State of Anxiety

Providing humorous perspective during & after a breakup or divorce

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This is Why Your Airline Boarding Process is a Pop-Up Circus…

In few other affairs is your life-status so publicly displayed than during the airline boarding process. This is by design. Airlines revel in publicly grading you by airport megaphone. It’s their preferred grandstand to reward or demean customers based on how much you spend with them.

The stress of traveling and the battle cry for the arm rest and window shade begin long before you’re seated. It starts with trying to determine what time to leave for the airport, followed by the wildly inconsistent process of “security” screening. Next is procuring one’s $9 bottle of municipal water to allay the low humidity, desiccating journey. Finally, you face the fire-sale of airline boarding.

All airlines all do the same thing – move people from one place to another via the troposphere. The way in which they begin their process, however, can greatly vary and is most evident in the boarding process.

As soon as the gate attendant blows into a hot mic, people leap to their feet into pole position, blocking all pathways to the jetway ready to blitz the ticket scanner.

There are notable reasons we act like Billy goats during the boarding process, to include the following:

  • Mob Mentality. Research scientists have found that the actions of as few as five people can influence a crowd of 100 to follow suit. Trust your inner oracle and initiate ‘active observer’ status.
  • Competition. We want to be first on and the first off the plane. It often becomes every passenger for him/herself, as if airports and planes are netherworlds where common sense and courtesies don’t apply.
  • Impatience. People crowd the gate under the illusion of getting to their destination faster. The plane doesn’t leave until everyone is on-board. A superior use of time is to find nearby space and do some birthing squats and leg stretches to avoid the onset of DVT.
  • Baggage fees. Ever since the airlines started charging for checked baggage, the boarding process has been more like a Walmart Black Friday than a process conducted by grownups. Planes almost always have enough overhead bin space for every passenger. In fact, newer planes have increased bin space. But they still don’t want you using it.

The airlines have mastered the manipulative art of anxiety seed-planting so you’ll pay a little more to check your bag or opt for earlier boarding. They depend on such fees to remain profitable. The U.S. Department of Transportation’s annual airline baggage fee report found that domestic carriers collected nearly $5 billion in baggage fees in 2018, up from $4.5 billion in 2017 and $1.1 billion a decade ago. They’ll do whatever it takes to scare you into dropping coin.

When you pay that $30 to check a bag or $25 to move up a boarding group, the fees go straight to the airline’s profit margin. While base ticket prices cover only operating costs (i.e., fuel, salaries, maintenance, etc. After making you feel lucky to get on their plane at all, airlines will ease your angst by selling an Economy ticket holder Priority Boarding for $15 and up. How selfless.

To maximize profits, airlines create the illusion of grossly limited bin space, while continuing to splice boarding groups into thinner stratifications. You board according to your value to the airline, with the last group boarding at a bargain price in exchange for a willingness to be degraded.

You must only consider the 10 tiers of the Delta Airlines boarding process as a depiction of the psychological game you’ve entered:

1. Pre-Boarding.

Reverence to this esteemed group for their sacrifices – whether in battle with enemies overseas, with unruly toddlers on the home front, or because they’ve been injured or debilitated along life’s way. No one can hate on a pre-boarder. Unless, they’re faking it to avoid the stigma of #9 below.

2. Delta One®

Like most of the groups in this boarding sequence, it’s unclear what these terms even mean – but, if you have to ask, you can’t afford it. Delta One® is the Illuminati of boarding groups. The only way into this stratum is to kill and assume the traveling victim’s identity.

3 & 4. First Class – OR – Delta Premium Select

Ah, a group where you may know someone who knows someone. It’s fancy like the others. But, it’s an extravagance that only the 1% or some lucky voyager of an oversold flight can aspire to.

5. Delta Comfort+®

It’s true, the birthright of comfort has been filched from us and monetized. “If you want to travel humanely, you’re going to pay.” Sincerely, The Airlines.

6. Sky Priority®

This subset of marquee member designees is a “who’s who” cadre of worldly movers and shakers. If you can’t be one, kindly step aside so they can crush your toes with their carry-on and confidence. If you’re lucky, they’ll apologize like you’re some sort of equal.

7. Main Cabin 1

A bougie collection of explorers who like sitting on the plane longer than others, and later scorn you for kindly asking if that window seat in their row is available, as if you’ve broken into their home to sit on their lap in a recliner. They’re the last lot of semi-elites before the fuselage filler-fruit of overhead bin peckers come nipping at their totes.

8. Main Cabin 2

The fodder of nameless, faceless passengers now trudge toward lap tray nirvana. These are hapless folk who roll onto the jet bridge like the end credits of a sad movie. Airline personnel avoid making eye contact as if they know you barely chipped-in for gas.

9. Main Cabin 3

This is Delta crypto-code for “you’ll be punished for your frugality once the cabin door closes.” Maybe sooner.

10. Basic Economy

These are my people – the pauper class. You can identify us by the panicked craning of necks toward airport windows to see if the plane is still there. We our further flagged to all by repeated announcements of “Lastly, BASIC ECONOMY and anyone without status or esteem may board.” The terminal feels empty. Our muted shame is palpable.

In order to increase your anxiety and subtly pressure you to pay for priority, the airlines apply these divisions while trading longer boarding times for additional revenue. United boards in six groups, while American and Delta each have 10.

However, because they’ve created so many layers, many early boarding groups are sparsely populated. In the seeming cataclysmic event no bin space is available, your bag will be gate-checked for free, and will likely appear before you do at the other end of the destination airport.

I’m a bag-checker. I like to travel nimble at the risk of landing in Bismarck while my bag lands in Biscayne. It has yet to happen, and I stride onto every flight with only a backpack of books, snacks, Sani-wipes, and the accoutrements to enhance an aerial penance. Truth is, I’ve flown Basic Economy on Delta countless times, on fully-booked flights, and sometimes with a carry-on. I had no issues. The illusion of a gate bag-check is worse than the reality, even if your bag ends-up in a bin rows behind you.

In the future, airlines could be under any array of boarding procedures – to include removing the seats altogether and tethering each passenger to a standing pole.

Airlines have razor thin margins, and they’re crafty at separating us from our money. Which is why they invented turbulence and baggage fees. One thing’s for sure: They will remain profitable, and we will remain uncomfortable.

Now, enjoy THIS parody of the aforementioned.

What to Do If Your Ex Contacts You After You’ve Said Goodbye

Ignoring your ex

How to handle an ex you want to keep in the past when they want to be in your present.

As you read this, there are millions of people across the world suffering from a love-rift somewhere while sending ill-fated texts. Studies show that to the brain, quitting love and heroin are the same. Our brains cannot differentiate another human from smack.

The initial stage of a breakup often includes regular and methodical text diatribes (aka, “terror texting”), along with emails and beguiling emojis in vain attempts to recon the defector, each time, vowing not to send another – only to do so within days … or, hours. This phase is rife with the fuzzy logic that there is just the right mix of words and pleading to get you to reconsider.

Why does My Ex Keep Contacting Me?

In short? Denial and the hope for a different outcome. Denial is a coping mechanism that gives us time to adjust to distressing situations. Being in denial gives your mind the opportunity to unconsciously absorb shocking or distressing information at a pace that won’t send you into a psychological tailspin (Mayo Clinic, Denial: When it helps, when it hurts, 2011). When the reality hits that you’ve been dumped, denial is a great tool; as in “If I don’t think about it, then it’s not happening,” or “I can totally fix this, I just need another shot.” A less obvious way denial presents could be as a denial of inner strength: “I can’t handle this sh#t!” The issue with denial as a coping mechanism is that it’s not a long-term solution. Remaining in denial is not healthy, and it’s unnerving to onlookers.

The agony following a broken relationship is an evolutionary adaptation that ensures the maintenance of close social ties. Rejection hurts so that we are hesitant to enter social situations in which rejection is likely. It’s also why hot people are crazy. It’s a deterrent for our own safety. But, breakups often include record-setting pleading; a deluge of one-way, restraining-order-level communications; panic that borders on neurosis; and trying to resuscitate the relationship pulse through text and social media.

Exes usually continue to talk because they miss having someone around. It’s old habit to say “goodnight,” or sext on a random weeknight to someone who won’t call the cops.

Now the breakupee stares thunderstruck at a silent phone, willing it to ding with a text from you, while feeling a dreadful void from losing that regular communiqué. If you reply to your late pursuer with anything less than F-bombs and the threat of legal action, it feels great to them. But it’s akin to another hit of heroin for a recovering addict. It will satiate the cravings for a bit, but you’re only resetting their recovery clock while adding to your own stress to keep them from teetering over an imperceptible edge.

What Does the Research Say?

Per a study published in the journal Review of General Psychology, just like the brain is hardwired to fall in love, it also has a mechanism that helps us fall out of love and move along. This is easier for some than others, however. Stalking is not cute, romantic, or funny. And, oftentimes it’s more than, “I was just bored and curious…” Conversely, an “I miss you” doesn’t equal “I want to get back together and adopt Russian toddlers.”

Take solace knowing that your ex’s love longings are quite normal – to an extent. Research eludes to a physiological basis to cravings for an ex. Lucy Brown, Ph.D., Professor in the Department of Neurology at Albert Einstein College of Medicine and her colleagues used functional magnetic resonance imaging (fMRI) to record the brain activity of adults who had experienced a recent unwanted breakup, and who reported still feeling love for their ex. “Upon viewing brain photographs of their former partners, there was activity in the areas associated with reward and motivation, specifically, the release of dopamine that is also seen in drug addiction. Therefore, people may experience cravings for their ex-partner similarly to the way addicts crave a drug they are withdrawing from.”

So, What Can You do About the Uninvited Contact?

In the throes of pain, the shortest route to ending heartache is seemingly with the source. It’s not. It is within us and not with our defector. Consequently, it is not your responsibility to ferry your ex to healing shores. Your takeaway is first to have empathy, followed by impenetrable boundaries and a steadfast “no contact” rule to the benefit of you both. Fully unplug from your ex – including from their social media. Until there’s a methadone for breakups, any reply keeps the dynamic going and prevents you both from moving on with your lives. It also exposes you to further distress, while hindering their emotional recovery and increasing their longing for reconciliation.

Required Steps for Managing an Ex Who Won’t Stop Contacting You:

  1. Stop communicating with your ex unless you share custody of a mini human(s).
  2. Repeat.

If for some reason you cannot block them – like maybe you’re keeping a tally of texts/calls for a judge, or you want your labradoodle back – then change their name in your phone to “Caution,” “Beelzebub,” or “Do Not Answer.” This is not a game; it’s not about punishment or revenge, or to make your ex mad while feeding your own ego. It’s self-care.

Do it for them. Do it for you.

Not everyone loves you enough to leave you alone. If you’re ever going to be friends, it will happen later. Or, never.

 

Breaking-Up Badly: 11 Tips to Avoid Self-Imploding Following A Breakup

“I’m sorry I annoyed you with my unconditional love.”

The early phase of a breakup is marred by feelings of inner turmoil, all-consuming grief, anxiety, low self-esteem, jealousy, lack of food or sleep and an indifference to personal hygiene, all peppered with moments of irrationality.

The exhausted brain loops re-enactments of the severed bond piece-by-piece in some macabre relationship forensics. You painstakingly dissect past conversations, events and nuances of the bond while cerebrally clawing towards a personal salvage strategy.

You become a pariah to friends and family who look upon you with pursed lips of empathy, while avoiding sustained eye contact or dialogue at the risk of triggering an emotional flare. People make tired comments like, “There are plenty of fish in the sea,” “You’re better off,” or “How long were you together?” so they can quickly determine if the number justifies your level of distress.

How long will the pain last? What is considered acceptable by friends … or society? Is the recovery period half the time you were together? No. There is no mystical breakup algorithm to yield your fixed emotional penance. It takes what it takes. And for everyone this is different. Everything you need to heal is already within you. Therein lies your freedom.

The pain of rejection is exacerbated by how we view and treat ourselves after it occurs. But rejection also causes physiological pain with an evolutionary purpose. Back in early times, being rejected by your people meant lone survival and imminent death. Now we have Netflix and DoorDash, and being alone for a period is an underutilized indulgence that too few learn to sit with and relish. Once we do, we glean how truly self-sufficient we are.

But, what does the research say?

Studies suggest that women experience more emotional anguish in the aftermath of a breakup, but it takes men longer to recover. A woman deals with a breakup head-on. By the time a woman is on the backside of a breakup, her ex-boyfriend is just coming to terms with what went down.

And contrary to widely held beliefs, closure is not necessary. Countless people never gain closure yet still move forward and heal. When we are broken-up with, our ability to reconcile who we are is upheaved. But you’re still in there … somewhere. You are whole. And you are grand. Despite what you might be thinking, you never need to know why your ex did anything they did. Your ex was never the reason you thrived.

Soulmate is what Satan puts in his coffee.

From an evolutionary perspective, if we were meant to be with only one person on Earth, society would collapse. You did not lose your soulmate. You can look for one of your other soulmates later. For now, any search for external breakup remedies and relief is rooted in a desire to short-circuit the recovery process. If evolution didn’t insert some physiological checks and balances in the form of heartache, we’d hook-up with the next thing in an Armani suit or Lululemon’s.

For those lacking breakup survival skills, the symptoms and manifestations associated with a breakup are measurably more self-defeating. So, here are some proven tactics to hasten your heal:

1. Don’t press “rewind” when you should hit “delete.”

Do not sleep with him/her one more time in the hope it will usher you back to better times. Delete your ex’s number from your phone — even if you have it memorized. Of all the things we lose during a breakup, keeping the locus of control is the most important and often ignored. The easiest way to control your current moods and keep your power is to not contact your ex.

2. Therapist? You mean bartender?

A breakup can lead to depression, isolation, self-accusation, or worse. You don’t always need to make grief clinical, but it’s imperative to know when to seek outside professional help. The easiest index to use is if your emotions are starting to interfere with daily life functioning — including sleep.

3. Only the strong forgive. 

Forgiveness is simply giving up the hope for a different past. They may not deserve your forgiveness; but you deserve peace. It’s about letting go of the outcome, rather than condoning any actions by someone whom inflicted the pain. Forgiveness takes only one person: You.

4. The power of three gratitudes. 

Not only does gratitude increase how much positive emotion we feel, it just as importantly deprives the negative energy that is the driving force of why we feel so badly. There is omnipotence in gratitude. Focus on three gratitudes daily, no matter how small.

5. Exorcise all relationship mementos.

Emails, toothbrushes, photos, texts, his Apple Watch, etc. and change all venues you frequented together, such as bars, cafes, Urban Outfitters, etc. You could use the change of scenery, while avoiding needless reminders of his love for salmon shorts and craft brews.

6. The quickest way over one is not under another. 

Rebounding is a brief distractor that invariably turns into sound-boarding your ex’s name and shortcomings onto some naked app prey beside this woeful version of you. A rebound won’t help you with healthy, long-term objectives. What will? Work with being solo for a bit to achieve self-improvement, reflection, and a righteous comeback.

7. But, veggies taste like dirt and sadness. 

To counter the melancholic feelings inherent to any breakup, it is imperative to spend time outside, get regular sleep, exercise, and eat right. Wean off the Pinot Gris and cookie dough and get some nutrients. Studies have shown that foods can directly influence the brain’s neurotransmitter systems that are related to mood. (Hopf, 2010).

8. Better than an FWB is a BuB. 

“He’s only ignoring my texts because I haven’t sent enough.” Utilize the exceptionally helpful camaraderie of a Breakup Buddy (BuB) to remediate poor decisions when reacting from emotions. These are dangerous moments of relapse; hence, the importance of someone who will think for you until logic is reengaged. Refer to them often.

9. Tweak small behaviors to dramatically shift moods. 

If you change small post-breakup behaviors, it will change your thoughts, feelings and emotions. This is paramount in helping you to feel less anxious, worried, depressed, or experiencing an intolerance of uncertainty following a split. For example, if you do the opposite of what your emotions are driving you to do — such as checking-out their social media or driving by their residence — your anxiety, worry, and pain will subside.

10. “Cowabunga, dude(tte)!”

Ride those thought waves. The technique of urge-surfing involves riding an emotional wave and not responding to any part of it, but letting it swell and then wane. This is an extremely helpful tactic to use in dealing with the impulsivity associated with a breakup, because you are observing your emotions, rather than acting on them. And this prevents regretful actions.

11. Cuddle the friendliest ghost of all. 

“Just gonna send him a message … Aaaaaaaannnnnd I’m blocked.” Going ghost is one of the most sagacious devices for self-preservation. Most breakup sufferers greatly add to their angst by not following this one, basic tenet. If you’re going to be friends with your ex, it’ll happen organically and only when you’re long over them. If you must see your ex, keep it cool and make it fast. Otherwise, ignore them so hard they doubt their own existence.

“Frankie says, relapse.”

A final note: Breakup recovery isn’t linear, but more a game of Chutes ‘n Ladders. Reverting and plateauing are common throughout the entire process. Healing is rarely direct in movement, but setbacks are temporary and short-term. You may feel stuck at the same level of muck for two weeks, only to suddenly leap forward in your progress out of nowhere. Your adherence to tactics such as the aforementioned will accelerate your imminent return to baller status.

10 Ways to Support a Loved One with Cancer. From a Son In Remission … with a Mom in Remission.

I currently share the mixed blessing of being in cancer remission with my mom. It’s not genetic; I’m adopted.

I’m remarkably grateful to be in remission with her; but uncertain how as a former athlete I succumbed to a smoker’s cancer diagnosis on my actual birthday. Or, far worse, how my mom was hit with a rare stage IV breast cancer called Inflammatory Breast Cancer. I would take her illness on if that were ever an option in my regular fantasy where Hollywood or some omnipotent entity granted me the power to switch maladies.

Being in this unenvied position, I’ve learned that the only thing worse than your own pain is helplessly watching a loved one suffer. The first being mostly physical; the latter crushingly emotional. Yet it does not stop me from trying to will health or strength upon her.

A major stressor faced by many people in their lifetime is a cancer diagnosis. Sadly, cancer patients too commonly cite instances of people they know who never communicated emotional support regarding their illness. While studies show that people do better emotionally in a crisis when they have strong support from family members and friends. However, if one of your friends or loved ones has been diagnosed with cancer you might not know what to say or do to help.

According to a recent study by Katharine J. Head of the Department of Communication Studies at Indiana University-Purdue University “Although adult cancer survivors and their families face unique psychosocial and health-related challenges related to cancer, little is known about how the illness experience of cancer may positively transform their mental, physical, and social well-being following primary treatment.”

Cancer has a way of quickly re-prioritizing life, while teaching a valuable lesson in perspective not otherwise gleaned.

My cancer diagnosis served as the perfect opportunity to “clean house” regarding friends, work, and how I spent my time. Suddenly, I was face-to-face with the regret of how I had been spending my life thus far, and with whom. I quickly removed shallow friends, a girlfriend who drank too much, and even a few family members from my sphere of influence. And, I never looked back.

Actions to support someone recently diagnosed with cancer:

1. Listen and give advice only when asked.

We all want to ease the pain of those we care about. But, dispensing unsolicited advice is one of the worst things to do to those newly diagnosed with cancer. One of the best things you can do, however, is to offer the gift of listening with empathy. Exclaiming to someone that frankincense, CBD, or turmeric can cure their cancer deserves a punch to the larynx. Just don’t.

2. Support their cancer treatment decision. 

We cannot impose our will on others, even in instances of record-level relevancy or as a shared decision-maker. The choice rests with the patient. And, if your loved one asks you to contact medical providers, be sure you have written consent. Privacy laws prohibit health professionals from speaking to relatives – including parents or adult children – without the patient’s permission. As I’ve learned firsthand, you can’t ‘parent your parents.’

3. Be present. 

Even in silence, the mere presence of someone we care for during a difficult time has immediate and lasting benefits. Sit with your loved one during treatment or have lunch with them afterward. Even better if it falls within the oncologist’s dietary recommendations. Your loved one may love sugar – but so do cancer cells.

4. Learn about the cancer and specific treatment plan. 

Cancer Care and other reputable organizations offer educational information and websites regarding cancer, respective treatments, and side effects. Be cautious of your sources or how much you read, however. It’s common to get overwhelmed and frantic – especially regarding prognosis percentages that are overgeneralized and unspecific to your loved one’s case. Internet research is an activity best kept in moderation.

5. Consider the caregiver.

Caregiver burnout and fatigue is a real thing. No matter the relation, this is an often-overlooked premise. Cancer caregivers take on many tasks, often including those formerly held by the recently diagnosed. The caregiver needs care too. Sometimes you need to call on backup in the form of additional family or friends. You can review and receive help at Cancer Caregivers, caregiver resources at the American Cancer Society, or from the National Cancer Institute caregiver support page.

6. Be steadfast.

Those with cancer often experience a discernible drop-off in support from friends and family after the initial diagnosis. Cancer is a long-term disease followed by a longer remission period. It requires more from supporters than a gratuitous slap on the back and “You’ll kick this, buddy!” flaccid approach. This ain’t the Flu. Prepare accordingly.

7. Keep the status quo.

For many people, being able to maintain life pre-cancer diagnosis can boost their sense of mastery over the illness and lessen the life-impact of the disease. Cancer is a silent narcissist best kept small.

8. Don’t be detached if you are long-distance.

Never underestimate the emotional support that comes from regular phone calls or texts. Since you might be too far to prepare food and bring it yourself, perhaps arrange to have meals delivered from a local restaurant or reputable and healthy meal service like Freshly or Hello Fresh. Or, consider ordering groceries online from a local supermarket that delivers. Use vacation time or a holiday weekend and visit with the ill person doing something enjoyable. For them.

9. If you have the means, offer financial assistance.

Cancer can strain finances to the point of financial ruin, and many people are too proud or ashamed to ask for monetary assistance. If you think it’s needed and are able to offer, raise the subject respectfully. Cancer is a selfish money pit. The Cancer Financial Assistance Coalition, Cancer Care, or the resources page via the American Cancer Society can also be of considerable help.

10. Pray.

I don’t care who you call your higher-power, this is the time to send some knee-mails. I regularly lean on prayer, daily gratitude’s, and striving to stay rooted in the moment. Helpful tactics I would not have learned sans cancer.

There is no education like struggle. Suffering is a conduit to empathy and awareness. Adversity yields purpose and refinement in life that can only come from life trials.

There is always an upside or takeaway to every hardship, though it often takes time and distance to source it. In my instance, I am much closer to my parents through our shared experience caring for mom. Adversity also gave me the incentive to leave a dead-end job and relegate my only toxic sibling to the “acquaintance” pool. Sometimes you get the best light from a burning bridge.

Hug your family and your hardships. They’re trying to tell you something.

 

How do You Know if You’re Depressed or Just Sad?

You might think you’re feeling lazy or unmotivated, but here are the signs that it’s something more serious

Is your two-day, Netflix binge of “Black Mirror” and “Stranger Things” a bout of laziness and apathy, a case of “the melancholies,” or … clinical depression?

Maybe you think you’re depressed, or you’re just using depression as an excuse to be lethargic – only to realize this itself might be a symptom of depression. It’s tough trying to figure-out your head with your own mind, right?

The brain is an organ that can malfunction like any organ. Mental illnesses are illnesses of that organ.

Brain scans show that there is a physical difference between a healthy brain and a sick brain. Telling someone with depression, “You don’t have an issue, it’s all in your head” is as inane as telling someone with diabetes, “You don’t have an issue, it’s all in your pancreas.” Any organ is susceptible to disease or disorder.

When you’re feeling down, it’s imperative to distinguish feelings of sadness versus depression because confusion can lead you to avoid evaluation and treatment of a serious condition. Alternatively, you might overreact to a normal emotional state of sadness.

“And, here’s why the distinction is crucial: If we (or a loved one) are depressed, it has huge implications for our long-term mental health, physical health, and longevity,” says NYC Psychologist and author Dr. Guy Winch. Sadness and apathy are normal emotions. “Sadness is usually triggered by a difficult, hurtful, challenging, or disappointing event, experience, or situation,” says Winch. This also means that when something shifts, or we’ve gotten over the hurt or event, the sadness also wanes.

“Whereas depression is an abnormal emotional state; a mental illness that affects our thinking, emotions, perceptions, and behaviors in pervasive and chronic ways,” says Winch. Depression can occur in absence of any of the triggers that cause sadness. Sadness is about something and depression is about … nothing.

Criteria for Depression

Depression is classified into different types using a book with diagnostic criteria for mental health disorders. Now in its fifth edition, the book is called the Diagnostic and Statistical Manual of Mental Health Disorders. But, everyone just calls it the DSM-5. Think of it as the owner’s manual for the brain but – like an iPhone user guide – you must make an appointment with an accredited genius to see one.

The DSM-5 outlines the following criterion to make a diagnosis of depression.

Note: These serve only as a guideline. You need to see a mental health professional for a conclusive diagnosis. The individual must be experiencing five or more of the following symptoms during the same 2-week period, and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.

  1. Depressed mood most of the day, nearly every day.
  2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
  3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
  4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
  5. Fatigue or loss of energy nearly every day.
  6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
  7. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
  8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

To receive a diagnosis of depression, these symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition. Afterall, a bottomless mimosa brunch or afternoon of beers is enough to spur a days-long depressive spell, as booze and other substances are known depressants.

Anxiety and depression disorders are often interlinked.

“It’s very hard to find patients who are depressed who don’t also have anxiety. It’s equally hard to find people with anxiety that don’t have some depression,” says Charles Goodstein, MD, a professor of psychiatry at New York University School of Medicine. So, don’t berate yourself if you’re feeling anxiety on top of everything else. It’s more likely than not to occur. And though signs of depression, anxiety disorder, and even bipolar disorder have similarities, each requires different treatments right down to the therapy and medications used. This is why a professional diagnosis is so important to obtain the correct treatment regimen.

A Quick Lesson in Sourcing the “Why” in Your Life…

One of the most poignant examples of suffering and sadness is the story of Viktor Frankl, a physician and psychiatrist who survived four Nazi concentration and death camps, including the infamous Auschwitz. Frankl epitomized the words of Nietzsche: “He who has a Why to live for can bear almost any How.” As a prisoner, Frankl kept himself and his hopes alive by a desire to see his wife again and one day teach about man’s quest for meaning.

Sadly, Frankl’s parents, brother, and pregnant wife were killed; but he was able to cope, source the importance of it all, and move forward with a renewed life purpose to include writing one of the most moving and significant books of our time, Man’s Search for Meaning. Frankl teaches us that “if there is a meaning in life at all, there must be a meaning in suffering. Suffering is an eradicable part of life, even as fate and death. Without suffering and death human life cannot be complete.”

We all face the opportunity to achieve something through our own suffering. Our unique opportunity lies in the way we bear our burden, and in our attitude toward difficulty while pondering our meaning. Make no mistake; you have a decisive and purposeful meaning in this world. For many of us – myself included – it takes suffering and hardship to find it.

We are supposed to feel like we can’t handle things alone sometimes. That’s when we find the grace or help through others. In times when life becomes unmanageable, we must be willing to ask for help and support one another. It’s by design. We can be with one another amid suffering, helping each other bear the weight. Part of life is the realization that sometimes we can’t make it on our own. For some, a spiritual leader is a person to whom you can turn and say, “I have a burden that I cannot bear.” All it takes is walking into a local church, mosque, synagogue, or temple and asking for help.

Live to the point of tears.  -Albert Camus

Conquering Teen Anxiety

In this excerpt from “101 Ways to Conquer Teen Anxiety,” learn the difference between “normal” anxious feelings and those that interfere with daily life

Am I Losing My Mind, or Is This That Anxiety Thing?

Anxiety can make you feel different. As a teen, I never knew why no one else seemed to struggle with life the way I did. And it wouldn’t have mattered what diagnosis or label was put on me because it would not have changed how I felt. Sadly, teenagers can let anxiety steer them through most life decisions. Left untethered, anxiety will drive every choice and action you take.

So how do you know if you’re experiencing anxiety or something more insidious with a Latin name in the Physician’s Desk Reference? The type of anxiety we address in this book is not the healthy, normal varietal that prompts you to get important stuff done, like studying for an exam or running from prom date requests. According to the National Institute of Mental Health (NIMH), “Severe anxiety that lasts at least six months is generally considered to be a problem that might benefit from evaluation and treatment.”

Rather than motivating you to act and get things done, anxiety at this level interferes with daily living, activities, and relationships.

The Accoutrement of Depression

Like a salad bar and sneeze guard go together, anxiety and depression disorders are often interlinked. So, don’t berate yourself if you’re feeling depressed on top of everything else. It’s more likely than not to occur. And though signs of depression, anxiety disorder, and even bipolar disorder have similarities, each requires different treatments right down to medications used. This is why a professional diagnosis is so important in order to obtain the correct treatment regimen. Having anxiety doesn’t have the social stigma it once did. It just means you’re really living.

But, there is a little-known dichotomy about anxiety that makes seeking treatment difficult: When you’re feeling anxious or depressed, it’s often hard to do what’s best for your welfare – this includes seeking help. Anxiety is a narcissist that wants you to focus on … anxiety. Anxiety will cloud your mind and fill your consciousness with a perverse volume of thoughts, noise, feelings, and stressors that have no validity. Next thing you know, you’re not turning in homework on time, missing chores, and arriving late to work or practice, and everyone’s wondering why you can’t get your act or matching socks together. If they saw the thought carnival in your mind, they’d surely understand.

No medication will cure anxiety. Medication treats the symptoms of anxiety.

Every case of anxiety is unique. Unfortunately, many anxiety sufferers use prescription medication when therapy, exercise, or self-help strategies such as those taught here would work just as well – if not better – because they are actual skills with no side effects. Therapy and skills usage include development of the necessary tools to beat anxiety.

The goal we’d like you to adopt from this book is not to remove anxiety, but to bring it down to more manageable levels. That means working with it directly, in a nonjudgmental way, and not avoiding it or thinking it’s bad or weak that you feel this way. We’ll talk specifically about how to do this in the book.

For more on 101 Ways to Conquer Teen Anxiety click here.

12 Ways for Parents to Effectively Manage the Top Teen Mental Health Concerns

Here are today’s most searched mental health questions surrounding teens, and how to help

Mental health issues can make teens feel vastly different than their peers. And not in a cool way, like having a cloak of invisibility or being able to down an extra-large pizza in one sitting; rather, having the powers of hypervigilance and social awkwardness. Sadly, they can let such disorders steer them through most life decisions. Left untethered, things like anxiety and depression will drive every choice and action they take.

Signs of a mental health condition

The signs of a mental health disorder will differ from person to person but can include any of the following: mood changes; irritability; loss of concentration; withdrawal from friends and social engagements; irrational or hostile behaviors; poor hygiene and lack of self-care; changes in diet; and changes in sleep patterns. There are common factors that can worsen mental health disorders such as not adhering to medication protocols, drug and alcohol abuse, lack of sleep, loneliness, health issues, and academic stress.

Paradoxically, mental health disorders such as anxiety and depression have been linked to early drug use. Many people with anxiety try to make themselves feel better with drugs or alcohol. And teen users are at significantly higher risk of developing an addictive disorder compared to adults, and the earlier they begin using, the higher their risk. Being aware of your teen’s predisposition for substance use and abuse, can head off budding disaster.

Top internet searches about teen mental health

Teen life struggles are exacerbated by the enigmatic teen brain which is not fully formed until between 25 and 30 years of age.

Shocking, right? Today’s parents suffer the plight of the unknown, as evinced by the top internet searches about teens:

  • Why do teenagers cut themselves?
  • Why do teenagers sleep so much?
  • Why do teens lie?
  • Why are teens depressed?
  • How Much Sleep do Teens Need?
  • Why do teens have anxiety?
  • What do I talk about with a teenager?
  • Why is my teen so mean to me?
  • Is social media bad for teens?

Consider this…

…adults think with the prefrontal cortex, the brain’s rational part, but teens process information with the amygdala, the emotional chunk. Here’s the hitch: It’s the prefrontal cortex that responds to situations with sound judgment and a grasp of long-term costs. It’s also one of the last brain regions to mature. Teen brains aren’t fully connected, which leaves them more prone to impulsive behavior, even without other influencing factors like genetics or K-pop.

All these changes the brain is experiencing could be why adolescence is when mental ailments such as schizophrenia, anxiety, depression, bipolar disorder, and eating disorders appear. Fortunately, most teens go on to become healthy adults. Changes in the brain during development may help protect against long-term mental disorders.

What can parents do?

As parents, we tend to jump in with advice to fix problems or place blame. But doing so can make teens less likely to be open in the future. You want to make it emotionally safe and easy for them to approach you. Never forget you’re the most important role model and influencer your kids have.

Start with the following teen mental health triage tactics:

1. Never in the history of calming down has anyone calmed down by being told to calm down.

Instead, ask if they want you to respond when they come to you with problems, or if they just want you to listen. What works isn’t telling a teen to calm down; it’s empathy and diplomacy.

2. Parenting is an army of one – two if you’re lucky.

Pay close attention to your child’s symptoms and what they might be telling you, while not discounting their feelings. Remind your teen that this is what they’re feeling and not who they are. Keep in mind that mental health issues are not an indicator of poor parenting! Try to keep your fears to yourself and present a positive – or at least neutral – assessment and attitude of the situation.

3. Make a plan – hope is not a strategy.

After asking them to share their worries and distresses, prompt them to problem solve what is causing them distress and help them develop an actionable plan to counter their distress. Once you have implemented some of the aforementioned, keep the momentum! Only through repetition of techniques will your child learn to counter and manage future distressing episodes.

4. This is how you role … model.

Model positive behavior and good self-care. If you take of yourself, your teen will learn that self-care is important. Promote good sleep practices. A lack of sleep alone can compromise mental health. Help them get into a routine that prepares them for relaxation. This can include reading, simple meditative breathing exercises, or guided meditations. Get to bed early and at the same time each night. And, turn off the electronics to turn off their brain.

5. A great parent shows a kid where they don’t want to be but need to be.

Teach your teen to have a productivity goal (something from a “To-Do” list) and a pleasure goal (something from a “Fun-To-Do” list) each day. Then review these goals the following day when setting the new goals.

6. Mindfulness is never asking, “Are we there yet?”

Guide your teen to stay grounded in the present. Depression is rooted in the past, and anxiety in future thinking. If their anxiety spikes, try 4x4x4 breathing (breathe in for 4 seconds, exhale for 4 seconds, and do this 4 times).

7. Penny for your lack of thoughts? 

Prompt them to channel nervous energy into something creative. Coach them to continually monitor their thoughts and dispute any that are negative, while citing three things (no more and no less) for which you are both grateful each day, no matter how small.

8. Show them how to live in opposite world.

Have them practice opposite action. In other words, regularly counter what anxiety or depression is prompting them to do. If depression wants them to watch “Riverdale” marathons from the couch, get them on a hike or nature walk. If social anxiety has them avoiding human contact, reward them to attend a social function.

9. But, first … a selfie.

Limit their time spent on social media. Consider offering your teen specific alternatives to daily social media use that include school or community-based sports, academic or social clubs, pursuit of creative or artistic interests, and even volunteering (start here: JustServe.org).

10. Render your teen powerful.

Remind your teen that they’re resilient and competent. Because they’re so focused in the moment, adolescents have trouble seeing they can play a part in changing bad situations. Reminding them of instances in the past they thought would be devastating but turned out for the best can help.

11. (A)ction + (B)ad Idea = (C)onsequences.

Help your teen link impulsive thinking with facts by reviewing with them all possible costs of their actions – especially those related to self-harm or suicide. Doing so helps their brains create these connections and can wire their brains to make this link more often. Seriously. This one is vital.

12. Show no interest, and they’ll show no effort.

Become familiar with things that are important to your teen. It doesn’t mean #hashtagging your bubble tea pics on IG, or sidewalk camping in January for BTS tix, but showing an interest in things they like expresses they’re important to you.

An Important Note About When to Seek Outside Help:

It’s normal for a teen to be down or sullen for two or three days. But, if you see notable mood or behavioral changes lasting more than a week, it could indicate something else is occurring, such as depression. In such cases, promptly seek professional treatment for your child.

Sources: Google Analytics, May 2019

What Is a Best Friend? Here’s How to Keep a Long-Term Friendship (as featured in Good Housekeeping Magazine)

These super sweet BFF stories will melt your heart.

Adult friendship is two people saying, “I haven’t seen you in forever — we should hang out!” Then later wishing you hadn’t made plans. In your 20s and 30s, new people stream into your life through college, work, weekend avocado toast and bottomless mimosa brunches, though as we approach mid-life, schedules compress, priorities shift, and we settle for Netflix and Pinot Gris at home. Oftentimes, we realize we’ve let close friendships lapse and reconnect only when faced with a life-event like a death or divorce.

Science proves making and maintaining long-term friendships as an adult can be tough. According to a 2019 study by OnePoll and Evite, the average American hasn’t made a new friend in five years. After asking 2,000 Americans, they discovered 45 percent of adults find it difficult to make new friends, with 42 percent mentioning introversion or shyness as the reason for the difficulty.

That makes it even more impressive when you see friendships that span a lifetime. It takes a lot of work to keep up a relationship for so long — but these six BBFs have done it, and are therefore our new best-friend-goals. Here, they reveal how they’ve able to keep it up, even after time, kids, and/or distance have gotten in the way.

Maricela Lau Prudhomme &
Pamela Yamamoto Ostrowski
Pacifica, CA & Dana Point, CA
39 Years

Best Friends Goals - Maricela and Pam
MARICELA LAU PRUDHOMME & PAMELA YAMAMOTO OSTROWSKI

How did you two meet?
Yamamoto Ostrowski: We met in the first grade at an all-girls Catholic school called Canonesas De la Cruz in Lima, Peru. I believe we were the only Asians that attended the school. In Peru, students remain in the same room for the entire year, while different teachers come to instruct the kids on various subjects, and they don’t have to change rooms. Maricela and I shared the same room for 11 years, and each year we tried to sit close so we could talk.

How did you initially know that you should be friends?
Lau Prudhomme: Pamela and I hung-out all the time during recess at school. We both have strong and competitive temperaments. Pamela is Peruvian-Japanese, and I am Peruvian-Chinese. Our shared Peruvian-Asian background made us feel connected.

How you kept this friendship alive for decades?
Yamamoto Ostrowski: We haven’t lived in the same place since we were 17 years old. After high school, Maricela moved to California and I moved to Japan. Ten years later, I received a beautiful letter in the mail from Maricela. She found my address in Japan and we picked up where we left off. We continued to keep in touch via letters. A few years later, I came to the U.S. for the first time just to visit Maricela, and stayed at her house with her parents. I’ll never forget the day that I arrived and she picked me up at the airport. We laughed, cried, and screamed at the same time. It was an amazing day, and I’ll hold that moment in my heart forever. Even today, each time that we see each other we jump up and down with tons of hugs and kisses, like the first time we reconnected.

What’s the most memorable thing that’s happened to you together?
Lau Prudhomme: I’ll never forget when Pamela chased me around the schoolyard after I slapped her in the face when she was being mean to me. But, more seriously, she was present at every significant day of my life. She was my maid of honor in both of my weddings. Our lives have played out quite similarly. We both divorced our first husbands; are now remarried; and we both began a family at the same time. I’ve always told her that she mimics my every step! Our friendship is the strongest now that we are learning to be moms for the first time.

How did you stay friends through raising families?
Lau Prudhomme: We have both always wanted a family. And, we both had a hard time conceiving. I finally got pregnant once I stopped trying at 43, and gave birth in November, 2018. While Pamela decided to adopt the same month. We now both have girls. No matter how busy we are, we continue having this sister-like friendship.
Yamamoto Ostrowski: Life is so amazing and made us mothers at the same time! Even more, her daughter was born on my birthday. We’re more connected now than ever.

Paula Didion & Pamela Zwicker Young
Litchfield Park, AZ and
Westerville, Ohio
43 Years

Best Friend Goals - Paula Didion & Pamela Zwicker Young
PAULA DIDION & PAMELA ZWICKER YOUNG

How have you kept this friendship alive for decades?
Didion: Simple friend love. There is no drama. We’re honest with each other, and we don’t judge — at least not openly! We’ve always been this way. I’ll support Pam to the ends of the Earth if necessary.
Zwicker Young: We were in each other’s weddings, are godparents to each other’s children, and we’ve always kept in touch over holidays and tried to get together in the summers when the kids were younger. Our daughters are close as well, and continue to maintain their friendship. They even refer to each other as cousins.

What’s the most memorable thing that’s happened to you together?
Didion: In 1978 we were in Toledo Ohio together during a blizzard. We spent a week snowed-in together, surviving on whatever means we had on-hand. We managed to make the most of it, and I think we grew even closer.

Do you think it’s better or worse for young people today trying to keep friendship alive in the internet age?
Didion: I think it is worse. Nothing beats old-fashioned physical contact, face-to-face honesty, and love to bond people. A touch is worth a million words.
Zwicker Young: I think it’s very important to have a real-life friendship outside of technology. Young people sometimes have difficulty dealing with real-life, adult situations face-to-face. Also, it is hard for some young people to just make friends because they don’t know how to communicate without texting.

Tracy Cook & Julie Carson Meeker
Campbell and Calaveras County, CA
39 Years

Best Friend Goals - Tracy Cook & Julie Meeker CarsonTRACY COOK & JULIE MEEKER CARSON

How did you two meet?
Cook: Julie and I first met in Kindergarten in 1980 at Kathryn Hughes Elementary School. In the 3rd grade she put a note in my cubbie box that said “Will you be my best friend?” and there was a hand-drawn box to check “yes” or “no.”

How you kept this friendship alive for decades?
Cook: It was easy when we were going to the same school. We lived less than a mile away from each other, yet talked on the phone while watching the same TV show together. Once Julie moved two and a half hours away after the eighth grade, we incurred so many long-distance phone bills, and our parents limited phone calls to 30 minutes a few times per week. But they also drove us back and forth to visit with each other during winter, spring, and summer vacations. As college students we didn’t have much money, but managed to afford gas to occasionally visit each other. It became easier as young adults with the advent of email, text messaging, and social media. In our thirties and now forties, we’ve been more deliberate in planning outings and celebrations together. Now that we’ve both lost our parents, we’ve connected on an even deeper level. Her dad died when we were 17 from throat cancer, and her mom in 2017 of breast cancer. I texted her so often after my mom and dad died, just to be reminded that life will go on.

What’s the most memorable thing that’s happened to you together?
Cook: On my 31st birthday, Julie drove hours to have a party with me and some other friends in my hospital room following my own complicated cancer surgery four days prior. I was so sad that morning, and feeling sorry for myself on my birthday when Julie and five other friends arrived to see me. I’ll never forget that. Three months later I was her maid of honor at her wedding. I told her she didn’t have to have me since I didn’t have hair, and did not want to ruin her pictures with a bald girl in them. She told me that I was ridiculous.
Carson Meeker: The most memorable things to me are the important events that have happened in our lives. We have been through breakups together. We stood for each other in our weddings. We have been through cancer together. We have been through the deaths of our mothers and fathers together. We have celebrated birthdays and anniversaries and mourned many losses together. I get to watch her raise her son and we get to grow old together. That’s the stuff that I think about.

Eric VanNorden and Gavin Sargent
Boring and Tigard, OR
39 Years

Best Friend Goals - Eric VanNorden and Gavin SargentERIC VANNORDEN AND GAVIN SARGENT

How did you two meet?
VanNorden: We attended Gresham Union High School together, and were both in the marching band as tuba players. Gavin was a long-haired, skinny kid with a great sense of knowing that I was the funnier and more handsome one.

How you kept this friendship alive for decades?
VanNorden: Over all the years, having a friend that understands the way you think is a blessing. We’ve never judged the other. No arguments, just acceptance.
Sargent: We’ve always had shared interests. From playing tuba to riding motorcycles, to playing wingman for each other, to having a drink or two. We seemed to be closely aligned. In the last couple decades as we got busier with families and life, our shared philosophies about family and politics have facilitated the bond.

Do you think it’s better or worse for young people today trying to keep friendship alive in the internet age?
VanNorden: I watch my children’s struggles and wonder how we would have managed it. I draw no other conclusion than not well. Interpersonal skills seem to be lacking, along with an inability to cope with simple issues that compound the “everyday life” skills we need to thrive.
Sargent: Also, I see kids cutting down their peers with little to no thought about it online, and hundreds of people can be in on those caustic comments. Whereas in the past, if someone had something bad to say, only a few were likely to be in the loop at the time.

Karin Salisbury Duprey &
Carolyn Greene Dalgleish
Cranston and North Kingstown, Rhode Island
46 Years

Best Friend Goals - Karin Salisbury Duprey & Carolyn Greene Dalgeish
KARIN SALISBURY DUPREY & CAROLYN GREENE DALGEISH

How did you initially know that you should be friends?
Salisbury Duprey: As kids growing up in the ’70s, we were pushed outside at dawn and told not to come back until the street lights came on. We lived in the same neighborhood, played in the same yards, attended the same schools, and shared the same friends. We became friends organically, and realized we needed to remain friends.
Greene Dalgleish: Initially, I was highly superficial in my decision to befriend Karin. She had a pool and junk food at her house, and I had neither at mine. In reality, I think I knew at a young age that Karin had traits that I needed to be around — and that I didn’t necessarily have! — that included intense loyalty, positivity, deep feelings, and a big sense of fun and adventure.

How you kept this friendship alive for decades?
Salisbury Duprey: We have so much respect for each other. She fills my heart with gratitude for the decades of invaluable friendship. You just don’t let that go. Besides, she knows too much!
Greene Dalgleish: We’ve always seemed to connect regularly even when distance was a factor; like during college when I was in Ohio and Karin in Boston, and for most of our twenties when we were living in different states. Karin has always been completely grounding for me, and I needed to connect with her periodically. And with her deep loyalty, she would often get the ball rolling and the plans organized.

Do you think it’s better or worse for young people today trying to keep friendship alive in the digital age?
Salisbury Duprey: I think today’s friendships are genuinely different because of the internet. I think kids need to peel away from technology in order to build the strength and deep roots to keep these kinds of friendships alive and healthy. Carolyn and I started our friendship because we were playing outside, away from technology and away from adults, which allowed us a more connected reality than I’ve seen in adolescents today.
Greene Dalgleish: Today, it seems easier to stay connected at a basic, more superficial level. But it feels like the deeper connections are much harder to develop for young people now. I think part of the reason our friendship has lasted and grown deeper is that we’ve really had to work for it, in good times and bad.

is the creator and co-author of 101 Ways to Conquer Teen Anxiety and the forthcoming In Case of Anxiety… Anxiety Hacks for a Janky World.

College Depression and Anxiety Are Serious – Here’s How to Help Yourself or a Friend (as featured in Good Housekeeping)

More than 41 percent of college students stated they felt so depressed that it was “difficult to function” in 2018.

There are many exciting things about entering college: possibly living apart from parents for the first time, new classes and friends, more freedom. But there’s a dark side to all of that new opportunity: U.S. college students are experiencing emotionally and physically harmful levels of college depression and anxiety. More than 41 percent of college students stated they felt so depressed that it was “difficult to function” in the past year, according to the 2018 study from the American College Health Association (ACHA). Another 63 percent said they had “felt overwhelming anxiety” within the last 12 months.

Specific biological, psychological, and environmental factors contribute to depressive symptoms in college students, the Journal of Affective Disorders notes. Signs that a student might be experiencing depression during college include sadness, hopelessness, irritability or frustration, loss of interest or pleasure in things, sleeping too little or too much, lack of energy, changes in appetite, anxiety, feelings of worthlessness, trouble concentrating or making decisions, suicidal ideation or attempts, and unexplained physical problems.

Be aware of the symptoms, and keep an eye out for these five common causes of college-age depression and anxiety.

Difficulty Transitioning

Moving and acclimating to a new environment or academic system can be disruptive and stressful. “Many teens might be at a genetic risk of developing depression, but the disorder isn’t actually triggered until the individual experiences some sort of significant environmental stressor, such as college,” says A.J. Marsden, Ph.D., assistant professor of psychology at Beacon College in Leesburg, FL. She notes our brains aren’t fully developed until the mid- to late-20s. “Student decisions aren’t always the best as their frontal lobe — the lobe responsibility for higher order processing such as critical thinking and decision making — is not yet fully formed,” she says. New surroundings, overwhelming classes, and bad decisions made in the wake of newfound freedom can be what pushes students past the breaking point.

Although there’s no failsafe way to prevent depression during college, “helping your student become accustomed to his or her campus before the start of the school year might prevent them from feeling overwhelmed by the transition,” says Nicole Beurkens, Ph.D., C.N.S., a clinical psychologist of Caledonia, MI. “Encourage your child to visit the campus and talk to students, peer counselors, or faculty about what to expect and where to turn for support. Also consider finding a doctor or therapist closer to campus to provide therapy or monitor medication.”

Jack J. Springer, M.D., assistant professor of emergency medicine at the Zucker School of Medicine at Hofstra-Northwell, says students can’t wait until things are at a crisis before they find help. “Mitigation needs to start far before college,” he notes. “Mental health awareness programs need to be readily visible to all, and be in a form that makes it minimally threatening for students to express their overwhelmed feelings and readily obtain counseling. Orientation at schools should involve education about these resources, and education should be ongoing.”

Stress

Student stressors can take countless forms including grades, deadlines, work, and finances. Moreover, if a student could arrive at college with unmet or unaddressed mental health issues, they could find themselves struggling with a lack of a support system.

“The most important issue is whether or not one is prone to depression — and usually anxiety, as the two are inherited together,” Mark D. Rego, M.D. of the Yale School of Medicine. “If you are prone, then many stressors may push you past a threshold. These may be things like lack of sleep, drug abuse, overwork, and interpersonal conflict.” Getting screened for the potential for Major Depressive Disorder at the start of school has been shown to be a promising strategy for identifying students who may be at risk, and can improve targeted preventive interventions. (Mental Health America offers a screening online.)

There’s also the issue of some students getting their first taste of the “real world” after living with parents who have paved their way. “In my work with clients in therapy, I’ve noticed that emerging adults who have parents whose level of involvement is overbearing are more prone to depression,” says Heather Z. Lyons, Ph.D., psychologist and owner of the Baltimore Therapy Group. “These college-aged individuals might have been protected from past failure, and hence haven’t developed the skills needed to self-soothe or persevere amid failure.”

“Students should learn to reframe setbacks or difficulties as problems that are solvable,” says Dr. Beurkens. “Then they can see themselves as capable of solving them on their own, so they develop better resilience and confidence.”

Uncertainty and Fear of the Future

Anxiety thrives in unknowns. Not knowing if they’ll have a job after school, where they will live, and how they’ll pay the bills can be a weight on students as they go through school. “In my experience working with college students, one of the biggest triggers for depression is the fear of unsuccessfully transitioning to the adult world of work and responsibilities,” Dr. Beurkens says. “We focus on personal strengths and capabilities to reframe their automatic negative thoughts about themselves and their perceived inability to handle the future.”

“The sense of uncertainty surrounding choosing a major or feeling without direction or inspiration, especially when the student’s friends all seem like they found their calling, can certainly lead to depression,” says Bryan Bruno, M.D. psychiatrist founder/medical director at Mid City TMS. But he offers this advice: “Remind them that finding your calling is what college is for. It’s also important tell them not to compare their experience with their peers’ because there is no wrong path when it comes to finding your calling.”

Interpersonal Relationships

Navigating relationships in college — platonic or romantic — can lead to problems for a generation that relies heavily on technology as a means of communicating. Social media proliferates a compare-and-despair dilemma. We are curious, so we look, and then we feel badly.

But, as we all know, social media isn’t real life. “College students benefit from seeking out peers with whom they can share vulnerability and have fun — fully in person and not mediated by technology,” says Deborah J. Cohan, Ph.D., sociology professor at the University of South Carolina Beaufort.

Here’s the hard part: To get around this hazard, students have to limit the amount of social media they take in each day; they should use it even less if they notice a mood decrease afterward, which is true for most people. Students who put a lot of effort into portraying themselves a certain way online are more vulnerable and would benefit more profoundly from regular breaks. Encourage them to try a one-week break and take it from there — offline is the new luxury.

Lifestyle Changes

Multiple recent studies show there’s a significant association between physical activity levels and sleep quality in regulating mental health and reducing anxiety and depressive symptoms. “A regular sleep schedule, healthy diet, and regular exercise have all been shown to decrease symptoms of depression,” says Dr. Marsden. But college life, with its late nights, parties, cramming sessions, and cafeteria food can make keeping a healthy lifestyle a challenge.

Depression is also strongly associated with substance use and abuse. “While the college atmosphere often encourages partying, students who do so excessively can be led to high-risk behaviors, mental health problems and depression,” says Jeff Nalin, Psy.D., executive director of the Paradigm Malibu Treatment Center. “For those wanting help, contacting student support services can be a step in the right direction. The key to managing any kind of anxiety or depression is to integrate self-care into our lives.”

What you can do if you think you need help:

Since 75% of all lifetime cases of mental illness begin developing by age 24, it’s imperative to seek help for mental health symptoms early, so college depression doesn’t become a lifetime disorder. The average delay between onset and intervention is eight to ten years, according to the National Alliance on Mental Illness and Centers for Disease Control and Prevention. If you find you’re struggling:

  • Call the campus counseling center or health center and ask about counseling sessions with graduate students.
  • Alternatively, reach-out to your school’s chaplains or religious/spiritual leaders for help or guidance.
  • Confide in a friend, RA, professor, or mentor, and ask him or her to go with you to seek professional help.
  • Call the number for the National Suicide Prevention Lifeline: 1-800-273-8255.
is the creator and co-author of 101 Ways to Conquer Teen Anxiety and the forthcoming In Case of Anxiety… Anxiety Hacks for a Janky World.