CAPS Staff: A Response to “13 Reasons Why”

By Tricia Besett-Alesch, PhD, licensed psychologist/clinical psychologist lead, training director/associate psychology manager
You or your friends may have heard about or viewed the hit Netflix series, 13 Reasons Why, based on the popular book by Jay Asher.  
 
The 13-episode series follows a group of high school students as they piece together a story left behind for them by their classmate Hannah Baker, who died by suicide and left 13 taped messages for friends and acquaintances. 
While this popular series sheds light on important topics (e.g., bullying, drinking behavior, sexual assault), there are some shortcomings:
  1. There is no mention of whether Hannah had a mental illness in any of the episodes. Mental illness affects one in five adolescents
  2. The series comes dangerously close to romanticizing suicide and misses a crucial opportunity to discuss depression and thoughts of suicide that is affecting so many teenagers and young adults
  3. There is no example of successful help-seeking. The series shows how one professional’s behavior was unethical and that counseling did not offer hope and resources. Unfortunately, it sends a message that mental health professionals are not a trusted source of help. There is a theme of silence throughout the story.
Furthermore, as Hannah’s classmates struggle with the aftermath of her suicide, there are no scenes highlighting the ways her peers reach out to talk with their parents, teachers, or coaches despite having a very difficult time coping with this loss. Without showing how to ask for help or that treatment and counseling are available and trustworthy, the show falls quite short on giving supportive examples of what to do and how to seek support. 
Please know University Health Center’s Counseling and Psychological Services is here to help and is a trustworthy resource for you, your friends and peers. Talk to Us. WE can HELP. Call 402.472.7450.
If you are struggling with thoughts of suicide, you can also text “START” to 741741 or call 1.800.273.TALK.
If you watch 13 Reasons Why, check out these important talking points developed by the Jed Foundation and Suicide Awareness Voices of Education.

How to Navigate End-of-Semester Roommate Conflict

By Danielle Parrish, LIMHP

If you haven’t already, you can start your countdown to the end of the semester. During this time, some of you may be experiencing end of the year stress. This may be caused not only by deadlines and exams, but possibly by roommate struggles as well.

The final weeks of the semester may not be the end of your relationship with your roommate, but remember this is not the time to work through every detail of every annoyance you’ve ever had with them.

Instead, focus on a temporary, solution-focused plan to get you both successfully through finals week (Later you can work through those bigger issues that have been brewing over time — Counseling and Psychological Services can help you with that, too!):

  1. Communicate – Set clear expectations by being open, direct and respectful ahead of time about what you need in order to be successful. Then, ask them what they need and really listen! This sets the stage to allow for ongoing dialogue to keep each other on track and to remind your roommate if they are not respecting your needs during times of high stress.
  2. Have a plan – Post a schedule of each of your final exams/projects so you can each be aware of the others’ level of stress throughout the coming weeks.
  3. Take accountability for YOU by practicing good self-care – Prioritize your sleep, nourish your body, stay physically active, shower(!), meditate, listen to relaxing music, spend time with friends and laugh.
  4. Support your roommate – Remember that they are stressed, too, and be there to support them, but also know your limits. Encourage them to rely on their friends and family and to reach out for professional support if needed.
  5. Get out of the room/apartment/house – Whether it’s a walk in the fresh air, a study session at the library or a coffee break downtown, just make an effort to change your scenery and take breaks from your roommate.
  6. Apologize when appropriate – We all make mistakes. If you’ve been the person who has taken out your stress on an unsuspecting, undeserving roommate, apologize! Then take some time to relax and do something fun together: watch Netflix, get ice cream or sit by the fountains at the Union.

CAPS is here if you need to talk. We offer individual counseling, free support groups, therapy groups and much more. Schedule an appointment by calling 402.472.7450.

Beat End-of-Semester Anxiety With These Tips

By Kylie (Xiping) Qiu, M.S., PLMHP

Our mind is like a wave. We can’t control the wave, but we can always learn how to surf.

No matter how busy we are, we all brush our teeth on average six minutes a day. We never question this routine, and yet when it comes to maintaining our mental health, many of us don’t do this until we are forced to because of a common reason — “I don’t have time.”

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But if we’re honest, this isn’t exactly true because we don’t skip brushing our teeth when we are busy. It all comes down to priorities.

We have to recognize that preventive care is just as important for our mental health as it is our physical health. Don’t wait until you have a mental break down to learn stress management!

How stress affects the body

Stress is our body’s response to a life-threatening situation, like suddenly stumbling across a venomous snack on a hike. On an abstract level, exams are the “life-threatening danger” for students.

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No one can avoid stress, but we can avoid anxiety. Our mind is like a wave. We can’t control the wave, but we can always learn how to surf.

To reduce our anxiety level while experiencing stress, we have to calm down first.

Be a bridge builder

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When “fighting” with finals, the sympathetic nervous system (SNS) is aroused by stress, anger or fear, which accelerates the heart rate, constricts blood vessels and raises blood pressure — the physical feelings of anxiousness. When the sympathetic nervous system is working, our parasympathetic nervous system (PSNS) is on leave. PSNS slows the heart rate, increases intestinal and glandular activity and relaxes the muscles.

SNS and PSNS are like two workers with their own shifts on duty. When one is always in charge and prohibits the other to work, it breaks the system’s balance. To make matters trickier, these two workers don’t talk to each other.

Don’t lose hope! The secret is that we were all born with the ability to manage and build bridges between those two workers. We do this by controlling our breathing and managing our judgmental thoughts.

Breathe to achieve mindfulness

Consider your natural breathing. Is it fast or slow? Deep or shallow? Stable or unstable? Breathing deeply and slowly can activate our PSNS. Intentionally do this whenever you can.

Manage your judgmental thoughts

Thoughts like “I need to skip this chapter because I don’t have time” or “I just couldn’t focus” help you make a decision, which is the type of thoughts we need. Judgmental thoughts like “I am stupid” or “it’s my fault that I didn’t study well enough throughout the semester, and see this is the consequence…” won’t help you manage stress because they hurt your self-esteem and confidence.

The three steps to thought management are:

  1. Recognize judgmental thoughts
  2. Observe your thoughts like a third party instead of reacting in your typical ways
  3. Let the thoughts go without reaction

You might say, “I couldn’t let it go.” That’s OK because you tried. You will build more skill and tolerance if you try it repeatedly.

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What else can I do?

  1. Educate yourself on stress management and take time to balance SNS and PSNS
  2. Evaluate yourself by scoring your anxiety or fear on a scale of one to 10 (10 being the most overwhelming) at least once a day
  3. Practice breathing skills instead of watching your cell phone during your study breaks. Intentionally slow down your breathing and make it as deep as you can, but don’t hold your breath. Follow these instructions:
    1. Sit comfortably. Devote 100 percent of your attention on your breathing. Breathe in all the air until your lungs are filled and then breathe out slowly until there is no air left. Repeat this five, 10 or 20 times.
  4. Repeat breathing skills until you feel much calmer or less stressed
  5. Manage your judgmental thoughts
  6. Plan six minutes in your daily schedule to focus on your mental health, just like brushing teeth
  7. Learn more stress management tips when you complete your final because you deserve to feel less stressed during your next finals preparation

If you need help managing your stress, talk with us. We can help. Make an appointment with Counseling and Psychological Services by calling 402.472.7450.

Shedding Light on Suicide Ideation

by Heather Patterson Meyer, PsyD, MAT, clinical psychologist

Suicide is the second leading cause of death among people 15 to 24, and more than 1,000 suicide deaths occur on college campuses annually, according to the Jed Foundation. White males under 21 and LGBTQ youth are the highest risk groups for suicidal ideation (thoughts about suicide), but anyone can experience those types of thoughts, regardless of race, religion, class or sexual orientation.

These statistics show that this issue cannot be ignored, especially on a college campus like Nebraska. It’s time to commit to learning more so we can help prevent suicide.

Know the warning signs

While there’s no surefire way to predict when or if someone will attempt suicide, there are warning signs that could indicate someone is struggling and needs help or support. According to the National Institute of Mental Health, these signs include:

  • Acting recklessly
  • Anxiousness and agitation
  • Extreme mood swings
  • Feeling trapped or in unbearable pain
  • Giving away prized possessions
  • Hopelessness
  • Increased alcohol or drug use
  • Intense anger or seeking revenge
  • Looking for a way to kill oneself
  • Sleeping too little or too much
  • Talking about being a burden to others or having no sense of purpose
  • Talking about death
  • Withdrawal and isolation

What to do if you are having thoughts of suicide

Get help immediately:

  • Call 911
  • Go to the nearest emergency room, Bryan West (2300 S. 16th St.)
  • Text “START” to 741-741 or call 1.800.273.TALK
  • Call Counseling and Psychological Services (CAPS) at 402.472.7450 or stop by the office at the University Health Center between 8 to 5 p.m. Monday through Friday
  • Call UNL Police at 402.472.2222

You may feel hopeless and that you are beyond help, but it’s important to know that you are not alone. With some support, you can find ways to cope with your problems and the pain can subside.

If you aren’t immediately considering attempting suicide but have had thoughts of death or suicidal ideation, reach out to a friend or family member — someone you can trust. Talking about your feelings can help you feel less overwhelmed and isolated. Make an appointment at CAPS (402.472.7450) as soon as possible, even if you feel it isn’t an emergency. The sooner you find support, the better you may feel.

Remember, even if you no longer have these thoughts or if they come and go, it’s important to seek help as it may be a signal of a more serious underlying issue.

What to do if you are worried about a friend or family member

If you notice someone exhibiting the signs mentioned above, don’t be a silent observer. Your support can be really meaningful to someone struggling with thoughts of suicide.

Here are a few ways you can help them get support and help as soon as possible.

  • Express your concern and ask directly if they have current, recent, or past thoughts of suicide. Bringing up your concern does not give them morbid ideas. In fact, it’s one of the most helpful actions you can take. Bringing it up can help them know they are not alone and that you care about them. It also can help you determine how urgent the need is for help. If they have a specific plan and means to carry out that plan, call 911 and stay with them until help arrives. Not sure how to get the conversation started? Visit helpguide.org for sample questions you can ask.
  • Listen to them and don’t try to problem-solve. People who struggle with suicidal thoughts are often frightened by what they feel. Simply being there for them and comforting them with your presence can make a huge impact. Don’t judge them for what they tell you.
  • Remind them of the truth. Reassure them that treatment can help and that these feelings can get better. Connect them to resources on campus, such as CAPS, or in their community.
  • Get support and guidance. Talk to an RA, RD, academic advisor or someone in CAPS about your concerns. If the need is urgent, call 911 and stay with them until help arrives. Speaking up and taking action is always appropriate because keeping your friend or family member safe is more important than losing their trust or friendship.

CAPS is here to support you, whether you are currently experiencing suicidal ideation, are depressed or anxious, have lost a loved one to suicide, are concerned about a friend or family member’s suicidal ideation, or need to talk for any reason. Call 402.472.7450 to make an appointment with one of our counselors or psychologists.

If you want to be more involved, participate in and/or donate to the UNL Out of the Darkness Campus Walk April 23 from 2 to 4 p.m. Out of the Darkness Walks like this and others across the country promote fundraising for the American Foundation for Suicide Prevention and promote healing to the local community to those who have lost someone or struggled. Join us on the UNL greenspace for activities, speakers, and, of course, the walk. Pre-registration is free at afsp.donordrive.com/event/unl.

Let’s Talk About Depression

“You say you’re ‘depressed’—all I see is resilience. You are allowed to feel messed up and inside out. It doesn’t mean you’re defective—it just means you’re human.” – David Mitchell, Cloud Atlas

Tomorrow is World Health Day, and this year’s theme is Depression: Let’s Talk.

Depression is one of the most common mental illnesses in the U.S. and yet it’s still considered somewhat of a taboo topic to discuss. There’s a perception that depression doesn’t exist or that it’s nothing more than a personal problem or sign of weakness. This stigmatization surrounding depression stems from a misunderstanding of what depression is and is not.

So let’s debunk a few depression myths, shall we?

  1. Depression isn’t a feeling or reality that a person brought on themselves and isn’t something you can “just get over.” It’s a serious illness, not a character flaw. You wouldn’t accuse someone with brain cancer for being lazy and causing their own illness, so why treat people with depression this way?
  1. Depression isn’t simply being sad. Some moments in life—the loss of a loved one, moving away from home or failing an exam—warrant grieving. Depression and grief share some of the same features, but they are not one in the same. For example, grief is often fleeting, whereas depression lasts for weeks. Grief doesn’t typically affect self-esteem, but with depression, it’s common to loathe oneself and feel hopeless. Grief can lead to depression in some cases, but it’s important to distinguish the two.
  1. Depression isn’t just a woman’s disease. While it’s true that women suffer from depression twice as often as men, no one is immune from depression; it’s an equal-opportunity illness. All ages, genders, races and economic statuses can be affected.
  1. Depression doesn’t just affect the mind, but the entire body as well. It can negatively impact your immune system, making it more difficult to fight off infections and illnesses. It affects appetite, which can cause serious weight loss or gain. Headaches, stomach pain and other physical symptoms can occur if depression is left untreated. Unipolar major depression is the leading cause of disability, and only heart disease tops depression in causes of lost work days in the U.S.
  1. Depression won’t usually disappear if the sufferer ignores it for long enough and refuses to seek help. If treated, depression symptoms can decrease or even disappear. If left untreated, it could lead to failing health or even suicide.

About one in five people will suffer from a mental illness at some point in their lives. With those odds, it’s likely you already interact with someone who currently deals with from depression. Here are a few ways you can help support them and end the stigma surrounding depression:

  • Be the example. Take an online mental health screening at least once a year and encourage your friends and family to do the same. If you are worried you might be struggling with depression, make an appointment with Counseling and Psychological Services by calling 402.472.7450.
  • Educate yourself. The more you know, the better stigma buster you’ll be. Take time to research depression and other mental illnesses. A good place to start would be the Anxiety and Depression Association of America.
  • Watch your language. Expressions like “get over it” or “just relax” can minimize how a person feels. Instead use supportive language like “I’m sorry you aren’t feeling well” and ask what you can do to help.
  • Listen and be supportive. People who are depressed often feel isolated, so check in on them and ask them how they’re doing. Spend time with them when you can and know it’s OK to not know what to say. Showing them you care may motivate them to seek treatment if they haven’t already.
  • Be kind. Small acts of kindness can go a long way, whether it’s a simple smile to your fellow classmate who passes you on campus or inviting that friend you haven’t talked to in a while out for coffee to chat.
  • Share your story. Talking about your struggle with depression can help you recover and challenge stereotypes. It may even encourage others to get help if they need it.

For more information on mental wellness and CAPS services, visit health.unl.edu/caps

Understand the Hidden Signs of an Eating Disorder

By Heather Patterson Meyer, PsyD, MAT, Counseling and Psychological Services licensed psychologist and Eating Disorders Treatment Team coordinator

There are many myths out there about eating disorders, so it’s no wonder that it can be difficult to truly understand the risks and warning signs of an eating disorder.

Unlike what some people assume, eating disorders are not limited to a particular age group, gender, race, sexual orientation or other identifier. They can affect anyone. It’s also important to recognize that eating disorders are not a choice but a mental illness that develops over time. People with eating disorders did not “bring it on themselves.” Eating disorders are not limited to anorexia, but they also can include ARFID, binge eating disorder, bulimia, pica, rumination disorder and other unspecified feeding or eating disorder. Understanding all of this will help you better recognize warning signs of an eating disorder.

While there are many signs, here is a list of more subtle ones that often slip by unnoticed:

  • Excessively looking in the mirror
  • Negatively commenting on your physical appearance
  • Wearing baggy clothes to hide your body shape
  • No longer eating with friends or family
  • Consuming caffeine to suppress your appetite
  • Constantly counting calories and/or micronutrients
  • Excessively chewing before swallowing
  • Taking a long time to eat
  • Obsessing over “clean eating
  • Consuming fewer calories in order to drink more alcohol
  • Frequently visiting nutrition websites
  • Spending hours exercising and obsessing over calories burned
  • Becoming upset if an exercise routine is disrupted and eating less to compensate
  • Using diet shakes, pills, teas, etc.
  • Losing interest in previously enjoyed activities.

If you or a loved one is exhibiting these behaviors, it could be a hidden sign of an eating disorder. Help is available. The UHC Eating Disorders Treatment Team specializes in helping individuals struggling with eating disorders or disordered eating attitudes and behaviors. They offer individual counseling, support and therapy groups, nutritional counseling, medical evaluations and more. To talk to a member of the team, call 402-472-7450. You can also get help by calling the NEDA Helpline at 1-800-931-2237.

For a full list of eating disorder warning signs, visit the Remuda Ranch website.

Also be sure to read Monday’s blog post about ways you can support Eating Disorders Awareness Week and help end the stigma surrounding eating disorders.

Fighting Seasonal Affective Disorder

By Ashley Grundmayer, M.A., licensed independent mental health practitioner and provisionally licensed alcohol and drug counselor with Counseling and Psychological Services (CAPS)

It’s common to feel a little down in the dumps during the cold and dark winter months. However, if the change of seasons has suddenly caused you to have low mood, decreased energy, irritability or excessive sleepiness, it could be a sign that the “winter blues” or “cabin fever” has developed into Seasonal Affective Disorder (SAD).

What is SAD?

SAD is a depressive disorder often triggered during the change of seasons. Most people with SAD experience an onset of symptoms in the fall that continues into the winter months, but it can appear during any change of season.

SAD affects people from all walks of life, but young adults, women and those with a family history of depression or SAD are more likely to experience the disorder.

What are the symptoms?

The National Institute of Mental Health reports people with SAD often experience symptoms of major depression, such as:

  • Feeling depressed during most of the day, nearly every day
  • Feeling hopeless or worthless
  • Feeling sluggish or agitated
  • Having difficulty concentrating
  • Losing interest in activities you once enjoyed.

Additionally, people with SAD may struggle with hypersomnia, overeating, decreased energy and an urge to “hibernate,” which could involve avoiding academic responsibilities and withdrawing from social opportunities.

What causes it?

The cause of SAD is unknown, but some medical and mental health experts suspect that a disruption of melatonin levels, serotonin levels and a person’s biological clock may be the primary culprit. As college students, any SAD symptoms caused by these changes in the body can be exacerbated by an increased workload and struggles with time management. This is why it’s especially important to keep an eye out for SAD symptoms, not only personally, but also in the lives of your friends, classmates and significant others.

What should I do if I think I have SAD?

The first step is to recognize the problem. If you are struggling with mild SAD symptoms, there are several coping strategies you can try:

  • Light therapy: Add another lamp or two to your dorm room. Consider purchasing a fixture designed specifically to emit light levels that have been found to be therapeutic. Weather-permitting, try to spend at least a few minutes outdoors in the sunlight each day.
  • Exercise: Whether it’s going to a group fitness class at the Campus Rec Center, lifting weights in your living area, taking a few laps around the interior of the Union or heading outdoors for a hike, find an activity that interests you and try to incorporate it into your daily winter routine.
  • Socialize: Combat the desire to isolate by making plans with friends, roommates or family. If you don’t have someone to spend time with, attend an on-campus activity, join a free CAPS support group, attend a Student Involvement Coffee Talks session or participate in some similar activity to meet new people.
  • Improve your sleep: As tempting as it may be, avoid oversleeping. Create a sleep schedule and try to stick to it every day. Limit caffeine consumption. Create a healthier sleep environment by not using electronic devices in bed. Stop by the Health Promotion & Outreach office in the lower level of the University Health Center to pick up a free sleep kit to help you get a better night’s rest.

If you are experiencing severe SAD symptoms, make an appointment with a therapist. Our Counseling and Psychological Services (CAPS) staff is here for you. Bonus: If you pay student fees, your first four therapy sessions per academic lifetime are no extra cost (Some restrictions apply).

For more information about CAPS, visit health.unl.edu/caps.