Helping Students in Uncertain Times

Students at GMU are likely to have a variety of responses to the uncertainty of terrorism and war. For some students this is an unfamiliar situation. They've never had to deal with these conflicts and may feel anxious and out-of-control.

Other students may have directly experienced war or terrorism here or in another part of the world. For these students, the current threats may bring new feelings, as well as, revive reactions to past experiences.

While we are all being affected in some way with these threats, many students who have family and friends living overseas may find it difficult to concentrate and manage school and other responsibilities.

Other students, with family and friends who've been called upon to participate in a war, may also experience similar difficulties. In general, we can expect that anxiety, as well as other feelings, will be higher for students, even though they may not attribute it directly to the threat of war or terrorism.

In this time, it's helpful to be observant of how students are doing. Are you seeing changes from how they usually function. Perhaps they're withdrawing from activities or friends, not attending classes or work, not getting schoolwork done or performing at a lower level, having difficulty in their relationships with peers.

Students who have difficulties on a more on-going basis may be particularly vulnerable to changes and increased difficulty in functioning during these times.

Tips for People Living with Mental Illness In Uncertain Times

With ongoing military action in Iraq and the continuing terrorist threat here at home, Americans are experiencing many powerful emotions.

For most people, the intense feelings of anxiety, sadness, grief and anger are healthy and appropriate. But some people may have more profound and debilitating reactions to the war. This could be especially true for those who live with serious mental illnesses, such as:

• schizophrenia
• bipolar disorder
• depression
• substance abuse problems
• anxiety 
• post-traumatic stress disorder

It's important to remember that everyone reacts differently to trauma and each person has his or her own tolerance level for difficult feelings.

When confronted with a crisis, a person with a mental illness may experience the symptoms of his or her disorder or see new ones emerge.

Some consumers who have experienced this say that there are warning signs. Here are some common warning signs of an oncoming relapse:

• Stopping your usual routines, such as attending school or joining family activities
• Changing your sleeping pattern or eating habits
• Not caring about your appearance
• Difficulties with your coordination
• Lapses in short-term memory
• Experiencing mood swings
• Feeling out of control or very agitated
• Thinking about suicide or violence
• Doing things that make others think you’re out of touch with reality
• Hearing or seeing things that other don't
• Being unable to let go of an idea, thought or phrase
• Having trouble thinking or speaking clearly
• Deciding not to take your medications or to follow through your treatment plan (missing appointments, etc.)
• Feeling unable to enjoy things that are usually pleasurable
• Being unable to make even routine decisions

Different people can have different warning signs, so be aware of anything that seems out of the ordinary for you. If people around you notice changes, listen to what they say. You could be totally unaware of changes in your behavior. Be sure to report any changes, especially any talk or thoughts of suicide or self-inflicted injury, to your doctor or treatment team.

Even in uncertain times such as these, you must take an active role in managing your illness. Continue to follow the treatment plan you’ve developed with your doctor or treatment team.

• Take your medications just as your doctor prescribed
• Keep your therapy appointments
• Avoid alcohol use
• Don't use illicit drugs or any that aren't prescribed specifically for you
• Keep a journal or diary
• Have prescribed laboratory and psychological tests
• Stay connected with or get involved in a support group
• Report any signs of a relapse to your treatment team

To get through the current crisis, take advantage of the people and tools that are available to you:

• Involve family and friends. Don’t be afraid to ask for help.
• Keep your doctor and treatment team informed about how the war is affecting you.
• Make contact with self-help groups and support organizations that help people with serious mental illnesses and related problems.
• Access peer support and other programs, ranging from drop-in centers to housing, employment and recreational opportunities, that can help you better manage your illness.
• Learn all you can about your illness and what you have to do to move to recovery.
• Use the computer to get information about your illness and to contact and exchange views and experiences with others who share your experiences.
• Stay in touch with your spirituality, if you find that comforting. Be optimistic about the challenges that lie ahead.

Find what works for you. The process of moving toward recovery, especially in times or war or crisis, isn't a simple one. Stay fully involved in the process by following your treatment plan and seeking the support you need, when you need it.

The National Mental Health Association has several resources available to help you and others cope with our ongoing national crisis, including fact sheets on post-traumatic stress disorder, depression, coping with loss, helping children handle war and other topics.

To obtain this information, go to www.nmha.org/reassurance/anniversary/index.cfm or call our toll-free line 800-969-NMHA (6642).

Cancer Support - Sharing Feelings

Some in the family are able to absorb the impact of diagnosis sooner than others. This can create clashing needs as some wish to talk and some need to be private and introspective.

Verbal and nonverbal clues help determine when is a good time to discuss the illness and how each will learn to live with it.

If family members can't help each other, other emotional support systems are available in the form of groups or professional counselors.

The person with cancer has the primary right to set the timetable for when he or she is ready to talk. Others can encourage that readiness through their love and continued presence.

Talking may include expressing anger, fear and inner confusion.

False cheeriness - the "everything will be all right" routine - denies the person with cancer the opportunity to discuss fears and anxieties.

Emphasizing the uniqueness of each person, positive test results or good response to treatment is true support, both valid and valuable.

The person with cancer needs family or friends as a constant in a changing world. "I'm here," offers great reserves of support.

Sometimes, the whole family suspects the truth before the diagnosis is made. Someone recognizes the symptoms, or the family doctor seems overly concerned. Nonetheless, hearing those words - tumor ... cancer ... leukemia - we're stunned as we never may have been in our lives.

It's often impossible to take in the diagnosis immediately. We hear it, but somehow we don't believe it. This is normal. People's minds have a wonderful capacity for absorbing information only as they're ready to accept it.

Emotional Timetables

All of us may not operate on the same emotional timetable. One of the family might feel the need to talk about the cancer before the others come to grips with it. Each of us has to decide when we are ready to talk; none should feel forced to do so.

This sometimes creates clashing needs - some need to talk; others need to be private and introspective or even to shut the whole subject out of their minds for a while. The desire to respect privacy may be pitted against an equal need to get the whole thing out in the open.

In some families everyone becomes overly considerate of everyone else's needs for time to adjust. Instead of meeting anyone's needs, everyone avoids one another, building walls just when they ought to be opening doors to communication.

It's important to let the person who has cancer call the signals for when it's time to talk. But, it is always helpful to look for clues to determine when might be a good time to discuss the cancer and how to live with it.

Signs such as apparently idle conversation, more time than usual spent with other family members, or even unusual nervousness might indicate that a person wants to talk but doesn't know where to begin. Yet, facing cancer together makes it easier. It eliminates the need for pretense when there are so many important matters to get on with.

As you talk, you should try to be sensitive to what family members or friends say,, how they position their bodies and whether or not they make eye contact. These clues suggest whether the conversation is serving a purpose or driving someone you care about into hiding.

Some people can't adjust their feelings and can't help each other. Not all families can be open and sharing and a crisis is a difficult time to be adjusting family patterns. Nonetheless, the situation may not eliminate the need to air feelings.

This is the time to turn to one of several sources outside the family for emotional support. These are described in the chapter "When You Need Assistance."

Consider Your Needs

When cancer is first diagnosed, some people can absorb only the most basic information and even that might need to be repeated. That's normal. We each have the right to digest information and to determine when we are ready for more, when we're ready to talk about what we know or want to know.

If others in the family want to talk about cancer before you're ready, try to postpone the discussion without rejecting the person.

"I appreciate your concern but not yet. I can't talk yet," for example, suggests that the day will come when you'll be ready to talk. Taking care of your own needs, which are great, while trying to recognize the fears and anxieties of those you love isn't easy, it's true.

The period right after diagnosis is often a time of anger, fear and inner confusion. You might need to sort out conflicting emotions before you can express them. Or, you might find yourself lashing out, wishing to find a target for anger and frustration.

Often it's those closest who bear the brunt of these outbursts. You don't want to hurt them, but you may be angry that they will live and you might die. Perhaps you assume that they'll understand and endure the rage.

Family members have feelings, too. They may lash back, expressing their own anger and hurt at your outbursts, at the possibility of losing you, at the burden of new responsibilities or at their powerlessness to change the reality of the disease. As you express your own feelings, try to remember that others need the same release.

The Family Adjusts

The period following diagnosis is a difficult time of adjustment for family members. Each has to deal with individual feelings, while trying to be sensitive to those of the person who has cancer.

Being part of the family doesn't mean you can make people talk about their feelings before they're ready, but you need outlets, too. There are ways to encourage openness. Be ready to listen when others are ready to talk and let your continued presence show your support. But remember, the person with cancer gets to set the timetable.

If the decision is to talk, you may find yourself the target for a lot of anger and frustration. It's easier to tell yourself that you aren't the cause of this hostility than it is to accept this. You know you should respond with patience and compassion, but sometimes you answer anger with anger. Even these exchanges can have value if everyone learns through them to share feelings.

The opposite of anger may be false cheer. In trying to bolster the person with cancer, you may actually cut off his or her attempts to express feelings. Remember that lifting the spirit doesn't mean hiding from the truth. Sensing despondency, some people rush in with assurances that "everything will be all right." But everything isn't "all right."

If you insist it is, you deny the reality of the patient's world. In response, he or she may withdraw, feeling deserted and left to face an uncertain world alone. Without meaning to, you've abandoned the one you hoped to help and set up patterns that can be difficult to change just when support is so important. Although the cancer may be controlled, the gulf between you may endure.

It may help the one with cancer to know that you share the same fears and anxieties about the uncertainty of the future. People who honestly share these feelings find they can hold them to the light, better accept that the future may be questionable and turn more readily to fulfilling the present.

This is a very difficult period, but if you can share the difficulties, you'll find there are more good days to enjoy together. And you are less likely to be devastated by truly difficult ones.

Finding Hope

There are ways to find hope during periods of despondency or despair. We all need to remember the individuality of each case. We tend to get caught up in statistics and averages, but no two cancers ever behave exactly the same way.

Each individual has different genes and an immune system, a distinctive will to live and an urge to fight. These can't be measured on charts or graphs. No one can offer any of us "forever," but there are good prognoses; with an increasing number of cancers, the outlook is good for a lifetime free of disease.

You can look to promising test results and to treatments that have been effective in many people before. Even if the future is guarded, there may be another remission, good days, comfortable nights and shared experiences. These are real beyond any statistics. The enjoyment of life's gifts constitutes living, not the number of days we are given in which to enjoy them.

There are safeguards against hopelessness even if there is no real cause for hope. You can still provide reassurance of continuing love and comfort. At times, "I'm here" may be the two most supportive words you can say.

Listening, Sharing, Being Yourself

There are different ways in which you can be important as a family member or friend. You can listen to expressions of feeling or act as a sounding board for a discussion of future plans. You can help focus anger or anxiety by helping to explore the specific causes - drug reactions, the job situation, finances and so forth. This may be what is needed - someone to listen, to react and absorb the patient's outpourings, not necessarily to "do" anything. It's a difficult role, but it can be immensely rewarding.

There is a more passive but equally difficult role. Some cancer patients view theirs as a private battle to be fought alone with only their physicians as allies and they prefer to fight their emotional battles alone as well. But they need family and friends for silent support, as respite, shelter or an island of normality.

It can be draining to provide "safe harbor" from a day in the clinic or nights of sleepless panic. It can be a struggle to be forced to plan an evening out, to ask friends in or simply to stand by with wordless support. However, there may be times when this is what's needed most.

Many people think they don't know "how to act" with people with cancer. The best you can offer is to be natural, to be yourself. Let your intuition guide you. Do what you comfortably can do; don't try to be someone you aren't. This in itself is comforting. Dealing with cancer entails enough mystifying changes without having to adapt to a new you.