Mental Health Care

Therapy (also called “counseling”) is the process of talking to a trained professional to explore your thoughts, beliefs and actions to understand and improve the way you feel. Therapy may include working to:

• Learn how your past can affect your current decisions
• Explore your automatic thoughts and core beliefs
• Increase your resiliency by developing new, more positive ways of responding to life’s challenges

Therapy can be helpful because the therapist or counselor is a neutral person. They can give you honest feedback, help you see things from a different perspective, and provide tools to handle tough situations. A therapist can listen and help you make connections between your thoughts, beliefs and actions; make observations; and provide you with opportunities to learn different ways of interacting with the world.

Anyone seeking to improve their mental health could benefit from professional therapy. People go to counseling for many reasons, including relationships, parenting, stress, depression and anxiety.

Keep in mind: Mental health is not the same thing as mental illness. Everyone has mental health. It’s defined as our cognitive, behavioral and emotional wellbeing. And just like our physical health, it’s important that we take care of our mental health.

Yes. Therapists differ in education, training and areas of specialty. When considering a therapist, make note of their:

• Licensure: All therapists must hold a license to practice therapy from a state licensing board. The specific requirements to attain licensure vary from state to state, but typically fall in three broad categories:
  • Licensed Professional Counselor (LPC) – a therapist who holds a Master’s degree in Counseling
  • Licensed Clinical Social Worker (LCSW) – a therapist who holds a Master’s degree in Social Work
  • Psychologist (Ph.D.) – a therapist who holds a Doctoral degree in Psychology
• Type of therapy practiced: Therapists also focus on different ways of practicing therapy. Evidenced-Based Therapy (EBT) is any therapy that has shown to be effective in peer-reviewed scientific experiments. Read more about what therapies are considered EBTs on the American Psychological Association’s website.
  • One of the most common EBT types is Cognitive Behavioral Therapy (CBT), which focuses on connecting your thoughts and beliefs to your actions. Thus, the way to change your actions is by reframing your thoughts.
  • Cognitive Processing Therapy (CPT) helps people heal from trauma.
  • Family therapy seeks to improve family dynamics.
• Areas of specialty: If you have a specific need, like anxiety or depression, you can look for a therapist who indicates they specialize in that area. This means they have had additional training on the topic and work with those areas more than others.

It can be tough to find a therapist who is accepting new patients and fits your needs, but getting the mental health support you need is worth it. Here are some suggestions:

• Ask friends or family members for referrals (if you feel comfortable).
• Reach out to the confidential Employee Assistance Program (EAP), who can match your needs with local therapists.
• Contact your medical plan to conduct a search of mental health providers in your plan’s network.
• Ask your primary care doctor for a referral to recommended therapists.
• Use online directories such as the “Find a Therapist” feature through Psychology Today.

Keep in mind, it may take some experimenting to find the right person.

Your first session is important to establishing a trusted working relationship. Preparing ahead of time can help reduce anxiety and stress.

Have your insurance card or your EAP registration code handy and consider writing down answers to the following questions:

• What would you like to explore in therapy?
• How long have you been thinking about this concern?
• What have you done in the past to address this concern?
• What’s worked and what has not worked in the past to address it?
• How will you know when you are making progress? What will you be doing differently?

1. Take a time-out. Stepping back from a problem helps clear your head. Try yoga, listen to music, meditate, get a massage, go for a walk or take a nap.
2. Talk to your doctor. Don't suffer in silence. Your doctor can guide you to the right medication and/or therapy to help you start feeling better, faster.
3. Get moving. Exercise reduces anxiety and helps you feel good. Set small, specific goals (“walk for 30 minutes every day”) and aim for daily consistency rather than marathon workout sessions.
4. Watch what you eat. Anxiety can wreak havoc on your diet — maybe you're overeating or skipping meals entirely. Try to eat well-balanced meals and keep healthy, energy-boosting snacks on hand. Limit alcohol and caffeine, which can worsen anxiety and trigger panic attacks.
5. Be curious. Pay attention to your body sensations, thoughts and emotions when you're feeling anxious — does your face feel hot? Is your heart beating rapidly? When you notice and name anxious feelings, you become less caught up in them.
6. Take time to self-reflect. Learn what triggers your anxiety. Is it work, family, friends or something else you can identify? Write in a journal when you're feeling anxious and look for a pattern.
7. See the big picture. Identify what's causing your anxiety, then put things in perspective: Is it as bad as you think? Will this matter a month or a year from now?
8. Learn to accept it. Anxiety is a normal emotional response that we all have. If you can accept anxiety as a part of life, you can learn to relate to it with self-compassion and even humor.

1. Know the warning signs. Burnout manifests in your body, so pay attention to what it's saying. Signs of burnout often include stress, fatigue, negativity, trouble thinking clearly, loss of motivation, physical and mental health problems — from aches and pains to frequent illnesses to depression.
2. Prioritize self-care. Since exhaustion is a core symptom of burnout, it's important to take steps to replenish your energy and ability to focus. This means prioritizing good sleep, nutrition, exercise, social connections and things to help you feel calm and centered, like meditating or enjoying nature.
3. Disconnect. Working too many hours, too many days in a row or being accessible to coworkers 24/7/365 exposes you to a steady influx of stressors that will prevent you from relaxing and recharging. Build sufficient off-hours into your work week so you'll have times when you can completely disconnect for a while.
4. Reset expectations. It may be time to reset expectations with colleagues, friends or family members for how much you're willing to take on. You might get pushback, but be clear that you're making these changes to improve your long-term productivity and protect your health.
5. Take breaks during the work day. Research shows it's unproductive to "power through" the day without any rest. Build 15-minute breaks into your work day — and try to take a few moments to stretch, walk around, drink some water or sit down away from your work space for a while whenever possible.
6. Learn to say no. Put your needs and priorities first — not those of the person asking you for something. Know when "no" is the right answer, then give yourself permission to say it and not feel guilty about it. The more you practice saying no, the easier it gets.
7. Schedule "me time." It's just as important to plan time for yourself as it is to plan time for work. Setting a reminder to do something as simple as "read for 30 minutes" can benefit you greatly. Scheduling relaxing activities ensures they will happen and gives you something to look forward to.
8. Lean on your loved ones. Don't withdraw from family and friends when you're struggling; they can be powerful allies in the battle against burnout. Spending time with people who care about you will help you distance yourself from the pressures of work and remind you to have fun.
9. Seek help when you need it. These are just a few ways to fight burnout on your own. If you’re experiencing overwhelming burnout, consider making an appointment with a therapist (online or in-person) or visiting a trusted health care professional.

1. Reach out for help. Most people with depression can recover fully with effective treatment. Your doctor can guide you to the right medication and/or therapy to help you start feeling better, faster.
2. Be kind to yourself. It's okay not to do things exactly "right" — no one is perfect. Allow yourself to feel positive about your accomplishments instead of berating yourself over the things you "didn't do."
3. Remember, tomorrow is a fresh start. Learn to accept that some days will be difficult while others will be great. If today wasn't your best day, tomorrow is an opportunity to try again.
4. Find a small hobby that makes you feel good. Maybe that's cooking or baking, video games or puzzles, reading, riding a bike — even keeping a plant alive counts! These types of activities can lift your spirits without requiring a ton of effort.
5. Connect with loved ones. It can be tempting to pull away from others when you're depressed, but face-to-face time with friends and family can help you feel better. If you can't see them in person, phone calls or video chats are easy for everyone.
6. Set attainable goals. Maybe your to-do list is so long, you'd rather do nothing. Try setting a small, specific goal — instead of "clean the house," try "do the dishes." Once you complete one small thing, set your sights on another, then another.
7. Take a walk. Exercise may seem like the last thing you want to do, especially on those days you don't want to get out of bed. But physical activity is a powerful depression fighter. For some people, exercise can be just as effective as medication at relieving depression symptoms.
8. Listen to music. Music has been proven to boost your mood and alleviate symptoms of depression. It can even strengthen your reception of positive emotions.
9. Practice gratitude. Gratitude can have lasting positive effects on your overall mental health. Try writing down a few things you're grateful for, including writing thank you notes to others.

1. Recognize the warning signs. Like many medical conditions, the sooner one identifies and begins to treat an eating disorder, the better chance for successful recovery. These are some behaviors that may indicate a problem:
   • Preoccupation with weight, body size/shape, food, calories or dieting
   • Skipping meals, eating small amounts of food or eating large amounts of food quickly
   • Discomfort eating around others
   • Noticeable fluctuations in weight
   • Gastrointestinal issues and/or menstrual irregularities
   • Extreme mood swings and/or withdrawal from usual friends and activities
   • Difficulty concentrating, sleep problems or dizziness upon standings
2. Voice your concerns. There is no shame in acknowledging an eating disorder or other mental health condition. If you are concerned about your eating patterns or the patterns of someone close to you, talk with your doctor or an eating disorder expert. Open up to a trusted friend or family member or offer to listen.
3. Know what to say. If you’re struggling with disordered eating, having support along your recovery journey can help. In addition to the support provided by medical and mental health professionals, friends and family can be equally important in this journey. Consider sharing your behaviors and feelings to the extent you feel comfortable and letting them know how they can best support you. You may want a compassionate listener, someone to help you problem solve or someone to help you find treatment options.
   If you’re concerned that someone close to you may be struggling with disordered eating, start by educating yourself and then asking for some private time to talk. Focus on the behaviors you have personally observed and use “I” statements. Try to stay calm and stick to the facts, without sounding judgmental or accusatory. For example, you could say, “I have seen you run to the bathroom after meals, and I’m worried you might be making yourself throw up.”
4. Know what not to say. Avoid making overly simplistic suggestions — to someone else or yourself, such as “You have to stop doing that.” This can leave the person feeling frustrated, defensive and misunderstood. It’s also important to avoid threatening statements, such as “If you keep doing this, our friendship is over.” Remain caring and understanding in your conversations — when talking with someone else or when using self-talk in your head.
5. Seek professional help. Many people with disordered eating require professional help. Ask your primary care doctor for a referral to a mental health professional with experience in eating disorders, contact your health insurance or your Employee Assistance Program (EAP). In addition, the National Eating Disorders Association (NEDA) operates a free, confidential Helpline to offer support and help you find treatment options.

1. Death of a loved one. The death of a loved one is usually the event that comes to mind when people think about grief. Whether a family member or dear friend, losing a loved one is devastating. Acknowledge your feelings without trying to suppress them. Take the time you need to grieve at your own pace and permit yourself to grieve in your way. Seek the support of friends and family or turn to a therapist if you feel you could use some professional help processing your loss.
2. Divorce or relationship breakup. Your whole world gets tossed upside down during a divorce or breakup — even if the relationship was an unhealthy one. It's important to remind yourself that you will feel better and eventually move on with renewed hope. Tell yourself it's OK to feel different things at different times. Most importantly, give yourself a break. Take time to heal, regroup and re-energize.
3. Loss of health. When faced with a serious medical condition, you're grieving the loss of your good health while also worrying about your future. Social support can have a huge impact on your mental health during this difficult time. Friends and family can also provide vital assistance to make your situation easier. Staying connected to people and activities can make a world of difference in your overall outlook as you undergo treatments.
4. Death of a pet. A pet is much more than "just a dog" or "just a cat." They're a beloved part of your family. So, when a cherished pet dies, it's only natural to grieve the loss. Allow yourself to feel genuine grief for your animal companion without embarrassment or judgment. Talk with others who have lost pets and share your happy memories and positive experiences. Remembering the fun and love you shared with your pet can help you to move on eventually.
5. Fertility challenges. Often overlooked by society, fertility challenges are a real source of grief, as women and men hoping to conceive a child go through the emotional process of discovering they cannot. Sometimes, miscarriages or stillbirths are involved, further compounding the grief. It's normal to feel a huge sense of loss, along with stress, sadness, frustration and even anger. Acknowledge your emotions without judgment, and most importantly, don't blame yourself (or your partner) for the situation. Turn to experts for guidance as you consider your options going forward while also reaching out to friends, family and professionals for emotional support. And, as you grieve, it's OK to skip baby showers or other events you find too painful.
6. Financial loss. Financial stress tops many people's lists of concerns. No matter how hopeless your situation may seem, there is a way out. A few simple strategies can help you break a downward spiral, ease money problems and find financial stability again. Start by talking with a trusted friend or loved one about your money problems. You might also consider debt counseling or other professional advice. Keep track of your income, debt and spending for at least a month — if not longer. Partner with an expert or use online budgeting tools to make a recovery plan, then stick to it.
7. Losing a job. Losing a job, no matter what the reason, is one of life's most stressful experiences. Our jobs help define us and how we view our place in the world. Suddenly finding yourself out of work can leave you feeling hurt, angry or depressed. Allow yourself to grieve the loss — loss of control over your life, loss of a professional identity, loss of a work-based social network, loss of a sense of security and more. Reach out to friends who are good listeners. Involve your family and make time for family fun.
8. Retirement. At first, the idea of retirement may seem like a great relief — the reward you've been working toward for decades. But after a few months, many retirees find that the novelty of being on "permanent vacation" starts to wear off. You may miss the sense of identity, meaning and purpose that came with your job as you grieve the loss of your former life. Think of retirement as a journey, not a destination. Find new purpose and meaning; pursue activities that add joy and enrich your life. Don't overlook your health. Keeping your body and mind active and healthy at this time is very important.

1. Don't avoid failure; embrace it. Failing is a natural part of the growth process, so embrace it. The challenges you experience now will help you be more successful in the future.
2. Keep trying. As painful as it is, repeated failure makes you better equipped — and more determined — to achieve your goals.
3. Build on your successes. As you begin to overcome a challenge, keep building your abilities and confidence little by little. Then watch how quickly positive changes occur.
4. Don't overthink things. Write down every idea you come up with when trying to create change, no matter how silly or pointless it seems.
5. Don't let others determine your path. Sometimes something you consider to be a weakness is actually a strength hiding in plain sight that those around you don't like, don't appreciate or feel threatened by.
6. You are enough. Keep reminding yourself that you have everything you need to reach your goals, you just need to figure out how to get there. If you don't believe in yourself, there's little chance anyone else will either.
7. Think positive and go for it! Stop focusing on why you think you can't do something and start looking for all the great reasons why you can.

Remember: You won't find your strengths if you aren't looking for them. Take a leap of faith. You just might discover happiness and success you didn't know was possible. What have you got to lose?

1. Know the signs. Watch for changes in your child’s attitude and behavior, including:
   • Loss of energy
   • Changes in appetite
   • Persistent irritable or angry mood
   • Excessive or prolonged sadness
   • Fixation on past failures or extreme self-criticism
   • Difficulty concentrating
   • Frequent unexplained body aches or headaches
   • Social isolation
   • Poor school performance or frequent absences
   • Angry outbursts
   • Self-harm
   • Less attention to personal hygiene or appearance
   • Substance abuse
   • Suicidal thoughts or actions
2. Don’t blame. If your teenager is suffering from depression, they can’t simply snap out of it. Don’t blame them — or yourself — for their condition. There are many contributing factors to teenage depression, including peer pressure, social media influences, academic expectations, hormonal changes, genetics, bullying, stressful experiences and lack of social support.
3. Talk to your teen. Bring up your concerns in a loving, nonjudgmental way. Without criticizing, let your teen know what symptoms of depression you’ve noticed and why you’re worried. Ask them to share what they’re going through. Then listen calmly, validate their feelings and offer your support. This isn’t the time to ask a lot of questions or lecture. What’s most important is letting your teen know you’re there for them, no matter what.
4. Keep trying. Your teen might not be willing to talk at first. Don’t nag, but don’t give up either. Experts advise a gentle yet persistent approach. Unfortunately, some of the symptoms of depression, like anger and sensitivity to criticism, make it harder for teens to open up about what’s going on.
5. Seek professional help. Depression is a serious mental health problem that needs professional treatment. With a therapist, your teen can talk about their feelings, better understand what may be causing them, and learn skills to help manage their emotions. In cases of more severe depression, your teen’s therapist may also recommend consulting a doctor with experience prescribing antidepressant medication. Be sure to call for help immediately if you suspect your teen may be considering suicide: dial 988 to reach the National Suicide Prevention Lifeline, dial 911 for immediate emergency response or go to the nearest emergency room.
6. Encourage social interaction. Depressed teens tend to avoid social activities and may lose touch with friends, which worsens depression. Suggest after-school clubs, sports teams or classes that match their interests while also encouraging get-togethers with friends to keep them connected
7. Make time for your teen. Carve out some time each day to give your teen your undivided attention. Showing how much you care can go a long way in giving your teen the strength to fight back against depression.
8. Support healthy habits. Eating healthy, getting the right amount of sleep and exercising are all powerful weapons in your teen’s battle with depression. Try to get your teen moving for at least an hour a day, whether it’s going for a walk, taking an exercise or dance class, riding a bike, playing a sport or doing yard work — anything that gets their heart rate up. Feed them nutritious meals and keep healthy snacks on hand. And, keep an eye on their sleep pattern — too much or too little sleep can negatively impact their mood and energy level.
9. Watch the screen time. Hiding behind a phone and spending a lot of time on social media sites is a recipe for disaster in a depressed teen. Encourage your teen to put down their phone for device-free breaks. Instead, invite them to join household tasks, like grocery shopping or cooking, and give them a say. Talk with them about how they feel about their social media experiences.
10. Take care of yourself and family members. Supporting a depressed teen is stressful for parents and siblings. Lean on friends and professionals for your own support and try to follow a healthy lifestyle (eating right, exercising and getting enough sleep). Allow yourself time to take a break and have fun, too. It’s also important to pay attention to the impact your teenager’s depression may be having on siblings. Talk with them about what’s going on, give them some one-on-one attention and consider professional counseling.

• Stick to a schedule. Go to bed around the same time every night and set your alarm for the same time every morning — even on the weekends. A consistent sleep schedule trains your brain to naturally feel tired at bedtime so you fall asleep faster and makes it easier to wake up feeling refreshed.
• Limit food and drink before bed. Eating a big meal before bedtime can cause restless sleep. Likewise, drinking too many fluids may lead to multiple bathroom trips that disrupt your sleep. You should also avoid alcohol, caffeine and nicotine a few hours before bed.
• Make a habit of dimming household lights in the lead-up to bedtime. If your bedroom lets in light, try using blackout curtains or an eye mask. A too-bright bedroom sends your body the wrong signals, triggering the release of hormones that promote alertness instead of sleepiness.
• Create a bedtime routine. Doing the same things in the same order at the same time every night helps your mind and body relax before bed. Beyond the basics like brushing your teeth, your routine should include a calming, screen-free activity such as reading, stretching, taking a bath or listening to music.
• Go screen-free. TVs, computers and smartphones emit blue light that trick your brain into believing it's daytime, so it's harder to drift off. If you can, avoid using electronics in the evening as much as possible.
• Exercise earlier. Regular exercise is known to lower stress and improve sleep quality, but when done at night, it can have the opposite effect. If you exercise in the evening, make sure your workout is moderate (not vigorous) intensity and ends at least one hour before bedtime.
• Keep it quiet. Noises can keep you awake or interrupt your sleep. Some people find that music or certain sounds, like white noise, help them fall asleep faster. Don't hesitate to silence your phone overnight — many smartphones now have settings that allow you to receive emergency calls even when the phone is on silent.
• Address your stress. If stress or worries are keeping you up at night, try incorporating stress management techniques into your day and seek help from a professional therapist for more serious symptoms. Meditating or deep breathing right before bed can also be an effective way to slow your heart rate and racing thoughts.
• Talk to your doctor. If you have ongoing sleep problems or concerns about insomnia that are affecting your daily life, it's time to seek help. Your doctor may be able to identify and treat an underlying condition, change your prescription medication if it's interfering with your sleep or refer you to a specialist.

1. Go barefoot. Spending time in nature can boost your mood and tame stress, but studies reveal you may get even more of a benefit by strolling around your backyard without socks and shoes.
2. Get moving. Just 30 minutes a day of moderate exercise, such as a brisk walk, can help boost your mood and limit the effects of stress on your body. Bonus points if you exercise outdoors in the sunshine.
3. Play with a pet. When you touch your pet, your body releases oxytocin — a hormone that's linked to positive mood. Plus, studies show that pet owners — especially those who have dogs — tend to have greater life satisfaction, better self-esteem and reduced levels of loneliness and anxiety. Caring for a pet also gives your life more purpose and keeps you active.
4. Meditate. Meditation is a form of mindfulness, which anchors you to the present moment. Meditating on a consistent basis, even for short periods of a few minutes, may help boost your mood and decrease symptoms of stress.
5. Take a nap. It's a misconception that you can't make up lost sleep. Inserting a nap when your energy level is low or you've had a bad night's sleep can actually reduce stress and help your brain return to high performance quicker. Studies show the best nap length for most adults is 10–20 minutes.
6. Get a hug. Physical touch, such as hugging, releases oxytocin (also known as the "cuddle hormone"). Oxytocin is associated with higher levels of happiness, lower levels of stress and a greater sense of relaxation. So don't be afraid to ask a loved one for a hug when you need it. It's one of the simplest forms of stress relief available.
7. Plan a date with nature. Studies show that spending time in green spaces such as parks, forests and even local botanical gardens is a healthy way to manage stress. Turn off your cell phone and truly immerse yourself in nature for the best results.
8. Practice gratitude. Thanking others more often may lower your stress levels. In one recent study, people who did nice things for friends and family during stressful times had fewer health issues than those who didn't.
9. Set aside time for self-care. Listen to your favorite tunes. Read a good book. Relax in the bath. Volunteer. Sing to an audience of one. Whatever it is, set aside time — even just 5 to 10 minutes — for yourself each day. Even caring for others is self-care, which boosts mood and wellbeing for everyone involved.
10. Bonus Tip: Seek help when you need it. If you're experiencing overwhelming stress, consider making an appointment with a therapist (online or in-person) or visiting a trusted health care professional to discuss ways to improve your mental health. There's no shame in admitting you need help.

1. Acknowledge the problem. For many people struggling with addiction, the hardest step toward recovery is the very first one: recognizing there's a problem and deciding to make a change.
2. Ask for help. It takes courage to seek help for substance abuse — but remember that treatment works, there are many paths to help and people recover every day. Good places to start include your doctor, your company's Employee Assistance Program (EAP), an addiction counselor or a psychologist. You can also call the National Drug Helpline at 844-289-0879 for confidential support and guidance
3. Explore treatment options. There are many approaches to overcoming addiction, including medication, detox therapy, behavioral therapy and 12-step programs. Keep in mind, it can take several attempts at treatment before finding the right approach. Some people find abstaining from substances most helpful, while others do best with reducing their use of substances through a harm reduction model. Find treatment options near you.
4. Be patient. Like other diseases, substance abuse can be managed successfully. It takes time, motivation and support, but by making a commitment to change, you can take back control of your life.
5. Find sober friends. Try taking a class, joining a church, volunteering or attending events in your community.
6. Join a support group. Spending time with people who know exactly what you're going through can be very healing. You can benefit from hearing the experiences of group members and what they're doing to stay sober or reduce the amount of substances being used. Some groups include:
   • Narcotics Anonymous
   • Nar-Anon
   • Alcoholics Anonymous
   • Al-Anon
   • Faces and Voices of Recovery
7. Lean on your loved ones. Encouragement and support from friends and family are crucial to recovery. If you're hesitant to turn to your loved ones because you've disappointed them before, consider relationship counseling or family therapy through your company's EAP.
8. Learn healthy ways to relieve stress. Negative emotions like stress, loneliness, frustration, anxiety and hopelessness are a normal part of life, but they can make it tempting to turn to drugs or alcohol to cope. When you're armed with healthy techniques to manage these feelings, facing them isn't as overwhelming. Taking a walk, listening to music, yoga and meditation are some good ways to relax and find balance.
9. Take care of your health. Exercise, adequate sleep and a healthy diet will help keep your energy levels up and your stress levels down.