Mental Wellness Promotion: Prevention and Treatment Jane Timmons-Mitchell, Ph.D. Cleveland Clinic October 7, 2014

Depression/Suicidality 3.3% of 13 to 18 year olds experience severe depression Treatment includes medication and “talk therapy” This combination can be very effective Cognitive-behavior therapy (CBT) helps people address thinking patterns that can distort what is happening to make them feel worse. CBT helps people evaluate what was really said and challenges thinking you are responsible, it couldn’t be worse, etc.

Anxiety/Stress Stress is normal; everyone experiences stress when there is a lot to do or something important is coming up. Anxiety is when worry becomes overwhelming. Sometimes, medication is needed. Talk therapy can also be helpful. CBT can address anxiety as well, by helping come up with things to do other than worrying, and by letting go of worries.

Things You Can Do to Help Yourself Sleep Exercise Use social media wisely Don’t use substances: they can interact negatively with other conditions Associate with positive peers Find at least one adult mentor Discover something that excites you and spend time doing it

Sleep Sleep is vital to your well-being, as important as the air you breathe, the water you drink and the food you eat. It can even help you to eat better and manage the stress of being a teen. It is natural to not be able to fall asleep before 11:00 pm. Teens need about 9 1/4 hours of sleep each night to function best. Most teens do not get enough sleep — one study found that only 15% reported sleeping 8 1/2 hours on school nights. Teens tend to have irregular sleep patterns across the week — they typically stay up late and sleep in late on the weekends, which can affect their biological clocks and hurt the quality of their sleep. http://sleepfoundation.org/sleep-topics/teens-and-sleep

Exercise Adolescents should do 60 minutes (1 hour) or more of physical activity each day. Aerobic activity should make up most of your child's 60 or more minutes of physical activity each day. Examples: brisk walking, running. Muscle strengthening like gymnastics or push-ups on 3 days per week Bone strengthening like jumping rope or running on 3 days per week Exercise can help reduce depression, anxiety and stress cdc.gov

Using Social Media Wisely Use Facebook to share, not to compare Be careful not to overshare: 39% of teens do not use privacy settings Say no to cyberbullying—tell a teacher or a parent Be positive; use the Golden Rule Keep your lovelife off line Keep your photos clean—if you wouldn’t want a college admissions officer of a future employer to see them, don’t share Choose your friends wisely—only allow people you really know. Research shows the more anonymous friends you have, the greater the anxiety and more possibility for unintended consequences. Take time to unplug and recharge off line—there is a chrome plugin that will block logging into social media sites. Consider using it occasionally. Huffington Post, 2/23/2013

Substances You will have another talk in this series on Substance Abuse For today’s topic, sometimes teens seek to self-medicate feelings of anxiety or depression with substances. Teens who are depressed, for example, are more likely to smoke. This can be very dangerous: many mental health issues can be made worse by using substances, and your health can be compromised.

Positive Peers Teens spend a lot of time with friends, who can be the most important people in your world. Others see your friends as a reflection of you. If you have positive peers, they will help you make good choices. Positive peers are people who make good choices for themselves and are engaged in things that help. They might be members of sports teams and clubs at school; they may have responsibility in a faith-based institution (church, synagogue, mosque, etc.) ; they may help out at home and in the community. Positive peers can help you decide when to seek help from others.

Mentors and Finding Your Passion All successful youth have at least one positive adult who they can talk to about things that are bothering them. It doesn’t have to be someone in your family; it could be someone at school, a neighbor, a boss. It should be someone you can contact regularly who you are comfortable asking what they think of your plans. A mentor can be someone who does a job you are interested in. If you want to become a teacher, for example, you might spend time with a teacher and ask questions about the profession. It’s important to find something you are excited about and can pursue.

Learn to Do Slow Breathing Very easy and effective way to increase relaxation You will need a way to time seconds --second hand --digital stopwatch --say to self “1 MISSISSIPPI, 2 MISSISSIPPI, etc” --begin by breathing in on a 5 count and out on a 5 count --gradually increase to breathing in on a 10 count and out on a 10 count --repeat consecutively for at least two minutes

Identify People Who Can Help If you are feeling overwhelmed or helpless, talk to someone. A friend (but know that a friend may need to tell someone else) Parents Teachers School Counselor Clergy Your doctor Call National Lifeline: 1-800- 273-8255 24/7

Effective Help is Available There are things to do that will help Reaching out to others can help you get connected to effective treatment if needed.