Four Tips for Dealing With Mental Health Needs in College

CAMBRIDGE, MA, USA - NOVEMBER 2, 2013: Harvard Yard, old heart of Harvard University campus, on a beautiful Fall day in Cambridge, MA, USA on November 2, 2013.
Photo Credit: Harvard University

Utilization of mental health services on college campuses have been increasing quickly each year, and college campuses are increasing mental health services in an effort to meeting the needs of students. A recent study found that 1 out of every 12 college students has written out a suicide plan.

Due to the increase in federal funding, programs that focus on eliminating suicide, reducing stigma, and bringing awareness of mental health issues have been placed in middle school, high school, and colleges throughout the country.

On many college campuses, counseling services have been improved in order to cater to students’ schedules and expand the utilization of therapy by hiring more counselors and extending the hours. Being a college student is already difficult and adding a mental health issue can make it seem impossible. Here are some tips to help you get through another semester.

1. Learn about the resources offered on campus

Many students with mental health needs don’t know that their campus has resources that can help them. Before you start classes it would be helpful to set up services at the Counseling Center and Disability Center. College offers accommodations that could help you get through a tough semester and really set you up to succeed despite any challenges you may face. Some accommodations that may be offered are extended deadlines, a quiet/private place to take exams, and more.

2. Don’t be afraid to ask for help.

Due to stigma, many people feel afraid or even ashamed to reach out for help. Just like going to the doctor for a physical illness, mental health needs should be dealt with in the same manner. There are people out there to help and the first step is to ask. Identify and locate your University’s Student Health and Wellness Center who can assist you or help provide you with information to assist someone you care about.

3. Stay connected on campus.

It’s very important to make connections on campus. Not only will you make friends, but it will also provide you with a support system on campus. Take a look at the clubs and events held on campus and join a few. Students who are a part of social life at their school tend to do better and cultivate solidarity in their lives.

4. Create a self care plan.

The most important of these tips to maintaining mental health during school is to create your own self care plan. These are your own steps, resources, and supports that can help you get through tough times. This may include remembering to take your medication every day, picking up yoga, going to a Zumba class each week, and/or eating healthy foods. Self care is such a vital part of mental well being. Even taking 10 mins at the end of each day to relax can help you feel so much better.

Mental Illness in ABC’s Black Box

ABC's Black Box
ABC’s Black Box

ABC’s Black Box premiered on April 24th with Kelly Reilly as the main character. Reilly plays Dr. Catherine Black, a brilliant neurologist, who suffers from bipolar disorder which is a chronic mental illness involving periods of mania and depression. The illness can have elated impacts on one’s mood, energy levels, and decision-making.

Those with this disorder are distinguished based on their intense highs and lows. Riley’s character is shown through the manic and depressive episodes of the illness throughout the show. The show refers to the brain as the black box, and Dr. Catherine Black is known as the curer of all neurological disorders while disregarding and hiding her own mental illness.

Catherine Black’s manic episodes conveniently occur when she’s away from work and the demands of the job. This show has brought on much controversy based on its portrayal of mental illness. Some questions I had while watching the show are:

  1. Is this a glamorized representation of mental illness?
  2. How accurate is the portrayal of Bipolar disorder?
  3. Can someone be in a 2-year relationship and hide their bipolar disorder from their partner?
  4. How can a neuroscientist hide their mental illness in the workplace without compromising their patients?

The creator of the show, Amy Holden Jones, grew up with a first hand witness to bipolar disorder. Her father was diagnosed with the illness and experienced the associated stigmas. When asked what sparked her inspiration for the show she answered:

“I’ve always wanted to get into the world of the brain, having personally lived in a family dealing with mental illness for a long time—I was 43 when my father finally died. In my era, with my father, there was so much secrecy. I never even had a conversation with him about his illness. We would live through his episodes and we’d never talk about them. He was very brilliant, high-achieving, worked 24/7 when he was younger. Then he had his first big breakdown at around 40.  He finally began taking lithium and it made such a difference in our lives—but there are a lot of things I don’t understand. Looking back, I assume he had something like high-cycling mania. When I read Kay Jamison’s An Unquiet Mind, I suspected maybe he sometimes stopped taking his medication. And I know, as a doctor, he often experimented with self-medicating.

In Kay’s book, I saw someone that had a full life, success and had mental illness. Black Box is not a show about bipolar; I only saw it as an opportunity to have a character that lived with it who had a full and interesting life. Because of my father, I did an enormous amount of reading about the brain always, people like VS Ramachandran, Steven Pinker, and Oliver Sacks, who was a big influence. What I took in most of all is that behavior is not the result of how your mother raised you, but the biology of brain you are born with. Our brains our built by our genes, just like our hair and our eyes and everything else. Read Full Article

The Case of Joshua Messier: Wrongful Use of Restrains and Seclusion

The use of restraints and seclusion in psychiatric hospitals has caused long lists of issues for patients and the rest of the mental health community. The tragic death of Joshua Messier was a prime example of how dangerous using restraints can be especially when dealing with someone who has a mental illness.

Joshua Messier was a schizophrenic patient at Bridgewater State Hospital. Bridgewater serves as both a prison and a mental health facility. Due to his schizophrenic outburst, Joshua was placed in prison even though he was not a criminal.

Joshua Messier
Joshua K. Messier

Joshua Messier was diagnosed with paranoid schizophrenia and was a patient at Bridgewater State Hospital at the time of his death on May 4th, 2009. On the night of his death, Messier was aggressively tied down to a bed after an outburst. During this time the guards used a method named suit casing to restrain him. This method involves holding the person’s knee onto their chest.

Suit casing was banned in Massachusetts because it can cause suffocation. Joshua stopped breathing and died after the aggressive restraints. To make matters worse, the guards who were handling him had no experience in mental health training.

Upon the autopsy examination, Joshua’s case was ruled a homicide due to appeared internal bleeding. Officials at Bridgewater claimed that the guards were following the “standard procedures” with Joshua. They even went as far as blaming Joshua and his mental illness for this tragedy. Joshua’s parents won a civil rights lawsuit and received a $3 million settlement this past March.

Since the death of Joshua, many patients at Bridgewater spoke up about the wrongful use of restraints while in treatment. Bridgewater officials promised to cut back on restraints and seclusion but the numbers have shown that they have actually increased.

The use of restraints and seclusion are just another way mental health facilities are becoming more like prisons. With proper training in mental health care and the elimination of dangerous restraints methods, cases like Joshua’s should not happen anymore.

Acceptance and Commitment Therapy: A Different Approach to Anxiety Disorders

Most coping techniques that teach people how to handle their abnormal anxieties focus on skills that reduce, replace, and avoid discomfort. These techniques are many that I have tried for my own anxiety including deep breathing, relaxing music, muscle relaxation, and more.

Cognitive behavioral therapy teaches people to control and change their upsetting feelings and thoughts. On the other hand, Acceptance and Commitment therapy teaches people not to change their thoughts or feelings but to change the way they react to them. The three steps of Acceptance and Commitment Therapy are; accept, choose, and take action.

According to Psychology Today,

Acceptance and Commitment Therapy (ACT) is a type of psychotherapy that helps you accept the difficulties that come with life. ACT has been around for a long time, but seems to be gaining media attention lately. Categorically speaking, ACT is a form of mindfulness-based therapy, theorizing that greater well-being can be attained by overcoming negative thoughts and feelings. Essentially, ACT looks at your character traits and behaviors to assist you in reducing avoidant coping styles. ACT also addresses your commitment to making changes, and what to do about it when you can’t stick to your goals. Read More

  1. Acceptance: Acceptance of anxious feelings means learning how to observe and sense them without judgment. Instead, you are able to use compassion and gentleness when confronted with anxiety, fear, worry, panic, and other sensations that may cause discomfort.
  2. Choose: This step is where you decide how you want your life to go. You can ask yourself do I want to remain a prisoner to this anxiety or do I want to live a fulfilling meaningful life?
  3. Take Action: This is by far the hardest step. This involves accepting that in order for things to change you much change your behavior. Taking action means facing your fears and anxieties and making them a small part of your life instead of something that consumes you.

To learn more about Acceptance and Commitment Therapy check out the book:  The Mindfulness & Acceptance Workbook for Anxiety by John P. Forsyth and Georg H. Eifert.

Diagnosis Disclosure in the Workplace

Deciding whether or not to disclose about your mental illness in the workplace can put you in a very compromising position. On one hand, you want to be comfortable in your workplace, but on the other hand, you may fear the chance of being shamed and judged because of it.

I faced this exact dilemma as I was on a job search. However, I questioned how much about my mental illness I should reveal or whether I should reveal it at all. Most importantly, I found that the best way to deal with this baffling decision is to weigh out the pros and cons of disclosing your mental illness in the workplace.

The social self. (Photo credit: Wikipedia)

Pros of disclosure in the workplace:

  • To acquire accommodations and protections from the Americans with Disability Act
  • To be honest with your coworkers but most importantly with yourself
  • Condense stigma
  • Help those in your work environment be more aware of mental illnesses
  • By law, it is required to keep your personal record confidential

Cons of disclosure in the workplace:

  • Not needing any accommodations
  • You fear the negative consequences of stigma
  • Protection of your privacy
  • The inability to progress up the employment ladder because of your disclosure

According to Occupational Medicine of Oxford Journals, their data revealed that discrimination in the workplace fell within the following three problem areas:

A framework for understanding these phenomena conceptualizes stigma as comprised of the three problems of: knowledge (ignorance or misinformation), attitudes (prejudice) and behaviour (discrimination)[8]. We have recently used this framework to undertake a survey of employer’s knowledge, attitudes and workplace behaviours [9]. Of the 502 employers who participated, a number of concerns were reported about hiring applicants with a mental health problem including: (i) symptom concerns such as threat to safety of other employees or clients (17%), person would be incapable of handling stress (14%) and strange or unpredictable behaviour (11%), (ii) work performance concerns, particularly impaired job performance (20%), (iii) work personality concerns, particularly absenteeism (29%) and (iv) administrative concerns including level of monitoring needed (7%) and negative attitude of other employees (2%).

In a study by Manning and White [10], standard of previous work (89%), job description (87%), whether receiving treatment (69%), time off sick in previous year (68%) and diagnosis (64%) were reported as factors always or usually considered in hiring decisions. Fenton and colleagues [11] similarly found that employment record (78%), sickness record (69%), diagnosis (36%), detention under the Mental Health Act (36%) and medical opinion regarding fitness to work (7%) were most commonly reported as influential factors. Read Full Journal Article

There are many more reasons for and against disclosure, but this decision will include figuring out which approach is best for you based on the type of environment you are in. It would be helpful to consider this decision while you are job searching to help alleviate any future stressors.

Preparing for the Holidays with an Anxiety Disorder

Holiday

The holidays can be an extremely stressful time, especially for those with an anxiety disorder.  If you have an anxiety disorder you are probably worried about the small talk, huge crowds, and being away from your comfort zone that the holidays can bring. Last year you were probably standing in the middle of the room surrounded by people with sweaty palms and a racing heart. This year I am going to give you some tips on how to make the holidays a little more bearable.

1. Be Prepared! If you are having the celebrations at home or elsewhere make sure you bring all tools you will need to handle abnormal anxiety. This may include medication, relaxing music on your phone, breathing, and grounding techniques. Be ready to use whatever you need to relax when things get too overwhelming.

2. Plan Ahead. Having an itinerary of what events you are attending during the holiday can be a great stress reliever. Make a list of where you will spend each holiday, who is accompanying you, and how you are going to get there.

3. Remember that it’s okay to take a break. Whenever I’m hosting an event in my house and things get too stressful I take a 5-10 break in my room to do some deep breathing. If you need to step outside to get some air do so.

4. Limit your alcohol intake. Many people tend to self-medicate with alcohol to alleviate their anxiety. Alcohol has been shown to increase anxiety symptoms. It is important to know your limits and drink responsibly during this stressful time.

5. Remember that you are human! Don’t be too hard on yourself this holiday season. You are going to get anxious and that’s okay. Always keep in mind that there are people around you who love and care for you. Let your mind and body relax and live in the moment.

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