About Your Mind

5 Ways to Deal With Anxiety

Everyone has feelings of anxiety, nervousness, tension, and stress from time to time. Here are 5 ways to help manage them.

Note: When anxiety or worry feels extreme, it may be a sign of an anxiety disorder. For someone who has an anxiety disorder, getting proper care from a heath professional is important. The tips below can help too, of course. But professional treatment is the only way to shake an anxiety disorder.

1. Become a relaxation expert. We all think we know how to relax. But chilling out in front of the TV or computer isn't true relaxation. (Depending on what you're watching or doing, it could even make you more tense.) The same is true for alcohol, drugs, or tobacco. They may seem to relieve anxiety or stress, but it's a false state of relaxation that's only temporary. What the body really needs is a relaxation technique — like deep breathing, tai chi, or yoga — that has a physical effect on the mind. For example, deep breathing helps to relax a major nerve that runs from the diaphragm to the brain, sending a message to the entire body to let go and loosen up.
   
2. Get enough sleep, nourishment, and exercise. Want your mind and body to feel peaceful and strong enough to handle life's ups and downs? Get the right amount of sleep for your needs — not too much or too little. Eat well: Choose fruit, vegetables, lean proteins, and whole grains for long-term energy (instead of the short bursts that come from too much sugar or caffeine). And exercise to send oxygen to every cell in the body so your brain and body can operate at their best.
3. Connect with others. Spend time with friends or family. Organized activities are great, but just hanging out works too. Doing things with those we feel close to deepens our bonds, allowing us to feel supported and secure. And the fun and sharing that go with it allow us to feel happier and less upset about things. If you feel worried or nervous about something, talking about it with someone who listens and cares can help you feel more understood and better able to cope. You'll be reminded that everyone has these feelings sometimes. You're not alone.
4. Connect with nature. Heading out for a walk in the park or a hike in the woods can help anyone feel peaceful and grounded. (Choose somewhere you feel safe so you can relax and enjoy your surroundings.) Walking, hiking, trail biking, or snowshoeing offer the additional benefit of exercise. Invite a friend or two — or a family member — along and enjoy feeling connected to people as well.
5. Think positive. A great way to keep our minds off the worry track is to focus our thoughts on things that are good, beautiful, and positive. Allow yourself to dream, wish, and imagine the best that could happen.

Having a Healthy Pregnancy

If you've decided to have a baby, the most important thing you can do is to take good care of yourself so that you and your baby will be healthy. Girls who get the proper care and make the right choices have a very good chance of having healthy babies.

Prenatal Care

See a doctor as soon as possible after you find out you're pregnant to begin getting prenatal care (medical care during pregnancy). The sooner you start to get medical care, the better your chances that you and your baby will be healthy.

If you can't afford to go to a doctor or clinic for prenatal care, social service organizations can help you. Ask your parent, school counselor, or another trusted adult to help you locate resources in your community.

During your first visit, the doctor will ask you lots of questions, including the date of your last period. This helps the doctor estimate how long you have been pregnant and your due date.

Doctors measure pregnancies in weeks. A baby's due date is only an estimate, though: Most babies are born between 38 and 42 weeks after the first day of a woman's last menstrual period, or 36 to 40 weeks after conception (when the sperm fertilizes the egg). Only a small percentage of women actually deliver exactly on their due dates.

A pregnancy is divided into three phases, or trimesters. The first trimester is from conception to the end of week 13. The second trimester is from week 14 to the end of week 26. The third trimester is from week 27 to the end of the pregnancy.

The doctor will examine you and perform a pelvic exam. He or she may also perform blood tests, a urine test, and tests for sexually transmitted diseases (STDs, including a test for HIV, which is on the rise in teens. (Some STDs can cause serious medical problems in newborns, so it's important to get treatment to protect the baby.)

The doctor will explain the types of physical and emotional changes you can expect during pregnancy. He or she will also teach you to how to recognize the signs of possible problems during pregnancy (called complications). This is especially important because teens are more at risk for certain complications, such as anemia, high blood pressure, and delivering a baby earlier than usual (called premature delivery).

Your doctor will want you to start taking prenatal vitamins that contain folic acid, calcium, and iron as soon as possible. The doctor may prescribe the vitamins or recommend a brand that you can buy over the counter. These vitamins and minerals help ensure the baby's and mother's health as well as prevent some types of birth defects.

Ideally, you should see your doctor once each month for the first 28 weeks of your pregnancy, then every 2 weeks until 36 weeks, then once a week until you deliver the baby. If you have a medical condition such as diabetes that needs careful monitoring during your pregnancy, your doctor will probably want to see you more often.

During visits, your doctor will check your weight, blood pressure, and urine, and will measure your abdomen to keep track of the baby's growth. Once the baby's heartbeat can be heard with a special device, the doctor will listen for it at each visit. Your doctor will probably also send you for some other tests during the pregnancy, such as an ultrasound, to make sure that everything is OK with your baby.

One part of prenatal care is attending classes where expectant mothers can learn about having a healthy pregnancy and delivery and the basics of caring for a new baby. These classes may be offered at hospitals, medical centers, schools, and colleges in your area.

It can be difficult for adults to talk to their doctors about their bodies and even more difficult for teens to do so. Your doctor is there to help you stay healthy during pregnancy and have a healthy baby — and there's probably not much he or she hasn't heard from expectant mothers! So don't be afraid to ask questions.

Be upfront when your doctor asks questions, even if they seem embarrassing. A lot of the issues the doctor brings up could affect your baby's health. Think of your doctor both as a resource and a friend who you can confide in about what's happening to you.

Changes to Expect in Your Body

Pregnancy causes lots of physical changes in the body. Here are some common ones:

Breast Growth

An increase in breast size is one of the first signs of pregnancy, and the breasts may continue to grow throughout the pregnancy. You may go up several bra sizes during the course of your pregnancy.

Skin Changes

Don't be surprised if people tell you your skin is "glowing" when you are pregnant — pregnancy causes an increase in blood volume, which can make your cheeks a little pinker than usual. And hormonal changes increase oil gland secretion, which can give your skin a shinier appearance. Acne is also common during pregnancy for the same reason.

Other skin changes caused by pregnancy hormones may include brownish or yellowish patches on the face called chloasma and a dark line on the midline of the lower abdomen, known as the linea nigra.

Also, moles or freckles that you had prior to pregnancy may become bigger and darker. Even the areola, the area around the nipples, becomes darker. Stretch marks are thin pink or purplish lines that can appear on your abdomen, breasts, or thighs.

Except for the darkening of the areola, which can last, these skin changes will usually disappear after you give birth.

Mood Swings

It's very common to have mood swings during pregnancy. Some girls may also experience depression during pregnancy or after delivery. If you have symptoms of depression such as sadness, changes in sleep patterns, thoughts of hurting yourself, or bad feelings about yourself or your life, tell your doctor so he or she can help you to get treatment.

Pregnancy Discomforts

Pregnancy can cause some uncomfortable side effects. These include:

• nausea and vomiting (especially early in the pregnancy)
• leg swelling
• varicose veins in the legs and the area around the vaginal opening
• hemorrhoids
• heartburn and constipation
• backache
• fatigue
• sleep loss

If you have one or more of these side effects, keep in mind that you're not alone! Ask your doctor for advice on how to deal with these common problems.

If you are pregnant and have bleeding or pain, call the doctor immediately, even if you are not planning to continue the pregnancy.

Things to Avoid

Smoking, drinking alcohol, and taking drugs when you are pregnant put you and your baby at risk for a number of serious problems.

Alcohol

Doctors now believe that it's not safe to drink any amount of alcohol when you are pregnant. Drinking can harm a developing fetus, putting a baby at risk for birth defects and mental problems.

Smoking

The risks of smoking during pregnancy include stillbirths (when a baby dies while inside the mother), low birth weight (which increases a baby's risk for health problems), prematurity (when babies are born earlier than 37 weeks), and sudden infant death syndrome (SIDS). SIDS is the sudden, unexplained death of an infant who is younger than 1 year old.

Drugs

Using illegal drugs such as cocaine or marijuana during pregnancy can cause miscarriage, prematurity, and other medical problems. Babies can also be born addicted to certain drugs.

Ask your doctor for help if you are having trouble quitting smoking, drinking, or drugs. Check with your doctor before taking any medication while you are pregnant, including over-the-counter medications, herbal remedies and supplements, and vitamins.

Unsafe Sex

Talk to your doctor about sex during pregnancy. If your doctor says it's OK to have sex while you're pregnant, you must use a condom to help prevent getting an STD. Some STDs can cause blindness, pneumonia, or meningitis in newborns, so it's important to protect yourself and your baby.

Taking Care of Yourself During Pregnancy

Eating

Many girls worry about how their bodies look and are afraid to gain weight during pregnancy. But now that you are eating for two, this is not a good time to cut calories or go on a diet. Both you and your baby need certain nutrients so the baby can grow properly. Eating a variety of healthy foods, drinking plenty of water, and cutting back on high-fat junk foods will help you and your developing baby to be healthy.

Doctors generally recommend adding about 300 calories a day to your diet to provide adequate nourishment for the developing fetus. You should gain about 25 to 35 pounds during pregnancy, most of this during the last 6 months — although how much a girl should gain depends on how much she weighed before the pregnancy. Your doctor will advise you based on your individual situation.

Eating additional fiber — 25 to 30 grams a day — and drinking plenty of water can help to prevent common problems such as constipation. Good sources of fiber are fresh fruits and vegetables and breads, cereals, or muffins that have lots of whole grain in them.

You'll need to avoid eating or drinking certain things during pregnancy, such as:

• certain types of fish, such as swordfish, canned tuna, and other fish that may be high in mercury (your doctor can help you decide which fish you can eat)
• foods that contain raw eggs, such as mousse or Caesar salad
• raw or undercooked meat and fish
• processed meats, such as hot dogs and deli meats
• soft, unpasteurized cheeses, such as feta, brie, blue, and goat cheese
• unpasteurized milk, juice, or cider

It's also a good idea to limit artificial sweeteners, and drinks that contain caffeine and artificial sweeteners.

Exercise

Exercising during pregnancy is good for you as long as you are having an uncomplicated pregnancy and choose appropriate activities. Doctors generally recommend low-impact activities such as walking, swimming, and yoga. Contact sports and high-impact aerobic activities that pose a greater risk of injury should generally be avoided. Also, working at a job that involves heavy lifting is not recommended for women during pregnancy. Talk to your doctor if you have questions about whether particular types of exercise are safe for you and your baby.

Sleep

It's important to get plenty of rest while you are pregnant. Early in your pregnancy, try to get into the habit of sleeping on your side. Lying on your side with your knees bent is likely to be the most comfortable position as your pregnancy progresses. Also, it makes your heart's job easier because it keeps the baby's weight from applying pressure to the large vein that carries blood back to the heart from your feet and legs.

Some doctors recommend that girls who are pregnant sleep on the left side. Because of where some of your major blood vessels are, lying on your left side helps keep the uterus from pressing on them. Ask what your doctor recommends — in most cases, lying on either side should do the trick and help take some pressure off your back.

Throughout your pregnancy, but especially toward the end, you may wake up often at night to go to the bathroom. While it's important to drink enough water while you're pregnant, try to drink most of it during the day rather than at night. Use the bathroom right before going to bed. As you get further along in your pregnancy, you might have a difficult time getting comfortable in bed. Try positioning pillows around and under your belly, back, or legs to get more comfortable.

Stress can also interfere with sleep. Maybe you're worried about your baby's health, about delivery, or about what your new role as a parent will be like. All of these feelings are normal, but they may keep you up at night. Talk to your doctor if you are having problems sleeping during your pregnancy.

Emotional Health

It's common for pregnant teens to feel a range of emotions, such as fear, anger, guilt, confusion, and sadness. It may take a while to adjust to the fact that you're going to have a baby. It's a huge change, and it's natural for pregnant teens to wonder whether they're ready to handle the responsibilities that come with being a parent.

How a girl feels often depends on how much support she has from the baby's father, from her family (and the baby's father's family), and from friends. Each girl's situation is different. Depending on your situation, you may need to seek more support from people outside your family. It's important to talk to the people who can support and guide you and help you share and sort through your feelings. Your school counselor or nurse can refer you to resources in your community that can help.

Sometimes girls who are pregnant have miscarriages and lose the pregnancy. This can be very upsetting and difficult to go through for some girls, although it may bring feelings of relief for others. It is important to talk about these feelings and to get support from friends and family — or if that's not possible, from people such as counselors or teachers.

School and the Future

Some girls plan to raise their babies themselves. Sometimes grandparents or other family members help. Some girls decide to give their babies up for adoption. It takes a great deal of courage and concern for the baby to make these difficult decisions.

Girls who complete high school are more likely to have good jobs and enjoy more success in their lives. If possible, finish high school now rather than trying to return later. Ask your school counselor or an adult you trust for information about programs and classes in your community for pregnant teens.

Some communities have support groups especially for teen parents. Some high schools have child-care centers on campus. Perhaps a family member or friend can care for your baby while you're in school.

You can learn more about what to expect in becoming a parent by reading books, attending classes, or checking out reputable websites on child raising. Your baby's doctor, your parents, family members, or other adults can all help guide you while you are pregnant and after the baby is born.

Fears and Phobias

The roller coaster hesitates for a split second at the peak of its steep track after a long, slow climb. You know what's about to happen — and there's no way to avoid it now. It's time to hang onto the handrail, palms sweating, heart racing, and brace yourself for the wild ride down.

What Is Fear?

Fear is one of the most basic human emotions. It is programmed into the nervous system and works like an instinct. From the time we're infants, we are equipped with the survival instincts necessary to respond with fear when we sense danger or feel unsafe.

Fear helps protect us. It makes us alert to danger and prepares us to deal with it. Feeling afraid is very natural — and helpful — in some situations. Fear can be like a warning, a signal that cautions us to be careful.

Like all emotions, fear can be mild, medium, or intense, depending on the situation and the person. A feeing of fear can be brief or it can last longer.

How Fear Works

When we sense danger, the brain reacts instantly, sending signals that activate the nervous system. This causes physical responses, such as a faster heartbeat, rapid breathing, and an increase in blood pressure. Blood pumps to our large muscle groups to prepare the body for

physical action (such as running or fighting). Skin sweats to keep the body cool. Some people might notice sensations in the stomach, head, chest, legs, or hands. These physical sensations of fear can be mild or strong.

This response is known as "fight or flight" because that is exactly what the body is preparing itself to do: fight off the danger or run fast to get away. The body stays in this state of fight–flight until the brain receives an "all clear" message and turns off the response.

Sometimes fear is triggered by something that is startling or unexpected (like a loud noise), even if it's not actually dangerous. That's because the fear reaction is activated instantly — a few seconds faster than the thinking part of the brain can process or evaluate what's happening. As soon as the brain gets enough information to realize there's no danger ("Oh, it's just a balloon bursting — whew!"), it turns off the fear reaction. All this can happen in seconds.

Fears People Have

Fear is the word we use to describe our emotional reaction to something that seems dangerous. But the word "fear" is used in another way, too: to name something a person often feels afraid of.

People fear things or situations that make them feel unsafe or unsure. For instance, someone who isn't a strong swimmer might have a fear of deep water. In this case, the fear is helpful because it cautions the person to stay safe. A person could overcome this fear by learning how to swim safely.

A fear can be healthy if it cautions a person to stay safe around something that could be dangerous. But sometimes a fear is unnecessary and causes more caution than the situation calls for.

Many people have a fear of public speaking. Whether it's giving a report in class, speaking at an assembly, or reciting lines in the school play, speaking in front of others is one of the most common fears people have.

People tend to avoid the situations or things they fear. But this doesn't help them overcome fear — in fact, it can be the reverse. Avoiding something scary reinforces a fear and keeps it strong.

People can overcome unnecessary fears by giving themselves the chance to learn about and gradually get used to the thing or situation they're afraid of. For example, people who fly despite a fear of flying can become used to unfamiliar sensations like takeoff or turbulence. They learn what to expect and have a chance to watch what others do to relax and enjoy the flight. Gradually (and safely) facing fear helps a person to overcome it.

Fears During Childhood

Certain fears are normal during childhood. That's because fear can be a natural reaction to feeling unsure and vulnerable — and much of what children experience is new and unfamiliar.

Young kids often have fears of the dark, being alone, strangers, monsters, or other scary imaginary creatures. School-aged children might be afraid when it's stormy or at a first sleepover. As they grow and learn, with the support of adults, most kids are able to slowly conquer these fears and outgrow them.

Some kids are more sensitive to fears and may have a tough time overcoming them. When fears last beyond the expected age, it might be a sign that someone is overly fearful, worried, or anxious. People whose fears are too intense or last too long might need help and support to overcome them.

Phobias

A phobia is an intense fear reaction to a particular thing or a situation. With a phobia, the fear is out of proportion to the potential danger. But to the person with the phobia, the danger feels real because the fear is so very strong.

Phobias cause people to worry about, dread, feel upset by, and avoid the things or situations they fear because the physical sensations of fear can be so intense. So having a phobia can interfere with someone's normal activities. A person with a phobia of dogs might feel afraid to walk to school in case he or she sees a dog on the way. Someone with an elevator phobia might avoid a field trip if it involves going on an elevator.

A girl with a phobia of thunderstorms might be afraid to go to school if the weather forecast predicts a storm. She might feel terrible distress and fear when the sky turns cloudy. A guy with social phobia experiences intense fear of public speaking or interacting, and may be afraid to answer questions in class, give a report, or speak to classmates in the lunchroom.

It can be exhausting and upsetting to feel the intense fear that goes with having a phobia. It can be disappointing to miss out on opportunities because fear is holding you back. And it can be confusing and embarrassing to feel afraid of things that others seem to have no problem with.

Sometimes, people get teased about their fears. Even if the person doing the teasing doesn't mean to be unkind and unfair, teasing only makes the situation worse.

What Causes Phobias?

Some phobias develop when a person has a scary experience with a particular thing or situation. A tiny brain structure called the amygdala (pronounced: uh-mig-duh-luh), keeps track of experiences that trigger strong emotions. Once a certain thing or situation triggers a strong fear reaction, the amygdala warns the person by triggering a fear reaction every time he or she encounters (or even thinks about) that thing or situation.

Someone might develop a bee phobia after being stung during a particularly scary situation. For that person, looking at a photograph of a bee, seeing a bee from a distance, or even walking near flowers where there could be a bee can all trigger the phobia.

Sometimes, though, there may be no single event that causes a particular phobia. Some people may be more sensitive to fears because of personality traits they are born with, certain genes they've inherited, or situations they've experienced. People who have had strong childhood fears or anxiety may be more likely to have one or more phobias.

Having a phobia isn't a sign of weakness or immaturity. It's a response the brain has learned in an attempt to protect the person. It's as if the brain's alert system triggers a false alarm, generating intense fear that is out of proportion to the situation. Because the fear signal is so intense, the person is convinced the danger is greater than it actually is.

Overcoming Phobias

People can learn to overcome phobias by gradually facing their fears. This is not easy at first. It takes willingness and bravery. Sometimes people need the help of a therapist to guide them through the process.

Overcoming a phobia usually starts with making a long list of the person's fears in least-to-worst order. For example, with a dog phobia, the list might start with the things the person is least afraid of, such as looking at a photo of a dog. It will then work all the way up to worst fears, such as standing next to a person who's petting a dog, petting a dog on a leash, and walking a dog.

Gradually, and with support, the person tries each fear situation on the list — one at a time, starting with the least fear. The person works on each fear until he or she is comfortable. The person takes as long as needed to feel comfortable and isn't forced to do anything.

A therapist could also show a person with a dog phobia how to approach, pet, and walk a dog, and help the person to try it, too. The person may expect terrible things to happen when near a dog. Talking about this can help, too. When people find that what they fear doesn't actually turn out to be true, it can be a great relief.

A therapist might also teach relaxation practices such as specific ways of breathing, muscle relaxation training, or soothing self-talk. These can help people feel comfortable and bold enough to face the fears on their list.

As a person gets used to a feared object or situation, the brain adjusts how it responds and the phobia is overcome.

Often, the hardest part of overcoming a phobia is getting started. Once a person decides to go for it — and gets the right coaching and support — it can be surprising how quickly fear can melt away.

Your Mind > Feeling Sad > Death and Grief

When coping with a death, you may go through all kinds of emotions. You may be sad, worried, or scared. You might be shocked, unprepared, or confused. You might be feeling angry, cheated, relieved, guilty, exhausted, or just plain empty. Your emotions might be stronger or deeper than usual or mixed together in ways you've never experienced before.

Some people find they have trouble concentrating, studying, sleeping, or eating when they're coping with a death. Others lose interest in activities they used to enjoy. Some people lose themselves in playing computer games or eat or drink to excess. And some people feel numb, as if nothing has happened.

All of these are normal ways to react to a death.

What Is Grief?

When we have emotional, physical, and spiritual reactions in response to a death or loss, it's known as grief or grieving. People who are grieving might:

• feel strong emotions, such as sadness and anger
• have physical reactions, such as not sleeping or even waves of nausea
• have spiritual reactions to a death — for example, some people find themselves questioning their beliefs and feeling disappointed in their religion while others find that they feel more strongly than ever about their faith

The grieving process takes time and healing usually happens gradually. The intensity of grief may be related to how sudden or predictable the loss was and how you felt about the person who died.

Some people write about grief happening in stages, but usually it feels more like "waves" or cycles of grief that come and go depending on what you are doing and if there are triggers for remembering the person who has died.

If you've lost someone in your immediate family, such as a parent, brother, or sister, you may feel cheated out of time you wanted to have with that person. It can also feel hard to express your own grief when other family members are grieving, too.

Some people may hold back their own grief or avoid talking about the person who died because they worry that it may make a parent or other family member sad. It's also natural to feel some guilt over a past argument or a difficult relationship with the person who died.

We don't always grieve over the death of another person. The death of a beloved pet can trigger strong feelings of grief. People may be surprised by how painful this loss can be. But the loving bonds we share with pets are real, and so are the feelings of loss and grief when they die.

All of these feelings and reactions are OK — but what can people do to get through them? How long does grief last? Will things ever get back to normal? And how will you go on without the person who has died?

Coping With Grief

Just as people feel grief in many different ways, they handle it differently, too.

Some people reach out for support from others and find comfort in good memories. Others become very busy to take their minds off the loss. Some people become depressed and withdraw from their peers or go out of the way to avoid the places or situations that remind them of the person who has died.

For some people, it can help to talk about the loss with others. Some do this naturally and easily with friends and family, while others talk to a professional therapist.

Some people may not feel like talking about it much at all because it's hard to find the words to express such deep and personal emotion or they wonder whether talking will make them feel the hurt more. This is fine, as long you find other ways to deal with your pain.

People sometimes deal with their sorrow by engaging in dangerous or self-destructive activities. Doing things like drinking, drugs, or cutting yourself to escape from the reality of a loss may seem to numb the pain, but the feeling is only temporary. This isn't really dealing with the pain, only masking it, which makes all those feelings build up inside and only prolongs the grief.

If your pain just seems to get worse, or if you feel like hurting yourself or have suicidal thoughts, tell someone you trust about how you feel.

What to Expect

It may feel like it might be impossible to recover after losing someone you love. But grief does get gradually better and become less intense as time goes by. To help get through the pain, it can help to know some of the things you might expect during the grieving process.

The first few days after someone dies can be intense, with people expressing strong emotions, perhaps crying, comforting each other, and gathering to express their support and condolences to the ones most affected by the loss. It is common to feel as if you are "going crazy" and feel extremes of anxiety, panic, sadness, and helplessness. Some people describe feeling "unreal," as if they're looking at the world from a faraway place. Others feel moody, irritable, and resentful.

Family and friends often participate in rituals that may be part of their religious, cultural, community, or family traditions, such as memorial services, wakes, or funerals. These activities can help people get through the first days after a death and honor the person who died. People might spend time together talking and sharing memories about their loved one. This may continue for days or weeks following the loss as friends and family bring food, send cards, or stop by to visit.

Many times, people show their emotions during this time. But sometimes a person can be so shocked or overwhelmed by the death that he or she doesn't show any emotion right away — even though the loss is very hard. And it's not uncommon to see people smiling and talking with others at a funeral, as if something sad had not happened. But being among other mourners can be a comfort, reminding us that some things will stay the same.

Sometimes, when the rituals associated with grieving end, people might feel like they should be "over it" because everything seems to have gone back to normal. When those who are grieving first go back to their normal activities, it might be hard to put their hearts into everyday things. Many people go back to doing regular things after a few days or a week. But although they may not talk about their loss as much, the grieving process continues.

It's natural to continue to have feelings and questions for a while after someone dies. It's also natural to begin to feel somewhat better. A lot depends on how your loss affects your life. It's OK to feel grief for days, weeks, or even longer, depending on how close you were to the person who died.

No matter how you choose to grieve, there's no one right way to do it. The grieving process is a gradual one that lasts longer for some people than others. There may be times when you worry that you'll never enjoy life the same way again, but this is a natural reaction after a loss.

Caring for Yourself

The loss of someone close to you can be stressful. It can help you to cope if you take care of yourself in certain small but important ways. Here are some that might help:

• Remember that grief is a normal emotion. Know that you can (and will) heal over time.
• Participate in rituals. Memorial services, funerals, and other traditions help people get through the first few days and honor the person who died.
• Be with others. Even informal gatherings of family and friends bring a sense of support and help people not to feel so isolated in the first days and weeks of their grief.
• Talk about it when you can. Some people find it helpful to tell the story of their loss or talk about their feelings. Sometimes a person doesn't feel like talking, and that's OK, too. No one should feel pressured to talk.
• Express yourself. Even if you don't feel like talking, find ways to express your emotions and thoughts. Start writing in a journal about the memories you have of the person you lost and how you're feeling since the loss. Or write a song, poem, or tribute about your loved one. You can do this privately or share it with others.
• Exercise. Exercise can help your mood. It may be hard to get motivated, so modify your usual routine if you need to.
• Eat right. You may feel like skipping meals or you may not feel hungry, but your body still needs nutritious foods.
• Join a support group. If you think you may be interested in attending a support group, ask an adult or school counselor about how to become involved. The thing to remember is that you don't have to be alone with your feelings or your pain.
• Let your emotions be expressed and released. Don't stop yourself from having a good cry if you feel one coming on. Don't worry if listening to particular songs or doing other activities is painful because it brings back memories of the person that you lost; this is common. After a while, it becomes less painful.
• Create a memorial or tribute. Plant a tree or garden, or memorialize the person in some fitting way, such as running in a charity run or walk (a breast cancer race, for example) in honor of the lost loved one.

Getting Help for Intense Grief

If your grief isn't letting up for a while after the death of your loved one, you may want to reach out for help. If grief has turned into depression, it's very important to tell someone.

How do you know if your grief has been going on too long? Here are some signs:

• You've been grieving for 4 months or more and you aren't feeling any better.
• You feel depressed.
• Your grief is so intense that you feel you can't go on with your normal activities.
• Your grief is affecting your ability to concentrate, sleep, eat, or socialize as you normally do.
• You feel you can't go on living after the loss or you think about suicide, dying, or hurting yourself.

It's natural for loss to cause people to think about death to some degree. But if a loss has caused you to think about suicide or hurting yourself in some way, or if you feel that you can't go on living, it's important that you tell someone right away.

Counseling with a professional therapist can help because it allows you to talk about your loss and express strong feelings. Many counselors specialize in working with teens who are struggling with loss and depression. If you'd like to talk to a therapist and you're not sure where to begin, ask an adult or school counselor. Your doctor may also be able to recommend someone.

Will I Ever Get Over This?

Well-meaning friends and family might tell a grieving person they need to "move on" after a loss. Unfortunately, that type of advice can sometimes make people hesitate to talk about their loss, or make people think they're grieving wrong or too long, or that they're not normal. It can help to remember that the grieving process is very personal and individual — there's no right or wrong way to grieve. We all take our own time to heal.

It's important for grieving people to not drop out of life, though. If you don't like the idea of moving on, maybe the idea of "keeping on" seems like a better fit. Sometimes it helps to remind yourself to just keep on doing the best you can for now. If you feel sad, let yourself have your feelings and try not to run away from your emotions. But also keep on doing things you normally would such as being with friends, caring for your pet, working out, or doing your schoolwork.

Going forward and healing from grief doesn't mean forgetting about the person you lost. Getting back to enjoying your life doesn't mean you no longer miss the person. And how long it takes until you start to feel better isn't a measure of how much you loved the person. With time, the loving support of family and friends, and your own positive actions, you can find ways to cope with even the deepest loss.

Your Mind > Parents > Dealing With Divorce

For many people, their parents' divorce marks a turning point in their lives, whether the divorce happened many years ago or is taking place right now.

About half the marriages in the United States today end in divorce, so children of divorce are certainly not alone. But when it happens to you, you can feel very alone and unsure of what it all means. It may seem hard, but it is possible to cope with divorce — and have a good family life in spite of some changes divorce may bring.

Why Are My Parents Divorcing?

Parents divorce for many reasons. Usually divorce happens when couples feel they can no longer live together due to fighting and anger, or because the love they had when they married has changed. Divorce can also be because one parent falls in love with someone else, and sometimes it is due to a serious problem like drinking, abuse, or gambling.

It's common for teens to think that their parents' divorce is somehow their fault, but nothing could be further from the truth. Some teens may wonder if they could have helped to prevent the split. Others may wish they had prevented arguments by cooperating more within the family, doing better with their behavior, or getting better grades. But separation and divorce are a result of a couple's problems with each other, not with their kids. The decisions adults make about divorce are their own.

If your parents are divorcing, you may experience a lots of feelings. Your emotions may change frequently, too. You may feel angry, frustrated, upset, or sad. You might feel protective of one parent or blame one for the situation. You may feel abandoned, afraid, worried, or guilty. You may also feel relieved, especially if there has been a lot of tension at home. These feelings are normal and talking about them with a friend, family member or trusted adult can really help.

How Will Divorce Change My Life?

Depending on what happens in your family, you may have to adjust to many changes. These could include things like moving, changing schools, spending time with both parents separately, and perhaps dealing with parents' unpleasant feelings toward one another.

Your parents may go to court to determine custody arrangements. You may end up living with one parent most of the time and visiting the other, or your parents may split their time with you evenly.

Some teens have to travel between parents, and that may create challenges both socially and practically. But with time you can create a new routine that works. Often, it takes a while for custody arrangements to be finalized. This can give people time to adapt to these big changes and let families figure out what works best.

Money matters may change for your parents, too. A parent who didn't work during the marriage may need to find a job to pay for rent or a mortgage. This might be something a parent is excited about, but he or she may also feel nervous or pressured about finances. There are also expenses associated with divorce, from lawyers' fees to the cost of moving to a new place to live.

Your family may not be able to afford all the things you were used to before the divorce. This is one of the difficult changes often associated with divorce. There can be good changes too — but how you cope with the stressful changes depends on your situation, your personality, and your support network.

What Parents and Teens Can Do to Make Divorce Easier

Keep the peace. Dealing with divorce is easiest when parents get along. Teens find it especially hard when their parents fight and argue or act with bitterness toward each other. You can't do much to influence how your parents behave during a divorce, but you can ask them to do their best to call a truce to any bickering or unkind things they might be saying about each other. No matter what problems a couple may face, as parents they need to handle visiting arrangements peacefully to minimize the stress their kids may feel.

Be fair. Most teens say it's important that parents don't try to get them to "take sides." You need to feel free to relate to one parent without the other parent acting jealous, hurt, or mad. It's unfair for anyone to feel that relating to one parent is being disloyal to the other or that the burden of one parent's happiness is on your shoulders.

When parents find it hard to let go of bitterness or anger, or if they are depressed about the changes brought on by divorce, they can find help from a counselor or therapist. This can help parents get past the pain divorce may have created, to find personal happiness, and to lift any burdens from their kids. Kids and teens can also benefit from seeing a family therapist or someone who specializes in helping them get through the stress of a family breakup.

Keep in touch. Going back and forth between two homes can be tough, especially if parents live far apart. It can be a good idea to keep in touch with a parent you see less often because of distance. Even a quick email saying "I'm thinking of you" helps ease the feelings of missing each other. Making an effort to stay in touch when you're apart can keep both of you up to date on everyday activities and ideas.

Work it out. You may want both parents to come to special events, like games, meets, plays, or recitals. But sometimes a parent may find it awkward to attend if the other is present. It helps if parents can figure out a way to make this work, especially because you may need to feel the support and presence of both parents even more during divorce. You might be able to come up with an idea for a compromise or solution to this problem and suggest it to both parents.

Talk about the future. Lots of teens whose parents divorce worry that their own plans for the future could be affected. Some are concerned that the costs of divorce (like legal fees and expenses of two households) might mean there will be less money for college or other things.

Pick a good time to tell your parents about your concerns — when there's enough time to sit down with one or both parents to discuss how the divorce will affect you. Don't worry about putting added stress on your parents. It's better to bring your concerns into the open than to keep them to yourself and let worries or resentment build. There are solutions for most problems and counselors who can help teens and their parents find those solutions.

Figure out your strengths. How do you deal with stress? Do you get angry and take it out on siblings, friends, or yourself? Or are you someone who is a more of a pleaser who puts others first? Do you tend to avoid conflict altogether and just hope that problems will magically disappear? A life-changing event like a divorce can put people through some tough times, but it can also help them learn about their strengths, and put in place some new coping skills. For example, how can you cope if one parent bad-mouths another? Sometimes staying quiet until the anger has subsided and then discussing it calmly with your mom or dad can help. You may want to tell them you have a right to love both your parents, no matter what they are doing to each other.

If you need help figuring out your strengths or how to cope — like from a favorite aunt or from your school counselor — ask for it! And if you find it hard to confront your parents, try writing them a letter. Figure out what works for you.

Live your life. Sometimes during a divorce, parents may be so caught up in their own changes it can feel like your own life is on hold. In addition to staying focused on your own plans and dreams, make sure you participate in as many of your normal activities as possible. When things are changing at home, it can really help to keep some things, such as school activities and friends, the same. If things get too hard at home, see if you can stay with a friend or relative until things calm down. Take care of yourself by eating right and getting regular exercise — two great stress busters!

Let others support you. Talk about your feelings and reactions to the divorce with someone you trust. If you're feeling down or upset, let your friends and family members support you. These feelings usually pass. If they don't, and if you're feeling depressed or stressed out, or if it's hard to concentrate on your normal activities, let a counselor or therapist help you. Your parents, school counselor, or a doctor or other health professional can help you find one. Many communities and schools have support groups for kids and teens whose parents have divorced. It can really help to talk with other people your age who are going through similar experiences.

Bringing Out the Positive

There will be ups and downs in the process, but teens can cope successfully with their parents' divorce and the changes it brings. You may even discover some unexpected positives. Many teens find their parents are actually happier after the divorce or they may develop new and better ways of relating to both parents when they have separate time with each one.

Some teens learn compassion and caring skills when a younger brother or sister needs their support and care. Siblings who are closer in age may form tighter bonds, learning to count on each other more because they're facing the challenges of their parents' divorce together. Coping well with divorce also can bring out strength and maturity. Some become more responsible, better problem solvers, better listeners, or better friends. Looking back on the experience, lots of people say that they learned coping skills they never knew they had and feel stronger and more resilient as a result of what they went through.

Many movies have been made about divorce and stepfamilies — some with happy endings, some not. That's how it is in real life too. But most teens who go through a divorce learn (sometimes to their surprise) that they can make it through this difficult situation successfully. Giving it time, letting others support you along the way, and keeping an eye on the good things in your life can make all the difference.

Your Mind > Feeling Sad > Bipolar Disorder

Bipolar disorders are one of several medical conditions called depressive disorders. Depressive disorders affect the way a person's brain functions.

Depressive disorders are widespread. In the United States alone, it's estimated that more than 17.4 million adults have a depressive disorder each year. That works out to about 1 out of every 7 people, so there's a good chance that you or someone you know is dealing with a depressive disorder.

What Is Bipolar Disorder?

Bipolar disorder goes by many names: manic depression, manic-depressive disorder, manic-depressive illness, bipolar mood disorder, and bipolar affective disorder are medical terms for the same condition.

Bipolar disorder is classified into four different types: Bipolar I, Bipolar II, Cyclothymic Disorder, or Bipolar Disorder Not Otherwise Specified. Mental health experts separate the condition into these four types because the symptoms of bipolar disorder show up differently in different people. When doctors know what type someone has, they can tailor treatment to that person's specific needs.

Bipolar disorder affects both men and women. For many people, the first symptoms show up in their early twenties. However, research has shown that the first episode of bipolar disorder is occurring earlier: It often shows up in adolescence, and even children can have the disorder.

Recent research suggests that kids and teens with bipolar disorder don't always have the same behavioral patterns that adults with bipolar disorder do. For example, kids who have bipolar disorder may experience particularly rapid mood changes and may have some of the other mood-related symptoms listed below, such as irritability and high levels of anxiety. But they may not show other symptoms that are more commonly seen in adults.

Because brain function is involved, the ways people with bipolar disorder think, act, and feel are all affected. This can make it especially difficult for other people to understand their condition. It can be incredibly frustrating if other people act as though someone with bipolar disorder should just "snap out of it," as if a person who is sick can become well simply by wanting to. Bipolar disorder isn't a sign of weakness or a character flaw; it's a serious medical condition that requires treatment, just like any other condition.

What Are the Signs and Symptoms?

A person with bipolar disorder will go through episodes of mania (highs) and at other times experience episodes of depression (lows). These aren't the normal periods of happiness and sadness that everyone experiences from time to time. Instead, the episodes are intense or severe mood swings, like a pendulum that keeps arcing higher and higher.

Symptoms of mania include:

• racing speech and thoughts
• increased energy
• decreased need for sleep
• elevated mood and exaggerated optimism
• increased physical and mental activity
• excessive irritability, aggressive behavior, and impatience
• poor judgment
• reckless behavior, like excessive spending, making rash decisions, and erratic driving
• difficulty concentrating
• inflated sense of self-importance

Symptoms of depression include:

• loss of interest in usual activities
• prolonged sad or irritable mood
• loss of energy or fatigue
• feelings of guilt or worthlessness
• sleeping too much or inability to sleep
• drop in grades and inability to concentrate
• inability to experience pleasure
• appetite loss or overeating
• anger, worry, and anxiety
• thoughts of death or suicide

In adults, episodes of mania or depression usually last for weeks or months, although they can be shorter in length. In children and adolescents, though, these episodes can be much shorter, and a kid or teen can even go back and forth between mania and depression throughout the day. Episodes of mania or depression may happen irregularly and follow an unpredictable pattern or they may be linked, with a manic episode always following a period of depression, or vice versa. Sometimes episodes have a seasonal pattern. Mania in the spring, for example, may be followed by depression in the winter.

Between episodes, a person with bipolar disorder usually returns to normal (or near-normal) functioning. For some people, though, there is little or no "break period" between their cycles. These mood swing cycles can change slowly or rapidly, with rapid cycling between mania and depression being much more common in women, children, and adolescents.

Some people with bipolar disorder turn to alcohol and drugs because they feel temporarily better when they're high. But using alcohol and drugs can have disastrous results for people with bipolar disorder. Substance abuse can actually make the symptoms worse, as well as making the condition hard for doctors to diagnose.

What Causes Bipolar Disorder?

Doctors and scientists don't know the exact cause of bipolar disorder, but they think that biochemical, genetic, and environmental factors may all be involved. It's believed this condition is caused by imbalances in certain brain chemicals called neurotransmitters. If the neurotransmitters aren't in balance, the brain's mood-regulating system won't work the way it should.

Genes also play a role. If a close relative has bipolar disorder, a person's risk of developing the condition is higher. This doesn't mean, though, that if you have a relative with bipolar disorder you will automatically develop it! Even in studies involving identical twins raised in the same home, one twin sometimes had bipolar disorder whereas the other did not. Researchers are now working on identifying the gene or genes involved in bipolar disorder.

Environmental factors may play a role in bipolar disorder. For some teens, stresses such as a death in the family, their parents' divorce, or other traumatic events could trigger a first episode of mania or depression. Sometimes, going through the changes of puberty can set off an episode. In girls, symptoms can be tied to their monthly menstrual cycle.

How Is Bipolar Disorder Diagnosed?

Most people with bipolar disorder can be helped — but a psychiatrist or psychologist must first diagnose the disorder. Sadly, many people with the condition are never diagnosed or are not diagnosed properly. Without proper diagnosis and treatment, the disorder can become worse. Some teens with undiagnosed bipolar disorder can end up in a psychiatric hospital or residential treatment center, in the juvenile justice system, abusing drugs, or committing suicide.

Because children and teens with bipolar disorder do not usually show the same patterns of behavior as adults who have the condition, a mental health professional will observe a teen's behavior carefully before making a diagnosis. This includes getting a complete history of a person's past and present experiences. Family members and friends can also provide helpful insights into the person's behavior. The doctor may also want a teen to have a medical exam to rule out other conditions.

Diagnosing bipolar disorder can be difficult. As yet, there aren't any laboratory tests like a brain scan or blood test that will diagnose it. In teens, bipolar disorder can sometimes be mistaken for illnesses like schizophrenia and posttraumatic stress disorder, attention deficit hyperactivity disorder (ADHD), and other depressive disorders. That's why a complete, detailed history is so important.

How Do Doctors Treat It?

Although there's no cure for bipolar disorder, treatment can help stabilize a person's moods and help the person manage and control symptoms. Like other teens with long-lasting medical conditions (such as asthma, diabetes, or epilepsy), teens with bipolar disorder need to work closely with their doctors and other medical professionals to treat it.

This team of medical professionals, together with the teen and family, develop what is called a treatment plan. Teens with bipolar disorder will probably receive medication, such as a mood stabilizer, from a psychiatrist or other medical doctor. A psychologist or other type of counselor will provide counseling or psychotherapy for the teen and his or her family. Doctors will watch the symptoms closely and offer additional treatment advice if necessary.

Living With Bipolar Disorder

Teens normally face ups and downs with school, family, work, and friends. Dealing with bipolar disorder at the same time is a very difficult challenge. One 16-year-old reader who was diagnosed with bipolar disorder at 14 wrote to us about the experience:

"I had mood swings that were the worst anyone could have ever seen. My poor parents thought I hated them, but really I was sick and didn't even realize it. But now I am on medications for my disorder and I live a pretty normal life. My family and friends support me, and they, along with my therapist, have helped me get to the point where I am today. I just want other teens to know that even though it is hard at times to be bipolar, things will get better."

If you've been diagnosed with bipolar disorder, taking your medications as prescribed, reporting any changes in how you feel or function, and participating in therapy will be key to living a successful life. In addition to treatment, making a few lifestyle changes, such as reducing stress, eating well, and getting enough sleep and exercise can help someone who is living with the condition. And many teens find it helps to join a support network such as a local support group for people with bipolar disorder.

Your Mind > Feeling Sad > 5 Ways to Fight Depression

5 Ways to Fight Depression

If you feel depressed, it's best to do something about it — depression doesn't just go away on its own. In addition to getting help from a doctor or therapist, here are 5 things you can do to feel better.

1. Exercise. Take a 15- to 30-minute brisk walk every day — or dance, jog, or bike if you prefer. People who are depressed may not feel much like being active. But make yourself do it anyway (ask a friend to exercise with you if you need to be motivated). Once you get in the exercise habit, it won't take long to notice a difference in your mood.
   
   In addition to getting aerobic exercise, some yoga poses can help relieve feelings of depression. Try downward-facing dog or legs-up-the-wall pose (you can find these poses on yoga websites). Two other aspects of yoga — breathing exercises and meditation — can also help people with depression feel better.
2. Nurture yourself with good nutrition. Depression can affect appetite. One person may not feel like eating at all, but another might overeat. If depression has affected your eating, you'll need to be extra mindful of getting the right nourishment. Proper nutrition can influence a person's mood and energy. So eat plenty of fruits and vegetables and get regular meals (even if you don't feel hungry, try to eat something light, like a piece of fruit, to keep you going).
3. Identify troubles, but don't dwell on them. Try to identify any situations that have contributed to your depression. When you know what's got you feeling blue and why, talk about it with a caring friend. Talking is a way to release the feelings and to receive some understanding. If there's no one to tell, pouring your heart out to a journal works just as well.
   
   Once you air out these thoughts and feelings, turn your attention to something positive. Take action to solve problems. Ask for help if you need it. Feeling connected to friends and family can help relieve depression. (It may also help them feel there's something they can do instead of just watching you hurt.)
4. Express yourself. With depression, a person's creativity and sense of fun may seem blocked. By exercising your imagination (painting, drawing, doodling, sewing, writing, dancing, composing music, etc.) you not only get those creative juices flowing, you also loosen up some positive emotions. Take time to play with a friend or a pet, or do something fun for yourself. Find something to laugh about — a funny movie, perhaps. Laughter helps lighten your mood.
5. Look on the bright side. Depression affects a person's thoughts, making everything seem dismal, negative, and hopeless. If depression has you noticing only the negative, make an effort to notice the good things in life. Try to notice one thing, then try to think of one more. Consider your strengths, gifts, or blessings. Most of all, don't forget to be patient with yourself. Depression takes time to heal.

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