California Considers Permitting Students Excused Mental Health Days

Parents, educators and clinicians are seeing an alarming increase in mental health problems among young people. Various national surveys show the rates of depression, anxiety, and suicide on the rise, but what to do about it is less clear.

In July of 2019, Oregon passed a bill that allows students to take excused absences for mental health related issues. Students advocated for the bill, saying it would reduce stigma about mental health issues, and encourage young people to seek the treatment they need.

Now, the California legislature is considering something similar. State Senator Anthony Portantino has introduced a bill that would change the education code to allow for mental health related excused absences. For him, mental health is a personal issue.

"I had a brother who took his own life," Portantino said. "And one of the reasons I talk about it is so people understand that mental health issues affect all of us."

He says anything that reduces stigma could go a long way to prevent tragedies like the one his family suffered.

"It's not the time to be shy. It's the time to bring these conversations out of the shadows so we can help those who need it."

Portantino isn't concerned that students will abuse the excused absences. If anything, he thinks it will take a lot of convincing to help families drop the barriers they hold around mental health.

But what would this really mean to schools?

"Young people are already missing school because of mental health challenges," said Jenn Rader, director of the James Morehouse Project at El Cerrito High School just outside of San Francisco. "So if this would make that reality more visible for all of us, and bring into sharper focus for all of us what it is we’re all up against, that would be a positive step."

Rader hadn't heard of the legislation, but was intrigued. She'd like to see what results Oregon sees a year into implementation, but agrees with Portantino that reducing stigma around mental health would be valuable.

El Cerrito High operates on a block schedule, which means each student only has four classes a semester with a year's worth of material condensed into each class. That makes it extra difficult to catch up when students miss a lot of instructional time. Rader says there's a clear correlation between students with mental health challenges and absences, especially for those with anxiety.

Dr. Mark Reinecke of the Child Mind Institute says the state needs to tread carefully with legislation like this. He understands the need for parity between mental health and physical health, but says it all depends on the specific situation.

“There are some situations where this entirely sensible and others where it doesn't make sense," Reinecke said.

Take anxiety, for example. Allowing kids with school avoidance problems or social anxiety to stay home from "is absolutely the wrong thing to be offering them. For those youngsters, what we want is exposure, we want the youngster to approach the things they fear."

Reinecke says letting anxious students avoid school only reinforces the behavior. But kids aren't doomed to suffer with anxiety forever. Research has show Cognitive Behavioral Therapy to be an effective treatment. For a student with debilitating depression, on the other hand, an excused absence to see a therapist may be very helpful.

The problem, says Reinecke, is that parents make these decisions in different ways. Some parents take a lot of convincing to call the school if a child is sick. Others, let them stay home at the slightest sign of fever. Excused absences for mental health issues would be similarly murky, he said.

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.

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How To Start Therapy

Feeling anxious? Overwhelmed? Unhappy? Not sure what you're feeling at all? These might be signs that your "check engine" light is on and seeing a therapist could help. 

If the mere thought of trying to find help seems overwhelming, you're not alone. Plenty of people put off seeking treatment or try to ignore symptoms because mental health is often easier to brush off as not urgent. 

"We feel like there's a hierarchy of pain, and if our problem doesn't feel big enough, we wait until we're basically having the equivalent of an emotional heart attack before somebody will make that call," says Lori Gottlieb, a psychotherapist, advice columnist and author of the book Maybe You Should Talk to Someone.

On top of that, the process of researching and scheduling that first appointment can be an emotional burden on its own — but procrastinating often allows the problem to grow. If you wait until things get really bad, the harder it will be to address.

We've got four tips to help you make therapy work for you. Be sure to listen to the Life Kit episode "How To Start Therapy" for more advice from experts who know that this is more than just making a phone call. If it were that easy, you'd have done it already!

1. Acknowledge stigmas that might be holding you back from seeking help.

The fear of being stigmatized can keep us from seeking treatment. Our attitudes about mental health likely come from family, friends, society at large, the media — and even our own inner voices.

"I think that a lot of people feel like if they start therapy, that means something's wrong with them and other people might look at them differently," says Gottlieb.

The reality is that people close to us often notice when we're having a hard time. In fact, they're likely catching some negative side effects, since we tend to take things out on our loved ones. Remember, you're doing this for them too. 

A good first step is to reframe therapy for yourself. "I think of seeing a therapist as just getting a second opinion about what you're doing," says Pahoua Yang, vice president of community mental health and wellness at the Amherst H. Wilder Foundation. "And then you can decide from there."

If you're concerned about privacy or disclosure, therapy is confidential. No one has to know! Licensed mental health professionals are bound by the law to protect your privacy. Unless someone is a threat to themselves or others, what goes on in therapy stays in therapy.

2. Find the right therapist — or type of therapy — for you.

Start by making a list of potential therapists. If you have medical coverage, your insurance company can help make that list for you. Ask the company for some nearby professionals who take your insurance. 

Psychology Today also has a database, which you can use to search for providers in your area, along with specialties, reviews and experience. 

Once you've identified a few potential therapists, reach out. Come up with some starter questions to ask when you interview them over the phone. What experience do they have working with your issue or community? How does a typical session with them work? Do their available hours match yours? 

Asking questions before a visit can help you know what to expect. But Gottlieb says the visit itself is the most important piece. "The reality is, you're not gonna know if it's the right fit until you're sitting in a room with that person," says Gottlieb. 

If transportation, access or motivation is a problem, online therapy like the app BetterHelp might be helpful. You can also ask to do Skype sessions, but make sure the therapist is licensed in your state. Otherwise, the therapist can't legally treat you. 

Not insured? Or on a tight budget? Look up a local clinic at a hospital or university where you can get low- to no-cost therapy with a therapist in training. 

That's actually how Gottlieb got her start as a therapist. "I trained at a clinic where people came in for no fee or a very low fee," she says. "I was supervised by licensed clinicians. That's also a great way to get help."

Don't feel ashamed or shorted by the idea of low-cost therapy. Gottlieb says clinic sessions actually have an advantage over pricier options. 

"In fact, you probably have more supervision than a private-practice clinician does, because when you're training, you have several sessions a week of supervision, so your case gets a lot of attention when you're in a clinic."

Group therapy can also be a great low-cost option. Group sessions tend to be relatively affordable compared with one-on-one sessions — sometimes even free. 

Open Path Collective offers a network of therapists who charge $30 to $60 a session. And some professionals price their sessions on a sliding scale fee, meaning their rates vary based on a customer's ability to pay. If you can't afford your preferred professional's rates, it's worth asking if sliding scale payments are an option at the therapist's practice.

3. It's OK to move on to a different therapist, or kind of therapy, altogether.

If your current therapist doesn't feel like a good fit, it's fine to "break up" with the person. 

"You want to make sure you find somebody who actually feels like they get you," says Joy Harden Bradford, Ph.D., host of the podcast Therapy for Black Girls. "It's OK to say, 'Hey, I think I may need something else' and to try to find another therapist who's going to be a better fit for you."

But after all that work of getting into therapy, it might feel daunting to dump someone and start over. 

Harden Bradford understands. She says it's important to push through that uncomfortable conversation and find something that works for you. Plus, she says, the therapist likely isn't going to be mad at you. 

"It is a part of our training, and we know that kind of thing happens," she says. 

Mental health professionals want you to get better, even if it's not in their care. Your current therapist might even be able to help identify a colleague who would fit better.

4. If you're comfortable with it, talk about therapy with others.

If you're already in therapy, and you feel comfortable, be open about it. 

John Kim, also known as The Angry Therapist, says he found an online following when he opened up about his divorce and his own mental health treatment. 

"I would share ... all the revelations I'm having about myself," says Kim. "And how much that's helping my relationships at work, at home ... and all of that happened because of me starting therapy." 

Kim says he wishes more people were open about going to therapy. He wants to see it normalized and encourages working it into conversation. 

Just keep it subtle. No need to share details. Simply let others know that you're prioritizing your mental health.

But Kim says it's important to remember that if you're sharing because you think someone else needs mental health support, it's best to show, not tell. 

"The best way to get someone in therapy is by example ... doing therapy and living a different way where they notice. To tell someone to go to therapy, that's not gonna land well."

Breaking down a stigma takes time. By talking openly about therapy and demonstrating its benefits, you just may inspire someone else to try it out.

Do You Have Anxiety?

Have you wondered if you struggle with anxiety? If any of these symptoms apply to you or a loved one, Change Counseling can help with relief!

Everyday Anxiety vs. Anxiety Disorder

When does anxiety turn into a problem? Anxiety is normal and helps alert us to stressors in our lives. However, it shouldn’t spill over into family, social or professional realms. Contact us today if you think you’re anxiety is having a negative impact on your wellbeing.

Season Affective Disorder and What You Need to Know

Seasonal Affective Disorder (SAD) is a type of depression that comes and goes with the seasons, typically starting in the late fall and early winter and going away during the spring and summer. Depressive episodes linked to the summer can occur, but are much less common than winter episodes of SAD.

Signs and Symptoms

Seasonal Affective Disorder (SAD) is not considered as a separate disorder. It is a type of depression displaying a recurring seasonal pattern. To be diagnosed with SAD, people must meet full criteria for major depression coinciding with specific seasons (appearing in the winter or summer months) for at least 2 years. Seasonal depressions must be much more frequent than any non-seasonal depressions.

Symptoms of Major Depression

• Feeling depressed most of the day, nearly every day

• Feeling hopeless or worthless

• Having low energy

• Losing interest in activities you once enjoyed

• Having problems with sleep

• Experiencing changes in your appetite or weight

• Feeling sluggish or agitated

• Having difficulty concentrating

• Having frequent thoughts of death or suicide.

Symptoms of the Winter Pattern of SAD include:

• Having low energy

• Hypersomnia

• Overeating

• Weight gain

• Craving for carbohydrates

• Social withdrawal (feel like “hibernating”)

Symptoms of the less frequently occurring summer seasonal affective disorder include:

• Poor appetite with associated weight loss

• Insomnia

• Agitation

• Restlessness

• Anxiety

• Episodes of violent behavior

Risk Factors

Attributes that may increase your risk of SAD include:

• Being female. SAD is diagnosed four times more often in women than men.

• Living far from the equator. SAD is more frequent in people who live far north or south of the equator. For example, 1 percent of those who live in Florida and 9 percent of those who live in New England or Alaska suffer from SAD.

• Family history. People with a family history of other types of depression are more likely to develop SAD than people who do not have a family history of depression.

• Having depression or bipolar disorder. The symptoms of depression may worsen with the seasons if you have one of these conditions (but SAD is diagnosed only if seasonal depressions are the most common).

• Younger Age. Younger adults have a higher risk of SAD than older adults. SAD has been reported even in children and teens.

The causes of SAD are unknown, but research has found some biological clues: 

• People with SAD may have trouble regulating one of the key neurotransmitters involved in mood, serotonin. One study found that people with SAD have 5 percent more serotonin transporter protein in winter months than summer months. Higher serotonin transporter protein leaves less serotonin available at the synapse because the function of the transporter is to recycle neurotransmitter back into the pre-synaptic neuron.

• People with SAD may overproduce the hormone melatonin.Darkness increases production of melatonin, which regulates sleep. As winter days become shorter, melatonin production increases, leaving people with SAD to feel sleepier and more lethargic, often with delayed circadian rhythms.

• People with SAD also may produce less Vitamin D. Vitamin D is believed to play a role in serotonin activity. Vitamin D insufficiency may be associated with clinically significant depression symptoms.

Treatments and Therapies

There are four major types of treatment for SAD:

• Medication

• Light therapy

• Psychotherapy

• Vitamin D

 These may be used alone or in combination.

Medication

Selective Serotonin Reuptake Inhibitors (SSRIs) are used to treat SAD. The FDA has also approved the use of bupropion, another type of antidepressant, for treating SAD.

As with other medications, there are side effects to SSRIs. Talk to your doctor about the possible risks of using this medication for your condition. You may need to try several different antidepressant medications before finding the one that improves your symptoms without causing problematic side effects. For basic information about SSRIs and other mental health medications, visit NIMH’s Medications webpage. Check the FDA’s website for the latest information on warnings, patient medication guides, or newly approved medications.

Light Therapy

Light therapy has been a mainstay of treatment for SAD since the 1980s. The idea behind light therapy is to replace the diminished sunshine of the fall and winter months using daily exposure to bright, artificial light. Symptoms of SAD may be relieved by sitting in front of a light box first thing in the morning, on a daily basis from the early fall until spring. Most typically, light boxes filter out the ultraviolet rays and require 20-60 minutes of exposure to 10,000 lux of cool-white fluorescent light, an amount that is about 20 times greater than ordinary indoor lighting.

Psychotherapy

Cognitive behavioral therapy (CBT) is type of psychotherapy that is effective for SAD. Traditional cognitive behavioral therapy has been adapted for use with SAD (CBT-SAD). CBT-SAD relies on basic techniques of CBT such as identifying negative thoughts and replacing them with more positive thoughts along with a technique called behavioral activation. Behavioral activation seeks to help the person identify activities that are engaging and pleasurable, whether indoors or outdoors, to improve coping with winter.

Vitamin D

At present, vitamin D supplementation by itself is not regarded as an effective SAD treatment. The reason behind its use is that low blood levels of vitamin D were found in people with SAD. The low levels are usually due to insufficient dietary intake or insufficient exposure to sunshine. However, the evidence for its use has been mixed. While some studies suggest vitamin D supplementation may be as effective as light therapy, others found vitamin D had no effect.

Join a Study

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions, including seasonal affective disorder. During clinical trials, treatments might be new drugs or new combinations of drugs, new psychotherapies or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individual participants may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Please Note: Decisions about whether to apply for a clinical trial and which ones are best suited for a given individual are best made in collaboration with your licensed health professional.

Clinical Trials at NIMH/NIH

Scientists at the NIMH campus conduct research on numerous areas of study, including cognition, genetics, epidemiology, and psychiatry. The studies take place at the NIH Clinical Center in Bethesda, Maryland and usually require regular visits. After an initial phone interview to see if any of the clinical trials recruiting subjects are a good match for you, you will come to an appointment at the clinic and meet with a clinician. Visit the NIMH Clinical Trials — Participants or Join a Study for more information.

How Do I Find a Clinical Trial Near Me?

To find a clinical trial near you, you can visit ClinicalTrials.gov. This is a searchable registry and results database of federally and privately supported clinical trials conducted in the United States and around the world. ClinicalTrials.gov gives you information about a trial's purpose, who may participate, locations, and contact information for more details. This information should be used in conjunction with advice from your health provider.

Learn More

Free Booklets and Brochures

You can download or order free copies of the following booklets and brochures in English or en Español:

• Depression: What You Need to Know: This booklet contains information on depression (depressive disorder or clinical depression), including signs and symptoms, treatment and support options, and a listing of additional resources.

• Depression: This brochure describes the two most common types of depression: major depression, and persistent depressive disorder. It lists symptoms, treatment options, and how the condition may look different in women, men, seniors, and children.

• Teen Depression: This flier for teens describes depression and how it differs from regular sadness. It also describes symptoms, causes, and treatments, with information on getting help and coping.

Federal Resources

• MedlinePlus offers information in English and en Español.

• Seasonal Affective Disorder - Medline Plus: Medical Encyclopedia

Research and Statistics

• ClinicalTrials.gov: Seasonal Affective Disorder

• Journal Articles: References and abstracts from MEDLINE/PubMed (National Library of Medicine).

• Statistics: Major Depression Among Adults: This webpage provides information on the statistics currently available on the prevalence and treatment of depression among adults in the U.S.

• Statistics: Major Depression with Severe Impairment Among Adults: This webpage provides information on the statistics currently available on the prevalence and treatment of severe depression among adults in the U.S.

• Statistics: Major Depression with Severe Impairment Among Adolescents: This webpage provides information on the statistics currently available on the prevalence and treatment of severe depression among adolescents in the U.S.

Choose Joy!

With our hectic everyday lives, it is hard to recognize that we have control over what we do and who we spend time with. Choose actions and people that will help you be the best version of yourself.

Millennials Are the Therapy Generation

People in their 20s and 30s seek mental-health help more often, and they are changing the nature of treatment

Kristina, a 27-year-old publicist living in Manhattan, has been in and out of therapy since she was 9, when her parents got divorced. Back then, she says, “I had a pretty pragmatic view of what was happening, and so did my parents—going to therapy was just something you make kids of divorce do.” During her first year of college, Kristina (who requested that only her first name be used) suffered a sexual assault. Again, she says, therapy afterward was a given. “I figured I would use therapy to get through my trauma and then be done,” she says. “I eventually learned that’s not really how it works.” She has had four or five different therapists since then. So have most of her friends.

The stigma traditionally attached to psychotherapy has largely dissolved in the new generation of patients seeking treatment. Raised by parents who openly went to therapy themselves and who sent their children as well, today’s 20- and 30-somethings turn to therapy sooner and with fewer reservations than young people did in previous eras. 

According to a 2017 report from the Center for Collegiate Mental Health at Penn State University, which compiled data from 147 colleges and universities, the number of students seeking mental-health help increased from 2011 to 2016 at five times the rate of new students starting college. A 2018 report from the Blue Cross Blue Shield Association found a 47% increase between 2013 and 2016 in depression diagnoses among 18-to-34 year-olds; the report attributed the rise largely to the fact that far more young adults are seeking help.

“Many of my clients joke that they and their co-workers often start conversations with, ‘My therapist thinks…’” says Elizabeth Cohen, a clinical psychologist in Manhattan, “The shame of needing help has been transformed to a pride in getting outside advice.”

One reason for the shift is celebrities such as Demi Lovato, Lady Gaga and Dwayne (“the Rock”) Johnson, who have publicly discussed their struggles with depression. Many therapists also credit social media—often criticized as a source of millennial distress—with helping to normalize mental illness and to remove any lingering stigma from seeking support. Vix Meldrew, 32, a London blogger, says that whenever she talks about mental health online, her response from readers skyrockets because she is “making them feel less alone.”

‘I think the therapist’s natural instinct to listen and not give advice can be challenging and threatening to millennials.’

Many younger people pursue therapy as another form of self-improvement and personal growth, not unlike yoga, meditation or “preventive Botox.” (A 2015 survey by the research firm Field Agent found that millennials spend $300 a month on such pursuits.) Some millennials also use life coaches. That includes Ali Wunderman, a 29-year-old freelance journalist in Whitefish, Mont. “My life coaching and my therapy work really well together,” she says. “It’s about forming habits and behaviors that lead to a fuller life.”

But young people are struggling to find such balance. A 2018 study of 40,000 American, Canadian and British college students published in the journal Psychological Bulletin found that millennials are suffering from “multidimensional perfectionism” in many areas of their lives, setting unrealistically high expectations and feeling hurt when they fall short. This propensity can motivate them to seek assistance when something goes wrong—but it also sometimes drives them to turn that assistance into dependence. 

Some young people think “that the therapist is going to provide an answer rather than help them discover the answer within themselves,” says Dr. Cohen, the Manhattan psychologist. Dr. Cohen recalls one recent 20-something client who was unsure about whether to stay in a relationship. “It really felt like she had gone from therapist to therapist looking for one that would tell her what to do,” says Dr. Cohen. “I think the therapist’s natural instinct to listen and not give advice can be challenging and threatening to millennials.”

Technology has contributed to the expectation of a quick fix. Apps and online services such as Talkspace and MyTherapist offer therapy by phone, chat, video and message board, making it more likely that young people will opt for superficial bromides over meaningful long-term help. Used correctly, however, tech-based therapies can fill in important gaps, especially for millennials more comfortable facing their devices than a therapist. Julia Koerwer, 28, a graduate student in social work in Queens, N.Y., uses textlines when she needs immediate help. “People tend to think crisis hotlines are for suicide only,” she says. “But just to be like, ‘OK, it’s Wednesday, I see my therapist on Sunday, and I feel like [expletive] right now. What can I do?’ That’s helpful.”

New studies also show that young couples are using therapy before moving in together or in the early years of marriage—something virtually unheard-of in earlier generations. Kristina and her partner started couples counseling in 2017 when they got their first apartment together. “If my mom and stepdad weren’t communicating well, they’d be like, ‘Oh, let’s just talk about it over dinner,’” she says. “But we work late, and then at home we’re answering emails on our phones, and talking it out over dinner just doesn’t work that way anymore.” 

For many, such “self-care” doesn’t feel like a chore. “I just enjoy therapy,” says Ms. Koerwer. “I don’t enjoy getting blood drawn—I’d be looking for ways to stop having to do something like that. But I like my therapist, I have a good relationship with him. It’s not like I’m trying to figure out, at what point can I stop doing this?”

Check Out Change Counseling’s Updated Services

Check out our updated services page with new and innovative interventions to help you in your healing process!

SPECIALIZED INTERVENTIONS

• ACCELERATED RESOLUTION THERAPY

  • ART incorporates a combination of techniques used in many other traditional psychotherapies. ARTworks directly to reprogram the way in which distressing memories and images are stored in the brain so that they no longer trigger strong physical and emotional reactions. ART accomplishes this through the use of rapid eye movements similar to eye movements that occur during dreaming. Although techniques similar to these are used in other types of therapies. ART’s very specific and directive approach can achieve rapid recovery from symptoms and reactions that may have been present for many years. ART combines long respected, sound treatment practices with safe and effective methods validated by current scientific research studies conducted by the University of South Florida. Find out more here.

• EQUINE THERAPY

  • Equine Therapy (also referred to as Horse Therapy, Equine-Assisted Therapy, and Equine-Assisted Psychotherapy) is a form of experiential therapy that involves interactions between patients and horse. It involves activities (such as grooming, feeding, haltering and leading a horse) that are supervised by a mental health professional, often with the support of a horse professional. The goal of equine therapy is to help the patient develop needed skills and attributes, such as accountability, responsibility, self-confidence, problem-solving skills, and self-control. Equine therapy also provides an innovative milieu in which the therapist and the client can identify and address a range of emotional and behavioral improvements. Check out an informational article here.

• CANINE THERAPY

  • Canine-assisted therapy uses dogs to promote health and healing. Like other animals, dogs are accepting, comforting and non-judgmental, making them ideal therapy companions. In canine therapy, patients may: learn to give a dog commands, walk and play with a dog, or pet and care for a dog. Canine therapy can be immensely healing. Children and teens respond particularly well to canine therapy, developing trust and strong bonds with the animals. Many find it easier to open up and talk when the focus is on the dog. The therapist working with the patient can gain valuable insights by observing the interactions between patients and their canine companions. More info here.

• ECO THERAPY

  • Ecotherapy is based on the idea that people are connected to and impacted by the natural environment. It can consist of walking, hiking, cycling or meditating in nature. Ecotherapy can be especially beneficial for those with depression, anxiety, stress or other emotional issues. Read more about its benefits here.

• TELE-COUNSELING

  • Video counseling provides behavioral health therapy in the privacy of your own home. It allows greater flexibility for clients who travel for work, have changing schedules not always allowing for consistent in-person sessions, identify transportation as a barrier to care, and more! It is 100% HIPPA compliant and in many cases provides more privacy than traditional in-person therapy. More about virtual therapy here.

How Thinking Changes Feelings and Behavior

Try this technique to help understand what your body is trying to tell you, learn from it, and move forward.

Is My Relationship Healthy?

Everyone deserves to be in a safe and healthy relationship. Do you know if your relationship is healthy? Click here to answer questions about your relationship. Contact us if you or your partner need guidance in moving towards a healthier dynamic.

Social Media Use Linked To Anxiety, Depression Among Teens, New Study Finds

A new study found social media use, television viewing and computer use over a four-year period predicted more severe symptoms of anxiety and depression among adolescents. 

Social media use and screen time can lead to an increase in depression and anxiety among teens and adolescents, a new study finds.According to a study published in the Canadian Journal of Psychiatry, researchers observed more than 3,000 seventh to 10th graders in the greater Montreal area over a period of four years.

Researchers measured how much time students spent in front of social media, television and computers. The data revealed the more time kids spent engrossed in digital screens, their symptoms of anxiety and depression became more severe.

Not all forms of screen use yielded the same impact on their mental health, says Patricia Conrod, one of the study’s researchers.

“In terms of the relationship between screen time and depression, what we found was that social media was very robustly related to increases in depressive symptoms, as was television,” she says. “And there was no relationship between video gaming and depressive symptoms.”

When watching TV, kids often consume idealized lives that are different from their own experiences, she says. But social media is unique because adolescents are seeing pictures, videos and status updates from their own network of friends and peers.

“In some way, you're being exposed to a slightly biased perspective on what young people's lives are like and you compare yourself to that,” she says.

Most adults experienced their childhood and teenage years without social media. Conrod says many adults developed a “more balanced perspective on what everyday life is like” since they did not have digital access as kids.

But digital technology is more accessible than ever, and adolescents tend to spend a good chunk of their day using it — teens average around seven hours per day on social media, while tweens clock in around five hours per day. In 2018, roughly half of U.S. teens said they spend too much time on their cellphones, according to the Pew Research Center.

This consistent use can blur the lines of reality for adolescents whose brains are still developing, Conrod says.

“Adolescents today spend a lot more of their time interacting with others through social media and therefore exposed to a reality that is biased,” she says.

Conrod says she is concerned that the filtered lives of others that many young people see while scrolling on their phones could influence how they critically examine information.

Multi-screening, the act of being exposed to more than one screen at a time, also contributes to whether young people can effectively parse out what’s biased and what’s not, she says. When you’re in front of multiple screens, “you become less critical of the information you're being exposed to because your attention is divided,” she says.

“If you're spending a lot of your time being exposed to biased information, there's a risk that you're going to develop a somewhat biased perspective of the world,” she says. “And that's concerning to me.”

Things That Can Worsen Your Anxiety

Many times we find ourselves in maladaptive patterns that make our anxiety worse. The things that may bring us instantaneous relief, can actually increase symptoms. Reach out to find ways to improve your mental health, and avoid these:

Love Everything About Yourself

It’s hard to love what we perceive as our imperfections, but with every thought and feeling our bodies are doing the very best they can. Your anxiety, depression, trauma have given you an opportunity to learn and grow. You are more empathetic and understanding to the struggles of others because of your imperfections. That is strength.

How to Find the Best Mental Health Professional for You

Do you need a psychiatrist, psychologist, counselor or someone else?

You work out for your physical fitness. You get your checkups, brush your teeth, get enough sleep and wash your face. You take so many steps to maintain your health, but they'll only take you so far if you feel depressed or struggle with alcohol or can't stop fighting with your spouse. "Mental health is essential to overall health," says Paolo del Vecchio, director of the Substance Abuse and Mental Health Services Administration’s Center for Mental Health Services. Most of us (hopefully) wouldn't think twice about seeing a doctor if we had, say, strep throat, and we'd gladly take the antibiotics prescribed. So if you're feeling sick in other ways – you're anxious, you don't want to eat – why wait to get help from a professional? Here are the different people who can help:

Psychiatrists

Psychiatrists are physicians specialized in mental health and sometimes more specific areas, such as psychiatry for addiction recovery or for children. They can diagnose and treat mental health disorders and hold either a Doctor of Medicine or a Doctor of Osteopathy degree, often shortened to M.D. and D.O., respectively. Because they’re medical doctors – unlike most other professionals on this list – they can prescribe medications. Del Vecchio says medication management is one of psychiatrists’ primary roles, and they are less likely (but certainly qualified) to provide counsel.

Psychologist

The two “psych-” professions can be easy to mix up. Here’s a basic distinction: While a psychiatrist holds a medical degree, a psychologist has a doctoral degree, either in clinical, educational, counseling or research psychology. Psychologists can diagnose mental health disorders and provide counseling in either an individual or group setting. While most psychologists cannot prescribe medications, they may work with a physician to coordinate a medical treatment plan, if necessary.

Counselor

The training and academic requirements for licensed counselors vary by state, but they typically have a graduate degree in a mental health field, along with clinical experience. Most counselors don’t diagnose conditions, and none prescribe medications. According to "8 Things You Didn’t Know About Counseling," they’re more likely to help with life transitions, which may include issues with family members, spouses or a changing work environment. 

So wait, what’s a therapist?

Here’s the thing: A “therapist” can be a number of mental health professionals, including a psychiatrist, psychologist or counselor. A therapist is simply someone who provides therapy, and it’s more so a general term than an official title. That’s why knowing the difference between the specific professions is key in figuring out who will work best with you.

And there are other folks who can help.

Depending on your needs, certain social workers, specialized nurses and physician assistants can also provide guidance. The range of their abilities and qualifications is wide and can include diagnosing conditions, counseling, and in some cases, prescribing medications.  

Don’t forget about your primary care physician.

Del Vecchio says more than 50 percent of mental health-related medications are prescribed through primary care physicians, who can diagnose many mental health issues, such as depression and anxiety. Your doctor’s office is a great place to start if you want to feel better. Tell her your concerns – whether you’ve been super stressed about the divorce or feeling very lonely – and she can help you determine your next step. Your primary care physician may prescribe medication or refer you to one of the professionals previously mentioned. 

So how do you know which kind of doctor you need?

Your primary care doctor may help you determine what kind of professional you should see, based partially on your needs for, say, medications. She will likely refer you to someone in the network of your health insurance, too. Another tip for finding the right professional: Consider your situation. Generally, the more severe your symptoms – you’re so depressed you’ve been skipping work – the more training you should look for in a professional. And if you’re looking to solve a specific issue, such as work stress or marital conflicts, seek providers specialized in those areas. 

Other considerations

Whoever you choose, comfort with that person is key, del Vecchio says. He encourages folks to ask the mental health professional plenty of questions about his or her specialty, approach and philosophy. And don’t be shy about discussing the cost of appointments, he says.

Don’t settle.

Given the important role your therapist may play in your life, del Vecchio says you ought to “shop around a little bit.” In addition to your primary care doctor’s referral and your insurance company’s network, ask friends and family for their suggestions. There are also online locator tools for mental health resources, like the one on the Substance Abuse and Mental Health Services Administration website.

Time Softens All Wounds

After a difficult experience, we wonder how our lives will return to normal. Compassion for the healing process allows you time to recover and grow. Change Counseling can help you on your healing journey.

What Parents Should Know About Teen Depression

Look for these signs and be proactive in addressing the mood disorder.

According to the Substance Abuse and Mental Health Services Administration, in 2015 an estimated 3 million teens in America between the ages of 12 and 17 experienced at least one major depressive episode in the past 12 months; that’s 12.5 percent of the U.S. adolescent population. An MDE is experiencing symptoms of depression, such as loss of interest in usual activities, lack of energy and hopelessness, accompanied by depressed mood for a period of two weeks or more. According to a study published in the journal Pediatrics, the prevalence of adolescents who reported they had an MDE in the previous year jumped from 8.7 percent in 2005 to 11.5 percent in 2014 – a 37 percent increase. Sadly, adolescent depression continues to rise.

However, despite the increase in adolescent depression, there hasn’t been a proportionate increase in mental health treatment. These teens are not receiving the professional services they need to help them cope and relieve their symptoms. Teen depression goes beyond sadness and can often manifest in anger, moodiness and isolation. Whether your teen is being moody or suffering from clinical depression can be difficult to determine, since depression can be easily mistaken for typical teen behavior.

It’s easy to dismiss adolescent behavior as a snarky attitude or being disrespectful, but perhaps there’s more to the story. What if behind the defiance, your teen is miserable, can’t remember the last time she felt happy, or worse yet, questioned whether she’d be better off dead? With these troublesome and dismal thoughts looming, your teen may know that something is wrong but not know how to talk with you about how she feels. Though it may be difficult to distinguish from teen angst, adolescent depression is real, it’s painful and it can take an emotional, mental and physical toll. The only way you can combat teen depression is to take a proactive approach.

How Do Adolescents Experience Depression?

To begin to understand depression, you have to know what it is and how to differentiate it from normal teen behavior. Depression can be described as the persistent feeling of deep sadness. Most of us have felt depressed at some point in our lives. Usually these feelings come and go, but sometimes they linger for days, weeks or even months.

Depressed adults and teens may experience similar symptoms. However, those symptoms may manifest in different ways, making it hard to separate normal adolescent behavior from the behavioral changes associated with depression. For example, depressed teens may show signs of anxiety, refuse to go to school, stop talking with friends, become extremely argumentative and stay awake most of the night, but sleep all day. Many teens who aren’t depressed may exhibit some these behaviors at one time or another. The difference between typical behavior and depression is the duration, frequency and intensity as well as the implications it has on personal, social and academic functioning. Unlike adult depression, teen depression may go unnoticed and get brushed off as rebellious adolescent behavior.

How Do I know If My Teen Is Depressed?

There are some tell-tale indicators of depression. The following are some common signs and symptoms of adolescent depression:

• pulls away from family and friends

• seems depressed or irritable more days than not

• disengages in things that were once fun and enjoyable

• sleeps too much or not enough

• eats too much or not enough resulting in weight loss or gain

• appears lethargic and is unmotivated

• expresses feelings of worthlessness and hopelessness

• pays little attention to personal hygiene

• expresses feelings of emptiness and being emotionally numb

• lacks the ability to focus and concentrate

• appears more argumentative and agitated than usual

• experiences bouts of crying without reason

• uses drugs to cope with problems

• engages in self-injurious behavior

• complains of stomach aches, headaches and other pains that don’t respond to treatment

• expresses thoughts about death or suicide

• some of these symptoms persist for two weeks or more

If you feel your teen is suffering from depression, please seek professional help immediately. Untreated depression is serious and can, in some instances, put an adolescent at risk for suicide.

How Can I Help My Teen Manage Depression?

If your teen is depressed, here are five things you can do right now to help him or her cope:

1. Stop and listen. Don't worry about what to say; be understanding and encouraging and let your teen know that you’re right there every step of the way. Set aside some face-to-face time each day to speak with your teen. Make sure there are no distractions during your time together, such as a vibrating cell phone or having to take dinner out of the oven. Your teen needs your undivided attention. There is nothing that can be more healing than the power of your presence.

2. Stay the course. Separate depression from your teen, and don’t let the illness push you away. Even if your teen refuses to talk, there is comfort in just sitting on the sofa together and watching Netflix. Small steps can lead to great strides.

3. Do something together. Go for a walk, play a game of one-on-one basketball or take up a new hobby, such as cooking or woodworking. Slowly reintroduce your teen to fun social activities. Keep in mind that depression may lead your teen to disengage, but with time, your teen may come around to doing the things he or she once found enjoyable.

4. Go there. Don’t steer clear of difficult topics, such as suicide or drugs. Too often parents avoid the tough conversations; but these are the exchanges that can have the most positive impact. For example, if you find your teen self-medicating with pot, discuss how marijuana is a depressant and can intensify depression. Likewise, ask your teen about thoughts of self-harm or suicide. Don’t worry about planting a seed, if the thought is there, you aren’t reinforcing it by saying it out loud. By bringing up the difficult topics, you make it clear that any subject can be discussed – and that can be comforting to a depressed teen.

5. Get help. Take your teen to see a mental health professional and stick with the treatment plan. Depression doesn’t develop overnight, and it won’t go away overnight either. Work closely with your child’s doctor and therapist, and sign a release for both to communicate with one another. These professionals will form your teen’s treatment team.

With modern advancements in medication and therapy, depression can be effectively treated in 70 to 90 percent of cases. So, your teen doesn’t have to suffer in silence. There is hope, there is treatment, and there are brighter days ahead.

How Therapy Can Help You

There are numerous benefits to counseling. Reach out if we can help you to improve in any of these areas!