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Resilience: build skills to endure hardship.

Resilience means being able to adapt to life's misfortunes and setbacks. Test your resilience level and get tips to build your own resilience.

When something goes wrong, do you tend to bounce back or fall apart?

When you have resilience, you harness the inner strength that helps you rebound from a setback or challenge, such as a job loss, an illness, a disaster or a loved one's death. If you lack resilience, you might dwell on problems, feel victimized, become overwhelmed or turn to unhealthy coping mechanisms, such as substance abuse, eating disorders or risky behaviors.

Resilience won't make your problems go away — but resilience can give you the ability to see past them, find enjoyment in life and better handle stress. If you aren't as resilient as you'd like to be, you can develop and learn skills to become more resilient.

Adapting to adversity

Resilience is the ability to adapt to difficult situations. When stress, adversity or trauma strikes, you still experience anger, grief and pain, but you're able to keep functioning — both physically and psychologically. However, resilience isn't about putting up with something difficult, being stoic or figuring it out on your own. In fact, being able to reach out to others for support is a key part of being resilient.

Resilience and mental health

Resilience can help protect you from various mental health conditions, such as depression and anxiety. Resilience can also help offset factors that increase the risk of mental health conditions, such as being bullied or previous trauma. If you have an existing mental health condition, being resilient can improve your coping ability.

• A very happy brain

[MUSIC PLAYING]

A very happy brain by Dr. Sood

Friends, this is the story of how Broody, a very unhappy brain, became very happy. You see Broody struggled with fear and self-doubt. He felt unsafe and unworthy. He didn't know what to do. Then Broody's friend suggested an idea. Together, they went to school to learn about the brain and about themselves. Come. Let's find out what they learned.

A short course in happiness

Your brain has trillions of junctions that manage millions of its functions. Let's learn about three traits of the brain that in overdrive can get you drained. First trait: Your brain feels others pain as its own. Your brain hurts just the same in personal or beloved's pain. The same neurons fire when you are in despair and when someone else is hurting about whom you care. Second trait: For your brain, imaginary is real. Your brain lights up the same nerve bundles for events real or imagined stumbles. If you dream of a spider on your shin, it might cause the same dread as the real thing. Third trait: The brain can't tell physical pain from emotional hurts. The pain of a mean scorn stings the same as agony of a hurtful thorn. Broken bone and broken heart both cause the same smart. Millennia ago, the spiritual minds described in their devotions, hymns and rhymes the same truths that the scientists of today write in thesis, books, journals and essays: compassion, kindness, gratitude, forgiveness, healing.

What do they all say? To find inner contentment and plenitude, snug yourself in the comfort of gratitude. Your greatest joys come from passions that are lush with true and deep compassion. Once you're lost in healing others and start seeing strangers as brothers, your brain will become the happiest of all -- be it summer, spring, winter or fall. When you pray for others, share their feeling in touching their lives, you will find healing. Help others feel safe and cherished, the joys in your brain will surely flourish. If you agree, then don't wait. Don't miss the feast nor leave it to fate. Start with the one a breath away. In this moment. Now. Today. Start with the one a breath away. In this moment. Now. Today.

Broody, the brain, came back from school with two important concepts: First, seeing others in pain, physical or emotional, fires his own pain network and second, his imaginary fears caused him real damage. The school also taught him solutions to these neural predispositions through cultivating deeper gratitude and compassion.

The daily practice of gratitude and compassion made Broody happier and stronger than ever. He defeated fear and self-doubt and then felt safe and worthy. [Applause] The brains that feel safe and worthy become happy. [MEOW] Happy brains, when they get busy in meaningful, creative and altruistic activities, become very happy. [MEOW]

Here is the secret to a happier life: Because of the way your brain operates the pursuit of gratitude and compassion will make you happier than the pursuit of happiness.

Brought to you by: Amit Sood, M.D., Gauri Sood, @amitsoodmd, Stressfree.org, Global Center for Resiliency and Wellbeing

Thank you for your attention. [Giggles]

Stressfree.org

Tips to improve your resilience

If you'd like to become more resilient, consider these tips:

• Get connected. Building strong, positive relationships with loved ones and friends can provide you with needed support, guidance and acceptance in good and bad times. Establish other important connections by volunteering or joining a faith or spiritual community.
• Make every day meaningful. Do something that gives you a sense of accomplishment and purpose every day. Set clear, achievable goals to help you look toward the future with meaning.
• Learn from experience. Think of how you've coped with hardships in the past. Consider the skills and strategies that helped you through difficult times. You might even write about past experiences in a journal to help you identify positive and negative behavior patterns — and guide your future behavior.
• Remain hopeful. You can't change the past, but you can always look toward the future. Accepting and even anticipating change makes it easier to adapt and view new challenges with less anxiety.
• Take care of yourself. Tend to your own needs and feelings. Participate in activities and hobbies you enjoy. Include physical activity in your daily routine. Get plenty of sleep and create consistent bedtime rituals. Eat a healthy diet. Practice stress management and relaxation techniques, such as yoga, meditation, guided imagery, deep breathing or prayer.
• Be proactive. Don't ignore your problems. Instead, figure out what needs to be done, make a plan and take action. Although it can take time to recover from a major setback, traumatic event or loss, know that your situation can improve if you work at it.

When to seek professional advice

Becoming more resilient takes time and practice. If you don't feel you're making progress — or you don't know where to start — consider talking to a mental health professional. With guidance, you can improve your resiliency and mental well-being.

Related information

• Resiliency during COVID-19 pandemic flu season (podcast) - Related information Resiliency during COVID-19 pandemic flu season (podcast)

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• Building your resilience. American Psychological Association. https://www.apa.org/topics/resilience. Accessed Jan. 25, 2022.
• AskMayoExpert. Resilience training. Mayo Clinic; 2021.
• Mesman E, et al. Resilience and mental health in children and adolescents: An update of the recent literature and future directions. Current Opinion in Psychiatry. 2021; doi:10.1097/YCO.000000000000074.
• Babic R, et al. Resilience and illness. Psychiatria Danubina. 2020;32:226.

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How to Improve Mental Health

What is mental health.

Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act as we cope with life. It also helps determine how we handle stress , relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood and aging .

Why is mental health important?

Mental health is important because it can help you to:

• Cope with the stresses of life
• Be physically healthy
• Have good relationships
• Make meaningful contributions to your community
• Work productively
• Realize your full potential

How can I improve my mental health?

There are many different things you can do to improve your mental health, including:

• Finding balance between positive and negative emotions. Staying positive doesn't mean that you never feel negative emotions, such as sadness or anger. You need to feel them so that you can move through difficult situations. They can help you to respond to a problem. But you don't want those emotions to take over. For example, it's not helpful to keep thinking about bad things that happened in the past or worry too much about the future.
• Trying to hold on to the positive emotions when you have them
• Taking a break from negative information. Know when to stop watching or reading the news. Use social media to reach out for support and feel connected to others but be careful. Don't fall for rumors, get into arguments, or negatively compare your life to others.
• Practicing gratitude , which means being thankful for the good things in your life. It's helpful to do this every day, either by thinking about what you are grateful for or writing it down in a journal. These can be big things, such as the support you have from loved ones, or little things, such as enjoying a nice meal. It's important to allow yourself a moment to enjoy that you had the positive experience. Practicing gratitude can help you to see your life differently. For example, when you are stressed, you may not notice that there are also moments when you have some positive emotions. Gratitude can help you to recognize them.
• Being physically active . Exercise can reduce feelings of stress and depression and improve your mood.
• Getting enough sleep . Sleep affects your mood. If you don't get a good sleep, you may become more easily annoyed and angry. Over the long term, a lack of quality sleep can make you more likely to become depressed. So it's important to make sure that you have a regular sleep schedule and get enough quality sleep every night.
• Healthy eating . Good nutrition will help you feel better physically but could also improve your mood and decrease anxiety and stress. Also, not having enough of certain nutrients may contribute to some mental illnesses. For example, there may be a link between low levels of vitamin B12 and depression. Eating a well-balanced diet can help you to get enough of the nutrients you need.
• Connecting with others. Humans are social creatures, and it's important to have strong, healthy relationships with others. Having good social support may help protect you against the harms of stress. It is also good to have different types of connections. Besides connecting with family and friends, you could find ways to get involved with your community or neighborhood. For example, you could volunteer for a local organization or join a group that is focused on a hobby you enjoy.
• Developing a sense of meaning and purpose in life. This could be through your job, volunteering, learning new skills, or exploring your spirituality.
• Developing coping skills , which are methods you use to deal with stressful situations. They may help you face a problem, take action, be flexible, and not easily give up in solving it.
• A quiet location with as few distractions as possible
• A specific, comfortable posture. This could be sitting, lying down, walking, or another position.
• A focus of attention, such as a specially chosen word or set of words, an object, or your breathing
• An open attitude, where you try to let distractions come and go naturally without judging them
• Progressive relaxation, where you tighten and relax different muscle groups, sometimes while using mental imagery or breathing exercises
• Guided imagery, where you learn to focus on positive images in your mind, to help you feel more relaxed and focused
• Biofeedback, where you use electronic devices to learn to control certain body functions, such as breathing, heart rate, and muscle tension
• Self-hypnosis, where the goal is to get yourself into a relaxed, trance-like state when you hear a certain suggestion or see a specific cue
• Deep breathing exercises, which involve focusing on taking slow, deep, even breaths

It's also important to recognize when you need to get help. Talk therapy and/or medicines can treat mental disorders . If you don't know where to get treatment, start by contacting your primary care provider.

• 31 Tips To Boost Your Mental Health (Mental Health America)

• Live Your Life Well (Mental Health America)

Treatments and Therapies

• For a Healthy Mind and Body Talk to a Psychologist (American Psychological Association) Also in Spanish
• Get Professional Help if You Need It (Mental Health America)

Related Issues

• Anger Management: 10 Tips to Tame Your Temper (Mayo Foundation for Medical Education and Research) Also in Spanish
• Mind/Body Connection: How Your Emotions Affect Your Health (American Academy of Family Physicians) Also in Spanish
• Resilience (American Psychological Association) Also in Spanish
• Stress Management: Stress Relievers (Mayo Foundation for Medical Education and Research)
• Connect with Others (Mental Health America)
• Create Joy and Satisfaction (Mental Health America)
• Creating a Healthier Life: A Step-By-Step Guide to Wellness (Substance Abuse and Mental Health Services Administration) - PDF
• Deal Better with Hard Times (Mental Health America)
• Eat Well (Mental Health America)
• Forgiveness: Letting Go of Grudges and Bitterness (Mayo Foundation for Medical Education and Research) Also in Spanish
• Friendships: Enrich Your Life and Improve Your Health (Mayo Foundation for Medical Education and Research) Also in Spanish
• Get Physically Active (Mental Health America)
• Help Others (Mental Health America)
• Managing Daily Stress (American Academy of Family Physicians) Also in Spanish
• Nutrition and Mental Health (American Academy of Family Physicians) Also in Spanish
• Self-Esteem: Take Steps to Feel Better about Yourself (Mayo Foundation for Medical Education and Research) Also in Spanish
• Spirituality and Health (American Academy of Family Physicians) Also in Spanish
• Stay Positive (Mental Health America)
• Take Care of Your Spirit (Mental Health America)

Statistics and Research

Find an expert.

• American Psychiatric Association
• Substance Abuse and Mental Health Services Administration
• 3 Ways to Practice Gratitude (For Teens) (Nemours Foundation)
• Gratitude (For Teens) (Nemours Foundation)
• Steps to Support Good Mental Health (Department of Health and Human Services, Office on Women's Health) Also in Spanish

The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

How to Be Mentally Strong: 14 Ways to Build Mental Toughness

Some people seem to quickly bounce back from personal failures and setbacks, while others find it much more difficult.

When life knocks you down, are you quick to pick yourself up and adapt to the circumstances? Or do you find yourself completely overwhelmed with little confidence in your ability to deal with the challenge?

If you find yourself in the latter category, not to worry. Luckily there are many practical strategies for building mental resilience; it is a quality that can be learned and honed through practice, discipline and hard work.

Our resilience is often tested when life circumstances change unexpectedly and for the worse — such as the death of a loved one, the loss of a job, or the end of a relationship. Such challenges, however, present the opportunity to rise above and come back even stronger than you were before.

Read on to learn techniques to build and improve your mental resilience, and deal effectively with the challenges of life.

Before you read on, we thought you might like to download our three Resilience Exercises for free . These engaging, science-based exercises will help you to effectively deal with difficult circumstances and give you the tools to improve the resilience of your clients, students or employees.

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Mental Strength is the capacity of an individual to deal effectively with stressors, pressures and challenges and perform to the best of their ability, irrespective of the circumstances in which they find themselves (Clough, 2002).

Building mental strength is fundamental to living your best life . Just as we go to the gym and lift weights in order to build our physical muscles, we must also develop our mental health through the use of mental tools and techniques.

Optimal mental health helps us to live a life that we love, have meaningful social connections, and positive self-esteem . It also aids in our ability to take risks, try new things, and cope with any difficult situations that life may throw at us.

Mental strength involves developing daily habits that build mental muscle. It also involves giving up bad habits that hold you back.

Morin, 2017

In order to be mentally healthy, we must build up our mental strength! Mental strength is something that is developed over time by individuals who choose to make personal development a priority. Much like seeing physical gains from working out and eating healthier, we must develop healthy mental habits, like practicing gratitude , if we want to experience mental health gains.

Likewise, to see physical gains we must also give up unhealthy habits, such as eating junk food, and for mental gains, give up unhealthy habits such as feeling sorry for oneself.

We are all able to become mentally stronger, the key is to keep practicing and exercising your mental muscles — just as you would if you were trying to build physical strength!

The term “ Resilience ,” commonly used in relation to positive mental health, is actually borrowed from engineering, where it refers to the ability of a substance or object to spring back into shape (“Resilience,” 2019). In the same way that a material object would require strength and flexibility in order to bounce back, so too does an individual require these characteristics in order to be mentally resilient.

The American Psychological Association (2014) defines Mental Resilience as:

“The process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of stress.”

A similar concept, Mental Toughness , refers to the ability to stay strong in the face of adversity; to keep your focus and determination despite the difficulties you encounter. A mentally tough individual sees challenge and adversity as an opportunity and not a threat, and has the confidence and positive approach to take what comes in their stride (Strycharczyk, 2015).

To be mentally tough, you must have some degree of resilience , but not all resilient individuals are necessarily mentally tough. If you think of it as a metaphor, resilience would be the mountain, while mental toughness might be one of the strategies for climbing that mountain.

Strycharczyk (2015) finds it useful to think of the difference in terms of the phrase ‘survive and prosper.’ Resilience helps you to survive, and mental toughness helps you to prosper.

Mental toughness begins when you choose to take notice of what’s passing through your mind, without identifying personally with those thoughts or feelings. Then, finding the determination to evoke optimistic thoughts about the situation at hand.

According to Strycharczyk and Clough (n.d.), techniques for developing mental toughness revolve around five themes:

• Positive Thinking
• Anxiety Control
• Visualization
• Goal Setting
• Attentional Control

As with building mental strength, developing mental toughness does require self-awareness and commitment. Generally speaking, mentally tough individuals appear to achieve more than the mentally sensitive and enjoy a greater degree of contentment.

Prof Clough (Strycharczyk & Clough (n.d.)) describes four important traits of mental toughness, which he calls the 4C’s: Control, Commitment, Challenge, and Confidence. One may possess a few of these traits, but having the four qualities in combination is the key to success.

Mental toughness can be measured using the MTQ48 Psychometric Tool, constructed by Professor Peter Clough of Manchester Metropolitan University. The MTQ48 Tool is scientifically valid and reliable and based on this 4C’s framework, which measures key components of mental toughness.

The 4 C’s of Mental Toughness:

This is the extent to which you feel you are in control of your life, including your emotions and sense of life purpose . The control component can be considered your self-esteem. To be high on the Control scale means to feel comfortable in your own skin and have a good sense of who you are.

You’re able to control your emotions — less likely to reveal your emotional state to others — and be less distracted by the emotions of others. To be low on the Control scale means you might feel like events happen to you and that you have no control or influence over what happens.

2. Commitment

This is the extent of your personal focus and reliability. To be high on the Commitment scale is to be able to effectively set goals and consistently achieve them, without getting distracted. A high Commitment level indicates that you’re good at establishing routines and habits that cultivate success.

To be low on the Commitment scale indicates that you may find it difficult to set and prioritize goals, or adapt routines or habits indicative of success. You might also be easily distracted by other people or competing priorities.

Together, the Control and Commitment scales represent the Resilience part of the Mental Toughness definition. This makes sense because the ability to bounce back from setbacks requires a sense of knowing that you are in control of your life and can make a change. It also requires focus and the ability to establish habits and targets that will get you back on track to your chosen path.

3. Challenge

This is the extent to which you are driven and adaptable. To be high on the Challenge scale means that you are driven to achieve your personal best, and you see challenges, change, and adversity as opportunities rather than threats; you are likely to be flexible and agile. To be low on the Challenge scale means that you might see change as a threat, and avoid novel or challenging situations out of fear of failure.

4. Confidence

This is the extent to which you believe in your ability to be productive and capable; it is your self-belief and the belief that you can influence others. To be high on the Confidence scale is to believe that you will successfully complete tasks, and to take setbacks in stride while maintaining routine and even strengthening your resolve. To be low on the

Confidence scale means that you are easily unsettled by setbacks, and do not believe that you are capable or have any influence over others.

Together, the Challenge and Confidence scales represent the Confidence part of the Mental Toughness definition. This represents one’s ability to identify and seize an opportunity, and to see situations as opportunities to embrace and explore. This makes sense because if you are confident in yourself and your abilities and engage easily with others, you are more likely to convert challenges into successful outcomes.

As mentioned earlier, mental resilience is not a trait that people either have or don’t have. Rather, it involves behaviors, thoughts, and actions that can be learned and developed in everyone. Of course, there may be a genetic component to a person’s level of mental resilience, but it is certainly something that can be built upon.

In a paper inspired by the 2013 panel of the International Society for Traumatic Stress Studies, Drs. Southwick, Bonanno, Masten, Panter-Brick, and Yehuda (2013) tackled some of the most pressing current questions in the field of resilience research.

The panelists had slightly different definitions of resilience, but most of the definitions included a concept of healthy, adaptive, positive functioning in the aftermath of adversity. They agreed that “ resilience is a complex construct and it may be defined differently in the context of individuals, families, organizations, societies, and cultures. ”

There was also a consensus that one’s ability to develop resilience is based on many factors, including genetic, developmental, demographic, cultural, economic, and social variables; but that resilience can be cultivated, nonetheless (Southwick et al., 2013).

Simply put, resilience can be cultivated through will-power, discipline, and hard work; and there are many strategies by which to do so. The key is to identify ways that are likely to work well for you as part of your own personal strategy for cultivating resilience.

Just like adults, mentally strong children and adolescents are able to tackle problems, bounce back from failure, and cope with life’s challenges and hardships. They are resilient and have the courage and confidence to reach their full potential.

Developing mental strength in students is just as important, if not more important, as developing mental strength in adults. According to Morin (2018), helping kids develop mental strength requires a three-pronged approach, teaching them how to:

• Replace negative thoughts with positive, more realistic thoughts
• Control their emotions so their emotions don’t control them
• Take positive action.

Though there are many strategies, discipline techniques, and teaching tools that help children to build their mental muscle, here are 10 strategies to help students develop the strength they need to become a mentally strong adult:

1. Teach Specific Skills

Rather than making kids suffer for their mistakes, discipline should be about teaching kids how to do better next time. Instead of punishment, use consequences that teach useful skills, such as problem-solving and impulse control.

2. Let Your Child Make Mistakes

Mistakes are an inevitable part of life and learning. Teach your child or student that this is so and that they shouldn’t be embarrassed or ashamed about getting something wrong.

3. Teach Your Child How to Develop Healthy Self-Talk

It’s important to help children develop a realistic and optimistic outlook on life, and how to reframe negative thoughts when they arise. Learning this skill early in life will help them persevere through difficult times.

4. Encourage Your Child to Face Fears Head-On

Enabling a child to face their fears head-on will help them gain invaluable confidence. One way to do this is to teach your child to step outside of their comfort zone and face their fears one small step at a time while praising and rewarding their efforts.

5. Allow Your Child to Feel Uncomfortable

It can be tempting to soothe or rescue your child or student whenever they are struggling, but it’s important to allow them to sometimes lose or struggle, and insist that they are responsible even when they don’t want to be. Dealing with small struggles on their own can help children to build their mental strength.

6. Build Character

Children with a strong moral compass and value system will be better able to make healthy decisions. You can help by instilling values such as honesty and compassion , and creating learning opportunities that reinforce these values, regularly.

7. Make Gratitude a Priority

Practicing gratitude is one of the greatest things you can do for your mental health, and it’s no different for children (for more, see our Gratitute Tree for Kids .) Gratitude helps us to keep things in perspective, even during the most challenging times. To raise a mentally strong child you should encourage them to practice gratitude on a regular basis.

8. Affirm Personal Responsibility

Accepting responsibility for your actions or mistakes is also part of building mental strength involves. If your student is trying to blame others for the way he/she thinks, feels or behaves, simply steer them away from excuses and allow for explanations.

9. Teach Emotion Regulation Skills

Instead of soothing or calming down your child every time they are upset, teach them how to deal with uncomfortable emotions on their own so that they don’t grow up depending on you to regulate their mood. Children who understand their range of feelings (see the Emotion Wheel ) and have experience dealing with them are better prepared to deal with the ups and downs of life.

10. Be A Role Model for Mental Strength

There’s no better way to teach a child than by example. To encourage mental strength in your students or children, you must demonstrate mental strength. Show them that you make self-improvement a priority in your life, and talk about your goals and steps you take to grow stronger.

As we’ve learned, your level of mental resilience is not something that is decided upon at birth — it can be improved over the course of an individual’s life. Below we will explore a number of different strategies and techniques used to improve mental resilience.

Rob Whitley, Ph.D. (2018), suggests three resilience-enhancing strategies:

1. Skill Acquisition

Acquiring new skills can play an important part in building resilience, as it helps to develop a sense of mastery and competency — both of which can be utilized during challenging times, as well as increase one’s self-esteem and ability to problem solve.

Skills to be learned will depend on the individual. For example, some might benefit from improving cognitive skills such as working memory or selective attention, which will help with everyday functioning. Others might benefit from learning new hobbies activities through competency-based learning.

Acquiring new skills within a group setting gives the added benefit of social support, which also cultivates resilience.

2. Goal Setting

The ability to develop goals , actionable steps to achieve those goals , and to execute, all help to develop will-power and mental resilience. Goals can be large or small, related to physical health, emotional wellbeing, career, finance, spirituality, or just about anything. Goals that involve skill-acquisition will have a double benefit. For example, learning to play an instrument or learning a new language.

Some research indicates that setting and working towards goals beyond the individual, i.e. religious involvement or volunteering for a cause, can be especially useful in building resiliency. This may provide a deeper sense of purpose and connection, which can be valuable during challenging times.

3. Controlled Exposure

Controlled exposure refers to the gradual exposure to anxiety-provoking situations, and is used to help individuals overcome their fears. Research indicates that this can foster resilience, and especially so when it involves skill-acquisition and goal setting — a triple benefit.

Public speaking, for example, is a useful life skill but also something that evokes fear in many people. People who are afraid of public speaking can set goals involving controlled exposure, in order to develop or acquire this particular skill. They can expose themselves to a small audience of one or two people, and progressively increase their audience size over time.

This type of action plan can be initiated by the individual, or it can be developed with a therapist trained in Cognitive Behavioral Therapy . Successful efforts can increase self-esteem and a sense of autonomy and mastery, all of which can be utilized in times of adversity.

11 Further Strategies From The APA

The American Psychology Association (“Road to Resilience,” n.d.) shares 11 strategies for building mental resilience:

1. Make connections.

Resilience can be strengthened through our connection to family, friends, and community. Healthy relationships with people who care about you and will listen to your problems, offer support during difficult times and can help us to reclaim hope. Likewise, assisting others in their time of need can benefit us greatly and foster our own sense of resilience .

2. Avoid seeing crises as insurmountable problems.

We cannot change the external events happening around us, but we can control our reaction to these events. In life, there will always be challenges, but it’s important to look beyond whatever stressful situation you are faced with, and remember that circumstances will change. Take notice of the subtle ways in which you may already start feeling better as you deal with the difficult situation.

3. Accept that change is a part of living.

They say that the only thing constant in life is change. As a result of difficult circumstances, certain goals may no longer be realistic or attainable. By accepting that which you cannot change, it allows you to focus on the things that you do have control over.

4. Move toward your goals. (*also suggested by Whitley, 2018)

Though it is important to develop long-term, big-picture goals, it is essential to make sure they’re realistic. Creating small, actionable steps makes our goals achievable, and helps us to regularly work towards these goals, creating small “wins” along the way. Try to accomplish one small step towards your goal every day.

5. Take decisive actions.

Instead of shying away from problems and stresses, wishing they would just go away, try to take decisive action whenever possible.

6. Look for opportunities for self-discovery.

Sometimes tragedy can result in great learnings and personal growth. Living through a difficult situation can increase our self-confidence and sense of self-worth, strengthen our relationships, and teach us a great deal about ourselves. Many people who have experienced hardship have also reported a heightened appreciation for life and deepened spirituality.

7. Nurture a positive view of yourself.

Working to develop confidence in yourself can be beneficial in preventing difficulties, as well as building resilience. Having a positive view of yourself is crucial when it comes to problem-solving and trusting your own instincts.

8. Keep things in perspective.

When times get tough, always remember that things could be worse; try to avoid blowing things out of proportion. In cultivating resilience it helps to keep a long-term perspective when facing difficult or painful events.

9. Maintain a hopeful outlook.

When we focus on what is negative about a situation and remain in a fearful state, we are less likely to find a solution. Try to maintain a hopeful, optimistic outlook, and expect a positive outcome instead of a negative one. Visualization can be a helpful technique in this respect.

10. Take care of yourself.

Self-care is an essential strategy for building resilience and helps to keep your mind and body healthy enough to deal with difficult situations as they arise. Taking care of yourself means paying attention to your own needs and feelings, and engaging in activities that bring you joy and relaxation. Regular physical exercise is also a great form of self-care.

11. Additional ways of strengthening resilience may be helpful.

Resilience building can look like different things to different people. Journaling , practicing gratitude , meditation , and other spiritual practices help some people to restore hope and strengthen their resolve.

The American Psychological Association (2014) defines resilience as the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress — such as family and relationship problems, serious health problems or workplace and financial stressors. In other words, “bouncing back” from difficult experiences. Resilience is not a trait that people either have or do not have.

It involves behaviors, thoughts, and actions that can be learned and developed in anyone.

Research has shown that resilience is ordinary, not extraordinary and that people commonly demonstrate resilience. A good example of this is the response of many Americans to the September 11 2001, terrorist attacks, and individuals’ efforts to rebuild their lives.

According to the APA, being resilient does not mean that a person doesn’t experience hardships or adversities. In fact, a considerable amount of emotional distress is common in people who have dealt with difficulties and trauma in their lives.

Factors in Resilience

Many factors contribute to resilience, but studies have shown that the primary factor is having supportive relationships within and outside of the family. Relationships that are caring, loving, and offer encouragement and reassurance, help cultivate a person’s resilience.

The APA suggests several additional factors that are associated with resilience, including:

• The capacity to make realistic plans and actionable steps to carry them out.
• A positive self-view and confidence in your strengths and abilities.
• Communication and problem-solving skills.
• The capacity to manage and regulate strong feelings and impulses.

All of these are factors that people can develop within themselves.

Strategies For Building Resilience

When it comes to developing resilience , strategies will vary between each individual. We all react differently to traumatic and stressful life events, so an approach that works well for one person might not work for another. For example, some variation as to how one might communicate feelings and deal with adversity may reflect cultural differences, etc.

Learning from your Past

Taking a look at past experiences and sources of personal strength may provide insight as to which resilience building strategies will work for you. Below are some guiding questions from the American Psychology Association, that you can ask yourself about how you’ve reacted to challenging situations in the past. Exploring the answers to these questions can help you develop future strategies.

Consider the following:

• What types of events have been most stressful for me?
• How have those events typically affected me?
• Have I found it helpful to think of important people in my life when I am distressed?
• To whom have I reached out for support in working through a traumatic or stressful experience?
• What have I learned about myself and my interactions with others during difficult times?
• Has it been helpful for me to assist someone else going through a similar experience?
• Have I been able to overcome obstacles, and if so, how?
• What has helped make me feel more hopeful about the future?

Staying Flexible

A resilient mindset is a flexible mindset. As you encounter stressful circumstances and events in your life, it is helpful to maintain flexibility and balance in the following ways:

• Let yourself experience strong emotions, and realize when you may need to put them aside in order to continue functioning.
• Step forward and take action to deal with your problems and meet the demands of daily living; but also know when to step back and rest/reenergize yourself.
• Spend time with loved ones who offer support and encouragement; nurture yourself.
• Rely on others, but also know when to rely on yourself.

Places to Look for Help

Sometimes the support of family and friends is just not enough. Know when to seek help outside of your circle. People often find it helpful to turn to:

• Self-help and community support groups Sharing experiences, emotions, information and ideas can provide great comfort to those who may feel like they’re alone during difficult times.
• Books and other publications Hearing from others who have successfully navigated adverse situations like the one you’re going through, can provide great motivation and inspiration for developing a personal strategy.
• Online resources There is a wealth of resources and information on the web about dealing with trauma and stress; just be sure the information is coming from a reputable source.
• A licensed mental health professional For many, the above suggestions may be sufficient to cultivate resilience, but sometimes it’s best to seek professional help if you feel like you are unable to function in your daily life, as a result of traumatic or other stressful life events.

Continuing on your Journey

To help summarize the APA’s main points, a useful metaphor for resilience involves taking a journey on a kayak. On a rafting trip, you can encounter all kinds of different waters — rapids, slow water, shallow water and all kinds of crazy turns.

Much like in life, these changing circumstances affect your thoughts, mood, and the ways in which you will navigate yourself. In life, as in traveling down a river, it helps to have past experience and knowledge from which to draw on. Your journey should be guided by a strategy that is likely to work well for you.

Other important aspects include confidence and belief in your abilities to navigate the sometimes choppy waters, and perhaps having trusted companions to accompany and support you on the ride.

The Resilience Builder Program for Children and Adolescents — Enhancing Social Competence and Self-Regulation is an innovative program designed to increase resilience in youth. The book is based on a 12-week resilience-based group therapy program and applies Cognitive Behavioral Theory and strategies.

The program outlines 30 group sessions that work on the areas of self-esteem, self-control, confidence and coping strategies (Karapetian Alvord, Zucker, Johnson Grados, 2011).

Key competencies addressed in each session include self-awareness, flexible thinking, and social competence. Through discussion and hands-on techniques such as role-playing, group members learn about anger/anxiety management, problem-solving, personal space awareness, self-talk, friendship skills, and other essential topics pertaining to social and personal wellbeing.

These group activities help develop specific protective factors associated with resilience.

The program includes relaxation techniques such as visualization , calm breathing, progressive muscle relaxation, and yoga , to enhance self-regulation. In order to apply their learnings to the outside world, the program assigns homework, community field trips, as well as a parent’s involvement component.

Resilience Builder Program is inventive, well thought out, sequenced and formatted, and offers a well-structured group framework, concrete enough for beginners. If you are looking for a detailed program to teach your child or student how to be resilient, this is an excellent option.

If you are a coach, teacher or counselor and it is your passion to help others become more resilient, then the Realizing Resilience Masterclass© is exactly what you need.

Consisting of six modules which include positive psychology, resilience, attention, thoughts, action and motivation, this comprehensive online course will provide you with key psychological concepts, in an easily digestible manner for anyone that is new to the field.

Upon completion of the self-paced course, you will be awarded a certificate and can use the extensive library of tools, worksheets, videos, and presentations to teach resiliency.

“ Stamina ” is defined by The Oxford Dictionary as the ability to sustain prolonged physical or mental effort (“Stamina,” 2019).

Mental Stamina is the single defining trait that enables us to endure the adversities of life. It is essential for withstanding both long-term challenges or unforeseen and unexpected struggles, concerns or trauma, and is only developed by practice and repetition.

Mental stamina requires planning, strength, perseverance, and concentration (Walkaden, 2016).

Mental Stamina is like an evolved hybrid between grit and resilience.

(Walkaden, 2016).

Often when we talk about stamina we reference elite athletes and sports teams, as both physical and mental stamina is crucial for this type of performance. However, everyone can benefit from increased mental stamina, not just athletes. Although no one builds mental stamina overnight, below Corb (n.d.) offers 5 tips for building your mental stamina over time:

1. Think Positively

Self-confidence and the belief in one’s ability to perform and to make decisions is one of the most important characteristics of a healthy mind. Training yourself to think optimistically and find the positive in every situation will most certainly help to build mental stamina over time.

2. Use Visualization

Visualization is an excellent tool for managing stress, overwhelming situations, and performance anxiety. Close your eyes and imagine a time that you succeeded in a similar situation. This includes remembering the feeling that accompanied that achievement, not just the visual.

3. Plan for Setbacks

Life most certainly does not always go the way we hoped or planned that it would. It’s important to re-center yourself and regain focus after a setback, as opposed to dwelling on the loss or misfortune. We cannot control the external events that happen around us, but we can control what we do afterward. It’s a good idea to have a plan in place that will help you to deal when things don’t go according to plan.

4. Manage Stress

Our ability to manage stress plays a large role in our ability to build mental stamina. Though not all stress is bad — positive stress (excitement) can be a motivating factor — it has the same physical effects on our bodies.

Useful techniques for managing stress include meditation and progressive muscle relaxation. It’s important to remember that you are in control and of your mental state, and how you will handle the stressor at hand.

5. Get More Sleep

It’s no secret that getting enough sleep is vital to our physical and mental functioning in everyday life. Sufficient sleep can help with on-the-spot decision making and reaction time. A sufficient amount of sleep is said to be seven to nine hours, or more if you are performing high-stress activities, both physical and mental.

Community resilience is the sustained ability of a community to utilize available resources (energy, communication, transportation, food, etc.) to respond to, withstand, and recover from adverse situations (e.g. economic collapse to global catastrophic risks) (Bosher, L. & Chmutina, K., 2017).

Successful adaptation in the aftermath of a disaster ensures that a community can return to normal life as effortlessly as possible. Community adaptation is largely dependent on population wellness, functioning, and quality of life (Norris, Stevens, Pfefferbaum, Wyche, & Pfefferbaum, 2007).

As is the case when faced with any problem, a community should implement a plan of action in order to come together and rebuild after a disaster. Below are the key components necessary for a community to build collective resilience after a tragedy:

• Reduce risk and resource inequities
• Engage local people in mitigation
• Create organizational linkages
• Boost and protect social supports
• Plan for not having a plan, which requires flexibility, decision‐making skills, and trusted sources of information that function in the face of unknowns.

While Mental Health Awareness draws attention to the importance of valuing your own mental health, it is also about positively impacting the lives (and mental wellness) of the people around you.

According to research on the foundation of social networks, the most important parts of establishing positive relationships are showing appreciation, being a good listener, and giving support to others when they need it (Ditzen & Heinrichs, 2014).

Furthermore, a strong social support network has been linked to a decrease in alcohol use, cardiovascular disease, and depressive thoughts (Cherry, 2020).

So do yourself and the ones around you a favor and remind them how loved and deserving they are of a little mood boost.

Remember : you never know what somebody else might be going through, so your random act of kindness might make a world of difference.

Resilience is a very important aspect of any relationship. Relationships require ongoing attention and cultivation, especially during times of adversity. Have you ever wondered what makes some friendships or romantic relationships more likely to survive than others? Below, Everly (2018) suggests certain factors which seem to foster resiliency in relationships, and increase their likelihood of survival.

Seven Characteristics of Highly Resilient Relationships

1. active optimism.

Active optimism is not just hoping that things will turn out well, rather, it is believing that things will turn out well and then taking action that will lead to a better outcome. In a relationship, this means an agreement to avoid critical, hurtful, cynical comments, and to instead, work together to harness the power of a positive self-fulfilling prophecy .

2. Honesty, Integrity, Accepting Responsibility for One’s Actions, and the Willingness to Forgive

When we commit to accepting responsibility for our actions, being loyal to one another and forgiving each other (and ourselves), we are bound to cultivate resilience within our relationships. This includes the old adage that honesty is the best policy, regardless of the outcome and consequences.

3. Decisiveness

This means having the courage to take action, even when the action is unpopular or provokes anxiety in a relationship. Decisive action sometimes means leaving a toxic relationship or one that is not serving you well anymore, often times promoting one’s own personal resilience.

4. Tenacity

Tenacity is to persevere , especially in the face of discouragement, setbacks, and failures. It is important in relationships to remember that there will always be ebbs and flows, good times as well as hard times.

5. Self-Control

As it pertains to relationships, the ability to control impulses, resist temptations and delay gratification are clearly important qualities. Self-control helps one to avoid practices that will negatively impact their relationship, while promoting healthy practices, especially in the face of adversity.

6. Interpersonal Connectedness Through Honest Communication

The sense of “belonging” and connectedness in a relationship is maintained and honed through open, honest communication . Often times the most difficult conversations to have are the most important ones.

7. Presence of Mind

Present mindedness has many positive implications for the individual, and this is also true for partners in a relationship. Present-minded awareness within a relationship leads to a calm, non-non-judgmental thinking style and open communication. Presence of mind enables collaborative thinking and openness to new solutions, rather than shooting them down and projecting blame.

These are just some of the characteristics that predict resilience in a relationship and increase the likelihood of a relationship rebounding after difficult situations.

If you want to become resilient for life, it’s best to start with building your resilience in the present moment! Practice and commitment to the strategies and tips discussed above, will over time increase your ability to bounce back and adapt once life has presented you with hardships.

The silver lining to experiencing adverse life events is that the more you are able to flex your resiliency muscle, the better you will be able to bounce back again the next time life throws you a curveball!

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In this study, Lipaz Shamoa-Nir (2014) presents a description of building organizational and personal resilience at three levels of institution: management, faculty, and students of a multi-cultural college. To do so, the college utilized three different framework models: the contact hypothesis model, the joint projects model, and the theoretical model.

The study discusses the complexities of constructing this multi-dimensional framework for improving communication between a radically diverse group of students with opposing political and cultural views. The students are immigrants living under a continuous threat of social and economic crisis, with tension and conflicts both internally and externally.

Each level of the institution must contribute to developing coping strategies for crisis situations as well as everyday reality. For faculty, this includes building a program that considers the strengths and weaknesses of students from social minority groups. For students, this includes social projects that express their cultural and national diversity.

Most importantly, the process requires leadership from management-focused solutions and activities intended to instill a sense of confidence and certainty at all levels of the organization.

Some key takeaways from the case study are that although processes for building resilience may take several years, they can be accelerated by changes or crises that arise; and that while aspects of resilience are built-in routine situations, most of them are only tested in crisis situations.

Although every individual develops their own unique coping style, the proposed multi-dimensional resilience model references these six factors that comprise each style:

• Beliefs and Values
• Imagination

Lastly, the case study may very well be relevant to other organizations or communities during or post-conflict.

Confidence is one of the 4C’s of mental toughness! Nurturing a positive self-view and developing confidence in your ability to solve problems and in trusting your instincts, is one of the main factors in building resiliency. So how do we cultivate a more confident mind?

Below are 10 surefire ways that you can begin building your confidence (Bridges, 2017):

1. Get Things Done

Confidence and accomplishment go hand-in-hand. Accomplishing goals, and even taking small steps towards your goals, can help build your self-esteem and confidence in your abilities.

2. Monitor Your Progress

When working towards a goal, big or small, it is important to break it down into smaller, more manageable steps. In doing so, one will find it easier to monitor their progress and build confidence as they see the progress happening in real time. It helps to quantify your goals, as well as the actionable steps towards those goals.

3. Do The Right Thing

Highly confident people tend to live by a value system and make decisions based on that value system, even when it’s not necessarily in their best interest. When your decisions are aligned with your highest self, it can cultivate a more confident mind.

4. Exercise

Exercise not only benefits your physical body but your mind as well. Mental benefits of exercise include improved focus, memory retention, and stress and anxiety management. Exercise is also said to prevent and aid in depression. Confidence from exercising comes not only from the physical, visible benefits but also from the mental benefits.

5. Be Fearless

To be fearless in the pursuit of your dreams and goals requires a level of confidence. Conversely, challenging yourself by diving head first into things that scare you, will help to build your confidence. Often when we set big goals for ourselves it is easy to get overwhelmed and be fearful of failure. In these instances, it is important to gather up your courage and just keep going, one step at a time.

6. Stand-up For Yourself

To stand up for yourself when someone tells you that you can’t accomplish something is an effective way to develop your confidence. All too often we may end up believing the naysayers, as they are echoing the self-doubt we may be hearing in our heads. To nurture a positive self-view is to replace those negative thoughts with positive ones. Try to do so as well when someone does not believe in you.

7. Follow Through

Following through on what you say you’re going to do, not only helps to earn the respect of others but also respect for and confidence in yourself. Developing your follow-through skills will also help you accomplish your goals and likely strengthen your relationships, too.

8. Think Long-term

Often times, we trade in long-term happiness for more immediate gratification. We can build up our confidence by making sacrifices and decisions based on long-term goals rather than short-term comforts. Finding the discipline to do so will bring greater happiness in the long-term and a higher likelihood of achieving the goals you’ve set for yourself.

9. Don’t Care What Others Think

It is easy to fall into the trap of wondering what others may think of you, but it’s important to remember that what others think actually means nothing in the pursuit of your dreams. Build your confidence by believing in yourself and continuing to move forward, even when others might not agree with you.

10. Do More Of What Makes You Happy

When we take time for self-care and doing the things that bring us joy, it helps to enrich our lives and becomes our best selves. Confidence comes when we are aligned with our highest selves and proud of it.

At the root of many of these tools and strategies for building your mental fitness, are Self-Awareness and Acceptance . In order to enhance, improve or build upon our existing mental strength, we must be aware of where we are at, and also accept that this is where we are at. Only then can we begin to take steps toward a stronger, healthier mental state.

Another key takeaway is that you cannot control everything that happens to you but you absolutely can control how you react to what happens. In these cases, your mind can be your biggest asset or your worst enemy. When you learn how to train it well, you can bounce back from difficult situations and can accomplish incredible feats.

If you want to experience greater overall life satisfaction, you must be in good mental health. Mental fitness includes strength, toughness, and resilience. Building these muscles may be very challenging, and might take years of effort and commitment, but the benefits of being mentally fit and resilient will be seen in all aspects of your life.

Enhanced performance, better relationships, and a greater sense of wellbeing can all be achieved by developing healthy mental habits while giving up unhealthy mental habits.

We can all improve our mental health by implementing these strategies and committing to the process for the long-term.

We hope you enjoyed reading this article. Don’t forget to download our three Resilience Exercises for free .

• Bosher, L. & Chmutina, K. (2017). Disaster Risk Reduction for the Built Environment . Hoboken, NJ: John Wiley & Sons.
• Bridges, F. (2017, July 21). 10 Ways To Build Confidence. Forbes.com. Retrieved from https://www.forbes.com/sites/francesbridges/2017/07/21/10-ways-to-build-confidence/#6f1a4a293c59
• Cherry, K. (2020). How social support contributes to psychological health . Verywellmind.com.
• Clough, P.J., Earle, K., & Sewell, D. (2002). Mental toughness: The concept and its measurement. In Kobasa SC, 1979. Stressful events, Personality, and health: An inquiry into hardiness. Journal of Personality and Social Psychology . 7: 413-423.
• Corb, R.E. (n.d.). 5 Tips for Building Mental Stamina. Retrieved from https://www.webmd.com/fitness-exercise/features/mental-stamina#1
• Ditzen, B., & Heinrichs, M. (2014). Psychobiology of social support: the social dimension of stress buffering. Restorative Neurology and Neuroscience, 32(1) , 149-162.
• Everly, Jr., G.S. (2018, April 24). 7 Characteristics of Resilient Relationships. Psychology Today . Retrieved from https://www.psychologytoday.com/intl/blog/when-disaster-strikes-inside-disaster-psychology/201804/7-characteristics-resilient
• Karapetian Alvord, M., Zucker, B., & Johnson Grados, J. (2011). Resilience Builder Program for Children and Adolescents — Enhancing Social Competence and Self-Regulation . Retrieved from https://www.researchpress.com/books/682/resilience-builder-program-children-and-adolescents
• Morin, A. (2017, April 29). Is It Best to Be Emotionally Intelligent or Mentally Strong? Psychology Today . Retrieved from https://www.psychologytoday.com/gb/blog/what-mentally-strong-people-dont-do/201704/is-it-best-be-emotionally-intelligent-or-mentally
• Morin, A. (2019, January 24). 10 Tips for Raising Mentally Strong Kids. Retrieved from https://www.verywellfamily.com/tips-for-raising-mentally-strong-kids-1095020
• Norris, F.H., Stevens, S.P., Pfefferbaum, B., Wyche, K.F., & Pfefferbaum, R.L. (2007). Community Resilience as a Metaphor, Theory, Set of Capacities, and Strategy for Disaster Readiness. Wiley Online Library . Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1007/s10464-007-9156-6
• Resilience. (2019). In OxfordDictionaries.com. Retrieved from http://www.oxforddictionaries.com/definition/english/resilience
• Shamoa-Nir, L. (2014). Defining Resilience from Practice: Case Study of Resilience Building in a Multi-Cultural College. ScienceDirect, Procedia Economics and Finance , (18), 279–286. Retrieved from https://ac.els-cdn.com/S2212567114009411/1-s2.0-S2212567114009411-main.pdf?
• Southwick, S.M., Bonanno, G.A., Masten, A.S., Panter-Brick, C., & Yehuda, R. (2014). Resilience definitions, theory, and challenges: interdisciplinary perspectives. Eur J Psychotraumatol. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4185134/
• Stamina. (2019). In OxfordDictionaries.com. Retrieved from http://www.oxforddictionaries.com/definition/english/stamina
• Strycharczyk, D. (2015, July 31). Resilience and Mental Toughness: Is There a Difference and Does it Matter? Retrieved from https://www.koganpage.com/article/resilience-and-mental-toughness-is-there-a-difference-and-does-it-matter
• Strycharczyk, D. & Clough, P. (n.d.). Resilience, Mental Toughness. Retrieved from https://www.fahr.gov.ae/Portal/Userfiles/Assets/Documents/4d12e7a0.pdf
• The Road to Resilience. (n.d.). American Psychology Association . Retrieved from https://www.apa.org/helpcenter/road-resilience.aspx
• Walkaden, C. (2017, July 14). What is Mental Stamina. Retrieved from https://www.cwcounselling.com.au/what-is-mental-stamina-watch-free-webinar/
• What is Mental Toughness? (n.d.). Retrieved from http://www.mentaltoughnessinc.com/what-is-mental-toughness/
• Whitley, R. (2018, February 15). Three Simple Ways to Enhance Mental Health Resilience. Psychology Today . Retrieved from https://www.psychologytoday.com/us/blog/talking-about-men/201802/three-simple-ways-enhance-mental-health-resilience

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Help me a lot to take a life forward with a lot of confidence. Actually after the pandemic i am a jobless person. Still i am jobless but i decided to face my challenge. Thanks for valuable article

Hello Doctors! The lessons are interesting and beneficial, I learned so much. kudos! to all, what you all shared in here are invaluable and that will remain as of the bests part of our lives.

These guidelines are really very useful. I have read through once but Iam going to give them more attention,because I have met of those that I had already practiced. Iam very grateful,and shall soon be sharing more. Kindest.

we appreciate your great work from RWANDA

very helpful for me i am in difficult situation in my life in am very diperresed my mid wos stuck but my confidence is not ded and i wos stand amd move on with problems thanks.

Really needed to hear this, today a warrior was born!

This seems to make sense but an overconfidence or ignorance can actually lead to inefficiency. As a gamer I have defeated many players who seemed more confident but did not really know what they were doing. So, this advice is good in a sense but does not really work as things are more complicated I guess.

I have learnt great motivation from this article. It’s a great ideas those who want mentally strong.

To Nicole Celestine Thank you so much for your great work. It is so good for all those who are willing to be good humans. So many people are in need of this kind of writing. I hope that you will write more of this kind.

I am 57 and on the outside, My disability is 2399 per month.I’ve because and tired and often want to not be on this planet, No one will help me friend. I have 2 narcisistc men are mean to me and so is boyfriend. I want out if Washington so badly. I have some money to use from paris. PLEASE countt me into this program. Thank this would peaceful to start over. I’m in. trap. 714 4933483.

Thank you @

I’m sorry to hear that you are struggling. Please know there are services and people in your area who care and can help you leave an abusive situation (which it sounds like you may be in). Therefore, I would encourage you to reach out for support. A good starting point may be to reach out to one or more of these shelters/services in the Washington area. At a minimum, they should be able to connect you to further support.

Keep safe, and I hope things start looking up for you soon.

– Nicole | Community Manager

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Coping with Mental Health Challenges During COVID-19

Sujita kumar kar.

3 Department of Psychiatry, Faculty of Medicine, King George’s Medical University (KGMU), Lucknow, India

S. M. Yasir Arafat

4 Department of Psychiatry, Enam Medical College and Hospital, Dhaka, Bangladesh

Russell Kabir

5 School of Allied Health, Faculty of Health, Education, Medicine, and Social Care, Anglia Ruskin University, Chelmsford, UK

Pawan Sharma

6 Department of Psychiatry, Patan Academy of Health Sciences, Arogin Health Care and Research Center, Kathmandu, Nepal

Shailendra K. Saxena

7 Centre for Advanced Research (CFAR), Faculty of Medicine, King George’s Medical University (KGMU), Lucknow, India

The ongoing pandemic of COVID-19 is a global challenge which resulted in significant morbidity and mortality worldwide. It has also adversely affected the economy and social integrity. There is rising concern about the mental health challenges of the general population, COVID-19-infected patients, close contacts, elderly, children and health professionals. This chapter focusses on various mental health challenges during the COVID-19 pandemic.

Introduction

There is a major health crisis going on in the world currently. A newly emerged zoonotic viral infection known as novel coronavirus disease (COVID-19) is affecting people, globally taking the form of a pandemic. Over the past few months, there is a significant increase in mortality and morbidity due to this pandemic. Till date (29 March 2020), there are more than 680,000 total cases with 31,920 deaths, 146,396 recovered over 202 countries (COVID-19 Coronavirus Pandemic 2020 ). As per the situation report of the World Health Organization (WHO), by the end of 28 March 2020, more than half of the global deaths and infected cases were from the European region (World Health Organization 2020a ). As the disease is spreading in a rapid pace, most of the affected countries are not able to meet the demands of the personal protective equipment (PPE) and infrastructure requirement (World Health Organization 2020a ). At the current stage, the major objectives laid by the WHO are prevention of human-to-human transmission, limiting the spread of infection to close contacts and medical professionals, preventing the development of complications in infected persons, isolation and quarantine facility provision, availing diagnostic and laboratory facility, research to produce specific treatment and vaccine and minimizing the socioeconomic impact on the community (World Health Organization 2020a ). It has been noticed over the past few months that during this outbreak of COVID-19 infection, there are increasing mental health issues among the general population, elderly, children, migrant workers and healthcare professionals other than the patients with COVID-19 infection (Duan and Zhu 2020 ; Chen et al. 2020 ; Liem et al. 2020 ; Yang et al. 2020a , b ). To date there are no specific recommendations from international bodies regarding addressing the mental health issues during this COVID-19 pandemic.

Impact of COVID-19 in Society

The global impact of COVID-19 has been profound, and the public health threat due to this is the most serious seen since the 1918 H1N1 influenza pandemic. The overall case fatality rate of COVISD-19 was 2.3% in China and could be variable in different countries (Novel Coronavirus Pneumonia Emergency Response Epidemiology Team 2020 ; Livingston and Bucher 2020 ). A nationwide analysis done in China showed that comorbidities are present in around one-fourth of patients with COVID-19 and predispose to poorer clinical outcomes (Novel Coronavirus Pneumonia Emergency Response Epidemiology Team 2020 ). The impact of the disease is beyond mortality, and morbidity has become apparent since the outbreak of the pandemic. A large population throughout the world is certain to have a massive psychological impact as evidenced by a preliminary report from China where among 1210 respondents more than half of the respondents rated the psychological impact as moderate-to-severe and about one-third reported moderate-to-severe anxiety (Wang et al. 2020a ). Studies post-SARS pandemic or post-Ebola indicate that even after recovering physically from the disease, individuals suffered from social and psychological problems and similar could be the impact with this pandemic (Bobdey and Ray 2020 ). Evidence suggests that vulnerable groups who are confined to their homes during a pandemic can have negative health outcomes. Children especially become physically less active and have much longer screen time, irregular sleep patterns and less favourable diets, resulting in weight gain and a loss of cardiorespiratory fitness (Wang et al. 2020b ). Also, there are other direct and indirect implications of the closure of schools like unintended childcare obligations, which are particularly large in healthcare occupations (Bayham and Fenichel 2020 ). This could be related to the current situation in most of the countries throughout the world not only in child care but also in the adult and geriatric population (Heckman et al. 2020 ).

COVID-19 is a supply shock and a demand shock. Both the aspects will impact on aggregate trade flow (Baldwin and Tomiura 2020 ). It has both direct and indirect economic implications. The stocks and flow of physical and financial assets are interrupted. An increase in health budget and a lowering of overall GDP is sure to impact the whole world (McKibbin and Fernando 2020 ). Another area of impact would be travel and tourism. In the current scenario, the travel of any citizen of any country has been virtually been stopped. Also, even once the pandemic is over, it is almost certain to take a long time before people become confident of travel (Anzai et al. 2020 ; Dinarto et al. 2020 ).

Stigma and fear are other aspects of the outbreak of a pandemic. It can present major barriers against healthcare seeking, social marginalization, distrust in health authorities and distortion of public perceptions of risk, resulting in mass panic among citizens and the disproportionate allocation of healthcare resources by politicians and health professionals (Barrett and Brown 2008 ).

Impact on the sports and other mass gatherings throughout the world cannot be ignored (Gallego et al. 2020 ). Within weeks of the emergence of this pandemic in China, there have been circulation of misinformation, misleading rumours and conspiracy theories about the origin paired with fear mongering, racism and compulsive buying and stocking of goods and face masks. This can be attributed to impact the social media has created (Depoux et al. 2020 ). Over all the pandemic will have impact in all domains of the current world starting from health, society and economy and would also impact the future policy making at global, regional and country level (Djalante et al. 2020 ).

Emerging Mental Health Issues in COVID-19 Pandemic

The COVID-19 pandemic is a global emergency situation while the diagnosis of specific disorders needs a specific time period which is a major constraint to quantify the mental health issues. Moreover, many of the survivors may develop mental disorders long after the event. Therefore, multiple and complex confounding variables makes the issue hazy. Fortunately, studies evaluating the mental health issue have been coming out gradually which needs more time certainly to get replicable findings.

Among General Population

As the COVID-19 pandemic has been spreading rapidly across the globe, the foremost mental health issue has raised the level of stress or anxiety expressed in public mental health term (Dong and Bouey 2020 ). Inadequate knowledge regarding the incubation period of the virus, route of transmission, treatment and safety measures cause fear and anxiety (Li et al. 2020 ; Ho et al. 2020 ; Goyal et al. 2020 ). The locked-down state bounds residents to become homebound which causes negative mental health outcomes like anxiety states and insecurity regarding the future (Li et al. 2020 ). The citizens also feel monotony, disappointment and irritability under the locked-down state (Ho et al. 2020 ). One study reported severe and wide spectrum mental health impacts of the pandemic (Goyal et al. 2020 ). The event can precipitate new mental disorders and exacerbate the previously present disorders (Goyal et al. 2020 ). The general population can experience fear and anxiety of being sick or dying, helplessness, blame the people who are already affected and precipitate the mental breakdown (Goyal et al. 2020 ). A wide range of psychiatric disorders can be found such as depressive disorders, anxiety disorders, panic disorder, somatic symptoms, self-blame, guilt, posttraumatic stress disorder (PTSD), delirium, psychosis and even suicide (Goyal et al. 2020 ; Yi et al. 2020 ).

Among COVID-19 Cases

The suspected and/or confirmed COVID-19 persons largely experience fear regarding the high contagiousness and fatality (Wang et al. 2020a ; Li et al. 2020 ). The quarantined people feel boredom, loneliness, anger, depression, anxiety, denial, despair, insomnia, harmful substance use, self-harm and suicidality (Wang et al. 2020a ; Dong and Bouey 2020 ; Li et al. 2020 ; Yi et al. 2020 ). The survivors are the high-risk people to develop a wide range of mental disorders such as depression, anxiety and PTSD (World Health Organization 2020a ). As a continuation of safety behaviours, patients may develop obsessive-compulsive disorder (OCD) (Li et al. 2020 ). Moreover, physical symptoms of COVID-19 such as fever, hypoxia and cough along with adverse effects of prescribed medications (corticosteroids) may cause more anxiety and mental distress (Wang et al. 2020a ). A recent study of 1210 participants from 194 cities in China reported that 53.8% had a moderate or severe psychological impact, 31.3% had some sort of depression, 36.4% had some sort of anxiety and 32.4% had some sort of stress (Liu et al. 2020 ). Poor or very poor self-rated health status was significantly associated with a greater psychological impact of the COVID-19 (Liu et al. 2020 ).

Among Family Members and Close Contacts

Along with the persons with COVID-19, the family members and close contacts face psychological problems as they have been traced, isolated or quarantined which makes people anxious and guilty regarding the aftermath of the contagion, quarantine and stigma on their family members and friends (Wang et al. 2020a ). The family members who lose their loved ones from the pandemic results in anger and resentment (Goyal et al. 2020 ). Furthermore, they also feel shame, guilt or stigma for those family members who are sick and/or quarantined, and some studies reported PTSD and depression among the family members and close contacts (Goyal et al. 2020 ). On the other hand, the children who have been isolated or quarantined during the pandemic have higher chances to develop acute stress disorder, adjustment disorder and grief (Shah et al. 2020 ). PTSD was reported among 30% of the children and early loss of or separation from parents during childhood also has long-term adverse effects on mental health, including higher chances of developing mood disorders, psychosis and suicidality (Shah et al. 2020 ).

Among Healthcare Workers

As pandemics are the global public mental health emergency, healthcare services demand increases sharply. Furthermore, many countries do not have adequate manpower as well as resources to cope with COVID-19. Thus, healthcare providers have to face an increased workload with the fear of being infected. Many times, they have been quarantined frequently when they contact COVID-19-confirmed persons.

Increased workload, isolation and discrimination are common which result in physical exhaustion, fear, emotional disturbance and sleep disorders (Ho et al. 2020 ). A recent study involving 1563 health professionals reported that more than half (50.7%) of the participants reported depressive symptoms, 44.7% anxiety and 36.1% sleep disturbance (Ho et al. 2020 ). Moreover, there are not adequate services to provide counselling and psychiatric screening services for anxiety, depression and suicidality for physicians who have been dealing with infected persons (World Health Organization 2020b ). It is also meaningful to postulate that many physicians develop PTSD, depression, anxiety and burnout after the cessation of the pandemic (World Health Organization 2020b ). Along with the physicians, the frontline healthcare providers (FHCP) can develop mental disorders such as depression, anxiety and PTSD (Li et al. 2020 ). Previous articles reported that FHCP (paramedics, ambulance personnel and healthcare workers) have also shown heightened stress and emotional disturbances and have higher levels of depression and anxiety (Goyal et al. 2020 ).

This is estimated as the chances of getting infected is much higher with the risk of exposure which creates a fear of transmission to their loved ones and children. Furthermore, the conflict professionalism and personal fear for oneself causes burnouts and physical and mental symptoms (Goyal et al. 2020 ).

Among Special Population (Old Age and Co-morbidities)

As this pandemic has been spreading rapidly across the world, it is bringing a considerable degree of fear, worry and concern among few certain groups particularly, in older adults and people with underlying comorbid disorders (Dong and Bouey 2020 ). It has a potential impact on the existing diseases, and the affected persons may lead to psychiatric symptoms which possibly related to the interplay of mental disorders and immunity (World Health Organization 2020b ). The symptoms of COVID-19 can also worsen cognitive distress and anxiety among people who have poor mental capabilities previously (World Health Organization 2020b ).

Patients with pre-existing severe mental illness (SMI) have been inevitably affected by the pandemic (Ho et al. 2020 ). In-patients, especially those requiring long-term hospitalization in closed wards, pose a high risk of cluster contagion. Due to traffic restrictions and isolation measures, outpatients with SMI are facing difficulties to receive maintenance treatment and may thus end up with mental relapse and uncontrollable situations (Ho et al. 2020 ). Patients with chronic physical illness (e.g., chronic renal failure, diabetes mellitus and cardio-cerebrovascular diseases) also need regular follow-up in hospitals which become problematic and raise the chances of deterioration.

Coping with Mental Health Issues During COVID-19 Pandemic

While the healthcare sector and government officials from all over the world is focusing on the control of the pandemic adopting various preventive strategies, there is little attention provided to the mental health status of the isolated, panicked and house-arrested people. Due to lack of regular social activities and staying at home for a longer time will impact their emotional well-being. Research has also shown that sudden outbreak can worsen the mental health conditions of those with pre-existing mental health illness (Ho et al. 2020 ).

To avoid a distressing situation, individuals should not get exposed to media coverage too much, to maintain a healthy relationship, get in touch with friends and family members on a regular interval using social media and start thinking positively (CDC 2020 ). If coronavirus anxiety shows up, try to share the fear with others, which will calm the fear, and also try to increase self-awareness by getting adequate sleep, exercising regularly and employing different relaxation techniques (Kecmanovic 2020 ). As recommended by Ho et al. ( 2020 ) in this era of technology, healthcare services can introduce providing online psychological support services for those individuals who lost their close relatives due to COVID-19 (Ho et al. 2020 ). To support the morale and mental health of the frontline healthcare professionals, healthcare organizations should introduce shorter working periods, regular breaks and rotating shifts (Ho et al. 2020 ). People can cope with the mental health challenges by adopting various lifestyle-related measures (Figs. 16.1 and 16.2 ).

Summary of coping measures during COVID-19 pandemic

Tips for positive mental health during COVID-19 pandemic

Myths and Facts About COVID-19

During a new infectious disease outbreak, a great deal of uncertainty remains from the pattern of transferring, risk factors involved and prevention and treatment (Schuchat et al. 2011 ). Rumours and myths create more panic among the general public as they are malevolent in nature and can alter people’s observations towards the disease. The world is witnessing the same for the new public health crises with the emergence and spread of 2019 novel coronavirus. When the disease originated from Wuhan city of China, it was declared as a second-class infectious disease, but most of the areas of the country adopted the first level of response measure to control, and the measures were taken has no scientific basis and no effective outcomes were recorded after applying those measures by the China government (Xiao and Torok 2020 ).

The virus cannot be killed by cold and snow, and it can be transmitted in areas with hot and humid climate (WHO 2020 ). People of all age groups are susceptible to get infected with COVID-19. Elderly people with underlying health conditions such as diabetes, heart disease and asthma are more vulnerable (Fong 2020 ). Although there is no significant number of paediatric cases so far, children are vulnerable to the infection (Hong et al. 2020 ), and to date, there is no evidence of vertical transmission of this infection (Baud et al. 2020 ).

Several national and international newspapers, tabloids and media channels all over the world are reporting that the smokers are prone to catch coronavirus infection due to weakened lungs and will put the smokers at risk (Mullin 2020 ). However, a recent systematic review finding revealed that no significant association is found between active smoking and the severity of COVID 19 (Lippi and Henry 2020 ).

There are reports of using oseltamivir, lopinavir/ritonavir, prednisone, antibiotics, and traditional Chinese medicine for the treatment of patients with COVID-19. Again, there is no scientific evidence to support that they will be effective against COVID-19 apart from scrupulous personal care such as the use of personal protection precaution to reduce the risk of transmission, early diagnosis, isolation and supportive treatments for affected patients (Xiao and Torok 2020 ; Wang et al. 2020c ).

There is also some misconception among the general people that by taking hot bath, people will not get infected with the infection or spraying alcohol or chlorine all over the body can kill the infection (WHO 2020 ). Proper public health information should be provided, based on scientific research to general people to reduce stress and anxiety, otherwise it will be difficult to implement control measures.

Precautionary Measures and Recommendations

No definite treatment is available for the treatment of the COVID-19 infection. Prevention is the best strategy to combat the COVID-19 pandemic. Prevention is not a difficult task as it is commonly thought to be. For the effective prevention of COVID-19, broadly two types of precautionary measures to be taken, as mentioned below:

General precautionary measures during COVID-19 pandemic. (Source: Adapted from Centre for Disease Control and Prevention, USA)

Specific precautionary measures during COVID-19 pandemic. (Source: Adapted from Centre for Disease Control and Prevention USA)

Broadly, there are three groups of population as mentioned below:

• General population
• COVID-19 cases and close contacts
• Healthcare workers

The precautions and recommendations are targeted to address the needs of the above three groups of the population. Prevailing myths and unawareness about precautionary measures may cause distress among people. There is a need to follow certain recommendations for effective coping with mental health challenges (Table 16.1 ).

Recommendations for effective coping with mental health challenges

Individuals who experience psychological distress must report or inform their difficulties, rather than hiding them. Individuals who experience persistence distress may seek help from the mental health professionals through helplines available or in hospitals in cases of emergency situations. Figures 16.5 and 16.6 summarize the recommendations according the risk severity and management approach to mental health difficulties during COVID-19 pandemic, respectively.

Recommendations according the COVID-19 risk severity

Management approach to mental health difficulties during COVID-19 pandemic

Conclusions

COVID-19 carries significant mental health hazards. There is a paucity of research addressing the mental health issues during the COVID-19 pandemic. As the mortality and morbidity statistics are reaching new peaks every day, isolation and lockdown states are getting prolonged, recreational opportunities for people are lessened and the financial crisis is building in, mental health issues are likely to grow exponentially. There is a need to understand the mental perspectives of COVID-19 and possible measures to cope with the pandemic for their effective management.

Future Perspectives

The mental health issues associated with the COVID-19 pandemic can be immediate (short-term) or remote (long-term). Existing literature addresses the immediate mental health concerns only. It is important to see the long-term mental health sequels of COVID-19 infection. Earlier pieces of evidence suggest that maternal exposure to influenza infection during the epidemic of influenza in Europe increased the risk of schizophrenia in offspring, possibly by altering the neurodevelopmental process (Mednick et al. 1988 ; Murray et al. 1992 ). Similarly, childhood exposure to measles may later result in the development of subacute sclerosing panencephalitis (SSPE) (Campbell et al. 2007 ). Nothing is known about the after-effects of novel coronavirus infection; hence, there is a need for extensive research in terms of its impact on various groups of populations (pregnant, young children, adults and other vulnerable populations).

Similarly, it is required to understand the mental healthcare needs of patients with COVID-19, close contacts, health professionals dealing with COVID-19 patients and the general population. Future research should also consider the feasibility and efficacy of various online psychotherapeutic interventions during the COVID-19 pandemic, globally with a specific focus in the low- and middle-income countries (LMICs). As there is a concern about contacting infection during direct contact with patients, online consultation can be a potential mode of delivering therapy (Greenhalgh et al. 2020 ).

Executive Summary

• Mental health issues differ among various populations during the COVID-19 pandemic.
• Vulnerable populations like COVID-19 cases, close contacts, elderly, children and health professionals are expected to have more difficulties with coping.
• Appropriate precautionary measures may reduce the psychological distress.
• Myths associated with COVID-19 may also lead to distress and inappropriate lifestyle measures.
• People experiencing distress should adopt various healthy relaxation measures and if required help from mental health professionals.

Contributor Information

Sujita Kumar Kar, Email: moc.liamg@atijusrd .

Shailendra K. Saxena, Email: ude.aidnicmgk@neliahs .

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The emotional effects of a serious illness or injury

Facing a serious diagnosis, coping with a serious illness tip 1: reach out for support, tip 2: explore your emotions, tip 3: manage stress, tip 4: pursue activities that bring you meaning and joy, tip 5: deal with anxiety and depression, how to help someone cope with a serious illness, coping with a life-threatening illness or serious health event.

A diagnosis of cancer, heart disease, or other serious illness can be devastating. But there are ways to cope with the emotional distress and preserve your quality of life.

A serious health problem can disrupt all aspects of your life, whether it’s a chronic or life-threatening illness, such as cancer, or a major health event such as a stroke, heart attack, or debilitating injury.

Many serious health problems seem to develop unexpectedly, upsetting your life out of the blue. You may feel overwhelmed by waves of difficult emotions—from fear and worry to profound sadness, despair, and grief—or just numb, frozen by shock or the feeling that you’ll never be able to cope. The emotional upheaval can make it difficult to function or think straight, and even lead to mood disorders such as anxiety and depression.

But whatever your diagnosis or emotional response, it’s important to know that you’re not powerless. There are steps you can take to better cope with your new situation, ease the stress and mental anguish that often accompany serious illness, and find a way to navigate this challenging new journey.

Common emotional responses to serious illness include:

• Anger or frustration as you struggle to come to terms with your diagnosis—repeatedly asking, “Why me?” or trying to understand if you’ve done something to deserve this.
• Facing up to your own mortality and the prospect that the illness could potentially be life-ending.
• Worrying about the future—how you’ll cope, how you’ll pay for treatment, what will happen to your loved ones, the pain you may face as the illness progresses, or how your life may change.
• Grieving the loss of your health and old life.
• Feeling powerless, hopeless, or unable to look beyond the worst-case scenario.
• Regret or guilt about things you’ve done that you think may have contributed to your illness or injury. Shame at how your condition is affecting those around you.
• Denial that anything is wrong or refusing to accept the diagnosis.
• A sense of isolation, feeling cut off from friends and loved ones who can’t understand what you’re going through.
• A loss of self. You’re no longer you but rather your medical condition.

How you react emotionally and the degree of psychological distress you experience depends on many different factors, including your age, personality, the type and prognosis of the medical problem you’re facing, and the amount of support you have.

Whatever your situation, you should know that experiencing a wide range of difficult emotions is a normal response to a potentially life-changing situation. It doesn’t mean that you’re weak, going crazy, or won’t be able to meet the health and emotional challenges that lie ahead.

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Everything changes when you learn that you have a life-threatening illness. Perhaps you cried, sought out the comfort of loved ones, or did your best to distract yourself or pretend like nothing had changed. Or maybe you simply froze, unable to process how your life had suddenly changed out of all recognition. Or perhaps you even jumped into action and started tackling your health problem head on.

It’s important to remember there’s no “right” or “wrong” way to respond. We’re all different, so don’t tell yourself what you should be thinking, feeling, or doing after a diagnosis or serious health event. Give yourself time to process the news and be kind to yourself as you adjust to your new situation. 

Allow yourself to feel. It may seem better in the moment to avoid experiencing your emotions, but they exist whether you’re paying attention to them or not. Trying to ignore your feelings will only increase stress and maybe even delay recovery. But if you allow yourself to feel what you feel, you’ll find that even intense, disturbing feelings will pass, the initial distress you felt at news of your diagnosis will start to ease, and some aspects of life will even return to normal.

Be patient with the pace of treatment and recovery . After receiving an initial diagnosis or suffering a major health event, it can take time and an array of tests and consultations before your medical team settles on an appropriate course of treatment. It’s easy to become anxious as you wait for a clearer picture of what your road to recovery will entail. But scouring the Internet and relying on what can often be inaccurate or scary information will only make you feel worse. When you’re faced with a lot of unknowns, you can still care for yourself—eat a healthy diet, exercise, sleep well—and pursue those relationships and activities that bring you joy.

Be open to change . Rationally, no one would consider having a heart attack or receiving a cancer diagnosis as ever having any positive consequences. But it can happen. Some people diagnosed with life-threatening conditions do undergo a change in perspective that focuses them on the important things in their lives—those things that add meaning and purpose. Negative emotions such as anger or guilt can even sometimes have a positive effect, motivating you to meet treatment goals, for example. Keeping your mind open may help you to find the positives and better cope emotionally in even the darkest situations.

Facing a life-threatening illness can leave you feeling alone and cut off from even those closest to you. You may feel that other people can’t understand what you’re going through. Or perhaps those around you are trying to be so positive that you don’t feel able to open up and express how you really feel. Or perhaps you’re worried about being a burden to other people if you talk honestly about what you’re experiencing. Whatever your situation, now is not the time to retreat into your shell.

Social support can have a huge impact on your mental health when you’re facing the stress of a serious medical condition. As well as providing practical assistance, such as driving you to medical appointments or aiding you with household chores, having people to lean on is essential to your emotional well-being. Staying connected to others and continuing to enjoy social activities can make a world of difference in your mood and outlook as you undergo treatment. 

A number of studies have demonstrated a higher survival rate following a cancer diagnosis, for example, among people who are married compared to those who are not. This can likely be attributed to the greater social support offered by a spouse and children. Of course, you don’t need to be married or in a long-term relationship to benefit from the support of others.

Choose the support that’s right for you. After a serious diagnosis or health event, who you choose to confide in, lean on, and the amount of information you elect to share about your medical situation are always very personal decisions. But trying to tough it out alone will only deny those who care about you the chance to offer support.

Don’t let worries about being a burden keep you from reaching out. The people who care about you will be flattered by your trust and won’t judge you as weak or being a burden. Reaching out to them will only strengthen the bond between you.

Look for support from friends and loved ones who are good listeners.  When you choose to confide in someone, try to find someone who’s a good listener—someone who’ll listen attentively and compassionately without being distracted, judging you, or trying to tell you how you should think or feel.

Make face-time a priority.  While it’s always good to have support from friends and loved ones via phone, text, or social media, it’s important to find in-person support as well. Connecting face to face with someone who cares about you can play a huge role in relieving stress and boosting your mood.

Join a support group. A support group can be a safe place to talk about what you’re going through and get coping tips from others who are undergoing similar medical problems. Don’t be put off if you don’t click with the first group you try—it can sometimes take several attempts to find the group that works best for you.

Seek out a peer support program . There are many disease-specific organizations that can match you with a person who has survived the same type of medical condition. Whether it’s in-person, online, or via telephone, you can receive one-on-one support from someone who has firsthand experience of what you’re experiencing.

Feel that you don’t have anyone to turn to?

Many of us find ourselves alone at some point in life. It can be especially tough when you’re also facing a serious illness. But even if you feel that you have no family or close friends to lean on, that doesn’t mean you have to face your challenges alone.

As well as taking advantage of the support groups and peer support programs mentioned above, there are also plenty of things you can do to expand your social network  to find support —even at this difficult time.

It’s easy to be frightened of your feelings when you’re facing a chronic or life-threatening health condition. Like many patients, you may think that bottling up your emotions, putting on a brave face, or forcing yourself to be positive and cheerful will provide the best outcome to your illness. However, being honest about any negative emotions you’re experiencing won’t delay your recovery in any way. It may even have the opposite effect.

A 2002 review of studies into the coping styles of patients with cancer concluded that being cheerful has little effect on the success of treatment or rate of recurrence. In fact, bottling up your emotions may only increase your stress levels, elevate the amount of pain you feel, and make you more susceptible to anxiety and depression. It’s often the act of refusing to face your fears that leads to the hopelessness, sadness, and pain that can come with battling a serious illness.

Facing your emotions on the other hand, even the most painful and fearful ones, can help you to ease your stress and suffering, better come to terms with your condition, and find greater peace and physical fortitude as you work towards recovery.

Learning to face your emotions

Many of us are taught in childhood to bottle up our feelings. We internalize emotions such as fear, grief, and anger or we explode inappropriately, which serves only to fuel rather than expend unpleasant feelings. By the time we reach adulthood, we often find it difficult to even recognize what we’re really feeling. But it’s never too late to learn to reconnect with your emotions. You can start by listening to your body.

When you experience a strong emotion, you likely also feel it somewhere in your body. Perhaps your stomach tightens up every time you feel anxious or afraid, for example, or your shoulder muscles get tense when you feel a sense of grief or loss. By concentrating on these physical sensations, you can start to explore your emotions rather than trying to ignore or repress them.

When your feelings are freed, you’ll find different emotions quickly come and go. Even the most painful and difficult feelings will rapidly subside. As you undergo treatment, you may hear, read, or see something that triggers a strong, unpleasant feeling. But if you allow yourself to feel what you feel, it won’t last, and a different emotion will soon take its place.

For more on learning to connect with your emotions, see HelpGuide’s free Emotional Intelligence Toolkit .

Stress can contribute to or exacerbate many different health problems , including cardiovascular disease, high blood pressure, gastrointestinal disorders, chronic pain , post-operative and wound healing, and some side effects of cancer and cancer treatments. Practicing stress management techniques, however, can help you manage these health issues.

Even after you’ve had a heart attack or heart surgery, for example, stress management can help by bolstering the benefits of cardiac rehabilitation or reducing the amount of medication you need to control your blood pressure . If you’re dealing with a cancer diagnosis, managing stress can help you relieve anxiety, alleviate fatigue and sleep disturbances, and boost your mood.

Whatever your specific diagnosis, the following stress management tips can help improve your overall health and wellbeing:

Talk to someone you trust . Nothing eases stress more effectively than chatting face-to-face with a friend or loved one—another good reason to maintain social ties and activities.

Adopt a relaxation practice . Practicing a relaxation technique such as mindfulness meditation, progressive muscle relaxation, or deep breathing can help you feel calmer, lower your blood pressure, and ease stress.

Get enough sleep . A lack of sleep can exacerbate stress just as stress can make it harder to get a good night’s sleep. You can break the cycle and ensure you get enough good quality sleep at night by modifying your daytime habits and developing a peaceful bedtime routine.

Be as active as possible. Exercise is an effective way to burn-off tension and relieve stress, and it can leave you feeling more relaxed and positive throughout the day. Even if your medical condition has limited your mobility, there may still be ways for you to get active and reap the benefits.

Whatever medical condition you’re facing, it doesn’t have to define who you are as a person. By continuing to pursue those activities that bring meaning, purpose, and joy to your life, you can reaffirm that it’s these things that define you as an individual, not your illness or injury or chronic health complaint.

We’re all different so we all have different ways of experiencing meaning and joy. If your medical condition means that it’s no longer possible to pursue some of the activities you previously enjoyed, you can still find other activities that nourish and enrich your spirit.

Pick up a long-neglected hobby or try a new hobby. Taking a class or joining a club can help you pursue a hobby and expand your social network at the same time.

Learn something new , such as an instrument, a foreign language, a new game, or a new sport.

Get involved in your community. Try attending a local event or volunteering for a cause that’s important to you.

Spend time in nature. Work in your yard, take a scenic hike, go fishing, or walk a dog in the park.

Enjoy the arts . Visit a museum, go to a concert or a play, join a book group, or take up painting or photography.

Write your memoirs, a how-to book, or a blog about your experiences.

When you have a serious illness, it’s normal to feel sad about your health and grieve the hopes and dreams you may have lost as a result of your medical condition. It’s also natural to worry about what the future may hold or be apprehensive about certain treatments, for example. But if such feelings persist and start to interfere with your daily life, you may be suffering from depression or anxiety.

While mood disorders like anxiety and depression are common among patients dealing with a serious illness, they can create a vicious circle. Your illness triggers anxiety or depression, which then erodes your overall health, which in turn negatively impacts the treatment of your illness. This then worsens your mood disorder, and so on.

As well as counseling and medication, the following can help you cope with anxiety and depression:

Manage debilitating symptoms such as pain. Left untreated, pain can have a detrimental effect on your mood and increase anxious thoughts and feelings of hopelessness. Talk to your medical team about ways to better manage pain and other distressing symptoms.

Ease up on the worrying. We all worry, especially when we’re sick. But if you’re constantly overestimating the possibility that things will turn out badly or immediately jumping to worst-case scenarios, it’s time to take action. There are steps you can take to challenge your anxious thoughts , distinguish between solvable and unsolvable worries, and develop a more balanced way of looking at your situation.

Take care of yourself. Confiding in others, exercising regularly, and eating and sleeping well are all proven ways to help improve depression and anxiety symptoms.

Cut down on sugar in your diet . By reducing the amount of soft drinks, sweets, and sugary snacks in your diet , you’ll feel less anxious and avoid the mood crashes that usually follow a sugar high.

Be smart about caffeine, alcohol, and nicotine. Reducing or cutting out your caffeine intake can help with anxiety. Similarly, alcohol can worsen both anxiety and depression symptoms . And while it may seem like cigarettes are calming, nicotine is actually a powerful stimulant that leads to higher, not lower, levels of anxiety and stress.

Countering your “what if’s…?”

What if … the treatment doesn’t work? I can’t cope with the side effects? I have to say goodbye to my loved ones?

It’s hard to imagine that anyone who’s faced a life-threatening illness hasn’t worried about “what if” scenarios at some point. When you’re fighting for your life and faced with great uncertainty, worrying can even seem like it’s giving you some control over your situation. But as with all anxious thoughts, there are ways to calm your worrying mind and take a more balanced view:

Tell someone what you’re thinking . Saying your “what if” out loud can help you put things in perspective. If your fear is unwarranted, verbalizing it can often help you expose it for what it is—an unhelpful worry.

Challenge the thought . What’s the probability that what you’re scared of will actually happen? What are some other likely outcomes? What would you say to a friend in your situation who had the same worry?

Accept the uncertainty . Much of dealing with a serious illness is about learning to come to terms with the uncertainty of your future. Worrying about all the things that could go wrong won’t make your life any more predictable. It will only keep you from enjoying the good things you are still able to experience in the present.

When someone you care about has suffered a serious health event or is dealing with a life-threatening illness, it can be difficult to know what to say or do. You loved one is likely experiencing some painful emotions and that can make even those closest to them feel uncertain about how to best offer your support. These tips can help:

Offer your support. Your friend or loved one may be reluctant to ask for help, but it’s support from people like you that can make all the difference in their recovery. Offer to help with a specific task, even if it’s simply to sit with them during or after treatment. Sometimes, the most important thing you can do for someone is to be there.

Listen . When you talk to someone with a serious illness, it’s natural to feel awkward or not know what to say. But often the most important thing is to listen to the person. Allow them to express what they’re going through without judging them, telling them how they should feel, or trying to put a positive spin on everything.

Educate yourself about the illness but don’t give advice unless you’re asked.  The more you know about your loved one’s diagnosis and treatment, the better prepared you’ll be to help. But that doesn’t mean you should tell the person what they should or shouldn’t do, unless they specifically ask for your opinion or want to know what you’ve researched. Treatment decisions are ultimately always up to your loved one, so be supportive even if you don’t always agree.

Stay connected . Some illnesses can involve lengthy treatment, so it’s important not to just provide support at the time of diagnosis and then let your attention lapse. Your support can be just as important after treatment as it is before. 

More Information

• Coping with a Serious Health Event - How to stay mentally well after a heart attack, cancer diagnosis, or other serious health event. (Beyond Blue)
• How to Support Someone with Cancer - Tips on supporting a friend or loved one that apply to cancer or any other serious disease. (Cancer Research UK)
• Influence of psychological coping on survival and recurrence in people with cancer - Research that shows effect of different psychological coping styles. (NCBI)
• Depressive Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders American Psychiatric Association. Link
• Zisook, S., & Shear, K. (2009). Grief and bereavement: What psychiatrists need to know. World Psychiatry, 8 (2), 67–74. Link
• Salleh, Mohd. Razali. “Life Event, Stress and Illness.” The Malaysian Journal of Medical Sciences: MJMS 15, no. 4 (October 2008): 9–18. Link
• Turner, Jane, and Brian Kelly. “Emotional Dimensions of Chronic Disease.” Western Journal of Medicine 172, no. 2 (February 2000): 124–28. Link
• Maunsell, E., J. Brisson, and L. Deschênes. “Psychological Distress after Initial Treatment of Breast Cancer. Assessment of Potential Risk Factors.” Cancer 70, no. 1 (July 1, 1992): 120–25. Link
• Hack, Thomas F., and Lesley F. Degner. “Coping Responses Following Breast Cancer Diagnosis Predict Psychological Adjustment Three Years Later.” Psycho-Oncology 13, no. 4 (April 2004): 235–47. Link
• Jim, Heather S., Susan A. Richardson, Deanna M. Golden-Kreutz, and Barbara L. Andersen. “Strategies Used in Coping With a Cancer Diagnosis Predict Meaning in Life for Survivors.” Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association 25, no. 6 (November 2006): 753–61. Link

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Overcome obstacles and cope with difficult emotions

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Overcoming Challenges

Mental illness affects children, teens and adults of every age. Mental illness can be treated. Living a healthy, positive life with mental illness is possible. Early detection matters.

IN A MENTAL HEALTH CRISIS

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Many people in Delaware experience mental health challenges. Some are not serious. Others may be signs of serious mental illness. Stress, depression or confusion. Changes in relationships, moods and feelings. Learn the signs of mental illness. Learn about treatment and counseling for mental illness in Delaware. Find out more about mental illness, including early onset psychosis and other mental illness that affects teens and young adults.

Psychosis is a brain-based condition that is made better or worse by factors like drug use and stress. Children and youth who experience psychosis often say “something is not quite right” or can’t tell if something is real or not real.

What to Know

When life’s challenges seem too big to cope, take a step back.  Think about how you’ve gotten through challenges in the past.  Think about how you can handle your current challenges.  Sometimes we need help, and that is OK! Talk to a relative, friend, or a professional counselor.

What to Look for

When over-stressed, people show different signs and symptoms. They can become upset, depressed or anxious. Others turn disruptive, impulsive or angry. Some may struggle with tasks that used to be routine. They may lose interest in activities they once loved. It’s important to take notice of any sudden changes in behavior or activities.

What to Do for You

It’s OK to feel overwhelmed. Most people struggle to cope at some point in their life. Give yourself some time to understand what you’re going through. Write down your experiences. Talk to someone who can listen without judgment. If you ever feel so bad that you think of harming yourself, call 1-800-969-4357.

What to Do for Others

When someone you know is overwhelmed it is best to just listen. Try to understand before you attempt to help them solve their problems. Make sure they feel heard. Sometimes that’s enough to make them feel better. If anyone you know ever feels so bad that they are thinking of hurting themselves, call 1-800-969-4357.

Promotion / Prevention

Mental health challenges are usually not treated in one visit. Success might mean changing one’s lifestyle over time. Be sure to celebrate small victories. Take preventative measures. Exercise. Manage your stress. Avoid friends that use drugs. These activities will start to become part of the new norm.

Overcoming Obstacles

Whatever your goal, there will be obstacles in your way. how do you react.

Posted May 12, 2016 | Reviewed by Davia Sills

You set goals and have dreams you want to fulfill. You are excited about life and what you want your life to be. You start the work to make your dreams a reality. Then you run into roadblocks.

Maybe you want a relationship, but no one responds to your profile on the dating site. Maybe you want to move to a place you love, but you can't find a way to pay for the move. Maybe you want a steady paycheck, and you can't keep a job. Whatever your goal is, there are obstacles in the way.

Your Perception of Obstacles Makes a Difference

Some people see obstacles as a puzzle to solve. Some see obstacles as an opportunity to grow. Others see obstacles as threats. Still others see obstacles as meaning they cannot succeed. Your view of barriers to achieving your goals affects how you react.

If you see obstacles as the world being against you or as meaning you failed, then you are likely to be overwhelmed with painful thoughts and difficult emotions when faced with blocks to your goals.

Perhaps you don't really experience thoughts when faced with an obstacle. Maybe you immediately experience fear or shame . Fear tells you to escape the situation, that you are in danger. Shame urges you to hide. If the situation isn't one in which you need to be afraid or ashamed, these emotions get in the way of your overcoming obstacles. (Other emotions that you might experience also urge you to take certain actions that might or might not be helpful. To understand more about your emotions and the actions associated with the emotions, try this fabulous atlas of emotions .)

Either your thoughts or your emotions or both can lead you to stop working on your goals. You lose your passion. Perhaps you become resigned and no longer think about your goals or what's important to you. Your reactions to obstacles stopped you from trying.

Think about the last obstacle you faced. What thoughts did you have? What emotions did you have?

Were your reactions to the last obstacle you faced accurate? Were they helpful? What is your pattern of responding to obstacles?

Discouragement, anger , sadness are all emotions that you might experience when faced with an obstacle. These emotions could dissuade you from attempting to overcome the obstacle.

Maybe you blame yourself or others that your path to your goal is blocked. Those thoughts could persuade you to stop pursuing your goal.

The truth is that achieving most goals means overcoming obstacles. That's normal and part of the process. There's a quote from Frank Clark, "If you find a path with no obstacles, it probably doesn't lead anywhere."

Sometimes obstacles can be overcome, and sometimes they can't. Sometimes you have to work around them or find alternatives. The key is to not give up without wise consideration because you hit an obstacle, or because of your emotional reaction to the obstacle.

Skills for the Wise Consideration of Obstacles

1. STOP. This is a good time to use the STOP skill from Dialectical Behavior Therapy . STOP stands for Stop, Take a step back, Observe, and Proceed mindfully.

Take a step back and observe your emotions. Let your emotions calm. Then observe the obstacle as you would if it were someone else facing it. What would you tell someone else to do?

2. Practice radical acceptance. Whatever goal you want to achieve will include overcoming obstacles. Expect obstacles and accept them as part of achieving the goal. Of course, you don't want that. No one does. And most often the truth is there will be obstacles.

3. Accept your emotions. When you encounter an obstacle, you'll experience emotions. Of course, you will! That's normal. Take a break and spend some time soothing yourself. The idea is to not let your emotions stop you from doing what you can. Get into "wise mind," which is able to think clearly to consider the emotional costs of pursuing a goal (Is it worth it?) and the facts of the situation.

4. Use your "wise mind." Make decisions about obstacles with your wise mind: Your emotion mind will urge you to quit, act impulsively, rage, or give up when faced with obstacles to your goal. Wait for your wise mind to be in charge. Your wise mind can take in new information, be flexible in considering alternatives, and be creative in thinking of solutions.

5. Be willing to consider different ways to reach your goal. In Radically Open DBT, Lynch refers to being in "flexible mind." A flexible mind is open to new ideas and new solutions. Knowing what doesn't work to get you to your goal allows you to think of alternatives that might work. Learning that the path you originally chose doesn't work is disappointing, but at least you know what doesn't work. That's important information.

Maybe you wanted to be a teacher, but you can't find the money to go to school. What would be an alternative? Think on what it is about teaching that you love. If you love helping children, then think of other ways to do that. Maybe being an assistant teacher or working with children in a daycare. Maybe you could teach a skill that you have, such as playing the piano or swimming.

Use your creativity . What else might be an alternative?

You could also work on ways to find the money to go to school. You could consider taking even one class at a time.

6. Find meaning. When we experience difficult situations, it's certainly uncomfortable, to say the least. At the same time, you can often find meaning in the obstacles you face. Ask yourself: What lesson can I learn from this? Does this add to my life or my understanding in any way?

I'm a cancer survivor. From having cancer, I realized that when you first learn about something scary or unwanted in your life is the worst time, perhaps second only to uncertainty. When you first learn about an obstacle, it may seem more overwhelming than it will after you have thought about it.

Once you know and accept that a problem exists, then you can work on solving the problem or on radically accepting the situation. The overwhelming feelings go down. Lack of acceptance keeps you from working on the solution or on accepting what you can't change. Look for what you can learn from the obstacles you face or have faced.

7. Be willing to ask for input. Asking for ideas from others is an interpersonal skill. Getting information from other people can be very helpful in overcoming obstacles. Other people are likely to know resources that you don't, and they will have ideas that you may not have thought of. They also see the world differently than you do and may see solutions you don't. Ask more than one person.

8. Set small goals that lead to the overall goal. Obstacles can be complex and difficult. Achieving goals can be challenging and overwhelming with all that you need to do. It's hard to keep motivation high over time. Break down what you need to do to overcome the obstacle into small steps. Focus on one step at a time. For example, if you want to learn to make more friends, then small goals could start with spending more time around people.

9. Mistakes are normal. As surely as the sun rises every morning, you'll make mistakes as you work toward your goal. It's just part of being human. If you find yourself judging others or yourself, or blaming others or yourself, just notice those thoughts and let them go. Remember nonjudgmental thinking. Acknowledge the mistake is there, and look at what you need to do next. Blaming discourages you, wastes your energy, and isn't helpful in solving the problem. Don't let making mistakes stop you.

10. Reevaluate. Sometimes what you think you want turns out to not be right for you. It's normal to work toward a goal and then change your plans along the way. Part of working toward a goal is getting more information and learning more about what you are working toward.

You might decide you want to run five days a week. As you work toward the goal, you learn that you actually prefer to do different activities and that you are bored by running every day. You change your goal to doing something physically active or to taking dancing lessons instead.

11. Celebrate! Recognizing your accomplishments is so very important. Celebrate the small steps you take. This helps you to stay motivated and to realize that you can do things. It helps you focus on what you do accomplish, not just on the obstacles or what doesn't work out.

If an obstacle can't be overcome, and you can't find an alternative to your goal, then celebrate that you put the effort in and did your best. Use your flexible, wise mind and think of another goal that you want to pursue.

Think about these steps. Which ones do you do well, and which ones could you add to your style of overcoming obstacles?

Karyn Hall, Ph.D. , is the author of The Emotionally Sensitive Person, Mindfulness Exercises, and co-author of The Power of Validation.

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Top 6 Challenges to Mental Health We Face Today

Table of Contents

The past year has taken a toll on the nation’s mental health. The country already had rising rates of anxiety and depression, but the pandemic only added to them. Stress is at all time highs, and many people are grieving the loss of loved ones to COVID-19 .

As a country we face mental health challenges as we move through, and beyond, the effects of the virus. It will surely take some time to become stable again. Meanwhile, we should be aware of the most common mental health issues we face today.

What Are the Top 6 Mental Health Challenges Today?

Here are the most common mental health issues at this time:

Anxiety remains the number one mental health challenge in the nation. Because of the added burden of Covid, people are more anxious than ever before. Much of this is due to the unknown aspects of the virus, which causes feelings of fear and distress. People just don’t know if they might get lucky and have no symptoms or if they will get very sick. All the other fallout caused by the virus, such as schools being closed, only adds to the anxiety.

2. Depression.

People’s lives have been in upheaval for a year now. Careers have been lost, plans have been shelved, and illness has been rampant. With all the problems caused by the virus many have become very depressed. Life has been turned upside down. Relationships have been stressed, only causing more conflict. Rates of depression have climbed in all age groups, and suicides are on the rise.

3. Loneliness.

So much of the impact of the virus on our mental health centers on feeling lonely. For the past year we have been forced to keep our distance from friends and family members. We have had to forgo our holiday celebrations and other milestones, and it all leads to feelings of isolation. People truly are social creatures at heart and all this loneliness has been very hard on mental health this year.

4. Financial Stress.

Along with the safety measures imposed by state and local leaders came job losses in the millions. What was thought to be a short-lived problem has lasted for many months, causing hardship. Money problems are one of the most stressful things in people’s lives. Small businesses have had to close, taking with the closures people’s life savings.

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5. grief and loss..

At this point in time, we have lost about half a million people here in the US to COVID-19. It is truly tragic what has happened to so many families. They have had to lose a loved one, often without even getting to say goodbye. The effects of grieving the loss of a loved one are profound, and hard to predict. Sadly, grief and loss will be with us at these rates for a while longer.

6. Substance Abuse.

Along with the emotional toll of the pandemic came an increase in substance abuse. People often turn to alcohol or drugs to help them cope with stress or depression . An unhealthy mode of coping through the use of a substance can then lead to a substance use disorder. This only compounds the mental health struggles.

How to Protect Mental Health in 2021

With all this strife, surely there are things we can do to protect our mental health . It is true, that with some lifestyle tweaks we can protect against much of the negative effects of the virus. Consider these ways to bolster our mental wellness:

• Work Out. If there is one thing you can add to your routine to improve mental health and overall wellness it is exercise. This can be tailored to your own interests and strengths, and should be fun. Consider adding cycling, rock climbing, hiking, swimming, dance cardio, running, or just a brisk daily walk. Anything that gets your heart pumping for 20-30 minutes 3 times a week is good for your mental health.
• Learn to Relax. There is no doubt that stress levels have been high and we all need to learn better ways to relax. High stress levels cause a burden on our hearts, can cause sleep disruption, and even weight gain. Try adding some form of stress-reduction action to your daily routine. Take an online yoga class, learn how to meditate, listen to soothing music, or practice deep breathing. There are online cooking classes and art therapy sessions that can also help you relax. Get creative to find ways to reduce stress in your life.
• Eat Better. One thing most of us are guilty of during the pandemic is eating more comfort foods. This isn’t good because our diet can have an affect on our mental health. Best to aim for a diet that is rich in lean proteins, whole grains, low-fat dairy, nuts and seeds. Add plenty of fresh fruits and veggies and drink lots of water. Limit sweets and processed foods for optimal health.

When to Seek Treatment

If the lifestyle changes do not seem to improve mental health, then it’s time to see a mental health provider. These experts can provide support and therapy, and sometimes medications as well. There are different types of mental health treatment to consider: If in person sessions are not available

• Telemental Health. If in-person sessions are not available you can receive psychotherapy via a digital platform such as Zoom.
• Outpatient Programs. Outpatient treatment is structured based on the level of care needed to treat the mental health issue.
• Residential Treatment. When a more intensive level of comprehensive treatment is needed, the residential treatment center for depression and anxiety option allows for a longer treatment window.

Taking care of our mental health this year needs to be a top priority. Get the help you need as early as possible for the best recovery outcomes.

Elevation Behavioral Health Provides Residential Mental Health Treatment

Elevation Behavioral Health offers a small, intimate residential setting for healing. With a caring team of mental health professionals, our focus is on customized treatment. Our team partners with you to support your journey back to wellness. If you are struggling with a mental health issue, give us a call today at (888) 561-0868.

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Mental Health Challenges and Recovery

I like referring to mental illnesses as mental health challenges.  This is because it is more inclusive of people who may not have a diagnosis.  It reminds us that there are many related challenges and it offers hope that the challenges can be overcome. 

A favorite thing for me to do is talk about what causes mental health challenges and that recovery is very possible because there are many people who have to deal with mental health challenges and they need to know it is not their fault and that there is good reason to be hopeful.  For too long, people were blamed and stigmatized because they had a mental health challenge and they were told not to expect very much from life because they had one.  Fortunately, in recent years, there has been a lot of good information available on what causes mental health challenges and that recovery is very possible. 

Mental health challenges can affect anyone regardless of race, gender, education, religion, age, intelligence or income.   They are not the result of personal weakness, lack of character, poor upbringing, or lack of faith. According to the National Institute on Mental Health, mental health challenges appear to be disorders of brain circuits.   While there can be a genetic pre-disposition to having a mental health challenge and a mental health challenge can be triggered by stress, illness or trauma, not everyone with a pre-disposition will develop a mental health challenge.  This is because we are all unique individuals. 

According to National Alliance on Mental Illness (NAMI), recovery is not only possible but probable for people because, with a combination of pharmacological and psychosocial treatments and support, 70 – 90% of people with a serious mental illness have significant reduction of symptoms and improved quality of life, .  The key to recovery is having hope.   Hope is the key to getting better because, without hope, a person will give up and not try anything that can make their life better.  The most important thing you can do for yourself or someone you care about is have hope that they can get better even when they cannot believe it for themselves. Have hope even when recovery seems hopeless because, according to the National Empowerment Center , a person can recover from a mental health challenge regardless of what disorder they have, when it began or how long they have had it. 

Most adults who have a mental health challenge do not seek help  because they fear being devalued, stigmatized, isolated, ignored and discriminated against if it is known that they have a mental health challenge.  This is unfortunate because often medication and support are needed, and most people who receive appropriate treatment and support get significantly better.  What is even more unfortunate is that, according to a recent study from Baylor University , when people do seek help, “clergy, not mental health professionals, are the most common source of help sought in times of psychological distress”  and clergy are ill prepared to provide help.  I was ordained, and, in seminary, I learned very little about mental health challenges and even less about recovery.  We were simply told to make referrals, but we do not always understand the local mental health system and know to where to make a referral.

If you or someone you care about is trying to deal with a mental health challenge, get help from a mental health professional.  Don’t wait, hoping it will go away on its down.  Be honest with your doctor and ask for a referral to a mental health professional.  Recovery is very possible, but it is often dependent on appropriate treatment and support.

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A Science-Supported Journaling Protocol to Improve Mental & Physical Health

Listen or watch on your favorite platforms.

In this episode, I explain a specific writing protocol shown in hundreds of scientific studies to significantly improve immediate and long-term health. I explain how to implement this specific protocol, which takes only four days and 15-30 minutes per day. I also explain the mechanism for how the four-day writing protocol affects neuroplasticity (brain rewiring) and brain function in the short and long term. I explain how these brain changes positively impact our physical health, including our system's immune function and thus our ability to combat infections, improve sleep, reduce feelings of physical and emotional pain, lower anxiety, and bring about healing from traumas. This episode ought to be of interest to anyone seeking better mental and/or physical health through the use of brief yet highly effective science-supported protocols.

• Confronting a traumatic event: toward an understanding of inhibition and disease ( Journal of Abnormal Psychology)
• Natural emotion vocabularies as windows on distress and well-being ( Nature Communications )
• Disclosure of traumas and immune function: Health implications for psychotherapy ( Journal of Consulting and Clinical Psychology )
• Putting Feelings Into Words ( Psychological Science )
• Increasing honesty in humans with noninvasive brain stimulation ( Proceedings of the National Academy of Sciences )
• The β1-adrenergic receptor links sympathetic nerves to T cell exhaustion ( Nature )
• Writing About Emotional Experiences as a Therapeutic Process ( Psychological Science )
• Brain and body are more intertwined than we knew ( Nature )
• Therapeutic Journaling (VA Office of Patient Centered Care and Cultural Transformation)
• " Opening Up by Writing It Down: How Expressive Writing Improves Health and Eases Emotional Pain "
• " Trauma: The Invisible Epidemic: How Trauma Works and How We Can Heal From It "

Other Resources

• Dr. James Pennebaker
• Dr. Paul Conti: Therapy, Treating Trauma & Other Life Challenges (Huberman Lab episode)
• Guest Series | Dr. Paul Conti: How to Understand & Assess Your Mental Health (Huberman Lab episode)
• Science of Social Bonding in Family, Friendship & Romantic Love (Huberman Lab episode)
• Using Your Nervous System to Enhance Your Immune System (Huberman Lab episode)
• Tools for Managing Stress & Anxiety (Huberman Lab episode)
• 00:00:00 Journaling Protocol for Mental & Physical Health
• ‍ 00:03:06 Sponsors: LMNT, Eight Sleep & Waking Up
• ‍ 00:07:16 Journaling & Confronting Traumatic Events
• ‍ 00:11:25 Tool: Expressive Writing
• ‍ 00:14:38 Morning Notes, Gratitude Journaling, Diary Journaling
• ‍ 00:18:00 Tool: Consecutive Writing Bouts; Trauma Definition
• ‍ 00:24:38 Low Expressors vs. High Expressors
• ‍ 00:29:29 Tools: Language, Vocabulary & Emotion; Analyzing Writing
• ‍ 00:35:02 Tool: Writing Session Tips
• ‍ 00:39:31 Sponsor: AG1
• ‍ 00:41:02 Positive Mental & Physical Benefits
• ‍ 00:46:45 Expressive Writing & Immune Function; Brain-Body Connection
• ‍ 00:57:02 Sponsor: InsideTracker
• ‍ 00:58:10 Neuroplasticity, Prefrontal Cortex & Subcortical Structures
• ‍ 01:05:00 Structured Writing, Trauma & Narratives; Truth-Telling
• ‍ 01:08:56 Neuroplasticity, Truth-Telling & Relief from Trauma
• ‍ 01:15:32 Honesty, Brain Activity & Narratives
• ‍ 01:22:01 Overcoming Trauma & the Brain; Stress, Emotions & Honesty
• ‍ 01:26:41 Expressive Writing Protocol & Benefits
• ‍ 01:36:16 Zero-Cost Support, Spotify & Apple Reviews, Sponsors, YouTube Feedback, Momentous, Social Media, Neural Network Newsletter

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The Times of India

Providing early mental health support can shape the future generation, say experts

Posted: 29 November 2023 | Last updated: 29 November 2023

We have to come to terms with the realities of the present generation. In this fast-paced,

competitive and constantly-evolving world, they face far more challenges than previous

generations did in their formative years.

There is pressure from society to conform, from parents and teachers to perform, and from

peers to fit in. They’re expected to do well academically, make tough career choices, and

take decisive steps towards a secure future. Insecurities, lack of confidence and struggle to

overcome challenges are major stumbling blocks for the youth. Moreover, the generation

gap between parents and young adults is growing by the day.

The mental health of our youth is more vulnerable and fragile than ever before. One in five

students shows signs of a mental health condition. 16.8% of the youth between the ages of

18-24 suffer from depression. 35% of suicides in India are of people between the ages of 15-

24 – the highest in the entire world. Most of these are young adults who have no one to talk

to about their stresses and mental health concerns.

Our youth needs society’s unconditional support. By creating awareness and allowing them

to feel comfortable with their feelings and be open about them from a very young age, we

can effectively promote long-term mental well-being.

At every stage of their formative years, young people experience conflicts that become

turning points in their overall development. When they deal with conflicts successfully, they

emerge with strong psychological skills that can serve them for the rest of their lives. These

skills allow for competence and motivate positive behaviours and actions. This is why,

creating mental health awareness at a young age is critical.

“I’m a strong supporter of having mental health curriculums as an integral part of the school

syllabus. Mental health curriculums help create awareness about mental health and teach

both students and teachers to identify signs of mental health issues. They help build resilience in students to deal with stress and difficulties and learn sufficient coping mechanisms. Importantly, they encourage help-seeking behaviour,” shares Dr Neerja Birla, founder of M Power.

When it comes to the older demographic of students, on-campus mental health support

cells can support young adults as they get ready to take their critical step into adulthood – a

phase of their lives that often proves to be daunting in so many ways. Student-led initiatives for peer mental health support are another great initiative. They promote a proactive and empathetic approach to mental well-being and facilitate peer-to-peer engagement by training students in mental health first aid, offering counselling services and creating a safe space for open conversations about mental health.

Most importantly, we need to involve all sections of society in sustained open dialogue

about mental health to ‘normalize’ mental health in India. By empowering the youth to be mentally strong and investing in their mental health, we can give them the tools and skills to navigate the chaos of their formative years and go on to become leaders who can take charge. Mental health awareness is in itself an indispensable leadership skill. Mentally strong individuals make confident and empathetic leaders, who can foster a supportive environment in society that does not stigmatise mental health.

—With inputs from Dr Neerja Birla, founder of M Power

For more news like this visit TOI . Get all the Latest News , City News , India News , Business News , and Sports News . For Entertainment News , TV News , and Lifestyle Tips visit Etimes

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Original Investigation | November 22, 2023

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