The website for the National Alliance on Mental Illness (NAMI) indicates that “…one in four adults — approximately 57.7 million Americans — experience a mental health disorder in a given year… and about one in 10 children live with a serious mental or emotional disorder.” Given these statistics, it seems likely that most families have at least some experience with mental illness of some sort. Finding out that a loved one has schizophrenia, obsessive-compulsive disorder, bipolar disorder or any other form of mental illness can be terrifying and overwhelming. Feelings of shame, guilt, anger, frustration and sadness are all likely to surface, and all are understandable.

Perhaps most important at first is educating yourself about the illness as knowledge truly is power. I sometimes encounter families who have learned very little about their loved one’s condition, and I believe that often stems from a fear of the unknown. Reading about the illness is invaluable, as is talking with others who are experiencing similar issues. I often refer to family members as “the silent sufferers.” As the focus is rightfully on getting help for the person in need, too often the needs of the family get overlooked. In addition to not forgetting the importance for sleep, a healthy diet, and pleasurable activities, getting your own counseling may also be very beneficial. Not only can counseling help to provide you with ways to best help yourself, but it can also aid you in better assisting your loved one.

Very few people are ever truly prepared to learn that a family member is suffering from a mental illness. This can lead to serious conflict amongst family members who may engage in counterproductivite activities such as blaming one another. Most psychiatric disorders are, however, very complicated and the cause usually lies in a combination of biological, psychological and environmental factors.

Questions about where to get help, education, housing, finances, and insurance are just some of the many issues people will often face, and understandably may find too overwhelming to deal with alone. While the stigma of mental illness may be less today than it was years ago, there is no doubt that it still does exist. It is one reason why so many people do not seek treatment, and why so many families struggle in isolation. Yet, there are many valuable resources available, whether in the form of support groups, treatment providers, and online information. No one should have to suffer in silence. Support and advocacy organizations such as The Depression and Bipolar Support Alliance (dbsalliance.org), The International Obsessive-Compulsive Disorder Foundation (ocfoundation.org), The Anxiety Disorders Association of America (adaa.org) and NAMI (namisanmateo.org) are truly just a click away.

— Scott M. Granet

Scott Granet, LCSW is a long-time resident of Redwood Shores, and is director of the OCD-BDD Clinic of Northern California in Redwood City. He would like to hear your suggestions for future columns, and can be reached at 650-599-3325 or .

I’m often asked how someone can get rid of anxiety. The answer is simple: we can’t and nor should we try. Anxiety is normal. It helps to protect us, and can optimize our performance in a multitude of situations. Any driver has had this experience: you’re driving on the freeway and suddenly you notice the car next to you coming into your lane. Your heart beats faster; your breathing becomes more rapid. You react quickly, swerve out of the way, and hopefully drive off safely. Without some anxiety propelling you into action, the outcome of such a situation may be very different. There are many other, far less dramatic examples of how anxiety helps us, such as in taking a test, in a job interview, and in playing sports.

There is, of course, a tremendous difference between normal, healthy anxiety and that which warrants being defined as a disorder. While forty million adults are believed to suffer from anxiety disorders, children are by no means immune to it. In fact, the Anxiety Disorders Association of America notes on its website that anxiety disorders affect 1 in 8 children. Left untreated, anxiety disorders in children may contribute to substance abuse, social difficulties, and academic problems.

Kids may not always be able to put words to their feelings, and so as parents it is especially important to be mindful of signs which could indicate the presence of an anxiety related problem. These include: physical symptoms such as persistent headaches, stomach aches and fatigue, as well as concentration problems, avoiding school, shyness, social isolation, sleep disturbance, nightmares, crying spells, and bedwetting. In addition, behaviors such as tapping, nail biting, skin picking, pulling out of one’s own hair, counting and excessive hand-washing all can be signs that anxiety is causing problems.

For most kids these symptoms will be transient and often will go away on their own without any intervention. Just as for adults, however, there is reason for concern when the symptoms persist and begin interfering with normal functioning. In addition, it is important to know that anxiety disorders come in many different forms. These include: separation anxiety, generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, phobias (i.e., social anxiety, fear of heights), and posttraumatic stress disorder. Identifying which may be present is often a complicated process and is best explored with a professional, such as the child’s pediatrician, or a mental health clinician.

As with many psychiatric problems, people with anxiety often experience considerable shame and may suffer in silence without sharing their fears with anyone. This is no different with children. Knowing the warning signs is an important step in identifying a problem before it becomes a more significant issue. Fortunately, anxiety disorders are generally quite treatable, whether through counseling, medication or a combination of the two.

— Scott M. Granet

Scott Granet, LCSW is a long-time resident of Redwood Shores, and is director of the OCD-BDD Clinic of Northern California in Redwood City. He would like to hear your suggestions for future columns, and can be reached at 650-599-3325 or .

On a wall in my office is a poster of John Lennon with the quote, “Life is what happens to you while you’re busy making other plans.” We all live with a relatively healthy sense of denial which keeps us from being overwhelmed by the tragic events which we know could occur at any moment. If we lived our lives consumed with fears of earthquakes, floods, hurricanes and terrorist attacks we would be too afraid to leave our homes. Yet, we also can’t ignore the possibility that disaster can strike at anytime and as such we should be as prepared for them as is reasonably possible. Since we live in earthquake country, most of us have come to appreciate the importance of having a family disaster plan, and a disaster preparedness kit.

Emotional responses to disasters will vary a great deal, though for most people their reactions will be well within what would be considered normal. Feeling a sense of shock or emotional numbing, some sadness and depression and even guilt are all normal. Anger, anxiety, panic, and irritability may also be present as may problems with concentration and physical symptoms such as headaches and stomach pains. Also, given that disasters often occur with little or no warning, it is very common to feel out of control with tremendous uncertainty about the future. Yes, a disaster preparedness kit is vital, but let’s not overlook the importance of preparing for the emotional challenges we will inevitably face as well.

While our reactions to disasters may differ, there are some very useful coping strategies which are beneficial for everyone. Perhaps most important is to accept that returning to normal life may take a while. When possible, however, it is still best to keep up with normal daily routines, and to make sure that you are eating properly, and keeping up with good sleep hygiene. Regular exercise and other activities such as meditation and yoga can also be very beneficial during a time of crisis. Resisting alcohol and drug use is also important as they can worsen an already difficult situation. Additionally, watching images of the disaster on TV and on the internet needs to be limited as well, especially for children. During the 9-11 terror attacks many people repeatedly watched the images of planes flying into the World Trade Center buildings. Some children believed that these were many different attacks while not understanding that they were actually repeated showings of the same event.

Perhaps our greatest resource during a disaster is the support we can give to each other. Keeping ourselves surrounded by family members and friends, and being a part of organizations such as religious and neighborhood groups is invaluable. Of course, professional counseling may also be important, especially if the above symptoms linger long after the crisis situation has ended.

— Scott M. Granet

Scott Granet, LCSW is a long-time resident of Redwood Shores, and is director of the OCD-BDD Clinic of Northern California in Redwood City. He would like to hear your suggestions for future columns, and can be reached at 650-599-3325 or .

We all know the feeling: you wake up, feel sluggish and have trouble getting ready to tackle the day. You’d rather just stay in bed, don’t really want to interact much with others and don’t have the energy you usually have. Basically, you feel kind of “blah.” Even so, you pull yourself together, go to work and have a decent enough day. The next day you’re back to your old self, and those other feelings are just a memory. While it’s an uncomfortable way to feel, in clinical terms it really isn’t depression. It’s normal to feel that way on occasion.

Given that the holiday season is upon us, it seemed like the right time to write an article on the subject of depression. This is a time of year many people look forward to with both excitement and trepidation. It’s also a time when some may experience heightened states of feeling depressed. There are several forms of depression to consider, such as that which occurs in the context of bipolar disorder (formerly called manic-depression), and dysthymia, which is a less severe, though fairly chronic condition that generally waxes and wanes for years. Additionally, post-partum depression is one that occurs in some women following childbirth, and seasonal affective disorder (SAD) has its onset during the winter months when there is less natural sunlight.

Major depression, however, is probably the form most people think of when the term depression is used. The diagnosis is not made unless someone experiences five or more of the following symptoms for at least a two week period: depressed mood, sleep and appetite disturbance, poor concentration, inability to derive pleasure, low energy, agitation, feelings of worthlessness and thoughts of death/suicide. Typically, major depression will also have an impact on important areas of functioning, such as with work and relationships. This is by no means a rare condition. The National Institute of Mental Health estimates that major depressive disorder affects approximately 14.8 million American adults and is the leading cause of disability for people ages 15-44.

So what can you do if you or a loved one suffers from depression? The combination of anti-depressant medication and psychotherapy is generally the best approach. There are, however, many forms of each, and so a good place to start may be to consult with your primary physician as they generally have a lot of experience with depression.

One final note about thoughts of suicide: always take them seriously. When someone is feeling such hopelessness and despair it’s not unusual for suicidal thoughts to surface. It is at those times that loved ones have to intervene. Taking the person to their physician or to an emergency room may be necessary and even calling the police is an option if you believe there is imminent risk and the individual is not cooperating in seeking help. While it’s often an uncomfortable topic to discuss openly, the consequences of not doing so can be much, much worse.

— Scott M. Granet

Scott  Granet, LCSW is a long-time resident of Redwood Shores, and is director of the OCD-BDD Clinic of Northern California in Redwood City. He would like to hear your suggestions for future columns, and can be reached at 650-599-3325 or .