Self-Injury: Cutting

Self-injury, also known as self-mutilation, is defined by intentional injury/harm to oneself. Although there are many different forms of self-injury, one of the most common and the focus of today's blog is cutting. Cutting is generally NOT a suicide attempt but rather an unhealthy way of coping with painful emotions. In conversations with multiple people who have cut in the past, they have reported that is was cleansing for them and one reported "it released the bad blood." It can have similar effects as substance use since it causes spikes in endorphin levels as your body is trying to compensate for the physical pain.

As noted by the Mayo Clinic information website-Through Self-injury, the person may be trying to:

• Manage or reduce severe distress or anxiety and provide a sense of relief
• Provide a distraction from painful emotions through physical pain
• Feel a sense of control over his or her body, feelings or life situations
• Feel something, anything, even if it's physical pain, when feeling emotionally empty
• Express internal feelings in an external way
• Communicate depression or distressful feelings to the outside world
• Be punished for perceived faults

 http://www.mayoclinic.com/health/self-injury/DS00775/DSECTION=causes

Cutting generally starts in early adolescence and is more common in females than males. However, there are adults who cut as well. Having friends who cut increases the risk for a person to start cutting and people who have stressful and/or traumatic family lives have higher incidences as well. Once again, it is an unhealthy way of coping with painful emotions. There are risks of infection, scarring, feelings of guilt/shame and/or possible fatal consequences from cutting to deep or doing it while under the influence.

If you are cutting:

• Try to find another way to get a similar release ie; hold a piece of ice in your hand, go for a walk/run or other physical exercise- positive ways to release endorphins
• Recognize your triggers that lead to cutting and make a plan in advance to distract or soothe yourself to avoid getting to that behavior
• Learn positive coping techniques such as; deep breathing/relaxation, expressing your painful emotions through talking, writing or art, spend time with people who make you happy.

If you are a friend or loved one of someone who is cutting:

• Try not to be judgmental
• Learn as much as you can about it
• Let them know you care
• Share your coping techniques with them

For more information on cutting visit the Mayo Clinic website at: http://www.mayoclinic.com/health/self-injury/DS00775

or to find a local therapist in Ulster County that is skilled in this area call: (845) 339-9090 x113- MHA information and referral hotline.

Ulster County NY Mental Health Crisis INFO

SUICIDE PREVENTION & SUPPORT

National Suicide Prevention 24 Hour Lifeline 1-800-273-TALK

WALK-IN CRISIS CENTERS

Family of Woodstock, 16 Rock City Road, Woodstock 845-679-2485

Family of Ellenville, 221 Canal Street, Ellenville 845-647-2443

Family of New Paltz, 51 North Chestnut Street, New Paltz 845-255-8801

7 Days/Week, 9:00am - 9:30pm

Monday - Thursday 10:00am - 5:00pm, Friday 10:00am - 4:00pm

Monday - Friday 9:00am - 4:30pm

Family of Woodstock, 39 John Street, Kingston 845-331-7080

Monday - Friday 9:00am - 11:00am; 1:00pm - 4:00pm

EMERGENCY MENTAL HEALTH SERVICES

845-334-4244

HealthAlliance of the Hudson Valley

Kingston Hospital, 396 Broadway, Kingston

7 Days/Week, 24 Hours/Day

CRIME VICTIMS ASSISTANCE

Family of Woodstock 24 Hour Hotline 845-338-2370

JustConnect Teen Hotline 845-331-5565

Ulster County Crime Victims Assistance Program 845-340-3443

Sexual Assault/Domestic Violence & Hotline 845-340-3442

INFORMATION, REFERRAL & SUPPORT GROUPS

MHA: Mental Health Association in Ulster County 845-339-9090

CRISIS INTERVENTION & SUPPORT

ULSTER COUNTY SUICIDE RESPONSE COORDINATING COMMITTEE

Ulster County Department of Mental Health 845-340-4173

Binge Drinking

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FACTS ABOUT MENTAL ILLNESS AND VIOLENCE

Facts about Mental Illness and Violence

• It is important to note that behavioral health research and practice over the last 20 years reveal that most people who are violent do not have a mental disorder, and most people with a mental disorder are not violent.*
• In fact, studies indicate that people with mental illnesses are more likely to be the victims of violent attacks than the general population. *
• Demographic variables such as age, gender and socioeconomic status are more reliable predictors of violence than mental illness.*
• Misconceptions about mental illness can cause discrimination and unfairly hamper the recovery of the nearly 20 percent of all adult Americans who experience a mental illness each year.
• Family, friends, employers and school personnel can be a line of “first response” if they notice a person is behaving differently and is of concern.  The choice to seek treatment is more likely if others are compassionate and supportive.   Mental health treatment can be effective and can enable a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.
• Treatment is effective and people recover from mental illnesses to live productive lives in our communities.

 *Source: http://www.samhsa.gov/mentalhealth/understanding_Mentalllness_Factsheet.aspx

Coping with Natural Diasters

In the wake of hurricane Sandy and residual stress from the prior year's hurricane Irene, coping with the stress/distress and trauma from a natural disaster can be overwhelming. From simply having no electricity for days to total devastation of your home and/or many other losses, these events are STRESSFUL.

First and Foremost, here are some common responses to a natural disaster:

• Disbelief and numbness
• Fear and anxiety about the future
• Loss of feeling secure in the world
• Self doubt
• Magical thinking, superstition and omens
• Disorientation; difficulty making decisions or concentrating
• Heightened response to noise, surprises, jumpiness
• Uncomfortable being alone
• Nightmares and reoccurring thoughts about the event
• Irritability and anger
• Sadness and depression
• Feeling powerless
• Changes in eating patterns; loss of appetite or overeating
• Crying for “no apparent reason”
• Headaches, back pains and stomach problems
• Difficulty sleeping or falling asleep
•  Sense that life is out of balance
• Physical discomfort, aches, cold-like symptoms
• Feeling guilty that others have suffered more than you have

So how do you get back into the routine of life and find a way to try re-establish some normalcy?
Research has shown that the way in which a person takes care of him or herself during the first few days following a traumatic event will help to minimize the development of future psychological reactions to the event.  Understanding the reactions of your body and your emotions can help you deal with the trauma of the event.

Be Gentle With Yourself

Your body and brain work together in reaction to things that happen to you.  As a result, you experience both emotional feelings and physical reactions to events.  Sometimes these reactions are pleasurable, such as when you receive praise from someone.  Other situations cause reactions of stress and discomfort.  Physical reactions can range from muscle tension, headache, elevated blood pressure, stomach distress, nausea, pain and almost any king of physical symptom.  Emotional reactions to a trauma can include anxiety, panic, depression, anger, panic, depression, anger, sleep disturbance and irritability, to name just a few.  

Try to Eat Well and Exercise Within Your Capabilities

People respond differently to traumatic events.  It is hard to predict who will react strongly and who will show little reaction to a particular event.  If you have strong reactions, it does not mean that you are mentally weak or mentally ill.  Reactions to traumatic events are considered “normal reactions to abnormal events.”  If you find that after several weeks you are still unable to cope with your feelings, you may want to consider getting extra help through a mental health professional.  This does not mean you are mentally ill, but simply means that your reaction needs more attention.

Additional ways to care for yourself after a Traumatic event:

•         Avoid Alcohol use.  Although you may feel like going home and relaxing with a glass of wine, it is very important that you avoid alcohol for at least 24 hours.  The reason is that alcohol works on the way which you preserve memories of recent events.  Because alcohol tends to “numb” your feelings, its influence causes your memories to be preserved in unpredictable ways.  It is very important that your brain have the opportunity to deal with all aspects of a traumatic event so that you will less likely to be bothered by it later in ways that you may not understand.

•     Avoid caffeine.  Caffeine is a stimulant.  You need to relax and be calm.  The stimulation of both caffeine and a traumatic event may make it harder to cope and settle down.

•        Communicate about the event  Your mind needs to process what happened so that it can resolve your personal feelings.  Talk with your co-workers, manager, EAP counselor, family member and friends.  Bottling up your feelings will inevitably cause them to appear later in unpredictable ways.  You may want to bring home the phone numbers of some of your co-workers to give support to one another in the coming days.

•      Ask for Nurturing and Understanding when you return home. Sometimes friends and family may not understand the feelings you experience following a traumatic event.  Ask your loved ones to help you relax by being supportive and understanding.

•       Use natural methods to relax.  A warm bath, massage and/or soothing music are much better means of relaxing after a traumatic event then alcoholic beverages.  Think in terms of pampering yourself after a difficult experience.  Exercise within healthful limits is also great way to deal with stress.

•       Seek help if the stress symptoms do not diminish after a reasonable amount of time.  You may want to consider getting some additional help through a mental health professional.  Prompt attention to traumatic stress can often minimize long-term effects. 

Taken from: Ways To Care For Yourself After a Traumatic Event- CISM literature

Local Ulster County New York Disaster Resources

American Red Cross
Ulster County Chapter
Ulster County Chapter
21 O'Neil Street
Kingston, NY 12401
Phone: (845) 338-7020

24 Hour Emergency:
(845) 338-7021

_________________________________________________

        FEMA ASSISTANCE

      FEMA provides funding and assistance to local residents (renters and homeowners) and businesses who have sustained loss of or damage to property that is not covered by insurance. Contact your insurance company first: If you are NOT covered for the storm damage by your insurance company, you may be eligible for federal aid. You will need to obtain a letter from your insurance company saying you are not covered for damage from the storm. 

      1-800-621-FEMA (3362)

__________________________________________

      Mental Health Association In Ulster County
      (845) 339-9090

Aging & Depression

Aging is an inevitable and normal part of human development. Development across the lifespan contains a series of stages from the prenatal period which is from conception to birth, through childhood, adolescence and into early, middle and then late adulthood. From the time we are born to the moment we die, we have taken momentous strides as well as losses as each of these stages present their own accomplishments as well as challenges. 

Depression is not a normal part of aging.

However, depression is one of the conditions most commonly associated with suicide in older adults and is often under-recognized and under-treated. Although only about 1 to 2% of older adults have major depression at some time, about 15% experience symptoms of depression. Also, many of these symptoms may be looked over due to similar symptoms caused by other health problems. For instance, symptoms such as fatigue, sleeping difficulty, cognitive issues and bodily complaints may be incorrectly interpreted as a sign of aging rather than of depression. Older adults also may express signs of depression differently than younger adults. For example older adults may communicate depression through physical complaints rather than through expressing emotional difficulties. However, depression in older adults is not significantly different than those in younger adults, meaning there is no need for different assessment tools. 

Emotional responses of sadness, grief and melancholy are normal. However, persistent feelings of depression that impacts a person’s ability to function is not. As we age, we may experience chronic or debilitating illnesses, loss of friends and loved ones, job retirement, financial issues and/or feelings of loss on control which can weigh heavy on our mental health and emotional well-being. For instance, weakening eyesight and hearing loss as well as the difficulty of getting around may cause feelings of insecurity, unhappiness or fear. All which could lead to social isolation, lowered self-esteem and even hopelessness. Another prime example is the transition from many years in the workplace to retirement with a potential loss of daily meaning or activity. These experiences can readily lead to chronic depression.

Also, there is some evidence that natural body changes associated with aging may increase a person’s risk of experiencing depression. For instance, studies suggest that lower concentrations of folate in the blood and nervous system may contribute to depression, mental impairment, and dementia. Researchers also suspect that there may be a link between the onset of depression in older adults and Alzheimer’s disease.

Regardless of its cause, depression can have serious physical effects on older people. The mortality rate for elderly men and women suffering from both depression and feelings of loneliness is higher than for those who report satisfaction with their lives.

So, what are some of the symptoms of depression? Symptoms include:

·         difficulty concentrating, remembering details, and making decisions

·         fatigue and decreased energy

·         feelings of guilt, worthlessness, and/or helplessness

·         feelings of hopelessness and/or pessimism

·         insomnia, early-morning wakefulness, or excessive sleeping

·         irritability, restlessness

·         loss of interest in activities or hobbies once pleasurable, including sex

·         overeating or appetite loss

·         persistent body aches or pains

·         persistent sad, anxious, or "empty" feelings

•  thoughts of suicide, suicide attempts

Depression can and should be treated. It is important to take care of your mental health just like you would treat physical health issues. Untreated depression can worsen daily health issues, create problems with your relationships, increase chances of drug/alcohol abuse and lead a person to death by suicide.

Talk to you doctor, therapist or other health professional to get more information and/or a referral to someone that can help you find treatment. 

For local Ulster County residents contact the MHA at (845) 399-9090 x113 for a list of mental health providers in your area.

Relationship Effectiveness

Effectively communicating to someone we care about in a conflict situation can sometimes be a daunting task, especially when the intensity of emotions are high. Pulling from a Dialectical behavioral therapy (DBT) approach, these are some tips on how to be effective communicating in a relationship that you want to keep.

1. Be Gentle- Be respectful, courteous and even-tempered. Imagine how you would want someone to approach you during/after a conflict. Remember that this is a person you care about and you want to improve the relationship with.

• Approach the person when you are calm and able to be temperate in your approach.
• Do not attack the person verbally, physically or use hostile body language, ie; clenching fists, furrowed eyebrows, dominating space.
• Do not use manipulative or threatening statements such ; "You cant see your son if you dont..." or "I'll kill myself if you..."
• Do not Judge. Do not says things like "if you were a good person, you would..." or use "you should..", "you shouldn't..."
• If it gets to heated take a break and come back when calm.

2. Be Attentive- 

• Try to actively listen to what the other person is saying. Try to understand their point of view or opinion. If you don't understand it, acknowledge you don't understand and ask them to re-explain it or just accept that that is their own perception and that is okay.
• Do not interrupt or talk over the other person.
• Validate or acknowledge the other person's feelings, thought's and difficulties. Validate them out loud by saying statements such as; "I can see that you are feeling....", "I realize this is hard for you...", "I know that you tried your best to..."

3. Use a balance of emotion and rational- Also known as the "wise mind," take in your emotions as well as use your reasonable thoughts. Try to keep a balance between both so that you don't go deep into one or the other. Too much emotion can make it difficult to overcome the conflict and not enough emotion can make it feel cold.