Tag: Depression

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Celebrities That Are Open About Their Mental Health

Celebrities have the unique ability to reduce mental health stigma with just a quote or two about their experiences. Many well-known celebrities, like Emma Stone and Howie Mandel, exercise this ability to show 1) mental health issues don’t discriminate and 2) how they healed, and that recovery exists for everyone. 

We’ll cover a few of the many celebrities changing the narratives about mental health and championing the freedom to heal openly.

Chrissy Teigen

Chrissy Teigen is a model and muse for her husband, singer John Legend. She’s also opened up to the public about her struggles with postpartum depression. Despite support from her family, fame, and fortune, she found herself unable to control or lessen her symptoms. 

Chrissy spoke up about her struggles to show how “postpartum does not discriminate,” even though she “has a good life.”

Selena Gomez

Singer and actress Selena Gomez has experienced depression, anxiety, and anxiety attacks. She posits them as side effects of, and exacerbated by, her medical condition, lupus. Her mental health led her to take a break from performing and speak up about her struggles, saying, “I know I am not alone by sharing this, I hope others will be encouraged to address their own issues.”

Emma Stone

Actress Emma Stone began experiencing anxiety and overwhelming anxiety attacks at a young age. For three years, the debilitating attacks and constant anxiety of something going wrong plagued her. She’s since learned to use her “big emotions” as an acting superpower and credits acting for helping her manage the anxiety. 

Dwayne Johnson

Dwayne Johnson, known more commonly as The Rock, is an actor and boxer. He’s tall and buff and stars in action movies, comedies, and children’s films. He’s also publicly acknowledged his struggles with mental health and the importance of maintaining mental well-being. By opening up about his struggles with depression, he hopes to give hope to others struggling and be the voice to tell them, “Hey, it’s gonna be OK. It’ll be OK.”

Lizzo

Body-positive rapper and singer Lizzo has spoken about her challenges with mental health, specifically after coming to fame. She notes, “My anxiety didn’t go away. My depression didn’t go away.” 

She’s taken to social media to document her struggles, bring fans into her healing, and acknowledge her progress, recently saying she’s much happier now than before. 

Lady Gaga

Lady Gaga experienced depression and anxiety at the sudden soar of her success as a musician and singer. She remembers little of this time, besides it being “traumatizing.” Now, she’s using resources like antidepressants to stabilize her mood and speaks out about her experience. She says,

“I openly admit to having battled depression and anxiety and I think a lot of people do. I think it’s better when we all say: ‘Cheers!’ And ‘fess up to it.”

Adele

Singer Adele has wowed listeners for years with her powerful voice and deep lyrics, but has also opened up to how mental health issues have impacted her career. She struggles with depression and experienced postpartum depression after the birth of her son. Talking about it was daunting at first, like it was for Chrissy Teigen, but she believes this openness can reduce stigma and embarrassment. 

Miley Cyrus

Singer, actress, and former Disney star Miley Cyrus has opened up about her depression and how it affects her. She acknowledges it is out of her control and unrelated to her lifestyle and status as a superstar, but recognizes she can help others by talking about it. She says,

“There’s not much that I’m closed off about, and the universe gave me all that so I could help people feel like they don’t have to be something they’re not or feel like they have to fake happy.”

Jared Padalecki

Despite the fame and acceptance actor Jared Padelecki experienced from a young age, he still struggled with depression and suicidal thoughts—even with career success, good friendships, and a strong fanbase. He notes how mental illness doesn’t discriminate, saying,

“It’s not just people who can’t find a job, or can’t fit in society that struggle with depression sometimes.”

Lili Reinhart

Actress Lili Reinhart’s struggles with anxiety peaked as she tried to navigate the world of auditions, hoping for roles and her non-acting life. Her anxiety became so severe it impacted her ability to work and made her physically unwell. She’s also spoken on social media about body image and her experiences in the spotlight, helping others (especially young girls) realize it’s okay to struggle and it’s okay to ask for help.

Kristin Bell

Depression is different than sadness, which actress Kristin Bell highlights after struggling with the condition. She describes it as much more than needing a hug or just “shaking off” the feeling, but rather needing professional help to challenge her thoughts and feel like herself again.

By voicing her experience, she hopes to validate others’ feelings and help them get the care they need. She says, “It’s important for me to be candid about this so people in a similar situation can realize that they are not worthless and that they do have something to offer. We all do.”

Gwyneth Paltrow

Famous for her wellness brand Goop and her skills as an actress, Gwyneth Paltrow has also come out to share her struggles with postpartum depression and how her experience differed widely from common perceptions. Rather than crying everyday and being unable to take care of her baby, she instead felt like a “zombie, unable to access emotions.”

Gwyneth notes, “But there are different shades of it and depths of it, which is why I think it’s so important for women to talk about it. It was a trying time. I felt like a failure.”

Howie Mandel

Comedian and actor Howie Mandel judges America’s Got Talent and advocates for more accessible and affordable mental health treatment. He was diagnosed with obsessive compulsive disorder (OCD) in his 40s, though the condition began early in his childhood. Receiving a diagnosis and beginning treatment validated his experiences and relieved the weight of managing it on his own.

Since his diagnosis, Howie strives to reduce the stigma around mental health conditions, particularly OCD, and help others get the care he needed.

Prince Harry

British royal Prince Harry has talked publicly about the effects of losing his mother, Princess Diana, and navigating grief and trauma in the public eye. He spent decades holding in his emotions and presenting a positive front, which he says strained his relationships and work. Now, he’s more upfront with his emotions and less focused on masking them.

Lil Wayne

Rapper Lil Wayne revealed he struggled with depression and loneliness as a young kid. He also disclosed the bullet wound by his heart, once called an accident, was actually the product of a suicide attempt. Lil Wayne rose to fame not long after the attempt, which he said didn’t cure his depression or loneliness.

But he feels better now than ever before, and wants others to know they can get better. He says, “(I’m) hoping I can help anyone else out there who’s dealing with mental health problems by… being vulnerable. To me, I look at it by being brave and stepping up.”

Why Is Addressing Mental Health Important?

Stigma thrives in silence and misconceptions. Speaking on mental health issues shows what the experience is really like—and that people heal. Celebrities set an example when they share their struggles, championing for vulnerability and community and showing that mental health conditions typically break the stereotypes that lead to stigma. 

Destigmatizing mental health conditions can encourage more people to seek help and view their mental wellbeing as a crucial aspect of their overall health. Both are vital components to recovery.

Find Treatment For Mental Health

Imagine your favorite actor or singer telling you they struggle with the same mental health condition you do. Discovering this connection point, and seeing how they’ve navigated the condition, can inspire hope and the willingness to get treatment. People heal in many different ways, and there’s a path for everyone.


You can find mental health treatment providers on Recovery.com and see pictures, reviews, insurance information, and more to find the best treatment for you.

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FMLA for Mental Health: What You Should Know

If you’re struggling with anxiety or depression that’s impacting your ability to work, you’re certainly not the only one. Millions of Americans face mental health challenges—but the good news is, you might be eligible for time off to focus on getting better. The Family and Medical Leave Act (FMLA) offers unpaid leave for qualified medical reasons, including mental health conditions.

Here’s everything you need to know about using FMLA for mental health.

Can You Use FMLA for Mental Health?

The FMLA covers mental health conditions.1 If your mental health significantly impacts your ability to work, you might qualify for FMLA leave. This allows you to take unpaid time off without fear of losing your job. The U.S. Department of Labor (DOL) explains: 

An eligible employee may take FMLA leave for their own serious health condition, or to care for a spouse, child, or parent because of a serious health condition. A serious health condition can include a mental health condition.

What Is FMLA?

The Family and Medical Leave Act (FMLA) is a U.S. law that provides eligible employees with unpaid, job-protected leave for specific family and medical reasons. This means you can take time off work to address serious health conditions, including mental health issues, or to care for a sick family member. FMLA is designed to help employees balance work, personal health, and family responsibilities.

Reasons for Leave

Treating the Employee’s Own Health Condition

The FMLA allows employees to take up to 12 weeks of unpaid leave to care for their health.2 According to the DOL,

An eligible employee may take up to 12 work weeks of leave for their own serious health condition that makes the employee unable to perform their essential job duties.

This includes both physical and mental health issues. If your anxiety or depression significantly interferes with your ability to work, you may qualify for FMLA leave to seek treatment. You may consult with your healthcare provider to determine if your condition qualifies.

Caring for a Family Member

The FMLA also allows employees to take unpaid leave to care for a family member3 with a serious health condition. The DOL specifies, 

Leave may also be taken to provide care for a spouse, child, or parent who is unable to work or perform other regular daily activities because of a serious health condition. Providing care includes providing psychological comfort and reassurance that would be beneficial to a family member with a serious health condition who is receiving inpatient or home care. FMLA leave for the care of a child with a serious health condition is generally limited to providing care for a child under the age of 18.   

This also includes caring for an adult child with a disability:4 

A parent may use FMLA leave to care for a child 18 years of age or older who is in need of care because of a serious health condition, if the individual is incapable of self-care because of a mental or physical disability.

Whether you need to provide physical care, emotional support, or attend medical appointments, using FMLA for mental health can offer some flexibility during times when you have extra family responsibilities.

Who Qualifies for FMLA?

To qualify for FMLA leave,5 eligible employees need to meet the following criteria: 

  • Work for a company with at least 50 employees within a 75-mile radius
  • Have worked for the company for at least a year 
  • Clocked 1,250 hours in the past 12 months

If you meet these criteria, you can apply for FMLA leave for mental health reasons.

What Mental Health Conditions Qualify FMLA Leave?

The FMLA covers a broad range of mental health conditions. This includes most common disorders:

Conditions like bipolar disorder, schizophrenia, and other serious mental illnesses are also typically covered under FMLA.6 According to the DOL,

A disability under the ADA is a mental or physical condition that substantially limits one or more of the major life activities of an individual, such as working. Major depressive disorder, bipolar disorder, obsessive compulsive disorder, and schizophrenia are a few examples of mental health conditions that may substantially limit one or more of an individual’s major life activities when active. A mental health condition requiring an overnight stay in a hospital or residential medical care facility would be a qualifying serious health condition under the FMLA. 

You can start by consulting with your healthcare provider to determine if your specific condition qualifies. 

Can You Get Paid Leave for Mental Health?

While FMLA provides job protection for unpaid leave related to mental health, it doesn’t guarantee paid time off. However, some employers offer additional paid leave options, like sick days or short-term disability, which may cover absences related to mental health. State laws also vary, with some providing paid family and medical leave benefits. Currently, 13 states have passed legislation to fund medical leave programs.7 Coverage varies according to your specific situation, so check your employer’s policies and state laws to understand your options.

Will My Boss Discriminate Against Me for Taking FMLA?

While the FMLA provides important protections,8 it’s normal to worry about potential discrimination or retaliation from your employer. However, the law prohibits employers from taking adverse actions against employees who use FMLA leave, including for mental health conditions. According to the DOL, employers are prohibited from interfering with employees’ right to take FMLA leave, as well as discriminating or retaliating those who do so. The following actions are also not allowed:

  • Refusing to authorize FMLA leave for an eligible employee
  • Discouraging an employee from using FMLA leave
  • Manipulating an employee’s work hours to avoid responsibilities under the FMLA
  • Using an employee’s request for or use of FMLA leave as a negative factor in employment actions, such as hiring, promotions, or disciplinary actions

Taking FMLA leave is your right. You shouldn’t have to worry about losing your job or facing negative consequences because you’re taking the time you need to care for your mental health. If you believe your rights have been violated, you may consult with an employment attorney. 

Who Can Fill Out FMLA Paperwork for Mental Health?

Typically, a healthcare provider, such as a psychiatrist, psychologist, or therapist, can complete the FMLA paperwork certifying your need for leave due to a mental health condition. They’ll provide the necessary information about your diagnosis and a treatment plan to support your FMLA request. While your employer doesn’t need to know your medical history, they can “request that you provide medical certification containing sufficient medical facts to establish that you are using FMLA leave for a qualifying serious health condition.”9

How to Apply for FMLA for Mental Health

Applying for FMLA leave for mental health reasons might seem daunting, but understanding the process can make it easier. Here’s a general guide:

  1. Inform your employer: Start by notifying your HR department or supervisor about your need for leave due to a mental health condition. While it’s not always required, providing 30 days’ notice is ideal.
  2. Complete FMLA paperwork: Your HR contact can help you with the FMLA paperwork.10 This usually includes a request form and a medical certification form.
  3. Obtain medical certification: Schedule an appointment with your mental health provider to complete the medical certification form. This document confirms that your condition qualifies for FMLA leave.
  4. Submit required documents: Return the completed FMLA paperwork and medical certification to your employer.
  5. Understand your rights: Familiarize yourself with FMLA regulations and with your employer’s leave policies. This knowledge empowers you to protect your rights around requesting and taking leave.

Everyone’s situation is unique. If you run into any difficulties, consider consulting with an employment attorney for guidance.

Employee Requirements 

Employees have responsibilities when taking FMLA leave:11 

  • You must provide your employer with sufficient notice when your need for leave is foreseeable.
  • You’ll need to cooperate with your employer in providing medical certification. 
  • While on leave, you may need to periodically update your employer on your status, especially if your return-to-work date changes. 

Follow your employer’s specific FMLA policies for accurate guidance.

Employer Requirements

Employers also have specific obligations under FMLA:12

  • They must provide eligible employees with unpaid, job-protected leave for qualified medical and family reasons. 
  • They have to maintain your group health insurance coverage during your leave. 
  • Upon return, they must reinstate you to your same position, or an equivalent position with equal pay and benefits. 

When it comes to FMLA and mental health, it’s important for both employers and employees to understand their rights and responsibilities. To learn more about how to talk to your employer, see our article on requesting time off work to go to rehab. 

Find Treatment for Mental Health

Taking care of your mental health is a priority—even if it means having a difficult conversation with your employer. If you’re struggling with a mental health concern that’s impacting your ability to function at work, look for professional help today. 

Frequently Asked Questions About FMLA for Mental Health

What mental health conditions qualify for FMLA leave?

The Family and Medical Leave Act (FMLA) covers a range of mental health conditions, including anxiety, depression, PTSD, bipolar disorder, and schizophrenia. If these conditions significantly limit your ability to work, you may qualify for FMLA leave. Consult your healthcare provider to determine if your condition qualifies.

Can FMLA leave be used to care for a family member with a mental health condition?

Yes, FMLA leave can be used to care for a spouse, child, or parent with a serious mental health condition. This includes providing physical care, emotional support, or attending medical appointments. The leave offers flexibility for family responsibilities during challenging times.

Does FMLA protect against job loss due to mental health leave?

Yes, FMLA provides job protection for eligible employees taking unpaid leave for mental health reasons. Employers cannot interfere with your right to take FMLA leave or retaliate against you for doing so. Your position or an equivalent role must be available upon your return.

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Can You Be Predisposed to Addiction?

Your genes affect your hair color, height, personality, and even your music taste. But can they go so far as predisposing you to a substance or behavioral addiction? Research says yes—but the reasons aren’t as cut-and-dried as having a certain gene or not. 

But in any case, it’s crucial to note that being predisposed to addiction doesn’t mean you’ll become addicted. Other factors contribute much more heavily to addiction, like your environment, life situation, past traumas, and more.

When The Apple Doesn’t Fall Far From The Tree

Certain genetic functions and traits can pass through families and predispose you to addiction, much like being predisposed to a condition like diabetes, depression, or heart diseases. The DNA you inherit can make you up to twice as likely to develop an addiction compared to someone with a different genetic makeup. 

So if your parents or grandparents have had an addiction, you’re more likely to develop one too. The likelihood varies slightly by substance, but hovers around 2x for most. 

This phenomenon has been meticulously studied and documented, mainly because it can seem so counterintuitive. If you see first-hand how an addiction has hurt a parent and affected your life, falling into the same patterns would seem like the last thing you’d expect to happen. But those genetic variables, plus your environment and life history, can turn casual substance use into an addiction right under your nose.

Genes Related to Addiction

Several genes code for different traits and predispositions that can lead to addiction. These genetic influences show a pattern of causation, but the exact reasons for those patterns isn’t as well-known or understood, yet. Here are a few examples of specific genes and genetic variants that can predispose someone to addiction:

  • One variation of the dopamine receptor gene can make you more susceptible to the addictive effects of substances because it changes how substances influence your brain’s reward pathway.
  • Variations in genes Per1 and Per2 can trigger someone (especially a teenager) to drink more alcohol than another, especially when stressed.  
  • People can be more likely to develop an alcohol or opioid addiction if they have a certain variation in their mu opioid receptor gene.
  • Dual copies of a gene called CHRNA5 makes people twice as likely to become addicted to nicotine, since the coding of that gene makes cells more sensitive to nicotine.

Is There an “Addiction Gene?”

In short, no. No one gene codes someone to become addicted to substances. And even for the genetic variations that can lead to addiction, it’s not a given that having those WILL make you addicted. That’s because addiction is the product of much more than your DNA. 

While there are “risk genes,” these aren’t the same as a gene that guarantees addiction. More often, genetic addiction risks relate to how your brain processes risk and reward, and if you’re more or less impulsive. How your brain regulates dopamine signaling also contributes to addiction risk, which is determined by your genes and various genetic variants.  

The Role of Epigenetics

Your behaviors and environment can activate or deactivate parts of your genes, a process called epigenetics. These changes aren’t to the DNA itself, but rather how your body reads and interprets genetic sequences. This can result in more or less proteins being made and when your body makes it, which can have cascading effects throughout your body. Epigenetic changes are reversible, unlike DNA mutations. They’re also what determines the function of your cells, like whether they become heart cells or nerve cells. 

A change in your behavior or environment could result in an epigenetic change that makes you more susceptible to addiction. For example, a highly stressful situation (like job loss) could vary how your body reads a sequence of DNA, triggering the small biochemical changes that make you more susceptible to addiction—like altering how your reward pathway handles dopamine. 

The epigenetic changes that make addiction more likely can happen with or without the inherited changes that can predispose you to addiction. 

Stress and Trauma as Triggers for Change

Trauma at any stage in your life can result in epigenetic changes, designed to help you survive in some way. These changes can also be passed down from a mother to her child. For example, mothers who experience greater stress and poor nutrition during pregnancy pass down epigenetically altered genes and the higher risk for diseases and addiction.

Chronic stress associated with trauma or other events can change how genes are expressed. The hormone released when we’re stressed, glucocorticoids, makes these changes through epigenetics. Other physiological changes related to hormones like adrenaline and cortisol also make epigenetic changes, altering how genes are read and expressed. When these changes affect your reward pathway, decision-making skills, and dopamine levels, you can become more predisposed to addiction.

Environment: The Other Side of The Coin

Your environment greatly affects if you do or don’t become addicted to substances or a behavior, like gambling. Did you grow up around others who used substances, or in a traumatic and chaotic home? Did your peers at school normalize substance use? Is instability and stress a daily norm for you?

Factors like these strongly contribute to both substance use and mental health conditions like depression, complex post-traumatic stress disorder (c-PTSD), and more. 

Social pressures make up your environment, too. If everyone around you uses substances, you’re more likely to as well. They might even encourage it as a bonding mechanism. Being genetically predisposed to addiction can make these environmental influences all the more impactful.

Would Knowing Risk Levels Lower Addiction Rates?

If you knew you had a higher risk of addiction based on your genes, would you be less likely to drink or take drugs? Some people might, but not everyone.

Studies found genetic risks don’t usually inspire changes in behavior. Risk doesn’t equal sureness, so people may not feel they need to make any changes. 

However, some people would find that information invaluable, much like discovering their genetic risks for cancer could help them navigate its prevention and treatment. It might inspire them to them take the appropriate steps to screen for it regularly and catch it early on. Depending on their risk levels, they may make changes to their lifestyle and diet to lower their risk of developing cancer. 

Similarly, someone who knows they’re at-risk to develop addiction can make lifestyle adjustments (like not drinking) and work on stress-management to lower their risk.

Knowing Your Risk Without Genetic Testing

You don’t need lab results to let you know if you’re predisposed to addiction or more likely to develop it. While that’s the most accurate route, you can also take a look into your past.

Did you have a parent or grandparent that struggled with addiction? You’ve likely inherited small genetic variations that make it more likely for yourself. And, that might also mean you’ve grown up in an environment that would contribute to addiction’s development. You may have PTSD, a mental health condition, or chronic stress from an unstable household or emotionally unavailable parenting, which can all heighten your chances of addiction.

Reflect on how drinking or taking drugs makes you feel—this can be another great indicator of your addiction risk, but it takes mindfulness and being willing to recognize issues. Ask yourself,

  • Do you feel markedly less afraid, anxious, or stressed after drinking or taking drugs? 
  • Do you like yourself better after you’ve drank or taken drugs?
  • Do you feel like you need it?

Recognizing these results early on and proceeding cautiously can prevent casual use from becoming an addiction. You may decide to abstain all together if the potential for addiction feels too great. The choice is yours. 

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Unravelling Risk Factors and Strategies for Prevention of Mental Illnesses

Within the global health landscape, the prevalence of Substance Use Disorders (SUDs) and mental illnesses is quite significant. Data reveals that almost 1 in 4 adults have experienced a mental illness in the past year. Approximately 60% of the population1 consumed tobacco products, consumed alcohol, or used illicit drugs in the past month in the US. 

The rising prevalence of substance use is a concerning trend, as it often escalates into Substance Use Disorders (SUDs) and other mental illnesses. Excessive substance use can lead to a range of problems, from deteriorating physical and mental health to strained family relationships. This escalation can result in various challenges, including financial issues, legal troubles, and decreased academic or professional performance.

Prevention refers to strategies and measures aimed at stopping or mitigating the initiation and escalation of substance use. Proactively addressing these concerns is crucial. By implementing prevention efforts, individuals and communities can work together to create environments that deter substance use.

Levels of Prevention

Prevention involves taking action and adopting strategies to avoid or reduce the development of mental health problems. It aims to promote well-being and create conditions that support mental health, ultimately preventing or minimising the occurrence of mental illnesses. 

Prevention can be done at different stages. Primary prevention works before the illness starts, while secondary and tertiary prevention focuses on dealing with the illness after it has begun.

Level 1: Primary Prevention – Stopping Mental Illness Before It Starts

Primary prevention involves actions and strategies that aim to prevent the initial occurrence of a health issue or condition before it develops. In the context of mental health, primary prevention focuses on addressing risk factors and promoting protective factors to stop mental health problems from emerging. 

It includes interventions designed to create supportive environments, enhance resilience, and reduce exposure to factors that may contribute to the development of mental illnesses. Primary prevention is proactive, aiming to build a foundation of mental well-being and resilience in individuals and communities.

Level 2: Secondary Prevention – Early Intervention for Emerging Issues

Secondary prevention involves efforts to detect and address a health issue at an early stage, especially after it has already begun but before it becomes more severe or leads to complications. In the context of mental health, secondary prevention focuses on identifying and intervening with individuals who may show early signs of mental health challenges.

By recognising and addressing problems in their early stages, secondary prevention plays a crucial role in minimising the impact of mental health challenges. It provides an opportunity for timely support, interventions, and resources to enhance overall well-being and prevent the exacerbation of mental health issues.

Level 3: Tertiary Prevention – Rehabilitating and Preventing Relapse

Tertiary prevention involves efforts to manage and minimise the impact of an existing health issue, especially one that has already reached a more advanced or chronic stage. In the context of mental health, tertiary prevention focuses on rehabilitation and preventing the recurrence of mental health problems.

It includes interventions designed to support individuals who have experienced mental health challenges, aiding in their recovery and implementing strategies to prevent further complications or relapses. Tertiary prevention aims to enhance the overall quality of life and well-being of individuals already dealing with mental health issues.

Risk Reduction as a Preventive Measure

The risk reduction approach is a systematic and proactive strategy aimed at minimizing the likelihood or impact of potential harm in various aspects of life. This method involves identifying potential risks, analysing their causes and consequences, and implementing targeted measures to mitigate or eliminate them.

For example, common risk factors of cardiovascular issues include unhealthy eating habits, lack of physical activity, and excessive consumption of processed foods high in saturated fats. To mitigate these risks, individuals can adopt a balanced diet rich in fruits, vegetables, and whole grains, engage in regular physical activity, and limit the intake of processed foods. These proactive measures work to manage weight, regulate cholesterol levels, and improve overall cardiovascular health, reducing the likelihood of heart-related problems.

To understand this in the context of mental health, consider the example of stress management. Chronic stress is a recognised risk factor for mental health issues such as anxiety and depression. To mitigate this risk, individuals can implement stress reduction techniques such as mindfulness, meditation, or engaging in activities that bring relaxation. By proactively managing stress, individuals decrease its potential negative effects on mental well-being, fostering resilience and reducing the risk of developing mental health issues.

Common Risk Factors of Mental Illness and Substance Use Disorders

With an understanding of how risk reduction plays a role in preventing mental illnesses, let’s delve into the common risk factors associated with mental health challenges. In the following section, we will examine how these factors might be effectively addressed both at the community and personal levels.

The Interplay of Genetics

Genetics plays a significant role in shaping an individual’s vulnerability to both mental illness and SUDs. Certain genetic factors may predispose someone to a higher risk of developing conditions such as depression, anxiety, or addiction.

Although we have limited control over genetics, understanding family history can pinpoint a vulnerable population, offering valuable insights for targeted interventions. If substance use disorders or other mental illnesses are prevalent in your family, it may indicate a heightened risk for you.

Environmental Influences

Environmental factors, encompassing early life experiences, trauma, and living conditions, contribute significantly to the risk of mental health challenges and substance use. 

  • Adverse childhood experiences (ACEs): Stressful or traumatic events during childhood such as physical, emotional or sexual abuse, can serve as catalysts2 for both mental illness and SUDs. 
  • Parenting Practices: Harsh parenting and physical punishment during childhood have been shown to undermine child well-being. 
  • Bullying: Bullying stands out as a primary risk factor for mental health issues. 
  • Socio-economic Factors: Lower education, unstable employment, and financial stress were associated with a higher risk of depression.

Coping Mechanisms and Stress

Individuals facing chronic stress or lacking effective coping mechanisms may be at a higher risk of both mental illness and substance use. Substance use can sometimes emerge as a maladaptive coping strategy, further exacerbating mental health challenges.

Substance Use

Excessive alcohol consumption, smoking, and marijuana use were identified as risk factors for depression. In India, 17% of children aged 13 to 15 years reported consuming alcohol3. These figures emphasise the vulnerability of the younger population, demanding a focused approach to prevention and support. 

Children whose parents use substances may face an elevated risk2 of developing a mental illness or substance use disorder. The environment in which children grow plays a critical role in their overall well-being. When parents engage in substance use, it introduces a complex set of factors that can impact their children’s mental health.

Childhood Symptoms of Depression

Childhood mental illness notably predicts adult mental health issues. The onset of many mental illnesses often occurs during adolescence. Timely identification during this crucial stage can significantly improve the prognosis and outcomes for individuals.

This list is not exhaustive, and various other risk factors contribute to mental illnesses. Research indicates that mental illnesses are at least partially preventable4. In the following section, let’s explore strategies to mitigate or manage these risk factors, aiming to decrease the likelihood of adult mental illness and substance use disorders.

Strategies to prevent mental illnesses and substance use disorders

Preventing mental illness necessitates coordinated actions both at the policy level and the individual level. The “Origins of Adult Mental Illness” (OrigAMI) model4 provides a structured approach to crafting a prevention program. The initial step is to identify modifiable risk factors, followed by the identification of vulnerable populations, such as children displaying early signs of mental illness. Subsequent steps entail determining effective intervention techniques and establishing a suitable workforce. 

In low to middle-income countries, task shifting may be essential, involving the collaboration of teachers, counsellors, parents, and volunteers. The final step involves a thorough policy analysis, ensuring that prevention efforts are integrated into broader healthcare policies for comprehensive and sustainable impact.

At the community level, schools and colleges play a pivotal role in fostering mental health awareness. Implementing intervention programs within these settings, where children and parents are easily accessible, can significantly contribute to preventive efforts. Equipping young individuals with healthy coping techniques early on is crucial for enhancing stress management skills. Integrating fundamental mental health education into the school curriculum ensures that children receive essential knowledge from an early age.

Beyond academics, educating children and adolescents about the potential effects of substance use is imperative. Workshops for new parents can serve as valuable platforms for learning about children’s needs and promoting healthy communication and parenting practices. Educational institutes should establish and strictly enforce protocols against bullying, recognizing that both the bullied and the bully may exhibit signs of psychological distress that require appropriate counseling.

Additionally, to curb substance use among adolescents, it is essential to limit advertisements and ensure restricted access to substances like cigarettes and alcohol. By adopting these comprehensive measures within educational institutions, communities can create environments that prioritize mental well-being, resilience, and healthy interpersonal dynamics.

Empowering Yourself for Mental Health And Wellbeing

Empowering yourself with knowledge and practical measures can significantly contribute to overall well-being. Here are a few things you can try to incorporate: 

  • Maintain a healthy lifestyle: Poor overall health is also a risk factor for poor mental health. Prioritize regular physical activity, a balanced diet, and adequate sleep to support overall well-being. 
  • Stress management techniques: Chronic stress is a common trigger to anxiety and depression. Learn and practice stress-reducing activities such as mindfulness, meditation, or deep breathing exercises.
  • Build a support system: Cultivate strong social connections with friends and family, fostering a support network for challenging times.
  • Seek professional help when needed: Don’t hesitate to consult mental health professionals if experiencing persistent emotional challenges. Seeking help early on can reduce the impact on daily functioning and improve prognosis.
  • Limit substance use: Be mindful of alcohol, tobacco, and drug consumption, keeping it within recommended limits to prevent substance use disorders. Substance use can put you and your loved ones mental wellbeing at risk. 
  • Educate yourself: Stay informed about mental health, substance use, and their potential risks to make informed lifestyle choices.
  • Mindful parenting: For parents, focus on creating a supportive and nurturing environment for children, fostering positive mental health from a young age.
  • Educate children on substance use: Initiate open and honest discussions with your children about the harmful effects of substance use. Provide them with accurate information, emphasizing the potential risks and consequences associated with alcohol, tobacco, and drug consumption.
  • Bullying awareness and action: Be vigilant for signs of bullying and engage in open conversations with your children about their experiences. If your child is facing bullying, take proactive steps by communicating with the school, teachers, or relevant authorities to address the issue promptly.
  • Educate others: Share knowledge and awareness about mental health and substance use disorders to contribute to a more informed and supportive community.

In closing, it’s essential to recognize that mental illnesses and substance use disorders are preventable to some extent through proactive measures and informed choices. Education plays a pivotal role in this prevention journey – empowering yourself and your loved ones with knowledge about risk factors, early signs, and effective preventive strategies. Additionally, embracing a culture of seeking professional help when needed fosters a supportive environment for overall well-being. Let’s prioritize mental health, advocate for awareness, and foster a community where wellbeing is a shared priority.

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Employee Wellness: What It Is And Why It Matters

Employee wellness means more than good job performance. It means you are well as a mother, father, child, spouse—as a person. Employee wellness focuses on your mental health, your physical health, your work satisfaction, and ensuring you have access to all available health resources in your company. 

Good job performance is a byproduct of employee wellness, as is a positive company culture and employee retention. Several platforms cater to employee wellness and mental health literacy to encourage this, including Spirence. 

Listen to our podcast episode with Spirence’s Vice President, Laura Kunz, to learn more about the platform and how it came to be.

What Is Employee Wellness?

Employee wellness broadly refers to the overall health and well-being of employees. Well-being is your ability to “address normal stresses, work productively, and realize one’s highest potential.” People with intact well-being perform better1 at work and other areas of life, including their overarching health. 

Employee wellness involves more than just the employee’s at-home efforts to better their health; it centers specifically on what companies can do to improve the workspace and the well-being of their employees. 

To do this, companies often offer an Employee Assistance Program (EAP). These include resources for therapy, stress reduction, and tips for general well-being.

Why Does It Matter?

A positive workplace culture that prioritizes employee wellness offers a host of benefits. It reduces turnover, as employees are most likely to quit a job over toxic workplace cultures2. Studies found poor company cultures are more likely to lead to resignations than low pay or burnout. 

Toxic workplace cultures contribute to higher percentages of depression2, stress, anxiety, and physical health conditions like heart attacks and high blood pressure. These issues follow employees home, affecting their free time and families. 

Even in healthy workplace cultures, heavy workloads, stress, and a lack of mental health resources can drive employees to a better opportunity. Offering them solutions in-house can prevent resignations and foster healthy cultures, healthy employees, and happier home lives. 

Improved Quality of Life

A positive workplace culture that prioritizes employee wellness can improve their overall quality of life. Plus, feeling positive toward work can make non-work hours more enjoyable and enable you to actually rest on days off, contributing to a better quality of life. You’ll have more time and mental energy to focus on who and what you love. 

Since work takes up a majority of our waking hours (⅓ of our lives3), positive or negative experiences there can dictate your well-being outside the office. Negative work environments and poor employee wellness can also affect virtual employees4. Focusing on their wellness and nurturing a positive culture benefits all employees, all the time. 

Higher Work Performance

Happier, healthier employees can connect more with their work and meet the standards set by themselves and their employers. Better mental health and well-being leads to improved productivity5, which benefits both the employee and their employer. Employees get more done and employers can focus more on their business, not rehiring employees. 

Better Overall Health

Poor well-being caused by negative work environments can affect your overall health6 via chronic stress and mental health conditions. Chronic stress can lead to conditions like cancer, heart disease, autoimmune flare-ups, and more. Conditions like depression and anxiety can also develop.

These issues are less likely to affect employees in a positive work environment, improving their overall health.

Tools And Programs for Employee Wellness

Many corporations, big and small, leverage tools and programs to improve the well-being of their employees. Employee Assistance Programs (EAP), for example, connect employees to resources about benefits, mental health, and other workplace issues. However, EAPs don’t always meet the needs of employees seeking support, but not clinical mental health services. They may want to learn more about their options or ask questions on behalf of a loved one—not go to counseling or connect with an inpatient program. 

New subclinical products can meet these needs and offer the educational tools needed to improve mental health literacy. Platforms like Spirence offer live webinars, bite-sized informational pieces on mental health, and weekly family sessions to help employees needing acute and non-acute support.

These types of platforms are designed to prevent mental health crises and the need for clinical care. Using them, employees can learn more about mental health and wellness as a whole, understand their treatment options, and pose questions to behavioral health experts. Other employee-wellness platforms include:

  1. Calm’s Corporate Well-Being Program
  2. headversity
  3. Headspace
  4. Limeade
  5. Starling Minds

Education as a Key Component

Many employee platforms share one key component: education. Webinars, articles, videos, and even games educate employees on mental health and treatment options in case their wellness suffers a drop. As their mental health literacy increases, employees can enjoy greater peace of mind knowing how to care for their mental health and well-being.

Platforms like Spirence also provide the option to pose questions to professionals, like therapists, psychologists, and coaches (for free).

The Trickle-Down Effect of Caring Employers

Offering an employee wellness platform, especially a comprehensive one, can make employees feel seen and cared for by their employer. This can build a positive work culture and psychologically safe work environment. In a culture like this, employees are “healthier, happier, more productive, and less likely to leave3.” Profits increase for the company, with higher productivity and less turnover.

Positive work environments contribute to a sense of belonging3, helping employees feel like their contributions and well-being matter. Employee wellness tools can go a long way in fostering this environment. 

How Employees Can Prioritize Their Well-being in and Outside of Work

Employee wellness platforms aren’t the only way to improve and prioritize your mental health and well-being. Here are a few strategies and practices that can protect your wellness and bolster your mental health literacy:

  • Set boundaries at work with clear office hours.
  • If a request beyond your role’s responsibilities comes in, communicate what is and isn’t your job to do.
  • Avoid water-cooler gossip to distance yourself from potential drama and stress. 
  • At-home employees can designate an area of their home solely for work, like a desk in a guest bedroom vs. working on the couch.
  • Seek mental health support through therapy.
  • Educate yourself on mental health and well-being through books, articles, podcasts, and more.

Educational Resources for Mental Health Literacy

These are a few options you can check out to teach you more about mental health in the workplace and beyond.

Books 

Podcasts 

Articles

Progression and Promises in Positive Workplaces

Creating positive work environments, healthy workplace cultures, and improving mental health literacy offer a much-needed shift in employee well-being. Wellness platforms can contribute to a healthy workplace by connecting employees to invaluable clinical and subclinical resources—and they show employers care. 

Self-education through books, podcasts, and articles can also bolster your mental health literacy and well-being. With these tools and resources, you can grow and maintain your wellness.

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Does a Good Therapeutic Relationship Matter in Therapy?

Effective therapists possess empathy, compassion, and trustworthiness that make them seem like superhuman healers. Those who find a good therapist often stay with them for years, which can strengthen their overall healing process and improve their resiliency. 

Building a rapport and sense of trust with your therapist can encourage you to share freely and feel safe doing so. This is crucial—if you’re going to therapy but don’t feel comfortable talking to them, you won’t reap the same benefits.

Many therapists encourage you to stay open-minded to the idea of switching therapists, so you can find your best fit. But how do you know what a ‘good fit’ is? And does it really matter?

Defining The Therapeutic Relationship

Therapeutic relationships1 build off mutual engagement, collaboration, and the bond patients and therapists form. Much of therapy’s success comes from this relationship, even more so than the type of therapy used and the therapist’s specific training. This positive effect exists in both medical and psychological treatment, and improves outcomes in both2.

The therapeutic relationship starts to form at your very first session. It can strengthen with each session2 as you and your therapist set goals, collaborate, and form a space you feel safe in. 

Benefits and Examples of a Positive Therapeutic Relationship

Ultimately, positive therapeutic relationships link to treatment success2 and healing. You’re more likely to continue with treatment and feel hopeful for change if your therapist makes you feel understood, safe, and an important part of the treatment process. 

Setting goals together and working to achieve them teaches practical skills for navigating future problems and concerns—without relying on advice from a therapist. This grows your agency and sense of self-efficacy, bolstering your hope and overall well-being. 

Here’s how a positive therapeutic relationship could look in practice:

  • You reach your first therapy appointment, nervous and unsure of how it’ll go. The therapist notes your discomfort and immediately works to reverse it: smiling, welcoming you, and introducing themselves. They ask questions about yourself and what brought you to therapy, listening attentively and engaging in the conversation with their body language and expressions. You feel cared for and safe, and start opening up more. Based on your first or second session, your therapist outlines a few goals you’ll work on together and asks you how they sound. You feel like a collaborative part of your treatment, which makes you want to engage more. 

Effects and Examples of a Negative Therapeutic Relationship

A negative therapeutic relationship can disrupt treatment and reinforce stigma about therapy and mental illness as a whole. You may feel uncomfortable, shamed, and belittled with a therapist that isn’t the right fit for you. But if that happens, don’t worry; you can always switch therapists. A therapist who isn’t the right fit for you could be perfect for someone else, and vice-versa. 

An example of an unhelpful therapeutic relationship could look something like this:

  • You go to your first session with the new therapist. Right away, they don’t exude compassion or much interest in you and your issues. You start to feel uncomfortable, and don’t trust them with your pain. They ask a few questions about yourself and why you’re there, but other than that, you feel pressured to fill the silence. They suggest modifications and changes to your behavior in a way that makes you feel diminished and a little embarrassed. You leave and cancel your next appointment.

How Therapists Can Foster a Good Relationship

Some people come to therapy with past misconceptions, shame, and nervousness. Therapists can alleviate these anxieties through the way they treat their patients and how they treat the act of getting help. 

For example, a kind, empathetic, and patient therapist can soothe initial nerves and validate their patient’s desire for getting help. They can express gratitude for their patient seeking care, and for trusting them with their emotions and struggles. These efforts connect the therapist and patient as humans, which can spark an immediate, positive affect on their relationship.

Aspects like these are key to forming a positive therapeutic relationship: 

  1. Listening without interrupting
  2. Validating fears and emotions
  3. Compassion
  4. Identifying and setting goals together
  5. Communicating regularly about your sessions and how they’re going

How You Can Contribute

A good therapeutic relationship takes effort on both sides, just like other relationships. Here’s what you can do (if and when you feel comfortable):

  1. Recognize your therapist can’t, and shouldn’t, think for you
  2. Engage in the goals you work on and any homework they may give you
  3. Communicate as openly as you feel comfortable
  4. Stay open-minded during your sessions
  5. Let your therapist know what is and isn’t working for you (they want to know!)

Signs You And Your Therapist Are a Good Fit

How you feel towards your therapist and the quality of your sessions can clue you into the nature of your connection. Do you enjoy talking to them? Do they make you feel safe and valued? Do you ever feel silly or foolish for opening up to them?

Reflect on your therapy itself too. Do you know what your treatment goals are, and has defining them been a collaborative process with your therapist? Do you feel like you’re making progress toward them? Do you feel hopeful in your recovery? 

Here are those questions laid out as boxes you can check to know if you’re a good fit:

  • You feel comfortable with your therapist.
  • You feel like they genuinely want to help and understand you.
  • You appreciate them as a person and feel appreciated in return.
  • You set clear goals and collaborate to meet them.
  • You feel hopeful and sense the tangible possibility of healing.

If you find you can’t check any of these boxes, or even feel the opposite, that’s a good sign you and your therapist aren’t the right fit. Remember, that’s okay. View any poor fits as a helpful learning experience that gets you closer to the right one. 

What to Do If Your Therapist Isn’t The Right Fit

First, know it’s acceptable and normal to not click with your therapist. Who you will feel comfortable with won’t be the same as your friends, or people in TV shows and movies. 

Therapists want you to feel comfortable and understood, and trying a new therapist is often one of the best ways to accomplish that. They’re used to it and don’t view it as a personal attack–not at all. People switch therapists for financial reasons, personal reasons, scheduling constraints, and much more.

Before you terminate your sessions, first have a conversation with your current therapist. You can bring up your concerns and what might make you feel more comfortable. For example, you might say you’re not seeing as much progress as you hoped and don’t feel like you’re learning coping strategies. You could also explain the behaviors or attitudes of your therapist that may make you less comfortable engaging in treatment. See what they say, and how they plan on addressing your concerns. 

You may find a solution and feel comfortable continuing services. If you don’t, here’s what you can do:

  1. Cancel any upcoming appointments with your current therapist.
  2. If you’re comfortable with it, explain that you’ll be leaving and looking for another therapist. Your current therapist can help connect you to other options. 
  3. Search for other therapists in your location or ones with online availability.
  4. Vet your new options for the qualities or treatment modalities you’d like to see after your first experience. Here’s 11 tips for finding the right therapist.
  5. Set up your first appointment; you can voice your concerns and preferences right away so your new therapist understands your past experience and treatment goals.

Empathy And Connection to Power Your Healing

In a good therapeutic relationship, you might feel like your therapist has superpowers. They help you see different perspectives, set personal goals, and feel–perhaps most importantly–that you and your experiences matter. You’ll ultimately learn to become your own therapist, navigating challenges and day-to-day life with new skills and coping strategies you learned in therapy.
Listen to our podcast episode to learn more about the therapeutic relationship and insights from renowned expert Dr. Donald Miechenbaum.

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Debunking the Rock Bottom Myth: A New Perspective on Addiction Recovery

The “rock bottom” myth suggests someone must hit a catastrophic low point before they recover from addiction. While pain and negative consequences can motivate change, it can be misguided and even dangerous to require this of everyone with an addiction. Many recover or start treatment without hitting their rock bottom. Staying connected to loved ones, work, and daily life often supports recovery.

Rock bottom is considered the ultimate low in someone’s life, like losing loved ones, money, status, freedom, and possessions. It can be a singular event of cumulation of consequences. Everyone will have a different rock bottom, which makes the myth even less defined—one person may consider becoming homeless and unemployed rock bottom, another may consider getting divorced to be their rock bottom.

Viewing “rock bottom” as the only entry point into treatment can harm a person with addiction and their loved ones. Instead of waiting to reach rock bottom, they can take agency over their treatment journey and seek help whenever they feel it’s necessary.

What Is The Rock Bottom Myth?

The rock bottom myth views hitting “rock bottom” as a requirement1 for addiction recovery. It sees pain, grief, and negative consequences as motivators for going to and engaging in treatment. While this can be true and often is, not everyone needs to hit a breaking point to get treatment or want help. You certainly don’t need to reach rock bottom to deserve help. 

The rock bottom myth originated in the 12-Steps2 of Alcoholics Anonymous (AA), where hitting rock bottom was once a sign participants were ready to practice and commit to the 12 Steps (and recovery). Rock bottom was portrayed as a launching pad into recovery. If participants didn’t reach this point, they weren’t seen as being able to commit to recovery and/or recover fully.

More recently, the rock bottom myth has faded to make room for unique recovery journeys, motivations, and underlying causes of addiction.

The Dangers of the Rock Bottom Myth

Waiting to hit rock bottom and going through it as a prerequisite for recovery poses several dangers. The components of rock bottom can be dangerous in themselves, like homelessness or committing a crime. 

The rock bottom myth can also keep someone from getting treatment and continuing in their addiction, which harms their mind and body. Waiting for a flip to switch, an epiphany, or acute realization of being at rock bottom delays treatment and can contribute to denial.

Someone may hesitate to pursue treatment if they’ve not hit a clear breaking point. They may worry treatment professionals won’t take them or their needs seriously if they don’t have evidence of hitting rock bottom. This can delay treatment, cause shame, and deepen hopelessness. These feelings can even build into a crisis point.

Rethinking Recovery: Early Intervention and Support

Early intervention is found to be the most effective preventative measure2 against addiction and its consequences. It can prevent addiction from worsening to a breaking point, and the harms that come with that. Knowing you can get treatment at any point, not just at the end of your rope, can encourage people to seek treatment sooner. 

Recognizing signs of addiction can help you get treatment early. For example, you may notice you’re drinking every night and feel uncomfortable or ill when you try to stop. Even though it hasn’t affected your relationships, work, or finances, you still feel like something’s wrong. Getting treatment once you realize that can stop its progression and hitting rock bottom.  

Alternatives to the Rock Bottom Approach

Many avenues to recovery don’t rely on hitting rock bottom or anything close to it. You can find the motivation to heal and treat underlying symptoms through therapy, supportive relationships, and various community resources.

Therapies like cognitive behavioral therapy (CBT) and motivational interviewing can disrupt unhealthy thought patterns and teach healthy coping mechanisms. Exploring past events and trauma can also help you identify triggers, connect them to substance or behavioral addictions, and find new ways to cope.

Connecting to peer support and community resources prevents the isolation and loneliness that can feed into substance use. Stay close to friends and loved ones, and try joining an in-person or online group focused on recovery. Twelve-Step groups may be a good option for you, or you could attend non-12-Step groups like SMART recovery. You could also join non-recovery focused communities, like clubs or sport teams, to meet new people and grow your support network. 

These communities and support networks can jumpstart your recovery by offering a subjective view of your situation. For example, an honest conversation with a friend or family member may open your eyes to your need for treatment, before you start experiencing consequences. Listening to their concerns and ideas can inspire you to begin treatment with their support. 

Shifting Societal Perceptions on Addiction and Recovery

Addiction and mental health conditions aren’t fully understood by the public—unless it happens to them or someone they love. This misunderstanding can lead to prejudice and stigma, which can make it hard for anyone to admit to struggling with a mental health condition or addiction. This can hinder early intervention and land people at their rock bottom.

Awareness on addiction, mental health, and the realities of recovery can change how the public views these conditions. Rather than seeing it as something that must reach a certain drastic point for treatment, addiction can instead be seen as something you treat as soon as you notice symptoms, much like most illnesses or wounds. If addiction or mental health conditions were seen in this light, more and more people might feel willing to admit their struggles and seek treatment before it becomes consuming.

Thankfully, many efforts and organizations are actively working on making the public aware of the realities of addiction and mental health—and reducing stigma along the way.

  • To Write Love On Her Arms raises awareness for depression, suicide, self-injury, and addiction. They offer a message of hope and unity and donate to treatment efforts by selling merchandise. 
  • The Herren Project helps individuals and families find treatment with personalized support and scholarships to cover treatment costs. They’re founded by former NBA player Chris Herren, who recovered from addiction and seeks to reduce the stigma surrounding recovery, bring awareness, and provide hope.
  • Red Ribbon focuses on youth and drug use prevention in schools. They advocate for drug use prevention and recovery, hosting events to spread awareness and help more and more people commit to drug-free lives.
  • The Pan American Health Organization (PAHO) runs a mental health awareness campaign addressing stigma and discrimination. They encourage countries and people to #DoYourShare in reducing stigma and making treatment more accessible.
  • CALM’s “Suicidal doesn’t always look suicidal” campaign uses photos and videos of people before the took their own life to bring awareness to suicide, encourage treatment, and start much-needed conversations without shame or judgment.
  • State campaigns are often run by state governments and aim to bring awareness to addiction and help people connect to treatment. Search the internet for local campaigns or check community centers, libraries, and churches in your town or city.

How to Seek Help Without Hitting Rock Bottom

You don’t have to hit rock bottom to heal. If you’re experiencing symptoms of addiction or a mental illness and notice they have an effect on your life, ask yourself, “Do I want to keep living like this?” The answer can inform what you do next.

If you answer no, you can begin seeking treatment or implementing changes into your daily life. You can set up an appointment with your primary care physician, bring your concerns to them, and see what they recommend. Keep questions like these in mind to get a full understanding of your condition and treatment options:

  1. Do my symptoms and experiences fall under a diagnosis? If so, which one(s)? (This can help insurance cover the costs of treatment.)
  2. What lifestyle changes or new habits would you recommend to improve my symptoms?
  3. Do you recommend I start medication to manage my symptoms? If so, which one, and what are its side effects?
  4. What type of treatment or level of care would you recommend?
  5. Will I need a referral for my next steps in treatment?

Use Recovery.com to find treatment centers for your condition and preferences, filtering by insurance coverage, amenities, and location. 

Helping Someone Else

An open and non-judgemental conversation with a friend or loved one could save them from the life-altering effects of hitting rock bottom—and even save their life. 

You may notice a friend or family member acting differently; seeming ‘off.’ They may drink more often or get drunk more regularly. They may seem sad and view life through a suddenly cloudy lens. If you notice signs like these or just intuitively know something’s wrong, voice your concerns calmly, non-judgmentally. Here’s how that could look:

  • “I’ve noticed you seem down lately. Would you like to talk to me or someone else about it?” 
  • “I see you’ve been drinking more and more often. Do you think you might need help to stop?”
  • “I feel like you’ve been acting differently lately—you seem sad. Can I help you, or help you find help?”

Together, you can look into treatment options, just talk, or both. Your support and care can make all the difference. 

Bridging Rock Bottom With Early Intervention

You don’t have to hit your breaking point to heal. Though the rock bottom myth holds truths about motivation to change, it’s not necessary for successful recovery. Getting help as soon as you notice signs in yourself or someone else can be key to early intervention and healthy living.
Browse Recovery.com to find a treatment center that fits your needs.

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Rural Recovery: Challenges and Hope

Rural areas offer great benefits, like a slower pace of life, open fields, and close-knit communities. But what happens when they can’t provide the resources someone vitally needs, like addiction and mental health treatment? Lacking what many urban dwellers take for granted—access to resources—can endanger the billions of people living in rural communities worldwide. 

Thankfully, technology has opened new doors for rural areas. With just a phone or laptop and internet access, people can attend therapy online and even virtual rehab. Increased mental health awareness in small communities may also create new and improved resources for areas in desperate need.

To learn more about the healthcare challenges in rural areas and how providers navigate them, listen to our recent podcast episode featuring Dr. Jonathan Rosenthal!

Behavioral Health Challenges in Rural Areas

About 1/5th of rural Americans have a diagnosed mental health condition1. Urbanites make up close to the same. However, those in rural areas have more trouble accessing care and finding clinicians, as opposed to urban cities with multiple clinics and practices to choose from. 

Over 60% of rural Americans live in ‘mental health provider shortage’ areas1, with 65% of rural counties without psychiatrists. Waiting lists for therapy or more intensive care can extend for months. Limited mental health knowledge and stigma often prevent rural residents from seeking treatment at all. If they do, low availability often means they must choose the first provider they can get, whether they’re a knowledgeable fit or not. Personalized care can become more of a luxury than a necessity.

Primary care physicians (PCPs) often become the first and only line of defense for mental health conditions and substance use. While PCPs can prescribe medications and recommend next steps, they often don’t have the specialized training in mental health or addiction to educate and support patients properly.

A Top Challenge: Growing Suicide Rates in Rural Communities

Rural residents are twice as likely to die by suicide than urban residents1. Isolation, stigma, poverty, and an inability to access care contribute to the steadily growing rate of rural suicides. Timely access to care, crisis services, and increased awareness of mental health could lower the risk of suicide among rural residents, particularly veterans and young adults. 

Boundaries to Effective Care in Rural Communities

People in rural areas face several prevalent barriers to care, including limited availability of resources, long travel times to get to treatment, and stigma. 

Lack of Access

Here’s a story highlighting a common treatment scenario in rural communities, where the necessary treatment simply isn’t available:

  • Rosie has been struggling with severe depression and loneliness. After months of waiting, she finally got into therapy. Rosie thinks group therapy would help her feel less alone and stigmatized. Her therapist agrees, but tells Rosie they don’t have any groups in town. Rosie keeps going to individual therapy but misses out on an aspect of treatment she feels is crucial.

Not having access to is the biggest bar to effective care1. Often, those in rural communities simply don’t have clear or easy access to treatment (or any access at all) and thus don’t receive it. And when they do seek treatment, overwhelmed medical providers can only refer to whatever resources they have and hope availability opens up.

Rosie’s story is a poignant illustration of the challenges faced by those seeking mental health care in rural areas. After enduring a prolonged wait to receive therapy, she encounters another hurdle: the absence of group therapy options in her area, which she and her therapist agree could be vital for her recovery. This scenario highlights the disparity in mental health resources available in less populated regions and the significant impact it can have on those in need of comprehensive care.

Long Wait Times

Waiting time poses another barrier to care. Here’s a second scenario highlighting this:

  • Darren has a paralyzing fear of socializing and talking in groups. He feels something isn’t right and seeks out therapy, but hears he’ll have to wait at least five months to get in. To manage his symptoms in the meantime, Darren starts bringing alcohol with him to work and getting tipsy to deal with his social anxiety. 

With these long wait times, symptoms can worsen; patients could lose motivation and back out. Being unable to access care could lead to substance use as a way to cope with conditions like depression, trauma, or anxiety. 

Darren’s situation underscores the pressing challenges that arise from the lack of timely access to mental health services. Suffering from a paralyzing fear of socializing and speaking in groups, Darren recognizes the need for professional help and reaches out for therapy. However, he bumps into a discouraging five-month wait. In a desperate attempt to manage his escalating anxiety, Darren resorts to bringing alcohol to work, using it to lessen his discomfort in social situations. This scenario highlights the detrimental effects that can occur when immediate mental health support is unavailable.

Behavioral Health Illiteracy

People in rural communities may not know how to identify behavioral health issues1 or how to get treatment. Bigger cities and communities often have more programs and initiatives highlighting behavioral health treatment and broadening awareness.

Stigma

Without adequate knowledge of behavioral health conditions, stigma can make mental health challenges and addiction seem unimportant or weak, discouraging rural residents from seeking help. Living where everybody knows everybody, they may worry they’ll be judged if they try to get help or admit to a problem. 

Travel Times

Rural residents often have long drives to get to a treatment facility or clinic that meets their needs. Juggling the time spent on the road, work, and other personal obligations can delay care2 or keep them from seeking it altogether. Here’s a predicament a farmer may face when trying to get treatment:

  • Bill seeks out treatment for his alcohol use disorder and needs a psychiatrist to go to once a week. The closest psychiatrist to him practices an hour and a half away, which means he’ll be gone for almost four hours each time. But Bill runs his own cattle farm, and he needs to milk his cows every morning and ensure they’re fed. Leaving for 4 hours feels out of the question; he cancels his appointments and decides to deal with his symptoms alone. 

Solutions for Better Access and Support

Rural areas need more general physicians, therapists, and specialists to meet the rising demand for behavioral health services. Incentive programs in some states encourage new physicians to practice in rural areas1, which could steadily grow their workforce and improve access to care. Other solutions, many already in play, include:

Virtual Care

Virtual care uses the internet3 to connect patients and care providers virtually. Since COVID-19, virtual care has become more commonplace and can serve as a vital connection for rural residents and treatment providers. You only need a phone or laptop and an internet connection to access virtual care. You’ll use a secure online platform to conveniently meet with a doctor, therapist, psychiatrist, or other healthcare provider.

With virtual care, you don’t have to live in a certain city or near a therapist’s office. You can even attend residential rehab online and outpatient levels of care. And with a larger pool of providers and specialists to choose from, you can get into treatment faster and find care specialized to your needs. 

Incentives for Rural Providers

Some state governments have incentivized more healthcare providers1 to practice in rural communities. If they practice for a set number of years, they receive additional financial compensation. If every state had the funding for this initiative, it could repopulate the rural workforce with eager health and mental health providers.

Increased Behavioral Health Training

Additional training would benefit current rural providers1 and help them make better-informed decisions on patient care. Primary care physicians would understand all the available options, including virtual care and local crisis services for mental health and addiction. Some programs have started training non-professionals to provide peer support, which has had success in the rural Native Alaskan community.

Known and Accessible Suicide Prevention Strategies

Death by suicide occurs more commonly in rural populations1, especially in kids, young adults, and older adults. Social isolation and not knowing what support they have can lead to untreated crises. Many programs and crisis services do exist and specifically serve rural populations, like local crisis teams, but residents don’t often know they’re there.

Educating community members on their available crisis services and support programs could save lives. Community leaders could make their crisis services more prominent and accessible by posting them in daily newspapers and highlighting crisis hotlines like 988 (National Suicide Prevention Hotline). Schools, churches, and businesses could also spread the word to destigmatize mental health and inform residents of their resources.

Better Support for Physicians

Physicians and mental health professionals face burnout in all settings, but rural providers can end up shouldering high caseloads and pressure to treat more people than they reasonably can. Compassion fatigue and discouragement can drive providers to areas with better support, so providing support in rural settings could help them stay. Financial incentives could bring more practitioners to rural areas, also lightening the load for current practitioners. 

Psychological care, peer support, and financial benefits can help providers retain their well-being and compassion, essentially helping them help others.  

Future Goals and Ideas

In an ideal world, rural populations would have the same access to and knowledge of mental health and addiction care as urbanites. Virtual health would fill in the gaps, with more better-trained and better-supported providers meeting the high need and demand for behavioral healthcare. Awareness and education on behavioral health would reduce stigma and help people feel more comfortable asking for help. 

Low-Cost Clinics

Low-cost clinics, funded by grants or donations, could offer the affordable care many rural residents in poverty need. Staff at these clinics could educate patients on good mental and physical health, with free resources for improving their diet and creating healthier habits.

Funding Local Resources

Funding for local programs could strengthen community services, too, helping them offer more robust non-clinical services. For example, funds to a local crisis support unit could go towards hiring full-time staff with specific crisis training.

In rural areas and beyond, everyone who needs treatment should have a clear path to it and support along the way, whether from their doctor, family, other community members, or all three. 

Learn more about future goals and ideas in improving rural healthcare by listening to our recent podcast episode here!

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Beyond Paradise: Exploring The Realities of Rural Healthcare in Hawaii

We were thrilled to talk with Dr. Jonathan Rosenthal, a hospitalist from Kauai, Hawaii, about his 23+ years as a hospitalist and his unique experiences practicing in rural Hawaii. In our newest episode, Dr. Jonathan Rosenthal talks with hosts Dr. Malasri Chaudrey-Malgeri, Editor-in-Chief, and Cliff McDonald, Chief Growth Officer.

Listen to Dr. Rosenthal’s episode and hear from our previous guests here!

Finding a Fit as a Hospitalist

Dr. Rosenthal is a hospitalist in an intensive care unit (ICU). He sees people in the emergency room and admits them into hospital care, working with his patients daily until they’re ready to leave treatment. Dr. Rosenthal has been working as a hospitalist in the remote town of Kauai for almost 13 years, starting his career in urban Seattle.

Dr. Rosenthal came to Kauai seeking a better quality of life and settled in, now living on the island with his wife. Kauai’s rural setting means Dr. Rosenthal works at the only major hospital on the island. He and his other 5-7 coworkers balance the needs of the island’s hospitalized patients. 

Challenges Faced in Rural Populations

Dr. Rosenthal’s community faces distinct challenges, like not having access to care, poverty, health illiteracy, and unhealthy eating. He frequently encounters metabolic disorders like diabetes, obesity, and hypertension as residents don’t have the means or access to healthy foods. Meth use also runs rampant:

“​​I was blown away that, like how frequently, you would come across people who are using methamphetamine. It’s really rampant. It often leads to problems that I need to see them for.”

Dr. Rosenthal notes his community has no public resources for the issue of meth use, making awareness and treatment difficult. Finding affordable care also poses a challenge for impoverished residents. 

For the physicians, they face discouragement from a lack of resources and support. Compassion fatigue, burnout, and the grief of being unable to help everyone pose significant challenges for providers in Kauai and other rural areas.

Encountering Wide-Spread Addiction and Mental Health Concerns

Of patients Dr. Rosenthal sees from the ER, he estimates:

“Almost every single time if you have to be hospitalized and you’re under 40, maybe 90 percent of the time, you have some sort of substance abuse and/or mental health, usually both, problem accompanying whatever else is going on.”

As the first line of defense, the emergency room takes the primary load of cases involving addiction and severe mental health concerns. Dr. Rosenthal highlights the inadequacy of emergency treatment for long-term recovery, as patients receive treatment for symptoms but not underlying issues.

Ideas and Solutions for All Rural Communities

Dr. Rosenthal notes Kauai actually has one of the highest life expectancies in America, but a large subset of the population are “still quite unhealthy” and don’t have access to healthy foods, as most of Kauai’s wealthier residents do. Nutrition education could go a long way in re-shaping eating habits and lowering the high rate of metabolic disorders.  

As for the addiction concerns his community faces, Dr. Rosenthal says, 

“We need to come up with some sort of public health system that will incentivize people to get clean and stay clean. And to be healthy in general.”

Dr. Rosenthal dreams of opening a low-cost clinic for impoverished residents to get affordable care and pick up fresh fruits and vegetables. Healthy food in his hospital’s cafeteria would also improve access to healthy foods. Showing residents what healthy foods they could buy with constrained budgets and providing cooking classes would educate residents and encourage healthier eating. 

Virtual addiction and mental health services can also make care more accessible for rural patients, as they’d only need a device and internet access to get treatment. Services like these could lighten the burden for Kauai’s emergency rooms and providers like Dr. Rosenthal. Making these resources known through community outreach plays a vital role in patient education and people using their resources.

Listen to Dr. Rosenthal’s episode on The Recovery.com Podcast to hear about his inspiring work and ideas. 

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The Untold Power of Compassionate Care: Addressing Stigma with Dr. Ishant Rana

In our recent podcast episode, Recovery.com was thrilled to talk with Dr. Ishant Rana, Clinical Director at Alpha Healing Center. We explored the weight of stigma in India and how rehabs like Alpha Healing Center actively shift from punitive approaches to compassionate, personalized care. Dr. Ishant describes the impact he sees and ways the behavioral healthcare system could improve even further. 

Listen to Dr. Ishant Rana’s podcast episode here. 

Building Experience and Understanding

Dr. Ishant Rana has practiced clinical psychology in India for over 13 years. He graduated from the National Institute of Mental Health and Neurosciences in Bangalore, India. He’s worked across a variety of focuses, including addiction, personality disorders, psychosis, depression, and anxiety. Dr. Rana joined Alpha Healing Center as Clinical Director, impressed with their multifaceted programs and respectful, non-stigmatized approach to care.

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Alpha Healing Center combines medical and psychological care, helping clients safely detox and receive the mental healthcare they need. They use advanced services like neurofeedback and repeated transcranial magnetic stimulation (rTMS) to heal addiction’s underlying causes, all while providing comfortable living spaces and an atmosphere of support and camaraderie.

Making a Difference with Personalized Treatment And Education

Dr. Rana’s work at Alpha Healing Center leverages multiple forms of therapy, medical services, and holistic practices to create personalized care plans for each patient. Alpha Healing Center treats both addiction and underlying mental health concerns, helping Dr. Rana and his colleagues provide the comprehensive care needed. 

Dr. Rana believes everyone needs and deserves help, especially people with substance dependence who may otherwise be seen as “too difficult.” His work at Alpha Healing Center allows him to provide the compassionate care needed to overcome stigma and impose the empowering possibility of recovery. He’s found psychoeducation to be a particularly powerful tool in disputing stigmas around addiction, including myths like:

  • Addiction is caused by a lack of willpower; enough willpower treats addiction
  • Relapses mean treatment failed
  • Someone with an addiction must also have a personality disorder

Science-backed truths educate patients and their loved ones, helping them heal as a unit.

Future Directions and Hope for Communities

As Dr. Rana outlines in his podcast episode, accurate addiction education can benefit both the person suffering and their loved ones. Psychoeducation teaches the truths about addiction and mental health conditions, helping communities view those with addiction in a more helpful light. Rather than being shunned or disgraced, those with addiction could instead receive support and encouragement to attend treatment. 

Fortunately, this is already happening in India and worldwide, especially as younger generations set the standard for mental health awareness and non-stigmatized care. As families and individuals learn more about addiction, they become more equipped to support their loved ones and pursue treatment with hope compassionately. Dr. Rana says,

“So people are getting better, they’re learning more, but I think we have to go a long way,” says Ishant.

Like recovery itself, education and awareness are journeys. Practitioners like Ishant Rana and Alpha Healing Center combat stigma and change viewpoints in hundreds of lives through their caring, evidence-based care, creating an approach that leaves a lasting impact.