Supporting a Friend or Family Member with a Mental Illness

It can be scary when someone you love is sick. It can be especially scary if they’re diagnosed with a mental illness. It’s hard to see someone you love in pain and it’s confusing when someone you know well is not acting like themselves. You know how you would take care of them if they had a cold or flu, but what do you do for a mental illness? Like any other health problem, someone with a mental illness needs extra love and support. You may not be able to see the illness, but it doesn’t mean that you’re powerless to help.

How can I help?

Research confirms that support from family and friends is a key part of helping someone who is going through a mental illness. This support provides a network of practical and emotional help. These networks can be made up of parents, children, siblings, spouses or partners, extended families, close friends and others who care about us like neighbours, coworkers, coaches and teachers. Some people have larger networks than others, but most of us have at least a few people who are there for us when we need them.

There are a number of major ways that family and friends can help in someone’s journey of recovery from a mental illness:

Knowing when something is wrong—or right: Getting help early is an important part of treating mental illness. Family and friends are often the first ones to notice that something is wrong. See “How do I know when to help?” on the next page for signs to watch for. Finding a treatment that works is often a process of trial and error, so family members may also be the first to see signs of improvement.

How do I do this?

  • TIP: Learn more about the signs and symptoms of different mental illnesses. Also learn more about how treatments work so that you know what side effects you may see, when to look for improvements and which ones to look for first. A recent review found that when the family is educated about the illness, the rates of relapse in their loved ones were reduced by half in the first year.

Seeking help: Families and friends can be important advocates to help loved ones get through those hard, early stages of having a mental illness. They can help their loved one find out what treatment is best for them. They can also be key in letting professionals know what’s going on, filling in parts of the picture that the person who’s ill may not be well enough to describe on their own.

How do I do this?

  • TIP: Offer to make those first appointments with a family doctor to find out what’s wrong or accompany your loved one to the doctor—these steps can be hard if your loved one doesn’t have much energy or experiences problems with concentration. If you do accompany the person, work with them to write down any notes or questions either of you have in advance so that you cover all the major points. If your loved one wants to do it on their own, show them your support and ask them if there’s anything you could do to help.
  • TIP: You can’t always prevent a mental health crisis from happening. If your loved one needs to go to hospital, try and encourage them to go on their own. If you’re concerned that your loved one is at risk of harm, they may receive treatment under BC’s Mental Health Act. It may be necessary in certain cases, but involuntary treatment can be complicated and traumatic for everyone. To learn more about the Mental Health Act, see the “Coping with Mental Health Crises and Emergencies” info sheet.

Helping with medications, appointments and treatments: If you spend a lot of time around your loved ones, you can help them remember to take their medications. You may also be able to help tell a doctor why medications aren’t being taken as they should be. Similarly, you may be involved in reminding your loved one to do their counselling homework or use their light therapy treatment each morning, or reminding your loved one to make or keep appointments for treatment.

How do I do this?

  • TIP: If you notice that your loved one is having trouble taking their medication, you can encourage them to talk to their doctor or pharmacist. They can suggest ways to make pill taking easier. If there are other problems with taking medicine, such as side effects, encourage your loved one to write down their concerns and questions and talk to their doctor. If they don’t have a good relationship with their doctor, help them find a new one. If cost is a barrier, learn about BC’s no-charge psychiatric medication coverage called Plan G.

Supporting a healthy lifestyle: Families can also help with day-to-day factors such as finances, problem solving, housing, nutrition, recreation and exercise, and proper sleeping habits.

How do I do this?

  • TIP: See our Wellness Modules at http://www.heretohelp.bc.ca for practical tips on how to have a healthy lifestyle for both you and your loved one. Case managers and peer support workers at mental health centres in your community may be able to help with life skills training as well as connections to income and housing.

Providing emotional support: You can play an important role in helping someone who’s not feeling well feel less alone and ashamed. They are not to blame for their illness, but they may feel that they are, or may be getting that message from others. You can help encourage hope.

How do I do this?

  • TIP: Try to be as supportive, understanding and patient as possible. See our “Where do I go from here?” section for resources on how to be a good communicator.
  • TIP: Taking care of an ill family member or friend can be stressful. Remember that you need emotional support, too. Consider joining a support group for family members of people with mental illness. There, you can connect with other people going through the same things and they can help you work through your own emotions. It’s very important to make sure you are taking care of your own mental health as well.

“Tom’s recovery has been an exercise in patience, love and understanding. We take one step forward and stumble two steps back; baby steps—small increments of success, tiny improvements of things we would ordinarily take for granted—are things we celebrate. When Tom smiles, cracks a joke or declares that he wants to go for a run, they are positive, encouraging signs: baby steps forward.”
—Family member from Family Toolkit

“The most important thing [families] have to do is accept you completely, with all your faults. Families can help by saying ‘You’re okay, we love you, and you’ll get better”
—Mariam, 31 in recovery from clinical depression 

If you need advice on how to get your loved one the help they need, there are a number of resources available to you.

Other helpful resources are:

BC Partners for Mental Health and Addictions Information
Visit www.heretohelp.bc.ca for info sheets and personal stories on supporting loved ones. You’ll also find more information, tips and self-tests to help you understand many different mental health problems.

Alzheimer Society of BC
Visit www.alzheimerbc.org or call 1-800-936-6033 (toll-free in BC) for information and community resources for individuals and families with dementia.

AnxietyBC
Visit www.anxietybc.com or call 604-525-7566 for information, tools, and community resources on anxiety.

British Columbia Schizophrenia Society
Visit www.bcss.org or call 1-888-888-0029 (toll-free in BC) or 604-270-7841 (in Greater Vancouver) for information and community resources on schizophrenia and other major mental illnesses and support for families.

Canadian Mental Health Association, BC Division
Visit www.cmha.bc.ca or call 1-800-555-8222 (toll-free in BC) or 604-688-3234 (in Greater Vancouver) for information and community resources on mental health and mental illnesses.

FORCE Society for Kids’ Mental Health
Visit.www.forcesociety.com or call 1-855-887-8004 (toll-free in BC) or 604-878-3400 (in the Lower Mainland) for information and resources that support parents of a young person with mental illness.

Jessie’s Legacy at Family Services of the North Shore
Visit www.familyservices.bc.ca or call 1-888-988-5281 ext. 204 (toll-free in BC)  or 604-988-5281 ext. 204 (in Greater Vancouver) for information and resources on body image and prevention of eating disorders.

Kelty Mental Health
Contact Kelty Mental Health at www.keltymentalhealth.ca or 1-800-665-1822 (toll-free in BC) or 604-875-2084 (in Greater Vancouver) for information, referrals and support for children, youth and their families in all areas of mental health and addictions.

Mood Disorders Association of BC
Visit www.mdabc.net or call 604-873-0103 (in the Lower Mainland) or 1-855-282-7979 (in the rest of BC) for resources and information on mood disorders. You’ll also find more information on support groups around the province.

Resources available in many languages:
*For each service below, if English is not your first language, say the name of your preferred language in English to be connected to an interpreter. More than 100 languages are available.

1-800-SUICIDE
If you are in distress or are worried about someone in distress who may hurt themselves, call 1-800-SUICIDE 24 hours a day to connect to a BC crisis line, without a wait or busy signal.

Source: Supporting a Friend or Family Member with a Mental Illness | Here to Help

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References

Brain Fog: How Trauma, Uncertainty and Isolation Have Affected Our Minds and Memory

After a year of lockdown, many of us are finding it hard to think clearly, or remember what happened when. Neuroscientists and behavioural experts explain why

Before the pandemic, psychoanalyst Josh Cohen’s patients might come into his consulting room, lie down on the couch and talk about the traffic or the weather, or the rude person on the tube. Now they appear on his computer screen and tell him about brain fog. They talk with urgency of feeling unable to concentrate in meetings, to read, to follow intricately plotted television programms.

“There’s this sense of debilitation, of losing ordinary facility with everyday life; a forgetfulness and a kind of deskilling,” says Cohen, author of the self-help book How to Live. What to Do. Although restrictions are now easing across the UK, with greater freedom to circulate and socialize, he says lockdown for many of us has been “a contraction of life, and an almost parallel contraction of mental capacity”.

This dulled, useless state of mind – epitomized by the act of going into a room and then forgetting why we are there – is so boring, so lifeless. But researchers believe it is far more interesting than it feels: even that this common experience can be explained by cutting-edge neuroscience theories, and that studying it could further scientific understanding of the brain and how it changes.

I ask Jon Simons, professor of cognitive neuroscience at the University of Cambridge, could it really be something “science”? “Yes, it’s definitely something science – and it’s helpful to understand that this feeling isn’t unusual or weird,” he says. “There isn’t something wrong with us. It’s a completely normal reaction to this quite traumatic experience we’ve collectively had over the last 12 months or so.”

What we call brain fog, Catherine Loveday, professor of cognitive neuroscience at the University of Westminster, calls poor “cognitive function”. That covers “everything from our memory, our attention and our ability to problem-solve to our capacity to be creative. Essentially, it’s thinking.” And recently, she’s heard a lot of complaints about it: “Because I’m a memory scientist, so many people are telling me their memory is really poor, and reporting this cognitive fog,” she says.

She knows of only two studies exploring the phenomenon as it relates to lockdown (as opposed to what some people report as a symptom of Covid-19, or long Covid): one from Italy, in which participants subjectively reported these sorts of problems with attention, time perception and organisation; another in Scotland which objectively measured participants’ cognitive function across a range of tasks at particular times during the first lockdown and into the summer. Results showed that people performed worse when lockdown started, but improved as restrictions loosened, with those who continued shielding improving more slowly than those who went out more.

Loveday and Simons are not surprised. Given the isolation and stasis we have had to endure until very recently, these complaints are exactly what they expected – and they provide the opportunity to test their theories as to why such brain fog might come about. There is no one explanation, no single source, Simons says: “There are bound to be a lot of different factors that are coming together, interacting with each other, to cause these memory impairments, attentional deficits and other processing difficulties.”

One powerful factor could be the fact that everything is so samey. Loveday explains that the brain is stimulated by the new, the different, and this is known as the orienting response: “From the minute we’re born – in fact, from before we’re born – when there is a new stimulus, a baby will turn its head towards it. And if as adults we are watching a boring lecture and someone walks into the room, it will stir our brain back into action.”

Most of us are likely to feel that nobody new has walked into our room for quite some time, which might help to explain this sluggish feeling neurologically: “We have effectively evolved to stop paying attention when nothing changes, but to pay particular attention when things do change,” she says.

Loveday suggests that if we can attend a work meeting by phone while walking in a park, we might find we are more awake and better able to concentrate, thanks to the changing scenery and the exercise; she is recording some lectures as podcasts, rather than videos, so students can walk while listening.

She also suggests spending time in different rooms at home – or if you only have one room, try “changing what the room looks like. I’m not saying redecorate – but you could change the pictures on the walls or move things around for variety, even in the smallest space.”

The blending of one day into the next with no commute, no change of scene, no change of cast, could also have an important impact on the way the brain processes memories, Simons explains. Experiences under lockdown lack “distinctiveness” – a crucial factor in “pattern separation”. This process, which takes place in the hippocampus, at the centre of the brain, allows individual memories to be successfully encoded, ensuring there are few overlapping features, so we can distinguish one memory from another and retrieve them efficiently.

The fuggy, confused sensation that many of us will recognize, of not being able to remember whether something happened last week or last month, may well be with us for a while, Simons says: “Our memories are going to be so difficult to differentiate. It’s highly likely that in a year or two, we’re still going to look back on some particular event from this last year and say, when on earth did that happen?”

Perhaps one of the most important features of this period for brain fog has been what Loveday calls the “degraded social interaction” we have endured. “It’s not the same as natural social interaction that we would have,” she says. “Our brains wake up in the presence of other people – being with others is stimulating.”

We each have our own optimum level of stimulation – some might feel better able to function in lockdown with less socialising; others are left feeling dozy, deadened. Loveday is investigating the science of how levels of social interaction, among other factors, have affected memory function in lockdown. She also wonders if our alternative to face-to-face communication – platforms such as Zoom – could have an impact on concentration and attention.

She theorises – and is conducting a study to explore this – that the lower audio-visual quality could “create a bigger cognitive load for the brain, which has to fill in the gaps, so you have to concentrate much harder.” If this is more cognitively demanding, as she thinks, we could be left feeling foggier, with “less brain space available to actually listen to what people are saying and process it, or to concentrate on anything else.”

Carmine Pariante, professor of biological psychiatry at King’s College London, is also intrigued by brain fog. “It’s a common experience, but it’s very complex,” he says. “I think it is the cognitive equivalent of feeling emotionally distressed; it’s almost the way the brain expresses sadness, beyond the emotion.” He takes a psycho-neuro-immuno-endocrinological approach to the phenomenon – which is even more fascinating than it is difficult to say. He believes we need to think about the mind, the brain, the immune and the hormonal systems to understand the various mental and physical processes that might underlie this lockdown haze, which he sees as a consequence of stress.

We might all agree that the uncertainty of the last year has been quite stressful – more so for some than for others. When our mind appraises a situation as stressful, Pariante explains, our brain immediately transmits the message to our immune and endocrine systems. These systems respond in exactly the same way they did in early humans two million years ago on the African savannah, when stress did not relate to home schooling, but to fear of being eaten by a large animal.

The heart beats faster so we can run away, inflammation is initiated by the immune system to protect against bacterial infection in case we are bitten, the hormone cortisol is released to focus our attention on the predator in front of us and nothing else. Studies have demonstrated that a dose of cortisol will lower a person’s attention, concentration and memory for their immediate environment. Pariante explains: “This fog that people feel is just one manifestation of this mechanism. We’ve lost the function of these mechanisms, but they are still there.” Useful for fighting a lion – not for remembering where we put our glasses.

When I have experienced brain fog, I have seen it as a distraction, a kind of laziness, and tried to push through, to force myself to concentrate. But listening to Loveday, Simons and Pariante, I’m starting to think about it differently; perhaps brain fog is a signal we should listen to. “Absolutely, I think it’s exactly that,” says Pariante. “It’s our body and our brain telling us that we’re pushing it too much at the moment. It’s definitely a signal – an alarm bell.” When we hear this alarm, he says, we should stop and ask ourselves, “Why is my brain fog worse today than yesterday?” – and take as much time off as we can, rather than pushing ourselves harder and risking further emotional suffering, and even burnout.

For Cohen, the phenomenon of brain fog is an experience of one of the most disturbing aspects of the unconscious. He talks of Freud’s theory of drives – the idea that we have one force inside us that propels us towards life; another that pulls us towards death. The life drive, Cohen explains, impels us to create, make connections with others, seek “the expansion of life”. The death drive, by contrast, urges “a kind of contraction. It’s a move away from life and into a kind of stasis or entropy”. Lockdown – which, paradoxically, has done so much to preserve life – is like the death drive made lifestyle.

With brain fog, he says, we are seeing “an atrophy of liveliness. People are finding themselves to be more sluggish, that their physical and mental weight is somehow heavier, it’s hard to carry around – to drag.” Freud has a word for this: trägheit – translated as a “sluggishness”, but which Cohen says literally translates as “draggyness”. We could understand brain fog as an encounter with our death drive – with the part of us which, in Cohen’s words, is “going in the opposite direction of awareness and sparkiness, and in the direction of inanimacy and shutting down”.

This brings to mind another psychoanalyst: Wilfred Bion. He theorised that we have – at some moments – a will to know something about ourselves and our lives, even when that knowledge is profoundly painful. This, he called being in “K”. But there is also a powerful will not to know, a wish to defend against this awareness so that we can continue to live cosseted by lies; this is to be in “–K” (spoken as “minus K”).

I wonder if the pandemic has been a reality some of us feel is too horrific to bear. The uncertainty, the deaths, the trauma, the precarity; perhaps we have unconsciously chosen to live in the misty, murky brain fog of –K rather than to face, to suffer, the true pain and horror of our situation. Perhaps we are having problems with our thinking because the truth of the experience, for many of us, is simply unthinkable.

I ask Simons if, after the pandemic, he thinks the structure of our brains will look different on a brain scan: “Probably not,” he says. For some of us, brain fog will be a temporary state, and will clear as we begin to live more varied lives. But, he says, “It’s possible for some people – and we are particularly concerned about older adults – that where there is natural neurological decline, it will be accelerated.”

Simons and a team of colleagues are running a study to investigate the impact of lockdown on memory in people aged over 65 – participants from a memory study that took place shortly before the pandemic, who have now agreed to sit the same tests a year on, and answer questions about life in the interim.

One aim of this study is to test the hypothesis of cognitive reserve – the idea that having a rich and varied social life, filled with intellectual stimulation, challenging, novel experiences and fulfilling relationships, might help to keep the brain stimulated and protect against age-related cognitive decline. Simons’ advice to us all is to get out into the world, to have as rich and varied experiences and interactions as we can, to maximize our cognitive reserve within the remaining restrictions.

The more we do, the more the brain fog should clear, he says: “We all experience grief, times in our lives where we feel like we can’t function at all,” he says. “These things are mercifully temporary, and we do recover.”

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Source: Brain fog: how trauma, uncertainty and isolation have affected our minds and memory | Health & wellbeing | The Guardian

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Sleep Deprivation Fuels Accumulation Of Two Alzheimer’s Proteins In The Brain

The brain of a sleep-deprived person is imbued with excess of two proteins that are substantially associated with Alzheimer’s disease.

According to the study published in the journal Science, a protein called tau is found in excess in the fluid that fills the brain and spinal cord of individuals with chronic sleep deprivation. The protein also drives neuron degeneration, and during Alzheimer’s, it scatters throughout the brain.

Similarly, sleep deprivation also induces accumulation of protein called amyloid-beta – a chunk of which dots the brains of Alzheimer’s patients.

In the study, researchers went over the samples of cerebrospinal fluid of eight adult participants who were sleep-deprived for nearly 36 hours. They found 51.5 percent increase in their tau levels. Similarly, mice that were rob of sleep were found to have twice the level of tau compared to well-rested ones.

Another study also reported that the lack of sleep to be the legitimate cause of increased level of A-beta in the cerebrospinal fluid, and if preceded by a week of poor sleep, the levels of tau also increased.

Since lack of sleep increases the levels of tau and A-beta in the brain, it appears that the only way to curtail the risk of developing Alzheimer’s symptom is to treat sleep disorders during mid-life and get good amount of sleep as much as possible. Proper sleep helps our brain get rid of excess proteins and other unnecessary stuffs, so getting less sleep means that wash cycle is disturbed.

References:

  • Lack of sleep is tied to increases in two Alzheimer’s proteins (Science News)
  • The sleep-wake cycle regulates brain interstitial fluid tau in mice and CSF tau in humans (Science)
  • Association of Excessive Daytime Sleepiness With Longitudinal β-Amyloid Accumulation in Elderly Persons Without Dementia (Jama Neurology)

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Source: Sleep Deprivation Fuels Accumulation Of Two Alzheimer’s Proteins In The Brain – Sparkonit

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This 4-minute video shows how Alzheimer’s disease changes the brain and looks at promising ideas to treat and prevent the disease. Alzheimer’s disease is the most basic form of dementia, and scientists are trying to understand how the affects the nervous system. This video illustrates how neurons communicate in a healthy brain compared to that of a person with Alzheimer’s disease. In a healthy brain, cells such as astrocytes and microglia help keep neurons healthy by clearing away debris that builds up over time. In a person with Alzheimer’s disease, toxic changes in the brain destroy the ability of these cells to maintain a healthy environment for the neurons in the brain, ultimately causing a loss of neurons. Researchers believe that the Alzheimer’s disease process involves two proteins: beta amyloid protein and tau protein. Within the brain of a person with Alzheimer’s disease, these proteins become compromised. Over time, abnormal tau accumulates and eventually forms tangles inside the neurons, and the beta amyloid clumps into plaques, which build up between the neurons. As the level of amyloid increases, tau rapidly spreads throughout the brain. Other changes that affect the brain may play a role in the disease, such as the inability of the vascular system to deliver enough blood and nutrients to the brain. These factors cause the brain to shrink in size, starting with the hippocampus. A person with Alzheimer’s gradually loses the ability to think, remember, make decisions, and function independently. Researchers are working on the key to understanding Alzheimer’s disease so that Alzheimer’s disease research can lead to the development of more effective therapies with the hope that we can delay or even prevent the devastation of dementia. This video was developed by the National Institute on Aging (https://www.nia.nih.gov/), part of the National Institutes of Health (https://www.nih.gov/). Want to learn more? Subscribe to the National Institute on Aging’s YouTube channel: https://www.youtube.com/user/NatlInst…. Find more information about Alzheimer’s disease from the National Institute on Aging: https://www.nia.nih.gov/health/alzhei…. Find more health information from the National

“Wakefulness” Part of the Brain Attacked First in Alzheimer’s, Study Says

Lea Grinberg, a neuropathologist and associate professor at the UCSF Memory and Aging Center in San Francisco’s Mission Bay, holds slides of brain tissue used for research on August 15, 2019. (Lindsey Moore/KQED)

People who donate their bodies to science might never have dreamed what information lies deep within their brains.

Even when that information has to do with sleep.

Scientists used to believe that people who napped a lot were at risk for developing Alzheimer’s disease. But Lea Grinberg with the UCSF Memory and Aging Center started to wonder if “risk” was too light a term — what if, instead, napping indicated an early stage of Alzheimer’s?

About a decade ago, Grinberg — a neuropathologist and associate professor — was working with her team to map a protein called tau in donated brains. Some of their data, published last week, revealed drastic differences between healthy brains and those from Alzheimer’s patients in the parts of the brain responsible for wakefulness.

Lea Grinberg uses a program that takes a microscope’s magnification of brain tissue on a slide and projects it on a computer screen on August 15, 2019. The different colors represent different biological features in the brain tissue sample, including neurons and tau protein. (Lindsey Moore/KQED)

Wakefulness centers in the brain showed the buildup of tau — a protein that clogs neurons, Grinberg says, and lets debris accumulate. Gradually, these clogged neurons die. Some areas of the diseased brains had lost as much as 75% of their neurons. That may have led to the excessive napping scientists had observed before. Although the team only studied brains from 13 Alzheimer’s patients and 7 healthy individuals, Grinberg says that the degeneration caused by Alzheimer’s was so profound they were sure of its significance.

“We are kind of changing our understanding of what Alzheimer’s disease is,” she says. “It’s not only a memory problem, but it’s a problem in the brain that causes many other symptoms.”

Although these symptoms aren’t as severe as complete loss of memory or motor functions, Grinberg says they can still hold real consequences for a person’s quality of life. “Because if you don’t sleep well every day and if you… are not in the mood to do things like you were before, it’s very disappointing, right? My grandparents were like this.”

Grinberg says it’s important to know whether napping could be an early sign of Alzheimer’s, for treating symptoms and developing drugs that could slow the progression of the disease. Although there are no prescription drugs available to treat tau buildup, she says, a few are in clinical trials.

Lea Grinberg holds boxes filled with samples of brain tissue for study on August 15, 2019. (Lindsey Moore/KQED)

A public health professor and neuroscientist at UC Berkeley says the new information offers hope to researchers. William Jagust, who has studied Alzheimer’s for over 30 years, says the results could help select patients for clinical trials of new drugs that require early treatment. “It’s also just very important for understanding the evolution of Alzheimer’s disease with the hope that we eventually will have a drug,” he adds.

It’ll be awhile before doctors can diagnose anyone with Alzheimer’s based on how often they doze off. “There’s no practical application of this to clinical medicine as of today,” Jagust says, “but I think it’s on the cutting edge of the very, very important questions.”

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Source: “Wakefulness” Part of the Brain Attacked First in Alzheimer’s, Study Says

What is Alzheimer’s disease? Alzeimer’s (Alzheimer) disease is a neurodegenerative disease that leads to symptoms of dementia. Progression of Alzheimer’s disease is thought to involve an accumulation of beta-amyloid plaque and neurofibrillary tangles in the brain. Find more videos at http://osms.it/more. Study better with Osmosis Prime. Retain more of what you’re learning, gain a deeper understanding of key concepts, and feel more prepared for your courses and exams. Sign up for a free trial at http://osms.it/more. Subscribe to our Youtube channel at http://osms.it/subscribe. Get early access to our upcoming video releases, practice questions, giveaways and more when you follow us on social: Facebook: http://osms.it/facebook Twitter: http://osms.it/twitter Instagram: http://osms.it/instagram Osmosis’s Vision: Empowering the world’s caregivers with the best learning experience possible.

9 Signs You’re Overdue for a Mental Health Day

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As a culture, we tend to toss around the phrase “mental health day,” joking about these kinds of sick days as if they’re somehow less important than those we take to recover from being physically ill. And the worst part? Even with all the joking, few of us actually cash in on the vacation and sick time that’s part of our total compensation from our employers, which means that we’re way backed up on our self-care.

The truth is that mental health days are genuinely important, and if you have the flexibility to take time off from work to tend to this part of your well-being, you absolutely should. Keep scrolling for nine signs that, according to experts, it’s time to take a break for your own good.

1. Your tolerance for other humans has reached an all-time low. Are you shutting down your coworkers more quickly than usual? Reacting emotionally to feedback from your boss? Snapping at your partner or kids even after you’ve gone home? If this sounds familiar, certified life coach and co-founder of the Conscious Coaching Collective Dr. Ariane Machín, PhD advises that you treat yourself to a day off.

2. You have to talk yourself into going to work. “Does it take you several minutes to actually leave your car after you arrive in the morning?” asks mental health therapist and Transcendence Counseling Center LLC owner Jessica Singh. “Often, this type of avoidance is a sign that something is wrong. This could be from a work-life imbalance, anxiety, boredom, or a lack of support at work.” It’s only a lucky few who feel genuinely excited to get to the office every day, but if you’re having to actively psych yourself up to make it happen at all, a mental health day is in order.

3. Your sleep is out of whack. When we experience elevated stress during the day, those annoying stress hormones keep firing well into the night, making it all the more difficult for us to fall asleep. This state, according to hormone and gynecological health expert Dr. Nisha Jackson, PhD, can leave our bodies completely confused, making us feel wired through the night and exhausted during the day. A restful mental health day is a good first step to get back on track.

4. You’re struggling to manage your emotions. You’re crying more frequently than usual. You’re angry and you’re not sure why. You’ve lost total control of your feelings, and your usual emotional coping mechanisms are letting you down. Per wholeness coach Jenn Bovee, these are all cues that it’s time to pump the brakes on your normal routine.

5. You can’t focus. If your mental health is suffering, you may find that it manifests physically and behaviorally, so stay tuned in to how your body and brain are working. “When you are no longer able to focus extended periods of time and attention toward completing your duties, chances are you may need a mental health day or two to reset your brain,” licensed mental health counselor and Grey’s Counseling Services founder Jovica Grey tells us. Even a single day off may be just what you need to come back with the concentration you need to succeed!

6. You’re not enjoying anything you do. It wouldn’t be reasonable to expect that the good times will roll 24/7 — especially during office hours — but when you can’t bring yourself to find joy in anything, that’s a big red flag. “When we start to reach a state of burnout, we usually stop enjoying things — even the things that used to bring us joy,” explains licensed marriage therapist and Wright Wellness Center co-founder Rachel Wright. “Once you’re resenting the work, it’s definitely time to take a mental health day.”

7. You can’t make decisions. “It’s time to take a mental health day when you can’t, for the life of you, make a decision,” says licensed psychotherapist and coach Tess Brigham. “You’ve hit decision fatigue, which happens when we have too many decisions to make. We get decision fatigue not because we have to make too many decisions but because we’re lacking energy and focus.” Stop beating yourself up if you’re struggling to make choices. Instead, consider it a potential cue that you need to give yourself a break (literally).

8. You’re routinely getting sick. Cold and flu season is one thing, but don’t eliminate the possibility that constant illness is actually pointing to something happening below the surface. “We know from research that physical and mental health are strongly linked, so if you’re getting ill a lot, then it’s a sign that you need to take some time to get yourself back into balance,” reveals online fitness coach Emma Green.

9. You can’t remember the last time you took time off. If you’re scratching your head trying to recall the last time you were out of the office, let us be the first to inform you that you’ve got a problem on your hands! You deserve some down time. Mental health and emotional well-being expert Kim Roberts tells us that regular mental health days are critical for maintaining healthy relationships with our minds, so make sure they’re coming up on the calendar at least every few months.

By: Alli Hoff Kosik

Alli Hoff Kosik is a freelance writer who is passionate about reading, running, rainbow sprinkles, her lipstick collection, watching embarrassing reality TV, and drinking pink wine. She lives in Brooklyn with her husband and (in her dreams, at least) three golden retriever puppies. Listen to her talk books on The SSR Podcast.
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