NAMI Mercer County

Families Meeting the Challenge of Mental Illness

Let's Talk Abt It

Weekly blog series created and posted by Summer 2025 Intern, Angelina Villalva. As part of NAMI Mercer's mission to spread mental health awareness, we want to open the conversation to various disorders and how to address it.

Managing MDD

By

Angelina Villalva, NAMI Intern

Two weeks ago on June 12, my grandmother passed away. Although everything had changed, in some ways, it felt like she wasn’t really gone. The sun kept coming, I still had to go to work, and my family kept moving forward as usual. For days, this normalcy left me with a bit of silent hope. I kept waiting for my cell phone to buzz, thinking it was my dad sending me a text that she was coming home, that somehow the hospital had gotten it wrong, and everything was going to be okay. It breaks my heart to say that text never came, and it hurts even more to say that time kept moving, and the days kept passing by. 

Some days I had trouble sleeping. Other days I felt nothing at all. Presently, I’m happy to say that I am in a much better place, and it’s thanks to my amazing support system that got me through this tough period. Family members who shared stories of my grandmother and friends that were willing to listen to my rollercoaster of thoughts allowed me to not just grieve, but remember to love, and how to pick myself up. Without my village of people, I might’ve had a harder time coming out of a depression. And for those who unfortunately don’t have such support, they often experience a harder time recovering from depression. 

Something that binds us all together in the human experience of life is going through loss and hardship. To have meaning is to find an end, and sometimes it comes sooner than we’d like. It’s not uncommon for those undergoing loss and hardship to be experiencing depression, but this is different from clinical depression, also known as major depressive disorder (MDD). 

While losing a loved one is a cause of MDD, other causes include (but are not limited to): 

  • Reduction in size of brain regions that regulate mood and cognition 
  • Neurotransmitter imbalance of serotonin, norepinephrine, and dopamine
  • Genetics; individuals with family members diagnosed with MDD are 3x as likely to develop it as well compared to someone without a family history of the condition
  • Adverse childhood experiences (such as abuse/trauma) 
  • Other stressful life events (trauma, divorce, isolation, lack of support) 

According to the DSM-5 (the standard classification of mental disorders), to be diagnosed with MDD an individual must have 5 or more symptoms to be present during a 2-week period. These symptoms must have significant distress or impairment as a result and must not be attributable to substance use or other medical conditions. In other words, multiple of these symptoms must be present in a single episode, not recurrent. The possible symptoms are as follows: 

  • Depressed mood (subjective/observed) 
  • Loss of interest or pleasure
  • Change in weight of appetite
  • Insomnia or hypersomnia
  • Psychomotor retardation or agitation (observed) 
  • Loss of energy or fatigue
  • Worthlessness or guilt
  • Impaired concentration or indecisiveness
  • Thoughts of death, suicidal ideation, or suicide attempt 

The treatments available for MDD include medication and psychotherapy. However, it is worth noting that while both separately prove to be effective, combining both of these treatments yield the highest positive results. In some further severe cases, individuals with MDD have limited responses to medication. In this event, other treatments such as electroconvulsive therapy are used in place. 

Aside from medication and therapy, John Hopkins Medicine highlights some important reminders on how to better address your depression: 

  • Break large tasks into small ones
  • Confide in the people around you
  • Do something nice for others 
  • Work in regular exercise
  • Eat health, well-balanced meals
  • Stay away from alcohol and other drugs

Something that brought me comfort during my time grieving my grandmother was the phrase, “Grief is love with nowhere to go.” Whether you’re grieving family or a friend, someone you used to know or even the person you used to be, that is all love you have inside of you. I’m not saying depression is cured from something as simple as feeling the love inside of yourself, but it is a nice place to start.

I leave you with a quote from a character from one of my favorite childhood comfort shows, Avatar: the Last Airbender. 

“Sometimes life is like this dark tunnel. You can’t always see light at the end of the tunnel, but if you just keep moving…you will come to a better place.” – Iroh

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Debunking DDD

By

Angelina Villalva, NAMI Intern

One of my all time favorite movies is The Truman Show. For those unfamiliar (or need a recap), the movie revolves around a guy named Truman, and unbeknownst to him, he’s the star of a TV show about his own life. Neighbors, friends, even his own family, are all actors. Every detail in his life, from his fear of dogs, to the woman he’s married to, was planned and controlled. As viewers progress through the film, we not only discover just how much of his life is being manipulated, but how far people will go to keep him from discovering the truth. 

Aside from the plot, what makes The Truman Show meaningful to so many people, including myself, belongs to its relatability. As Truman slowly discovers the truth about the world around him, he’s faced with weird feelings that something in his environment is not quite right, or that the things around him are not real. As he begins to break down and become more and more suspicious of these things, Truman begins to exhibit symptoms of derealization. 

It is very common for people to experience feelings of derealization. In fact, according to the Merck Manual, almost one half of people will have experienced feelings of detachment from themselves (depersonalization) or their surroundings (derealization) at some point in their life. This can occur after experiencing life-threatening danger, taking certain hallucinogens or drugs, becoming very tired, or being deprived of sleep. 

However, some individuals may be afflicted from symptoms of depersonalization and derealization for long periods of time, which can make it hard to function. This is what’s known as Depersonalization-Derealization Disorder (DDD). 

As mentioned before, individuals with DDD may experience feelings of detachment from their surroundings, but they may also experience detachment from their body. Therefore, symptoms of DDD are split between derealization experiences, and depersonalization experiences. 

Derealization Symptoms

  • Feeling that people and surroundings are not real (almost like you’re living in a movie/dream) 
  • Feeling emotionally disconnected from people you care about 
  • Surroundings that appear out of their usual shape or are blurry or colorless
  • Thoughts about time that are not real such as recent events feeling like the distant past
  • Unrealistic thoughts about distance and the size and shapes of objects

Depersonalization Symptoms

  • Feelings that you’re seeing thoughts, feelings, or body or parts of body from the outside 
  • Feeling like a robot or that you’re not in control of what you say or how you move 
  • The sense that your body, legs, or arms, appear twisted or like they’re not the right shape 
  • Emotional or physical numbness of your senses or responses to the world around you
  • Sense that memories lack emotion and they may or may not be your own memories

The causes of DDD are still not well understood. Some think that high levels of stress, fear, childhood trauma or generally stressful and traumatic events could lead to bouts of DDD. It is also highly probable that due to genetic and environmental factors some people may be more likely to experience depersonalization and derealization than others, but again there is no definite source. 

What sets DDD apart from a psychotic disorder is awareness. Despite feeling this detachment and separation from bodily or environmental senses, individuals remain in touch with reality and understand that these perceptions aren’t real. This often causes frustration and anxiety, with people commonly reporting feeling that they are going crazy. This awareness can lead to comorbidities such as depression, anxiety, OCD, PTSD, or personality disorders. 

While it is still unsure about the best way to treat DDD, the most current available options are to use various psychotherapies (cognitive behavioral, eye movement desensitization processing) or medication. 

As always, remember you are supported and loved, even if you feel alone. There will always be someone willing to listen, and you deserve to get the resources you need. 

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Bearing BPD

By

Angelina Villalva, NAMI Intern

Have you ever been told by a parent, “Where’s the you I used to know?” In some ways, you feel that you have not changed at all. Yet, from the eyes of someone who’s watched you grow and go from a small infant to a teenager and then adult, you’ve become someone entirely different. 

It’s not unheard of for us to experience changes in our personality and self-image as we develop and grow into ourselves. It’s common that we often look back and see phases of our lives where we behaved or dressed a way that is so far removed from what we act and look like presently. 

Although everyone experiences shifts and changes in personality as we age, some are afflicted with personality disorders (PD), something more severe than just meager shifts in typical mood and behavior changes exhibited in teenagers. 

So what is a personality disorder? According to Mayo Clinic, personality disorders are defined as a condition where people have a lifelong pattern of seeing themselves and reacting to others in ways that cause problems. 

Personality disorders often begin in adolescence but are not diagnosed until much later due to the rapidly changing personality and self-image of adolescents and teenagers with development. As categorized in the DSM-5, personality disorders can fall under 3 clusters: 

  • Cluster A: Odd or eccentric disorders
  • Cluster B: Dramatic, emotional, or erratic disorders
  • Cluster C: Anxious or fearful disorders

You may already be familiar with some of the personality disorders found amongst Cluster B, those being antisocial PD, borderline PD, histrionic PD, and narcissistic PD. (In fact, if you haven’t already, check out more information on histrionic personality disorder in fellow intern, Bella Santulli’s, post Histrionic Minds). 

Today, we’ll mainly be covering the symptoms and treatments available for borderline personality disorder (BPD). 

BPD is the most widely studied personality disorder. Those afflicted are characterized with high impulsivity and high emotional instability. Provided from Cleveland Clinic are the following common symptoms: 

  • Fear of abandonment
  • Unstable, intense relationships
  • Unstable self-image or sense of self
  • Rapid mood changes
  • Impulsive and dangerous behavior
  • Repeated self-harm or suicidal behavior
  • Persistent feelings of emptiness
  • Anger management issues
  • Temporary paranoid thoughts

Up to 75% of people diagnosed with BPD are female, although males may be equally affected but misdiagnosed with PTSD or depression. Causes of BPD may vary, but unfortunately there is a correlation between childhood abuse and trauma, with 70% of people who have reported experiencing sexual, emotional, or physical abuse as a child developing BPD. Similarly, those with family members who experience BPD are more likely to develop BPD as well. 

Historically, BPD has been difficult to treat. While medication may help, there is not a definite correlation created as of recent. However, current treatment which has been showing promise pertains to psychotherapy treatment such as dialectical behavior therapy (DBT), cognitive behavioral therapy (CBT), or group therapy. 

Individuals with BPD are more likely to partake in self-harm or suicidal tendencies than the average person. If you or someone you know is afflicted with BPD or similar thoughts/actions, please reach out for help. As always, no one is alone and there are resources available to you for support. 

Despite how you change, you will always be important and loved. 

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Advocating for ASD

By

Angelina Villalva, NAMI Intern

As humans, we have an innate drive for social connection with others. It is foundational to not just being emotionally stable, but as a basic need as essential as food and water. When that gets taken away, we tend to struggle quite a bit. 

At some point in your life, you probably have felt a moment of feeling ostracized. Left outside of the group. In other words, the odd-one-out. Can you remember what it felt like to be in that moment? For a lucky group, they’ve might’ve had the occasional buffer but for the most part live unafflicted from this fear. Unfortunately, the same can’t be said for adolescents and young adults who live with ASD. 

ASD stands for autism spectrum disorder. This is a neurological and developmental disorder that affects the way that people interact with others, communicate, learn, and behave. Due to this, people with ASD commonly experience feelings of social isolation and problems in forming relationships. 

The word spectrum in ASD refers to the wide range of symptoms and severity that can be present in various individuals. Some autistic people have intellectual disabilities, while others do not. Some require significant support in their daily lives while some need little to no support and can live independently. However, getting early treatment for ASD can make a big difference in how severe autism presents later in life. 

Signs of autism are usually seen around 2–3 years old. These can include(but are not limited to): 

  • Having poor eye contact and little to no expression on their face
  • Doesn’t speak, have delayed speech, or lose the ability to say words/sentences as they could before
  • Make the same movement over and over again (rocking, spinning, hand-flapping, etc.) 
  • Become withdrawn or aggressive
  • Doesn’t respond to their name 
  • Have unusual, stiff, or exaggerated body language
  • Sensitive to light, sound or touch but may not be affected by pain or temperature

Today, there is no single known cause of autism. A common misconception is that ASD is caused by vaccines, but this has been disproven as untrue. In fact, the original study in which this claim originated was retracted due to poor design and questionable research methods. Others suggest genetic and environmental factors have a correlation, but this does not apply for all ASD cases.  

As social beings, struggling to make connections can be very distressing and affect us in all parts of our life. For people living with autism, facing this struggle is part of their reality. It can feel overwhelming, and incredibly lonely at times. However, it is important to note that no one is ever alone. Not only are there resources available for those who struggle with autism, but also for those who live without it and can support those who do.

I highly encourage you to check out the resources below to find more information and support. 

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Attending to ADHD

By

Angelina Villalva, NAMI Intern

It’s 11:00 PM. There are 3 assignments that you have to turn in by 11:59 tonight, and another 2 due tomorrow. You already missed the previous assignments due this past week, but for some reason or another, you absolutely cannot bring yourself to start. You know you should, in fact you tried your best to. But you still can’t focus. Why? 

For many of us, forgetting deadlines and losing track of time is nothing new. It can be hard to juggle a busy schedule, balancing the time needed for chores, job responsibilities, upcoming appointments, and social relationships. However, if you find yourself with an excessive inability to stay organized and complete your assignments (whether schoolwork, chores, and/or job duties) it may indicate a sign of ADHD. 

ADHD stands for attention deficit/hyperactivity disorder. For those unfamiliar, ADHD is commonly characterized with symptoms of poor time management, difficulty in focus, trouble multitasking, and impulsivity. However, ADHD is much more complicated than that, presenting symptoms differently in not only genders, but also age groups.

Many children exhibit common issues with impulsivity and hyperactivity. But what separates that from ADHD lies in symptoms being noticeably greater than expected for their age or developmental level and then furthermore causing problems at home and school.

In adults, ADHD can present itself as low self-esteem, trouble coping with stress, avoiding mentally straining tasks, and having unstable mood swings. Furthermore, adults with undiagnosed ADHD may have relied on unsustainable coping mechanisms such as substance abuse or binge eating. 

Overall, ADHD is more commonly diagnosed among boys than girls. Boys tend to present symptoms that indicate hyperactivity and externalizing symptoms (such as fidgeting, impulsivity, and high energy) while girls tend to present inattentive symptoms (problems focusing, organizing, remembering tasks, etc.)

Unfortunately, there is no designated cause of ADHD. However, there are multiple suggested correlations between the likelihood of someone to develop ADHD if they have the following: 

  • Low birth weight
  • Premature birth
  • Exposure to toxins during pregnancy
  • A family member who also has ADHD

Currently, medication treatments and psychological counseling are available to help individuals who are impaired from severe ADHD. There are also several further coping strategies that former NAMI Intern, Matthew Michibata, highlights in his toolkit titled, “ADHD: A Guide for Adults.” (https://namimercer.org/wp-content/uploads/2023/08/ADHD-A-Guide-for-Adults.pdf)

Remember that you are more than your diagnosis, and to treat yourself kindly. As former President Theodore Roosevelt says, “Do what you can, with what you have, where you are.” 

Resources: 

  • Nami Mercer Helpline: 609-799-8994 x17
  • Attention Deficit Disorder Association (ADDA): https://add.org/
  • Fact sheets, infographics, and other resources about ADHD signs, symptoms, and treatment options posted by the CDC: https://www.cdc.gov/adhd/

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Addressing Anxiety

By

Angelina Villalva, NAMI Intern

It was difficult waving goodbye to all my hometown friends, knowing that it would be months before I saw any of their faces again. Months before I saw my family again. Months before I would be home. I was prepared for this, I knew this was the natural course of progression for every college student. Yet, at the same time, I felt a heavy pit settle in my stomach for the uncertainties I would have to face alone. 

While most college students are already accustomed to this familiar feeling, some are experiencing these changes for the first time. That is, of course, anxiety. Everyone feels anxious from time to time, whether that be for an upcoming exam, or forgetting to wake up on time for class. However, that is drastically different from having an anxiety disorder, which can present itself in numerous forms: social anxiety, generalized anxiety, separation anxiety, or panic disorder. 

According to the National Institute of Health (NIH), roughly a third of U.S. adolescents and adults will experience an anxiety disorder at some point in their lives. Compared to feelings of anxiousness, anxiety disorders are much more pervasive– causing intense, excessive, and persistent emotions of fear and worry that do not go away for long periods of time. 

It is important for those experiencing or undergoing anxiety disorders to reach out for support. Talking to friends, family, and especially healthcare professionals can begin to make headway into finding solutions. Aside from reach out for support, here are some other tips provided from Mayo Clinic towards coping with anxiety: 

  • Identify triggers – learn what causes or increases your anxiety 
  • Make sleep a priority – increased sleep has shown evidence of reduced stress
  • Use stress management and relaxation techniques 
  • Use the 3-3-3 rule – in event of a panic attack, identify three things you can see, three sounds you can hear, and three things you can move or touch

Remember that you are never alone, and it is okay to reach out for help. Anxiety can be overwhelming, but it doesn’t have to overpower your life. As author Dan Millman says, “You don’t have to control your thoughts; you just have to stop letting them control you.” 

If you’d like to read more details about anxiety specifically pertaining to college students, I highly suggest reading through the toolkit called, “Anxiety and the Roller Coaster of the College Experience,” created by NAMI Intern, Jacob Adam. (https://namimercer.org/wp-content/uploads/2024/07/Anxiety-in-College-Students-Toolkit-Jacob-A.pdf)

Resources: 

  • Nami Mercer Helpline: 609-799-8994 x17
  • Anxiety & Depression Association of America: adaa.org

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