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Fact Sheet

Panic attacks


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What are panic attacks?

Panic attacks are sudden periods of intense fear or extreme anxiety.  They occur when the “fight or flight” response in your brain is triggered, even though there is no sign of danger. The fight or flight response is a survival system that your body uses. It means that when your brain thinks it is in danger, your body gets ready to fight or run away.  If you are experiencing a panic attack, the body will react like you are in a dangerous situation even though you are not.

Panic attacks can happen without any warning. The attack could last for a few minutes or up to half an hour.  After the attack, it might take some time to start to feel O.K. again. It is not unusual to experience a panic attack. At least 10% of people will experience a panic attack this year.

After experiencing one panic attack, it is not uncommon to worry about having another. You might even start avoiding situations or activities that you think might trigger an attack, like busy shopping centers, public transportation, airplanes, elevators or isolation.

What are the effects of a panic attack?

The effects of a panic attack vary from person to person. Some might include:

  • Sweating;
  • Feeling short of breath, or like you can’t get enough air;
  • A pounding heartbeat;
  • Chest pains;
  • Feeling unsteady;
  • Feeling like you’re choking;
  • A dry mouth;
  • Hot or cold flashes;
  • A tingling feeling;
  • Feeling faint;
  • Trembling;
  • Nausea or diarrhea;
  • Feeling like you’re losing control or you can’t escape.

If you are experiencing any of these effects, it is important to look after yourself.

What causes panic attacks?

The causes of panic attacks are still being researched. But there is evidence that stress as such is associated with panic attacks. Stress alters the chemicals in your body that influence the fight or flight response.

There are some illnesses like diabetes, asthma or inner ear problems that cause similar symptoms to panic attacks, so it is a good idea to check with your doctor to see if the symptoms are due to the illness.

Depression, anxiety and obsessive compulsive disorder have also been associated with panic attacks. Check out these fact sheets for more information on these issues.

How can I manage panic attacks?

Self-talk. Remind yourself that this is only an uncomfortable feeling and it will pass. To help it pass, try and distract yourself by thinking about something different, like counting backwards in threes from 100 or singing the lines of your favorite song. You can also concentrate on slowing your breathing down to focus your attention on something else. Check out the fact sheet on Self-talk for more info.

Diet. Be aware that stimulants—like coffee, soft drinks or anything else with caffeine in it—drugs, alcohol and smoking can all act as triggers for a panic attack.

Exercise. When you start panicking, a lot of hormones, like adrenaline, start pumping through your body. These hormones keep you feeling panicky.  A way to help get rid of them is to exercise, especially by doing something that raises your heart rate. Regular exercise can help lessen panic attacks.

Relaxation. If you are having a lot of panic attacks, it can help to get a relaxation CD and listen to it for half an hour (or however long you like) every day. This can help to reduce your overall stress. Other forms of relaxation are also useful, such as yoga, Tai Chi, meditation, swimming and going for a walk.

Slow breathing. This is something you can practice while you’re not having an attack, and when you get good at the technique, you can try to use it while panicking to slow your breathing down:

  • Hold your breath and count to 10, then breathe out.
  • Breathe in through your nose and count to three. Then breathe out through your mouth and count to three. Continue this for one minute.
  • Hold your breath again to the count of 10.
  • Do this for about 20 minutes a day (you can break it up, like doing 4 5-minute sessions), and any time you’re feeling panicky.

Seek help. If you are having a lot of panic attacks, or if they are preventing you from doing everyday things that you enjoy, it is possible that you are suffering from an anxiety disorder. You might want to see a counselor or other mental health provider that specializes in these disorders.

Cognitive behavioral therapy, and in some cases medication, can help ease panic attacks.  Check out the cognitive behavioral therapy fact sheet for more info about this form of treatment.

Panic attacks can be frightening experiences, but if dealt with properly, can be overcome. The important thing is that you look after yourself and seek help to avoid future panic attacks.

How do I know this?

Anxiety Matters
National Institute on Mental Health

Last reviewed: Mar 11, 2013

Fact Sheet

Social anxiety


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What is social anxiety?

Social anxiety disorder, or social phobia, is a persistent and extreme fear of being watched or judged by other people. People who have social anxiety might also be nervous or worried that they might do something embarrassing. This anxiety can last for days before and after an encounter that triggers the anxiety. This might lead someone to avoid situations or places with lots of people. It can also make it difficult for people to take part in everyday activities, like work and school.

Is social anxiety the same as being shy?

No. Everyone feels shy once in a while, especially when meeting new people or in unfamiliar situations. However, shyness doesn’t typically prevent people from taking part in activities that they enjoy.

Social anxiety can make ordinary situations very uncomfortable, and friendships hard to keep. People with social anxiety often experience symptoms like sweating, blushing, shaking and nausea. Generally, these feelings occur during certain stressful situations-like public speaking or informal conversations, or when you’re eating or drinking in front of others.

What causes social anxiety?

There are a number of factors that might cause social anxiety:

  • Genetics: Some scientists believe that certain genes can affect how people react to stress and social interaction, causing some people to become more anxious in social situations than others.
  • Behavior learned by the people around you, especially your parents: In some cases, children raised by people who avoid social interaction might grow up to have social anxiety.
  • Life events: Harmful situations like being bullied or more serious traumatic events that cause people to be fearful of certain situations can also lead to social anxiety.

Getting help for social anxiety

People with social anxiety often know that their fears are irrational, but don’t know how to control them. There is help available for people with social anxiety. If you think you might have social anxiety, start by sharing your concerns with a friend or family member. It is also important that you talk to a doctor, counselor, psychiatrist or psychologist because these health professionals can help you begin to build the skills you need to manage your anxiety. In some cases, medications may also be used to help you control your anxiety.


Social anxiety isn’t the only type of anxiety disorder that can interfere with day-to-day activities. For more information, check out our other anxiety fact sheets.

Information

Information in this fact sheet was provided by:

Last edited by Kristie - Feb 2014.

Fact Sheet

Anxiety disorders: types, causes, and symptoms

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Anxiety versus anxiety disorders

Everyone gets anxious from time to time. Anxiety can help you stay safe. For example, it brings about physiological symptoms that warn you to fight, flee or freeze in dangerous situations. Anxiety also helps you perform better. For example, feeling anxious before an exam can assist you to stay alert, which helps you to do your best. It’s not uncommon to feel anxious before exams or when there are stressful events in your life. For more info, check out the Anxiety fact sheet.

If this anxiety is interfering with many areas of your day-to-day life like schoolwork or relationships, it’s possible that you have an anxiety disorder. Anxiety disorders can make you feel nervous a lot of the time in different situations and for maybe long periods of time.

Anxiety disorders affect about 40 million Americans. If you have an anxiety disorder you are definitely not alone.

What causes anxiety and anxiety disorders?

Anxiety can be part your genetic and biochemical make up, as well as part of your personality. There are many things that can trigger anxiety, such as your environment, stressful situations, problems within the family, or a traumatic event.

Some causes of an anxiety disorder might be:

  • Genetics: A history of anxiety within your family;
  • Biochemical: An imbalance of the chemicals in the brain that regulate feelings and physical reactions, which can alter your thoughts, emotions or behavior;
  • A stressful event: A single event or chain of events such as divorce, abuse, ongoing bullying at school, sexual abuse, a death, a relationship break-up, or family conflict;
  • Personality: Certain personality types are more at risk of anxiety than others.

Types of anxiety disorders and symptoms

There are many different types of anxiety disorders, each with their own symptoms and treatments. Here is a list of examples:

General anxiety is an extreme and uncontrollable worry that is not specific to any one thing.

Social anxiety or social phobia involves a fear of social or performance situations (such as meeting new people) in which an individual may be embarrassed. People with social anxiety commonly avoid social situations. Check out the Social anxiety fact sheet for more info.

Agoraphobia is anxiety about being in places or situations from which escape might be difficult or embarrassing if an individual has a panic attack. It usually leads to avoidance of certain places and situations.

Claustrophobia is the fear of enclosed or confined spaces. People with claustrophobia may experience panic attacks, or fear of having a panic attack, in situations such as being in elevators or trains.

Panic disorder occurs when you have regular panic attacks. Some people may develop agoraphobia as a result of the panic attacks. Check out the Panic Attacks fact sheet for more info.

Specific phobias involve intense and ongoing fear of particular objects or situations. Seeing the object you’re afraid of might trigger a panic attack. Usually the object or situation is avoided.

Hypochondria refers to an extreme concern or worry about having a serious illness. People with hypochondria have a constant fixation with their body, self-examining and self-diagnosing.

Obsessive Compulsive Disorder (OCD) involves unwanted thoughts, impulses, or obsessions and repetitive, routine behaviors, also called compulsions. Check out the OCD fact sheet for more info.

Post Traumatic Stress Disorder (PTSD) is an anxiety disorder sparked by a major traumatic event, such as rape or accident. It is marked by upsetting memories, “blunting” of emotions, and difficulties sleeping. Check out the PTSD fact sheet for more info.

Treatments

There are a number of treatments for the different anxiety disorders. It might be a good idea to research the disorder relevant to you and arrange to see your doctor. They should be able to tell you about the different treatment options available and let you know what the best approach is for you.

Try to remember that managing your anxiety disorder may take time. There may be good days and not so good days. Dealing with your anxiety disorder is possible. For more information and on how to get help, visit Mental Health Support and Treatment Options. You can also look at the Anxiety Disorders of America for more information.

The following source provided information for this fact sheet:

Statistics provided by the National Institute of Mental Health.

Last edited by Kristie - Feb 2014.

 

Fact Sheet

Anxiety

3

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What is anxiety?

Anxiety is an uncomfortable feeling of fear or imminent disaster, and is a normal emotional response to danger. What makes one person anxious may not trigger the same response in someone else. Events like breaking up, exams or a fight with a friend may cause you to feel anxious, worried or scared.

Everyone feels some anxiety at different times during life. It becomes a problem if you feel so anxious that it interferes with your normal day-to-day activities. If this occurs, it’s important that you seek help. A local doctor or a mental health professional is a good place to start if you’re looking for help.

What are the symptoms of anxiety?

Anxiety can affect both your physical health and your mental health (behavior and feelings). The symptoms you experience can depend on a number of factors. These might pass quickly or can stay for a long period of time. Some common ways that anxiety might affect your mental health include:

  • Irritability or constantly being in a bad mood
  • Feeling worried, or a constant feeling that something bad is about to happen
  • Often asking many unnecessary questions and requiring constant reassurance
  • Getting upset when your routine changes; for example, a substitute teacher, unexpected visitors, or a trip to an unfamiliar place
  • Being a loner, or hanging out with a small group of group of people (who are often younger or older)
  • Being a perfectionist; for example, taking a long time to complete homework because you try to make it absolutely correct
  • Being argumentative (but not usually aggressive), especially when trying to avoid a feared situation
  • Being pessimistic and easily able to identify what may go wrong in any given situation
  • Not answering questions and rarely volunteering comments or information at school

Some common ways that anxiety might affect your physical health include:

  • Dry mouth or difficulty swallowing
  • Nightmares
  • Difficulty getting to and staying asleep
  • Difficulty concentrating
  • Muscle tension and headaches
  • Rapid heart rate and breathing
  • Sweating
  • Trembling
  • Diarrhea
  • Flare-up of another health problem or illness (for example, dermatitis or asthma)
  • Sexual problems, such as not having any sexual feelings or interest in sex

What can I do if I am feeling anxious?

Changing your lifestyle: There are many things that you can do to decrease anxiety in your life. Look at the things that are causing you stress and, if possible, change your lifestyle to avoid or confront those things.

Eating and exercise: When people feel anxious, they often neglect themselves. Ensuring that you’re eating healthy foods, regular meals, and getting frequent exercise will improve your overall health and well-being.

Relaxation: There are many ways you can relax. Check out the Relaxation fact sheet or some of the many self-help books on the topic. Some ideas include going for a walk, taking a class like yoga or Tai Chi, learning to meditate or playing soccer with a friend.

Talking: Bottling things up is likely to keep your anxiety levels high. If possible, talk to a friend, family member, or counselor about the things that are making you feel anxious and see if they can be resolved.

Anxiety disorder

If you are feeling so anxious that it’s impacting your day-to-day life, you may have an anxiety disorder. Check out the Anxiety disorders: types, causes and symptoms fact sheet for more information on the different anxiety disorders and how they can be treated.

Research has shown that cognitive behavioral therapy is very effective in helping people overcome anxiety disorders. People like your local doctor or a mental health professional can help you, or refer you to someone who specializes in treating anxiety disorders. Medication may also be helpful in managing symptoms and is something that a doctor or psychiatrist may advise as part of treatment.

Check out the Get Help section of the site to find more about what these people do and how they can help.

Last edited by Kristie - Feb 2014.

 

Fact Sheet

Cheating


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When someone cheats on their partner in a committed relationship, it can raise a lot of complicated feelings and difficult questions. If your partner cheated, you might wonder why it happened or how it could have been prevented. If you were the one who did the cheating, you might have regrets or wonder if there is a way to gain forgiveness.  

The reality is that there isn’t one simple solution for dealing after someone has cheated. Every relationship is different and the options for next steps are as varied as the reasons the person cheated in the first place.

This fact sheet covers some of the more common reasons why people cheat and helps you, as someone who cheated or the partner of someone who cheated, assess your options for next steps. 

What to do if you suspect your partner is cheating.

Take care of yourself. Know that if your partner has cheated or you suspect they have cheated, that you may be experiencing some very intense feelings. It is not uncommon to have situations such as this remind you of other times in the past when you experienced some kind of loss related to your self-esteem, relationships (romantic or not), or other painful times. You may find yourself more sensitive in general and easily agitated. This is because when people experience a loss, or threat of loss, they will often be hyper vigilant about the potential for other losses. Be gentle with yourself and take a minute to review your self-care routines. As you will read throughout this fact sheet – this may be a good time to seek support in the form of counseling, whether or not your partner has actually cheated. 

Approach your partner at a calm time and raise your concerns. Try not to make accusations and instead focus on the behavior that’s raising a red flag for you. For instance, if your partner has been acting distant, secretive, temperamental , or has not been hanging out with you as much, ask them about those signs. You can also express how you feel in terms of security in the relationship and your ability to trust each other.

If they deny that they are cheating and you do not believe them, there may be something wrong in the relationship, whether they are cheating or not. If you are unable to determine the source of your mistrust and concerns through communicating with your partner, you may want to consider counseling for you as a couple or as an individual. Outside help can be useful for helping you work on how to fix issues, and whether you both want to fix it. 

If they confirm that they are cheating than you need to decide what you want.  Do you want to stay in the relationship and work together to fix it?  Do they?  Would you be happier if you left the relationship and worked individually with a therapist to determine how to move on from a relationship that ended with a betrayal of trust, so that your next relationship will be a better and healthier one? You may want to use the rest of this fact sheet to determine the best next steps for you.

Why do people cheat?

Below are some common explanations for why people cheat. But it’s good to know that the list isn’t comprehensive. There also might be more than one reason that a person cheated, or motivations the cheater isn’t entirely aware of themselves.

Some reasons for cheating:

  • They are unhappy with the relationship. This can be because you’ve grown apart over time, because they don’t know what they want in a relationship, or a variety of other reasons.
  • They feel insecure or unhappy with themselves.
  • They are scared to communicate their needs and wants in a constructive and healthy way.
  • They’re addicted to the thrill of the chase and novelty of cheating.
  • They’re afraid of commitment or the possibility of being alone.
  • They don’t want to be with their partner (for any number of reasons having to do with themselves or the relationship) but don’t want to break up with them because are afraid to hurt their feelings.
  • They want to be with their partner but also want freedom/variety.

Next steps after cheating

In this next section, we’ll cover some options for next steps after a partner cheats. The list below does not cover all of the options so if none of them feel right for you that’s okay. Think about your unique situation and the best way to communicate with your partner about the outcome you are hoping to achieve.

No matter how you proceed, it’s good to prepare for emotional fallout on both sides, including:  guilt, anger, sadness, loss, confusion, depression, placing blame (on yourself and the partner) over what happened among other feelings.

If you are struggling with these feelings, it is important to talk with someone for support.  It can be a friend, family member, therapist, or anyone you feel comfortable and safe talking to. Regardless of whether you cheated or were cheated on, it’s okay to ask for help.

I’m cheating: What do I do?

If you are the one who cheated or is currently cheating, you may feel guilt or remorse. You may be fearful or anxious about being caught, hurting your partner, or being left by your partner. In some cases, you may feel anger because you have convinced yourself that it is your partner’s fault that you are cheating.

These are all common reactions. It can be hard to take responsibility for your actions and address the reasons why you have been driven to cheat on your partner , but doing so can also help you process what happened and move on.

Here are some options if you are the person who cheated:

If your partner does not know, you’ll need to decide whether or not you are ready to be honest with them.

  • If you are ready, it will be important to pick a calm time where you have time to discuss the situation privately. You may also want to prepare what you are going to say ahead of time. 
  • If don’t feel ready to tell your partner, you may want to examine your hesitation.
    • If you feel conflicted about whether or not you want to stay in your relationship, this can be a good opportunity for you to assess your needs and the general health of the relationship. Even if your partner is unaware of the fact that you are cheating, there is a fair chance your relationship has been affected.
    • Imagine what you would want from your partner if the situation were reversed.
    • If you have been sexually active with the person you cheated with, it is important that you take responsibility for staying safe, getting tested and protecting your partner from STIs (sexually transmitted infections).
    • Knowing that you cheated or are cheating may cause you stress and anxiety. You may feel like there is no undoing what you’ve done and no way out. It’s important to know that there is support to help you cope. No matter how messy the situation seems, there is always a way forward. Feel free to talk it out in the ReachOut Forums.

Whether your partner knows or not, it’s good to consider the following

  • Look at why you are cheating or cheated – be honest with yourself.
  • Sometimes it is hard to know why you cheated, especially if the relationship is a good one for you. It may be that you are “sabotaging” its success. This kind of sabotaging urge, often happens below the radar, and is hard to be aware of, or know the exact reasons why, until you explore it in a safe place, such as with a therapist.
  • Figure out whether you want to be in a relationship. If you realize you cheated because you haven’t been getting what you want or need from your current relationship, this will be important for you to process as you figure out your next steps.
    • If you choose to work on your relationship and move on after cheating, this reflection will be helpful to share with your partner.
    • If you come to the conclusion that you are unable to get your needs met in your current relationship, this may help you to be more direct and honest with your partner around your decision to move on. See the fact sheet on breaking up for more information.

I was cheated on: What do I do?

When you are the one who was cheated on it’s normal to many conflicting feelings. You may blame yourself, think you did something wrong, or feel that there is something wrong with you. If you feel this way, remember— relationships take two people and each person is responsible for their actions, words, and the effects those words and actions have on their partner.

You may feel anger at your partner or resent them. You will most likely feel sad and hurt. You may be reminded of times when you were hurt in the past and feel extra sensitive. The thought of what to do from here may be scary and confusing or it may be very clear. Either way it can be difficult to take steps towards moving on after a betrayal and it might be good to seek support outside of the relationship if it becomes overwhelming.

Let’s look at some common options for when someone cheats on you:

Again, this list is not comprehensive. You may decide on one option and feel compelled to choose another after some time. Ultimately, the most important thing is that you feel comfortable with your choice and supported by your partner.

  • You may feel too hurt, angry or disappointed to continue the relationship. In this case, you may make the decision to leave your partner and
    • Stop communicating with them as much as possible
    • Have limited or infrequent communication
    • Break up, but attempt to stay friends. This may require you taking some time and space before making that transition.
  • Stay with them and work on the relationship by communicating openly about what led to the cheating and how you can move on for the future
  • Take a break from the relationship to decide what you really want
  • Change the parameters of the relationship – i.e. have an open/polyamorous relationship
  • Couple’s or Individual counseling
  • Talking about how you feel with your partner, a friend, therapist, parent, or school counselor.

Is moving on after cheating a possibility?

Different individuals will respond differently to cheating and explore different options for what to do next. Before we can look at options, it is important to think about forgiveness and trust.

In order to begin the process of forgiving and grow to trust again you and your partner will need to commit to using healthy communication tools. You may want to work with a mediator or counselor at first to help you navigate these potentially difficult conversations.  Talking about these issues will bring up intense emotions, and it can be a challenge to stay in touch with the goal of communicating what hurts, while staying away from blaming and critical language.  You can also read this fact sheet on resolving an argument for some tips.

The Process of Forgiving:

  • Forgiving someone is an active process and takes a lot of work. It can be extremely difficult.  You have to ask yourself if you are able to do this, if you want to do this, or even if you should do it. 
  • If you decide to forgive, it is important to think about why you are doing it.
    • Is it for you or for the person who cheated on you?
    • What will forgiveness look like, feel like, and do for you?
    • If the relationship continues what will it mean for the relationship and the person who cheated?

The Process of Rebuilding Trust:

  • If you decide to forgive and continue the relationship, the next hurdle is trust. It takes both people in the relationship to rebuild trust.
  • There has to be an openness to try to trust again and a willingness to do whatever it takes to help the person who was cheated on to trust again.
  • Communication, flexibility, and commitment are vital in rebuilding trust and mending the relationship.

If you were the one who was cheated on, it is important to communicate what would help you to trust your partner again and to make sure they have a clear understanding of what you need.  Once you express your needs, being a bit flexible in how your partner meets those needs would be helpful. When discussing how to rebuild trust it is vital that both of you talk about what a commitment to fixing the relationship looks like and means to each of you.

If you are the one who cheated, it is important for you to listen to what your partner needs to trust you again and to communicate what you are willing to do to help them trust you again. Being open in hearing your partner’s needs and flexible in how you are willing to meet those needs will help the process of regaining trust.

How to approach your next relationship.

If you decide to end a relationship after cheating,  you may want to take some time to be with yourself and work through what happened before starting a new relationship. It would be helpful to work with a therapist; however if that is not an option, consider reading a self-help book or books on the topic, and talking with a close friend, family member or someone else you feel safe with and close to.  If you are feeling bad about yourself, learn to like and then to love yourself before thinking about another relationship.

Once you have done those things, you will be ready to start dating and thinking about relationships again.  Because you have done these things for yourself, you will be more open and ready to be with someone who will be good for you, someone that you can have a healthy relationship with.  That type of person will also be drawn to you. 

It would be understandable if you still feel anxious or worried about your new partner cheating on you, however if you communicate well with each other you will start to be able to trust them and you will start to realize how different and how much better this relationship feels as compared to your last one, as well as how different and how much better you feel in this relationship.

Fact Sheet

Miscarriage: what to expect and finding support


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Please note: If you think that you are having a miscarriage, seek medical attention immediately. Call your healthcare provider as soon as possible. The information provided here is to be used as a guide only and is not to replace medical advice. Please seek guidance from a medical provider.

When a pregnancy ends prematurely, it can be difficult to process. You may experience many different feelings, including confusion, guilt, sadness or numbness. Whatever you are going through, you're not alone. This fact sheet will help you know what to expect, emotionally and medically, and also give you guidance for seeking support.

What is a miscarriage?

A miscarriage is when a woman’s pregnancy ends suddenly before the 20th week (or the middle of the second trimester). Medical professionals also call this a spontaneous abortion, though this is not the same as the medical procedure that is also called an abortion.

A miscarriage is something that a woman cannot control. It can just happen. Most of the time, it is because the embryo or fetus is not developing correctly.

Most people don’t know that miscarriages happen to a lot of women. A lot of pregnancies end in miscarriage (about 10-20%). Many times, we don’t know why they happen.

Different types of miscarriages

The symptoms you experience and the medical treatment you receive will depend on the type of miscarriage you experience. No matter what type it appears to be, it’s always a good idea to seek medical attention to help you take the best possible care of yourself. 

There are five different types of miscarriage: threatened miscarriage, inevitable miscarriage, incomplete abortion, complete miscarriage, and missed abortion. The descriptions below may help you better understand what you are experiencing and the treatment that may be recommended.

A threatened miscarriage is when there is bleeding from your vagina, but your cervical os (the small opening located in the middle of your cervix) is still closed. If you experience a threatened miscarriage, your healthcare provider may give you medication or suggest bed rest to help stop your symptoms. Sometimes a threatened miscarriage will not result in a miscarriage. Other times, it can develop into a different type of miscarriage, and the pregnancy will not continue (see below).

If you experience a complete miscarriage, most, if not all of the tissue comes out of the uterus through your vagina on its own (a uterus is a hollow organ of the female reproductive system. If you become pregnant, this is where the embryo develops). Sometimes, the healthcare provider can’t be sure if all of the tissue has actually come out of your uterus. You will probably have to go to the clinic to have the tissue removed with a procedure called dilation and evacuation (D&E). A D&E is done to prevent bleeding or an infection from making you very sick.

If you have to have a D&E, you may experience the following:

  • You will receive pain medications and medication to help you relax during the procedure. You will also receive antibiotics to prevent infection.
  • Next, a speculum will be inserted into your vagina. The healthcare provider will then inject numbing medication into the cervix.
  • The opening of your cervix, (cervical os) will be stretched (or dilated).
  • Instruments are used to empty the contents of the uterus. This includes a thin tube, inserted through your cervical os to suction the tissue out.
  • A D&E takes about 10-20 minutes.

An inevitable miscarriage is when there is more bleeding over time from your vagina and your cervical os opens. The pregnancy will not continue in this case.

An incomplete abortion is when only some of the tissue comes out of the uterus and some stays inside. You may need to go to a clinic to have it removed, with a D&E.

If you have a missed abortion: the pregnancy has ended but there may or may not be symptoms of a miscarriage. The tissue usually stays inside the uterus. Sometimes the tissue will come out of your uterus through your vagina on its own. You may need to have the rest that hasn’t come out on its own removed at a clinic.

  • What is the difference between an incomplete abortion and a missed abortion? In both cases, the pregnancy has ended. However, with a missed abortion, you may not feel or experience (have signs or symptoms) the miscarriage. In both an incomplete abortion and missed abortion, tissue often stays in the uterus and will probably have to be removed at a clinic.

If you think you’ve had any of these types of miscarriages, It’s important for you to go to a clinic. You may need to be given medications, have tissue removed to prevent infection, have a D&E procedure, or you may be given supportive care (fluids to keep you hydrated, for example).  It depends on your situation. Everyone is different and a medical professional can help you figure out what's best for you.

No matter what type of miscarriage a woman experiences, it can be a very stressful and emotional time.

Why does a miscarriage happen? What causes a miscarriage?

A lot of times we don’t know why a woman has a miscarriage. Most of the time, it’s because the embryo or fetus wasn’t developing properly.

There are some things that increase the risk of a miscarriage:

  • If you have already had a miscarriage.
  • Regular smoking. Being a heavy cigarette smoker (10 or more cigarettes a day) increases your risk.
  • Drinking moderate-high amounts of alcohol, especially at the beginning of the pregnancy.
  • Drinking a lot of caffeine (10 cups of coffee or 1000mg of caffeine) over 8-10 hours in a day.
  • Some prescription and recreational drugs, especially cocaine.
  • If you are overweight or underweight.
  • If other long-term (a.k,a., chronic) health conditions, like diabetes, aren't .
  • If you are older than 35 years old. 

What doesn’t cause a miscarriage:

  • Sex
  • Exercise
  • The mother (a.k.a., “It’s my fault): remember, most of the time, miscarriages are caused by the embryo or fetus not developing correctly. Not by you.

What are the signs and symptoms of a miscarriage?

It's important to know that while the symptoms below are common signs of a miscarriage, every woman’s experience is different. It's possible have bleeding that lasts for a long time or to see large blood clots as well. The cramping may feel very intense, or not feel intense at all. If you experience any one of these symptoms, consult a medical professional for help.

  • Bleeding, “spotting”, or tissue from your vagina. Sometimes the bleeding can get heavier over time
  • Cramping in your lower abdomen (lower stomach area). The cramping can come and go, and get worse or better over time
  • Back pain 
  • Fever

What will happen if I seek medical attention?

The healthcare provider may ask you some questions about how you have been feeling. Next, they may do a physical exam. They might:

  • Do a pelvic exam.
    • This may include putting a speculum in your vagina to look inside at your cervix, to see if it is open. For more information on pelvic exams in general, see the fact sheet about a Women’s Health Visit (link to my fact sheet/what to anticipate during a pelvic exam). 
  • Do an ultrasound
    • An ultrasound is a procedure where a tool is either inserted into the vagina or applied to the stomach to see inside of your uterus.
  • They may have to remove some of the tissue from your uterus by doing a D&E. See the section above for more details on a D&E. 
  • If you do not have a D&E, you may be given medication called Misoprostol to help the tissue to come out of your uterus. The medication will be given to you to take orally (by swallowing a pill), or inserted into your vagina.
    • When you take Misoprostol, it will cause you to have cramps and bleed. This can last for several hours. You may have large pieces of tissue or blood clots pass through your vagina. Most of the time, the majority of the tissue will come out of your uterus within 3 days. Sometimes, it can take up to 8 days for all of the tissue to come out. 
    • During this process, you may experience: cramping, feel dizzy, nausea (feel like you need to vomit), feel like you have the flu (fevers, chills), and some abdominal pain.

After a Miscarriage

If you experience a miscarriage, you will not be able to put anything in your vagina (aka pelvic rest) for about two weeks. After that, you can use tampons, and it’s okay to have sex again. If you would like to try to get pregnant again, you should wait at least two months.

You may have a little bit of bleeding after the tissue comes out: that’s totally normal. However, if the bleeding gets worse over time, you feel like you have a fever, or have pain in your abdomen (your stomach area), make sure to seek medical care as soon as possible. It could mean that you have an infection.

Most of the time, you will get your period again in about six weeks.

How will you feel after a miscarriage?

You may feel many different emotions after a miscarriage, including:

  • Depression
  • Anger
  • Frustration
  • Relief
  • Stress
  • Guilt
  • Grief

Whatever you feel is okay and completely normal. No one person’s experience is the same as someone else’s. Seeking support from someone else can help you process these feelings and move through this emotional time.

Telling others what happened.

Telling other people what happened can very challenging. You may not feel like telling anyone at first. That’s okay. Sometimes it’s scary to tell other people about this sort of thing. What’s important is to get support to help you through a challenging time. This may be found in a trusted friend, adult, or a support group. You may also choose to tell the father about the miscarriage. This is a personal decision. It depends on your relationship with the father, your comfort level, and what feels right for you. If you do decide to tell the father, the tips below can help you prepare.

If you feel like you can’t tell people in person, there are other ways to communicate what’s just happened. You can tell them over the phone, write a letter, tell them over instant message, or write an email. You can even have a friend or family member tell people for you.

It can be helpful to prepare yourself for other people’s reactions. Sometimes they won’t know what to say. Some folks might not say anything, or feel like they have to give you a lot of advice. Others may open up to you and share their own experience with miscarriage.

To take the best care of yourself possible, you may want to make a list of what you need. You can start by asking yourself:

  • Do you need lots of hugs?
  • Do you just need to be left alone?
  • Want a distraction (movie or TV marathon)?

 You can also share this list with other people in your life to help them support you.

 

If you feel like you can’t tell anyone about what you’ve been through, there are a lot of online resources that can support you during this emotional and stressful time. The most important thing is finding what you need to feel better and process what you’ve experienced in a safe and supportive environment. The resources section below is a good starting point for taking that brave step. Remember, you are not alone.

Where to Get More Information and Support Around Miscarriage

Unspoken Grief  
Backline 1-888-493-0092 
Planned Parenthood Federation of America: 1-800-230-PLAN 

 

Fact Sheet

Abortion: options and finding support


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Please note: The information provided here is to be used as a guide only and is not to replace medical advice. You should seek guidance from a medical provider.

Considering an abortion?

Thinking about having an abortion, experiencing an abortion, or moving on after an abortion can be a very emotional time. These feelings can be complicated and can include depression, anger, frustration, relief, stress, guilt, and grief…sometimes all at the same time. Whatever you feel is okay and completely normal. No one person’s experience is the same as someone else’s.

Knowing what to expect, both medically and emotionally, can help you prepare and seek out the support you’ll need to cope.

What is an abortion?

Abortion is a medical procedure undergone when a woman decides to end a pregnancy. You may also hear it called pregnancy termination.

If you are pregnant and you decide to end a pregnancy, you can go to a clinic that provides abortion services.

There are two ways that a pregnancy can be terminated at a clinic. They are: the abortion pill, and an abortion that is done at the clinic (surgical abortion). The type of abortion done depends on the gestational age (weeks since your last menstrual period) of the pregnancy, your medical history, what is available at the clinic or in your state, and what your preference is.

If you are considering or have had an abortion, you are not alone. According to Planned Parenthood, about 3 out of 10 women have had an abortion by the time they reach 45 years old.

How do you know what method is best for you?

A medical professional will ask you questions to determine the best option for you. You can also take into consideration:

Would you prefer to take a couple pills at the clinic and go home to be in your own space? The abortion can take a few days to complete with this method. If you don’t like the idea of the process being drawn out over a couple of days, you may feel more comfortable with a medical abortion.

Would you prefer to go to the clinic once to have an in-clinic surgical abortion and be done once you leave the clinic? If you don’t like the idea of surgery, then the abortion pill might be better for you.

Please note: abortion services and availability vary from state to state. For a map of abortion laws by state:https://www.prochoice.org/Pregnant/find/. You can also call the National Abortion Federation (NAF) Hotline on 1-800-772-9100.

Telling the father about your decision

If you haven’t made the decision together, it is your choice whether or not to tell the father about your decision to have an abortion. There is no right or wrong answer for this. It depends on your relationship with the father, your comfort level, and what feels right for you. If you decide to tell the father, read on for tips on how to disclose your decision.

There are many different ways to communicate with the father. You can tell him over the phone, write a letter or write an email, for example. You can even have a friend or family member tell him for you (or with you).

Be prepared for his reaction. Sometimes he won’t know what to say. He may be happy, sad, angry, or supportive. Just as you may be experiencing a lot of mixed emotions, he probably will, too. See sharing difficult news with someone for more information.

What will happen when I go to a clinic?

Consider taking someone with you to the clinic to wait until after the abortion is completed. It may be comforting to you to know that there is someone who can just be there to offer their support and potentially take you home after it’s all done.

At the clinic, the healthcare provider will ask a few questions and do an examination. They will assist you to make a decision that is best for you.

When you arrive at the clinic, you may need to fill out some paperwork. Then, you will see a healthcare provider. This may be a medical doctor (MD), an Obstetrician-Gynecologist (Ob-Gyn), a Certified Nurse Midwife (CNM), or a Nurse Practitioner (NP).

When you begin your visit with your healthcare provider you will:
Talk about your options:

  • The healthcare provider will ask you questions to figure out if the abortion pill (medical abortion) or an in-clinic abortion (surgical abortion) is best for your situation.

     

  • These questions can include: When was your last menstrual period? Are you 18? Who will help you during and after you’ve had the abortion? Will you be coming for the procedure on your own, or will someone else be supporting you? Have you had an abortion before?
  • Some states have restrictions on what types of abortions can be performed at a certain stage of pregnancy. Some states require parent(s) to be notified if you have an abortion. Get more information about state laws concerning parental notification for women under 18 years old
  • The choice is usually made based on how many weeks the pregnancy is (weeks since your last menstrual period), what is available at the clinic and/or in the state, and what method you prefer.
  • Discuss any medical history
  • Have a physical exam done, which may include a pelvic exam
  • Complete and sign paperwork

What is the Abortion Pill?

The abortion pill is used to end a pregnancy in its earliest stages, usually up to 9 weeks into the pregnancy (9 weeks since a woman’s last menstrual period). This timeframe varies from state to state. This procedure is also known as a medical abortion.

Your healthcare provider will be able help you determine if the abortion pill is a safe and effective way to end your pregnancy, and if the state you live in has laws about when the abortion pill can be given.

The abortion pill is also called mifepristone. At one point, it was called RU-486, so you may hear people call it RU-486.

How does the Abortion Pill work?

Progesterone, a hormone, is blocked when you take the abortion pill. Without progesterone, the uterus begins to shed the inside lining of the uterus, and the pregnancy will no longer be able to progress.

What happens if I decide to take the Abortion Pill?

If you decide to take the abortion pill, you will most likely have to visit the clinic a couple of times. In addition, the abortion may take several days to complete. You may be more aware of the process of a medical abortion than a surgical abortion, as you may be very conscious of the tissue and blood that passes through your vagina over several days. In addition, you may experience some the side effects of the pill over several days (nausea, cramping, vomiting, and bleeding).

A couple of weeks after taking the abortion pill, you will need to come back to the clinic to see your healthcare provider. You will need to have a couple of tests done, including having an ultrasound (to look inside your uterus), and some blood tests.

Video from Planned Parenthood:

What happens during an in-Clinic Abortion?

There are two types of abortions that can be done in-clinic. They are called aspiration (also known as a vacuum aspiration) and dilation & evacuation (D&E). These are also known as surgical abortions. If you decide to do an in-clinic abortion, you will only have to visit the clinic one time once you decide to have the procedure done. After the procedure is complete, the abortion is finished - there is nothing more to be done to terminate the pregnancy.

When you arrive at the clinic, you will:
Talk about your options.

  • The healthcare provider will ask you questions to determine if the vacuum aspiration or D&E is the best option for you.
  • These questions can include: When was your last menstrual period? Are you 18? Who will help you during and after you’ve had the abortion? Will you be coming for the procedure on your own, or will someone else be supporting you? Have you had an abortion before?
  • Some states have restrictions on what types of abortions can be performed at a certain stage of pregnancy. Some states require parent(s) to be notified if you have an abortion.
  • The choice is usually made based on how many weeks the pregnancy is (weeks since your last menstrual period), what is available at the clinic and/or in the state, and what method you prefer.
  • Discuss any medical history
  • Have a physical exam done, which may include a pelvic exam.
  • Complete and sign paperwork.

Aspiration (vacuum aspiration): What to Expect

  • Aspiration is usually done up to 16 weeks since your last period.
  • You will receive pain medications and medication to help you relax during the procedure. You will also receive antibiotics to prevent infection. You may feel a bit uncomfortable during the procedure, but the pain medication should prevent you from experiencing intense pain.
  • Next, a speculum (a duckbill-shaped metal or plastic tool that separates the walls of the vagina when it opens and allows the healthcare provider to see inside) will be inserted into your vagina. The healthcare provider will then inject numbing medication into the cervix.
  • The opening of your cervix will be stretched (or dilated).
  • A thin tube connected to a suction machine is inserted through your cervix and into your uterus.
  • The contents of the uterus are suctioned out.
  • This procedure does not take very long, only about 5-10 minutes.
  • You may experience mild to moderate cramping over the next couple of days. Your healthcare provider will likely provide you with pain medication or pain relief techniques to help you.

Dilation & Evacuation (D&E)

  • Usually done after 16 weeks since your last period.
  • You will receive pain medications and medication to help you relax during the procedure. You will also receive antibiotics to prevent infection. You may feel a bit uncomfortable during the procedure, but the pain medication should prevent you from experiencing intense pain.
  • Next, a speculum will be inserted into your vagina. The healthcare provider will then inject numbing medication into the cervix.
  • The opening of your cervix (the cervical os) will be stretched (or dilated).
  • If the procedure is done during the later part of the second trimester of a pregnancy, a shot is first given to stop the fetal heart.
  • Instruments are used to empty the contents of the uterus. This includes a thin tube, inserted through your cervical os to suction the tissue out.
  • A D&E takes about 10-20 minutes.
  • You may experience mild to moderate cramping over the next couple of days. Your healthcare provider will likely provide you with pain medication or pain relief techniques to help you.

After the Procedure

After the aspiration or dilatation and evacuation are performed, you will be taken to an area to rest and recover.
You will be given pain medication and instructions on how to care for yourself at home. You do not need to stay overnight in the hospital.
There will be several healthcare staff available to support you a. They provide you with medical support, such as administering medications and IV fluids. They will also provide emotional support. You can talk to them about any feelings you may be having about the abortion.
Your healthcare provider may ask you to come back for a follow-up appointment in the next few weeks. They can also provide you with resources for emotional support specific to your area. You can also always call Exhale: the after-abortion talkline for support: 1-866-4-Exhale

If you feel like you are struggling with challenging feelings after the procedure, let the healthcare staff know. They are there to support you. For more info, watch this video from Planned Parenthood: In-Clinic Abortion

After an Abortion

You may feel many different emotions following an abortion, including:

  • Relief
  • Guilt
  • Grief
  • Sadness

You may feel all of these things or none of them. Whatever you feel, it’s okay.

What’s important is to get support to help you through a challenging time. Sometimes that can be a trusted friend, older adult, family member, or a support group. Remember: you are not alone.

Telling other people what happened can very challenging. You may not feel like telling anyone at first. That’s okay. Sometimes it’s scary to tell other people about this sort of thing. It is completely your choice who to tell and who not to tell.

However, it can be helpful to tell at least one person that you can trust. Support can be a powerful tool for working through feelings of depression, anxiety, and general negativity.

If you feel like you can’t tell people in person, there are other ways to communicate what’s happened.<

  • You can tell them over the phone.
  • Write a letter, tell them over instant message or even write an email.
  • You can even have a friend or family member tell people for you.

Be prepared for other people’s reactions. Sometimes they won’t know what to say. Some folks might not say anything, or feel like they have to give you a lot of advice. Others may open up to you and share their own experience with abortion.

Lastly, make a list (a mental list, or write it down!) of what you need.

  • Do you need lots of hugs and emotional support?
  • Do you just need to be left alone for a period of time?
  • Do you need a distraction (movie or TV marathon)?

Whatever it is that makes you feel better, safe, and helps you process what you’ve experienced, make a list. You can even share this list with other people in your life. It will help them support you.

If you feel like you can’t tell anyone about what you’ve been through, there are a lot of online resources that can support you. See the Resources section below. Remember, you are not alone.

Where to Get More Information and Support About Abortions

There are a lot of resources available to talk with you if you are thinking about an abortion, just had an abortion, or had an abortion a lot time ago. It can be a stressful and emotional time.
Remember, having or thinking about an abortion is a very personal choice. You need to make a decision that is best for you.

Information about Abortions/General Information about Women’s Health

Parental Consent and Notification Laws (posted on Planned Parenthood’s website)
backline 1-888-493-0092
Planned Parenthood Federation of America: 1-800-230-PLAN
National Abortion Federation: 1-877-257-0012 or call toll-free 1-800-772-9100. Open weekdays: 8am-11pm Eastern Time & Saturdays: 9am-9pm Eastern Time
Pregnancy Options Workbook

After an Abortion

Exhale: After-Abortion Talkline: 1-866-4-Exhale
Connect & Breathe: 1-866-647-1764

Fact Sheet

How do you know if you’re in love?


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The ‘Big L’

Whether you’re starting a new relationship or feel yourself developing deeper feelings about one you’ve been in for a while, you might wonder if you’re falling in love. It can be tricky to tell, especially when a relationship is new, whether or not it’s love or just an intense crush.

It is also important to remember that if you don’t feel like you’re in love right away, that’s okay. In many relationships, it’s a feeling that grows over time. Sometimes, you might have a couple crushes before you find love.

How do you know if you’re in love?

If this special person is the first thing on your mind when you wake up, the last person on your mind when you go to sleep, and the person you think about the most throughout the day, you’ve probably wondered if you’re in love. You might sporadically call or text them during the day to ask them how they’re doing or what they’re doing later just to keep the conversation flowing. Your mind and your heart may be in the wonderful first stage of being in love.

What is love?

Love can be expressed in many different ways because it has no set definition. It’s a feeling, it’s a mood and it’s also a different way of thinking about someone. When you love someone you invest a lot of time and effort into that one person. You may spend so much time thinking about this one person that you feel certain other relationships or interests become less of a priority.  Love is not always a fairy tale and intense feelings can sometimes get a little confusing. You might feel the sense of being in love early on in a relationship, after time and deep talks about your feelings for one another or, even, for an ex. Love can be expressed by telling to “get some rest” or “you should relax, you’ve had a long day.” Love doesn’t always need to be expressed from “I love you.”

Love versus Like (or a crush):

Love is:

  • Responsible. When you admit to your mistakes and not point fingers as to who started what it shows great maturity in the relationship
  • Unselfish. When you put your significant others needs/feelings before your own it shows how much your care for him/her
  • Constant. Though love does have it’s occasional rough patches, love will always bounce back to its original state of happiness
  • Understanding. You may experience disagreements with your significant other, but if you come to a mutual consensus then it shows that you’re willing to compromise to make things work
  • Comfortable. You may find yourself exhibiting habits that you only would show in front of your best friends (ie: dressing sloppily, stuffing your face food,  and even showing your emotional sides)

Like may be:

  • More Shy. You might not feel comfortable talking about your feelings and thoughts that run through your mind because you might be afraid that they might judge you and not like you as much anymore
  • Misunderstanding. If someone text you or call you when they’re suppose to you might point fingers as to who’s fault it was and you may argue for a little bit thinking that who ever was wrong should apologize

How will I know when I’m ready to say ‘I love you?’

Sometimes it can be helpful to wait for some time to pass to see whether the strength of your feelings has staying power. Healthy relationships can be tested by disagreements and the partners will continue to love each other. Before you tell someone you love them, it can be helpful to ask yourself if you feel confident in your feelings.  This can make it easier to say. It can also be helpful to ask how you’d feel if your partner isn’t ready to say it back.

How do I know if I’ll hear they love me back?

Unfortunately, no one can tell you how your partner will react.  Even in healthy, happy relationships, the “l word” can make some partners nervous, so preparing yourself for different possibilities can make it easier to talk about your feelings.

If you feel attracted to your partner, respected in your relationship and happy about your dynamic, then the feeling might be mutual. It still might be possible that your partner doesn’t feel ready to use that word, but communication and not applying pressure (i.e., feeling okay with saying it first and not hearing it back) can help you continue to feel connected.

If they tell you that they only want a casual relationship or see you as a friend, don’t feel discouraged. While it may be painful at the time, in the long run it’s better that they’re being honest with you. It may take time and support from good friends to accept, but this information will help you decide on your next steps.

If you fall in love, remember:

  • Don’t hold on too tightly – Healthy loving relationships require trust and faith that the other person returns your feelings – even if they’re not constantly demonstrating their love. You have to make sure that there’s freedom in a relationship. Let your partner go out with their friends or if he or she wants to sleep a little early, don’t make them stay on the phone with you. If you hold something too tight, it’ll crumble.  And this is applicable to your significant other as well. They should allow you to flourish because you shouldn’t feel restrained in a relationship.
  • Don’t lose yourself. If you feel used or disrespected in a relationship, don’t feel obligated to stay with a person just because you’ve said you love them or they’ve said they love you. Loving yourself is the most the important thing and that means getting the respect and kindness you deserve in a relationship

Is love complicated?

Love isn’t always complicated. You and your partner may have some disagreements here and there about the smallest things, but if you are both willing to work on the relationship and communicate about any issues that come up (effective communication fact sheet), love can prevail. If you don’t feel heard or understood in a relationship, it can be a sign that you need to communicate more. If your partner is unwilling to talk about or your concerns or what feels challenging, it may be time to reassess the relationship.

Compromise is key and it can really help mend your arguments. Talk it out with your partner, say what bothered you because your partner can’t read your mind. You may not even have realized that you did something that irked your partner until after you two talk it out. Love isn’t always complicated if there’s communication.
It is important to remember that there is no one way to tell if you are in love or to tell if your partner is in love with you. You cannot be told that you love someone because the feeling you are feeling (whether that be love or an intense like) can only be felt by you. No matter what you call the feelings you share., the most important thing this is feeling happy and respected in your relationship.

Fact Sheet

Trust Issues


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What is trust?

Trust is the confidence two or more people place in each other. It involves faith that the other will be sincere, loyal, and consistent. You might trust your friends to keep your secrets, your significant other to be faithful to you and your family to protect you. When you trust someone you feel that you can tell them whatever you are feeling or ask them for help and they will be there for you, without resentment or judgement. Trust is a part of all significant relationships: friends, parents, siblings and the person you are dating.

How is it built?

Trust can be built in many ways. Spending time with someone, having fun, and even just talking can build trust. Showing someone you are there for them when they are struggling with something - from homework to personal problems - is a great way to build trust. Depending on the relationship, it can be built very fast or take months - even years - to develop.

Having difficulty trusting?

For many people trusting people can be a big challenge. If you have been hurt or betrayed, you might feel like closing up is the best way to protect yourself. You may feel scared to be hurt again by the same person or open up to another person about your life. Although it may protect you from getting hurt, it also makes it difficult for you to create honest connections with people and build healthy relationships.

When someone breaks your trust, how you might react:

If you’ve had your trust broken by those closest to you like family or friends, it’s normal to feel hurt and even betrayed. 

You may even start questioning other relationships. If the people who were supposed to be the closest to you broke your trust, you might worry that someone else might break your trust (or the same person who broke your trust will do so again).

In order to keep from getting hurt again, you may have started closing yourself off to others. You may start omitting certain details of your life, or hiding how you truly feel so that this information won’t be used against you. Building a mental wall that appears to protect you from sharing too much can feel like a natural defense. But when you completely close yourself off, it can also have negative consequences. It can lead to:

  • Stress: Constantly guarding yourself is a strenuous job!
  • Negative self-talk: When you hold all these emotions in they can become heavier and heavier. You may become sad, angry or frustrated with yourself.
  • Loneliness: You can even begin to feel more alienated by always trying to hide how you really feel.

The benefits of rebuilding trust

When someone has betrayed your trust, you may feel reluctant to give them another chance. This is understandable and most people require at least some time and space in order to become clear on their feelings and whether or not they want to attempt to repair the damaged relationship. It is ultimately up to you to decide whether to work through the betrayal, but there are some cases when talking through things can ultimately strengthen a relationship between two people.
Effective communication may be able to help you move past the issue if the person is:

  • Remorseful
  • Takes responsibility for their mistake
  • Is willing to change and support you in moving past their betrayal and does not dismiss your feelings or urge you to "get over it"

When you meet a new person and are still getting to know them, you may share a bit of yourself and feel uncertain if that person is going to have good intentions and treat you with respect. It’s a risk. When opening up to a new person, you might feel:

  • Nervous about if they will like you
  • Shy
  • Worried they will judge you

These are all normal things to feel when hanging out with someone new. But they are uncomfortable feelings and you have a lot to gain by moving through them. A relationship founded on trust has many benefits:

  • Connection: When we feel connected with people we feel better. We share the stuff that makes us happy and the stuff that makes us sad. When we feel that we can share things with someone we trust, the good stuff feels better and the bad stuff doesn’t seem quite as bad.
  • Closer friendships
  • Meaningful relationships with parents and family
  • Healthier romantic relationships

Remember that just because someone else has disappointed you and broken your trust, this is not your fault. The actions of other people should not stop you from opening up and building new connections.

Learning to trust again

It’ll be challenging to open up and you may get hurt again, but building resilience is part of the process. We all have to learn to open up; it’s a skill that improves with practice. It takes time and effort to open up again so be patient with yourself. Here are some suggestions that may help you start building trust with a friend or family member:

  • Start off slow
  • Talk about things you like and make you feel comfortable
  • Find out if they have similar interests
  • Try doing some activities together to build up your comfort level
  • Listen to what they say for clues about how much they are opening up to you
  • When you feel comfortable start sharing some stuff about yourself and take it slow

Getting someone to open up to you

If you are trying to start a relationship with someone who has difficulty trusting, it can be difficult. You might feel like they are distant or that they push you away sometimes. Patience is usually the key. Show them that you are there for them. With time, hopefully they will open up. If they don’t though, realize it is about their fear and not about you.

The goal is to form healthy, positive, mutually-supportive relationships. Remember that regardless of the actions of others, you choose who you want to be. Don’t let other people’s decisions stop you from being happy, opening up and meeting some great people!

For more information, check out these fact sheets
Effective communication
More tips for communicating effectively
Meeting new people

 

Fact Sheet

What happens during a gynecological exam?


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Photo by: Shutterstock

If you’re nervous about seeing the gynecologist for the first time, you’re not alone. Many women feel intimidated. After all, it involves talking about very intimate things and having the most private parts of your body examined. It is completely normal to be nervous about the experience, but just like a yearly check-up from your doctor, receiving an annual gynecological exam can help you better look after your health. As an added benefit, it can also help you get to better know your body and the way it works. Remember, your safety and comfort are their first priority. Here is a basic overview of what you can expect:

Who conducts the exam?

There are many different types of healthcare providers that can answer questions or meet girls’ and women’s health needs, including an Obstetrician–Gynecologist (or Ob-Gyn or just Gynecologist), a Certified Nurse-Midwife, Nurse Practitioner, or a Pediatrician. You might see your regular medical doctor, or a doctor or nurse at a community health center or a family planning clinic like Planned Parenthood. No matter what type of healthcare provider you see, the most important thing is that they make you feel comfortable.

When to see a healthcare provider for girls’/women’s health (also known as a Well Woman Exam):

  • If you’re a girl between the ages of 13 and 15 years old, the American College of Obstetricians and Gynecologists recommends you start seeing a health care provider for women’s health issues.
  • If you are having sex or thinking about having sex with men or women. This includes sexual intercourse [when a penis is put inside a vagina], oral sex, anal sex, or any skin-to-skin contact around genitals (vagina, scrotum, penis, anus or thighs).
  • If you are having sex with men and you have missed your period.
  • If you are having any problems with your period: really bad cramps, pain, heavy bleeding or periods that last longer than usual.
  • If you’ve been having a period but it’s still not regular: it doesn’t come once a month, or comes more than once a month.
  • You are 15 years old, you haven’t gotten your period or you haven’t gotten your period in the 3 years after your breasts started to grow.

What are the benefits of seeing a healthcare provider for girls’/women’s health issues?

  • They can give you information and safer sex advice so you can protect yourself from sexually transmitted infections.
  • Explain and provide contraceptive choices to prevent pregnancy (i.e., condoms, birth control, etc.) for women who have sex with men.
  • They can help you recognize what is normal for your body (everyone is different!) such as:
    • Vaginal discharge: what normal healthy discharge looks like and when there might be an infection.
    • Periods (menstruation): what is normal, and what might not be normal for you.
  • They dispel myths: healthcare providers can give you correct information about sex, sexual health, periods, breasts, and any other questions you may have about your body.

What to expect during your visit

The first time you meet with your healthcare provider, they might:

Ask you questions about your health, and your family’s health. They may ask you health questions in general, and some questions that are personal. These could include questions about your period, and your sexual health. They may ask if you have been having sex, including oral, vaginal, or anal sex.

  • If you are worried about confidentiality (i.e., whether will they tell anyone what you are talking about), make sure you talk to them about it. Most of the information that you give them will be kept private. But make sure to ask them first.

They may do an exam. What to expect:

  • First, they may do a general exam, like taking your blood pressure, your temperature, your height and your weight.
  • Then, they will provide you with a paper gown and leave the room to allow you to change.
  • Next, they may do a breast exam: the healthcare provider will check your breasts while you are sitting up, and again with the pads of their fingers to detect lumps or other changes, while you are laying down.
  • You may also need a pelvic exam. If so, they will have you lay down and scoot all the way to the end of the table. They will then help you put your feet in stirrups.
    • They will start with an external genital exam (the area around the vagina, anus, and the thigh).
    • Next, they will move on to the pelvic exam. They will insert a speculum (a duckbill-shaped metal or plastic tool that separates the walls of the vagina when it opens and allows the doctor to see inside). This may feel uncomfortable but not painful. Let your health care provider know if it is. They can most likely adjust the size or position of the speculum. If they are going to do a Pap Test, they will collect cells from your cervix (the narrow opening between your vagina and uterus).
      • It’s totally normal to feel nervous or weird about this part of the exam! If you are feeling really uncomfortable, let the healthcare provider know. They can help you relax and make you feel more comfortable. If a male doctor is conducting the exam, you can request to have a female nurse in the room.

You can stop the exam at any time if you feel too uncomfortable. These exams should only take a few minutes! Remember: if you want to stop at any time, tell the healthcare provider and they will stop.

What happens after the exam?

The healthcare provider can answer any questions you may have about the exam, or what happens next. If you had any tests done (like the Pap test), you will get a phone call about your results.

If you are still nervous about the prospect of an exam, you might try talking to a woman you are close to about it, and ask her about her experience.

For more information on sexual health:

Check out the Taking care of your sexual health and the Intro to STIs fact sheet

The information in this fact sheet is based on the following resources. Check them out for more on when and why to see a healthcare provider and what to expect:

Planned Parenthood: Video on What to Expect at Your Exam
Girlshealth.gov: Visiting the gynecologist
Planned Parenthood: The Pelvic Exam
The American College of Obstetricians and Gynecologists: Frequently Asked Questions Especially for Teens (warning: this is a PDF document, and may automatically download on some computers)
Girlshealth.gov: A glossary (or dictionary) of health terms, including terms you may hear during your visit

This information is not to replace medical advice: you should seek guidance and ask questions of your healthcare provider for your well-woman needs.

 

Fact Sheet

What does it mean to be an introvert?


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What is Introversion?

Introversion is usually thought of as the tendency to enjoy solitude rather than time with a group of people. Introverts are often described as “recharging” on their own rather than when socializing. Extroverts often gain energy from spending time with lots of other people while introverts expend energy. It can be exhausting for introverts to spend time around lots of people, but that doesn’t necessarily mean they don’t like people.

Most people live somewhere on the spectrum between introversion and extroversion. How introverted/extroverted you are can also change over time, either as you mature or after major life events.

Common Misconceptions about Introverts

They are anti-social. Most introverts care a great deal about people, but they prefer to engage with them one-on-one rather than in a group. Most introverts find small talk a little uncomfortable and prefer to have deep conversations with one person at a time instead of struggling to hang out with a large group of people.

They are shy. Not all introverts are shy. Some of them enjoy meeting new people, spending time with lots of people, and behave like social butterflies. The only difference is that socializing is tiring rather than energizing for them. Lots of introverts prefer time one on one, and enjoy engaging in deep and close conversations.

They are lazy/inactive. Introverts are often mellower than extroverts, but this doesn’t mean they don’t like sports or more active activities. For introverts, being “rowdy” is not something that comes easily, and being in large groups of rambunctious people can feel pretty overwhelming. But that doesn’t mean they don’t love sports or can’t be in a crowd, it’s just that the social aspect of these activities can add another energy-depleting aspect to them. 

Benefits of being an introvert

Creativity. Introverts can be great writers, artists, and problem-solvers because many great ideas come out of introspection from spending time alone. 

Deeper Relationships. Because introverts enjoy spending time one on one and generally prefer deeper, more intense conversations, they tend to have fewer but stronger relationships with their friends. Introverts usually are good listeners, which makes them excellent friends.

Thinking big. Introverts tend to see the big picture and spend time reflecting on their lives. This can make them great decision makers, compassionate leaders, and generally “old soul” types. 

Challenges of Being an Introvert

Difficulty making friends. When you move to a new place or start at a new school, it can be difficult if you are more introverted in approaching and meeting new people. You might feel awkward and uncomfortable trying to socialize in a group and it might take time to find people that have shared interests.

How to deal: It might be easier to text or write messages over the internet when first getting to know people, or you might try to meet people outside of group settings, like when you are working on a project with someone.

Being misunderstood. Introverts can sometimes be picked on because they tend to be quieter. They can be misunderstood as being anti-social and weird. Bullying can be trickier to manage as an introvert because you might be less likely to speak up for yourself or less comfortable with asking anyone for help.

How to deal: If you are suffering from bullying and are uncomfortable asking for help, you can try asking a friend to come with you when you approach an adult. You might also want to write a note or an e-mail to a teacher or school counselor about the issue. 

Can introverts and extroverts get along?


Absolutely! Relationships between introverts are extroverts are usually very rewarding, because an extrovert can help bring an introvert “out of his/her shell,” while introverts can help extroverts slow down and take time to think and reflect.

Fact Sheet

My friends don’t like my boyfriend or girlfriend


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Your friends not getting along with your boyfriend or girlfriend, or vice versa?

Sometimes two people get along very well because of the person they have in common. Other times, they can clash for the exact same reason.

When your friend and your significant other don’t get along, or you don’t get along with your friend’s partner, it can cause tension and even conflict between all involved. You might feel like creating a distance, taking sides or making your friend pick a side. This can hurt feelings and make the person in the middle feel even more torn. But the good news is communication can help.

Read on for tips and strategies for addressing and working together to resolve the issue. First, it might help to understand the conflict:

Why do friends and significant others not get along sometimes?

  • Personality Clash: Even if your friend and significant other have one thing in common (you), they can still be totally different people with different tastes, interests and senses of humor. Having to spend time with someone you didn’t choose to hang out with can be difficult.
  • Jealousy: If you are the friend who isn’t in the relationship, then you might feel excluded from your friend’s new social calendar. On top of having to carve out time to hang out with your best friend, you now have to deal with “stealing them away” from their partner.
  • Mistrust: Your negative feelings might be based on reputation, rumors or personal experience with the new partner, but you have a sense your friend’s new partner is not to be trusted. Do you confront them, tell your friend or just keep your mouth closed? If you’re the one in the relationship, you might be hearing this information from your friend and facing the difficult question of who to believe. No matter who you are in the situation, if a friend doesn’t believe a partner is “good enough for you,” it can create a tough situation.

How to handle the situation if you’re the friend:

No matter what the reason, the bottom line is you are not a fan of your friend’s new boyfriend or girlfriend. You may feel like he or she is out to make your life miserable by creating a divide between you and your best friend. But your friend really, really likes them. So what do you do?

You have a bad feeling or just don’t like their partner

Give careful thought to if and how you will approach your friend. Simply stating your opinion ("I just don't like him") may not open the dialogue for further discussion and could potentially hurt your friendship. You may need to take some time and self-reflection to get to the issue at the core of your negative feelings. Ask yourself: Is the issue between you and your friend or between you and the partner?

  • If you find yourself getting jealous that your friend isn’t spending enough time with you, then try to put yourself in their position and remember the feeling of being in a relationship. Your friend may not even be aware that your feelings are getting hurt. To clue them in in a non-accusatory way, try to approach at a calm time when you two can talk one on one. Let your friend know that you miss him/her and ask if the two of you can make plans to hang out again with just the two of you.
  • If you don’t enjoy spending time with their new partner, you may be need to be sensitive about how you approach the issue to not insult your friend (after all, your friend chose and likes this partner). It is okay to sometimes choose not to hang out with the two or ask for your friend for some one on one time, but if the three of you end up hanging out occasionally you may need to bite your tongue and hold back on the eyerolls.

If you think that your friend’s significant other is truly a bad influence or untrustworthy

You have a few options for how you can approach your friend

  1. You can talk to your friend one and one and explain what you know and why you think their significant other is not right for them
  2. You can approach your friend’s significant other at a calm time and discuss your concerns directly with them
  3. You can approach your friend and the significant other together

Before you choose any of these options, it is important to think about what your feelings are based on and how this may affect your relationship if your friend doesn’t believe you or doesn’t want to believe you.  If you do choose to address the issue with your friend or the significant other or both, it is important to emphasize that you are coming from a compassionate, caring place. You may also want to read this fact sheet on effective communication to help you prepare.

Know that you can give them the facts, but you’ll ultimately have to let them decide what to do with those facts. If you think the issue is serious and your friend’s health or safety may be in danger, it is important to talk to your friend. It may still create a divide or tension between the two of you, but in the long term you are doing the right thing. Read this fact sheet on abusive relationships for more information.

How to handle the situation if you’re the person in the relationship:

You think you’re in love and you’ve found the perfect guy or girl for you. You want to share this great new person with your best friend, but your best buddy just doesn’t like him or her. They refuse to see what you see. So now what?

If your friend feels hurt

Communicate. Talk to your friend and see why he or she is giving off these negative vibes. Approach them separately at a calm time when you can give them your full attention. Sometimes your friend may just feel a little neglected or protective without a clear reason why. 

  • Think about if you’ve been spending less time together lately or generally talking/texting/chatting less. This might be a sign you’ve been caught up in your new relationship.
  • If so, try not to be defensive. Ask them if you can work together to find a balance between spending time with the two important people in your life
  • Reassure them. If your friend is just being wary of this new person in your life, then have a heart to heart with your friend. From the outside your friend might know all the reasons why your partner is such a good fit for you.

If your friend expresses concern

Investigate. We all have blind spots sometimes. If your friend brings up something to question your partner’s integrity, or says that he/she is a bad influence on you, take a moment to step back and examine your relationship.

  • Are you doing things you normally wouldn’t have done when you’re with your partner — in the bad sense (drinking, drugs, risk-taking)?
  • Does your partner seem evasive at times, and isn’t always open and honest with you?
  • Your friend may be wrong, but if they’re a good friend they wouldn’t bring the issue up if they weren’t genuinely concerned. Remember that they are your friend for a reason and try to give them the benefit of the doubt. If this sounds like a possibility, see the worried about losing yourself in a relationship fact sheet

Whatever the cause may be, when the dynamics of a close friendship change, it can be hard on everyone involved.

If your friendship is strong and you’re willing to communicate and address the issue, then your friend and you will find a way to work things out.

Check out these fact sheets for related topics:
Resolving an Argument or Disagreement
Assessing a Relationship
More tips on communicating effectively Friendships

Last edited by LC on Feb 2014

Fact Sheet

Worried about losing yourself in a relationship


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Your relationship and its course

In the Native American community we have lots of different relationships; from our friends, family, teachers and classmates to our boyfriends and girlfriends. Sometimes relationships work well and are easygoing and other times they can be hard and you might wonder if they’re worth it.

Most relationships occasionally go through difficult times. During these times, you might feel like avoiding the other person in the relationship, or you might want to reassess the relationship altogether. Just like anyone from any background, we all have witnessed our share of healthy to down right toxic relationships between other people. What stands out in our culture is the high number of unhealthy relationships due to dependency or codependency, where one or both partners lose their own identity and relies too heavily on the other. The dependent person can feel like a “small satellite circling a planet.” This dynamic can be learned through exhibited behavior in relationships we observe growing up (for example, our parents), especially when one or both partners abuse drugs and/or alcohol.

Some researchers suggest that the historical trauma endured by Native Americans can also be linked to the high number of unhealthy relationships. As a result of historical victimization, they suggest some Native Americans, especially women, suffer from internalized oppression and a normalization of violence.. A recent study from nonprofit Futures Without Violence also shows that the Native American population has higher levels of alcohol abuse and dependence than the general population.

How can you tell if you’re too dependent?

Dependency in the context of a relationship is a personality style in which the person affected exhibits huge “need” or dependency on another. In relationships where one partner is dependent (or both partners are dependent on each other, i.e, codependent), one partner consistently puts their partner’s needs and wants before their own needs or wants. Sometimes this can happen because one person wants to help their partner with a pervasive problem such as substance or alcohol abuse. Sacrificing one’s own needs and wants may be a learned behavior that can be passed down through generations in families. The majority of Native American communities pass their knowledge, their behaviors and their beliefs orally from generation to generation, and this can include unhealthy behaviors and dynamics.

Some signs of dependency

● Constantly putting someone else’s needs above your own
● Not wanting people to “focus” on you or your problems
● You spend a lot of time “taking care” of someone who has substance abuse problems
● Unable to be alone or not in an intimate relationship
● Appearing very competent on the outside but actually feeling quite needy, helpless, or numb
● Childhood neglect or abuse, including having a parent who had substance abuse issues
● Not expressing your thoughts or feelings in fear of not “pleasing” the people around you

Reassessing the relationship

In reassessing a relationship with another person, you might want to consider some of the following questions.

Are you getting what you want from the relationship?

If being in the relationship isn’t making you or the other person satisfied, it might be worth reconsidering how much time you spend with that person. You should also consider what you want from a relationship and whether you want a relationship at all. Check out the Do I want a relationship? fact sheet for more information.

Are you happy outside the relationship?

While it might be difficult to picture your daily life without a person who plays such a prominent role, sometimes the idea of their absence can bring a sense of freedom. You might imagine yourself stressing a little less and having fun with friends more. You might be happier outside of the relationship if when your significant other isn’t “in the picture” you consistently feel like:
● You have less stress
● You’re emotionally upset less
● You’re surrounded by friends more
● You sleep better
● You’re more outgoing

It is also possible that the thought of leaving your current relationship is extremely stressful. You may worry that you would feel quite alone and lost without your partner.  For example, if the relationship has become so much the focus of your life, other friends and family may have fallen by the wayside. In most healthy relationships, both partners are able to strike some balance between their independent lives and the relationship they have with each other. If it feels like you can’t survive without their partner, this is another possible indicator of dependence (or codependence).

Are you willing to compromise?

When you disagree, argue or are fighting with someone, you might find it hard to listen to his or her point of view. To maintain a relationship you may both need to:
● Agree to disagree
● Walk away and take time out
● Compromise
● Keep talking about what is important to you, and listen to what is important to the other person
● Respect yourself and the other person
● Think about what is fair
● Remember that having different opinions and ideas is ok. Avoiding conflict is not necessarily healthy. Resolving disagreements in a respectful way can be a sign of a healthy relationship

How significant is the person to you?

If this person means a lot to you, it’s probably worth putting effort into maintaining the relationship in some way. You might have relationships where you feel you have limited choices. These relationships may be with a teacher, employer, co-worker or family member. It’s also not uncommon to be in a relationship with someone you do not like. You might not like the person because:
● You have a personality clash
● He or she has done something you don’t like
● You don’t agree with his or her decisions or rules
● They don’t seem to be the person you fell “in love” with
● He or she is abusive. Verbally or physically. If this is the case, you might want to check out the Abusive Relationships fact sheet for more information

Native Americans have a larger domestic violence rate than a lot of other ethnicities. It is nearly 50% more likely that a Native American will suffer from domestic violence than any other ethnicity, according to Futures Without Violence.

It’s not ok to be abused (or abusive). If you fear or are experiencing physical violence and/or emotional put-downs and bullying, you might want to talk to someone you trust, like a friend, family member or counselor. See the Get Help section for more information.

Are you safe?

In some cases you might feel threatened in a relationship or fear for your safety. If you don’t feel safe with someone, avoid situations where you are alone with that person. Make a safety plan for yourself by:
● Letting people know where you are and who you are with
● Telling friends, family and people you trust about your relationship, and asking them to help protect you by being around when the abusive person is there
● Listening to your feelings, and leaving a place as soon as you feel unsafe
● Keeping a phone and transport money with you when you’re away from home, or arranging for someone to pick you up
● Having someone with you or close by when you end the relationship
● Talking to someone about what you can do to legally protect yourself

Your local police can advise you on steps you can take to protect yourself. See the fact sheet on Assessing Your Safety fact sheet for more information. You can also contact the Rape, Abuse, Incest National Network (RAINN) for assistance 1-800-656-4673.

Resolving problems

If you feel that a relationship is worth maintaining, you might need to be clear about what problems you are having and try to find solutions with the other person in the relationship.

Before talking to the other person you may want to:

● Write down a list of your concerns
● Consider talking to someone who isn’t involved in the situation-this outsider can provide a different perspective and help you sort things out for yourself
● Think about what you are willing to compromise
● Think of a time and space where you can talk about your relationship calmly

If you’ve determined you have a codependent relationship:

● If you feel safe, share with your partner your concerns about dependency at a calm time in a non-confrontational way
● Practice independent time in the relationship, time spent away from partner
● Assess your needs and work on the best strategies for prioritizing them
● If you need additional help, talk to a trusted adult or a professional counselor or therapist. In Native communities, you may also be able to find additional support in talking groups through local counseling groups, community centers or afterschool programs
● If you’ve determined that your partner’s drug or alcohol problems are contributing to the codependency, seek help for yourself to create a healthy distance while encouraging their recovery.  You may want to seek out a talking group specifically devoted to this issue in your community or a general support group like Al-Anon to help you deal with the impact of their substance abuse
● Openly communicate and express your emotions with your partner throughout this process

More information:
Future Without Violence
Symptoms of Codependency (PsychCentral)

Fact Sheet

Dating someone older or younger than you


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In any relationship it can be a nerve-wracking experience to introduce a partner to your family. If you happen to be dating someone who is not your age, and especially if that age difference is considerable, the situation can become even more complicated.

In addition to questions you may have about your relationship, the people in your life who care about you, such as your family members or friends, may also express concern or even disapproval of your significant other. It can cause stress and put a strain on your relationship with your family as well as with your partner. But the good news is communication can help.

Read on for tips on assessing your relationship and starting a dialogue with your family

How do you know if dating someone older or younger is right for you?

Ask yourself these questions:

  • Do you feel comfortable being yourself around them? If this relationship is right, then just because this guy/girl is older or younger than you, you won’t feel the need to act or behave in a way that you think is more or less mature. This person should like you for who you are, so don’t feel pressured to act differently or behave as his/her friends do.
  • If the person you are dating is older, do you feel treated you as an equal? If you are thinking about or are attracted to an older person, then you are probably on the mature side, so don’t let this person constantly make you feel like you are younger. You have the right to have your own personality, your own likes and dislikes, as well as your own wants.  If you feel trapped or belittled by this person (regardless of the age difference), that raises concerns about how freely you are entering into or staying in this relationship and whether or not it is emotionally healthy for you. Check out this fact sheet on breaking away from an abusive relationship.
  • Are you friends? Relationships work the best when they are built upon a foundation of friendship. Can you and this guy/girl talk about anything and everything? No matter what the age difference, if you’re able to take it slow and try to get to know this person well, then you’re probably off to a good start.
  • Is one partner in a position of power? Pursuing a relationship when one partner is the other’s boss, teacher, or simply someone who is in a higher position is very tricky ground to tread on. Firstly, make sure that being with this person doesn’t break any rules. Secondly, try to think about what would happen if things ended badly between you two. Would it affect your job, career, or reputation negatively?  If you are the student or employee in the situation, could the other person use his/her power to limit or punish you if they were upset with you?

Is it illegal to date someone older than me?

While dating someone older or younger than you is not a crime by itself, if you are engaged in a sexual relationship it can become a legal issue. In the U.S., it is considered statutory rape to have sex with minors under “the age of consent.”  This age varies from state to state (check the laws in your state here), ranging from 10 to 18, as do the complexities of the law (some states factor in the degree of age difference), but it is important to be aware that statutory rape is a serious charge that may carry heavy penalties. It’s also a good reason to take a relationship with someone older or younger at a slow pace.

Telling your parents that you’re dating someone older or younger:

  • Assess your relationship first. This conversation has more potential to go well if you are confident that you and your partner have a relationship where you both respect each other. Use the questions above to help you evaluate the relationship.
  • Consider your past actions and behaviors. If you have acted maturely in the past, then remind your parents that you can be responsible. If you haven’t, then spend some time showing them that you’re prepared to make wise decisions before delving into your relationship.
  • Choose your time wisely; try to tell your parents when they are calm and not already stressed about something else.
  • Be direct. Although it might be intimidating to start the conversation, it is better to come straight out and tell them rather than avoiding the subject or hiding the relationship. By handling the subject maturely, you can set a good tone for the discussion.
  • Try to be calm and not lash out at them for not understanding. People handle tough news differently, and if your parents seem upset, then they were probably unprepared for the news and need time to think it over. Remember that they do want the best for you. Check out this fact sheet on telling someone difficult news for more tips.
  • Plan ahead. Preparing what you want to say ahead of time and considering some potential concerns your parents might have can help keep the conversation on track. Check out this fact sheet on effective communication for help starting the conversation.

Why your parents may disapprove and how to understand their point of view:

  • Your parents want you to feel safe and comfortable to be yourself in a relationship. If you’re younger and do not have a lot of experience with relationships, then saying “No” to an older person is much more difficult than saying that to someone your age.
  • Difference in life experience. When you’re in your 20s and 30s dating an older person may not seem like such a big deal because you have matured and experienced life and so has the other person. But when you’re young, your parents know that you’ve had less experience and they don’t want you to give up the opportunity of discovering the world on your own terms at your own pace.
  • Your parents simply don’t want you to grow up too quickly. If you’re dating someone older, you might feel pressure to drop interests, hobbies, or even friends that make you feel younger. It’s a choice that might seem tempting in the short-term, but as time goes on you might find yourself missing your favorite comic books or “Pretty Little Liars” marathons.

Stay safe:

  • Start slowly If you’re younger than your partner, it’s a good idea to hang out in public if possible when first starting this relationship so you can get to know them better in a low-pressure environment.
  • Keep perspective. Sometimes it’s easy to get caught up in the romance of dating an older or younger person. If your friends or family don’t approve of this person after having met them, then try to step back and assess why you like this person and why this person likes you. Remember that your friends and family have an outside view of your relationship and may see something that you don’t.  They want to make sure your relationship is safe and healthy.
  • Communicate to this person what you’re boundaries are. Again, don’t feel pressured to do anything you don’t want to do just to prove your maturity or how much you care. Check out this fact sheet to manage any relationship pressures that may arise.

For more information, check out these fact sheets:
Abusive Relationships
Thinking about Having Sex
Managing Relationship Pressure

 

Fact Sheet

What to expect when calling a helpline


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Why should I call a helpline?

Talking in real-time to a trained counselor or volunteer provides you with immediate support and, allows counselors to easily connect you with additional places to get help. If you’re feeling nervous about calling, that’s okay. It can be scary to pick up the phone, especially if you don’t know what to expect. This fact sheet can help.

If you’re facing a serious issue or worried for your safety, we encourage you to contact crisis helplines, such as:

For more information on the different services, you can also see this list of National Hotlines http://us.reachout.com/get-help/getting-help-in-a-crisis

Below, we answer some questions you may have and also walk you through some typical questions you may be asked.

Who answers your call?

When you call a helpline, a trained counselor will answer your calls. Many have a background in mental health or social work, but all volunteers receive training in crisis counseling and suicide intervention.

When should you call?

You do not have to be in a serious crisis to call a helpline. Some call simply to obtain information and referrals for local community services. Others just have something that’s on their mind that they want to talk over with someone outside of the current situation. Of course, if you are in a serious emotional crisis, they’re there for that too.

How can they help?

Above all, the counselor who answers your call is there to listen.  Whether you’re feeling hopeless, angry or confused, counselors can help you process your feelings and assess your situation before working out what comes next.

Different helplines focus on different topics, but all will be able to provide support, information and referrals. Whatever your issue, your call will be answered by someone who will be supportive and non-judgmental, and who will try to understand exactly what you’re saying and how you’re feeling.

They want to help you stay safe, think through your situation or problem, explore your options, and to help you figure out what you want to do, if anything.

What types of questions will you be asked?

A lot of help lines are designed to be anonymous and confidential. This means that while you may be asked to give your first name, you will not need to provide any additional identifying information like last names or addresses, etc. Many find that this anonymity helps them to feel more comfortable when answering personal questions about their situation.

Some sample questions you may be asked include:
● Are you in a safe place to talk?
● How can I help you today?
● How old are you?
        - This helps counselors understand your eligibility for different types of services
        - If you are a minor (legal definition varies from state to state) and have specific questions related to your age and the issue you’re experiencing the counselor can address those questions. 
● Tell me a little about what happened that led you to call?
● When you are upset, to whom do you usually go to for support?
● Is there anyone else that you feel you can talk to about this situation?
● How are you surviving, and do you need a safe place to go? 
        - For those callers who express a need for safe shelter, counselors, like those at National Runaway Safeline, will need to know your city and state to begin locating an available safe shelter for you.

Why do they ask so many questions?

It‘s important for them to get a clear understanding of your situation and see it from your perspective. Remember, they don’t know you or anything about your life. They don’t ask questions to be nosy – they ask questions to find the source of your trouble and develop an action plan that makes you feel comfortable.

Regardless of age or location, these services are in place to provide support and assure your safety. Honesty about your situation will help counselors determine the best resources for you whether you’re dealing with LGBTQI issues, child abuse, mental health struggles, etc.

Are there alternatives to calling?

Yes. We know some people may be more comfortable reaching out over the Internet, and many services also offer chat, email and online forum or text options.

You can also reach out to someone in person. Speaking to a trusted adult, teacher, school counselor, doctor, or another mental health professional is also a great option.

No matter how you reach out, the most important thing is getting help. You’re not alone!

Last updated April 2014

Fact Sheet

Crisis Resources: Shelter, Food and Support Services


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If you’re in crisis, whatever the situation, you’re not alone. Rest assured, help is out there; by reaching this page you’re halfway there.  If you’re in immediate danger, call 9-1-1 for emergencies or 1-800-RUNAWAY if you have left home or are considering leaving home. You can also call 2-1-1 if you are seeking local support services  in certain active counties*. If you need support at anytime, you can call any of the free confidential services on the chart below 24/7. Use the following chart to assess your situation:

Your situation Who can help            Contact Information How they can help
Worried about hurting yourself National Suicide Prevention Lifeline 1-800-273-TALK (8255)

Live chat:  suicideprevention.lifeline.org  (2 p.m. – 2 a.m. EST)
A trained counselor can provide crisis support and information options to help you cope.
You are thinking about leaving home or have run away National Runaway Safeline 1-800-RUNAWAY For bulletin board, live chat and email options: 1800runaway.org Help work out the best next steps for you. If appropriate, they can locate local resources including:

‌• Family mediation to help improve your home life
‌• Youth shelters
‌• Street outreach
‌• Transitional living programs
‌• Mental health services
Dealing with a difficult situation ‌• Your Life Your Voice ‌

• California Youth Crisis Line
Your Life Your Voice
1-800-448-3000

Email support and live chat
Mon-Thurs, 7:30-12 a.m. CST: yourlifeyourvoice.org

California Youth Crisis Line
1-800-843—5200
‌• Your Life Your Voice youth helpline, run by Boys Town for everyone, offers national support, information and referrals for housing, financial counseling services.

‌• If you're in California, the California Youth Crisis Line can help you find homeless youth shelters, youth-serving medical clinics, on-going counseling services and much more throughout the state.
Looking for a meal Free food freefood.org Locate free and low-cost local services for meals and non-perishable food.

*Note:Services for young people in need vary from city to city with more programs in well-populated cities than rural communities. Click here for details

You can look up the availability of 2-1-1 in your local area by entering your zip code or city on the nationwide 2-1-1 site. If you're in California, you can also use this map of active service areas. If 2-1-1 is unavailable in your area, you can always call the National Runaway Safeline (1-800-RUNAWAY) for information and referrals or the Boys Town helpline (1-800-448-300 for support. Close
 

First steps: You can take the first step towards finding the help you need by picking up the phone or starting a chat with a trained counselor at one of the sites listed above. This is especially important if you are thinking of leaving home or have recently left home. Trained professionals work with you to determine if family conflict can be resolved, staying/ returning home is an option, or if you need support to help you become independent and live away from home.

We know you may be feeling scared, worried or angry. Counselors can help you process those feelings; provide completely confidential support and discover options you may not have considered including finding someone who can work with you to help you and your family. For more information, check out this fact sheet on what to expect when calling a help line. Whatever you’re going through, we strongly encourage you to call or chat today before taking your next step. It is never too late to reach out.

In the case that you feel unable to stay or return home…

We’re here to help break down the most common services youth need in times of crisis. These include shelters, food services and support services.Whether you’re looking for a bed for the night, a hot meal or emotional support, help is nearby.

If you are able to pick up the phone, the National Runaway Safeline (NRS) at 1-800-RUNAWAY can provide resources for all of your basic needs including food, shelter, clothing, etc, NRS is also available online via email, bulletin board, and chat.

Below is a rundown of typical resources, the services they offer and some helpful tips to get you what you need as quickly and conveniently as possible.

Shelter

Overview: Shelters provide a temporary place to stay when you feel you are unable to go home (also see our Homelessness fact sheet). Shelters are available in most large cities, and a growing number of smaller cities as well.

If you are enrolled in school (K-12) and do not have stable or healthy housing, you also have access to a liaison through the McKinney Vento program who can help you with things like transportation, clothing, and toiletries so you can attend school.

How to find them:

  • Non-emergency police number (i.e., 3-1-1)
  • City hall information center: You can find contact information for your city hall by entering the name of your city and the phrase “city hall” into a search engine (ex. “San Francisco City Hall”) and clicking on the official website. This should come up high in the search results and have a url that ends in an .org or .gov.
  • 1-800-RUNAWAY or National Runaway Safeline website

shelters

Food Services

Overview:There are a variety of emergency food services available to those in need. Some supply canned goods and jars of food that are easy to preserve while others provide hot meals at designated times during the day.

How to find them:

Support Services and Supply Providers

Overview: Support services provide a wide variety of resources from clothing, blankets and hygiene kits to counseling, job training and referrals for emergency shelters or transitional living programs. Some organizations provide crisis-intervention and counseling services.

How to find them:

  • 1-800-RUNAWAY
  • 2-1-1 (Provides information and referrals for local services in certain counties in California.)
  • National organizations Goodwill and the Salvation Army provide a range of crisis services that vary according to site with a general focus on clients 18 or older.

support services

Get the help you need today. Contact Your Life Your Voice, Lifeline,1-800-RUNAWAY or 2-1-1 today.

 

More information

If you live in the United States and are seeking immediate help for a specific issue, go here for a list of National Hotlines http://us.reachout.com/get-help/getting-help-in-a-crisis

 

Fact Sheet

Wanting to start a family at a young age


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Note: If you’re pregnant or think you may be pregnant, check out our fact sheets on finding out for sure and preparing to take care of a child. Guys preparing for parenthood can also check out our fact sheet on becoming a father. The information below is aimed specifically towards those only considering starting a family.

In your teen years or early twenties, the urge to have a baby may come and go.  It’s natural; some might even say we’re biologically programmed to feel that way. It doesn’t necessarily mean you or your partner are equipped – emotionally or financially – to make a huge lifelong commitment to a child. Why not? In this fact sheet we attempt to answer that question and help you better assess your parental impulses.

Some reasons that starting a family may seem appealing:

  • Your family member or friend just had a baby, and they seem so happy.
  • You babysat recently, and taking care of a little baby seemed like the most glorious job.
  • You know you would give a baby a lot of love, and in turn, they would love you more than anything.
  • You are upset with your own parents and the way they treat you, so you want to fix that by having a child of your own and doing everything right.
  • You think it will make your partner want to be with you even more.
  • Babies are just so cute.

What you may not know about taking care of a baby:

We agree that babies are cute, but it isn’t always lullabies and onesies. Looking after a baby is difficult—in more ways than one.  Here are just some basic baby care realities to consider:

  • Babies don’t have sleeping patterns like normal adults. They sleep 16. 5 hours on average every day, but not all at once. They could wake up anywhere from every two hours to five hours.  If the baby is awake, you’ll be awake.
  • Newborns need to be fed every two to three hours. Just like those cute little toes and fingers, babies also have little stomachs.  This means you’re on call for feeding duty 24-hours a day.
  • Babies cry. A lot. They cry when they’re hungry, when they’re too hot or cold, when they want their diapers changed, when they need to burp, when their sleepy, and sometimes, for no reason at all. This can be extremely frustrating for a parent trying to calm their baby down, especially if you’re already feeling frazzled from a lack of sleep.
  • Babies require a lot of attention. That may come across from the points above, but it’s worth considering what dedicating yourself to parenthood will mean for you as a teenager. The short answer is sacrifice. Less time with your friends, less time for yourself and just generally less flexibility. This can affect everything from your weekend plans to your plans for the future.
  • Taking care of a baby is expensive! From hospital bills to diapers to clothes, cribs, food, car seats, strollers, and even more diapers, parenting requires a lot of money.  And those are just some of the expenses you have to think about. In the first month alone, you would have to dish out close to $2000, and in the months following, somewhere close to $500, with diapers alone costing you $100 monthly. Beyond that, you’ll also need to think of your child’s future. You want your child to have the best life possible, and for that you need money to be able to provide for their needs, at least for the next 18 years and possibly even longer.
  • Babies don’t stay babies. It’s important to think about how your baby will need more and different things from you as he or she grows up.  In about a year, your baby will be walking around, in about two years your child will be talking, and will be in day care or school within the first three to five years.  You should think about how you will meet the increasing needs of your child and how you will be responsible to keep them safe and well cared for.

How a baby can change your lifestyle:

Beyond the baby’s basic needs covered above, it’s important to also consider the impact that giving birth and raising a child can have on you:

  • Responsibility overload. If you forget to feed the dog one morning or sometimes don’t feel like cooking, it’s not a huge deal. When there’s a baby in your life, you always have to provide for them.
  • Physical changes. Teenagers have bodies that are still developing. So, in addition to significantly changing your appearance, being pregnant means you’ll also have to take extra precautions to make sure your baby will be healthy.
  • Financial considerations. If you are a single parent or your partner and/or parents aren’t able to financially support you and your baby, consider the fact that you’ll need to work to provide for your child. This can have an impact on your personal time, your educational plans and the amount of time and energy you have to spend with your child.
  • Selflessness. From your long-term plans to small sacrifices like giving up that phone upgrade for diapers, you may want to consider what it would mean for your baby to be your top priority. How will it affect your day to day? Your plans for college? A career?
  • Stress. The combination of little sleep and constant demands can put a lot of pressure on you and strain on your relationships. If you and your partner remain together, this may translate to tension or even resentment if one of you feels the other isn’t pulling their weight. If your parents are helping you, stress may lead to an increase in fights over who does what for the baby when.

What makes someone ready to become a parent?

You may be wondering why the reasons above don’t deter other people from starting a family. The truth is it’s all about timing, preparation, and feeling as ready emotionally, physically, and financially as you possibly can. If you feel you are in that position and ready to take the next step, the most important thing is to be informed and supported. We encourage you to check out this fact sheet with tips and resources for preparing for parenthood.

How do you know if you’re ready to become a parent?

If you feel uncertain about whether it’s the right time, know that there is no rush. According to Pew Research, the average age of first-time mothers is 25 years old. Moreover, your teen and young adult years are a perfect time to explore all of your options for the future. And if you choose to spend them building strong, loving relationships, figuring out your career path and learning how to take care of yourself, you will be all the more prepared when the time does come to start a family.

For more information
Sex, Etc. is an award-winning national magazine and website on sexual health that is written by teens, for teens.

 

Fact Sheet

Crushing on your best friend


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Photo by: Roxanne Milward

Imagine this scenario: One second you’re laughing over a joke with your cute study buddy and the next a flurry of thoughts overtakes you: “I like you! I totally like you. Do you like me? Could you like me? Maybe? Possibly?” This is the feeling of a new crush taking hold. But wait. This time it’s different because the study buddy is your best friend. He or she already knows about all your crushes, all your bad habits, and all your baggage. Dating would mean that solid part of your life would be shaken into uncertainty. Is it worth risking?

Assessing your feelings

Are you really ready to take that next step?

It’s totally normal and common to develop feelings for a close friend, but sometimes it’s less about romance and more about circumstance. If you feel a crush coming on, you may want to consider whether the following scenarios apply before making your big move:
          • You have just broken up with your ex and your friend is always there comforting you.
          • A mutual friend said you and your friend would be the “couple of the year” if you guys got together.
          • You and your friend had a project that you were working on together and over that time period, you got really close.

Ok yes, one of the above reasons was why I started crushing on my friend. Now what?
        • Take a few weeks to truly think about what attracts you to this person. 
        • Consider what would change in your friendship if it were to become a romantic relationship. If you’ve seen your friend in a relationship before, consider your reaction at the time. 
        • Confiding in one trusted friend can be helpful for gaining perspective, but you may want to think twice before sharing your inkling of a crush with a large group of other friends. With more people in the loop, there’s a      
          greater chance that someone might “accidentally” let your secret out before you’re ready.

So you’ve decided that yes, I really like him or her.

Should you tell your friend and risk your friendship? This could definitely complicate a friendship, especially if your feelings are not returned, but you could also end up having an amazing relationship. This is why it is crucial to think about the pros vs. the cons when starting something with your friend.

Deciding your next move

Should I go for it?

Before you take the big plunge, you might want to take small steps. Flirt first and see how your friend reacts. Try to keep it subtle. A casual touch during a conversation or direct eye contact can send the hint that you want more than just friendship.
          • If your friend responds in kind, then that’s a good sign he may share your more than platonic feelings!
          • If it’s been a few weeks and your friend isn’t noticing your actions, you may want to amp up your flirt! Sometimes good friends can be clueless to those signals, and you’ll have to be direct.
          • If you feel ignored or avoided, you may want to reconsider your efforts. You don’t want to lose your best friend to awkwardness.

Times you should hold off on making a move.
          • If your best friend is in a relationship. It might be difficult to accept the presence of their girlfriend/boyfriend, but as a good friend, it’s important to respect your friend’s relationship, just as you want your relationship with him to be respected by the other person in his or her life.
          • If you are in a relationship currently. If you feel strongly that you and your friend would be happier together, then end your relationship first. It isn’t fair to your boyfriend or girlfriend if you’re with them but thinking about someone else. Just think how you would feel if the positions were reversed.
          • If your friend has a major stressor or is dealing with a difficult issue.  Expressing your feelings does require a lot of courage, but it’s important to consider what else is going on in your friend’s life, like major   school problems or family troubles. If your friend is overwhelmed, focus on helping get him or her through the tough time. Later, when things have cooled down, you can share your feelings.

For more tips check out the fact sheet on http://us.reachout.com/facts/factsheet/do-i-want-a-relationship">deciding whether you want a relationship .

So, I’m ready to share my feelings. How should I do it?
        • Arrange a time and place to meet privately.  Try not to blurt it out in class or a place where you can’t discuss in detail.
        • Tell him your feelings in short sentences and with direct eye contact. “I’m beginning to like you as more than a friend,” is a great starter.  Check this out for general tips on communicating more effectively
        • Your crush could feel more intense than any previous crushes you’ve had due to your closeness, but think twice before using the word “love.” You want to be sure of how you feel before using the ‘L’ word, and you don’t want to scare your friend away if they don’t feel the same.

The Outcome

Congratulations on taking the brave step of sharing your feelings. Now that you’ve expressed yourself, one of two things can happen:

      Your friend feels the same! Congratulations, you now have a best friend and boyfriend/ girlfriend all rolled up in one sweet package.
                • Good thing you were brave enough to tell them. Check out the fact sheet on maintaining a happy relationship
     
      Your best friend doesn’t feel the same way. We know it hurts, but at least a weight is off your chest: you told him/her and you were brave. A good friend will be kind and sensitive of your feelings.
Here are some things you can do to help heal:
                •  You may need to take some time to get over your feelings. This may mean distancing yourself from your friend during this period. If you still want to be friends after the fact, ask for some time and space. A true BFF will understand.
                •  Check out other potential crushes! There’s someone out there who will love you back just as much as you love them or even more!
                •  Enjoy being by yourself for the time being! http://us.reachout.com/facts/factsheet/im-single-and-im-happy

Crushes can be confusing and complicated. Try to give yourself time to think and process your feelings. If a relationship is meant to happen, things will work out!

 

Fact Sheet

Service member’s guide to returning home


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Welcome home! Thank you for your sacrifice and service. 

The purpose of this guide is to assist you in transitioning back to life at home with your family.  By highlighting some of the potential challenges of returning home, we hope that you and your family/ friends will be able to make a smooth readjustment.

Normal Reactions to Stress

Most servicemen and women who return home from a combat situation will experience some of the following common stress-related reactions during their readjustment period.  According to the Veterans Administration, more than 50 percent of service members will be able to readjust with few major problems.  It is important to remember that the following reactions to stress are normal and predictable, and do not necessarily indicate a deeper problem such as Post Traumatic Stress Disorder (PTSD). 

Physical & Behavioral Reactions
• Trouble sleeping or a lack of energy
• Loss of appetite or stomach pain
• Head pain
• Trouble breathing or panic attacks
• Trouble focusing
• Avoiding certain people or places, desire for seclusion
• Hyper-vigilance, an excessive focus on security
• Alcohol or drug abuse
• Unconcern for personal health
• Recklessness, especially when driving
• Unable to be intimate with a partner
Emotional Reactions
• Feelings of panic, anxiety, or nervousness
• Nightmares or insomnia
• Flashbacks or unwanted memories
• Anger, quick tempered with overreactions to minor problems
• Feelings of guilt or self-blame
• Feelings of sadness or rejection
• Feelings of mistrust
• Feelings of hopelessness or numbness

PTSD: Post Traumatic Stress Disorder

Many of the common reactions and emotions listed above can indicate a more serious problem, such as PTSD.  PTSD is an anxiety disorder that can develop after experiencing a traumatic event. For more information please see our Post-Traumatic Stress Disorder
fact sheet.  With PTSD the reactions described above are more intense and persist for many months, even years.  According to the Veterans Administration, 11 - 20% of veterans from Iraq and Afghanistan have developed PTSD.  If you find that your moods and behaviors mirror those above and have not lessened after a few months it is most likely time to seek treatment from a professional.  The most important thing to remember about PTSD is that it is treatable.

Steps YOU Can Take to Cope with Stress – How to Help Yourself

The following are tips that you can try on your own to help with some of the physical and emotional reactions to trauma:

• Developing a routine, including a regular sleep schedule and exercise
• Pursuing your interests or hobbies
• Attempting to relax through meditation, yoga or breathing exercises
• Balancing your time to include time with family and friends
• Communicating with those you love and trust. letting people know what you are thinking and feeling
• Responsibly indulging in alcohol, and not as a means of escape
• Establishing reasonable workloads for home, school, or work
• Identifying triggers for your anger (or other emotions) in order to mentally prepare yourself before your emotions get out of control
• Thinking of the negative consequence that may follow an outburst
• Think about talking to your doctor or a counselor about your trauma and related feelings, thoughts and behaviors

Where to Get Help

The conditions and feelings discussed in this guide are treatable by qualified mental health professionals. These include psychologists, psychiatrists and counselors. For more information on who can help, check out the services below, our fact sheets on these providers, or the ReachOut Get Help
section.
Please remember that seeking assistance is a sign of bravery and strength.

For more information, check out the following sites:

VA Medical Centers – Health and Mental Health Services; Readjustment, Alcohol & Drug Counseling: www.va.gov
Vet Centers – Readjustment, PTSD, Marriage & Family, Alcohol & Drug Counseling; Job Services: www.vetcenter.va.gov
Veterans Crisis Line – 24 Hour, toll-free, confidential suicide prevention hotline: 1-800-273-TALK (8255) OR 24 Hour online chat center:www.veteranscrisisline.net
Iraq & Afghanistan Veterans of America – community and support network: www.iava.org
Wounded Warrior Project – Resources and support designed specifically for injured service members: http://www.woundedwarriorproject.org

Fact Sheet

Drinking and driving


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So you go to a party, have a few drinks, and when the party dies down, you and your friends decide to move the party to another location. You get behind the wheel and, soon enough, there are red and blue lights flashing in your mirrors. Thought you were driving just fine? Think again.

Drunk driving, or drinking and driving, is a term used when one is driving under the influence of alcohol. No matter how much alcohol you have consumed—even if it’s under the legal limit provided by your state— your ability to drive may be impaired.

Alcohol may make you feel confident and more sociable at first, but the alcohol is essentially tricking your body into feeling that way. It stimulates areas of the brain that are related to relaxation and also dulls the area responsible for planning. Therefore, you may feel less stressed. However, alcohol is a depressant, meaning that it slows the central nervous system—which includes your brain—resulting in delayed reaction times, lack of coordination, and out of character behavior. In other words, all of these side effects have a direct negative impact on your driving.

So why do people still drink and drive?
● They believe they’re less drunk than they actually are.
● They feel confident that they can drive extra carefully and avoid incident.
● Their ability to rationalize is suppressed, leading them to make rash decisions.
● They want to escape personal problems.
● They are ashamed or afraid to call someone to pick them up.

How does alcohol affect different people?
Alcohol has different effects on different people for various reasons including gender, weight, how quickly the alcohol is consumed, etc. Alcohol can affect your own body differently on separate occasions as well. Even if you have had the same amount of alcohol, your blood alcohol concentration (BAC) may vary at different instances. (A BAC of 0.05 indicates that there is 0.05g of alcohol in every 100ml of blood in the body.)

BAC depending factors:
● Body size: a smaller person will have a higher BAC than a larger person
● Body fat: a person with more body fat will have a higher BAC than a person with less body fat
● Gender: a female will almost always have a higher BAC than a male even if she drinks the same concentration of alcohol as a male. This means that it takes fewer drinks for females to be at the legal limit, so be aware of how much alcohol you are consuming, ladies!

What happens when you’re caught?
After you see the red and blue flashing lights in your mirrors and you (hopefully) are able to properly park the car on the side of the street, an officer will come approach your car. The following may ensue:

● You may be asked to undergo a sobriety test. This includes being asked to walk in a straight line, stand on one leg, or follow a light with your eyes.
● If you fail the sobriety test, you will be given a breathalyzer test. In the United States the legal limit is 0.08% BAC.
● If the driver is under the age of 21, the Zero Tolerance law is also applicable. This law states that the legal BAC for those under 21—the legal drinking age—is 0.01% or 0.02%. It only requires 1 teaspoon of cough syrup to reach a BAC of 0.01%!
● The driver may then have their driver license revoked, be charged a fine, or be assigned community service, depending upon the state.

Besides for dealing with the considerable expense and inconvenience of having your license revoked for months or even years, there is also a wide range of personal, professional and safety reasons you should consider before taking the wheel under the influence.

Other Potential Consequences of Drinking and Driving:
● Severely or fatally injuring yourself. a passenger or another person on the road: This is especially taxing mentally and no one wants to live the rest of their life feeling guilty about one mistake they made.
● Financial burdens: If you crash the car and/or had to visit the hospital, you’ll likely face a huge setback in your savings. This could also negatively affect your parents’ insurance
● Future employment: Receiving a DUI shows up during your background check, and employers don’t want an irresponsible person working for them.
● Disappointment: We all know that having your parents be disappointed in you is much worse than dealing with their anger. It lasts longer and, once trust is lost, it will take time and effort to win it back.

In the moment, it can be hard to recall and fully weigh these long-term consequences, so it’s best not to put yourself in a compromised position in the first place.  This does not mean that you should never drink—though you can enjoy yourself equally well while sober. We simply recommend that you drink smartly (http://us.reachout.com/facts/factsheet/drinking-smart) and don’t drive while under the influence.

What to do to avoid driving drunk?

● Before starting the party, pick a person in your group to be the designated driver. You can switch off every time you go out or come up with a fun game to pick the DD.
● Call a cab.
● Plan to take the bus or subway after the party.
● Call your parents. They will be happier that you called them instead of driving home drunk.
● Consider crashing at a friend’s place that is nearby.
● If your friend is drunk and thinking about driving home, take your friend’s keys and call a cab for them or find an alternative, safe method to get them home. For more tips, check out Helping a Drunk Friend: http://us.reachout.com/facts/factsheet/helping-a-drunk-friend. 

Although current awareness regarding drunk driving has reduced the number of DUI related deaths and injuries, the laws surrounding drugged driving remain yet to be standardized. That doesn’t mean that driving while under the influence of drugs is less dangerous. A National Highway Traffic Safety Administration (NHTSA) study conducted in 2009 found that 18% of fatally injured drivers tested positive for at least one drug. Drugs affect your body in a similar way that alcohol does, including alteration of perception, lack of coordination and balance, and slow reaction times. Be aware of the facts and be responsible. For more information on drugs: http://us.reachout.com/facts/factsheet/impact-of-drug-use-on-your-life

More Information:
Drug overview
CDC on Drinking and Driving
Above the Influence: Drinking

Fact Sheet

Bystanders role in cyberbullying


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What is cyberbullying?

Cyberbullying is a form of bullying that is carried out through an Internet service such as e-mail, chat rooms, discussion group, online social networking, instant messaging or web pages. It can also include bullying through mobile phone technologies such as text messaging. According to some estimates, more than one-third of American teens have experienced cyberbullying.

Examples of cyberbullying behavior are:

  • Teasing and being made fun of;
  • Spreading of rumors online;
  • Sending unwanted messages; and
  • Defamation or putting down or damaging someone’s reputation

Cyberbullying can happen to anyone, and the bully can act anonymously. People can also be bullied online by groups of people such as classmates or collective members of an online community.

What is a bystander?

A bystander is someone who sees what is happening between the bully and the victim but is not directly involved in the bullying.

What makes a bystander different from a victim or a bully?

Bystanders are very different from either victims or bullies mainly because they make a decision to stay on the outside of the situation. Whereas victims and bullies are directly involved, bystanders think that avoiding the conflict altogether is either the right move or the best thing for them personally.

How exactly is someone a bystander?

It is difficult to describe what makes a person a bystander. There are several things a person does, or does not do, that can make them a bystander.

  • Purposefully ignoring the event entirely;
  • Witnessing the event and choosing not to take the appropriate actions;
  • Witnessing the event thinking something on the lines of, “at least that person wasn’t me.”

What is so wrong with being a bystander?

Research on bullying has often concluded that it occurs most frequently in the presence of bystanders who choose to merely watch the events unfold instead of doing something.  Just by being a part of a social media or other online space, you may give a cyberbully an incentive to embarrass or threaten a victim because the bully will have an audience.

Unfortunately, many people believe that being a bystander is the best option to take. There are many reasons for this.

  • Some may believe that the bullying scenario is “none of their business,” and therefore they choose not to take sides because it seems too nosy;
  • Others feel that stepping in will make them the new target for the bully, making it seem as though intervening would only make things worse;
  • There is also a fear that intervening in a bullying situation by telling a teacher or a counselor will give them the unwanted stigma of being a “tattletale;”
  • Bystanders may feel that intervening will also do little. This is especially true in students who have approached teachers before regarding bullying, only to find that no action was taken.

 

How might a bystander help a cyberbullying victim?

 

Bystanders need to realize that bullying is a serious problem, and that a lack of action on their part will only give bullies more opportunities to torment their victims. Some argue that close to 50% of all bullying events stop when a bystander decides to intervene which just further shows the importance of intervening.

Things a bystander can do:

  • Take action by posting words of support for the victim. “I disagree with what’s been said.”
  • Encourage the victim to seek help. “You are being bullied. Don’t keep what’s happening bottled up inside. Seek help from someone you trust.”
  • Rally your friends to post comments that show support for the victim.
  • Alert someone in authority (your teacher, parent, other adult) about what you are observing online or what is being transmitted through cell phones.
  • Report what you are observing to the security team for the site you are visiting.  Facebook provides a number of suggestions depending upon where on the site the abusive content is located. For specific information, follow this link.
  •  

Here are a couple of things a bystander should keep in mind when witnessing incidents of cyberbullying:

  • Do not assume that this is a private matter between the bully and the victim. Incidents of bullying, especially those that are frequent, are often not because of personal reasons.
  • Do not combat violence with violence. It takes a lot of courage for someone to step up on behalf of a bullied person. However, don’t use insults or threats to defend the victim. Now is not the time to show off. You will most likely only make it harder for the victim.
  • Do not get discouraged if you have already talked to teachers or other persons in authority and nothing happened. Keep trying. Teachers and other school authorities will respond if they find out that the bullying is becoming a recurrent problem. Try talking to other teachers and counselors so that you can get more people involved in trying to stop the situation.
  • If you feel that this is none of your business, put yourself in the victim’s shoes. Bullying can cause severe anxiety, depression, anger, and frustration in a person, and can turn their life into a nightmare. You wouldn’t want to feel that way.

 

Is stepping in yourself the only way? What if the bully tries to attack you?

 

You should never step in to protect a bullied victim if it might put your own safety at risk. If this is the case, you should talk to a teacher, counselor, or even the school principal if the problem keeps happening. Be sure to ask if you can speak to them in private, in case you are afraid of being the next target for bullies. Even if you are not directly stopping the bullying, by taking action and going to seek outside help, you are taking steps away from being a bystander.

To share your cyberbullying experience, either as a victim or bystander, register for the forums and post here.

Fact Sheet

Anorexia Nervosa


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What is anorexia?

Anorexia Nervosa is an eating disorder that causes people to obsess about their weight and the food they eat.  The disorder is primarily characterized by excessive weight loss and self-starvation, or a refusal to eat the amount of food required to maintain a healthy body weight. Anorexia is often found in people who have also been diagnosed with Body Dysmorphic Disorder, causing them to desire a body much different than their own.

Anorexia Nervosa is often found in a younger population, specifically recognized in girls aged 15 to 18. It can also occur in older populations, and can often be seen as an issue in the lives of celebrities. “Manorexia” is a term that has been penned to describe men with anorexia.

What causes anorexia?

While an exact cause can be difficult to determine, anorexia nervosa is generally caused by a combination of genetic and environmental factors.  Anorexia Nervosa is also a psychological disorder, where people, who develop this disorder, tend to have certain personality types, such as perfectionism, neuroticism and low self-esteem. Recently. studies have reported a connection between body image issues and popular culture that have been pervasive direct link between the two

Other Common Causes

  • Broken relationships
  • Stress
  • Exposure to new situations
  • Loss
  • Genes
  • Extreme dieting
  • Abuse
  • Peer pressure
  • Crisis
  • Family history of addictive personalities

What are the warning signs?

People with Anorexia Nervosa may show off their weight loss with revealing or tight-fitting clothing.  However, another common practice is wearing baggy clothing to cover up the amount of weight they have lost.  Other warning signs include:

  • Eating very little, if at all
  • Extreme weight loss
  • Withdrawal from social situations, especially those involving food
  • Frequent comments about or preoccupation with food, calories and fat
  • Thinning hair
  • Forgetfulness or lack of concentration
  • Depression
  • Excessive exercise or strict adherence to an exercise program
  • Only eating alone
  • Excluding certain types of food from one’s diet, such as carbohydrates or foods high in saturated fat
  • Irregular/nonexistent menstrual cycles in women

How is Anorexia Nervosa different from other eating disorders?

Anorexia Nervosa is similar to other eating disorders, like Bulimia Nervosa and binge eating, in that it is generally connected with a distorted body image and altered eating habits.  Even if all the evidence points to the contrary, a person with Anorexia Nervosa, Bulimia Nervosa, or a binge eating disorder will convince themselves that they are overweight. No matter how much weight they lose, they will always think they have to lose more.

However, anorexia is different from the other two because of the severe restriction of the amount of food consumed.  People suffering from anorexia may go through periods of binge eating or purging, but these episodes may occur less often than with people suffering from a different disorder.  Also, a person suffering from anorexia will typically have a body weight well below a healthy range, less than 15 percent below normal weight.

How to get help

If you think you or a friend might have any one of these symptoms, there are options available to aid in reversing the disorder.  Besides therapy—both group and personal—there are body image resources out there.

Your own personal body image may not be the only issue causing the disorder. Anorexia Nervosa is a psychological disorder, which means treatment from a mental health professional may be necessary to address the root causes of the disorder, not just the effects. The sooner a person receives treatment, the easier it will be to recover. Also, the way that other people see a person takes a toll on how they see themselves.  It is important to surround yourself with people who support you getting better.

For more information check out the National Eating Disorders Association and the National Institute of Mental Health. Last edited by Kristie - March, 2014.

Fact Sheet

Putting pressure on yourself


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There are no shoulds

We all have rules that underlie many of the things that we do. We call these shoulds because we often think in terms of ‘I should do this’ or I should do that.’

In our society, certain behaviors and qualities are promoted as desirable, while others are given very little importance. For instance, things like being good at our work or being attractive, outgoing, sociable, self-disciplined, etc. are often reinforced by our parents, schools, friends and the media.

Some of our shoulds can be helpful. For example, believing you should be friendly and supportive to others will help you get along with people and have better relationships. Similarly, the belief that you should work hard at school may help you do well on your exams, and the belief that you should look for solutions when problems arise may help you to solve problems.

In an effort to be liked and accepted by other people, we often take on many of these rules, which become part of our own belief system. These shoulds can get us into trouble, especially when we can’t live up to them. Often we aren’t even aware of our shoulds until we start to think about them.

Shoulds can make you feel bad

While some of our shoulds are helpful, when you hold onto these beliefs in an absolute, inflexible way, it raises your chances of feeling bad about yourself and can damage your self-esteem. This is particularly the case when we can’t meet our own expectations. For example, if we believe that we should always do well in our assignments but in reality we fail to do so, or if we believe that we should always be confident and relaxed, but in reality we feel shy and self-conscious, we end up feeling very stressed and unhappy.

Whenever we tell ourselves that things must be a certain way or that we must achieve certain things, we put ourselves under a huge amount of pressure and increase the likelihood of upsetting ourselves.  Of course, learning to be flexible doesn’t mean that you have to ignore your values or preferences. It is important to know what you want and to work towards your goals.

You also need to accept that things won’t always work out the way that you would like. For example, self-talk, such as: ’I would like to do well in my assignments, and I will try my hardest’ is healthy and appropriate because it is flexible - it doesn’t demand that it must be perfect. This type of self-talk doesn’t create stress or anxiety because the thoughts are preferences rather than shoulds or rigid rules.

Some common shoulds

Take a look at some of the common shoulds or rules that many people live by. Are any of these relevant to you?

  • I should be liked and approved of by everyone
  • I should always be successful in the things that I do
  • I should always do things perfectly
  • I should be thin/muscular/sexy, etc.
  • I should always look good
  • I should have a boyfriend/girlfriend
  • I should be the same as everyone else (I shouldn’t be different)
  • I should feel confident in every situation
  • I should be clear about my future and know where I am heading
  • I should always say the right things at the right time
  • I should always be able to meet other people’s expectations
  • I should always do what people want
  • I should always feel calm and in control
  • I should always be happy
  • I should never make mistakes
  • I should put other people’s need before my own
  • I should never say anything that might make other people feel uncomfortable
  • I should always make the right decisions

The trouble with shoulds is that they are inflexible. While there is no problem with wanting or preferring things to be a certain way, when we believe that things must be a certain way we make ourselves feel bad.

Converting shoulds into preferences

Identifying and challenging your shoulds is one of the most helpful ways of avoiding upsetting emotions like anxiety, anger, depression, or resentment.

Example: Michelle: “I don’t have as many friends as some of the other girls in class”

Michelle’s shoulds: I should be popular. I should be more outgoing and make friends with everyone.  Everyone should like me and want to hang out with me. If I’m not as popular as everyone else, then I am no good. Because I don’t have as high a number of friends, it means that I am no good.

Converting Michelle’s shoulds into preferences. I prefer to be popular, but this isn’t always possible. People are different and have different personalities.  Sometimes it’s better to have a few friends I truly care about then a lot of friends who I hardly know. I am OK as a person, whether I have 10 friends or 100.  My friends do not define who I am as a person.

Blaming others

People let us down at times, and sometimes you might do things that you later regret. It is reasonable to be disappointed or annoyed when this happens. However if you have very strong shoulds about how people should behave you may end blaming people for their actions: ‘They should do the right thing! Or perhaps ‘I should do the right thing!’

The problem with blaming is that it makes you feel angry and frustrated, but it doesn’t solve the problem. In the end it is a waste of your energy. Even if other people are at fault, telling yourself that they should not be this way doesn’t change the situation - it just makes you feel bad.

Try it out

You can avoid getting upset in all sorts of situations by learning to think flexibly. This means learning to prefer things to be a certain way, but accepting that situations will not always be the way we would like them to be. Try it out - try and identify any shoulds that cause you to feel bad, and change that should into a preference. What would be the advantages of doing this? What would you need to say to yourself to do this? How might changing this should into a preference affect the way you feel?

More info: Challenging negative self talk

Acknowledgement: This fact sheet came from: Taking Charge! A Guide for Teenagers: Practical Ways to Overcome Stress, Hassles and Upsetting Emotions. By: Dr Sarah Edelman and Louise Rémond Foundation for Life Sciences (2005) www.fls.org.au

Fact Sheet

Risk taking


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What is risk-taking?

Taking a risk is when you experiment with a new behavior.

It can be healthy and a positive way to:

  • learn new skills and experience new things (in work, school, or relationships)
  • experiment with new identities
  • increase your self-esteem
  • take on more independence and responsibility for your life

When taking a risk might be a problem

Taking a risk might become a problem if it has a negative effect on your day-to-day life.

Examples of when taking a risk is unhealthy: 

  • unprotected sex
  • drunk driving
  • train surfing
  • drug or alcohol abuse, including binge-drinking
  • deliberate self-harm
  • dropping out of school or getting suspended regularly
  • breaking the law, e.g. shoplifting
  • severe or excessive dieting

How can you tell when risk taking is a problem? The following questions may help you decide: 

  • Does it interfere with, or have a negative effect on, other parts of your life, such as relationships, school and work?
  • Does it put yourself or others in danger?
  • Do you have previous experience or enough information about it or the consequences of the behavior?

Less risky ways to get that adrenaline rush

It’s possible to get an adrenaline rush without risking injury or the safety of yourself or others.

Depending on what gets you going, you might try:

  • surfing or skate boarding
  • bungee jumping
  • skydiving
  • canyoning
  • rock-climbing
  • rollerblading
  • going on rides at an amusement park

Why take unhealthy risks?

The reasons you might take unhealthy risks include:

  • Peer pressure - It is not uncommon to want to have respect from your friends or those whose opinion may be important to you. Engaging in a risky, dangerous activity or behavior may be a way for you to feel accepted and part of the group. For more information about peer pressure and how to manage it, check out the peer pressure fact sheet.
  • Falsely believing that it’s a way of proving to yourself or others that you’re an adult and that you are responsible for your own actions.
  • Dealing with problems or escaping from unhappy situations or feelings. It may not always be obvious that you are using the behavior as a way of managing your problem or unhappy situation. For ideas on how you might be able to manage your situation in a healthier and safer way, check out the fact sheet on finding healthy ways to cope.
  • As a form of rebellion against something or someone.
  • To get attention or a response from someone.

Deciding to change your behavior

You may be thinking about taking a risk or are already taking risks. Changing your behavior can be tough, particularly if you have been doing it for a while, feel pressure to do it, or if it means changing your lifestyle or separating from people you’ve always hung around with.

The following steps may help you decide whether you want to continue or change your behavior:

Identify: Sometimes you may not be aware that a behavior is unhelpful or unhealthy. Identify the risks and benefits of your behavior and how it effects others and yourself (e.g. health, work, family etc).   

Analyze: Think about the pros and cons of changing your behavior. This might include thinking about how you can reduce the risks associated with the behavior. 

Decide: If you do decide a change in behavior is needed, start by making a plan to change. This might include action plans and setting small, gradual goals.

Act: As you start carrying out your action plan, make sure you reward yourself for reaching each goal by to providing yourself with some positive reinforcement. Identifying barriers to change, coping skills, and social supports is also important.

Maintain: Develop strategies for sustaining the changes. This may be through your social supports and by reminding yourself why you changed your behavior.

Relapse: You might find yourself reverting back to the unhelpful behavior. It’s important not to blame yourself or feel guilty. Changing behavior can be hard and relapse is not uncommon. If you do relapse, go back to the Decide and Act steps.  

Fact Sheet

Diaphragms


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What are diaphragms?

Diaphragms are a form of contraception. These are soft rubber caps worn inside the vagina to cover the cervix, the entrance to the uterus. They prevent the sperm from entering the uterus.

How well do they work?

For a diaphragm to work it needs to:
• fit properly
• be put in correctly
• be used with spermicide
• be used every time you have sex
• be free from holes and tears

Research shows that the diaphragm is not as effective as the Pill.

Where do you get it?

You need to be fitted with the correct size diaphragm and shown how to use it.  You can be fitted at:
• your private health care provider
• a local clinic
Planned Parenthood health center
• a sexual and/or women’s health center

Advantages Vs. Disadvantages

It may be helpful for you to consider both the advantages and disadvantages before deciding whether to use a diaphragm.

Some advantages include:
• You put it in before you have sex. It can be inserted up to 24 hours before and it should be left in for 6 hours after sexual intercourse.
• It is used only when you have sex and does not affect the body the rest of the time.
• It can be used when a woman has her period.
• It can be washed and reused, lasting 1 to 2 years.

Some of the disadvantages include:

• Diaphragms can be harder to use than other forms of contraception. Knowing your body and being comfortable with it may make it easier to use a diaphragm.
• You might be allergic to rubber.
• A weight change of 8lbs or more may mean you need to change your diaphragm to a different size.
• Diaphragms may not protect you against all STDs.

 

Fact Sheet

HIV (Human Immunodeficiency Virus)


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What is HIV?

HIV (Human Immunodeficiency Virus) is the virus that causes AIDS (Acquired Immunodeficiency Virus). The body has an immune system that fights infections. HIV attacks the immune system so that it can’t protect the body from different kinds of infection - even colds and flu - and it’s harder for someone to recover once they get sick.

Is HIV the same as AIDS?

Inside the body are billions of cells with different jobs. Some of these cells, called T-cells, help the body stay healthy by fighting off disease. The HIV virus kills the T- cells, so that over time, the body can’t fight disease any more. When that happens, that person has AIDS.

Most HIV infections do progress into AIDS, but if someone has HIV, they may not develop AIDS for many years - often more than 10 or 15 years. In some (rare) cases they may not get AIDS at all. Coping with AIDS is like living with any other chronic disease (one that can’t be cured). Sometimes people can feel very sick, and at other times they may feel fine and have a normal lifestyle.

Is there a cure for HIV?

No, not yet. If someone is diagnosed with HIV they can control its effects with medication and by looking after their health, but there is no cure. Today, people can live long lives with HIV.

How do I catch it?

To catch HIV, the virus has to enter the bloodstream. This can only happen by sharing one of four kinds of fluid with a person that has the HIV virus:
1. Blood
2. Semen (cum)
3. Vaginal fluid
4. Breast milk

These fluids can be transmitted through unprotected sex (sex without a condom), by sharing contaminated needles, or by receiving a transfusion of infected blood. HIV can also be passed on to a baby during pregnancy, birth or breastfeeding, but mother to child transmission can be prevented through early treatment.

You cannot get HIV by hugging, kissing, or by shaking hands, or by sharing food or toilet seats with an infected person.

How can I tell if I have it?

You might develop what feels like the flu one to two weeks after getting infected, but many people who have HIV don’t know because it can take years before symptoms start to show. You can pass on HIV even if you don’t know you have it.

Other HIV and AIDS symptoms can include:

• sores around the mouth
• aching muscles or joints
• headaches
• diarrhea
• swollen glands
• tiredness
• rapid weight loss
• rashes
• fevers and chills

It’s not useful to try to figure out if you or somebody else has HIV based on the symptoms. You can worry yourself unnecessarily about what might simply be the flu. The only way to know for sure is to have a blood test if you have done any risky activities.

How can I avoid getting it or spreading it?

You can protect yourself from HIV infection by using condoms when you have vaginal, anal or oral sex, and by not sharing needles or injecting equipment. Check out the condoms factsheet for details on how to use condoms correctly.

What happens in a HIV test?

It’s a good idea to get tested if you have had oral, vaginal or anal sex without a condom, or if you have shared needles with anybody. It’s also important to wait for 14 weeks after the last time you have engaged in high-risk behavior, to make sure that the result is accurate. This waiting period is necessary because the body’s immune system needs time to respond and develop antibodies. HIV tests screen for the presence of antibodies.

There are different kinds of tests for HIV. It is increasingly common for clinics to use Ora-sure tests, which don’t require blood draws, but rather swabbing the inside of the mouth and collecting skin cells. For an Ora-sure test, the results are available in 20-30 minutes.

If you are given a test that requires blood to be drawn, a nurse or doctor will take a blood sample from your arm and send it to a lab to be analyzed. You will be informed when to come back for the results.

You can also now purchase home kits to test yourself at home without going into a clinic. 

Having another sexually transmissible disease (STD) can also increase the risk of getting HIV, so it’s useful to get checked out at a clinic if you have any concerns. Check out the ‘Taking Care of Your Sexual Health’ factsheet for information on what happen during a sexual health check.

My test has come back positive. What now?

Your doctor or nurse will tell you about treatment options. They may provide you with some written information. They will also talk to you about contact tracing, which means that all your partners over the last three months should also be contacted and tested. The doctor or nurse will give you a letter to give to all your partners so they can go to a doctor for testing. You have some legal obligations if you have been diagnosed with HIV. This means that in the future you need to tell all your sexual partners that you have HIV.

Your doctor or nurse should also arrange a follow-up appointment with you, and refer you to a specialist for counseling and potential treatment.

You may feel shocked and scared by your diagnosis. It’s a big thing to take in. Some people will react by feeling anxious, depressed, angry, worried, ashamed - or all of these things at once. Other people might just feel numb.  There’s no shame in having an emotional reaction; but it is good to try and get the emotion out and work through it. Talking to a close friend, parent or counselor can help to explore all your feelings about having HIV. The important thing to remember is that many people with HIV live a long, healthy life, but you will need to take some special care of yourself from now on.

What about PEP? How does that work?

PEP (Post-Exposure Prophylaxis) is a 4-week course of anti-HIV drugs that may stop HIV infection if started soon after exposure to HIV. To use PEP, you have to move fast. To be most effective, treatment should begin within a few hours of unsafe sex, or possible exposure to HIV. As PEP is an expensive treatment and can make you feel sick, the doctor will ask you some questions to assess your risk of contracting HIV before giving you PEP.

You can get PEP from sexual health clinics, or some specialists emergency departments.

For more information on safer sex and treatment and/or prevention for HIV and AIDS, check out the Planned Parenthood website or the US Office of Public Health website.

If I go to a clinic, will the doctor tell my parents?

According to the law, if you’re 18 or older, your health information is completely private. At the clinic, your discussion with your doctor or nurse, and the information you give the staff is completely confidential. It can’t be shared with your parents or people you know, unless the law requires staff to do so. Examples of this would be if health staff thought you were at risk of serious harm, or if your files were required in a court case.

If you are under the age of 18, there are certain states that allow physicians to inform your parents that you are seeking or receiving STI services. However, with the exception of one state that requires parental notification in the case of a positive HIV test, physicians are not required to notify your parents of test results. 

How do I know this?
The Centers for Disease Control and Prevention website
Planned Parenthood
US Department of Health and Human Services

 

Fact Sheet

Girl versus girl bullying?


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What is girl versus girl bullying?

Girl vs. girl bullying is a form of relational aggression.  Relational aggression is a type of aggression that harms a person’s social status, reputation, or relationship within a group of friends.  This type of aggression is an ego-booster for the aggressor and does not involve physical violence.

Girls are more likely to be involved in bullying than boys are.  Whether the prevalence of girl vs. girl bullying is the result of an innate tendency of young woman towards aggression is yet to be solidly determined. Brigham Young’s Sarah Coyne points a finger at television and current media as the primary perpetrator.

Some common effects of girl vs. girl bullying include:

  • Loss of friendships and social standing
  • Isolation
  • School absences
  • Anxiety
  • Depression
  • Long-term mental health problems

Why does girl vs. girl bullying happen?

Bullying can sometimes be difficult to pinpoint in girl groups, as oftentimes the girls consider each other “friends.”  But it can be seen in many forms, such as physical harassment, threats, name-calling, negative gossip and the silent treatment.  Marion K. Underwood suggests, in the article “Social Aggression Among Girls,” that because girls tend to invest more into relationships, platonic and otherwise, tension between two or more females has been noticed to develop into a deeper grudge, as opposed to situations with boys, who often shrug off the tension and simply move on to another group of friends.

Although the occurrences in the movie Mean Girls seem a bit ludicrous, these types of situations actually do happen.  Young women often do spend their days trying to get an “in” with the “in-crowd”, attempting to raise their own social status by bringing the status of others down.  The “high value” young women place on their relationships “cycle of wanting to be popular.” Research shows that girl bullies spend time meticulously planning and executing their revenge/plan of action.

 

Reasons for girl vs. girl aggression:

  • Jealousy
  • Need for attention
  • Anger
  • Fear
  • Competition

 

How can you tell if someone is a friend or bully?

So how are you supposed to know who is your friend and who is a bully? Could some friends be using you?  If someone only shows up when you have free concert tickets or your boyfriend has cute friends, they might not really be your friend. Or you may find girls who constantly talk you down or talk themselves up. This could be a red flag. Another red flag? Girls who only talk about themselves. These are girls who may feign interest in your stories but who cut you off to talk about their hair, their boyfriend and their lives. If they are talking bad about themselves constantly, they are using you for a boost of self-esteem. This is considered a manipulative form of bullying because it makes the people around them feel less significant.

From personal experience, girl bullying can develop and multiply. Girls who talk about you behind your back will try to get others to do the same. It might seem as though there is a militia of people who cannot stand you. The problem is that most of them just want to fit in to the conversations around them and might not be aware of what they are doing to you as a person.

 

How to get help

Share your story Either as a victim or bystander, register for the forums and post here to share your experiences with bullying, your current challenges, or how you overcame it. Get Busy Join a new group, like the chess club, yearbook or track.  Extracurricular activities can distract you from the issue and changing your scenery by getting involved can help you find friends who share your interests.  Focusing more on grades, athletics or extracurricular activities will take your mind off your peer struggles.

Talk to Someone Whether you are a victim of relational aggression or acting as the aggressor, talking to someone can help.  You can find a peer counseling group or psychologist or school counselor who offers individual sessions.

Write it Out Journaling is a great way to express your feelings - happy, sad or angry - in a safe way, without fear of being judged.  Also, be sure to write down the positive things as well as negative ones to keep things balanced.

Get Help Look for a group or task force at your school that fights relational aggression.  If one does not exist, talk to school administrators, counselors and parents to get one started.

For more information Visit the this site if you’re a teacher or paretnt.

Fact Sheet

Social workers


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Photo by: *margotta*

Social workers offer practical help

There are several different types of social workers. Some provide therapy for personal problems, while others can give you information about housing, finances or other practical help.

Clinical social workers and substance abuse social workers help individuals with mental illness or substance abuse problems, including abuse of alcohol, tobacco, or other drugs. They work with individuals and conduct group therapy sessions, crisis intervention, and teach skills needed for everyday living. If you have been hospitalized, a social worker also may help plan for supportive services to ease your return home or back to school. Clinical and substance abuse social workers are likely to work in hospitals, substance abuse treatment centers, individual or family services agencies and mental health clinics. Many of the services provided by clinical social workers are similar to those provided by counselors and psychologists.

School social workers often serve as the link between students’ families and the school, working with parents, guardians, teachers, and other school officials to ensure students reach their academic and personal potential. In addition, they address behavior problems, truancy, and teenage pregnancy and advise teachers on how to work effectively with challenging students.

Child welfare or social services social workers work in human service agencies and provide case management services and assistance helping people access support services related to housing, food stamps, job training, and finances.

Licensure

All the States and the District of Columbia have licensing, certification, or registration requirements regarding social work practice and the use of professional titles. Although standards for licensing vary by state, a growing number of States are placing greater emphasis on communications skills, professional ethics, and sensitivity to cultural diversity issues. Most states require 2 years (3,000 hours) of supervised clinical experience for licensure of clinical social workers. When looking for a social worker to provide mental health counseling, the person should have an LCSW (Licensed Clinical Social Worker) after his or her name.

Making an appointment

Usually you’ll need to make an appointment to see a social worker. There are some instances when you might be appointed a social worker, particularly if you are under the age of 18 and the issues relate to child welfare or social services or are involved with the court system.

When you make that first call, you may be asked for your health insurance information. (For more information about health insurance check out the Paying for mental health services fact sheet).

If you want to talk to someone right now, you can call youth helpline Your Life Your Voice at 1-800 448-3000, run by Boys Town for everyone. If you feel you are in crisis or having thoughts of suicide, you can call the National Suicide Prevention Lifeline at 1-800-273-8255. Both hotlines are free and staffed with trained volunteers 24 hours a day.

Like anyone else you talk to, if you don’t feel comfortable with the first person you see, or if you think he or she isn’t listening to you, try to see someone different. Don’t give up.

For help finding a licensed clinical social worker in your location, try the National Social Worker Finder Search sponsored by the National Association of Social Workers.

Ask about confidentiality

It is a good idea to talk to your social worker about keeping your information private. This is generally something that your counselor will bring up in your first session, but if they don’t, it’s OK for you to ask. In most situations, unless you ask the social worker to share information, your social worker will keep what you tell him or her confidential. One exception to this is if your social worker is court appointed. He or she will be required to keep the court updated on your progress.

If you would tell your social worker something that suggests you are in serious danger to yourself or another person the social worker would be ethically and legally bound to share that information so that you or the other person could be safe. Social workers are also required by law to report instances of abuse and there may be circumstances where they would be compelled to testify in a court case. The parameters for when a mental health professional can be required to testify vary by state. For more information about confidentiality, check out the Confidentiality fact sheet.

After speaking with a social worker

After speaking with a social worker you might have mixed reactions. You might feel calmer and understand your concerns more clearly, but it’s also not uncommon to feel confused, stressed, or sad after you have spoken to your social worker. This could be because the session has brought up some scary emotions. It might take a number of visits to your social worker to deal with this stuff. If this is the case, it’s a good idea to talk to your social worker about your reactions and the best way to manage them.

How do I know this?

US Department of Labor, Occupational Handbook, 2008-2009.

Social Workers, Help Starts Here.

Fact Sheet

Paying for mental health services


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Do I need to pay to speak to a mental health professional?

The answer to this question is a tricky one. In some cases, yes, you will have to pay something to receive services. How much you will have to pay will be determined by your insurance coverage. In some cases, no, you won’t have to pay.  For instance, if you don’t have insurance, it doesn’t mean you won’t be able to receive services. But it could mean that your choice of service providers will be more limited.

What if I have private insurance?

Insurance coverage for seeing a mental health professional works similarly to how coverage works when you see your medical doctor. If the mental health professional you are seeing is a preferred provider in your insurance network, you will generally only have to pay your co-pay. A co-pay could be somewhere around $20 to $40. If your mental health professional is “out of network” you will have to pay the full amount of the visit and then be reimbursed by your insurance company for the percent of cost that the insurance company will pay.  Your insurance may only cover a certain number of visits and in some cases, you might need to get a referral from your medical doctor.

Before making an appointment, it is good to first check with your insurance provider to find out what exactly the policy covers for mental health related issues. In some cases, the policy may only cover medical, not mental health services; or if it covers mental health services, it may do so at a different reimbursement rate than medical coverage, or only cover certain types of disorders.

This differential reimbursement rate is about to change with the passage of the Mental Health Parity and Addiction Equity Act of 2008. This act will require most private insurance plans to cover mental health and addiction services on the same terms and conditions as other types of care. There are some important exceptions. You can read more about this Act and exceptions from the legislative update provided by the American Counseling Association.

In many cases, a teen or young adult is covered under their parents’ insurance plan. If this is true for you, and you have received services with payment provided through your insurance carrier, your parent will receive a statement from the insurance company indicating you have received services.

What if I don’t have private insurance?

There are a number of options for you if you do not have private insurance, or if you wish to not use your insurance so that your parents will not be notified.

Community-based resources.  Many communities have community mental health centers. These centers offer a range of counseling services, usually at a reduced or free rate – or sliding scale - for those with a low income. However, some community mental health clinics may require you to have private insurance or be a recipient of Medicaid. Clinics that are designated as a Federally Qualified Health Center will have mental health services available at no charge.

School-based resources. Secondary schools and university/college campuses generally provide counseling services on campus. In many cases services are free to students. If a student has health insurance with mental health coverage, the school may want to bill your insurance company. Some universities and colleges provide health insurance policies for students at minimal annual costs.

Religious institutions. Your church, mosque, or synagogue may provide counseling services. Service providers in this type of setting are often trained as pastoral counselors who have advanced degree training in counseling with a specialized emphasis on spirituality. A religious minister, priest, rabbi, or other clergy may also provide support but not all religious clergy are necessarily trained mental health professionals or pastoral counselors.

Self help groups.  This type of group is a collection of people who come together because they share a common problem and want to help each other deal with and recover from the problem. There are self help groups for all kinds of concerns, such as eating disorders, chemical dependence, anxiety, bi-polar, etc. Some self help groups may have a professional leader, whereas others rely on peer participation only. For a directory of national self help groups and state specific resources check out the American Self Help Group Clearinghouse.

Hotlines.  There are a number of hotlines associated with specific topics and areas of concern. Numbers are easily found on the web. For those in heightened distress who need immediate crisis assistance, the National Suicide Prevention Lifeline is a good resource – 1-800-273-TALK(8255) as is youth helpline Your Life Your Voice at 1-800 448-3000, run by Boys Town for everyone.

Is public assistance an option?

Medicaid is a form of public assistance that pays for some health and mental health care costs for those who are impoverished and fit within certain eligibility groups. Although there are certain Federal requirements, each State has its own rules and regulations for Medicaid. Medicaid does not pay money to you; instead, it sends payments directly to your health care providers. Depending on your state’s rules, you may also be asked to pay a small part of the cost (co-payment) for some medical services. 

State Children’s Health Insurance Program (SCHIP) is another type of public assistance that pays for some health and mental health care for those who have limited income, but whose income exceeds the parameters required for Medicaid.  This type of coverage is only available for those under the age of 19.

Finding out if you qualify for these programs is not easy and will require accessing information from your state’s medical assistance office. The Federal Centers for Medicare and Medicaid assistance will help you locate the best state contact.

Your local community social service agency may also be able to assist with obtaining eligibility information. These agencies are generally located within the Department of Health, but different communities have different names for this department and it might be difficult to find.  If you get stuck or need some help finding the right contact, your medical doctor, school counselor, minister, or librarian might be able to assist you.

Tips for speaking with an insurance company or public assistance provider

When speaking with or writing to an insurance company or your state’s Medicaid or SCHIP program manager, it may be helpful to keep these six points in mind:

  • Don’t be afraid to ask questions;
  • When communicating with the insurance company, be sure to have your member number and/or plan number ready;
  • Keep good communication records, including with whom you spoke and on what day and time;
  • Be polite;
  • Be patient;
  • Be persistent.

For more information about Medicaid or SCHIP contact the Centers for Medicare & Medicaid Services at 1-877-267-2323.

Fact Sheet

Psychotherapy


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Psychotherapy is a form of counseling that involves talking with a trained mental health professional, such as a psychiatrist, psychologist, social worker or counselor. Psychotherapy can help you with a lot of emotional and behavioral concerns, including problems with family, friends or partners, and issues such as depression, anxiety or phobias.

Psychotherapy can be carried out one-on-one, in groups or with couples or families.

Different approaches to psychotherapy

Psychotherapists can use a number of different approaches. They might use just one approach, or they can combine techniques depending on factors like their training, the type of issues you might be facing, and your particular needs.

Here are the most common types of psychotherapeutic approaches:

Behavioral therapy

Behavioral therapy focuses on changing patterns of behavior by adopting techniques derived from learning principles, like rewarding positive actions. In this type of therapy, a therapist assumes that certain behaviors are learned, and these learned behaviors can be changed. Behavioral therapy includes an array of methods such as stress management, biofeedback, and relaxation training. Behavioral therapy is an approach that is often used to help change compulsive behaviors.

Cognitive therapy

Cognitive therapy focuses on identifying and changing unhelpful thoughts (called cognitions) that can lead to unproductive feelings and behavior. Beliefs and thoughts are explored to identify how they affect your behavior. If a thought or belief is too rigid and causes problems, the psychotherapist can help you change it and relearn healthier thinking patterns.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) can help you recognize negative thought patterns and behaviors and replace them with positive ones. CBT combines the techniques of behavioral therapy and cognitive therapy, and is one of the most common forms of counseling. CBT is a short-term, focused approach that often lasts about 12 weeks, and is commonly used for obsessive compulsive disorders, anxiety and depression.

Interpersonal therapy

Interpersonal therapy (IPT) is a short-tem therapy. IPT focuses on relationships and the ways you can improve your social support. This can include developing better communication skills, learning how to express emotions more effectively, and being more confident with people at school and at work.

Psychoanalysis

This type of psychotherapy involves exploring the reasons behind why you behave in a certain way. Psychoanalysts look at unconscious motivations and reasons for behavior that you might not normally be aware of. In this type of therapy, you might talk about your life and events that happened when you were young. These discussions might help you discover how things you experienced in your past can affect your current behavior and feelings. Psychoanalysis can be a long process, often lasting several years.

Narrative therapy

Narrative therapy uses storytelling techniques to explore problems and issues. During narrative therapy, a therapist will encourage you to tell and retell your life in the form of stories, helping you see the same behavior and issue in different ways. By doing this, you can recognize patterns for types of behavior and find more positive ways of coping with problems. Narrative therapy is often used as part of family therapy.

Family therapy

Family therapy is used when a whole family decides to work through their relationships to improve communication. The family looks at how to solve a problem or to adjust to a new situation. In this case, the whole family goes along to the initial appointment with a counselor or therapist.

Information for this fact sheet

Substance Abuse and Mental Health Services Administration: Mental Treatment and Therapy Guide

The Mayo Clinic: An overview of types of therapy

Fact Sheet

Local doctor or primary care provider


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Why visit a doctor?

You might hear a doctor called a primary care provider or a general practitioner.  Nurses and physician assistants are also referred to as primary care providers.  All of these providers have been trained to deal with any sort of mental or physical health issue that any person of any age might have. They are considered the health care professional that you would primarily see for anything that is physically or mentally bothering you (That’s why they’re called ‘general’ or ‘primary.’) Doctors can be a good place to start if you are concerned about the way you’re feeling. A doctor can help or give you advice about issues including depression, drugs or alcohol, insomnia, relationships, STDs (sexually transmitted diseases), contraception, or if you being hurt or sexually assaulted.

Doctors can help you to find different ways to cope with these issues, or they can refer you to, other health professionals who have had training in specific areas — for example, a gynecologist, a therapist, or a counselor — to give you additional support. Not all medical doctors feel it is part of their role to treat mental health problems, so in some cases they may feel reluctant to discuss this type of issue. If that happens it’s OK to still ask for a referral.

Here are some things to keep in mind when choosing a doctor

  • You might feel more comfortable seeing a doctor who is the same gender as you.
  • You might prefer to see a different doctor than your family’s doctor.

Making an appointment

When you are making the appointment, you might have to tell the scheduler what you want to talk to the doctor about but don’t worry; you do not have to be specific.  You can say something like ‘you aren’t feeling well” or “you need a check-up”.  The scheduler is only asking or needs to know because different reasons for seeing the doctor usually mean a different amount of time with the doctor.  For instance, an annual checkup is usually scheduled for a half hour and all other appointments are usually 15 minutes.  The scheduler will need your name and health insurance information. They will ask these questions even if you have been going to this doctor for a long time.

Appointments sometimes run longer than anticipated, and your appointment might be delayed, so take a something to read or listen to in the waiting room. Ask the receptionist how long you’ll have to wait when you get there.

Call and cancel your appointment if you can’t make it, so another patient can use the appointment time.

Things to think about when talking to your doctor

  • Ask about confidentiality at the beginning of your first appointment if you have any concerns.
  • Ask questions if you don’t understand something. Sometimes doctors tend to speak in medical jargon.
  • If you feel that the doctor is not really the right one for you, try another.
  • Be honest about your health, previous treatment and medication (including if you’ve taken recreational drugs before) and your lifestyle, even if it seems embarrassing. Doctors have heard it all before! This will help you get the best possible treatment.

Confidentiality

Doctors are required by law to keep information about their patients confidential (this means they won’t tell anyone else). If you would tell your doctor something that suggests you are in serious danger to yourself or another person the doctor would be legally and ethically bound to share that information for that you or the other person could be safe. Doctors are also required by law to report instances of abuse and there may be circumstances where they would be compelled to testify in a court case. The parameters for when a health professional can be required to testify vary by state. For more information about confidentiality, check out the Confidentiality fact sheet.

Paying for treatment

Doctors work in a variety of settings.  They work in a private practice with one or several other doctors.  They can work in hospitals, student health center as a university or university medical centers.  They also work in community health care centers and rural health centers too.  Some doctors are free but many accept health insurance.

Almost every doctor will take some form of insurance.  If you are going to the doctor for the first time, you need to check with the doctor’s scheduler if they take your insurance, even if that insurance is Medicaid or another government paid insurance.  If you find that you can’t find a doctor who takes government insurance or you might not have insurance, you can go see a doctor is a community based health center or rural health center.  You will need to tell that scheduler whether you have insurance or not.

Private health insurance, on the other hand, should pay for the costs to see a doctor.  If you’re insured, your insurance provider might require you to see a doctor within a specified network, and you might have to pay for part of your visit.  This payment is called co-pay, and usually costs between $20 and $40. Your insurance might also only cover specific treatments.  Every insurance carrier is different, and you might want to ask your doctor or the doctor’s scheduler about payment before you make an appointment.

Some concerns you might have about doctors

Will the doctor take me seriously?

It can be hard when you feel that someone isn’t listening to what you have to say. If you feel a doctor isn’t listening, it might be that he or she doesn’t have the best communication skills or not very comfortable talking about mental health issues or tough times.  They may seem like they are in a rush.  Like anyone, some doctors are better at talking and listening than others.

If you don’t think your doctor is taking your concerns seriously, you might want to let them know or ask them if they can suggest another doctor or primary care provider (like a nurse) for you to see. It can take time and practice to get to know someone new, so if the basic vibe is that your doctor is one that you want to stick with, you might want to give them a chance to get to know you better. After some time, if things still aren’t working out, it might be better to see another doctor.

Don’t be discouraged if your doctor doesn’t seem to get the mental health issues you are having.  Usually if you just tell them you need some assistance in the areas you are having a hard time with and they can’t help you immediately, they will refer you to someone that can like a psychologist, counselor or social worker.

Will the doctor judge me?

It is important that you trust your doctor. You want to feel respected and not judged by your doctor. Many people might worry about being judged if they’re seeing a family doctor that they’ve seen all their lives, especially when you are talking about sensitive topics.  Doctors are people too with personal or religious beliefs.  These beliefs might make it difficult for them to provide unbiased advices, especially on certain things like abortion or contraceptives.  If you think your doctor is being judgmental or biased, then it might be a good idea to let them know. If you aren’t comfortable with them after that or don’t see a change, it is okay to go to another doctor.

What if I’m too embarrassed to be honest about my lifestyle?

Talking to your doctor about your feelings and body can seem weird or uncomfortable at first, but it gets easier with practice. (Really!) It’s important to be honest about your lifestyle and background in order to be properly treated and get the best advice from your doctor. It might be useful to keep in mind that doctors have heard it before — it’s their job to talk about to you about this stuff.

Will my doctors want to get my family involved?

Your doctor can only tell your parents and family what you give them permission to tell (unless of course it’s a serious safety issue or you’re under 18). Also bear in mind that if you see a doctor and you use your parent’s insurance company for payment, the insurance company will send a statement to your parents indicating your visit and related charges.

Having your family’s support might be helpful, so your doctor might suggest that it’s important that your family is involved in some way. Talking this through with your doctor might help you to work out what you want to do.

Your rights

It might be useful to remember that you have the right to:

  • Courtesy, respect and treatment in a non-judgmental setting;
  • Confidentiality and respect for your privacy;
  • Receive accurate information, communicated in a simple, straight-forward manner;
  • Choose your own doctor;
  • Ask questions and have them answered;
  • Get another doctor’s opinion;
  • Feel safe and comfortable;
  • Get care provided quickly;
  • A choice about accepting treatment;
  • Ask for an explanation if you don’t understand.

 

Fact Sheet

Going to a nurse


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Why go to a nurse?

Sometimes you may have a problem that you want to talk about, and you don’t feel comfortable turning to a friend or family member. Though you can also speak with a counselor or psychologist, a nurse may also be a good person to talk to. Nurses work in a variety of settings. They work in schools, private medical practices and hospitals, and at student health centers at universities or university medical centers.  They also work in community health care centers and rural health centers too. There are also various kinds of nurses.  A few are described below.

School nurses

At schools, you can always talk to a school counselor or advisor if you have any sort of problem, but a school nurse is another person who is there for you without even having to leave the school grounds. A school nurse must be registered by a national board and have a bachelor’s degree in nursing or another health-related field. If the problem is related to physical health, the school nurse will probably be able to help you right away or refer you to a doctor, and if the issue has to do with anything else, a nurse can still be helpful. A school nurse can help you find the right person to talk to about your problem, or may know a lot about the subject, having dealt with similar situations before. Each school has a different policy on visiting your school nurse. You might have to make an appointment. To find out how your school operates, ask a teacher or the front office.

Registered nurses

You’re mostly likely to see a registered nurse at your doctor’s office. Registered nurses (RNs) must be certified and have a bachelor’s degree in nursing. RNs are often much more accessible and will likely give you more time than a doctor. Whether you have a mental or physical health issue that you want to talk about, a nurse will be there to listen. Working in the field of medicine or mental health, a nurse would understand your situation and help you with your next step.  If they cannot help you directly, nurses will be able to refer you to a doctor or other mental health professional.

Nurse practitioners

Nurse practitioners have completed advanced nursing education (like a Master’s degree) and training in the diagnosis and treatment of medical conditions. They may work in emergency rooms in hospitals or may even run their own clinics. It’s possible that a nurse practitioner could be your primary health care provider. Nurse practitioners are trained to understand how illnesses and conditions affect people and their families.  While you may feel that some healthcare workers do not give you enough personal attention, nurse practitioners’ focus is on individualized care. In some cases, a nurse practitioner will take the place of a general practice doctor and take on the full responsibility of an individual’s care.

Licensure

In the United States, each individual state has different laws regarding nursing practice. Nurses may be licensed in more than one state, and licenses must be periodically renewed. Certain states require continuing education in order to renew licenses.

Talking to a nurse

Be sure to:

  • Ask about confidentiality at the beginning of your first appointment if you have any concerns;
  • Ask questions if you don’t understand something. Sometimes nurses, like doctors, tend to use medical terms that you might not understand or know;
  • If you feel that the nurse is not really the right one for you, try another;
  • Be honest about your health, previous treatment and medication (including if you’ve taken recreational drugs before) and your lifestyle, even if it seems embarrassing. Nurses have heard it all before! This will help you get the best possible treatment.

Will the nurse take me seriously?

It can be hard when you feel that someone isn’t listening to what you have to say. If you feel a nurse isn’t listening, it might be that he or she doesn’t have the best communication skills or is not very comfortable talking about mental health issues or tough times. They may seem like they are in a rush.  Like anyone, some nurses are better at talking and listening than others.

If you don’t think your nurse is taking your concerns seriously, you might want to let them know or ask them if they can suggest another nurse or primary care provider (like a doctor) for you to see. It can take time and practice to get to know someone new, so if the basic vibe is that your nurse is one that you want to stick with, you might want to give them a chance to get to know you better. After some time, if things still aren’t working out, it might be better to see another nurse.

Don’t be discouraged if your nurse doesn’t seem to get the mental health issues you are having.  Usually if you just tell them you need some assistance in the areas you are having a hard time with and they can’t help you immediately, they will refer you to someone who can, like a psychologist, counselor or social worker.

Will the nurse judge me?

It is important that you trust your nurse. You want to feel respected and not judged by your nurse. Many people might worry about being judged if they’re seeing a nurse or other primary care provider that they’ve seen all their lives, especially when you are talking about sensitive topics.

Nurses are people too with their own personal or religious beliefs.  These beliefs might make it difficult for them to provide unbiased advice, especially on certain things like sex or contraceptives. If you think your nurse is being judgmental or biased, then it might be a good idea to let them know. If you still aren’t comfortable with them after that or don’t see a change, it is okay to go to another nurse.

It might be useful to remember that you have the right to:

  • Courtesy, respect and treatment in a non-judgmental setting;
  • Confidentiality and respect for your privacy;
  • Receive accurate information, communicated in a simple, straight-forward manner;
  • Choose your own health care provider;
  • Ask questions and have them answered;
  • Get another opinion;
  • Feel safe and comfortable;
  • Get care provided quickly;
  • A choice about accepting treatment;

Ask about your privacy

Nurses are required to keep information about their patients confidential. (This means they won’t tell anyone else.) However, there are some instances where a nurse might have to let other people know how you’re feeling. If you were to tell the nurse something that suggests you are in serious danger to yourself or another person, the nurse would be legally and ethically bound to share that information so that you or the other person could be safe. Nurses are also required by law to report instances of abuse, and there may be circumstances where they would be compelled to testify in a court case. The parameters for when a health professional can be required to testify vary by state. It is a good idea to talk to your nurse about your privacy rights before you start the session. For more information about confidentiality, check out the Confidentiality fact sheet.

Will my nurse want to get my family involved?

Your nurse or other health care provider can only tell your parents and family what you give them permission (unless of course it’s a serious safety issue and you’re under 18). Also bear in mind that if you see a nurse and you use your parent’s insurance company for payment, the insurance company will send a statement to your parents indicating your visit and related charges.

Having your family’s support might be helpful, so your nurse might suggest that it’s important that your family is involved in some way. Talking this through with your nurse might help you to work out what you want to do.

Paying for Treatment

Some nurses are free but almost every nurse will take some form of insurance.  If you are going to a nurse for the first time, you need to check with the nurse’s scheduler to see if they take your insurance, even if that insurance is Medicaid or another government-paid insurance. If you find that you can’t find a nurse or other primary care provider who takes government insurance or if you might not have insurance, you can go see a nurse in a community based health center or rural health center. You will need to tell that scheduler whether you have insurance or not.

Private health insurance, on the other hand, should pay for the costs to see a nurse. If you’re insured, your insurance provider might require you to see a nurse within a specified network, and you might have to pay for part of your visit. This payment is called co-pay, and usually costs between $20 and $40. Your insurance might also only cover specific treatments.  Every insurance carrier is different, and you might want to ask your nurse or the scheduler about payment before you make an appointment. You might also want to check out the Paying for mental health services fact sheet for more information.

Other people you can talk to

Youth helpline Your Life Your Voice at 1-800 448-3000, run by Boys Town for everyone, is a 24-hour hotlines that has trained volunteers you can talk to. You might also want to check out the Get Help section for other helpful services within your area. If you are feeling suicidal you may also want to call the National Suicide Prevention Lifeline (1-800-273-8255).

How do I know this?

National Association of School Nurses
National Council of State Boards of Nursing

Fact Sheet

When someone pushes you away


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Do they still need your support?

When people are going through a tough time they may be angry or withdrawn. If you try and help them, they may try to push you away. It may appear that their anger or lack of interest is aimed at you. Try not to take this personally as often it is not true. Instead it may be that they are having trouble managing their feelings because they are upset. Chances are they may appreciate some support but are not ready to ask for it. It may be helpful to let them know that you are around if they would like to talk.

Let your friend know that you care about them. Sometimes just knowing that there is someone there who cares, or that they can hang out with can be help enough.

Worried about someone’s safety?

If you are concerned about a friend’s safety, it is important that you talk to someone you trust. This may be someone like a counselor, doctor, family member, youth worker or teacher. It may be a good idea to talk to your friend first letting them know that you are worried about them.  If you’re looking for information on signs that your friend may be suicidal, check out nineoutoften.org. You could also let your friend know that you could go and talk to someone together.

If you feel your friend needs emergency help, you should call the police (dial 911). The National Suicide Prevention Lifeline is a source of crisis support - 1-800-273 TALK (8255) - where trained volunteers answer crisis calls 24/7.

For more info about what to do in an emergency check out the Getting Help in a Crisis section of ReachOut.

Looking after yourself

It is sometimes hard when someone you care about is sad or distant. Helping a friend may mean that you are giving up on some of your needs. Try to remember to look after yourself as well.

Speak to someone you trust, such as a family member, friend or counselor.Having time away from your friend can be an important way to help you relax. Make sure you spend some time doing what you enjoy. You may want to play a sport, hang out with other friends, listen to music, or go for a walk.

Last Reviewed: July 6, 2009

Fact Sheet

Psychoanalytic therapy


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What is psychoanalytic therapy?

Psychoanalytic therapy is a type of therapy that focuses on a person’s unconscious motivations. During treatment, a psychiatrist or psychologist will talk to you about your life and childhood experiences to find out how your past life experiences might affect your current feelings and behaviors.

What happens during psychoanalytic therapy?

More specifically, in this type of therapy, your therapist will ask a lot of questions and will listen carefully to your responses in order to gain an understanding of your thoughts, feelings and motivations. Here are a few of the main approaches you therapist might use:

Free association. A therapist will help you explore the hidden meaning behind responses you give to certain words and how they might relate to your personality and motivations.

Resistance. You explore how and why your behavior and responses towards your therapist might prevent progress in your therapy or help you avoid discussing issues by keeping secrets or not talking about certain topics.

Dreams. You might discuss the details of your dreams with your therapist to identify symbols and hidden meanings, and how they might relate to your behavior and motivation.

Transference. The way you feel and behave towards your therapist can be similar to how you feel and behave towards important people or events in your life. For example, if you’re angry at your partner, you might transfer this feeling and show anger at the therapist.

Issues treated with this type of therapy

Psychoanalytic therapy can be used to treat a wide range of issues, including

  • Depression;
  • Anxiety and obsessive compulsive disorders;
  • Relationship problems with your partner or family;
  • Eating disorders;
  • Physical problems that have a psychological origin.

How long does this type of therapy last?

There is no time limit. While many people experience positive changes to their thinking and behavior within several months, this type of therapy can be a long process, sometimes taking a couple of years.

Last Reviewed: June 17, 2009

 

Fact Sheet

Psychologist


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Psychologists are mental health professionals who can assist you

Psychologists are mental health professionals who are trained to talk to people about a wide range of concerns. Relationships, family issues, troubles with school, and drug and alcohol abuse are some of the things a psychologist can talk with you about. They can also help you develop the skills to live a better life and to solve problems more effectively.

Clinical psychologists and counseling psychologists are a particular type of psychologist who are trained to diagnose and treat mental health problems. These problems can vary considerably as to their degree of severity. Although very similar, clinical and counseling psychologists differ with respect to the types of problems that they treat. Typically, clinical psychologists work with people who have more severe problems, such as phobias, bipolar disorder, and schizophrenia. On the other hand, counseling psychologists work with people suffering from everyday stresses, including career planning, academic performance, and relationship and family difficulties (licensed professional counselors have a similar role, you might want to check out the fact sheet on Counselors).

School psychologists are another type of psychologist that can help you with problems. School psychologists work in a K-12 school setting. Generally they focus on learning and behavior problems and they also work with teachers and family members to suggest ways to improve classroom climate and parenting skills.

Licensure

Psychologists in private practice must meet certification or licensing requirements in all States and the District of Columbia. These laws can vary by State. Generally, clinical and counseling psychologists usually need a doctorate in psychology, an approved internship, and 1 to 2 years of professional experience to be licensed. In addition, all States require that licensed professionals pass an examination. States also have requirements that school psychologists must meet in order to be licensed.

For more information about the licensing requirements in your state you can visit the Association of State and Provincial Psychology Board.

Finding a psychologist

The American Psychology Association offers an online directory to help people find psychologists in their area. You can also use the database on the counselor network theravive.

You can also ask your medical doctor, school counselor, counselor at your college counseling center, or religious minister to refer you to a psychologist who can help you.

Like anyone else you talk to, the first person you talk to might not always feel like the right fit. If you don’t think your psychologist is listening to you, or you just don’t feel comfortable with the person, it’s OK to see someone else. Try not to give up.

Making an appointment

Psychologists will usually want you to make an appointment. Sometimes they are busy. You may have to wait a while before your first appointment. Remember, if things feel really desperate tell them it’s urgent — they might be able to fit you in. Also keep in mind that you can take a friend or family member with you to the appointment.

If you need to talk to someone now, call The National Suicide Prevention Lifeline at 1-800-273-8255, or youth helpline Your Life Your Voice at 1-800 448-3000, run by Boys Town for everyone.

Paying for treatment

Some psychologists are free. These experts might work for a community center or school and are paid by that particular institution. Other psychologists work privately, and you will probably have to pay them. When you make an appointment ask how much it will cost. In some cases, psychologists provide a sliding scale for payment which means that they base their payment on the person’s ability to pay.

Private health insurance might pay for part of what it costs for you to see a psychologist. If you’re insured, your insurance provider might require you to see a psychologist within a specified network, and you might have to pay for part of your visit. This payment is called a co-pay, and usually costs between $20 and $40. Your insurance might also only cover specific treatments. If you don’t have insurance, you might have to pay for your treatment out-of-pocket, which can be costly.

Every insurance carrier is different, and you might want to ask your psychologist about payment before you make an appointment. The Paying for mental health services fact sheet has additional information about insurance coverage.

For more information on finding a mental health professional that suit your emotional and financial needs, visit the US Department of Health and Human Service’s National Mental Health Information Center.

Asking about your privacy

It’s a good idea to talk to the psychologist you see about keeping your information private. This is generally something that your psychologist will bring up in your first session, but if they don’t, it’s OK for you to ask. In most situations, unless you ask the psychologist to share information, your psychologist will keep what you tell him or her confidential. If you would tell your psychologist something that suggests you are in serious danger to yourself or another person the psychologist would be ethically bound to share that information for that you or the other person could be safe. Psychologists are also required by law to report instances of abuse and there may be circumstances where they would be compelled to testify in a court case. The parameters for when a mental health professional can be required to testify vary by state. For more information about confidentiality, check out the Confidentiality fact sheet.

Others you can talk to

The National Suicide Prevention Lifeline (1-800-273-8255) or the Boys Town National Hotline (1-800-448-3000) should be able to help you with some local resources in your area.

Fact Sheet

Psychiatrist


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Psychiatrists can help

Psychiatrists are licensed as doctors but also have special training in mental health issues. Psychiatrists treat conditions such as depression, severe anxiety, schizophrenia and bipolar disorder. Psychiatrists have medical training, and as such, they can prescribe medication if they think it will help you. If your medical doctor thinks that it would be helpful for you to see a psychiatrist, he or she can refer you to one.

Your psychiatrist will listen to you. He or she will talk to you about your emotions and how your emotions may be affecting your behavior. Most psychiatrists are happy to assist young people in this way. If you think your psychiatrist is not listening or hearing you concerns, or if you’re uncomfortable seeing a particular psychiatrist, you can go back to your doctor and ask to see a different one. If you are feeling anxious about a first appointment, you can take a friend or family member to the appointment with you. Sometimes a psychiatrist teams with a psychologist or other mental health professional, with the psychiatrist handling the medication aspect of treatment and the other mental health professional providing the counseling or therapy.

Taking medication

Sometimes just talking to someone will help. Other times, you might need medication to feel better. If a psychiatrist suggests you take medication, make sure you understand the effects of the drug and what some of the potential side effects might be. Some people find it useful to get a second opinion about taking medications. A second opinion may help you decide if using medication is something you want to do. It is important that you receive the information you need to make this decision.

Making an appointment

Psychiatrists work in both agency or hospital settings as well as private practice. Regardless of the setting, you will usually have to make an appointment. If they are busy, you may have to wait a while before your first appointment. If things feel really desperate, tell them it’s urgent, and they may be able to fit you in. If you want to talk to someone now, particularly if you feel you are in crisis or have thoughts of suicide you can call the National Suicide Prevention Lifeline at 1-800-273-8255 or Your Life Your Voice at 1-800 -448-3000, run by Boys Town for everyone.

Asking about your privacy

It’s a good idea to talk to the psychiatrist you see about keeping your information private. This is generally something that your psychiatrist will bring up in your first session, but if they don’t, it’s OK for you to ask. In most situations, unless you ask the psychiatrist to share information, your psychiatrist will keep what you tell him or her confidential. If you would tell your psychiatrist something that suggests you are in serious danger to yourself or another person the psychiatrist would be ethically bound to share that information so that you or the other person could be safe. Psychiatrists are also required by law to report instances of abuse and there may be circumstances where they would be compelled to testify in a court case. The parameters for when a mental health professional can be required to testify vary by state.

For more information about confidentiality, check out the Confidentiality fact sheet.

Paying for treatment

If you’re insured, your insurance provider might require you to see a psychiatrist within a specified network, and you might have to pay for part of your visit. This payment is called a co-pay, and usually costs between $20 and $40 or a percentage of the costs (e.g. insurance will be 80% and you will pay 20%). Your insurance might also only cover specific treatments. If you don’t have insurance, you might have to pay for your treatment out-of-pocket, which can be costly.

Every insurance carrier is different, and you might want to ask your psychiatrist about payment before you make an appointment. Some community agencies may offer a sliding scale which means you pay according your income and what you can afford.

You may also want to check out the fact sheet on Paying for mental health services for more information.

Other people you can talk to

The National Suicide Prevention Lifeline (1-800-273-8255) or the Boys Town National Hotline (1-800-448-3000) should be able to help you with some local resources in your area.

Fact Sheet

Psychiatric hospitals or wards

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Psychiatric hospitals and wards specialize in treating people who are experiencing a variety of different mental illnesses, including depression, schizophrenia, anxiety and eating disorders.

Psychiatric hospitals and wards can be part of a larger hospital or located in a smaller building like a clinic.

Many people find spending time in a psychiatric hospital a very helpful way to:

  • Rest and reflect;
  • Find out what is happening emotionally, and why;
  • Stabilize medications they might be taking;
  • Get intensive treatment from doctors and other health professionals with specialist training, like nurses, occupational therapists, social workers and psychologists.

Voluntary and involuntary admission

A voluntary admission is when a person enters a psychiatric hospital at his or her own request or at the suggestion of a doctor, parent, or guardian. This can be at a time when that person feels he or she needs some extra support. Voluntary admission can be organized by the person who is being admitted, or by a doctor, parent, or guardian, by getting in contact with the psychiatric hospital.

There are times when a person becomes so ill that they are at risk of hurting themselves or others and hospitalization becomes necessary even though the individual does not wish to enter a hospital. This is called an involuntary admission. This occurs when someone else has recognized that the person is imminently a danger to him or herself or others. In most states, police officers and designated mental health professionals can require a brief commitment of an individual for psychiatric evaluation. If the individual is evaluated as needing further hospitalization, a court order must be obtained.

Where are psychiatric hospitals located?

You might find it difficult to research psychiatric wards and hospitals over the Internet, but your medical doctor or psychiatrist should be able to recommend one that will suit you best.

Some are privately run, while others are within larger hospitals. Some might also have a limited number of places available, while others may only admit people at certain times of the year.

Things you might consider when choosing a psychiatric hospital is the cost, program (including any restrictions in activity and other policies), size and length of stay.

How much will it cost to stay at a psychiatric hospital?

The cost of a stay in a psychiatric hospital or ward varies widely. Some run on donations or require a very small fee, while others are privately run and expensive. You or your parents might be able to claim back some of costs through private health insurance or through federally funded health insurance programs. For more information on how to pay for these services, check out the Paying for mental health services fact sheet.

How much time do people spend in psychiatric hospitals?

The length of stay depends on a variety of factors. These can include what you are being treated for, the type of treatment you need and what your doctor decides will help you best. Most stays are short-term.

It’s common that programs will run for a set period of time, and most people stay for the duration of that period. Involuntary patients may have the length of time set by a judge. After that set amount of time expires, a doctor will usually decide if further treatment is needed. Sometimes, the judges and doctors will not agree, and a lawyer might need to get involved.

What happens in the psychiatric hospital?

Upon arrival at the hospital, a patient will have a consultation with a doctor.  The doctor will give an assessment of the situation a patient is in, and tell him or her a bit more about how everything works. If you’re a patient, this is a good time for to ask any questions you might have about your treatment or what you should expect. Depending on state law, you might get a second opinion from another doctor early on in your stay.

During your stay, the activities you take part in will vary depending on what your goals are. They might include:

  • Group work. This is a group discussion with other patients that is facilitated by a social worker, nurse, doctor, psychiatrist, psychologist or counselor.
  • Individual therapy. This is one-on-one counseling with a social worker, psychologist, psychiatrist or counselor.
  • Personal time. You’ll probably find that you have a lot of time to yourself during your stay. How you fill this time is up to you, but it might include interacting with other patients, doing work or studying if you feel able, or just chilling out and reflecting. Depending on the hospital and your needs, you might have your own room, or you might have to share with others. You might also be allowed to bring your own books, phone and music. 
  • Visitors. Many hospitals have set visiting times so you can see family and friends. You might also be allowed to go home during weekends.

Medication

Unless it is an emergency situation, you can work with your psychiatrist on deciding whether medication should be part of your treatment.  Medication might include antidepressants, sedatives, anti-psychotics and occasionally electric shock treatment for very severe mental illnesses. Just because a person is on more or less medication than you doesn’t mean that you are any better or worse than they are. You can read more information about medication on the Managing Long Term Medication fact sheet.

What to do if you’re unhappy with treatment

If you’re unhappy or unsatisfied with any part of your treatment, it’s important that you talk about it with your doctor or psychiatrist. They may not realize you’re unhappy unless you say something. You might then discuss ways to adjust your treatment so you’re getting the best possible outcome. If you continue to be unhappy with your treatment, you have the right to ask for a second opinion.

Dealing with fears about going home

You might look forward to going home, or you might feel scared or nervous at the thought of leaving the hospital. You might be scared that things will go back to the way they were, that you’ll be alone, or that you won’t be able to cope with the added pressures of home, like chores, work and school.
The first few days at home can be tough. If you’re having a rough time, it’s important to make use of the supportive people you have around you. Try to identify people that you can talk to or call when you are having a hard time, like friends, family or a counselor. You might want to set this up before you leave the hospital.

It might also help to arrange activities before you leave the hospital so you have something to look forward to and to make you feel less alone. It’s a good idea to investigate and list these activities before leaving the hospital so that supports are in place before returning home, making the transition a little easier and less overwhelming. Hospital staff or a community mental health team member can assist you in doing this.

Fact Sheet

Counselors who work in schools


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There are two kinds of counselors who work in schools: school counselors who traditionally have been referred to as school guidance counselors and school-based mental health clinicians. Not all schools have both types, although most have school counselors. Both are mental health professionals who can help you manage the issues that stress you out. Both will work with you to find a solution to the problems you’re facing, which could include difficulties at school, problems with friends or teachers, and homework and exam stress, as well as issues you might be having at home.

School guidance counselors spend time making sure all of the students assigned to them satisfy the academic requirements needed for graduation. They also assist students with other academic concerns such as course selection, study habits, and time management, as well as planning for college and other post-high school career opportunities. Because these activities may take up a majority of a counselor’s time, students often don’t think of their counselor as someone who can help with more personal problems.

School-based mental health clinicians may be trained either as counselors, psychologists, or social workers, or in some cases as family therapists. Generally they are employed by a community-based or private agency that contracts with the school system to provide services to students in offices located within the school grounds. School-based mental health clinicians focus primarily on helping students with personal problems and helping those students with chronic or more severe mental health problems.

Both school counselors and school-based mental health clinicians also consult with teachers and family members and in some cases will involve family members in counseling sessions.

Making an appointment

Each school has a different policy on how to visit your school counselor or your school’s mental health clinician. In most cases, you’ll need to make an appointment. To find out how your school operates, ask a teacher or friend that you trust, check out the school website or ask the front office.

Paying for services

Generally if you see a counselor at your school you will not have to pay. This is always the case with school counselors who are employees of the school system. School-based clinicians are generally paid under a contract with the school system; however in some instances the clinician will bill your insurance company if you are covered by insurance. Different school systems have different arrangements with school-based clinicians so it is best to ask about payment when you make your first appointment.

Ask about your privacy

It’s a good idea to talk to the counselor you see about keeping your information private. This is generally something that your counselor will bring up in your first session but if they don’t it’s OK for you to ask. In most situations, unless you ask the counselor to share information, your counselor will keep what you tell him or her confidential. If you would tell your counselor something that suggests you are in serious danger to yourself or another person the counselor would be ethically bound to share that information so that you or the other person could be safe. Counselors are also required by law to report instances of abuse. For more information about confidentiality, check out the Confidentiality fact sheet.

Other people you can talk to

Youth helpline Your Life Your Voice at 1-800 448-3000, run by Boys Town for everyone, is a 24-hour hotline that has trained volunteers you can talk to. You might also want to check out the Get Help section for information on who else you might be able to speak with.

Remember

Everyone has problems. It might feel scary to step out and talk to someone. Just sharing your problem with someone who will listen can bring some relief.

For more information

American School Counselor Association

Fact Sheet

Counselors


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Counselors can help you change things

Counselors are trained mental health professionals who you can help you change the things that cause you distress. A counselor will work with you to help you find a solution to your problem. Counselors often work in schools, at community health centers, on university or college campuses, and family planning clinics. Some may also work privately, having an office alone or with a group of other professionals. (Psychologists have a similar role, you might want to check out the Psychologist fact sheet).

Licensure

In the United States, 49 states (with the exception of California) and the District of Columbia, Guam, and Puerto Rico have some form of counselor licensing. This means that in order to practice as a licensed professional counselor (LPC), the counselor must meet certain requirements. These requirements could vary from state to state, but generally this includes at a minimum a master’s degree in counseling or a related field with supervised clinical experience.  In addition to the required education and clinical experience, an LPC must also pass a licensing exam. When you are searching for a counselor, it is important to look for a licensed professional. Over time the term “counselor” has been used in ways that do not always mean a mental health professional (employment counselor, camp counselor, tax counselor, etc). Generally a licensed counselor uses LPC after their name. In some cases these initials might vary because a state might call their licensed professional counselor something different – for example a state might use LCPC, which is a slightly different designation, meaning licensed clinical professional counselor.

You can get more information on the meaning of licensure from the American Counseling Association.  And, you can get more information on what the licensing requirements are in your state and what your state calls licensed professional counselors, also from the American Counseling Association.

Drug and alcohol counselors and residential treatment counselors, who work for large agencies, or in hospitals, are examples of exceptions to the counselor licensure standards. Many of these persons have only bachelor’s degrees. In these cases, the “counselor” is a job title, not a license to practice. State standards for credentialing drug and alcohol counselors vary from state to state.

Different approaches to counseling

Not all counselors are the same — each has his or her own personality, theoretical orientation or approach to counseling and general style. Finding someone to suit you is important. It’s helpful to remember that this can take time, and the first counselor you see might not be the right one for you. Try not to give up. If you don’t feel comfortable with the first counselor you see, or if you think the person isn’t listening to you, it’s OK to find a different counselor.

Making the first appointment

Seeing a counselor is a big step, and you may feel scared, embarrassed or nervous at first. People of all ages and backgrounds see counselors and the person you choose to see will in most cases have seen a lot of young people who are taking this first step.

Usually you will need to make an appointment to see a counselor. If you want to see a counselor at your high school, college or university, you will need to check out the process for making an appointment with the school’s counseling center. In some cases you might be able to make an appointment on line.

If the counselor you want to see is in private practice or part of a community health center, you will probably have to make an appointment by phone. When you make that first call, you may be asked for your health insurance information. (For more information about health insurance check out the Paying for mental health services fact sheet).

If you have made an appointment, but you want to talk to someone now, you can call youth helpline Your Life Your Voice at 1-800 448-3000, run by Boys Town for everyone.

For more information about finding a counselor that is right for you, check out the Get Help section.

Ask about your privacy

It’s a good idea to talk to the counselor you see about keeping your information private. This is generally something that your counselor will bring up in your first session, but if they don’t, it’s OK for you to ask. In most situations, unless you ask the counselor to share information, your counselor will keep what you tell him or her confidential. If you would tell your counselor something that suggests you are in serious danger to yourself or another person the counselor would be ethically bound to share that information so that you or the other person could be safe. Counselors are also required by law to report instances of abuse and there may be circumstances where they would be compelled to testify in a court case. The parameters for when a mental health professional can be required to testify vary by state. For more information about confidentiality, check out the Confidentiality fact sheet.

After speaking with a counselor

After speaking with a counselor you might have mixed reactions. You might feel calmer and understand your concerns more clearly, but it’s also not uncommon to feel confused, stressed, or sad after you have spoken to your counselor. This could be because the session has brought up some scary emotions. It might take a number of visits to your counselor to deal with this stuff. If this is the case, it’s a good idea to talk to your counselor about your reactions and the best way to manage them.

There are other people to talk to

The Boys Town National Hotline (1-800-448-3000) should be able to give you some numbers in your area. You can also read about other services on this site and look them up in your local phone book, or check out the Yellow Pages online. Your counselor can also point you to other people you can talk to. If you are feeling suicidal, call the National Suicide Prevention Hotline at 1-800-273-TALK (8255) to speak with a trained crisis volunteer.

Fact Sheet

Confidentiality


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What is confidentiality?

Confidentiality means information you share with another person, either written or verbal, will be kept between you and that person. It’s common to confide in friends because you trust them. Keeping certain things confidential is kind of an “unspoken rule” in a friendship, but it can also be important that others-like health and mental health professionals-keep your information private as well.

Confidentiality and health and mental health professionals

For doctors, nurses, counselors and all other health and mental health professionals, confidentiality is part of a professional code of ethics. Health professionals agree to abide by a set of ethical principles that include keeping your information confidential. Doctors and nurses cannot disclose your medical information unless you give them permission to do so. However, if you threaten bodily harm to yourself or another person, then your physician must reveal this information to the proper authorities. If you’re unsure about what a health professional might report, you should talk to the person about your concerns. You might also want to find out who will receive the information-in some cases, it could be your family, the police, or state and local officials. In some rare situations, it could involve speaking in court. Private communication between you and your physician is also protected by law.

Like physicians, mental health professionals also abide by a code of ethics that means they will not disclose information unless you give them permission to do so. They also have the duty to disclose information if they feel you or someone else is in imminent danger. And, your communication with mental health professionals may also be protected by law, however this varies state by state, and by type of mental health professional. For example, one state may grant by law “privileged communication” between a client and psychiatrists or psychologists, but “privileged communication” may not exist for clients and school counselors.

For both medical and mental health professionals, this becomes further complicated by a patient or client’s age. States have different laws and regulations regarding the age at which an adolescent has the legal right to consent to medical care or mental health care without being required to notify their parents or obtain authorization for care. For minors, is some states, the right to privacy legally belongs to parents or guardians, meaning that the adolescent has the same right to have information kept confidential, yet this information by law cannot be kept from parents or guardians.

And, in most states, physicians and mental health professionals are required by law to report suspected cases of child abuse (abuse of those under the age of 18) and in four states, domestic violence. This is called “mandatory reporting”. This will include physical abuse, sexual abuse, emotional abuse, and neglect. Other circumstances where states may require mandatory reporting include sexually transmitted diseases, communicable diseases, HIV/AIDS, or other conditions deemed to be risks to the health and safety of the public at large.

Talking about confidentiality with a mental health professional

Generally when you first see a mental health professional, the issue of confidentiality is discussed as part of a first appointment. For those under 18, the mental health professional typically has parents or guardians sign a form that describes the limits of confidentiality and the professional’s expectations for keeping session content private - meaning only between the mental health professional and you, and what the circumstances are when the professional will feel obligated to share information with parents. This is a good time for you to raise any concerns that you may have. You can do this in the privacy of your session with the mental health professional.

How important is confidentiality?

The answer is simple: it’s really important, especially because confidentiality is a big part of trusting a medical or mental health provider. You might be worried about whether this professional will keep what you tell them confidential. This type of worry is normal. Going to see someone might be a new experience for you, and it may take time to understand and trust the person. It’s also possible that you or someone you know might have had a negative experience with a health or mental health professional. This might affect your ability to trust. If this is the case, try to remember that not all health or mental health professionals are the same. Trust usually evolves over time and as you become more comfortable in the relationship, you will begin to be able to share more about the things that are causing you stress and pain. It is important for you to find someone you can trust. Sometimes this can happen through word of mouth from friends who have had good experiences or through recommendations from other professionals. And if you do not feel at ease with your counselor, don’t get discouraged. It’s OK. Mental health professionals have different personalities, approaches and styles. The most important thing is that you don’t give up, but instead look for a person who you will feel comfortable with.

For more information

For more information on the privacy of your health records, click here.

Last reviewed: May 22, 2009

Fact Sheet

Get the most out of your mental health provider


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Reaching out to someone for help can be a big step, but it’s important that you get the best help possible. There are steps you can take to make sure that you’re getting the best help for you. Here are a few examples:

Know your medical history. When you see any health or mental health professional-like a doctor, nurse, psychiatrist or psychologist-he or she will ask you some questions about your health and medical background, like:

  • If you’re taking any medications or herbal treatments;
  • If you smoke, drink or use illegal drugs;
  • If you have any allergies or had any reactions to medication.

By knowing the answers to these questions, you can help your provider give you the best treatment.

Be honest. Sometimes health and mental health professionals need to know things about you that you might find embarrassing or uncomfortable. It’s important to try to be as honest as possible with the provider you’re seeing. If you’re unsure about why your provider is asking you certain questions, it’s O.K. to ask him or her why the information is necessary. If you’re worried about your rights or whether your provider will keep your information confidential, make sure to talk to him or her about it. For more information, check out the Your rights when receiving health care and the Confidentiality fact sheets.

Ask questions. Don’t be afraid to ask questions about your health or treatment. If you don’t understand what your provider says, ask him or her to explain it again or in a different way. Health and mental health professionals should help you find the best solution to your concerns.

Seek support. Talking to family and friends about any treatment decisions you might need to make can help you make the right choice for you. Sometimes you might need to talk to your doctor or mental health care provider again, or get a second opinion from another provider.

Take notice of any side effects. If you’re taking medication, make sure to ask your doctor about any possible side effects. If you do experience undesirable side effects, tell your doctor.

Express your concerns. If you’re unhappy with the provider (doctor, counselor, therapist) you’re seeing, it might be a good idea to let him or her know about your concerns. It’s important that you’re comfortable with your provider, and if talking with the person isn’t comfortable, you might want to also consider changing providers.

It’s also important that you let your provider know about beliefs and cultural practices that may be relevant to your care so that he or she can be more sensitive to your needs. You might also find it easier to see a provider who has similar cultural or religious beliefs, or is the same gender as you.

Having trouble finding a mental health provider? Contact Your life your voice helpline, run by Boys Town, at 1-800-448-300 for help with resources in your area.

Last Reviewed: May 25, 2009

Fact Sheet

Community health center


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Community health centers are places (usually clinics) where health care professionals provide medical, mental health, and dental care and treatment. According to the National Association of Community Health Centers, there are 1,200 community health centers (CHCS) in the U.S. that serve about 18 million people in all 50 states. Often, CHCs serve people who might not be able to afford health care at a hospital or physician’s office.

How are CHCs different from other medical providers?

CHCs focus primarily on preventive or non-urgent care-for instance, if you have a cold or need a routine check-up. The medical professionals that work at CHCs can also help you manage long-term, chronic diseases like diabetes.

Unlike hospitals and doctors’ office, CHCs offer a wider range of services in addition to medical, mental health and dental care. These services include pharmacies, as well as social services like substance abuse education, nutrition counseling, translation for patients who may have trouble speaking English, and transportation to and from the clinic. CHCs also treat people regardless of their insurance status or ability to pay for treatment. In many cases, private physician offices or practices might only accept private insurance.

Who do CHCs serve?

CHCs are designed to treat “underserved” populations, or groups of people who don’t have regular access to health care. These people might not have access because they’re geographically isolated from hospitals or doctors’ offices, or because they don’t have health insurance. Here are a few examples of the underserved populations that CHCs treat:

  • Residents of rural areas;
  • Migrant or seasonal workers;
  • American Indians and Native Hawaiians;
  • The elderly;
  • The uninsured or underinsured;
  • Homeless families and individuals;
  • Families and individuals living in public housing.

CHCs = Patient-Centered Medical Homes

The Patient-Centered Medical Home (PCMH) concept is an approach to health care where a patient’s medical care and other social services care coordinated by a primary care physician (PCP), who oversees all medications and treatments (whether prescribed by the PCP or other specialists). The idea is that the PCP and patient should build a strong, long-term relationship so that a patient can be cared for over a range of different issues. PCMHs emphasize that care should be preventative (meaning that it should aim to prevent disease, rather than just treat them), and that treatment should be continuous, safe, high-quality, and easily accessible for all people-regardless of their insurance status or ability to pay.

Where can I find a CHC near me?

To locate a community health center in your area, check out the Department of Health and Human Services Health Resources and Services Administration website.

Information

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Last reviewed: July 23, 2009

Fact Sheet

Your first visit with a mental health profesional


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Why might you want to see a mental health professional?

Asking for help can sometimes feel scary. It probably feels like a big step. It’s really important to take that step and to get help if things are not going well. A mental health professional can help you work through whatever is troubling you and will work with you to find solutions to your problems. Talking with a mental health professional might leave you feeling less alone and like a load has been taken off your shoulders.

There are lots of reasons why you might go and see a mental health professional. For example, you might feel like life is overwhelming and like you aren’t taking care of yourself. Or, you might feel like it would be helpful to talk with someone about a major event in your life that is impacting your day to day activities in a negative way and just won’t go away. It might even be that you are concerned about a friend or family member and want to talk with someone about this who has more expertise than friends or family.

How you might be feeling or questions you might have

Before your first visit to a mental health professional, you might be experiencing a lot of emotions and have a lot of questions. You might feel:

  • Worried or scared;
  • Embarrassed;
  • Unsure.

Here are some questions you might be asking yourself:

  • What will happen at the session?
  • How will I tell the mental health professional what’s wrong?
  • What if the problem isn’t important enough and I’m just wasting the person’s time?
  • What if the person thinks I’m really strange?
  • What if my problem is embarrassing?
  • Will the mental health professional tell my parents?
  • Should I just deal with this by myself?

Experiencing any of these feelings and asking yourself these questions is not at all uncommon. It is important to realize that mental health professionals are used to dealing with all sorts of issues, and that no problem is too big or small. Every problem is important. If your issue is affecting your day to day routine and is troubling you, this is reason enough to talk to a helping professional.

Setting up a visit

It can help to lessen some of your concerns by arming yourself with information about what your session might be like. If you do decide that you want to talk to someone, there are a lot of different services available. Check out the Individual counseling or therapy fact sheet and the Finding people to help and support you section on ReachOut for more information about what type of provider might be right for you.

What might happen at the first session?

Talking to a mental health professional can feel pretty scary. Sometimes it is really hard to say the things you are feeling because you might be worried that the mental health professional might judge you. In the first session, it is likely that the mental health professional will want to get some general information about you. They might ask questions about:

  • How you have been feeling lately;
  • What’s been happening in your life;
  • Your past;
  • How things are with your family and at school;
  • Your physical health.

You might also have to fill out a questionnaire or survey that will help the mental health professional understand what the problem might be.

The reason a mental health professional will ask you all these questions is so he or she can better understand what is going on in your life. It is important to be honest and try to say as much as you can so that the mental health professional can get a better understanding of your situation and you feel.

Sometimes people feel concerned because their counselor or therapist doesn’t give them a diagnosis right away, but this is not at all unusual. A mental health professional will not give you a quick diagnosis because he or she will want to have a really good understanding of your emotional state and what can make you happier and healthier.

After your first session, your mental health professional will probably talk to you about what you would like to do from there. He or she might suggest that you come back and visit regularly, but this decision is ultimately up to you.

Tips to getting the most out of your sessions

Here are some general things you might want to keep in mind if you decide to see a mental health professional. You can apply these tips to your first visit and every visit after that.

Write ideas down beforehand. You might want write down some issues you want to talk about in case you forget them.

Ask lots of questions. It’s OK to ask lots of questions, especially if you don’t understand why the counselor or therapist is asking you to talk about, or do certain things.

Go in to your sessions with a positive attitude. Keeping an open mind and positive attitude will help you get the most possible out of your counseling session. You might as well give it a shot!

Don’t be thrown off by note taking. Your counselor or therapist will probably take notes while you are talking. Don’t be put off by this. Often a mental health professional will write down things like names of people and events so they can talk about it with you later. He or she might also write down specific things you have said that are important. If you feel uncomfortable with your mental health professional writing things, you can ask to see the notes or talk to your counselor about it.

Understand your confidentiality rights. Client confidentiality is an ethical code that mental health professionals should adhere to. This means that your mental health professional should not disclose information about your sessions without your consent. One universal exception to this is if the mental health professional is genuinely concerned that you are at risk of harm or harming someone else. There are other state specific exceptions about what a mental health professional can and cannot keep confidential, and the age at which a client’s parent or legal guardian is no longer entitled by law to information. It’s best to ask your mental health professional about his or her confidentiality policy and state law and regulations before your sessions start. In most cases this is something that your mental health professional will bring up as part of an initial meeting. Check out the Confidentiality fact sheet for more info.

Be honest with your mental health professional. Your mental health professional will try to help you feel better, but you need work with mental health professional and open up about how you are feeling and the things that are causing you stress and pain. It’s OK if you are having trouble finding the right words. This isn’t unusual. Sometimes a counselor or therapist will use writing or drawing, or other art such as making a collage or painting a picture to help you tell your story.

Don’t be afraid to change mental health professionals. Sometimes you won’t “click” with the first person you see (or the second, or maybe even the third). If that’s the case and you’ve given the relationship some time, it might be a good idea to try seeing another person. Just because it didn’t work with one, doesn’t mean it won’t work with another. Keep trying.

Don’t be afraid of your counselor. Remember that your mental health professional wants to help you. You can disagree with the person and question things if you don’t feel comfortable.

Last Reviewed May 25, 2009

Fact Sheet

Individual counseling or therapy


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Discuss what you want to resolve or change

People who want advice and help with their problems often go to see a mental health professional to talk about what they want to resolve or change. Generally these are individual sessions, with just you and the counselor or therapist. Sometimes, however, your therapist could suggest that you join a group with others who have similar concerns, or your therapist might also have sessions with you and your parents and other family members.

What happens during individual counseling or therapy?

Individual counseling involves talking about your feelings, thoughts, and behaviors and the things that are troubling you. You might spend time talking about your relationships with others, the things you are good at and the things you would like to do better. Your counselor or therapist will work with you to set goals or identify the things you would like to accomplish by working together. The counselor or therapist will also work with you on different strategies to help you reach your goals. In some cases this could mean helping you to change patterns of thinking or learning new skills or ways to behave. Your counselor or therapist might also give you homework so that you can practice outside of the counseling sessions some of the things you are learning.

At the first appointment, it’s typical for both you and your counselor or therapist to talk about what you want from the therapy. There are many different approaches to managing mental health difficulties. You may find it helpful to know more about some of approaches. For more info, check out the Get Help section of the web site.

Paying for services

Before you have your first appointment, it’s a good idea to be clear about how much the counseling session will cost or whether the service is free. If you have private insurance, it may or may not cover all of the expenses. You can be in touch with your insurance provider to get further clarification. This information could be available online at your provider’s website. Recipients of Medicaid may be able to have their services paid through this federal-state partnership program. For more information on how to pay for services see the Paying for mental health services fact sheet. Insurance plans usually limit the number of sessions the plan will pay for in a calendar year.

Asking questions

The time you spend with your counselor or therapist is valuable, so it’s O.K. to ask any questions you might have about how therapy works. It’s also fine to ask your counselor about his or her experience and background and approach to counseling. You can ask these questions at your first session, or you can ask them when you first make the appointment. Here are some questions you may want to ask:

  • What training or experience does the counselor or therapist have?
  • Does he or she belong to a professional association?
  • How many sessions does your counselor want you to commit to?
  • How often does your counselor want you to make an appointment?
  • What experience has your counselor had with problems or concerns such as yours?
  • Will your counselor be discussing your case with anyone else?

Deciding to continue your therapy

Within the first few sessions, you need to decide whether you want to continue seeing your counselor or therapist. You will only have your own impressions to rely on. Make sure you feel comfortable enough with the person you are seeing.

If your counselor or therapist does anything that makes you feel uncomfortable, talk to someone you trust about it. For information about who else you could talk with, you may want to check out the Get Help section in the Web site. It is not O.K. for a counselor or therapist to make sexual advances towards you. If you feel that this is happening, it’s important that you talk with someone. This might be a family member, teacher, local doctor or another counselor - or contact a hotline like the Boys Town National Hotline at 1-800-448-3000 1-800-448-3000, where a trained volunteer will listen to your concerns.

More information on finding a therapist

Theravive

Last reviewed: May 25, 2009

Fact Sheet

Worried about a friend who is self-harming

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What is self-harm?

Self-harm is when people deliberately hurt themselves. It is not necessarily a suicide attempt, and may not mean the person wants to die. Self-harm includes deliberately cutting, burning, biting and hitting your body. The reasons why a person self-harms can differ, but they may be doing so to change how they are feeling when they are depressed or angry, or because they are frustrated or don’t know what else to do.

What to do in an emergency?

If someone has harmed themselves intentionally and is hurt seriously, it is important to get medical help. Call an ambulance (dial 911) right away.

You may want to support your friend by going with them to the hospital. This may help to reassure them.

At the hospital, after the person has been physically checked, they will usually be assessed by a mental health professional. In big hospitals, this person will probably be a psychiatrist. For more information about psychiatrists and other mental health professionals, you may want to check out the Get Help section of ReachOut.

When do I tell someone else?

If you are concerned about your friend’s safety, it is important to let someone like a counselor, teacher or youth worker know what is going on. These people should be able to help you make sure your friend stays safe.

If possible, it is a good idea to be honest with your friend, letting them know that you will have to let someone know if they tell you that they are harming themselves. If your friend chooses not to tell you things on that basis then that is their call. This way you are not being put in a situation where you feel like you are breaking their trust or risking them harm.

How can you help?

Supporting a friend who is self harming may be hard. Often the reasons why someone self-harms are complex and managing these reasons needs help from someone like a psychologist, psychiatrist or a counselor. Helping your friend might mean encouraging your friend to get help and then standing by them when they do seek help.

It may be helpful to encourage your friend to try some alternatives to self-harming. The following are a few things you might suggest:

  • Punching a pillow or punching bag;
  • Yell or sing loudly;
  • Take a cold shower;
  • Carry a token to remind you of something comforting or peaceful;
  • Write in a journal;
  • Color in coloring books;
  • Make a phone list of people you can call when you want to self harm - and then use it!
  • Plan activities for your most difficult time of day;
  • Ask for help.

If you feel you need some advice on how to help your friend, you can call Your Life Your Voice at 1-800-448-3000, run by Boys Town (for everyone). They may be able to offer you support, advice, and encouragement. If you feel your friend is in serious crisis or is thinking about suicide, you may also call the National Suicide Prevention Lifeline 1-800-273-TALK (8255) for advice.

Looking after yourself

Sometimes we can get so concerned about our friend that we may end up feeling stressed and anxious ourselves. If you are worried about your friend, you may find it helpful to share your concerns with someone you trust. If things start to become overwhelming it may help to take some time out. You may want to listen to some music, go for a walk, go shopping or hang out with other friends.

Last Reviewed July 6, 2009

 

Fact Sheet

Dealing with Anger


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Everyone gets angry at one time or another. Anger is a normal and healthy human emotion. However, anger can be a difficult emotion to express and manage, particularly if we have often been taught not to show or express our anger. It is not uncommon to feel guilty or ashamed about being angry, even though it’s a very normal and necessary emotion.
While anger itself is a normal and healthy human emotion, when anger gets out of control, it can lead to problems in personal relationships, particularly if anger leads to emotionally or physically abusive behavior or other acts of violence.

Why do people get angry?

There are many different reasons why people get angry. Some reasons why you might be feeling angry include:

  • You may have been treated unfairly
  • You might feel you have no control over things
  • You could be stressed or under a lot of pressure
  • You might be experiencing body changes, which cause major mood swings
  • You could be depressed
  • You might just have a personality that has a short fuse.

All of these things can lead to anger, which is, in itself, a normal and healthy emotion. Anger only becomes unhealthy when it’s expressed in a way that hurts others or yourself. When anger gets out of control, people can behave in ways that are destructive. Likewise, if you bottle up your anger and don’t express it at all, you might find that it will come out in ways that you didn’t expect. There are many ways of expressing your anger, but becoming violent is never okay.

The good news is that people can learn to manage their anger. In some cases this means learning to express anger in healthy ways, learning to keep yourself calm and controlling your reactions, avoiding people or situations that make you angry or enraged, or leaving a situation if you feel yourself becoming angry or losing control.

Expressing anger in healthy ways

Let’s suppose you are in a cafeteria line, just about to get your tray, when someone steps in ahead of you. Anger starts bubbling up, but what should you do? Here are a few options that give you healthy ways to express your anger.

Option 1: Communicate assertively—not aggressively—before your anger gets out of control.

Being assertive doesn’t mean being pushy or demanding; it means expressing your feelings and needs in a way that is respectful of yourself and others. An aggressive response might be “Hey, buddy, who do you think you are? Go to the back of the line.” An assertive response might be “Sorry, but I think I’m next. The line forms over here.”

Option 2: Recognize your anger and keep calm.

Anger isn’t just emotional—a physiological response actually occurs when a person gets angry. Heart rate increases and muscles become tense. These physiological responses can actually be cues that signal a person that they are becoming angry. Recognizing those cues and learning how to calm internal responses when faced with a person or situation that arouses anger can help angry feelings subside. Different relaxation strategies might also be helpful, such as breathing deeply, repeatedly telling yourself to remain calm or take it easy, counting from 10 backwards, or visualizing an image that helps you relax or feel calm. These responses can also be used before coming face to face with the person or situation - almost as a way to anticipate or prepare for what is stressful.
Remembering to slow down and stopping to think before reacting can also help you keep your cool. Reacting impulsively to what someone else says or does can fuel anger. By slowing down and stopping to think, you are better able to listen and really hear what the other person is trying to communicate. By stopping to think you can also give yourself time to think of other ways of solving the problem you’re facing.

Option 3: Be aware of and adjust your way of thinking.

At times the things we say to ourselves - or how we think—when faced with a situation or person who makes us angry, can actually fuel the angry feeling. The scientific term for changing your thinking is “cognitive restructuring” and it’s a technique rooted in cognitive behavioral therapy. Changing the way you think means switching up the irrational kinds of messages you give yourself to those that are more logical. For example, switching from “this guy must be cutting in front of me on purpose” or “I must keep my spot in line” to “I’d prefer that this guy would leave after I point out that I was here first, but I can survive if he doesn’t.”

Option 4: Avoiding or leaving a stressful situation.

In some cases, a person can identify the situations that often trigger their anger. Staying away from the situation isn’t always an option, but in some instances it could. For example, if you know that it really pisses you off to see your old girlfriend hanging with her new boyfriend, you might want to avoid going to their favorite place to hang out. It doesn’t mean you will never go where they are, but maybe avoiding them initially while you are getting over the break up might help you keep your cool.
Also, if you feel yourself getting angry, another option is to leave the situation before things escalate. Sometimes people feel that leaving isn’t always easy to do because “reputation” or “being respected” might be involved. Cognitive restructuring might be useful as a way of challenging these thoughts.

Other ways to manage your anger…

  • Count to 100. It sounds cliché, but when people are angry, they can say or do things that they regret later. If you feel that you are becoming angry, do something to cool down, like counting to 100.
  • Leave the room. If a situation is getting to the point where people are yelling or are possibly even being violent, leave the room and tell them you will talk about it when everyone is calm.
  • Work off some steam. Doing something active like kicking a soccer ball, punching a pillow, or going for a run can help you release some angry energy and calm down.
  • Play video games. If you feel as if you are going to get into a fight, it’s better to do it in a video game than in real life. This can also be a good way to release some anger and energy.
  • Play some tunes. Strap on the headphones and play your favorite music for a while.
  • Sit in a quiet place. Go to a park or wherever you feel calm and just chill out. Try and think about why you are angry, as well as some solutions to the problem you are having.

What can I do if I keep getting angry?

If you find that you keep getting angry, or that you are lashing out and regularly becoming violent toward people or things, it may be helpful to speak to a friend or family member, or a health care professional like a counselor or your doctor. Speaking to someone may help you identify why you’re getting angry and help you deal with your anger so you don’t need to resort to lashing out. Check out the Get Help section for more information about what these professionals can do to help you.

For more information

American Psychological Association online

Fact Sheet

Helping a friend in a sexually abusive relationship


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It is usually difficult to know if a friend is in a sexually abusive relationship. But there are some warning signs that you might notice, especially in his or her behavior.

What to look for:

  • Your friend is losing interest in activities he or she used to enjoy;
  • Your friend is overly worried about what his or her boyfriend or girlfriend thinks;
  • He or she is acting overly happy or seems to be worried and anxious when with his or partner;
  • If someone calls your friend’s partner out on something negative, your friend makes excuses for his or her partner all the time;
  • He or she is avoiding friends and social activities that do not include his or her partner;
  • Your friend jokes about his or her partner’s violent outbursts;
  • Your friend has unexplained injuries and the explanations seem odd or unlikely;
  • Your friend’s behavior has changed dramatically since he or she started dating this current partner.

How you can help

If you do suspect that your friend is being abused by his/her partner, there are some ways you can help, but it is always important to remember that if you believe that you or your friend are in some immediate danger, you need to go to the police.

Encourage your friend to talk. Try to get your friend to do most of the talking. Here are some open-ended questions you can ask your friend:

  • How are you feeling about your relationship?
  • What do your friends and family think about your relationship?
  • Do you have plans for the future of your relationship?

Try to talk when you’re alone with your friend, not in front of other friends or family members, especially his or her partner. Sometimes it can be easier to talk if you’re also focused on another activity like going for a drive, making a meal or doing the dishes. You should talk to your friend or seek help from an outside source, but do not confront your friend’s partner. This could make the situation worse and you could even be putting yourself in an unsafe position. You will also want to suggest that your friend not go talk to his or her partner about your conversation.

Listen to your friend. Don’t be judgmental. If your friend is in an abusive relationship, he or she probably already feels down. Don’t make your friend feel worse.

Don’t blame your friend for what’s happening. Don’t tell your friend what he or she should have done differently. Concentrate on what makes him or her happy and how your friend can take action to change things now.

Don’t tell your friend what to do. Instead, encourage your friend to think about options. You might ask your friend if he or she has already tried getting help, or you might suggest places to seek help.

Be specific about why you’re concerned. For example, say things like I feel bad when he says you’re stupid or We hate to see you nervous and unhappy.

Make sure your friend knows he or she has your support. Your friend might be feeling very isolated and alone. Let your friend know that you are there for him or her, and that he or she has already begun seeking help by talking to you. Make sure your friend knows you are willing to support him or her in any way that will help.

Help your friend work out some realistic strategies. What works in this situation will depend on how willing your friend is to see that there is a problem.

Your friend has to find his or her own way through the situation, but talking to you or a trusted person can help. If your friend does not want to talk to you about it, you might just suggest that your friend call a hotline (like one of the ones listed below), where he or she can get help without bringing anyone personal into the situation. Encouraging your friend to realize his or her strengths as an individual can be the best protection you can give, and the best way to ensure that your friend does not become a victim of abuse again.

Where to get help

Finding the courage and the appropriate way to talk about these issues with your friend is important. If you need advice or information for how to do this, there are lots of services and support available. Don’t be afraid to ask for help, especially if you or someone you know is in a violent relationship or has been sexually assaulted. Though you should not feel personally responsible for a friend’s situation, you can always choose to help.

You can call The Rape, Abuse, & Incest National Network (RAINN) at 1-800-656-HOPE or the National Domestic Violence Hotline at 1-800-799-SAFE for help and more information for either you or your friend. For emergency situations where your friend is in immediate danger, call 911. You can also call Boys Town National Hotline at 1-800-448-3000 to speak with trained volunteers who can direct you to support services in your area.

For more information


Last reviewed: April 26, 2012

Fact Sheet

Stopping anger turning into violence


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Anger is a normal, healthy emotion that we all express. Sometimes, anger can be a positive emotion, driving us to right wrongs or fix injustices. But sometimes a person’s anger can become uncontrollable and harmful—and it can even lead to violent behavior.

Expressing your anger in negative ways

Just as everyone feels angry from time to time, everyone also expresses their anger in different ways. Some ways are more constructive than others, and chances are, you’ve learned the ways you respond when angry and frustrated from your environment—like the people in your life or the situation you grew up in.

Violent behavior, toward oneself and others, can result from anger. It is one way that people express anger and try to control the situations that they find themselves in—but violence is never a positive or constructive way to deal with your emotions.

Certain factors might put you at a greater risk of acting out violently. For example, you might be violent because the people you hang out with use violence or other types of aggression. You might think violence is more acceptable because you’ve seen it on television, in the movies or in video games. You might also act violently because someone—like a bully or even a family member—is being violent toward you. If you grew up in a violent household, you might think that it’s OK to deal with your feelings in a physically aggressive way. Research shows that children who grow up with disruptive home situations might have a harder time controlling anger and are more likely to act out violently. This is often called a “cycle of violence.”

Recognizing the potential for violence

There are certain warning signs that people might have a hard time controlling their violent behavior. Here are a few examples:

  • Regular loss of temper;
  • Frequent physical fighting;
  • Drug or alcohol abuse;
  • Vandalism or property destruction;
  • Harming other living things, like animals;
  • Making frequent threats toward others.

Tips for breaking the cycle of violence

The good news is that any learned behavior—such as violence—can also be unlearned. The key is to first take control of situations that make you angry and manage your reaction to frustration. Here are some tips to get started:

Use your anger as a signal. The next time you feel angry, stop and count to 10. Then think about the situation you’re in and why it’s making you feel this way. Tell yourself “I can calm down.”

Think about the things that trigger your anger. By identifying common factors in the situations that seem to trigger your anger, you might be able to predict and prepare for future anger-producing circumstances.

Take a ‘time out.’ If you feel that you might lose control, get yourself out of the situation that is provoking you. Take a break from the situation to reevaluate what’s happening and think about your next steps and whether any actions could be potentially harmful. Again, tell yourself “I can calm down” or something like “I’m not going to let this get to me.”

Use this time out to think about what really is going on. For example, if you’re feeling angry because your teacher or boss yelled at you, your anger might be stemming from a deeper feeling of inadequacy or disappointment in yourself.

Talk to the person who is making you angry. When feeling more in control of your emotions, explain your side of things and assert your opinions in a positive way. For example, use “I statements” like I feel this way because…” Be prepared however to keep your cool if the other person doesn’t respond the way you think he or she should.

Respect others’ opinions and reactions. It is important to remember that you can only control your reactions to situations and you can’t control the other person’s. Remember, it’s OK to disagree.

Don’t let it all hang out! While it’s important to express yourself, it isn’t always best to “let it all out.” In fact, fully acting on your angry feelings without taking others into consideration could actually have negative and harmful consequences.

Avoid using drugs and alcohol. Sometimes it’s easy to turn to substances like drugs and alcohol to help you forget or suppress angry feelings, but the relief you get from drugs and alcohol is only temporary, and the side effects of abuse can make a situation worse.

Talk to someone. Friends and family can be great sources of support if you’re feeling angry and frustrated—as long are you’re talking with them in positive ways and not taking your anger out on them. If your anger is becoming increasingly disruptive and harmful, and you find yourself unable to manage your violent behavior, you might also want to consider talking to a mental health professional for extra support.

For more info

There are several ways that anger and violence can play into your life. For more information on the relationship between these two, check out the Anger and Interpersonal violence fact sheets.

Violence can manifest itself in many different situations. If you’re in a position where you’re dealing with violence, it might be helpful to check out some of these fact sheets as well:

If you’re having trouble controlling your anger or channeling your frustrations into positive actions, you might want to also check out the Relaxation and Coping with a stressful event fact sheets for more tips on how to effectively manage your anger.

The following sources provided information for this fact sheet:

American Psychological Association Help Center

U.S. Substance Abuse and Mental Health Services Administration Anger Management Workbook (This is a manual for group therapy. Certain sections hold relevant material that may be of interest to individuals who would like to learn more about anger management.)

Fact Sheet

Spring break


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Spring break is a great time to kick back, hang out with your friends and take a break from all of your course work. Some people like to use spring break to go home and see family and friends, some like to stay at school and enjoy it without being too busy with classes, and others like to take a trip somewhere.

Ways to be safe while on break

If you do take a trip during spring break, it’s important that you take a few extra precautions while you’re in a new and unfamiliar place. Here are a few suggestions that can help you stay safe and still have a good time:

  • Always walk around in a group. Don’t wander off alone or go with someone who you don’t know very well or have just me.
  • If your hotel is in a busy area, keep your doors locked while you’re not in your room. This will help keep your belongings safe while you’re out.
  • If you’re going to a beach for spring break, don’t swim at night. Make sure you follow the beach safety rules that that should be posted near busy areas.
  • Be careful when meeting new people. You never know who might take advantage of the fact that you’re unfamiliar with the area. Avoid going somewhere with strangers or people you’re not friends with, particularly when you have been partying.

For more information, check out the Assessing your safety fact sheet.

Avoiding violent or potentially volatile situations

Parties involving a lot of people, alcohol or drug use can increase the likelihood that something could get out of control. Remember that you are on spring break to have fun, not to find yourself in a potentially violent or volatile situation.

Be aware if the party you’re at is getting too loud with too many people hanging around outside and standing in the street. Neighbors might complain and the cops may be called. Be smart, leave situations before they erupt or get out of hand.

If someone you don’t know is being violent at a party or a public place, it is probably best just to leave. If two people you don’t know are fighting or causing trouble, it is not your problem-just get out before you get hurt. If you think it is getting out of hand and you are afraid that someone will get seriously hurt, it is a good idea to call the cops to let them know. Even if you left the situation, other people might be in danger, and calling the cops could be the best way to helping everyone. If you are in a public place, such as a bar, the bartender probably already sees the situation, but you might want to let him or her know on your way out so they can call the cops.

If one of your friends starts to provoke a fight, try to quietly let them know that it’s not worth it and that you guys should probably leave. You want to be there for your friend, but you also don’t want to get yourself in trouble. Try to convince your friend to stop and leave before the situation escalates any further, but don’t push them to the point at which you become involved in the violence.

It’s never a good idea to start a fight, or start acting violently. It’s just going to get you hurt or get you into trouble. If someone starts acting violently towards you, let them know you don’t want to get involved and just walk away. There is no shame in walking away from violence.

Sex & spring break

You might consider having sex while you’re on spring break. If you do, protect your body and be responsible. For instance:

  • Only agree to sex if it’s going to be protected sex with a male or female condom. Don’t expect that the other person is “prepared” - make sure you are prepared with condoms to protect your body if you think you might have sex. Unprotected sex puts you at risk of getting sexually transmitted diseases and if you are a girl - getting pregnant.
  • Don’t agree to have sex if you don’t want to. It’s your right to say no or change your mind. It’s wrong to pressure someone else into having sex.
  • Drugs and alcohol can affect your judgment and prevent you from thinking clearly, particularly in situations where sex might be involved. Remember to listen to your instincts before having sex.

Drugs & alcohol

Some parties have people drinking alcohol or using drugs. Because of this, you might feel pressured to drink or take drugs with them. It is always O.K. to decide to not drink or use drugs. If you aren’t feeling like you want to be part of this kind of partying, you do not have be there or do what others are doing there. Deciding what is best for you is the one thing you can do for yourself. Instead of following everyone by drinking or doing drugs, you can lead by your own example and stick to your decision to not drink or do drugs. You might feel uncomfortable at first but that strength may actually inspire others to follow your lead.

You can still be a part of the group even if you don’t drink or do drugs but you might also want to reassess whether or not this is the type of scene you want to be part of during break. If that is the case, tell your friends. Suggest that you all go to something else. It might surprise you when your friends say they don’t want to stay either and were just going along because they thought everyone else wanted to go or they thought that this is “what you are supposed to do” when on break. If they are your friends, they will be okay with your decision not to do drugs or drink. They will also understand if you don’t want to be at a scene like that.

It takes courage to say no or suggest that you want to do something else. But it is a good feeling to stick to what you believe in and hold true to your feelings. And you might be surprised at how others will admire you for sticking to your decision. In fact, some may follow in your footsteps.

Friends look out for friends

Don’t leave your friends alone. It is good to have the agreement with your friends that when you are on spring break that you are all looking out for each other. You should have an agreed plan for how to get each other out of an awkward situation. But also keep an eye out for each other and help them when they need it.

And don’t forget—have fun

Don’t forget that you are on spring break to have fun! While your safety and health are priorities, you should try to enjoy your week off. Bring your camera and capture all those Kodak moments so that you can look back on the break with your friends later and have only positive memories.

Information

Information in this fact sheet was provided by:

eCampusTours “Spring Break Dos and Don’ts”


Last Reviewed: June 17, 2009

Fact Sheet

Getting wasted


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In our society, it’s socially acceptable to drink alcohol.  Many Americans drink alcohol after work or with meals, at social gatherings or parties, on the weekend, at sporting events, concerts and other social situations. Although we may not talk about alcohol as a drug, it is a widely used one.  Many people abuse alcohol by drinking so much that they get drunk or ‘binge drink’. Binge drinking can have many negative side effects and can compromise your safety and the safety of others.

What is binge drinking?

Binge drinking is heavy drinking over a short period of time or drinking continuously over a number of days or weeks. You might refer to it as “getting wasted” or “getting drunk.” When a person binge drinks, his or her blood alcohol content (BAC) is at .08 or higher. This typically means five alcoholic beverages in two hours for a man, and four beverages in two hours for a woman, although BAC varies according to a person’s weight and height.

Drinking like this can happen in a variety of situations. You might find yourself in a situation where the people around you are drinking to get drunk at a party or a bar, and feel pressured to do the same. Or you might feel uncomfortable in a social situation and drink to lessen these feelings. Other times, you might end up drinking excessively because you don’t recognize your own limits or you might be depressed or upset.

Is binge drinking harmful? Yes, it can be. Binge drinking can lead to several negative short-term and long-term side effects, many of which won’t hurt just you, but also the people you’re with.

Short-term side effects

Your health and well-being.  Drinking too much can have immediate side effects on your health and well-being. You might become dizzy, shaky, nauseated and disoriented from too much alcohol. You might also vomit, or have a hangover the day after you drink. Being drunk can leave you vulnerable as well; you might let down your guard and have unprotected or unwanted sex, which can lead pregnancy or the spread of STDs.  In really serious cases, binge drinking can lead to alcohol poisoning and death. (See below for links to more information on alcohol poisoning).

Others’ health and well-being.  Because alcohol can seriously impair your judgment, binge drinking might cause you to do some things you might not do if you were sober. For example, you might become violent and hurt others around you. You might also try to drive somewhere—which is not only very dangerous, but also illegal.

Long-term side effects

Your health and well-being. Alcohol abuse can also affect your long-term health, and lead to weight gain, liver and brain damage, high blood pressure and increased cancer risk. It can also lead to alcoholism, a physical and psychological dependence on alcohol.

Others’ health and well-being. It’s important to recognize that binge drinking can affect your behavior, and in the long-term, bad behavior can ultimately cause you to lose friends and loved ones. Excessive alcohol abuse can also affect your school work or your job performance, and leading to bad grades or you getting fired from you.

How much can you drink?

We all respond to alcohol differently. It is important that you know your limits and monitor how much you’ve had to drink. How alcohol affects you may be influenced by a number of factors, including how much alcohol you drink, how quickly you drink it, whether you consume the alcohol with other drugs, your mood, your body type, and the amount of food in your system. If you’re taking medication, alcohol could also interact with your medicine and cause you to get drunk very quickly or worse, overdose.

To get a sense of how much you’ve been drinking, measure your intake against a “standard” drink—one 12 oz. beer, a glass of wine, or one shot of liquor. Each of these drinks has the same amount of alcohol, and none of them are “better” or safer to drink than the others. The National Institute of Alcohol Abuse and Alcoholism recommend that you consume at most only one drink per day if you are female and two “standard” drinks per day if you are male. If you’ve never drank alcohol before, you need to be extra cautious.  It might be hard for you to know what to expect or understand your limit.

Tips for controlling your drinking

Knowing your limit is just the first step in managing your alcohol intake. Here are some tips to help you control how much you’re drinking while you’re out with friends.

Start or finish with a non-alcoholic drink, like a soda or water. You might also want to drink a “spacer” non-alcoholic drink between drinks.

Try a low-alcohol alternative.  Certain drinks have lower alcohol contents than others. Go for the drink with the lowest percentage of alcohol by volume—this will be labeled clearly on the front of the bottle. 

Eat before or while you are drinking. This will fill you up and prevent you from getting too drunk too quickly. Also try to avoid salty snacks, because these can make you thirsty.

Set limits for yourself and stick to them. Remember that drinking more than one or two drinks is probably excessive. Don’t give into peer pressure and drink more than you want or intend to.

Drink slowly. Take sips instead of gulps. Avoid rounds or shots. Don’t get involved in competitive drinking games like quarters that can cause you to drink a lot in a short amount of time.

Mingle. Staying busy instead of just sitting and drinking can keep you occupied so you don’t just drink.

Managing alcohol intake

Because alcohol is a drug, you might find that you crave alcohol when you start to limit your intake. And because alcohol is so widely used in many different social situations, it might be hard to avoid. But you don’t need to drink to have a good time. If you’re having trouble managing your alcohol use, talk to your friends and family about how they can help you manage your drinking. If your drinking becomes a serious problem, you might also want to talk to a doctor or counselor about stronger steps that you can take to curb your alcohol use.

Information in this fact sheet was provided by:

The National Institute of Alcohol Abuse and Alcoholism

Dietary Guidelines for Americans 2005

The Centers for Disease Control and Prevention, Alcohol and Public Health

For more information on alcohol poisoning check out the Mayo Clinic. If you suspect that one of your friends has consumed a dangerous amount of alcohol, contact the National Poison Control Center (1-800-222-1222) for immediate assistance or call 911 for an ambulance.

 

Fact Sheet

Flunking at school or college


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Flunking out at school or college, or getting worse than expected grades, can be stressful, especially if you’ve previously averaged higher grades, or are depending on high grades to get into a particular course or profession. It might feel like everyone except you is doing well at school, or that everyone else is passing. Try to remember that everybody’s learning and working style is different and we all work through things at our own pace.

Why you might be flunking out at school or college

Sometimes the reason why you are failing or getting worse than expected grades might be obvious, while at other times it might be for reasons you hadn’t considered. Some reasons might include:

  • Increase in workload;
  • Poor study habits or organization - not enough time spent studying, especially common if you moved from the highly structured environment of high school to more relaxed college environment;
  • Unrealistic expectations;
  • Lacking the motivation to study;
  • Illness including physical or emotional problems;
  • Family or relationship issue;
  • High stress levels related to studying;
  • Poor attendance at classes;
  • The way material is being taught is not best suited to your learning style.

How failing might affect you

You may be experiencing a range of emotions, including feeling:

  • Overwhelmed;
  • Surprised or disappointed, particularly if you’ve worked hard and/or previously received higher grades;
  • Stressed or anxious;
  • Annoyed and frustrated at yourself or others;
  • Down or depressed;
  • Hopeless or as if you want to give up;
  • A sense of regret, shame or failure

The situation at school or college may also be affecting you physically. For example, you might:

  • Feel physically sick, including headaches or migraines;
  • Find it hard to concentrate;
  • Sleep too much or not enough

Failing in school or college may affect other parts of your life too and you might find you’re not able to enjoy the things you normally would. You might also feel more likely to abuse drugs or alcohol as a way to escape or numb overwhelming feelings.

Suggestions for managing the situation

If you are failing or not performing as well as expected at school or college, there are a range of things you can do:

Talk to your teacher/professor/teaching assistant/tutor. Explain that you are having difficulty completing/handling in the work. If they are not given a reason to explain a poor performance on an exam or assignment, they have no choice but to give you a bad grade. However, if you speak with them about what the problem may be, they will be more inclined to help.

Get extra help to understand the course content. If you are finding the course tough, you may be able to get a tutor to help you understand the subject content. This might be a subject tutor/teacher, a friend who is doing well or someone from a study help center at your college.

Get organized. If you are finding it hard to stay on top of your studying, it may help to work out a study plan so you can balance your subject load and other commitments - it can make a significant difference in how productive you are. Your teacher, tutor or school counselor should be able to help you create a plan.

Reassess your subject choices. If you are not enjoying the content of your subjects, it might be hard to stay focused. Sometimes your subjects might be compulsory and you just have to stick it out but it may be possible for you to change to something that you find more interesting.

Challenge and reset your expectations. Sometimes it can be helpful to re-think your own expectations. This may help you decide if they are achievable for you. A useful question to ask might be “What would I suggest to a friend in this situation?”

Have a range of options for the future. Sometimes expectations are only focused on one outcome and if you don’t meet it, you might feel disappointed or that you have failed. Usually there are a number of ways to achieve a goal. Other options that you may be better suited to could include internships, short courses, or even taking one or two classes at college instead of a full time load. Just because you aren’t getting the grades you would like doesn’t mean that education is not for you.

Get to know your learning style. Learning styles are characteristics that refer to how you approach learning tasks and how you process information. Everybody has different learning styles and no one style is right or wrong. It might be that the way subjects are being taught at school or college is not best suited to your learning style. Knowing your style might help you to take advantage of it when you study and help you to improve your school/college grades.  There are usually resources at school or college that can help you identify your learning style.

Get some head space/chill out. Sometimes getting some head space and a change of scenery can be helpful - it’s important to give yourself permission to do this regularly. This might include going for a walk or listening to your favorite music, reading a book, going to the movies - whatever works for you.

Don’t give up and keep it in perspective. Getting lower grades than you hoped for does not mean you are a failure or a bad person, but rather that you might benefit from improved study habits or reassessing your choices. It doesn’t necessarily mean that you’d be better off giving up entirely.

Look after yourself. It’s important to take time out by doing something that you enjoy. Even though you might not feel like it or have time, exercising and eating well can help. When you exercise your body releases endorphins which help you think more clearly and feel better about yourself. If you haven’t done a lot of exercise before, it might be a good idea to start doing something small a couple of times each week, such as a 15 minute walk or 2 or 3 laps of a pool. Getting plenty of sleep can also help.

Visiting your doctor for a general check up can be a way of making sure there isn’t any physical problem.

Monitor your diet. Making sure your body has the right fuel could impact on your head space. Speak to somebody. Get some support from somebody you respect and ask for some guidance about the direction you’re heading and try to make a plan to get back on course.

Avoid drugs and alcohol. Try not to use alcohol or other drugs (including caffeine or other energy boosting drinks) in the hope of feeling better or forgetting expectations and pressure. The feeling is usually temporary and the after effects often make you feel even worse.

Repeating or taking a year off.  You might decide to repeat a year. Alternatively, you might decide that school or college is not the right place for you at the moment and taking a year off (or more) to work might be the most suitable option for you. You might find it helpful to talk it through the pros and cons with family, friends and teachers.

Fact Sheet

Looking after your child


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Becoming a parent

It can be an overwhelming experience, full of many new responsibilities. You may not even realize some of the important duties you’ll have as a mom or dad, because they might be aspects of your life that you’ve taken for granted—like making sure you have a safe place to live and the right food to eat for you and for your baby. However, because the first years of a child’s life are the most important (these are when people develop the most), it’s crucial that your baby is raised in a healthy and secure environment. Here are a few practical matters to remember as you become a parent:

Have a place to call home

Having a home is an important part of feeling secure in your new role as a parent. It’s also important for your child to have a stable home. While it’s necessary to have a “roof over your head,” a home is more than just four walls. Your home may be your parents’ or guardian’s house, a multi-family house, or your own apartment or house, but it’s key that you’re living in a regular, safe, and supportive place. Before your baby is born, make sure you have a comfortable place to bring him or her home to. This may mean rearranging your space to make room for a crib, changing table, and everything else you will need for your baby. If you are moving to a new apartment or house, make sure it is safe and comfortable for you, your baby, and anyone else you will be living with. Plan ahead so that your home will be ready for your new baby.

Keep your baby healthy

It’s important that you find a pediatrician for your baby before he or she is even born. You can get a referral from your medical doctor or nurse for pediatricians in your area. You will need to begin seeing your own doctor while you are pregnant for prenatal care. Prenatal care monitors the progress of pregnancy and makes sure your baby will be healthy. For more important information, check out the March of Dimes.

Once your baby is born, he or she should see a doctor regularly every few months for “well-baby” visits. Your baby’s first checkup should be within a few weeks of birth. The next checkups generally occur every two months, at 2, 4, and 6 months old. After 6 months, you can begin scheduling visits every 3 months, at 9, 12, 15, 18, and 24 months old. Of course this schedule depends on your baby and what your pediatrician feels would be best. Well-baby visits can help you ensure that your baby is growing and developing normally. At these visits, the pediatrician will perform a physical exam on your baby and give him or her any immunization shots that are necessary. Your baby’s doctor will also talk to you about your nutrition, as well as any concerns or questions you might have. Remember: it’s O.K. to call your pediatrician between visits. It’s also important that you always have your pediatrician’s name and number available for any child care providers who might need it while you’re away.

Feeding your baby

During your well-baby visits, you can talk to your pediatrician about the best way to feed your baby. Newborns need to eat every two to four hours, depending on whether you (and your partner if you have one) decide to breast feed or use formula. Either option is healthy, and your doctor can walk you through the steps to do both. When your child is six months old, he or she may begin to eat more solid foods like applesauce or cereal.

When your baby sleeps, get some sleep yourself

Newborns often sleep as many as 16 hours a day—which can seem like a lot, but unfortunately, they only sleep in three- or four-hour shifts. This can make it hard for you to catch the amount of shut-eye that you’re used to. Try to sleep as much as you can while you’re baby is sleeping. By six months, your baby will probably be sleeping through the night.  Most experts suggest that your baby sleeps in a crib (not with you) and on his or her back without a pillow. When you have some free time, if someone is watching your baby for you, you may want to take a nap to catch up sleep. Though you may be used to spending your free time with friends or doing fun activities, it will be worth it to get some sleep and be awake and alert to enjoy and care for your new baby.

Find extra support

If you plan on working or returning to school after you’ve had your baby, you’ll need to use some form of child care to ensure that your child is cared for while you’re at work. If you live near or with your family, you might want to ask a relative that you trust to watch your child while you’re working. You might also need to hire child care or a full-time babysitter. Before choosing a child care provider, there are a few factors you might want to consider, such as:

  • The number of hours in a day or week you’ll need child care;
  • The amount of money you’ll be able to spend;
  • The number of children a care provider looks after, and how much time he or she will be able to devote to your baby;
  • The kind of environment in which you’d like your child to be cared for;
  • Whether your provider is licensed or required to be licensed by your state. (States vary on these requirements and you may want to search online to find what your state requires).

There are several different kinds of child care you can use—each with benefits and drawbacks that you’ll need to consider. Here are a few.

Home daycare: In this situation, one person cares for several children at his or her home. Home daycare can be less expensive than a private nanny, and it can be a good opportunity for your baby to socialize with other children. However, just like nannies, home daycare providers aren’t often licensed or formally trained. A benefit of home daycare is that your child experiences a warm and inviting home environment. Your child will be in a small group and a stable setting, which may be more comfortable than a childcare center. Additionally, home daycare providers may be more flexible if you have an unusual work schedule.

Childcare centers: This form of child care is often the least expensive because multiple care providers are working at the same time with several groups of children. Group child care in a center can also help your baby socialize with other kids, and child care centers are regularly inspected by state and local officials. However, because lots of kids often attend this kind of center, your child might not receive one-on-one attention all the time, and centers might not be able to accommodate an unusual work schedule. If you are able to bring your child to a child care center, make sure you research the center to ensure that it is somewhere you feel comfortable sending your child.  For information on how to choose the right child care center, check out the National Resource Center for Health and Safety in Child Care and Early Education. If you are in school or college, or are working, you may be able to bring your child to a school or work childcare center. You may want to ask a school counselor or your boss if this option is available. At college, you may want to go to your school’s office of family services to find out more information. A school or work based childcare center could be the most convenient and cheapest option for you and your child.

Private nanny or babysitter: A nanny can care for your baby at your home, which can be convenient and comfortable for your child. Nannies can also fit to your schedule if you’re working unusual hours. However, because a nanny will care for only your child, hiring one could be expensive. Nannies are also not often licensed or trained in a particular way, so you’ll need to do more work investigating if a particular person is trustworthy or right for your family. If you only need someone to care for your child for short periods of time, a babysitter could help you out immensely.  Babysitters are usually rather inexpensive to hire and easy to find. If you care for your baby all day and just want a break some evenings, for example, hiring a babysitter could give you that time for yourself.

Set up a support network

It takes many people to raise a healthy, happy child, so enlist your loved ones to help out. Remember that parenting isn’t just for moms. Dads are a crucial part of children’s lives! To find out more about how to emotionally prepare for parenthood, check out the Preparing for parenthood fact sheet.

Information in this fact sheet was provided by:

March of Dimes, “Caring for your baby”

The Centers for Disease Control and Prevention, Child development fact sheet

Last reviewed: Feb 28, 2013

Fact Sheet

Becoming a father


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Finding out you’re going to be a father can take you by surprise. It’s normal to feel a variety of emotions—like disbelief, anger, fear or happiness—all at the same time.

Having mixed feelings about the possibility of being a dad is normal. It’s not unusual to feel excited and happy about the idea of being a dad, but you might find it hard to deal with the idea of being a father because you feel:

  • Unprepared;
  • Too young;
  • Not settled enough in life to take on this role.

It’s important to take time to understand your feelings, but keep in mind while it can take time to adjust to the idea of becoming a father, if you decide to consider options like adoption or abortion, you might have a limited timeline for making these decisions. For more on these choices, check out the I think I’m pregnant fact sheet.

The importance of fathers

A father is a vital part of a child’s upbringing. Children who are raised by both parents are less likely to experience educational, emotional, social, behavioral and health-related problems later in life than peers who don’t grow up with a father in the picture. So, while you might be questioning your ability to be a good father, just your presence is really important! Try not to sweat the small stuff, and remember that fatherhood doesn’t come with a training manual—it takes time to master.

Suggestions for transitioning to fatherhood

Most of what you’ll need to know immediately about fatherhood you’ll be able to learn in parenting classes. These classes cover a variety of topics—like the birthing process, how to child-proof your home and how to care for your newborn—and typically begin when your partner is in her seventh month of pregnancy. Check with your partner’s obstetrician for more information on classes in your area.

Here are some other issues you might want to consider before you become a father:

Finances. Feeding, clothing and providing shelter for another person costs money. It’s important that you get your finances in order and make a plan for how you’ll earn income before your child is born. You might also want to create a budget, and speak to someone who has raised a child about the costs of things like food and clothing. If you don’t already have one, it might be helpful to open a savings account so that you can start to set aside money for long-term expenses like college.

Independence. Becoming a father means you’ll probably have a lot less time to yourself, and you’ll most likely get much less sleep at night. But that doesn’t mean you can’t still have fun! As your child gets older, you can include him or her in family-friendly activities.

Relationships. Without a doubt, your pregnant partner is going through some emotional issues as well. Although you shouldn’t assume that a child will bring you emotionally closer to your partner, you should take this time to communicate your fears and expectations for raising your child together. It’s also important that you set parameters for your romantic relationship—whether you decide to remain a couple or not.


The following sources provided information for this fact sheet:

U.S. Department of Health and Human Services, “Promoting Responsible Fatherhood”

The National Responsible Fatherhood Clearinghouse, “Tips for parents”

The Nemours Foundation, “Becoming a father”

Fact Sheet

I think I might be gay, lesbian or bisexual or transgender

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…but what if I don’t know for sure?

Trying to know for sure if you’re attracted to someone of the same sex can be very confusing. The process of discovering sexuality differs for everyone. It might take a while for you to figure it out, and there’s no need to rush. Some gay, lesbian, bisexual or transgender people say they “felt different” from the time when they were young. They had an idea or sensed they might be different, but it took a while to think of themselves as gay, lesbian, bisexual or transgender. As they grew older, they realized that those words fit in with their feelings.

Many other people don’t discover their attractions until later in adolescence and some not even into adulthood. If you’re feeling confused, you’re not alone. It isn’t unusual to feel attracted to someone you’re close to or admire, like a close friend or a great teacher. But this doesn’t mean you’re gay, a lesbian, or bisexual.

You also don’t need to be sexually active with other people to recognize your sexuality. One or two experiences with someone of the same sex may not mean you’re gay, a lesbian, or bisexual, just as one or two experiences with someone of the opposite sex may not mean you’re straight.

Sexual orientation and gender identity, like many things in life, develop over time. Don’t worry if you aren’t sure. Experimentation and exploration are often a part of figuring things out. Over time, you’ll find that you are drawn mostly to men or women, or both, and you’ll know then. And over time your questions about gender will also become clearer.

Remember: A label is something you need to feel comfortable with, and you don’t have to label yourself today or ever. The choice is yours.

For more information

There are many misunderstandings about sexuality and gender, and exploring your sexuality might be a confusing thing to do, whether you’re straight, gay, lesbian, bisexual or transgender. If you’re curious to learn more about your sexuality, you might want to check out these additional fact sheets:

These resources may also be helpful:

Trevor Project and Trevor helpline (1-866-488-7386)
GLBT National Resource Database
National GLBT Talkline (1-800-246-7743)
National GLBT Hotline (1-888-843-4564)
GLSEN, the Gay, Lesbian and Straight Education Network
The National Day of Silence (brings attention to anti-LGBT name-calling, bullying and harassment in schools).
National Coalition for Gay, Lesbian, Bisexual, Transgender Youth
Youth Resource, a website by and for gay, lesbian, bisexual, transgender and questioning young people
PFLAG, Parents, families, and friends of lesbians and gays

Last reviewed: Mar 13, 2013

Fact Sheet

I think I’m pregnant

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Figuring out if you’re pregnant is not always an easy thing to do. If you aren’t planning a pregnancy, you might be worried and scared. These feelings are normal.

When you’re pregnant the following things might happen:

  • You miss a period;
  • You’re tired and don’t have much energy;
  • You vomit;
  • You have food cravings;
  • You need to urinate more than usual;
  • You have tender or swollen breasts.

It’s important to remember that having one or more of these signs does not necessarily mean you’re pregnant. There might be other reasons why you are experiencing these symptoms.

If you think you have one or more of these signs, it might be helpful to go and see your doctor. Check out the Get Help section for more information about how your doctor can help you.

Testing to see if you’re pregnant

Taking the step to test if you’re pregnant might be scary. But knowing if you are pregnant will allow you to move forward in deciding what to do next. Having support from a friend or someone you trust while you’re figuring out if you’re pregnant can be helpful. Here are two ways you can determine if you’re pregnant:

Home pregnancy test.  Home pregnancy tests are available at most drug stores and pharmacies. Most home pregnancy tests work 99 out of 100 times if used after a missed period. They can be less effective if you take the pregnancy test too early, if you do not use it correctly, or if the expiration date on the pregnancy test has passed.

Seeing your local doctor or go to a family planning clinic. Your doctor or the staff at a family planning clinic like Planned Parenthood will be able to let you know if you’re pregnant. These professionals will also be able to talk to you about the best ways to look after yourself during the pregnancy. If you are pregnant and you’re unsure about what to do, they might also be helpful people to talk to about your options. Your local phone book or yellow pages online should list the doctors and family planning clinic in your area.

Information for this fact sheet

Journal of the American Medical Association : How do I know if I’m pregnant?

Planned Parenthood Federation of America Pregnancy fact sheet

Fact Sheet

STIs: Sexually Transmitted Infections (or STDs)


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What is an STI?

STI stands for sexually transmitted infection, which is an infection that is passed from person to person during sexual activity. You might have heard of some STIs before, including:

  • Chlamydia;
  • Human Immunodeficiency Virus (HIV);
  • Genital warts or Human Papillomavirus (HPV);
  • Genital herpes;
  • Hepatitis B;
  • Gonorrhea;
  • Pubic lice;
  • Syphilis.

STIs are caused by organisms like viruses, fungi, bacteria or parasites. Different types of STIs need different kinds of treatment. But many STIs, like chlamydia and gonorrhea, are easily treated. On the other hand, STIs like HIV and herpes are not curable. This means that you can treat some of the symptoms, but you cannot remove the virus from your system. If untreated, some STIs can cause problems with menstruation, pelvic pain and infertility. But you can avoid STIs by keeping a few important things in mind.

How could I get an STI?

During vaginal, anal or oral sex, STIs can be transmitted through the exchange of blood, semen and vaginal fluids, or through skin contact.

Can I protect myself from getting an STI?

Yes you can, in most cases, by practicing safe sex.

Massage, touching and mutual masturbation are ways to get sexual that don’t involve contact with—or exchange of—body fluids.

If you’re having vaginal, oral or anal sex, it’s important to use a condom and a water-based lubricant every time. Condoms are the best protection from STIs. Lube should always be water-based, like KY Jelly, because using moisturizer, body lotion or Vaseline can cause the condom to break. Check out the Condoms fact sheet for useful tips, like how to put a condom on properly and how to use the right kind of lube.

For oral sex with women or rimming (licking around the anus) you can use a dental dam, which is a square of latex that covers the vagina and anus. To use them, you place the dam on top and then lick over it. Like condoms, dental dams keep fluids out of each other’s bodies. They also prevent skin-to-skin contact. A special kind of dam, the Sheer Glide dam, has been approved by the FDA specifically for safer sex. You can get dental dams and Sheer Glide dams online, in some drugstores, at surgical supply stores, at Planned Parenthood clinics, and other health centers. Dental dams are NOT a method of birth control. You should always use a dental dam to be sure that you are protecting yourself from getting an STI, but even if you are having trouble finding dental dams, there are other ways to protect yourself. As a last resort, you can make a dental dam from a condom by cutting up the middle and opening the condom out into a square. To use dams correctly: make a mark on one side of the dam with marker or pen and place the marked side on the body. If you accidentally flip it over you’re no longer having safe sex. Remember that if you are making the dental dam yourself, there is a greater chance that you might make a mistake, and you could be having less-safe sex than if you use a real dental dam. For more information on safer sex and on how to properly use dental dams, check out the Planned Parenthood website or the US Office of Public Health website.

Keep in mind that condoms will not protect you from some STIs like herpes and HPV because the condom might not cover the infected area.

How can I tell if I have an STI?

Often, you can’t tell. Some people with an STI have no symptoms at all, while others may feel sick. Different types of STIs will have different symptoms. Some common symptoms can be itching, rashes, discharge, burning when you urinate and sores on the genitals.

Can I tell if somebody else has an STI?

No. You can’t always tell. The only way to know for sure is by having an STI test. Before deciding to sleep with someone, make sure you ask them if they’ve been tested. For more info, check out the Thinking about having sex fact sheet.

I think I might have an STI. What do I do?

The easiest way to find out if you have an infection is to get tested.

It’s a good idea to have regular sexual health check-ups every year once you start having sex or change sexual partners. Women need to have a pap smear annually to screen for cell changes on the cervix and certain types of STIs. Check out the Taking care of your sexual health fact sheet for more details.

Most medical doctors offer sexual health checks. You can also go to your local health clinic or a Planned Parenthood center for more information on how to get tested.

What happens if I have an STI and just leave it alone? Will it go away?

Most STIs can be quickly and effectively taken care of. But if they go untreated, they can affect your reproductive organs, which can lead to infertility and other serious complications.

A good example of this is chlamydia, the most common STI among young people. Chlamydia is tricky as often there are no symptoms of the infection. Young people can have chlamydia and feel fine, but the infection can grow and lead to long-term problems with your health, like pelvic pain and difficult menstrual cycles. Chlamydia can be treated with antibiotics.

If I go to a clinic, will the doctor tell my parents?

According to the law, if you’re 18 or older, your health information is completely private. At the clinic, your discussion with your doctor or nurse, and the information you give the staff is completely confidential. It can’t be shared with your parents or people you know, unless the law requires staff to do so. Examples of this would be if health staff thought you were at risk of serious harm, or if your files were required in a court case.

How do I know this?

The Centers for Disease Control and Prevention website
Planned Parenthood
US Office of Public Health
US Department of Health and Human Services

Last reviewed: Feb 28, 2013

Fact Sheet

Herpes


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What is herpes?

Herpes is a common, recurring sexually transmitted disease (STD) caused by a virus called the Herpes Simplex Virus (HSV). Results of a nationally representative study show that genital herpes infection is common in the United States. Nationwide, at least 45 million people ages 12 and older, or one out of five adolescents and adults, have had genital HSV infection. (Centers for Disease Control and Prevention Fact Sheet)

There are two kinds of HSV: Herpes Simplex 1 (HS1) and Herpes Simplex 2 (HS2). Usually, HS1 infects the mouth and causes sores called “cold sores” and HS2 infects the genitals. Both types can be transmitted sexually. Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.

How do I get it?

Herpes is transmitted when an infected part of one person’s body touches an uninfected part of another person’s body. This can be through different kinds of contact, like:

  • Kissing somebody who has a cold sore;
  • Having oral sex with somebody who has a cold sore;
  • Touching genital or mouth sores and then touching another part of the body; or
  • Unprotected vaginal or anal sex.

Genital herpes can lead to potentially fatal infections in babies. A newly acquired infection during late pregnancy poses a greater risk of transmission to a baby. If a woman has active genital herpes at delivery, a cesarean delivery is usually performed. Fortunately, infection of a baby from a woman with herpes infection is rare.

Herpes can be transmitted before a sore appears, so you can’t always be sure that somebody is outbreak-free just by looking closely.

How can I tell if I have it? Does it hurt?

The first sign of herpes is an itchy or tingling feeling. Next, blisters will appear in small clusters on the outside or inside of your vagina, penis, anus or butt, or on your mouth. When the blisters break, they turn into sores, which can be itchy and painful. The sore forms a scab, which heals itself.

A first time outbreak of herpes will probably be the worst. You might feel as though you have the flu for a few weeks; and feel headachy, tired and sick. Most people with the infection have outbreaks more than one time, but usually the first outbreak is the worst, and outbreaks after that are not as bad.

If you have herpes, it’s important to eat well and exercise because you’re more likely to have an outbreak if you are stressed out, tired, in the sun a lot, or sick. Women are more likely to have an outbreak if they have their period or are pregnant.

How can I avoid it?

Some people might not know they have herpes but can pass it on. Using condoms or dams when you have sex will lower the risk, but doesn’t make it completely safe, because herpes can affect parts of the skin not covered by condoms.

Herpes is most contagious when one person with the infection has sores, but herpes can also be spread when no sores are visible. There are several days throughout the year when herpes can be spread even when no symptoms are present. This is referred to as asymptomatic shedding.

Remember:

  • Avoid oral sex when you or your partner has a cold sore around the mouth.
  • If you or your partner have genital sores, or can feel the tingling that indicates an outbreak is coming, avoid having sex until the sores have healed.

How do I get tested for herpes?

Herpes can only be diagnosed when you have an active sore. This means going to the doctor within three days of finding a sore, because it’s difficult to diagnose once a sore heals. To find out where you can go for a sexual health check-up, call your doctor, a local health clinic, or a Planned Parenthood sexual health center.

Is there a cure for herpes?

No. Currently there is no cure for the herpes virus, but a doctor can help you manage the symptoms and outbreaks with medication. During an outbreak it can help to keep the area clean and dry, treat pain with aspirin and if your outbreak is in the genital area, take warm baths.

It’s important to look after yourself, know the signs of an outbreak and seek treatment to assist with the symptoms.

Will it go away if I ignore it?

Each outbreak of sores will heal by itself eventually, but the virus will stay in your body.

If I go to a clinic, will the doctor tell my parents?

According to the law, your health information is confidential if you’re 18 or older. If you are over 18, then the information you give a clinic staff will be completely confidential. It can’t be shared with your parents or people you know, unless required by law. Examples of this would be if the health staff thought you were at risk of serious harm, or if your files were required in a court case.

For More Information

Check out the Herpes Resource Center at the American Social Health Association.

Fact Sheet

Gonorrhea

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What is gonorrhea?

Gonorrhea, also known as ”the clap,” is a common sexually transmitted disease (STD). It can affect the penis, cervix, anus, throat or eyes.

How do you catch it?

Gonorrhea is transmitted through unprotected sex—vaginal, anal or oral sex without a condom or dental dam. A pregnant woman who has gonorrhea can also pass it onto her baby when she gives birth.

How can I avoid gonorrhea?

Practicing safe sex by using condoms or dams every time you have sex will protect you from gonorrhea and other STDs. Body fluids like sperm, saliva and vaginal lubricant can contain gonorrhea, but condoms and dams form a barrier between you and your partner that can prevent the transfer of these fluids. Check out the Condoms fact sheet for tips on how to use condoms correctly.

How can I tell if I have it?

You can’t always tell if you have an STD. Some people get gonorrhea and have no symptoms, so you could pass it on without even knowing you have it. If symptoms show, they’ll usually appear within a week after contact, and can include:

  • An unusual discharge from the penis or vagina (sometimes yellow or bloody);
  • An itchy, swollen or red testicles or vagina;
  • Pain in your stomach;
  • Pain during sex; and
  • Pain when you urinate.

Both men and women can get a gonorrheal infection in their anuses, and symptoms might include:

  • Discharge;
  • Itchiness;
  • Soreness; and
  • Bleeding.

Gonorrhea can infect your throat too, through oral sex. It might give you a sore throat, but sometimes you won’t have any symptoms. If you’re experiencing any of these symptoms, or if you’ve had unprotected sex, contact your doctor or a local health clinic about getting tested.

What happens during a gonorrhea test?

For women, a doctor or nurse will take a sample from the cervix. This means he or she will take some tissue from inside the vagina with a long cotton swab and send it to a lab to be looked at under a microscope. For men, the doctor will take a sample from the opening of the penis. He or she might also take a urine sample, so it’s a good idea not to urinate for two hours before the test. The doctor or nurse can also examine a sample from your throat.

Many people infected with gonorrhea also have Chlamydia, another common STD. You can be tested and treated for this at the same time as gonorrhea, so ask your doctor if you’re concerned. Check out the Chlamydia fact sheet for more information.

Will it go away if I ignore it?

No, you need to take care of gonorrhea with antibiotic pills. If it’s not treated, gonorrhea can lead to Pelvic Inflammatory Disease (PID) for women or infertility for both men and women. It can also increase your risk of getting or passing on HIV.

To find out more about getting a sexual health check, talk to your doctor, or go to a clinic or Planned Parenthood office.

How will treatment work?

Once you’ve started taking antibiotics, the infection will clear up in about seven days, but you should avoid having sex during that time. About a month later, you’ll need a check-up from a doctor or nurse to make sure the infection is completely gone. It is important to follow the doctor’s instructions for how to take your prescribed medication.

Your current sexual partner needs to get treated, too, so you don’t pass the infection back and forth. All of your partners over the past three months should also be contacted and tested. This process is called ”contact tracing,” and it can help prevent the spread of gonorrhea. Your doctor should discuss with you the different ways that you can inform your partners that you have an STD. In some states, you might also be able to tell your partners anonymously with the help of a social worker or counselor.

After your treatment is finished, if you have unprotected sex with somebody who has the infection, you can catch gonorrhea again.

What if I’m pregnant? Can I still get treated, or will that harm my baby?

During birth, gonorrhea can be passed from mother to baby and can affect the baby’s eyes. Without quick treatment, the eye damage can be serious and permanent. But there are antibiotics you can take that are safe when you are pregnant. Talk to your doctor for more information.

If I go to a clinic, will the doctor tell my parents?

If you’re 18 or older, your medical records are private according to the law. Any information that health staff receive or discuss with you at a clinic is completely confidential and cannot be shared with your parents or people you know without your permission. Regardless of your age, health care providers, including mental health professionals like counselors, are also bound through ethical practices to keep your health information confidential. The only exception to this is if providers believe you are at risk of serious harm to yourself or others. If you’re concerned about keeping your medical information confidential, it’s best to speak with your doctor before being treated.

Doctors are also required to report cases of gonorrhea to the government so the disease can be monitored throughout the U.S. Your identifying information like your name will not be used. They don’t need to know who you are, they only want to keep track of how many people are getting the infection across the country.

How do I know this?

The Centers for Disease Control and Prevention, Gonorrhea fact sheet

Fact Sheet

Emergency contraception


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What is emergency contraception?

Emergency contraception is a special type of oral contraceptive that can be used if you didn’t use a contraceptive during sex, or if you used a condom that broke. Emergency contraception reduces the chance of pregnancy. While there are other emergency contraception pills, including certain brands of daily birth control pills,  the only pill developed specifically for emergency contraception—is Plan B, which is sometimes called the “morning after pill.” This name can be misleading, because its use is not limited to just the morning after. It can actually be effective if used up to five days after having unprotected sex. However, the sooner you start the better your chances of not getting pregnant.

How does emergency contraception work?

Plan B is a series of two or more pills. Other types of emergency contraception may require more pills. Emergency contraception works in two ways: It can delay ovulation, or the release of an egg from a woman’s ovaries; or it can thicken a woman’s cervical membrane to prevent sperm from reaching an egg. If you use emergency contraception, you should continue to use other forms of contraception, like birth control pills or condoms. Without continual protection, you could still become pregnant.  It is important to understand that taking emergency contraception does not guarantee you won’t get pregnant and it will not have any effect if you are already pregnant. It also will not protect you from getting sexually transmitted diseases STDs.

Where can you get emergency contraception?

Plan B is available for women 17 and older at most drug stores with pharmacies, health centers and Planned Parenthood clinics.  This contraception will not be on the shelves but behind the counter.  You must ask the pharmacist for them.  If you’re younger than 17, you will need to go to a health center or visit your medical doctor to get a prescription for emergency contraception, with one exception. In some states, women under 18 can get emergency contraceptives directly from some pharmacists without a prescription. This is possible because of special pharmacy regulations in these states. Even in states that allow this, not all pharmacists participate, so be sure to call ahead to see a participating pharmacist is on duty. Click to see if you live in a participating state.

Pharmacists are required to counsel anyone who wants to purchase emergency contraception. If you take emergency contraception, a pharmacist will give you some written information and ask a few questions. This will include asking you about other medication you are taking that could interfere with the effects of emergency contraception.

How should you take it?

If you have unprotected sex and you don’t want to get pregnant, you need to take the first dose of Plan B within 5 days, but it’s more effective the earlier you take it. There are several types of emergency contraception pills that you can use, and some might require you to take as many as 12 pills in two doses over 12 hours. Whichever kind of emergency contraception you take, it is important to take it exactly as it’s recommended. You can safely use any of these methods more than once in a menstrual cycle.

If you’re worried about taking emergency contraception, it might help to speak to a doctor, nurse or counselor who can talk you through it. You can also find someone to speak to at a family planning center or a women’s health center.

What to expect after taking emergency contraception

After taking emergency contraception, there can be some side effects. You might feel nauseous and some women throw up. Most women have a period at about the expected time. Your period might be lighter or heavier than usual, or spotty. If your period is more than a week late, if side effect continue, or if you have any other concerns, contact your doctor or a family planning center for advice.

Protect yourself

Emergency contraception is best for emergencies only. It isn’t meant to be used as a regular form of contraception. If you don’t have a regular method of contraception, talk to a doctor or nurse to find out what forms of contraception might work best for you. You can also check out the ReachOut fact sheets on Condoms and Taking care of your sexual health. Even though you have used emergency contraception, you might still need to be tested for STDs.

Seek support from someone you can trust

Even if you regularly use contraceptives, accidents can happen. If you need emergency contraception or if you’re pregnant, you might want your partner, a friend or a parent to go with you to the clinic or pharmacy. These situations can be stressful, and it can be helpful to have someone supporting you through the experience. If you still feel anxious or depressed afterwards, it might help to see a counselor to talk through your feelings

If you’ve been sexually assaulted or raped, talk to your doctor, or visit a local clinic or hospital immediately for help.  You can also call the police department or the Rape, Abuse, Incest National Network (RAINN) at 1-800-656-4673 to speak anonymously with a trained crisis worker 24/7.

For more information

You can also visit the Planned Parenthood, the National Women’s Health Information Center and the Emergency Contraception website sponsored by the Office of Population Research at Princeton University in collaboration with the Association of Reproductive Health Professionals for further information on the topic.

Last reviewed Feb 27, 2013

Fact Sheet

Condoms

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Why is it a good idea to use a condom during sex?

Condoms are the only form of contraceptive that protects you against sexually transmitted diseases (STDs). It is a good idea to use one when you’re having sex. Using a condom with a water-based lubricant every time you have sex helps lower your risk of:

  • Becoming pregnant;
  • Getting your partner pregnant; or
  • Contracting an STD, including HIV/AIDS.

Using water-based lubricants, like K-Y Jelly, each time you use a condom reduces the risk of breaking the condom. Avoid oil-based lubricants like petroleum jelly (Vaseline), massage oil or other body lotions because these can cause the condom to break.

When choosing a condom, you can use either a male or female condom.

Male condoms

The male condom is a thin latex sheath that is worn on an erect or stiff penis. The condom collects the sperm and stops it from entering the vagina and uterus.

How well do male condoms work?

Male condoms, when used correctly, can be 98% effective in preventing pregnancy. They can also be very effective in preventing the contraction of STDs. To make sure you are using one correctly, you should:

  • Check the “use by” date;
  • Use a new condom every time you have sex;
  • Make sure you are putting it on and taking it off the right way;
  • When putting the condom on, leave a small space at the tip to collect the sperm and help prevent breakage.

Side effects

There should be no side effects when you use a male condom, unless you are allergic to latex rubber or the lubricant. This isn’t common, but if you do have an allergic reaction, you might be able to use a non-latex condom.

Advantages and disadvantages of male condoms

Like any other type of contraceptive, male condoms have advantages and disadvantages. Before having sex, you might want to think about what these factors mean for you. Here are some of the advantages:

  • Condoms decrease the risk of pregnancy and STDs including HIV/AIDS.
  • Condoms are easy to find. They’re in almost every drug or grocery store, and you don’t need a doctor to get them.
  • They’re inexpensive.

One disadvantage of using a condom is that the latex is perishable, which means it needs to be kept in a cool place and used before the expiration date. Male condoms can also sometimes break, especially if they’re used with an oil-based lubricant like massage oil or Vaseline. It’s best to use male condoms with water-based lubricants like K-Y Jelly.

Where do you buy male condoms?

You can usually get male condoms and water-based lubricant at a variety of places, including:

  • Supermarkets;
  • Drug stores;
  • Clinics;
  • Sexual health centers like Planned Parenthood.

Female condoms

Female condoms are inserted into the vagina, and also collect the sperm and stop it from entering the vagina and uterus. Female condoms are made of non-latex polyurethane and are lubricated with a silicone-based lubricant. Oil-based lubricants can also be used with female condoms.

How well do female condoms work?

Like male condoms, female condoms are also effective at preventing pregnancy and STDs if they are used properly. When used correctly, female condoms are 95% effective at preventing pregnancy.

It’s a good idea to read the instructions on the condom packet before you use one. This will show you how to put the female condom into the vagina. Female condoms should also only be used once, and should not be used at the same time as male condoms, because it can cause at least one of the condoms to tear or move out of place and become ineffective.

Side effects

The only side effect of using a female condom might be an allergic reaction to the polyurethane or the lubricant, but this is uncommon. Female condoms might also cause some irritation. If you are worried about an allergy, contact your medical doctor or clinic.

Advantages and disadvantages of female condoms

Here are some advantages of female condoms: 

  • A female condom can be put in before sex and does not need to be removed immediately after sex.
  • It will reduce the risk of pregnancy and STDs.
  • You don’t need a doctor to buy them.

Some disadvantages of female condoms include:

  • Cost—female condoms are usually more expensive than male condoms;
  • Availability—some stores don’t carry female condoms, so they might be difficult to find;
  • Use—female condoms might be more difficult to use; make sure you know your body and are comfortable with it before using a female condom.

Where do you get them?

You can pick up female condoms from local health care clinics and Planned Parenthood centers, as well as some drug stores and supermarkets. You can ask your doctor for more information. For more information on condoms and other birth control methods as well as free reminders, check out Bedsider.org.

Statistics in this fact sheet were provided by:

The Mayo Clinic, “Condoms: STD protection plus effective birth control.”

Family Health International, “The Female Condom.”

Fact Sheet

Chlamydia


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What is chlamydia?

Chlamydia is a sexually transmitted bacterial infection—in fact, it’s the most commonly passed sexually transmitted disease (STD) in the United States. Chlamydia can affect the penis, cervix, fallopian tubes, anus, throat and—in rare cases—the eyes. It can cause serious health problems such as pelvic inflammatory disease and infertility if it isn’t treated.

How do you get chlamydia?

Chlamydia can be passed on through unprotected oral, vaginal or anal sex with an infected person. This means sex without a condom or dental dam. (For more info on safer sex, check out the Thinking about having sex fact sheet.) A pregnant woman can also pass Chlamydia to her baby during childbirth.

How can I avoid it?

Using condoms or dental dams will protect you from chlamydia. You can also avoid it by making sure that your partner has been tested for STDs before you engage in sexual activity with that person. For more information, check out the Condoms and Intro to STDs fact sheets.

What are the symptoms of chlamydia?

Chlamydia can be a sneaky infection. Up to 75% of women and 50% of men who are infected with chlamydia show no symptoms at all, so you can pass it on without even knowing you have it. Symptoms, if they do occur, usually show up within one to three weeks of infection. For women, symptoms can include:

  • Unusual vaginal discharge;
  • Frequent urination;
  • A burning feeling during urination;
  • Itchiness;
  • Bleeding or deep pain during sex;
  • Bleeding between periods;
  • Painful periods;
  • Fever;
  • Stomach pain.

Men with chlamydia might notice:

  • Frequent urination;
  • A burning feeling during urination;
  • Watery discharge from the penis;
  • Burning and itching around the hole of the penis;
  • Pain in your balls;
  • Swelling of your balls.

What if I don’t have any symptoms?

You could be one of the many people who never show signs of having it. This is why chlamydia is known as the “silent” disease.  It’s a good idea to get tested for chlamydia if:

  • You’ve been diagnosed with another STD, like gonorrhea or herpes;
  • Your partner has been diagnosed with chlamydia or another STD;
  • You or your partner have had more than one sexual partner, or you’ve recently changed partners;
  • You’ve had unprotected sex with a casual partner.

Will chlamydia go away if I ignore it?

No! This infection won’t get better on its own. When chlamydia isn’t treated, women can end up with Pelvic Inflammatory Disease (PID). They also run the risk of having an ectopic pregnancy, where an egg grows in the wrong place outside of the uterus.

Both men and women can become infertile, which means they aren’t able to have kids. Having chlamydia can also increase the risk of becoming infected with HIV.

What happens during a chlamydia test?

During a chlamydia test, a doctor or other health care professional will check for infection by either looking at your urine or taking a small amount of tissue from the penis or vagina. Your doctor will explain any preparation you need to do for the test like not urinating two hours before the test, not taking the test near when you get your period.  Both men and women might need to follow these procedures.

You can get tested by your medical doctor, at a local health clinic or Planned Parenthood office.  If you are going to get tested in a clinic that you have not been before, you will need to check how you need to pay for the test and treatment for chlamydia.  If you have insurance, you will need to check with the doctor or clinic to see if they take your insurance, even if that insurance is Medicaid or another government paid insurance.  If you find that you can’t find a doctor who takes government insurance or you might not have insurance, you can go see a doctor in a community based health center.  If you’re insured, you might have to pay for part of your visit.  This payment is called co-pay, and usually costs between $20 and $40. Your insurance might also only cover specific treatments.

Is chlamydia curable?

Yes! chlamydia can be easily treated with antibiotic pills. After you’ve had the antibiotics, you’ll need to do a follow-up test to check that the infection is really gone. A high number of people infected with chlamydia also have gonorrhea, so you might need to be tested and treated for that as well.

If I go to a clinic, will my parents find out?

If you’re 18 or older, your medical records are private according to the law. Any information that health staff receive or discuss with you at a clinic is completely confidential and cannot be shared with your parents or people you know. Health care providers, including mental health professionals like counselors, are also bound through ethical practices to keep your health confidential. The only exception to this is if providers believe you are at risk of serious harm to yourself or others.

If you get your test through a publicly funded program, the doctor is required to report cases of chlamydia to the government so that researchers can monitor the disease in the U.S. Your identifying details will not used, though. Researchers don’t need to know who you are; they only want to keep track of how many people are getting the infection.

Statistics in this fact sheet were provided by

Centers for Disease Control and Prevention Chlamydia

 

Fact Sheet

Rape and sexual assault


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Sexual assault is a crime and can refer to any type of sexual activity where consent is not obtained or freely given. The person responsible for the assault is often someone known to the victim, and can be, but is not limited to, a friend, family member, coworker, or neighbor. Sexual assault is never the fault of the victim.

There are many different types of sexual assault. Certain types, including sexual harassment, threats, intimidation, peeping, and taking nude photos, do not include physical contact between the victim and the perpetrator. Other types of sexual assault, such as unwanted touching, sexual assault, and rape, do include physical contact.

”Sexual assault” in everyday language is a general term that includes rape and other offenses like assault/battery and sexual groping. The definitions and labels for sexual offenses can differ slightly from state to state. In some states, sex without consent is called “rape,” while in others, it is called ”sexual assault,” ”sexual intercourse without consent,” or “sexual penetration without consent.” Though the term “assault” may bring physical attack to mind, it isn’t just about hitting. Sexual assault can also include using force or fear to make you do things that you don’t want to do.

Why are people sexually violent toward others?

Sexual assault is not about offenders getting pleasure from sex or any other form of harassment, but rather about them asserting power and control over someone else. Some offenders have been abused themselves, but this is not always the case, and there’s no evidence that a victim or survivor of sexual assault will become a perpetrator. To learn more about the theories behind sexual aggression, check out the U.S. Department of Justice’s National Criminal Justice Reference Service.

How experiencing sexual assault might affect you

Everyone reacts to the types of sexual assault differently. Individuals can experience a variety of immediate, short-term and long-term effects on her (or his) physical and emotional well being. These can include:

Shock and denial. Someone who has been a victim of sexual assault might not accept that it has really occurred.  Has this really happened to me? and Why me? might be common questions that someone might ask himself or herself.

Fear. After any form of sexual assault occurs, a person might be afraid of the offender, other people, or of being alone.  A person might also be afraid to deal with the medical, legal or social consequences of the crime, and of being rejected by loved ones because of the sexual assault.

Silence.  A sexual assault survivor might be unable to talk about the experience or describe what it means and feels like.

Anxiety. A survivor might always be on edge. He or she might be unable to relax or feel safe.

Depression. Survivors might be at a greater risk of depression after the incident.

Guilt and blame. A survivor might continually question the events leading up to the violent event, and find fault with him or herself, or others for the assault. Questions he or she might ask include Why did I go there? Why did I let it happen? Why did I not fight back?”

Low self-esteem. A survivor might feel ashamed or dirty after the assault.

Isolation. A survivor might want to be alone, and have a tendency to close him or herself off from friends and family members. A survivor might also have a hard time getting emotionally close to others after experiencing sexual assault.

Nightmares and flashbacks. Images and memories of the violence might continue in a survivor’s daily life and sleep.

Mood swings. Survivors might quickly change moods from anger and rage to tears and despair.

Loss of confidence. Survivors might become apathetic or self-conscious when working, studying or socializing with friends.

Loss of trust. After an assault, a victim might have a hard time trusting people who weren’t even connected with the incident, including friends and family members.

Lack of intimacy. Survivors might be afraid of, or uncomfortable in, sexual relationships after an assault.

To stay safe, play it safe

Most sexual assault occurs within a relationship (intimate partners, family members, or acquaintances). On average, 74% of sexual assaults are perpetrated by a non-stranger, and 30% are by an intimate partner, according to the Centers for Disease Control and Prevention. But sexual assault can also happen outside of relationships. Check out the CDC fact sheet on sexual assault or the Rape, Abuse, and Incest National Network website for more statistical information.

Here are some tips or things you can do to keep safe:

  • Plan to go out and hang out in a group;
  • Go out with people you feel safe with and who you know have your best interests at heart. Good friends make sure that their friends are safe and make safe choices;
  • Have transportation plans to make sure you can get to where you’re going and back safely. Carry money for a taxi-cab just in case;
  • Let someone—like your parents, siblings or roommates—know where you’re going and when you’ll be home. If your plans change, let these people know - check out the Circle of 6 App to do this with your smartphone;
  • Alcohol and sex can be a dangerous mix. Remember: if you aren’t in control of yourself, you won’t be able to control your situation;
  • Avoid being alone and isolated with someone you don’t know well. If you start to feel uncomfortable, go with your feelings, and get to a safe place as fast as you can;
  • Take a self-defense class at your local high school, college or recreation center.

Agreeing to one type of activity such as kissing doesn’t mean that it’s a ”green light” for other sexual contact. Remember: it’s OK to change your mind and say no at any stage. Also keep in mind that you shouldn’t stop being careful just because you know the person you’re with. You might not know the person as well as you think.

Sexual assault and the law

In the United States, laws relating to sex and sexual assault can differ between states. Crimes such as statutory rape, sexual assault, and sexual abuse can just mean people having sex under a certain age (the age of consent), and do not necessarily include force. The age of consent varies between the states, ranging from 14 to 18, with most states setting it at 16. This means that having sex with someone under that age, even if it is consensual, is a crime. Some states base the penalty for these violations on the age of the offender, with older offenders receiving harsher punishments. For example, in certain states, a minor might receive as little as six months or one year in prison, and an older offender might receive life imprisonment. Most penalties range from 10 to 30 years, depending on age and state, according to the Connecticut General Assembly Report.

The federal government has certain laws to ensure that all victims of violence have their rights. Since 2003, every state has some sort of crime compensation program and victims’ rights legislation. The Crime Victims’ Rights Act, a component of the Justice for All Act of 2004, specifies the roles of various criminal justice officials in supplying the information the victim is to receive, as well as in implementing victims’ rights. A second act, the Violence Against Women Act of 1998, enhances the investigation and prosecution of violent crimes against women and increases the jail time of the accused perpetrator before the trial. These laws, along with other state and federal laws are continuously updated and reauthorized.

Sexual assault is a crime. If you or someone you know has been sexually assaulted or was a victim of another type of sexual assault —either recently or in the distant past—you have the right to report it to the police. If you decide to report an assault, an officer will take your statement. If the assault was recent, he or she might also ask you to have a medical examination, during which a health care professional will make sure you’re physically OK and possibly take evidence. Check out the Rape, Abuse and Incest National Network for more about what happens during an examination and who might conduct it.

Where to get help

Finding the courage to talk about sexual assault is important.

If you need help, you can call the Rape, Abuse and Incest National Network (RAINN) at 1-800-656-4673 or the National Center for Victims of Crime hotline at 1-800-FYI-CALL. You can also call The Boys Town National Hotline at 1-800-448-3000 to find help in your area. And remember do not hesitate to call your doctor, nurse, or local health professional if you feel comfortable doing so.

Each state has a sexual assault coalition that can provide with state-specific information and resources.  You can access each state’s coalition through the Office of Violence Against Women at the U.S. Department of Justice.

For emergency situations that require immediate and urgent assistance call 911.

How do I know this?
Centers for Disease Control and Prevention
National Center for Victims of Crime
National Sexual Violence Resource Center
Rape, Abuse & Incest National Network
U.S. National Institute of Justice
Connecticut General Assembly
National Criminal Justice Reference Service

Last reviewed: Mar 11, 2013

Fact Sheet

Interpersonal violence


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What is interpersonal violence?

Interpersonal violence occurs when one person uses power and control over another through physical, sexual, or emotional threats or actions, economic control, isolation, or other kinds of coercive behavior. Some different types of interpersonal violence include:

Abuse is any behavior toward another person that is physically violent or involves emotional coercion, or both and one person is in a position of authority.

Bullying which is a type of harassment that can be either verbal or physical, or both. It can also take the form of coercion where someone is threatened by another person and as a result of those threats, the bully’s victim feels intimidated and pressured into acting a certain way or doing a certain thing. Bullying can occur in all settings – school, work, home, neighborhood and the internet.

Dating/Relationship Violence occurs when one intimate or romantic partner tries to maintain power and control over the other through words and actions that are physically and emotionally abusive. Dating violence can take many forms including physical violence, coercion, threats, intimidation, isolation, and emotional, sexual or economic abuse. It occurs in both heterosexual and homosexual relationships and can be instigated by either males or females. Women ages 16 to 24 experience the highest per capita rates of intimate violence—nearly 20 per 1000 women. (Bureau of Justice Special Report: Intimate Partner Violence, May 2000). Some examples of dating violence include: hitting, slapping, kicking, punching, strangling, holding down, abandoning in a dangerous place, and forcing or attempting to force unwanted sexual acts.

Sexual Violence is any type of sexual activity that a person does not agree to. It includes inappropriate touching; vaginal, anal, or oral penetration; sexual intercourse that a person says no to; rape or attempted rape; sexual harassment, threats or peeping. Sexual violence can be verbal, visual, or anything that forces a person to join in unwanted sexual contact or attention. Examples of this are voyeurism (when someone watches private sexual acts), exhibitionism (when someone exposes him/herself in public), incest (sexual contact between family members), and sexual harassment. (Taken from the US Department of Health and Human Services, Women’s Health Information website. See below for more information on accessing this website).

Youth Violence refers to aggressive behaviors, including slapping, hitting, kicking, bullying, punching, fist fighting and knife fighting, as well as robbery, rape and homicide.

Gang Violence refers to acts of aggression and violence and criminal activity committed by a group of peers where the group usually has an identity (e.g. a name; a sign; a neighborhood). In some neighborhoods, the pressure to join a gang occurs early and can be very difficult to resist. Members often join to feel a sense of family and community, and to achieve power and respect. On the flipside, members may worry about their own safety and fears of being abused by others in the gang. Gang members include both males and females.

What triggers violence?

There are a number of reasons why a person might become violent. For example, he or she might be angry, frustrated, or sad; or trying to control another person; or just generally short tempered.

A person’s belief system might also influence how the person behaves. A person who acts aggressively or violently may believe that violence is an acceptable way to deal with anger or an acceptable way to get something that the person wants. The person may also have grown up in a family where violence was part of how family members interacted with each other.

Some ways to stop being violent

Violence is not O.K., and nobody should have to put up with it. Being angry, confused or frustrated are all normal emotions, and there are non-violent ways of expressing these emotions. If you’re having trouble managing your anger, you might want to check out the Anger fact sheet and the Anger and violent behavior: what’s the connection fact sheet.

Deciding to do something about your violent behavior is a big step and it takes a lot of courage.

Look at what makes you violent. To stop this behavior, it might be useful to make a list of the things that trigger your violent behavior. This could be a person, a situation, a mood, or drugs and alcohol. By knowing what triggers your violent behavior, you can start to avoid these things or try to work out ways to deal with the situation.

Who is affected by your violent behavior? Does it hurt anyone physically or emotionally? Do you want to have safe and secure relationships, or do you want people to be scared of you? These questions might help you see how your violent behavior can negatively affect you and the people around you.

Talk to someone. Putting an end to violent behavior is not always easy, and having someone to support you can be helpful. You don’t have to do it by yourself. A counselor or another mental health professional might be able to help you find ways to deal with your violent behavior. Check out the Get Help section for more info about these providers.

Drugs, alcohol and violence

Using drugs and alcohol increases the likelihood that a person might act in a violent way. If you’re finding that you become violent while drinking or taking drugs, you might want to look at ways to better manage your drug and alcohol intake. A counselor or other mental health professional who specializes in addictions counseling can help you do this. Check out the Get Help section for more information on how these professionals can help.

Information for this fact sheet

The National Youth Violence Prevention Resource Center

The National Center for Victims of Crime, National Dating Resource Center

U.S. Department of Health and Human Services, Women’s Health Information

If you are a victim of sexual assault, call a friend or family member you trust. You also can call a crisis center or a hotline to talk with a trained volunteer. One hotline is the Rape, Abuse, Incest National Network (RAINN) at 1-800-656-4673.

Feelings of shame, guilt, fear, and shock are normal. It is important to get counseling from a trusted professional. The US Department of Health and Human Services, Women’s Health Information website provides additional information about what to do if you have been sexually assaulted.

Last reviewed: Feb 28, 2013

Fact Sheet

A guy’ s guide to sex myths

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Rumors and myths about sex are everywhere. Between what you hear from your friends and what you see on TV, it can be hard to know what’s true and what’s false when it comes to doing the deed. But if you’re thinking about having sex, it’s important that you know the facts. Below, we’ll debunk some of the rumors guys might hear about sex, condoms, STDs and pregnancy. You might want to check out the Thinking about having sex and A girl’s guide to sex myths fact sheets for more info, too.

Having sex

Is having too much sex bad for you?

Nope! On the other hand, you might feel a lot of pressure from your friends to be a “player.” But remember: it’s not a competition to see how many times you can have sex. Sex is about being intimate with someone you care about. If this isn’t your plan, then you might need to think about what sex means for you.

Is it possible that my penis won’t fit?

The vagina is a muscle that can expand and contract. Under tension, it tightens and might need to be relaxed. The vagina can fit comfortably around the penis whatever its size. Just take your time, try to relax and use extra lubricant if you think it might help.

Is it normal to get erections often?

An erection is a natural hardening of the penis that occurs when blood rushes to the area and this can sometimes happen at inconvenient times. Everyone is different, and there’s no way to tell what a “normal” amount of erections is. It’s perfectly normal to have a lot of unexpected erections when you’re younger, but because they’re uncontrollable, there’s not much you can do to prevent them. However, as you get older and your hormones settle, chances are that you’ll get unexpected erections less frequently.

Does a person who says “no” or “stop” when we are hooking up really mean “yes” or “keep going?”

Some might think that the person is just playing a game or pretending to push you away but you should always believe that the person is telling the truth. A person does not need to be aggressive in stopping anything from happening, but will let you know that he or she does not want to have sex or even kiss.  In all of these cases, it is your duty to stop. Alcohol and drugs can make you think that you are both comfortable, but if you’re so drunk that you don’t know if the other person is consenting, stop. When you know that the other person is so drunk that he or she might not be capable of giving consent, don’t do it because this is rape. Sex always needs to be consensual.

Got any more questions, or stories about sex? Share them in the forums here, or register to post.

Condoms and contraceptives

Will a condom protect me from sexually transmitted diseases (STDs)?

A condom will protect you from some STDs, but not all of them. There are some STDs that can be transmitted by skin–to-skin contact, like genital warts and genital herpes, and a condom will not provide 100% protection against these.

I’ve heard that condoms don’t work, or fail too often to be worth using. Is this true?

While not having sex is the only fool-proof way to avoid pregnancy, condoms are a safe bet and using a condom is much, much better than using nothing at all. For more information, check out the Condoms fact sheet.

What if my penis is too small for the condom?

Condoms are made in many different sizes. The key is to find the right size for you. If a condom doesn’t fit properly, there’s a higher chance that it could slip or break during sex. Condoms should fit snugly on your penis, leaving a small gap at the tip of penis and the end of the condom.

Is there a wrong way to wear a condom?

Yes! Each package of condoms will have instructions on how to put one on. Make sure you unroll the condom over the penis when it’s hard, and leave a half-inch of room at the tip of the condom to collect semen. You can read more on how to properly wear a condom at Planned Parenthood.

Will a condom make sex less enjoyable?

Although condoms are very thin layers of latex, some people feel that they change or dull the sensation of sex. However, most people overlook this because condoms are important to prevent pregnancy and the spread of STDs. Plus, if used properly, condoms may prevent premature ejaculation.

If the condom breaks, can I get emergency contraception for my girlfriend?

Yes. Emergency contraception is available at most pharmacies for men and women 18 or older, and in some states may be available for those younger than 18 without first seeing a physician. For more information on how these work, check out the Emergency contraception fact sheet.

If I withdraw before ejaculating, can she still get pregnant?

Yes! Withdrawing early doesn’t prevent pregnancy, because sperm can enter the vagina before ejaculation. It’s also possible for semen on the outside of the vagina to work its way inside as long as the sperm is fluid.

If we have sex while she’s having her period, can she still get pregnant?

Yes! Some women can ovulate, or produce eggs, at the end of their periods. Combine that with the fact that sperm can survive for up to five or six days after sex and you’ve got a recipe for pregnancy.

Sexually transmitted diseases (STDs)

How can you tell if a person has an STD?

A lot of STDs are asymptomatic, which means they don’t show any signs. You probably won’t be able to tell if a person has an STD just by looking at him or her. Sometimes people might not even know they’re carrying an STD. The only way to be 100% sure is to have an STD screening and to keep the lines of communication open with your partner. Ask that person if he or she has been tested before having sex. Never assume anything.

Can love protect me from getting an STD?

No matter how much people love each other, there’s no guarantee against contracting an STD or getting pregnant. Don’t fall into the “it’ll never happen to me” type of thinking, either. Using condoms and being knowledgeable about STDs are your best protection.

If I get an STD, does that mean I’m dirty?

No. Getting an STD is just like getting a cold. You’ll go to the doctor, find out what treatments are available and maybe most important of all, give yourself piece of mind. Remember that sex is a natural part of human expression, and sometimes these things happen.


The following sources provided information for this fact sheet:

Nemours Foundation

The Body.com

Planned Parenthood Federation of America

Fact Sheet

Abusive relationships


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When you’re in a healthy relationship, both individuals support each other by sharing the good times and helping each other through the tough ones. When someone matters deeply to you, and those feelings of trust and respect are returned, it enables you to face the world with confidence.

Building and maintaining a healthy relationship takes a commitment from both sides. But it’s worth it, because in a good relationship, you feel good about your boyfriend or girlfriend and good about yourself.

Not all relationships work out, no matter how much we might want them to. When a relationship becomes violent or destructive, it can be both physically and emotionally dangerous for the people involved.

Key signs of an abusive relationship

While everyone’s experience of an unhealthy or abusive relationship will be different, there are some common patterns of controlling behavior and abuse that can surface before the relationship becomes physically violent. These include:

Possessiveness. This could mean that your partner is checking on you all the time to see where you are, what you’re doing and who you’re with; or trying to control where you can go and who you can see.

Jealousy. This includes accusing you—without good reason—of being unfaithful or flirting, or isolating you from your family and friends, often by exhibiting rude behavior.

Put-downs. These can happen either privately or publicly by attacking how smart you are, your looks or capabilities. In an abusive situation, your boyfriend or girlfriend might also constantly compare you unfavorably to other people, or blame you for all the problems in the relationship.

Threats. An abuser might use threats against you, for example, that he or she will use violence against you, your family or friends, or even a pet. He or she might tell you that no one else will ever want to date you. Yelling, sulking, and breaking things are also signs of abuse.

What to do if you are being abused

It’s not OK to be physically threatened or scared into things that make you uncomfortable or unhappy just because you are in a relationship.

It’s not OK to be put down and pushed around—shoved, hit, slapped, kicked or punched. No one deserves to be treated this way. No one should use violence—or the threat of violence—to make you do what you don’t want to do.

It’s not OK for someone to use the excuse that they are tired, stressed, over-worked or under financial pressure as a reason for their violent behavior.

If you’re living with your boyfriend or girlfriend and are feeling unsafe, find other accommodations with friends or family, or if that’s not possible, an emergency shelter.

Breaking the cycle of violence

A violent relationship may not be violent all the time. Sometimes, violent people treat their boyfriends or girlfriends very well. They can be loving and sorry for their violent behavior. This can make it hard to see what’s really happening. There is a strong chance that the violence will get worse, and the relationship more abusive over time.

After a violent event, it’s common for both of you to try and make things better by making excuses, apologizing, or promising to change. But there is no excuse for this behavior, and just saying sorry is not good enough. Sometimes the violent person will blame the victim by saying things like “it wouldn’t happen if you did what I said.” Things might settle down for a while, but usually it’s only a matter of time before the build-up to violence starts again.

If you’re experiencing violence in a relationship, things can feel very confusing, especially if it’s your first relationship. You might try to make excuses, think of the violence as a one-time incident, or blame the abuse on the fact that the abuser was drunk or stressed. You might not be sure what behavior to expect from him or her.

You might begin to think that the violence is your fault. You might start to try to fit in with whatever the abuser wants, even if it makes you uncomfortable. You might also feel scared that he or she will hurt you if you try to leave.

Ending any kind of relationship is hard to do, but it can be particularly difficult to leave a violent relationship. When you’re frightened and your self-esteem is low, it can be hard to find the strength to leave or break-up. Sometimes it’s easier to hope that things will change for the better, but too often they don’t.

The first step in changing things is to understand that what’s been happening to you is wrong. Even if your boyfriend or girlfriend says they care about you, it’s not OK to be treated like this.

Where to get help

Listen to your feelings and trust them. If something doesn’t feel right, it probably isn’t. Talk to someone who cares about you. Talk to your mom or dad, a family member, a friend or someone in your community like your doctor, your teacher or your local religious leader. Don’t feel ashamed or embarrassed. You are not responsible for somebody else’s violent behavior. Your first responsibility is to yourself. The sources listed below can help you get safe.

Hotlines

Many free help hotlines are available if you think you’re being abused, or are worried for a friend you suspect could be being abused. Try the National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or youth helpline Your Life Your Voice at 1-800 448-3000, run by Boys Town for everyone. Both hotlines are confidential and staffed 24-hours a day by trained volunteers who are ready to talk to you about whatever you’re feeling.

You can also call the National Teen Dating Abuse Helpline at 1-866-331-9474, or visit their website at http://www.loveisrespect.org. This site also has a free live web chat that’s staffed by young people who can offer you support.

State resource

You can also reach out to an abuse coalition in your state, which can help connect you to more local resources. Check out the Domestic Violence Coalitions website for more information in your state.

The following sources provided information for this fact sheet:

National Teen Dating Abuse Helpline

U.S. Department of Justice, State Domestic Abuse

Your Life Your Voice Youth Helpline

Fact Sheet

Intimate partner violence


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What is intimate partner violence?

Intimate partner violence (IPV) is abuse that takes place between two people who have a romantic relationship-spouses, partners, boyfriends and girlfriends. Many people also use the word “domestic violence.” IPV can occur in many forms and can affect people of any age. If someone is hurting you, it can be frightening, and you might not know how to make the abuse stop-especially if you live with the person who is abusing you. It’s important to remember that no one has the right to be violent toward you and there are people who can help you.

IPV can take on many forms, including:

Physical/Sexual. Forms of physical violence include pushing, shaking, punching, slapping, forcing you to do sexual acts against your will, throwing things at you, using weapons, damaging your property, or hurting or killing your pets. If someone is being physically violent to you, seek safety as soon as possible. Leave the situation as quickly and safely as possible, and call 911 or your local police.

Emotional/Verbal. This form of violence is often unrecognized as IPV, but it can be just as hurtful and damaging as physical violence. If someone is making threats, speaking or texting you in a way that is frightening, isolating you from your family and friends, putting you down, or using blackmail against you, he or she is being emotionally violent. Emotional violence also includes insulting you or teasing you in front of other people, keeping you isolated from family and friends, preventing you from having your own opinions and controlling what you do and where you go.

Economic. Having money-and making decisions about how to use it-is one form of independence. If someone is controlling your money, keeping you financially dependent, or forcing you to ask for money unreasonably, this is another form of IPV.

You might assume that IPV only happens between adults or in relationships where two people are living together. But this isn’t the case. In fact, according to the Centers for Disease Control and Prevention, teens are more likely to report violence in their romantic relationships than any other age group. Among adult victims of rape, physical violence, and/or stalking by an intimate partner, 22.4% of women and 15.0% of men first experienced some form of partner violence between 11 and 17 years of age, and 9% of high school students say they’ve been physically hurt by someone they’re dating.

How can I keep myself safe?

At times you might underestimate the amount of danger you’re in, either because you might not realize it or don’t want to accept how dangerous a situation is because you think that your partner really loves and cares for you. Your partner might promise to “never do it again” or you might feel that you are to blame for his or her behavior, or you might think you can change your partner. But you are not responsible for your partner’s action-ever-and there are actions you can take to ensure that he or she does not hurt you anymore.

Steps to ensuring your safety:

  • Call the police. If you’re in immediate danger, call 911 or your local police.
  • Leave. It can be incredibly hard to end a relationship, especially if you’re sharing a home with the person who’s hurting you. Because the person who is abusing you might be manipulating you or isolating you from your friends and family, you might feel like you can’t leave, or that you have nowhere to go. But there is support for you when you feel like you should leave a place where you feel threatened or unsafe. If you need to leave, make sure to take important items, like your IDs, credit cards, cash and cell phone.
  • Get support. Making a decision to leave an unsafe relationship can be difficult. You don’t have to do it alone. Talk to someone you trust, like a friend, family member, counselor or social worker. You might also want to call the National Domestic Violence Hotline at 1-800-799-SAFE or the National Teen Dating Abuse Hotline at 1-866-331-9474 or 1-866-331-8453. Hotline volunteers can direct you to local resources and shelters in your area where you can find additional help and support.

For more information

IPV is just one form of violence. Abuse can come from adults, strangers, or your peers at school. You have the right to feel and be safe. For more information on steps you can take to ensure your safety, check out the following fact sheets:

Information in this fact sheet was provided by:

 


Last reviewed: Feb 28, 2013

Fact Sheet

A girl’s guide to sex myths

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It’s easy to be confused about sex. There are so many mixed messages and myths surrounding sex, it can be hard to know what’s true and what’s not. Before you decide to have sex, it’s important that you know the facts.

Here are some important facts about contraception, pregnancy, sexually transmitted diseases (STDs) and having sex.

Having sex

Is having too much sex bad for you?

Nope! But remember: it’s not a competition to see how many times you can have sex. Sex is about being intimate with someone you care about. If this isn’t your plan, then you might need to think about what sex means for you.

Is it possible that his penis won’t fit inside me?

The vagina is a muscle that can expand and contract. Under tension, it tightens and might need to be relaxed. The vagina can fit comfortably around the penis whatever its size. Just take your time, try to relax and use extra lubricant if you think it might help.

When I go to the bathroom after sex, my vagina stings. Is there something wrong with me?

Probably not. Sometimes the thrusting motion during sex can rub the outer lips of the vaginal area, making it sensitive when you are urinating. In some cases, burning when you go to the bathroom can indicate a bladder infection or urinary tract infection, so it’s important to have a check-up with a doctor if you’re concerned.

Does sex hurt?

Sometimes sex does feel uncomfortable. It could mean you don’t have enough lubrication or you need to try a different position. It could also mean your partner is going too fast, using too much pressure, or that you’re nervous. It could be a combination of all of these. If you’re hurting, stop and talk to your partner. Try some more lubrication, a different position or ask your partner to go slower. If that doesn’t help, then stop. Sex shouldn’t be painful. It’s important to talk to your partner about these issues and work out ways to make sex more comfortable. If you find that sex still hurts , you might want to go to your doctor to see if he/she can see if there is a medical reason for your pain.

Got any more questions, or stories about sex? Share them in the forums here, or register to post.

Contraception

Will a condom protect me from sexually transmitted diseases (STDs)?

A condom will protect you from some STDs, but not all of them. There are some STDs that can be transmitted by skin–to-skin contact, like genital warts, HPV and genital herpes and a condom will not provide 100% protection against these. Check out the Intro to STDs fact sheet for more information.

I’ve heard that condoms don’t work, or fail too often to be worth using. Is this true?

While not having sex is the only foolproof way to avoid pregnancy, condoms are a safe bet and using a condom is much, much better than using nothing at all. It’s also important that a condom be placed on the penis properly to decrease the chance of breaking.

Can a condom get lost inside you?

If a condom comes off during sex, it won’t get lost inside, but sometimes it can be difficult to get out. It’s also important to make sure that after a guy has ejaculated, someone holds the base of the condom as he withdraws his penis; otherwise there is a chance the condom might fall off and spill semen into the vagina.

If a condom breaks during sex, can you avoid being pregnant by washing your vagina?

No. After sex, sperm have already entered the uterus (they’re fast swimmers), and washing the vagina won’t help. If you’ve had unprotected sex, a better solution might be to find out about emergency contraception. Emergency contraception is not hard to get, but you will need to contact a doctor, hospital, health clinic or sexual health center like Planned Parenthood, especially if you are under 18. While talking to one of these providers, you should also talk to them about taking a test for any STDs just in case you might have caught one.

If I’m on a birth control pill and I take a pregnancy test, will the results work properly?

A pregnancy test measures a hormone that is produced when conception occurs. This is a different hormone than the ones in the pill, so the pill won’t affect a pregnancy test.

If I’m on the pill and a guy ejaculates inside me, does that mean I won’t get pregnant?

The pill, if taken correctly, will prevent pregnancy but it won’t protect you from STDs. Also, be aware that if you’ve been vomiting, taking certain medications, or you’ve skipped taking the pill for a day, there is a chance the pill won’t protect you from getting pregnant.

Is there such a thing as a woman’s condom?

Yes, but female condoms aren’t as readily available as men’s condoms. You might be able to find some at your local drug store, health center or Planned Parenthood clinic.

Find out more about different methods of contraception and sign up for free reminders at Bedsider.org.

Getting pregnant

If you have sex during your period, does that mean that you can’t get pregnant?

No. If you have a short period cycle, you’ll start ovulating by the end of your period. Combine that with the fact that sperm can survive for up to five or six days after sex, and you’ve got a recipe for pregnancy.

If I had unprotected sex but got my period since, does that mean I can’t be pregnant?

There have been cases where women continue to have their periods during their whole pregnancy. The only way to find out for sure is to have a urine or blood pregnancy test. You can buy a pregnancy test kit at a local drug store but it is always a good idea to have a doctor or nurse give you a test if you think you might be pregnant.

Is it true that a woman can get pregnant from swallowing sperm?

No. Sperm are mighty little swimmers, but if you swallow a guy’s semen, it can only go as far as the stomach where stomach acid will kill them. Even if the sperm did survive, there’s no way they can travel to the fallopian tubes or uterus from the stomach.

Is it true that a woman can only get pregnant during sexual intercourse?

No. It’s possible to get pregnant if a man ejaculates on or near the opening to the vagina because the sperm can enter the vagina and swim up the fallopian tubes where they can fertilize an egg.

Do I have to wait until I skip a period to tell if I’m pregnant?

You can tell if you’re pregnant as soon as 10 days after you’ve had sex by taking either a urine or blood pregnancy test.

If a guy withdraws before ejaculating, does that mean I won’t get pregnant?

Even if a guy doesn’t ejaculate inside you, there is a possibility that semen might dribble from the end of his penis into your vagina during sex and result in pregnancy. It is also possible for semen on the outside of the vagina to work its way inside a woman’s vagina as long as the sperm is fluid.

Can you get an abortion without telling your parents?

It depends on the laws of the state in which you live, or where you’re planning to get an abortion. Before you make any decisions regarding abortion, make sure you check out your local laws, or speak to a counselor or doctor.

Sexually transmitted diseases (STDs)

How can you tell if a person has an STD?

A lot of STDs are asymptomatic, which means they don’t show any signs. You probably won’t be able to tell if a person has an STD just by looking at him or her. Sometimes people might not even know they are carrying an STD. The only way to be 100% sure is to have an STD screening and to keep the lines of communication open with your sexual partner. Before having sex,  ask that person if he or she has been tested. Never assume anything.

Can love protect me from getting an STD?

No matter how much people love each other, there’s no guarantee against contracting an STD or getting pregnant. Don’t fall into the “it’ll never happen to me” type of thinking, either. Using condoms and being knowledgeable about STDs are your best protection.

If I’m on the pill, does that mean I won’t get an STD?

No. The pill will only protect you from pregnancy, not STDs.

If I get an STD, does that mean I’m dirty?

No. Getting an STD is just like getting a cold. You’ll go to the doctor, find out what treatments are available and maybe most important of all, give yourself piece of mind. Remember that sex is a natural part of human expression, and sometimes these things happen.

If you’re thinking about having sex for the first time, you might also want to check out the Thinking about having sex fact sheet for more information.

The following sources provided information for this fact sheet:

Planned Parenthood Federation of America

Avert.org

Fact Sheet

Thinking about having sex


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Deciding if you're ready to have sex

Being sexual is a very personal way of communicating with someone else. It’s a physical way of expressing love and affection. Being sexual is an important personal choice and it’s not uncommon to take time to make the decision to become physically intimate with another person. It’s important to know that love doesn’t equal sex. Relationships can be happy and fun without being sexual.

Talking about sex with a person you are sexually attracted to—whether that person is a friend, acquaintance or your boyfriend or girlfriend—will help you both work out if you want to begin a sexual relationship. Talk about your expectations for the relationship, including your worries, fears, anxieties, and what you hope to get out of the experience. If it’s relevant, don’t forget to talk about contraception, like birth control and condoms.

If you decide to have sex, remember:

  • Sex must be consensual—both of you must want to engage in sex;
  • Have sex safely.

Suggestions for safe sex

It’s always important that you engage in safe sex. This means making sure you don’t risk becoming pregnant unless you want to, or catching a sexually transmitted infection (STI) or sexually transmitted disease (STD), like HIV/AIDS, herpes, Chlamydia or gonorrhea.

It’s a good idea to find out about safe sex, how different STIs are passed on and how to prevent unwanted pregnancy. Using condoms with water-based lubricants and dental dams are one way to protect yourself from some STIs. You can also get informed by:

Check out some of our other fact sheets:

Talking with your doctor or any other health professionals can help too- planned parenthood can help you plan your birth control options. Once you start having sex, make sure to get screened regular by having a gynecological exam, Learn what to expect here.

Saying no

Being in a sexual relationship can be enjoyable and rewarding when that relationship is negotiated and agreed on by both people. Sometimes people think they can demand that someone be sexual with them, or force them to have sex against their will. Remember: No one has the right to force you to have sex. You have the right to say no. Don’t let yourself be intimidated into having sex with anyone.

When can I legally have sex?

The answer to this question depends on the state in which you live. Consensual sex laws—which determine the age at which you can legally agree to have sex—vary from state to state, but for the most part require that you be at least 18 years old to consent. If you’re younger than 18, check out the laws in your state before deciding to become intimate with anyone.

For more information

It’s important that you think through your decision to have sex with someone. You might want to discuss it, not only with your partner, but with people whom you trust. This could include a friend, an older sibling, a counselor, a religious leader, your parents or a medical doctor. You can also find more information on your options at community health clinics or Planned Parenthood centers.

Information for this fact sheet

LIVESTRONG

Planned Parenthood Federation of America or call 1-800-230 PLAN

Last reviewed: July 2014

Fact Sheet

Safe online chat


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The Internet has become a place where we talk to many people, through e-mail, chat rooms, MySpace, Facebook, Bebo, and other social networking sites.

Meeting people with similar interests can be fun and exciting, and it’s not unusual to want to share information about yourself. When doing this, it’s important to keep in mind how much you know about the person you’re sharing your information with. Sometimes you might not know a lot about the person you’re chatting with, which makes it harder to stay safe. There are a number of things you can do to stay safe when chatting or meeting with someone you’ve met online.

Using the Internet to communicate

The Internet is a great way to stay in touch and meet people. Chat rooms, MySpace, Facebook and e-mail make it easy to speak to people from all over the world. However, the Internet can also be used for inappropriate communication, and it’s important that you know how to use it safely.

Some of the ways in which the Internet can be wrongly used include:

  • Someone harassing you for information when you’ve asked not to be contacted.
  • Someone using the Internet to gain your trust so he or she can then have sexual contact with you.
  • Someone using the Internet to know your schedule so that he or she can rob your house or even, worse stalk and harass you in person.

There are a number of things you can do to help to reduce the likelihood of these things happening.

Avoid giving out personal details. Remember, using the Internet to meet people means you don’t really know who is on the other end of the line. It’s possible to get to know someone’s interests and be friends with them without giving out personal details like your address, last name or phone number. Don’t send your picture, credit card number or bank details to anyone.

If you’re using a credit card online, make sure you’re confident that the site you’re on is secure. If someone is pressuring you to give out these details, it might be a good idea to question why this person needs them.  To avoid giving out your last name—which can allow people to find out more about you—you might want to sign in with just your first name when chatting. Using a pseudonym or screen name (for example, Dolphin99) is also a good idea. When you’re setting up an e-mail account, you might also want to use a pseudonym.

Meet new people in a group. If you decide to meet someone you’ve chatted with online, make sure you meet in a place where there are lots of people around. This could be at the movies, coffee shop or in a shopping center. You might also want to take a friend or two with you. Having a group of friends nearby is a good idea and the same goes for letting people know where you are going and how long you plan to be there. Meeting in places where no one is around, like a park or someone’s house, can be dangerous because it can harder to get help or leave this situation if things become dangerous. Some experts advise that it is never safe to meet in person with someone you have met in a chat room situation.

Avoid chatting with people who make sexual references. If someone is using sexual language or references, you might want to think about if this is a relationship you want to continue.  People who are looking for inappropriate sexual contact often use the internet as a place to attract people, and they often start by talking sexually before asking to meet the person face-to-face. If you’ve cut off contact with a person who is using sexual language, but that person keeps contacting you, notify the police.

Creating your own website

Creating your own website can be a good way to let people know something about you. However, you might want to keep in mind that it can also let people know your personal details like where you live. To avoid letting people know these details it is a good idea to:

  • Use a nickname. This can be safer than using your real name, as it makes it harder for people identify you.
  • Avoid mentioning the name of your school. With a photo or the name of the school, someone could obtain a yearbook and find out your last name, or even just wait outside and follow you home.
  • Try not to be too specific with where you live, especially if it’s a small town. Writing the name of a large area like your city is or state is O.K., but identifying the name of your neighborhood isn’t.

Information for this fact sheet

Microsoft.com, Safety Tips

Fact Sheet

Managing relationship pressures


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When you’re in a sexual or romantic relationship, you might experience different kinds of pressure, either from within the relationship, or from other people and external factors. External pressures can stem from issues concerning money, health, school, work or friends. At times, these factors can be stressful and cause a lot of tension, especially when they challenge your cultural, religious or personal ideas and beliefs.

Types of relationship pressures

Relationship pressure can come from a variety of factors, including:

  • Culture or race. You might feel pressure to follow cultural or racial beliefs and traditions;
  • Age and maturity. A big age difference between you and your partner might raise differences in beliefs or expectations;
  • Family. Your family might put pressure on the relationship for a variety of different reasons, such as cultural, religious, age or racial differences, or feeling you are not old enough or mature enough to have a healthy relationship;
  • Religion. Having different religious beliefs or customs could put a strain on your relationship;
  • Money. Working out who pays the bills can be difficult, particularly when you’ve just moved in together or when one of you is earning more than the other;
  • Jealousy. Jealousy toward or from your boyfriend or girlfriend about relationships with other people can increase tension in a relationship;
  • Mental or physical disabilities or illnesses. Many extra issues and pressures are added to a relationship when you, your boyfriend or girlfriend, or a family member suffers a mental or physical illness or disability;
  • Friends. Sometimes your friends might be annoyed that you have less time for them because you’re spending more time with your partner;
  • Sex. You might feel pressure to have sex from your boyfriend or girlfriend or friends when you’re not ready. Check out the Thinking about having sex fact sheet for more information;
  • Cohabitation. When you live with your boyfriend or girlfriend, this can lead to another set of pressures discussed in the Moving in with your boyfriend or girlfriend fact sheet.

Managing relationship pressures

Pressures on a relationship can be overwhelming and stressful. Here are some hints on how to handle them:

  • Talk with your boyfriend or girlfriend about what you’re feeling and what your expectations are for the relationship;
  • Spend time working on your relationship. Relationships don’t just “happen.” They are something you need to put time and energy into maintaining. This might include doing fun things together like going to the movies;
  • Talk to those people involved in your situation—like your parents and friends—honestly and discuss their concerns about your relationship. Acknowledge their feelings and discuss your own;
  • Talk to someone outside the situation, like a counselor;
  • Find out more about your boyfriend or girlfriend’s culture, illness, religion, or things you don’t feel you understand well enough. This can help you respect differences, expectations, and needs. You could also collect information about your own culture, illness or religion and give it to your boyfriend or girlfriend. They may not know where to look for information about you;
  • Respect your differences. Differences are often what make a relationship great;
  • Remember to regularly make time outside the relationship for your friends and yourself.
Fact Sheet

Maintaining a happy relationship


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Maintaining a happy relationship

Dating can be a great way to have fun and learn a lot about yourself and another person. Healthy relationships are those that are partnerships, in which you can laugh, feel safe and supported, share ideas and feelings, and respect another person, as well as feel respected yourself.

Every relationship is unique, and you might have your own way of knowing that a relationship is right for you. Even when a relationship is going well, it’s important to work at it and not take it, or your partner, for granted. The best way to keep a relationship strong, healthy and growing is for you to be aware of your needs and expectations and communicate those with your partner. Here are some more suggestions for how you can keep your relationship strong:

Be honest and trusting. Learning to trust and be honest with someone you just started dating can take time, but honesty and trust are two important ingredients in a healthy relationship. As you spend more time with someone and start to share experiences together, your level of trust may increase.

Keep communicating. It’s a good idea to keep the lines of communication open between you and the person you’re dating. This might mean talking regularly about what’s happening in your lives and how you’re feeling about life in general. When people share their opinions and feelings, they develop a greater understanding of each other’s likes and dislikes. It’s also a good idea to talk about your relationship every once in a while, including your expectations.

Accept your differences. It isn’t unusual to care about someone who has different ideas, interests, and opinions to your own. These differences are what make relationships exciting! But sometimes it can be difficult to manage these differences. It might be helpful to calmly discuss those differences or agree to disagree. By accepting someone’s values and opinions, you might encourage him or her to respect yours as well, and respect is an important aspect of any relationship.

Voice your opinions and frustrations. It’s natural that people sometimes argue or have differences of opinion. Disagreements might leave you feeling angry or frustrated with yourself and your partner, but it’s important that you let the person you’re dating know about your opinions and frustrations. It’s a good idea to express your opinions, but remember to listen to the other person as well. For more information on how to resolve arguments, check out the Resolving an argument or disagreement fact sheet.

Respect each other’s time and space. Hanging out with your partner can be a lot of fun and a great way to get to know him or her. But it’s also important that you respect your partner’s space-physically and emotionally, and that your partner does the same for you. Maintain the relationships that you have with your friends and family, expand your interest, and keep up with the activities that you were involved in before you started your relationship. This can help your relationships continue to grow and be fun and interesting.

Spend time with yourself. Having alone time can be fun and an important way to keep yourself healthy and happy. It can also help you understand yourself and your relationships with others. Spend time getting to know you. You might want to start by doing something you really enjoy, like going for a run, listening to music or reading.

Ending a relationship

Unfortunately, sometimes relationships turn sour, no matter how hard you work at them. If you’re in a situation where your relationship isn’t a positive factor in your life, it’s a good idea to end it. See the Getting through a break up for more information.

Worried you’re in an abusive relationship?

It’s especially important to end your relationship if you’re in a situation where you’re being hurt or abused by someone. If you’re worried, read Abusive relationships and Intimate partner violence or take the Is this abuse quiz on Love is Respect.

Acknowledgment

The information provided here is based on “An Intergalactic Guide to Relationships,” a project of the New South Wales government.

Last reviewed: April 27, 2014

Fact Sheet

Losing your virginity

21

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Deciding when to lose your virginity

It seems like everyone talks about sex. Your friends, TV show characters, magazines, movies and maybe even your family. Sometimes it’s hard to work out what’s true, or what information you need to make a decision about becoming sexually active for the first time.

It’s normal to feel excited or anxious when thinking about losing your virginity. Just remember that there’s no right or wrong time to become sexually active—it varies for each person. It might take time to decide what’s right for you.

Being sexually active can mean different things to different people, and can include different activities with partners that are the opposite sex, the same sex, or both. Sex is about giving and receiving pleasure in a way that is comfortable for both people.

Am I ready for sex?

You might choose to become sexually active for a variety of reasons. You might:

  • Think it could be fun;
  • Feel like you’re in love;
  • Think it feels good;
  • Take it as a sign of commitment;
  • Feel emotionally ready;
  • Feel informed, and like you’ve thought it through;
  • Feel prepared and ready to practice safe sex;
  • Be curious and want to experiment;
  • Think all your friends are doing it.

There might be several reasons why you choose not to have sex. You might:

  • Not feel ready or comfortable yet;
  • Not think you’ve found the right person;
  • Have religious or cultural reasons;
  • Feel more anxious than excited;
  • Not have condoms or dams on hand to practice safe sex;
  • Not want to respond to pressure from your friends or partner;
  • Be too young legally. Check out the laws on age of consent in your state for more info;
  • Feel you don’t have to prove yourself by having sex.

It’s really important that you feel like you’re able to talk to your partner about how you feel and any worries you have about having sex and using contraception. It can be weird and embarrassing to have this sort of conversation, but if you’re not comfortable enough to talk about it, then maybe you aren’t ready to have sex.
Got any concerns about your first time? Share them in the forums here, or register to post.

Some facts and myths about your first time

You might have a lot of questions about what your first time will be like. It’s not always easy to find the answers you need. Here are some common myths that people believe about sex—and the facts.

MYTH: You can’t get pregnant or sexually transmitted diseases (STDs) the first time.

FACT: Yes you can! When thinking about being sexually active, you need to consider protecting yourself against pregnancy and STDs by practicing safe sex. Using protection like condoms and dams will not necessarily make sex less enjoyable. The important thing is to be safe. To find out more about practicing safer sex, check out the fact sheets on Condoms and Emergency contraception.

MYTH: First time sex will hurt.

FACT: For some people, the first time can be pleasurable, comfortable and fun. For others, first-time sex does feel uncomfortable—it could even hurt. Pain during sex could mean you don’t have enough lubrication or need to try a different position. It could also mean your partner is going too fast or using too much pressure, or that you’re nervous. It could be a combination of all of these. If it’s hurting, stop and talk to your partner. Try some more lubrication or a different position, or ask your partner to go slowly. If it’s still hurting, stop. Sex shouldn’t be painful. It’s important to talk to your partner about these issues and work out ways to make sex more comfortable.

Sometimes there might be some bleeding for girls during their first time. This shouldn’t last long. If pain or bleeding continues, it’s important to talk to a doctor or nurse.

MYTH: The first time will be perfect.

FACT: TV and movies often glamorize the first time, which might give you unrealistic expectations about what it’s really like. It’s O.K. if your first time isn’t perfect. It’s not uncommon to feel awkward or self-conscious about your body or sex. And sometimes unexpected things happen when having sex for the first time, so it’s good to feel comfortable enough to talk about it with your partner.

What happens after I have sex?

After you have sex, especially if it’s your first time, you might experience a whole lot of emotional stuff—some good and some confusing. For example, you might feel worried or guilty, or sex could enhance your feelings of affection for your partner. If you’re having trouble dealing with these issues yourself, you might want to talk with your partner, or with other people you can trust, like friends, family members or a counselor or other mental health professional.

Acknowledgment

For more information on this topic see “Am I Ready for Sex, from Avert, an international AIDS charity.

Fact Sheet

Finding the right person for you


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You know that saying, someone will come along when you least expect it? That can be hard when you want a relationship! Read more about finding that person and coping with the wait.

Get to know yourself

Being happy with yourself, your life and your interests can help you feel content, regardless of whether you are in a relationship or not. Being single offers a great opportunity to get to know yourself better. It offers a chance to follow your interests and try new things. You might want to try spending some time alone doing things you enjoy. This can help you think about what you want if you do choose to have a boyfriend or girlfriend.

Being happy with yourself helps make future relationships better, as you are more likely to have confidence in what you want from the relationship. It can be helpful to consider what you would want from a relationship beforehand, too.

Meeting someone you like

Everyone has different tastes and interests, and we are all attracted to people for a number of different reasons. Some of these might include:

  • The way someone looks;
  • Whether we are already friends with a person;
  • Common interests;
  • Similar ways of thinking about things; or
  • A combination of these factors.

If you meet someone that you like, it might be because you are doing things that you enjoy. Chances are that someone you are looking for likes doing the same things as you, so you will have something in common to share. Together you might:

  • Play a sport;
  • Join a class or club at school;
  • Paint or work on some form of art;
  • Volunteer;
  • Play an instrument in a band;
  • Dance;
  • Hang out at the same places.

Meeting people can be tough. Try not to be too hard on yourself if you don’t meet someone when you want to. Remember that being single is O.K., and it doesn’t mean there is something wrong with you.

Meeting someone online

Some people meet others over the Internet. If you plan to meet face-to-face with someone you met online, it is a good idea to be cautious of giving out personal details like where you live and your phone number. If you decide to meet someone you don’t know, it is a good idea to meet in a public place where lots of other people are, like a movie theater, coffee shop or shopping center. It might also be a good idea to have a friend near by. Some people are not always honest and they might give you false information and might not have your best interests at heart.

Acknowledgment

The information provided here is based on “An Intergalactic Guide to Relationships” A project initiated by Central Coast Health.

Thanks to FPA Health for editing this fact sheet.

Fact Sheet

Do I want a relationship?


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Do I want a relationship?

Deciding whether to have a boyfriend or girlfriend can be a big decision. When figuring out what you want, it’s important to remember that being single can be an enjoyable time.

If you choose to be single, it might give you more time to do stuff that you want to do, like:

  • Hang out with friends
  • Focus on school work
  • Enjoy extracurricular activities, like learning a new sport or developing new creative skills

Being single can mean you get to find out more about yourself. Not everybody wants to be in a relationship. You might:

  • Not feel ready
  • Feel independent
  • Not be attracted to anyone at the moment

Only you can decide if you want a relationship. It’s alright to take time to decide if a relationship is right for you. In making this decision, you might want to consider what you want from a relationship. Different people want different things.

Some of the qualities of healthy relationships are:

  • Honesty
  • Intimacy
  • Love
  • Affection
  • Respect
  • Communication
  • Trust
  • Commitment

Am I ready for a relationship?

It’s not unusual to want to be in a relationship; wanting affection and support from a romantic partner is a normal part of developing as a young person. You might find yourself more attracted to men, women, both, or have a preference that falls somewhere less defined on the gender spectrum. You might also still be working it out. There is no pressure or hurry to find someone you like right away. It’s O.K. to take your time. Taking it slow might be hard if you are attracted to someone and you are not sure whether they feel the same way. It takes courage to show someone you are interested in him or her.

I’m attracted. Now what?

It’s important to spend time getting to know the person you’re attracted to. Your first impression might not always be accurate. You can discover more about each other by spending more time together. If you already know the person, it might be a good idea to think about how a romantic relationship might affect the friendship.

How can I start a conversation?

For even the most confident people, starting a conversation with someone you are attracted to can be scary. If you’re attracted to someone, it’s common to be nervous. A great strategy for starting a conversation and getting to know a person better is by asking casual questions and allowing them to elaborate on their answers. Some examples would be like:

  • What else do you have planned for today?
  • What’d you do over the weekend?
  • What do you like to do for fun?

Along with asking questions and talking about yourself, it might also be helpful to let the person know you are listening to him or her. Here are some tips to let others know you’re listening:

  • Ask questions to get a better understanding of what the person has been talking about
  • Say what you think, feel or sense about what he or she has said
  • Repeat in your own words what he or she has been saying

Here are some tips on how to let others know you’re listening:

  • Ask questions to get a better understanding of what the person has been talking about
  • Say what you think, feel or sense about what he or she has said
  • Repeat in your own words what he or she has been saying

What if they don’t like me back?

It can be hard when you realize that a person you’re interested in doesn’t feel the same way. You might feel rejected, embarrassed or sad. Try to remember the good qualities about yourself, the interests that you enjoy, and the positive things in your life. Talking to someone you can trust can also be helpful. Try talking to a friend or family member. If you’re finding that your feelings are getting in the way of doing everyday stuff, it may be helpful to talk to someone like a counselor.  Check out the Get Help section for more information about how professionals can help.

Dating safely

If you’re starting to meet people online, or are hanging out with new people in person, be aware of giving out personal details, like where you live or your phone number. If you do decide to meet someone you don’t know, try to do it in a place where other people are around. It might also be a good idea to have a friend nearby for support. Some people are dishonest and might give you false information or try to exploit you.

It’s important to remember that there is no right time or age to start a relationship. What’s more important if figuring out what’s right for you.

For more information

Check out the I’m single and I’m happy fact sheet, and the Having difficulty finding the right person for you fact sheet for more information.

Last edited by Becca

Fact Sheet

Being gay


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What does it mean to be gay?

Men usually describe themselves as gay when they find that they are physically, emotionally and sexually attracted to other men.

It’s not uncommon for men to have gay experiences and feelings as part of exploring their sexuality. However, for men who eventually identify themselves as gay, there’s a strong physical and emotional attraction to men that they don’t usually feel for women.

However, it is important to remember that just because at some point in your life you experience an attraction for the same sex, you don’t have to label yourself as gay. It is your choice. It can be hard for men to come out as gay because sometimes society doesn’t accept people who are attracted to their same sex.  For this reason, being gay can cause feelings of isolation for some young men, because they feel a lot of pressure to be straight. Unfortunately, some people find homosexuality hard to understand, but remember: there’s nothing “wrong” about feeling or being gay.

Why are some men gay?

There’s no real explanation of why some men are gay and some aren’t. Some people recognize their attractions at an early age while others don’t identify their attractions until well into adulthood. Most young people, however, begin to develop gay feelings and attractions during their teenage years. The main thing to remember is that being gay is not something to be”cured” or”fixed.” It’s part of the broad spectrum of human sexuality.

How do I know if I’m gay?

There’s no easy answer to this question. You can’t fill in a questionnaire or take a test that will give you a definite answer. What’s important is that you explore your sexuality in a way that makes you feel comfortable and safe. Allow yourself time to understand what being gay means to you.

It’s also important to remember you don’t have to address these questions alone. You might have friends or family members who have had similar experience and can talk with you about your feelings. If you’d rather speak to people who aren’t directly involved in your life, you can also find a support group in your area though the Human Rights Campaign or the Gay-Straight Alliance. If someone tells you that gay people are just confused about their sexuality, or that you can change, look for someone else to talk with.

How do I know if someone else is gay?

Chances are, you probably won’t know until someone tells you. Gay men come in all shapes and sizes. It’s important that you don’t judge others based on stereotypes, or assume someone’s sexuality because of the way he dresses or the people he hangs out with. At the same time, if you identify as gay, how you dress and behave is about your personal identity, not a stereotype.

Gay relationships

In most respects, gay relationships are no different from straight relationships. Like everyone else, gay men fall in love and form committed relationships. Regardless of your sexuality, it’s important to be open and honest with your partners about your feelings and attraction to other people.  Beyond that, there are no predetermined rules to follow in any relationship.

For more information

There are many misunderstandings about sexuality and sex, and exploring your sexuality might be a confusing thing to do, whether you’re straight, gay, lesbian, or bisexual. If you’re curious to learn more about your sexuality, you might want to check out these additional fact sheets:

Information in this fact sheet was also provided by

The Human Rights Campaign
Gay-Straight Alliance

Other resources

Trevor Project and Trevor helpline (1-866-488-7386)
GLBT National Help Center
National GLBT Talkline (1-800-246-7743)
National GLBT Hotline (1-888-843-4564)
GLSEN, the Gay, Lesbian and Straight Education Network
The National Day of Silence (brings attention to anti-LGBT name-calling, bullying and harassment in schools).
National Coalition for Gay, Lesbian, Bisexual, Transgender Youth
Youth Resource, a website by and for gay, lesbian, bisexual, transgender and questioning young people
PFLAG, Parents, families, and friends of lesbians and gays

Last reviewed: Mar 7 2013

Fact Sheet

Being bisexual

8

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What does it mean to be bisexual?

People who are physically and sexually attracted to both men and women usually identify themselves as bisexual. However, not everyone who has had feelings or experiences with both men and women describe themselves as bisexual.

Sometimes, people are happy to explore their sexuality, but will identify themselves as mainly straight, gay or lesbian, or have no label at all. Other times, it can be hard for people to come out as bisexual because society doesn’t accept people who are attracted to both men and women.  For this reason, being bisexual can cause feelings of isolation for some young men and women, because they feel a lot of pressure to be either straight or gay. Some people find bisexuality hard to understand, but remember: there’s nothing “wrong” about feeling or being bisexual.

Why are some people bisexual?

There is no real explanation of why some people are bisexual, and some are not. The main thing to remember is that being ‘Bi’ is not a disease or illness to be cured or fixed. It is part of the broad spectrum of human sexuality.

What does it mean to be pansexual or polysexual?

There are some people who find "bisexual" to be a limited label because it implies that gender is a binary (i.e., can be divided into two categories: men and women) rather than a spectrum of  gender identities. Some people therefore identify as pansexual to indicate that they are attracted to "all genders" or "polysexual" to indicate that they are attracted to "many genders." It is completely up to you what label, if any, feels right for you. 

How do I know if I’m bisexual?

There’s no easy answer to this question. You can’t fill in a questionnaire or take a test that will give you a definite answer. You might be bisexual if you recognize that you’re attracted to women and men, but these feelings don’t necessarily have to come up at the same time or with the same intensity. What’s important is that you don’t deny your feelings and that you take time to explore your sexuality at your own pace.

It’s also important to remember that you’re definitely not alone, and you don’t have to deal with your questions or problems by yourself. You might have friends or family members who have had similar experiences and can talk with you about your feelings.

If you’d rather speak to people who aren’t directly involved in your life, you can also find a support group in your area though the Human Rights Campaign or some of the other resources listed below. If someone tells you that bisexual people are just confused about their sexuality, that bisexuality doesn’t exist, or that you can change, look for someone else to talk with.

How do I know if someone else is bisexual?

You probably won’t know unless someone tells you. You can’t tell whether a man or woman is bisexual just by looking at him or her, or by the group her or she hangs out with. It’s important to remember that bisexual, straight, gay and lesbian people don’t “look” a certain way or confine to common stereotypes.

Bisexual relationships

Regardless of your sexuality, it’s important to be open and honest with your partner about your feelings and attraction to other people. Beyond that, there are no predetermined rules to follow in a bisexual—or any type—of relationship.

And, a person who is bisexual can be in a monogamous relationship with someone of the same or opposite sex. To be bisexual does not mean that a person has to be with someone of both sexes at the same time.

For more information

There are many misunderstandings about sexuality and sex, and exploring your sexuality might be a confusing thing to do, whether you’re straight, gay, a lesbian, or bisexual. If you’re curious to learn more about your sexuality, you might want to check out these additional fact sheets:

Information in this fact sheet was also provided by

The Human Rights Campaign
Gay-Straight Alliance

Other helpful resources

Trevor Project and Trevor helpline (1-866-488-7386)
GLBT National Resource Database
National GLBT Talkline (1-800-246-7743)
National GLBT Hotline (1-888-843-4564)
GLSEN, the Gay, Lesbian and Straight Education Network
The National Day of Silence (brings attention to anti-LGBT name-calling, bullying and harassment in schools).
National Coalition for Gay, Lesbian, Bisexual, Transgender Youth
Youth Resource, a website by and for gay, lesbian, bisexual, transgender and questioning young people
PFLAG, Parents, families, and friends of lesbians and gays

Last reviewed: Mar 5, 2013

Fact Sheet

Taking care of your sexual health


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If you’re sexually active, it’s important to regularly visit a health care provider, like a doctor or nurse, to have sexual health check-ups and discuss sexual health issues.

What is a sexual health check-up?

A sexual health check-up is an examination by a doctor or nurse for sexual health issues like sexually transmitted diseases (STDs). During your sexual health check, you can also ask any questions you have about reproductive and sexual health.

Who can carry out a sexual health check-up?

A sexual health check will be carried out by a health care provider, but who exactly this will be depends on where you go for your check-up. You might see your regular medical doctor, or a doctor or nurse at a community health center or a family planning clinic like Planned Parenthood.

Check out the Get Help section for more information about how you can get access to a health services.

Who needs a sexual health check?

Anyone who is sexually active should have a sexual health check-up. How often and when you need to have a check-up depends on your lifestyle and sexual activity, so a sexual health check is advisable sooner rather than later if any of the following circumstances apply to you:

  • If you think that you might have an STD;
  • If you’ve had unsafe sex, including vaginal, oral and anal sex;
  • If you’ve had a condom break or fall off during sex;
  • If your partner has another sexual partner;
  • If you have more than one sexual partner;
  • If you’ve shared injecting equipment like needles;
  • If you’re starting a new sexual relationship.

What happens during a sexual health check-up?

A health care provider will usually begin a check-up by talking with you about your sexual history. Some of the questions your doctor or nurse will ask you might seem personal. Here are some examples of questions he or she might as you:

  • How many sexual partners you have had?
  • What kinds of sexual activities you have engaged in?
  • Have you had sex with men, women or both?
  • Do you have any symptoms?
  • Have you injected any drugs or shared needles?
  • Do you have tattoos or body piercings?

You might feel uncomfortable telling the truth when answering these questions. But if you don’t give your provider accurate information, you might not get the best advice or be given the appropriate tests. This could mean your health could be seriously affected. Some STDs can lead to long-term health problems if they’re not treated properly.

During your examination, with your consent, your external genital area might be examined for any signs of STDs. A variety of tests might be conducted, including

  • A urine sample or blood test;
  • Swabs, where a sample of fluid or discharge from your genital area will be taken and examined under a microscope. Sometimes it might be necessary to take extra swabs from the throat or inside the anus;
  • For women, a vaginal examination, like a Pap smear, might also be performed. A Pap smear is a routine swab of the cervix that all sexually active women are advised to undergo. You should confer with your doctor about how often you should have a pap smear.

Whatever your results might be, your medical records are private according to the law if you’re 18 or older. Any information that health providers receive or discuss with you at a clinic is completely confidential and cannot be shared with your parents or people you know. Regardless of your age, health care providers are also bound through ethical practices to keep your health records confidential.

If you do test positive for an STD, your doctor is obligated to report cases of certain STDs to the government so the disease can be monitored throughout the U.S. Your identifying information like your name will not be used. They don’t need to know who you are, they only want to keep track of how many people are getting the infection across the country.

You might also want to consider telling your previous sexual partners about it so that they can get tested, and treated if necessary. There are many ways that you can tell them—face-to-face, over the phone, or even in an e-mail. But any way you tell them, it’s important to their sexual health that they be informed.

Asking questions

Consider a sexual health check-up a good opportunity to ask any questions you have about your sexual health or discuss anything that’s worrying you. A good health care provider will encourage you to ask questions.

It’s important that you feel like you are able to ask any questions you have. It’s equally important that your provider answers your questions and explains all procedures in a way that you’re able to understand.

Important questions to ask during your check-up

Some of the questions you might want to ask your provider before your sexual health check-up include:

  • Can you be seen by a provider without a parent or guardian present?
  • What kind of insurance does the provider accept? Will you be able to pay for the services?
  • Will you be able to get a free or low-cost Hepatitis B vaccination? (This is a vaccination that is recommended for young people.)
  • Will you be able to receive written documentation on the tests you were given and your results?
  • Will your provider keep your information confidential?
  • Will the provider allow time for urgent visits for issues like pregnancy and emergency contraception?

Here are some questions you might want to ask during your visit:

  • What STDs are you being tested for?
  • Will the test be a blood test, or urine test? How often should you undergo these tests?
  • If any of the tests are positive, do you have to tell anyone? Will the provider tell anyone?
  • If the test is positive, how will you be treated?
  • Will your infection affect your future fertility, pregnancy or general health?

Feeling comfortable

Stay in touch with how you’re feeling. It’s normal to feel uncomfortable discussing these topics. If you’re your doctor or nurse makes you feel uncomfortable in how they respond to you, you may want to try seeing someone else.

For more information

Check out the Intro to STDs fact sheet for more information on you sexual health.

Fact Sheet

Non-traditional medicine & treatment


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What are non-traditional medicine and treatments?

There is a lot of debate about what should be included in non-traditional medicine and treatments. There are even many different names for this kind of medicine and treatment to go by—alternative medicine; homeopathic medicine or you might hear the name, complementary and alternative medicine (CAM). CAM is often the formal term used for it. These medicines and treatments can range of things from herbal supplements, chiropractic care, eating chicken soup for a cold, acupuncture or yoga. Basically, CAM covers everything that doesn’t fit into Western (also called “conventional”) medicine.

CAM is used and may be helpful for many ailments—both physical and mental - like stress, colds, headaches and even, diseases like cancer.

Are non-traditional medicines or treatments an option for me?

Commonly, these non-traditional medicines or treatments can be used on their own or combined with Western or conventional medicines. However, the use of some non-traditional medicines is very controversial. Some medical doctors do not believe in their use and may discourage it. Others will only use or suggest them if it is proven to actually to help people through research studies. The problem is that there aren’t many studies to check out whether non-traditional medicines or treatments work.

The best way to make an informed decision is to talk to your doctor about the type or treatment you are considering. You can also consult with an alternative medicine practitioner. You should never try non-traditional medicine or treatment without consultation. You should also tell your doctor about medications you are currently taking to make sure that the CAM treatment you might be considering wouldn’t have a dangerous reaction with your current medication.

You can also call the National Center for Complementary and Alternative Medicine Clearinghouse (1-888-644-6226). They provide publications and searches of the scientific literature on CAM, including topics such as “Selecting a CAM Practitioner” or “Are You Considering Using CAM?” but they do not offer medical advice, treatment recommendations or referrals.

Some information was provided by and for more info:

National Center for Complementary and Alternative Medicine


Last reviewed: May 17, 2012

Fact Sheet

Chronic illness


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What is chronic illness?

Chronic illness refers to a group of illnesses that are permanent or last a long time. Examples of chronic illnesses include:

  • Allergies
  • Arthritis
  • Asthma
  • Cancer
  • Crohn’s disease
  • Cystic fibrosis
  • Diabetes
  • Epilepsy
  • Hemophilia
  • Celiac Disease
  • Multiple sclerosis
  • Lupus
  • Chronic fatigue syndrome

Each condition has a different course and different effects. It may be that the illness slowly gets worse over time, causes permanent changes to the body or it may go away. Chronic illness may affect your quality of life and management of the illness can minimize its effects.

Living with a chronic illness

It is not uncommon to feel overwhelmed when you are first diagnosed with a chronic condition. It may be the first time that you have had to think seriously about your health and about the future. Chronic illnesses may also require changes to your lifestyle by:

  • Introducing regular medication and/or monitoring of your body;
  • Making changes to your diet;
  • Managing your alcohol use.

There may also be the long-term impact of the illness to consider. It can be a big adjustment to make.

Living with a chronic illness can be frustrating, monotonous, stressful and depressing. It is not unusual to be frustrated by your illness and want to ignore it or rebel against it. If you are feeling this way it may be helpful to speak to your local doctor, counselor or nurse. The Get Help section gives you more information about what these services do.

Living with a chronic illness may make you much more knowledgeable about how your body works and give you a renewed perspective on life.

Managing your chronic illness

Learn as much as you can about it - get all the facts!

Knowing information about the condition may make you feel more comfortable and in control. One way of doing this is by becoming involved with an organization that specializes in your illness. That can give you the opportunity to keep in touch with what’s new with the illness. Your local doctor should be able to tell you the name of the relevant organization for you, or look for National organizations on the internet. Many of these organizations may have state and local chapters.

Find good supports

Friends and family can be valuable sources of support. Other good avenues for support may be medical specialists, your local doctor, counselor or other mental health professional, or another person with the illness. It may be helpful talking to someone who:

  • Is knowledgeable about your illness;
  • Is approachable and you can speak openly with about all the different aspects of it when necessary; and
  • Is up-to-date with the requirements for managing your condition and is able to refer you to appropriate people and resources when necessary.

Ensuring you get the best support

It is likely that you will be seeing a medical specialist who will oversee the management of your illness. Even if your specialist is not the main person you call on for support and information, it can be helpful to have a doctor who:

  • You can be honest with;
  • You trust;
  • You feel understands you.

Check out the Finding People to Help and Support You section in Get Help for more information on finding the best support for you

Speaking to someone with your illness

When diagnosed with a chronic illness you may feel different from other people. This can be really scary and frustrating. Speaking to people who have the same illness may help reduce this feeling of isolation. Organizations that specialize in your illness should be able to put you in touch with people with your illness.

Helping out within the organization could also lead to connecting you with people with your illness.

 

Fact Sheet

Your rights when receiving health care


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What can you expect from a health care professional?

When you visit your medical doctor, counselor, psychiatrist, psychologist, nurse or any other health/mental health professional, you’re entitled to be treated in a certain way. Here are some of your rights as a patient or client:

  • Honesty. You have a right to receive all available and accurate information about your mental and physical health from your provider so you are able to make educated decisions about your care. If there’s something that you don’t understand, your provider should clarify.
  • Control over your treatment. You have the right to make decisions about your care. If you feel like you can’t make these decisions on your own with the information that your provider has given you, you also have the right to be supported by friends and family in your decision-making process. Additionally, many hospitals have patient advocates who can provide support to patients who are making decisions about medical care. (The information provided below on “Giving Consent” will further clarify your right to be involved in decision making.)
  • Choice. You have the freedom to choose whomever you want to be treated by. If you’re unhappy with the person who’s treating you, you have the right to switch providers. For more information on changing providers, check out the “I think I might need to see a new counselor” fact sheet.
  • Respect. You have the right to receive care that’s respectful of you and your background, religious beliefs, cultural needs and values. Health care providers should never discriminate against you based on your gender, race, ethnicity, sexual orientation, age or ability.
  • Confidentiality. You have the right to talk with your health care provider and know that everything you say will be kept confidential. Health care professionals are required ethically to keep all your information private unless they think that you might be at risk of harming yourself or others. The privacy of your medical records is also protected by law. Check out the Confidentiality fact sheet for more information.
  • Speedy care. You have the right to receive prompt treatment. If you’re facing an emergency, you also have the right to services like ambulances and emergency department care.

Your right to complain

If you feel like your rights aren’t being met by your health care provider, you have the right to say so. Talk to your provider about your concerns. If you’re still unhappy with your treatment, you can change providers, and in certain situations, file a formal complaint with your state department of health.

Treatment

If you’re receiving treatment, your health care provider should talk to you about the treatments available and any risks that may be involved. Before deciding on treatment, it’s a good idea to make sure that you understand the information that’s been given to you. All the information you receive about your health care should be given to you in a language and way you can understand. Sometimes it may be helpful for your doctor or health care provider to use pictures, models or written summaries to get the information across in way that makes it easy to understand.

If you’re having difficulty understanding the information being provided by your health care provider, it may help to bring someone you trust with you to your appointment. You should also ask your provider a lot of questions, and if possible, get some information in writing so that you can learn more while you’re out of your provider’s office.

Giving consent

You have the right to be involved in decisions about your health and you should be informed and allowed to make choices. Making a considered decision about your treatment, and having all the information you require to make that decision is called giving “informed consent”. Generally, medical treatment or care should not be given to you unless you give “informed consent”. States vary in the age at which someone is able to “give consent” for treatment. If you are under the required age (which in some states is age 13), a parent or guardian maybe be required to give consent. At the age of consent, you may seek treatment or care and give consent for it on your own behalf without parental notification. It may be that even if you have reached the age of consent, you also choose to make such decisions jointly with your parents. The actual age of consent could be different for the treatment of medical problems, mental illness and substance abuse.

It may take time to think over major decisions and can sometimes be helpful to talk to friends and family. If you wish, your parents may stay with you during consultations, minor procedures and when in hospital, unless there is some medical or legal reason to stop this. If this is the case the reasons should be discussed with you. If you are not sure what to do, it may be a good idea to have further talks with your health provider or to get a second opinion.

Information

Information in this fact sheet was provided by:


Last Reviewed May 17, 2012

Fact Sheet

Being a lesbian

2

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What does it mean to be a lesbian

Women describe themselves as a lesbian when they find that they are physically, emotionally and sexually attracted to other women; an attraction they don’t have for men. It’s not uncommon for women to have experiences and feelings with other women as part of exploring their sexuality. Sometimes this helps women confirm or discover their identity as a lesbian. Others may feel that the label of “lesbian” doesn’t quite fit who they are. They may identify as bisexual, queer, or have a personal definition of their orientation. The most important thing is feeling comfortable with your identity as a whole, sexual orientation included.

Why are some women lesbians?

There is no real explanation of why some women are lesbians and some are not. Some people recognize their attractions at an early age while others don’t identify attractions until they are well into adulthood. Many young women, however, begin to develop feelings and attractions to other women during teenage years.

How do I know if I’m a lesbian?

There is no easy answer to this question. You can’t fill in a questionnaire or take a test to give you a definite answer. What is important is that you explore your feelings and attractions at a pace that makes you feel safe and comfortable. It’s also important to remember that you don’t have to deal with your questions or problems by yourself. You might have friends or family members who have had similar experience and can talk with you about your feelings. If you’d rather speak to people who aren’t directly involved in your life, you can also find a support group in your area though the Human Rights Campaign or Gay-Straight Alliance.
If someone tells you that lesbians are just confused about their sexuality, that homosexuality doesn’t exist, or that you can change, look for someone else to talk with.

How do I know if someone else is a lesbian?

Basically, you won’t know if someone’s a lesbian until someone tells you. Lesbian women come in all shapes and sizes. It’s important that you don’t assume that someone is a lesbian based on the way she looks or the group of people she hangs out with. It’s also important to remember that if you identify as a lesbian, how you dress and behave is about your personal identity, not a stereotype.

Lesbian relationships

In most respects, same-sex relationships are not different from straight relationships. Like everyone else, lesbian women fall in love and form committed relationships. Regardless of your sexuality, it’s important to be open and honest with your partner about your feelings and attraction to other people. Beyond that, there are no predetermined rules to follow in any relationship.

For more information

There are many misunderstandings about sexuality and sex, and exploring your sexuality might be a confusing thing to do, whether you’re straight, gay, lesbian, or bisexual. If you’re curious to learn more about your sexuality, you might want to check out these additional fact sheets:

To learn more about this topic:

Trevor Project and Trevor helpline (1-866-488-7386)

GLBT National Resource Database

National GLBT Talkline (1-800-246-7743)

GLSEN, the Gay, Lesbian and Straight Education Network

The National Day of Silence (brings attention to anti-LGBT name-calling, bullying and harassment in schools).

National Coalition for Gay, Lesbian, Bisexual, Transgender Youth

Youth Resource, a website by and for gay, lesbian, bisexual, transgender and questioning young people

PFLAG, Parents, families, and friends of lesbians and gays

Other resources

The Human Rights Campaign

Gay-Straight Alliance

Last reviewed: Mar 7, 2013

Fact Sheet

Time management


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Ideas for managing your time

Meeting deadlines for work and school can sometimes seem overwhelming. Managing your time may help you to be more organized and meet the deadlines you have. Here are some suggestions for maximizing the time you have available:

Set goals. It may be a good idea to think about what you need and want to do with your time. From this, you can set your goals, which may help you to manage your time more effectively. You may want to check out the fact sheet on Putting your goals into action for more information.

Project plan. Ever had a big project to do for work or school and never quite know where to start? It may help to write down all the things you need to do to complete the project and list the order in which you can do this. This can give you some direction and help you to form a timeline.

Use a planner. Writing down appointments, homework, or things you have to do may help you to keep track of what’s on. This way you may avoid things catching you by surprise. Use a wall calendar. Having a calendar that shows everything that is on during the month, or even the year, might help remind you of events that are coming up.

Turn the phone and internet off! If you find that you are being distracted by the phone or internet, it might help to disconnect them or let the calls go to voicemail on for a while. You can always call people back later.

Be flexible. Sometimes situations change and you may need to re-adjust your goals or work plan to fit in with the changes.

Balance your time. Having a balance of activities in your life may help to avoid you burning out. It is a good idea to find time for relaxing, being active and hanging out with friends. Spending time relaxing or re-energizing yourself may help you with your work and study.

Talk to someone. It is not uncommon to have lots of things we need to get done and this may make it difficult to manage your time. If you are finding these hard it may be helpful to talk to a teacher, lecturer, or counselor. Check out the Get Help section for more information about how these people may be able to help.

Procrastination

When you have something that needs to get done, it can often become easy to find a million other things to do instead. If you have a paper to write, you might decide to clean your room or take out the trash, even if you normally dislike those tasks, just to put off writing the paper. It becomes especially easy to procrastinate if an opportunity pops up, and you feel as though you will still have enough time to take advantage of it and finish your paper.

Though it can be tough to break the habit of procrastinating, you will be glad you did in the long run. If you save everything until the last possible second, you are bound to stress out, not produce your finest work, become sleep deprived, and possibly miss out on something that pops up last minute. For example, if you have a paper due on a Friday, you might hang out all week, watch TV, go out, and assume that Thursday night will be more than enough time to write the entire paper. Even though you are not writing the paper all week, you still have it looming over your head. You can put off actually starting the paper, but you will probably still be thinking about the fact that you need to write it.  Once Thursday night rolls around, you will likely become extremely overwhelmed.  You may realize that you needed to do research for the paper beforehand, or that the paper is actually much more difficult than you originally thought it would be. You may then become very stressed out, wondering how you are going to finish the paper in time, and you may even pull an all-nighter to get it done. Additionally, a friend might call you up on Thursday and tell you about something fun going on that you will have to miss, because you cannot procrastinate any longer.

Realizing the potential consequences of procrastinating can help you break the habit. Try using some of the above techniques to organize your tasks and goals, and make the most of your time. When you first find out about something you need to do, such as a new assignment, don’t just put it aside for later. Read it through or look into what you will need to do, so that once you actually begin the task, you will not be surprised.

Plan out how much time you think you will realistically need to complete the task, giving yourself extra time just in case. Working on something in smaller, more frequent sections makes the entire task much easier than trying to do it all at once. If you just write one page of a five page paper, each day, you will be finished in less than a week. You may not even have to miss out on anything that you want to do this way, because you will still have free time each day.

The next time you have to complete a task you do not want to do, try breaking up the amount of time you will need to spend on it, or just try getting it out of the way early. You’ll notice that you’ll be stress-free, and it will help you develop great time management skills for the future!

Fact Sheet

Starting at a new school


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There are many reasons why you might be starting at a new school—leaving high school to move into college, choosing a different school that better suits you and your needs, or transferring because of problems, whether they be student, teacher or work-related. Whatever your reason, moving into a new school can be an intimidating and nerve-racking experience.

Some of the things that might stress you out include:

  • Being in an unfamiliar environment;
  • Feeling sad about not hanging out with old school friends;
  • Being worried about making new friends;
  • Being nervous or worried about your workload;
  • Having low energy levels as a result of getting organized for school;
  • Being bullied or harassed by other students. If this is happening to you, check out the interpersonal violence fact sheet and the cyberbullying fact sheet for more information.

Making life easier at school

It might help to remember that you’re not alone. Everyone at some point in life has started at a new school, and it’s likely that other people have similar feelings to you. Here are some suggestions for making the move to a new school as stress-free as possible:

Get involved. A good way to make new friends is to become involved in activities that interest you. This way, you can meet people with whom you have things in common. You might want to get involved in:

  • Sports;
  • Music;
  • Debate; or
  • Student clubs or government

If there is something you would like to do and it’s not offered by your school, you might also consider finding 3-5 other people who are interested in the same thing, and then start a new club.

Break the ice. Often other people feel just as nervous about making new friends as you do. Break the ice by asking someone in your class to go get coffee or have lunch or go see a movie on Friday night. The great thing about starting a new school is that it gives you an opportunity to break out of cliques and meet new people. It’s often easy to identify different groups: popular, academic, sport or rebellious. But interacting with anyone, no matter what group he or she hangs out with, can help you to be more open-minded and meet people that you might not otherwise be friends with.

Also, give some thought to reaching out to those who might be in special education, or those who have a disability. Everyone deserves a friend!

Express yourself. Expressing how you feel might help you release some of the tension that might be building up inside. There are a number of ways that you can express yourself safely, through exercising or writing in journal, for example. Check out the Express yourself fact sheet for more ideas.

Stay in contact with old friends. While you’re making new friends, it might help to stay in touch with your old ones. You might like to chat with your old friends about how it feels to start at a new school. Along with hanging out face-to-face, you can keep in touch through texting, phone, e-mail, online chat, or social networking sites like Facebook.

Have something to look forward to. Sometimes it’s helpful to plan ahead so that you have something to look forward to. You may want to plan to catch up with friends after class or do something special during the weekend.

Get your bearings. Try and become familiar with your school schedule, where your classes are, who your teachers or professors are, and where the library and lockers are. Knowing where you’re going can help reduce stress at school.

Giving it time

Adjusting to big changes like starting school often takes time, particularly if you’re transferring at a time when other people have already settled in. Allow yourself to get used to the changes. Try to take it one day at a time. Life will start to get easier as you become more familiar with the school routine and start making new friends—the new school won’t seem “new” anymore. Friends will be made, new experiences will be had, and you will learn things that will stay with you for life. If you try to make going to your new school a positive and pleasurable experience, it will be!

Getting help

It might be helpful to talk to someone, like a friend or family member, about how you’re feeling.

Sometimes talking to someone who is removed from the situation can also be helpful. This person might be able to give you a different perspective on things and offer other suggestions for dealing with situations. This can be someone like a school counselor, dorm resident advisor, or a teacher. Remember: It’s part of their job to support students.

If you’d rather talk to someone anonymously, you can call The Boys Town National Hotline at 1-800-448-3000. This hotline is staffed 24/7 with trained volunteers who can talk to you about how you’re feeling.

Fact Sheet

Relaxation


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Putting things in perspective

Relaxation is important. It’s easy to forget to make time for yourself when things get stressful. Sometimes you might get so pre-occupied that days can go by without you doing anything for yourself.

Many forms of relaxation, like walking or sitting quietly, are very simple, easy to do and don’t cost a thing. Others, like yoga or meditation, require some training or discipline. Going fishing or playing sports can be a great way of relaxing too.

Put aside some time in the day and try out some of these relaxation techniques to see which ones work for you.

  • Go for a walk. Take time to notice the things around you;
  • Listen to some music you really like;
  • Go fishing;
  • Sit quietly in a park and look at the things around you;
  • Play your favorite sport;
  • Take a bath;
  • Go to a movie or watch a DVD;
  • Visit a friend;
  • Go for a swim;
  • Do a puzzle;
  • Read a book;
  • Learn yoga or meditation.

Breathing techniques

When you’re anxious or stressed, your breathing can become quick and shallow, which reduces the amount of oxygen going to your organs. Learning how to breathe deeply can help reduce some of the physiological symptoms of anxiety.

To become aware of your breathing, place one hand on your upper chest and one on your stomach. Take a breath and let your stomach swell forward as you breathe in, and fall back gently as you breathe out. Try to get a steady rhythm going, take the same depth of breath each time to breathe. Your hand on your chest should have little or no movement.

When you feel comfortable with this technique, try to slow your breathing rate down by putting a short pause after you have exhaled and before you breathe in again.

Initially, it might feel as if you aren’t getting enough air in, but with regular practice this slower rate will soon start to feel comfortable.

It might help if you imagine that you’re blowing up a big balloon in your stomach when you breathe in and deflating it when you breathe out. This exercise helps you to breathe more oxygen into your stomach rather than restricting the amount of oxygen by breathing into your chest.

For more information

The Mayo Clinic

Fact Sheet

Physical disability


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Physical disabilities can be either short term (e.g. a broken wrist) or long term (e.g. paraplegia). Some disabilities can improve over time while others may not. Depending on your disability, it might be controlled with medication and physical therapy (physiotherapy). Some people are born with physical disabilities, while other physical disabilities are caused by illness, injury or accident.

Having a disability can be a huge challenge and might mean having to make changes to many aspects of your life. It might mean having to find alternative ways to achieve your goals (or make new ones).

Reactions to Disability

Having a disability can be hard to deal with - you might experience a wide range of feelings or reactions. These are things you might feel when you first find out you have a disability. However, you might experience them at other times too. Some feelings or reactions you might experience include:

  • Anger;
  • Sadness or depression;
  • Feeling scared;
  • Feeling overwhelmed;
  • Stress or anxiety;
  • Shock;
  • Frustration;
  • Denial;
  • Confusion.

What can you do?

It can be overwhelming trying to understand why you have to deal with something that can be so difficult and seem so unfair. Some suggestions that might help:

Support. Don’t be afraid to ask for support, be it from a counselor, family member or friend. Asking for support doesn’t mean you’re weak or a failure; it’s a sign of strength. It might help to ask whether the doctors have had training for both the physical and psychological aspects of disabilities. Remember, it’s okay to get a second opinion or try a new doctor or counselor if you’re not happy.

Try and be patient. Finding yourself with a disability can be really frustrating and mean that you are more dependent on other people, at least for a while.

Get informed. As with chronic illnesses, having a good understanding of your disability can help you learn to accept it. Knowing what to expect with your condition can take some of the anxiety away and help you manage it best.

Take care of yourself. Make sure that you eat well and exercise if you can. And making sure you do something special for yourself each day, even if it’s just watching your favorite TV show. Having a disability doesn’t mean you can’t have fun!

Discrimination

Discrimination is against the law. Disability discrimination happens when you are treated less fairly than people without a disability. Disability discrimination also occurs when you are treated less fairly because you are a relative, friend, care taker, or co-worker of a person with a disability. Discrimination can happen at work, college, school or a sports club. You can also be discriminated in a shop, bar or sports venue.

If you are experiencing discrimination there are things you can do:

Get informed. Check out the US Department of Justice website or the Americans with Disabilities Act to know your rights and what your options are for fighting it.

Take action. Tell or write to your manager or the person in charge about what is happening. Keep a journal to record events. If you aren’t believed or the person does not take any action, go to someone else who is in a more senior position of authority.

Get support. Tell someone you trust what is happening and take them with you when reporting the discrimination if you need the support.

Discrimination also includes bullying or harassment, which can seem less obvious.

Where to get help?

Knowing what services are available to assist you can help you to better plan around any challenges. Physical disabilities can impact on your day to day life but there are lots of services designed to assist you.

Work. The US government can provide assistance if you are unable to work due to disability. They can also provide help to continue studying or working. Some employment agencies help people with disabilities find suitable work.

Study. Most universities have disability support offices that are designed to help students with disabilities. Services can include special consideration on exams/essays, organizing for someone to take notes for you and organizing on-campus parking.

Organizations and support groups. Some disabilities are represented by non-government organizations. Support groups can be a great way to get support and advice from people who are going through and have gone through what you are going through. They provide support, advice and information. Check the yellow pages for organizations and support groups for contact details (listed under ‘Health Support Organizations).

Travel. Getting around can be a difficult when you have a physical disability. Disability access on public transport varies widely, depending on where you live (though is generally much better in cities). Give the transport company a call to find out more. Your local community service should be able to provide more information about the sorts of services they offer. If you are planning to go overseas or interstate there are travel agents who specialize in travel for persons with disabilities (check the yellow pages).

Attendants. An attendant can give you extra support and help around the house, even if it’s only for a short period. Your hospital should be able to help you find someone.

More information


Last Reviewed: May 17, 2012

Fact Sheet

Long distance relationships

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What's a long distance relationship?

A long distance relationship is where two people live far enough away from each other that they don’t see each other on a day-to-day basis. They might live in different states or cities, or even different countries. Some long-distance romantic relationships begin when you meet someone travelling or online, and some relationships change to a long distance relationship when one of you moves away for work, school, or because your family moves.

Benefits of long distance relationships

Long distance relationships can be as satisfying as regular relationships. Some positive things about having a long distance relationship include:

  • Space and independence. Not having someone living near by can be an opportunity for you to explore your interests, your dreams, and other relationships that you may have. Strengthening other relationships might mean that you are less dependent on your long distant relationship for support.
  • Exploring different ways to communicate. Being able to talk on the phone or email/write to someone can be a great way to find out more about each other. It is not uncommon to discover things about each other that may have been harder to do if you were face to face. This could be especially so at the beginning of a relationship.
  • Valuing the relationship. Being away from someone can help you to better appreciate them and you may be less likely to take them for granted (or just focus on the physical side). When you do see them it may be more special and exciting.
  • Stronger relationship. The additional challenges and commitment of a long distance relationship might make the relationship stronger.

Challenges of long distance relationships and ways to overcome them

All relationships have challenges; however long distance relationships often present additional ones. Some of tough things about being in a long distance relationship might include:

  • Physical distance. Not having someone that you care about close to you, especially when you might need them for emotional support (or a hug!) can be tough. If you are feeling this way, you might ask for a hug from another friend or family member. Even though it’s not the same, it can sometimes be a good substitute until next time you meet up.
  • Loneliness - You might feel lonely and sad about not being able to go out regularly and have fun with the person, or because you’re not able to be more involved in their life. If you are feeling this way, give that person a call to say hi - hearing their voice might help you to work through the loneliness and look forward to your next meeting.
  • Jealousy and insecurity. You might worry that a friend no longer needs you or that your boyfriend/girlfriend will break up with you because they are interested in someone else (even though you have nothing to base the thought on). If you are feeling this way, it might help to talk to someone outside the relationship, such as a family member, friend or counselor who can help you work through why you might be feeling that way and provide ideas that can help you deal with those feelings.

Sustaining a long distance relationship

Sustaining a long distance relationship can be challenging and, like most relationships, needs commitment, trust, patience and honesty to work. Some things that might help to create and sustain a fulfilling long distance relationship include:

  • Regular communication. Keeping in contact with someone in a long distance relationship might take extra effort. Conversation via phone, Skype, emails, texts, snapchats, and letters can be a great way to express your feelings, share your experience and allow them to stay involved in your life.
  • Talk to other friends and family about your relationship. This can be a great way to remind yourself and others that this person is still an important part of your life even though they live miles away.
  • Trust and openness. It is important to have trust in a relationship, and to have confidence that they are faithful and are thinking of you.
  • Plan times when to meet up with the person. It might be helpful for you to plan when you are next seeing the person you are away from as this can give you something to look forward to. If your relationship is a romantic one, you might plan to live in the same place at some stage in the future.

When things aren’t working out

Like any relationship, there can be times in a long distance relationship that you argue or go through tough times. This may not mean the end of the relationship; instead it could be a result of a lack of communication, a difference in opinion, or uncertainty about how the relationship is going. It may be helpful for you to check out these fact sheets for more information on how to resolve your argument or manage the rough patch you may be experiencing:

 

 

Fact Sheet

Stress

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What is stress?

Stress is a common feeling that comes from a physiological reaction your body has to certain events. It is the body’s way of rising to a challenge and preparing to meet a tough situation with focus, strength, stamina and heightened alertness.

Even though stress can be a positive thing - like motivating us to make positive changes in our lives or giving us that “extra push” for an exam, sometimes we have too much stress and begin to feel that our lives are out of balance. When this happens managing stress could become a challenge.

What causes stress?

Many tings cause people stress including:

  • Exams
  • Problems at school or work
  • Relationships
  • New and greater responsibilties
  • Sexual, physical, or emotional abuse
  • Moving to a new place
  • A traumatic event - such as the death of a loved one
  • New or chronic illness or disability
  • Peer pressure or being bullied
  • Unrealistic expectations placed on you by yourself, friends, family, or culture
  • Watching parents argue
  • Feeling guilty

None of these factors are necessarily bad, and sometimes you can balance the stress symptoms just fine. At other times, trying to balance several factors of stress all at once may or even one factor alone can cause too much stress.

How does stress affect the body?

The human body responds to events that provoke stress (stressors) by activating the nervous system and specific hormones. The brain tells your glands to produce more of the hormones, adrenaline and cortisol, and to release them into the bloodstream. These hormones speed up heart rate, breathing rate, blood pressure and metabolism. These changes within your body help prepare you to deal with pressure, which is also known as a stress response. When this natural reaction works properly, the body’s stress response improves your ability to perform well under pressure.

Can I be too stressed?

If you have too much stress in your life, it can do more harm than good, but sometimes stress is necessary to get through certain situations. For example, feeling stressed out about an exam might encourage someone to study more and prepare for the exam. However, it can seem as if stress is taking over, making you panic and feel overwhelmed, like being so nervous about an exam that you can’t study or concentrate.

It’s important to remember that stress affects people in different ways, and what causes one person to become stressed may not have the same effect on someone else.

What can happen if you’re experiencing too much stress?

Too much stress may have negative consequences for your health, both physical and mental.

Psychological/Emotional Consequences

  • Feeling hostile, angry, or irritable
  • Feeling anxious
  • Avoiding other people
  • Crying
  • Moodiness, feeling frustrated with things that normally don’t bother you
  • Low self-esteem or lack of confidence
  • Anxiety attacks
  • Depression or sadness

Physical Consequences

  • Upset stomach, diarrhea, or indigestion
  • Headache
  • Backache
  • Inability to sleep
  • Eating too much or too little
  • Raised heart-rate
  • Smoking

If you are experiencing any of these problems you may want to talk to your local doctor, counselor or other mental health professional.

Managing stress

It may not be possible to get rid of the stress altogether in your life, however managing your stress is possible. Below are some ideas for managing stress:

Stress and relationships

Maintaining relationships with friends, family, co-workers, or boyfriends/girlfriends may cause you to become stressed, or your being stressed might effect those relationships. To help manage the stress, it could be helpful to talk to someone about what’s upsetting you. Talking to someone that you trust could help you work out why you are stressed out by the situation or relationship and also offer solutions about healthy ways to manage the stress. You can talk to a friend, family, member, or teacher but if you feel more comfortable talking with someone else, you can also talk to a doctor, counselor, or even trained volunteers at youth helpline Your Life Your Voice, at 1(800) 448-3000 run by Boys Town.

For additional information:


Last edited by Kristie - March, 2014.

  • Tackling the problem: When you’re feeling stressed, you might not realize right away what is causing you stress. First you need to figure out what the problem is and make it manageable. The problem will not go away on its own. In fact, if you ignore the problem, it will probably just get worse. Once you know what the problem is, there are a number of ways you can de-stress.
  • Go for a walk or run: Exercising can be a good way to relieve stress. It helps to get rid of pent up energy and can leave you feeling much calmer. Exercising also releases endorphins, the body’s natural feel-good hormones, which make you feel less pain, and make you happier overall! Any sort of exercise can be helpful during stressful times. You may want to go and kick a football with friends or head to the gym.
  • Hang out with friends: If you are feeling stressed, hanging out with friends can be a great way to keep your mind off of things for a while. By talking with friends, you could realize that similar things that stress you out, also stress your friends out. If you are stressing out about school or work, remember that it is also important for you to have a social life. It is okay to go do something fun with your friends and take a break from your other responsibilities sometimes.
  • Turn the stressor into something fun: Sometimes you might find that the problem is not all bad. It might even be fun! For example, locking yourself in your room or library to focus on doing work might help with stress. However, working in a silent room might also be making you more stressed. You might want to try getting a group of friends together to study in one place, and then maybe grab a bit to eat after. Studying together could lower everyone’s stress level.
  • Take some deep breaths: Deep breathing can help to relax the body and calm you down. Taking deep breaths before an exam, game, job interview or before going on stage may help to calm you down and allow you to focus on the task at hand.
  • Set realistic goals: With unrealistic goals, it is hard to keep things in perspective and cause you to get too stressed out. Setting realistic goals (both short-term and long-term ones) and managing your time and expectations may help to reduce or manage stress. You may want to check out other fact sheets such as Managing expectations, Looking for work after graduation, and Relaxation for additional information.
  • Have multiple paths to achieve your goals: There is never one path to achieving your goals. It is important not to put all your eggs in one basket. You could investigate and plan other ways to get where you want to go, whether it’s a university degree, job, or holiday vacation. Everything might not always play out how you thought it would, but you might end up happy with the results. For example, you might get a new job and be very excited about it. After a few days, you might realize your tasks are not as enjoyable as you had hoped. Though your path to achieving job experience is not exactly what you thought it would be, in the end, you might reach your goal and be completely happy with it.
  • Try to avoid harmful behaviors: It may be tempting to use smoking, alcohol, and caffeine as a means of managing your stress. Try to avoid using these substances as a coping mechanism because, in the long run, they may make you more stressed out and can be harmful to the body. Once you rely on something like caffeine, you may realize you are unable to function without it. You may also be tempted to engage in other negative behaviors besides using drugs or alcohol, such as procrastinating, overeating, skipping class, or blaming others. These behaviors will likely get you into trouble, create conflicts, or make you even more stressed out once everything begins piling up.
  • Watch what you’re thinking: Your outlook, attitude, and thoughts influence the way you see situations, people, and the world around you. Is your cup half full or half empty? A healthy dose of optimism can help you make the best out of stressful circumstances. Even if you’re out of practice, or tend to be a bit of a pessimist, everyone can learn to think more optimistically and reap the benefits.
  • Speaking to someone: If you find that you are always stressed and have a hard time focusing on daily tasks, it may be helpful to talk to someone. It can be hard to ask for help, but your friends and family members might not be able to read your mind and know what’s going on with you. Talking to someone else might help you realize that something you are so stressed out about is actually pretty manageable. Parents, teachers, or a school counselor may be able to help you cope. Check out the Get Help section for more information on who can help you.
Fact Sheet

Helping a friend but feeling stressed out?


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Helping a friend can be hard

Trying to help a friend through a tough time can be hard on you too. After hearing about your friend’s feelings, it is common to feel shocked, sad, scared or overwhelmed but it’s impossible to help other people if you can’t first care for yourself. Here are some ideas to help you look after yourself:

Listen to your feelings. You care about your friend, and so it’s only natural that you’ll be affected by his or her distress. Acknowledge how you’re feeling—including what makes you comfortable an uncomfortable about the situation, and what you’re willing to talk about with your friend.

Talk to someone you trust. If you’ve had a similar experience to the one your friend is having, it might bring up old feelings for you. Seeing your friend upset might also upset you. Other times, it might just be hard to comprehend everything that’s happening in your friend’s life. Regardless of how you’re feeling, it’s important that you have emotional support from the people around you so that you can continue to be a support for your friend. It can help to talk to someone who is removed from the situation about how you’re feeling. And while you don’t have to tell this person exactly what your friend is going through, it might also be helpful to seek advice on how you can help your friend. You might want to talk to another friend, a family member, counselor or teacher. Check out the Get Help section for more information about how these people can support you.

Take time out for yourself. It’s great to talk to others about how you’re feeling, but it’s also important that you have time alone to reflect on what you’re going through. You might try listening to some music, going for a walk or run, or just watching some T.V. by yourself to clear your head. At the same time, make sure you’re still doing what you like to do. Hang out with your friends, take a class keep up with your routine as much as you want to or can. Check out the fact sheets on Relaxation or Coping with a stressful event for more ideas on how you can chill out.

Recognize your limits. Your friend is lucky to have you! But even though you’d like to do everything in your power to help your friend, sometimes it’s important to acknowledge that some factors are out of your control or comfort zone. It’s important that you’re comfortable with your level of involvement in your friend’s situation. Remember that staying within your boundaries doesn’t make you any less of a friend.

Acknowledgements:

Nemours Foundation website, Stress
Columbia University, Go Ask Alice website
American Cancer Society website, Talking with friends and family

Fact Sheet

Helping a friend with a chronic illness


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Photo by: kristofabrath

A chronic illness is a medical condition that will last a long time or may even be permanent. There are lots of different illnesses that can be classified as chronic. Some of these include:

  • Arthritis
  • Diabetes
  • Cystic Fibrosis
  • Cancer
  • Epilepsy
  • Chronic fatigue syndrome

How do chronic illnesses affect a person?

Some chronic illnesses, although permanent, vary in severity over time. Sometimes they get worse over time (degenerative conditions), sometimes they improve (as a result of treatment or just the illness running its course) and sometimes they remain stable. Many chronic illnesses lie dormant and then raise their head in an “acute episode” (when the condition temporarily flares up and becomes more severe).

How do I talk about it?

People with chronic illnesses often feel isolated, both mentally (“Am I the ONLY one going through this?”) and physically (when they can’t always head out with friends etc). If your friend is happy to chat about their condition (and you’re comfortable with it) it may be worthwhile to find out:

  • what restrictions their condition might put on them (some chronic illnesses can be quite limiting in a physical sense…so a group trek through Nepal might not be the best way to pass a week during vacation). Talk to your friend and find out what works for them…they know their body best.
  • what you can do to help (particularly in those “acute episodes” mentioned above)

What if they don’t want to talk about it?

If your friend doesn’t want to talk about things (and if they’ve just spent the past three days in the hospital talking about nothing else, there’s a chance they may not be in the mood), just letting them know that you’re willing to listen can make a huge difference (knowing there’s someone with an open ear to listen goes a long way in curing that feeling of isolation). If they don’t feel like chatting, you could do some of your own research to find out more about their illness (the internet can be a great place to start). It’s important to remember that everyone’s case is different though.

A few things to understand about chronic illness

Chronic illness can mean your friend has chronic pain and has to make adjustments to many aspects of their life. The following might help you understand what they’re going through:

  • Illness can often affect a person’s mobility or independence and that this is often a huge adjustment for a young person to make;
  • Bad days really suck and the frustration can sometimes be overwhelming and people aren’t as patient or relaxed as they usually are;
  • Illnesses don’t always make sense. On Monday your friend may be fine, and by Tuesday they could be in tears with pain. “Flare ups” can start in a matter of minutes (e.g. Asthma attacks)...or may come on over days and so plans may need to be adjusted or postponed. Flare ups are often difficult to predict;
  • If they seem to disappear off the social radar for a while, it may just be that they’re not feeling well at the time and not that they don’t want to catch up or go out;
  • No two people are the same even if suffering with the same condition. Don’t assume that your Nana’s arthritis is the same as the arthritis that knocks your athletic friend around;
  • They are still the same person. Illness doesn’t define a person.

Looking after you

Remember, while it’s great to be there for your friend, it could put a strain on you. If the situation gets you down reach out and talk to someone.


Last reviewed May 17, 2012

Fact Sheet

Studying tips for exam time


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Exam season is a time when stress levels are higher than usual. Stress can be positive, helping you stay motivated and focused. But too much stress can be unhelpful, and it can make you feel overwhelmed, confused, exhausted and edgy.

During exam time, it’s important to try and keep things in perspective and find ways of reducing stress. The key is to maximize your study time without increasing your anxiety.

Tips about study habits

Keep a study area. Having a good study area can make a huge impact on how well you learn. Study in a well lit, quiet area, away from noises and other people. If this is impossible, it might be better to study at the library. Make sure your desk or the table you study at is tidy and organized. This will help you concentrate on studying and learning instead of trying to find information.

Find out more about the exam. Find out what format the exam will take. Will it be an essay test, short answer or multiple-choice?  Will your professor let you use your notes or textbooks during the exam? You might also want to find out how the exam will be graded, and what percentage of your final grade will be affected by your score on the exam. Knowing this information will help you study effectively.

Make a to-do list. Make a to-do list before each study session. Breaking tasks down into small, manageable tasks will make studying less overwhelming. Cross them off with a pen as you go.

Study past tests. Ask your teacher for your old tests and papers. These can be helpful insight into what your exam will be like, and they can also provide a guide for which areas you excel in and which you need to concentrate on more. If possible, ask your teacher to give you some practice questions and have him or her grade your answers.

Join a study group. Forming a studying group with your classmates can be a helpful way to revise your notes and work through past exam questions. It can also help you feel supported, and keep you motivated and focused. If you have questions about your work, members of your study group might know the answers. Ask your teacher if he or she knows of classmates who are interested in studying with other people.

Switch the phone and e-mail off. If you find that you are being distracted by the phone, e-mails or the Internet, it might help to put the answering machine on or get others in the house to take messages for a while. You can always call people back later. If you don’t need to study at the computer, try to stay away from it, so you can avoid being distracted by the Internet.

Wallpaper your room. Write down key concepts you have to learn on small sheets of paper. Post these sheets around your house in places that you normally go, like above your bed, on the bathroom door or in front of the refrigerator.  Wallpapering can help you remember things like equations, quotes and foreign languages.  If you share a room, this might not be feasible. You might try using index cards that create a flash card system for easy review.

Ask lots of questions of your teacher or tutor. Your teacher or tutor can help if you’re having trouble developing a study routine or if you need help understanding a particular topic. Asking for help doesn’t mean you’re stupid—it’s smart to tap into their experience and knowledge to help you perform better. Keep going back to them if you’re still unsure or if you have more questions. It’s their job to be available to you.

Know your preferred learning style. Some people learn better by listening, while others learn visually. Which are you? Think about how you comprehend what your teacher says in class, and this can help you study more effectively. For example, if you find that you’re more of an audio learner, you might want to record your teacher’s lectures on a recorder and listening to them while you’re studying. If you’re a visual learner, you might want to make flash cards.

Take regular breaks. Getting up and moving around away from your desk for 10 minutes at least every 50 minutes makes you concentrate and learn better.

Time management

Avoid procrastination. Procrastination happens when you do everything but the task you need to do. It’s normal to procrastinate a little. But too much procrastination can just add to your stress and can result in you not having enough time to prepare. Managing your time and setting realistic goals for each study session can be helpful ways to avoid procrastinating and make tasks seem less overwhelming.

Make a study timetable. Write down all the things you need to do each day of the week, and how long you need for each, including time for enough sleep, relaxation, and exercise. Find out the date of each exam and work out a study timetable leading up to them. Include the time you’ll spend taking pre-tests that will help you identify gaps in your knowledge. This can give you some direction and help you focus on what to study each week or day.

For more information

Most libraries or book stores stock a variety of books on effective studying and time management that can help reduce exam stress.  You can also check out the fact sheet on managing expectations for more information.

Fact Sheet

Coping with bad grades

6

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Not doing as well as you expected on your exams can be really tough, especially if you need higher grades to get into a particular college, graduate school or career. It can also be tough if you feel like you didn’t meet your family members’ or teachers’ expectations.

You might be feeling a variety of feelings, including disappointment, anger, numbness, guilt, confusion, sadness, physical sickness or hopelessness. Getting a bad grade can be especially difficult if your friends are celebrating and are happy over their grades—or if you feel you really studied hard for the exam.

Tips for coping with bad grades

Even though your grades might not be what you were hoping for, they don’t mean that your future is hopeless, that you’re a failure, or you won’t be able to achieve great things. Here are some suggestions that can help you manage the situation:

Talk to someone outside the situation. Talking to a friend, teacher, professor, or school or college counselor can be a great way of expressing your feelings and exploring other options. A teacher or professor in particular might be able to help you brainstorm ideas to boost your grades, like extra credit or tutoring.

Talk to people who are setting unhelpful expectations. If you’re feeling academic pressure from the people around you, try to talk to them. Discuss the pressure you’re feeling without laying blame. For example, try using phrases like “I feel like anxious/stressed when you…”

Challenge and reset your expectations. Sometimes, the biggest pressures we feel come from our own expectations. It can be helpful to re-think your own expectations to help you decide if they’re realistic and achievable. A useful question to ask yourself might be ”What would I suggest to a friend in this situation?” For more information, check out the Managing expectations fact sheet.

Explore other options for the future.  It's likely one bad grade won't change the course of future. Sometimes expectations are only focused on one outcome, and if you don’t meet that outcome, you might feel disappointed or like you’ve failed. Usually there are a number of ways to achieve a goal. It might help to talk to someone you trust about what some different strategies might be. Try talking to friends, family members, teachers or a counselor.

Chill out. Sometimes getting some space and a change of scenery can be helpful, and it’s important to give yourself permission to do this. Try going for a walk, listening to your favorite music, reading a book or going to the movies—whatever makes you happiest.

Express your feelings. Write down your feelings in a journal. This can be a great way to help you understand a situation and your expectations for the outcomes. Journaling can also help you think about alternative solutions to problems. You might want to also try expression yourself in other ways, like yelling, crying into a pillow or dancing around your room to loud music.

Look after yourself. Expectations can lead to a lot of stress. It’s important to make sure that you’re taking care of yourself physically as well as mentally. Even though you might not feel like it or think you don’t have time, exercising and eating well can help you feel better. Making sure you are getting enough sleep can also help.

Exercise helps stimulate hormones that help you feel better physically and emotionally. If you haven’t exercised a lot before, it might be a good idea to start out by doing something small a couple of times each week, like a 15-minute walk or a few laps in a pool. You can also visit your medical doctor for a check-up to make sure you’re physically healthy.

Avoid drugs and alcohol. Try not to use alcohol or other drugs—including lots of caffeine or other energy drinks—in the hope of feeling better or forgetting about expectations and pressure. The feeling is usually temporary and after the substance wears off, you often feel worse than when you started.

Fact Sheet

Coping with a stressful event


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What’s going on?

There are many life events that can be viewed as stressful. Examples of these include being involved in, or witnessing an accident, being a victim of, or witnessing abuse or violence, or having someone close to you die. Any stressful event can affect your emotions.

When a stressful event occurs, it is normal to feel some level of stress, anxiety, sadness or fear.  It can take time for you to adjust to changes and return to a normal routine.

If the experience causes you to have flashbacks of the event, have bad dreams, lose your appetite, lose sleep or become distant from day to day activities, and these experiences persist, you may want to consult your doctor, a counselor, or other mental health professional.

You may want to check out the Stress fact sheet.

What can I do?

It is important for you to find a healthy way to deal with your feelings before they become overwhelming. Here are some tips that may be helpful:

Paint it! It is sometimes helpful to let go of your feelings and express yourself in a creative manner. Try to draw or paint a picture or image that expresses what you are feeling.

Keep a diary or journal.  It may be useful for you to keep a diary or journal where you can write down your feelings, as well as keep a record of any other activities or events which you’ve experienced.

Talk to someone. Bottling your thoughts inside you can oftentimes make your reactions worse. It may be helpful to talk to a friend, family member or someone else you trust about the event and your feelings. Another option is for you to share your feelings with someone who was involved in the event.

Seek help. Your local doctor, therapist, counselor or youth worker will also be able to help you to develop coping strategies.  In some cases medication may help to relieve your anxiety. Your medical doctor or psychiatrist can point out the benefits and side effects of medications.

Getting help

If you feel like your stress is overwhelming and you need to speak with someone else immediately or maybe someone that doesn’t know you but can help, you might want to call youth helpline Your Life Your Voice at 1-800 448-3000, run by Boys Town for everyone. The hotline is free and staffed with trained volunteers who can speak with you 24/7.

Fact Sheet

College exams: hints for managing stress


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Exam season is a time when stress levels are higher than usual. Stress can be positive; helping you to stay motivated and focused. But too much stress can be unhelpful. It can make you feel overwhelmed, confused, exhausted and edgy. It’s important to try and keep things in perspective and find ways of reducing stress if things seem to be getting on top of you.

Suggestions for managing exam stress

Learn effective study habits. Many people feel overwhelmed at exam time. Relearning a lot of information in a short period of time or not understanding course material can be a big stress. Check out the Exam time: tips for effective studying fact sheet for more practical advice on effective study techniques.

Keep your routine outside studying and take regular breaks. It’s important to have regular study breaks and time for relaxation and exercise. Going for a walk, run, or to the gym is not a waste of time—it’s a great way to clear your head and help you study better. Watching your favorite TV show or going to the movies are also good ways to take a break from studying. Check out the Relaxation fact sheet for more ideas to help you relax.

Don’t abuse. Caffeine from coffee, No Doze pills and energy drinks, as well as other drugs like speed or cocaine can give you a short lift before causing you to crash and burn. They can make you feel sick and keep you from sleeping well or concentrating properly. You’ll actually study better with regular breaks, lots of sleep and regular exercise.

Manage expectations. External pressures surrounding exams and grades can be huge. It might be hard to deal with these pressures, especially with family and people you respect, but remember that you’re in control of your life and your grades. Here are some tips to help you manage these pressures:

  • Base expectations on your past performance and doing the best you can do;
  • Put the exam in context.  In the scheme of your life, how important is it? If you don’t do as well as you’d hoped, there are always alternatives. One grade won’t dictate whether you are a good or a bad person, or whether you are a success or failure. Exams can’t measure these sorts of things. All they measure is how well you can present the material asked for by the examiner—nothing more, nothing less;
  • Take the pressure as a compliment. This can be easier said than done, but remember that the people putting pressure on you want you to do well, and think that you’re capable of achieving. Their definition of success is sometimes a little misguided, so you need to educate people about what you think is realistic. Talk to them, find out what they hope for you, and tell them what you’re thinking and feeling;
  • Use the expectations you have for yourself and the expectations of others to assist your studying.  Talk to people about how you are feeling, and see if they have any advice or help they can offer. It’s important to ask for, and accept support from those around, especially family members.

Look after your body. It’s easy to let exams overwhelm you and cause you to forget to look after yourself. If it’s possible, try to get a good night’s sleep. It’s also a good idea to eat plenty of fruits and vegetables and drink plenty of water.

Ask for and accept support. If you’re feeling overwhelmed, you might find it helpful to talk to a teacher or counselor. It’s also important to ask for and accept support from your family if you can. This support might be practical—like picking you up from the library or emotional like advice on how to study. If you need to talk to someone for additional support try the Boys Town National Hotline at 1-800-448-3000.

Have a number of options for the future. Getting the grades to pass a class or get into your first choice of school is great, but it’s not the end of the world if you don’t. There are other options to achieving your goals. These include deferring a year to work in the area you’re interested in; writing to the university; retaking some subjects; or transferring to that school after a year or two at another.

Remember…

There’s always a light at the end of the tunnel. Exam season has a beginning and an end, and the stress that goes along with it should end with the exam. Once the paper’s been turned in, there’s nothing more you can do to influence the outcome, which means it’s now time to chill and enjoy your break!

Fact Sheet

Benefits of activity and exercise


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The Benefits of exercise and being active

Being active helps you to stay healthy, happy and fit. You can enjoy the benefits of a healthy life in a way that is fun and suitable for your lifestyle. There are many different ways you can get active and finding the activity that suits you is an important first step.  You may enjoy walking, running, dancing, surfing, going to the gym, swimming, yoga, Pilates, hiking, playing a team sport or a number of other activities. Whatever activity you choose, some of the benefits include:

  • Improving your strength, fitness, and confidence which can help you to achieve your goals in life
  • Enabling you to become involved in fun new activities
  • Increasing your energy, flexibility and mobility
  • Helping you to manage stress and anger
  • Increasing your self-esteem
  • Helping you sleep better at night
  • Improving metabolic rate which prevents weight gain and allows you to manage a healthy weight
  • Exercising can be a good way to clear your head if you have a lot on your mind
  • Playing a team sport or joining an exercise center can introduce you to new people

Suggestions for becoming active

Everyone has a different level of physical fitness and finding a pace that is right for you is important. Exercise doesn’t have to be painful; it can be fun and require minimal organization and money.

If you have medical difficulties or are feeling pain when you exercise, it is a good idea to talk with your doctor.

Here are some suggestions that may help when you start exercising:

Start gradually. Try not to do too much too fast.  As a general rule, you should be able to hold a conversation, but not be able to sing while you are exercising.  Remember that any amount of exercise is beneficial. You could start by using the stairs instead of the escalator or going for a 5 - 10 minute walk. As being active becomes easier, you can increase the time and intensity of your activity.

Make it social. It can be more inspiring, helpful and fun if you exercise with a friend.  Having someone else join you may increase your motivation and give you the opportunity to catch up socially.  You could go for a walk, run, or swim together or you could join a group activity together.

Make it part of your routine. With the busy lives we lead, it is sometimes difficult to include exercise into our routine.  A great way to start would be to set aside a time in the day for exercising, such as before or after dinner or before school or work.  Other options include incorporating exercise into your daily life, like walking to school or work instead of catching the bus.

Make it fun. If you choose something you enjoy, being active and exercising can be a fun part of your day. You may want to kick a soccer ball with friends, play tennis, go dancing with a group, listen to music while walking or running or take the dog for a walk.  Also, playing a team sport or joining a group activity will enable you to make new friends while still being active.

Where to go if you want to start to get active

Go to your local YMCA or YWCA

A YMCA or YWCA is a great place to go to work out or join a health or well-being program.  Unlike a typical gym, the YMCA is catered towards activities and programs for young people and families.  You could go just for a swim, take a class, and join a longer-term program or any number of other activities.

Your local park

There is a good chance your local park has organized team sports.  Joining a community team could be a fun, casual way to exercise and play your favorite sport.  If you are worried about your ability to play the sport, these sorts of teams are usual more relaxed than a school or college team.  Parks also sometimes hold events such as tournaments, festivals, yoga lessons or other activities that could be a different way of exercising.  Also, a park is always a great place to go for a jog, ride a bike, exercise alone or play a sport with your friends.

Your school

Many states require physical education in schools by law.  Taking a physical education class at school is a great way to get your daily exercise and start forming healthy exercise habits early on.  If physical education is not a requirement, you may want to take a class anyway, especially if you are too busy with schoolwork and external activities to exercise outside of school.  Another great way to exercise in school or college is by joining a team.  You can do something you love, make a new group of friends, and have fun all while increasing your health!  At the college level, many universities have fitness and recreation centers with a ton of options for exercising.  Stop by your college’s fitness center and check out everything you could do there!

More information

To find out which type of exercise is best for you, you may want to ask your doctor for some suggestions.

Fact Sheet

What is happiness?


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Happiness can mean different things to different people. For example, for one person, it may mean being in a relationship, whereas for someone else, it could mean feeling like you have the ability to handle whatever life throws at you.

While you might think that there are certain things that make you happy (or could make you happy if you had them), research has shown that there are certain common traits among happy people—and they aren’t necessarily what you might think.

What makes happy people happy?

You might think that happy people have lots of money, are physically attractive, have great jobs, or own the latest gadgets. Or, you might just think happy people are plain lucky and are born that way.

Research suggests, however, that there are a number of variables that make a far greater contribution to happiness than external and more superficial factors.

That doesn’t mean that if you have a lot of money you won’t be happy, or that having a lot of money is bad, it just means that other factors are more important in determining happiness. In fact, a strong positive relationship between job status, income, and wealth and happiness only exists for those who live below the poverty line or who are unemployed.

What distinguishes happy people is that they have a different attitude—a different way of thinking about things and doing things. They interpret the world in a different way, and go about their lives in a different way.

Why is happiness important?

This might seem obvious. (Why wouldn’t you want to be happy!) But the implications are greater than you might think. Happier people are generally healthier people—not only mentally, but also physically. Happiness is actually something that is really important, and that you might want to increase if you can.

The ‘happiness equation’

It has been suggested that there are several factors that contribute toward happiness. This is an ”equation for happiness,” suggested by psychologist Dr. Martin Seligman:

H = S + C + V

H = Happiness
S = Set range (genetics: about 50%)
C = Circumstances (8-15%)
V = Voluntary Control (past, present, future)

This looks very scientific, and is actually based on research findings, but it can be explained quite simply:

Set range/genetics. There is some evidence to support that people are born with a certain “set-point” of happiness, which is determined by our genes. This is supposed to change only slightly, if at all, as we get older. Our genetic predisposition to happiness contributes around 50% to our level of happiness.
So if something dramatic happens—for example, you win the lottery or break up with your boyfriend or girlfriend—within a year or so (depending on the situation), your happiness level will return to its set point.

Circumstances. There’s also some evidence to suggest that the circumstance we live in influence our level of happiness. You don’t always have a lot of control over your circumstances—for example, we can’t all live in mansions and drive new cars. Evidence suggests, however, that this accounts for only about 8% to 15% of our happiness, which really isn’t that much.

Voluntary control. This third factor is the most important factor in the equation, because you can control it, and in the process control your happiness. It includes all aspects of your life over which you have a relatively high degree of control, including your thoughts and actions. This includes the way you choose to think about and act on the past, present, and future, and seems to have a significant impact on how happy you are—it could be up to 42%!

  • Past. When thinking about the past, people who are happier pay attention to what was good about the past, rather than focusing on the unhappy times. They are grateful, forgiving, and don’t believe that the past will determine what happens in the future. For more information on gratitude, for the past, check out the Gratitude, forgiveness and their influence on your happiness fact sheet.
  • Future. When it comes to thinking about the future, happy people are flexibly optimistic. What this means is that they are optimistic (in a realistic sense) about how their future is going to be, but if it doesn’t turn out that way, they know it’s not going to be the end of the world either.
  • Present. The way you think about and act in the present is also essential in determining how happy you are. This might include actions like taking pleasure in life and your surroundings, building and being in meaningful relationships, and the way we react to things in life, good and bad.

You do have control over your happiness

You can see from this equation that you do have some control over your happiness. Even though a certain proportion of your happiness is beyond your control, and is determined by genetics and by circumstances (which you can only control to a certain extent), you can increase your happiness level by focusing on those areas in your life that you can control.

You might choose to control your attitude, the way you interpret situations and the way you think about yourself. If you think about it, and the fact that it could be accountable for around 40% of your happiness, this could make a big difference in your life.

But does aiming to be happy mean you can’t be sad?

Not at all. In fact, going through times where you’re sad can sometimes make that happiness all the brighter.

Sadness is a part of life, and sometimes it’s even possible to feel happy and sad about something. For example, you might be happy to move out of home, but sad that you won’t see the family, or your family dog, as much any more.

You might even wonder whether it’s possible, or O.K. to be happy, when there is so much suffering and injustice in the world. Happiness is natural, and it’s possible to be compassionate and caring, and in tune with the sadness of the world, while still experiencing happiness in your life. This awareness might even prompt you to act in a way to help improve the situation of others—an action that might actually increase your happiness.

Working on happiness

Happiness is something that means different things to different people, but overall it seems that it’s the way we choose to think about ourselves, our place in the world, and how we act in that world, that differentiates the happy people from the less happy people.

Happiness is something that you actually have voluntary control over and can work on in your daily life. Not only that, but it can contribute to a large proportion of your happiness, as seen in the equation. It’s up to you.

Acknowledgment

The Happiness Handbook
Dr. Timothy Sharp
The Happiness Institute
http://www.thehappinessinstitute.com

Authentic Happiness
Dr. Martin Seligman
http://www.authentichappiness.org
Note: you’ll have to join, free of charge, to access the various questionnaires on this site.

Fact Sheet

Self-esteem


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What is self-esteem?

Your self-esteem is the way you look at or perceive yourself. If you have healthy self-esteem, it means that you like yourself and you believe that you are just as cool as everyone else. If you have low self-esteem, it means that you believe that you’re inferior to others. People who have low self-esteem tend to focus on what they believe are their shortcomings, and sometimes blow those flaws out of proportion. They might ignore their strengths and achievements.

How does your self-esteem affect your life?

Your self-esteem can affect how you feel, how you relate to other people, how you deal with challenges and how relaxed and safe you feel in your daily life. Here are a few examples:

The way you feel. In order to be happy you need to like yourself. If you have low self-esteem or if you’re constantly putting yourself down, you’re more likely to feel depressed, anxious or unhappy than someone who has a positive view of himself or herself.

Your relationships. Low self-esteem can influence the way you interact with other people. For instance, you might find yourself being unassertive (not saying what you think, feel or want), and doing things you don’t want to do. Low self-esteem might also cause you to seek constant reassurance from your friends, because deep down, you might not be sure that they like you. Or you might find yourself trying too hard to please other people. You might always agree with them and offer to do things for them in order to”earn” their friendship. Being treated badly by other people can reinforce the belief that you aren’t good enough and lower your self-esteem even more.

Your willingness to move out of your comfort zone. Trying new things and moving out of your comfort zone every now and then is important for growing and developing as a person. Low self-esteem might hold you back from new experiences because you may become overly concerned with the possibility of failure or looking stupid.

How relaxed and comfortable you feel in the world. When your self-esteem is low, it can be difficult to feel relaxed and comfortable in everyday situations. For instance, if you have low self-esteem, you might feel awkward and self-conscious in many situations. You might worry too much about what others think of you, and you might be constantly on the lookout for signs that people don’t like you. If someone doesn’t acknowledge you, you might immediately assume that he or she doesn’t like you.

The self-fulfilling prophecy of low self-esteem

Low self-esteem can become a vicious circle. For example, if you don’t feel good about yourself, you might withdraw from people and give out unfriendly vibes. You might not look people in the eye, smile or initiate conversations. This kind of behavior might make you appear cold and distant, and as a result, people might not make the effort to be friendly toward you. You might then detect unfriendly vibes from people, and your belief that you’re not very likeable would be reinforced. This is called a “self-fulfilling prophecy” because your low self-esteem affects your behavior towards others, which in turn causes people to be distant toward you and reinforce your original beliefs about yourself.

Building healthy self-esteem

There are many benefits associated with having good self-esteem—feeling good, taking up appropriate challenges, relating to people as equals and feeling relaxed in daily life situations. Good self-esteem isn’t something that you can achieve overnight. You need to work on it over time. This is particularly important in situations where you’re faced with setbacks or difficulties. Here are a few ways that you can build and maintain healthy self-esteem.

Accept yourself. Every one of us has faults and weaknesses—this is part of being human. The key to good self-esteem is self-acceptance. This means accepting yourself as you are without condemning yourself for your perceived shortcomings.

Avoid labeling yourself. When you don’t reach a goal or perform as well as you hoped, it’s easy to label yourself as”bad” in some way. For example, you might say things like I’m an idiot. This is a form of labeling. Labeling yourself is a negative way of thinking, because it relies on an over-generalization. Each person is a complex mixture of characteristics, traits, qualities and behaviors, and no one—including you—can be summed up by just one trait. Labeling simply makes you feel bad about yourself, and serves no useful purpose. It’s much more helpful to be specific and stick to the facts. For example, instead of labeling and saying things like I’m a failure, stick to the facts and say I didn’t get the grade I wanted. Check out the fact sheet on Common thinking errors for more tips on how to avoid labeling.

Recognize your strengths and weaknesses. Having healthy self-esteem means that you are able to feel good about yourself even though you’re not perfect. You can be aware of your strengths and still acknowledge your weaknesses without judging yourself. Many people are too aware of their weaknesses, but ignore their strengths and good qualities. For this reason, it can be helpful to spend some time thinking about all the positive qualities that you take for granted. It might be helpful to make a list of your strengths and weaknesses you’d like to improve upon.

Set goals. Although it’s important to practice self-acceptance, this doesn’t mean that you shouldn’t aim to improve some things about yourself or your life. Sometimes it’s helpful to set goals for things that you’d like to achieve, or to change things that you aren’t happy with. For example, if you don’t feel comfortable in some social situations, it might be useful to work on your communication skills and taking more social risks. While it’s often very helpful to set meaningful goals, it’s also important to maintain a flexible attitude. This means accepting yourself whether or not you achieve your goals. For more information on goals, check out the Putting your goals into action fact sheet.

Be objective about situations. When you personalize an event or situation, you take responsibility for things that aren’t your fault, or you blame yourself for negative outcomes without taking all factors into account. In reality, situations and circumstances might have been beyond your control. Instead of personalizing things by saying I failed because I’m dumb, be objective and say I failed because I didn’t study or I failed because I don’t like French class.

Avoid comparisons. Some people are in the habit of comparing themselves to others. They judge themselves on things like their looks, their grades, their friends, their achievements and even their personality. There will always be people who seem to be doing better than you are, and if you compare yourself to them, you’ll end up always feeling unsatisfied with yourself. The reality is that people have different strengths and weaknesses. Focus on your strengths, have realistic expectations of the things that you could change or improve, and most importantly, avoid comparing yourself to others.

Sometimes parents compare siblings. If this happens to you, you might try asking your parents to stop, letting them know how this makes you feel.

Communicate assertively. The way you communicate to other people gives them information on how you feel about yourself. When you communicate what you think, feel or want in a clear way, the unspoken message you give out is I matter and my opinion and needs are as valid and important as anyone else’s. You can communicate assertively by looking another person in the eye and speaking in a clear, audible voice, rather than looking down at your shoes and mumbling, or communicating in hostile, angry tone. Assertive communication encourages other people to treat you with respect, and helps you to feel good about yourself. Be aware not only of the things you say, but also the way you say them. You’re far more likely to be treated with respect when you communicate self-respect. For more communication tips check out the fact sheet on More tips for communicating effectively.

Watch this video on self-esteem from our we can help us campaign:

For more information about self-esteem:

Kids Health

Substance Abuse and Mental Health Services Administration

 

Fact Sheet

Going back to school after break


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Going back to school after break

Going back to school after break, like over summer or the holidays, can be hard. You might be sad that the days of sleeping in and having extra time on your hands are over until the next break. Or alternatively, you might be really excited to get back to school, catch up with all your friends and start your new classes.

No matter what you might be feeling, here are a few tips that can help you get back into the right frame of mind to go back to school and get motivated for the new semester or quarter.

How going back to school might affect you

At the beginning of the semester or quarter, it’s not uncommon to feel:

  • Stressed or anxious;
  • Excited to see friends again;
  • Sad or down that break is over;
  • Pressure or expectations-from yourself or others-to perform well in school;
  • Concerned about your course load.

If you’re experiencing these feelings, take time to ease back into school and do things that can help you be less stressed out. For example, even if you don’t feel like it, exercising and eating well can help. If you’re finding that your feelings are affecting your day-to-day life, it’s a good idea to talk to someone you trust.

Suggestions for easing the transition back to school

It may help to remember you’re not alone; a lot of other people are just as likely to be anxious about returning to school as you are. Here are some suggestions for making going back to school as stress-free as possible:

Set some goals for the year or even just the semester. A good way to get motivated for the new semester or quarter could be thinking about the things you’d like to achieve. These might be school-related goals, like getting good grades in certain classes, or personal goals, like joining a club or volunteering. Check out the Putting your goals into action fact sheet for more information.

Get involved. A good way to get back into things at school and possibly make new friends is to become involved in activities or clubs. You may have been overwhelmed during your first semester or first year, or may not have been interesting in joining a club or other activity. Even if you have already made friends on your own, this could be a great time to meet some new people who share common interests with you. You might want to try a sports league, debate team, volunteer activity, student council, or fraternity or sorority. Now that you are settled into college and might feel more comfortable exploring your school’s social scene, it could be fun to get more involved.

Break the ice. It’s possible that you will find yourself in classes with people you don’t know. Other people often feel nervous about making new friends or being in a situation with strangers. Try breaking the ice by asking someone in your class to hang out after class, have coffee or join a study group. You may have gotten used to your classes and classmates in the previous semester or quarter, so you’ll have to introduce yourself to your new classmates to feel the same this semester.

Don’t stick to stereotypes. It’s often easy to identify different groups at your school: common stereotypes are jocks, hipsters, business or international students, for example. However, interacting with anyone (no matter what group they hang out with usually or what stereotype you think they fit into) can help you expand your circle of friends and become more open-minded.

Express yourself. Release some of the tension you’re feeling by expressing yourself. There are a number of ways that you can do this, including exercising, writing in a journal, or doing another activity that you enjoy. Check out the Express yourself fact sheet for more ideas.

Have something to look forward to. Sometimes it can be helpful to plan ahead so that you have something to look forward to. It can change your mindset completely. You may want to plan to catch up with friends after school or do something special over the weekend. And there’s always next break to look forward to!

Getting help

If you find that you aren’t coping well with the thought of going back to school, it may be helpful to talk to someone about how you’re feeling. Try talking with a friend or family member.

Sometimes talking to someone who isn’t directly involved in your situation can also be helpful. This person might be able to give you a different perspective on things and offer suggestions to deal with your feelings. Try talking to someone like a school counselor, or a counselor at the campus counseling center, or a professor-it’s part of their job to support students.

If you would prefer to talk to someone anonymously you can call Boys Town National Hotline at 1-800-448-3000.

Information

Information in this fact sheet was provided by:

Going home for the summer,” Ecampustours.com


Last reviewed: May 28, 2009

Fact Sheet

Being single


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It's ok to be single!

Sometimes you might feel like everybody around you is in a relationship. This can be tough, especially if you feel pressure to be in a relationship. Remember: it’s okay to be single.

Everyone is different. We all want different things out of life. There are lots of reasons why you might not want a relationship, or feel like you are not ready to have a relationship right now, and might be happiest single.

There are also a lot of great things about being single:

  • Your decisions only affect you and don’t involve a partner’s wants or needs
  • You can concentrate on doing things you enjoy
  • You can spend time with your friends and venture to new places to make new memories
  • You can meet new people and not have to worry about a partner’s jealousy

If you do choose to be single, it’ll give you more free time to do what you want, like:

  • Hang out with friends and rekindle old connections
  • Focus on school and/or work
  • Enjoy extracurricular activities, like learning to play a sport or acquiring new skills

If your friends give you a hard time

If friends are hassling you because you are single, it might make you feel angry or hurt or embarrassed.

Reflecting on why you are choosing to be single can also be empowering. Maybe at this very moment being in a relationship isn’t something on your priority list. You may have a sense of independence and you feel like being in a relationship will hold you down.

If you don’t feel like you’re ready for a relationship, then don’t rush into it. If your feelings change in the future, that’s okay too. In the meantime, enjoy yourself.

Last reviewed: February 27, 2014
Edited by: Becca

Fact Sheet

How do I become more resilient


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Photo by: bogd

A number of factors contribute to a person’s ability to be resilient when faced with adversity. We call these protective factors. Some protective factors exist outside of our control. These include such things as (1) having people in your life who care about you and help you through tough times, (2) having people who believe in your abilities and strengths and who have high expectations for you to be successful, and (3) living in a community that provides opportunities for meaningful participation, including being involved in decision making, contributing your talents to the good of the community, and other forms of service.

Other protective factors have to do with personal strengths, skills and abilities that buffer against stress and help an individual manage stressful situations. These are things that are in your control and things you can learn and develop.

Personal factors that help build resilience

Some skills to help manage stress and increase your ability to be resilient:

  • Positive social skills. Open, respectful but direct communication techniques, maintaining a positive attitude and having a sense of humor when faced with challenges;
  • Problem-solving skills.  Being able to stop and think before reacting, being able to generate alternative solutions, and weighing consequences of decisions before you act, and openness to seeking support when needed;
  • Feeling secure about yourself, having a sense of self worth, and having a clear sense of self identify so that you step away or create some physical or psychological distance from things that pull you down or give you stress;
  • Having a sense of purpose and hope for the future such as having personal goals, strong values and connectedness to others.

And if you find that you don’t have people in your life who provide the kinds of external supports that help build resilience, try to be proactive in searching out mentors who care about you and believe in your potential. Some high schools and colleges have mentoring programs. Some of these programs may be linked with career planning and the college application process. Church youth groups, athletic teams, and community sponsored programs like Big Brothers/Big Sisters programs could be potential sources of support.

So even if you don’t have all the external protective factors in your life – you can still develop skills and attitudes and take actions that will help you become resilient against the stressors that you encounter. It might be harder for you than someone who has a readymade support system in place, but it is important to remember there are still things you can do to help yourself!

This video from our we can help us campaign, has more information around building resilience and overcoming negative thoughts:

For more information

For more about Big Brothers/Big Sisters and to locate an agency in your area, check out the Big Brothers/Big Sisters website.

Fact Sheet

Getting through a break up

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Breaking up

Over time, you and your partner’s interests might change. You can grow apart or have less in common with the person you’re dating, and it might be time for you to think about ending the relationship.

If you decide to end a relationship, it can be difficult for both people, and respecting one another will make things easier. Once you decide to end the relationship, it’s a good idea to be honest, kind and definite.

You might want to tell the other person what you’ve been feeling and thinking, and what you want for yourself. It’s not helpful to blame the other person or try to pick out faults. Sometimes relationships end simply because people are different, and getting to know someone during a relationship can reveal differences that you didn’t see before. Differences are natural, but they might prevent you from keeping your relationship happy, healthy and strong.

Not sure whether to break up?

It can be hard to tell when exactly a relationship should ‘end’, often, there’s no exact point. However, healthy relationships involve trust, support and respect. If those are absent, you might consider whether that relationship is good for you. Check out the assessing your relationship and maintaining a happy relationship fact sheets, or take the Healthy Relationships Quiz on Love is Respect for more help.

How do I break up with someone?

Breaking up with someone can feel daunting, especially because you don’t want to hurt them. Try to pick a good time to break the news to someone, where they’ll be able to react naturally, express how they’re feeling and not get rushed. Often it takes some time for the news to sink in, especially if it’s a surprise. People might react to a break up differently. It’s not uncommon to feel sadness, anger, disbelief, guilt or even indifference. If you’ve been experiencing difficulties in your relationship for some time, your partner might even seem relieved.

Managing these feelings can be hard. Try to be calm, kind and gentle when you’re ending a relationship but also be firm and clear. Think about how you’d want someone to talk to you about ending your relationship. Get more tips no effective communication here.

Getting over an ex and moving on after a break up

Breaking up is hard, but try to remember the reasons why you or your partner made that decision and that it’s the best thing for two people when they can’t grow anymore in that relationship. It is not unusual to go through the different stages of grief after a big relationship in your life has ended.

It might take some time to accept that your relationship has ended and to move on from the relationship. The end of a relationship can give you time to learn more about yourself, spend time with your friends and do things that you enjoy doing. Having someone you can talk to about your feelings might be helpful. This can be a friend, family member or counselor or other mental health professional.

You may also find it helpful to:

Stay busy: Staying active and doing things you enjoy might help keep your mind off the break up. You might want to hang out with friends, read a book, go for a run or walk or listen to music.

Try something new: Sometimes it’s helpful to make a fresh start by trying something different. There might be a class you’ve always wanted to take—like drama, art or yoga—or you might want to start playing sport.

Look after yourself: This might be a difficult time, and it’s important that you look after yourself. Eating a healthy diet and staying physically active can be helpful. It might also help to treat yourself to something special. Do something that you enjoy.

Try to stay positive: Think about your achievements, your friends, things you enjoy and the good people in your life, and the positive things they have said about you. This can help you stay upbeat.

Talk with someone you trust: Getting some support when a relationship is ending might help you work through how you’re feeling. You might find it helpful to talk to your friends, your parents, a teacher, school counselor, doctor or another person that you can trust. Check out the Get Help section for more info about how these people can help.

It’s OK to be single: We promise- it can even be fun. Just give yourself time. We’ve got a fact sheet on being single here.

Need more info?

Visit Love is Respect for more info and quizzes like the Healthy Relationships Quiz.
assessing your relationship fact sheet
Managing anger fact sheet.
Maintaining a happy relationship fact sheet

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