple steps to prevent spreading the virus.

Wash your hands multiple times a day for 20 seconds. Singing "Twinkle, Twinkle Little Star" or "Happy Birthday" twice is about 20 seconds.

Compliment your children when they use a Kleenex or sneeze or cough into the bend of their elbow. Teach them the importance of throwing away used tissues immediately after sneezing or coughing.

Sadly, handshakes and hugs need to be limited to immediate family members, at least for now.

Foster a sense of control. Offering guidance on what your child/children can do to prevent infection offers them a greater sense of control, which reduces anxiety.

Build the immune system. Encourage your child to eat a balanced diet, get enough sleep, and exercise regularly; this will help them develop a robust immune system to fight off illness.

BE AWARE OF YOUR CHILDREN'S MENTAL HEALTH

Most children will manage well with the support of parents and other family members, even if showing signs of some anxiety or concerns, such as difficulty sleeping or concentrating. Some children, however, may have risk factors for more intense reactions, including severe anxiety, depression, and suicidal behaviors. Risk factors can include a pre-existing mental health problem, prior traumatic experiences or abuse, family instability, or the loss of a loved one. Parents and caregivers should contact a professional if children exhibit significant changes in behavior or any of the following symptoms for more than 2 weeks.

Preschoolers -thumb sucking, bedwetting, clinging to parents, sleep disturbances, loss of appetite, fear of the dark, regression in behavior, and withdrawal.

Elementary school children -irritability, aggressiveness, clinginess, nightmares, school avoidance, poor concentration, and withdrawal from activities and friends.

Adolescents -sleeping and eating disturbances, agitation, increase in conflicts, physical complaints, delinquent behavior, and poor concentration.

ADDITIONAL RESOURCES
For more information related to schools and physical and mental health, visit www.nasponline.org and © 2020, National Association of School Psychologists, 4340 East Wes t Highway, Suite 402, Bethesda, MD 20814, 301-657-0270 www.nasn.org.
Adapted from, Talking to Children About COVID-19 (Coronavirus): A Parent Resource, National Association of School Psychologists and National Association of School Nurses, NASP, 2020.

Contributor: School Psychologist Kathy Sievering

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Helping Children Cope With Changes Resulting From COVID-19

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Families across the country are adapting to the evolving changes in daily life caused by the COVID-19 pandemic. Most schools, places of public gathering, and nonessential businesses are closed, and parents and other caregivers are faced with helping their families adjust to the new normal.

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Browse our extensive directory of the best Therapists, Psychologists and Counselors near you.

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If you you need to speak with a mental health provider urgently about what you are experiencing, you can call your local Emergency Services Program (ESP). ESPs are staffed by mental health clinicians. They can talk to people who feel they are in or near crisis, and try to help them find the supports they need to manage the crisis.

ESP services are available 24 hours a day, 7 days a week, 365 days a year. You can find the ESP serving your area, by calling 1-877-382-1609 and entering your zip code. You can also check out this list of ESPs by location (pdf - opens in a new window).

Note that all ESPs accept MassHealth and Medicare (including OneCare and Senior Care Options plans), and also support people without health insurance. Many ESPs also contract with commercial insurance plans. You can contact your local ESP to confirm what insurance coverage they can accept.

ESPs often cannot support people who have recently used substances. If you need urgent substance-related care and cannot get support through your local ESP, you can try a substance use urgent care clinic.

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Navigating a Mental Health Crisis - NAMI Massachusetts

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If you you need to speak with a mental health provider urgently about what you are experiencing, you can call your local Emergency Services Program (ESP). ESPs are staffed by mental health clinicians. They can talk to people who feel they are in or near crisis, and try to help them find the supports they need to manage the crisis.

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Providers and Programs - NAMI Massachusetts

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First Episode/Early Psychosis Programs are a team-oriented care approach designed to treat people who are showing signs of psychosis or who were recently diagnosed with psychosis. The Massachusetts Psychosis Network For Early Treatment provides information about First Episode/Early Psychosis Programs and a list of programs in Massachusetts.

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Self-harm or self-injury means hurting yourself on purpose. Learn about why people self-harm and treatment and coping.

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Psychiatry.org - What Is Obsessive-Compulsive Disorder?

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Obsessive-compulsive disorder (OCD) is a disorder in which people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning, can significant…

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Borderline Personality Disorder (BPD) is a condition characterized by difficulties regulating emotion. This means that people who experience BPD feel emotions intensely and for extended periods of time, and it is harder for them to return to a stable baseline after an emotionally triggering event.

This difficulty can lead to impulsivity, poor self-image, stormy relationships and intense emotional responses to stressors. Struggling with self-regulation can also result in dangerous behaviors such as self-harm (e.g. cutting).

It's estimated that 1.4% of the adult U.S. population experiences BPD. Nearly 75% of people diagnosed with BPD are women. Recent research suggests that men may be equally affected by BPD, but are commonly misdiagnosed with PTSD or depression.

Symptoms

People with BPD experience wide mood swings and can feel a great sense of instability and insecurity. According to the Diagnostic and Statistical Manual diagnostic framework, some key signs and symptoms may include:

Frantic efforts to avoid real or imagined abandonment by friends and family.

Unstable personal relationships that alternate between idealization ("I'm so in love!") and devaluation ("I hate her"). This is also sometimes known as "splitting."

Distorted and unstable self-image, which affects moods, values, opinions, goals and relationships.

Impulsive behaviors that can have dangerous outcomes, such as excessive spending, unsafe sex, reckless driving, or misuse or overuse of substances.

Self-harming behavior including suicidal threats or attempts.

Periods of intense depressed mood, irritability or anxiety lasting a few hours to a few days.

Chronic feelings of boredom or emptiness.

Inappropriate, intense or uncontrollable anger-often followed by shame and guilt.

Dissociative feelings-disconnecting from your thoughts or sense of identity or "out of body" type of feelings-and stress-related paranoid thoughts. Severe cases of stress can also lead to brief psychotic episodes.

Causes

The causes of BPD are not fully understood, but scientists agree that it is the result of a combination of factors, including:

Genetics. While no specific gene or gene profile has been shown to directly cause BPD, research suggests that people who have a close family member with BPD may be at a higher risk of developing the disorder.

Environmental factors. People who experience traumatic life events-such as physical or sexual abuse during childhood or neglect and separation from parents-are at increased risk of developing BPD.

Brain function. The emotional regulation system may be different in people with BPD, suggesting that there is a neurological basis for some of the symptoms. Specifically, the portions of the brain that control emotions and decision-making/judgment may not communicate optimally with one another.

Diagnosis

There is no definitive medical test to diagnose BPD, and a diagnosis is not based on one specific sign or symptom. BPD is best diagnosed by a mental health professional following a comprehensive clinical interview that may include talking with previous clinicians, reviewing previous medical evaluations and, when appropriate, interviews with friends and family.

Treatment

An effective treatment plan should include your preferences while also addressing any other co-existing conditions you may have. Examples of treatment options include psychotherapy; medications; and group, peer and family support. The overarching goal of treatment is for a person with BPD to increasingly self-direct their own treatment plan as they learn what works and what doesn't.

Psychotherapy-such as dialectical behavioral therapy (DBT), cognitive behavioral therapy (CBT) and psychodynamic psychotherapy-is the first line of choice for BPD. Learning ways to cope with emotional dysregulation in a therapeutic setting is often the key to long-term improvement for those experiencing BPD.

Medications may be instrumental to a treatment plan, but there is no one medication specifically made to treat the core symptoms of BPD. Rather, several medications can be used off-label to treat various symptoms. For example, mood stabilizers and antidepressants help with mood swings and dysphoria. And for some, low-dose antipsychotic medication may help control symptoms such as disorganized thinking.

Short-term hospitalization may be necessary during times of extreme stress, and/or impulsive or suicidal behavior to ensure safety.

Related Conditions

BPD can be difficult to diagnose and treat, and successful treatment includes addressing any other conditions a person might have. Many with BPD also experience additional conditions like:
Reviewed December 2017

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Borderline personality disorder | NAMI: National Alliance on Mental Illness

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Borderline Personality Disorder (BPD) is a condition characterized by difficulties regulating emotion. This means that people who experience BPD feel emotions intensely and for extended periods of time, and it is harder for them to return to a stable baseline after an emotionally triggering event.

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Personality Disorders
Personality is the way of thinking, feeling and behaving that makes a person different from other people. An individual's personality is influenced by experiences, environment (surroundings, life situations) and inherited characteristics. A person's personality typically stays the same over time. A personality disorder is a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time.1

There are 10 specific types of personality disorders. Personality disorders are long-term patterns of behavior and inner experiences that differs significantly from what is expected. The pattern of experience and behavior begins by late adolescence or early adulthood and causes distress or problems in functioning. Without treatment, personality disorders can be long-lasting. Personality disorders affect at least two of these areas:

Way of thinking about oneself and others

Way of responding emotionally

Way of relating to other people

Way of controlling one's behavior

Types of Personality Disorders

Antisocial personality disorder: a pattern of disregarding or violating the rights of others. A person with antisocial personality disorder may not conform to social norms, may repeatedly lie or deceive others, or may act impulsively.

Avoidant personality disorder: a pattern of extreme shyness, feelings of inadequacy and extreme sensitivity to criticism. People with avoidant personality disorder may be unwilling to get involved with people unless they are certain of being liked, be preoccupied with being criticized or rejected, or may view themselves as not being good enough or socially inept.

Borderline personality disorder: a pattern of instability in personal relationships, intense emotions, poor self-image and impulsivity. A person with borderline personality disorder may go to great lengths to avoid being abandoned, have repeated suicide attempts, display inappropriate intense anger or have ongoing feelings of emptiness.

Dependent personality disorder: a pattern of needing to be taken care of and submissive and clingy behavior. People with dependent personality disorder may have difficulty making daily decisions without reassurance from others or may feel uncomfortable or helpless when alone because of fear of inability to take care of themselves.

Histrionic personality disorder: a pattern of excessive emotion and attention seeking. People with histrionic personality disorder may be uncomfortable when they are not the center of attention, may use physical appearance to draw attention to themselves or have rapidly shifting or exaggerated emotions.

Narcissistic personality disorder: a pattern of need for admiration and lack of empathy for others. A person with narcissistic personality disorder may have a grandiose sense of self-importance, a sense of entitlement, take advantage of others or lack empathy.

Obsessive-compulsive personality disorder: a pattern of preoccupation with orderliness, perfection and control. A person with obsessive-compulsive personality disorder may be overly focused on details or schedules, may work excessively not allowing time for leisure or friends, or may be inflexible in their morality and values. (This is NOT the same as obsessive compulsive disorder .)

Paranoid personality disorder: a pattern of being suspicious of others and seeing them as mean or spiteful. People with paranoid personality disorder often assume people will harm or deceive them and don't confide in others or become close to them.

Schizoid personality disorder: being detached from social relationships and expressing little emotion. A person with schizoid personality disorder typically does not seek close relationships, chooses to be alone and seems to not care about praise or criticism from others.

Schizotypal personality disorder: a pattern of being very uncomfortable in close relationships, having distorted thinking and eccentric behavior. A person with schizotypal personality disorder may have odd beliefs or odd or peculiar behavior or speech or may have excessive social anxiety.

Diagnosis of a personality disorder requires a mental health professional looking at long-term patterns of functioning and symptoms. Diagnosis is typically made in individuals 18 or older. People under 18 are typically not diagnosed with personality disorders because their personalities are still developing. Some people with personality disorders may not recognize a problem. Also, people may have more than one personality disorder. An estimated 9 percent of U.S. adults have at least one personality disorder. 2

Treatment

Certain types of psychotherapy are effective for treating personality disorders. During psychotherapy, an individual can gain insight and knowledge about the disorder and what is contributing to symptoms, and can talk about thoughts, feelings and behaviors. Psychotherapy can help a person understand the effects of their behavior on others and learn to manage or cope with symptoms and to reduce behaviors causing problems with functioning and relationships. The type of treatment will depend on the specific personality disorder, how severe it is, and the individual's circumstances.

Commonly used types of psychotherapy include:

Psychoanalytic/psychodynamic therapy

Dialectical behavior therapy

Cognitive behavioral therapy

Group therapy

Psychoeducation (teaching the individual and family members about the illness, treatment and ways of coping)

There are no medications specifically to treat personality disorders. However, medication, such as antidepressants, anti-anxiety medication or mood stabilizing medication, may be helpful in treating some symptoms. More severe or long lasting symptoms may require a team approach involving a primary care doctor, a psychiatrist, a psychologist, social worker and family members.

In addition to actively participating in a treatment plan, some self-care and coping strategies can be helpful for people with personality disorders.

Learn about the condition. Knowledge and understanding can help empower and motivate.

Get active. Physical activity and exercise can help manage many symptoms, such as depression, stress and anxiety.

Avoid drugs and alcohol. Alcohol and illegal drugs can worsen symptoms or interact with medications.

Get routine medical care. Don't neglect checkups or regular care from your family doctor.

Join a support group of others with personality disorders.

Write in a journal to express your emotions.

Try relaxation and stress management techniques such as yoga and meditation.

Stay connected with family and friends; avoid becoming isolated.

Source: Adapted from Mayo Clinic, Personality Disorders
Family members can be important in an individual's recovery and can work with the individual's health care provider on the most effective ways to help and support. But having a family member with a personality disorder can also be distressing and stressful. Family members may benefit from talking with a mental health provider who can provide help coping with difficulties.

References

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). American Psychiatric Association. (2013).

Lenzenweger MF, Lane MC, Loranger AW, Kessler RC. 2007. DSM-IV personality disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 62(6), 553-564.

Physician Review By:

Rachel Robitz, M.D.
November 2018

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Personality Disorders Personality is the way of thinking, feeling and behaving that makes a person different from other people. An individual's personality is influenced by experiences, environment (surroundings, life situations) and inherited characteristics. A person's personality typically stays the same over time.

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National Institute of Mental Health (NIMH)

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What is ASD?

Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. Although autism can be diagnosed at any age, it is described as a "developmental disorder" because symptoms generally appear in the first 2 years of life.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a guide created by the American Psychiatric Association that health care providers use to diagnose mental disorders, people with ASD often have:

Difficulty with communication and interaction with other people

Restricted interests and repetitive behaviors

Symptoms that affect their ability to function in school, work, and other areas of life

Autism is known as a "spectrum" disorder because there is wide variation in the type and severity of symptoms people experience.

People of all genders, races, ethnicities, and economic backgrounds can be diagnosed with ASD. Although ASD can be a lifelong disorder, treatments and services can improve a person's symptoms and daily functioning. The American Academy of Pediatrics recommends that all children receive screening for autism. Caregivers should talk to their child's health care provider about ASD screening or evaluation.

What are the signs and symptoms of ASD?

What are the causes and risk factors for ASD?

How is ASD diagnosed?

What treatment options are available for ASD?

How can I find a clinical trial for ASD?

Where can I learn more about ASD?

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Learn about autism spectrum disorder, including signs and symptoms, causes, how it is diagnosed, and potential treatments.

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Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act, and helps determine how we handle stress, relate to others, and make choices.

Mental health is important at every stage of life, from childhood and adolescence through adulthood. Over the course of your life, if you experience mental health problems, your thinking, mood, and behavior could be affected.

Mental Health Conditions

Mental illnesses are disorders, ranging from mild to severe, that affect a person's thinking, mood, and/or behavior. According to the National Institute of Mental Health, nearly one-in-five adults live with a mental illness.

Many factors contribute to mental health conditions, including:

Biological factors, such as genes or brain chemistry

Life experiences, such as trauma or abuse

Family history of mental health problems

Some mental health topics include:

A Serious Mental Illness (SMI) is a mental illness that interferes with a person's life and ability to function. Despite common misperceptions, having an SMI is not a choice, a weakness, or a character flaw. It is not something that just "passes" or can be "snapped out of" with willpower.

View SAMHSA's Public Message about Serious Mental Illnesses.

Early Warning Signs & Symptoms

Not sure if you or someone you know is living with mental health problems? Experiencing one or more of the following feelings or behaviors can be an early warning sign of a problem:

Eating or sleeping too much or too little

Pulling away from people and usual activities

Having low or no energy

Feeling numb or like nothing matters

Having unexplained aches and pains

Feeling helpless or hopeless

Smoking, drinking, or using drugs more than usual

Feeling unusually confused, forgetful, on edge, angry, upset, worried, or scared

Yelling or fighting with family and friends

Experiencing severe mood swings that cause problems in relationships

Having persistent thoughts and memories you can't get out of your head

Hearing voices or believing things that are not true

Thinking of harming yourself or others

Inability to perform daily tasks like taking care of your kids or getting to work or school

Do you think someone you know may have a mental health problem? Talking about mental health can be difficult. Learn about common mental health myths and facts and read about ways to help you get the conversation started.

Tips for Living Well with a Mental Health Condition

Having a mental health condition can make it a struggle to work, keep up with school, stick to a regular schedule, have healthy relationships, socialize, maintain hygiene, and more.

However, with early and consistent treatment-often a combination of medication and psychotherapy-it is possible to manage these conditions, overcome challenges, and lead a meaningful, productive life.

Today, there are new tools, evidence-based treatments, and social support systems that help people feel better and pursue their goals. Some of these tips, tools and strategies include:

Stick to a treatment plan. Even if you feel better, don't stop going to therapy or taking medication without a doctor's guidance. Work with a doctor to safely adjust doses or medication if needed to continue a treatment plan.

Keep your primary care physician updated. Primary care physicians are an important part of long-term management, even if you also see a psychiatrist.

Learn about the condition. Being educated can help you stick to your treatment plan. Education can also help your loved ones be more supportive and compassionate.

Practice good self-care. Control stress with activities such as meditation or tai-chi; eat healthy and exercise; and get enough sleep.

Reach out to family and friends. Maintaining relationships with others is important. In times of crisis or rough spells, reach out to them for support and help.

Develop coping skills. Establishing healthy coping skills can help people deal with stress easier.

Get enough sleep. Good sleep improves your brain performance, mood and overall health. Consistently poor sleep is associated with anxiety, depression, and other mental health conditions.

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Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act, and helps determine how we handle stress, relate to others, and make choices.

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Being healthy means dealing with the changes in your body - and your mind. Relationships, body image, families, emotions ... sort it all out in this section.

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We are calling on our community to help us share brightness this season! Together we can provide empowering resources and services for mental well-being. Visit our toolkit to learn how you can spread awareness and support DBSA during our busiest giving time.

Your support is an investment in fostering hope, healing, and a brighter future for all those living with mood disorders.
Brighten Lives Toolkit!

Treatment Options

Seeking mental health treatment is not a sign of weakness or failure, but rather a show of great strength and compassion for yourself and those you love. Learn more about options to treat mood disorders and how to choose a provider.
See Treatment Options

Daily tools empower your wellness journey

Each person's wellness journey is unique. With that in mind, DBSA has developed tools to help you take the first steps and determine what support you may need along the way.

Start with Strengths

The DBSA Wellness Wheel is an easy-to-use tool that focuses on your strengths in 7 key areas of life.
Wellness Wheel

Keep Daily Logs

Our Wellness Tracker can be an essential resource to understand your moods, symptoms, medications, and lifestyle.
Wellness Tracker

If there's a young child in your life, we think you'll be excited to learn more about the DBSA Mood Crew®
Meet the DBSA Mood Crew!

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DBSA - Depression and Bipolar Support Alliance

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Living with depression or bipolar disorder? Find free support groups, resources, and wellness tools.

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In schizophrenia, knowledge of the disease itself is important. Spend time learning about the disease, and ask your psychiatrist and treatment team all the questions you can think of. This article provides an overview of nine important things to know about schizophrenia.

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In schizophrenia, knowledge of the disease itself is important. Spend time learning about the disease, and ask your psychiatrist and treatment team all the questions you can think of. This article provides an overview of nine important things to know about schizophrenia.

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1 in 5 of Us Lives With a Mental Illness

The Latest Research Discoveries

Donate Now

Awarding Grants for scientific research

100% of every donation for research goes to research

World-renowned scientists

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1 in 5 of Us Lives With a Mental Illness The Latest Research Discoveries Awarding Grants for scientific research 100% of every donation for research goes to research World-renowned scientists

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Mental Health America's Advocacy Network is a powerful voice for change. The Advocacy Network is comprised of thousands of individuals nationwide who take an active role in protecting America's mental health through legislative advocacy. Because of the support of individuals like you, we have won major victories such as the Affordable Care Act and the Mental Health and Addiction Parity and Equity Act.

Together, we speak out and make our voice heard on prevention for all, early identification and intervention for those at risk, access to quality, integrated health care for those who need it with recovery as the goal.
Learn more about our #B4Stage4initiative

Our Affiliates

With more than 200 affiliate organizations in 41 states, MHA is a powerful voice for healthy communities throughout the nation. MHA affiliates around the country advocate at the state and local levels so that all individuals living with mental health conditions get the help they want when they need it.
Find an affiliate near you

Regional Policy Council

MHA's Regional Policy Council (RPC) acts as a hub of mental health policy information and activities between MHA national and the affiliate network. Through the RPC, affiliates engage with stakeholders and policymakers to initiate, advocate for, and implement policies that positively affect the lives of children, youth, and adults with mental health and substance use conditions.
Learn more about the Regional Policy Council

Support Our Advocacy Efforts

MHA's Advocacy Network has put mental health on the national agenda. Now, we want to make sure those whose lives are affected by the decisions made in Washington and around the country are represented. Your support makes the difference in winning the changes we need.

Join us today. Please make a tax-deductible donation to Mental Health America and strengthen our voice.
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NAMI Awards Each year NAMI recognizes outstanding achievements and celebrates accomplishments made by individuals and organizations that advance NAMI's mission to improve the lives of people affected by mental illness and their loved ones. Learn More Work at NAMI Become part of a team that is committed to improving the lives of individuals across mental illness.

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Active Minds Giving Tuesday

It is that time of year...your chance to support young adult mental health and Active Minds during Giving Tuesday.

Adding to your impact, our friends at Urban Outfitters are #GivingToSay that "Mental Health Matters" by generously matching any gift over $25 (up to $50,000).

Maximize your impact. Maximize your support of young adult mental health across the country.

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Active Minds - Changing the conversation about mental health

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Active Minds is the nation's premier nonprofit organization supporting mental health awareness and education for young adults.

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You have likely heard about the importance of self-care and some ways to practice it. Every adult should practice self-care to give themselves a break from their hectic lives, refresh, and take care of themselves mentally, emotionally, and physically ( be sure to read our blog about this!). While we all know that self-care is important for adults, it is also important for kiddos!

While your child likely does not deal with as much stress during a day at preschool as you do, self-care is still beneficial and important for them to practice. When you teach your child about self-care at a young age, it will teach them to prioritize their mental and physical health, now and as they age. According to a Parents article, when you introduce your kiddos to these habits of caring for themselves, it can help them learn how to deal with stressors in the future and reduces their risk of developing mental health conditions, such as anxiety and depression!

At Growing Kids Learning Centers in Northern Indiana, we understand the importance of implementing these types of things when a child is young. As your kiddo develops, they will learn skills that they will carry throughout their adult life, including skills for caring for their own wellbeing. In this blog, we are going to go over some tips that can help you teach your child about self-care. Read on to learn more and start practicing together!

Teach Basic Skills

Start by teaching your child basic skills they need to follow to keep themselves healthy. From personal hygiene to diet, you can start teaching these things at a young age. If you are feeding your kiddo healthy foods, giving them baths, and helping them brush their teeth, you are helping them to develop a foundation for taking care of themselves as they grow. These are things that your child will have to learn how to do eventually and if you work with them early on, you can help them develop healthy habits. While these may not seem like huge self-care habits, they are some of the most important and they show your child that you have to take care of yourself to keep yourself healthy.

Work on the Mind

Nowadays, kids often get lost watching episodes of their favorite TV show, playing video games, or consuming too much screen time. While technology is a huge part of the future and your child's life, you should also encourage them to nourish the mind and get away from the TV or tablet for a while. Buy toys that get your child to think, allow them to practice imaginative play, or work on some crafts. These all can help them develop different skills and allow them to work things through in their minds. Take it a step further and have them practice yoga or something else that helps them get in touch with their inner selves with you. This is a great way to help them gain insight and awareness.

Talk About Emotions

A huge part of self-care revolves around mental health and emotions. While talking to your toddler about emotions will be different than talking to a teenager about emotions, it is a great way to help them develop the right skills to identify and manage their emotions. When your child has a tantrum or is feeling sad, help them talk about their emotions and figure out ways to manage them. Many adults do not know how to manage their emotions and may not even know how to properly identify them, which can lead to problems of their own. By helping your kiddo better understand their emotions, they can understand how to handle them, even as an adult. This is a great way to practice self-care and get in touch with their emotions.

Get Active

Exercise is a great self-care habit that is easy to teach your child. While it is unlikely that you will bring your toddler to the gym and teach them how to lift weights, there are so many ways you can encourage an active lifestyle. Play soccer or basketball with them, bring them to the park, go on bike rides, go for long walks, do yoga, the list goes on and on. When you live an active lifestyle, you are more likely to be healthier mentally, physically, and emotionally. Help your children learn that being active can help them destress and feel better. They will carry this into their future.

Allow For Downtime

Don't teach your child that downtime is bad. Sometimes the best self-care practice is doing nothing. Especially in the fast-paced lives we live as adults, sometimes all we need is a break from it all to do absolutely nothing. Allow for your kiddos to have some downtime, whether that means just cuddling with them on the couch for a few minutes, reading to them, or sitting outside and watching the clouds float by. Teaching your child that it is okay to take some downtime and that it can help them slow down their busy lives when they become adults.

Spend Time Together

Spending time with loved ones is not only a great self-care act for adults, but also for children! Make it a habit of spending some quality time with your children every week and doing something fun. Get some ice cream, play a silly game, or do some other fun activity. Not only can it work as a self-care practice, but it can also help you bond with your child!

Get Outside

Spending time outside can help you and your kiddos refresh and is another great self-care practice. Spend time outside with your kiddos whenever you can. Have fun outdoor adventures that allow them to explore and enjoy time outside. By making the outdoors a major part of your family life, you can help your child develop a love for it and use it as a self-care tactic as they grow.

There are many ways to teach your child self-care and to practice with them! By teaching your children self-care at a young age, you can help them develop these important habits as they age and become adults.

If you are interested in our learning center, be sure to contact us today! We have multiple programs that help kids to learn and develop skills they will use throughout the rest of their lives. Get started and enroll your child at one of the Growing Kids Learning Centers across Northern Indiana!

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You have likely heard about the importance of self-care and some ways to practice it. Every adult should practice self-care to give themselves a break from their hectic lives, refresh, and take care of themselves mentally, emotionally, and physically ( be sure to read our blog about this!).

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Time Required

5 minutes, three to six days per week. Research suggests that people who practice the body scan for longer reap more benefits from this practice.

How to Do It

The body scan can be performed while lying down, sitting, or in other postures. The steps below are a guided meditation designed to be done while sitting. You can listen to audio of this three-minute guided meditation, produced by UCLA's Mindful Awareness Research Center (MARC), in the player; if it doesn't play, you can find it here or download it from MARC's website.*
Especially for those new to the body scan, we recommend performing this practice with the audio. However, you can also use the script below for guidance for yourself or for leading this practice for others.

Begin by bringing your attention to your environment, slowly looking around and noticing that you are safe in this moment.

Bring your attention into your body.

You can close your eyes if that's comfortable for you or maintain a soft gaze, with your eyes partially closed but not focusing on anything in particular.

You can notice your body seated wherever you're seated, feeling the support of the chair or the floor beneath you.

Take a few deep, long breaths, within the range of what is comfortable for you.

And as you take a deep breath, bring in more oxygen, enlivening the body. And as you exhale, you might experience a sense of relaxing more deeply.

You can notice your feet on the floor, notice the sensations of your feet touching the floor. The weight and pressure, vibration, heat.

You can notice your legs against the chair, pressure, pulsing, heaviness, lightness.

Notice your back against the chair, supporting you. If you are not able to notice sensations in all areas of the body, that is OK. We are more connected to certain areas of the body than others, at different times of the day.

Bring your attention into your stomach area. If your stomach is tense or tight, can you allow it to soften? Take a breath.

Notice your hands. Are your hands tense or tight? See if you can allow them to soften.

Notice your arms. Feel any sensation in your arms. Do your best to allow your shoulders to be soft.

Notice your neck and throat. Try to allow them be soft. See if you can invite a sense of relaxation in.

Try to soften your jaw. Do your best to allow your face and facial muscles to be soft.

Then notice your whole body present. Take one more breath.

Be aware of your whole body as best you can. Take a breath. Slowly open up the eyes, without focusing on anything in particular. Allow the head and neck to gently rotate, taking in the space you are in. When you feel ready, you can return to your normal gaze.

* You can also listen to a 45-minute version of the Body Scan that the UC San Diego Center for Mindfulness uses in its trainings in Mindfulness-Based Stress Reduction.

Why You Should Try It

This exercise asks you to systematically focus your attention on different parts of your body, from your feet to the muscles in your face. It is designed to help you develop a mindful awareness of your bodily sensations, and to relieve tension when possible. Research suggests that this mindfulness practice can help reduce stress, improve your well-being, and decrease aches and pains.

Why It Works

Our body can sometimes be a source of pain and negative emotions, whether they are caused by injury or disease, or experiences of discrimination and prejudice. The body scan provides a rare opportunity for us to experience our body as it is, including any difficult feelings that come up, without judging or trying to change it.

It may allow us to notice and release a source of tension we weren't aware of before, such as a hunched back or clenched jaw muscles. Or it may draw our attention to a source of pain and discomfort.

Our feelings of resistance and anger toward pain often only serve to increase that pain, and to increase the distress associated with it. According to research, by noticing the pain we're experiencing, without trying to change it, we may actually feel some relief. Even if the pain doesn't go away, we can take steps to shift our relationship to pain and our relationship to our body in general.

The body scan allows us to work with these types of negative feelings. This practice may also increase our general attunement to our physical needs and sensations, which can in turn help us take better care of our body and make healthier decisions about eating, sleep, and exercise.

Evidence That It Works

Carmody, J. & Baer, R. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms, and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine, 31(1), 23-33.

Body Scan is one of the practices included in Mindfulness-Based Stress Reduction (MBSR). Developed by Jon Kabat-Zinn and based on Buddhist teachings, MBSR is a six- to 10-week program that teaches various mindfulness techniques through weekly sessions and homework assignments. More information about this program is available in Kabat-Zinn's book Full Catastrophe Living.

People in Massachusetts who attended an MSBR program showed increases in mindfulness and well-being, and decreases in stress and symptoms of mental illness, at the end of eight weekly sessions. Time spent engaging in the Body Scan was associated with increased psychological well-being and greater levels of two components of mindfulness-non-reacting to stress and observing thoughts, feelings, and physical sensations.
Who Has Tried the Practice?
Additional studies explore how the Body Scan benefits people outside the U.S.:

Research suggests that MBSR, which includes the Body Scan, benefits the mental health of various groups, including the following:

People in different cultures and countries, such as bilingual Latin-American families, university students in China, disadvantaged families in Hong Kong, low-income cyclo drivers in Vietnam, males with generalized anxiety disorder in Iran, Indigenous people in the Republic of Congo, and Aboriginal Australians.

Women around the world, including pregnant women in China, rural women in India who experienced still-birth, at-risk women in Iran, Muslim women college students in the United Arab Emirates, American survivors of intimate partner violence, and socioeconomically disadvantaged Black women with post-traumatic stress disorder.

People with certain diseases, such as New Zealanders with rheumatoid arthritis, male patients with heart disease in India, patients with diabetes in South Korea, cancer patients in Canada, breast cancer survivors in China, and HIV-positive individuals in Toronto, San Francisco, Iran, and South Africa.

More research is needed to explore whether, and how, the impact of this practice extends to other groups and cultures.

Keep in Mind

A 2015 study found that MBSR "improved depressive symptoms regardless of affiliation with a religion, sense of spiritually, ... sex, or age." However, other studies suggest that MBSR may not benefit everyone equally:

References

Adelian, H., Sedigheh, K. S., Miri, S., & Farokhzadian, J. (2021). The effect of mindfulness-based stress reduction on resilience of vulnerable women at drop-in centers in the southeast of Iran. BMC Women's Health, 21, 1-10.

Fogarty, F. A., Booth, R. J., Lee, A. C., Dalbeth, N., & Consedine, N. S. (2019). Mindfulness-based stress reduction with individuals who have rheumatoid arthritis: Evaluating depression and anxiety as mediators of change in disease activity. Mindfulness, 10(7), 1328-1338.

Gallegos, A. M., Heffner, K. L., Cerulli, C., Luck, P., McGuinness, S., & Pigeon, W. R. (2020). Effects of mindfulness training on posttraumatic stress symptoms from a community-based pilot clinical trial among survivors of intimate partner violence. Psychological Trauma: Theory, Research, Practice, and Policy, 12(8), 859-868.

Gayner, B., Esplen, M. J., DeRoche, P., Wong, J., Bishop, S., Kavanagh, L., & Butler, K. (2012). A randomized controlled trial of mindfulness-based stress reduction to manage affective symptoms and improve quality of life in gay men living with HIV. Journal of Behavioral Medicine, 35(3), 272-285.

Greeson, J. M., Smoski, M. J., Suarez, E. C., Brantley, J. G., Ekblad, A. G., Lynch, T. R., & Wolever, R. Q. (2015). Decreased symptoms of depression after mindfulness-based stress reduction: Potential moderating effects of religiosity, spirituality, trait mindfulness, sex, and age. The Journal of Alternative and Complementary Medicine, 21(3), 166-174.

Hecht, F. M., Moskowitz, J. T., Moran, P., Epel, E. S., Bacchetti, P., Acree, M., Kemeny, M. E., Mendes, W. B., Duncan, L. G., Weng, H., Levy, J. A., Deeks, S. G., & Folkman, S. (2018). A randomized, controlled trial of mindfulness-based stress reduction in HIV infection. Brain, Behavior, and Immunity, 73, 331-339.

Ho, R. T. H., Lo, H. H. M., Fong, T. C. T., & Choi, C. W. (2020). Effects of a mindfulness-based intervention on diurnal cortisol pattern in disadvantaged families: A randomized controlled trial. Psychoneuroendocrinology, 117, 7.

Hoffman, D. M. (2019). Mindfulness and the cultural psychology of personhood: Challenges of self, other, and moral orientation in Haiti. Culture & Psychology, 25(3), 302-323.

Jung, H. Y., Lee, H., & Park, J. (2015). Comparison of the effects of Korean mindfulness-based stress reduction, walking, and patient education in diabetes mellitus. Nursing & Health Sciences, 17(4), 516-525.

Kabat-Zinn, J., De Torrijos, F., Skillings, A. H., Blacker, M., Mumford, G. T., Alvares, D. L., & Rosal, M. C. (2016). Delivery and effectiveness of a dual language (English/Spanish) Mindfulness-Based Stress Reduction (MBSR) program in the inner city - A seven-year experience: 1992-1999. Mindfulness & Compassion, 1(1), 2-13.

Kabat-Zinn, J., & Hanh, T. N. (2009). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Delta.

Lavrencic, L. M., Donovan, T., Moffatt, L., Keiller, T., Allan, W., Delbaere, K., & Radford, K. (2021). Ngarraanga giinganay ('thinking peacefully'): Co-design and pilot study of a culturally-grounded mindfulness-based stress reduction program with older First Nations Australians. Evaluation and Program Planning, 87, 12.

Le, T. N. (2017). Cultural considerations in a phenomenological study of mindfulness with Vietnamese youth and cyclo drivers. International Perspectives in Psychology: Research, Practice, Consultation, 6(4), 246-260.

Li, J., & Qin, X. (2021). Efficacy of mindfulness‐based stress reduction on fear of emotions and related cognitive behavioral processes in Chinese university students: A randomized controlled trial. Psychology in the Schools, 1-17.

Majid, S. A., Seghatoleslam, T., Homan, H. A., Akhvast, A., & Habil, H. (2012). Effect of mindfulness based stress management on reduction of generalized anxiety disorder. Iranian Journal of Public Health, 41(10), 24-28.

McIntyre, T., Elkonin, D., de Kooker, M., & Magidson, J. F. (2018). The application of mindfulness for individuals living with HIV in South Africa: A hybrid effectiveness-implementation pilot study. Mindfulness, 9(3), 871-883.

Neto, A. D., Lucchetti, A. L. G., Ezequiel, O. S., & Lucchetti, G. (2020). Effects of a required large-group mindfulness meditation course on first-year medical students' mental health and quality of life: A randomized controlled trial. Journal of General Internal Medicine, 35(3), 672-678.

Noh, S. & Cho, H. (2020). Psychological and physiological effects of the mindful lovingkindess compassion program on highly self-critical university students in South Korea. Frontiers in Psychology, 11, 2628.

Parswani, M. J., Sharma, M. P., & Iyengar, S. S. (2013). Mindfulness-based stress reduction program in coronary heart disease: A randomized control trial. International Journal of Yoga, 6(2), 111.

Roberts, L. R., & Montgomery, S. B. (2016). Mindfulness-based intervention for perinatal grief in rural India: Improved mental health at 12 months follow-up. Issues in Mental Health Nursing, 37(12), 942-951.

Samuelson, M., Carmody, J., Kabat-Zinn, J., & Bratt, M. A. (2007). Mindfulness-based stress reduction in Massachusetts correctional facilities. The Prison Journal, 87(2), 254-268.

SeyedAlinaghi, S., Jam, S., Foroughi, M., Imani, A., Mohraz, M., Djavid, G. E., & Black, D. S. (2012). Randomized controlled trial of mindfulness-based stress reduction delivered to human immunodeficiency virus-positive patients in Iran: effects on CD4⁺ T lymphocyte count and medical and psychological symptoms. Psychosomatic Medicine, 74(6), 620-627.

Speca, M., Carlson, L. E., Goodey, E., & Angen, M. (2000). A randomized, wait-list controlled clinical trial: The effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine, 62(5), 613-622.

Takahashi, T., Sugiyama, F., Kikai, T., Kawashima, I., Guan, S., Oguchi, M., . . . Kumano, H. (2019). Changes in depression and anxiety through mindfulness group therapy in Japan: The role of mindfulness and self-compassion as possible mediators. BioPsychoSocial Medicine, 13, 10.

Thomas, J., Raynor, M., & Bahussain, E. (2016). Stress reactivity, depressive symptoms, and mindfulness: A Gulf Arab perspective. International Perspectives in Psychology: Research, Practice, Consultation, 5(3), 156-166.

Tsang, S. C., Mok, E. S., Lam, S. C., & Lee, J. K. (2012). The benefit of mindfulness‐based stress reduction to patients with terminal cancer. Journal of Clinical Nursing, 21(17-18), 2690-2696.

Vinesett, A. L., Whaley, R. R., Woods-Giscombe, C., Dennis, P., Johnson, M., Li, Y., Mounzeo, P., Baegne, M., & Wilson, K. H. (2017). Modified African Ngoma healing ceremony for stress reduction: A pilot study. The Journal of Alternative and Complementary Medicine, 23(10), 800-804.

Waldron, E. M., & Burnett-Zeigler, I. (2021). The impact of participation in a mindfulness-based intervention on posttraumatic stress symptomatology among Black women: A pilot study. Psychological Trauma: Theory, Research, Practice, and Policy, 14(1), 29-37.

Williams, J. M., & Kabat-Zinn, J. (2013). Mindfulness: Diverse perspectives on its meaning, origins and applications at the intersection of science and dharma. Routledge.

Zhang, J., Cui, Y., Zhou, Y., & Li, Y. (2019). Effects of mindfulness-based stress reduction on prenatal stress, anxiety and depression. Psychology, Health & Medicine, 24(1), 51-58.

Zhang, J., Zhou, Y., Feng, Z., Fan, Y., Zeng, G., & Wei, L. (2017). Randomized controlled trial of mindfulness-based stress reduction (MBSR) on posttraumatic growth of Chinese breast cancer survivors. Psychology, Health & Medicine, 22(1), 94-109.

The Body Scan Meditation helps us become more aware our bodies, an awareness we often neglect. Are you attuned to the present moment? Take our Mindfulness quiz to find out:

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Body Scan Meditation (Greater Good in Action)

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Feeling tense? Feel your body relax as you try this practice.

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How to Do It

This exercise draws on a guided meditation created by researcher Helen Weng and her colleagues at the Center for Healthy Minds (CHM) at the University of Wisconsin, Madison. Dr. Weng called this meditation a "compassion meditation," though a similar kind of meditation is also referred to as a "loving-kindness meditation."

We recommend listening to audio of this guided meditation in the player below; you can also download it from the CHM's website. We have included a script of this meditation to help you follow it yourself or teach it to others. In brackets are the lengths of the pauses in the original guided meditation, to give you a sense of how much time to allot to each step.
Settling
Please settle into a comfortable position and allow yourself to relax.

Take a deep breath and release. [2 seconds] For a few moments, just focus on your breath and clear your mind of worries. Notice when you are breathing in ... and breathing out. Let yourself experience and be aware of the sensations of breathing. [10 seconds]
Loving-kindness & Compassion for a Loved One
Picture someone who is close to you, someone toward whom you feel a great amount of love. Notice how this love feels in your heart.

Notice the sensations around your heart. Perhaps you feel a sensation of warmth, openness, and tenderness. [10 seconds]

Continue breathing, and focus on these feelings as you visualize your loved one. As you breathe out, imagine that you are extending a golden light that holds your warm feelings from the center of your heart. Imagine that the golden light reaches out to your loved one, bringing him or her peace and happiness. At the same time, silently recite these phrases.

May you have happiness.

May you be free from suffering.

May you experience joy and ease.

May you have happiness.

May you be free from suffering.

May you experience joy and ease.

[1 minute]

As you silently repeat these phrases, remember to extend the golden light to your loved one from your heart. Feel with all your heart that you wish your loved one happiness and freedom from suffering.
Compassion for a Loved One
Now think of a time when this person was suffering. Maybe they experienced an illness, an injury, or a difficult time in a relationship. [15 seconds]

Notice how you feel when you think of his or her suffering. How does your heart feel? Do the sensations change? Do you continue to feel warmth, openness and tenderness? Are there other sensations, perhaps an aching sensation? [10 seconds]

Continue to visualize your loved one as you breathe. Imagine that you are extending the golden light from your heart to your loved one, and that the golden light is easing his or her suffering. Extend this light out to them during your exhalation, with the strong heartfelt wish that they be free from his or her suffering. Recite silently to him or her:

Notice how this feels in your heart. What happened to your heart? Did the sensations change? Did you continue to feel warmth, openness and tenderness? Were there other sensations, an aching sensation perhaps? Did you have a wish to take away the other's suffering? [30 seconds]
Compassion for Self
Contemplate a time when you have suffered yourself. Perhaps you experienced a conflict with someone you care about, or did not succeed in something you wanted, or were physically ill. [15 seconds]

Notice how you feel when you think of your suffering. How does your heart feel? Do you continue to feel warmth, openness, and tenderness? Are there other sensations, perhaps an aching sensation? [10 seconds]

Just as we wish for our loved one's suffering to end, we wish that our own suffering would end. We may also envision our own pain and suffering leaving us so that we may experience happiness.

Continue to visualize yourself as you breathe. Imagine that the golden light emanating from your heart is easing your suffering. With each exhalation, feel the light emanating within you, with the strong heartfelt wish that you be free from your suffering. Silently recite to yourself:

Again, notice how this feels in your heart. What kind of sensations did you feel? Did they change from when you were envisioning your own suffering? How is this feeling different from when you wished your loved one's suffering to be relieved? Did you feel warmth, openness and tenderness? Were there other sensations such as pressure? Did you have a wish to take away your own suffering? [30 seconds]
Compassion for a Neutral Person
Now visualize someone you neither like nor dislike-someone you may see in your everyday life, such as a classmate with whom you are not familiar, a bus driver, or a stranger you pass on the street. [5 seconds]

Although you are not familiar with this person, think of how this person may suffer in his or her own life. This person may also have conflicts with loved ones, or struggled with an addiction, or may have suffered illness. Imagine a situation in which this person may have suffered. [30 seconds]

Notice your heart center. Does it feel different? Do you feel more warmth, openness and tenderness? Are there other sensations, perhaps an aching sensation? How does your heart feel different from when you were envisioning your own or a loved one's suffering? [10 seconds]

Continue to visualize this person as you breathe. Imagine that you are extending the golden light from your heart to them, and that the golden light is easing his or her suffering. Extend this light out to them during your exhalation, with the strong heartfelt wish that he or she be free from suffering. See if this wish can be as strong as the wish for your own or a loved one's suffering to be relieved. Silently recite to him or her:

Again, notice how this feels in your heart. Did the sensations change from when you were envisioning this person's suffering? Did you continue to feel warmth, openness and tenderness? Were there other sensations? Did you have a wish to take away this person's suffering? How were these feelings different from when you were wishing to take away your own or a loved one's suffering? [30 seconds]
Compassion for an Enemy
Now visualize someone with whom you have difficulty in your life. This may be a parent or child with whom you disagree, an ex-girlfriend or boyfriend, a roommate with whom you had an argument, or a co-worker with whom you do not get along. [5 seconds]

Although you may have negative feelings towards this person, think of how this person has suffered in his or her own life. This person has also had conflicts with loved ones, or has dealt with failures, or may have suffered illness. Think of a situation in which this person may have suffered. [30 seconds]

Notice your heart center. Does it feel different? Do you feel more warmth, openness and tenderness? Are there other sensations, perhaps an aching sensation? How does your heart feel different from when you were envisioning your own or a loved one's suffering? [10 seconds]

Continue to visualize this person as you breathe. Imagine that you are extending the golden light from your heart to him or her, and that the golden light is easing his or her suffering. Extend this light out to him or her during your exhalation, with the strong heartfelt wish that he or she be free from suffering. See if this wish can be as strong as the wish for your own or a loved one's suffering to be relieved. Silently recite to him or her:

If you have difficulty in wishing for this person's suffering to be relieved, you may think of a positive interaction you have had with this person that can help you in wishing them joy and happiness. Perhaps there were times when you got along, laughed together, or worked well together on an assignment. Continue to silently recite:

May you be free from this suffering.

May you have joy and happiness.

[2 minutes]

Again, notice how this feels in your heart. Did the sensations change? Did you feel warmth, openness and tenderness? How were these feelings different from when you were wishing for your own or a loved one's suffering to end? Were there other sensations, perhaps a tightness in the chest? Did you have a wish to take away this person's suffering? [30 seconds]
Compassion for All Beings
Now that we are almost at the end of this meditation, let's end with wish for all other beings' suffering to be relieved. Just as I wish to have peace, happiness, and to be free from suffering, so do all beings. [10 seconds]

Now bask in the joy of this open-hearted wish to ease the suffering of all people and how this attempt brings joy, happiness, and compassion in your heart at this very moment.

You have now finished this compassion meditation session.

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Compassion Meditation (Greater Good in Action)

# data[].attributes.attachment_link.description
This exercise draws on a guided meditation created by researcher Helen Weng and her colleagues at the Center for Healthy Minds (CHM) at the University of Wisconsin, Madison. Dr. Weng called this meditation a "compassion meditation," though a similar kind of meditation is also referred to as a "loving-kindness meditation."

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We will walk you through how to meditate properly, the benefits of regular meditation practice, and the various styles of meditation. Free guided audio meditations and resources.

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Getting Started with Mindfulness You have questions about mindfulness and meditation.Mindful has the answers. What is mindfulness? Mindfulness is the

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complementary and alternative mental health treatment

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how can i help myself with my mental illness?

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Self-Help Techniques for Coping with Mental Illness

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Some common self-help suggestions people receive are to exercise, meditate and be more present, which are helpful and work for many people. However, other proven methods aren't mentioned as often.

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In the midst of hectic schedules, remembering to take care of our emotional well-being sometimes falls to the bottom of our priority list. This is especially true for children, who aren't yet aware of how important their mental health is. Even with exposure to this concept, mental health is complex and overwhelming. While trying to navigate the trials and tribulations of growing up, expecting your child to be mindful of fitting in mental health promotion into their day can be a reach.

Nearly of children in the US have a diagnosable mental health condition - an emotional or behavioral disorder that gets in the way of them living their best life and reaching their full potential. And, some suggest that these numbers are increasing. Now more than ever, there is a clear need for taking precaution with your child's mental health , which can begin with their personal routine.

Healthy routines build coping skills and mindsets that promote resiliency as children develop. Think of these positive, early habits as "vaccinations" for the soul; they can help prevent or ameliorate a more serious mental health condition from developing.

Since the concept of self-care is still too complicated for most children to understand, it's important for parents and other adult caregivers to figure out ways to seamlessly incorporate it into their week. There are a variety of activities that you and your child can do that provide significant mind and body benefits without feeling like an intense, therapeutic routine..
1.) Create a Winning Family Routine
Children crave structure and a successful family contributes to the well being of the entire household. Routines give children a sense of security and predictability limits anxiety, making transitions throughout the day easier and limiting power struggles. Regular daily routines that emphasize consistent wake up, eating, homework, bedtime, play, and chore schedules will provide the structure they need to understand and predict their world.

One of the overlooked elements of family routines for children, however, is building in "slow down" time. And regular, built in "slow down" time during the day allows children to learn how to make mindful choices. Even the youngest of children can integrate mindfulness into their "slow down" time with activities like yoga and deep breathing, routines that can help wire their brain for success .
2.) Focus on Sleep
is one of the most crucial ingredients for learning, performance and mental health and good sleep starts with a consistent and early bedtime. The hours of sleep before midnight lend themselves to more deep non-REM sleep, making them much more beneficial for young children, so sticking with an early bedtime of 7-8pm provides children with more deep sleep and higher levels of concentration the next day. Sleep deprivation is a huge contributor of mental health issues for children, especially teenagers. Even the typical teenager requires 9 hours of sleep each night, and while activities may dictate the need for a slightly later bedtime, ensuring a full night of rest will go a long way in helping teenagers' mood and academic performance .
3.) Get healthy together 4.) When in doubt, write it out
For some, verbalizing emotions can difficult. This could be due to an inability to understand how to articulate certain, confusing feelings, or just because saying them aloud is intimidating and vulnerable.

Identifying and expressing feelings is something that needs to be , and this can be acquired as early as age 3. Helping children to verbalize emotions is as simple as teaching feeling words and discussing the emotions of characters in your child's favorite stories. These simple strategies can go a long way in benefitting your child's social relationships and help seeking behaviors . Children who use emotion-related words were found to be better-liked by their classmates . And the ability to use words to express emotions gives young children a valuable tool in gaining the assistance or social support of others .

J ournaling is an excellent practice to introduce to your child around the age of 6-7 , as it provides a private space in which they can write out their thoughts and work through them. Expressive writing like journaling helps to manage and reduce stress by allowing your child to map out their emotions and make sense of what they are experiencing. This can help them explore solutions to their life challenges and prioritize certain aspects that are causing them the most stress.
5.) Express yourself (creatively)
is a practice that is both mentally and physically Art therapy beneficial to individuals of all ages. Through creativity, the practice enables your child to reconnect with their emotions and work towards understanding them. This provides significant cognitive support, leading to stronger mental health, as well as physical benefits due to its relaxing properties. Practices like painting, coloring, or molding clay won't appear as a chore to your child, motivating them to work on their mental health!

Bring music into the mix: encouraging your child to practice creating music, whether it be through songwriting or playing an instrument, will help with cognitive development, which can lead to a greater sense of self-awareness. Helping your child remain connected with their emotions will make coping with mental health concerns an easier feat.

In general, listening to music can have a tremendously positive impact on your child's mental health. Music, through its rhythmic appeal, engages your child's brain, specifically the neocortex, which reduces stress and lowers impulsivity . If your child is struggling with severe anxiety or depressive episodes, play softer or more uplifting music to counter these dips in mood.

Dance: In addition to art and music, expressive therapies such as dance can be impactful resources for your child's mental health promotion. Performing arts serve as powerful outlets for expressing emotion in a healthy and constructive way, and the opportunity to be creative will motivate your child to fit it into their self-care routine. is particularly beneficial due to the brain's response to aerobic exercise. As your child dances through their emotions, they will also be elevating their endorphins, which boosts their mood!

One of the overlooked elements of family routines for children, however, is building in "slow down" time. And regular, built in "slow down" time during the day allows children to learn how to make mindful choices. Even the youngest of children can integrate mindfulness into their "slow down" time with activities like yoga and deep breathing, routines that can help wire their brain for success .

6.) Play to promote mental health
Ample time for "play" is one of the most important ingredients in healthy child (and adult) development. Play provides opportunities to think creatively, engage with others, and regulate impulses.

Regular doses of play that involve physical activity and exercise should be incorporated into your child's routine, as this is an excellent way to tap into endorphins and boost their mood. Engaging in physical activity , especially outdoors, can help your child release stress that may have built up in their body. Taking this time outside in has been found to specifically reduce depression. Carve out time in the week to go on a hike or walk around the neighborhood. If your child prefers to be a part of organized sports, find an opportunity in the area for them to join a league. The socialization will give them additional mental health benefits!
7.) Foster social skills
Just like adults, young people need to feel a sense of belonging in order to thrive. Feeling like you're part of the something larger than oneself is key when it comes to mental health. Some children may fill their cup by having a few close friends, whereas others will feel most alive when engaging regularly in larger group activities. Figure out what works best for your child, recognizing and honoring their particular personality style, strengths and vulnerabilities.

As a parent, you can be mindful of modeling prosocial behavior within your family and community. You can also introduce social skill building activities that may benefit your child. For example, check out this list of 17 evidence-based " " from Gwen Dewar, PhD., of ParentingScience.com. Even if your child appears to have a high Social skills activities for children and teens EQ (social-emotional intelligence quotient), the growing never stops; there's always more to learn about being a thoughtful, compassionate, and connected human being...especially during these times of socio-cultural division and potential for .

Most problems in life cannot be solved with formulae or memorized answers of the type learnt in school. They require the judgment, wisdom and creative ability that come from life experiences. For children, those experiences are embedded in play. -Peter Gray, Ph.D., Bio-Psychologist
8.) Collaborate on screen time
What children are watching and playing also needs to be developmentally appropriate and consistent with your families values. It can be hard to monitor everything your child sees on screen, but there are resources to help you better understand the media your child has access to. Common Sense Media is a comprehensive online resource for parents that rates movies, tv shows and video games by developmental age. It also provides a comprehensive review of the content, including levels of sex, violence, drugs/alcohol references and consumerism, so that you can discuss the content with your child after watching.

The American Academy of Pediatrics recommends creating a "Family Media Plan" - a joint collaboration among caregivers and children that reflects on the pros and cons of media usage as individuals and a family. You can try their free tools known as "Create Your Family Media Plan" and "Media Time Calculator" at healthychildren.org .
In Conclusion
Talk to your child to introduce the concept of self-care and explore what types of activities they'd like to include in their routine. Creating a routine of self-care activities that they look forward to doing is key to encouraging them to place their mental health first!

We also recommend that you regularly consult with your family doctor, child's teachers, and other key figures in their life on how they're doing and ways to enhance their mental well-being. Below is some additional, important information from the National Institute for Mental Health (NIMH) about children and mental health.

"** Children and Mental Health - Points to Remember (from the )

Always seek immediate help if a child engages in unsafe behavior or talks about wanting to hurt him or herself or someone else.

Seek help when a child's behavior or emotional difficulties last for more than a few weeks and are causing problems at school, at home, or with friends.

A thorough evaluation can help determine if treatment is necessary, and which treatments may be most effective.

Early treatment can help address a child's current difficulties and can also help prevent more serious problems in the future.

When to Seek Help

Even under the best of circumstances, it can be hard to tell the difference between challenging behaviors and emotions that are consistent with typical child development and those that are cause for concern. It is important to remember that many disorders like anxiety, attention deficit hyperactivity disorder and depression, do occur during childhood. In fact, many adults who seek treatment reflect back on how these disorders affected their childhood and wish that they had received help sooner. In general, if a child's behavior persists for a few weeks or longer, causes distress for the child or the child's family, and interferes with functioning at school, at home, or with friends, then consider seeking help. If a child's behavior is unsafe, or if a child talks about wanting to hurt him or herself or someone else, then seek help immediately.

Young children may benefit from an evaluation and treatment if they:

Have frequent tantrums or are intensely irritable much of the time

Often talk about fears or worries

Complain about frequent stomach aches or headaches with no known medical cause

Are in constant motion and cannot sit quietly ( when they are watching videos or playing video games)

Sleep too much or too little, have frequent nightmares, or seem sleepy during the day

Are not interested in playing with other children or have difficulty making friends

Struggle academically or have experienced a recent decline in grades

Repeat actions or check things many times out of fear that something bad may happen.

Older children and adolescents may benefit from an evaluation if they:

Have lost interest in things that they used to enjoy

Have low energy

Sleep too much or too little, or seem sleepy throughout the day

Are spending more and more time alone, and avoid social activities with friends or family

Fear gaining weight, or diet or exercise excessively

Engage in self-harm behaviors (e.g., cutting or burning their skin)

Smoke, drink, or use drugs

Engage in risky or destructive behavior alone or with friends

Have thoughts of suicide

Have periods of highly elevated energy and activity, and require much less sleep than usual

Say that they think someone is trying to control their mind or that they hear things that other people cannot hear.

First Steps for Parents

If you are concerned about your child, where do you begin?

Talk with your child's teacher. What is the child's behavior like in school, daycare, or on the playground?

Talk with your child's pediatrician. Describe the behavior, and report what you have observed and learned from talking with others.

Ask for a referral to a mental health professional who has experience and expertise dealing with children.**"

**Source: https://www.nimh.nih.gov/health/publications/children-and-mental-health/index.shtml#pub2
Contributor: this article was a collaboration between Jumo Health and HealthyPsych. Jumo Health is an organization based in London and NYC, that produces health resources for children and families in 50 countries and 30 languages. Disclaimer: the content provided here and throughout HealthyPsych.com is for informational purposes only and is not intended as medical advice. Please consult directly with your medical provider on your specific needs. Our full disclaimer and terms of use can be found here: Terms of Use.

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Self-Care for Kids: 8 Practical Ways to Promote your Child's Mental Health on a Daily Basis

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In the midst of hectic schedules, remembering to take care of our emotional well-being sometimes falls to the bottom of our priority list. This is especially true for children, who aren't yet aware of how important their mental health is. Even with exposure to this concept, mental health is complex and overwhelming.

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Self-care includes all the things we do to tend to our physical, mental, and emotional health needs. Here are just some of the many ways you can do it.

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Illustration by Kathleen M.G. Howlett

Second of two parts
On a cold winter evening, six women and two men sat in silence in an office near Harvard Square, practicing mindfulness meditation.

Sitting upright, eyes closed, palms resting on their laps, feet flat on the floor, they listened as course instructor Suzanne Westbrook guided them to focus on the present by paying attention to their bodily sensations, thoughts, emotions, and especially their breath.

"Our mind wanders all the time, either reviewing the past or planning for the future," said Westbrook, who before retiring last June was an internal-medicine doctor caring for Harvard students. "Mindfulness teaches you the skill of paying attention to the present by noticing when your mind wanders off. Come back to your breath. It's a place where we can rest and settle our minds."

The class she taught was part of an eight-week program aimed at reducing stress.

Studies say that eight in 10 Americans experience stress in their daily lives and have a hard time relaxing their bodies and calming their minds, which puts them at high risk of heart disease, stroke, and other illnesses. Of the myriad offerings aimed at fighting stress, from exercise to yoga to meditation, mindfulness meditation has become the hottest commodity in the wellness universe.

Modeled after the Mindfulness-Based Stress Reduction program created in 1979 by Jon Kabat-Zinn to help counter stress, chronic pain, and other ailments, mindfulness courses these days can be found in venues ranging from schools to prisons to sports teams. Even the U.S. Army recently adopted it to "improve military resilience."

Harvard offers several mindfulness and meditation classes, including a spring break retreat held in March for students through the Center for Wellness and Health Promotion. The Office of Work/Life offers programs to managers and staff, as well as weekly drop-in meditation sessions on campus, online guided meditation resources, and even a meditation phone line, 4-CALM (at 617.384.2256).

"We were tasked to find ways for the community to cope with stress. And at the same time, so much research was coming out on the benefits of mindfulness and meditation," said Jeanne Mahon, director of the wellness center. "We keep offering mindfulness and meditation because of the feedback. People appreciate to have the chance for self-reflection and learn about new ways to be in relationships with themselves."

More than 750 students have participated in mindfulness and meditation programs since 2012, said Mahon.

Part of mindfulness' appeal lies in the fact that it's secular. Buddhist monks have used mindfulness exercises as forms of meditation for more than 2,600 years, seeing them as one of the paths to enlightenment. But in the Mindfulness-Based Stress Reduction program, mindfulness is stripped of religious undertones.

Mindfulness' popularity has been bolstered by a growing body of research showing that it reduces stress and anxiety, improves attention and memory, and promotes self-regulation and empathy. A few years ago, a study by Sara Lazar, a neuroscientist and assistant professor of psychology at Harvard Medical School (HMS) and assistant researcher in psychiatry at Massachusetts General Hospital, was the first to document that mindfulness meditation can change the brain's gray matter and brain regions linked with memory, the sense of self, and regulation of emotions. New research by Benjamin Shapero and Gaëlle Desbordes is exploring how mindfulness can help depression.

The pioneer of scientific research on meditation, Herbert Benson, extolled its benefits on the human body - reduced blood pressure, heart rate, and brain activity - as early as 1975. He helped demystify meditation by calling it the "relaxation response." Benson is director emeritus of the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital and Mind/Body Medicine Distinguished Professor of Medicine at HMS.

In the 1980s, mindfulness had yet to become a buzzword, recalls Paul Fulton, a clinical psychologist who has practiced Zen and insight meditation (vipassana) for more than 40 years. In the mid-1980s, when he was working on his doctoral dissertation on the nature of "self" among Buddhist monks, speaking of mindfulness in a medical context among scientists was "disreputable," he recalled.

"Gradually because of the research, it became chic, no longer disreputable," said Fulton, a lecturer in psychology in the Department of Psychiatry at HMS and co-founder of the Institute for Meditation and Psychotherapy. "And now you can't step a foot out of the house without being barraged by mindfulness."

Melanie Denham, head coach of Harvard women's rugby team, recently attended a mindfulness workshop, intrigued by the idea of incorporating the techniques into her players' training regimen to help them cope with the pressures of "expectation and performance."

"In and out of the classroom, these student-athletes are immersed in a highly competitive culture," said Denham. "This is stressful. This kind of training can develop a more-skillful mind and a sense of focus and well-being that can help them better maintain control and awareness of their thoughts, emotions, and presence in the moment."

The growing interest in the field is reflected in Harvard's course catalog. This spring, Lazar is teaching "Cognitive Neuroscience of Meditation," Ezer Vierba leads an expository freshmen writing course on "Buddhism, Mindfulness, and the Practical Mind," and Metta McGarvey teaches "Mindfulness for Educators" at the Graduate School of Education.

Due to high demand, McGarvey, who holds a doctorate in human development and psychology, teaches a three-day workshop for educators. It offers tools to enhance their work and their focus through breathing practices and self-compassion exercises.

Mindfulness meditation made easy

Settle in

Find a quiet space. Using a cushion or chair, sit up straight but not stiff; allow your head and shoulders to rest comfortably; place your hands on the tops of your legs with upper arms at your side.

Now breathe

Close your eyes, take a deep breath, and relax. Feel the fall and rise of your chest and the expansion and contraction of your belly. With each breath notice the coolness as it enters and the warmth as it exits. Don't control the breath but follow its natural flow.

Stay focused

Thoughts will try to pull your attention away from the breath. Notice them, but don't pass judgment. Gently return your focus to your breath. Some people count their breaths as a way to stay focused.

Take 10

A daily practice will provide the most benefits. It can be 10 minutes per day, however, 20 minutes twice a day is often recommended for maximum benefit.

"A lot of them are working in really tough environments, with all kinds of pressures," said McGarvey. "The rates of burnout in some of the more challenging environments are very high."

Ayesha Hood, a police officer from Baltimore who is interested in running a day care center, attended McGarvey's workshop last fall, and found it helpful. "As a police officer, I live in high stress, and as a public servant, I tend to neglect myself," she said. "I want to calm myself and be conscious about it."

Christine O'Shaughnessy, a former investment bank executive who lead workshops at Harvard, said, "All day we're bombarded with social media, colleagues, work, children, etc. We don't have time to spend it in quiet reflection. But if you practice it at least once a day, you'll have a better day."

To skeptics who still view mindfulness as hippie-dippy poppycock, O'Shaughnessy has four words: "Give it a try." When she first signed up for a mindfulness workshop in 1999, she said she was skeptical too. But once she realized she was becoming calmer and less stressed, she converted. She eventually quit her job and became a mindfulness instructor. (She recently launched a free meditation app.)

"Doing mindfulness is like a fitness routine for your brain," she said. "It keeps your brain healthy."

Mindfulness practitioners admit the practice can offer challenges. It requires consistency because its effects can be better felt over time, and discipline to train the wandering mind to keep coming back to the present, without judgment. A 2014 study said that many people would rather apply electroshocks to themselves than be alone with their thoughts. Another study showed that most people find it hard to focus on the present and that the mind's wandering can lead to stress and even suffering.

Related

Despite the rising acceptance of mindfulness, many people still think the practice involves emptying their minds, taking mini-naps, or going into trances. Beginners often fall asleep, feel uncomfortable, struggle with difficult thoughts or emotions, and become bored or distracted. Adepts recommend practicing the process in a group with an instructor.

After the training session led by Westbrook, one participant said she couldn't stop thinking about what was for dinner during the meditation practice; others nodded in agreement. Westbrook reassured her, saying that mindfulness is not about stopping thoughts or emotions, but instead about noticing them without judgment. Mindfulness builds resilience and awareness to help people learn how to ride life's ups and downs and live happier and healthier lives, said Westbrook, who, after helping heal the bodies of thousands of patients in 36 years as a doctor, plans to devote her second career to caring for people's spirits and souls, maybe as a chaplain.

"Mindfulness is not about being positive all the time or a bubblegum sort of happiness - la, la, la," she said. "It's about noticing what happens moment to moment, the easy and the difficult, and the painful and the joyful. It's about building a muscle to be present and awake in your life."

For more information about the Mindfulness & Meditation program at Harvard University, visit its website. For a list of spring courses for Harvard faculty and staff, visit the Mindfulness at Work Program website.

Health & Medicine

Health & Medicine

Harvard file photos

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Less stress, clearer thoughts with mindfulness meditation

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Rooted in Buddhism, mindfulness meditation has developed a prominent perch in the self-help movement. Its popularity has been fueled by research that indicates mindfulness often reduces stress and promotes emotional well-being.

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Life is stressful and sometimes the stress can overwhelm you, but there are steps you can take to learn how to relax.

Normal everyday activities like grocery shopping or traffic jams can make you tense. You might find it hard to unplug from digital devices and streaming services in a 24/7 world. Work deadlines, handling the kids or dealing with a difficult relationship can get you down.

The coronavirus pandemic, a chronic illness, or caring for an elderly relative might be a strain.

"Stress is really how your body and brain respond to challenges, such as pressure at work, [handling] the pandemic, increasing family responsibility, other negative experiences that may impact and create stress," says David Shurtleff, PhD, deputy director of the National Institutes of Health's National Center for Complementary and Integrative Health.

The COVID-19 pandemic has highlighted the concerns around stress.

"We're seeing a lot more anxiety and depression over the last year given the COVID situation," Shurtleff says.

When you feel overwhelmed or can't handle a situation, your body might respond in a bad way. The so-called "fight or flight" response kicks in to get you ready to run, and that creates stress.

"Experiencing short periods of stress is just fine, in fact, it's even healthy," says Jonathan C. Smith, PhD, a professor of psychology at Roosevelt University, founding director of the university's Mindful Initiative, and a prolific author of books on relaxation practices.

"Living a stress-free life is unhealthy and dangerous. We need a little bit of challenge to keep us alive," Smith says.

But too much stress isn't good for you. Some situations, like the isolation you may have faced during the pandemic, for example, can cause ongoing stress, which, in turn, can bring on health problems.

It's normal to feel overwhelmed by something like a global pandemic, but it's also important to find ways to relax, Shurtleff says. He practices yoga about three times a week and uses a treadmill daily to help keep worries under control.

"Stress over time can really impact our bodies and our brains and lead to really devastating chronic conditions such as anxiety and depression," he says

However, a whole range of relaxation practices can help you power down and de-stress.

"There's no one shoe that fits all," Smith says. He points to "five or six" approaches based on scientific observation and experience that really do work for stress reduction. There are other therapies, too, that you might find helpful. You can do one at a time or you can practice some together.

This is one of the easiest stress reduction practices because you simply focus on your breathing.

Sit or lie down in a quiet place, take a deep breath through your nose and breathe out slowly through your mouth, or your nose if it feels better.

Texas psychiatrist Gregory Scott Brown, MD, suggests the 4-7-8 approach. Breathe in for 4 seconds, hold your breath for 7 seconds, then exhale for 8 seconds.

Deep breathing can help you calm down and relax, he says.

"When I'm talking to patients, I typically start with breath work because, again, we all breathe every single day, but many of us don't realize that breath work, you know, done in a specific way, is medicine," says Brown, who's founder and director of the Center for Green Psychiatry in Austin, TX.

Mindfulness is an ancient form of meditation that promotes awareness of what's happening in the moment.

It encourages you to focus on your body, your thoughts, and what's going on around you.

Mantra meditation, on the other hand, is the opposite of mindfulness. In this practice, you place all your attention on a single target, like a mantra, a candle flame, or a phrase.

In both types of meditations, whenever your mind wanders -- and it will Smith says -- you simply re-focus.

It's a brain skill, he says. In that in the first 2 weeks you won't be able to do it very well. Your mind will constantly chatter and distract, and that's normal, that happens.

But as you practice, you'll get better at it.

In this technique, you focus on slowly tightening and relaxing muscle groups. You can practice it along with breathing exercises and guided imagery.

Find a comfortable place to sit or lay down, close your eyes and take a few deep breaths. Expand your stomach as you breathe in and contract it as you exhale.

You can either start with your head and face muscles and work your way down your body or you can start with your toes and work your way up. While you focus on each muscle group, tense and hold for about 5 seconds and relax for 30 seconds, then repeat.

"Tensing certain muscle groups while you're combining breath work with that can, again, instill a sense of calm and relaxation," Brown says.

If you have heart disease, talk to your doctor before you start progressive muscle relaxation therapy.

Imagine yourself lying on a sandy beach with a soft breeze gently stirring the warm air. Use your senses to smell the saltwater and feel the sun as you transport yourself there. That's guided imagery or visualization.

It uses the power of your mind to change your focus to a peaceful time or event.

"If we're in a stressful situation, you know, just shifting our mind and focusing on a time when we were really, really relaxed" is an effective way to calm down, Brown says.

In this practice you focus on feeling warmth and heaviness in different parts of your body. Then silently repeat pleasant words or statements for each body part, like my arms feel heavy and warm. This technique can create feelings of emotional and physical calmness.

Autogenic therapy also combines guided imagery and breathing exercises to reduce stress and your heart rate.

These low-intensity exercises are similar and have been around for thousands of years. Both include physical and so-called "meditative" movements to ease stress and lower blood pressure.

In yoga, you perform different stretching and strengthening postures. You remain still and focus on your breathing as you do each posture.

Tai chi involves slow, graceful movements, like a dance. You'll breathe deeply and concentrate on your body as you move your weight from one pose to the next.

Depending on your physical abilities, you can perform both exercises while sitting in a chair, although you usually do tai chi while standing.

Before you start yoga, it's a good idea to find a licensed professional who can help you learn the basic postures and which form of yoga might work best for you.

Many people swear by exercise to help reduce stress in their daily lives.

Whether it's walking, running, biking, hiking, or tennis, movement of any kind can boost your endorphins, the chemicals in your brain that make you feel good. When your body creates more endorphins, you may find it easier to forget your worries and find a lasting sense of well-being.

Atlanta-based life coach Trisha Harp says she often recommends exercise to people she counsels.

Harp and her husband work next to each other all day, she says. Several times a week they get up in the middle of the day when they're feeling in a slump and do a walk and talk.

Exercising with someone else can get you out of your physical space and gives you another person to chat with, which is also a stress reducer, she says.

Many de-stressing therapies have common goals. They aim to help you pay attention to your body and focus on aspects of your breathing or other exercises that will lower your blood pressure and increase feelings of well-being. You can try:

Biofeedback, which measures body functions and helps you learn to control them.

Self-hypnosis, in which a practitioner teaches you to relax when you hear a phrase or get a nonspoken cue.

Massage therapy, which can include Swedish, sports, Shiatsu, or other types of massage.

Music therapy, when a therapist uses music to accomplish health goals.

Art therapy, which uses art to enhance your physical, emotional, and mental well-being.

Aromatherapy, or using essential oils as a type of treatment.

Hydrotherapy, which can include soaking, compresses, or even steam baths.

While relaxation practices are mostly safe for heathy people, there have been reports of negative impacts, such as increased stress, bad thoughts, or a fear of losing control. Talk to your doctor about what practice might be best for you, depending on the relaxation technique you want to try and your health.

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Feeling Stressed Out? Learn How to Relax.

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Life is stressful and sometimes the stress can overwhelm you, but there are steps you can take to learn how to relax. Normal everyday activities like grocery shopping or traffic jams can make you tense. You might find it hard to unplug from digital devices and streaming services in a 24/7 world.

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Stress relievers: Tips to tame stress

Stress getting to you? Try some of these tips for stress relief.
By Mayo Clinic Staff
Is stress making you angry and grouchy? Stress relievers can help bring back calm and peace to your busy life. You don't have to put a lot of time or thought into stress relievers. If your stress is getting out of control and you need quick relief, try one of these tips.

Get active

Almost any form of physical activity can act as a stress reliever. Even if you're not an athlete or you're out of shape, exercise can still be a good stress reliever.

Physical activity can pump up your feel-good endorphins and other natural neural chemicals that boost your sense of well-being. Exercise also can refocus your mind on your body's movements. This refocus can improve your mood and help the day's irritations fade away. So go on a walk, take a jog, work in your garden, clean your house, bike, swim, weight train, vacuum or do anything else that gets you active.

Eat a healthy diet

Eating a healthy diet is an important part of taking care of yourself. Aim to eat many fruits, vegetables and whole grains.

Avoid unhealthy habits

Some people may deal with stress with unhealthy habits. These may include drinking too much caffeine or alcohol, smoking, eating too much, or using illegal substances. These habits can harm your health and increase your stress levels.

Meditate

During meditation, you focus your attention and quiet the stream of jumbled thoughts that may be crowding your mind and causing stress. Meditation can give you a sense of calm, peace and balance that can help both your emotional well-being and your overall health. Meditation can empower us to enhance our well-being.

You can practice guided meditation, guided imagery, mindfulness, visualization and other forms of meditation anywhere at any time. For example, you could meditate when you're out for a walk, riding the bus to work or waiting at your health care provider's office. Try an app to show you how to do these exercises. And you can try deep breathing anywhere.

Laugh more

A good sense of humor can't cure all ailments. But it can help you feel better, even if you have to force a fake laugh through your grumpiness. When you laugh, it lightens your mental load. It also causes positive physical changes in the body. Laughter fires up and then cools down your stress response.

So read some jokes, tell some jokes, watch a comedy or hang out with your funny friends. Or give laughter yoga a try.

Connect with others

When you're stressed and irritable, you may want to isolate yourself. Instead, reach out to family and friends and make social connections. Even one good friend who listens can make a difference.

Social contact is a good stress reliever because it can offer distraction, give support, and help you put up with life's up and downs. So take a coffee break with a friend, email a relative or visit your place of worship.

Got more time? Try volunteering for a charity and help yourself while helping others.

Assert yourself

You might want to do it all, but you can't, at least not without paying a price. Learning to say no or being willing to delegate can help you manage your to-do list and your stress. Healthy boundaries are important in a wellness journey. Everyone has physical and emotional limits.

Saying yes may seem like an easy way to keep the peace, prevent conflicts and get the job done right. But instead, it may cause you inner conflict because your needs and those of your family come second. Putting yourself second can lead to stress, anger, resentment and even the wish to take revenge. And that's not a very calm and peaceful reaction. Remember, you're a priority.

Try yoga

With its series of postures and breathing exercises, yoga is a popular stress reliever. Yoga brings together physical and mental disciplines that may help you reach peace of body and mind. Yoga can help you relax and ease stress and anxiety.

Try yoga on your own or find a class - you can find classes in many areas. Hatha yoga, especially, is a good stress reliever because of its slower pace and easier movements.

Get enough sleep

Stress can cause you to have trouble falling asleep. When you have too much to do - and too much to think about - your sleep can suffer. But sleep is the time when your brain and body recharge. Most adults need about 7 to 9 hours of sleep each night.

And how well and how long you sleep can affect your mood, energy level, focus and overall functioning. If you have sleep troubles, make sure that you have a quiet, relaxing bedtime routine. For example, listen to soothing music, make sure the area you sleep in is cool, dark and quiet, put phones and tablets away, and stick to a regular schedule.

Keep a journal

Writing down your thoughts and feelings can be a good release for otherwise pent-up feelings. Don't think about what to write - let it happen. Write anything that comes to mind. No one else needs to read it. So don't aim for perfect grammar or spelling.

Let your thoughts flow on paper, or on the computer screen. Once you're done, you can toss out what you wrote or save it to think about later.

Get musical and be creative

Listening to or playing music is a good stress reliever. It can provide a mental distraction, lessen muscle tension and lower stress hormones. Turn up the volume and let your mind be absorbed by the music.

If music isn't one of your interests, turn your attention to another hobby you enjoy. For example, try gardening, sewing, reading or sketching. Or try anything that makes you focus on what you're doing rather than what you think you should be doing.

Seek counseling

If new stressors are making it hard for you to cope or if self-care measures aren't relieving your stress, you may want to think about therapy or counseling. Therapy also may be a good idea if you feel overwhelmed or trapped. You also may think about therapy if you worry a great deal, or if you have trouble carrying out daily routines or meeting duties at work, home or school.

Professional counselors or therapists can help you find the sources of your stress and learn new coping tools.

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Show references

How stress affects your health. American Psychological Association. http://www.apa.org/helpcenter/stress.aspx. Accessed Jan. 24, 2023.

Relaxation techniques: What you need to know. National Center for Complementary and Integrative Health. https:// www.nccih.nih.gov/health/relaxation-techniques-what-you-need-to-know. Accessed Jan. 23, 2023.

Meditation and mindfulness: What you need to know. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/meditation-and-mindfulness-what-you-need-to-know. Accessed Jan. 23, 2023.

Yoga: What you need to know. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/yoga-what-you-need-to-know. Accessed Jan. 23, 2023.

Stress and your health. U.S. Department of Health & Human Services. https://www.womenshealth.gov/mental-health/good-mental-health/stress-and-your-health. Accessed Jan. 23, 2023.

I'm so stressed out! Fact sheet. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/so-stressed-out-fact-sheet. Accessed Jan. 24, 2023.

Seaward BL. Essentials of Managing Stress. 5th ed. Jones & Bartlett Learning; 2021.

Creagan ET (expert opinion). Mayo Clinic. Feb. 8, 2023.

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Stress relievers can help restore calm to your chaotic life. When stress gets out of control, try these tips for quick relief.