Why the NAMI + Google mashup is not the best

Why our Director Wouldn’t Take Google’s New Depression Test


At the end of August, Google decided to make available directly on its site (through a “knowledge panel”) the ability to take a depression screening quiz. We know a thing or two about online depression screening quizzes, because back in 1996 I put one of the first interactive depression screening quizzes online, long before Google even existed.

Here’s the thing… Depression screening tests — like the PHQ-9 that Google is now offering on its website — are super helpful tools to give a person a little more insight into the possibility of having a serious mental illness. 

What’s NAMI Doing Here?

I guess to make people feel better about taking a quiz that’s been available online for more than a decade, Google partnered with a non-profit that works in the area of mental illness, the National Alliance on Mental Illness (NAMI).

This is no dig on NAMI, but NAMI is not a scientific organization, nor does it have much to do with the PHQ-9. It is an organization that does great, amazing work from a family perspective of mental illness. But why only NAMI specifically? Why didn’t Google reach out to more than just one non-profit in mental illness to contribute to this effort?

There are literally hundreds of non-profits dedicated to ending the stigma of mental illness, and many who have done really great work in the past few years. For instance, Bring Change to Mind has really changed the modern conversation, in my mind, about mental illness. And Mental Health America Chapters and the Mental Illness Policy Org. has also worked very hard in this area of education and helping to reduce the stigma of mental illness. And that’s to name just two out of hundreds.

But only NAMI was chosen to help with Google’s effort, which seems a little unfair to me.

The rise in student mental health problems – ‘I thought my tutor would say: deal with it’

Students starting university face different pressures from earlier generations.
What are the potential troubles and how can young people be prepared?

It was at 3am that film student Nicola Gee finally managed to confess, in an anonymous text to Samaritans, how depressed she had become at university. “By then, I felt isolated and shut off from my friends. I had put myself under a lot of pressure to achieve, and then would get annoyed with myself for feeling low and stressed. I had this constant feeling of being a failure, like nothing I did was ever good enough.”

She started closing herself away in her room for hours to study, and stopped eating regular meals. Her sleeping pattern became disrupted and she struggled to get up in the mornings. Then she’d tell herself it was her fault she wasn’t coping: “Everyone else seemed to be managing, and meeting their deadlines.” That belief put her off from seeking help. “I thought if I went to the doctors and said I was stressed, they’d laugh at me. And if I asked my personal tutor for help, I’d be told: just deal with it, like everyone else.”

Her mother and sisters were going through a difficult time following the breakup of her parents’ marriage, and she felt guilty she wasn’t there. “Getting a first was the only way I could validate my decision to live so far away.”

Gee, who was studying at Leicester University, eventually sought help. “I was lying awake, feeling depressed and alone. I remembered hearing that Samaritans have a 24-hour number you can text.”

Writing her feelings down in a text message proved a relief and within five minutes she had a helpful reply.

Thanks to regular support from Samaritans, she worked up the courage to talk to her tutors and got extensions on her deadlines, and then began running regularly to help release stress.

“I used that time to wind down and have a break from thinking about my degree and my family. I’d come back from a run relaxed and able to sleep.” She graduated with a first and, over the past 18 months, has run 24 races to raise money for Samaritans.

Sadly, many university students like Gee will fail to get the help they need. The Higher Education Statistics Agency recently revealed the number of students who drop out of university with mental health problems has more than trebled since 2009-10, with a record 1,180 university students with mental health problems abandoning their studies in 2014-15, the most recent year for which data was available.

How can those starting university this academic year avoid this? Do today’s students find university more of a struggle than their predecessors and, if so, why?

Dr Fredrik Johansson, a consultant psychiatrist for Camden and Islington NHS Foundation Trust, thinks they do. Around 5% to 10% of his caseload at any one time are university students, studying at, for example, nearby UCL, LSE or the University of the Arts. Their numbers have significantly increased recently, he says.

“Those who would have suffered in silence may now be accessing help. However, I do think the students I see feel under a lot more pressure and they have more extreme reactions to stress. They are less resilient than in the past.” He fears that the students he treats represent “the tip of the iceberg”.

Helicopter parenting and over-monitoring are partly the reason some undergraduates struggle to cope, he thinks – “they haven’t experienced making mistakes by themselves” – but he also blames financial pressures. “They take university more seriously than we did. They are very aware they will owe a lot of money when they graduate and they feel they absolutely have to do well as a result.”

Dr Aleksej Heinze, senior lecturer at the University of Salford Business School, has noticed the vast majority of his students now have a part-time job. “They feel under immense financial pressure.” For some students he sees in his capacity as a personal tutor, this can create what he describes as the perfect storm: having to meet work commitments as assignment deadlines pile up.

“Sometimes these students are tempted to take shortcuts like plagiarism, even though our plagiarism detection rates are very high nowadays. Others will get into strange sleeping and eating patterns because they are working shifts and don’t know how to look after themselves.”

Studying and working has replaced studying and socialising. “As a result, it’s not as easy for students today to make close friendships, and some think their existing relationships on social media are enough for them. That tends to make them less resilient if things do go pear-shaped, because they don’t have a support network at university.” He typically refers at least one student a month for counselling.

Homesickness is another common reason freshers struggle, says Dr Hinnah Rafique, a lecturer in public policy at Oxford University and a director at Generation Medics, which helps young people from all backgrounds access medical and health careers. “Some students are still unprepared for university and, especially if they are the first in their family to do a degree, don’t know what to expect.”

The good news is that university pastoral staff are better trained nowadays, she says, and recognise how overwhelming homesickness can be. “It can rear its ugly head at any time, and it tends to be triggered by really small things that seem completely insignificant to someone from the outside looking in. Students should seek help early.”

Meanwhile, Dr Ewan Jones, director of studies in English at Downing College, Cambridge, has noticed many more freshers struggling to make the transition from school, where they are frequently measured and tested, to a different form of thinking, where they are encouraged to explore ideas and try them out.

Some obsessively compare themselves to their peers, especially on social media. “Our first year students are used to being big fish in small ponds. They can’t all be the smartest kid in the room at Cambridge. Many find that difficult.”

Freshers are routinely asked if they have previously experienced any mental health problems and, over the past 10 years, Jones has observed greater numbers reporting these problems, both before and after they arrive at Cambridge. He believes this may be partly because the support services for students have increased.

“We encourage our students to feel there’s no stigma in speaking out and deliberately give them personal tutors who do not teach the subject they are studying. That way, they don’t have to put on a brave face.”

Last year, just before exams started, the college also offered students meditation sessions and puppies to stroke. “The puppies in particular proved very popular.”

Statement on Trump TransBan

Griffin Ambitions Ltd. condemns in the strongest terms President Trump’s executive memo banning transgender individuals from enlisting in the United States military and denying medically necessary care for transgender individuals already serving. As a mental health organization, we are all too aware of the trauma and pain caused by this kind of discrimination and the disproportionate mental health needs of the LGBTQ community, stemming in part from this discrimination. We stand with all trans service members.   

Personality disorders

The term “Personality Disorder” implies there is something not-quite-right about someone’s personality. However, the term “personality disorder” simply refers to a diagnostic category of psychiatric disorders characterized by a chronic, inflexible, and maladaptive pattern of relating to the world. There are many subset of personalities, all identifiable by their patterns. Personality disorders in particular are subsets that use maladaptive patterns of functioning, causing distress or problems integrating into society. This maladaptive pattern is evident in the way a person thinks, feels, and behaves. The most noticeable and significant feature of these disorders is their negative effect on interpersonal relationships. A person with an untreated personality disorder is rarely able to enjoy sustained, meaningful, and rewarding relationships with others, and any relationships they do form are often fraught with problems and difficulties.

 

To be diagnosed with a “personality disorder” does not mean that someone’s personality is fatally flawed. In fact, these disorders are not that uncommon and are deeply troubling and painful to those who are diagnosed. Studies on the prevalence of personality disorders performed in different countries and amongst different populations suggest that roughly 10% of adults can be diagnosed with a personality disorder (Torgersen, 2005).

 

Many types of disorders are evidenced by a complete and total deviation from normal and healthy functioning (e.g., epilepsy). However, personality disorders cannot be understood independently from healthy personalities.  Since everyone has a personality (but not everyone has epileptic seizures), personality disorders reflect a variant form of normal, healthy personality. Thus, a personality disorder exists as a special case of a normal, healthy personality in much the same way as a square is a special case of the more general construct of a rectangle. Therefore, it is useful for us to begin our discussion of personality disorders by first discussing the broader, more general construct of personality.

Resources:

http://www.mayoclinic.org/diseases-conditions/personality-disorders/home/ovc-20247654

https://medlineplus.gov/personalitydisorders.html

https://www.psychologytoday.com/basics/personality-disorders

https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders

https://www.nami.org/Learn-More/Mental-Health-Conditions/Borderline-Personality-Disorder

Personality Disorders: Crash Course Psychology #34

https://www.mentalhealth.gov/what-to-look-for/personality-disorders/index.html

http://www.nhs.uk/conditions/personality-disorder/Pages/Definition.aspx

Substance Abuse/Addiction

Very generally, substance abuse and addiction occurs when an individual compulsively and uncontrollably seeks out a substance or action despite the consequences associated with it. It is possible to be addicted to anything that activates the pleasure center of the brain. Dopamine is released in the reward pathway and triggers the pleasure response. Normally, this rewards you for doing behaviors that are essential for survival, like eating or socializing. But in addiction, the substance or action overloads the reward pathway with dopamine and the person then attempts to have the same “high” as the first time they experienced it. Addictions can be physical, where the body has adapted to the drug existing in the body and tolerance is developed. Sometimes cues related to the substance, such as walking into a bar, increase the desire for it. Psychological dependence occurs when the search for a high is related to coping with stress or other negative emotions. Someone who is addicted, no matter what the addiction is, will have a number of characteristics associated with the addiction. They do not have control over their substance use. They likely take more of the substance than planned or for a longer period of time than intended. They may make multiple attempts at lowering their intake of the substance or quitting use altogether with no success. Addicts spend much of their time obtaining substances, taking them, and recovering from the effects. They may have physical symptoms of craving and withdrawal. Use typically interferes with family and other role obligations, though the addict will continue to use the substance despite these social or interpersonal conflicts. Addicts may only realize they have a problem when they hit “rock bottom”. Treatment takes into account the individual and the type of addiction itself. Individuals are encouraged to quit with the help of a medical professional. Alcohol, benzodiazepine, and opiate withdrawal can be deadly and should not be quit “cold turkey”. Relapse, even years after successful treatment, is still possible. The structures in the brain and new circuits created from the addiction remain even after use is stopped. Recovery is completely attainable and maintainable with consistent treatment.

Resources:

http://americanaddictioncenters.org/withdrawal-timelines-treatments/dangers/

http://americanaddictioncenters.org/withdrawal-timelines-treatments/

https://www.psychologytoday.com/blog/all-about-addiction/201001/alcohol-benzos-and-opiates-withdrawal-might-kill-you

https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction

https://www.psychologytoday.com/basics/addiction

https://www.nytimes.com/2017/07/15/business/lawyers-addiction-mental-health.html

Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) consists of excessive worry around a variety of situations and functions. Most people are worried about something, but the worry of GAD is extreme and unwarranted by the specific situation. Normal worries may escalate to something beyond the individual’s control. These excessive worries must last most days for the 6 months and be around a variety of activities. There also has to be three or more physical symptoms, such as sleep disturbances, restlessness, and irritability, along with the anxiety. These symptoms cause significant distress and cannot be explained by any substance or other mental illness. GAD affects about 3.1% of Americans. Treatments for GAD involve medication and psychotherapy, usually in tandem. Medications can target the feelings of anxiety as well as the physical symptoms. Psychotherapy works on the behaviors and thinking surrounding the anxiety, developing new habits around the anxiety. This can help in coping with the anxiety and reduce its effect.

 

The nature of GAD is that worry is about anything and everything, and most likely the sufferer knows that it is. But they have no control over what they have anxiety around or how great it is. And sometimes this can prevent the individual from performing tasks, sleeping, and drain all energy. Part of college is to be efficient with time and energy, and anxiety makes it very hard to do that. The college environment in general is stressful, which exacerbates the problem. The majority of those with GAD have other mental illnesses as well, compounding the difficulty. They are more likely to have substance abuse problems. Someone with GAD in college can contact the disabilities office to set up accommodations that may aide in reducing anxiety and fostering success. This may include more time on exams, changes in housing, and more flexibility in course work. Medications and therapy are effective as well as likely essential. When untreated, GAD can lead to many other health problems, so it is important to address it. However, it is completely treatable and success in college is very possible.

Resources:

https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad

http://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/basics/complications/con-20024562

https://www.psychologytoday.com/conditions/generalized-anxiety-disorder

https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad/index.shtml

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

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.