Redundancy — losing your job in a layoff — is difficult for most people. I’ve worked with many people who have been made redundant and struggled with the aftermath. On the whole, these individuals have been hard workers, intelligent, and loyal to their companies; when the hammer finally fell, they often went into an emotional tailspin.

After the initial shock, and even though many had been compensated well for losing their job, it’s interesting to note money became the least important factor.

What really mattered was suddenly losing direction and meaning in their lives. Without work, they became unsure and lost.

One executive I worked with received a very healthy financial package when he’d been made redundant. With money and time on his side, he could have used this opportunity to take his family away for a long-needed vacation, something he hadn’t done in many years. But instead, all he started to focus on was, “I should have done better at my job. I’ve failed.” This became his daily mantra and within a week he started to become very depressed.

His sense of self had been totally shattered by this turn of events. He’d worked with the same company for twenty years, he was the VP of a large multinational company, and his identity was wrapped up with what that meant: the power, the prestige, and the financial trappings that came with the title. In his eyes, he’d absolutely failed, therefore he was a total failure. Period.

There was no rational thinking going on here — he wasn’t able to step back and rationally examine the work situation, and what might have lead to him being let go. He couldn’t see that after his company had been taken over, the new management structure meant there were two people in his position. Too many chiefs and his position was superfluous. Nothing personal.

To add to his depressive emotional state and irrational thinking about being a failure, he began to create anxiety by asking his wife over and over, “I will be all right, I will get another job won’t I?” At the beginning she would reassure him, but as is the way with anxious thinking, his incessant need for reassurance meant she lost patience with him, causing a rift in their relationship, which he then used to reinforce his belief that he was a ‘failure.’ Down, down, down he went.

Long story short, he tried to hang himself — and fortunately failed. This is when I met him and started to help him on a long road back to being a confident, capable man.

Redundancy can be a shock to the system, and that’s completely natural. It threatens our sense of safety. But when our sense of safety is threatened, our emotions can take over. It’s important to keep calm because anxiety and depression are not good bedfellows. The last thing you need to do is have your cognitive abilities impaired because you’re thinking irrationally about yourself and the situation you’re in.

Don’t let your thoughts overwhelm you. If you catch yourself constantly thinking things like, “I can’t stand this, I must get another job” or “I’m going to lose everything, I’m such a failure,” then there’s a good chance you’re going to become anxious and depressed – and that’s not going to help.

If you are in this situation, I always think it’s a good idea to talk to somebody else, quickly. Often people feel shame for being made redundant and will hide away, but don’t ruminate on your plight, talk. Friends and family are helpful, but they may not be objective enough. Also, family members tend to have their own anxieties about you not working and this might influence your thinking and mood. One of the best early options is to talk to a coach or therapist. This can be an efficient way to help you organize your thoughts, while setting realistic goals and addressing how you’re going to achieve them.

Some people worry about the cost of this help, but it’s quicker and cheaper to spend a few hours with a coach forging a sense of direction than it is to ruminate on your plight and become depressed. If depression takes hold, you probably won’t be in a good place to think rationally, or function well enough to look for work, let alone be able to work. In the face of redundancy, it helps to be calm, be smart, and get support.

This is all to communicate this message: marriages in which one person suffers from depression or bipolar disorder can be extremely fragile.

I know, because I’m in one.

Here are six tips that have helped us and other couples I know defy the statistics.

1. Cut Through the Crap

If you are married to someone who is in denial, you have quite a job ahead of you. “I’m not crazy.” “There is nothing wrong with me.” “I am not taking meds.” These statements do little to move your marriage into the happy zone. In her book, “When Someone You Love Is Bipolar,” psychologist Cynthia Last, Ph.D. dedicates a chapter to the subject of denial and what you can do. She suggests giving your partner a book that he can relate to and providing literature on the topic.

You could also try a scientific approach and provide some evidence in the form of feedback from his friends and family, a list of compelling symptoms (embarrassing photos are great), or a rundown of the disorder in his family. He could balk at that, and tell you that you dress like his mother for even implying such things; however, you’ve done your job to try to educate, and that’s really all you can do.

2. Find the Right Doctor

I consider shopping for the right doctor much like buying your first house. Many components need to go into the decision — it’s not enough to like the bathroom tiles and the bedroom closet — and some bickering is to be expected. If you rush the decision, you might wind up living in a house that you hate for a long time except for the great bathroom tiles. Good doctors save marriages. Bad doctors destroy them. Good doctors help you get better. Bad doctors worsen your condition.

If your partner is bipolar, this is especially important because the average patient with bipolar disorder takes approximately 10 years to get a proper diagnosis. About 56 percent are first diagnosed with unipolar depression. I know this topic well. I went through seven doctors and a ton of diagnoses before I found the right fit. She saved my life and my marriage.

3. Enter into a Triangle Relationship

In any other situation, I hate threesomes. Someone always gets left out and people play dirty — at least they do at my daughter’s play dates. But for marriages that involve illnesses such as depression or bipolar, a triangle relationship with a doctor or mental health professional is essential. It keeps your partner honest, or at least required to unfudge the truth. He reports:“ Feeling perfect. Meds really kicking in. All is going better than it ever has.” Then wifey comes in and spills the beans. “He has been curled up on the couch in tears for the last two weeks, not taking calls from any friends and skipping important meetings at work.”

The triangle relationship also allows you some education about his condition. For example, you might not be aware of what a hypomanic episode looks like until you hear the doctor describe it. In some cases a mutual understanding of symptoms is enough for a couple to avert a full-blown manic or depressive episode because together you can take steps to change the course.

4. Abide by Some Rules

My husband and I have several rules: I call the doctor after three days of incessant crying or no sleep. I tell him when I’m suicidal. He stays with me when I’m a danger to myself. However, the most important rule is this: I have promised him that I will take my meds. It’s like how Jack Nicholson told Helen Hunt in the movie “As Good As It Gets” that she makes him want to take his meds, she “makes him want to be a better man.” The truth is that many marriages get stuck on this one.

Without a doubt, the biggest challenge we face in treating bipolar disorder is medical adherence, according to psychologist Kay Redfield Jamison. “I’d like to make the obvious point that I don’t think is made enough, which is that it doesn’t do any good to have effective medications for an illness if people don’t take them,” she said at the Johns Hopkins 21st Annual Mood Disorders Symposium. Approximately 40 – 45 percent of bipolar patients do not take their medications as prescribed. Come up with some rules, and be sure to include in there “medication adherence.”

5. Learn the Language of the Illness

Sometimes I forget how hurtful my words can be when I’m expressing how anxious or depressed I feel. “I just want to be dead.” “I don’t care about anything.” “If only I was diagnosed with cancer and could make a graceful exodus out of this world …” Oh, no offense. Thankfully my husband knows that it’s my depression speaking, not me. He has been able to separate his wife from the illness. That is the result of lots of research on his part and a few conversations with my psychiatrist.

6. Keep Yourself Sane

Spouses of persons with depression and bipolar unwittingly become caretakers for major chunks of time. And caretakers are at high risk for depression and anxiety. Researchers at Yale University School of Medicine have found that nearly one-third of caregivers who are nursing terminally ill loved ones at home suffer from depression. A study in Great Britain found that one in four family caregivers meets the clinical criteria for anxiety.

Pay attention to these symptoms: feeling tired and burned out much of the time; physical signs of stress such as headaches and nausea; irritability; feeling down, deflated, reduced; changes in sleep or appetite; resentment toward your spouse; decreased intimacy in your relationship. Remember that if you don’t secure your oxygen mask first, no one gets air. If my husband didn’t take time to run and play golf he would be hospitalized alongside me.

By diverting your attention away from your thoughts and focusing your visual attention on the world outside, you will be able to overcome your negative thoughts and emotions. The idea is cutting-edge and still in its initial stages; it’s best not to take it as qualified medical advice.

However, the technique is simple enough for anyone to try out and does not have any potential for obvious adverse effects.

Based on the large amount of anecdotal evidence that I gathered, I theorized in the Elsevier journal Medical Hypotheses that psychiatric illnesses could be alleviated by counteracting inward attention with externally directed visual attention.¹

Much research over the last two decades has found that an excessive tendency toward inward attention correlates with a wide range of psychiatric disorders. R.E. Ingram, widely considered to be one of most experienced researchers on the subject, noted that “it is difficult to find a psychological disorder that is not characterized by a heightened degree of self-focused attention.”² Not surprisingly, these days, cognitive models of several disorders incorporate “inward attention” in their theoretical framework.

“Inward attention” describes where one’s attention is on one’s thoughts and feelings rather than the outside world. Hence, the term “inward attention” includes reflecting on your thinking, being self-absorbed in your thoughts or any other activity that involves being engrossed in your thoughts to the exclusion of the world around you. People often engage in a state of excessive inward attention during times of fear, anxiety and negative mood.

Research indicates that an excessive tendency for engaging in one’s thought process occurs in psychiatric illnesses ranging from obsessive-compulsive disorder to schizophrenia. For example, in the case of a person with OCD, the occurrences of obsessive impulse often are accompanied by intense thinking about the rationality of the impulses. In the case of a socially anxious person who is about to give a public speech, he is more likely to be attending to his fears and thoughts than the audience outside. For a person with schizophrenia, his mind is so overwhelmed by his thoughts that he loses his ability to differentiate reality from his own thoughts.

The underlying neurobiological causes of these illnesses are indeed different. Hence, some people may be predisposed to OCD, some to schizophrenia, some to depression and so on. However, not everybody who may have an inherent predisposition actually goes on to develop an illness. It is accepted by several researchers that an excessive and prolonged tendency toward inward attention could be an important factor in the exacerbation of psychiatric illnesses.

Two reasons make inward attention so potent in exacerbating psychological problems.

First, when a person is engrossed in himself, he is more attentive to his thoughts and moods to the exclusion of the outside world. Being self-absorbed or engrossed in oneself amplifies the experience of negative thoughts and emotions.

Second, since inward attention amplifies a person’s engagement in his thoughts and emotions, the corresponding neural pathways are reinforced in the brain. Hence, these negative thoughts and emotions become more likely to recur in the future, leading to the exacerbation of psychiatric symptoms in a vicious cycle.

The best way to stop this vicious cycle is to constantly divert your attention to your surroundings so that you become less attentive to your inner thoughts and worries.

1. Sebastian R. A novel technique of using externally directed visual attention to treat psychological illnesses. Med Hypotheses. 2013 Mar 11. pii: S0306-9877(13)00091-1. doi: 10.1016/j.mehy.2013.02.019.
2. Ingram RE. Self focused attention in clinical disorders: review and a conceptual model. Psychol Bull 1990;2:156–76.

For many, the security of having a job is essential for their well-being. If you know anything about Maslow’s hierarchy of needs, safety and employment are in the second level, just above breathing — so it’s pretty important.

If you are facing the threat of redundancy then I imagine you’re going through many different emotions right now, but there are some things you can do to help you deal with these rumors more easily.

Take my friends, for instance. A few welcome the idea of redundancy and are actively seeking to be made redundant. Others are struggling with the idea, mainly because of their unhealthy thinking about redundancy and how it will ultimately affect them.

It’s important to learn to deal with unknown threats well, otherwise anxiety can become overwhelming. Once that happens, it’s very easy to cause ourselves even more emotional, cognitive, and behavioral problems.

So what can those facing redundancy do?

First, understand that this is a rumor and may not be true. Worrying about something that doesn’t exist or over which you have no control is a waste of time and effort.

Second, check that you are not causing yourself anxiety by creating unhealthy thoughts and putting yourself in a “loss-condition.” That’s when you focus so much on the potential loss that you magnify it and take it to a catastrophic conclusion. For example, a person in a loss-condition might start thinking, “What if I lose my job? I can’t lose my job, that would be awful. What if I don’t find another one and can’t afford to pay my rent? My children won’t be able to go to school and my wife will leave me. I’ll then be alone and homeless on the streets. Oh God, I can’t stand it. This must not happen!”

The problem with creating this loss scenario is that once you think it, your mind will create a visual story of that thought and react accordingly. Your brain will begin to believe that thought is true. The more you think that irrational belief, the quicker your brain will recall that devastating visual and it’ll react to the threat by creating even more anxiety symptoms. Before you know it, you won’t be able to think clearly and cope with the threat or the reality of redundancy.

Essentially, you’ve created a fictitious scenario that your brain believes to be true. You’ll be convinced that this will be your ultimate outcome. This thinking is very dangerous to your health.

Third, while you are focusing on the loss scenario, you are not focused on what you might be able to do to help yourself if the redundancy does become real and does affects you. While you’re becoming more anxious and spending more time thinking about how awful life will be, you could have gotten your resume updated, gotten an idea about the state of your finances, checked out insurance policies to see if you have unemployment payment protection, and so on. (There are many good sites that offer practical advice.)

It’s perfectly healthy to have concerns over being made redundant, because it’s not a small thing. It’s also healthy to be cautious and prepared for the possibility that you may be made redundant. But it’s too easy to let our healthy concerns turn into unhealthy anxiety.

With just a small change in thinking, while rationally assessing the situation, you will be putting yourself in a healthier position to react, and manage any potential loss situation in healthier, more productive ways.

“A young girl’s traumatic event may have triggered her inherited undiagnosed mental illness. The Turned Leaf follows one woman’s struggle with a mental illness, the effect it has on her and her loved ones. This drama is infused with modern dance , video elements, modern song and digs deep into the heart of the illness. ”

Below is a brief synopsis of how she came to write the play and what she hopes to accomplish with it.

Walking on eggshells is not just a phrase to me. It is a living, breathing entity where one false step can have catastrophic repercussions. I grew up with a mother who could literally turn on a dime and what set her off is, to this day, a mystery. I have spent my life trying to reconcile the fact that it is the illness which I hate and the mother’s heart which I love.

Those lines recently blurred when her blind rage attack sent my father to move in with me and my husband. This is what prompted me to write The Turned Leaf.

Growing up I never knew what was the truth or a made-up truth to cover the hurt but throughout the years a pattern prevailed. The Turned Leaf is based off of some moments of lucidity and by putting together pieces of a very abstract puzzle.

She is undiagnosed. She is untreated. She is miserable. And she is lonely.

The Turned Leaf is ultimately a love letter to my mother’s heart, and may help to shed an understanding light into mental illness, the demon within, and how it may have gotten there.

The Turned Leaf will be performed at the NewBridge Theatre Company in Hastings, Minn. May 16-18 and May 23-25, 2013.

Mental health and wellness is the state at which one feels, thinks, and behaves. Mental health can be viewed on a continuum, starting with an individual who is mentally well and free of any impairment in his or her daily life, while someone else might have mild concerns and distress, and another might have a severe mental illness.

Everyone has “stuff” that they keep contained in a tightly sealed plastic bag. There are some who occasionally can’t help but let the “stuff” leak, and there are those with the bag wide open.

However, in our society, we still tend to stigmatize those who let their “stuff” leak out instead of helping them, understanding them, or simply not judging them. Just as we all know someone with cancer, we all know someone with a mental health disorder.

Mental health is just as vital as physical health. In reality, the two coexist and should not be treated separately. There are many mental health disorders that exacerbate physical concerns or disorders, and vice versa.

For instance, someone who suffers from chronic migraines might also suffer from an anxiety disorder. Obesity contributes to the severity of symptoms of depression. Poor anger management is associated with high blood pressure. Behind every medical illness, it is possible to find a mental health concern as well.

It is also possible that a boost to mental health can alleviate symptoms of a medical condition. As an example, those who receive art therapy or pet therapy in hospitals are shown to have a speedier recovery than those without, as well as a decrease in severity of symptoms experienced.

A holistic approach for individuals needs to be the standard. Physicians, nurses, dentists, psychiatrists, psychologists, mental health counselors, and other mental health professionals need to collaborate to provide a complete treatment plan. A medical doctor who doles out prescriptions for irritable bowel syndrome also can refer the patient to a therapist for stress management. A dentist whose patient is suffering from extreme anxiety can have a mental health professional onsite or have one to whom to refer the patient. A psychologist can suggest that his patient see a specialist for any symptoms that can be contributing to his or her eating disorder.

As reported by the National Institute of Mental Health, more than 26 percent of the adult U.S. population has a mental health disorder, with over 22 percent of cases being considered “severe.” Mental health disorders include anxiety disorders, attention-deficit/hyperactivity disorder, autism, eating disorders, mood disorders, personality disorders, and schizophrenia.

Still, only 1 in 3 individuals will seek treatment for his or her disorder. It’s as if only 1 in 3 individuals who suffered from a high fever or a broken bone sought out a doctor.

We tend to view mental health as something that is an illusion, “all in one’s head,” or that certain disorders are overdiagnosed. Has anyone ever exclaimed that “cancer is overdiagnosed”? Yet, I have heard countless times that attention deficit hyperactivity disorder (ADHD) is being diagnosed too loosely in children and adolescents.

This month is to advocate for the awareness of mental health; however, it should be a consistent concern. Recent events have brought mental health awareness to the surface. We need to know what that means. This does not mean all catastrophic events are caused by those who are mentally ill and therefore we need better treatments. In fact, statistics show that those who are severely mentally ill are more likely to be victimized than to do harm.

It is easy to blame or stigmatize a certain group when events that cannot be understood occur and we grasp for any bit of reasoning we can. But it is neither accurate nor fair. This is the time that we educate ourselves and become properly informed, and develop compassion and understanding.

References

Brodie, S. J., Biley, F. C., & Shewring, M. (2002). An exploration of the potential risks associated with using pet therapy in healthcare settings. Journal of Clinical Nursing, 11(4), 444-456.

Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J. P., … & Chatterji, S. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA: The Journal of the American Medical Association ,291(21), 2581.

Monti, D. A., Peterson, C., Kunkel, E. J. S., Hauck, W. W., Pequignot, E., Rhodes, L., & Brainard, G. C. (2006). A randomized, controlled trial of mindfulness‐based art therapy (MBAT) for women with cancer. Psycho‐Oncology, 15(5), 363-373.

“Between a shaky world economy, increasing unemployment, and related issues, many today are being forced to come to the edge of uncertainty. Just like the baby sparrows, they find themselves leaning into the mystery that change brings, because they have no choice: It’s fly or die.”

For persons struggling with depression and anxiety — and for those of us who are highly sensitive — uncertainty is especially difficult. Forget about learning to fly. The uncertainty itself feels like death and can cripple our efforts to do anything during a time of transition.

I have been living in uncertainty, like many people, ever since December of 2008 when the economy plummeted and the creative fields — like architecture and publishing — took a hard blow, making it extremely difficult to feed a family. In that time, I think I have worked a total of 10 jobs — becoming everything from a defense contractor to a depression “expert.” I even thought about teaching high school morality. Now that’s desperate.

I don’t think I’ll ever be comfortable with uncertainty, but having lived in that terrain for almost five years now, I’m qualified to offer a few tips of how not to lose it when things are constantly changing.

1. Pay attention to your intention

I’m not a new-age guru. I don’t believe that you can visualize a check for $20,000 and find one in your mailbox the next day. Nor can you get on Oprah by believing you’ll be her next guest. (I tried both of those.) But I do recognize the wisdom in tuning into your intention because therein exists powerful energy that you can tap.

Awhile back I did Deepak Choprah’s exercise of recording my intentions and seeing how many of them actualized. I was surprised at the synchronicity between intention and events. Psychologist Elisha Goldstein writes in his book, The Now Effect: “Our intention is at the root of why we do anything and plays a fundamental role in helping us cultivate a life of happiness or unhappiness. If we set an intention for well-being and place it at the center of our life, we are more likely to be guided toward it.”

2. Tune into the body.

Psychologist Tamar Chansky, Ph.D. reminds us to listen to the body when we get anxious. If you understand why certain symptoms occur in the body – racing heart, dizziness, sweating, stomachaches – and repeat to yourself, “This is a false alarm,” you are less afraid, less panicked by the situation. Knowing that these symptoms are part of the sympathetic nervous system (SNS) trying to protect you from danger – part of the primitive regions of the brain mobilizing the “flight-or-fight” response –the reaction becomes less about the situation and more about talking to your body about why it’s freaking out so that you can use the parasympathetic nervous system (PNS) to restore the body to normalcy, which, in my case, is still pretty panicky.

3. Imagine the worst.

I’m not sure you will find a psychologist to agree with me on this exercise, but it has always worked for me every time I do it. I simply envision what it would look like if my worst nightmare happened. What if my husband and I could not get any architecture gigs or writing assignments? What if we can’t pay for health care insurance and my heart malfunctions (I have a heart disorder)? What if we both come to a bone fide professional dead end? Then I move to my actions. I think about selling our house, moving into a small apartment, and working as a waitress somewhere or maybe as a barista at Starbucks. (If you work more than 20 hours, you get health care insurance.) I research health care insurance options for persons who make minimum wage. Under ObamaCare, my kids, at least, would be covered. I invariably come to the conclusion that we will be okay. All is okay. A huge adjustment. Yes. But we are getting to be pros at that. This exercise makes me fret less about the things that I think I must have and get back to the essentials—literally a warm meal on the table, even if it’s one a day.

I am comforted by the words of Charles Caleb Colton: “Times of general calamity and confusion have ever been productive of the greatest minds. The purest ore is produced from the hottest fire.”

4. Describe, don’t judge.

In his book Get Out of Your Mind and Into Your Life, Steven Hayes, Ph.D. dedicates a few chapters to learning the language of your thoughts and feelings. Especially helpful to me is learning how to distinguish descriptions from evaluations.

Descriptions are “verbalizations linked to the directly observable aspects or features of objects or events.” Example: “I am feeling anxiety, and my heart is beating fast.” Descriptions are the primary attributes of an object or event. They don’t depend on a unique history. In other words, as Hayes, explain, they remain aspects of the event or object regardless of our interaction with them. Evaluations, on the other hand are secondary attributes that revolve around our interactions with objects, events, thoughts, feelings, and bodily sensations. They are our reactions to events or their aspects. Example: “This anxiety is unbearable.”

If we are feeling anxious about the uncertainty of our job, for example, we can tease apart the language of our thoughts and try to transform an evaluation, “I will be destroyed if I am fired,” to a description, “I am feeling anxious and my job is unstable.” By naming the emotion and the situation, we don’t necessarily have to assign an opinion. Without the opinion, we can process the object, event, etc. without hyperventilation.

5. Learn from fear.

Eleanor Roosevelt wrote, “You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face … You must do the thing you think you cannot do.” My body usually protests against that statement, but theoretically I concur with Eleanor. I sincerely believe the good stuff happens when we are afraid. If we go a lifetime without being scared, as Julia Sorel said, it means we aren’t taking enough chances.

Fear is rather benign in itself. It’s the emotions we attach to it that disable us. If we can confront our fear, or rather approach it as an important messenger, then we can benefit from its presence in our life. What is the fear saying to us? Why is it here? Did it bring roses or chocolate? According to Jones, this is an exercise of getting comfortable with being out of control, of learning to let go of the illusion of control — because we never really had it in the first place — and developing an inner knowing that everything will be okay.

It remains a topic few health professionals want to discuss openly with their patients. It remains a topic avoided even by many mental health professionals. Policy makers see it as a black hole without an obvious solution.

And now grim new statistics confirm a disturbing trend — more people are taking their own lives than ever before in the U.S.

The U.S. Centers for Disease Control and Prevention released statistics yesterday showing that 33,687 people died in motor vehicle accidents, while nearly 5,000 more — 38,364 — died by suicide. Middle-aged Americans are making up the biggest leap in the suicide rate.

It’s data that should make us sit up and think.

The New York Times has the story:

From 1999 to 2010, the suicide rate among Americans ages 35 to 64 rose by nearly 30 percent, to 17.6 deaths per 100,000 people, up from 13.7. Although suicide rates are growing among both middle-aged men and women, far more men take their own lives. The suicide rate for middle-aged men was 27.3 deaths per 100,000, while for women it was 8.1 deaths per 100,000.

The most pronounced increases were seen among men in their 50s, a group in which suicide rates jumped by nearly 50 percent, to about 30 per 100,000. For women, the largest increase was seen in those ages 60 to 64, among whom rates increased by nearly 60 percent, to 7.0 per 100,000.

What’s the cause of the rise in suicides in this country? Nobody can say for sure, but the CDC officials have some ideas:

But C.D.C. officials cited a number of possible explanations, including that as adolescents people in this generation also posted higher rates of suicide compared with other cohorts.

“It is the baby boomer group where we see the highest rates of suicide,” said the C.D.C.’s deputy director, Ileana Arias. “There may be something about that group, and how they think about life issues and their life choices that may make a difference.”

The rise in suicides may also stem from the economic downturn over the past decade. Historically, suicide rates rise during times of financial stress and economic setbacks. “The increase does coincide with a decrease in financial standing for a lot of families over the same time period,” Dr. Arias said.

Another factor may be the widespread availability of opioid drugs like OxyContin and oxycodone, which can be particularly deadly in large doses.

Men continue to prefer using a firearm to kill themselves at a rate far higher than all other methods combined (suffocation comes in a far second). Women prefer, instead, to poison themselves, followed by the use of a firearm. Suffocation (predominantly hanging) has risen as the new preferred method for committing suicide, rising 75 percent among men and 115 percent among women in the ten years studied.

Because the reasons for most people’s suicides are fairly complex, targeting new prevention methods and public educational campaigns to this problem is difficult. While suicide is most often the result of untreated or undertreated depression, getting more people who are suicidal to seek out treatment (or enhanced treatment) remains a challenge.

That does not mean we shouldn’t try, however. If anything, such reports point to the need of a redoubled effort to helping those in desperate need of intervention. Suicide is preventable, if only society put forward more effort to care and reach out to those in need. And not through the use of bandaid suicide crisis hotlines, but through the greater access of compassionate mental health treatment.

Read the article: Suicide Rate Rises Sharply in U.S.

Read the CDC Report: Suicide Among Adults Aged 35–64 Years — United States, 1999–2010

Then I was going to relate the story about how, in the summer of 2002, I chose to stop taking my medicine the way my doctor directed me to take it, and then I stopped taking my medicine at all.

This was a bad choice. As a result, my illness became an emergency.

Nine hours in the ICU, four days in a private room, and two more weeks of hospital care brought a bill that topped $95,000.

The cost of nine years of care was eaten up by just a few weeks of my irresponsibility. That was cost that the health care industry, including my insurance company, would not have had to bear if I had only taken my medicine as directed.

It then seemed easy for me to extend this argument to all patients with any chronic disease. Do what your doctor tells you and your condition should improve, or, at least, be far less likely to worsen. By patients only complying with their prescribed treatment regimens the cost of health care in the United States would go down.

How much? A lot. As a matter of fact, a New England Healthcare Institute study of health care costs in the United States pegged the added cost of care due to patient noncompliance at $290 billion. That’s 15 percent of the country’s total annual health care cost. And a Medco study found that only 50 to 65 percent of patients with chronic conditions adhere to the medication therapy prescribed for them.

It seemed clear. I am, for my lost summer, and everyone else who does not take responsibility for their own treatment, everyone who does not comply with their doctor’s orders, are responsible for the high cost of health care in the United States.

When noncompliant, a person does not take his or her medicine as directed. This often leads to their condition worsening and results in higher costs of doctor visits, emergency room visits, and hospitalizations. On the other hand, medication compliance can significantly reduce these costs.

According to Medco, for every dollar spent on diabetes medication medical cost savings are $7.00, for every dollar spent on high cholesterol medication medical cost savings are $5.10, and savings of $3.98 are found for every dollar spent on prescription medication for high blood pressure. Mental illness costs are surely similar.

So if simply taking one’s medicine can lead to lower total health care costs, why are so many patients not taking their medication as prescribed?

Reasons for noncompliance include side effects, lack of continuing symptoms, and, yes, irresponsibility. But cost may loom largest.

I have always had health insurance. The co-payment for my medicine is $49 per month when I’m stable (it was higher, but one drug went generic). It goes up during rough patches. I’m responsible. I pay it. I’m well. I thought, perhaps I adhere to my treatment regimen because I am so heavily invested in it.

Maybe if everyone paid a larger share of his own health care bill, compliance with treatment would increase. Maybe personal responsibility, sacrifice when necessary, and more participation by each individual in the cost of his or her care would improve compliance rates and reduce the overall cost of health care.

But the cost of medication to the individual must be considered. As costs increase, fewer can afford to pay them. A study from the National Bureau of Economic Research finds that an increase in medication co-payments from only $6 to $10 results in a 6.2 percent increase in noncompliance and a 9 percent reduction in the share of fully compliant persons. The same study finds that increases in coinsurance lead to even larger increases in noncompliance. As for the uninsured, the American Public Health Association has found that 89 percent have not filled a prescription due to cost.

What was lost on me was some very simple economics. If each individual pays less for his or her prescriptions, compliance increases and the nation and insurance companies pay less of a total health care bill. Unfortunately, the trend in health insurance is for each individual to pay higher co-pays or coinsurance. As these costs go up out-of-pocket expenses may exceed one’s ability to pay. The choice? Noncompliance or increased debt and possible bankruptcy.

So yes, compliance is a choice. And noncompliance greatly increases the nation’s health care bill. Every proposal on the table that makes an individual pay more for his medicine will increase noncompliance and add even more to the nation’s health care bill. High deductibles and higher co-payments charged by insurance companies against each individual will only make the problem worse. Paradoxically, as cost-driven noncompliance pushes total health care costs higher, these same insurance companies may find themselves less profitable over the long run as they face the higher cost of complications caused by medication noncompliance.

Perhaps if insurance companies lowered prescription co-payments more patients would take their medicine as directed and the insurance companies, with fewer complication-related charges against premiums, could actually increase profits. Pharmaceutical companies would benefit as well as more prescriptions would be filled. We should have no problem with health insurance and pharmaceutical companies making more money if the profits they earn come from lower total health care costs and healthier individuals.

As for my, and others’, idea that if people pay a larger percentage of their health care costs they will live healthier, more compliant, lives, the truth is that health and compliance can be expensive. Low-cost prescription benefits must be considered as we approach ideas to lower total healthcare costs. Higher costs to individuals for medication lead to higher rates of noncompliance, which lead to a higher national health care bill that, one way or another, we all must share.

References

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3326767/

http://www.hreonline.com/HRE/view/story.jhtml?id=5059249

http://www.nber.org/digest/apr05/w10738.html

http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2010/Jun/1408_Morgan_Prescription_drug_accessibility_US_intl_ib.pdf

Maybe they’re being secretive and have even stolen money from your wallet. Maybe their physical appearance has changed with rapid weight loss or red eyes. Maybe you’ve noticed a change in their sleep habits, energy level and mood. Maybe you’ve actually found marijuana or other drugs in their room.

Naturally, the thought and possible confirmation of your child using drugs trigger a rush and range of emotions: anger, frustration, disappointment, sadness, fear.

If you think your child is using drugs, how do you approach them? Where do you start?

Two parenting experts shared their insight below.

1. Be direct and calm.

“This issue is too serious for subtlety,” said John Duffy, Ph.D, a clinical psychologist and author of the book The Available Parent: Radical Optimism for Raising Teens and Tweens. He suggested readers approach their kids “directly and immediately.”

Avoid letting your anger and frustration spill over into the conversation. According to Lisa Kaplin, Psy.D, a psychologist and life coach who teaches parenting classes, “The best way to approach your child is with delicacy, not drama. If you approach them with panic, anger, aggression or accusations, you can be sure your child will tell you absolutely nothing.”

Yelling, threatening and lecturing your child typically leads them to withdraw, sneak around and lie, she said.

Duffy also suggested approaching your child “from an emotional space of genuine concern for well-being.” He understands that being calm and centered is a lot to ask of parents. “But it is, without a doubt, the approach that works best in my experience.”

It’s common for kids to deny their drug use, or to respond casually (e.g.,” It’s just pot, and I don’t smoke it that often, anyway”). If this happens, “give a brief response in which you tell them that you do not want them to use drugs of any kind,” Kaplin said. Reiterate your house rules about drugs and alcohol use and “the consequences that come with that behavior.”

2. Talk when your child is lucid.

Don’t try to have a serious conversation when your child is drunk or high, Duffy said. “This might seem like common sense, but I have worked with many parents who have attempted to lecture an inebriated teenager.”

3. Ask open-ended questions.

It’s more likely that your child will be honest, and talk about their drug use if you ask open-ended questions. According to Kaplin, these are several examples: “Can you tell me more about that?  How did you feel in that situation? What will you do if that happens again? How can I help you with this?”

If your child admits to using drugs, again, “ask them with open-ended, non-judgmental questions about what drugs they have used, how often, and if they plan on using again.” You also can ask “for their input on how to proceed.”

4. Don’t punish your child.

Avoid punishing your kids, Duffy said. It rarely works. For instance, “Taking a cell phone away will never keep a drug user away from using.”

5. Show your support.

If your child reveals their drug use, “Thank [them] for being honest with you,” Kaplin said. Let them know that you’re “here to help them. Tell them you love them.”

6. Get your child treatment.

It’s key to take your child to see a qualified therapist who specializes in working with teens and young adults. When talking about professional help, don’t negotiate with your child, or take “no” for an answer, Duffy said.

Instead be brief, firm and clear, he said. Duffy gave the following example of what you might say to your child: “It is clear to us that you have been using something, and we are really concerned for your safety. As your safety is our domain as Mom and Dad, we are going to pull rank here and schedule an appointment for someone for you, and all of us, to talk to about this issue.”

Depending on the situation, you can “give [your child] options regarding therapists or treatment centers,” Kaplin said.

Even if your child is over 18 years old, Duffy suggested having a similar conversation. While you can’t force your older child to attend therapy, you can leverage other things, such as your financial position, he said.

It’s also important to get clear on your limits, communicate them to your adult child and follow through, Kaplin said. For instance, “can your child still live with you if they’re using drugs? If not, when must they leave and will you help them with treatment or other living arrangements?”

Knowing your child is possibly using drugs is stressful, scary and painful. And it can be incredibly hard to have a calm conversation. If you feel yourself losing control, take a break, and return when you’ve cooled off. Whether your child admits to using drugs or not, having them see a qualified therapist is critical.

Further Reading

Here’s more on symptoms of teen substance abuse, what parents can do, and reasons your child might use drugs and how to help them.

Colleges and university are cutting back on their involvement with ADHD, primarily due to abuse of the psychiatric medications — stimulants like Ritalin — prescribed to treat the disorder. Students — whether they are malingering the symptoms or actually have it — are prescribed a drug to treat ADHD (sometimes from different providers in different states), then sell a few (or all the) pills on the side. Profit!

Now universities are becoming wise to the epidemic nature of the problem, as some studies have suggested up to a third of college students are illicitly taking ADHD stimulants.

This might help curb the abuse problem, but will it also make it harder for people with actual ADHD to receive treatment?

The short answer is, yes, of course. Students with a pre-existing diagnosis of attention deficit or attention deficit hyperactivity disorder will still often be able to get their prescriptions filled while at school. The university just doesn’t want to do the diagnosing of ADHD any longer.

I’ve long wondered at the wisdom of universities getting into the ADHD business in the first place. University counseling centers generally shrug off long-term treatment of serious mental illness. So it’s never been clear to me why they were comfortable prescribing medications for ADHD.

The New York Times notes — in a well-written take on this issue by Alan Schwarz — that the changes are sweeping campuses throughout the country:

Lisa Beach endured two months of testing and paperwork before the student health office at her college approved a diagnosis of attention deficit hyperactivity disorder. Then, to get a prescription for Vyvanse, a standard treatment for A.D.H.D., she had to sign a formal contract — promising to submit to drug testing, to see a mental health professional every month and to not share the pills. [...]

The University of Alabama and Marist College, like Fresno State, require students to sign contracts promising not to misuse pills or share them with classmates. Some schools, citing the rigor required to make a proper A.D.H.D. diagnosis, forbid their clinicians to make one (George Mason) or prescribe stimulants (William & Mary), and instead refer students to off-campus providers. Marquette requires students to sign releases allowing clinicians to phone their parents for full medical histories and to confirm the truth of the symptoms.

“We get complaints that you’re making it hard to get treatment,” said Dr. Jon Porter, director of medical, counseling and psychiatry services at the University of Vermont, which will not perform diagnostic evaluations for A.D.H.D. “There’s some truth to that. The counterweight is these prescriptions can be abused at a high rate, and we’re not willing to be a part of that and end up with kids sick or dead.”

Not everyone is convinced:

“If a university is very concerned about stimulant abuse, I would think the worst thing they could do is to relinquish this responsibility to unknown community practitioners,” Ms. Hughes [CEO of CHADD, an advocacy organization] said. “Nonprescribed use of stimulant medications on campus is a serious problem that can’t just be punted to someone else outside the school grounds.”

She has a point. The 2010 suicide death of Kyle Craig, who abused Adderall prescribed by his local physician at home and not by the university he attended, suggests the problem is more wide-ranging than perhaps some university officials understand.

However, this sort of effort on the part of Fresno State is amazing and should be applauded:

And in a rare policy among colleges, students receiving prescriptions to treat A.D.H.D. must see a Fresno State therapist regularly — not for a cursory five-minute “med check” but for at least one 50-minute session a month.

Psychotherapy required for ADHD treatment? Nice — finally an institution that listens to the research and understands that medications are, for most, not a life-long answer.

I think that, by and large, this is a measured response to a very serious problem of stimulant abuse among college students. Students have long enjoyed free healthcare on campus, with counseling an additional free service they receive. But student counseling centers mostly refer students with serious, ongoing mental health or mental illness to local providers in the community — they’re simply not well-equipped to treat people with such concerns. I see no reason why ADHD should be an exception.

What this does for the colleges that are mostly getting out of the ADHD business is to limit the overall amount of prescriptions floating around for these stimulant meds. That should drive down supply, drive up prices, and make it less attractive as a “study” option for students without ADHD.

As for the students who actually have attention deficit disorder? I think they will still be able to get the treatment they need. Having seen people at community mental health centers, I know that if there’s a will, people will find a way to pay for mental health services.

Read the full article: Colleges Tackle Illicit Use of A.D.H.D. Pills

How then later did I come to embrace cognitive behavioral and related therapies that spell out that we are, essentially, just a mess of behaviors (good and bad)?

If you dig into your family dynamic, and maybe establishing relationships with others from equally dysfunctional backgrounds, you are bound to have a change of heart about old Skinner. Maybe there is something to behaviorism after all, and it can jibe with the deeper therapies that ask you to reflect on early places of pain and identity-molding.

Dialectical Behavior Therapy (DBT) is particularly of interest not just to me, but folks trying to come to grasp with certain subsets of mental illness — borderline personality disorder, bipolar and other depressive disorders. But its principles can be significantly farther-reaching than mental illness circles alone.

There are 4 critical components to the DBT methodology. The categorical names alone should conjure hope for those suffering from mental illness symptoms and individuals afflicted with interpersonal issues at home and in workplace: mindfulness, interpersonal effectiveness, distress tolerance and emotion regulation.

Any reader of Daniel Goleman’s Emotional Intelligence, with an introduction by the Dalai Lama, knows that mindfulness is at the core of human attempts to find balance and centeredness in our own body, as well as connection to others. Nothing is more key for individuals with beginner-level trust in family or therapists or slowly-developing insight into dysfunctional ways of relating to colleagues.

Interpersonal effectiveness involves “strategies” — practical, effective means of dealing with thought, mood and behavioral maladjustments. Yes, actual skills are taught, driven by goals for different situations. (Sound like business counsel?) This is invaluable to those with borderline personality disorder, who “possess good interpersonal skills in a general sense” but are unable to have self-insight to get past “problematic situations” when stress hits.

Now, what better need do we have as humans than to develop distress tolerance? It can help us in our workplace, for ill loved ones, and for ourselves when debilitated by depression, addictive thoughts, or the surfacing of manic traits. This is integral to DBT’s beauty. As in Alcoholics Anonymous, where people are encouraged to discern between what can be changed and what can not, distress tolerance skills involve “the ability to accept, in a non-evaluative and non-judgmental fashion, both oneself and the current situation.”

The heart of helping ill individuals and ourselves lies, I believe, in letting this mindset seep in, allowing for gentle, passive strength. (Not to mention that this simple maxim is a behavioral powerhouse when artfully practiced and applied, and can profoundly affect our professional, family and social life.) “Self-soothing” and “pros and cons” work are two tactics in the distress tolerance strategy, one whose benefits to mentally ill family systems can certainly be equally applied to the needy masses of a larger society.

The last outlined DBT component is emotion regulation, so critical to disorders such as bipolar, where emotional intensity and stress make for frequent anxiety. But we all have encountered situations with bosses and friends that contain these elements. How do we identify obstacles and triggers, and then work on changing emotional patterns? And can we increase positive emotional experiences? Like the mouse after his cheese, is it not possible to stack the deck a certain way in families, in the workplace and within the mental health system so that the satisfaction of getting a little more of that nibble — stability, harmony, collaboration — can happen more effectively and more often?

Want to learn more about dialectical behavior therapy?
Follow our blog, Dialectical Behavior Therapy Understood or read the article, An Overview of Dialectical Behavior Therapy.

Register:  https://www4.gotomeeting.com/register/469236071

Description:  This special Mother’s Day webinar features best-selling author and Psych Central blogger Zoë Kessler (ADHD from A to Zoë) and special guest Lisa Aro, aka “Queen of the Distracted.”

Mark it on your calendar now, and check out additional information about the webinar inside…

Aro has earned her crown as the busy mom of 7 kids (6 with ADHD), and a husband who also has ADHD. Aro chronicles her family life at her blog, Queen of the Distracted. No family is without its challenges; when you add ADHD into the mix, family life gets even more complicated.

Join Zoë and Lisa for an informal and informative chat on parenting ADHD kids from the perspective of a grown-up ADHD kid (Zoë) and a non-ADHD mom (Lisa) with lots of insights on how to manage the many foibles and follies while still enjoying the fun of an active ADHD family.

You’ll get lots of tips on how prevent burnout and bring out the best in your ADHD bunch as Lisa and Zoë share their stories with honesty and insight.

We look forward to having you join us on Tuesday, May 7 at 7:00 p.m. (EST) for this special one-hour pre-Mother’s Day event.

Register today!
Click here to register: Mother’s Day with ADHD: How to Keep it Happy!

Proper treatment doesn’t suppress emotions or dull a person’s ability to feel things deeply. It builds a protective layer — an emotional resilience — to safeguard a depressive from becoming overwhelmed and disabled by the difficulties of daily life.

However, the tools found in happiness research are those I practice in my recovery from depression and anxiety, even though, theoretically, I can be happy and depressed at the same time. I came up with my own recovery program that coincides with the steps toward happiness published in positive psychology studies.

1. Sleep

Sleep is crucial to sanity because sleep disturbances can contribute to, aggravate, and even cause mood disorders and a host of other illnesses. The link between sleep deprivation and psychosis was documented in a 2007 study at Harvard Medical School and the University of California at Berkeley. Using MRI scans, they found that sleep deprivation causes a person to become irrational because the brain can’t put an emotional event in proper prospective and is incapable of making an appropriate response. Chronic sleep deprivation, especially, is bad news. It often affects memory and concentration. And, according to one recent study, it can cause a decline in cognitive performance similar to the intoxicated brain.

2. Diet

My mouth and brain are in constant negotiation with each other because while one loves white bread, pasta, and chocolate, the other throws a hissy fit whenever they enter my blood stream. My diet has always been an important part of my recovery from depression, but two years ago — after working with the naturopath and reading Kathleen DesMaison’s “Potatoes Not Prozac” — I could more competently trace the path from my stomach to my limbic system. Moreover, I recognized with new clarity how directly everything that I put in my mouth affects my mood.

Here are the bad boys: nicotine, caffeine, alcohol, sugar, white flour, and processed food — you know, what you live on. Here are the good guys: protein; complex starches (whole grains, beans, potatoes); vegetables; vitamins (vitamin B-complex, vitamins C, D, and E, and a multivitamin); minerals (magnesium, calcium, and zinc); and omega-3 fatty acids. I’m religious about stocking up on omega-3 capsules because leading physicians at Harvard Medical School confirmed the positive effects of this natural, anti-inflammatory molecule on emotional health.

3. Exercise

Dr. James A. Blumenthal, a professor of medical psychology at Duke University, led a recent study in which he and his team discovered that, among the 202 depressed people randomly assigned to various treatments, three sessions of vigorous aerobic exercise were approximately as effective at treating depression as daily doses of Zoloft, when the treatment effects were measured after four months. A separate study showed that the depressives who improved with exercise were less likely to relapse after 10 months than those treated successfully with antidepressants, and the participants who continued to exercise beyond four months were half as likely to relapse months later compared to those who did not exercise.

Even as little as 20 minutes a week of physical activity can boost mental health. In a new Scottish study, reported in the British Journal of Sports Medicine, 20,000 people were asked about their state of mind and how much physical activity they do in a week. The results showed that the more physical activity a person engaged in — including housework, gardening, walking, and sports — the lower their risk of distress and anxiety.

Exercise relieves depression in several ways. First, cardiovascular workouts stimulate brain chemicals that foster growth of nerve cells. Second, exercise increases the activity of serotonin and/or norepinephrine. Third, a raised heart rate releases endorphins and a hormone known as ANP, which reduces pain, induces euphoria, and helps control the brain’s response to stress and anxiety. Other added benefits include improved sleep patterns, exposure to natural daylight (if you’re exercising outside), weight loss or maintenance, and psychological aids.

4. Relationships and Community

We are social creatures and are happiest when we are in relationship. One of the clearest findings in happiness research is that we need each other in order to thrive and be happy, that loving relationships are crucial to our well-being. Relationships create a space of safety where we can learn and explore. Belonging to a group or a community gives people a sense of identity. Studies indicate that social involvement can promote health, contribute toward faster recovery from trauma and illness, and lower the risk of stress-related health problems and mental illness.

Plenty of evidence indicates that support groups aid the recovery of persons struggling with depression and decrease rates of relapse. The New England Journal of Medicine published a study in December 2001 in which 158 women with metastatic breast cancer were assigned to a supportive-expressive therapy. These women showed greater improvement in psychological symptoms and reported less pain than the women with breast cancer who were assigned to the control group with no supportive therapy.

Another study in 2002, published in the American Journal of Psychiatry, followed a group of more than 100 persons with severe depression who joined online depression support groups. More than 95 percent of them said that their participation in the online support groups helped their symptoms. The online groups here on Psych Central are a great resource where you can find support from people going through similar struggles.

5. Purpose

The father of positive psychology, Martin Seligman, explains in his book, “Authentic Happiness,” that a critical element to happiness exists in using your signature strengths in the service of something you believe is larger than you. After collecting exhaustive questionnaires he found that the most satisfied people were those that had found a way to use their unique combination of strengths and talents to make a difference. Dan Baker, Ph.D., director of the Life Enhancement Program at Canyon Ranch, believes that a sense of purpose — committing oneself to a noble mission — and acts of altruism are strong antidotes to depression. And then there’s Gandhi, who wrote: “the best way to find yourself is to lose yourself in the service of others.”

6. Gratitude

Gratitude doesn’t come easily to me. When my girlfriend sees a half-full glass of fresh milk, I see a half-empty glass of cholesterol-rising, cardiac-arresting agents. And when the kids’ school is called off because some road somewhere in our county apparently accumulated a half of an inch of snow, she thanks God for an opportunity to build snowmen with she kids. I have a conversation with God, too, but it’s much different.

However, I train myself to say thank you more often than is natural for me because I know that gratitude is like broccoli — good for your health in more than one way. According to psychologists like Sonja Lyubomirsky at the University of California Riverside, keeping a gratitude journal — where you record once a week all the things you have to be grateful for — and other gratitude exercises can increase your energy, and relieve pain and fatigue.

Shameless plug! Join me at one of three private screenings of “Happy,” a film that explores what makes us happy, followed by a discussion on depression and happiness and a book signing. Click the following links for more information:

People who are all about thinspiration engage in disordered eating in order to be as thin as possible — a common symptom of anorexia. But they don’t see it as a disorder or a problem, making this an insidious problem.

Nonetheless, such eating and self-image problems can result in health problems, even putting the individual’s life at risk.

Some people have sought to get common words or terms that people engaged in thinspiration use banned from social networking websites. One such woman is Torri Singer, a broadcast journalism major who has recently begun a petition to get such terms banned from Twitter.

Many social networks have already climbed aboard the bandwagon, including Tumblr, Instagram, Facebook and Pinterest. And while such policies have been implemented, thinspiration content is still easily found on many of these networks. I suspect that’s one of the challenges of implementing a policy like this — it’s extremely difficult to police, especially if people can just slightly alter the terms they use to talk about these issues.

But that hasn’t stopped Torri from putting Twitter on notice.

“[I want] to raise awareness about the harm of destructive thinspiration messages, and to prompt Twitter to make real change in order to stop the spread of this preventable growing trend,” Singer recently told me. Her inspiration for this campaign came from family:

My sister suffered on and off with eating disorders in her early adult life, so preventing other intelligent, strong, and beautiful girls from forming or elongating their disorders has always held a place of importance in my life. I know how difficult it is to be a girl and have constant exposure to beauty ideals, I don’t think we need any more pressure from self-generated pro-eating disordered “lifestyle” hashtags.

But when a website or social network changes its Terms of Use to remove such discussion from their networks, can it be an effective deterrent? “There is no doubt that other media sites such as Facebook, Instagram, Pinterest, and Tumblr have a long way to go before they are really safe and free of thinspiration triggers,” replied Singer.

“But they have made the first steps toward taking action and being responsible for the safety of their users.”

She also addressed people trying to change the spelling of terms they were using to get around the service’s policing efforts: “Instagram’s initial attempt to limit thinspiration led users to create new spellings (such as thynspo). Instead of giving up on the effort, Instagram revised the policy, stating it will disable “any account or hashtag found to be encouraging eating disorders.”

“The first step is ensuring that these messages are not readily available, and that is where policy change comes into play and really matters.”

Of course, trying to stamp out discussion of a topic on the Internet is impossible, given the hundreds of millions of websites, social networks, forums, and online communities. “By reducing the number of mainstream venues where these pro eating disorder messages are displayed,” Singer says, “we are reducing the exposure, and therefore the dangerous behavior that results (or continues) because of these online interactions.”

I agree — efforts such as Singer’s can make a perceivable impact on the popular, mainstream sites, reducing the likelihood of exposing this ideology to a new, naive audience. Especially when that site is a social network as large as Twitter.

“Banning thinspiration terminology means less accessibility to damaging phrases, encouragement, and images that propel disorders,” notes Singer. “It will prevent susceptible people from forming eating disorders, and people recovering/struggling with eating disorders from exposure to triggers.”

“In my mind, just getting people to have this conversation means that it has been some degree of successful. It is really amazing to see people who sign generating comments about their personal stories and their struggles. Many have said that thinspiration has been a big trigger in their lives and that they support any effort to ban it from impacting others like them.”

Efforts such as Singer’s are a good attempt at bringing attention to the problem and helping people understand that use of these kinds of keywords and hashtags only reinforce the disordered behavior — on a scale that wasn’t readily possible just five years ago. We applaud and support Singer’s petition and efforts to help reduce thinspiration messaging on mainstream social networks.

We encourage you to sign the petition:
Twitter: Restrict use of thinspiration language and hashtags