Mental Health 101

How common are mental health issues?

Studies have shown that 1 in 4 individuals globally struggle with a mental health issue at any given time. If you expand that to the course of a lifetime, the number increases to 1 in 2. That means if it’s not you who is struggling, it’s someone you know or love.

Why is it important to talk about stigma?

When discussing mental health, two main types of stigma exist. One type is external stigma, which refers to the attitudes held by society that people with mental health issues are somehow lacking, incapable, incompetent, or not worthy of dignified and equitable treatment. The other type is internal stigma, which is the attitude held by the person with mental health challenges that they are unworthy, unlovable, and unvalued.

Stigma does a lot of harm to our society. For the people struggling with a mental health challenge, they often lack hope in recovery and don’t pursue treatment because they either don’t believe they can get better or fear discrimination from others. For those who don’t struggle but hold positions of power (such as law enforcement, educators, landlords, community leaders, etc.), stigma can lead to discrimination, which is the unfair treatment of those with mental health challenges.

Having honest conversations about stigma and sharing our personal stories of recovery are small steps we each can take to making our society more equitable and inclusive.

Is recovery actually possible?

Absolutely! One of the biggest misperceptions in society is that mental health issues are a life sentence.

Recovery means many things to many people and is personal in nature. For some, recovery is the complete absence of symptoms. For others, recovery means successfully managing symptoms as a normal part of life with no disruption to daily activities. Research has shown that even for those with the most serious mental illnesses, the right treatment can have someone living an independent, fulfilling, and successful life.

Does everyone with a mental health diagnosis need medication? What alternatives to medication exist?

It’s a common thought that the only cure to a mental health diagnosis is medication and if one stops taking his or her pills, it’s all downhill from there. While medication works for some people, it is hardly a cure-all. In fact, some medications can have side effects that are more harmful than the symptoms of the mental health challenge!

Deciding to try medication is a personal decision. The good news is that it is not the only option. Research has shown that other types of therapies can be extremely effective in maintaing a person’s level of wellness, including mindfulness, talk therapy, peer support, physical activity, and visual and performing arts, to name a few.

So, do I have to share my mental health issue with the world?

Not unless you want to! Some people are very open about their mental health issues because they value transparency and/or want to be an example of recovery. Others may not feel comfortable because they fear stigma, or simply don’t want the world knowing their personal business. Some may choose to tell family and close friends, but not coworkers or acquaintances. There is no right or wrong answer. You should do what makes you comfortable. If you want to start dialogue around mental health but aren’t quite sure if you’re ready to share your experiences, you can always frame the conversation around wellness, which applies to everyone, diagnosis or not.

What should I do if someone discloses their challenge to me?

Just listen. Providing a supportive ear is the best thing you can do for someone who chooses to open up. It’s not always easy to share something so personal with another human being, so taking a genuine interest and being free of judgment can go a long way and do a lot of good.

Feeling Anxious?

When most people think about anxiety, they picture the typical nervousness folks experience before taking a test at school, or perhaps speaking in public. Their pulse may quicken a bit, their face may feel a bit flushed, they may have “butterflies in their stomach,” but that is about it. It is a temporary feeling, and is generally considered to be a normal human reaction.

For some people though, anxiety rises to the point where a person’s ability to work or lead a normal life is impacted. According to the Centers for Disease Control and Prevention (CDC), in the U.S. the estimated lifetime prevalence of any anxiety disorder is over 15%, while the 12-month prevalence is more than 10%.

For example, if a child is so anxious about going to school that they regularly cannot get out the door on time, it may be time to see a mental health professional.  If a person avoids socializing with friends because the thought of being around people makes them feel lightheaded and nauseous, this may be cause for concern. Worse, if a person feels these sorts of symptoms WITHOUT a triggering event, then a conversation with a medical professional is may be warranted.

There are a number of anxiety disorders including:  generalized anxiety disorder, specific phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, panic disorder, and selective mutism.

Panic Disorder

Let’s take a closer look at Panic Disorder. This disorder is known for the occurrence of “panic attacks” which is when the body’s “fight or flight” response kicks into overdrive, seemingly for no apparent reason. People who experience this describe feelings of imminent death, being unable to breathe properly, having sweaty palms and/or tingling hands or feet, of feeling pain in their chest and the belief that their racing heart will suddenly stop and they will die. In other words, an abject feeling of terror; again, coming on without warning after no apparent triggering event.

Treatment for Anxiety Disorders

There are common medical treatments for anxiety disorders. Medication, such as simple antidepressants like Lexapro or Prozac can be effective. Sometimes, anticonvulsant medicines (typically taken for epilepsy) and low-dose antipsychotic drugs can be utilized in conjunction with antidepressants. Other medications can include benzodiazepines (such as Klonopin, Xanax, Librium, Valium, etc.), or opioids (OxyContin, Vicodin, codeine, morphine, etc.). Care however must be taken, as these sorts of medications can become addictive.

Other, non-pharmacological interventions can be employed as well and include Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), meditation, mindfulness, breathing exercises, or even yoga. If the person has had a traumatic event in their past which acts as a trigger to their anxiety disorder, there are also therapies which can address and defuse trauma: EFT (Emotional Freedom Technique), EMDR (Eye Movement Desensitization and Reprocessing), art therapy, and even trauma informed yoga. Some folks have even had good results with therapy animals, such as dogs, cats, horses, or even guinea pigs or rabbits. Positive changes in diet and exercise have also proven to be beneficial.

Bottom Line

If you or a loved one is experiencing an anxiety disorder, treatment is readily available.

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.

“Smiley” Depression

Staff Reports—

 

When many people think of depression, they often think of sadness — and not much else. This generalization can be harmful to people who experience depression, but may not “look” depressed. For some, depression may look like sadness or exhaustion. For others, depression might look like a smiling face, or a person who “has it all together” — something we think of as “smiling depression.”

It’s important to remember every person’s experience of depression needs to be taken seriously, no matter what it looks like on the outside.2 We wanted to know things only people with “smiling depression” understand, so we asked members of our mental health community to weigh in.

Here’s what they shared with us:

  1. “It’s easier to cheer people up but not myself. I can make them feel great when they’re going through the worst [times], but I cannot get myself happy, really happy. That happiness you see is just a way of not letting people [see] my problems.” — Sofia V.
  2. “I am so tired. So, so tired, all of the time. It doesn’t matter if I’m sitting and pouting or smiling and engaging. [It doesn’t matter if I’m] dancing, running, swimming, eating, brushing my teeth, by myself or in a room full of people or sleeping. I. Am. Exhausted.” — Rinna M.
“Other people don’t get it. What it’s like to feel so trapped and in darkness, because I appear ‘happy’ and strong — even though [it feels like] I’m slowly dying.”
— Nicole G.
  1. “[I] fake it because [I believe] no one wants to hear about [my] depression. [I] fake it because [I am] tired of hearing all the ‘expert’ advice insinuating that [I’m] just [not] trying hard enough.” — Lisa C.
  2. “[I] don’t always wear the mask for other people. Sometimes [I] wear it because [I] don’t want to believe [I] feel as miserable as [I do]. [For me], it isn’t always about making other people with [me feel] OK. Sometimes it’s wearing the mask so [I] don’t lose [my] job or so [I] can just get takeout without being asked what’s wrong.” — Melinda A.
  3. “I can still laugh and give a big belly laugh about things, but on the inside, I feel empty. It’s a weird feeling being happy as much as you can, but your mind won’t follow suit. [I] just feel empty and the happiness isn’t genuine. It’s fake but [I] can’t change that no matter how hard [I] try for it to be a real feeling. Depression drains everything out of me. It takes an enormous amount of strength to appear ‘normal,’ it exhausts me… [My] smile doesn’t reach [my] eyes.” — Rebecca R.
  4. “The problem lies in the fact that no one truly and honestly knows me. I feel like I’m alone every day — even when I’m surrounded by people.” — Jen W.
  5. “[I] constantly doubt whether [my] struggles are real. When [I] finally get the courage and strength to open up about [my] depression, [I] always hear, ‘But you don’t act like you have depression.’ It took me years to come to terms and believe my own struggles.” — Adrianna R.
  6. “Most days, I feel like I’m just barely surviving. Once I’m alone at the end of the day, all I have the energy for is crying. Crying because I’m just so exhausted with life and I’ll convince myself I can’t handle tomorrow and I need to call in sick. But when the next day actually comes, I’m too afraid to not show up. Eventually, after debating with myself for far longer than I should, I drag myself out of bed. The cycle [feels] never-ending. It’s like, if I choose one day to just stay in bed instead of getting up, it would be the most horrible thing in the world, so I eventually always get up, no matter how exhausted I am. It’s inevitable.” — Keira H.
  7. “I try to keep up appearances to protect my family because my depression upsets them. I’m not very outwardly emotional, so everything gets to me more than I show it. I can’t open up to them, because I just get told, ‘Change your thoughts,’ ‘You seem fine, why do you want to go to a therapist?’ It makes those times when I can’t control my emotions even worse. I feel alone, tired and lost.” — Jessica C.
  8. “Sometimes I really, like really want to show people how I’m really feeling, but I just physically cannot take the mask off. It’s like the walls just grow stronger the more I try to tear them down.” — Kira H.
  9. “[I thought] if I faked being happy enough, then maybe I could get a glimpse of what it’s like to be ‘normal.’ I always feel like such a burden on the people [who] love me. [I feel] I have no choice but to pretend.” — Bree N
  10. “The time I’m most encouraging to myself is when I’m telling myself, I can make them laugh so they never suspect anything! I’m funny, right?” — Shelby S
  11. “The physical pain as well as the emotional pain. It hurts to walk, get up, move, force [myself] to smile, try to look ‘normal,’ happy.” — Keara M.
  12. “[ I believe] we are the best actors in the world. Because if I have to explain depression one more time… it’s just easier to fake it until I get home.” — Lisa K.

 

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text “START” to 741-741.

 

Unique Hurdles to Managing Stress in College

Managing Stress

College requires significantly more effort from students than high school.  Once you enter college, you will probably find that your fellow students are more motivated, your instructors are more demanding, the work is more difficult, and you are expected to be more independent. These higher academic standards and expectations are even more evident in graduate school. As a result of these new demands, it is common for college students to experience greater levels of stress related to academics.

Many students find that they need to develop new skills in order to balance academic demands with a healthy lifestyle.  Fortunately, the University of Michigan offers many resources to help students develop these skills.  Many students find that they can reduce their level of academic stress by improving skills such as time management, stress management, and relaxation.

The Pros and Cons of Stress

Stress is anything that alters your natural balance. When stress is present, your body and your mind must attend to it in order to return you to balance. Your body reacts to stress by releasing hormones that help you cope with the situation.  That in turn takes energy away from the other functions of your brain, like concentrating, or taking action.  There are two different sources of stress: external triggers, like getting a poor grade or breaking up with your girlfriend/boyfriend, and internal triggers, like placing high expectations on yourself.

La Di Da by Asher Roth:
“How are you dealing?”

Watch this music video which shows how six college students deal with stress.
From halfofus.com

Stress is a part of everyday life. There are many instances when stress can be helpful. A fire alarm is intended to cause the stress that alerts you to avoid danger. The stress created by a deadline to finish a paper can motivate you to finish the assignment on time. But when experienced in excess, stress has the opposite effect. It can harm our emotional and physical health, and limit our ability to function at home, in school, and within our relationships. But the good news is that, since we are responsible for bringing about much of our own stress, we can also do much to manage stress by learning and practicing specific stress-reduction strategies.

Click here to learn more about academic stress.  This link will take you to information and helpful tips including a study skills checklist.

Are you experiencing too much stress?

Here are a few common indicators:

  • Difficulty concentrating
  • Increased worrying
  • Trouble completing assignments on time
  • Not going to class
  • Short temper or increased agitation
  • Tension
  • Headaches
  • Tight muscles
  • Changes in eating habits (e.g., “stress eating”)
  • Changes in sleeping habits

People with mental health disorders are more likely to notice that their specific symptoms reemerge or grow worse during stressful times. In many cases, stress can act as the “spark” that ignites a mental health episode. But this does not mean that every time you are busy or face a difficult challenge you will have a mental health episode. Not everyone responds the same way to potentially stressful circumstances. For example, during final exams many students feel very overwhelmed and anxious, while others are able to keep their stress under control. If you are one of the many people who have difficulty managing stress during difficult times, look for some helpful tips below.

Ways of reducing and managing stress

  • A feeling of control and a healthy balance in your schedule is a necessary part of managing stress. Learning how to manage your responsibilities, accomplish your goals and still have time for rest and relaxation requires that you practice time management skills.
  • Try setting a specific goal for yourself that will improve your mood and help you reduce stress. Start by filling out a goal-setting worksheet.
  • Avoid procrastination. Putting off assignments or responsibilities until the last minute can create more mental and physical stress than staying on top of them.  Procrastination can affect many aspects of daily life, such as the quality of your work, the quality of your sleep, and your mood.
  • Exercise regularly. Physical activity can help you burn off the energy generated by stress.
  • Practice good sleep habits to ensure that you are well-rested. Sleep deprivation can cause many physical and mental problems and can increase stress.
  • Try mindfulness meditation.
  • Limit (or eliminate) the use of stimulants like caffeine, which can elevate the stress response in your body.
  • Pace yourself throughout the day, taking regular breaks from work or other structured activities. During breaks from class, studying, or work, spend time walking outdoors, listen to music or just sit quietly, to clear and calm your mind.
  • Start a journal. Many people find journaling to be helpful for managing stress, understanding
    emotions, and making decisions and changes in their lives.
  • Realize that we all have limits. Learn to work within your limits and set realistic expectations for yourself and others.
  • Plan leisure activities to break up your schedule.
  • Recognize the role your own thoughts can play in causing you distress. Challenge beliefs you may hold about yourself and your situation that may not be accurate. For example, do you continuously fall short of what you think you “should” accomplish? When our minds continuously feed us messages about what we “should” achieve, “ought” to be, or “mustn’t” do, we are setting ourselves up to fall short of goals that may be unrealistic, and to experience stress along the way. Learn techniques for replacing unrealistic thoughts with more realistic ones.
  • Find humor in your life. Laughter can be a great tension-reducer.
  • Seek the support of friends and family when you need to “vent” about situations that bring on stressful feelings. But make sure that you don’t focus exclusively on negative experiences; try to also think of at least three things that are going well for you, and share those experiences.
  • Try setting a specific goal for yourself that will improve your mood and help you reduce stress. Start by filling out a goal-setting worksheet then help yourself stay on track.

Mental Health 101

How common are mental health issues?

Studies have shown that 1 in 4 individuals globally struggle with a mental health issue at any given time. If you expand that to the course of a lifetime, the number increases to 1 in 2. That means if it’s not you who is struggling, it’s someone you know or love.

Why is it important to talk about stigma?

When discussing mental health, two main types of stigma exist. One type is external stigma, which refers to the attitudes held by society that people with mental health issues are somehow lacking, incapable, incompetent, or not worthy of dignified and equitable treatment. The other type is internal stigma, which is the attitude held by the person with mental health challenges that they are unworthy, unlovable, and unvalued.

Stigma does a lot of harm to our society. For the people struggling with a mental health challenge, they often lack hope in recovery and don’t pursue treatment because they either don’t believe they can get better or fear discrimination from others. For those who don’t struggle but hold positions of power (such as law enforcement, educators, landlords, community leaders, etc.), stigma can lead to discrimination, which is the unfair treatment of those with mental health challenges.

Having honest conversations about stigma and sharing our personal stories of recovery are small steps we each can take to making our society more equitable and inclusive.

Is recovery actually possible?

Absolutely! One of the biggest misperceptions in society is that mental health issues are a life sentence.

Recovery means many things to many people and is personal in nature. For some, recovery is the complete absence of symptoms. For others, recovery means successfully managing symptoms as a normal part of life with no disruption to daily activities. Research has shown that even for those with the most serious mental illnesses, the right treatment can have someone living an independent, fulfilling, and successful life.

Does everyone with a mental health diagnosis need medication? What alternatives to medication exist?

It’s a common thought that the only cure to a mental health diagnosis is medication and if one stops taking his or her pills, it’s all downhill from there. While medication works for some people, it is hardly a cure-all. In fact, some medications can have side effects that are more harmful than the symptoms of the mental health challenge!

Deciding to try medication is a personal decision. The good news is that it is not the only option. Research has shown that other types of therapies can be extremely effective in maintaing a person’s level of wellness, including mindfulness, talk therapy, peer support, physical activity, and visual and performing arts, to name a few.

So, do I have to share my mental health issue with the world?

Not unless you want to! Some people are very open about their mental health issues because they value transparency and/or want to be an example of recovery. Others may not feel comfortable because they fear stigma, or simply don’t want the world knowing their personal business. Some may choose to tell family and close friends, but not coworkers or acquaintances. There is no right or wrong answer. You should do what makes you comfortable. If you want to start dialogue around mental health but aren’t quite sure if you’re ready to share your experiences, you can always frame the conversation around wellness, which applies to everyone, diagnosis or not.

What should I do if someone discloses their challenge to me?

Just listen. Providing a supportive ear is the best thing you can do for someone who chooses to open up. It’s not always easy to share something so personal with another human being, so taking a genuine interest and being free of judgment can go a long way and do a lot of good.