There are now 260 counties where the risk of catching Lyme disease is at least twice the national average, up from 130 a decade earlier, the report shows.
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Lyme disease is most common in wooded suburban and far suburban counties. Scientists aren’t sure why high-risk areas are expanding, but it likely has something to do with development and other changes that cause the mice, deer and ticks that carry the bacteria to move, Kugeler said.
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Overall, 17 states have high-risk counties. The entire state of Connecticut, where the illness was first identified in 1975, has been high-risk for decades. Now, high-risk zones encompass nearly all of Massachusetts and New Hampshire and more than half of Maine and Vermont.
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Other states that saw expansion of high-risk areas include Virginia, Pennsylvania and New York along the Eastern seaboard, and Iowa, Michigan and Minnesota in the Midwest.
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The disease is transmitted through the bites of infected deer ticks, which can be about the size of a poppy seed.
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Symptoms include a fever, headache and fatigue and sometimes a telltale rash that looks like a bull’s-eye on the tick bite. Most people recover with antibiotics. If left untreated, the infection can cause arthritis and more severe problems.
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About 20,000 to 30,000 U.S. cases are reported each year, but experts say there actually are as many as 10 times more.
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Some counties have dropped off the high-risk list, including those in Virginia, Georgia, Missouri and North Carolina where significant clusters were reported in the 1990s. Scientists now think those cases were caused by a different tick bite, Kugeler said.
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The article was published online in a CDC journal, Emerging Infectious Diseases.
The CIA ran a fake vaccine programme in the Pakistani town of Abbottabad to try to get a DNA sample from the family of Osama Bin Laden, media reports say.
The Guardian newspaper says CIA agents recruited a Pakistani doctorthere to organise the vaccination drive. The paper says he has since been arrested.
The CIA has refused to comment on the report, which comes as tensions run high between Islamabad and Washington.
The al-Qaeda chief was killed in a US commando raid on his compound on 2 May.
Relations between Pakistan and the US have plummeted since the raid with many in the US questioning how the fugitive could live undetected for years in a Pakistani cantonment town so close to the capital.
As part of extensive preparations for the raid that killed Bin Laden, CIA agents recruited senior Pakistani doctor Shakil Afridi to organise the vaccine drive in Abbottabad where it believed he was hiding, said the Guardian report.
‘DNA search’
The newspaper says “it is not known whether the CIA managed to obtain any Bin Laden DNA, although one source suggested the operation did not succeed”.
The BBC’s Urdu service also spoke to an unnamed source in the Pakistan military, who said that a health official who administered polio drops to children within Bin Laden’s compound was arrested shortly after the 2 May raid.
BBC Urdu said the military source quoted the health official as saying that a number of children were called in from the inner quarters of the compound to be given the drops.
The official also told investigators that the children spoke fluent Pashto, as did the woman who brought them from inside, although he said he could not see the woman’s face as she was veiled.
The source said the official is still in custody, but he is not suspected of having collaborated with the American secret agents.
The BBC has also learned that the doctor, named by The Guardian as Shakil Afridi, employed two health workers to assist in the scheme and one of them did manage to enter the Bin Laden compound – that person remains untraceable and it is unclear if they managed to get DNA samples.
There has been no official comment on the report from the Pakistani authorities.
Courier trail
The “project” was started in a poorer part of town to make it look more authentic, the paper said.
According to the report, the CIA launched the campaign after it tracked down a Bin Laden courier to the compound in the town of Abbottabad.
Before launching an operation on the compound, US officials wanted to match DNA samples from people living in the compound with a sample they had from his sister, the report said.
Separately, the New York Times also cited an unnamed US official who said that a vaccination programme was set up as a ruse in the town, because the CIA was struggling to learn whether Bin Laden was truly hiding in the compound.
At the time of the raid on Bin Laden’s compound, a shopkeeper close to the fortress told the BBC’s M Ilyas Khan that a vaccination team had visited the area just a week or two earlier.
He had said that they were only vaccinating Afghan nationals living in the area and were also obtaining their blood samples for what they described as tests to identify certain diseases.
Three of Bin Laden’s wives and several children were detained after the raid on the compound near Islamabad.
The family are said to have provided vital information about the al-Qaeda leader’s activities and are among the main witnesses of the covert US operation that killed him.
Bin Laden orchestrated the 9/11 attacks on New York and Washington in which nearly 3,000 people died.
He evaded US forces and their allies for almost a decade, despite a $25m (£15m) bounty on his head.
Vegetarian food isn’t hard to come by in New York, if you know where to look. Meat may dominate menus around town, but there are plenty of healthy restaurants, cafés and bakeries that specialize in meatless food. Check out our list of the best vegan and vegetarian restaurants restaurants in NYC, from Indian food buffets to high-concept cooking. Did we miss your favorite? Join the conversation in the comments. Do you want more great stories about things to do, where to eat, what to watch, and where to party? Obviously you do,
Best vegan and vegetarian restaurants
Angelica Kitchen
Organic-minded, kid-toting yuppies and vegan East Villagers commune over the tofu at this enduring health-food hot spot. Share the Pantry Plate (rich walnut-lentil pâté, mellow hummus and ruby sauerkraut), but snag the velvety, sesame-sauced Soba Sensation for yourself. Massive, super-popular Dragon Bowls (rice, beans, tofu, steamed veggies) get their kick from dressings like creamy carrot or black sesame wasabi. Don’t know your kombu from your kudzu? The helpful menu glossary gets you ready for the macrobiotic big-leagues in no time flat.
Blossom du Jour
The eight-seat location of this café proves that vegan cuisine and comfort food aren’t paradoxical terms. Look into the open kitchen, where chefs cook up meatless dishes, like the Midtown Melt (Cajun-spiced seitan, vegan cheddar and chipotle aioli on rosemary focaccia) and a vegan burger with soy bacon and onion rings. Healthy organic fruit and vegetable juices are blended on site, including the Supreme Green, which combines spinach, kale, ginger, lemon, apple, cucumber and parsley.
Blossom Vegan Restaurant
For cautious carnivores, Blossom offers one big surprise: All the eggless pastas and mock meats actually taste pretty good. For vegans, it’s a candlelit godsend. Guiltily dreaming of veal scaloppine? Try the pan-seared seitan cutlets, tender wheat gluten served with basil mashed potatoes, swiss chard, a white-wine caper sauce and artichokes. With fake-meat entrées averaging $17, carnivores may feel compelled to eat the real thing elsewhere, but vegetarians have indeed found a great date place.
Candle Café
Train budding vegans at this Upper East Side favorite. If they’re not quite ready to tackle baked tempeh with pumpkin-seed–guajillo sauce, suggest easy-to-eat grilled seitan skewers or the chipotle tofu club with vegan mayo and balsamic-drizzled mesclun salad.
Caravan of Dreams
Vegetarians, vegans and raw-foodists, unite! This longtime East Village hangout offers both regular meat-free dishes—grilled seitan nachos, black-bean chili, stir-fries—and “live foods” made from uncooked fruits, vegetables, nuts and seeds. Live “hummus” (whipped from cold-processed tahini and raw almonds instead of the usual chickpeas) can be scooped up with pressed flaxseed “chips”; the live Love Boat pairs almond–Brazil nut “meatballs” with mango chutney and cool marinara sauce on a napa cabbage leaf. Naturally, there are loads of salads and some macrobiotically balanced quinoa-and-seaweed combos.
Dirt Candy
Fueled by the ambition to make people crave vegetables, Amanda Cohen revived her beloved East Village eatery on the Lower East Side with a ramped-up menu and a space three times the size of the 18-seat original. Emblazoned with a mural of greenery by graffiti artist Noah McDonough, the sprawling dining room is focused on the open kitchen at its heart—complete with a chef’s counter—and a full bar along one wall. Much like the plates of Cohen’s past, each dish is anchored by one vegetable, but her retooled offerings layer multiple ingredients.
Erin McKenna’s Bakery NYC
You’ll be hard-pressed to put anything off-limits at this almost completely organic bakery, which shuns dairy, eggs, soy and gluten. Babycakes also avoids using any nuts except for coconut, considered a tree nut. (Its chocolate and flour suppliers, though, handle nuts in their facilities.) Tempt the kids with a red velvet cupcake, a double-chocolate-chip cookie, an agave-sweetened brownie or—why not?—all three.
Hangawi
Be sure your socks are looking good: You’ll have to surrender your shoes upon entering this Korean vegetarian’s paradise. Carefully crafted dishes include thin leek, kimchi, mushroom and mung-bean pancakes, andmaitake mushrooms sautéed with spinach. The scene is serene, but the Zen detachment may not suit all tastes—the quiet waitstaff can seem as chilly as the delicious dessert of chocolate-tofu ice cream.
Kajitsu
Critics’ pick
Diners often compare eating great food to a religious experience, but at Kajitsu—possibly New York’s only kaiseki restaurant to offer the centuries-old Zen Buddhist vegetarian cuisine known as shojin, from which modern-day Japanese cooking is thought to have developed—there’s something literal in the restaurant’s connection to the divine. The sparse, hushed interior suggests a reverence for nature that is also expressed in the food. For those accustomed to bold flavors, the preparations can at first seem understated to a fault. But with each jewel-like course, the meal emerges as an artful meditation on simplicity and seasonality. Though nothing we ate shouted for attention, all the subtleties added up to a memorable, if not exactly sacred, meal.
Peacefood Cafe
Critics’ pick
This vegan gem, outfitted with soothing sage-colored walls, soft amber lighting and a buzzing, cheerily staffed counter, is a welcome addition to the only slightly veggie-compliant Upper West Side. An earthy salad combines red quinoa, white beans, corn, red peppers, avocado and lime-mustard vinaigrette in one invigoratingly fresh starter. It provides a light counterpoint to the fried seitan medallion panino, a creation that teams a wheat-gluten cutlet with cashew-based “goat cheese,” peppery arugula and chopped tomatoes on a hunk of yeasty homemade focaccia. Smoothies and fresh-juice blends, like the pineapple-beet-lime concoction, are thoughtfully crafted, as are the desserts. The standout not-too-sweet coconut cream pie gets its silky texture from a dose of tofu.
If someone you love is addicted to drugs or alcohol, then you’re no stranger to heartache and worry. In addition to those feelings, bitterness and disappointment are probably unfortunate staples of your home. Life kind of becomes a pressure cooker; things are always on the verge of blowing up.
It’s hard to understand substance abuse if you’ve never been in its clutches and it can be more than frustrating to stand idly by while a loved one slowly destroys his life. You want to help, but you’re not sure how. You don’t understand why he refuses to listen; you may even believe that – if he really loved you– he’d stop taking drugs.
Whether your loved one is an active addict, in early recovery, or in the middle of a treatment program, you have to re-learn communication skills. And part of that process includes learning what not to say. Every situation is unique, but certain words are universally more harmful than helpful when dealing with addiction.
With that in mind, let’s look at three things you should never say to a loved one who is struggling with substance abuse and addiction.
You’re so selfish. Why don’t you just stop doing drugs?
It’d be wonderful if all addicts could instantly stop feeding their addictions, but most need help. You can’t just will away a condition that has literally reprogrammed your loved one’s brain chemistry. On top of his physical issues, there’s a ton ofemotional trauma lying just underneath the surface.
Please understand that nobody wants to live this way. Addiction creates a dark and lonely existence. You must know that, if he could, he’d gladly choose to walk away from drugs or alcohol. Since that’s not generally an option, show your love and concern by providing support, consistency, and courage.
I give up. You’ll never beat this addiction!
The constant fighting and deceit that accompanies addiction surely weighs heavy on your heart. This becomes even more frustrating when you’re a witness to multiple episodes of relapse. But if you give up on him, it can feel like a death sentence for both of you.
No one can predict the future; you can’t determine his fate by looking solely to the past. Loving an addict can be exhausting, but nothing good comes from verbally beating him up. That’s not to say you can’t cut ties; sometimes that’s what it takes. But there are thousands of recovering addicts out there right now leading happy, healthy lives. Never give up hope.
You’re doing it all wrong. Recovery has to be done this way!
Alcoholics Anonymous and Narcotics Anonymous have helped usher thousands of people into recovery, but they aren’t right for everybody. You have to understand that the the map to sobriety isn’t set in stone. People might take different routes to get there, but when it’s all said and done, the destination is the only thing that matters.
Instead of trying to dictate the recovery plan, offer to help find a program that feels right for him. Modern addiction treatment comes in all shapes and sizes. Individual counseling, group therapy, resident rehabilitation centers, medically assisted detox/maintenance programs, and holistic therapies are just a few of the many routes you can explore…together.
Researchers have identified a protein that controls how breast cancer cells spread around the body, according to a new study. This study sheds light on how cancer cells leave the blood vessels to travel to a new part of the body, using a technique that allows researchers to map how cancer cells interact and exchange information with cells that make up the blood vessels.
Researchers have identified a protein that controls how breast cancer cells spread around the body, according to a Cancer Research UK-funded study published in Science Signaling.
This study sheds light on how cancer cells leave the blood vessels to travel to a new part of the body, using a technique that allows researchers to map how cancer cells interact and exchange information with cells that make up the blood vessels.
When tumour cells spread, they first enter the blood stream and grip onto the inner walls of blood vessels. The researchers found that the cancer cells control a receptor protein called EPHA2 in order to push their way out of the vessels.
When cancer cells interact with the walls of the blood vessels, EPHA2 is activated and the tumour cells remain inside the blood vessels. When the EPHA2 is inactive, the tumour cells can push out and spread.
Dr Claus Jorgensen, who led the research at The Institute of Cancer Research, London, and at Cancer Research UK’s Manchester Institute at the University of Manchester, said: “The next step is to figure out how to keep this receptor switched on, so that the tumour cells can’t leave the blood vessels — stopping breast cancer spreading and making the disease easier to treat successfully.”
Nell Barrie, Cancer Research UK’s senior science information manager, said: “This is important research that teaches us more about how breast cancer cells move. Research like this is vital to help our understanding of how cancer spreads, and how to stop this from happening. More research is needed before this will benefit patients but it’s a jump in the right direction.”
Now the gangsters face deportation after an undercover operation by detectives in Manchester’s swankiest bar
A sophisticated ‘ dial-a-drug ‘ crime syndicate has been brought down by a huge police operation.
The gang of 20 Albanian criminals scooped £250,000 pound selling high-grade cocaine the Manchester’s clubbers .
Now the gangsters face deportation after an undercover operation by detectives in some of the city’s swankiest bars.
Known in underworld circles as ‘The Albanians’, the network of dealers dressed in designer gear to blend in at venues at Deansgate, the nearby Locks and Spinningfields.
They even targeted affluent revellers outside the luxury Beetham Tower – but ended up selling to a covert officer instead.
Based in lavishly decorated apartments in the outskirts of the city centre, the dealers were recruited in Albania to operate in Manchester because of the city’s thriving nightlife, officers believe.
Having entered the country illegally, gang members used fake Italian and Greek passports to evade detection.
They would offer to people on the street and in bars, as well as running a 24/7 ‘dial-a-drug’ line which surprised officers with its speed and professionalism.
Police believe they worked with Manchester’s more established gangs – but were arming themselves with guns in case of conflict.
The authorities will now seek to claw back some of the cash made from their racket using the Proceeds of Crime Act.
It’s understood around £125,000 in assets is recoverable – much of it in cash seized on raids on their adresses.
GMP
Purity: Officers said the drugs they sold were top quality
Codenamed Operation Cortez, GMP’s crackdown is the first-ever ‘test purchase’ operation in the city centre.
Test purchase operations involve police posing as drug users to build cases against dealers.
Previous operations have concentrated on pushers selling crack and heroin to addicts in deprived areas, but this campaign involved dealers targeting upwardly mobile recreational users.
The operation climaxed with dawn raids in February 2015 at 17 addresses across North and South Manchester, Salford, Trafford and North Wales. A total of 24 people were arrested for drugs, immigration, firearms and false document offences.
In total drugs with an estimated value of £130,000 were recovered, two firearms, ammunition, a magazine and silencer.
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The full details of the racket can be revealed now the last criminal identified by the operation, which involved five months of covert work, has been locked up.
Gentjan Baro’s flat at Ludgate Hill, Collyhurst, was raided after police arrested the 25-year-old in the company of a drug dealer pal. A gun and ammuntion was found hidden behind his toilet cistern.
Mevlan Gjeta, 33, of Ellesmere St, Hulme was one of the main players. A kilo of cocaine was found at his address, plus £55,000 in a drawer. He has been jailed eight years for supplying cocaine and possessing criminal property.
Detective Constable Alex Mulhall, who led the undercover team on the ground, said: “Manchester city centre had a problem with cocaine, so we used covert tactics, went into the city centre and purchased it.
It was totally different sort of test purchase job, because in criminal terms the dealers were under the radar.
“They didn’t have previous and we didn’t know who they were, or where they were from.
“What we found was the supply of cocaine was extremely lucrative, the quality of cocaine was of extraordinary quality – 60 to 80 per cent import quality – and the dealers were making significant money from it.
“It’s not the usual low level street supply you see, if you were a drug user it was a good quality service.
“The dealers would turn up quickly, on time, very polite. These lads were quick, they didn’t want to chit chat with you, very professional.
“They would be deployed from a location on foot, sometimes with vehicle drop-off.
“They were mingling in high end bars so they had to look the part, they were well dressed – not the typical dealer.
“1g was £100, half a gram was £50. They were selling half a gram, most cocaine users are not used to such a high quality cocaine so that was more than adequate.
“Its relatively unusual for a foreign gang in Manchester, but the world is getting smaller.
“The vast majority of the gang were of Albanian origin.
“We believe that they were recruited over in Albania and brought over to the UK, knowing that they’re coming to be drug dealers, so there’s no element of trafficking.
“Most of them are illegal immigrants in the UK as Albania is not in the EU. They were doing it as a job.
GMP
Foiled: The gangsters, many of whom are illegal immigrants, face deportation
“The Albanian community are fantastic hardworking people – it’s not a reflection on them at all, but there’s an element of criminality in all strands of society.
“Here, we had an Albanian gang that landed in Manchester city centre.
“Manchester is a growing city economically, and they have seen that as a market they can get on. For the existing organised crime groups there was a benefit to working with them, because of their links to the supply and importation.
“We launched the operation in May 2014 after getting intelligence from the community, and the bars and clubs. The city centre now is a big residential area and these concerns were being raised from people within the community, residents and businesses.
“The challenge to the investigation was because these people were illegal immigrants. We didn’t know their names, their birthdays or addresses so it took a lot of investigation, a lot of time and effort into locating these people, finding out where they were living and finding out the identities they were using.
“They were using multiple identities, fake Greek and Italian documents, so we worked very closely with the UK Borders Agency.”
DC Mulhall went on: “The discovery of the gun goes to show that underlying this professional, well-manned outfit is is the threat and fear that they will, if confronted and if they don’t get what they want, use firearms and the threat of firearms to other organised crime groups.
“People might think they are friendly or nice and offer a good service, but where firearms are concerned, where drugs are concerned there is potential for conflict.
“It’s an illicit market where the control is not with trading standards, you can’t go and say my product’s not quite right, they govern themselves.
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“And in the world of drugs those who bite the hardest are the ones who decided what goes.”
DC Mulhall said while the situation with open dealing in the city centre is now vastly improved, there is no room for complacency.
“The feedback we have from the clubs and bars is very positive.
“But this is an ongoing process of work in relation to this new organised crime group. It’s something we’re working tirelessly against. But there may be a number of them.
“It doesn’t stop here, this isn’t the end of it, we keep going until the problem is totally eradicated.
“People come to Manchester to have a good time – the night time economy is massive to the city centre – they don’t come to be surrounded by people dealing drugs.”
Officers are still trying to trace three men in connection with the drug-dealing operation.
Others in the conspiracy
Manchester Evening News
Cash: Huge quantities of money were seized
As well as linchpin Mevlan Gjeta , 19 others were convicted of a range of crimes.
Holly Brown , 21, of Ellesmere Street, Hulme was convicted of being concerned in the supplying class A drugs.
She was handed a two-year suspended sentence.
Ellis Rrukay , 30, of no fixed abode, was convicted of supplying class A drugs.
He was sentenced 32 months in prison.
Emir Ceka , 30, of Wellmead Close, Cheetham Hill, was convicted of supplying class A drugs; possession with intent to supply class A drugs; and money laundering – and sentenced to five years behind bars.
Thanas Troka , 38, of Bury Street, Salford, was convicted of supplying class A drugs and sentenced to three years and nine months in prison.
Vilson Jacaj , 26, of no fixed abode, was convicted of supplying class A drugs; and possession with intent to supply class A drugs – and sentenced to four years in prison.
Eric Jacaj , 30, of Barnfield House, Salford, was convicted of supplying class A drugs; possession with intent to supply class A drugs; and money laundering.
He was handed a five year sentence.
Nehat Elshani , 38, of Richmond Grove, Longsight, was convicted of supplying class A drugs; and possession with intent to supply class A drugs – and was sentenced to four years in jail.
Elton Kalemi , 24, of Chester Road, Manchester, was convicted of supplying class A drugs; possession with intent to supply class A drugs; and money laundering – and sentenced to four years.
Nailr Piri – also known as Danielo Boni, 25, of no fixed abode, was convicted of supplying class A drugs and was sentenced to two-and-a-half years in prison.
Clirim Malecaj , 33, of New Bailey Street, Salford, was convicted of supplying class A drugs and possession with intent to supply class A drugs – and sentenced to six years.
Arkadiusz Jakubiec , 34, of no fixed abode, was convicted of supplying class A drugs and possession of ammunition – and sentenced to four years in jail.
Kamila Jakubiec , 30, of Dragonfly Close, Lower Broughton was convicted of possessing ammunition – and sentenced to nine months in prison.
Schembi Doci, 27, of no fixed abode, was convicted of supplying class A drugs and possession with intent to supply class A drugs – and sentenced to five-and-a-half-years in prison.
Muhamed Gazided , 21, of no fixed abode, was convicted of supplying class A drugs and possession with intent to supply class A drugs.
He was sentenced to four years.
Emiljan Cutaj, 35, of no fixed abode, was convivted of possession of cocaine with intent to supply – and was sentenced to three years behind bars.
Edvin Dervishi, 32, of Bury Street, Salford, was convicted of possession with intent to supply class A drugs; and possessing false ID – and sentenced to three years and eight months.
Hakuran Curaj , 22, of no fixed abode, was convicted of possession with intent to supply class A drugs and possessing criminal property – and sentenced to two-and-a-half years in prison.
Orion Pira , 20, of no fixed abode was convicted of posession with intent to supply class A drugs and sentenced to three years in prison.
Gentjan Baro , 27, Ludgate Hill, Collyhurst, was convicted of posesssion of a firearm and false documents – and sentenced to seven years in prison.
Tiffany Posteraro, 24, struggled with a rare skin condition for her entire life—but she’s done hiding her true self from the world.
It all began when she was only 7 years old, when she noticed small white spots starting to sprout on her knees. Soon it spread—she found the spots on her wrists, and then her kneecaps were covered in the mysterious patches.
Posteraro explained how frustrating the process was. “I showed my parents but we just thought they must be scars or something. […] We had no idea what it was. A dermatologist gave me some ointment but it did nothing.”
The real breakthrough occurred not after a doctor’s official diagnosis, but when she was 11 years old, running errands with her mother. A man pulled her aside at a grocery store and explained to her that she had vitiligo, a skin condition in which causes the loss of skin pigment.
Posteraro was glad to learn what the real problem was, but soon things took a turn for the worst. As the condition accelerated and the patches on her body started to grow larger, she had to endure bullying and mean comments.
She said, “People stared and made nasty comments.” Strangers went so far as to call her “cow,” “Dalmatian,” and “burn victim.”
Soon, Posteraro had to learn how to put on heavy-duty makeup just to cover up her skin in order to avoid attention. “I tried everything possible to cover it up. I got really dark spray tans and used industrial-strength foundation, the kind used to cover deep scars.”
It was only after meeting a fellow vitiligo sufferer that Posteraro finally decided to stop hiding. She thought, “Why should I hide who I am? It’s exhausting.” Empowered with a new bout of confidence, Tiffany decided to get her condition “emblazoned” on her forever—she got a tattoo with the words “It’s called Vitiligo” on her forearm.
Posteraro admitted the tattoo was totally “liberating”—people love her new tattoo, and they find they know want to learn more about the condition.
Posteraro is working hard to remove the stigma associated with the skin condition, and we hope she succeeds. You go, girl!
Mental illnesses like general anxiety disorder (GAD) don’t discriminate, no matter what your race, background, or socioeconomic status is. That said, women are 60 percent more likely than men to have an anxiety disorder, so chances are, you or someone close to you is dealing with it. It could be anyone — even that gorgeous, friendly woman you sometimes commute to work with. When it comes the “type” of person wrestling with this illness, don’t get sucked into what the media portrays — there isn’t one type.
People with anxiety disorders are struggling behind closed doors more than they are in public, and just because they seem put together when you meet them for weeknight cocktails doesn’t mean they’ve got it all figured out. Having suffered from acute anxiety — it was tied up with my binge eating disorder (BED) — since I was a teenager, I have learned a few things about getting people to understand the struggles I go through. The best gifts I ever received from friends were space and understanding. The more you hover over somebody with anxiety, the quicker you will push them away, the faster you will make them feel like they’re abnormal.
The assistance we do need isn’t always what you think it is though, like taking us to the doctor. We might just need a pair of ears to hear us out — or some alone time. The most important thing is to love us unconditionally and never make assumptions about our condition.
Here are 11 things people with anxiety want you to know.
1. Social Gatherings Are Hard
Parties are no fun. Neither are baby showers. We would rather watch paint dry than go to a big wedding where everyone is dolled up — and chatty. With anxiety disorders comes stress in large social situations, particularly when it’s an event where everybody is smiling and celebrating a happy life event. If we turn down an invite, it’s not because we don’t love you — the party might just be genuinely overwhelming to us.
2. Sometimes We Just Don’t Feel Like Laughing
People who see us on edge automatically assume that the best thing to do is tell a joke, or do something silly to make us smile.
There’s a difference between forcing us into laughter and lightening the mood; the former always comes off as inauthentic — because it usually is — while the latter can be done naturally, without making us feel like we’re being treated in a loony bin. Don’t force us to laugh, please.
3. This Doesn’t Define Us
Please don’t whisper about us behind our backs and label us according to what kind of anxiety disorder we harbor (I swear, I was once dubbed Nervous Nancy). This disease doesn’t make up our entire identity; that’s a fact we lose sight of at times, which just makes us feel worse about ourselves, so try to steer clear of insensitive comments and nicknames. Instead, remind us of all the reasons we are wonderful — no harm can come out of that.
4. Things That Don’t Affect You Bother Us
I’m talking about those little, tiny, minute occurrences that you probably don’t even give a second thought to, like having you come over to our apartment for the very first time. Our brains are wired differently, and we might even be dealing with some chemical imbalances, so those small thingsmake our minds run wild while you can merely shrug them off and continue on with your life. If we seem a little nervous, please don’t make fun of us, or make us feel guilty.
5. We’re Physically Exhausted
In case you haven’t heard, the mind and body are intricately connected, so if one is facing difficulties, the other will visibly suffer. People with anxiety disorders tend to live in a hyper-tense state, especially when they’re not getting the treatment they need. This causes the heart rate and blood pressure to rise, and our digestive system might not be working properly. Be gentle with us if you see that we’re tired and cranky, because we probably didn’t sleep at all last night.1
6. We’d Appreciate The Space To Vent
It’s hard to find a good enough friend or family member out there who can listen to our troubles without passing any judgment whatsoever. If you could be that person for us, we’d love you forever. The more we bottle stuff up, the more likely we are to have a panic attack or end up locked up in our bedroom, surrounded by Ben & Jerry’s. Plus, nothing is worse than being honest, only to see the person across from us with a disgusted look on their face. Try not to be supportive and non-judgmental — and remember, you don’t have to fix it.
7. We’re Trying Our Hardest
Just because you don’t see us running to a therapy session every Wednesday doesn’t mean we’re not doing our absolute best to work on this mental illness. It’s really, really hard being trapped in this head constantly and not fully understanding all the emotional phases that pass by. Please don’t assume that we aren’t aware of our troubles. We. So. Are. And we’re doing our best to heal ourselves, in our own ways.
8. We Appreciate You
Yeah, it’s hard to say out loud, but we love all the support and encouragement you give us. We might not show it, and that’s only because we get so caught up in trying to make sense of the chaotic, demanding world around us. So, thanks for late-night chats and the text messages that are meant to bring us out of hiding on a weekend night. We’re trying to get better at saying thank you more often.
9. We’ll Never Be Just Like You
There might be a “normal” mold out there that you and many other people fit into — and we may never be granted citizenship on that land. There’s nothing wrong with that, so don’t make us feel like there is. We might never be interested in Halloween parties or Saturday morning yoga classes, no matter how rad you think they are. Let us be our own people, and, I promise, we’ll have a much better shot at getting along.
10. We Don’t All Need Medication
It far too common: people struggling with a mental illness are told that we should think about a certain kind of medication. But what works for your younger, manic depressive cousin may not necessarily work for us. Some respond well to anti-anxiety prescriptions, while it exacerbates the symptoms of others. Instead of telling us we need to take pills, ask us openly if we’ve ever considered it. We’ll tell you where we stand.
11. You May Never Know The Whole Story
Countless parts of illnesses like GAD are suffered behind closed doors. We don’t like being the center of attention, so we do everything we can to hide all the awful things we’re going through; this could mean that we aren’t going to tell you everything when you ask us to share our personal stories. Don’t take it personally — we’re either not ready yet to reveal corners of ourselves, or we’ve decided that there are some things we’d prefer to keep private.
My recent blog post focused on what notto say to a depressed person. I presented common statements that people tell friends and loved ones in an attempt to alleviate the depressed person’s discomfort, but more so their own unease in the face of a difficult, heart-wrenching situation. Unwittingly or not, statements that put blame on a depressed person’swillpower, lack of motivation, or negative mindframe often backfire and increase that person’s feelings of isolation and hopelessness. The statements sometimes come from a fundamental misunderstanding of the depression illness. It is a biopsychosocial condition that traps its victims in a circuitous broken-record mindset that creates vulnerable, despondent thinking patterns.
So how can well-meaning people provide support to someone with depression, aside from avoiding tendencies towards judgment? How can one show empathy and understanding? Here are 6 things to say to connect with someone living with depression:
1. “I’m here for you.“
Just offering to be there for someone with depression helps. Someone who feels trapped in a cycle of self-loathing often feels unworthy of reaching out to people around them. They often worry about being a burden or nuisance to others, since they are aware of how infectious their mood can be for those nearby. When you decide to let them know you will be there for them, regardless of their fears of judgment or of wasting your time, they can feel less alone and feel less social pressure. You don’t even have to necessarily say anything to them while you’re with them. This can help put a crack in the cycle of negative self-worth and enable them to realize people still care regardless of their sad outward presentation.
2. “What can I do to help?”
Depressed people may not necessarily be in a state of mind to know or say what will help them, but just hearing someone’s willingness and openness can help lift their spirits. Even if they say nothing needs to be done, they have heard you. They can sense that you care, and that can reassure them when they’re caught in guilt-ridden thinking. If they do request something, you’re in a great position to help. Even just being there to listen to their worries can help.
3. “I like [X/Y/Z] about you.”
Low self-esteem becomes a self-fulfilling prophecy with depression. It leads to feeling misunderstood and out of sync with everyone else. Depressed individuals often mentally beat themselves up. Hearing positive reinforcement can help soften their self-berating tendencies and test the reality of their thoughts. Do not offer fake praise, but share honest reasons why you enjoy the person’s company or love them. Often their mood skews their perception of their lovability.
4. “Yeah, that is lousy.”
Some negative outlook during depression is not necessarily skewed or delusional. Although some issues are magnified, or the person can become oversensitive to a bad event, there are often real stressors that get them down. It’s important to acknowledge those concerns when they’re brought up, so a person doesn’t feel they aren’t being heard or are being misunderstood, ignored, or forced to be artificially happy. If they don’t feel alone in seeing a problem, they feel there is potential to move forward.
5. “There are ways to get through this difficult time.”
If you notice someone falling into a serious depression and not improving, despite offering your finest support, the best thing you can do is to guide them to professional help. Taking that step can feel scary for most people. Being there to reassure and accompany them in the process can make the difference between someone falling through the cracks or not. Feel free to reach out to mental-health resources online or telephone hotlines as needed; to people you know who are mental-health providers; or look up NAMI. Help people make appointments with therapists and/or help them consider adjunct medication carefully. Take someone to an emergency room if you are really worried about their safety. Negotiating the fragmented mental-health system can be tricky, so your advocacy can really matter to someone who can’t fight for themselves.
6. “I’ve been through it, too.”
Coming from a place of mutual suffering can matter to someone who feels that no one understands them, or feels too ashamed to talk about their situation. More stories are shared in the media, books, and magazines about people from all walks of life who have gone through mental illness and struggled to survive and improve. The more people talk about the reality of their conditions, the less misinformation will confuse the general public. It will help reduce ongoing feelings of stigma, loneliness, and social punishment, allowing people to see the potential for recovery.
Overall, the goal in helping a loved one or friend with depression is to be caring and supportive, but also realistic and open to their state of mind. Each individual case of depression can be much more complex than I’ve outlined here, especially if complicated personality traits or problematic behaviors or substance abuse issues are mixed into the equation. In general, accept a depressed person without expectations of quick change or judgment—let them know they are loved and not alone in their struggles. Your caring can make a real difference.
Brain injury is confusing to people who don’t have one. It’s natural to want to say something, to voice an opinion or offer advice, even when we don’t understand.
And when you care for a loved one with a brain injury, it’s easy to get burnt out and say things out of frustration.
Here are a few things you might find yourself saying that are probably not helpful:
1. You seem fine to me.
The invisible signs of a brain injury — memory and concentrationproblems, fatigue, insomnia, chronic pain, depression, or anxiety — these are sometimes more difficult to live with than visible disabilities. Research shows that having just a scar on the head can help a person with a brain injury feel validated and better understood. Your loved one may look normal, but shrugging off the invisible signs of brain injury is belittling. Consider this: a memory problem can be much more disabling than a limp.
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2. Maybe you’re just not trying hard enough (you’re lazy).
Lazy is not the same as apathy (lack of interest, motivation, or emotion). Apathy is a disorder and common after a brain injury. Apathy can often get in the way ofrehabilitation and recovery, so it’s important to recognize and treat it. Certain prescription drugs have been shown to reduce apathy.Setting very specific goals might also help.
Do beware of problems that mimic apathy. Depression, fatigue, andchronic pain are common after a brain injury, and can look like (or be combined with) apathy. Side effects of some prescription drugs can also look like apathy. Try to discover the root of the problem, so that you can help advocate for proper treatment.
3. You’re such a grump!
Irritability is one of the most common signs of a brain injury. Irritability could be the direct result of the brain injury, or a side effect of depression, anxiety, chronic pain, sleep disorders, or fatigue. Think of it as a biological grumpiness — it’s not as if your loved one can get some air and come back in a better mood. It can come and go without reason.
It’s hard to live with someone who is grumpy, moody, or angry all the time. Certain prescription drugs, supplements, changes in diet, or therapy that focuses on adjustment and coping skills can all help to reduce irritability.
4. How many times do I have to tell you?
It’s frustrating to repeat yourself over and over, but almost everyone who has a brain injury will experience some memory problems. Instead of pointing out a deficit, try finding a solution. Make the task easier. Create a routine. Install a memo board in the kitchen. Also, remember that language isn’t always verbal. “I’ve already told you this” comes through loud and clear just by facial expression.
5. Do you have any idea how much I do for you?
Your loved one probably knows how much you do, and feels incrediblyguilty about it. It’s also possible that your loved one has no clue, and may never understand. This can be due to problems with awareness, memory, or apathy — all of which can be a direct result of a brain injury. You do need to unload your burden on someone, just let that someone be a good friend or a counselor.
6. Your problem is all the medications you take.
Prescription drugs can cause all kinds of side effects such as sluggishness, insomnia, memory problems, mania, sexual dysfunction, or weight gain — just to name a few. Someone with a brain injury is especially sensitive to these effects. But, if you blame everything on the effects of drugs, two things could happen. One, you might be encouraging your loved one to stop taking an important drug prematurely. Two, you might be overlooking a genuine sign of brain injury.
It’s a good idea to regularly review prescription drugs with a doctor. Don’t be afraid to ask about alternatives that might reduce side effects. At some point in recovery, it might very well be the right time to taper off a drug. But, you won’t know this without regular follow-up.
7. Let me do that for you.
Independence and control are two of the most important things lost after a brain injury. Yes, it may be easier to do things for your loved one. Yes, it may be less frustrating. But, encouraging your loved one to do things on their own will help promote self-esteem, confidence, and quality of living. It can also help the brain recover faster.
Do make sure that the task isn’t one that might put your loved one at genuine risk — such as driving too soon or managing medication when there are significant memory problems.
8. Try to think positively.
That’s easier said than done for many people, and even harder for someone with a brain injury. Repetitive negative thinking is called rumination, and it can be common after a brain injury. Rumination is usually related to depression or anxiety, and so treating those problems may help break the negative thinking cycle.
Furthermore, if you tell someone to stop thinking about a certain negative thought, that thought will just be pushed further towards the front of the mind (literally, to the prefrontal cortex). Instead, find a task that is especially enjoyable for your loved one. It will help to distract from negative thinking, and release chemicals that promote more positive thoughts.
9. You’re lucky to be alive.
This sounds like positive thinking, looking on the bright side of things. But be careful. A person with a brain injury is six times more likely to have suicidal thoughts than someone without a brain injury. Some may not feel very lucky to be alive. Instead of calling it “luck,” talk about how strong, persistent, or heroic the person is for getting through their ordeal. Tell them that they’re awesome.
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