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Helping a Depressed Family Member

How to Reach Out and Help Someone While Taking Care of Yourself

Helping a Depressed PersonIn This Article

When a family member or friend suffers from depression, your support and encouragement can play an important role in his or her recovery. However, depression can also wear you down if you neglect your own needs. These guidelines can help you support a depressed person while maintaining your own emotional equilibrium.

Helping a depressed friend or family member

Depression is a serious but treatable disorder that affects millions of people, from young to old and from all walks of life. It gets in the way of everyday life, causing tremendous pain, hurting not just those suffering from it, but also impacting everyone around them.

If someone you love is depressed, you may be experiencing any number of difficult emotions, including helplessness, frustration, anger, fear, guilt, and sadness. These feelings are all normal. It’s not easy dealing with a friend or family member’s depression. And if you don’t take care of yourself, it can become overwhelming.

That said, there are steps you can take to help your loved one. Start by learning about depression and how to talk about it with your friend or family member. But as you reach out, don’t forget to look after your own emotional health. Thinking about your own needs is not an act of selfishness—it’s a necessity. Your emotional strength will allow you to provide the ongoing support your depressed friend or family member needs.

Understanding depression in a friend or family member:

  • Depression is a serious condition.Don’t underestimate the seriousness of depression. Depression drains a person’s energy, optimism, and motivation. Your depressed loved one can’t just “snap out of it” by sheer force of will.
  • The symptoms of depression aren’t personal. Depression makes it difficult for a person to connect on a deep emotional level with anyone, even the people he or she loves most. In addition, depressed people often say hurtful things and lash out in anger. Remember that this is the depression talking, not your loved one, so try not to take it personally.
  • Hiding the problem won’t make it go away. Don’t be an enabler. It doesn’t help anyone involved if you are making excuses, covering up the problem, or lying for a friend or family member who is depressed. In fact, this may keep the depressed person from seeking treatment.
  • You can’t “fix” someone else’s depression. Don’t try to rescue your loved one from depression. It’s not up to you to fix the problem, nor can you. You’re not to blame for your loved one’s depression or responsible for his or her happiness (or lack thereof). Ultimately, recovery is in the hands of the depressed person.

Is my friend or family member depressed?

Family and friends are often the first line of defense in the fight against depression. That’s why it’s important to understand the signs and symptoms of depression. You may notice the problem in a depressed loved one before he or she does, and your influence and concern can motivate that person to seek help.

Be concerned if your loved one...

  • Doesn’t seem to care about anything anymore.
  • Is uncharacteristically sad, irritable, short-tempered, critical, or moody.
  • Has lost interest in work, sex, hobbies, and other pleasurable activities.
  • Talks about feeling “helpless” or “hopeless.”
  • Expresses a bleak or negative outlook on life.
  • Frequently complains of aches and pains such as headaches, stomach problems, and back pain.
  • Complains of feeling tired and drained all the time.
  • Has withdrawn from friends, family, and other social activities.
  • Sleeps less than usual or oversleeps.
  • Eats more or less than usual, and has recently gained or lost weight.
  • Has become indecisive, forgetful, disorganized, and “out of it.”
  • Drinks more or abuses drugs, including prescription sleeping pills and painkillers.

How to talk to a loved one about depression

Sometimes it is hard to know what to say when speaking to a loved one about depression. You might fear that if you bring up your worries he or she will get angry, feel insulted, or ignore your concerns. You may be unsure what questions to ask or how to be supportive.

If you don’t know where to start, the following suggestions may help. But remember that being a compassionate listener is much more important than giving advice. You don’t have to try to “fix” the person; you just have to be a good listener. Often, the simple act of talking to someone face to face can be an enormous help to someone suffering from depression. Encourage the depressed person to talk about his or her feelings, and be willing to listen without judgment.

Don’t expect a single conversation to be the end of it. Depressed people tend to withdraw from others and isolate themselves. You may need to express your concern and willingness to listen over and over again. Be gentle, yet persistent.

Ways to start the conversation:

  • I have been feeling concerned about you lately.
  • Recently, I have noticed some differences in you and wondered how you are doing.
  • I wanted to check in with you because you have seemed pretty down lately.

Questions you can ask:

  • When did you begin feeling like this?
  • Did something happen that made you start feeling this way?
  • How can I best support you right now?
  • Have you thought about getting help?

Remember, being supportive involves offering encouragement and hope. Very often, this is a matter of talking to the person in language that he or she will understand and respond to while in a depressed mind frame.

What you can say that helps:

  • You are not alone in this. I’m here for you.
  • You may not believe it now, but the way you’re feeling will change.
  • I may not be able to understand exactly how you feel, but I care about you and want to help.
  • When you want to give up, tell yourself you will hold on for just one more day, hour, minute—whatever you can manage.
  • You are important to me. Your life is important to me.
  • Tell me what I can do now to help you.

Avoid saying:

  • It’s all in your head.
  • We all go through times like this.
  • Look on the bright side.
  • You have so much to live for why do you want to die?
  • I can’t do anything about your situation.
  • Just snap out of it.
  • What’s wrong with you?
  • Shouldn’t you be better by now?

Adapted from: The Depression and Bipolar Support Alliance

Taking care of yourself while helping a depressed person

There’s a natural impulse to want to fix the problems of people we love, but you can’t control a loved one’s depression. You can, however, control how well you take care of yourself. It’s just as important for you to stay healthy as it is for the depressed person to get treatment, so make your own well-being a priority.

Remember the advice of airline flight attendants: put on your own oxygen mask before you assist anyone else. In other words, make sure your own health and happiness are solid before you try to help someone who is depressed. You won’t do your friend or family member any good if you collapse under the pressure of trying to help. When your own needs are taken care of, you’ll have the energy you need to lend a helping hand.

Tips for taking care of yourself

Think of this challenging time like a marathon; you need extra sustenance to keep yourself going. The following ideas will help you keep your strength up as you support your loved one through depression treatment and recovery.

  • Speak up for yourself. You may be hesitant to speak out when the depressed person in your life upsets you or lets you down. However, honest communication will actually help the relationship in the long run. If you’re suffering in silence and letting resentment build, your loved one will pick up on these negative emotions and feel even worse. Gently talk about how you’re feeling before pent-up emotions make it too hard to communicate with sensitivity.
  • Set boundaries. Of course you want to help, but you can only do so much. Your own health will suffer if you let your life be controlled by your loved one’s depression. You can’t be a caretaker round the clock without paying a psychological price. To avoid burnout and resentment, set clear limits on what you are willing and able to do. You are not your loved one’s therapist, so don’t take on that responsibility.
  • Stay on track with your own life. While some changes in your daily routine may be unavoidable while caring for your friend or relative, do your best to keep appointments and plans with friends. If your depressed loved one is unable to go on an outing or trip you had planned, ask a friend to join you instead.
  • Seek support. You are NOT betraying your depressed relative or friend by turning to others for support. Joining a support group, talking to a counselor or clergyman, or confiding in a trusted friend will help you get through this tough time. You don’t need to go into detail about your loved one’s depression or betray confidences; instead focus on your emotions and what you are feeling. Make sure you can be totally honest with the person you turn to—no judging your emotions!

Encouraging a depressed person to get help

While you can't control someone else’s recovery from depression, you can start by encouraging the depressed person to seek help. Getting a depressed person into treatment can be difficult. Depression saps energy and motivation, so even the act of making an appointment or finding a doctor can seem daunting. Depression also involves negative ways of thinking. The depressed person may believe that the situation is hopeless and treatment pointless.

Because of these obstacles, getting your loved one to admit to the problem—and helping him or her see that it can be solved—is an essential step in depression recovery.

If your friend or family member resists getting help for depression:

  • Suggest a general check-up with a physician. Your loved one may be less anxious about seeing a family doctor than a mental health professional. A regular doctor’s visit is actually a great option, since the doctor can rule out medical causes of depression. If the doctor diagnoses depression, he or she can refer your loved one to a psychiatrist or psychologist. Sometimes, this “professional” opinion makes all the difference.
  • Offer to help your depressed loved one find a doctor or therapist and go with them on the first visit. Finding the right treatment provider can be difficult, and is often a trial-and-error process. For a depressed person already low on energy, it is a huge help to have assistance making calls and looking into the options.
  • Encourage the person to make a thorough list of symptoms and ailments to discuss with the doctor. You can even bring up things that you have noticed as an outside observer, such as, “You seem to feel much worse in the mornings,” or “You always get stomach pains before work.”

Supporting your loved one's depression treatment

One of the most important things you can do to help a friend or relative with depression is to give your unconditional love and support throughout the treatment process. This involves being compassionate and patient, which is not always easy when dealing with the negativity, hostility, and moodiness that go hand in hand with depression.

  • Provide whatever assistance the person needs (and is willing to accept). Help your loved one make and keep appointments, research treatment options, and stay on schedule with any treatment prescribed.
  • Have realistic expectations. It can be frustrating to watch a depressed friend or family member struggle, especially if progress is slow or stalled. Having patience is important. Even with optimal treatment, recovery from depression doesn’t happen overnight.
  • Lead by example. Encourage your friend or family member to lead a healthier, mood-boosting lifestyle by doing it yourself: maintain a positive outlook, eat better, avoid alcohol and drugs, exercise, and lean on others for support.
  • Encourage activity. Invite your loved one to join you in uplifting activities, like going to a funny movie or having dinner at a favorite restaurant. Exercise is especially helpful, so try to get your depressed loved one moving. Going on walks together is one of the easiest options. Be gently and lovingly persistent—don’t get discouraged or stop asking.
  • Pitch in when possible. Seemingly small tasks can be hard for a depressed person to manage. Offer to help out with household responsibilities or chores, but only do what you can without getting burned out yourself!

The risk of suicide is real

What to do in a crisis situation

If you believe your loved one is at an immediate risk for suicide, do NOT leave the person alone.

In the U.S., dial 911 or call the National Suicide Prevention Lifeline at 1-800-273-TALK.

In other countries, call your country’s emergency services number or visit IASP to find a suicide prevention helpline.

It may be hard to believe that the person you know and love would ever consider something as drastic as suicide, but a depressed person may not see any other way out. Depression clouds judgment and distorts thinking, causing a normally rational person to believe that death is the only way to end the pain he or she is feeling.

When someone is depressed, suicide is a very real danger. It’s important to know the warning signs:

  • Talking about suicide, dying, or harming oneself
  • Preoccupation with death
  • Expressing feelings of hopelessness or self-hate
  • Acting in dangerous or self-destructive ways
  • Getting affairs in order and saying goodbye
  • Seeking out pills, weapons, or other lethal objects
  • Sudden sense of calm after a depression

If you think a friend or family member might be considering suicide, talk to him or her about your concerns as soon as possible. Many people feel uncomfortable bringing up the topic but it is one of the best things you can do for someone who is thinking about suicide. Talking openly about suicidal thoughts and feelings can save a person’s life, so speak up if you're concerned and seek professional help immediately!

More help for depression

Resources and references

General information about helping a depressed person

Helping Someone with a Mood Disorder – Covers how to support a loved one through depression treatment and recovery. (Depression and Bipolar Support Alliance)

Helping Someone Receive Treatment – What to do (and not to do) when trying to help a loved one get help for depression. (Families for Depression Awareness)

Depression and the family

Helping Someone Manage Depression – Tips on how families can work together to manage depression treatment. (Families for Depression Awareness)

Depression and Relationships: Living with a Depressed Person – Includes nine rules for living with a depressed person. (Uplift Program)

Action Strategies: Family and Depression – Offers strategies for helping a family member who is suffering from depression, as well as protecting the family. (Psychology Today)

Helping a suicidal person

How to Help Someone in Crisis – Advice on how to deal with a depression crisis, including situations where hospitalization is necessary. (Depression and Bipolar Support Alliance)

Suicidal helplines around the world

National Suicide Prevention Lifeline – Suicide prevention telephone hotline funded by the U.S. government. Provides free, 24-hour assistance. 1-800-273-TALK (8255).

Samaritans UK – 24-hour suicide support for people in the UK (call 08457 90 90 90) and Ireland (call 1850 60 90 90). (Samaritans)

Lifeline Australia – 24-hour suicide crisis support service at 13 11 14. (Lifeline Australia)

Crisis Centers in Canada – Locate suicide crisis centers in Canada by province. (Centre For Suicide Prevention)

IASP – Find crisis centers and helplines around the world. (International Association for Suicide Prevention).

International Suicide Hotlines – Find a helpline in different countries around the world. (Suicide.org)

Helping Someone With PTSD

Helping Someone with PTSD

Helping a Loved One or Family Member with Post-Traumatic Stress Disorder

PTSD in the FamilyIn This Article

When someone you care about suffers from post-traumatic stress disorder (PTSD), it affects you too. The symptoms of PTSD aren’t easy to live with, and the changes in your loved one can be downright terrifying. You worry that things won’t ever go back to the way they were before. At the same time, you may feel angry about what’s happening to your family, and hurt by your loved one’s distance and moodiness. It’s a stressful situation all around—one that can leave you feeling overwhelmed, even as you try your best to stay strong. The most important thing to know is that you aren’t helpless. Your support can make a huge difference in your partner, friend, or family member’s recovery. But as you do your best to care for someone with PTSD, you also need to take care of yourself.

Understanding the impact of PTSD on family & relationships

PTSD can take a heavy toll on friends and family members, and relationship difficulties are common. It can be hard to understand your loved one’s behavior—why he or she is less affectionate and more volatile. You may feel like you’re walking on eggshells or living with a stranger. You may even be afraid of the person. The symptoms of PTSD can also result in job loss, substance abuse, and other stressful problems that affect the whole family.

It’s hard not to take the symptoms of PTSDpersonally. When someone you love is distant, anxious, or angry all the time, your relationship suffers. But it’s important to remember that the person may not always have control over his or her behavior. Anger, irritability, depression, apathy, mistrust, and negativity are common PTSD symptoms that your loved one can’t simply choose to turn off. With time and treatment, they will get better, but it’s a gradual process.

Tips for coping with PTSD in the family

  • Be patient. Getting better takes time, even when a person is committed to treatment for PTSD. Be patient with the pace of recovery. It’s a process that takes time and often involves setbacks. The important thing is to stay positive and keep at it.
  • Educate yourself about PTSD. The more you know about the symptoms, effects, and treatment options, the better equipped you'll be to help your loved one, understand what he or she is going through, and keep things in perspective.
  • Don’t pressure your loved one into talking. It can be very difficult for people with PTSD to talk about their traumatic experiences. For some, it can even make things worse. Instead of trying to force it, just let them know you’re willing to listen when they’re ready.
  • Take care of your emotional and physical health. As the saying goes, put on your own oxygen mask first. You won’t be any good to your loved one if you are burned out, sick, or exhausted.
  • Accept (and expect) mixed feelings. As you go through the emotional wringer, be prepared for a complicated mix of feelings—some of which you’ll never want to admit. Just remember, having negative feelings toward your family member doesn’t mean you don’t love them.

PTSD & the family: Social support is vital to recovery

It’s common for people with PTSD to withdraw from their friends and family. While it’s important to respect your loved one’s boundaries, too much isolation is unhealthy. Your comfort and support can help a person with PTSD overcome feelings of helplessness, grief, and despair. In fact, trauma experts claim that receiving love from others is the most important factor in PTSD recovery.

Knowing how to best demonstrate your love and support, however, isn’t always easy. You can’t be your family member’s therapist, and you can’t force him or her to get better. But you can play a major role in the healing process by spending time together and listening carefully.

Why someone with PTSD might be reluctant to seek support

  • Being afraid of losing control
  • Feeling weak or ashamed
  • Not wanting to burden others
  • Believing that others won’t understand
  • Wanting to avoid thinking about what happened
  • Fear that others will judge or pity them

How to be a good listener

While you shouldn’t push a person with PTSD to talk, you can let them know you’re available for them. If they do choose to share, try to listen without expectations or judgments. Make it clear that you’re interested and that you care, but don’t worry about giving advice. Leave that to the professionals. Instead, do your best to simply take in what they’re saying. Never underestimate how much the act of empathetic listening can help.

A person with PTSD may need to talk about the traumatic event over and over again. This is part of the healing process, so avoid the temptation to tell your loved one to stop rehashing the past and move on. Instead, offer to talk as many times as needed. And remember, it’s okay to dislike what you hear. Some of the things your loved one tells you might be very hard to listen to. But it’s important to respect their feelings and reactions. If you come across as disapproving, horrified, or judgmental, they are unlikely to open up to you again.

Communication Pitfalls to Avoid

  • Giving easy answers or blithely telling the person everything is going to be okay
  • Stopping the person from talking about their feelings or fears
  • Offering unsolicited advice or telling the person what he or she “should” do
  • Blaming all of your relationship or family problems on the person’s PTSD
  • Invalidating, minimizing, or denying the person’s experience
  • Telling the person to “get over it” or “snap out of it”
  • Giving ultimatums or making threats or demands
  • Making the person feel weak because they aren’t coping as well as others
  • Telling the person they were lucky it wasn’t worse
  • Taking over with your own personal experiences or feelings

PTSD & the family: Tips for rebuilding trust and safety

Trauma alters the way a person sees the world, making it seem like a perpetually dangerous and frightening place. It also damages people’s ability to trust others and themselves.

Anything you can do to rebuild your loved one’s sense of security will contribute to recovery. This means cultivating a safe environment, acting in a dependable and reassuring way, and stepping in to help when needed. But it also means finding ways to empower the person. Smothering someone with PTSD or doing things for them that they’re capable of doing for themselves is counterproductive. Better to build their confidence and self-trust by giving them more choices and control.

Things you can do to increase your loved one's sense of safety

  • Express your commitment to the relationship. Let the person know you’re here for the long haul.
  • Create routines. Structure and predictable schedules will enhance the person’s feelings of security. You can also help create a safe place.
  • Be aware of things that can make a person with PTSD feel unsafe, such as new places, crowds, confusion, or being physically constrained or ordered around.
  • Try to minimize stress at home and make sure your loved one has time alone for rest and relaxation.
  • Speak of the future and make plans. This can help counteract the common feeling among people with PTSD that their future is limited.
  • Keep your promises. Help rebuild trust by being trustworthy. Be consistent and follow through on the things you say you’re going to do.
  • Tell them you believe they are capable of recovery. Emphasize their strengths. Help them (and others) see their positive qualities and successes.

PTSD & the family: Encouraging and supporting treatment

Despite the importance of your love and support, it isn’t always enough. Many people who have been traumatized need professional PTSD treatment. But bringing it up can be touchy. Think about how you’d feel if someone suggested that you needed therapy.

Wait for the right time to raise your concerns. Don’t bring it up when you’re arguing or in the middle of a crisis. Also be careful with your language. Avoid anything that implies that he or she is “crazy.” Frame it in a positive, practical light: treatment is a way to learn new skills that can be used to handle a wide variety of PTSD-related challenges.

  • Emphasize the benefits. For example, therapy can help them become more independent and in control. Or it can help reduce the anxiety and avoidance that is keeping them from doing the things they want to do.
  • Focus on specific problems. If your partner shuts down when you talk about PTSD or counseling, focus instead on how treatment can help with specific issues like anger management, anxiety, or concentration and memory problems.
  • Acknowledge the hassles and limitations of therapy. For example, you could say, “I know that therapy isn’t a quick or magical cure, and it may take awhile to find the right therapist. But even if it helps a little, it will be worth it.”
  • Enlist help from people your loved one respects and trusts. He or she may be more open to counseling if the idea comes from someone else. Suggest the person see a doctor or talk with his/her pastor, rabbi, or spiritual leader.
  • Encourage the person to join a support group. Getting involved with others who have gone through similar traumatic experiences can help your loved one feel less damaged and alone.

PTSD & the family: Anticipating and managing triggers

A trigger is anything—a person, place, thing, or situation—that reminds your family member of the trauma and sets off a PTSD symptom, such as a flashback. Sometimes, triggers are obvious (for example, a military veteran might be triggered by seeing his combat buddies or by the loud noises that sound like gunfire). Others may take some time to identify and understand. For example, maybe a song was playing when the traumatic event happened, and now that song or even others in the same genre of music are triggers. And triggers aren’t just external. Internal feelings and sensations can also trigger PTSD symptoms.

Types of PTSD triggers
Common external triggers
  • Sights, sounds, smells, or touches associated with the trauma
  • People, locations, activities, or things that remind you of the trauma
  • Significant dates or times, such as anniversaries or a specific time of day
  • Nature (certain types of weather, seasons, etc.)
  • Conversations or media coverage about trauma or negative news events
  • Situations that feel confining (stuck in traffic, at the doctor’s or therapist’s office, in a crowd)
  • Relationship, family, school, work, or money pressures or arguments
  • Funerals, hospitals, medical treatment or procedures
Common internal triggers
  • Physical discomfort, such as hunger, thirst, fatigue, sickness, and sexual frustration
  • Any bodily sensation that reminds you of the trauma, including pain, old wounds and scars, or a similar injury
  • Strong emotions, especially feeling helpless, out of control, trapped, or unprotected
  • Feelings toward family members, including mixed feelings of love, vulnerability, and resentment

Talking to your family member or partner about triggers

Ask your loved one to sit down with you and make a list of triggers that have previously led to flashbacks or other PTSD symptoms. If you're aware of the triggers that may cause an upsetting reaction, you can take steps to minimize or avoid them.

You can also talk about things he or she did in the past in response to a trigger that seemed to help (as well as the things that didn’t). Then you can come up with a joint game plan for how you will respond to a flare-up of symptoms. Ask your loved one what he or she would like you to do during a nightmare, flashback, or panic attack. Having a plan in place will make the situation less scary for both of you. You’ll also be in a much better position to help your loved one calm down.

How to help in the middle of a flashback or panic attack

During a flashback, people often feel a sense of disassociation, as if they’re detached from their own body. Anything you can do to “ground” them will help.

  • Tell them they’re having a flashback and that even though it feels real, it’s not actually happening again
  • Help remind them of their surroundings (for example, ask them to look around the room and describe out loud what they see)
  • Encourage them to take deep, slow breaths (hyperventilating will increase feelings of panic)
  • Avoid sudden movements or anything that might startle them
  • Ask before you touch them. Touching or putting your arms around the person might make him or her feel trapped, which can lead to greater agitation and even violence

PTSD & the family: Dealing with volatility and anger

PTSD can lead to difficulties managing emotions and impulses. In your loved one, this may manifest as extreme irritability, moodiness, or explosions of rage. In fact, anger is so common in people with PTSD that it is considered one of the prime symptoms of hyperarousal.

Understanding anger in PTSD

People suffering from PTSD live in a constant state of physical and emotional stress. To make matters worse, they usually have trouble sleeping. They are exhausted, on edge, and physically strung out—which increases the likelihood that they’ll overreact to situations and stressors in their day-to-day life.

For many people with PTSD, anger can also be a cover for other feelings or a defense against grief, helplessness, guilt, or shame. They’d rather be mad than sad. Anger makes them feel powerful, instead of weak and vulnerable. For others, their anger is so intense that they’re afraid of letting it out. Instead, they try to suppress it. But it simmers under the surface, like an active volcano, and can erupt when you least expect it.

  • Watch for signs that your loved one is angry. Their face may get red, they may clench their jaw or fists, talk louder, start pacing or getting agitated. Take steps to defuse the situation as soon as you see the initial warning signs.
  • Try to remain calm. During an emotional outburst, do your best to stay calm (or at least pretend to be). This will communicate to your loved one that you are “safe.” It will also help keep the situation from escalating.
  • Give the person space. Don’t come closer unless asked and avoid crowding or grabbing the person. This can make a traumatized person feel threatened.
  • Ask how you can help. For example: “Do you want me to help you calm down?” or “What can I do to help you right now?” You can also suggest a time out or change of scenery if you think that might help.
  • Put safety first. If the person gets more upset despite your attempts to calm him or her down, stop what you’re doing and go for help. Leave the house or lock yourself in a room if necessary. Call 911 immediately if you fear that your loved one may hurt himself or others.

Learning how to control anger

Anger is a normal, healthy emotion, but when chronic, explosive anger spirals out of control, it can have serious consequences on a person’s relationships, health, and state of mind. But anger doesn’t have to hijack your (or your family’s) life. You can get anger under control by exploring the root issues and learning healthier ways to express your feelings.

Read more: Anger Management: Tips and Techniques for Getting Anger Under Control

PTSD & the family: The importance of self-care

As previously mentioned, if a loved one has PTSD, it’s essential that you take care of yourself and get extra support. Looking after your own well-being isn’t selfish—it’s necessary. In addition to putting a lot of time and energy into your family member’s problems, you’re probably taking on a bigger share of the household responsibilities as well. That’s a big caregiver burden that can lead to emotional strain and physical exhaustion if you don’t take steps to recharge and find balance.

Letting your family member’s PTSD dominate your life while ignoring your own needs is a surefire recipe for burnout. In order to have the strength to be there for your loved one over the long haul, you have to nurture and care for yourself. Like proper maintenance on a car, it’s what will keep you going.

Tips for taking care of yourself

Self-care begins with taking care of your physical needs: getting enough sleep, exercising regularly, eating properly, and looking after any medical issues. From there, it extends to your mental, social, and emotional needs.

  • Cultivate your own support system. This can include other family members you know you can rely on, trusted friends, your own therapist or support group, or your faith community.
  • Make time for your own life. Don’t give up friends, hobbies, or activities that make you happy. It’s important to have things in your life that you look forward to.
  • Spread the responsibility. You can’t do it all. Ask other family members and friends for assistance so you can take a break. You may also want to seek out respite services in your community.
  • Set boundaries. Be realistic about what you’re capable of giving. Know your limits, communicate them to your family member and others involved, and stick to them.
  • Talk to someone about your feelings. It can be a therapist, a friend, or your religious leader. Expressing what you’re going through can be very cathartic, making it easier to get through tough times.

Trauma can be "contagious"

Another reason why self-care is so important is because of the potential for secondary traumatization. What that means is that the spouses, partners, and family members of people with PTSD can develop their own symptoms. This can happen from listening to trauma stories or being exposed to scary symptoms like flashbacks. The more depleted and overwhelmed you feel, the greater the risk that you yourself may become traumatized.

Support for people taking care of veterans

If the person you’re caring for is a U.S. military veteran, home health care coverage, financial support, nursing home care, and adult day care benefits may be available. Some Veterans Administration programs are free, while others require co-payments, depending upon the veteran’s status, income, and other criteria. Visit VA Caregiver Support to explore your options, or call Coaching into Care at (888) 823-7458 for free, confidential advice about how to help your veteran.

More help for PTSD in the family

Resources and references

General help for people with PTSD and their family members

National Suicide Prevention Lifeline – This 24-hour hotline for anyone in emotional distress: 1-800-273-TALK (8255).

SIDRAN Institute – A nonprofit organization that helps people understand, recover from, and treat traumatic stress. Includes a referral list of therapists for PTSD.

National Alliance on Mental Illness (NAMI) – Call the Helpline at 1-800-950-NAMI (6264) or check out the Family-to-Family Education Program for caregivers of people with severe mental illness.

Help for veterans and their family members

Coaching Into Care – Call (888) 823-7458 for free, confidential coaching designed to help family members learn how to talk to their veteran about their concerns and about treatment options.

Veterans Crisis Line – A confidential, free hotline for veterans and their families and friends. Call 1-800-273-8255 (Press 1) or connect via chat or text (838255).

Military OneSource – Call 1-800-342-9647 for confidential counseling, non-medical services, and other resources for veterans and their family members. The line is open 24/7.

Help for Veterans with PTSD – Learn how to earn how to earn how to enroll for VA health care and get an assessment. (National Center for PTSD)

Give an Hour – A nonprofit organization that offers free mental health services to U.S. military personnel and their families affected by the ongoing conflicts in Iraq and Afghanistan.

24/7 Outreach Center for Psychological Health & Traumatic Brain Injury – Get help for traumatic brain injury and other psychological health issues. Call 1-866-966-1020 or connect through chat or email. (DoD's Defense Centers of Excellence)

A Guide to VA Mental Health Services for Veterans & Families (PDF) – Comprehensive guide to VA mental health services, including programs and resources for PTSD.   

General information about PTSD in veterans and the family

Effects of PTSD on Family – When someone in the family has PTSD, everyone feels the effects. Learn about common feelings and reactions among family members. (National Center for PTSD)

About Face – Hear the stories of veterans who live with PTSD. Listen to personal experiences about how PTSD affected their families and how treatment turned things around.

Returning from the War Zone (PDF) – Learn about issues families face when a spouse returns from war and what can be done to prepare for the reunion and cope with the transition to civilian life.

Authors: Melinda Smith, M.A. Last updated: April 2015.


Grief After Suicide

This article provides practical suggestions to help you toward healing under the headings:
  • Why Suicide?
  • Initial Shock – this isn't happening!
  • Anger –Why am I so angry?
  • Guilt – if only I'd done something more
  • Relief – I'm almost glad it's over
  • Stigma – What do I tell people?
  • Talking to Children
  • Suicide is not inherited
  • Looking ahead

Someone close to you has died. Your grief is intensified because the death was a suicide. The healing process will be painful and often seem unnaturally slow. Understanding your emotions, as well as learning something about suicide in general, may ease your grief. 

WHY SUICIDE? 

Suicide cuts across all sex, age, and economic barriers. People of all ages complete suicide, men and women as well as young children, the rich as well as the poor. No one is immune to this tragedy. 

Why would anyone willingly hasten or cause his or her own death? Mental health professionals who have been searching for years for an answer to that question generally agree that people who took their own lives felt trapped by what they saw as a hopeless situation. Whatever the reality, whatever the emotional support provided, they felt isolated and cut off from life, friendships, etc. Even if no physical illness was present suicide victims felt intense pain, anguish, and hopelessness. John Newer, author of After Suicide, says, "He or she probably wasn't choosing death as much as choosing to end this unbearable pain." 

Were there financial burdens that couldn't be met? ...marriage or family problems? ...divorce? ...scholastic goals that weren't achieved? ...loss of a special friendship? ...the death of a close friend or spouse? A combination of these or other circumstances could have precipitated suicide, or it could have been a response to a physiological depression. Although many people face similar problems and overcome them, your loved one could find no solution other than death. 

But sometimes there are no apparent causes. No matter how long and hard you search for a reason, you won't be able to answer the "WHY" that haunts you. Each suicide is individual, regardless of the generalisations about the "whys", and there may be no way you will completely understand the suicide victim's thought process. 

As you look for answers and understanding, you also need to deal with your feelings of shock, anger and guilt. The intensity of your feelings will depend on how close you were to the deceased and the degree of involvement you had with his or her life. As each suicide is individual, so will your reaction, healing, and coping process be unique. The general observations that follow may help you deal with your grief. 

INITIAL SHOCK  THIS ISN'T HAPPENING! 

Shock is a first reaction to death. You may feel numb for a while, perhaps unable to follow a normal daily routine. This shock can be healthy, protecting you from the initial pain of the loss, and it may help you get through funeral arrangements and services. It may last a few days or go on for several weeks. Take some time to be alone, if that's what you want, but it is also important to be with other people and to return to your normal routine. 

After the initial shock you may feel angry, guilty, and of course, sad. These feelings may overwhelm you all at once, and immediately, or they may surface in the weeks, months, and years ahead. You may handle them well initially only to have them return for no apparent reason. These feelings, and the helplessness that comes with them, will pass. Try to understand and accept the things you feel. It is OK, it is healthy, and it is all part of the healing and coping process. 

ANGER  WHY AM I SO ANGRY? 

As a relative or loved one coping with a suicide death, you may experience anger, often directed at the deceased – "How could he do this to me?" If the deceased was receiving psychiatric or medical care you may ask, "Why didn't THEY prevent it? You may find yourself angry with God for "allowing this to happen". The anger may be self-directed – "What could I have done?" or "Why wasn't I there?" 

Don't try to deny or hide this anger. It is a natural consequence of the hurt and rejection you feel. If you deny your anger, it will eventually come out in other, possibly more destructive ways and it will prolong the healing process. You need to find someone you can talk to about this feeling – perhaps a close friend or your clergyman. You may need to release your anger physically; take long brisk walks or any exercise that is reasonable for your physical capabilities. 

Your anger with the deceased is normal when the manner of death is suicide. The deceased has thrown your emotions into turmoil, and caused pain for you and for others you care about. 

Anger with the medical or mental health profession can occur if the suicide victim was receiving treatment or therapy. Though you may have had experience with someone unable to help, the professionals are dedicated and well trained, providing help for many people. These professionals will be the first to recognise that your anger is a valid emotion. 

If you're angry with God, share your feelings with a sympathetic clergyman even if you don't have any close religious ties. Hewett says, "If you're ticked off at the Almighty, for His sake, tell Him. God is the only one prepared to handle all your anger." 

Don't deny your anger. Talk about it, think about it, and constructively deal with it. 

GUILT – IF ONLY I'D DONE SOMETHING MORE 

Perhaps the most intense anger you experience will be the way you feel about yourself. This anger is closely linked with feelings of guilt. "But I just talked with him!" "Why didn't I listen?" "If only... I should have..." etc. You'll think of a lot of others. 

If the deceased was someone with whom you had regular close contact, your guilt possibly will be intense. And if the death came as a complete surprise, you will be desperately searching for reasons. A person who completes suicide has usually given out some clues, and as you look back on the last few months (or years) maybe you can now see some hints you missed earlier. You'll wish you'd recognised the problem early enough to do something about it. 

Perhaps you were aware of the deceased's suicidal feelings and you did try to help. You may have thought you had because in the time proceeding the death you noticed he or she seemed to be feeling a lot better and you relaxed your concern. You need to know it's not uncommon for a suicidal person to feel better once the decision to die has been made. The problem has not been resolved, but the victim has found an answer – suicide. 

As you are trying to cope with your guilt feelings, try not to criticise yourself too harshly for your behaviour toward the victim while he was alive. Are you now wishing you could have found the right solutions or offered more support? Thoughts like "I shouldn't have gone to the movie", or "I should have been there", may constantly be running through your head. If you had stayed home, or if you had been with him, the suicide could and possibly would have happened at another time. If you feel your presence at a particular time could have prevented the suicide, you are assuming too much. Of course we all like to think we can help our troubled friends and families, and we do try. But, the person determined to complete suicide is likely to accomplish it. 

If you realistically feel there was something you could have done, face it, think about it, and accept it. Your loved one can't be helped any more, and you need to go on with your life. You can learn from, and grow with, your experience. 

Some people believe an individual has a right to end his life. The term 'rational suicide' is used to describe a suicide that has been thought about, and planned, perhaps as a way of dealing with a painful terminal illness. This is an area of controversy, and whether you accept it or not, what you do need to think about is that the suicide was an individual decision – rational or not. It was his choice, not yours. You may accept this intellectually long before your emotions accept it. 

What value does your anger or guilt have in the healing process and beyond? Rather than letting the hurt isolate you, share your time and understanding with someone else who is hurting. You can provide friendship and support. Get involved with others; actively support suicide prevention services in your area, or any worthwhile cause or issue that means something to you. 

RELIEF  I'M ALMOST GLAD IT'S OVER 

If you were closely involved with the deceased, perhaps his pain and suffering had become an emotional drain for you. You may have felt unfairly burdened, or just exhausted from being involved with an intense situation. Now you may be feeling a sense of relief that you don't have to worry any more, or perhaps relief that the deceased's pain has finally ended. A sense of relief when a difficult situation ends is normal. When the 'end' is an unhappy one, the relief can still be there, but now it is coloured with guilt. Remember, don't expect perfection of yourself, accept your relief and don't let it grow to inappropriate guilt. The late psychiatrist, Dr. Theodore Reik, said, "One can feel sorry for something without feeling guilty". Remember, too, that the suicide victim saw death as the only relief possible at that particular time. 

STIGMA - WHAT DO I TELL PEOPLE? 

The stigma or shame, you may think others associate with suicide, stems in part from its historical and religious interpretations. Early Roman and English laws established suicide as a crime because it was thought a person ended his life to avoid paying taxes! Though the Bible itself contains no prohibition against suicide, the early Christian church equated suicide with murder. Today very few laws exist that equate suicide with crime, and those few are rarely invoked. 

If your friends seem uncomfortable talking about the death, or even being with you, it's most likely the type of discomfort felt when facing death of any kind, or a reaction to your discomfort. And if you're not comfortable relating the circumstances to others, don't. Your close friends will already know. Let others simply respond to the death of your loved one. You don't need to share the complete story with those not close to you any more than you would share all the details of a recent surgery with them. 

However, it is very important that you do confront the word 'suicide'. Practice thinking, hearing, and saying it. Don't try to do this alone. You need someone, or several people, with whom you can share your feelings. For a few days – possibly a week or two – you may want to isolate yourself and take time to recover by yourself. But don't cut yourself off for too long. Let friends and relatives help you. No one will have any magic answers for you. No one will be able to make you hurt less. But the healing and coping process requires that you talk about your feelings – about all the sadness, anger, hurt and guilt you are carrying around inside you. Friends may provide all the emotional support you need or you may want to join a mutual support group and meet with others who have experienced the suicide of a loved one. The suicide hotline in your area may be able to offer you some understanding and support over the telephone. Often these hotlines are answered 24 hours a day by people especially trained to help you through the rough spots. They will understand your feelings and help you find ways to work things out. 

If you need some professional counselling, your doctor, clergyman, or your Mental Health Association can help you find appropriate services. Remember, you may be blaming yourself in some way but here are people who will share your sorrow and help you see things more clearly. 

TALKING TO CHILDREN 

If the deceased was a parent, or if there are children who were close to the deceased, talking to the children about the death may be one of the most difficult tasks you face. You can't ignore their needs, especially if you are the primary adult in their lives. 

The National Institute for Mental Health says, "By talking to our children about death, we may discover what they know and do not know – if they have misconceptions, fears, or worries. We can help them by providing needed information, comfort, and understanding. Talk does not solve all problems, but without talk we are even more limited in our ability to help." 

Even very young children will be aware of the death of someone in their lives, and they need an opportunity to ask questions and to get truthful answers. If you're reluctant to talk about suicide – what it means and why it happened – remember that the children are likely to hear about it from other sources, and their confusion will be intensified if they have not had some communication with you. You will need to let them know that the suicide victim was unhappy without giving the impression that death is the answer to unhappiness. You will need to let them know that the deceased felt he had a lot of problems or was ill, without giving them the slightest reason to suspect that they were the cause of the problems or responsible for the illness. They need assurance that YOU will be with them for a long time and that your unhappiness over the death will not be reason for your death. 

Older children may be more aware of the circumstances surrounding the death but may be less open about sharing their feelings. They may also feel more responsible than young children and search harder for answers. They may be freer to blame someone, you, for instance. 

All children may need some time – a few days at most – to think about the death, to probe their feelings, and to formulate their own questions. The young child's natural openness may make it easier for him to talk about the death. An older child's growing sense of maturity may prevent him from sharing feelings. 

Some children, regardless of age, won't ask questions at all and you need to encourage communication. As comfortable as it may be for you to 'let it ride', don't do it. Children, like adults, need to talk about and share their feelings about the suicide. Their reactions may be similar to yours. They may seem insensitive or they may show more anger, hurt, and guilt. You need to accept their reactions, whatever they are, even if you don't fully understand them. 

If communication with a child is difficult, make it a point to talk with people the child has contact with, especially teachers. Teachers need to know what the child is reacting to and they could help you pinpoint emotional responses that may be emerging, such as a change in behaviour at school. They can help you reach the child and provide additional support. 

Whether your children are preschool or teen, be honest and listen to what they say as well as to what they do. Make time to be with them. Accept their feelings and share your own. When they ask questions you don't have answers for, don't ignore those questions or make up answers. Especially when the death is a suicide, a lot of 'answers' will be "I don't understand either". 

Just as you need emotional, non-judgemental support from someone close to you, your children need your support at this time. 

Your library or the local book store may be able to recommend some reading material that will help you discuss death with your children, or books to read to them. 

SUICIDE IS NOT INHERITED 

Suicide may occur more than once within a family, but it not something that is inherited. In a family, or even among friends, suicide may establish a destructive model or a behaviour to imitate. Thoughts of your own suicide are not an uncommon reaction to the suicide of someone you love and may surface immediately, or years later. A fleeting thought now and then shouldn't cause alarm. But extended depression and continuing suicidal thoughts need immediate attention. Don't hesitate to seek out professional help if your problems seem more than you can handle alone. 

LOOKING AHEAD 

Your grief and sadness will eventually subside, and you will be able to pick up the pieces of your life and rebuild. 

There will be times, however, when these feelings will surface very strongly. Holidays or other special times, may renew your sadness. Especially for the first year, you'll need to decide if you want to maintain traditions you shared with the deceased or if you want new settings and activities to ease painful memories. 

On the anniversary of the death, you may want to be alone, attend church, or observe the day in a manner that means something special to you. You may prefer to spend that time with someone close to you or make plans for a family gathering. You can't avoid these periods of sadness, but whenever possible, try to plan ahead so that they won't be overwhelming. And sometimes, your loneliness and sadness may come back for no special reason. Be prepared to face this also. Ask for help from friends or a counselling service, if you need it. You can't expect to forget, but you will be able to cope. 


Tips for Getting a Good Night’s Sleep

Tips for Getting a Good Night’s Sleep

How to Sleep Better In This ArticleHow you feel during your waking hours hinges greatly on how well you sleep. Similarly, the cure for sleep difficulties can often be found in your daily routine. Your sleep schedule, bedtime habits, and day-to-day lifestyle choices can make an enormous difference to the quality of your nightly rest. The following tips will help you optimize your sleep so you can be productive, mentally sharp, emotionally balanced, and full of energy all day long.

The secret to getting good sleep every night

Well-planned strategies are essential to deep, restorative sleep you can count on, night after night. By learning to avoid common enemies of sleep and trying out a variety of healthy sleep-promoting techniques, you can discover your personal prescription to a good night’s rest.

The key, or secret, is to experiment. What works for some might not work as well for others. It’s important to find the sleep strategies that work best for you.

The first step to improving the quality of your rest is finding out how much sleep you need. How much sleep is enough? While sleep requirements vary slightly from person to person, most healthy adults need at least eight hours of sleep each night to function at their best.

How to sleep better tip 1: Keep a regular sleep schedule

Getting in sync with your body’s natural sleep-wake cycle—your circadian rhythm—is one of the most important strategies for achieving good sleep. If you keep a regular sleep schedule, going to bed and getting up at the same time each day, you will feel much more refreshed and energized than if you sleep the same number of hours at different times. This holds true even if you alter your sleep schedule by only an hour or two. Consistency is vitally important.

  • Set a regular bedtime. Go to bed at the same time every night. Choose a time when you normally feel tired, so that you don’t toss and turn. Try not to break this routine on weekends when it may be tempting to stay up late. If you want to change your bedtime, help your body adjust by making the change in small daily increments, such as 15 minutes earlier or later each day.
  • Wake up at the same time every day. If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock to wake up on time, you may need to set an earlier bedtime. As with your bedtime, try to maintain your regular wake-time even on weekends.
  • Nap to make up for lost sleep. If you need to make up for a few lost hours, opt for a daytime nap rather than sleeping late. This strategy allows you to pay off your sleep debt without disturbing your natural sleep-wake rhythm, which often backfires in insomnia and throws you off for days.
  • Be smart about napping. While taking a nap can be a great way to recharge, especially for older adults, it can make insomnia worse. If insomnia is a problem for you, consider eliminating napping. If you must nap, do it in the early afternoon, and limit it to thirty minutes.
  • Fight after-dinner drowsiness. If you find yourself getting sleepy way before your bedtime, get off the couch and do something mildly stimulating to avoid falling asleep, such as washing the dishes, calling a friend, or getting clothes ready for the next day. If you give in to the drowsiness, you may wake up later in the night and have trouble getting back to sleep.

Discovering your optimal sleep schedule

Find a period of time (a week or two should do) when you are free to experiment with different sleep and wake times. Go to bed at the same time every night and allow yourself to sleep until you wake up naturally. No alarm clocks! If you’re sleep deprived, it may take a few weeks to fully recover. But as you go to bed and get up at the same time, you’ll eventually land on the natural sleep schedule that works best for you.

How to sleep better tip 2: Naturally regulate your sleep-wake cycle

Melatonin is a naturally occurring hormone controlled by light exposure that helps regulate your sleep-wake cycle. Melatonin production is controlled by light exposure. Your brain should secrete more in the evening, when it’s dark, to make you sleepy, and less during the day when it’s light and you want to stay awake and alert. However, many aspects of modern life can disrupt your body’s natural production of melatonin and with it your sleep-wake cycle.

Spending long days in an office away from natural light, for example, can impact your daytime wakefulness and make your brain sleepy. Then bright lights at night—especially from hours spent in front of the TV or computer screen—can suppress your body’s production of melatonin and make it harder to sleep. However, there are ways for you to naturally regulate your sleep-wake cycle, boost your body’s production of melatonin, and keep your brain on a healthy schedule.

Increase light exposure during the day

  • Remove your sunglasses in the morning and let light onto your face.
  • Spend more time outside during daylight. Try to take your work breaks outside in sunlight, exercise outside, or walk your dog during the day instead of at night.
  • Let as much light into your home/workspace as possible. Keep curtains and blinds open during the day, and try to move your desk closer to the window.
  • If necessary, use a light therapy box. A light therapy box can simulate sunshine and can be especially useful during short winter days when there’s limited daylight.

Boost melatonin production at night

  • Turn off your television and computer. Many people use the television to fall asleep or relax at the end of the day, and this is a mistake. Not only does the light suppress melatonin production, but television can actually stimulate the mind, rather than relaxing it. Try listening to music or audio books instead, or practicing relaxation exercises. If your favorite TV show is on late at night, record it for viewing earlier in the day.
  • Don’t read from a backlit device at night (such as an iPad). If you use a portable electronic device to read, use an eReader that is not backlit, i.e. one that requires an additional light source such as a bedside lamp.
  • Change your bright light bulbs. Avoid bright lights before bed, use low-wattage bulbs instead.
  • When it’s time to sleep, make sure the room is dark. The darker it is, the better you’ll sleep. Cover electrical displays, use heavy curtains or shades to block light from windows, or try a sleep mask to cover your eyes.
  • Use a flashlight to go to the bathroom at night. If you wake up during the night to use the bathroom—as long as it’s safe to do so—keep the light to a minimum so it will be easier to go back to sleep.

How to sleep better tip 3: Create a relaxing bedtime routine

If you make a consistent effort to relax and unwind before bed, you will sleep easier and more deeply. A peaceful bedtime routine sends a powerful signal to your brain that it’s time to wind down and let go of the day’s stresses.

Make your bedroom more sleep friendly

Make Sure Your Bed Is Comfortable
  • Keep noise down. If you can’t avoid or eliminate noise from barking dogs, loud neighbors, city traffic, or other people in your household, try masking it with a fan, recordings of soothing sounds, or white noise. You can buy a special sound machine or generate your own white noise by setting your radio between stations. Earplugs may also help.
  • Keep your room cool. The temperature of your bedroom also affects sleep. Most people sleep best in a slightly cool room (around 65° F or 18° C) with adequate ventilation. A bedroom that is too hot or too cold can interfere with quality sleep.
  • Make sure your bed is comfortable. You should have enough room to stretch and turn comfortably. If you often wake up with a sore back or an aching neck, you may need to invest in a new mattress or a try a different pillow. Experiment with different levels of mattress firmness, foam or egg crate toppers, and pillows that provide more or less support.

Reserve your bed for sleeping and sex

If you associate your bed with events like work or errands, it will be harder to wind down at night. Use your bed only for sleep and sex. That way, when you go to bed, your body gets a powerful cue: it’s time to either nod off or be romantic.

Relaxing bedtime rituals to try

  • Read a book or magazine by a soft light
  • Take a warm bath
  • Listen to soft music
  • Do some easy stretches
  • Wind down with a favorite hobby
  • Listen to books on tape
  • Make simple preparations for the next day

How to sleep better tip 4: Eat right and get regular exercise

Your daytime eating and exercise habits play a role in how well you sleep. It’s particularly important to watch what you put in your body in the hours leading up to your bedtime.

  • Stay away from big meals at night. Try to make dinnertime earlier in the evening, and avoid heavy, rich foods within two hours of bed. Fatty foods take a lot of work for your stomach to digest and may keep you up. Also be cautious when it comes to spicy or acidic foods in the evening, as they can cause stomach trouble and heartburn.
  • Avoid alcohol before bed. Many people think that a nightcap before bed will help them sleep, but it's counterintuitive. While it may make you fall asleep faster, alcohol reduces your sleep quality, waking you up later in the night. To avoid this effect, stay away from alcohol in the hours before bed.
  • Cut down on caffeine. You might be surprised to know that caffeine can cause sleep problems up to ten to twelve hours after drinking it! Consider eliminating caffeine after lunch or cutting back your overall intake.
  • Avoid drinking too many liquids in the evening. Drinking lots of water, juice, tea, or other fluids may result in frequent bathroom trips throughout the night. Caffeinated drinks, which act as diuretics, only make things worse.
  • Quit smoking. Smoking causes sleep troubles in numerous ways. Nicotine is a stimulant, which disrupts sleep, plus smokers experience nicotine withdrawal as the night progresses, making it hard to sleep.

If you’re hungry at bedtime

For some people, a light snack before bed can help promote sleep. When you pair tryptophan-containing foods with carbohydrates, it may help calm the brain and allow you to sleep better. For others, eating before bed can lead to indigestion and make sleeping more difficult. Experiment with your food habits to determine your optimum evening meals and snacks.

If you need a bedtime snack, try:

  • Half a turkey sandwich
  • A small bowl of whole-grain, low-sugar cereal
  • Granola with low-fat milk or yogurt
  • A banana

You’ll also sleep more deeply if you exercise regularly. You don’t have to be a star athlete to reap the benefits—as little as 20 to 30 minutes of daily activity helps. And you don’t need to do all 30 minutes in one session. You can break it up into five minutes here, 10 minutes there, and still get the benefits. Try a brisk walk, a bicycle ride, or even gardening or housework.

Some people prefer to schedule exercise in the morning or early afternoon as exercising too late in the day can stimulate the body, raising its temperature. Even if you prefer not to exercise vigorously at night, don’t feel glued to the couch, though. Relaxing exercises such as yoga or gentle stretching can help promote sleep.

How to sleep better tip 5: Get anxiety and stress in check

Do you find yourself unable to sleep or waking up night after night? Residual stress, worry, and anger from your day can make it very difficult to sleep well. When you wake up or can’t get to sleep, take note of what seems to be the recurring theme. That will help you figure out what you need to do to get your stress and anger under control during the day.

If you can’t stop yourself from worrying, especially about things outside your control, you need to learn how to manage your thoughts. For example, you can learn to evaluate your worries to see if they’re truly realistic and replace irrational fears with more productive thoughts. Even counting sheep is more productive than worrying at bedtime.

If the stress of managing work, family, or school is keeping you awake, you may need help with stress management. By learning how to manage your time effectively, handle stress in a productive way, and maintain a calm, positive outlook, you’ll be able to sleep better at night.

Relaxation techniques for better sleep

Relaxation is beneficial for everyone, but especially for those struggling with sleep. Practicing relaxation techniques before bed is a great way to wind down, calm the mind, and prepare for sleep. Some simple relaxation techniques include:

  • Deep breathing. Close your eyes, and try taking deep, slow breaths, making each breath even deeper than the last.
  • Progressive muscle relaxation. Starting with your toes, tense all the muscles as tightly as you can, then completely relax. Work your way up from your feet to the top of your head.
  • Visualizing a peaceful, restful place. Close your eyes and imagine a place or activity that is calming and peaceful for you. Concentrate on how relaxed this place or activity makes you feel.

How to sleep better tip 6: Ways to get back to sleep

It’s normal to wake briefly during the night. In fact, a good sleeper won’t even remember it. But if you’re waking up during the night and having trouble falling back asleep, the following tips may help.

  • Stay out of your head. The key to getting back to sleep is continuing to cue your body for sleep, so remain in bed in a relaxed position. Hard as it may be, try not to stress over the fact that you’re awake or your inability to fall asleep again, because that very stress and anxiety encourages your body to stay awake. A good way to stay out of your head is to focus on the feelings and sensations in your body.
  • Make relaxation your goal, not sleep. If you find it hard to fall back asleep, try a relaxation technique such as visualization, deep breathing, or meditation, which can be done without even getting out of bed. Remind yourself that although they’re not a replacement for sleep, rest and relaxation still help rejuvenate your body.
  • Do a quiet, non-stimulating activity. If you’ve been awake for more than 15 minutes, try getting out of bed and doing a quiet, non-stimulating activity, such as reading a book. Keep the lights dim so as not to cue your body clock that it’s time to wake up. Also avoid screens of any kind—computers, TV, cell phones, iPads—as the type of light they emit is stimulating to the brain. A light snack or herbal tea might help relax you, but be careful not to eat so much that your body begins to expect a meal at that time of the day.
  • Postpone worrying and brainstorming. If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when you are fresh and it will be easier to resolve. Similarly, if a brainstorm or great idea is keeping you awake, make a note of it on paper and fall back to sleep knowing you’ll be much more productive and creative after a good night’s rest.

How to sleep better tip 7: Cope with shift work sleep disorder

A disrupted sleep schedule caused by working nights or irregular shifts can lead to sleepiness in the work place, affect your mood, energy, and concentration, and increase your risk of accidents, injuries, and work-related mistakes. Shift workers tend to suffer from two problems: sleeping at home during the day and staying awake at work during the night. To avoid or limit these problems:

  • Limit the number of night or irregular shifts you work in a row to prevent sleep deprivation from mounting up. If that’s not possible, avoid rotating shifts frequently so you can maintain the same sleep schedule.
  • Avoid a long commute that reduces sleep time. Also, the more time you spend traveling home in daylight, the more awake you’ll become and the harder you’ll find it to get to sleep.
  • Drink caffeinated drinks early in your shift, but avoid them close to bedtime.
  • Take frequent breaks and use them to move around as much as possible—take a walk, stretch, or even exercise if possible.
  • Adjust your sleep-wake schedule and your body’s natural production of melatonin. Expose yourself to bright light when you wake up at night, use bright lamps or daylight-simulation bulbs in your workplace, and then wear dark glasses on your journey home to block out sunlight and encourage sleepiness.
  • Eliminate noise and light from your bedroom during the day. Use blackout curtains or a sleep mask, turn off the phone, and use ear plugs or a soothing sound machine to block out daytime noise.
  • Make sleep a priority at the weekends or on your nonworking days so you can pay off your sleep debt.

How to sleep better tip 8: Know when to see a sleep doctor

If you’ve tried the tips above and are still struggling with sleep problems, you may have a sleep disorder that requires professional treatment. Consider scheduling a visit with a sleep doctor if, despite your best efforts at self–help, you are still troubled by any of the following symptoms:

  • Persistent daytime sleepiness or fatigue
  • Loud snoring accompanied by pauses in breathing
  • Difficulty falling asleep or staying asleep
  • Unrefreshing sleep
  • Frequent morning headaches
  • Crawling sensations in your legs or arms at night
  • Inability to move while falling asleep or waking up
  • Physically acting out dreams during sleep
  • Falling asleep at inappropriate times

More help for how to sleep better

Solving sleep problems

Resources and references

Tips for getting better sleep

Twelve Simple Tips to Improve Your Sleep – Explore simple tips for making the sleep of your dreams a nightly reality. (Healthy Sleep, Harvard Medical School)

Healthy Sleep Tips – A variety of sleep tips including bedtime snacks, exercise, room temperature, noise, and light control. (National Sleep Foundation)

Adopt Good Sleep Habits – Learn how improving your sleep environment and sticking to a regular schedule can improve the quality of your sleep. (Get Sleep, Harvard Medical School Division of Sleep Medicine)

Sleep Hygiene: Helpful Hints to Help You Sleep – More tips for getting better sleep. (University of Maryland Medical Center)

Sleep environment

The Sleep Environment – Learn about the dos and don’ts of the sleep environment and get tips for making your bedroom more sleep-friendly. (National Sleep Foundation)

Inside your bedroom – use your senses – Your bedroom is your sanctuary from the stresses of the day. Use your senses to create the best environment for sleep (National Sleep Foundation)

Lifestyle habits and sleep

5 Foods that Help You Sleep: Eat right, sleep better – Food relates directly to serotonin, a key hormone that—along with Vitamin B6, B12, and folic acid—helps promote healthy sleep. (Cleveland Clinic)

Foods That Help You Sleep – Guide to foods and bedtime snacks that can help you sleep. Also learn about foods that keep you awake. (AskDrSears.com)

Authors: Melinda Smith, M.A., Lawrence Robinson, and Robert Segal, M.A. Last updated: April 2015


Help for Parents of Troubled Teens

Help for Parents of Troubled Teens

Dealing with Anger, Violence, Delinquency, and Other Teen Behavior Problems

Improving Emotional Health In This ArticleParenting a teenager is never easy, but when your teen is violent, depressed, abusing alcohol or drugs, or engaging in other reckless behaviors, it can seem overwhelming. You may feel exhausted from lying awake at night worrying about where your child is, who he or she is with, and what they're doing. You may despair over failed attempts to communicate, the endless fights, and the open defiance. Or you may live in fear of your teen's violent mood swings and explosive anger. While parenting a troubled teen can often seem like an impossible task, there are steps you can take to ease the chaos at home and help your teen transition into a happy, successful young adult.

Normal teen vs. troubled teen behavior

As teenagers begin to assert their independence and find their own identity, many experience behavioral changes that can seem bizarre and unpredictable to parents. Your sweet, obedient child who once couldn’t bear to be separated from you now won’t be seen within 20 yards of you, and greets everything you say with a roll of the eyes or the slam of a door. These, unfortunately, are the actions of a normal teenager.

As the parent of a troubled teen, you’re faced with even greater challenges. A troubled teen faces behavioral, emotional, or learning problems beyond the normal teenage issues. They may repeatedly practice at-risk behaviors such as violence, skipping school, drinking, drug use, sex, self-harming, shoplifting, or other criminal acts. Or they may exhibit symptoms of mental health problems like depression, anxiety, or eating disorders. While any negative behavior repeated over and over can be a sign of underlying trouble, it’s important for parents to understand which behaviors are normal during adolescent development, and which can point to more serious problems.

When Typical Teen Behavior Becomes Troubled Teen Behavior

Typical Teen Behavior

Warning Signs of a Troubled Teen

Changing appearance. Keeping up with fashion is important to teens. That may mean wearing provocative or attention-seeking clothing or dyeing hair. Unless your teen wants tattoos, avoid criticizing and save your protests for the bigger issues. Fashions change, and so will your teen.

Changing appearance can be a red flag if it’s accompanied by problems at school or other negative changes in behavior, or if there’s evidence of cutting and self-harm or extreme weight loss or weight gain.

Increased arguments and rebellious behavior. As teens begin seeking independence, you will frequently butt heads and argue.

Constant escalation of arguments, violence at home, skipping school, getting in fights, and run-ins with the law are all red flag behaviors that go beyond the norm of teenage rebellion.

Mood swings. Hormones and developmental changes often mean that your teen will experience mood swings, irritable behavior, and struggle to manage his or her emotions.  

Rapid changes in personality, falling grades, persistent sadness, anxiety, or sleep problems could indicate depression, bullying, or another emotional health issue. Take any talk about suicide seriously.

Experimenting with alcohol or drugs.Most teens will try alcohol and smoke a cigarette at some point. Many will even try marijuana. Talking to your kids frankly and openly about drugs and alcohol is one way to ensure it doesn’t progress further.

When alcohol or drug use becomes habitual, especially when it’s accompanied by problems at school or home, it may indicate a substance abuse issue or other underlying problems.

More influenced by friends than parents.Friends become extremely important to teens and can have a great influence on their choices. As teens focus more on their peers, that inevitably means they withdraw from you. It may leave you feeling hurt, but it doesn’t mean your teen doesn’t still need your love.

Red flags include a sudden change in peer group (especially if the new friends encourage negative behavior), refusing to comply with reasonable rules and boundaries, or avoiding the consequences of bad behavior by lying. Your teen spending too much time alone can also indicate problems.

Seeking professional help for a troubled teen

All teens need to feel loved

Teenagers are individuals with unique personalities and their own likes and dislikes. Some things about them are universal, though. No matter how much your teen seems to withdraw from you emotionally, no matter how independent your teen appears, or how troubled your teen becomes, he or she still needs your attention and to feel loved by you.

If you identify red flag behaviors in your teen, consult a doctor, counselor, therapist, or other mental health professional for help finding appropriate treatment.

Even when you seek professional help for your teen, though, that doesn’t mean that your job is done. As detailed below, there are many things you can do at home to help your teen and improve the relationship between you. And you don’t need to wait for a diagnosis to start putting them into practice.

Understanding teen development

No, your teen is not an alien being from a distant planet, but he or she is wired differently. A teenager’s brain is still actively developing, processing information differently than a mature adult’s brain. The frontal cortex—the part of the brain used to manage emotions, make decisions, reason, and control inhibitions—is restructured during the teenage years, forming new synapses at an incredible rate, while the whole brain does not reach full maturity until about the mid-20’s.

Your teen may be taller than you and seem mature in some respects, but often he or she is simply unable to think things through at an adult level. Hormones produced during the physical changes of adolescence can further complicate things. Now, these biological differences don’t excuse teens’ poor behavior or absolve them from accountability for their actions, but they may help explain why teens behave so impulsively or frustrate parents and teachers with their poor decisions, social anxiety, and rebelliousness. Understanding adolescent development can help you find ways to stay connected to your teen and overcome problems together.

Teens see anger everywhere

Teens differ from adults in their ability to read and understand emotions in the faces of others. Adults use the prefrontal cortex to read emotional cues, but teenagers rely on the amygdala, the part of the brain responsible for emotional reactions. In research, teens often misread facial expressions; when shown pictures of adult faces expressing different emotions, teens most often interpreted them as being angry.

Source: ACT for Youth

Anger and violence in teenagers

If you feel threatened by your teen

Everyone has a right to feel physically safe. If your teen is violent towards you, seek help immediately. Call a friend, relative, or the police if necessary. It doesn’t mean that you don’t love your child, but the safety of you and your family should always come first.

If you’re a parent of a teenage boy who is angry, aggressive, or violent, you may live in constant fear. Every phone call or knock on the door could bring news that your son has either been harmed, or has seriously harmed others.

Teenage girls get angry as well, of course, but that anger is usually expressed verbally rather than physically. Teen boys are more likely to throw objects, kick doors, or punch the walls when they’re angry. Some will even direct their rage towards you. For any parent, especially single mothers, this can be a profoundly upsetting and unsettling experience. But you don’t have to live under the threat of violence.

Dealing with angry teens

Anger can be a challenging emotion for many teens as it often masks other underlying emotions such as frustration, embarrassment, sadness, hurt, fear, shame, or vulnerability. When teens can’t cope with these feelings, they may lash out, putting themselves and others at risk. In their teens, many boys have difficulty recognizing their feelings, let alone being able to express them or ask for help.

The challenge for parents is to help your teen cope with emotions and deal with anger in a more constructive way:

  • Establish rules and consequences. At a time when both you and your teen are calm, explain that there’s nothing wrong with feeling anger, but there are unacceptable ways of expressing it. If your teen lashes out, for example, he or she will have to face the consequences—loss of privileges or even police involvement. Teens need rules, now more than ever.
  • Uncover what’s behind the anger. Is your child sad or depressed? For example, does your teen have feelings of inadequacy because his or her peers have things that your child doesn’t? Does your teen just need someone to listen to him or her without judgment?
  • Be aware of anger warning signs and triggers. Does your teen get headaches or start to pace before exploding with rage? Or does a certain class at school always trigger anger? When teens can identify the warning signs that their temper is starting to boil, it allows them to take steps to defuse the anger before it gets out of control.
  • Help your teen find healthy ways to relieve anger. Exercise, team sports, even simply hitting a punch bag or a pillow can help relieve tension and anger. Many teens also use art or writing to creatively express their anger. Dancing or playing along to loud, angry music can also provide relief.
  • Give your teen space to retreat. When your teen is angry, allow him or her to retreat to a place where it’s safe to cool off. Don’t follow your teen and demand apologies or explanations while he or she is still raging; this will only prolong or escalate the anger, or even provoke a physical response.
  • Manage your own anger. You can’t help your teen if you lose your temper as well. As difficult as it sounds, you have to remain calm and balanced no matter how much your child provokes you. If you or other members of your family scream, hit each other, or throw things, your teen will naturally assume that these are appropriate ways to express his or her anger as well.

Red flags for violent behavior in teens

It only takes a glance at the news headlines to know that teen violence is a growing problem. Movies and TV shows glamorize all manner of violence, many web sites promote extremist views that call for violent action, and hour after hour of playing violent video games can desensitize teens to the real world consequences of aggression and violence. Of course, not every teen exposed to violent content will become violent, but for a troubled teen who is emotionally damaged or suffering from mental health problems, the consequences can be tragic. 

Warning signs that a teen may become violent include:

  • Playing with weapons of any kind
  • Obsessively playing violent video games, watching violent movies, or visiting websites that promote or glorify violence
  • Threatening or bullying others
  • Fantasizing about acts of violence he’d like to commit
  • Being violent or cruel to pets or other animals

Helping troubled teens tip #1: Connect with your teen

Whatever problems your teen is experiencing, it is not a sign that you’ve somehow failed as a parent. Instead of trying to assign blame for the situation, focus on your teen’s current needs. The first step to doing this is to find a way to connect with him or her.
It may seem hard to believe—given your child’s anger or indifference towards you—but teens still crave love, approval, and acceptance from their parents. That means you probably have a lot more influence over your teen than you think. To open the lines of communication:

  • Be aware of your own stress levels. If you’re angry or upset, now is not the time to try to communicate with your teen. Wait until you’re calm and energized before starting a conversation. You’re likely to need all the patience and positive energy you can muster.
  • Be there for your teen. An offer to chat with your teen over coffee will probably be greeted with a sarcastic put-down or dismissive gesture, but it’s important to show you’re available. Insist on sitting down for mealtimes together with no TV or other distractions, and attempt to talk to your teen then. Don’t get frustrated if your efforts are greeted by nothing more than monosyllabic grunts or shrugs; you may have to eat a lot of dinners in silence, but when your teen does want to open up, he or she will have the opportunity to do so.
  • Find common ground. Trying to discuss your teen’s appearance or clothes may be a sure-fire way to trigger a heated argument, but you can still find some areas of common ground. Fathers and sons often connect over sports, mothers and daughters over gossip or movies. The objective is not to be your teen’s best friend, but to find common interests that you can discuss peacefully. Once you’re talking, your teen may feel more comfortable opening up to you about other things.
  • Listen without judging or giving advice. When your teen does talk to you, it’s important that you listen without judging, mocking, interrupting, criticizing, or offering advice. Your teen wants to feel understood and valued by you, so maintain eye contact and keep your focus on your child, even when he or she is not looking at you. If you’re checking your email or reading the newspaper, your teen will feel that he or she is not important to you.  
  • Expect rejection. Your attempts to connect with your teen may often be met with anger, irritation, or other negative reactions. Stay relaxed and allow your teen space to cool off. Try again later when you’re both calm. Successfully connecting to your teen will take time and effort. Don’t be put off; persevere and the breakthrough will come.

Helping troubled teens tip #2: Make healthy lifestyle changes

The tips below can help put balance back in your troubled teen’s life, no matter the exact diagnosis of his or her problems:

  • Create structure. Teens may scream and argue with you about rules and discipline, or rebel against daily structure, but that doesn’t mean they need them any less. Structure, such as regular mealtimes and bedtimes, make a teen feel safe and secure. Sitting down to breakfast and dinner together every day can also provide a great opportunity to check in with your teen at the beginning and end of each day.
  • Reduce screen time. There is a direct relationship between violent TV shows, movies, Internet content, and video games, and the violent behavior in teenagers. Even if your teen isn’t drawn to violent material, too much screen time can still impact brain development. Limit the time your teen has access to electronic devices—and restrict phone usage after a certain time at night to ensure your child gets enough sleep.
  • Encourage exercise. Even a little regular exercise can help ease depression, boost energy and mood, relieve stress, regulate sleep patterns, and improve your teen’s self-esteem. If you struggle getting your teen to do anything but play video games, encourage him or her to play activity-based video games or “exergames” that are played standing up and moving around—simulating dancing, skateboarding, soccer, or tennis, for example. Once exercise becomes a habit, encourage your teen to try the real sport or to join a club or team.
  • Eat right. Healthy eating can help to stabilize a teenager’s energy, sharpen his or her mind, and even out his or her mood. Act as a role model for your teen. Cook more meals at home, eat more fruit and vegetables and cut back on junk food and soda.
  • Ensure your teen gets enough sleep. Sleep deprivation can make a teen stressed, moody, irritable, and lethargic, and cause problems with weight, memory, concentration, decision-making, and immunity from illness. You might be able to get by on six hours a night and still function at work, but your teen needs 8.5 to 10 hours of sleep a night to be mentally sharp and emotionally balanced. Encourage better sleep by setting consistent bedtimes, and removing TVs, computers, and other electronic gadgets from your teen’s room—the light from these suppresses melatonin production and stimulates the mind, rather than relaxing it. Suggest your teen tries listening to music or audio books at bedtime instead.

Helping troubled teens tip #3: Take care of yourself

The stress of dealing with any teenager, especially one who’s experiencing behavioral problems, can take a toll on your own health, so it’s important to take care of yourself. That means looking after your emotional and physical needs and learning to manage stress.

  • Take time to relax daily and learn how to regulate yourself and de-stress when you start to feel overwhelmed.
  • Don’t go it alone, especially if you’re a single parent. Seek help from friends, relatives, a school counselor, sports coach, religious leader, or someone else who has a relationship with your teen. Organizations such as Boys and Girls Clubs, YMCA, and other youth groups can also help provide structure and guidance.
  • Watch out for signs of depression and anxiety, and get professional help if needed.

This won’t last forever

It’s worth reminding your teen that no matter how much pain or turmoil he or she is experiencing right now, with your love and support, things can and will get better—for both of you. Your teen can overcome the problems of adolescence and mature into a happy, successful young adult.

More help for parents of troubled teens

Resources and references

Teenage behavior issues

Teens and Violence Prevention – Tips for parents about reducing or eliminating teen violence. (Palo Alto Medical Foundation)

Understanding Teens (PDF) – Information about typical adolescent development and how to handle common teen problems. (New Mexico State University)

A Parent's Guide to Surviving the Teen Years – What to expect during the teenage years and how to handle typical adolescent behavior problems. (KidsHealth)

Parenting Troubled Teens – Articles and resources for parents raising a troubled teen, including information on programs for troubled teens. (About.com)

Teenage brain development

Adolescent Brain Development (PDF) – Research from Cornell University, University of Rochester, and the NYS Center for School Safety about brain development in teens. (ACT for Youth)

That Teenage Feeling – How Harvard researchers may have found biological clues to quirky adolescent behavior. (APA)

Authors: Lawrence Robinson and Jeanne Segal, Ph.D. Last updated: April 2015.


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