Tag: Depression

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Antidepressants Misuse and Addiction

Some people, especially those in recovery, may worry about developing an addiction to antidepressants. Thankfully, antidepressant addiction doesn’t occur often, but it is a possibility at non-therapeutic doses. This is due to how they can affect and change the brain, leading to a dependence then compulsory use. 

Anyone worried about their antidepressant use can bring their concerns to their doctor, who can start a tapering plan or even switch to a different type of antidepressant. Behavioral strategies, like therapy, can help people transition off antidepressants while still managing their symptoms.

What Are Antidepressants?

Antidepressants primarily treat depression1 and other mood disorders, plus conditions like obsessive compulsive disorder (OCD). They work by balancing disruptions in neurotransmitters and boost the reception of serotonin, which can make people feel happier. 

Most antidepressants work on serotonin and another neurotransmitter called norepinephrine1. When your brain can receive and process more of these neurotransmitters, symptoms of depression can fade. Depression can go fully into remission due to neuroplasticity1, where your brain changes and adapts to sustain these positive changes. 

Common Types of Antidepressants

Antidepressants can have a variety of formulas and interact with different parts and systems within the brain. Your doctor and/or psychiatrist will aim to find the best match for you. A genetic test can help you pinpoint good matches. Sometimes, people cycle through a few antidepressants to find the one that works best.

Interestingly, many antidepressants have off-label uses for conditions besides mood disorders. For example, trazodone can help people fall asleep1. Some other antidepressants help patients with chronic pain.

SSRIs

Selective serotonin reuptake inhibitors (SSRIs) are often the first line of defense against depression2 due to their low side effects and general effectiveness. Most people respond positively to them, and doctors can smoothly pivot to another if one doesn’t seem to have much effect.

Prozac, Zoloft, Lexapro, Paxil, and Celexa are all common SSRI antidepressants. Potential side effects of SSRIs1 include:

  • Weight gain.
  • Dizziness.
  • Nausea, especially for the first couple weeks after starting the medication. In most cases, it goes away.
  • Sexual dysfunction.
  • Headaches.

SNRIs

Serotonin/norepinephrine reuptake inhibitors (SNRIs) work similarly to SSRIs1, but also block the reuptake of norepinephrine, not just serotonin. Doing this helps various synapses in your brain access more of these neurotransmitters, making you feel better. Norepinephrine triggers the central nervous system’s fight-or-flight response, leading to anxiety and panic disorders if these triggers don’t come when needed. SNRIs can reduce symptoms of both depression and anxiety.

SNRI brand names include Cymbalta, Pristiq, Effexor, and Fetzima. They can cause most of the same side effects as SSRIs, like:

  • Nausea that typically goes away after a week or so.
  • Headaches.
  • Excessive sweating.
  • High blood pressure.

MAOIs

Monoamine oxidase inhibitors (MAOIs) are a less-commonly prescribed antidepressant3, often used when an SSRI or SNRI doesn’t work. They’re more likely to have side effects, drug-food interactions, and drug interactions, which is why they’re prescribed with caution.

Common MAOIs include Marplan, Nardinm and Emsam. They can have side effects like:

  • Serotonin syndrome (too much serotonin).
  • Dizziness.
  • Vomiting.
  • Constipation.
  • High blood pressure and potential death if foods with tyramine are consumed (cheese, alcohol, leftovers, certain fruits, and more).

TCAs

Tricyclic antidepressants (TCAs) also inhibit the reuptake of serotonin and norepinephrine4, which can boost mood and attention. Some versions of TCAs are also used off-label to treat obsessive compulsive disorder (OCD), insomnia, migraines, and chronic pain.

Common TCAs include Elavil, Silenor, and Asendin. Their side effects1 include:

  • Dry mouth.
  • Difficulty peeing.
  • Constipation.
  • Seizures.

How Are Antidepressants Misused?

An increase in feel-good neurotransmitters like serotonin can cause a reinforcing effect, though rare in antidepressants since this boost in mood is often subtle and feels natural. Misuse often happens outside prescribed doses5; for example, someone may take double or triple their prescribed dose (sometimes even 10x more) to achieve a ‘high’ similar to other drugs. This sensation only happens with high doses of certain antidepressants5, like bupropion.

Someone taking antidepressants for the sensation of being high may dissolve several pills in water and inject it using a syringe, take multiple pills orally, or crush them into a powder and snort it. To maintain their high dosing, they might request refills sooner than needed, take out prescriptions through multiple doctors, or request higher and higher doses without a demonstrated need.

Sadly, some people misuse antidepressants with the intent of taking their lives. In 2011 nearly every emergency room visit for a drug-induced suicide attempt came from prescribed medications; 20% of those overdoses involved antidepressants5, the highest percentage after prescribed opioids.

Can You Become Addicted to Antidepressants?

It’s very unlikely. One study answers this question6 with, “antidepressants do not have a clinically significant liability to cause addiction.” This is because most antidepressants don’t cause pleasurable or rewarding effects6, as addictive drugs like cocaine or alcohol do. And compulsive use of antidepressants, as seen in substance use disorders, is “exceptionally rare.”6

Antidepressants can cause withdrawal symptoms7, which raises an argument for their addictive potential since people may need to keep taking the substance to avoid withdrawals, similar to opioids and other addictive substances. Tapering plans can prevent uncomfortable withdrawals.

Factors Contributing to Antidepressant Misuse

Those who misuse antidepressants often have a history of substance use disorders5 or other comorbid conditions. And, as expected, people who misuse antidepressants typically have a mental health condition like depression. Since symptoms of depression can include suicidality8, these patients can be more likely to misuse their prescribed antidepressants in an overdose. 

Signs of Antidepressant Addiction

If you’re worried a loved one struggles with an antidepressant addiction, you can watch for signs and start an open-minded conversation. If you’re worried about your antidepressant use, you can bring your concerns to your doctor and look for signs of addiction in your own life.

Some key signs of an antidepressant addiction include:

  • Taking more than their prescribed dose. For example, you may notice they take three pills when the prescription bottle only says to take one. 
  • An inability to stop taking the pills, even if negative health, work, or relationship consequences arise.
  • Spending excessive time and money to procure antidepressants. 

Treatment Options for Addiction

If you’re struggling with an antidepressant addiction or any drug or alcohol addiction, you have resources available for recovery. Treatment options broadly fall into 2 categories: inpatient and outpatient care.

Inpatient Care

Inpatient treatment includes treatment in a hospital (often for acute withdrawal needs or overdoses) or attending a residential rehab. At rehab, you’ll live with peers and receive treatment from clinical staff, who monitor your health and emotional needs around the clock. 

Each day often follows a structure, with time for therapy (group therapy, 1:1 sessions with your therapist, and family therapy), fun activities, peer meetings, and downtime. Rehabs last 28+ days, aiming to treat both mental and physical needs for comprehensive healing. You’ll also learn relapse prevention strategies and get connected with outpatient levels of care, if desired, to continue your healing journey.

Outpatient Care

In short, outpatient care is the treatment you attend without living at a treatment facility. You return home after treatment and have more flexibility to work, attend school, and meet family needs. Outpatient care could include

  1. Day treatment, where you undergo therapeutic treatment and practice practical recovery skills for 5-7 days a week. Sessions often last 5-7 hours daily, making day treatment the most intensive version of outpatient care.
  2. In intensive outpatient programs (IOPs), you attend treatment 3-4 days weekly for about 3 hours a day. These also offer therapy, peer support, and an encouraging and supportive recovery environment but with a less intensive schedule.
  3. General outpatient can include 1-2 weekly group therapy sessions, lasting an hour or so each. 
  4. Regular 1:1 therapy sessions with a therapist. You may see them once a week, once every two weeks, or at the cadence best fit to your recovery needs.

Help from Your Doctors

As medication prescribers, your primary care physician (PHP) and/or psychiatrist can also help you. They can ensure that, going forward, all antidepressant prescriptions are carefully considered and that you have a clear plan for how to take them without risking addiction.

For example, your doctor may only prescribe a week’s worth and set up regular appointments to check in and monitor your use. Or you can work out a plan with loved ones, like a spouse or parent, to keep your medications locked in a safe. This can also be a preventative measure for people struggling with suicidal thoughts or with a history of suicidal ideation and attempts.

At your appointment, you can ask questions like,

  • “What is the addictive potential of this medication?”
  • “Are there other medications with less addictive potential that I could try first?”
  • “What signs should I look out for that mean this medication isn’t a good fit?”
  • “What can I do if I start to feel like I’m relying on it too much?”

Find Treatment for Drug Misuse

Recovery exists for all types of addictions, including antidepressant addiction. Treatment can help you navigate the underlying causes of addiction and address emotional struggles with healthy coping strategies and new behaviors. 
You can use Recovery.com to find prescription drug treatment centers and see their insurance information, reviews, photos, and more.

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Navigating the Conversation: Talking to Your Boss About Mental Health Needs

Navigating the Conversation: Talking to Your Boss About Mental Health Needs

By Dr. Malasri Chaudhery-Malgeri 

In today’s high-stress work environments, mental health has catapulted to the forefront of workplace wellness discussions. Yet, many employees still hesitate to approach these conversations with their bosses, fearing stigma or professional repercussions. However, broaching this subject thoughtfully can enhance your well-being and professional performance. Here’s a nuanced guide on effectively communicating your need for support or time off for mental health reasons.

Setting the Stage

Preparation Is Key: Before setting a meeting, clarify what adjustments would help ease your mental burden. Are you looking to lighten your load, extend a few deadlines, hand off specific projects, or take some time off? Concrete solutions will guide the conversation.

Know Your Rights: Arm yourself with knowledge about your workplace policies and any relevant laws—like the Family and Medical Leave Act (FMLA) in the U.S., which safeguards your position during extended leaves for health reasons. This preparation ensures you understand the boundaries and possibilities within your discussion.

Timing and Atmosphere

Choosing the Moment: Timing is everything. Opt for a moment when office rhythms are calm—perhaps a quiet morning or a slow afternoon. Avoid the crunch times, like the hectic end-of-quarter weeks, when stress levels are already high.

The Setting Matters: Privacy is paramount. A secluded spot, away from the hustle of office life, sets a tone of confidentiality and seriousness. A quiet conference room or a scheduled private office meeting can make a difference in how comfortably you can speak.

Crafting the Dialogue

Open Positively: Begin with a nod to the positive aspects of your role and the company. This shows your appreciation and frames the conversation as coming from someone invested in the company’s success.

Clarity and Honesty: Without delving into overly personal details, be clear about how your mental health impacts your work. Stick to specific examples and focus on the effects rather than the causes. Use “I” statements to keep the conversation personal and less accusatory.

Propose Smart Solutions: Bring potential solutions rather than presenting your problems alone. This could involve suggesting temporary help from colleagues, tweaking deadlines, or introducing new tools to improve your productivity without lowering the team’s output.

Highlighting Mutual Benefits

A Two-Way Street: Emphasize how supporting your mental health benefits you and the company. A healthier mindset can lead to sustained, even enhanced, productivity. It’s an investment with a valuable return.

The Preventative Approach: Stress the importance of tackling these issues to prevent more significant problems—this can minimize potential future disruptions.

Preparing for All Responses

Be Ready for Anything: While you hope for understanding and support, prepare for any outcome. If the response is less supportive, be ready to suggest a follow-up meeting after they’ve had time to consider your requests.

Plan B: If the conversation does not yield the hoped-for support, know where to turn next—perhaps HR can offer another pathway or external professional advice may be necessary.

What to Do If You Cry During a Conversation with Your Boss

Crying during a conversation with your boss, especially when discussing personal needs or challenges, can be an unexpectedly emotional experience. While it might feel awkward or uncomfortable, it’s important to remember that crying is a natural human response to stress, frustration, or even relief. Here’s how you can navigate this situation with professionalism and grace:

1. Acknowledge Your Emotions

If tears start to flow, acknowledge them without feeling ashamed. You can say, “I apologize, I’m just very passionate about this,” or “I didn’t expect to become this emotional.” Recognizing your tears helps to normalize the situation, showing that while you are emotionally affected, you are still in control of the conversation.

2. Take a Moment

Allow yourself a moment to breathe and collect your thoughts. You can ask for a brief pause, like saying, “Please bear with me for a moment while I gather my thoughts.” Use this time to take deep breaths and regain your composure. Deep breathing helps control your emotions and signals your body to calm down.

3. Maintain Your Composure

Once you’ve acknowledged your tears and taken a moment to breathe, try to continue the conversation. Maintain eye contact and keep your voice steady. If you feel overwhelmed, it’s perfectly acceptable to say, “I might need a moment, but I’d like to continue discussing this.” This demonstrates your commitment to the conversation and your professionalism.

4. Refocus on the Topic

Direct the conversation back to the main topic. Reiterate your key points or where you left off to demonstrate that, despite the emotional moment, your focus remains on addressing the issue at hand. For example, you can say, “To return to what I said earlier, I believe making these changes could improve my productivity.”

5. Use the Opportunity to Emphasize Your Point

Sometimes, showing emotion can underscore the seriousness of your statements. You can frame your emotional response as a demonstration of how much you care about your work and your commitment to performing well. For instance, “My reaction shows how important this is to me and how much I want to find a way to make this work for both of us.”

The Follow-Up

After the meeting, consider sending a follow-up email summarizing the discussion and expressing your thanks for the understanding shown during the conversation. This serves as a professional courtesy, reinforces your points in writing, and demonstrates your proactive approach to resolving workplace issues.

Crying is not a sign of professional weakness but reflects your sincerity and dedication. By handling the situation with poise and focus, you can move past the moment of vulnerability and continue to engage in meaningful dialogue with your boss.

Seal It with Gratitude

Follow up your conversation with a thank-you email outlining what was discussed and any agreed-upon steps. This shows your professionalism and provides a written record of your proactive approach.

Opening up about mental health in the workplace can seem daunting. Still, with the right preparation and approach, these conversations can significantly improve your work life and mental well-being. By framing your needs within the context of mutual benefits and coming prepared with solutions, you can foster a more understanding and supportive workplace culture.

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Creating a Safety Plan for Times of Suicidal Crisis: Gina Capobianco

I have lived with depression for decades. Suicidal thoughts have accompanied the depression most of my life. While facing a difficult time a couple years ago, the psychiatric nurse practitioner (PMHNP) I was seeing brought up the idea of a safety plan. I had never heard of this type of plan but was willing to try it.

Like many people with suicidal thoughts, when the depression is not bearing down on me, I don’t want to die. It is just when the thoughts get going and the depression turns everything dark that dying seems like my only escape. I needed a plan for dealing with the suicidal thoughts.

My PMHNP explained what a safety plan is and how it works. A safety plan is an intervention that helps a person survive a suicidal crisis by providing them with a set of steps, which they have helped create, to follow during the crisis that will decrease the chances they will engage in the suicidal behavior.  My PMHNP described the plan as my action steps for when I feel that the suicidal thoughts are becoming overwhelming. Together we laid out the plan. It has been necessary for me to use the safety plan a couple of times, and it has been effective each time.

Let’s go through the steps my PMHNP and I used when creating my safety plan.

Purpose of a Safety Plan

First, we identified the purpose of the safety plan. The main purpose of a safety plan is to prevent suicide. The plan provides a way to cope with the crisis of suicidal thoughts using a guide to get help in a way that is comfortable and not overwhelming. The plan allows an individual to reach out to family or friends, who will serve as a support person, as well as provides connections to mental health professionals. The plan lets the support person know how to help you in a crisis.  

It is helpful if the plan is written in the individual’s own words. This ensures the person understands the steps and can enact the plan in a crisis. The words should be simple and easy to follow. The person should keep it in a place that is easily accessible. The people involved in enacting the safety plan should also have a copy. 

Components of a Safety Plan

Identifies When It Will Be Used

The safety plan should spell out when it will be enacted. I discussed this with my PMHNP.  Discussing this with your mental health professional can ensure that you are aware of when to utilize it.  When the plan is used differs for each individual. So, the plan should include when to enact it in language that can be comprehended in a crisis. My plan is enacted when I recognize my thoughts becoming overwhelming and I start thinking about acting on my suicidal thoughts.

Provides Coping Strategies 

Coping strategies are going to vary from person to person. These may include breathing exercises, meditation practice, distractions, or anything that helps the person cope with suicidal thoughts. The plan should include how to know if the strategies are working. If the coping strategies are not working or the person recognizes they are beyond the use of coping strategies, it is time to reach out for support. My coping strategies include journaling and listening to music. When these are not working it means it is time to reach out for help.

Identifies Individual(s) Who Will Support You

When you are in a suicidal crisis, you need to be able to reach out to others for support. When developing your plan, identify a friend or family member who you can reach out to. The individuals on the safety plan need to be willingly involved and consent to being a part of the plan. It is not enough to just be willing to be part of the plan. The individuals need to be able to be an active part of the plan. You need to be able to reach them in a crisis. Share your plan with them and make sure they understand the plan. Your plan should also include who your mental health professionals are and their contact information. In addition, the 988 number, the Suicide and Crisis Lifeline, should be a part of your plan. 

Provides the Questions Your Support Person Will Ask You

Your support person refers to the safety plan when you contact them. My support person has the safety plan on her phone, so she does not have to look for it.  The first question the support person should ask is if you are safe. If you are not safe, they may need to call for emergency support. My plan is set up so that I am asked if I need comfort or support once it is established that I am safe. This gives the person an idea of how severe my suicidal thoughts are at that moment. 

If I respond that I need comfort, my support person will ask me if I need to be listened to or distracted? She then responds accordingly. If I respond that I need support, she will ask me if I need her to help connect me to my mental health professional or if I need her to do it for me.  If I respond that I need help, she reminds me of who to call and may need to provide the number. As I make the call, she stays in contact with me through texting. 

Provides Steps to Be Taken to Get Professional Help

If I need her to make the contact for me, she asks me for my location and what I am thinking. She will relay this information to my mental health professional when she contacts them. 

The 988 Hotline can be called if it seems like I need professional support, and it is at a time when my mental health professionals would not be able to be reached. Some people may not have mental health professionals that can be contacted. In this situation, if the person is not in imminent danger 988 can be contacted. The person can make the call themselves or the support person can call for them. 

If I say or indicate that I am not safe, my support person may need to call 911. While waiting for emergency help to arrive, my support person needs to stay in contact with me. It is important not to leave a person who is in crisis alone. The responders on the 988 hotline and at 911 have the ability to transfer a caller to the other line depending on the need and the level of safety concern.

Plan for Follow-Up

Once intervention has taken place the support person should follow-up with the individual. When my support person does this, it lets me know that I am not alone.  The support person should check in to see how the individual is doing and to ensure that the care provided was helpful. My support person calls me to just talk.

Conclusion

Having a safety plan has made a difference in how I cope with suicidal thoughts. It ensures that I am safe even in my darkest moments. Being a part of a safety plan requires a commitment on the part of the support person. I am grateful that I have a friend who is willing to fill this role. If you deal with suicidal thoughts, talk to your mental health professional about creating a safety plan. Your plan may look different than mine. That is okay. We each have our own needs and cope with our suicidal thoughts in our individual ways. Despite the differences, a safety plan can prevent a suicide attempt and save a life.

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25 Inspiring Quotes for Veteran’s Day

Veteran’s Day is a time to honor and celebrate the courage, sacrifice, and dedication of our military veterans. It’s a moment to pause and reflect on the freedoms we enjoy and the extraordinary individuals who have served to protect them.

Words have a unique power to connect, uplift, and inspire. On this day, we use them to express our deepest gratitude for the sacrifices made by veterans and their families. Through heartfelt quotes and messages, we aim to convey the appreciation they deserve for their selfless service and enduring commitment.

Join us in honoring these heroes by sharing words of gratitude that celebrate their unwavering bravery and dedication to our nation.

25 Inspiring Quotes for Veteran’s Day

Quotes about Honor and Sacrifice

#1: “A hero is someone who has given his or her life to something bigger than oneself.” — Joseph Campbell

#2: “We don’t know them all, but we owe them all.” — Unknown

#3: “This nation will remain the land of the free only so long as it is the home of the brave.” — Elmer Davis

#4: “On this Veteran’s Day, let us remember the service of our veterans and let us renew our national promise to fulfill our sacred obligations to our veterans and their families.” — Dan Lipinski

Quotes about Courage and Bravery

#5: “Courage is almost a contradiction in terms. It means a strong desire to live taking the form of readiness to die.” — G.K. Chesterton

#6: “Bravery is being the only one who knows you’re afraid.” — Franklin P. Jones

#7: “Never was so much owed by so many to so few.” — Winston Churchill

#8: “How important it is for us to recognize and celebrate our heroes and she-roes!” — Maya Angelou

Quotes of Gratitude for Veterans

#9: “To be free is the most wonderful thing in the world, but it comes at a great cost. Thank you, veterans, for paying that price.” — Unknown

#10: “In the face of impossible odds, people who love this country can change it.” — Barack Obama

#11: “The willingness of America’s veterans to sacrifice for our country has earned them our lasting gratitude.” — Jeff Miller

#12: “Veterans are a symbol of what makes our nation great, and we must never forget all they have done to ensure our freedom.” — Rodney Frelinghuysen

Quotes from Veterans Themselves

#13: “The true soldier fights not because he hates what is in front of him, but because he loves what is behind him.” — G.K. Chesterton

#14: “America’s veterans embody the ideals upon which America was founded more than 229 years ago.” — Steve Buyer

#15: “Some people live an entire lifetime and wonder if they have ever made a difference in the world. A veteran doesn’t have that problem.” — Ronald Reagan

#16: “I have long believed that sacrifice is the pinnacle of patriotism.” — Bob Riley

Famous Historical Quotes for Veterans

#17: “The brave men, living and dead, who struggled here, have consecrated it, far above our poor power to add or detract.” — Abraham Lincoln

#18: “Freedom is never free.” — Unknown

#19: “In war, there are no unwounded soldiers.” — José Narosky

#20: “My heroes are those who risk their lives every day to protect our world and make it a better place—police, firefighters, and members of our armed forces.” — Sidney Sheldon

Modern Quotes for Veteran’s Day 2024

#21: “Honor to the soldier and sailor everywhere, who bravely bears his country’s cause.” — Abraham Lincoln

#22: “A veteran is someone who, at one point in their life, wrote a blank check made payable to ‘The United States of America’ for an amount of ‘up to and including their life.'” — Unknown

#23: “To our men and women in uniform, past, present, and future, God bless you and thank you.” — Anonymous

#24: “For it is the veteran, not the preacher, who has given us freedom of religion. It is the veteran, not the reporter, who has given us freedom of the press.” — Unknown

#25: “As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them.” — John F. Kennedy

How to Use These Quotes on Veteran’s Day

Sharing on Social Media

Veteran’s Day is an opportunity for all of us to come together and show our appreciation for the incredible sacrifices made by veterans. Sharing a heartfelt message or a meaningful quote is a simple but powerful way to honor their service. Consider taking a moment to reflect on what veterans’ sacrifices mean to you personally, and share those thoughts with others. Whether it’s through a conversation, a handwritten note, or a post on social media, your words can make a difference.

You can encourage others to join in by tagging veterans you know, thanking them directly, or highlighting the importance of their contributions. Using hashtags like #VeteransDay2024 and #ThankYouVeterans can help connect your message to a larger community of gratitude. 

More than anything, let your voice be a part of the collective recognition and support for those who have served. Your words of appreciation, no matter how small, have the power to remind veterans that their sacrifices are seen, valued, and deeply respected.

Including in Speeches or Letters

Veteran’s Day quotes hold the power to deepen our expressions of gratitude and honor for those who have served. Whether used in speeches, public ceremonies, or personal letters, they help us articulate the profound respect we feel for veterans’ sacrifices and dedication. 

In a speech, a well-chosen quote can set the tone or leave a lasting impression, highlighting the significance of their service. At public ceremonies, including a quote during a moment of silence or tribute, such as a flag-raising, adds depth and solemnity to the occasion. Personalized letters gain even greater meaning with a thoughtful quote that frames your message of thanks. In group gatherings, sharing a quote during a toast, prayer, or discussion encourages reflection on veterans’ contributions and sacrifices. 

However they are used, these quotes serve as a powerful connection to the enduring legacy of our nation’s heroes, ensuring their service is remembered and honored.

Creating Veteran’s Day Cards

Creating Veteran’s Day cards with meaningful quotes is a powerful way to honor the sacrifices and service of our veterans. These cards serve as a personal gesture of gratitude, showing veterans that their efforts and dedication are recognized and deeply appreciated. Including a meaningful quote alongside a heartfelt message allows you to convey your respect and admiration in a thoughtful way. Reminding veterans that their service has made a lasting impact and that their sacrifices are valued, offering them a tangible reminder of the gratitude felt by those they have served.

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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.