I have seen enough episodes to ask the question, “Why?”

What draws people to watch faithfully every week or watch every series every week? What satisfaction is had by watching women backstab each other, trash-talk each other behind each other’s backs, steal each other’s men, lie and manipulate others for attention, and flaunt their excessive lifestyles?

In short, what is to be gained by watching women treat each other so poorly?

This type of show seems only to feed the drama and stereotypes often associated with female friendships. Somehow it has become “entertaining” to watch women beat each other up mentally, emotionally, and in some cases physically each week in the “entertainment” boxing ring.

In an effort to learn more about the appeal of the “Real Housewives” antics, I started to wonder if those addicted to the show related in any way because of their own real-life friendships. Do the most loyal fans watch to find out why these women behave the way the do, or do they watch because they can resonate with them or find aspects about the “characters” they relate to or even secretly admire in some cases? Loyal fans have their favorites and in most cases fans seem to be drawn to the most outrageous, vindictive, and despicable woman among the group.

Some fans argue they watch the show because it is like a train wreck that they can’t help but watch. However, the difference between a train wreck and the “Real Housewives” is that unlike a train wreck, which is a horrible accident, the “Real Housewives” is a horribly staged event with the sole intent of setting women up to knock each other down.

So for all of you who Real Housewives fans, I challenge you to take this mini-quiz to see how your real-life friendships stack up to the ones on this widely popular show.

1. Do you spend most of your time with your friends gossiping and judging other friends or people in general? Or do you find the time you spend with your friends is often spent listening to them gossip about and judge other people?
2. Do you gossip about your friends behind their backs rather than talk to them directly about something that’s bothering you or about some ongoing conflict? Or do your friends gossip to you about friends they are having issues with versus talking to that person directly?
3. Do you get defensive if a friend tries to communicate to you their feelings or take it as an insult or criticism? Or do you find that when you try to talk to your friends about something they said or did that upset you, they react in ways that make you feel like you did something wrong and even some cases they stop talking to you?
4. Do your loyalties shift depending on which friend you happen to be with at the moment? Or do you find your friends’ loyalties seem to shift depending on who they are around?
5. Do you find you have very little to say to a friend if you aren’t gossiping about another friend or passing judgment on others in general? Or do you find your friend has very little to say to you other than sharing gossip or criticisms of others?

If you have answered “yes” to any of these questions, then it may be time to take a closer look at the quality of your friendships, and even how your friends would rate you as a friend. Are these the type of friendships you want to put your energy into, and is this the type of friend you want to be considered as by others?

If you are guilty of any of these “Real Housewives” types of behaviors, it is pretty safe to assume that the ones you are exhibiting this behavior with are doing the exact same thing with the other “housewives” in your group when you are not around.

When it comes to mental illness, people say the darnedest things. As illustrated above, even medical staff can make incredibly insensitive and downright despicable remarks.

Others think teasing is okay.

Fast, a coach who works with partners and families of people with bipolar disorder, has heard stories of people getting teased at work. One client’s son works at the vegetable department of a grocery store. He has obsessive-compulsive disorder and poor social skills. When his symptoms flare up, his coworkers will ask questions like, “Why do the labels have to be so perfect? Why do they have to be in line like that?” They’ve also teased him about being in a psychiatric facility.

But most people — hopefully — know that being an outright jerk to someone about their mental illness isn’t just inappropriate and ignorant. It’s cruel.

Yet there are moments when even neutral words may be misconstrued, because the person is in a vulnerable place, according to F. Diane Barth, LCSW, a psychotherapist and psychoanalyst in private practice in New York City. “The truth is that it can be complicated to find the right comment to make to someone who is struggling with emotional difficulties.”

This is why it’s so important to educate yourself about helpful things to say. In fact, Fast, author of several bestselling books on bipolar disorder, including Loving Someone with Bipolar Disorder, believes that we have to be taught what to say. “It’s not innate at all to help someone who has a mental illness.”

So what makes an insensitive remark? According to clinical psychologist Ryan Howes, Ph.D, “The problems happen when people make statements that imply that mental illness is a sign of emotional weakness, it’s something that can be quickly overcome with some trite homespun advice or they minimize it as a minor issue you can just get over.”

Below are additional examples of problematic statements, along with what makes a good response.

1. “Get busy, and distract yourself.”

“With significant mental illness, [distractions] won’t work, not even temporarily,” Howes said. After a person slogs through various diversions, they’re still left with the same issues. “Ignoring the issue doesn’t make it go away.”

2. “Do you want to get better?”

For mental health blogger Therese Borchard, this was the most hurtful thing anyone has ever said to her. While she knows the person didn’t have ill intentions, it still had a powerful effect. “It implied that I was staying sick on purpose, and that I had no interest in pursuing health, not to mention that I was too lazy or disinterested to do what I needed to do to get better.”

3. “Change your attitude.”

While a change in perspective can be helpful, it doesn’t cure conditions such as ADHD, bipolar disorder, PTSD or schizophrenia, said Howes. And changing one’s attitude isn’t so easy either. “It’s incredibly difficult for a high-functioning person to change their attitude, let alone someone debilitated by an exhausting mental illness.”

4. “Stop focusing on the bad stuff, and just start living.”

According to Barth, “one of the most common mistakes is to tell a person to stop focusing on themselves, or on the bad things, or on the past, and just start living.” Why is this so problematic? It can make a person feel even worse about themselves. “[T]hey figure the fact that they can’t do it is, in their mind, just one more sign of their failure.”

5. “You have everything you need to get better.”

“This is well intentioned, but to me it sounded like an indictment against me for not trying hard enough,” said Borchard, also author of the book Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes. Plus, this might not even be accurate. Sometimes people don’t have everything they need to improve. “Sometimes you need a little assistance.”

6. “You can snap out of it. Everyone feels this way sometimes.”

Everyone experiences a range of emotions. For instance, everyone feels sad occasionally. But sadness on some days isn’t the same as “a hopeless pit of despair where it’s so dark I’ve forgotten what light looks like,” a description of depression that one client gave to Howes. Feeling anxious isn’t the same as having a panic attack, “a terrifying lightning storm of despair, self-hatred and the absolute certainty of my immediate death,” he said.

7. “Just pray about it.”

Prayer is powerful for many people. Centering yourself and feeling support from a higher power can be very helpful, Howes said. “[B]ut this advice alone can minimize the problem, ignore many proven medical and psychological treatments and can even make someone feel like they’re not being healed, because they lack sufficient faith, which adds insult to injury.”

8. “Why can’t you work?”

It’s no doubt hard to watch someone who’s smart and capable unable to work. But telling a person who’s already struggling that they’re lazy, just making excuses or aren’t trying hard enough can be incredibly hurtful, Fast said.

She’s personally heard the following before: “I don’t see why you have such a tough time with work. Everyone works. You need to just get over it and work.” Even just asking a question like “Why is this so hard for you?” can make a person wonder what’s wrong with them. They might say, “Why can’t I work? They are right and I am a failure!” Fast said. “And they will push themselves too far.”

9. “You have the same illness as my ______.”

Years ago, when Fast’s partner Ivan, who has bipolar disorder, was in the hospital, she didn’t know anything about the illness. She told her friend that Ivan had something called “manic depression.” Fast’s friend responded with: “Oh. I know what that is. My grandfather had it and he shot himself.” A person Fast barely knew told her: “My uncle has that, but we don’t know where he is!”

“I remember every minute of Ivan being ill, and I remember those two comments the most — 18 years ago!”

The Right Responses

While reading this piece, you might be wondering if you should say anything at all. “Silence is, in my experience, the worst response, because it’s generally interpreted in the negative,” Barth said.

According to Howes, these are helpful responses:

• “[S]incerely express your concern: ‘You’re having panic attacks? I’m so sorry to hear that. From what I’ve heard, that can be just awful.’

• Offer your support: ‘Please let me know if you need anything, or if you’d just like to talk.’
• Talk to them the same way you did before, which lets them know your feelings about them or respect for them hasn’t changed; your relationship is stable. They’re the same person, just dealing with an issue that is less visibly obvious than a broken arm or the flu.”

When it comes to mental illness, people make everything from insensitive to totally outrageous comments. When in doubt, Howes suggested offering “compassion, support and stability in your relationship and leav[ing] the advice to the psychological or medical experts… [A]ny advice beyond ‘I hope you’ve found good, caring treatment’ and ‘come talk to me anytime’ can be experienced as intrusive and can even cause more problems.”

For more on this topic, read Borchard’s pieces on what not to say to someone with depression and what to say.  

We stay silent. We say stupid things. We go from being sensitive, sensible, kind adults to rambling niceties or making downright rude remarks.

Illness, understandably, makes us nervous.

Fortunately, Pogrebin’s book helps us navigate the muddied waters of illness and mortality. It’s packed with practical tips and valuable insights.

Pogrebin was inspired to write the book after observing the varied reactions from her own friends to her breast cancer diagnosis. Some friends misunderstood her needs and acted awkwardly. Others were supportive and compassionate.

In the book, she shares these personal experiences, along with powerful accounts of people offering support to others. She also shares the words of almost 80 of her fellow patients at Memorial Sloan Kettering Cancer Center. She interviewed these individuals to find out how they really wanted to be treated.

Here’s a snippet from Pogrebin’s book on communicating with a sick friend.

What Not To Say To A Sick Friend

Pogrebin advises against saying phrases like “Everything happens for a reason” and “You need to be strong for your kids.”

Even seemingly positive statements become anything but. For instance, let’s say you’re trying to cheer up a friend who just received a cancer diagnosis. You might say something like, “I know ten women who’ve had breast cancer, and they’re all doing fine” or “My sister had a double mastectomy, and she’s climbing mountains!”

One cancer patient told Pogrebin that these comments were insulting and dismissive. They also didn’t mean anything to her: “Every woman and every cancer is different,” she said.

Another seemingly positive but problematic phrase is “You look great.” According to Pogrebin, when you focus on your friend’s appearance, it can discourage them from telling you how they truly feel; if they don’t look good, they won’t believe anything you say; and if you don’t compliment their appearance in the future, they might assume they look worse.

What To Say To A Sick Friend

Pogrebin stressed the importance of being honest with your sick friends. She also notes that everyone should be able to say these three statements: “Tell me what’s helpful and what’s not;” “Tell me if you want to be alone and when you want company;” and “Tell me what to bring and when to leave.”

In addition to honesty, it’s also important to express empathy and availability. Pogrebin includes a list of seven phrases that sick people want to hear. All of these include empathy or availability or both elements.

• “I’m so sorry this happened to you.”
• “Tell me how I can help.”
• “I’m here if you want to talk.”
• “Just give me my marching orders.”
• “That sounds awful; I can’t even imagine the pain.”
• “I’m bringing dinner.”
• “You must be desperate for some quiet time. I’ll take your kids on Saturday.”

The Commandments of Conversing

In her book, Pogrebin features a list of 10 commandments for conversing with sick friends. For instance, she suggests celebrating your friend’s good news and not downplaying their bad news. This doesn’t mean sugarcoating or “slapp[ing] a happyface decal on a grim diagnosis,” she writes. Instead you can say, “Tell me what I can do to make things easier for you — I really want to help.”

Also, treat your friends the same way you always have, but don’t forget their new circumstances. For instance, tease and joke around with them, but “indulge their occasional hissy fits.”

Talk about other things. According to Pogrebin, this helps “speed the journey from the morass of illness to the miracle of the ordinary.”

Similarly, emphasize their skills and talents, which will help them feel valued. This can be anything from asking a poker aficionado for pointers on playing to asking a retired teacher for guidance on college applications for your teen.

Unless you’ve been there, avoid talking about yourself or telling your friend that you understand what they’re going through. Avoid complaining about comparatively small things. (“Don’t tell someone with congestive heart failure that you have a migraine headache, as painful as it may be,” Pogrebin writes.)

Before saying anything, make sure you know the facts of your friend’s sickness and situation. Pogrebin shares the story of one woman who had three friends tell her that they were glad the cancer was caught early. It wasn’t.

Don’t treat your friend like a child or pressure them into being positive. Positive thinking can help people endure tests and treatments, but it’s not a cure. Don’t imply that negative thinking caused or exacerbated their illness. As Pogrebin says, the last thing your friend needs to be doing is blaming themselves.

When thinking about how best to approach a sick friend, Pogrebin quotes Hillel’s famous words: “Do not say unto others what you would not have them say unto you. All the rest is commentary.”

One of the hosts said that he dealt with a difficult personal issue a few years ago. He described conversations he had with friends who wanted to offer their support and condolences, and he said, “Most of them told me, ‘I’m so sorry. I don’t know what to say to you.’”

And then the host made a particularly interesting comment: “Then my friends opened their mouths anyway — and that’s when I wished they had never said anything in the first place.”

I’ve certainly been on both ends. When I attempt to give my grieving friends comfort or insight, too often I walk away feeling as if I’ve failed. My words are balloons that have come untied, or antiseptic on a burning wound. I long to help — and stumbling over my words, confused over what angle I should take, I feel a miserable failure.

How many of us have admitted that we have nothing comforting to say, and then turned right around and scraped together some kind of awkward, unhelpful comment? Why is it that we feel we must speak, and why do our words so often harm the mourner?

Whether our losses have been large or small, most of us understand how kind and comforting the presence of a friend feels in the midst of grief.

I remember when my grandfather died unexpectedly. I got the call from my parents while I was at my freshman college roommate’s house. My cell phone had no coverage in that tiny Michigan town, so my dad had called my roommate’s parents’ house. My roommate’s mother looked concerned as she handed me the phone. She didn’t walk away.

When I’d heard the news, my roommate’s mother immediately pushed a box of tissues my way and went to the stove to pan-fry French toast, handing me a plate with a fork ready to go. I remember as I cried and took bites of that syrup-drenched bread, she told me stories of when she lost her grandfather. The kindness was real; the words were well-intentioned. Yet I can’t remember anything she said, nor was I comforted by any of it. What lingers is that memory of the French toast, her maternal presence, her action in my grief.

Life’s tragic occurrences pop up more often than we would hope in the lives of the people we love. Yet few people have mastered the art of responding well to heavy news. We’re simply not all trained in the art of listening. Professional counselors and psychiatrists are the ones who know how to listen and what is most helpful to say in response. They understand what kinds of comments a grieving person will receive as helpful, and likewise, the type of comments that will sting, irritate, and fall flat.

I spend a lot of time in the car with nothing to do except steer and soak up radio waves. After I listened to the radio host say “I wish they had never said anything in the first place” so bluntly, I pondered his response. Was it too harsh to react to his friends this way? Did he have a right to request his friends’ silence, like the Biblical character of Job? Job endured endless words from his three unhelpful friends in the midst of losing everything.

A few days ago, I received news that a friend is dealing with deep, debilitating depression that has left her hospitalized. I haven’t talked to this friend in a long time, nor am I geographically close or able to do anything, really. Should I offer possibly unwanted words? What to say when there’s nothing to say?

There is a time to speak and a time to remain silent. The radio host needed that silence desperately. I cannot do anything else for my friend, thousands of miles away from her anguish. Speaking words into her grief is my only contribution when I have no physical presence to give. All else is the silence that lacks any presence at all.

Eventually, I sent a short email — words that I know won’t fix her problem. I’m aware that they’re not helpful. But when I cannot provide physical presence or French toast, I find myself needing to do something. Is that why we all are so prone to opening our mouths in these circumstances – because we have this human need to help the healing?

She may not even open it. She may not want or need to hear my attempts to be there for her. All my words will do is symbolize my love and my awareness of her sorrow and provide a type of presence.

It can be more harmful than physical abuse because it can undermine what we think about ourselves. It can cripple all we are meant to be as we allow something untrue to define us. Emotional abuse can happen between parent and child, husband and wife, among relatives and between friends.

The abuser projects their words, attitudes or actions onto an unsuspecting victim usually because they themselves have not dealt with childhood wounds that are now causing them to harm others.

In the following areas, ask these questions to see if you are abusing or being abused:

1. Humiliation, degradation, discounting, negating. judging, criticizing:
   • Does anyone make fun of you or put you down in front of others?
   • Do they tease you, use sarcasm as a way to put you down or degrade you?
   • When you complain do they say that “it was just a joke” and that you are too sensitive?
   • Do they tell you that your opinion or feelings are “wrong?”
   • Does anyone regularly ridicule, dismiss, disregard your opinions, thoughts, suggestions, and feelings?
2. Domination, control, and shame:
   • Do you feel that the person treats you like a child?
   • Do they constantly correct or chastise you because your behavior is “inappropriate?”
   • Do you feel you must “get permission” before going somewhere or before making even small decisions?
   • Do they control your spending?
   • Do they treat you as though you are inferior to them?
   • Do they make you feel as though they are always right?
   • Do they remind you of your shortcomings?
   • Do they belittle your accomplishments, your aspirations, your plans or even who you are?
   • Do they give disapproving, dismissive, contemptuous, or condescending looks, comments, and behavior?
3. Accusing and blaming, trivial and unreasonable demands or expectations, denies own shortcomings:
   • Do they accuse you of something contrived in their own minds when you know it isn’t true?
   • Are they unable to laugh at themselves?
   • Are they extremely sensitive when it comes to others making fun of them or making any kind of comment that seems to show a lack of respect?
   • Do they have trouble apologizing?
   • Do they make excuses for their behavior or tend to blame others or circumstances for their mistakes?
   • Do they call you names or label you?
   • Do they blame you for their problems or unhappiness?
   • Do they continually have “boundary violations” and disrespect your valid requests?
4. Emotional distancing and the “silent treatment,” isolation, emotional abandonment or neglect:
   • Do they use pouting, withdrawal or withholding attention or affection?
   • Do they not want to meet the basic needs or use neglect or abandonment as punishment?
   • Do they play the victim to deflect blame onto you instead of taking responsibility for their actions and attitudes?
   • Do they not notice or care how you feel?
   • Do they not show empathy or ask questions to gather information?
5. Codependence and enmeshment:
   • Does anyone treat you not as a separate person but instead as an extension of themselves?
   • Do they not protect your personal boundaries and share information that you have not approved?
   • Do they disrespect your requests and do what they think is best for you?
   • Do they require continual contact and haven’t developed a healthy support network among their own peers?

Whenever I make those associations, there’s always a negative connotation to the emotion. But what about the good and more beneficial kind of vulnerability? What about the kind where you share yourself for the potential to forge a connection with those around you?

I tend to think that expressing a vulnerable state doesn’t necessarily require disclosing very personal information right away.

I do believe, however, that by showing people who you are (flaws, quirks and all), and ‘letting them in,’ you’re demonstrating vulnerability in a positive light. You’re asking to be seen.

Brene Brown, a social worker who studies human connections, was featured on a 2010 video that gave great insight into the power of vulnerability. “Connection is why we’re here,” she said. “It’s what gives purpose and meaning to our lives.”

She interviewed two different groups of people: those who had a strong sense of love and belonging, and those who really struggled with that mindset. What were the distinguishing factors between these two groups? The people who internalized a sense of love and belonging believed they were worthy of love and belonging. Worthiness was the key. Now, what do the individuals in that group have in common? This is where it got interesting.

The people who felt worthy of love and belonging all demonstrated courage, compassion and connection. “They had a connection as a result of authenticity,” Brown said. “They were willing to let go of who they thought they should be, in order to be who they were.”

Vulnerability was another common denominator in the group. They fully embraced the notion that what made them vulnerable also made them beautiful. “They talked about it being necessary; they talked about the willingness to say ‘I love you’ first; they talked about the willingness to do something where there are no guarantees.”

Brown proceeded through the discussion candidly, talking about her internal struggle with her newly-researched discovery. (She actually had to see a therapist of her own to work through it.) She used to lament how vulnerability was always the birthplace of shame and fear, but she now realizes that it also fuels joy, creativity, belonging and love.

A recent post on Tinybuddha.com offered a similar theme. Contributor Sahil Dhingra underwent a heavy period of isolation and despair when he was diagnosed with a brain tumor in 2011.

“I felt scared to let people in,” he said. “The few relatives who knew what I was going through told me to think positive, that everything would be okay, and not to worry or be afraid. They told me to take my mind away from it, cheer up, and to stay busy.”

While he appreciated their suggestions, he realized that by setting his true feelings aside, he wasn’t allowing himself to just be. Once he decided to contact the people he cared about, he felt overwhelmed by all the love he received in return. “The people in my life during this challenging time were invaluable; by reaching out and feeling vulnerable, and letting others in, I felt more connected and confident that I would get through this.”

In May 2012, Sahil’s neurologist gave him the incredible news that the mass in his brain hadn’t continued to grow — in other words, it no longer qualified as cancer.

“Today I still have an olive-sized mass in the right side of my brain,” he stated. “But it is no longer my foe. Rather, it has become the greatest blessing I could have asked for. Sometimes, all it takes to connect with someone else is sharing our vulnerable story, lending an ear or a shoulder, and just being present for them.”

We often tend to dismiss the admirable components of vulnerability (where it can manifest in love and happiness), but in reality, being vulnerable is necessary in order to establish relationships with others. When going through something stifling, sharing your experience can also spawn connection as well.

Susan J. Elliot, author, relationship coach, counselor and speaker/ presenter, wrote an article on the subject that was featured last year on the Huffington Post. Elliot stresses that even after an amicable breakup, it’s extremely difficult to be friends, at least initially. The bond of the couple needs to break and sifting through the emotional aftermath takes time in order to efficiently heal.

“Each needs to deal with the breakup in their own way, apart from the scrutiny of the person they just broke up with,” she said.

“Most people cannot remain friends after a breakup, but if it will ever be, it will be later — much later. The atmosphere immediately following a breakup is too emotionally charged for it to happen right away, if at all.”

Elliot references a couple who had dinner together every now and then after they ended their relationship; two months into this new “friendship” routine, one of their meals turned into a heated fight. Both were moving on, which brought certain feelings to the surface.

If you’re the one pushing to be friends, Elliot suggests examining your motives. Perhaps you’re trying to avoid your grief or you want the benefits without the responsibility. If you’re on the receiving end of a “let’s be friends” agenda, she says to just be honest; there’s no long-winded explanations needed if you don’t want to venture into that realm.

“I think that maintaining a friendship with an ex or someone you previously dated is dependent on a few things,” Ashley Knox, who has her masters in social work, said.

“One, how the relationship ended, two, whether both parties have been able to move on successfully enough so that they can begin purely a friendship and three, whether any new boyfriends or girlfriends in the picture are accepting of you maintaining contact with your ex.”

Alex Karpovsky plays Ray, a witty, cynical 20-something on the award-winning HBO series, “Girls” (a show that’s entwined with relationship dilemmas). Karpovsky fielded questions on Rookie, a Web site for teenage girls. The second question that was asked in this quirky video-chat inquired about staying friends with an ex.

“I’m personally of the opinion that it’s hard,” he said. Karpovsky mused that the only way it’s likely is when you’re both completely over each other and have moved on.

Yet if someone still harbors a glimmer of hope, being platonic friends may prove to be difficult.

“Being friends with your ex can be a minefield,” Elliot noted. “Don’t try to cross it in the early stages of a breakup. The early stage is about taking care of you.”

Okay, micro-vacation over. Back to reality, where people blame and criticize all the time — and that’s on their good days! On their bad days, they throw in insults, curses, ridicule and humiliation.

When you’re on the receiving end of such put-downs, how should you respond?

Most people are familiar with only three strategies:

1. Explain or justify why you did what you did
2. Respond offensively by attacking the attacker.
3. Say nothing and silently stew.

Such responses frequently result in attacks and counterattacks or passive-aggressive behavior laced with blame and shame. Thus, it’s a good idea to expand your repertoire of responses. Here are seven ideas for you to try on:

1. Agree with what’s been said. Disagree with the negative value judgment.

   “Yes, I agree. My room is a mess. No need to call me names, though. I’ll clean it up this evening. Promise.”

2. Respond to what’s happening (the process), not to what was said(the content).

   “I can see you’re upset with me. Can you calmly explain what I did that’s bothering you?”

3. Agree that you did something wrong and apologize.

   “Yes, I should have called earlier to cancel. I apologize. I’d like to set another date now if that’s OK with you.”

4. Disagree but try to understand the other person’s viewpoint.

   “I didn’t think I did anything wrong but I see you’re upset. Tell me more about what’s upsetting to you so I can understand.”

5. Enlighten the person about your sensitivities.

   “I feel demeaned when you use that tone of voice with me. You may think there’s nothing wrong with it, but it feels patronizing to me.”

6. Offer the person another way to phrase what he said.

   “I don’t mind if you call me ‘sensitive’ but it feels like a putdown when you say I’m ‘overly sensitive.’

7. Be succinct.

   Often, the less you say, the more powerful your message. “The name you just called me is totally unacceptable. I don’t deserve to be treated that way.”

If you believe that you’ve been unfairly put down, your goal should be to respond with valuable, constructive information in a confident, strong tone of voice.

Most of us know someone who has mental illness. For some of us, it is a loved one or a family member. For others, it may be a friend, classmate or co-worker. People who suffer everything from depression and bipolar disorder, to severe anxiety and even schizophrenia.

Some of us live closely with such folks, responsible for their care and their very lives.

Sadly, there just aren’t a lot of resources or support for such caregivers. What information and support that is out there is often lacking. I hope this blog by Tamara Hill, MS can change things.

This blog is primarily about the challenges facing family, friends, and caregivers who have a family member with an untreated or severe mental illness.

Here’s an example Tamara will talk more about:

In the state of PA (where I am), it is VERY difficult to get an individual with a severe, untreated mental illness involuntarily committed if that individual has not threatened harm to him/herself or another person. In the case of John Shick at Western Psychiatric Institute and Clinic (the man who opened fire on staff in 2012), he was turned away from the hospital a day prior because there weren’t enough beds. Assisted Outpatient Treatment (AOT) laws may have prevented the incident.

Tamara’s new blog is intended to help offer social service resources and inform family, caregivers, and friends about challenges and holes in the system. Tamara says, “I will use a lot of videos, news reports, and questions to stimulate discussion.”

“I’m of the firm belief that knowledge is empowering and many families lack knowledge, which leads to a lack of empowerment,” notes Tamara.

I couldn’t agree more. Please give Tamara a warm Psych Central welcome over on her blog today, Caregivers, Family & Friends.

I’m not a huge fan of the holiday season. When I was 19, I worked in a grocery store. I’m pretty sure my relative disdain for the season started while working a cash register between aisles of Santa-shaped chocolates and overpriced eggnog. I tolerated the crowds of people who purchased produce and cookies and I smiled, my irritation level peaking each time I was asked if the store sold organic carrots.

The customer, after all, is always right.

But the dreadful repetition of Christmas music drove me to surrender my apron midway through December.

My experience aside, many people look forward to the holiday season. We relish cherished time with family and with friends, fantastic food, time off from work and the giving and receiving of gifts. It’s a time when children smile and shake the gifts under the tree. Pretty great, right?

I hate be somber, but these things often lead to a holiday hangover. Unfortunately, twelve glasses of water, an aspirin and time in bed won’t cut it.

So here are some tips — sarcasm included! — to get back on track:

• Ban Christmas music. Hide Christmas CDs in a drawer and listen to something else. Frank Sinatra or Miles Davis, Metallica or Eminem, CNN or Howard Stern. Anything else.
• Do not look at your credit card bills for one week, or as long as possible. Buying gifts for those we care for is always fun (well, usually) but sometimes we get carried away. I’m not sure my mother needed two pairs of pajamas, matching slippers, a bathrobe and three types of exfoliating body wash.
• Take a couple of days to unwind. My family always has half the neighborhood over Christmas Eve. People play guitar, my lovely mother sings Neil Young and halfway through the night I hide in the spare room. Time with family and friends is great, it’s healthy, but once the holidays are over we need some time to unwind. Read a book while wearing your pajamas, drinking tea and finishing off the chocolate and turkey.
• Leave the Christmas tree up. That’s right, leave it up, at least until the New Year. Often, amid the chaos of Christmas, we don’t really get a chance to enjoy it. You can skip this step if you own pets that have holiday fun eating the tree and everything on it. My cat has a penchant for candy canes and my dog enjoys eating the artificial branches, lights and all.
• Pick a day to do some holiday cleaning. This is similar to spring cleaning but involves shiny paper, bits and pieces of tinsel, leftover food and sometimes relatives who are staying a bit longer than planned.
• Gear up to get back to work. Whether you are going back to work before the New Year or after, it’s important to get back into the swing of things. Holidays are a disruption to our schedule: our sleep pattern changes, as does our level of socialization and our eating habits. Ease yourself back into life.
• Exercise. Exercise not with the goal of losing the weight gained from boxes of chocolate and gravy (save that for New Year’s if you must) but because we often exercise less during the holiday season. Exercise helps to regulate our lives and schedule.
• Secretly organize and consider ‘re-gifting.’ This is optional (and perhaps in bad taste?). Gather the gifts that you may already own or just don’t like. Mentally thank the person — this eradicates possible guilt — that presented them to you. Place them in your closet and next year give them to someone else.
• After New Year’s take some time to reflect on your life. New Year’s Eve is sort of like the icing on an overly-decorated cake. Right when we start to get back into the swing of things, New Year’s kicks our lives back into high gear. Whether you celebrated it quietly, or celebrated it in large company, spend the time following reflecting on the year and the year ahead.

When all is said and done, the New Year having passed and the tree having been packed away, it’s time to get back to life. Like any bad hangover, give it some time: life moves on. Enjoy it. Relish in the ‘normal’ parts of life — before Halloween reminds you that the holiday season is right around the corner.

Sarcasm aside, try a few of these out and if all else fails, well, try a long nap and aspirin.

Our postings in the ether expose our true feelings to an extent far beyond what we might normally reveal. Facebook (and other social media) leads us to disclose things that we might not otherwise share freely. It creates a paradoxical sense of privacy that dissipates as soon as we click “post.”

Although postings enable us to connect with others we might not otherwise, highly charged public events incite us to share sentiments that are intensely emotional and potentially very divisive.

I was a latecomer to the Facebook game, only signing up a few years ago because my brother had refused to email anyone the pictures of his kids, saying it was too labor intensive. Instead, he uploaded them once, making them available for loved ones as well as for the e-masses.

Originally, I had no intention of posting anything at all, particularly since my profession has advocated a “tabula rasa” (blank slate, in English) stance since it began over 100 years ago. I am private by nature, and at the time could not conceive of posting my more uncensored, and sometimes provocative thoughts on politics, societal trends, and electrically charged current events — particularly to a large group of “friends,” many of whom I only knew in a pleasantly superficial way.

Initially, I friended few. And each invitation I accepted increased my anxiety about the whole thing, prompting me to consider editing my photo albums (though tame, by any standard). Over time, however, I relaxed my guard, and the “community” felt more like an actual rather than a virtual one.

I became genuinely curious about how some “friends” were doing, what they thought about current events, and the like. I got to “e-know” cousins I had met only a handful of times and in rare cases, I would now have a difficult time identifying on the street, so infrequent were our interactions. My great-uncle friended me, and I was unusually touched by this. Colleagues, former professors, spouses of friends, and people I hadn’t seen since the late ‘80s were now part of my network.

In an effort to maintain some semblance of healthy boundaries, I adjusted my privacy settings to make me difficult (although not impossible, I soon discovered) to find. I blocked others in an effort to maintain what I considered healthy boundaries. Initially, I rarely posted, and what I said was generally nice and not particularly personal.

With the Blackberry, and later, the iPhone, came the Facebook app, however, and I soon slipped into a false sense of “okayness” with regard to my posts, which became both more frequent and more frank. I could now rant about such inane but exasperating things as the Jerseylicious woman who cut the morning bus line and the maniac who refused to obey the “yield to pedestrians” sign near my apartment. With each, I felt a little release, a guilty pleasure.

As I became more relaxed, I reflexively “liked” posts that were congruent with my political and social views, initially not realizing these were more than just affirmations of my particular points of view. Nor did I realize that some of my “friends” would vehemently disagree with the positions I naively assumed to be beyond questioning. And I grew to know the political and other leanings of (real) friends, relatives, and colleagues, often to my significant discomfort. I would never again be able to see someone at a family gathering or dinner party without their “status” superimposed on them. Red state-er or blue? Pro guns or pro choice? Happy Holidays or Merry Christmas?

Facebook forced me, with mounting discomfort, to have to integrate new ideas and feelings with my existing ones about people with whom I am close, as well as those I would not ordinarily think much about at all. And it forced me to take a closer look at myself. Who was I willing to piss off with my honesty, my indignation, my zeal for what I considered “justice?”

I have never actually unfriended anyone, but on rare occasions, I have blocked others’ posts from my feed in an effort to self-regulate. I have fantasized about who was probably now blocking mine, in this Facebook nation of Us vs. Them. Would I continue to patronize a store if the owner’s posts were unduly polemical? Were family and friends “tsk-tsk-ing” and head-shaking as I revealed myself to be more than the bland but polite niece/cousin/colleague?

An in-person friend recently revealed to me that in an effort to reduce her growing antipathy toward an in-law, she had blocked her completely after the in-law posted one too many pictures of her pristine McMansion and her morning mimosas in the immediate wake of Hurricane Sandy. Both the friend and I live in areas that were hard hit by Sandy, and I found the relative’s oblivion insensitive to the point of enraging. I commiserated with my friend, as I too had contemplated a mass purging shortly prior to the election. I attempted, sometime unsuccessfully, to guard against the tendency to diagnose people based on “crazy,” polarizing, and perseverative rants.

Today, just a week or so after the shooting in Connecticut that claimed the lives of 27 people, most of whom were children, I looked on my phone app to find e-pleading for stricter gun laws, and greater awareness of mental health issues. There were also impassioned challenges resembling Charlton Heston-esque threats against anyone “trying to take my guns!” My response this time, save for a few “likes” of posts that encourage sane dialogue has been to indulge in a Facebook semi-fast.

Forgiving by nature, I am aware that my feelings about this person or that one may shift with the next major issue or catastrophe, and some I have mentally pigeonholed may in fact surprise and enlighten me. At present, however, I remain curious and uncertain about who has passively or privately moved me from the “friend” into the “foe” category.

Or not.

The holidays are stressful. There are the challenges of too much family, not enough family, not enough money, continual exposure to food and alcohol, and perhaps worst of all, the gap between our actual life and our fantasy life. As if gazing into the perfect happy scene within a snowglobe, we might fall into a trance of how our life should be.

We might feel torn apart by nostalgia and grief over the good times and good people of the past, and wracked with guilt and inadequacy for failing to create a more wonderful life for ourselves. We might feel scared about our dissatisfaction and hypnotized by the promise of fulfillment just beyond the hard glass.

Addictive and codependent behaviors thrive during this season of fantasy.

We use our drugs and habits to escape the pain, while imagining how we will miraculously make changes, always tomorrow, or next week, or next year. We frantically try to keep our idea of the all-good holiday alive through our codependent behaviors, imagining that we have the power to make sure that everyone else is happy and no one gets upset, while suppressing our own feelings of anger and disappointment.

So what should we do about our addictive or codependent behaviors during the holidays? Should we just give up and wait until January 1? Or is there hope for progress now?

One option involves using the holiday season to take an honest and compassionate look at our current behaviors. Instead of using up all of our mental energy imagining how our life used to be better, or how our life should be different, or how we need to change, we can turn our minds and eyes toward simply observing present reality.

We can watch our relationships with alcohol, marijuana, cigarettes, chewing tobacco, prescription and non-prescription drugs, gambling, pornography, video games, television or Internet videos, social media, food, exercise, work, and shopping. We can ask ourselves: How much are we using? How much of our time does it consume? How much money are we spending on our habits? How long have we been using? Is it increasing, decreasing, or remaining constant?

We can watch our relationships with our loved ones. We can ask ourselves: How much of our energy is being devoted to worrying about or trying to control other people’s addictive behaviors? How much are we being controlled by fear of others’ reactions to our boundaries or limits?

Then we can ask ourselves: why are we doing this? What purpose does it serve? What immediate rewards do we attain? In what ways are our behaviors fulfilling our needs? Are there feelings of shame, anger, sadness, loneliness, anxiety, or depression tangled up in our habits? How do these feelings lead to our behaviors? How do these feelings result from our behaviors?

How are our habits affecting our physical health? How are our behaviors affecting our relationships with others? How are our drugs, habits, or relationship patterns affecting our work life? What are the short- and long-term benefits and costs?

As we watch and explore our behaviors in an open and neutral manner, we set the stage for our growth toward increased health. We emerge into the New Year with information about ourselves that we need in order to develop a plan of action, if we so choose, toward change. And by being more honest with ourselves and more present in the life we currently are living, we have broken the paralyzing spell of fantasy: We have begun moving toward a better life.

Still, many of us get sucked into the holiday spending spree.

“When we are pressured to match a transaction of cash and heart-felt emotion, it feels like we can never spend enough,” said Mara Glatzel, MSW, a coach who helps women cultivate the lives they deserve.

Gift-giving is a loaded topic with many layers. For instance, it sparks comparison-making and fears about not being good enough, according to Ashley Eder, LPC, a psychotherapist in Boulder, Colo. “It’s natural that some people turn to high-value items to soothe their fears about gift exchange,” she said.

People also think that pricey presents will perk up a relationship or solve specific problems. “People turn to interesting gifts to distract from other painful things about the holidays, hoping that giving someone a nice gift will make up for gaps in the relationship,” Eder said.

Consider the reasons you’d like to give your loved one a costly gift. “Look honestly at your triggers around self-esteem and worthiness in a relationship,” she said.

Holiday Gift Ideas

“Great gifts that don’t cost any money are experiential, such as things that you can do together, experience together, or something that you can do for someone else,” Glatzel said. Here are a few ideas.

1. Set a date. If it’s someone you don’t get to see often, set a time to get together. Eder suggested everything from taking your dogs on a hike to catching up over coffee. And if a face-to-face isn’t possible, schedule a “holiday phone call, where you both make sure you have uninterrupted time and adequate phone batteries.”

Whatever you do, just be sure to follow through or remind your loved one to take you up on your gift, Glatzel said. “The real value is in the follow-through of holiday promises,” she said.

2. Be charitable. “Do some community service or volunteer work in that person’s name,” Eder said. Or plan to spend the day volunteering together. Pick your favorite charity, or donate your time to a different organization each year.

3. Get creative. Create a poem, painting or an original song for your loved one, said Julie Hanks, LCSW, a therapist and blogger at Psych Central. You can ignite your inspiration by checking out Bentlily.com, where Samantha Reynolds pens a poem a day. She even has a tool that instantly creates a poem for you after you answer a few questions.

Digital gifts are another option, such as creating photo collages for each person in your family. Every year one of Hanks’s sisters creates a personalized photo set on Flickr as her holiday gift.

4. Write a letter. “Handwritten letters are becoming rare,” Hanks said. But they’re a beautiful way to express your feelings for a loved one. She suggested writing down your favorite memories or expressing gratitude for your relationship.

5. Agree not to exchange gifts. Many of your friends and family will probably be relieved to hear you’d rather skip gift-giving this year. But you can still give them a sweet handwritten note, Eder said. (Or get creative with any of the above ideas.)

6. Do a holiday swap. If you’d still like to exchange gifts, Glatzel suggested setting a price point and tossing names in a hat for each person to pick out. “This can be such a fun way to enjoy a holiday all together without enormous stress to buy everyone at the shindig an expensive gift,” she said.

Gifts for Kids

“Kids are great at asking for more than is feasible or reasonable to spend,” Eder said. But that just opens the door to an important discussion, she said. Be compassionate, and avoid getting defensive, she said.

Acknowledge their disappointment and talk about what it’s like not to have what their classmates have, she said. “See this as a chance to relate to your child about feeling left out or uncool, not about your salary or generosity.”

Model moderation and budgeting, she said. “You might come up with a plan together for your child to save for the things you won’t be buying this time.”

So when you’re shopping this year, consider why you’re reaching for gifts that bust your budget. Pricey gifts don’t improve relationships – at least not for long. And, as Eder said, “If you feel like you have to get someone a gift you cannot afford in order to maintain the relationship, it might not be a relationship you want to keep.”

Sharing experiences, giving to charity and crafting handmade gifts are often the sweetest – and most rewarding — gestures, anyway.

What are your favorite gifts to make? What are your favorite experiences to have?

Volunteering photo available from Shutterstock

As a result of all the strain, many resent what should be “the most wonderful time of year.”

In her article, How to Enjoy the Holiday Season Again, author Debbie Mandel discusses how the holidays may ignite stress, sadness and loneliness. Missing a loved one, for instance, only intensifies those feelings.

“You don’t have to accomplish the impossible, which is to forget your loss and your grief in order to be happy. Turn the loss into a triumph by strengthening your spirit and making yourself kinder and more compassionate,” Mandel says.

Mandel also argues that the holiday season is the perfect opportunity to be a “romantic and a healthy narcissist.” You can take the time to enjoy the simple gratifications, whether it may be gazing at beautiful window displays, creating spontaneous celebrations, singing carols, or admiring all the pretty lights, tinsel and mistletoe.

While it’s assumed this festive season perpetuates family conflict, the author notes that research from the University of Pennsylvania illustrates how increased community support and family gatherings during the holidays actually uplift the spirit.

April Durret’s article, Enjoying the Holiday Season, relays well-pointed advice from Larry Cammarata, PhD, a clinical and consulting psychologist and a mind-body wellness expert. He advocates that family connections are key for savoring this time of year — and isn’t that what this season is all about anyway?

“Spend time with the most important people in your life, especially those who offer you emotional support, caring and a good sense of humor,” he notes.

Finally, developing your own inner joy is another component of truly celebrating the holiday season. In “Enjoying the Holiday Season,” Mary E. Miriani, a personal trainer from Illinois, claims that one definitive way to decrease stress and make the most out of the holidays is to hone in on pure joy.

“As long as I smile at people and offer help when I can, I am giving joy,” she says. “Joy is always returned in the gratitude people feel. The power to enjoy the holidays resides in me and not in decorations, gifts or holiday meals. It is always with me whenever I choose to bring it up into my consciousness.”

Every year around Christmastime, I search for my Nsync holiday album (that ’90s boy band will always and forever have a special place in my heart) and head over to my aunt’s, where there is a cozy fireplace, a beautiful tree, and glasses of egg nog, cinnamon sticks and all. Every year, I also sit around a large table, filled with rich conversation, in celebration of Hanukkah, enjoying crispy potato latkes and other (really yummy) traditional dishes.

How do you plan to wholeheartedly enjoy the holidays this year?

For More Information…

Debbie Mandel is author of Changing Habits: The Caregivers’ Total Workout and Turn on Your Inner Light: Fitness for Body, Mind and Soul. April Durrett, an IDEA contributing editor, is an award-winning health, fitness and lifestyle writer and editor.

One day life is going on as it always has. The next day life deals you such a blow that nothing will ever be the same.

“It’s not supposed to be this way,” you wail. “How could this have happened? Someone, someone, please someone wake me from this horrific nightmare and tell me it’s all a dream.”

But no one does.

As the days pass, you realize that nothing, absolutely nothing, halts the ache in your heart. Nothing soothes the fear in your soul. Nothing drives your sadness away. So much has been lost. Not only material possessions but also irreplaceable memorabilia. Not only stuff but a sense of safety. And for some, the ultimate price, the loss of life.

Shock, bewilderment and confusion take up residence in your brain. You never anticipated anything like this. How can you possibly cope with the loss? All you want to do is crawl into bed and forget about it. But you have no bed. You have no home. You have no place to retreat to.

It’s impossible to imagine that just a short time ago, everything was just fine. But that was before. This is after.

There’s so much to deal with. You are overwhelmed. You are exhausted. You are depressed. No, depression is for people who have a gray cloud over their head. This is beyond depression; this is despair.

Each day is different. One day, emptiness and loneliness reign. Another day, anger and resentment erupt. Then, the following day, a melancholy crushes whatever get-up-and-go-spirit you had. You realize you have no idea how to go on.

Yet, you do go on. Though a part of you wants to give up, a bigger part of you wants to overcome. You may want to connect with compassionate friends or you may want to be alone. You may want to sleep your days away or you may want to keep busy. You may hunger for painkillers to numb you or you may want to suffer the pain. There is no right course; there is no proper path.

You have the right, even the obligation, to feel whatever you are feeling; to think whatever you are thinking; to do whatever you are doing. Though, right now, hope may seem to reside in another galaxy, next week hope will once again be part of your life, teaching you ways to survive this catastrophe.

Many people’s hearts and prayers are with you. Many individuals and organizations are ready to assist you. Let them assist you in whatever ways they can. Let their caring and support be a source of comfort. And give yourself time to heal.