help for anxiety

One of the Best Panic Books of All Time!

101 Ways to Conquer Teen Anxiety made it to the Best Panic Attack Books of All Time

I’m happy to announce that 101 Ways to Conquer Teen Anxiety: Simple Tips, Techniques and Strategies for Overcoming Anxiety, Worry and Panic Attacks, made it to BookAuthority’s Best Panic Attack Books of All Time.

BookAuthority collects and ranks the best books in the world, and it is a great honor to get this kind of recognition. Thank you for all your support.

The book is available for purchase on Amazon and everywhere the best books of all time are sold. 🙂

The Relationship Between Anxiety and Grief

It’s no surprise that levels of anxiety are surging right now. Repeated waves of COVID-19, and the lockdowns they bring in their wake, make this an incredibly difficult time for our mental health. There are many contributing factors to anxiety – with our lifestyle, environment, genetics, and even hormonal imbalances all having their part to play.

What’s not always acknowledged for its role in anxiety, however, is grief.

Discussions about grief tend to focus on the feelings of sadness, loss and desolation that can follow the death of a loved one. What they rarely touch upon is how anxiety and grief are intrinsically bound up with one another. Even someone who has previously enjoyed low-levels of anxiety can be hit with a sudden unexpected tsunami of worry as they come to terms with their loss. In fact, many grief counsellors suggest that anxiety should be included as one of the stages of grief that we all have to go through.

Why do anxiety and grief so often go hand in hand? There are many reasons behind this, of course, and it’s impossible to cover them all, but the following points are some of the most important.

Bereavement is the most stressful event we will ever experience. Anxiety is exacerbated by stressful life events. These can be any number of things, with both marriage and divorce scoring highly as a potential stressor. Beating them all on the Holmes-Rahe Life Stress Inventory is the death of a spouse, with the death of a close family member a little further behind.

The death of a loved one reminds us that we are mortal. When we lose someone we love, we’re reminded just how little control we have over our lives. We’re all going to die at some point, and this realisation hits particularly hard after our first significant bereavement. How we come to terms with the fact of our own mortality will play a key role in the future quality of our lives.

Credit: Sandy Millar

We fear more loss. As well as bringing our own mortality into focus, grief reminds us that we may lose other people who are close to us. If we lose one parent, we may then be excessively anxious about losing the other. Intense anxiety may make it difficult to enjoy what time we have left with those we love.

Trauma teaches us to be anxious. Traumatic events can lead to what’s known as classical conditioning. If the news of our loved one’s death came in a phone call, then every time the phone rings we may fear the worst.

We may be anxious about our ability to cope. How will we manage without our loved one? We may fear that we won’t be able to take care of the practical and emotional challenges that we may face now that we’re on our own. In a particularly challenging year like 2020, these worries become even more pressing.

Credit: Thomas Bormans

You fear the intensity of emotions that grief can bring. Grief is a deeply unpleasant state to be in, and it can be overwhelming. Going through it, however, is vital if we’re to move forward in life. Many people, particularly if it’s their first experience of grief, work hard to push it away and move on. This creates anxiety around their own emotional responses.

You begin to overestimate the risk of negative life events. Before a significant loss, you might have had a generally benevolent view of life. Bereavement, particularly when you’ve lost someone who was relatively young or who died in tragic circumstances, can radically unsettle that world view. You may now overcompensate by overestimating the risk of accidents, serious illness or early death, leading to increased levels of anxiety.

Grief, whenever it comes, is a complex and, to a degree, mysterious state. It’s unavoidable for most of us, and how we respond to it can determine the future course of our lives as the pain starts to heal. Understanding the role our anxiety plays can be a valuable part of the grieving process. It can help us to accept, then begin to move through the painful emotions we are experiencing.

There is No “New Normal” Because There Was Never a “Normal.”

If you were to ask the general public what specific outbreak might wreak mayhem within our lifetimes, you’d likely hear Flu, locusts, boils, frogs, politicians or something similar from social media prophetics or the Book of Revelations.

Even when news of another coronavirus hit, it was in a far away land impacting only “other peoples.” It would seem hyperbole that cruise ships would become the vector ferrying tiny, spiky, murder spheres to our own shores.

Our sole defense was keeping the potentially contagious temporarily adrift on floating petri dishes, while enjoying 24-hour buffets and sequined ABBA and NSYNC cover bands.

But we’d soon be worried over parents, grandparents, and ourselves as we came face-to-face with our vulnerability and the inter-connectedness of our Planet. Moreover, we realized that nothing was ever “under control” – an illusion we had believed and subscribed to for a generation. And we became angry at the thin veil through which life was sewn.

Didn’t Someone’s God assure us we’d never be given more than we can handle?

Actually, no. This guarantee isn’t in the Bible, Quran, Torah, Guru Granth Sahib, Vedas, Tripitaka, or Kojiki. It’s a motivational quip we like to keep next to those Live, Love, Laugh prints from Bed, Bath & Beyond.

The problem with living such a comfortable existence for so long, is the depth of the fall to a life of discomfort.

Thankfully, we’re buoyed by the frontline workers in healthcare, at nursing homes, behind badges, delivery personnel, pharmacists, grocery employees, and perhaps the most unexpected superheroes: undocumented agriculture workers – without whom we’d lose a vital tier of the food pyramid.

Mid 2020 has seen the indoctrination of millions of newcomers into the anxiety and depression clubs – the steep dues paid with inner chill and peace of mind. Though many of us (i.e., the anxious) have been mentally prepping for a lifetime, we too found ourselves ill-equipped for an epidemic. You can’t train for a contagion that exists only in one’s mind (another reason why worry is a useless endeavor). But suddenly it’s not so weird to clean an apple with a bleach wipe.

Find the humor, find the cure.

It’s always there. This might not be the best time to ponder Dostoyevsky’s Poor Folk or The House of the Dead – though I’m a huge proponent of the man otherwise. A pandemic calls for some light and cheery reading to facilitate levity and laughs. Consider anything from Dave Barry or Augustin Burroughs. And don’t overlook works by other great contributors like Erma Bombeck and Dorothy Parker.

Mark Twain knew it best: “The secret source of humor itself is not joy but sorrow.” Studies confirm that laughter lowers blood pressure and releases beta-endorphins, a chemical in the brain that creates a sense of joy. Moreover, humor is clinically validated to reduce stress long-term by improving the immune system through the release of neuropeptides, relieving pain, increasing personal satisfaction, and lessening depression and anxiety. The simple act of smiling causes the brain to release dopamine, which in turn makes us feel happy. But don’t worry about the science. Just YouTube “Sebastian Maniscalco” or “cat videos” and away you go.

Humor = Calamity + Time.

Humor will change your relationship to the problem of stress, worry, or anxiety. It reduces stigma, promotes wellbeing, helps you to cope with difficult situations, reduces tension, discomfort and stress; and strengthens your immune system. It’s pretty much a miracle elixir.

Austrian neurologist, psychiatrist and Holocaust survivor, Viktor Frankl, sourced and used humor as one tactic to survive German concentration camps, and he highlighted humor as ‘another of the soul’s weapons in the fight for self-preservation.’ “The attempt to develop a sense of humor and to see things in a humorous light is some kind of a trick learned while mastering the art of living,” cited Frankl.

Humor produces endorphins that soothe the body and allows a responsive brain to take charge – like a legal massage somewhere with no blacked-out windows.

There cannot be a “normal” in an unpredictable world. We use terms like “new normal” to instill an element of control over things. Control is an illusion.

But radically accepting the randomness of life, while staying mindful in the present is damn liberating. We don’t like to admit that we actually have little control over anything – especially our own fates – yet we do things that impact our longevity. You can now observe the rampant OCD taking place nearly everywhere by those not accustomed to proper OCD’ing. For example, shaking hands during Flu season (or otherwise) has always been an archaic practice in the transmission of filth. Have you seen what you do with your hands?! Despite lacking opposable thumbs, even dogs know that sniffing butts is a more hygienic “hello.”

And consider a University of Arizona study revealing that cellphones carry 10 times more bacteria than most toilet seats. Yet we don’t hesitate to pinch zoom a pic when someone hands us their toilet phone.

And, how many times have you eaten birthday cake blown on by someone you didn’t like or barely knew? Well, you might as well have them blow directly into your open mouth. A study in the Journal of Food Research determined that blowing out candles over that sweet, sticky icing resulted in 1,400% more bacteria compared to icing spared the puff (The study was aptly titled “Bacterial Transfer Associated with Blowing Out Candles on a Birthday Cake”).

Black-light most any hotel room and it will look like a Jackson Pollock painting.

Hotels will charge $250 for smoking in your room, but you can leave a bodily bio-hazard at no charge. This serves to heighten my perception of hotels as wildly filthy. And do you think the card keys ever get cleaned? I question the entire arrangement altogether. Most of us make that room as cozy as our own, in full denial that few people tip the maids upon checkout.

Hotels are where people go to cut their toenails, trim body hair, or bleed. The mattresses are literal smut sponges. But we gladly pay for the privilege of rubbing our faces into the pillows and bleach-infused towels.

Humor is ever present. You just gotta peek through the dank mental hues of your angst. Sourcing the lighter side of your emotions is vital – particularly when a third of Americans are now showing signs of clinical anxiety or depression.

Covid created a massive wake of anxiety and depression across the globe, along with budding terms like “immunity privileged” and “vaccine nationalism.”

Understandably, as most of us had not incurred a life disruption of this magnitude prior. During the initial stages of the pandemic, I spent most of my time hiding from humanity to avoid the contagion. My sole activity was sterilizing everything I ordered via Instacart and Amazon with disinfectant wipes. I wondered if anyone else was using hospital grade wipes on their organic lettuce.

There are a handful of things I’ve done to maintain internal peace and manage my anxiety during the quarantines and isolation. One of the most vital was distraction afforded by Netflix binges, naturally. But I also read a lot. At any given time during the pandemic, I’ve been concurrently reading five to six books depending on mood.

I also attend live or archived online church and devotional sessions to feel grounded. This is where I learned specific scriptures that also helped carry me through the salty times. Isaiah 41:10-13, Isaiah 53, Psalm 23, Psalm 40:1-3, Psalm 91, and particularly Philippians 4:6-8 were pivotal in smoothing the frays. Memorizing scripture is also a form of meditation. And it helps train the brain for other things – like remembering to brush your teeth or what day it is.

A good chunk of my Covid coping time was spent on building an in-home gym since my fitness center closed. This was exceptionally challenging as millions had the same idea, and every dumbbell, kettlebell, and old-school cement-filled, vinyl prison weight was sold-out everywhere.

Over weeks, I slowly accrued a Frankenstein gym of mismatched heavy things.

I converted my living room into a carpeted fitness studio where I performed calisthenic and plyometric feats of athleticism, such as 3,000 burpees and push-ups per month. I also fast-walked like a soccer mom late to A.A. 25 miles per week. Sadly, my ”nothing succeeds like excess” mindset and compromised shoulders reminded me why my body was made for writing in an ergonomic chair. I was soon too injured from one of the physical endeavors to do anything else, and I had to take two months off. But my anxiety did not.

Anxiety and depression can pique in the absence of coping skills. When we assign value or validity to intrusive thoughts and fears, it’s like mental Miracle-Gro. Talking to a therapist via phone or teletherapy is a measurably effective adjunct tool during stressful times.

There is a little-known dichotomy about mental health issues 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. My anxiety doesn’t want me to pay bills until I’m getting hate mail from creditors, fold laundry until I have no room on my bed to sleep, get groceries until I’m down to ramen and a jar of crusted mayo, or wash my car until stranger’s spell profanities on the windows.

There are two incidences when you should seek out a professional.

If you are in danger of hurting yourself or others, or if you are having passive thoughts about hurting yourself or others (even if you don’t have a plan or any real intent to follow through with these thoughts).
If your symptoms are starting to interfere with your daily life. Such symptoms could include suddenly not getting along with friends or family, difficulty with sleep, problems eating, doing poorly in school or work, or starting to use alcohol or drugs to cope or feel better.

How to choose a therapist

There are many different types of talk therapies available, and many types of therapists to choose from. So which therapy and therapist is right for you? When it comes to treating all mental health issues, especially anxiety or depression, you want to make sure you chose a therapist that uses an approach that is evidence based or empirically validated. This means that they say and do things to treat your symptoms that have been proven by research to be effective. It doesn’t mean watching episodes of Dr. Phil or Dr. Oz.

Client: “What should I do?”
Therapist: “What do you think you should do?”
Client: “Alright then, keep your secrets.”

When choosing a therapist, there’s an array of therapy degrees that include psychiatrists (M.D.), psychologists (PsyD.), and masters level therapists (LCSW, MCSW, etc.). Don’t get hung-up on the pedigree. Just make sure the person is licensed – meaning s/he went to a school that was accredited, received training that was accredited, and have passed both a national and state licensing examination to prove they know what they are talking about.

Equally important, you want to see someone that you like. If you’re going to see a therapist, the type of degree is less important than making sure they are licensed, using techniques that are supported by research, and are someone you can trust and get along with. I personally know some smart but ~~asshole~~ jerk psychologists that shouldn’t be advising anyone on anything, despite their diplomas. Remember who’s paying whom, and hire/fire accordingly.

How long will you need to attend therapy?

The duration of therapy needed is unique for everyone. Many people experience improvement within only a few sessions, while others reap benefits through months or even years of seeing a professional. There’s no commitment required. The goal is simply helping you achieve measurable improvement.

You can also access the “Managing Covid-19 Anxiety” resource page by the reputable Anxiety & Depression Association of America (ADAA).

Just come away from this knowing that you never need to white-knuckle things alone. Your state-of-mind can make it hard to reach-out, which is precisely when you should.

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.

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

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

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

TRACY 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 3^rd 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 31^st 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

ERIC 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

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.

JON PATRICK HATCHER 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.

JON PATRICK HATCHER 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.

ANXIETY: Find the Humor, Find the Cure (as featured at ADAA.com, March 2018)

The first time I saw a flameless cigarette lighter anywhere but a car was on an enclosed patio wall of the Oakland psychiatric facility where my therapist had sent me due to anxiety and depression. Smoking was the only vice afforded to us. Though even while despondent, I wasn’t interested in adding nicotine to a budding alcohol addiction. Perhaps I had hope after all.

He who has a why to live can bear almost any how. – Friedrich Nietzsche

I left triage a few days later, knowing the next bout of crippling anxiety or profound depression was a breakup or mere bad day away. I had no more coping skills than I did before arriving. Beyond therapy and medication, I needed to find a motive to get right with the world and somehow thrive.

I began to journal and noticed a subtle pattern throughout my anxious behaviors. Humor. Many of my anxiety-related mannerisms are dysfunctional, but laughable and cathartic. By way of example:

I have never sat on a public toilet – including hotel rooms. I now have sturdy quads.
I wear medical exam gloves during gym workouts. Dumbbells and people are filthy.
I have extraordinary ability (aka, Spidey-sense) to detect and avert imminent danger. Though not exactly crucial in my quiet suburb.
I go to notable lengths to avoid shaking hands with someone – like feigning leprosy, or resorting to casual fist-bumps in formal situations.
I will walk 50-yards around anyone that coughs or sneezes indoors, or leave the building and my reason for being there entirely.
When someone in my condo complex recently reported bedbugs, I immediately packed and moved. I no longer share walls. Or the potential for vermin.

Mark Twain was prescient in stating, “The secret source of humor itself is not joy but sorrow.” Studies confirm that laughter lowers blood pressure and releases beta-endorphins, a chemical in the brain that creates a sense of joy. These endorphins counter the adrenaline and cortisol that fill the anxious. The calmer we are, the more we remain in rational or positive mind.

Moreover, humor is clinically validated to reduce stress long-term by improving the immune system through the release of neuropeptides, relieving pain, increasing personal satisfaction, and lessening depression and anxiety (source: Mayo Clinic, April 21, 2016). The simple act of smiling causes the brain to release dopamine, which in turn makes us feel happy.

Our thoughts affect our body, and vice versa. Anxiety in the mind creates a stress response in the body. Conversely, calming the body will yield positive cerebral results. All physiological functions are linked, and the mind-body connection is especially strong.

Perhaps most impactful to the sufferer, however, is that humor provides a unique and unrivaled perspective that shifts our thinking away from despair and toward the awareness that a radically different outcome is possible. Humor is the most accessible form of relief. It may initially feel counterintuitive to associate humor with misery. But sourcing the comical manifestations can separate you from your affliction. It’s also how I salvaged my life.

So how do you find the lighter or even amusing side of a debilitating disorder? First recognize that what you’re feeling might be an irrational anxiety. Now dig a bit deeper. What are the potentially laughable nuances of your anxiety? Maybe you occasionally freak-out when you text someone about something seemingly dire and don’t hear back for a while. Your rumination and worry churns into resounding panic, yielding a volley of additional texts – all met with successive silence. Next you concoct a series of worst-case scenarios about why they’re not responding to you; not limited to them driving off a bluff while reading your original text, or deciding they just don’t like you anymore. And just as you’re texting a coup de gras, they reply. It’s like the Heavens opened and gossamer-winged angels descend upon you because it came with a heart emoji.

Alternatively, perhaps you get uncomfortable during long pauses in a conversation. Even a few moments feel far too angst-ridden, so you fill the void with a non-sequitur about your husband’s botched hysterectomy, or you ask your boss how her divorce is going. Your attempts at social stimulus are met with chirping crickets. And, now scorn. Embrace your angst with a cozy smattering of acceptance, and remember that Humor = Calamity + Time. Gain some intellectual distance from your anxiety, and you’ll start to perceive the humor within your anxious thoughts, feelings, and behaviors.

When you acknowledge your anxiety, and detach yourself from it (i.e., you are not your anxiety), you can then take note of the humor. In turn, you will feel a sense of control over your anguish. Find the humor, and you’ll feel the hope for a better state of mind.

It is well known that humor, more than anything else in the human make-up, can afford an aloofness and an ability to rise above any situation, even if only for a few seconds. – Viktor Frankl

Tackling Teen Anxiety (as seen in Diablo Magazine, June 2017)

A Fremont native’s new book helps parents of teens struggling with anxiety.

BY LOU FANCHER

When he was 13, Jon Patrick Hatcher began cutting himself, and he wrestled with years of substance abuse and panic attacks. As his parents struggled to understand him, they decided their son would benefit from professional help. Talk therapy—and Hatcher’s instinctive sense of humor—were key to helping him accept, acknowledge, and manage his anxiety.

Decades later, Hatcher, who got an M.A. from Cal Poly, San Luis Obispo, met Thomas McDonagh, Psy.D., a clinical psychologist in San Francisco. It was a perfect matchup that led to their new book, 101 Ways to Conquer Teen Anxiety: Simple Tips, Techniques, and Strategies for Overcoming Anxiety, Worry, and Panic Attacks.

Hatcher writes with a touch of humor, a tool he still uses to combat the anxiety he will never completely eliminate. We talked to the Fremont-raised author about his new book, why talk therapy is so effective, and practical things parents can do—and not do—to help their teenagers struggling with anxiety.

Q: Why did you write 101 Ways?

A: You can survive is really my message. If you look at the most brilliant minds on the planet, people like Einstein, they suffer a double-edged sword of depression and anxiety. The premise I want to get out is that it’s OK: Anxiety doesn’t define the rest of your life, and there are therapies designed to get you through it. If this reaches one kid out there and helps [him or her], that’s my mission.

Q: What should parents know about teen anxiety?

A: When teens react in an anxious state, they perceive the world in a vastly different, threatening way. A teen might act like a ferocious animal. If they self-
medicate, that might add to the out-of-control impression. What works isn’t telling a teen to calm down; it’s empathy and diplomacy that work best.

Q: What are some things parents can do to help their kids cope with anxiety?

A: Pay close attention to your [children’s] symptoms and what they might be telling you, while not discounting their feelings. Remind your [teens] that anxiety is what they’re feeling and not who they are. Keep in mind that anxiety is not an indicator of poor parenting. Anxiety disorders affect over 25 percent of all teens. Try to keep your fears to yourself and present a positive—or at least neutral—assessment and attitude of the situation. Consider adding some humor where you’re able. Humor is proven to help us deal with disappointments and uncertainties.

Model positive behavior and good self-care. If you take care of yourself, your child will learn that self-care is an important facet. Promote good sleep. A lack of sleep alone can lead to problematic anxiety. Help them get into a routine that prepares them for relaxation. This can include simple meditative breathing exercises or guided meditations. After asking them to share their fears and anxieties, prompt them to problem solve what is causing them anxiety, and help them to develop an actionable plan to counter their distress. Once you have implemented some of the aforementioned, keep the momentum [going]. Only through repetition of anxiety management techniques will your child learn how to counter and manage future stressful scenarios or periods of anxiety—particularly if the anxiety is long-term or chronic.

Q: What should parents not do?

A: Avoid making the problem worse: If parents haven’t had anxiety themselves, they might unintentionally create more anxiety by telling their teen that there’s dangerous stuff out there. Don’t overreact to teen drama. Remember, the teen brain is undergoing constant change. Offer empathy and help from a mental health professional.

Q: Why did you use humor in this book, and in what ways do you find humor useful – or even necessary?

A: The most successful, inadvertent coping technique I developed to alleviate anxiety in my own life is by sourcing the humor in the angst. That said, it definitely does not take away from the serious nature of the subject. Nor does it trivialize anyone’s suffering. It simply makes the material more approachable and relatable.

Q: How can teens avoid becoming overwhelmed?

A: The media show dramatic situations; news headlines make it seem like the world is falling apart; social media is like a mental filter that causes misperception. [Limit] time spent on social media platforms. Start with creating phone-free times. Parents might consider spending time offering their children specific alternatives to daily social media use that include school- or community-based sports, academic and social clubs, pursuing creative or artistic interests, and even volunteering. Engaging in talk therapy with a licensed psychologist [is also] important for managing extreme anxiety.

Q: What are your thoughts on medicating kids who suffer from anxiety versus using talk therapy?

A: I do feel we’re overmedicating kids. Parents [often] demand it, physicians feel put on the spot, and teens aren’t getting the skills they need in therapy. That said, there’s definitely a place for medication in chronic anxiety and depression—especially if a teen talks of suicide and practices self-harm. A pill is easy, and the effect is quicker than acquiring the skills of therapy. But the skills are going to last longer and have fewer side effects. I emphasize therapies and say always bring in a medical professional for medication and a licensed psychologist for mental health support.

Q: Therapy can be effective in managing teen stress, but what can we do about the stigma attached to mental health issues like depression and anxiety?

A: We’ve come a long way, but kids are still bullied, mental health is played down, and kids are told they’re flawed. Cutbacks in programs to help people who need mental health support have made it worse. A lot of people play down the suffering of any mental illness. The brain is an organ like any part of the human body. We don’t say the person with diabetes suffers insulin shock on purpose. We have to have more empathy.

Q: What other types of therapies have you found to be most helpful?

A: Evidence-based therapies that are the most researched and effective that helped me are cognitive behavioral therapy and dialectical behavioral therapy. Cognitive breaks down anxiety into thoughts, behaviors, and physical symptoms. It involves identifying and disputing irrational thoughts. Dialectical builds on the foundation of cognitive to help enhance it’s effectiveness and address specific concerns.

Q: What should a teen experiencing extreme anxiety do immediately?

A: Go to an adult to ask for help. If teens feel different, if they think bad thoughts and don’t know why, they need to talk to an adult who is close. For immediate relief, they should use the four-by-four-by-four breathing technique recommended in my book. [Breathe in for four seconds; hold for four seconds; breathe out for four seconds. Do it four times.] It is clinically proven to calm the body. stateofanxiety.com.