SAMHSA Blog

May 15, 2023

By: Mitchell Berger, M.P.H., National Mental Health and Substance Use Policy Laboratory and Maggie Jarry, M.Div., Office of Intergovernmental and Public Affairs

Last year, amidst one of the warmest global summers recorded, the Biden Administration launched Heat.gov as a “a one-stop hub on heat and health for the nation.” The website provides information on at-risk groups, tools and resources, and ways to prepare for extreme heat. Heat.gov is overseen by the National Integrated Heat Health Information System (NIHHIS), an interagency collaboration that includes the National Oceanic and Atmospheric Administration, Centers for Disease Control and Prevention (CDC), Federal Emergency Management Agency, Administration for Strategic Preparedness and Response and the Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA was a founding member of NIHHIS. As NIHHIS plans for its annual social media campaign, it’s important to note SAMHSA’s role and why heat awareness is important for the behavioral health community.

Key Take Aways – Heat Health

1. More people die in heat-related weather events than in other types of extreme weather events.
2. Risks of heat-related illnesses or death begin even before “extreme heat” emergencies are declared, as ambient temperatures rise.
3. People with behavioral health conditions are among those at highest risk of heat-related illnesses or death from extreme temperatures, including heat waves. Psychotropic medications may increase risk, and use of alcohol and other substances also can place people at more risk of harm.
4. Sleep loss during periods of prolonged, extreme heat may be a contributing stressor for mental health and substance use conditions.
5. During a heat event, if a person is facing a barrier to accessing air conditioned or cooler environments (such as during a blackout),one good way to cool down is to take a bath or shower.
6. People who are unhoused, housing insecure, or lower income (and therefore perhaps unable to afford air conditioning) face higher risks during extreme heat.

Climate Change Impacts Mental Health and Substance Use

Climate change is already having significant impacts on mental health and substance use. A 2021 report by the environmental group ecoAmerica and the American Psychological Association (APA) describes growing “climate anxiety” among those concerned that climate change will impact their lives and those of their friends and loved ones. Many young people, as those likely to experience the most intense climate-change-related impacts in their lifetime, are especially concerned about the impact of climate change. For instance, a June 2022 Oregon report that included a literature review and focus groups found that youth “are experiencing feelings of hopelessness, despair, anxiety and frustration about climate change.” Many report feelings of anger and not being taken seriously by adults.

Climate-related natural disasters, the ecoAmerica/APA report observes, can cause post-traumatic stress disorder, anxiety, and depression, as well as undermine strong social connections. Heat itself impacts both the body and mind, making it a “physiological and psychological stressor.”

Extreme Heat Can Be Dangerous for Those with Behavioral Health Conditions

The importance of health providers, government agencies, and communities paying attention to the risks of extreme heat and climate change were underscored by a 2021 heat wave on the West Coast, including Washington and Oregon as well as parts of Canada. The heat wave, described by researchers as “unprecedented,” led to record-setting temperatures in the last week of June 2021 as what the media called a ‘heat dome’ covered the region. There is a 50 percent chance that such events become a “yearly occurrence by 2050,” according to one research team. An analysis of the event by Multnomah County (OR), which includes Portland, attributed 69 deaths to the extreme heat during that time. Those most vulnerable included older adults, homeless or those at-risk of homelessness, and those living in multi-family buildings. A similar analysis in Washington attributed 100 deaths statewide to the heat wave. Emergency department use increased across the region. A study published by British Columbia public health researchers found those with schizophrenia were among those at highest risk during the heat wave. And while those with schizophrenia were especially vulnerable, those with other conditions such as depression and substance use disorder also faced increased risks of death. Other researchers have found emergency department visits related to mental health conditions and substance use disorders may increase more often than those for other conditions during a heat wave. Those in at-risk groups such as homeless populations, some of whom may have substance use conditions or mental health disorders, may be especially at risk.

Heat events also have implications for those who do not have preexisting mental health conditions and substance use disorders. One review, for instance, indicates a relationship between extreme or prolonged heat events and exacerbation of mental health conditions and suicide risks (though more research is needed). Increases in temperatures can lead to disrupted sleep patterns and sleep deprivation, which may contribute to mental health and substance use complications during heat events. For example, a 2022 study “Rising Temperatures Erode Human Sleep Globally” found that per one degree of warming, sleep loss was about twice as high among the elderly compared to younger adults and sleep loss was three times higher among people who are low income. Sleep loss can exacerbate stress and anxiety. Research also shows a relationship between ambient warm temperatures and human emotional states; for example, researchers found worsened expressed sentiments in social media during heat waves. This type of research appears to support other observed and researched relationships between increased warm temperatures and acts of aggression. The relationship between these factors and increased substance use is a growing area of research.

Extreme heat events also interact with social economic status in a variety of ways. People who have lower socioeconomic status have more likelihood to be exposed to extreme heat (e.g., longer periods of being outdoors during wait times for public transportation, financial challenges in paying for home air-conditioning). In attempting to avoid these exposure factors, people with lower socioeconomic factors may also have less ability to access in-person health appointments. As mentioned throughout, along with higher likelihood of exposure, people with chronic health conditions such as serious mental illness or substance use disorder have high susceptibility to worse heat health and behavioral health outcomes in these events.

SAMHSA is Working to Reduce Risks of Extreme Heat for Those At-Risk

Given the increased vulnerability of those individuals that SAMHSA serves, such as people with behavioral health conditions and people experiencing or at risk of homelessness, SAMHSA’s engagement in NIHHIS is vital. SAMHSA staff and experts helped to support the group’s second conference in April. NIHHIS also is developing a federal strategic plan for how federal agencies will work together and with others to lead federal efforts related to extreme heat. The Administration is supporting many other efforts, including an interagency working group focused on coordination and data sharing.

In addition to supporting NIHHIS, SAMHSA has collaborated with the HHS Office of Climate Change and Health Equity (OCCHE), an office in HHS focused on the health impacts of climate change and environmental justice issues, to ensure behavioral health needs are among the Department’s climate change priorities. SAMHSA staff are implementing action items developed through collaboration with OCCHE. SAMHSA worked with OCCHE to develop a public website on climate change and health equity and introduced more climate-related supports into materials from the Disaster Technical Assistance Center (DTAC). SAMHSA also noted the impacts of extreme heat in its 2022 Request for Information (RFI) on climate change and health equity and is in the process of analyzing comments received.

Though a full analysis is still in process, several comments urged SAMHSA to work with federal and other partners to focus on persons with behavioral health conditions, children and youth, people from indigenous communities and communities of color, first responders, climate migrants (those leaving areas due to climate-related circumstances or disasters), people from lower income communities, and others. Respondents noted the importance of more education about the risks of medications, including psychiatric medications, and extreme heat as well as need for additional research on the effects of climate on mental health and substance use and need for evidence-based climate behavioral health adaptation resources.

Responding to such concerns, SAMHSA recently developed a fact sheet titled Tips for People Who Take Medication: Coping with Hot Weather, discussing steps those taking medications for mental health conditions can take to help reduce their risk. SAMHSA also provides input to the CDC and other NIHHIS partners on their extreme-heat-related educational materials.

Examining the groups of those at risk from heat-related disasters, persons with behavioral health conditions, as well as their families/caregivers and providers, should ensure they have a plan for emergencies and disasters, whether a heat wave, hurricane, tornado, or flood. Heat.gov has excellent tools on recognizing signs and symptoms of illness when someone experiences extreme heat and how to help. The website has good advice about how to stay safe during hot weather, such as wearing sunscreen and light clothing, cooling down when needed, drinking water, and avoiding the outdoors when feasible.

Concluding Thoughts

As summer approaches, it can be great to enjoy the outdoors and all that warmer weather has to offer. Yet, when there are extreme temperatures, individuals, families/caregivers, behavioral health providers, and government agencies should try to reduce the risk for people with behavioral health conditions, people experiencing lack of access to stable housing, and others who may be at risk. NIHHIS and Heat.gov provide excellent starting points for actionable ideas on how to help. SAMHSA staff are carefully reviewing comments received in response to the Climate Change RFI. In that review process, SAMHSA staff will discuss internally and with federal and other partners how behavioral health systems and services can increasingly become climate informed.

May 5, 2021

SAMHSA Blog

Category: Suicide Prevention

By: Anita Everett, M.D. DFAPA, Director of the Center for Mental Health Services (CMHS)

National suicide rates are rising, and this is especially true for our nation’s youth suicide rate. Suicide is largely a preventable cause of death, and you are more able to help prevent it than you might think.

Suicide is the result of actions being connected to a self-harm idea. Many more people think about suicide than those who die by suicide; however, no one dies by suicide without having thought about it first. There is a thinking-planning phase followed by an action phase. The thinking phase is different for different people: Sometimes it is recurring and intense. Other times it may be fleeting.

There is a suicide sequence that can be interrupted, and those interruptions can be lifesaving. There are several strategies for preventing suicide that have been developed for various settings. Generally, there are several components in these trainings that aim to separate a person’s thinking of suicide from their acting on suicidal thoughts.

Being aware of signs that something has changed in a person’s life that might make them susceptible to suicide is an important initial step. One sign that a person might be having thoughts of suicide would be indications that they already might be engaging in self-harming behaviors. Non-suicidal self-harm often can be a precursor to a suicide attempt. Reaching out to the person in a caring, respectful way is a next important step. The third step is to gently challenge negative thoughts that often accompany or precede suicidal thoughts, and the final step is to encourage the person to seek help or to take some other positive action.

An example of this type of training strategy is the be NICE program that has been widely used and promoted by the Mental Health Foundation of West Michigan. This suicide prevention program uses the acronym “NICE” to represent intervention steps. Here, “N” is for noticing the people in your environment, and “I” is for inviting a person into a conversation that creates a safe space to talk about their worries. “C” is for challenging them to think of themselves as worthy of treatment, and “E” is for encouraging them to feel empowered to get help.

Suicide is preventable. Negative thoughts don’t have to lead to painful actions. Working together, we can make a difference!

Use it to inform and direct growth, never to attack self-esteem.

Posted May 8, 2023 

Psychology Today

KEY POINTS

• Part of parental responsibility with an adolescent is a critical one—to monitor and direct youthful growth.
• All criticism is not the same: Helpful criticism is advisory and educational, but harmful criticism is judgmental and punitive.
• Because of growing changes and social comparisons with peers, adolescence is a more self-critical age.

Part of parental responsibility with an adolescent is a critical one: monitoring youthful conduct and growth to encourage what is healthy and to discourage what is harmful. In the process, parents rely on their longer life experience and more seasoned judgment to decide what is wise—which youthful behaviors work well, and which do not.

Helpful and harmful criticism

Not all parental criticism is the same.

Their criticism can be helpful when it informs understanding and improves functioning: “Having my parent correct my papers usually makes them better.” This is advisory criticism, sharing the wisdom from longer life experience.

Their criticism can be harmful when it attacks image and injures self-esteem: “Having my parent put down my friends hurts and make me angry.” This is evaluative criticism, negatively judging based on personal preference.

In the first case, one can feel improved; in the second case, one can feel attacked. Parents need to be ever-mindful of this difference.

While their teenager may discount the painful impact of parental criticism—“I don’t care what you think of me!”—they lie. In truth, they care too much to let that caring show. They still want to shine in parental eyes at a time when it is harder to shine in their own.

Self-critical adolescents

Adolescence is a doubly critical age. The young person typically becomes more self-conscious about appearance and more comparative with peers, on both counts increasingly self-critical for how she or he is and isn’t developing: “I wish I didn’t look like this!” “Others are growing older faster!”

And she or he becomes more critical of parents—how they are and what they want: “Why do you have to be like you?” “Stop getting on my case all the time!” Feeling hurt or offended by youthful criticism, now parents can become more negative and critical in response, which injures the relationship.

While the cuddly little child was often a play companion, at times the separating adolescent can often feel more like a family adversary. On the youthful side, parental authority that once was inspiring can now become harder to put up with.

While love still holds as always, growing separation makes getting along sometimes harder to do. So, keep perspective. On both sides of the relationship, developmental change is at work. Much abrasion that develops is about the adolescent process, not just the other person.

The matter with friends

Then there is the social pressure of keeping up with peers, some of whom are always ahead of where you are—better looking, older growing, life experienced, greater achieving, higher performing, more popular and cool. As for getting ready for the school day each morning, two critical encounters cannot be avoided because there is no escaping growing self-consciousness—how one looks in the mirror and what one will wear to school. Enter the law of defensive dressing: “Make the most of the good and cover up the bad.” Now personal appearance can take center stage, as one becomes more vulnerable to criticism from self and others.

As for popular entertainment, fashion, and advertising media, they are no help—parading ideal-looking and outstanding-performing young people with whom, by painful comparison, you are never going to measure up: “I’ll never look that good!” “I’ll never do that well!” “I’ll never be that cool!” Comparison incites criticism.

Important to remember, particularly during the vulnerable middle-school years when acts of social cruelty—teasing, bullying, exclusion, rumoring, and ganging up—become more unhappily common, put-downs become the most painful social criticism there is. With the onset of puberty, feeling out of control of bodily changes, self-consciousness can often be a cruel companion: “Look how I look!”

All of this is just to suggest that adolescence is a more self-critical age, and, so, it really helps if parents keep the family free of evaluative criticism and teasing.

In the family

Thus, parents should only criticize to instruct; not to punish or diminish, coupling discipline with injury. Now the pain of being negatively judged by the most powerful adults in your life gets in the way of whatever lesson they were trying to teach. Now some measure of safety with parents, and trust in the relationship, has been lost as personal injury has been sustained.

So,

• Never criticize in anger.
• Never criticize to retaliate.
• Never criticize to correct or punish.

Only use criticism to

• Provide a personal perspective.
• Increase knowledge and understanding.
• Offer insight from older and experienced opinion.

And, of course, avoid all adequacy complaints like “What’s wrong with you?” “Are you stupid?” “You’ll never learn!” “You can’t do anything right!” Statements of extreme parental frustration or exasperation such as these can be destructive: “From being criticized, I’ve learned not to like myself.”

So, parents: Don’t hurtfully criticize your adolescent. She or he may act as if it doesn’t matter (“I don’t care what you think!”), but that is a lie. They care too much to let their caring show. While criticism from peers like teasing can certainly hurt; criticism from parents, the most powerful adults in your world, those who love and know you the best, can hurt worst of all. They speak on highest authority.

Alternatives to criticism

Criticism is not a good parental corrective because it can injure the teenager’s self-esteem, put the young person on the defensive, arouse resistance, reduce trust in safety of the relationship, make her or his listening to you harder to do, and may inspire criticism in return. So, instead of expressing criticism of your teenager, consider some less damaging and more productive alternatives:

• Making observation: “This is what I saw.”
• Expressing concern: “Are you feeling OK?”
• Offering suggestion: “You might try doing this instead.”
• Stating disagreement: “I don’t see things the same as you.”
• Inviting discussion: “Can we talk about what just happened?”

Your relationship will benefit when you do.

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About the Author

Carl Pickhardt Ph.D. is a psychologist in private counseling and public lecturing practice in Austin, Texas. His latest book is Holding On While Letting Go: Parenting Your Child Through the Four Freedoms of Adolescence.

Online:

 Website: Carl Pickhardt Ph.D.

The morality of manipulation, like human nature, can be confusingly ambiguous.

Updated June 21, 2023

Psychology Today

KEY POINTS

• However unconsciously, we all engage in forms of communication that are anything but frank or forthright.
• Even nudging someone could be done either out of kindhearted benevolence or ego-driven self-interest.
• Seen psychologically—vs. morally—all needs are understandable, and so deserving of (unprejudicial) empathy.

How We Address Our Dependency Needs—and We All Have Them

Basically, there are only two ways to get dependency needs met. Being assertive represents the direct approach, and it’s almost always viewed positively. Much less acceptable is being manipulative, the indirect approach.

Synonyms for manipulating others to get them to respond favorably to what you need aren’t at all flattering. They include (and this is just a small sampling) controlling, cunning, deceitful, double–dealing, and insidious.

In short, the tendency to influence others indirectly is generally disapproved of as devious or dishonest, for it’s assumed to be inequitable and thus exploitative.

However unconsciously, all of us at times engage in this less-than-aboveboard form of communication. It’s sometimes necessary, even essential, in instances where another’s welfare is at stake, and we haven’t been able to positively influence their thinking or behavior directly.

Nudging someone who’s on the verge of sabotaging themselves could be viewed as “manipulation-light.” Say, we’re strategically (i.e., indirectly) prompting a fully qualified person to attend college, despite their dislike for formal academic learning. Clearly, there’s nothing dishonorable about such a roundabout approach.

Still, even nudging another could be done primarily—or wholly—out of self-interest and thereby be no better ethically than abusive bullying or gaslighting.

How Does Manipulation Become Part of Our Behavioral Repertoire in the First Place?

Whether or not we’re comfortable admitting it, we’re all social creatures, and to truly feel good about ourselves, we need others to take our needs seriously and respond to them favorably.

Unable to accomplish such a supportive, validating relationship, we’ll feel deprived, isolated, and perhaps unworthy of others’ caring. And this experience can link to chronic problems with anxiety and depression.

The practice of manipulating others to get our needs met makes its dubious entrance considerably before we reach adulthood.

In fact, even as a newborn, as pre-verbal and cognitively undeveloped as we are, our behaviors can be understood as combining both the assertive and the manipulative.

If you’re in distress—too hot, cold, hungry, in physical pain, or simply needing to be held—you’ll cry. It’s instinctual, intimately connected to your primal sense of survival.

But less instinctive is crying when, literally, your predominant needs have already been taken care of. If you like being cuddled and you’ve begun to associate crying with your caretakers immediately coming to your side, then you’ll begin to cry “opportunistically” to receive the welcoming pleasure of a parent’s touch.

Although this more conscious stratagem could also be said to deal with an elemental interpersonal need, it has a calculating, deliberative quality to it missing in bawling because you’re experiencing your current circumstances as mortally endangering. And the same might be said when you cry because you’d enjoy engaging in imitative play with a family member.

But what needs to be emphasized is that needs are needs, whether they’re mental, emotional, or physical. Also, it’s often nearly impossible to distinguish between a want and a need. Seen psychologically versus morally, they’re all authentic and understandable, and so deserving of some impartial or unprejudicial empathy.

Moreover, although certain interpersonal needs are universal—so widespread as to be “natural”—not all children (or adults) target these needs similarly.

So variables in identifying one’s needs aren’t relevant in assessing their (subjective) validity. And that’s true regardless of how inconsiderately expressed or downright nasty they may be in relationship to respecting the needs of others.

So How, Without Succumbing to Moral Nihilism, Can We Differentiate Between Acceptable and Unacceptable Manipulation?

The goals of manipulation, conscious or not, range from virtuous to vicious, good-willed to sadistically malevolent, and pursuing justice disinterestedly to seeking revenge out of purely ego-dominated mechanisms.

Here is where you need to focus more on the motivation behind acting manipulatively than on what—internally or externally—provoked your circuitous behavior. Inasmuch as your communication (though it may have turned out to be wrongheaded) was spurred by benign intentions, it’s only fair to qualify the theoretical “badness” of your behavior.

Additionally, it’s kindheartedly reasonable for others to take a humane approach toward your judgment when, though charitable, it’s found to be mistaken—versus appraising your behavior from a pessimistically nihilistic viewpoint.

If we’re to regard compassionately what may drive individuals to act out against innocent people—or, vigilante-like, take the law into their own hands—we’re not thereby required to open up our jail cells and let the freed prisoners, unmonitored, act however they wish.

Doubtless, it’s crucial to protect citizens against those who can’t be trusted not to—impulsively or, for that matter, compulsively—act against them.

Even if a murderer, for example, was victimized as a child by a rageaholic father and subject to the harshest corporal punishment imaginable, that past ill fortune still can’t exonerate him from his own (distrustful and displaced) later transgressions against humanity.

But if, as a society, we’re to escape self-righteous vengefulness, prison reform centering on rehabilitation rather than retribution is the enlightened response to those less fortunate than us.

To add one final layer of complexity to this thorny subject, what about someone who purposely avoids what they regard as manipulativeness because they apprehend it as being (because of its undesirable connotations) something to systematically shun?

Thinking in absolutes is almost always problematic. And there are numerous examples demonstrating that withholding one’s influence when a person is about to make a harmful decision is actually deserving of disapprobation.

So, what if your friend at work shares their decision to forcefully confront your boss about his loathsome, condescending attitude?

You’ve already concluded that this disagreeable individual possesses an extraordinarily defensive narcissistic personality such that directly confronting him will almost certainly lead to your friend’s getting fired.

Not to try, however indirectly or craftily, to influence him to limit his sharing to other like-minded cohorts at work would give you some moral responsibility in the all-too-likely event that his directly blowing off steam would leave him unemployed—particularly when you know that outcome could be financially disastrous for him.

In situations like this, the willingness to employ some form of chicanery to keep your friend gainfully employed makes ethical as well as practical sense.

Consequently, there will always be a place for manipulation when simply asserting the facts about a situation cannot enable you to achieve a hoped-for—and self-disinterested—result.

Like so many things in reality, a “sin,” relatively considered, can be one of omission as well as commission. Thus, manipulating another—but far more for their sake than your own—doesn’t warrant criticism merely because it’s not free of artifice or guile.

© 2023 Leon F. Seltzer, Ph.D. All Rights Reserved.

References

Buss, S. (2006, Jan). Valuing autonomy and respecting persons: Manipulation, seduction, and the basis of moral constraints. Ethics, 115(2),195-235. https://doi.org/10.1086/426304

Fischer, A. (2022, Feb 27). Then again, what is manipulation? A broader view of a much-maligned concept. Philosophical Explorations: An International Journal for the Philosophy of Mind and Action, 25(2), 170-188. https://doi.org/10.1080/13869795.2022.2042586

Manne, K. (2014). Non-Machiavellian manipulation and the opacity of motive. In Manipulation: Theory and Practice, M. Weber & C. Coons, eds. New York: Oxford University Press.
.
Noggle, R. (2022, Jun 21). The ethics of manipulation. The Stanford Encyclopedia of Philosophy. https://plato.stanford.edu/archives/sum2022/entries/ethics-manipulation/.

Seltzer, L. F. (2013, Apr 30). A new take on manipulation. https://www.psychologytoday.com/intl/blog/evolution-the-self/201304/new…

About the Author

Leon F. Seltzer, Ph.D., is the author of Paradoxical Strategies in Psychotherapy and The Vision of Melville and Conrad. He holds doctorates in English and Psychology. His posts have received over 50 million views.

FEB. 10, 2023

By Ivory Smith

NAMI Blog post

Most of us have heard the saying: “Cleanliness is next to Godliness.” This old-fashioned mantra reinforces a long-held, misguided belief: that being “unclean” equates to laziness and moral ineptitude. As a result, our culture often takes an unsympathetic approach to addressing issues like poverty and homelessness; far too many of us interpret these situations as a personal failing rather than a product of structural inequality. And, significantly, our ideas about the morality of cleanliness can shape how we view mental illness.

Hygiene is one of the many symptoms that is frequently left out of the mental health conversation. This is largely because the subject is difficult to talk about — many of us feel the weight of stigma when talking about our bodies and our personal habits. However, indifference to hygiene tasks, including showering, brushing teeth, doing laundry or brushing hair, is a common symptom of mental health conditions (particularly depression).

As a health care professional and someone living with depression, I can speak to the very real manifestations of this symptom. My personal understanding of hygiene and my professional understanding of germ theory was simply not enough to beat the confines of a depressive episode. As I bathed others and taught caregivers, I, myself, struggled to take a shower. This was difficult to wrap my head around, but I have come to understand that neither a professional designation, nor “knowing better,” can shield you from mental health symptoms.

The Connection Between Hygiene And Mental Health

In my work in the health care profession, I have found that difficulty with hygiene tasks can be an early warning sign of mental illness. I have seen how bipolar disorder can present in its early stages in the form of changed feelings about daily hygiene practices. This symptom can seemingly come “out of nowhere.” When bipolar depression or mania are looming, symptoms can come in like a roaring tiger — or they can sneak up gently and go unnoticed until you find yourself in the pit of the deepest valley.

Hygiene issues can also appear during more advanced stages of mental illness; I have even witnessed patients in psychosis experiencing irrational thoughts about hygiene. I have also seen how major depression can extend to hygiene practices. When experiencing the crushing weight of depression, showering can feel like an ordeal that requires exhausting amounts of forethought and effort. The number of steps feel intimidating; making sure the water is hot, washing everywhere, drying off efficiently, moisturizing, then putting on clean clothes can feel like a lot to handle with deep depression.

My Experience With Depression

When I was struggling, I found those steps to be excruciating; I would often say, “Why bother, I’ll do it tomorrow.” Suddenly, showering felt like a huge task — like doing an entire spring cleaning of my house every day.

During my year-long episode of depression, I saw firsthand how hygiene could fall by the wayside. And I was not even fully aware that my habits had changed.

I was embarrassed when my spouse told me, gently, “You may want to go and take a shower” or “Make sure you take a shower before being around people tomorrow.”

I would say that I was sorry, and, sometimes, I would get up and take one.

I began to keep track of my bathing habits so I could get a clearer picture of how my depression was impacting my hygiene. A “moderately” depressed week usually accompanied three showers a week. As the depression became more severe, I was shocked to realize that I had bathed only twice that week. Things I once enjoyed like pedicures and facial grooming faded away.

To make myself bathe, I would have a conversation with myself. For example, I would say (in third person), “Ivory, since it is Saturday, and Sunday is the Sabbath, you need shower that night or that morning.” Or I might say, “Ivory, since you take very strenuous exercise classes two nights out of the week, then that is a good time to take a bath.” Essentially, I attached bathing to something else I was already doing. It was no longer performing hygiene activities; I associated it with my manageable everyday tasks as well as staying healthy.

I also shared my “secret” with two family members and my bipolar support group members. Several people in the group chimed in, saying that they went through the same thing. They reported being oblivious or indifferent to bathing. One of my family members helped by reminding me to take a shower after I get off the phone with her — and we turned this practice into a “deal” I would make with her when I was struggling.

Tips For Practicing Hygiene During A Mental Health Episode

For those who are struggling with the effort to maintain hygiene, I have a few suggestions:

1. Attach the act of bathing to the start of something, like the beginning of the work week. This built-in routine can be a helpful reminder when you might otherwise forget about showering.
2. Attach showering to the end of a workweek. This adds more consistency to your routine.
3. If showering is too much of an ordeal, keep adult disposal bathing cloths handy. These can be bought at any pharmacy or medical supply store.
4. Make agreements with supporters that you will bathe on a specific day or night. Sooner is better as I have found that, if I wait, I can come up with a reason for not taking care of hygiene.
5. If possible, splurge on quality soaps and shampoos. This act of self-care can be fun and make for a more pleasant showering experience.
6. On days when you cannot follow a showering routine, simply cleanse your face and the perineal areas for express cleaning and put on clean clothing. This will cover certain health precautions and likely give you more energy.

When we are having difficulty functioning, we deserve help. Struggling to practice hygiene (even when you know you “should”) isn’t a moral failing; it’s simply a sign that we need extra support. You should not feel ashamed about voicing your struggles and reaching out to members of your support team. This journey can be difficult, but you don’t have to do it alone.

Ivory Smith Causey has a B.A. in sociology from Georgia Southern University and a B.S. in nursing from Macon State College. Ivory is a registered nurse at McIntosh Trail Management in Macon, Ga. and works as an assessment nurse. She is a member of the American Holistic Nurses Association and hopes to be certified in holistic nursing.

March 1, 2021

By Leo Newhouse, LICSW, Contributor

It’s safe to say that 2020 gave us more than enough to cry about. Yet even prior to last year, it seems that we were crying fairly often. Researchers note that, on average, American women cry 3.5 times each month, while American men cry about 1.9 times each month. These figures may take some of us by surprise, especially as our society has often looked at crying — particularly by men — as a sign of weakness and lack of emotional stamina.

Health benefits of crying

As a phenomenon that is unique to humans, crying is a natural response to a range of emotions, from deep sadness and grief to extreme happiness and joy. But is crying good for your health? The answer appears to be yes. Medical benefits of crying have been known as far back as the Classical era. Thinkers and physicians of ancient Greece and Rome posited that tears work like a purgative, draining off and purifying us. Today’s psychological thought largely concurs, emphasizing the role of crying as a mechanism that allows us to release stress and emotional pain.

Crying is an important safety valve, largely because keeping difficult feelings inside — what psychologists call repressive coping — can be bad for our health. Studies have linked repressive coping with a less resilient immune system, cardiovascular disease, and hypertension, as well as with mental health conditions, including stress, anxiety, and depression. Crying has also been shown to increase attachment behavior, encouraging closeness, empathy, and support from friends and family.

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Not all tears are created equal

Scientists divide the liquid product of crying into three distinct categories: reflex tears, continuous tears, and emotional tears. The first two categories perform the important function of removing debris such as smoke and dust from our eyes, and lubricating our eyes to help protect them from infection. Their content is 98% water.

It’s the third category, emotional tears (which flush stress hormones and other toxins out of our system), that potentially offers the most health benefits. Researchers have established that crying releases oxytocin and endogenous opioids, also known as endorphins. These feel-good chemicals help ease both physical and emotional pain. Popular culture, for its part, has always known the value of a good cry as a way to feel better — and maybe even to experience physical pleasure. The millions of people who watched classic tearjerker films such as West Side Story or Titanic (among others) will likely attest to that fact.

Rethinking crying in boys and men

“I know a man ain’t supposed to cry,” goes the lyric of a popular song, “but these tears I can’t hold inside.” These words succinctly summarize many a man’s dilemma about emotional expression. From early on, boys are told that real men do not cry. When these boys grow up, they may stuff their feelings deep inside and withdraw emotionally from their loved ones, or self-medicate with alcohol or drugs, or even become suicidal. Many men therefore need to learn the skills of how to reconnect with their emotions. Back in the 1990s, the poet Robert Bly led men’s seminars at which he taught the participants how to get in touch with their long-buried feelings of sadness and loss, and to weep openly if they needed to. Ideally, however, such education should begin early on, at home or at school, with adults making it safe for boys to talk about difficult feelings.

Crying during COVID

As of this writing, the nation has registered over 500,000 deaths from COVID-19. The collective grief over these losses can only be described as staggering. It is no surprise, then, that at times like these our feelings are closer to the surface, and that many people who were not previously prone to crying find themselves tearing up more easily. In fact, as one medical professional put it, showing emotion in public may have become a new normal.

When are tears a problem?

There are times when crying can be a sign of a problem, especially if it happens very frequently and/or for no apparent reason, or when crying starts to affect daily activities or becomes uncontrollable. Conversely, people suffering from certain kinds of clinical depression may actually not be able to cry, even when they feel like it. In any of these situations, it would be best to see a medical professional who can help diagnose the problem and suggest appropriate treatment.

Takeaways

As challenging as it may be, the best way to handle difficult feelings, including sadness and grief, is to embrace them. It is important to allow yourself to cry if you feel like it. Make sure to take the time and find a safe space to cry if you need to. Many people associate crying during grief with depression, when it can actually be a sign of healing. Teaching boys and young men that it’s okay to cry may reduce negative health behaviors and help them have fuller lives.

If crying becomes overwhelming or uncontrollable, see a doctor or mental health professional for evaluation and treatment.

About the Author

Leo Newhouse, LICSW, is a Senior Social Worker in Neurology at Beth Israel Deaconess Medical Center (BIDMC). In this capacity, he works with patients and families coping with life-limiting illness, aging, and loss. In his spare … See Full Bio

Disclaimer:

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

June 2023

Fathers, Daughters and Sons – Exercises (All About Me/Resolving Blame and Guilt)

                                

I recommend that these exercises be used for daughters and sons over 25 years old. This is because daughters and sons have reached the level of adulthood and are at a stage of being able to express themselves more fully and understand various childhood issues that need to be addressed.

Invite your father and daughter and father and son to participate by stating that both of you will have an opportunity to know more about each other as a person at this stage of your life.

These exercises are about healing, love, and acceptance of who fathers, daughters, and sons are at the stage of their lives.

I recommend a date, time, and place that will only include the father and son and father and daughter. I recommend that these exercises be in person, not on the phone or Zoom. This is important because you want to be in a position of responding to information received from the exercises with feelings and hugs, when necessary. 

Remember, crying is a form of healing because you may need to release feelings to move forward. if the two of you must meet again. Schedule another time for an in-person visit to address whatever was left out in the initial exercises. This should be done in person. Do not address them on the phone or Zoom.

If father and daughter and father and son believe they could benefit from professional counseling in addressing issues from these exercises, please do so.  I recommend individual counseling and family counseling when needed.

Because fathers, daughters, and sons may not be physically present for fatherless daughters and sons, does not mean that these exercises cannot be used. However, I recommend professional counseling with a therapist, social worker, or life strategy specialist.

Information that has been shared between fathers, daughters, and sons should be respected as private.

ALL ABOUT ME EXERCISE

Each person completes the All About Me exercise form.

Fathers will read from their daughter’s exercise forms. Daughters will read from their father’s exercise form. This will help you to learn how well you know each other.
This is a 20 – minute exercise.

Fathers will read from their son’s exercise forms. Sons will read from their father’s exercise forms. This will help you learn how well you know each other.
This is a 20-minute exercise.

Fatherless daughters and sons. Complete the exercise form about yourself. Complete the exercise form about your mother, daughter, or son to the best of your knowledge.
This is a 20-minute exercise.

                                                                                          

                   RESOLVING GUILT AND BLAME

Fathers and daughters and mothers and sons are to sit opposite each other.

Each person will complete the Resolving Guilt and Blame exercise form.
This is a 5-minute exercise.

Daughters will read their father’s exercise form. Fathers will read their daughter’s exercise forms.
This is a 20-minute exercise.

Sons will read their father’s exercise form.  Fathers will read their son’s forms.
This is a 20-minute exercise.

Fatherless daughters and sons will complete the exercise form and read it aloud. Allow yourself to feel whatever is necessary.

Permitting yourself to cry is a release and healing. you may share this information with a professional therapist, social worker, or life strategist specialist.

FATHERS and DAUGHTERS

ALL ABOUT ME EXERCISE

Instructions: Complete each sentence. After completion, place the father’s exercise form in the daughter’s basket. Place the daughter’s exercise form in the father’s basket.

1. The color of my eyes are: __________________________

2. My favorite color is: ____________________________

3. My favorite hobby is: ______________________________

4. The most important thing in my life is: _____________________________

5. A difficult thing that I had to face in the past was: ___________________________

6. My first “REAL BOYFRIEND’ taught me: _______________________________

7. The most exciting thing that has ever happened to me is: _____________________

8. My best friend growing up was: _____________________________

9. My favorite food is: ___________________________________

10. My favorite music is: _________________________________

11. My favorite subject in elementary school was: ______________________________

                                                                                                      

FATHERS AND SONS

ALL ABOUT ME EXERCISE

Instructions: Complete each sentence. Place the son’s exercise form in the father’s basket. Place the father’s exercise form in the son’s basket.

1. The color of my eyes are: ______________________________

2. My favorite color is: _______________________________

3. My favorite hobby is: _____________________________

4. The most important thing in my life is: ___________________________

5. A difficult thing that I had to face in the past was: ______________

6. My first ‘REAL BOYFRIEND/GIRLFRIEND’ taught me: _____________

7. The most exciting thing that ever happened to me is: ____________

8. My best friend growing up was: ______________________________

9. My favorite food is: ________________________________

10. My favorite music is: ________________________________

11. My favorite subject in elementary school was: ____________________

                                                                                                           

 FATHERLESS DAUGHTERS AND SONS
 ALL ABOUT ME

 Instructions: Complete each sentence about yourself.  Complete each sentence about your father to the best of your knowledge.

1. The color of my eyes are: ________________________________

2. My favorite color is: __________________________________

3. My favorite hobby is: ________________________________

4. The most important thing in my life is: _____________________________

5. A difficult thing that I had to face in the past was: _________________

6. My first ‘REAL BOYFRIEND/GIRLFRIEND’ taught me: ________________

7. The most exciting thing that has ever happened to me is: __________

8. My best friend growing up was: ______________________________

9. My favorite food is: _________________________________

10. My favorite music is: ___________________________________

11. My favorite subject in elementary school was: _____________________

                                                                                                      

FATHER and DAUGHTER

RESOLVING BLAME AND GUILT EXERCISE

Instructions: Complete all sentences as honestly as possible.
It will help you let go and heal.

1.  I was angry at you for __________________________________

2. I’m angry at myself for ________________________________

3.  I should have ___________________________________

4. You should have ___________________________________

      5.  I wish we could have ________________________________

      6.  I am sorry for ________________________________

      7. I want to acknowledge ___________________________________

      8. I feel you owe me __________________________________

      9. I feel I owe you _____________________________________

     10. I need to forgive myself for _______________________________________

     11. I need to forgive you for __________________________________________

     12. I learned from you. Knowing you I gained the following::

           _______________________________________________________________

           _______________________________________________________________

     13. I enriched you in these ways:

           _______________________________________________________________

           _______________________________________________________________

    14. My wish for our relationship is _________________________________

          _______________________________________________________________

                                                                                                      

  FATHER and SON

  RESOLVING BLAME and GUILT EXERCISE

Instructions: Complete sentences as honestly as possible.  It will help you let go and heal.

1. I am angry and you for ________________________________

2. I’m angry at myself for ________________________________

3. I should have ___________________________________

4. You should have _________________________________

5. I wish we could have _________________________________

6. I am sorry for ____________________________________

7. I want to acknowledge _________________________________

8. I feel you owe me ____________________________________

9.  I feel I owe you _________________________________

10.  I need to forgive myself for _____________________________________

11.  I need to forgive you for _______________________________________

12.  I learned from you. Knowing you I gained the following:

___________________________________________________________

___________________________________________________________

     13. I enriched you in these ways: ___________________________

           ___________________________________________________________

     14. My wish for our relationship is _________________________________

           ___________________________________________________________

                                                                                              

     FATHERLESS DAUGHTERS AND SON

     RESOLVING BLAME and GUILT EXERCISE

Instructions: Complete sentences as honestly as possible. It will help you let go and heal.

1. I am angry at you for __________________________________

2. I’m angry at myself for _________________________________

3. I should have ______________________________________

4. You should have __________________________________

5. I wish we could have __________________________________

6. I am sorry for _____________________________________

7.  I want to acknowledge __________________________________

8. I feel you owe me ____________________________________

9.  I feel I owe you ____________________________________

10.  I need to forgive myself for _______________________________________

     11. I need to forgive you for ______________________________________

     12. I learned from you. Knowing you I gained the following:

           ______________________________________________________________

           ______________________________________________________________

     13. I enriched you in these ways ________________________________

     14. My wish for our relationship is _____________________________________

                                                                                                        

As a bereavement specialist, I have met people who have not healed. Some parents and children have died with unresolved issues between themselves and their parents.

Unfortunately, when one doesn’t do the work to heal emotional, physical, and spiritual baggage. The baggage is passed to the next generation.

As a child, I grew up and did not receive the love, care, and support that I wanted and needed from my birth parents.  God had a plan for my life. He gave me my maternal grandmother and great-grandparents, who gave me everything that my birth parents could not give me.

During my childhood years, I wanted to know why my birth parents did not parent me. I talked to their friends and received information that I wanted to know about them. What I learned helped me to understand why they did not have what I needed to love, care and parent me.  I thank them for giving me life. I learned how to forgive them for my emotional and physical pain. I forgave them. 

My maternal great-grandparents taught me that God creates families in different ways. Some are from the womb, and some are from the heart. Throughout my childhood and adulthood, I learned what they told me was true.  I thank God for my emotional, physical, and spiritual healing.

The exercises in this newsletter are not about blaming or hating your parents. It is not about parents disliking their children’s behavior or choices. It is about forgiving and letting go.

June 2023

FATHERS, DAUGHTERS AND SONS

Father’s Love:

A father’s love is sacrificial, patient, kind, humble, honest, forgiving, faithful, and selfless. It is constant and unchanging. These are the things that a father should want his life to be about and for his children to know and feel from him.

Responsibilities of a Father:

• Is a protector. Children will feel safe and secure when he is present.
• Provide unconditional love.
• Show love and respect for the mother of the child.
• Spend quality time with his child.
• Teaches his child accountability.
• involved in all aspects of his child’s life

FIVE ROLES A FATHER SHOULD LEARN and BE:

MOTIVATOR: a dad, a helper, a coach, and a friend.

ENCOURAGER: every child loves positive fatherly encouragement.

ENFORCER: a father enforces consequences of his child’s undesirable behavior and actions. Establishes positive desirable behavior. He disciplines calmly and fair and shows love to his child.

TRAINER: teaches his child how to be a boy and prepares him to be a man.

COUNSELOR:  available to his child for discussions on life experiences. Be willing to seek professional counseling.

A dad’s love for his daughter is sacrificial, patient, kind, humble, honest, forgiving, faithful, and selfish. It is constant and unchanging and a father’s love.

Fathers and mothers are helpful in the development of a child’s emotional well-being. Children look to their fathers to lay down the rules and enforce them. They also look to their fathers to provide a feeling of security, both physical and emotional.

“Dad” is a term of affection and familiarity When men actively participate in their child’s life. They can achieve the title of “Dad” Men should learn to apply the three p’s: provide, protect families, present.

Daughters need fathers to believe in them. A father is neither an anchor to hold a daughter back nor a sail to take her there but a guiding light whose love shows her the way.

A father holds his daughter’s hand for a while and holds her heart forever. When a father teaches his daughter practical life skills. They will provide confidence in all aspects of her life. A Dad can teach his daughter about finances, working on cars, music, cooking, grilling, art, and sports. 

Dad’s relationship with their daughters is unique. Young girls depend on their fathers for security and emotional support. A father shows his daughter what a good relationship with a man is like.  If a father is loving and gentle, his daughter will look for those qualities in men when she’s old enough to begin dating.

A father-daughter relationship can harm the way a woman relates to men. Women with “daddy issues” do not have specific symptoms but common behaviors, including having trouble trusting men and jealousy.

A father’s influence in his daughter’s life shapes her self-esteem, self-image, confidence, and opinions of men.

Daughters’ relationship with their dads determines their ability to trust, their need for approval, and their self-belief.  It can even affect her love life. Healthy father-and-dad relationships should have love, trust, respect, and communication. Relationships, boundaries, trust, and support should be established and maintained.to create a positive relationship between fathers and daughters

Sons need love and guidance from their father. A father’s compassion and mercy are always an option for his son. The hardest thing for fathers to learn is that they can’t always protect their families. But a father’s son needs to know that their father will never give up trying.

Fathers can only become a leader if they lead by example. Some dads do not believe in God. However, don’t put your belief on your child. Allow your sons to establish their knowledge of God.

Boys rely on fathers for guidance on how to live in the world and their relationships. Research suggests that the time fathers and sons spend together can reduce the likelihood of boys becoming anxious, depressed, or aggressive. Boys also crave warmth, affection, and tenderness from their fathers.

Constant clashes and power struggles are most common in a father-son relationship. Generations might divide fathers and sons, and personalities slice through communication and relationships. Whether by nature or nurture, fathers can be less open to sharing their feelings and emotions than mothers.

Fathers and sons with widely different interests can find it hard to relate to one another. Sometimes. Fathers and sons feel competitive against one another. Other times communication issues are compounded when both want a better father-son relationship, but neither one knows how to go about it

FIVE STAGES OF FATHER-SON RELATIONSHIPS

First Stage: Idolize.  Refers to a childhood view of our fathers when they seem invincible

Second Stage: Discord. Refers to a lack of harmony and agreement between father and son

Third Stage: Evolving! Refers to you caring about each other. You enjoy being together. You can handle disagreements and conflicts. You can talk openly about your relationship.

Fourth Stage:  Acceptance. You value your differences, Willing to compromise and forgive mistakes.

Fifth Stage: Legacy. You want to preserve memories and life lessons. You want future generations to have a sense of pride in your family.

  FATHER and SON RELATIONSHIPS

1. A son needs his father to show love to his mother.
2. When a father shows love to his wife and the mother of his son. He is showing his son how to treat his mother, sisters, and women he will meet in e.

Set a foundation for relationships in your life. If the father is divorced or has a different type of relationship., Do whatever you can to respect your child’s mother.

3. Your child needs to see a father fail, not just succeed. The best teacher is a failure. The best type of failure is to learn from someone else. When a son sees a father fails and handles the failures well. He can see that it’s okay to make mistakes, and they can be great teachers.

A child who is not always afraid of making mistakes will grow into a man positioned to accept and conquer challenges.

 Son Needs His Father’s Servant Leadership

A father may or may not be the boss at home. He may or may not be a pastor at church. He may or may not be a leader in his community. He is the leader of your family, and his son needs to see leadership in his home. He needs his father to lead by serving. When a son  sees his father leading and serving. His son understands leadership and can be more effective in leading versus following.  As the son grows up, he will know how to lead his family and be a leader at church and in his community.

A Father Needs To Be Present

As a father fulfills different roles, he can be pulled in multiple directions. A father should be present in his son’s education and social community.

Some areas of a son’s life are not intended for Mom only. A father should establish and maintain a friendship relationship and presence in his son’s life and give him whatever time he needs.

A Son Needs His Father’s Love Regardless of the Situation.

A father may be a sports junkie and athlete, and his son is not one. The father should not care if his son is not an athlete or enjoys sports.

A father may be a pastor and spends more time at church and congregation than with his son.

A son wants his father to laugh and play with him. Sometimes young male adults do not attend church because of their experience during childhood when their fathers seemed to care more about their congregation’s needs than their sons.

No matter what choices a son makes. they need their father’s love., Even when they are different from their fathers and when sons make wrong choices. A father’s loving guidance will open the door to trust and build a relationship with their sons. It will build his self-esteem.

A Son Needs His Father to Affirm__

“I love you, Son.” “I’m proud of you, son.” “You are an amazing son”

“That was an amazing play you made”. “You are a hard worker, keep it up. I know you’ll bounce back”. A son needs to hear words of encouragement from a father to let him know you love having him as a son.

A Son Needs A Father to Discipline in Love

A father needs to set boundaries and expectations for his son. He will make mistakes, just like you did as a kid and just like you do now. Your son should learn that his choices, behaviors, and actions have consequences. Teach him with love. Sons need to think and evaluate the choices that they make both now and in the future.

Fatherless daughters need to prove their value in the world. They try hard to avoid conflict. They try hard to make relationships work and do want to be abandoned by anyone again. They often sacrifice their own needs to meet others’ needs. They need to feel that they are appreciated and need to belong

**********************************************

HOW IMPORTANT IS IT FOR A SON TO HAVE A FATHER?

A growing body of research points to positive effects on children of having an uninvolved father. On average, children whose father is involved tend to have fewer problems with school achievement behavior and social interactions than children who have  inactive fathers.

When you hear the word “Daddy Issues.” It is an emotional disorder that stems from issues with trust and lack of self-esteem that can lead to a cycle of repeated dysfunctional decisions in relationships with men

FATHERS WHO ARE ABSENT HAVE AN IMPACT ON A CHILD’S BEHAVIOR:

1. Decrease Communication Ability in a child’s earliest years. A child with both mother and father develops better communication than a child who does not have both parents.

Direct Communication includes more than just one voice talking to a child. A child receives communication skills when they witness good behavior between their parents.

2. DECREASE COGNITIVE ABILITIES

    An absent father cannot help his child learn how to be heard and acquire knowledge.

3. RELATIONAL and BEHAVIORAL ISSUES.

Children who grow up without a father struggle socially. Feeling rejected by their father, they fear abandonment and have difficulty trusting and committing. A father’s absence can often lead to behavior problems. 

Children don’t know how to process their anger and anxiety, especially if they have a diminished ability in communication. So they lash out and ultimately continue to have negative relationships

MENTAL HEALTH ISSUES

Children with an absent father grow up without the sense of security a father can provide. A father’s presence and love in a child’s life can provide an understanding of their identity and a sense of belonging.

An absent father can leave a child’s world feeling shattered and unstable. Children with absent fathers suffer from anxiety and depression in much larger numbers than children without mothers and fathers present in a child’s life.

SEXUAL HEALTH and BEHAVIOR

Because children with absent fathers have decreased development in their prefrontal cortex, they can be impulsive. Their ability to deal with the long-term consequences of actions is debilitated. Many engage in sexual activities at young ages that can have dire consequences, including pregnancy.

Girls growing up without a father can develop a developmental attachment to males and see sex as a way to fulfill a male connection

AN EMOTIONALLY ABSENT FATHER  

An emotionally unavailable father has a negative attitude toward his child in many ways. This father often prioritizes material things, other people, and their work over their children. They avoid emotional conversations with their children and do not facilitate a safe place for their children to discuss feelings.

These are toxic father-daughter and son relationships. These fathers usually invade their child’s privacy disregarding their feelings and making decisions for their child without even asking for their input or giving a good reason other than “because I said so and you will do as you are told.”

Information compiled by Peaceful Journeys

EULA’ S FAVORITE QUOTES

God’s promises to the fatherless. He will give justice to the weak and the fatherless, and maintain the right of the afflicted and the needy. He states: “ I will not leave you as an orphan.  I will come to you. A father to the fatherless, a defender of widows, is God in his holy dwelling.

Never live your life in shame because you are the child of an absent father. Always be proud to be you and be bold enough to grow up without a birth father and face the world.

FATHER TO SON                 

Compassionate and mercy are always an option.  The hardest thing you’ll ever do is learn that you can’t always protect your family. But as my son, I know you’ll never give up trying. You can become a true leader if you lead by example. Even if you don’t believe in God, at least send prayers to yourself.

********************************************

EULA’S FAVORITE SCRIPTURE

“Father of the fatherless and protector of widowers is God in his holy habitation” He aims to show orphans mercy, care, and protection. Because these waiting children are essential to him, they should be to his church.  

                                     Psalms 68:5

********************************************

 

The Holy Spirit directed me to provide information in this newsletter for father-son, father-daughter, and fatherless-sons-daughters. As a social worker and mentor, I meet people who need healing in their relationships.

My personal and professional experience allows me to help people achieve their goal of healing in their relationships.

As a bereavement specialist, I have met  people who have not healed. Some parents and children have died with  unresolved issues between themselves and their parents.

Unfortunately, when one doesn’t do the work to heal emotional, physical, and spiritual baggage. The baggage is passed to the next generation.

As a child, I grew up and did not receive the love, care, and support that I wanted and needed from my birth parents.  God had a plan for my life. He gave me my maternal grandmother and great-grandparents, who gave me everything that my birth parents could not give me.

During my childhood years, I wanted to know why my birth parents did not parent me. I talked to their friends and received information that I wanted to know about them. What I learned helped me to understand why they did not have what I needed to love, care and parent me.  I thank them for giving me life. I learned how to forgive them for my emotional and physical pain. I forgave them. 

My maternal great-grandparents taught me that God creates families in different ways. Some are from the womb, and some are from the heart. Throughout my childhood and adulthood, I learned what they told me was true.  I thank God for my emotional, physical, and spiritual healing.

March 01, 2023

By Public Safety and Health Care Initiatives Team

NAMI Blog post

With the many health-related awareness dates throughout the year, it can be easy for information on important topics to get lost in the stream of social posts and catchy phrases. However, we encourage people with mental illness to learn about the effects of diabetes.

When faced with this diagnosis, remember: The prevention and management of diabetes is important, because diabetes and mental health are connected.

What’s The Connection?

Diabetes is a serious health condition that results from uncontrolled levels of sugar in the bloodstream. Type 2 diabetes is the most common form, accounting for 90-95% of diabetes cases. Its major risk factors include being physically inactive, being over 45 years of age, genetic history of diabetes and being overweight.

Research suggests that there are complex links between diabetes and mental health conditions, such as depression, bipolar disorder or schizophrenia — connections that are not fully understood. For example, studies show that people who are diagnosed with depression are 60% more likely to develop diabetes than the general population.

One study found that people with serious mental illness who had never taken psychiatric medication were more likely to have blood sugar levels meeting diagnostic criteria for type 2 diabetes and less likely to be obese compared to the general population. In other words, SMI may be a risk factor for developing type 2 diabetes unrelated to issues with weight. However, more research is needed to better understand this potential relationship.

Additionally, some people experience abnormal blood sugar levels during the onset of schizophrenia and related disorders, even though they don’t yet have diagnosable diabetes. This may, in part, be due to lifestyle choices often related to symptoms, such as a poor diet or physical inactivity, or as a result of medications used in treatment.

Many medications can change the way your body and brain send signals that help manage appetite, energy and cravings for certain foods. These signaling pathways also affect obesity, metabolic, cardiovascular and mental health conditions — and they are influenced by changes in body functions that keep your health balanced. This includes changes in how your body regulates energy, responds to inflammation and how it manages hormones — all of which are also key factors in preventing or managing type 2 diabetes.

None of this means that people who are managing mental illness and other chronic health conditions are unable to improve their health, or that they must simply accept weight gain or type 2 diabetes as an unavoidable outcome. If you’re feeling discouraged, there is hope, and you can do something about it. You have more control over your health than you may realize.

Forge A New Path

How we care for our bodies — everyday behaviors or habits — can reinforce the factors that can either lead to chronic illness and worsening outcomes or a new path to better health. To prevent or manage type 2 diabetes, you can change the risk factors that are within your control with a few simple steps.

Maintain A Healthy Diet

For example, small changes to your diet can have a positive impact. Your stomach and brain work together in very important ways — this is known as the gut-brain axis. Incorporating whole, unprocessed foods such as vegetables, whole grains and lean meats gives you nutrients and energy that are important for efficient functioning of your body, much of which occurs through processes that begin in the gut.

Start small and build on each step. Add an extra vegetable at dinner or swap out potato chips for popcorn as a snack. Choices that contain protein and fiber can help you feel full and reduce cravings. One study even found that people who ate a high protein breakfast had lower blood sugar levels and reduced appetite later in the day.

Start Moving

Physical activity is an important part of improving your physical and mental health. Exercise can help reduce blood pressure, improve sleep, improve cognitive function and lower insulin resistance. Exercise has also been shown to improve symptoms of depression, anxiety, trauma and other mental health conditions, and the multitude of benefits builds as it becomes a regular part of self-care.

If you’re currently inactive, you can get started with stretching, taking a daily walk and finding ways to incorporate other types of physical activity into your life. As you add movement to your daily routine, you may find yourself feeling better, more motivated and even excited to try new activities. Get creative and make it fun.

Prioritize Sleep

Sleep is also key to good health. How long and how well you sleep can affect your health in many ways, influencing inflammation and metabolism, body weight and mood. Promote sleep quality by limiting artificial light exposure before bedtime, minimizing light in your bedroom when you are ready to go to sleep, and maintaining a cool room temperature to help you fall and remain asleep.

Find Peer Support

Peer support can be a great resource for understanding type 2 diabetes and how you can change or improve factors that are within your control. Peer support can help you find additional resources, learn new strategies and feel more confident about your ability to manage diabetes. It also provides social interaction and connection, which is important to overall health. You may even discover a new exercise partner.

Self-Advocate

It’s important to advocate for your health with your physician and other providers. Talk to your doctor about any medications that may have weight gain as a side effect. If you are taking one of these medications, ask about ways to manage this side effect or ask about other medication options.

There is a clear connection between mental and physical health. NAMI leaders and members have always understood the unique challenges of managing a mental health condition, as well as conditions that frequently co-occur, like type 2 diabetes. Everyone should feel empowered to manage their health, reduce risks and improve outcomes. You are not alone — and you can do it.

For more information on how protecting and strengthening physical health has the added benefit of improving mental health, visit NAMI Hearts+Minds. You can also find out more by contacting your local NAMI.

“Just as there are multiple ways to game plan for an opponent, there are many ways to address your weight and different strategies may work for different people” – NFL Alumni Association, Huddle Up: Let’s Talk Obesity.

MARCH 13, 2023

By Sophie Szew

NAMI Blog Post

I was 10 years old when I decided my girlhood was over. Growing up — bullied for my size and isolated due to learning disabilities — my girlhood was one of privilege and a loving family; of itchy, sparkly dresses; obsession over whether my hair part was straight and drinking chocolate milk on the white couch with my little sister (and pinching my stomach afterwards to make sure it hadn’t changed). I loved being a girl but hated girlhood.

So, on that fateful day in 2013 when my iPod-touch screen lit up with Instagram-explore-page-graphics about “how to get abs in two minutes,” I decided I’d begin what I called a “health journey.” I would transform into a body that I wouldn’t associate with my girlhood. I made a promise to myself that I would do every exercise on every graphic that made its way onto social media, even if that meant working out all day. I’d try every diet that promised it would cure my fatness — which I was conditioned to believe was the underlying condition for my “symptoms” of bullying and self-loathing.

I looked in the mirror and decided I was a budding young woman who was finally taking control of her life — a woman who would no longer struggle to gasp for air in this all-consuming wave of sadness and loneliness. The shore of thinness and adulthood was so close that if I sank just a bit deeper, I could feel the sand tickle the soles of my tired feet. But I didn’t take the undertow into account. The more I tried to reach the shore, the harder I was pulled away into the ocean of sadness, loneliness, isolation, confusion and frustration over the fact that I was still deep in a helpless state of girlhood.

10 years and 13 eating-disorder-related hospitalizations later, I now know that I was not alone in that ocean. A recent CDC report highlighted in a PBS NewsHour episode concluded that “girls in the U.S. are engulfed in a growing wave of sadness, violence and trauma.” According to the research, 25% of girls experienced suicidal ideation, 14% experience sexual violence and 22% of queer teens have attempted suicide in the past year.

Folks’ reactions to those numbers, I’ve observed, seem to be something along the lines of “I am saddened but not shocked.” Why, as a nation where gender equality is far too often painted as something that has already been achieved, are we not shocked that girlhood and queer adolescence is riddled with suffering?

Unpacking The Invalidation Of Girls’ Experiences

Looking back at the reactions from adults to my attempts to voice my struggles with mental health and self-esteem, my experience was often dismissed as “a normal part of growing up,” pushing a narrative that went something like “you’re a moody depressed teenage girl. You’re supposed to feel like this.” The normalization of teenage mental health struggles is justified by the cultural narrative of the “moody teenager,” what my Argentinean family calls “abhorrecencia” — which directly translates to “abhoresence,” a wordplay combining the words “abhorrent” and “adolescence.” For many members of my community, mental health issues and real, traumatic experiences are pinned as a “normal part of growing up” or “just a phase” until they become so serious that they require immediate intervention.

For example, when I first came forward to teachers and trusted adults to share my experiences with bullying, I was told I was being dramatic— and that it’s perfectly normal and acceptable for kids to be mean. I was told that if I wanted more friends, I should be less judgmental about their behaviors and stop taking everything so personally. I came to internalize that I was not being bullied (even though I very clearly was) and that if I wanted my problems to go away, I just needed to stop being a “dramatic teen.”

While this cultural narrative of teenhood being an inherently difficult period being (and the root cause of youth mental health struggles and symptoms of trauma) may have been beneficial to validate teens’ emotions as a natural part of life, the report by the CDC is demonstrative of a tragically overlooked side-effect of this framework. Teenagers, especially teenage girls, are facing life-threatening mental health challenges that are being brushed off as simply being “hormonal teens.”

Addressing The Mental Health Impacts

The very real and tragic effects of this are that teenagers who have experienced sexual assault and struggle with depression and suicidal ideation may feel forced into silence because they have had their experiences minimized by this narrative. Or they believe the narrative themselves, thinking that they are supposed to feel overwhelming waves of sadness and that time and that adulthood heals all. I know I certainly belonged to this second category of teenagers, and it took me encounters with multisystem organ failure, a lot of trauma therapy and a whole lot of learning and un-learning to recognize that no, this is not simply “teenage girl hormones.” Because I was so used to hearing the voices of others telling me that I was sad because I was a teenage girl, those voices soon began to transform into my own. Even from my hospital bed, I felt that my disordered behaviors were a normal —and even healthy — reactions the conditions of teenhood, and that I was simply one of the unlucky ones who ended up in life-disrupting treatment because of them.

The statistics in the article are not shocking because we all realize that being a teenager is hard. But now it is time to take that work a step forward and radically reframe how we view the difficulties teenagers face in America today. Adolescent mental health is a public health issue, not a “hormone issue.” And no, society is not going to just “grow out of it.”

Sophie Szew (she/they) is a Los Angeles-born Jewish and Latina mental health activist, writer, and public speaker and an undergraduate student at Stanford University. She was a youth leader at MTV’s Mental Health Youth Action Forum at the White House where she shared her story with President Biden to help guide the administration on how to best serve the needs of youth in the mental health care system. Sophie uses knowledge from her lived experience in the mental health care system to advise organizations on youth mental health, including Lady Gaga’s Born This Way Foundation, Mental Health America, the California Mental Health Consortium and NAMI.