’13 Reasons Why’ warning is a start, experts say, but they want more

By Alessia Grunberger, CNN
Updated 4:00 AM ET, Thu April 5, 2018
Read this article online

(CNN) Almost immediately, Kate was hooked. She’d seen advertisements for the hit Netflix series “13 Reasons Why” and heard that some friends were watching it, so she gave it a try.

“Within one or two episodes, I was completely hooked and was super into it and felt really emotionally involved in it,” she said. “And, so I, essentially, sped through the whole show … which is not easy to do when you are working and also going to school. But I ended up doing it.”


Kate, 25, is a victim of domestic abuse and sexual assault, and she has depression, anxiety and post-traumatic stress disorder. CNN agreed to use only her first name in order to protect her privacy. She didn’t watch “13 Reasons Why” because it was enjoyable as much as for its relatable — albeit graphic — content.

The 13-episode drama, which was released in March 2017, follows the fictional story of a teenager named Hannah Baker who takes her own life, leaving behind 13 audio recordings on cassette tapes. It sparked a national debate about mental health and suicide and prompted some mental health professionals to warn that “13 Reasons Why” could pose risks for viewers, especially for those already struggling with mental health issues.

'13 Reasons Why' tied to rise in suicide searches online
“Ideally, we hope that young people will avoid Season 1, as it was proven to increase Google queries about suicide, and several local mental health service providers have reported increases in instances of suicidal thoughts and suicide attempts among their clients as a result of the series,” said Laura Horne, director of programs at Active Minds, a mental health organization that works with young adults.


Fans of the bingeable show, however, commend the series for raising awareness about suicide and shedding light on how to spot warning signs of depression or suicidal thoughts. A second season is planned, but its release date has not been announced.


In response to the controversy, Netflix has taken extra steps to provide viewers with more resources on mental health, bullying and other tough topics. The changes, which are the result of a study commissioned by Netflix to look at the impact of the series, include the addition of a warning video that will air at the start of each season, an after-show that features the cast and experts, and more crisis information and suicide prevention resources online at 13ReasonsWhy.info.


“Soon after the Season 1 launch, we saw global conversation explode on the controversial topics covered by the series and understood we had a responsibility to support these important discussions,” Netflix said in a statement. “To understand whether and how the series opened dialogue between teens and parents, we commissioned a global research study with Northwestern University’s Center on Media and Human Development, which has an active research focus on the impact of media on children and teens.”


Viewers want more resources

The study found that “nearly three-quarters of teen and young adult viewers said the show made them feel more comfortable processing tough topics.”

Responding to concerns over the possible impact on vulnerable viewers of "13 reasons Why," Netflix said it "had a responsibility to support these important discussions."

Opinion: Why '13 Reasons Why' is dangerous

 “To the extent that Netflix is helping us have a better conversation about depression and other mental health diagnoses that contribute to suicide, I think that part is good. I just think the follow-through could be improved a bit,” said Lauren Caldwell, director of the American Psychological Association’s Children, Youth, and Families Office. She suggested that Netflix play its introductory video before each episode, add “more depth” to its viewing guide and air its after-show following each episode. 

Netflix didn’t respond requests for comment on this story.


Other mental health experts agree that the efforts are a step in the right direction but say they don’t go far enough.


Attention, not understanding


” ’13 Reasons Why’ brought an astounding amount of attention to suicide,” Active Minds’ Horne said. “It didn’t bring understanding about this one crucial fact: that suicide is preventable.
Why teen mental health experts are focused on '13 Reasons Why'
“We believe Netflix had a responsibility to add crisis and other resources for Season 2 because that context is crucial,” she said. “The new resources are a plus, but not having seen the second series, we don’t know if messages about prevention are embedded within the show itself in a way that better balances safety and accuracy with entertainment.”


Overall, viewer Kate was pleased to read that Netflix was incorporating new ways to better protect and inform its viewers. But she thinks the streaming service shouldn’t limit airing the advisory message to once a season. “I think it’s good that they’re having this video at the beginning of the season,” she said. “However, I don’t really know if a video at the beginning would help as much as a video at the middle or the end, because it seems to go pretty downhill, at least in the first season. And I don’t always know how likely … people are to reach out about the things that they’re feeling during the show. I think the video is a good effort, but I wonder what kinds of real-life effects it’s going to have versus it’s more Netflix being able to have a disclaimer like ‘oh, we know this is triggering; here’s our blurb about it,’ ” she said. 

Kate also said the show made her feel more depressed.


“I really identified with (Hannah) from past experiences and knowing how low she can get. And I felt lower and lower and lower as I watched her get lower and lower and lower.”


Discussing tough topics ‘important’

 Despite its negative effects on Kate, she said, it’s important to have shows that discuss such tough topics. She suggests a warning screen at the beginning of each episode, urging viewers to take a break. “Even something as simple as that, because I think especially in the first season, it was really suspenseful and really easy to go from one episode feeling really crappy to another episode feeling even crappier.”
She also suggested that Netflix broadcast messages throughout the show, asking people to hit pause if they need a moment to process the content.”You know how they have the ‘are you still watching’ reminder?” she asked. “It could be something like ‘hey, maybe take a break from watching’ or ‘this episode is going to depict x, y, z. If you’re not comfortable with that, consider reading a synopsis online.’ “


National Suicide Prevention Lifeline
1-800-273-TALK (8255)
Trevor Lifeline
Trans Lifeline
US: 1-877-565-8860
Canada: 1-877-330-6366
Crisis Text Line
Text “741741”

Therapist seeks to work with KCSD on school safety initiatives

By Richard L. Gaw
Staff Writer
Originally appeared 03/20/2018 01:22PM in Chester County Press, www.chestercounty.com

On February 14, a mass shooting occurred at Marjory Stoneman Douglas High School in Parkland, Florida that resulted in the deaths of 17 people and the wounding of 17 others.

It became one of the world’s deadliest school massacres on record, and just the latest in a continuum of school tragedies that have burned names like Sandy Hook and Columbine into the consciousness of America.

As she watched the events unfold on television and social media over the next few days, Winden Rowe, M.S., a Kennett Square resident, therapist and the mother of two teenage sons who are students in the Kennett Consolidated School District, feared that the Florida shooting, on the heels of countless other tragedies just like it, had become just the latest stopping off point for a once seething rage against violence that was tapering off on its way to full acceptance.

She wrote a letter to KCSD Superintendent Dr. Barry Tomasetti that detailed her rage against complacency, both in the community and what she perceived was also true in the school district itself.

In short, Rowe wanted to work with the school district on finding ways to address the causes of school shootings, not just reactive protocols. “Silence in anything is cosignatory, and irresponsible in this matter,” she wrote.

The letter, which was later published in the Chester County Press, invited Tomasetti and district officials to explore the possibility of opening up a dialogue in an effort to “break the silence and demonstrate to our children that we are not willing to go on another day acting as if this is not a national crisis,” she wrote. “Please come to the table. Please offer more than a ‘We understand your concern.’”

She received it.

On Feb. 27, accompanied by her friend Colleen Kauffman, a mother of five who currently has four children in the school district, Rowe met with Tomasetti and Assistant Superintendent Dr. Michael Barber to further a dialogue that in many ways, the school district has already begun to have with the population it serves.

During the meeting, Rowe and Kauffman asked the Kennett school district to create district-wide efforts that recognize potential warning signs in students whose actions may be triggered by stress and trauma, which could subsequently lead to negative health outcomes, mental health concerns and violence. Rowe encouraged the Kennett school district to adopt the Adverse Childhood Experience Study (ACE) questionnaire, a 10-item self-report to identify childhood experiences of abuse and neglect. The study, conducted by Kaiser Permanente and the Centers for Disease Control and Prevention, proposes that childhood trauma and stress early in life, apart from potentially impairing social, emotional and cognitive development, indicates a higher risk of developing health and behavioral issues later in life.

Among the ten questions on the questionnaire are:

Prior to your 18th birthday:

  1. Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you, or act in a way that made you afraid that you might be physically hurt?
    No___If Yes, enter 1  __
  2. Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you or ever hit you so hard that you had marks or were injured?
    No___If Yes, enter 1  __
  3. Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way or attempt or actually have oral, anal, or vaginal intercourse with you?

“One of the things that came up in dialogue was that there are two branches of discussion regarding school violence – regulations related to security and safety, and approaches to mental health,” Rowe said. “The overarching one for me, given my training, is wellness, and wellness gets overlooked but is the primary and most important aspect of prevention and building resilience in communities, so that we don’t see these incidents happen again.”

In the case of Nikolas Jacob Cruz, the 19-year-old convicted of the Florida shooting spree, “he faced a lot of adversity in his home environment that wasn’t being addressed,” Rowe said to a group of residents she met with on March 14 at Anchor Fitness in Kennett Square. “What we know about him is that he faced a lot of adversity in his childhood development. What we know about children with higher ACE scores are that they are far more likely to have poorer health outcomes caused by stress, and a higher likelihood of being incarcerated and involvement with the law.

“This is not a report card that means that something is wrong. It means that things have happened, and if you’re addressing the outcomes, this is where you go in order to treat the root causes. This is where the plumbing issue exists, but rather, we go clean up the spill.”

Since it was first introduced in the 1990s, the ACE questionnaire has helped lay the foundation for growing recognition of the prevalence and impact of childhood adversity, stress and trauma on children and youth. Rowe said that the ACE questionnaire is being incorporated into cities and towns, who in turn infuse it within schools and law enforcement systems.

‘Executive function’

Rowe said that living in a stress-filled environment contributes to a life imbalance, which makes it more difficult for the individual to access “executive function,” a self-regulation system that allows an individual to plan, focus attention, remember instructions and juggle multiple tasks successfully.

Using the analogy of seeing a bear in the forest, Rowe said that the first reaction is to run, “but what if you’re the kid in the home, and the bear comes home every night?” she said. “What if you have to go home to the bear every night? What if school is the bear, and you’re an under-functioning student who’s not quite cut out for the system?”

While the Kennett school district does not administer an ACE questionnaire to students, there are several measures in place that provide each student with social, academic and personal lifelines. The Student Assistance Program (SAP) at Kennett Middle School and the Kennett Intervention Program (KIT) at Kennett High School provide additional resources for students and their parents who are in need of support, and is staffed by trained social workers, counselors, teachers, administrators and nurses.

In addition, teachers in the district are trained in suicide prevention, opioid training and mandated reporting which, in accordance with Pa. Act 126 (2013), requires that all school and independent contractors of school entities provide child abuse recognition and reporting training to all employees, including contracted substitute teachers who have direct contact with children.

Several years ago, Dr. Terri Erbacher, an author, school psychologist for 15 years and professor of psychology at Philadelphia College of Osteopathic Medicine, met with school staff in order to provide the district with a screening instrument that counselors and social workers can use to asses students at risk.

“Based on the results of the risk screening, we move forward with with a recommendation for parents,” Barber said. “It is our own tool that was vetted through professionals in the field.”

“The ultimate outcome is that we find out more about the students and what may be the cause for what’s happening,” Tomasetti said. “They yield the same outcome [as the ACE questionnaire], even though they are not necessarily the same instrument.”

‘Minding Your Mind’

The Kennett school district is about to take another step to address mental health in its schools. On April 17 at the Kennett High School auditorium, beginning at 6:45 p.m., the district will welcome a presentation by Minding Your Mind, an organization that provides mental health education to adolescents, teens and young adults, their parents, teachers and school administrators, and the community, in order to reduce the stigma and destructive behaviors often associated with mental health issues. Minding Your Mind student presentations help students learn to recognize the warning signs of mental illness in themselves and their friends, and teach students that mental health issues and illnesses are common and treatable.

“Some of our constituents might think that mental health really isn’t a school district’s responsibility, but our staff’s point is, ‘We know it is,’” Tomasetti said. “We wish it wasn’t, but we know that there are kids who come to us who have difficulties.

“Everyone can sit around and ask who’s job is it to do this, but we’re going to do whatever we can in working with parents to give our kids the best education possible,” Tomasetti added. “We want them to be high achievers, but we also want them to be good citizens. A lot of times, because we have a lot of students in our school district, they tell us things. They tell their teachers things, they tell their counselors things that maybe they don’t tell other people. We look at this as a collaborative effort. We’ve got to help where we can help.”

Barber referred to the meeting he and Tomasetti had with Rowe and Kauffman as “a continued discussion on school safety, and what we can do to best support our students and parents, from a mental health perspective – continuing the conversation about what’s being done and what we can continue to do to best support our community.”

Rowe and Kauffman said that they plan to extend the conversation beyond the KCSD and into the community. They are currently in discussions with Kennett Flash General Manager Andrew Miller to begin hosting TED Talk-like seminars at the venue.

“Our kids, born after a certain date on the calendar, think that [school shootings] are a part of the normal world,” Rowe said. “For those of us who didn’t grow up this way, we’re watching these school shootings and thinking, ‘This is totally insane.’ Our goal with the district is not to ask about safety issues. We know that they’re handling that. We don’t want to talk about guns in schools, or have debates about mental health. Our goal is to talk about how can we infuse wellness into this school district.”

To contact Staff Writer Richard L. Gaw, email rgaw@chestercounty.com.

Anxiety Over School Shootings: Finding proactive ways to deal with worried feelings

by Rachel Ehmke
Originally appeared on Child Mind Institute www.childmind.org


Anxiety over school shootings has become a common fear in America. When something that once seemed unthinkable happens with some regularity, added to our feeling of horror that it’s happened (again!) is another kind of alarm: Could this happen at my child’s school?

And many parents have begun to worry whether the news of school shootings, along with the active-shooter drills most schools are now conducting, are frightening children in a damaging way.

Responding to this concern, Jamie Howard, PhD, director of the Trauma and Resilience Service at the Child Mind Institute, says that parents tend to worry about school shootings more than their children do. “Even though they’re the ones going into school every day, I just don’t hear a lot of kids worrying about it,” she says. “When children are younger they’re more egocentric. As they get to become teenagers this changes.” This developmental selfishness is a quality that often protects younger children from the kind of anxiety that the adults around them are experiencing.

This is good news for parents who worry about their children feeling afraid. But kids are very good at picking up on the fears of their parents, and if they sense that Mom or Dad is afraid, they will take notice.

Unhealthy anxiety

Psychologists sometimes describe anxiety as the body’s internal alarm system. You want your alarm system to go off if there is a threat nearby. But sometimes the alarm is triggered too easily and you are alerted when there isn’t any danger at all. Or maybe there is a threat, but it doesn’t actually warrant a full-fledged alarm response.

The way school shootings are covered on television and discussed on social media is intense. We can hear about the tragedy throughout our day, often for several days, whenever we look at a screen. Besides making us feel upset and frustrated, it can also make us feel less safe. “Because it’s so horrific and scary and important it dominates the media and therefore our minds, and we think of it as a much bigger threat than it is, explains Dr. Howard. “The more you watch, the more it tricks your mind into thinking it’s an increased probability of occurring.”

School shootings actually are not very common, so while they are a threat, the likelihood that one will personally affect you is slim. In Dr. Howard’s words, “some anxiety is warranted, debilitating anxiety is not.” If you feel that you are more anxious than you should be, a good first step is always to take a break from any media that might be focusing your attention in an unhealthy direction.

Related: How to Avoid Passing Anxiety on to Your Kids

Look for ways to be proactive

Because anxiety is meant to prepare us for action, it makes sense to channel the worries you are feeling into something proactive you can do. One of the things Dr. Howard recommends is forming a parent group at the school. Assessing what the school needs, getting involved in the planning process for drills, and having ongoing conversations about keeping the school safe can make worried parents feel better.

Likewise, participating in political activism or efforts to support mental health and wellness in your community can make you feel like you are making a difference. It also sets a good example for your children, who may want to get involved, too. Many of the students at Marjory Stoneman Douglas High School began lobbying lawmakers after the tragic shooting at their school, and they inspired students across the country to think about ways they might make their own voices heard. Participating in a school walkout or even just getting their opinion across in a conversation with a parent can make kids feel like their thoughts and values matter, which will feel reassuring.

Talk to your children

Parents are sometimes afraid to bring up school shootings with their children, because they don’t want to scare them. But children will have often heard about a school shooting that is getting a lot of attention in the media, and bringing it up can actually alleviate any anxiety they might be feeling. Avoiding potentially scary topics can make them scarier to children.

These discussions are a chance for you to answer questions that they might have and provide some reassurance. While you can’t promise that their school will never have a shooting, you can in good faith tell them that school shootings are actually very rare and remind them that they practice drills at school to keep them safe.

If you aren’t sure what to say, you can always ask your kids if they have any questions. Use common sense about how much detail to go into, and try not to use euphemisms or fuzzy language, which can make a young child’s imagination run wild.

You can also take this opportunity to share important messages that you want to communicate. For example, Dr. Howard suggests saying, “If a classmate of yours is struggling, we don’t do nothing. We don’t gossip about them. We tell a grownup so they can get help.” Or if your child is a teenager, and another student says or writes something scary, the same advice holds: they should let an adult know.

Active shooter drills

Most schools today practice active shooter drills. The goal of these drills should never be to scare children. Just as we don’t use fake smoke in fire drills, schools don’t need to use fake guns during active shooter drills. Schools who try to make the drills as realistic as possible risk scaring students (and teachers), and miss the point of these drills in the first place.

Schools have active shooter drills to get everyone used to their safety plan. “The more you practice something, the more you rehearse it, you lay the mental tracks so that you decrease the tendency to freeze in the case of a real emergency and you can go quickly into action,” explains Dr. Howard. “In the military you do realistic drills because you really will be in combat, but this is a low-probability event. You just need to lay the tracks so you decrease those few seconds of reaction time.”

When teachers (and parents) talk about the drills, they should do it with a lot of confidence. They should make it clear that school shootings, just like fires, are unlikely, but, says Dr. Howard, “We are going to be ready if it happens. This is what we’re going to do to stay safe.”

In High School, the Kids Are Not All Right

With social and academic pressure mounting, a teacher shares what he’s learned about tracking his students’ mental well-being.

By David Tow
March 7, 2018
Originally appeared on www.edutopia.com

I lost my first student to suicide not long ago. The student was no longer in my class at the time, nor even at the school, but I was flooded with the expected surge of feelings: overwhelming sadness, periodic despair, compulsive frame-by-frame replays of our every interaction. I felt the loss deeply. It was unspeakably tragic—for the student’s friends and family, for me, and for the world I’d hoped the student would help shape.

I was haunted, too—I still am—by the fear of a similar tragedy among my raw-nerved and anxious students. And the recent spike in teenage suicides in my area has underscored this fear sharply.

Based on my observations, the lives of the high school students I teach are hemmed in everywhere by social pressures and expectations: high-stakes testing, the looming shadow of college admissions, the fiercely competitive school system, the painful process of figuring out who you are, and the ubiquitous desire for peer acceptance. Add to this the unseen pressures—fractured or fragmented home lives, emotional or physical violence and abuse, struggles with substance use, legal problems, and the wide range of issues borne by the many immigrant communities across the country—and it makes for a period of unsustainable emotional distress. In recent weeks the constant pressure has meant dealing with student depression almost daily, and helping support those who I feel might be toeing the line of self-harm.

There are plenty of resources for dealing with student mental health issues, of course—though most of them are geared either toward college kids or, more tragically, toward elementary and middle school-aged children. The sources that do offer strategies tailored for high school students tend to be either excessively academic or so general as to be useless. Reviewing my notes from my joint credential and master’s program, I find inconsistency and a frustrating lack of clarity. The strategies include things like teaching positive management strategies and promoting emotional competency, or educating staff on mental health issues and encourage social supports.

As a practicing teacher, I don’t find that very helpful. And in my day-to-day work life, I see two common—and mostly inadequate—mental health strategies deployed to help high schoolers who look like they might be struggling: First, take some time, and second, get caught up. Even if the advice is phrased differently, it’s usually a variation on the same theme. Students are advised to take the adolescent equivalent of a personal day, and then complete their work accordingly. I’m not pointing fingers. I’ve done it myself.

In my case, frustration drove me to seek some better answers. In a series of recent conversations with the mental health professionals I trust, with colleagues who have a long history of putting students’ mental well-being first—and of course with students—I’ve assembled a list of strategies for classroom teachers to implement that might help not just treat the symptoms but also address the underlying issues.


1. Ask “How are you doing?”—and mean it. For the past six years, I’ve stood at the door and welcomed my high school students in with a handshake and a variant of that question. If I sense any problems, I might ask “Really?” or “You sure?” I think it’s reassuring to students to know that an adult in their life cares about their well-being, and the research strongly supports that position.

Student responses, even if they don’t answer honestly, can reveal volumes about their actual mental and emotional status. In my class, as students complete the warm-up, I go to my roster and note which students seemed upset or otherwise off.

Over the course of an average month, I think it’s a good goal to seek out one substantial check-in with every student, no matter how they seem to be doing. The teacher will have made a meaningful one-on-one contact, and the student will know that the teacher has their well-being at heart. Furthermore, it’s easy and cheap in terms of time invested, but can yield important insights.

2. Set office hours. This is a policy I’ve borrowed from some of the best teachers I’ve worked with: Set formal office hours and use them to meet with students about more than just academic concerns. For example, I’ll try and meet with each of my students once per semester at some point outside of class time and use the conversation to learn more about who they are, what their academic goals are, and whatever other concerns they have. More often than not, these conversations move into more meaningful territory—most of my students just want or need someone to talk to. The primary objection is that this costs a great deal of time, and I agree. It’s time intensive, but I think it’s worth it.

3. Remember your Maslow. It seems trite to point this out, but in the midst of all the testing and the grading, we need to remind ourselves that mental health trumps academic performance every time. Students who don’t feel grounded or safe or healthy cannot do their best work. Instead of constructing a classroom environment that operates at 100 percent difficulty all the time, consider alternate models that allow students to feel supported and competent first—and then consciously and explicitly ratchet up the difficulty and complexity as appropriate. I try to practice a type of curricular minimalism: lots of guided and independent low-stakes practice, culminating in a manageable set of summative exercises.

4. Consider what matters. I have often spoken with both past and current colleagues about makeup work. Many are of the belief that if a student misses an assignment, they should be—and often must be—responsible for timely completion upon their return. Others tend to recommend a gardener’s approach, pruning the material to its most vital branch. More specifically, when a student is out, it’s important for teachers to consider what work, what skills, and what benchmarks are actually important for outcomes.

When a colleague suggested to me that not all assignments matter, and those that do matter don’t all matter the same, I balked—but there’s plenty of wisdom in the idea. When a student falls behind, consider dropping assignments or editing down the work and, most importantly, explain to the student why that exception is being made. They will appreciate the clarity and the empathy, and most respond by working with greater discipline toward more manageable outcomes in the future.

5. Use the professionals. The best attempts of teachers pale in comparison to the support, resources, and guidance of professionals. I cannot advocate enough for teachers and all school staff to get to know your on-site school psychologists or mental health counselors (if you are so lucky), or to find those very important names and numbers immediately. Every mental health professional I’ve met in education has impressed me with their sensitivity, care, and ability to identify underlying issues well beyond my knowledge, and they explain the connection between a student’s case history and my observations in a way that is both useful and crystal clear. Although teachers tend to try to be self-sufficient and eschew asking for help from those outside the classroom, we aren’t mental health professionals—and this sort of assistance is necessary.

And don’t forget to talk to someone yourself. This last strategy emphasizes self-care. I’ve seen teachers look just as punch-drunk as students, sometimes suffering from the same anxiousness and depression. It’s important that teachers make an effort to talk to someone else—especially since the old truism that each classroom is its own kingdom is generally still true. A teacher who is burdened with the trials and tribulations of their hundred-plus students—and their own struggles to boot—won’t have the headspace to be a humane, observant, and effective shepherd.

Whether it’s in small doses with a spouse or significant other, structured sessions with a therapist, or even informational conversations with colleagues, getting those feelings and thoughts out of your head will make you more capable of responding to the needs of others.

We Can All Do Something, by Carolyn

I just wanted to sincerely thank you again for visiting our school. I promise to use this momentum you have given me to make even more positive changes for my school. I’ve done several things this past year with mental health:

  • I found a curriculum created in Canada called “Mental Health and High School Curriculum Guide”. The process of implementing the curriculum was long, and I went through it mostly alone besides asking for advice from my school psychologist. I was in contact with a board member of the curriculum asking questions and forming a proposal when I pitched the idea to my principal. I annotated the entire guide, which was 167 pages, but all on topics I’m familiar with. We had a few meetings and through collaborating with the health teacher, the psychologist, and principal, we were able to seamlessly fit the 12-module lesson plan in our curriculum. So far the class has been going good, I’ll be able to sit in on the class next week and I hear students are actively participating!
  • I found Minding Your Mind and decided you needed to come to our school. I went through a similar process on researching, writing proposals, and having meetings until we were finally able to book a presentation.
  • I have more plans for the future, I need to find ways to fundraise because I have been told that my plans could cost money. Since May is Mental Health Month, I want to have events and really educate the people in my school.
Throughout this year I have found my passion in life, I never expected to be where I am now. Things were a lot different and much darker over the summer with my mental issues. Keep doing what you’re doing, man.

Beneath the Surface, by Carlie

The purpose of my club, “Beneath the Surface,” is to help those who face challenges that cannot be seen by the naked eye, to educate people about these hidden challenges, and to teach the power of empathy. I started this club because of my own experiences with pain disorders as well as mental disorders that are not visible to others. My mission is to raise awareness and promote compassion across hidden differences. 

I wrote this last year. It explains some of the struggles I faced and why I want to raise awareness for anxiety, depression, and other invisible illnesses. 

Sometimes the biggest smile contains the most pain. November 19, 2015 was the day I had my surgery. Before surgery I have never experienced a day in pain, but ever since then I have never completely healed physically and emotionally. I have lived every single day of my life in pain. Once in a while I’ll have a good day with my pain being at a 5/10 but more often my days last with my pain being at a 10/10. My pain varies from sudden severe stabs to long aching cramps, in my temples, my jaw, my base of my skull, my neck, and down to my shoulder blades. 

My surgeon, “Dr. L,” said to me, “This has never happened to me in the 30 years I been doing oral surgery, I don’t know what to tell you, but I’m never doing the arch bar technique again .” As a 16 year old, hearing that internally destroyed me. I think to myself everyday why me? Why was I the one my surgeon used as the Guinea pig by using arch bars for the first time? 

Pre operation, I had so much hope leading up to my surgery. Believing that it was going to turn out great and I would finally have a smile without a huge over/open bite (a bite I would finally be able to chew food with) and now all of that hope has been crushed within the past year. I have been to doctors in numerous states for my relapsed jaw and have gotten replies like, “I have to cut your jaw into 3 pieces to help you, but I can’t guarantee it won’t relapse again” , “you need a prosthetic joint replacement”, “you have cheerleader,s disease” (condylar resorption), “you have TMJ and need to get your condyles reconstructed”, “you should have had braces and been wired shut after surgery, that’s a surgeons error”. As well as professionals that have said, “this is a complicated case, I don’t know what I can do for you.” How is that ok? All doctors have been scared to touch me or try to help me because I’m the rare  patient that can relapse easily.

IT’S BEEN OVER A YEAR AND WE HAVE GOTTEN NOWHERE. I have been in chronic pain. It has taken away from my entire life. I never sleep. I toss and turn all night because my jaw and neck are in excruciating pain. And when I do finally get sleep, I’ll wake up in the middle of the night because I have nightmares of being in mid surgery. My anxiety level has became unbearable ever since my surgery. I have flashbacks to surgery because of my pain constantly reminding me that’s there is something wrong with me, and will have anxiety attacks because I don’t know what’s to come next. I can’t even do things like look down for more than 10 minutes, sit in a chair comfortably, chew, brush my teeth, put on makeup around my cheek area, or yawn without being in pain. I live on pain killers which I quickly gained a tolerance to. 

Oral surgery is not an easy recovery. Surgeons have carelessly told me, “I’ll just have to redo the oral surgery,” with no positivity it will work better than it did the first time. I am traumatized. Waking up from surgery looking/ feeling like I got hit by a bus, having 102 fever every other day, getting an allergic reaction to the morphine and having hives all over my body, throwing up blood, and not being able to walk on my own for two weeks because of the dizzy spells. People get upset when they don’t eat for two hours, imagine being on a liquid diet for over two months. In addition to the recovery process, it was so emotionally challenging for me to have my face reconstructed, going out in public and get weird looks like I have something wrong with my face. 

I have been positive for so long through the recovery process. However, it’s at the point I have been to all the best surgeons in the country and have gotten nothing but negative responses about my case. I spent three months, three times a week going to physical therapy and got no progress. Now, I go four times a week to the chiropractor and two times a week to an acupuncturist. They give me a small amount of temporary relief. So, I plan my schedule around my pain management doctor appointments. I can’t even last a full day in school! I can’t even ride my horse more than once a week! How could Dr. L look at me and say, “you’ll be ok,” after knowing everything I been through and everything he’s done wrong?

My most recent diagnoses is trigeminal neuralgia. It is a chronic pain disorder affecting the trigeminal nerve in the face. This is because of my bio-mechanical malfunction in my jaw. It was caused by my oral surgery/face trauma. Doctors today call this the “suicidal nerve.” This is known to be one of the worst medical conditions. If it wasn’t for my amazing family and chiropractor I wouldn’t have the smile on my face I use to hide my pain. My chiropractor is the first doctor who has been there for me and continues to constantly check on me and offering to help.

However, there are so many people in this world who have no integrity. Small comments hurt. By this point I’m just frustrated. People make fun of me for having to carry a rolling backpack in school (because my of my neck), by kicking it and saying, “nice suitcase” while laughing sarcastically. That’s bullying. You have no moral qualities if you watch me sit in class with an ice pack on my neck and having all my work on a book reader (because I can’t look down for more than 10 minutes without getting jabbing neck pain) and tell me, “I’m just doing it for attention.”  I have endured so many hurtful comments about my jaw and what I’m going through. I have had people say, “you’re being dramatic, it’s just a little jaw/neck ache, it can’t be that bad.” Other people have said, “I wish I had a medical condition so I can get into any college I want.” Growing up around people with no heart make me really appreciate how my mom has raised me. I know from experience that the people who are in the most pain tend to be the ones who are always trying to make others smile. And for the evil people out there who know who they are, it is not that hard to think before you say! Just because I have a smile on my face when you see me does not mean I am physically and emotionally OK. No one will ever understand my pain unless they experience it. I am thankful for the few true friends in my life who have been there as my shoulder to cry on. 

God gives the toughest battles to his strongest soldiers. Sometimes it’s hard for me to understand what God really wants to happen to me. And I will not always believe in the quote, “everything happens for a reason,” because what is the reason for the pain people suffer from around the world? However, I trust that God will put me where I am meant to be someday. And I know that through this dreadful experience I am growing. Everyday I act like nothing is wrong, and it’s simply called being strong.

The author with MYM speaker Drew Bergman at the Ranney School in New Jersey