It’s difficult to watch your child experience emotional pain. It’s even more difficult to see physical signs of their pain. Cutting is the act of purposely cutting yourself with a sharp object, such as a knife or razor blade. It’s an unhealthy way to relieve emotional pain, sadness, intense frustration, and anger.

Cutting commonly occurs on the arms, legs, or torso. These are places that can be hidden by clothing. Cutting affects men and women of all ages. It usually starts in the teenage years and is more common in girls. Except in rare cases, cutting is not a sign that your child has thoughts of suicide. If you are concerned your child is cutting, learn the warning signs and speak with your child’s doctor.

Path to improved emotional well being

Even though cutting causes physical pain, people cut because they believe it brings them emotional relief. It may be in response to problems at home, school, or in other areas of their life. If your child is cutting, they may not be able to cope with their feelings. These can include loneliness, confused sexuality, deep anger, rejection, guilt, self-hatred, or panic.

Cutting is a clear sign of your child’s emotional distress. However, it usually catches most parents by surprise. Teenagers cleverly cover up their cuts. Unless you know what to look for, it may go undetected for a long period of time. Warning signs that your child is cutting include:

• Multiple, fresh cuts across the skin, and usually clustered together in the same area
• Scarring and bruising
• Having sharp objects nearby for no apparent reason
• Wearing long sleeves and pants at odd times, such as when it’s hot outside
• Making excuses about the reason for the cuts you see

Additionally, your child may be experiencing problems with a relationship. They may be making statements about poor self-worth or hopelessness. Your child may be questioning their identity and reason for living. They could be showing signs of behavioral issues, such as impulsivity and unpredictability.

If you suspect or see evidence of your child’s cutting, do not yell or criticize your child. Offer your support, express your concern, and tell them that you will do what it takes to help them with whatever is causing the urge for cutting. Speak with your child’s doctor. Your doctor will want to see your child and can provide you with referrals for treatment with a mental health professional.

Counseling or psychotherapy is commonly used to treat unhealthy coping methods, such as cutting. Counseling can take the form of one-on-one sessions with your child, family sessions, or a combination of the two. There are many different types of psychotherapy treatments, including:

• Cognitive behavioral therapy (CBT), which identifies and replaces unhealthy behaviors and beliefs.
• Dialectical behavior therapy (DBT), which teaches skills to handle, manage, or balance your emotions and improve relationships.
• Psychodynamic therapy, which helps you identify past experiences that may be at the root of your emotional stress.
• Mindfulness-based therapy, which teaches you how to live in the moment with appropriate thoughts and actions.

Your child’s therapy will depend on their emotional health and the seriousness of their cutting. Counseling and psychotherapy are not one-time treatments. It generally takes time, maybe even years, to uncover the reason for your child’s cutting and teach healthy strategies for coping.

Beyond emotional treatment, your doctor may need to treat the physical effects of cutting to reduce infection, permanent scarring, or severe (or potentially fatal) injury. Additionally, your doctor can help determine if there is an underlying medical condition (such as anxiety or depression) that may benefit from medications.

Things to consider

Continue to pay attention to your child’s friends. Research shows that people who cut spend time with friends who cut. Drug and alcohol use also increase your child’s risk of cutting. While thoughts of suicide aren’t common with cutting, your child could accidentally cut deep enough or cut an artery that could result in death if not treated immediately.

Questions to ask your doctor

• What is the best way to raise the issue of cutting with my child?
• If I confront my child about cutting, will this make them want to cut more and hide it more?
• How do I know if what I see is an accident or true cutting behavior?
• Is this behavior an inherited mental health condition?
• Should I talk to my child’s doctor before bringing them to the office?
• What if I’m wrong? Will I put the idea in my child’s head?

Resources

Centers for Disease Control and Prevention: Self-Directed Violence

National Institutes of Health, MedlinePlus: Self-Harm

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It’s important to take care of both your mind and body. It will pay off in many ways, including:

• Allowing you to take charge of your life and feel good about the choices you make
• Gaining energy and feeling more fit
• Improving your physical health
• Gaining a positive outlook and finding more enjoyment in your life
• Being a role model for your family and friends

Any lifestyle change is a “work in progress.” Lasting changes take time. So, begin by setting small goals that are easy to add to your daily life and that you control. Wellness and fitness involve being aware and making healthy choices about diet, exercise, and staying positive. This is the most important investment you can make in your life. Strive for the best health you can have in all areas of your life by making mindful, healthy choices.

Path to improved health

Caring for your physical health through proper diet and nutrition

Whether meal preparation is for yourself or your family, focus on making smart, healthy meals. Tips for success include:

• Have more home-cooked meals. This can help encourage healthy eating. Also, it promotes more family time.
• Let your kids help plan menus. Kids love to help make meals and snacks.
• Keep healthy snacks on hand to help kids make good choices. Have more fresh fruits, vegetables, and whole grains. Have fewer chips and sweets in the house.
• Teach kids to eat when they’re hungry, not when they’re bored, sad, or angry. Respect their ability to know when they feel full. Don’t push them to “finish everything on your plate.”
• Eat breakfast. It helps jump start the day, and provides fuel for an active lifestyle and gives you and your child the energy to think faster and more clearly.
• Play “Put the Fork Down” at meals. Put your forks down between bites and take turns sharing your day.
• Strive for balance. Balance what you eat to meet your need for nutrition and enjoyment.
• Seek variety. Enjoy all foods from important food groups (fruits, vegetables, lean sources of protein, low-fat dairy, and whole grains).
• Everything in moderation. Focus on feeling comfortable instead of being too full after you eat. Use moderation when choosing less nutritious foods.
• Use a smaller plate. The portion will look bigger on a smaller plate. This can trick your brain into thinking that you are eating a regular-size portion.

A food and activity journal can help you understand your eating patterns. Also, it can help you find ways to make simple, healthy changes. Ask your family doctor about how to get started.

When unhealthy food choices lead to weight gain, some people turn to popular diets to achieve quick weight loss. Diets usually tell you what you should or should not eat. Instead, focus on understanding why you eat in the first place. Are you eating because you are hungry, bored, sad, or angry? Is there something else causing your urge to eat?

Also, don’t restrict your foods. Try to balance between good and bad choices. Make good choices more often and limit the bad foods to small portions once in a while. For lasting dietary changes, there are some simple keys to eating healthy. Start by asking yourself if you are hungry. Hunger signals your body when it needs to be nourished. Let hunger tell you when you need to eat and how much to eat. Many people don’t drink enough water and the brain can mistake thirst for hunger. So if you feel hungry, it can be a good idea to drink an 8 ounce glass of water first to see if you are really just thirsty.

True hunger signals:

• Hunger pangs, gnawing, growling, or rumbling in your stomach
• Weakness or loss of energy
• Slight headache or trouble concentrating
• Irritability

False hunger signals:

• Thirst
• Cravings
• Emotions
• External cues (like mealtimes or social events)

Learn to listen to your hunger signals so you can determine when to eat and how much food is right for you. Make mindful decisions about eating by paying attention to how you feel. And don’t use diet “rules” to restrict what, when, and how much you eat. Instead, learn to trust your body to tell you when it needs food. If you are truly hungry, ask yourself what it is that you want, what your body needs, what you have available (so you can make a healthy choice), and how much food you need.

Caring for your physical health through exercise

Being active also is important to a healthy lifestyle. And it’s important in preventing serious problems like heart disease and diabetes. However, before you increase your activity level, talk to your doctor. Your weight is affected by the energy you take in (what you eat and drink) and the energy you use (physical activity). Every step counts. Studies have shown that every step you take helps you manage your weight and improve your overall health. You may want to track your steps with a step counter (pedometer) or an activity tracker. This can encourage you to increase your daily activity. The more steps you take per day, the better. One goal is to aim for at least 10,000 steps per day, and you should be trying to get in at least 150 minutes of exercise each week. Other tips for achieving an active lifestyle include:

• Limit screen time (TV, computer and video games). Suggest or consider other options like reading, board games, puzzles, and playing outside.
• Enjoy the outdoors. Go to the park, ride bikes, swim, or enjoy a walk around the neighborhood.
• Participate in (or encourage your children to participate) in sports. This is a great way to build coordination, skills, and confidence.
• Plant a garden.
• Wash your car.
• Walk to the mailbox.
• Walk over to a neighbor’s house to visit.
• Turn off the TV. Turn on some music and dance.
• Walk or bike to work, school, or in the community.
• Stretch at your desk.
• Take the stairs instead of the elevator or escalator.
• Use lunchtimes to take a walk.
• Get up and move around your office.
• Take “active” vacations.
• Go hiking or biking.
• Park farther away.

Caring for your physical health through a positive attitude

Staying positive and motivated can help you live a healthy life. Also, it makes it easier to make healthy food decisions and to stay active. Tips for staying positive include:

• Choose to do something you enjoy. Many people prefer walking. You can walk outdoors, at home on a treadmill, alone, or with friends and family.
• Make it fun. Listen to music or audio books while you walk or jog. Watch TV or a video while you exercise.
• Keep it interesting. Try different activities like tennis, swimming, dancing, biking, team sports, or yoga.
• Write it down. Schedule time to be active just as you would for any other important appointment.
• Give yourself credit. Set short-term goals and plan rewards for yourself all along the way.
• Be flexible. Life will sometimes get in the way of your plans. Stay flexible and get back on track right away.
• Spend time with friends who try to be more active and positive.
• Get away from the office, school, or everyday life with day trips, mini vacations, or full vacations.
• Read an inspirational book.
• Helping others can improve your emotional outlook.

If you are a parent, help your family develop good emotional health. Parents are the most important role models. As parents, you set examples by being active, eating healthy, and living a balanced lifestyle. The following family tips can help:

• Commit to making healthy choices and involve your kids. Ask them what your family can do to make healthy changes in your lives.
• Take time out to have fun and connect with each other. Playtime for all ages is part of a healthy life.
• Have a positive attitude. Show your kids how great it feels to lead a healthy lifestyle.

Things to consider

Don’t let stress get you down. We all feel stressed at times. How you react to stress will determine its effect on you. Take steps to prevent stress when you can and manage it when you can’t.If the stress is chronic, consider talking with a mental health professional.

Take care of you. It is important to be mindful of the choices you make for your personal health and wellbeing. Nothing is more important than taking care of you. Set aside time every day for yourself. Be active, enjoy hobbies, and share time with your family and friends.

Additionally:

• Strive for balance in both your personal and work life.
• Make time for important relationships in your life.
• Ask for help whenever you need support from others.
• Find ways to relieve stress, like physical activity and relaxation techniques.
• Be open-minded to try something new, like a hobby or activity.
• Don’t let special events and holidays sabotage your healthy lifestyle. Remember to get back on track with a healthy diet if you splurge at Christmas or a wedding. Use the hotel gym if you travel. And enjoy the opportunity to meet new people when you can.

Questions to ask your doctor

• Is there an easy way to get back on track with diet after a holiday or vacation?
• Making healthy food choices when you travel internationally is difficult. Do you have tips?
• Can I reverse chronic diseases (such as diabetes) by committing to a healthy lifestyle?
• What if lifestyle changes don’t improve my mood and emotional wellness?

Resources

National Institutes of Health, MedlinePlus: Healthy Living

U.S. Department of Agriculture: My Plate

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Emotional health is an important part of your overall health. People who are emotionally healthy are in control of their thoughts, feelings, and behaviors. They’re able to cope with life’s challenges. They can keep problems in perspective and bounce back from setbacks. They feel good about themselves and have good relationships.

Being emotionally healthy doesn’t mean you’re happy all the time. It means you’re aware of your emotions. You can deal with them, whether they’re positive or negative. Emotionally healthy people still feel stress, anger, and sadness, but they know how to manage their negative feelings. They can tell when a problem is more than they can handle on their own. They also know when to seek help from their doctor.

Research shows that emotional health is a skill. There are steps you can take to improve your emotional health.

Path to improved health

Emotional health allows you to work productively and cope with the stresses of everyday life. It can help you realize your full potential. It also helps you communicate with other people and contribute to society.

Your emotional health affects your physical health. Research shows a link between an upbeat mental state and physical signs of good health. These include lower blood pressure, reduced risk of heart disease, and a healthier weight.

There are many ways to improve or maintain good emotional health:

• Be aware of your emotions and reactions. Notice what in your life makes you sad, frustrated, or angry. Try to address or change those things.
• Express your feelings in appropriate ways. Let people close to you know when something is bothering you. Keeping feelings of sadness or anger inside adds to stress. It can cause problems in your relationships at home, work, or school.
• Think before you act. Give yourself time to think and be calm before you say or do something you might regret.
• Manage stress. Learn methods to cope with stress. These could include deep breathing, meditation, and exercise.
• Strive for balance. Find a healthy balance between work and play, and between activity and rest. Make time for things you enjoy. Focus on positive things in your life.
• Take care of your physical health. Exercise regularly, eat healthy meals, and get enough sleep. Don’t abuse drugs or alcohol. Try to keep your physical health from affecting your emotional health.
• Connect with others. Make a lunch date, join a new group, or say hi to strangers. We need positive connections with other people.
• Find purpose and meaning. Figure out what’s important to you in life, and focus on that. This could be your work, your family or friends, volunteering, caregiving, or something else. Spend time doing what feels meaningful to you.
• Stay positive. Focus on the good things in your life. Forgive yourself for making mistakes and forgive others. Spend time with healthy, positive people.

Things to consider

People who have good emotional health can still have problems. Mental illness often has an emotional and physical cause. There could be a chemical imbalance in your brain. Stress and problems with family, work, or school can trigger mental illness or make it worse.

Counseling, support groups, and medicines can help people who have emotional problems or mental illness. If you have an ongoing emotional problem, talk to your doctor right away. They can help you find the right type of treatment.

Questions for your doctor

• What steps should I take to improve my emotional health?
• Are there medicines that could help me cope better?
• Should I see a therapist or counselor?
• How does my physical health affect my emotional health?
• What stress management techniques would work best for me?

Resources

National Institutes of Health: Emotional Wellness Toolkit

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Testosterone is a sex hormone that your body makes. Normally, men produce more of it than women do. Some men may have low amounts of testosterone. This is known as hypogonadism. Your hormone level decreases as you get older. Certain medicines and health conditions may affect it as well, including:

• Cancer treatment, such as chemotherapy
• Testicular cancer
• Injury to your testicles
• Hypothyroidism (low thyroid levels)
• Problems with your nervous system
• Obesity
• Diabetes

Path to improved health

Low testosterone can affect your physical and mental behavior. Talk to your doctor if you have symptoms, such as:

• Low sex drive
• Low sperm count
• Infertility
• Erectile dysfunction
• Changes in mood
• Depression
• Muscle or bone loss
• Decreased strength
• Weight gain
• Hair loss
• Trouble sleeping
• Trouble focusing

These can also be caused by other health issues. Your doctor will likely perform a physical exam and review your lifestyle to determine the problem. In addition, they may run a blood test to check your levels. Men usually have between 300 and 1,000 nanograms (ng) of testosterone per deciliter (dL). If your test results show a low level, you may need to increase the hormone. This can be done naturally.

Testosterone replacement therapy (TRT) is most common. This involves using man-made hormones. There are several forms that your doctor can prescribe. They include gel, a patch, or an injection. TRT is not an option for men who have certain health issues, including prostate or breast cancer. TRT also may not help men who have low testosterone due to advanced age.

TRT often is done in combination with other lifestyle changes. These changes promote overall good health. If you are obese, you should lose weight. You can do this by eating better and getting more exercise. Aim to get 7 to 8 hours of sleep each night. Try to control your stress levels. This allows your body to focus its energy on testosterone production.

Men low in testosterone should eat foods with zinc and vitamin D. These can help balance your hormones and produce more testosterone. Adult men should get about 11 milligrams of zinc per day. Zinc is in meat, poultry, seafood, and shellfish. Beans, nuts, and whole grains are also good sources. These foods, plus dairy, also contain vitamin D. Adult men should get about 600 international units (IUs) of vitamin D per day. You also should eat less sugar and saturated fat.

Things to consider

Your doctor may want to perform other tests to find the cause of low testosterone. This will help them decide if you need other treatment, as well.

There are benefits and risks to TRT. The goal of therapy is to get rid of symptoms of low testosterone. The treatment has been known to improve men’s sexual drive and mood. However, studies show that it may increase your risk of plaque buildup and heart disease. Talk to your doctor more about specific concerns. Make sure they know if you are at risk of any other health conditions.

Questions to ask your doctor

• Will I always have low testosterone?
• How long does TRT last?
• Should I take a supplement to increase my testosterone?

Resources

Endocrine Society: Hypogonadism in Men

National Institutes of Health, MedlinePlus: Could You Have Low Testosterone?

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Any sexual activity with a child (by an adult or another child) is sexual abuse. It causes physical and emotional pain. It has long-term effects on the child. And it is a crime. Recognizing childhood sexual abuse isn’t easy. Children are often afraid and embarrassed to tell someone. Many times, the abuser is someone the child knows and trusts. This could be a family member or someone living in the child’s home. It also can be a stranger.

Path to improved health

You do not need to be overly suspicious of sexual abuse. The risk of childhood sexual abuse is low. A stable family home lowers a child’s risk of sexual abuse. However, parents should always keep a watchful eye on any form of childhood abuse. These physical and behavioral signs should raise concern:

• Your child tells you they have been touched inappropriately or sexually.
• Your child is behaving sexually inappropriately around others (this includes touching others inappropriately).
• Your child uses sexually inappropriate language.
• Your child’s knowledge of sex seems to be more than it should be at their age.
• Your child seems withdrawn and doesn’t want to be hugged by some or all of their family members, family friends, teacher, or a particular person.
• Your child is suffering from depression or anxiety.
• Your child has harmed themself.
• Your child is making comments about their low self-worth.
• Your (young) child has blood in their underwear.
• Your (young) child is complaining of pain in their genital area.
• Your child has injuries in their genital area, such as bruising, bleeding, or swelling. The injuries might cause your child pain when walking or sitting.
• Your child shows signs of infection in their urinary or genital area. This would include frequent burning, itching, or discharge.
• Your child becomes pregnant.
• Your child has new academic changes (falling grades, missing assignments, repeated absences).
• Your young child is regressing, such as wetting the bed or thumb sucking.
• Your child is acting overly concerned for a sibling.
• Your child has changes in hygiene, such as refusing to take a bath (in younger children). Older children may shower more (to cleanse themselves of what they perceive as shame and embarrassment).
• Your child is suddenly receiving gifts or money from a person in authority (a teacher, coach, etc.).

If you know your child has been sexually abused, report it to the police. Take your child to the doctor for an exam. Ask your child’s doctor for the name of a counselor or psychologist. Talk to your local police about tracking sex offenders in your neighborhood or city.

Things to consider

Certain situations put children at a higher risk of sexual abuse. Your child may also be at higher risk if they:

• Live in a home where the parents are divorced and/or living with stepparents
• Live in a home without either parent (in foster care)
• Live in a rural or low-income area
• Have been a victim of another type of abuse, such as physical or emotional
• Spend long periods of time alone with people in authority (teachers, clergymen, coaches, babysitters, etc.)

Girls and children with intellectual disabilities face a higher risk. Remember, childhood sexual abuse can occur between a male and female, as well as in same-sex situations.

Questions to ask your doctor

• What other things could explain injuries to my child’s genitals?
• How young can a girl become pregnant?
• What are the signs of sexually transmitted diseases or infections in boys and girls?
• What is the treatment for sexually transmitted disease?
• Can my child eventually overcome the emotional pain of childhood sexual abuse?
• What physical or behavioral signs should I look for if I suspect my child is the one sexually abusing a child?
• How do I raise a concern with my child about possible sexual abuse?

Resources

National Institutes of Health, MedlinePlus: Sexual Abuse in Children – What to Know

Rape, Abuse & Incest National Network: Child Sexual Abuse

The U.S. Department of Justice National Sex Offender Public Website: How to Identify

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Caring for a loved one who is chronically ill can be challenging. Many family caregivers also work outside the home. If you do, you might feel overwhelmed by the difficulty of balancing all your responsibilities. You’re not alone.

Path to improved health

If you are having trouble balancing work with caregiving, there are some things you can do. Here are some tips to help you ease the burden.

Research employer policies and programs

Talk with your human resources department and look through your employee manual. Determine whether your company has policies in place or benefits available to help you manage your roles. Examples may include:

• The Family and Medical Leave Act (FMLA) – gives eligible employees 12 weeks per year of unpaid leave. They can use this to care for an ill family member. Taking this leave would not impact your health insurance coverage or job security.
• Employee assistance programs – help employees deal with problems that might affect their work. Often, these programs include short-term counseling and referrals to services in the community.
• Flex time – allows you to work a flexible work schedule. If your company offers flex time, your employee handbook should define it. Usually, there is a core period of time when you must be at work. You then create your schedule around these hours. For example, you may choose to work from 10 a.m. to 6 p.m., or from 7 a.m. to 3 p.m.
• Telecommuting – allows you to work from another location, such as your home or your loved one’s home.
• Job sharing – when two people work part-time to share a job normally held by one person full-time.

Talk to your supervisor

Think about your company’s policies and what changes would help you better manage your responsibilities. Draft a proposal, then schedule a meeting with your supervisor to talk it over. Be honest about your situation and open to any ideas your supervisor may have. Be sure to communicate how the changes you’ve proposed will benefit your employer.

Be an activist

Your company or supervisor might not be able to accommodate your requests. Try not to be upset. Instead, set an example. Work with human resources to help your company’s leaders understand caregivers’ needs. Keep the channels of communication open and try again after some time has passed.

Things to consider

Some people have done everything they can to balance work with caregiving, but they still need help. If this is your experience, here are some resources that can help:

• Referral services – Many local, county, or state governments have agencies on aging. They can help you locate programs and services in your area. The U.S. Administration on Aging offers information on area agencies and other services. This can be found through its online Eldercare Locator tool.
• Adult day care – These centers offer social and therapeutic activities in a safe environment. They often provide meals, personal care, medical care, and even transportation.
• In-home care – This can be an informal arrangement with a friend, neighbor, or volunteer. It can also be a formal arrangement with a private aide or a home care agency.

Questions to ask your doctor

• What can I do to keep from getting overwhelmed when trying to balance work with caregiving?
• What signs should I look for that I’m doing too much?
• Can you fill out FMLA paperwork for me to give to my employer?
• Can you refer me to an agency on aging so I can find more help caring for my loved one?

Resources

U.S. Administration on Aging: Eldercare Locator
U.S. Department of Labor: Family and Medical Leave Act

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Professional therapy and counseling can improve your mental wellness. This therapy can help people who are experiencing emotional or behavioral problems. Also, it can help people who have a mental health disorder. Therapy is sometimes called psychotherapy or talk therapy. Many times, therapy is used in combination with prescription medicine to treat a mental health disorder. Therapy will usually improve the results you get from the medicine.

There are different types of mental health providers. Professionals trained in psychotherapy include those representing the following types:

• Psychiatry
• Clinical psychology
• Mental health counseling
• Clinical social work
• Marriage and family therapy
• Rehabilitation counseling
• Psychoanalysis

Fee structures and access to prescriptions is different for each. For example, a psychiatrist has a medical degree and is allowed to write prescriptions. A counselor does not have a medical degree and is not allowed to write a prescription. Your doctor can suggest a professional that is right for you.

Some people do not want professional therapy or counseling. They feel ashamed of their problems. Others believe therapy and counseling are for seriously mentally ill or “crazy” people. However, this is not true. Don’t let shame and fear stop you from getting the help you need. Good mental health is part of your overall health and wellness.

Path to improved health

Different types of therapy use different techniques. In most types of therapy and counseling, the person receiving treatment talks with a professional therapist. However, therapy is more than just talking about your problems. Therapy can teach you new ways to think about the situations that bother you. It can help you cope with feelings and situations. It can help with feelings of anger, fear, anxiety, shyness, and panic. It also can give you tools to help fight low self-esteem and depression.

Therapy can help treat a variety of problems. Some common reasons people seek therapy include:

• Depression
• Marriage problems, infidelity, divorce, or other relationship issues
• Sexual problems
• Stress and anxiety
• Addictions and compulsions
• Grief, loss, or bereavement
• Anger
• Career choice
• Parenting or family problems
• Phobias
• Insomnia
• Fertility issues
• Chronic pain or illness
• Domestic violence or abuse
• Eating disorders

If you are not sure if therapy and counseling are right for you, talk to your family doctor. Your doctor can refer you to a trained professional who can help with your problems.

If you choose therapy or counseling, you’ll talk about any problems you’ve been having and how you’ve been feeling. You’ll also talk about your goals for therapy. You and your doctor will decide how frequently you will meet. Your doctor, therapist, or counselor will help you decide what’s right for you.

Things to consider

Different kinds of therapy and counseling are based on different ideas about how the brain works. Also, it considers what causes people to act in certain ways. Many therapists use more than one type of technique to help you. Common kinds of therapy include:

• Family counseling. This helps family members understand problems within the family and how to resolve them.
• Cognitive therapy. This is sometimes called cognitive behavior therapy. It’s based on the idea that your thoughts cause your feelings and actions. If you change the way you think about something, you can feel or behave better even if the situation doesn’t change. This kind of therapy helps you understand negative or false thought patterns. Negative thought patterns cause troubling feelings and behavior.
• Behavior therapy. Sometimes called behavior modification therapy, this treatment focuses on changing unwanted or unhealthy behaviors. You replace them with healthy ones. This treatment involves using a system of rewards and reinforcement of positive behavior.
• Psychoanalytic therapy. This type of treatment encourages you to think and talk about memories and feelings from the past. These memories will help you understand how you act and feel today.
• Group therapy. Group therapy is led by a qualified professional. He or she facilitates a small group of people who have similar issues or problems. Groups can improve honesty with others. Members support each other during times of crisis.
• Couples therapy or marriage counseling. This treatment can help couples solve problems together, communicate in healthier ways, and learn to work out differences.

Questions to ask your doctor

• What if my partner or child is resistant to therapy?
• How do I find a therapist that’s right for me?
• Can my child’s therapist tell me what they talked about?
• Will my therapist recommend prescription medicine?
• What if I don’t like my therapist? Can I change?

Resources

National Alliance on Mental Illness: Types of Mental Health Professionals

National Institute of Mental Health: Psychotherapies

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Mental illness is a common health problem and nothing to be embarrassed about. It happens because of a change in your brain. It includes a range of conditions, such as depression, anxiety, and bipolar disorder. Mental illness affects people’s thoughts, feelings, and behavior. Most often, people have and show early signs of illness. Learn what these signs are so you or someone you know can get help.

Path to improved health

Warning signs of mental illness vary by person and problem. Below are some of the most common signs. Talk to your doctor if more than one of these occur. Also note if they happen suddenly.

• Changes in mood. Your feelings may alter over time or all of a sudden. In addition, they can shift back and forth. For instance, you may feel happy or excited one day or in a certain situation. Then, you may feel sad or upset the next day or in a new situation.
• Changes in sleep.You may be sleeping too much and feel like you can’t get out of bed. Or you may feel like you don’t need to sleep much at all.
• Fear or uneasiness. You may start to feel afraid, anxious, nervous, or panicked.
• Decreased performance. Your work suffers. You may find it harder to complete things that once were easy or enjoyable. If you’re in school, you may notice your grades begin to drop.
• Lack of interest. There are several things that can cause you to lose interest in certain things or people. This can lead to broad or complete withdrawal.
• Altered senses. Your basic senses—sound, smell, touch, or sight—may become more or less sensitive.
• Lifestyle changes. You may sleep longer than usual or have a hard time sleeping. You also could develop an eating disorder, where you eat more, less, or not at all.
• Troubled mind. It’s possible to have clouded thinking that makes it hard to focus, remember, or process things.
• Changes in behavior. Your actions may alter in ways that are abnormal for you.
• Loss of control. Over time, you may lose the ability to manage stress, tasks, or life’s demands.
• Out of touch with reality. Mental illness can cause you to become detached from your surroundings. You may feel lost, distant, or numb. You may have hallucinations or nightmares. You may forget how to relate to others or show care or concern.

Other possible warning signs include:

• Alcohol or drug abuse
• Sexual abuse
• Feelings, thoughts, or actions of anger or violence
• Unexplained physical symptoms, such as stomach pain and headaches

Things to consider

It’s important to know the signs of mental illness because it affects so many people. You or someone you know may have a problem at some point in your life. If you know the warning signs, you can detect them early. The sooner you see a doctor and get diagnosed, the sooner you can begin treatment.

Don’t ignore these warning signs. It can make mental illness worse and cause harm to others. When you learn about mental illness, share information with others, and talk about your story, you help stop the stigma.

When to see your doctor

Contact your doctor if you have multiple warning signs. They will do an exam and discuss your state of health. Only a doctor can diagnose mental illness. If someone you know displays these signs, talk to them about your concerns. Suggest that they visit a doctor to find out what’s going on.

Seek help right away if you have thoughts of murder or suicide. Call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). As of 2022, you can also dial 988 for the Suicide and Crisis Lifeline.

Questions to ask your doctor

• How can I tell if I have a mental illness?
• How can I tell if someone I know has a mental illness?
• Are there other warning signs I should look for?
• What are the best resources to use if I want to learn more about mental illness?

Resources

American Academy of Family Physicians, Mental Health Myths

Mental Health America: Mental Illness and the Family: Recognizing Warning Signs and How to Cope

U.S. Department of Health & Human Services, mentalhealth.gov: What to Look For

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If you have depression, your doctor may prescribe medicine to treat it. This medicine is called an antidepressant. There are many types of antidepressants. Finding the one that’s right for you can take time. It’s important to work with your doctor to find it.

Path to improved health

Your doctor will consider many factors when choosing the antidepressant medicine to give you:

• If you were depressed before and a certain antidepressant worked well, that medicine might be the right choice for you again.
• If any of your brothers, sisters, parents, uncles, or aunts had depression and a certain antidepressant worked well for them, that medicine might work for you, too.
• The choice of an antidepressant depends on your health. Certain antidepressants may have a bad effect on a health problem you have. That medicine wouldn’t be the right choice for you.
• Antidepressants can have side effects. The right medicine for you may be the one that gives you the fewest side effects.
• The choice of an antidepressant may depend on how often you must take it. It is important to take antidepressants as prescribed and daily medications may make this easier.
• Some antidepressants cost more than others. Your doctor will choose an antidepressant that works for you and your budget.
• Your doctor will likely choose a medicine they have experience prescribing.
• Some antidepressant can help you with sleeplessness, anxiety, and lack of energy if these are part of your symptoms.
• If you’re taking other medicines, your doctor will consider how an antidepressant will work with these other medicines.
• Some antidepressants don’t work well with certain foods. If your doctor gives you one of these antidepressants, they will let you know which foods you should stop eating.

Keep in mind that antidepressant medicines are not “downers”  or “uppers.” You will not get  high when you take them. They are not addictive.

You’ll know if your antidepressant is working based on how you feel. You’ll be able to sleep better. You’ll have more energy to meet your day-to-day obligations. You can take care of yourself. Your appetite will be closer to normal. You’ll have an increased desire to engage in life. You and your family and friends will notice these changes. Be patient, though. It may take some time to get back to the way you felt before the depression.

While antidepressants can help with symptoms of depression, that’s only part of the treatment. These medicines work best when you try to have an active lifestyle with exercise, get eight hours of sleep a night, and eat healthy foods. Your doctor may also recommend working with a counselor to help you improve the thoughts of depression.

How to take antidepressants

Antidepressants are usually taken every day. It can take 1 or even 2 months to see the full results. You may need to try different doses or change medications to find the antidepressant that works best for you.

Your doctor will let you know how long to take your antidepressant. If this is the first time you have been treated for depression, you will probably continue to take this medicine for at least 6 months after you begin to feel better. If this is the second time you’ve been depressed, you might keep taking the medicine for at least a year. Depression that comes back a third time may require you to continue taking an antidepressant for a longer time.

Do not stop taking antidepressants suddenly.  You can get unwanted side effects if you stop taking your antidepressant suddenly. If you want to stop taking your medicine, talk to your doctor first. They can try to help you avoid these side effects.

Alcohol and antidepressants

Talk to your doctor about drinking alcohol while taking an antidepressant. You should be careful about drinking until you know how the medicine affects you. The effects of alcohol can combine with the effects of the antidepressant and cause problems. Regular heavy drinking can make it harder to treat depression. Certain kinds of medicine can lead to seizures for heavy drinkers.

Antidepressants and other medicines

Antidepressants can effect many other medicines. If you’re taking an antidepressant, tell your doctor about all other medicines you take, including over-the-counter (OTC) medicines and herbal health products (such as St. John’s wort). They can let you know if your regular medicines may cause problems when combined with an antidepressant.

Antidepressants for children and teens

In some cases, the use of antidepressants has been linked to an increase in suicidal thoughts and behavior in children, teens, and young adults. The Food and Drug Administration (FDA) now requires antidepressants to carry a warning about the risk of suicide in children, teens, and young adults 24 years of age or younger. However, this doesn’t mean that people in this age group shouldn’t take antidepressants. It means they should be carefully monitored by their doctor and loved ones while taking the antidepressant.

Many doctors will want to see a child or teen sometime in the first few weeks after starting an antidepressant to assess any risk for suicide. If you’re worried your child may be suicidal, call your doctor right away or take your child to the nearest emergency room.

Things to consider

All antidepressants have some side effects. However, not all people taking antidepressants have these side effects. Most of the side effects happen in the early weeks of therapy and lessen over time. You may experience the following:

• Anxiety
• Bladder problems
• Blurred vision
• Constipation
• Diarrhea
• Dizziness when standing up
• Dry mouth
• Excessive tiredness
• Feeling of weakness
• Hand tremors
• Increased heart rate
• Increased sleepiness
• Insomnia
• Muscle twitching
• Nausea
• Sexual dysfunction (inability to ejaculate or to have an orgasm)
• Tremor
• Vomiting
• Weight gain or loss

Talk to your doctor if these side effects don’t go away. They may change your dosage or suggest another medication.

Considerations for women

If you’re planning to get pregnant, talk to your doctor about your medicines before you try to get pregnant. If you accidentally get pregnant while taking an antidepressant, tell your doctor right away. Your doctor will know if your antidepressant is safe to take while pregnant.

Most medicines you take can pass into your breast milk. That means it may be passed on to your baby. If you’re planning to breastfeed or you currently breastfeed, talk to your doctor about your medicine.

In most cases, it’s okay to take birth control pills or hormone replacement therapy (also called HRT) at the same time as depression medicines. Taking hormones may even help some depressed women feel better. However, if your birth control pills seem to be causing symptoms of depression, discuss it with your doctor. They may suggest you use another method to prevent pregnancy for several months to find out if your birth control pills are causing depression.

Antidepressant discontinuation syndrome

Antidepressant discontinuation syndrome can occur if you suddenly stop taking your antidepressant medicine. Antidepressant discontinuation syndrome is not dangerous or life threatening. It usually goes away within a week. The symptoms include:

• Anxiety
• Feelings of sadness
• Irritability
• Fatigue
• Headaches
• Nausea and vomiting
• Dizziness

You’re more likely to have antidepressant discontinuation syndrome if you stop taking certain antidepressants, such as paroxetine and sertraline. However, you can get symptoms from stopping any antidepressant medicine.

If you accidentally missed a dose of your antidepressant medicine, start taking it again as soon as possible. If you’re out of medicine, call your doctor so they can refill your prescription.

If you decided to stop taking your antidepressant medicine on your own, talk to your doctor about why you stopped. For example, was the medicine causing an unpleasant side effect? Did it cost too much? Your doctor can help by altering your dosage or suggesting another antidepressant.

If your doctor recommended you take a lower dosage of your medicine and you’re experiencing symptoms of antidepressant discontinuation syndrome, talk with your doctor. You may need to take a higher dosage before weaning your body from the medicine completely.

To keep antidepressant discontinuation syndrome from happening again, take your medicine exactly as your doctor tells you. If you want to stop taking it, talk to your doctor first. Just because you’re unable to stop taking your medicine suddenly doesn’t mean you’re addicted. Your body often needs time to adjust to lower levels of the medicine. That’s why your doctor may recommend tapering off an antidepressant rather than abruptly stopping it.

Questions to ask your doctor

• How can I know if I have depression?
• Are there ways to treat depression that don’t involve medicine?
• If I am depressed, should I also be talking to a mental health professional?
• Are there coupons I can use to help lower the cost of antidepressants?
• How long will it take to get the dosage right for my medication?
• How will I know the medicine is working?

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Mental health or psychiatric conditions are common. Many times, they run in families. Some of the most common mental health conditions are depression, anxiety, and bipolar disorder. These illnesses and others like them interfere with your thoughts, feelings, and behaviors. Learning you have a mental health condition can be upsetting. But there is hope. There are a variety of treatments available for mental health conditions. Don’t be afraid to ask for help.

Path to improved health

There are several types of treatment for mental health problems. They include:

• Psychotherapy or counseling. This also is called talk therapy. It is one of the most common treatments for mental health disorders. It involves talking about your problems with a mental health professional but is so much more. The is an education element, a focus on relaxation exercises and coping skills as well as stress management. There are many types of talk therapy. Some common ones include cognitive behavioral therapy or dialectical behavior therapy. Talk therapy is often done one-on-one. It can also be done in a group setting or with your family. Individual and group talk therapy is sometimes helpful. This type of therapy can be useful even for those who do not have a mental health condition and are simply going through challenging life situations (grief, divorce, etc.).
• Prescription medicine. Prescription medicine is another popular treatment method. Medicines for mental disorders make changes to brain chemicals that are involved in emotions and thought patterns. Medicines don’t cure psychiatric conditions or health problems. But they can improve your symptoms. They can make other treatments, such as counseling, more effective. There are many kinds of prescription medicines available that work in different ways. Your doctor will make a recommendation and share any side effects.
• Support groups. Self-help and support groups can help you gain insight into your condition. They can provide friendships, support, resources, and tips on how to live with your condition. They also help address the feelings of isolation that often go along with mental health conditions.
• Other therapies. There are many types of therapies people use to help treat mental health problems. These can include physical activity, such as exercise or yoga. They can also include creative therapies. These are therapies done using means of expressing yourself creatively. They can include using art, music, movement, or writing.
• ECT or other brain stimulation therapy. Electroconvulsive therapy (ECT) is a safe procedure that sends electric currents into the brain. This causes changes in the brain that can improve and even reverse troubling symptoms. ECT and other brain stimulation therapies are often used when other kinds of treatment haven’t worked.
• Eye Movement Desensitization and Reprocessing (EMDR) therapy. This type of therapy is used to relieve psychological stress. It has become an effective way to help treat trauma, especially post-traumatic stress disorder (PTSD).
• Hospital or residential treatment program. Sometimes your mental health issues become so bad that you need to receive treatment in a hospital or a long-term program. This can happen when you can’t take care of yourself. Or it happens when you are in danger of harming yourself or others.

Not every treatment works or is necessary for everyone. Some people benefit from a combination of treatments. Your doctor will help you find the treatment that’s right for you.

Things to consider

Sometimes, there is an unfair stigma that surrounds mental health and mental conditions. This stigma can prevent people from getting the help and support they need. They are afraid of what people will think of them. So they don’t seek treatment. Their condition often gets worse. Sometimes people even take their own lives because the stigma of mental illness kept them from seeking help.

Healthcare professionals, educators, and organizations are working to overcome the stigma. Individuals and their loved ones are more likely to speak up about mental health disorders. They are encouraged to get treatment.

Look for these signs that you or a loved one may be experiencing signs of mental health conditions:

• Feeling sad or depressed
• Trouble concentrating
• Extreme feelings (including fear, guilt, sadness, or anger)
• Withdrawal from friends or activities
• Extreme mood changes
• Alcohol or drug abuse
• Unexplained hostility or violence
• Inability to cope with stress or your feelings
• Delusions, paranoia, or hallucinations (such as hearing voices)
• Thinking about hurting yourself or others

Don’t be afraid to ask for help. You have many treatment options available to you. Mental illness is nothing to be embarrassed by or ashamed of. Being aware of mental health issues and learning the truth can help you and others. It can even save lives.

Questions to ask your doctor

• I have some of these symptoms. Could I have a mental health condition?
• What is the best kind of treatment for me?
• Do I need to take prescription medicine? Do I need to see a psychiatrist?
• Do I need psychotherapy?
• Can you recommend a counselor or therapist I could see?
• Is this a temporary problem or is it permanent?
• Will I need treatment for the rest of my life?
• What can I do at home to help me recover?
• How can I explain to other people the mental problem that I’m having?

Resources

MentalHealth.gov: Local Organizations with Mental Health Expertise

National Institutes of Health, MedlinePlus: Mental Disorders

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