Obsessive Compulsive Disorder

Obsessive compulsive disorder, or OCD, is characterized by disruptive obsession and compulsions. Obsessions are recurrent and persistent thoughts that are both unwanted and cause distress. The individual attempts to neutralize them by performing an action. Compulsions are repetitive behaviors or mental acts that the individual feels compelled to complete. These acts aim to reduce anxiety and distress, even though they may only be loosely related to the cause of distress or are excessive. The individual may even be aware that the thoughts and actions used to reduce them are unreasonable and unlikely, but they have no power over them. Obsessions and compulsions usually occur together, though only one may be present in some individuals. These obsessions are time consuming or cause significant distress and impairment in several areas of functioning. Obsessions can take up anywhere between 1-3 hours per day in more mild cases, and in more severe  cases consuming most of the day. Symptoms cannot be associated with substance use, medications, or be better explained by another mental illness. About 1.2% of Americans have OCD. Treatment consists of typically a combination of medication and psychotherapy, though medication will not work for all cases. Medications for OCD are most commonly antidepressants in high doses. Psychotherapy focuses on reducing anxiety surrounding obsessions and reducing compulsive behaviors. Eventually, after managing the anxiety, the individual will feel less and less anxiety around the obsessions.

 

Depending on the obsessions and compulsions, OCD can be very disruptive in a lot of different areas. But specific functioning differs between sufferers. Some have problems with relationships because they obsess over losing or hurting loved ones. Some have rituals that make completing school-related tasks difficult or time consuming, such as needing to read each page a certain number of times or anxiety surrounding a task becoming so overwhelming that the task is avoided altogether. Those without OCD have a hard time understanding that these are not made up, that someone with OCD cannot control what they obsess over or what compulsions are needed to reduce anxiety. And because these thoughts can pop up at any time, it is difficult to predict what the student will need to succeed. Many of the more common accommodations are of no use to a student with OCD. Students are encouraged to seek help in managing their symptoms, as this will aide them in the long run for reducing stress. While in college, it may be helpful to contact the disabilities office and set up specific accommodations for what the individual needs to function in college while being treated. Not all accommodations will look the same from one OCD student to the next. This illness is completely manageable, and success in a college environment is very possible.

Resources:

https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

https://iocdf.org/about-ocd/

http://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/dxc-20245951

https://www.collegemagazine.com/feel-crazy-living-ocd/

https://www.hercampus.com/school/chapel-hill/her-story-coping-ocd-college

https://psychcentral.com/lib/ocd-and-college-accommodations/

http://beyondocd.org/information-for-college-students/disability-accommodations

Post-traumatic Stress Disorder

Post-traumatic stress disorder, or PTSD, is characterized by negative symptoms and behaviors surrounding a traumatic event or events. Not all traumatic experiences lead to PTSD, and not all PTSD is chronic. The lifetime prevalence rate is about 8.7%, with 3.5% of Americans dealing with PTSD per year. Exposure to trauma can be direct or indirect, like sexual assault or the death of a loved one. Afterward, a number of symptoms occur: one or more symptoms of intrusion, where the trauma is re-experienced. One or more symptoms of avoidance, where anything related to the trauma is avoided. Two or more symptoms of negative alterations in mood or cognition, where beliefs surrounding the event or self are skewed. Finally, two or more alterations in arousal and reactivity, where the body reacts to stimuli in a different way than before the trauma. These symptoms must last for at least one month, cause clinically significant distress, and are not attributable to any other condition. Treatment consists of medication and psychotherapy. Medication is usually an antidepressant, though there is a medication used for treating sleep problems and nightmares. Cognitive behavioral therapy works to restructure thoughts surrounding the trauma, creating healthier responses to the event and reminders, and dealing with guilt or shame surrounding the event. Unlike some other mental illnesses, it is possible to recover from PTSD completely.

 

PTSD can be overwhelming. For a college student, this can mean a variety of things. Concentration is inhibited, making it difficult to complete assignments or study for exams. Depending on the trauma, certain normal college situations may be triggering to the individual. Students with PTSD can be self-destructive in a number of ways, including not going to class and alcohol or drug abuse. Many people with PTSD also have other mental illnesses, like depression, anxiety, or eating disorders. These problems simply compound the issue. Students with PTSD may need accommodations specific to reducing stress and anxiety, like more time for assignments or exams. Treatment is also essential to this process. Students with PTSD can and do succeed in college, they just need the right support in order to cope with their trauma and reduce its effects on their ability to function.

Resources:

https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

http://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/dxc-20308550

https://www.psychologytoday.com/blog/somatic-psychology/201208/students-ptsd

https://www.mirecc.va.gov/visn19/docs/presentations/Overview_PTSD_College_Setting.pdf

Anorexia [nervosa]

Anorexia nervosa, or simply anorexia, is an eating disorder characterized by an individual restricting their diet because of an intense fear of gaining weight. This fear of gaining weight is usually founded in personal insecurities, and not necessarily a vain attempt to be thin. Anorexic individuals restrict their energy intake, relative to their individual requirements, which leads to significantly low body weight. They will continue to take weight loss measures, such as excessive exercise or laxative use, even though they are at a significantly low weight already. Anorexia also involves a skewed vision of the individual’s body, undue influence of body weight or shape on self-evaluation, or a consistent lack of recognition of seriousness of current low body weight. About 0.3-0.4% of women and 0.1% of men in America have anorexia. Treatment consists primarily of psychotherapy, though medications can be used to treat underlying conditions such as depression. If not treated, anorexia can lead to anemia, heart problems, bone loss, gastrointestinal problems, kidney problems, death, and other issues.

 

Anorexia tends to take over the individual’s life. And stressful life events can trigger disordered eating, so college is no exception. College is used as an excuse. “I didn’t have time to eat.” “I could only grab something small on the go.” Drowning in responsibilities can be an excellent reason not to eat properly or at all. But it can also lead to avoiding going out with friends, especially when social interactions in college frequently surround a meal. If the individual ends up participating in meals with friends, they spend their time counting calories, hiding food, and worrying about weight gain rather than enjoying the experience. Functioning is possible, as this does not directly interfere with the ability to finish assignments, study, or get to class. However, anorexia is not sustainable considering other health problems that develop and thought patterns that are self-destructive. Other mental illnesses may occur along with anorexia, and those also need to be treated in tandem. Psychiatric services and counseling support may be helpful throughout this process. In some cases, taking a semester off to visit a treatment facility can do more for the individual than traditional counseling. It is possible to reach remission and return to normal college life.

Resources:

https://www.nationaleatingdisorders.org/anorexia-nervosa

http://www.mayoclinic.org/diseases-conditions/anorexia/symptoms-causes/dxc-20179513

https://www.psychologytoday.com/conditions/anorexia-nervosa

http://proud2bme.org/content/recovering-eating-disorder-college-survival-guide

http://www.seventeen.com/life/real-girl-stories/a29763/my-struggle-with-an-eating-disorder-forced-me-to-take-a-semester-off-of-college/

https://www.hercampus.com/health/food/her-story-i-recovered-anorexia

Bulimia [nervosa]

Bulimia nervosa, or simply bulimia, is an eating disorder characterized by purging following a binge eating episode. During binge eating, the individual eats more than what an average person would eat in the same amount of time under the same circumstances. They feel a lack of control over eating, often unable to stop once started and may enter into a trance while eating. After eating, they use inappropriate behaviors to compensate for overeating. This may include vomiting, laxative use, diuretic use, excessive exercising, or other ways of purging. Binging and purging cycles happen at least once a week for three months or more. Self-evaluation is unduly influenced by body weight and shape. None of these symptoms occur during periods of anorexia nervosa. About 1.1%-4.6% of females and 0.1%-0.5% of males will have bulimia. Treatment consists primarily of psychotherapy and medications to treat underlying conditions. Psychotherapy aims to interrupt the binge/purge cycle, address negative thought about self and body image, and resolve emotional issues related to the disorder. Bulimia frequently occurs with other mental illnesses, such as depression and alcohol abuse.

 

Bulimia, like anorexia, takes over the individual’s life. Life becomes about staying thin, taking steps to lose weight, and trying to hid how much food you consume. Some people will spend upwards of three hours a day exercising. Health problems related to the eating disorder can get in the way of school work. But generally bulimia doesn’t interfere with the individuals ability to complete school work, study, get to class, or keep appointments. Bulimia is not, however, a sustainable habit. Severe health complications arise, other mental illnesses can develop, and even death can occur. Specifically, bulimia can cause dehydration, kidney failure, heart problems, severe tooth decay and gum disease, digestive problems, alcohol or drug use, and possibly suicide. Balanced living is a large part of the college life, and bulimia disrupts that. Treatment is the best option for restoring balance and recovering. Sometimes campus psychiatry and support services can be enough. Sometimes taking a semester off and going to a recovery facility may be more effective. It depends on the individual, but recovery is always possible.

Resource:

https://www.nationaleatingdisorders.org/bulimia-nervosa

https://www.eatingdisorderhope.com/information/bulimia

http://www.mayoclinic.org/diseases-conditions/bulimia/diagnosis-treatment/treatment/txc-20179842

http://www.mamashealth.com/eat/bulstory.asp

http://www.teenvogue.com/story/eating-disorder-recovery-bulimia

Binge Eating Disorder

Binge eating disorder, or BED, is an eating disorder characterized by binge eating episodes that result in feelings of shame, guilt, or depression. Eating more than someone else in similar circumstances during a specified period of time, as well as feeling a lack of control over food consumption during that time, is considered binge eating. Three or more physical symptoms are also present during this time, such as eating more rapidly than normal or eating when not feeling hungry. The individual has marked distress from their binge eating. Binge eating occurs at least once per week for three months and does not occur during anorexia nervosa or bulimia nervosa. There is also no inappropriate use of compensatory actions for the amount eaten, such as laxative use or inducing vomiting. Prevalence in the United States is about 1.6% of females and 0.8% of males. About 0.2%-3.5% of all females and 0.9%-2.0% of all males will develop BED. Treatment consists of mostly psychotherapy and nutrition counseling. Medications can help to treat underlying conditions that frequently come along with BED. The goal of therapy is to work though issues that lead to eating disorder and develop a better relationship with food consumption.

 

BED, like other eating disorders, affects mostly the social side of college life. Eating in and of itself does not affect academic performance, unless it takes up more than its allotted time per day. However, much of college life revolves around eating. Social outings typically revolve around a shared meal. But someone with BED has severe shame around these situations, and will often avoid them. Or they will binge eat and have guilt around people seeing them that way. College also comes with complete control over what, when, and how much you eat. Late night studying is often fueled by food. Students don’t have time to make food and dining options typically aren’t healthy. Anxiety and stress over school and other obligations can be hard to handle, for anyone. But for those who already have an eating disorder or are already predisposed to it, the stress can fuel the disease. The best course of action is treatment. Throughout treatment, the individual learns to handle food and themselves better, which will help in getting through social situations involving food. Without treatment, BED can lead to many health issues related to obesity. Enjoying college while maintaining academic status is the goal, and is completely possible with an eating disorder.

Resources:

https://www.nationaleatingdisorders.org/binge-eating-disorder

http://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/symptoms-causes/dxc-20182932

http://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/diagnosis-treatment/treatment/txc-20182948

https://www.hercampus.com/health/mental-health/binge-eating-invisible-eating-disorder

Gender Dysphoria

Gender dysphoria stems from a innate feeling of one’s assigned gender or gender characteristics being different from their experience or expressed gender. All babies are assigned a gender when they are born. Typically this is just “male” or “female” and based exclusively on what genitalia can be seen. But gender isn’t necessarily experienced from sex organs, and sometimes sex organs do not develop properly or do not regulate hormones in the way healthy organs do. Society also creates how we look at gender and what we expect from different genders. In these and many other ways, we experience gender. Gender dysphoria happens when the person feels as though their experience of gender (for example: male, female, or non-binary constructs) and their body characteristics do not match up with the typical sex characteristics(for example: penis, vulva, ovaries, testicles) of the gender they experience. Because of this feeling, they also have a strong desire to rid themselves of their primary and/or secondary sex characteristics, be of a different gender, and be treated like another gender. Gender dysphoria creates a strong sense that one has the typical feelings and reactions of the gender that they prefer. All of this produces clinically significant distress and disruption of functioning. Treatment consists of psychotherapy, hormone treatments, sex reassignment surgery, or a combination of those. The course of treatment primarily depends on the individual’s needs, gender identity, and personal identity.

Resources:

https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria

https://www.psychologytoday.com/conditions/gender-dysphoria

12 Ways to Be a White Ally to Black People

Michael Brown, an African-American teenager, was shot six times and killed by Darren Wilson, a white police officer, during a stop for jaywalking in Ferguson, Mo. Some facts are uncontroverted: Brown was unarmed when he was shot about 35 feet away from Wilson, who didn’t know that Brown was a suspect in an alleged shoplifting incident that occurred a short time before the shooting. Other facts are disputed: Some people claim that Brown attacked Wilson, and others claim that Brown was running away from Wilson with his hands in the air. Either way, another young black man is dead because of use of excessive force by the police in a situation that did not justify shooting to kill.

Most of us have watched as Ferguson’s black community rose up in outrage against the almost all-white police department, demanding justice and accountability. Our disbelief and heartache turned to collective anger and fear as the response to the protests became more militarized, with the deployment of police dogs, riot gear, tear gas and rubber bullets. And we’ve started speaking out in opposition to these developments, all of which have the hallmarks of being rooted in systemic, institutionalized racism.

Yet some people, especially some white people, have not yet become engaged. Perhaps they don’t know what to say or how to say it or are concerned about backlash from other white people. This is understandable but not acceptable when the continuation of white silence and inaction means the oppression and death of black people.

So let’s talk about an active role for white people in the fight against racism, because racism burdens all of us and is destroying our communities. White people have a role in undoing racism because white people created and, for the most part, currently maintain (whether they want to or not) the racist system that benefits white people to the detriment of people of color.

White people who hate racism should work hard to become white allies. Here are some ways for a white person to become engaged, thoughtfully and critically, in examining the crisis in Ferguson and systemic racism in America.


1. Learn about the racialized history of Ferguson and how it reflects the racialized history of America. Brown’s killing is not an anomaly or a statistical outlier. It is the direct product of deadly tensions born from decades of housing discrimination, white flight, intergenerational poverty and racial profiling.

2. Reject the “He was a good kid” or “He was a criminal” narrative and lift up the “Black lives matter” narrative. Those who knew him say Brown was a good kid. But that’s not why his death is tragic. His death isn’t tragic because he was on his way to college the following week. His death is tragic because he was a human being and his life mattered. The good-kid narrative might provoke some sympathy, but what it really does is support the lie that as a rule black people, black men in particular, have a norm of violence or criminal behavior. The good-kid narrative says that this kid didn’t deserve to die because his goodness was an exception to the rule. This is wrong. This kid didn’t deserve to die, period. Similarly, reject the “He was a criminal” narrative surrounding the convenience store robbery because even if Brown did steal some cigars and have a scuffle with the shopkeeper, that is still not a justification for his killing. All black lives matter, not just the ones we deem to be “good.”

3. Use words that speak the truth about the disempowerment, oppression, disinvestment and racism that are rampant in our communities. Be mindful, and politically and socially aware with your language. Notice how the mainstream news outlets are using words like “riot” and “looting” to describe the uprising in Ferguson. What’s happening is not a riot. The people are protesting with a righteous anger. This is a justified rebellion.

4. Understand the modern forms of race oppression and slavery and how they are intertwined with policing, the courts and the prison-industrial complex.Black people aren’t enslaved on the plantation anymore. Now African Americans are locked up in for-profit prisons at disproportionate rates and for longer sentences for the same crimes committed by white people. And when we’re released we’re second-class citizens, stripped of voting rights in some states and denied access to housing, employment and education. Mass incarceration is the new Jim Crow.

5. Examine the interplay between poverty and racial equity. The twin pillar of racism is economic injustice, but don’t use class issues to trump race issues and avoid the racism conversation. Although racism and class oppression are tangled together in this country, the fact remains that the No. 1 predictor of prosperity and access to opportunity is race.

6. Diversify your media. Be intentional about looking for and paying close attention to diverse voices of color on television, on radio, online and in print to help shape your awareness, understanding and thinking about political, economic and social issues.

7. Adhere to the philosophy of nonviolence as you resist racism and oppression. Martin Luther King Jr. advocated for nonviolent conflict reconciliation as the primary strategy of the civil rights movement and the charge of his “final marching orders.” East Point Peace Academy offers online resources and in-person training on nonviolence that is accessible to all people, regardless of ability to pay.

8. Find support from fellow white allies. Challenge and encourage one another to dig deeper, even when it hurts and especially when you feel confused, angry and hopeless, so that you can be more authentic in your shared journey with people of color to protect principles of anti-racism and equity. Go to workshops like Training for Change’s Whites Confronting Racism or the People’s Institute’s European Dissent. Attend the White Privilege Conference or the Facing Raceconference. Some organizations offer scholarships or reduced fees to help people attend.

9. If you are a person of faith, look to your Scriptures or other holy texts for guidance. Seek out faith-based organizations like Sojourners, and follow faith leaders who incorporate social justice into their ministry. Ask your clergyperson to address anti-racism in sermons and teachings. If you are not a person of faith, learn how the world’s religions view social-justice issues so that when you have an opportunity to invite people of faith to also become white allies, you can talk with them meaningfully about why being a white ally is supported by their spiritual beliefs.

10. Don’t be afraid to be unpopular. If you start calling out all the racism you witness (and it will be a lot, once you know what you’re seeing), some people might not want to hang out with you as much. But think about it like this: Staying silent when you witness oppression is the same as supporting oppression. So you can be the popular person who stands with oppression, or you can be the (maybe) unpopular person who stands for equality and dignity for all people. Which person would you prefer to be?

11. Be proactive in your own community. As a white ally, you are not limited to reacting only when black people are subjected to violence very visibly and publicly. Moments of crisis do not need to be the catalyst. Taking action against systemic racism is always appropriate because systemic racism permeates this country. Some ideas for action: Organize a community conversation about the state of police-community relations in your neighborhood; support leaders of color by donating your time or money to their campaigns or causes; ask the local library to host a showing of, and discussion group about, the documentary Race—the Power of an Illusionattend workshops to learn how to transform conflict into opportunity for dialogue. Gather together white allies who represent the diversity of backgrounds in your community. Anti-racism is not a liberals-only cause. Anti-racism is a movement for all people, whether they are conservative, progressive, rich, poor, urban or rural.

12. Don’t give up. We’re 400 years into this racist system, and it’s going to take decades—centuries, probably—to dismantle. The anti-racism movement is a struggle for generations, not simply the hot-button issue of the moment. Transformation of a broken system doesn’t happen quickly or easily. You may not see or feel the positive impact of your white allyship during the next month, the next year, the next decade or even your lifetime. But don’t ever stop. Being a white ally matters because you will be part of what turns the tide someday. Change starts with the individual.

People of color cannot and should not shoulder the burden for dismantling the racist, white-supremacist system that devalues and criminalizes black life without the all-in support, blood, sweat and tears of white people. If you are not already a white ally, now is the time to become one.

Editor’s note: A version of this article was previously published at What Matters.

101 Fantastic Ideas for Students when Feeling College is TOO MUCH

I think that, for most of us, there are times in life when it all just feels like Too Much. Can you say #SelfCare?

There may be some days, weeks, months, maybe even years when — for whatever reason — just getting through the day or going to work or putting one foot in front of the other feels hard. Really, really hard.


Maybe it’s because you’re wrestling with anxiety, depression, or some other mental illness.

Maybe it’s because you’ve had your heart broken. Maybe you’ve gone through a physical or emotional trauma. Maybe you’re deeply grieving. Or maybe there’s no easily understood reason for why you’re feeling bad.

Whatever the case, I want you to know that it’s OK if you’re going through a tough time.

This doesn’t make you any less lovable, worthy, or capable. This just means you’re human. Being a human can be a messy, hard, confusing, painful experience sometimes.

So if you or someone you love is going through one of these tough times right now, a time where it all just feels like too much, I want to offer up 101 suggestions for self-care to help you or your loved one get through this time.

Photo via iStock.

1. Have a good, long, body-shaking cry.

2. Call a trusted friend or family member and talk it out.

3. Call in sick. Take comp time if you can. Take a mental health day.

4. Say no to extra obligations, chores, or anything that pulls on your precious self-care time.

5. Book a session (or more!) with your therapist.

6. Dial down your expectations of yourself at this time. When you’re going through life’s tough times, I invite you to soften your expectations of yourself and others.

7. Tuck yourself into bed early with a good book and clean sheets.

8. Watch a comforting/silly/funny/lighthearted TV show or movie. (“Parks and Recreation,” anyone?)

9. Reread your favorite picture and chapter books from childhood.

10. Ask for some love and tenderness from your friends on social media. Let them comment on your post and remind you that you’re loved.

11. Look at some some really gorgeous pieces of art.

12. Watch YouTube videos of Ellen DeGeneres and the adorable kids she has on her show.

13. Look at faith-in-humanity-restoring lists from around the internet.

14. Ask for help. From whomever you need it — your boss, your doctor, your partner, your therapist, your mom. Let people know you need some help.

15. Wrap yourself up in a cozy fleece blanket and sip a cup of hot tea.

16. Breathe. Deeply. Slowly. Four counts in. Six counts out.

17. Hydrate. Have you had enough water today?

18. Eat. Have you eaten something healthy and nourishing today?

19. Sleep. Have you slept seven to nine hours? Is it time for some rest?

20. Shower. Then dry your hair and put on clothes that make you feel good.

21. Go outside and be in the sunshine.

22. Move your body gently in ways that feel good. Maybe aim for 30 minutes. Or 10 minutes if 30 feels like too much.

23. Read a story (or stories) of people who overcame adversity or maybe dealt with mental illness, too. (I personally admire J.K. Rowling’s story.)

24. Go to a 12-step meeting. Or any group meeting where support is offered. Check out church listings, hospital listings, or school listings, for example.

25. If you suspect something may be physiologically off with you, go see your doctor and/or psychiatrist and talk to them. Medication might help you at this time, and professionals can assist you in assessing this.

26. Take a long, hot bath. Light a candle and pamper yourself.

27. Read inspirational quotes.

28. Cuddle someone or something. Your partner. A pillow. Your friend’s dog.

29. Read previous emails, postcards, letters, etc. from friends and family reminding you of happier times.

30. Knit. Sculpt. Bake. Engage your hands.

31. Exhaust yourself physically — running, yoga, swimming, whatever helps you feel fatigued.

32. Write it out. Go free-form in a journal or on a computer. Get it all out and vent.

33. Create a plan if you’re feeling overwhelmed. List out what you need to do next to tackle and address whatever you’re facing. Chunk it down into manageable and understandable pieces.

34. Remind yourself you only have to get through the next five minutes. Then the next five. And so on.

35. Take five minutes to meditate.

36. Write out a list of 25 reasons you’ll be OK.

37. Write out a list of 25 examples of things you’ve overcome or accomplished.

38. Write out a list of 25 reasons you’re a good, lovable person.

39. Write out a list of 25 things that make your life beautiful.

40. Sniff some scents that bring you joy or remind you of happier times.

41. Ask for support from friends and family via text if voice-to-voice contact feels like too much. Ask them to check in with you via text daily or weekly, whatever you need.

42. Lay down on the ground. Let the Earth or floor hold you. You don’t have to hold it all on your own.

43. Clean up a corner of a room of your house. Sometimes tidying up can help calm our minds.

44. Ask yourself: What’s my next most immediate priority? Do that that. Then ask the question again.

45. Read some poetry. RumiHafiz, and Mary Oliver are all excellent.

46. Take a tech break. Delete or deactivate social media if it feels too triggering right now.

47. Or maybe get on tech. If you’ve been isolating, maybe interacting with friends and family online might feel good.

48. Go out in public and be around others. You don’t have to engage, but maybe sit in a coffee shop or on a bench at a museum and soak up the humanity around you.

49. Or if you’re feeling too saturated with contact, go home. Cancel plans and tend to the introverted parts of yourself.

50. Ask friends and family to remind you that things will be OK and that what you’re feeling is temporary.

51. Put up some Christmas lights in your bedroom. They often make things more magical.

52. Spend a little money and treat yourself to some self-care and comfort. Maybe take a taxi versus the bus. Buy your lunch instead of forcing yourself to pack it. Buy some flowers that delight you.

53. Make art. Scribble with crayons. Splash some watercolors. Paint a rock. Whatever. Just create something.

54. Go wander around outside in your neighborhood and take a look at all the lovely houses and the way people decorate their gardens. Delight in the diversity of design.

55. Go visit or volunteer at your local animal rescue. Pet some animals.

56. Look at photos of people you love. Set them as the wallpaper of your phone or laptop.

57. Create and listen to a playlist of songs that remind you of happier times.

58. Read some spiritual literature.

59. Scream, pound pillows, tear up paper, shake your body to move the energy out.

60. Eat your favorite, most comforting foods.

61. Watch old “Mister Rogers’ Neighborhood” videos online.

62. Turn off the lights, sit down, stare into space, and do absolutely nothing.

63. Pick one or two things that feel like progress and do them. Make your bed. Put away the dishes. Return an email.

64. Go to a church or spiritual community service. Sit among others and absorb any guidance or grace that feels good to you.

65. Allow yourself to fantasize about what you’re hoping or longing for. There are clues and energy in your reveries and daydreams that are worth paying attention to.

66. Watch autonomous sensory meridian response videos to help you calm down and fall asleep at night.

67. Listen to monks chantingsinging Tibetan bowls, or nature sounds to help soothe you.

68. Color in some coloring books.

69. Revisit an old hobby. Even if it feels a little forced, try your hand at things you used to enjoy and see what comes up for you.

70. Go to the ocean. Soak up the negative ions.

71. Go to the mountains. Absorb the strength and security of them.

72. Go to the forest. Drink in the shelter, life, and sacredness of the trees.

73. Put down the personal help books and pick up some good old-fashioned fiction.

74. Remember: Your only job right now is to put one foot in front of the other.

75. Allow and feel and express your feelings — all of them! — safely and appropriately. Seek out help if you need support in this.

76. Listen to sad songs or watch sad movies if you need a good cry. (“Steel Magnolias,” anyone?)

77. Dance around wildly to your favorite, most cheesy songs from your high school years.

78. Put your hands in dirt. If you have a garden, go garden. If you have some indoor plants, tend to them. If you don’t have plants or a garden, go outside. Go to a local nursery and touch and smell all the gorgeous plants.

79. If you want to stay in bed all day watching Netflix, do it. Indulge.

80. Watch or listen to some comedy shows or goofy podcasts.

81. Look up examples of people who have gone through and made it through what you’re currently facing. Seek out models of inspiration.

82. Get expert help with whatever you need. Whether that’s through therapy, psychiatry, a lawyer, clergy, or something else, let those trained to support you do it.

83. Educate yourself about what you’re going through. Learn about what you’re facing, what you can expect to feel, and how you can support yourself in this place.

84. Establish a routine and stick to it. Routines can bring so much comfort and grounding in times of life that feel chaotic or out of control.

85. Do some hardcore nesting and make your home or bedroom as cozy and beautiful and comforting as possible.

86. Get up early and watch a sunrise.

87. Go outside, set up a chair, and watch the sunset.

88. Make your own list of self-soothing activities that engage all five of your senses.

89. Develop a supportive morning ritual for yourself.

90. Develop a relaxing evening ritual for yourself.

91. Join a support group for people who are going through what you’re going through. Check out the listings at local hospitals, libraries, churches, and universities to see what’s out there.

92. Volunteer at a local shelter or hospital or nursing home. Practice being of service to others who may also be going through a tough time.

93. Accompany a friend or family member to something. Even if it’s just keeping them company while they run errands, sometimes this kind of contact can feel like good self-care.

94. Take your dog for a walk. Or borrow a friend’s dog and take them for a walk.


This kangaroo dog loves walks.

95. Challenge your negative thinking.

96. Practice grounding, relaxation techniques.

97. Do something spontaneous. Walk or drive a different way to work. Order something new off the menu. Listen to a playlist of new songs.

98. Work with your doctor, naturopath, or nutritionist to develop a physical exercise plan and food plan that will be supportive to whatever you’re facing right now.

99. Pray. Meditate. Write a letter to God, the universe, the Source, your higher self — whatever you believe in.

100. As much as you can, try and trust the process.

101. Finally, remember, what you’re going through right now is temporary. It may not feel like that from inside the tough time you’re in, but this too shall pass and you will feel different again someday. If you can’t have faith in that, let me hold the hope for you.

This list is really just a starting point meant to catalyze your own thinking about how you can best take care of yourself during life’s tough times and to spark your curiosity and interest in strengthening your self-care now and ongoing.

It’s not meant to be prescriptive nor do I mean to imply you need to do all or any of these things to take good care of yourself. You are the expert of your own experience, and I trust that you know what’s best for you.

Also, my hope is that in reading this, you’re hearing me say how normal and natural it is to struggle and to have these tough, hard times. It’s part of being human.

You’re not alone in this.

The suggestions and ideas mentioned herein— in no way are a substitute for care or advice from a licensed mental health care clinician, doctor, or other accredited professional. These are self-care coaching suggestions, not therapeutic advice. Moreover, if you feel suicidal or find yourself having suicidal ideations, call the 24/7 National Suicide Prevention Lifeline at 800-273-8255.

Racism’s Emotional Toll on Student Minds

Our screens and feeds are filled with news and images of black Americans dying or being brutalized. A brief and yet still-too-long list: Trayvon MartinTamir RiceWalter ScottEric GarnerRenisha McBride. The image of a white police officer straddling a black teenager on a lawn in McKinney, Tex., had barely faded before we were forced to grapple with the racially motivated shooting in Charleston, S.C.

I’ve had numerous conversations with friends and colleagues who are stressed out by the recent string of events; our anxiety and fear is palpable. A few days ago, a friend sent a text message that read, “I’m honestly terrified this will happen to us or someone we know.” Twitter and Facebook are teeming with anguish, and within my own social network (which admittedly consists largely of writers, academics and activists), I’ve seen several ad hoc databases of clinics and counselors crop up to help those struggling to cope. Instagram and Twitter have become a means to circulate information about yoga, meditation and holistic treatment services for African-Americans worn down by the barrage of reports about black deaths and police brutality, and I’ve been invited to several small gatherings dedicated to discussing these events. A handful of friends recently took off for Morocco for a few months with the explicit goal of escaping the psychic weight of life in America.

It was against this backdrop that I first encountered the research of Monnica Williams, a psychologist, professor and the director of the University of Louisville’s Center for Mental Health Disparities. Several years ago, Williams treated a “high-functioning patient, with two master’s degrees and a job at a company that anyone would recognize.” The woman, who was African-American, had been devastated by racial harassment by a director within her company. Williams recalls being stunned by how drastically her patient’s condition deteriorated as a result of the treatment. “She completely withdrew and was suffering from extreme emotional anxiety,” she told me. “And that’s what made me say, ‘Wow, we have to focus on this.’ ”

In a 2013 Psychology Today article, Williams wrote that “much research has been conducted on the social, economic and political effects of racism, but little research recognizes the psychological effects of racism on people of color.” Williams now studies the link between racism and post-traumatic stress disorder, which is known as race-based traumatic stress injury, or the emotional distress a person may feel after encountering racial harassment or hostility. Although much of Williams’s work focuses on individuals who have been directly targeted by racial discrimination or aggression, she says race-based stress reactions can be triggered by events that are experienced vicariously, or externally, through a third party — like social media or national news events. She argues that racism should be included as a cause of PTSD in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (D.S.M.).

Williams is in the process of opening a clinical program that will exclusively treat race-based stress and trauma, in a predominantly black neighborhood in Louisville. Shortly after the Charleston shooting, I called Williams to discuss her work; what follows is a lightly edited and condensed transcript of our conversation.

What is race-based stress and trauma?

It’s a natural byproduct of the types of experiences that minorities have to deal with on a regular basis. I would argue that it is pathological, which means it is a disorder that we can assess and treat. To me, that means these are symptoms that are a diagnosable disorder that require a clinical intervention. It goes largely unrecognized in most people, and that’s based on my experience as a clinician.

What are the symptoms?

Depression, intrusion (the inability to get the thoughts about what happened out of one’s mind), vigilance (an inability to sleep, out of fear of danger), anger, loss of appetite, apathy and avoidance symptoms and emotional numbing. My training and study has been on post-traumatic stress disorder for a long time, and the two look very much alike.

Over the weekend, I received several distressing emails and texts from friends who were suffering from feelings of anxiety and depression. Do you think we should all be in treatment?

I think everyone could benefit from psychotherapy, but I think just talking to someone and processing the feelings can be very effective. It doesn’t have to be with a therapist; it could be with a pastor, family, friends and people who understand it and aren’t going to make it worse by telling you to stop complaining.

What do you think about the #selfcare hashtags on social media and the role of “Black Twitter” as resources for people who may not have the resources they need to help process this? Are online interactions like that more meaningful than they initially might seem?

Online communities such as VitalStudentMinds.com — can be a great source of support, of course — with the caveat that even just one hater can be stressful for everyone, and that’s the danger of it. But if you don’t have a friend or a family member, just find someone who is sensitive and understanding and can deal with racial issues.

In our initial email about the ripple effects of the murders in Charleston, you used the phrase “vicarious trauma.” What does that mean?

Because the African-American community has such a long history of pervasive discrimination, something that impacts someone many miles away can sometimes impact all of us. That’s what I mean by vicarious traumatization.

Is racial trauma widely recognized as a legitimate disorder?

The trauma of events like this is not formally recognized in the D.S.M. It talks about different types of trauma and stress-related ailments, but it doesn’t say that race trauma can be a factor or a trigger for these problems. Psychiatrists, unless they’ve had some training or personal experience with this, are not going to know to look for it and aren’t going to understand it when they see it. In order for it to be recognized, we have to get a good body of scientific research, a lot of publications in reputable peer-reviewed journals. Right now, there’s only been a few. And we need to produce more.

On your blog, you chronicled the experience of a woman who encounters a therapist who dismisses her fears about racism. Is one barrier to treatment getting the medical community to acknowledge that racism exists?

Yes. A lot of people in the medical community live very privileged lives, so racism isn’t a reality to them. When someone comes in and talks to them, it might sound like a fairy tale, rather than a real daily struggle that people are dealing with. Research shows that African-Americans, for example, are optimistic when they start therapy, but within a few sessions feel less optimistic and have high early dropout rates. It could be that clinicians don’t know how to address their problems, or they may even be saying things that are subtly racist that may drive their clients away. If the patient feels misunderstood or even insulted by the therapist and they don’t go back and get help, they end up suffering for years or even the rest of their lives for something that is very treatable.

Is there a recommended model for treatment?

We have great treatments that are empirically supported for trauma, but the racial piece hasn’t really been studied very well. That’s no easy task, because when we write these articles, they go to journals, where an editor looks at it and decides if it’s worthy and applicable to go in the journal. And then it goes to reviewers who decide if it’s a worthy and applicable topic.

Why has it taken so long to get momentum?

If you think about it, they weren’t even letting black people get Ph.D.s 30 years ago in a lot of places. Ethnic minority researchers are the ones who are carrying the torch, by and large. We’re only to the place now where we have enough researchers to do the work. And there’s so much work that needs to be done.

Checkout our handout for more information on coping with trauma. 

Poetry Addressing Racism and Black American Identity

Here’s some poetry that could also be healing for students addressing racism and Black American Identity:

 

1. A Litany for Survival” by Audre Lorde

So it is better to speakrememberingwe were never meant to survive

Amazon

 

 

So it is better to speak

remembering

we were never meant to survive

2. The Last Quatrain of the Ballad of Emmett Till” by Gwendolyn Brooks

after the murder,

after the burial

Emmett’s mother is a pretty-faced thing;

the tint of pulled taffy.

3. Cordon Negro” by Essex Hemphill

I’m dying twice as fast

as any other American

between eighteen and thirty-five

This disturbs me,

but I try not to show it in public.

4. Where Do You Enter” by Nikki Giovanni

We begin a poemwith longingand end withresponsibilityAnd laugh all through the stormsthat are boundto come

Pictorial Parade / Getty Images

 

We begin a poem

with longing

and end with

responsibility

And laugh

all through the storms

that are bound

to come

5. Lineage” by Margaret Walker

My grandmothers are full of memories

Smelling of soap and onions and wet clay

With veins rolling roughly over quick hands

They have many clean words to say.

My grandmothers were strong.

Why am I not as they?

6. The Night Rains Hot Tar” by Lance Jeffers

The night rains hot tar into my throat,

the taste is good to my heart’s tongue,

into my heart the night pours down its moon

like a yellow molten residue of dung:

the night pours down the sea into my throat

my heart drains off its blood in love and pain:

the night pours a Negro song into my throat,

bloodred is the color of this rain:

7. Bullet Points” by Jericho Brown

I will not shoot myselfIn the head, and I will not shoot myselfIn the back, and I will not hang myselfWith a trashbag, and if I do,I promise you, I will not do it In a police car while handcuffed

Amazon / Via amazon.com

 

 

I will not shoot myself

In the head, and I will not shoot myself

In the back, and I will not hang myself

With a trashbag, and if I do,

I promise you, I will not do it

In a police car while handcuffed

8. ” A Small Needful Fact” by Ross Gay

Is that Eric Garner worked

for some time for the Parks and Rec.

Horticultural Department, which means,

perhaps, that with his very large hands,

perhaps, in all likelihood,

he put gently into the earth

some plants which, most likely,

some of them, in all likelihood,

continue to grow,

9. Black Lady Lazarus” by Diamond Sharp

Dying is an art and we Black girls do it so well.

Sandra &

Aiyana &

Rekia &

10. If It Is The Summer Of 2009” by Hanif Abdurraqib

…we revel in long enough to forget

that we are black in our 20’s which is to say that we are too old

for this shit

and by this shit I of course mean living

I of course mean that we have carried the lifeless bodies of enough younger brothers to never forget that we should be dead by now

we should have the decency to unburden America

by our dying on the side of a cracked road

11. praise song” by Nate Marshall

praise the Hennessy, the brown shine, the dull burn. praise the dare, the take it, the no face you’re supposed to make.praise the house, its many rooms,hardwood and butter leather couches;its richness. praise the rich, their friendship.praise the friends: the child of the well off,the child of the well off, the child of  well,the child of welfare, the child of welfare.

Amazon / Via amazon.com

 

praise the Hennessy, the brown

shine, the dull burn. praise

the dare, the take it, the no face

you’re supposed to make.

praise the house, its many rooms,

hardwood and butter leather couches;

its richness. praise the rich, their friendship.

praise the friends: the child of the well off,

the child of the well off, the child of  well,

the child of welfare, the child of welfare.

12. What They Did Yesterday Afternoon” by Warsan Shire

later that night

i held an atlas in my lap

ran my fingers across the whole world

and whispered

where does it hurt?

it answered

everywhere

everywhere

everywhere.

13. Self-Portrait In Case of Disappearance” by Safia Elhillo

girls with fathers gone or gone missing

sistered to dark boys marked to die & our own

bodies scarved & arranged in rows on prayer mats

we go missing too & who mourns us who

falls into the gap we leave in the world

14. Elegy” by Aracelis Girmay

What to do with this knowledge
that our living is not guaranteed?

Perhaps one day you touch the young branch

of something beautiful. & it grows & grows

despite your birthdays & the death certificate,

& it one day shades the heads of something beautiful

or makes itself useful to the nest. Walk out

of your house, then, believing in this.

Nothing else matters.

15. Gravity” by Angel Nafis

After Carrie Mae Weems’s ‘The Kitchen Table Series’

I. THE STRAW

Can you throw this away Maybe you should hire more Black staff
Where are you really from You’re not busy are you You look ethnic today
Where’s the African American section Can you turn the music down
Fasterfasterfaster Let me see those eyes Beautiful If you were mine
I’d never let you leave the house It’s like you went straight to Africa
to get this one Is that your hair I mean your real hair Blackass
Your gums are black You Black You stink You need a perm
I don’t mean to be
racist

16. Let Me Handle My Business, Damn” by Morgan Parker

Took me awhile to learn the good words

make the rain on my window grown

and sexy now I’m in the tub holding down

that on-sale Bordeaux pretending

to be well adjusted I am on that real

jazz shit sometimes I run the streets

sometimes they run me I’m the body

of the queen of my hood filled up

with bad wine bad drugs mu shu pork

sick beats what more can I say to you

17. Summer, Somewhere” by Danez Smith

no need for geographynow that we’re safe everywhere.point to whatever you please& call it church, home, or sweet love.paradise is a world where everythingis a sanctuary & nothing is a gun.

Courtesy of danezsmithpoet.com / Via danezsmithpoet.com

 

no need for geography

now that we’re safe everywhere.

point to whatever you please

& call it church, home, or sweet love.

paradise is a world where everything

is a sanctuary & nothing is a gun.