Self-Care in the Mental Health World

             Today I would like to revisit self-care. I wrote about it last June (Self-Care Ideas for When You Are Struggling with Depression) but I think it is worth revisiting. At its very core self-care is doing things to take care of yourself. We all need to take care of ourselves. Unfortunately, in the hustle and bustle of life, caring for ourselves often gets lost. Self- care is important for everyone. Today I would like to focus on two groups of people. First, individuals with depression and other mental illnesses. Second, I will address the need for mental healthcare professionals to ensure that they are engaging in self-care.

According to the National Institute of Mental Health, “self-care means taking the time to do things that help you live well and improve both your physical health and mental health.” On the surface this seems like a simple task, but for many of us it is difficult to prioritize self-care. Living with mental illness can make engaging in self-care even more difficult. The depression tells us not to get out of bed. It tells us that self-care is not worth the energy it requires. Depression and other mental illnesses tell us that we are not going to get better even if we engage in self-care activities. We are up against a mountain of reasons not to take care of ourselves. But mental illness is a liar. If we can just get ourselves to start, we would find that we will do so much better. 

What does self-care include? Really there are no limits to what can be considered self-care. It depends on the individual. In general, self-care includes getting enough sleep, but not too much, regular exercise, eating healthily, engaging in relaxing activities, setting goals and priorities, thinking positively, and staying connected. Sounds easy, right? I wish it was. When you struggle with mental illness, these basic routines can become difficult. Try focusing on one to start with. 

There are times when I can only focus on one aspect of self-care. Those are the times when my depression is bad. At these times I need to pick one self-care routine to focus on. Maybe it is exercising regularly. For me that looks like taking walks several times a week. It can be difficult to drag myself onto the sidewalk when I am feeling down. I need to remind myself that I will feel better, even if only slightly, afterwards. This helps me get my feet going. I have found that linking exercise with goalsetting helps me. So, I use the notes app on my phone to track how many times I walk each week. This allows me to see that I am really doing it, which builds my self-esteem. That in turn helps lift my depression.

Self-care is important when you live with mental illness. It helps you climb out of the pit that so often we fall into. It allows us to feel positives. Sleep, healthy eating habits, exercise, and regular engagement are all things that can help us when we are struggling. Start small. Don’t pressure yourself to jump in and do everything. That is likely to result in failure. Starting small allows us to see the positives and experience the successes. Whatever self-care looks like to you, make an effort to do it for your mental health. 

What about mental healthcare professionals? Why is self-care so important for these individuals? According to an article by Posluns and Gall, there is a prevalence of stress, burnout, and professional impairment among mental healthcare professionals. These authors found that self-care is important for mental healthcare professionals. Think about it. Psychiatrists, psychologists, and therapists (and other mental healthcare professionals work with people who are often struggling. They see people at their lowest and help them cope with or overcome their mental illnesses. These professionals see a lot of struggle. They are expected to express caring in a relationship where the client is often not capable, or at least not expected to return, that care. That can take a toll on someone. 

According to Posluns and Gall a mental health practitioner must be well themselves in order to provide care to patients/clients. This obviously requires engaging in self-care. Posluns and Gall cite the Canadian Code of Ethics for Psychologists, which states that psychologists should “engage in self-care activities that help to avoid conditions (e.g., burnout, addictions) that could result in impaired judgment and interfere with their ability to benefit and not harm others”.

The same guidelines I provided above for self-care apply to mental healthcare professionals. Self-care may look different for mental healthcare professionals because they are not dealing with the difficulties of mental illness. The important thing is that the professional carves out time in their day for themselves. They need to make an active attempt to engage in self-care. Likely they are encouraging their patients/clients to engage in self-care. The mental healthcare professional needs to lead by example. This doesn’t mean they need to share what they are doing with their patients. The fact that they are engaging in self-care will be evident from their overall well-being and lack of burnout. 

Self-care is part of healthy living for everyone. People with mental illness may need more support to engage in self-care. We can all take small steps to improve our lives through self-care. Take a moment to examine what you are doing. Can you take a step to engage in a self-care activity?  If you are already engaging in self-care activities, can you add to what you are already doing? 

We are all worthy of care. It starts with us. We need to take steps to care for ourselves. That is how we all can become healthier. 

For tips on self-care activities see my previous post, (Self-Care Ideas for When You Are Struggling with Depression).

 

Source: Posluns, K., & Gall, T. L. (2020). Dear Mental Health Practitioners, Take Care of Yourselves: a Literature Review on Self-Care. International journal for the advancement of counseling, 42(1), 1–20. https://doi.org/10.1007/s10447-019-09382-w

 

 

                  

World Bipolar Day

                  March 30^th was World Bipolar Day. I do not know what it is like to live with bipolar disorder, but I think it is important that a depression blog spend a little time sharing about this mental illness.

                  The purpose of World Bipolar Day is to bring awareness to bipolar disorder and eliminate the stigma surrounding it. This day is meant to be an opportunity to educate people about bipolar disorder. It is celebrated on March 30^th because it is the birthday of Vincent Van Gogh, who was posthumously diagnosed with bipolar disorder. 

                  Bipolar disorder was previously known as manic-depressive illness. This disorder causes shifts in a person’s mood, energy, and ability to function. These shifts can be severe. The shifts are not normal ups and downs. The shifts of bipolar disorder can be dramatic mood swings. A person can go from being overly high and/or irritable to sad and hopeless. Then shift back again. The high periods are called manic, while the low periods are called depressive episodes. 

                  Hypomania is mild to moderate level of mania. It often feels good to the person, and they may function well. As a result, they may not recognize that there is something wrong. Severe episodes of mania can include symptoms of psychosis, in which the person is out of touch with reality. They may have hallucinations, which can lead to a misdiagnosis of schizophrenia. 

                  The symptoms of mania include, but are not limited to increased energy, activity, and restlessness, excessively “high”, overly good, euphoric mood, extreme irritability, racing thoughts and talking very fast, jumping from one idea to another, distractibility, and little sleep needed. 

                  The symptoms of depression include, but are not limited to poor appetite or eating too much, trouble sleeping or sleeping too much, nervousness or worry, loss of interest in and withdrawal from usual activities, feelings of sadness that don’t go away, irritability or restlessness, repeated thoughts of death or suicide. 

                  There are four types of bipolar disorder: Bipolar I Disorder, Bipolar II Disorder, Cyclothymic Disorder or Cyclothymia, and Bipolar Disorder, “other specified” and “unspecified”.

                  Treatment includes psychotherapy, medication, self-management strategies, and complementary health approaches (these compliment the first three and do not treat bipolar disorder on their own).

                  Organizations such as NAMI and the International Bipolar Foundation can provide support for individuals living with bipolar disorder. I used resources from both of these organizations to write this post. NAMI also supports loved ones and caregivers of individuals living with bipolar disorder.

                  It is important that we work to reduce the stigma surrounding bipolar disorder. Too often people refer to everyday mood swings as bipolar disorder. As you have read here, there is more to bipolar disorder than mood swings. It is a stigma to casually use bipolar disorder as a description of a person. Bipolar disorder is an illness and as such should be treated as one. 

 

   

                  

Women in Mental Health Who Are Influential in My Life

                  I would like to wrap up this series on influential women in mental health by highlighting women I find influential in my own life. These women include some women who have influenced not only my mental health journey, but also my life. After these women I would like to share some women I have encountered who while not personally impacting my journey, are still influential and who I look up to.

                  There are some women who have provided me with amazing mental health care. I would not be where I am without them. I would not be in a place to write this blog without them. I am not sure I would even be here without them. They are among the amazing women who contribute to the mental health field and belong among the other women I have featured in this series. These women make a difference in my life, and I am truly grateful for their healing presence. 

                  Thank you, Dr. S. You are incredible. You have changed my life and the course of my mental illness. You are there when I need support. You have restored my faith in psychiatrists by being the best. 

                  Thank you, Stephanie. You have guided me and held my hand when I didn’t know if I would make it. You have been there in my moments of crisis. You are incredible.

                  Dr. S and Stephanie, I appreciate both of you more than you will ever know.

                  Thank you, Brittany. You have kept me on the healing track and allowed me to search for my way. I appreciate you.

                  To all the techs who have been a part of both my esketamine and TMS treatments, thank you. Your work is important and healing. 

                  Thank you, Cristina. You understand the importance of mental health and support me in a way many primary care providers have not figured out. You are a reminder that mental health is a part of healthcare. I appreciate you.

                  Thank you to all the women working in mental health. You are seen and appreciated. 

                  And now for a couple women whose work inspires me to keep trying to make a difference.

                  Terry McGuire is the host of the podcast Giving Voice to Depression. As her podcast title says, Terry gives the voices of depression a place to be heard and shared. Her work has made a difference for many including me.

                  Katherine Ponte runs For Like Minds and Psych Ward Greeting Cards. These programs bring understanding to people living with mental illness. Her work inspires me to work to help others living with mental illness. 

                  Both Terry and Katherine use their lived experience to help others. Their work has influenced me, and I hope that one day I will have the reach they have achieved. 

                  I would also like to acknowledge all the women who work for NAMI (National Alliance on Mental Illness). Your work is healing and makes a difference. I have met too many to name all here. Please know that your work and dedication make a difference.

                  My posts this month have highlighted women who have been influential in the mental health field. I shared the work of 10 women this month in addition to the women I have shared in this post. The work of all these women has made a difference. I highlighted them during Women’s History Month, but we should recognize them all year long. This is important. Right now, people in the United States, including our current government, want to minimize or even erase the accomplishments of women. We cannot allow that to happen. I encourage you to recognize the women who make a difference in your life. Share their influence. Reach out and let them know you appreciate them. Give them a card or just say “thank you”. I chose to recognize women in mental health because this is a depression blog. Don’t let Women’s History Month end without acknowledging the amazing things women do every day. Don’t let that acknowledgment end on March 31^st. The achievements of women are not confined to one month.

                  

 

There Are More Influential Women in the Mental Health Field

                  As Women’s History Month nears an end I would like to share the stories of a few more women this week. As I have said, it is important that we recognize their contributions to the mental health field. Men get so much of the recognition, but many advancements would not have happened if it were not for women. There are many women studying psychology and related fields in colleges today. They need to learn about the women who came before them. This knowledge will serve as a motivator and a call to strive for further advancements. Men can also learn from the work of all these women I have written about this month. After you read about these women, share their stories with others, men and women. Let’s give these amazing women the credit they deserve.

 

Leta Stetter Hollingworth (1886-1939)

 

"I do not know. I was intellectually curious. I worked hard, was honest except for those minor chicaneries which are occasionally necessary when authority is stupid, disliked waste, and was never afraid to undertake an experiment or to change my mind."

 

                  Leta Stetter Hollingworth was the first female psychologist in New York City. She worked at Columbia University. Her worked challenged the belief that women had inferior intelligence to men. She studied under educational psychologist E.L. Thorndike. She demonstrated that differences in intelligence was a result of societal roles not being born male or female. 

                  Hollingworth’s dissertation focused on women’s intelligence during menstruation. At the time it was believed that women had a decrease in performance on mental tasks during menstruation. Hollingworth’s work proved that there was no empirical evidence for this.

                  She also worked in educational psychology and coined the term “gifted”. Her work focused on nurturing gifted children. At the time it was believed that gifted children could take of themselves, but Hollingworth showed that these children needed to be nurtured. She developed a curriculum for gifted children.

                  Hollingworth’s early work studied women and led to changes in how women’s intellectual abilities were acknowledged. Most of her work was in the school setting where she worked in educational psychology. She died at the age of 53 from abdominal cancer. At the time of her death, she had more work planned.

                                                                                                                                   

Anna Freud (1885-1982)

 

"The best way to understand children is to observe them when they're on their own, unobserved."

 

                  Anna Freud was the daughter of Sigmund Freud, but she was more than just his daughter. She was an influential psychologist in her own right. She is the founder of child psychoanalysis. Anna Freud’s work contributed to the understanding of child psychology. Interestingly, Erik Erikson, a male psychologist who many in the world of psychology can name easily, was strongly influenced by the work of Anna Freud. 

                  Anna Freud recognized that children had different symptoms than adults, noting that these were often related to developmental stages. Her work included how the ego played a role in managing anxiety. The work of Anna Freud is the basis of modern child therapy and developmental psychology.

She also made contributions in understanding how the mind uses defense mechanisms to protect itself. She demonstrated that everyone uses defense mechanisms, not just people with psychological disorders. 

 

Leta Stetter Hollingworth and Anna Freud both made significant contributions in the field of psychology that have impacted mental health. They are examples of women who dedicated their lives to understanding the mind. 

If you have missed the first four post in this series on influential women in the mental health field, I encourage you to read them. The series started on March 10 and includes posts on 3/13, 3/17, and 3/20. There will be one more post on Thursday. 

 

 

Continuing to Discuss Women Who Have Made Contributions to Mental Health

                  I think it is important that we recognize the many women who have made contributions to the mental health field. Even today there are people who try to diminish the accomplishments of women. This makes it even more important that we learn about and celebrate these women.  If you took a high school or college introductory psychology course, you are no doubt familiar with Freud, Maslow, Piaget, Skinner, and Watson. All men. I did a Google search for pioneers of psychology. The results were all men. As my last few blog posts have shown, there are many women who have made equally as important contributions to psychology and mental health. So, here are two more women that we should know about.

 

Francine Shapiro (1948-2019)

 

“The past affects the present even without our being aware of it.”

 

                  Francine Shapiro created Eye Movement Desensitization and Reprocessing (EMDR) therapy.  This treatment is a safe and effective way to help people address and process traumatic memories. Even though this treatment has been controversial, it has been found to be effective for working with trauma and post-traumatic stress disorder. 

                  Shapiro realized that when people have unprocessed trauma or trauma that is not fully processed, the feelings associated with it linger in the nervous system. Her first realization that eye movements could decrease negative emotion came while she was walking in a park in 1987 and noticed how her eye movements were associated with distressing memories that she had. She experimented with eye movements and found that others experienced a desensitization to distressing memories as a response to eye movements. This led her to develop EMDR. It includes work with the therapist and the eye movements. There is a set procedure that involves recalling a memory before the work with eye movements. EMDR is generally, conducted over 6 to 12 sessions.

                  In 2004 the American Psychiatric Association recommended EMDR as an effective treatment for trauma. Shapiro’s discovery and work are helping people with post-traumatic stress disorder. 

 

 

Nellie Bly (1864-1922)

 

“It is only after one is in trouble that one realizes how little sympathy and kindness there are in the world.”

 

                  Nellie Bly was a journalist, not a psychologist. As a woman, she fought to create opportunities to write newspaper articles. She wanted to write an article on immigrant’s experiences, but was denied by the editor of a newspaper, Joseph Pulitzer. Instead, he challenged her to investigate and write an article about Blackwell’s Island, a notorious New York mental asylum. Bly went undercover by acting as if she had a mental illness. She was admitted to Blackwell’s Island, where she experienced how badly people with mental illness were treated. The result of her time at Blackwell’s Island was a six-part series entitled Ten Days in the Madhouse. People were shocked by what she reported. Her reporting led to increased funding to improve conditions in the asylum. 

                  While Bly is remembered as the founder of investigative journalism, her series, Ten Days in the Madhouse, helped to change conditions in mental health facilities. She exposed the mistreatment of people with mental illness. She gave these people a face and made others aware of their humanity.  Bly’s work demonstrates that a person can influence how people with mental illness are treated even if they are not trained in psychology, leading the way for future mental health advocates.

 

                  Shapiro and Bly made contributions to mental health in different time periods. Bly’s efforts demonstrate that the treatment of mental illness has long been an issue. We are still fighting to improve the care of those with mental illness. Bly’s writing opened doors to allow the world to see that improvements in the care of those with mental illness are necessary. 

                  Shapiro’s work is much more recent. Her work provides a treatment option for people living with a specific mental illness, post-traumatic stress disorder. It demonstrates that new approaches to treatment are always possible. We cannot stop researching and developing treatments for mental illness. 

                  As with the other women I have featured in the last few posts, I am guessing most readers have never heard the names of these women. I encourage you to remember the work of these women. Recognize their work. Celebrate it.

 

 

Even More Influential Women in the Mental Health Field

                   Today I continue sharing the stories of influential women in the mental health field. I believe it is important as woman, an individual with mental illness, and a mental health advocate for me to share the accomplishments of these women. That is why I have dedicated posts to their stories. I have been appalled by the current administration’s diminishing of women. I am also aware of their attempts to reduce mental health diagnoses and treatment. (More on that in a future post. I just need to spend some time researching first.). So, I will continue to post about women’s contributions to mental health. I am dedicating the month of March to talking about these amazing women. It is my hope that people will read and share these posts. I realize I have a small audience, but I can still do my part. If you are reading this, please help me by sharing with at least one person. Together we can make a difference.

                  

Martha E. Bernal (1931-2001)

“However critical I might be of this country, I have felt grateful for the opportunities of which I availed myself.”

 

                  Martha E. Bernal was the daughter of Mexican immigrants. She was the first Latina to receive a doctorate degree in psychology in the United States. She faced discrimination based on being female when she searched for a position after earning her PhD. That did not stop her. She made contributions in the area of learning theory and the methods of treatment and assessment of children with behavior problems.

                  She also helped advance multicultural psychology. Her work helped bring an understanding of the importance of diversity in training, recruitment, and research. In the 1970s she worked to ensure that students of color had the opportunity to receive graduate training. She drew attention to the lack of ethnic minority psychologists. She offered steps to improve this. 

                  Bernal helped establish the National Hispanic Psychological Association. She served as this group’s second president. 

                  The “Martha Bernal Scholarship Fund was established at Arizona State University to honor her commitment to advancing scholars of color. 

 

E. Kitch Childs (1937-1993)

“We must generate a systematic method for conflict resolution so as to lose none of the power of our anger in useless wheel spinning…By doing so we may amplify and augment sisterly cooperation, understanding and in the meantime enhance our self-empowerment.”

 

                  E. Kitch Childs was a clinical psychologist. Through her work she advocated for marginalized women, sex workers, and the LGBTQ+ community. She was the first African American woman to earn a PhD in human development from the University of Chicago. 
                  Childs was very aware of the lack of organized research into the psychology of women. A great deal of her work was focused on feminist therapy. She helped found Chicago’s Gay Liberation Front. Childs provided therapy for the LGBTQ+ community, especially those with AIDS.

                  E. Kitch Childs was recognized for her work to change the American Psychiatric Association’s position on homosexuality, which had listed it as a psychological disorder. 

                  She tailored her approach with clients to meet their specific needs. Often her approach went beyond traditional therapeutic practices. Her clients included the most marginalized and poorest people. She offered sliding scale fees and free services to those who needed it. Childs also offered group therapy that was focused on community-building. Childs used her professional expertise and her own experiences with discrimination to build up communities.

 

                  Bernal and Childs are examples of women who made a difference in not only the field of mental health, but also for people who are the most marginalized. Their work showed that all people matter. The mental health of all regardless of race, gender, and socio-economic status should be valued and cared for. The work of Bernal and Childs are examples of what we should be focusing on as nation.

 

More Influential Women in the Mental Health Field

                 I was going to wait until Monday to write another post on influential women, but there are so many women to discuss, I decided to include more posts. Today I will feature two more women who made important contributions to the mental health field.

 

Mary Whiton Calkins (1863-1930)

“For with each year I live, with each book I read, with each observation I initiate or confirm, I am more deeply convinced that psychology should be conceived as the science of the self, or the person, as related to its environment, physical and social.”

 

                  Mary Whiton Calkins is a graduate of Wellesley College. After graduating she was given permission to attend seminars at Harvard University, which at the time was an all-male institution. She completed all the requirements for a PhD but was denied the degree because she was a woman. 

                  She taught psychology a Wellesley College, where she established one of the first psychological laboratories in the United States. Her research was focused on memory, dreams, and consciousness. She developed a system of self-psychology. According to this system the foundation of the study of psychology should be the conscious self. She opposed behaviorist John Watson’s idea that introspection was not a part of scientific psychology. 

                  Calkins invented a technique, called the paired-associate technique that is still used in memory research today. In this method pairs of items are presented. The items are usually words. Recall is tested by presenting the first item as cue and asking the person to recall the second item.

                  In 1905 Calkins became the first female president of the American Psychological Association. She was the 14^th president in the organization’s history. In addition, she became president of the American Philosophical Association in 1918.

It should be noted that Harvard still refuses to grant Mary Whiton Calkins the PhD posthumously, stating that Harvard did not admit women at the time she completed coursework there.

 

Mamie Phipps Clark (1917-1983)

“A racist system inevitably destroys and damages human beings; it brutalizes and dehumanizes them, blacks and whites alike.”

 

                  Mamie Phipps Clark grew up in the Jim Crow South. She lived with segregation. She witnessed the violence that goes with segregation. 

                  Clark earned a master’s degree from Howard University. She earned a PhD in psychology from Columbia University in 1943. She was the first African American woman to earn a PhD from Columbia University.

                  Her research was focused on child development and racial trauma. Her work was instrumental in desegregating schools in the South. She, along with her husband Kenneth Clark, is known for using doll tests to demonstrate how segregation negatively affected Black children. Her research with the “Doll Test” key evidence in the Supreme Court case Brown v. Board of Education. 

                  Along with her husband, Phipps Clark worked to make the field of psychology more inclusive. Mamie Phipps Clark was a Black woman in psychology when that was a rarity in the United States. She opened the door for diversity in the field of psychology. She used her own personal experiences to devise research that led to the end of segregation in schools. 

 

                  Mary Whiton Calkins and Mamie Phipps Clark made important contributions to the field of psychology and to American society. They paved the way for the women who are doing great work in mental health and psychology today. They broke barriers. Their work should not be forgotten.