Infectious Diseases Resources

by Band Back Together | Aug 11, 2018

What Are Infectious Diseases?

Infectious diseases (also known as transmissible diseases or communicable diseases) are clinically evident illnesses caused by microorganisms, such as bacteria, viruses, fungi, or parasites that can be spread – directly or indirectly – from one vector to another. Some infectious diseases are caused by person-to-person contact, others are passed via animal or insect bite, and still others are caused by ingestion of infected, contaminated food, water, or other environmental exposures.

Infectious diseases can even be caused by normally-inert microorganisms present on the skin or in our bodies that, under the right circumstances, can cause illness. These are called “opportunistic infections.”

Many infectious diseases, such as the chicken pox virus, can be prevented by vaccination; other infectious diseases can be prevented (or risk for infection lowered) by frequent and proper hand-washing.

Symptoms of infectious diseases may vary wildly based upon the microorganism that causes the disease, but many infectious diseases are accompanied by fever and chills. People may complain of mild complaints while others experience life-threatening infections that require IV antibiotics and hospital care.

Infectious diseases are often called “contagious diseases,” when these illnesses are easily transmissible from secretions or other contacts with an ill person. A contagious disease is easily transmitted and considered especially infective.

Not all infectious diseases are easily transmittable from person to person – many require other ways of transmission, such as via vector or sexual contact. Those who have less communicable diseases don’t require medical isolation or special precautions as the infectious agent is only transmissible via certain routes.

How Are Microorganisms Classified?

While there exists an almost infinite amount of microorganisms, most do not cause disease. Infectious diseases are the result of the interplay between the few disease-causing pathogens and the host’s defenses. The severity and appearance of disease from a pathogen depends largely upon the ability of the pathogen to infect the host as well as the ability of the host to resist infection by the pathogen. Most clinicians classify infectious microorganisms according to the status of the host’s defenses:

1) Primary Pathogens cause disease due to their presence in a normal and healthy host. The virulence (the severity of the diseases they cause) of a microorganism is a consequence of the need for that microorganism to breed and spread. Most of the common primary pathogens that affect humans only infect humans, although it’s important to note that many of the serious diseases are caused by environmental factors. Primary pathogens often cause a more severe form of disease in those who already have decreased immune system or resistance.

2) Opportunistic Pathogens are microorganisms that infect a person with weakened defenses; often caused by microorganisms that normally in contact with the host without causing disease, like fungi or pathogenic bacteria in the GI tract. These impairments in the hosts defenses may be the result of genetic defects, immunosuppressive medications, radiation, or as a result of a disease that causes immunosuppression (such as HIV/AIDS)

How Are Infectious Diseases Transmitted?

Infectious diseases are transmitted from source to source, and learning about the mode of transmission is a vital component to understanding the inner workings of the microorganisms.

Respiratory Illnesses/Meningitis: caused by contact with aerosolized droplets caused by sneezing, coughing, kissing, laughing, talking, or singing.

GI Diseases: often spread by ingesting contaminated food or water.

Sexually Transmitted Diseases: spread through contact with bodily fluid, typically as the result of sexual activity.

Fomite: an inanimate object that, when in contact with it, can spread disease, such as a coin or a used tissue.

Vector: many diseases are carried through vectors, in which an agent picks up an infectious agent and transmits it to the host directly (through a mosquito bite, for example) or indirectly (like a fly landing on food).

What Are Microorganisms?

Most people tend to associate the word, “microorganism” with pathogen (or disease-producing), while, in reality, only a small subset of microorganisms cause disease.

Most microorganisms are crucial to the welfare of the world, by helping to maintain the balance of living organisms. Some examples of non-pathogenic microorganisms and their functions include:

• Microorganisms found in bodies of water are the basis of the food chain in oceans, lakes, and rivers.
• Soil Microorganisms help to break down wastes and incorporate nitrogen gas from the air into organic compounds, thereby recycling chemical elements.
• Microbes play a role in photosynthesis – a food and oxygen process critical to life on earth.
• The microbes within our body help digest our food as well as synthesize vitamins that our bodies require, such as Vitamin K and Vitamin B.

It’s now understood that microorganisms are found almost everywhere, which helps scientists and researchers determine the disease-causing organisms and develop methods to cure them.

How Are Microorganisms Named?

Nomenclature (naming) of organisms are traditionally done in Latin – the language of scholars. In this way, organisms are assigned two names. The genus, which is always capitalized, followed by the species name, which is never capitalized. Both names are either underlined or italicized.

After mention of an organism, the first initial (rather than the whole name) can be used following the species name. In this way, we’d describe humans as Homo sapiens during one part of a resource page while we could simply abbreviate it later by saying, H. sapiens.

What Are Types of Microorganisms?

There are a number of types of microorganisms. Each type of microorganism will be discussed in greater detail below, including common characteristics of each type the of microorganisms.

Bacteria As Infectious Diseases:

Bacteria (singular: bacterium) are simple, single-celled organisms that are not enclosed by a nuclear membrane, which makes bacterial cells “prokaryotics.”

While bacteria are often thought to be harmful, invisible microorganisms, less than one percent cause disease. In fact, most bacteria that live in the body aid in bodily functions such as digesting food, destroying other disease-causing microorganisms, as well as providing nutrients to the body. There even exist bacteria that help in the creation of cheese and yogurt.

Most bacterial cells appear in one of several forms:

• Bacillus – rod-like bacterium
• Coccus – oval-shaped bacterium
• Spiral – curved and/or corkscrew shaped

Bacteria can move using a large variety of mechanisms:

Flagella – semi-rigid cylindrical type of appendages that function like a propeller on a boat. Flagella fall into a number of different arrangements on bacteria:

• Monotrichous – a single flagella attached to the bacteria.
• Lophotrichous – clusters of flagella at the pores of the cell.
• Peritrichious – flagella are distributed evenly across the surface of the cell.
• Spirochetes – unique type of bacteria have flagella between the two membranes in the periplasmic space.

Bacterial Gliding – movement of bacteria across the surfaces.

Twitching Motility – bacteria use their pili as a grappling hook, anchoring it, then retracting it.

It’s important to note that bacteria that cause infections can make one very ill, as they multiply quickly inside the body. Many of these infectious bacteria cause tissue damage by releasing toxins into the body. Examples of infectious bacteria include:

• Staphylococcus
• Streptococcus
• Cholera
• Syphilis
• Anthrax
• Black Plague
• Escherichia coli

Most types of bacterial infections are managed by antibiotics, which can help to fend off the illness-causing bacteria and allow the person to return to a state of health.

Unfortunately, antibiotic use and overuse mean that there are antibiotic-resistant strains of bacteria that cannot be treated by normal antibiotics.

Bacteriophages are viruses that can infect bacteria – they infect and lyse their host bacteria, or they insert themselves into the bacterial chromosome – common examples include Escherichia coli O157:H7 and Clostridium botulinum.

Viruses As Infectious Diseases:

Viruses (singular virion) are tiny microorganisms that require the use of an electron microscope to visualize. Structurally simple, viruses are not cellular (acellular), instead the virus particle contains a core surrounded by a protein coat (sometimes covered in a second layer – a lipid membrane, called an envelope) made simply of one type of nucleic acid: DNA or RNA.

All living cells have RNA and DNA, that carry out chemical reactions and reproduce as self-sufficient units. Viruses can only replicate by using the cellular makeup of other organisms. This means that viruses are actually parasitic and can attack animals, plants, bacteria, and humans.

A virion is comprised of three parts:

1. Nucleic Acid – forms the core of the virus with DNA or RNA, which holds all of the information about the cell and aids in virus replication.
2. Capsid (Protein Coat) – this covering protects the nucleic acid.
3. Envelope (Lipid Membrane) – covers the capsid of the virus cell; although not all viruses have an envelope – these are called “naked viruses.”

Viruses are spread in many ways:

• By vectors – disease-bearing organisms that infect other organisms.
• Coughing and sneezing – as is the case with the influenza virus
• Fecal-oral route of transmission – via contact or food and water.
• Sexual contact – such is the case with HIV.

Prevention of viral infection can occasionally be done utilizing vaccines – artificially acquired immunity to a specific virus. There are a number of viruses that evade our immune response and lead to chronic illness.

Antibiotics have zero effect on viruses, but several drugs called “antivirals” have been developed.

Replication cycle of a virus, which are acellular organisms that use a host cell to produce copies of themselves and assemble themselves within a cell. The replication cycle of a virus includes the following six stages:

1. Attachment – a specific binding between receptors on the hosts cellular surface and the viral capsid proteins. Viruses have evolved to favor viruses that only infect cells that are capable of replication.
2. Penetration – viruses enter the host cell in a process known as “viral entry.”
3. Uncoating – the removal of the viral capsid by degradation of enzymes, and the end result is the release of the viral nucleic acid (DNA or RNA).
4. Replication – involves multiplication of the genome and assembly of the viral proteins.
5. Assembly – the viral particles are assembled, either within the host cell or once outside of the host cell.
6. Release – Lysis (process of killing the cell wall and membrane – if present) occurs and the virus is released into the body.

Specific Viruses Include the following:

• HIV
• Common cold
• Warts
• Smallpox
• Influenza

It’s important to remember that viruses, unlike other microorganisms are not alive, cannot grow or multiply on their own, and require a host cell for replication. Viruses may also infect bacterial cells.

Virus particles are extraordinarily small; up to 100 times smaller than a single bacterium, which is ten times smaller than a human cell.

Fungi As Human Pathogens:

While fungal diseases sound mysterious and strange, they’re often caused by fungi common in the soil, on plants, in trees, on our skin, inside our intestinal tracts, and on our mucous membranes. In fact, most fungi are not only not harmful, they’re helpful. Pennicilin, one of the most important antibiotics is made from fungi, as are many different types of alcoholic beverages.

However, there are certain types of fungi that can be pathogenic and cause infectious disease in humans.

Symptoms of a fungal infection depend wildly upon the type of infection and location within the body. Fungal infections can include rashes or a mild respiratory illness while others can become sepsis, meningitis, or pneumonia.

Mycotic (or fungal) infections pose an increased risk to the public for a number of reasons, which include:

1. Opportunistic infections such as cryptococcosis and aspergillis are on the rise for those with weakened immune systems (the very old, the very young, cancer patients, those with immunodeficiencies).
2. Nosocomial Infections (also known as “hospital acquired infections“) such as candidemia, are one of the leading causes for blood-borne infections in the US. Thanks to advancements and changes in healthcare practices, there are increased opportunities for new, drug-resistant fungi to emerge in hospital and hospital-like settings (like a nursing home).
3. Community-Acquired Infections (like histoplasmosis, blastomycosis, and coccidioidomycosis) are caused by environmental fungi that live in the soil, on plants, or in compost heaps, and are common throughout the US. The changes in climate may be affecting these fungi.

Parasitic Infectious Diseases:

A parasite is an organism that lives on – or inside – a host organism and gets its food at the expense of the host. Parasitic infections are a huge problem in the tropics and subtropics, as well as more temperate locals. Of all parasitic diseases, malaria causes the most deaths worldwide, killing about 1 million people (mostly young children) in sub-Saharan Africa.

However, parasitic pathogens also affect the developing countries. In the US, trichomoniasis is the most common parasitic infection, followed by Giardia and Cryptosporidium infections.

The most common parasitic disease-causing organisms in humans are:

1) Protozoa – these microscopic, one-celled organisms can be parasitic OR free-living in nature and can multiply in humans, continuing their survival while allowing very serious infections to develop. Transmission from the human GI tract generally occurs through the fecal-oral route, while transmission from protozoan blood disorders is transmitted via arthropod vector (mosquito, fly, or other insect). The four types of protozoa that are infectious to humans are classified based upon their movements:

• Cilliophoria – the cilliates, such as Balantium, are characterized by hairlike organelles called “cilia,” which are used for swimming, crawling, feeding, sensation, and attachment.
• Mastigophora – the flagellates, such as Giardia, Leishmania, have one or more whip-like organelles that are used for movement.
  
• Sarcodina – the amoeba, such as Entamoeba, use their pseudopods – lobe-like bulges from the cell membranes – that are used for locomotion and feeding.
• Sporozoa – adult stage is immotile, such as Plasmodium, Cryptosporidium, which means that they lack any locomotor organs.

2) Helminths – these large, mulch-cellular organisms are usually seen with the naked eye in its adult stages. Similar to protozoa, helminths can be parasitic or free-living, but adult helminths cannot reproduce in humans. The three primary groups of helminths that can cause parasitic infections in humans are:

1. Platyhelminthes (flatworms) – include both trematodes (the flukes) and cestodes (tapeworms!) and are simple, unsegmented, soft-bodied animals without body cavities or circulatory systems.
2. Acanthocephalins (thorny-headed worms) – adult versions of these worms live in the gastrointestinal tracts and are considered to be intermediate between cestodes and neatodes.
3. Nematodes (roundworms) – adult versions of these worms live in the GI tract, blood, lymphatic system, or subcutaneous tissues.

3) Ectoparasites – blood-sucking arthropods that burrow into the human skin and reside their for a long timeframe and include, ticks, fleas, mites, and lice. Not only can these ectoparasites cause diseases, they may also act as biological vectors in transmission of different pathogens that can lead to diseases that cause high mortality and morbidity.

Prion Infectious Diseases:

Prion Diseases (also known as transmissible spongiform encephalopathies or TSEs) are a family of rare, yet progressive, neurodegenerative disorders that affect humans and animals. Prion related infectious diseases are distinguished from other pathogenic diseases by the long incubation periods, characteristic spongiform changes with associated neuronal loss, and a failure to induce an inflammatory response.

Prions, transmissible, abnormally-folded, disease-causing agents, cause abnormal folding of specific normal cellular proteins called “prion proteins,” found most frequently in the brain, are suspected as the causative agents for TSEs. This folding of the prion proteins causes progressive brain damage and death.

The most well-known prion disease is Creutzfeldt-Jakob Disease Disease (CJD) or mad cow disease.

How Are Infectious Diseases Diagnosed?

If an infectious disease is suspected by a physician, your doctor will take a complete medical history and order some laboratory tests or imaging scans to determine the cause for the symptoms. The following tests may be utilized to ascertain the particular infectious agent:

Laboratory Tests:

• Laboratory blood tests – a sample of blood may be taken by inserting a needle into the vain.
• Urinalysis – urinating into a container, avoiding contamination to ascertain if there’s something growing in the urinary tract.
• Throat swabs – samples of bacteria at the back of the throat may be taken using a sterile swab.
• Lumbar puncture – also known as a spinal tap, this procedure obtains a sample of cerebrospinal fluid through a needle inserted between the bones of the spine.

Imaging Scans:

• X-Ray – a small dose of radiation is aimed at the affected part of the body to reveal images of the structures within the body, such as pneumonia.
• CT Scan – a CT scan digitally combines X-rays taken from a number of angles to produce cross-sectional images of the bones, organs, and soft tissues.
• MRI Imaging – radio waves combined with a strong magnetic field produces detailed images of the internal structures.

Biopsies:

a small sample of tissue is removed from an internal organ to be tested by the pathology laboratory to detect the presence of certain diseases.

How Are Infectious Diseases Treated?

Infectious diseases are treated in accordance to the type of disease causing the infection.

Bacterial Infections are treated with antibiotics and grouped into families of similar types of antibiotics. Certain classes of bacteria are more susceptible to certain types of antibiotics. Treatment is often targeted at the infectious disease present.

It’s important to note that the overuse of antibiotics has resulted in antibiotic resistant bacteria, which makes treatment of the infectious diseases more difficult.

Viral Infections are occasionally treated with antiviral medications. While there are some medications that can be used to treat viruses, but not all viruses have a corresponding medication. Examples of drugs that are targeted to viruses include:

• AIDS
• Herpes
• Hepatitis B
• Hepatitis C
• Influenza

Fungal Infections can infect the lungs or the mucous membranes of the mouth and throat, often in those who are immunocompromised. Anti-fungal medications are the treatment of choice for those with fungal infections.

Parasitic Infections are diseases that are caused by parasites are often treated with anti-parasitic medications. It’s important to note that many varieties of parasites have developed a resistance to the anti-parasitic medications.

How Are Infectious Diseases Prevented?

One of the most important ways to prevent – or slow – the transmissions of infectious diseases is to understand and recognize the characteristics of the different diseases. These characteristics include the virulence, distance traveled by victims, and level of contagiousness.

Another way to prevent the transmission rates of infectious diseases is to recognize the way that diseases can jump between hubs – groups of infected individuals.

Know the modes of transmission. Infectious diseases can enter the body via:

• Skin contact or injuries to the skin
• Inhalation of airborne pathogens
• Ingestion of contaminated water or food
• Sexual contact
• Tick or mosquito bites

These tips can reduce the risk of spreading infectious diseases to you and others around you:

• Wash hands, especially after using the bathroom, preparing food, before eating.
• Be sure to rest as much as possible.
• Keep hydrated – drink water or sports drinks.
• Practice proper food preparation – keep counters and surfaces in the kitchen clean while preparing foods.
• Quickly refrigerate leftovers – no food should be left out of the refrigerator at room temperature for long periods of time.
• Ensure vaccinations are up-to-date, including a yearly flu shot and making sure your tetanus vaccination is current.
• Don’t leave the house – don’t go to work or school if you’re running a high fever, vomiting, have diarrhea. Keep your child home as well.
• Always practice safe-sex. Use condoms and birth control even if you or your partner doesn’t engage in high risk sexual behavior.
• Travel smart – don’t get on a plane if you’re sick. You’ll merely infect other passengers and your trip will probably not be much fun if your sick.
• When traveling, ensure that you’re up-to-date on your vaccinations.
• Don’t share your personal items with other people. This includes drinks, toothbrushes, silverware, razors, combs and other personal hygiene items.

Additional Infectious Disease Resources:

National Prion Disease – surveillance and research site supported by CDC to uncover more information about prion diseases.

Emedicine’s List of Infectious Disease Articles – a thorough A-Z list of infectious diseases with links to various articles.

World Health Organization – information, links, and articles related to various types of infectious diseases from around the world.

Infectious Disease Society of America – represents physicians, scientists and other health care professionals who specialize in infectious diseases. IDSA’s purpose is to improve the health of individuals, communities, and society by promoting excellence in patient care, education, research, public health, and prevention relating to infectious diseases.

Page last audited 8/2018

PTSD And Veterans

by Band Back Together | Aug 11, 2018

What is PTSD in Veterans?

For very many veterans, returning from military service also means dealing with symptoms of post-traumatic stress disorder (PTSD). You may be having a hard time readjusting to life out of the military. Or you may constantly be feeling on edge, emotionally numb and disconnected, or close to panicking or exploding. But no matter how long the V.A. wait times, or how isolated or emotionally cut off from others you feel, it’s important to know that you’re not alone and there are plenty of things you can do to start feeling better. These steps can help you learn to deal with nightmares and flashbacks, cope with feelings of depression, anxiety or guilt, and regain your sense of control.

Post-traumatic stress disorder impacts 11-20 percent of Iraq and Afghanistan War veterans, approximately 12 percent of Gulf War veterans, and 15 percent of Vietnam veterans. In addition to the combat-related PTSD, roughly 1 in 4 women and 1 in 100 men utilizing the VA report instances of sexual assault, which can also result in prolonged traumatic stress.

What Causes PTSD in Veterans?

Post-traumatic stress disorder (PTSD), sometimes called “combat stress” or “shell shock,” happens after you experience severe trauma or a life-threatening event. It’s normal for your mind and body to be in shock after such an event, but this normal response becomes PTSD when your nervous system gets stuck between fight and flight syndrome. Post-traumatic stress disorder (PTSD) can occur after you have been through a trauma. A trauma is a shocking and dangerous event that you see or that happens to you. During this type of event, you think that your life or others’ lives are in danger.

Read more about PTSD

Your nervous system has two automatic or reflexive ways of responding to stressful events:

Mobilization, or fight-or-flight, occurs when you need to defend yourself or survive the danger of a combat situation. Your heart pounds faster, your blood pressure rises, and your muscles tighten, increasing your strength and reaction speed. Once the danger has passed, your nervous system calms your body, lowering your heart rate and blood pressure, and winding back down to its normal balance.

Immobilization occurs when you’ve experienced too much stress in a situation and even though the danger has passed, you find yourself “stuck.” Your nervous system is unable to return to its normal state of balance and you’re unable to move on from the event. Immobilization is PTSD.

Recovering from PTSD involves transitioning out of the mental and emotional war zone you’re still living in and helping your nervous system return to normal.

Going through trauma is not rare. About 6 of every 10 men (or 60%) and 5 of every 10 women (or 50%) experience at least one trauma in their lives. Women are more likely to experience sexual assault and child sexual abuse. Men are more likely to experience accidents, physical assault, combat, disaster, or to witness death or injury.

PTSD can happen to anyone. It is not a sign of weakness. A number of factors can increase the chance that someone will develop PTSD, many of which are not under that person’s control. For example, if you were directly exposed to the trauma or injured, you are more likely to develop PTSD.

PTSD And The Military:

When you are in the military, you may see combat. You may have been on missions that exposed you to horrible and life-threatening experiences. These types of events can lead to PTSD.

The number of Veterans with PTSD varies by service era:

• Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF): About 11-20 out of every 100 Veterans (or between 11-20%) who served in OIF or OEF have PTSD in a given year.
• Gulf War (Desert Storm): About 12 out of every 100 Gulf War Veterans (or 12%) have PTSD in a given year.
• Vietnam War: About 15 out of every 100 Vietnam Veterans (or 15%) were currently diagnosed with PTSD at the time of the most recent study in the late 1980s, the National Vietnam Veterans Readjustment Study (NVVRS). It is estimated that about 30 out of every 100 (or 30%) of Vietnam Veterans have had PTSD in their lifetime.

Other factors in a combat situation can add more stress to an already stressful situation. This may contribute to PTSD and other mental health problems. These factors include what you do in the war, the politics around the war, where the war is fought, and the type of enemy you face.

Another cause of PTSD in the military can be military sexual trauma (MST). This is any sexual harassment or sexual assault that occurs while you are in the military. MST can happen to both men and women and can occur during peacetime, training, or war.

Among Veterans who use VA healthcare, about:

• 23 out of 100 women (or 23%) reported sexual assault when in the military.
• 55 out of 100 women (or 55%) and 38 out of 100 men (or 38%) have experienced sexual harassment when in the military.

There are many more male Veterans than there are female Veterans. So, even though military sexual trauma is more common in women Veterans, over half of all Veterans with military sexual trauma are men.

What Are Some Of The PTSD Symptoms of Veterans?

While you can develop symptoms of PTSD in the hours or days following a traumatic event, sometimes symptoms don’t surface for months or even years after you return from deployment. While PTSD develops differently from veteran to veteran, there are four symptom clusters:

Being on guard all the time, jumpy, and emotionally reactive, as indicated by irritability, anger, reckless behavior, difficulty sleeping, trouble concentrating, and hypervigilance.

Recurrent, intrusive reminders of the traumatic event, including distressing thoughts, nightmares, and flashbacks where you feel like the event is happening again. Experiencing extreme emotional and physical reactions to reminders of the trauma such as panic attacks, uncontrollable shaking, and heart palpitations.

Extreme avoidance of things that remind you of the traumatic event, including people, places, thoughts, or situations you associate with the bad memories. Withdrawing from friends and family and losing interest in everyday activities.

Negative changes in your thoughts and mood, such as exaggerated negative beliefs about yourself or the world and persistent feelings of fear, guilt, or shame. Diminished ability to experience positive emotions.

Suicide Prevention For Veterans With PTSD

It’s common for veterans with PTSD to experience suicidal thoughts. Feeling suicidal is not a character defect, and it doesn’t mean that you are crazy, weak, or flawed, it simply means that you are overwhelmed and need some help. If you are feeling suicidal, please seek help immediately. If you don’t feel you can talk to your friends and loved ones, there are a great number of suicide hotlines available that offer free, non-judgemental, confidential counseling. Here are some of the following suicide help lines. You are not alone, no matter how you feel. Things can get better. Please call:

In the US:

• call 911
• Visit the Online National Suicide Helpline
• call 1-800-273-8255

In Canada:

• CALL TOLL FREE 1.833.456.4566 Available 24/7.
• CHAT available 5pm-1am ET 
• Text 45645 Available 5pm-1am E

In the UK and ROI:

• Hotline: +44 (0) 8457 90 90 90 (UK – local rate)
• Hotline: +44 (0) 8457 90 91 92 (UK minicom)
• Hotline: 1850 60 90 90 (ROI – local rate)
• Hotline: 1850 60 90 91 (ROI minicom)
• Website: samaritans.org
• E-mail Helpline: jo@samaritans.org

In Australia, call:

• 13 11 14
• Online Crisis Support Chat
• https://www.lifeline.org.au/get-help/online-services/crisis-chat

Wordwide:

• Visit IASP to find a helpline in your country.
• Visit List of Worldwide Suicide Hotlines Via Wikipedia

Learning To Live With And Heal From PTSD In Veterans:

Step One: Regulate Your Nervous System

PTSD can leave you feeling completely vulnerable and totally helpless. However, you have more control over your nervous system than you may know. When you feel agitated, anxious, or out of control, these tips can help you change your arousal system and calm yourself.

Sensory input: We know that loud noises, certain smells, or the feel of sand in your clothes can instantly transport you back to the combat zone. Sensory input quickly calm you. Everyone responds a bit differently, so experiment to find what works best. Think of your time on deployment: what brought you comfort at the end of the day? Perhaps it was looking at photos of your family? Or listening to a favorite song, or smelling a certain brand of soap? Or maybe petting an animal quickly makes you feel calm?

Mindful breathing: To quickly calm yourself, begin by taking 60 breaths, focusing your attention on each breath. Breathe in, hold for a couple of seconds, breathe out. In with the good air, out with the bad. Count them – it helps your mind to focus on something other than your anxiety.

Reconnect emotionally: If you can react to uncomfortable emotions without becoming overwhelmed, you can make a huge difference in your ability to manage stress, balance your moods, and take back control of your life

Step Two: Move Your Thing

Making time for regular exercise has always been one of the keys to cope for veterans with PTSD. Not only does physical activity help to burn off adrenaline, exercise can release endorphins and improve your mood. And by really focusing on your body and how it feels as you exercise, you can even help your nervous system become “unstuck” and move out of the immobilization stress response.

Exercise that is rhythmic and engages both your arms and legs—such as running, swimming, basketball, or even dancing—works well if you stop feeling your feelings and focus your thoughts upon how your body feels.

Try to notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of wind on your skin. Many veterans with PTSD find that sports such as rock climbing, boxing, weight training, and martial arts make it easier to focus on your body movements – obviously, if you don’t, you could get injured. Whatever exercise you choose, try to work out for 30 minutes or more each day—or if it’s easier, three 10-minute spurts of exercise are fine.

One of the great parts of being outside is that pursuing outdoor activities in nature like hiking, camping, mountain biking, rock climbing, whitewater rafting, and skiing can help challenge your sense of vulnerability and help you transition back into civilian life.

Seek out local organizations that offer outdoor recreation or team building opportunities, or, in the U.S., check out Sierra Club Military Outdoors, which provides service members, veterans, and their families with opportunities to get out into nature and get moving.

Step Three: Take Care of Yourself

The symptoms of PTSD in veterans, such as insomnia, anger, concentration problems, and jumpiness, can be hard on your body and eventually take a toll on your overall health. That’s why it’s so important to take care of yourself.

You may be drawn to activities and behaviors that pump up adrenaline, whether it’s caffeine, drugs, violent video games, driving recklessly, or daredevil sports. After being in a combat zone, that’s what feels normal. But if you recognize these urges for what they are, you can make better choices that will calm and care for your body—and your mind.

Relax: Relaxation techniques such as massage, meditation, or yoga can reduce stress, ease the symptoms of anxiety and depression, help you sleep better, and increase feelings of peace and well-being.

Find safe ways to blow off steam: Pound on a punching bag, pummel a pillow, go for a hard run, sing along to loud music, or find a secluded place to scream at the top of your lungs.

Support your body with a healthy diet: Omega-3s play a vital role in emotional health so incorporate foods such as fatty fish, flaxseed, and walnuts into your diet. Limit processed and fried food, sugars, and refined carbs which can exacerbate mood swings and energy fluctuations.

Get plenty of sleep: Sleep deprivation exacerbates anger, irritability, and moodiness. Aim for 7 to 9 hours of quality sleep each night. Develop a relaxing bedtime ritual (listen to calming music, take a hot shower, or read something light and entertaining), turn off screens at least one hour before bedtime, and make your bedroom as dark and quiet as possible.

Avoid alcohol and drugs: It can be tempting to turn to drugs and alcohol to numb painful memories and get to sleep. But substance abuse can make the symptoms of PTSD worse. The same goes for cigarettes. If possible, stop smoking and seek help for drinking and drug problems.

Step Four: Connect With Others

Connecting face-to-face doesn’t have to mean a lot of talking. But for any veteran with PTSD, it’s important to find someone who will listen without judging when you want to talk, or just hang out with you when you don’t. That person may be your significant other, a family member, one of your buddies from the service, or a civilian friend.

Volunteer your time or reach out to someone in need. This is a great way to both connect to others, feel good about yourself, while reclaiming your sense of power.

Join a PTSD support group. Connecting with other veterans facing similar problems can help you feel less isolated and provide useful tips on how to cope with symptoms and work towards recovery.

Connecting with Civilians

You may feel like civilians in your life can’t understand you since they haven’t been in the service or seen the things you have. But people don’t have to have gone through the exact same experiences to relate to painful emotions and be able to offer support. What matters is that the person you’re turning to cares about you, is a good listener, and a source of comfort.

You don’t have to talk about your combat experiences. If you’re not ready to open up about the details of what happened, that’s okay. You can talk about how you feel without going into a blow-by-blow account of events.

Tell the other person what you need or what they can do to help. That could be just sitting with you, listening, or doing something practical. Comfort comes from someone else understanding your emotional experience.

People who care about you want to help. Listening is not a burden for them but a welcome opportunity to help.

If Connecting Is Too Difficult

No matter how close you are to someone, PTSD can mean that you still don’t feel any better after talking. If that describes you, there are ways to help the process along.

Exercise or move. Before chatting with a friend, either exercise or move around. Jump up and down, swing your arms and legs, or just flail around. Your head will feel clearer and you’ll find it easier to connect.

Vocal toning. As strange as it sounds, vocal toning is a great way to open up to social engagement. Find a quiet place before you meet a friend. Sit straight and simply make “mmmm” sounds. Change the pitch and volume until you experience a pleasant vibration in your face.

Step Five: Flashbacks, Nightmares, and Intrusive Thoughts

For veterans with PTSD, flashbacks usually involve visual and auditory memories of combat. It feels as if it’s happening all over again so it’s vital to reassure yourself that the experience is not occurring in the present. Trauma specialists call this “dual awareness.”

Dual awareness is the recognition that there is a difference between your “experiencing self” and your “observing self.” On the one hand, there is your internal emotional reality: you feel as if the trauma is currently happening. On the other hand, you can look to your external environment and recognize that you’re safe. You’re aware that despite what you’re experiencing, the trauma happened in the past. It is not happening now.

State to yourself (out loud or in your head) the reality that while you feel as if the trauma is currently happening, you can look around and recognize that you’re safe.

Use a simple script when you awaken from a nightmare or start to experience a flashback: “I feel [panicked, overwhelmed, etc.] because I’m remembering [traumatic event], but as I look around I can see that the event isn’t happening right now and I’m not in danger.”

Describe what you see when look around (name the place where you are, the current date, and three things you see when you look around).

Try tapping your arms to bring you back to the present.

Tips For Grounding Yourself During A Flashback:

If you’re starting to disassociate or experience a flashback, try using your senses to bring you back to the present and “ground” yourself. Experiment to find what works best for you.

• Sight – Blink rapidly and firmly; look around and take inventory of what you see
• Movement – Move around vigorously (run in place, jump up and down, etc.); rub your hands together; shake your head
• Sound – Turn on loud music; clap your hands or stomp your feet; talk to yourself (tell yourself you’re safe, you’ll be okay)
• Taste – Suck on a strong mint or chew a piece of gum; bite into something tart or spicy; drink a glass of cold water or juice
• Touch – Splash cold water on your face; grip a piece of ice; touch or grab on to a safe object; pinch yourself; play with worry beads or a stress ball
• Smell – Smell something that links you to the present (coffee, mouthwash, your wife’s perfume) or a scent that has good memories

Step Six: Work through survivor’s guilt

Feelings of guilt are very common among veterans with PTSD. You may have seen people injured or killed, often your friends and comrades. In the heat of the moment, you don’t have time to fully process these things as they happen. But later—often when you’ve returned home—these experiences come back to haunt you. You may ask yourself questions such as:

• Why didn’t I get hurt?
• Why did I survive when others didn’t?
• Could I have done something differently to save them?

You may end up blaming yourself for what happened and believing that your actions (or inability to act) led to someone else’s death. You may feel like others deserved to live more than you—that you’re the one who should have died.

This is survivor’s guilt.

Healing from survivor’s guilt:

It’s important to remember that healing doesn’t mean that you’ll forget what happened or those who died. And it doesn’t mean you’ll have no regrets. What it does mean is that you’ll look at your role more realistically.

• Is the amount of responsibility you’re assuming reasonable?
• Could you really have prevented or stopped what happened?
• Are you judging your decisions based on full information about the event, or just your emotions?
• Did you do your best at the time, under challenging circumstances?
• Do you truly believe that if you had died, someone else would have survived?

Honestly assessing your responsibility and role can free you to move on and grieve your losses. Even if you continue to feel some guilt, instead of punishing yourself, you can redirect your energy into honoring those you lost and finding ways to keep their memory alive. For example, you could volunteer for a cause that’s connected in some way to one of the friends you lost. The goal is to put your guilt to positive use and thus transform tragedy, even in a small way, into something worthwhile.

Step Seven: Seek professional treatment

Professional treatment for PTSD can help you confront what happened to you and learn to accept it as a part of your past. Working with an experienced therapist or doctor, treatment may involve:

Cognitive-behavioral therapy (CBT) or counseling. This involves gradually “exposing” yourself to thoughts and feelings that remind you of the event. Therapy also involves identifying distorted and irrational thoughts about the event—and replacing them with more balanced picture.

Medication, such as antidepressants. While medication may help you feel less sad, worried, or on edge, it doesn’t treat the causes of PTSD.

EMDR (Eye Movement Desensitization and Reprocessing). This incorporates elements of CBT with eye movements or other rhythmic, left-right stimulation such as hand taps or sounds. These can help your nervous system become “unstuck” and move on from the traumatic event.

Effects of PTSD On Relationships:

PTSD can affect how couples get along with each other. It can also affect the mental health of partners. In general, PTSD can have a negative effect on the whole family.

Male Veterans with PTSD are more likely to report the following problems than Veterans without PTSD:

• Marriage or relationship problems
• Parenting problems
• Poor family functioning

Most of the research on PTSD in families has been done with female partners of male Veterans. The same problems can occur, though, when the person with PTSD is female.

Effects on marriage

Compared to Veterans without PTSD, Veterans with PTSD have more marital troubles. They share less of their thoughts and feelings with their partners. They and their spouses also report more worry around intimacy issues. Sexual problems tend to be higher in combat Veterans with PTSD. Lower sexual interest may lead to lower satisfaction within the relationship.

The National Vietnam Veterans Readjustment Study (NVVRS) compared Veterans with PTSD to those without PTSD.

The findings showed that Vietnam Veterans with PTSD:

• Got divorced twice as much
• Were three times more likely to divorce two or more times
• Tended to have shorter relationships

Family violence

Families of Veterans with PTSD experience more physical and verbal aggression. Such families also have more instances of family violence. Violence is committed not just by the males in the family. One research study looked at male Vietnam Veterans and their female partners. The study compared partners of Veterans with PTSD to partners of those without PTSD. Female partners of Veterans with PTSD:

• Committed more family violence than the other female partners
• Committed more family violence than their male Veteran partners with PTSD

Mental health of partners

PTSD can affect the mental health and life satisfaction of a Veteran’s partner. The same research studies on Vietnam Veterans compared partners of Veterans with and without PTSD. The partners of the Vietnam Veterans with PTSD reported:

• Lower levels of happiness
• Less satisfaction in their lives
• More demoralization (discouragement)
• About half have felt “on the verge of a nervous breakdown”

These effects were not limited to females. Male partners of female Veterans with PTSD reported lower well-being and more social isolation.

Partners often say they have a hard time coping with their partner’s PTSD symptoms. Partners feel stress because their own needs are not being met. They also go through physical and emotional violence. One explanation of partners’ problems is secondary traumatization. This refers to the indirect impact of trauma on those close to the survivor. Another explanation is that the partner has gone through trauma just from living with a Veteran who has PTSD. For example, the risk of violence is higher in such families.

Caregiver burden

Partners have a number of challenges when living with a Veteran who has PTSD. Wives of PTSD-diagnosed Veterans tend to take on a bigger share of household tasks such as paying bills or housework. They also do more taking care of children and the extended family. Partners feel that they must take care of the Veteran and attend closely to the Veteran’s problems. Partners are keenly aware of what can trigger symptoms of PTSD. They try hard to lessen the effects of those triggers.

Caregiver burden is one idea used to describe how hard it is caring for someone with an illness such as PTSD. Caregiver burden includes practical problems such as strain on the family finances. Caregiver burden also includes the emotional strain of caring for someone who is ill. In general, the worse the Veteran’s PTSD symptoms, the more severe is the caregiver burden.

Why are these problems so common?

The exact connection between PTSD symptoms and relationship problems is not clearly known. Some symptoms, like anger and negative changes in beliefs and feelings, may lead directly to problems in a marriage. For example, a Veteran who cannot feel love or happiness may have trouble acting in a loving way towards a spouse. Expression of emotions is part of being close to someone else. Not being able to feel your emotions can lead to problems making and keeping close relationships. Numbing can get in the way of intimacy.

Help for partners of Veterans with PTSD

The first step for partners of Veterans with PTSD is to gather information. This helps give you a better understanding of PTSD and its impact on families. Resources on the National Center for PTSD website may be useful.

Some effective strategies for treatment include:

• Education for the whole family about the effects of trauma on survivors and their families
• Support groups for both partners and Veterans
• Individual therapy for both partners and Veterans
• Couples or family counseling

VA has taken note of the research showing the negative impact of PTSD on families. PTSD programs and Vet Centers have begun to offer group, couples, and individual counseling for family members of Veterans.

Overall, the message for partners is that problems are common when living with a Veteran who has been through trauma. The treatment options listed above may be useful to partners as they search for better family relationships and mental health

How PTSD Can Affect The Family:

When a loved one returns from military service with PTSD, it can take a heavy toll on your relationship and family life. You may have to take on a bigger share of household tasks, deal with the frustration of a loved one who won’t open up, or even deal with anger or other disturbing behavior.

Family members may feel hurt, alienated, or discouraged because your loved one has not been able to overcome the effects of the trauma. Family members frequently devote themselves totally to those they care for and, in the process, neglect their own needs.

Sympathy: You may feel sorry for your loved one’s suffering. This may help your loved one know that you sympathize with him or her. However, be careful that you are not treating him or her like a permanently disabled person. With help, he or she can feel better.

Negative feelings PTSD can make someone seem like a different person. If you believe your family member no longer has the traits you loved, it may be hard to feel good about them. The best way to avoid negative feelings is to educate yourself about PTSD. Even if your loved one refuses treatment, you will probably benefit from some support.

Avoidance: Avoidance is one of the symptoms of PTSD. Those with PTSD avoid situations and reminders of their trauma. As a family member, you may be avoiding the same things as your loved one. Or, you may be afraid of his or her reaction to certain cues. One possible solution is to do some social activities, but let your family member stay home if he or she wishes. However, he or she might be so afraid for your safety that you also can’t go out. If so, seek professional help.

Depression This is common among family members when the person with PTSD causes feelings of pain or loss. When PTSD lasts for a long time, you may begin to lose hope that your family will ever “get back to normal.”

Anger and guilt: If you feel responsible for your family member’s happiness, you might feel guilty when you can’t make a difference. You could also be angry if he or she can’t keep a job or drinks too much, or because he or she is angry or irritable. You and your loved one must get past this anger and guilt by understanding that the feelings are no one’s fault.

Health problems: Everyone’s bad habits, such as drinking, smoking, and not exercising, can get worse when trying to cope with their family member’s PTSD symptoms. You may also develop other health problems when you’re constantly worried, angry, or depressed.

Helping a Veteran With PTSD

Social support is extremely important for preventing and helping with PTSD. It is important for family members to take care of themselves; both for their own good and to help the person dealing with PTSD.

Family members may feel hurt, alienated, or discouraged because your loved one has not been able to overcome the effects of the trauma. Family members frequently devote themselves totally to those they care for and, in the process, neglect their own needs.

Social support is extremely important for preventing and helping with PTSD. It is important for family members to take care of themselves; both for their own good and to help the person dealing with PTSD.

Don’t take the symptoms of PTSD personally. If your loved one seems distant, irritable, angry, or closed off, remember that this may not have anything to do with you or your relationship.

Don’t pressure your loved one into talking. Many veterans with PTSD find it difficult to talk about their experiences. Never try to force your loved one to open up but let them know that you’re there if they want to talk. It’s your understanding that provides comfort, not anything you say.

Be patient and understanding. Getting better takes time so be patient with the pace of recovery. Offer support but don’t try to direct your loved one.

Try to anticipate and prepare for PTSD triggers such as certain sounds, sights, or smells. If you are aware of what causes an upsetting reaction, you’ll be in a better position to help your loved one calm down.

Take care of yourself. Letting your loved one’s PTSD dominate your life while ignoring your own needs is a surefire recipe for burnout. Make time for yourself and learn to manage stress. The more calm, relaxed, and focused you are, the better you’ll be able to help your loved one.

Additional PTSD and Veterans Resources:

Real Warriors: A website to support the promotion of psychological health, reduce stigma of psychological health concerns and encourage help seeking behavior for service members, veterans and their families.

VA Caregiver Support website: Support for caregivers and loved ones of veterans who have PTSD.

Call the VA Caregiver Support Line: 1-855-260-3274

Sierra Outdoors Club: Military Outdoors organizes outdoor trips for veterans, other service members and their families, because we know that time spent in nature provides a unique experience to foster mental and physical health, emotional resiliency, and leadership development. For many veterans, spending time in the outdoors can also help ease the transition to civilian life.

VA Peer Support Groups: Peer support groups are led by someone like you who has been through a trauma. Groups often meet in person, but many groups also provide online (Internet) support.

Page last audited 8/2018

How To Help A Friend Through Miscarriage

by Band Back Together | Aug 9, 2018

What Is A Miscarriage?

Miscarriage is the term for a pregnancy that ends on its own within the first twenty weeks of gestation. Miscarriage is the most common type of pregnancy loss, yet one of the most misunderstood and often glossed-over types of loss. An early pregnancy loss is an often viewed as a discounted loss.

It’s time to break down that stigma and talk openly about miscarriages, the loss we feel, and how we can help a friend who is mourning an early pregnancy loss.

Read more clinical information about miscarriage here.

This page isn’t intended to be clinical – it’s how to help yourself – or someone else – cope with a miscarriage.

Miscarriages are a fact of pregnancy. It happens. It’s the most common complication of early pregnancy. Oftentimes nobody knows why. Unfortunately, it’s something that happens to a lot of women.

In fact, between 20 percent and 25 percent of pregnancies end in miscarriage, three percent of them after 16 weeks. One minute someone’s life is filled with expectations of a new baby, a new family member! Someone mom had real hopes and dreams for. Pretty much every waking minute while pregnant is devoted to thinking about their baby, and then the next minute it’s all gone.

It’s tough to know what to say when a friend breaks the news. Traditionally, women wait until they’re three months along before sharing the news, but increasingly, women are telling their big news before then. This, I believe, is a very good thing.

Women originally wanted to wait until they learned the baby made it past the risky first trimester. But what if she does miscarry? She carries her grief alone? The statistics tell us that’s a lot of women carrying a very heavy burden without support. We think telling people about the pregnancy earlier is better. If you do miscarry, you have a support group to help you through something that hasn’t always been recognized as the extremely difficult event that it is.

Women who miscarry haven’t always been offered the same level of sympathy and comfort as a woman who lost a child that’s been born. Most miscarriages happen early in the first trimester, so the mom-to-be doesn’t look pregnant. That, coupled with the fact that there is no body to bury, causes people to forget a woman is actually mourning the very real and very painful loss of a child, not to mention the accompanying guilt that a woman who has had a miscarriage is likely to feel even though it isn’t her fault

How To Help Yourself While Grieving A Miscarriage:

Having a miscarriage or early pregnancy loss may bring about a whole host of emotions – sadness, guilt, anger, feelings of failure. The time following the loss may be incredibly painful, especially if this wasn’t your first pregnancy loss. You may feel withdrawn and unable to sleep. You may feel moody and unpredictable. The emotions you feel after a miscarriage are impossible to predict – each day may bring about new feelings.

Here are some ways to cope with a miscarriage.

There is no right or wrong way to grieve a miscarriage. Some people may be devastated, barely functional for months, while others feel it’s merely a blip on the radar. THAT IS OKAY. It does not mean that you are a “bad person” or that you weren’t meant to be a mother – it simply means that you’re grieving in your own way.

Remember, the miscarriage is not your fault. It is not due to anything you did wrong – miscarriages just happen. And coping with a miscarriage is really hard.

Ask a friend or trusted loved one to share that the pregnancy you’ve announced has ended if it’s too hard for you to talk about. There’s no shame in asking for help.

Allow yourself your feelings. It’s really easy to try to dismiss the early pregnancy loss as “being so early” or “better now than later,” but a loss is a loss. And every loss deserves to be grieved.

There is no timeline for grief. For some people, it’s a couple of days. Others grieve a miscarriage for several months. Some people may be devastated for much, much longer. Whatever your grief timeline is, accept it.

Take all of the time you need to grieve.

Don’t close yourself off from other people. Sometimes, it feels painful to talk about the pregnancy loss, but sharing your story – here on Band Back Together or elsewhere – can make you feel more connected to others who may understand what you are going through.

Take care of yourself. When you’re feeling at your absolute worst, it’s often hard to provide self-care, but that’s when it’s most important.

Don’t feel guilty about failing to meet your obligations. Take some time off work, take some time off from the housework, and give yourself permission to just be. Even if you’re physically well, taking some time to process the loss is very important.

If you feel up to it, do something with your hands. Plant a garden, bake some cookies, knit something. Sometimes, using your hands can free up your mind to process and heal.

Know and watch for the signs of postpartum depression in yourself, especially if this is your first child. Just because the pregnancy ended in miscarriage does not mean you are immune to postpartum issues. Read more about the signs and symptoms of postpartum depression here.

If you feel like you simply cannot cope with the loss of your baby, don’t hesitate to talk to a therapist. There is no shame in seeking help for being unable to cope with such a tragic loss.

If you’d like to, plan a small memorial service for your baby. Invite close friends and relatives and plant a tree or a flower in honor of your lost little one.

Do not expect that your partner will grieve the loss of your baby in the same way. Men and women grieve miscarriages in very different ways. Women look for support and express their feelings openly, while men hold their feelings about the miscarriage inside. Men also may feel as though they need to be “strong” and “brave” for their partner.

If you have older children, don’t be afraid to cry in front of them.  They probably have already picked up on your sadness, and may need reassurance that they are not the cause of it.  If it’s just too painful to let them see you cry, that’s okay, too.  Ask a friend to entertain them while you tend to your needs for a bit.

Find any support groups for pregnancy loss in your area. Your doctor or midwife may be able to suggest local support groups for early pregnancy loss.

Write your feelings down. If it’s in a journal, in a word document, on your blog, or here on Band Back Together, it can help to put all of your feelings down in one place.

How Do I Help A Friend Going Through A Miscarriage?

Remind yourself that a loss is a loss, and everyone grieves their losses differently. Just because you didn’t (or don’t think you would) feel a certain way, everyone is entitled to their feelings – especially when it comes to a loss.

Validate and acknowledge your friend’s feelings. When a baby is lost, all of the dreams parents have for their child are lost too.

Be supportive if the family wants to have a funeral or memorial for their lost child.

If your friend has taken pictures of the baby, be sure to look at them, just as you would any other baby pictures. This, after all, is what your friend has left of his or her child.

Check in on your friend. Call, send a text, email, or visit them every few days. While they may not be able to immediately get back to you, knowing that you are thinking of them will mean an enormous amount to them.

If they’re up for it, take your friend out for a cup of coffee, a movie, anything to get them out of the house. The grief may make leaving the house alone a tremendous burden.

Allow your friend to grieve openly and honestly – we are noneof us alone.

Encourage your friend to take the time she needs to grieve – time off from work, from household chores, and other commitments that may be difficult to handle.

If you see your friend developing signs of postpartum depression, don’t hesitate to let her know what you see, in the most non-judgmental way possible. Hormones can be out of whack, even if the baby didn’t survive. This may be especially shocking when a woman miscarries her first child and doesn’t know if she will have postpartum depression.Read more about the signs, symptoms, and treatment of postpartum depression here.

Frequently ask your friend how she is doing and listen – really listen – to what she has to say. If there are gaps in the conversation, don’t prattle on, just sit and be near her.

There is no time limit on grief and grieving, so don’t expect your friend will “be better in two weeks,” or “two months.” A miscarriage can be a life-changing experience.

Remember that her needs are going to be ever-changing, as is the way it goes with all grief and grieving. Be flexible and remember that what she needs today may not be what she needs tomorrow.

Sometimes, all your friend may want is someone to be near her. If that means sitting quietly and holding her hand while you watch television together, so be it.

Arrange some kind of chore list with her family and friends so that she can have simple chores, like taking her older kids to school or cooking dinner, taken off her hands for a while.

Prepare meals for her and the family that are simply heat and eat. Those who are grieving often forget about eating or are too overwhelmed to think about cooking. Having something simple available will make it easier for her and the family to eat.

Hire someone (or do it yourself) to clean your friend’s house. It may be a chore to even get out of bed in the morning, let alone clean the kitchen.

A couple months after a miscarriage, most of the support will have dropped off, which increases feelings of loneliness and isolation. Make sure that you continue to support your friend.

Buy the family a Christmas ornament (or some keepsake) with the baby’s name on it (if they named the baby). They may never display the ornament, but it will be in a treasured place for them.

Remember to use the baby’s name (if the baby was named) when talking to the family. So many forget that the baby was here – that he or she did exist – and hearing that name will make the parents feel like the baby hasn’t entirely been forgotten.

Help the her return or send back any baby gifts received that she does not want to keep. This is entirely up to the mother’s discretion.

Offer to help pack up any reminders of the baby, if your friend wants them put away. It can be a huge burden for your friend to have to pack those items away.

What Should I NOT Say To My Friend Who Has Suffered A Miscarriage?

Many times, people who are grieving a miscarriage are comforted by those who love them. Unfortunately, certain types of comfort may not actually help the grieving mother.

Here are some things not to say to someone who has just suffered a miscarriage.

Do not say, “It was God’s will.” That sounds an awful lot like, “Your baby is supposed to be dead.” Those words sting more than you can imagine.

Do not say, “Better now than later.” It’s not comforting to anyone but the person who says it.

Do not say, “The baby must’ve had something wrong with it.” Even if it’s true, it’s a hurtful sentiment.

Do not compare grief. Yes, it was tragic that your pet hamster died, and nothing diminishes that, however, it is unhelpful for many people to hear that sort of thing when their loss is so fresh.

Do not say, “I know just how you feel…” and launch into the story of the death of someone you know and love. No two losses are the same. While you may have experienced complicated feelings when you lost someone you love, it is entirely unfair to make the person grieving a fresh loss comfort you.

Be wary of discussing your own miscarriage(s), or someone else you know that suffered miscarriages, especially if the stories end with, “…but went on to have a healthy pregnancy,” or “….and continued having miscarriages.” Some people find these stories comforting, while others will be insulted.

If the baby was lost in the second trimester or beyond, do not use the word “miscarriage,” unless the mother herself uses it.

Don’t offer to help unless you mean it.

Also, if you offer to help, offer to help with specific things.

Do not ask “do you need help?” or “What do you need from me?” because chances are, in the midst of grief, the mother will be unable to tell you what it is that she needs.

Don’t forget the dad. Even if he’s being stoic about the early pregnancy loss, he, too, is grieving. Remember that the mother and father both lost a baby.

If the family has older children, don’t forget about them.  Even if they aren’t old enough to comprehend exactly what has happened, even the youngest toddlers know when their parents are sad. They may be confused and need reassurance that the sadness isn’t their fault.  Offer to spend time with them – take them to a playground, play a board game, let them talk about how they are feeling.

This Is Not Supportive After a Miscarriage:

Giving advice.

Criticizing what you have heard.

Minimizing the miscarriage e.g. “That’s okay, you were only three months.”

Using cliches e.g. “It was God’s will” or “You’ve already had one healthy child.”

Talking about your own story of loss. Some identification may be helpful, but keep it to a minimum. This is not about you.

Not allowing the person to express emotions such as guilt, shame, and anger.

Taking over completely may cause potential feelings of helplessness and powerlessness.

Fixing it (you cannot take the grief away).

If you have more suggestions not listed here, please email bandbacktogether@gmail.com and we will add them to our list

Page last audited 8/2018

Multiple Sclerosis Resources

by Band Back Together | Aug 6, 2018

What is Multiple Sclerosis?

Multiple sclerosis is a disease that causes an immune-mediated process that leads to an abnormal response by the body’s immune system that eventually damages the CNS – or central nervous system. This damages central nervous system (CNS) tissues in which the immune system attacks the myelin, the substance that surrounds and insulates nerves fibers causing slow loss of mylein that leads to nerve damage. As the exact antigen or target of the immune-mediated attack is not known, many experts prefer to label multiple sclerosis as “immune-mediated instead of an “autoimmune disease.”

In order to properly understand what actually happens to someone with MS, we must first discuss the ways in which these body parts work in a person living without MS. The neurons are structures composed of a cell body as well as an axon – the part of the cell body that carries messages from place to place. These neurons are incredibly important to our body – they allow us to see, think, hear, feel, speak, eliminate and move. The axons, the part of the nervous system that carries messages around the body is coated with myelin, sort of like a barrier around an electrical wire, are comprised of proteins and a lipid rich substance. This myelin sheath insulates and protects the axon to help increase the speed of nerve transmissions.

While myelin is present in the both the central nervous system (CNS) and peripheral nervous system (PNS), only the central nervous system is affected by MS. CNS myelin is created by cells called oligodendrocytes. while the PNS myelin is produced by Schwann cells. The two types of myelin are chemically different, but both do the same function – to increase efficient transmission of a nerve impulse along the axo.pids (fatty substances) and proteins. Like the coating around an electrical wire, myelin insulates and protects the axon, while increasing the speed of nerve transmission

Myelin is present in the central nervous system (CNS) and peripheral nervous system (PNS); however only the central nervous system is affected by MS. CNS myelin is produced by special cells called oligodendrocytes. PNS myelin is produced by Schwann cells. The two types of myelin are chemically different, but they both perform the same function — to promote efficient transmission of a nerve impulse along the axon. Damage to the myelin sheath is caused by inflammation and can occur anywhere in the central nervous system, including the brain and spinal cord. The optic nerves are also frequently affected.Multiple sclerosis is a chronic disease that affects the nervous system. It is often difficult to diagnose because symptoms frequently come and go, and can also mimic other diseases.

MS affects more women than men, and patients are usually diagnosed between the ages of 20 and 50, although MS can occur in young children, teenagers, and older adults.

What Is Abnormal Immune System Response in MS?

What is known is that when the myelin sheath surrounding a nerve cell is damaged by inflammation, scar tissue forms (a process called sclerosis), resulting in the slowing down or stopping of the impulses that travel along the nerve cell. This means that the impulses cannot travel effectively across the nerve cells, the affected area cannot function correctly, and the symptoms of MS appear.

What Are The Types of Multiple Sclerosis?

Just like any other disease, multiple sclerosis affects each person differently. The following are the most common types of MS:

Clinically-Isolating Syndrome:

CIS is the first episode of neurologic symptoms caused by inflammation and demyelination in the central nervous system. By definition, this episode must last for at least 24 hours and is very characteristic of multiple sclerosis, however it doesn’t yet meet the criteria for a proper diagnosis of MS. People who experience a CIS may or may not develop MS.

The episode usually has no associated fever or infection and is followed by a complete or partial recovery. CIS can be either monofocal or multifocal:

• Monofocal episode: A person experiences a single neurologic sign or symptom – such as an attack of optic neuritis – caused by a single lesion.
• Multifocal episode: The person experiences more than one sign or symptom – such an attack of optic neuritis accompanied by numbness or tingling in the legs – caused by lesions in more than one place.

People who experience Clinically-Isolated Syndrome  may or may not go on to develop MS. While diagnosing the healthcare provider faces two challenges: first, determining whether the person is experiencing damage in the CNS; and second, to determine the chance that a person experiencing this type event will go onto develop MS.

• Higher risk for developing MS: When CIS is accompanied by magnetic resonance imaging (MRI)-detected brain lesions similar to those seen in MS, the person has a 60 to 80 percent chance of a second neurologic event and diagnosis of MS within several years.
• Lower risk for developing MS: When CIS is not accompanied by MRI-detected brain lesions, the person has about a 20 percent chance of developing MS over the same period of time.

People with CIS who are at high risk for developing MS may now be treated with a disease-modifying therapy approved by the U.S. Food and Drug Administration (FDA) for that purpose. Early treatment of CIS has been shown to delay onset of MS.

Relapsing-Remitting MS (RRMS)

RRMS is the most common disease course of MS (Approximately 85 percent of people with MS are initially diagnosed with RRMS) that is characterized by clearly-defined attacks of new or increasing neurologic symptoms (attacks can take the form of worsening of old symptoms or appearance of new symptoms depending upon which areas of the nervous system are affected). These attacks (also known as relapses and exacerbations) are generally followed by partial or complete recovery (called “remissions”).

Following a relapse, the new symptoms may disappear without causing any increase in level of disability, or the new symptoms may partially disappear, resulting in an increase in disability. New lesions on MRI often occur as part of a relapse. However, new MRI lesions indicating MS activity may also occur without symptoms of which the person is aware.

During remissions, all or some symptoms may disappear while others become permanent. There are no obvious progressions of MS during periods of remissions.

At other times, RRMS is classified as:

1. Active – relapses and evidence of new MRI activity
2. Not active
3. Worsening – diagnosed increase in disability over a period of time following a relapse.
4. Not Worsening.

Symptoms of RRMS: People with progressive forms of MS are more likely to experience gradually worsening problems with walking and mobility, in addition to other symptoms they may have.

• Episodic bouts of fatigue
• Numbness
• Vision problems
• Spasticity or stiffness
• Bowel and bladder problems
• Problems with cognition (including learning, memory, and information, or information processing).

• Active (with relapses and/or evidence of new MRI activity) or not active
• With progression (evidence of disease worsening on an objective measure of change over time, with or without relapses) or without progression

What Cause Multiple Sclerosis?

As of today, the cause of MS is not known. Scientists believe MS is triggered by a combination of factors. To identify the cause, research is ongoing in areas of immunology (the study of the body’s immune system), epidemiology (the study of disease patterns in large groups of people) and genetics (understanding the genes that may not be functioning correctly in people who develop MS). Scientists are also studying infectious agents that may play a role.

Understanding what causes MS will speed the process of finding more effective ways to treat it and — ultimately — cure it, or even prevent it from occurring in the first place.

Potential Immunologic Factors of MS:

In recent years, researchers have identified immune cells that target the CNS in people with MS, some of the factors that cause them to respond abnormally, and the process of the immune system response. Ongoing efforts to learn more about the immune-mediated process in MS — what sets it in motion, and how to slow or stop it — will bring us closer to understanding the cause of MS.Although the cause of MS is not known, more is being learned about environmental factors that contribute to the risk of developing MS.  There is no single risk factor that provokes MS, but several factors are believed to contribute to the overall risk.

Geographic Factors of MS:

Multiple sclerosis occurs more often in areas farther from the equator. Scientists who study disease patterns in large groups of people trying to understand why and are looking at changes in geography, demographics (age, gender, and ethnic background), genetics, infectious causes, and migration patterns. Some data suggest that exposure to some environmental agent before puberty may predispose a person to develop MS later on.

Vitamin D
Growing evidence suggests that vitamin D may an important role in MS. Low vitamin D levels in the blood have been identified as a risk factor in the development of MS. Some researchers believe that increased exposure to the sun (a natural form of Vitamin D) – such as experienced by people in areas closer to the equator, may support immune function and help protect us from MS and other diseases similar to MS.

Smoking
Researchers have begun to suspect that smoking plays an important role in the development of multiple sclerosis. Studies show that smoking increases a person’s risk of developing MS and is associated with more severe disease and more rapid disease progression. This evidence also suggests that stopping smoking — before or after the onset of MS — is associated with a slower progression of MS disability.

Obesity
Childhood obesity, notably in girls, puts children at an increased the risk for developing MS. Other studies show that obesity in early adulthood may also contribute to an increased of developing MS.  Also, obesity may contribute to inflammation and more MS activity in those already diagnosed with MS.

Symptoms of Multiple Sclerosis:

Patients with MS experience a variety of symptoms with a wide range of severity, depending upon which area of the central nervous system is affected and the course of their particular disease.  More than one area can be affected at a time. No two patients’ symptoms are exactly alike.

The most common symptoms of MS include:

Bladder Problems: Bladder dysfunction, occurring in at least 80% of people with MS, can often be managed quite successfully with medications, fluid management, and intermittent self-catheterization.

Bowel Problems: Constipation is a particular concern among people with MS, as is loss of control of the bowels. Bowel issues can typically be managed through diet, adequate fluid intake, physical activity, and medication.

Cognitive Changes: a range of high-level brain functions are affected in more than 50% of people with MS, including the ability to process incoming information, learn, remember new information, organize, problem-solve, focus attention, and accurately perceive the environment.

Depression:  Studies have suggested that major depressive disorder –  the most severe type of depression – is one of the most common symptoms of MS. It is more common among people with MS than it is in the general population or in people who have many other chronic, disabling conditions.

Dizziness and Vertigo: People with MS may feel off balance or lightheaded, or -less often –  have the sensation that they or their surroundings are spinning (vertigo).

Emotional Changes: Can be a reaction to the stresses of living with MS as well as the result of neurologic and immune changes. Significant depression, mood swings, irritability, and episodes of uncontrollable laughing and crying pose significant challenges for people with MS and their families

Fatigue: occurs in about 80% of people with MS and can significantly interfere with the ability to function at home and work. In fact, fatigue may be the most prominent symptom in a person who otherwise has minimal activity limitations.

Numbness or Tingling: Numbness of the face, body, or extremities (arms and legs) is often the first symptom experienced by those eventually diagnosed as having MS.

Pain: Pain syndromes are common in MS. In one study, 55% of people with MS had “clinically significant pain” at some time, and almost half had chronic pain.

Sexual Problems: are very common in the general population including people with MS. Sexual responses can be affected by damage in the central nervous system, as well by symptoms such as fatigue and spasticity, and by psychological factors.

Spasticity: Refers to feelings of stiffness and a wide range of involuntary muscle spasms. These spasms can occur in any limb, but it is much more common in the legs.

Walking (Gait) Difficulties:  Related to several factors including weakness, spasticity, loss of balance, sensory deficit and fatigue, walking and gait challenges can sometimes be helped by physical therapy, assistive therapy, and medications.

Weakness; Weakness in MS, which results from de-conditioning of unused muscles or damage to nerves that stimulate muscles. Weakness may be managed with rehabilitation strategies and the use of mobility aids and other assistive devices.

Vision Problems: The first symptom of MS for many people. Onset of blurred vision, poor contrast or color vision, and pain on eye movement can be frightening and should be evaluated promptly.

Breathing Problems: Respiration problems occur in people whose chest muscles have been severely weakened by damage to the nerves that control those muscles.

Headache Although headache is not a common symptom of MS, some reports suggest that people with MS have an increased incidence of certain types of headache.

Hearing Loss About 6% of people who have MS complain of impaired hearing. In very rare cases, hearing loss has been reported as the first symptom of the disease.and swallowing

Itching: is one of the family of abnormal sensations — such as “pins and needles” and burning, stabbing or tearing pains — which may be experienced by people with MS.

Speech Problems: Speech problems, including slurring and loss of volume occur in approximately 25-40% of people with MS, particularly later in the disease course and during periods of extreme fatigue. Stuttering is occasionally reported as well.

Swallowing Problems Swallowing problems result from damage to the nerves controlling the many small muscles in the mouth and throat.

Tremor: Tremor, or uncontrollable shaking, can occur in various parts of the body because of damaged areas along the complex nerve pathways that are responsible for coordination of movements.

Seizures: Seizures, the result of abnormal electrical discharges in an injured or scarred area of the brain, have been estimated to occur in 2-5% people with MS, compared to the estimated 3% of the general population.

What Are The Effects of Multiple Sclerosis on the Body?

Diagnosis of Multiple Sclerosis:

Diagnosing MS is often difficult because symptoms can mimic other diseases.  In addition, there are no tests specifically designed to detect MS. Healthcare professionals typically rule out other diseases first and then use a combination of medical history, neurological exams, blood tests, MRIs, visual evoked potential tests, and cerebrospinal fluid analysis to determine if a patient has MS

A patient is considered to have MS if all of the following criteria are met:

• The patient has damage in at least two separate areas of the central nervous system (brain, spinal cord and optic nerves) AND
• The damage has occurred at least one month apart AND
• All other possible diagnoses have been ruled out.

Treatment for Multiple Sclerosis:

Patient Organizations:

Multiple Sclerosis Foundation (MSF) is a site dedicated to supporting and educating those touched by MS.  They also offer a directory of MS support groups by state.

Multiple Sclerosis International Foundation (MSIF) is a worldwide foundation that connects patients and professionals.

The MS International Federation is a unique global network of MS organizations, people affected by MS, volunteers and staff from around the world. Our movement is made up of 48 MS organisations with links to many others.

Educational Resources and Fact Sheets:

National Institute of Neurological Disorders and Stroke – Multiple Sclerosis provides information and educational information about multiple sclerosis.

Sadness Resources

by Band Back Together | Aug 5, 2018

What Is Sadness?

Emotions describe our physiological and psychological reaction to any given situation. They color and describe our emotional experience and do a lot to shape how we remember things. Emotions can be confusing, scary, and upsetting at times, and are often the balanced counter-point of emotions that are uplifting, joyous, and shiny.

One of the most complex feelings we experience is the feeling of sadness. Feelings of sadness often occur as a result of disappointment, loss, and grief. While emotions such as sadness may be very difficult to deal with, the first step is learning how to really understand what the emotion IS.

What Does Sadness Feel Like?

One of the most distinct characteristics of emotion is the fact that they have an intense physiological experience to accompany the intense emotional and logical experience. Many people have a difficult time learning how to identify and label the emotions that they feel, which can make it harder to understand and find a way to manage the feelings that you are experiencing, particularly when you are in crisis.

Physiological symptoms are those symptoms we physically feel in our bodies. Feeling sadness is no exception to this idea. The following are common physiological symptoms associated with sadness:

• Heaviness
• Fatigue
• Headache
• Stomachache
• Restlessness
• Aches
• Numbness or tingling
• Swollen eyes or nose
• Runny nose
• Crying
• Hot flashes or chills
• Tired
• Sleepy

While having any of these symptoms does not mean you are sad, experiencing these symptoms offers a clue in identifying what you are feeling. When processing an emotion, we often feel it in our bodies before we react to it. Understanding that when your skin feels prickly and you start to cry you are likely feeling sad, it gives you a leg up to understanding WHY you’re sad, and to begin processing the situation.

Types Of Sadness:

Like many emotions, sadness has a very broad range in which it can be experienced. The immediate sharpness of a sudden loss is very different than a persistent, low-level sadness that you feel every day. Here are some of the types of sadness.

Agony: Agony describes a raw and powerful pain.

Anguish: Similar to agony, anguish is an intense emotional pain that is paired with feelings of despair.

Discouraged: This describes the feeling associated with real or perceived failure. After repeated unsuccessful attempts, it is typical to feel as though you will never be able to do said task. The situation feels insurmountable and your self-esteem plummets.

Distressed: This describes a feeling of helplessness, usually accompanied by an impending sense of doom. Knowing that something bad is going to happen and being powerless to stop it.

Distraught: This is a similar feeling to distress; however, it’s slightly different in that it is a pervasive sense of upset that can be overwhelming to the point of being paralyzed to inaction.

Dismay: Dismay is a form of sadness that often has notes of hopelessness and regret.

Grief: Grief is one of the purest forms of sadness. It is a deep, consuming, powerful feeling of sadness, usually occurring around episodes of major loss.

Homesick: Homesickness is a feeling of sadness that comes from being away from where you feel most comfortable. This can be the result of seeing friends and family less, being in an unfamiliar situation or location, or after periods of change.

Hurt: Hurt is a powerful feeling experienced after you have been wronged or perceived to be wronged by another person, typically by someone you love or trust deeply. You may feel betrayed, that the action was taken with malicious intent, or that the action causing the hurt was personal in nature.

Unhappy: This term describes a general sense of sadness. It may not be specific to any instigator or trigger, and it may vary in it’s intensity. This is often described as “feeling blue,” or “being under a storm cloud.”

Sorrow: Sorrow is largely a feeling of sadness that accompanies a feeling of regret. You may feel sorrow after hurting another person, losing an opportunity, or when the outcome is not what you were hoping for.

Dejected: Dejected sounds very much like rejected, which is a good way to remember this one. Feeling dejected is a feeling of being put-out, as though you are not being accepted or appreciated.

Related Emotions:

As you can see, sadness takes many many forms for a variety of reasons. It is expressed by differing physical symptoms, emotional symptoms, desired outcomes and treatments. No sadness is exactly like another, and yet all fit under the umbrella of sadness. Because sadness is often related to a negative situation, emotions become more tangled due to cross-over emotions. Cross-over emotions are other emotions or feelings that occur directly before, after, or because of the feeling of sadness.

Because of these cross-over emotions, emotions can be really hard to detangle. Again, learning to physiologically categorize your feelings so that you can observe and describe the feeling will help you identify the emotions you feel. Here are some of the most common emotions that occur in tandem with sadness:

Anger: Anger is generally described by an escalation of your emotional state. Many people report feeling hot, revved up, energized, and explosive. Anger can also be cold, when it is laced with fury and cruelty. Anger is typically a defensive response to an uncomfortable situation in which we don’t otherwise know how to respond to it. This can be born out of feelings of shame, guilt, hurt, embarrassment, or frustration.

Blame: Blame is when you assign measures of fault to another individual. By placing all the responsibility on another, it is easier to feel “wronged” and wind up your anger. While there are situations in which someone else truly is at fault, many many situations are a combination of fault on every side. Because it is difficult to admit to fault for many people, blame allows a person to hide behind the assignment of guilt to another person rather than address the discomfort around how he or she impacted the situation.

Stress: Stress describes the physical feelings associated with negative events. Feeling “Stressed out” is usually a term that refers to feeling emotionally depleted and overwhelmed. Because emotions can be so intense, it is draining to the body and the mind, and is summed up as stress. Typical physical feelings of stress include headache, stomach ache, changes to sleeping or eating, tight or sore muscles, and difficulty concentrating.

Guilt: Guilt is the term to describe a feeling that occurs when you know or believe that you have wronged another person. It is a feeling of fault that you assign to yourself, that leads to feeling uncomfortable, embarrassed, or ashamed. Running away or avoiding a situation is a common reaction to feelings of guilt.

Grief: Grief is one of the most raw emotions we feel as human beings. It is largely a deep and pervasive sense of loss that is absolutely consuming and devastating.

Anxiety: Anxiety is a very general term that describes feelings of unease, nervousness, restlessness, or on some level, fear.

Hopelessness: Hopelessness describes a feeling that things will never get better. Because you feel unable to change your situation or make any kind of meaningful change, you become hopeless upon acceptance of this as your immediate reality.

For more information about feelings and emotions.

Myths About Sadness:

While much about sadness is undesirable and is not much fun to experience, it does serve a purpose. It is the counterpoint to happiness and joy, which provides a deeper range of emotional experience. It also helps us identify situations that we can improve for ourselves and for those around us. Here are some common thoughts around sadness.

My sadness brings everyone around me down. While sadness does impact those around you, it is not out of anger or frustration. Your friends, family, and loved ones care about you and want to help you as best as they can. Sometimes for the person who is sad, that is simply having someone to listen and validate their feelings of sadness.

No one understands my sadness. We are none of us alone. Sadness can be a hard window to look through, but there is always the outside, the brighter side, a way to get through this. While someone may not EXACTLY understand every detail of what you are feeling, humans are unique in their capability to empathize with others, and be attuned to other’s feelings of distress.

I have no right to be sad when so many worse things happen to others. It is easy to feel this way; however, remember that it is apples and oranges. How you feel about your situation is no less or no less important than how another person feels about his or her situation. While there is benefit and value in recognizing perspective, it does not mean you should feel your sadness any less. You feel what you feel.

You should just snap out of it and focus on being happy. Sadness, like many emotions, can  be somewhat tempered by your mental attitude. However, there are other times that it can’t be. For example, those who suffer from depression or dysthymia, have a biological factor that impacts mood.

You should stop choosing to be sad. As above. While to some degree we can choose our attitude, there is a lot to consider regarding why you’re sad. Take a long look and evaluate your situation.

I’ll get over it. Yes, it will get better. How long and how easily it goes depends on a great many things, including your emotional support system, your health, and your mental space to deal with things. We all have shit and sometimes it’s hard to make space for it. It’s okay to put it on the back burner, as long as it’s not purely an attempt to avoid the discomfort. You will deal with it in your own time, and there are many resources available to help you, such as therapy, friends and family, or submitting a post to the Band.

What To Do If You’re Sad:

Okay okay, so you’re sad. You’re tired of reading about the numerous ways you can feel sad and why you feel sad. But what do you DO about feeling sad? No one answer is perfect and it may take a lot of trial and error to find what works for you. It may be one thing, it may be a blend of many many things. It might resolve with time, or it might be the worst moment of your life. Just remember that all things pass, and that emotions crest and subside like a wave. You CAN get through this.

Sleep is one of the major factors that impact mood. It is well researched that poor mood and poor sleep correlate with one another. Sleep is often disrupted when we are upset because our bodies ache, we don’t feel well, our mind races or won’t turn off. Establish a relaxing bedtime routine that will cue your body that it’s time to prepare for sleep. This can include taking a warm bath, a cup of tea, reading a book, meditating, whatever slows your body and mind down. Above all remember to breathe. Being consistent in doing this and going to bed at the same time will truly help you get quality sleep.

Diet can be really hard to control when you’re upset. As our cortisol (stress hormone) increases, our natural instinct is to go in to “survival mode,” which includes eating a lot of fatty foods and sleeping all day. Motivation and energy go out the window. On the other hand, some people stop eating entirely. Remember, food is fuel for your body and your mind. If you do not feed them properly, they are less efficient and make it harder for you to deal.

Exercise is the best, the ONLY way to reduce levels of cortisol in our body. While cortisol will naturally deplete itself, it happens very slowly to the point that your body creates more than it disperses at any given time. Exercise naturally reduces cortisol while increasing your feel-good hormones at the same time. Even if you start slowly by walking for ten minutes, it’s okay. You’re helping yourself even with that little bit.

Talk to someone, silence is the greatest ally of sadness. Feeling unable or unwilling to break your silence is a desperate feeling. The first step is the hardest step. Let someone in to help you.

Find an activity is a great way to refocus your energy. For some, it is building confidence through developing a competency, for others it’s exhausting their emotions through physical activity. Whatever allows you to focus and relax your mind, bringing some logic and order in, will help you sort and organize everything going on, and allow you to take a much needed break.

Contribute to your local community. Help someone. It can be completely empowering to find ways to help others. Bringing joy and happiness to others is often contagious and it is a rewarding feeling that you are making a difference. Further, if you can help others, it serves to remind you that you can be helped too.

Journal or find another creative outlet to let it all out. Art, dance, music, writing – all of these allow you to just get it all out. Putting your thoughts to paper so to speak allows you to just SEE it from a different perspective, and not have to work so hard to just hold it all in.

Therapy is the act of talking it out with someone well versed in the psychological side of the mind. It can be a relief to find a neutral observer to give you perspective and advice. He or she may also be able to refer you to an appropriate health care provider to utilize medication treatments as relevant.

How To Help Someone Who Is Sad:

So taking this all in to account, what does that mean you should do at the end of the day? How can you help someone who is sad? This frustratingly is a complicated answer, as detailed there are many ways and reasons for someone to be sad. Usually the key is to say something, reach out, show that you care, and support however you can.

Ask questions – Don’t be afraid to comment that someone has seemed down lately and ask if everything is okay or how you can help. He or she may not know what to say or do, or what he or she may even need, but by asking you’re showing that you care.

Find information – Be a source of information and resources. Sometimes it’s too scary to take the first step to call a therapist, or join a class. Gather information to reduce the feeling of being overwhelmed.

Be a support – Show your friend or loved one that you care, through thick and thin. Be consistent, and be there.

Validate – Above all else, validate the person’s feelings. Sometimes the best gift you can give someone, is helping to give them their voice.

Page last audited 8/2018