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Beneath The Folded Hands

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In shared rituals of prayer and reflection, religious communities often foster a deep sense of connection. For many, these spaces serve as a refuge—a place to belong, to believe, and to find support during times of hardship. Yet beneath this sense of sanctuary, complex psychological effects often go unspoken.

Religious communities often fulfill essential psychological needs: structure, purpose, and identity. In the best of circumstances, faith-based belonging can act as a buffer against anxiety, depression, and loneliness. Studies have shown that people who are active in religious communities often report higher levels of well-being and lower rates of substance use and suicidal ideation. For individuals grappling with grief, trauma, or existential doubt, spiritual rituals and belief systems can offer grounding—a symbolic language to make sense of suffering.

But this psychological support comes with nuance.

While faith can soothe, it can also silence. In many religious spaces, suffering is spiritualized: sadness is seen as a lapse in faith, anxiety as a lack of trust in a higher power. This creates a culture where individuals may feel pressure to “pray it away” instead of seeking professional mental health care. The result? Silent suffering beneath the surface. Congregants learn to mask panic with piety and to suppress anger with grace.

This dynamic is especially harmful for those experiencing mood disorders, PTSD, or gender and sexuality struggles that clash with traditional doctrine. When mental health is treated as a moral or spiritual failing, rather than a clinical reality, shame festers.

Religious communities are not monoliths. Some nurture resilience through communal care, mutual aid, and faith-led therapy initiatives. Others, however, perpetuate cycles of guilt, spiritual bypassing, or even emotional abuse under the guise of discipline or “God’s will.” For individuals raised in rigid or fundamentalist environments, this can leave lasting trauma, including religious OCD, identity confusion, and chronic fear of punishment or abandonment.

Healing begins when we acknowledge both sides: the warmth and the wounds. Religion is not inherently a psychological cure or curse—it is a powerful force that shapes minds, behaviors, and emotions. When religious communities are trauma-informed, inclusive, and mental-health literate, they have the capacity to transform lives. But when mental health is ignored or stigmatized in favor of spiritual performance, the fold of the hands becomes a fold of silence.

To create truly sacred spaces, we must ask deeper questions beneath the rituals. We must listen to the quiet confessions that never make it into the sermon—the ones whispered in therapy rooms, or sobbed into pillows after church.
Because beneath the folded hands is not just prayer, but a person—aching to be understood.

Book of the Week: The Monk by Sinclair Lewis (Check Trigger Warnings)

Shocking, erotic and violent, The Monk is the story of Ambrosio, torn between his spiritual vows and the temptations of physical pleasure. His internal battle leads to acts of sexual obsession, murder, and yet this book also contains knowing parody of its own excesses as well as social comedy. Written by Matthew Lewis when he was only nineteen, it was a ground-breaking novel in the Gothic Horror genre and spawned hundreds of imitators, drawn in by its mixture of bloodshed, sex and scandal.

Resources

  • NAMI Mercer Helpline Phone Number: 609-799-8994 x17
  • NAMI Mercer Helpline Email: helpline@namimercer.org
  • https://mentalhealthgracealliance.org/

References 

  • Zarah, Fatimah. “The Stigma Attached to Mental Health in Religious Communities.” The Seattle Collegian, 25 Jan. 2023, seattlecollegian.com/the-stigma-attached-to-mental-health-in-religious-communities/.
  • Boateng, Augustine, et al. “Religiosity & Mental Health Seeking Behaviors among U.S. Adults.” The International Journal of Psychiatry in Medicine, vol. 59, no. 2, 30 June 2023, https://doi.org/10.1177/00912174231187841.
  • Nicolini H, Salin-Pascual R, Cabrera B, Lanzagorta N. Influence of Culture in Obsessive-compulsive Disorder and Its Treatment. Curr Psychiatry Rev. 2017 Dec;13(4):285-292. doi: 10.2174/2211556007666180115105935. PMID: 29657563; PMCID: PMC5872369.

Grappling Gambling

By

Angelina Villalva, NAMI Intern

What comes to mind when I mention gambling? Is it the slot machines? Perhaps poker or blackjack? Maybe certain locations are pictured, like Atlantic City. Some people may think of mobile betting platforms like FanDuel Sportsbook or DraftKings. For others, gambling might bring to mind gacha games, such as Genshin Impact or PokĂ©mon Trading Card Game Pocket. 

The point is, gambling can take multiple forms and appears more frequently in our lives than we may initially realize. In a traditional sense, gambling can be seen as a rite of passage, with friends and family taking trips to casinos for birthdays, vacations, or other various celebrations. Gambling appears in our sports, with fans oftentimes betting on their favorite teams or creating fantasy leagues to earn money from their favorite players. It also appears in video games, allowing players to spend just a little more money to earn a better item or character. 

This large presence and availability is then in turn why gambling addiction is so hard to recover from. With so much exposure to gambling and having these mechanisms easily available to us both in-person and virtually, it can be quite easy to relapse and fall back into bad habits. 

So what exactly is gambling addiction, and how does it begin? As defined by MayoClinic, gambling addiction is the uncontrollable urge to keep gambling despite the toll it takes on your life. Similarly to drug or alcohol addictions, partaking in gambling stimulates the brain’s reward system. Overtime, overconsumption (and additionally overstimulation of this reward system) can alter how we perceive pleasure from activities, therefore causing a positive feedback loop of needing to do more and more to achieve the same high.  

Compared to casual gamblers who are able to stop when losing or be able to set limits on how much they’re willing to bet, people suffering from compulsive gambling have problems controlling their impulse to gamble, even when there are negative consequences. There are several risk factors that can contribute to individuals developing a gambling disorder, such as trauma, social inequality, low income, unemployment, poverty, and other unaddressed mental health disorders (particularly bipolar disorder or ADHD). 

According to the American Psychiatric Association (APA), to obtain a diagnosis of gambling disorder, a person must exhibit 4 of the following during the past year: 

  • Reliving past gambling or planning future gambles
  • Need to gamble with increasing amounts to achieve the desired excitement
  • Repeated unsuccessful efforts to control, cut back on, or stop gambling
  • Restlessness or irritability when trying to cut down or stop gambling
  • Gambling when trying to escape from problems or negative mood/stress
  • After losing an item or money by gambling, feeling the need to continue to get even (referred to as “chasing” one’s losses) 
  • Often gambling when feeling distressed
  • Lying to hide the extent of gambling involvement
  • Losing important opportunities such as a job or school achievements or close relationships due to gambling
  • Relying on others to help with money problems caused by gambling

Only 1 in 10 people with gambling disorders seek treatment. Compared to other substance use or addictive disorders, gambling has shown to carry the highest risk of suicide. Roughly 1 in 2 gamblers will think about suicide, while 1 in 5 will attempt. It is imperative for individuals suffering from gambling disorders to receive proper care and support. 

Depending on how gambling disorder affects the individual will influence what their recovery path will look like. For individuals who suffer from other untreated mental health disorders, medication and therapy may be used to treat those symptoms and diagnoses. In other cases, the main form of treatment may lie in therapy and support groups, with further counseling pertaining to other aspects of the individual’s problems (such as marriage, career, or credit counseling). 

You are more capable than you believe, and you are more loved than you know. Remember to rely on the people around you, and to find the support you deserve. It is hard to begin recovery, but it is harder to have addiction rule your life. As novelist Charlotte BrontĂ« has once said, “I avoid looking forward or backward, and try to keep looking upward.” 

Resources:

  • NAMI Mercer Helpline Phone Number: 609-799-8994 x17
  • Suicide and Crisis Lifeline: Text or call 988
  • National Suicide Prevention Lifeline: Call 1-800-273-8255
  • National Problem Gambling Helpline: 1-800-522-4700

Citations: 

The Body Remembers the Break

By

Bella Santulli, NAMI Intern 

When mental health declines, the body responds as well. We often think of psychological issues as separate from physical ones, assuming that emotions only exist in our minds. However, stress, anxiety, and depression do not stay confined to our thoughts. They travel through our nerves, settle into our muscles, and resonate within our organs. These emotions can impact our bodies—bending our backs, twisting our guts, compressing our lungs, and weighing down our chests. Our bodies remember the pain long after our minds have tried to forget it.

One of the most compelling examples of the mind-body connection is Broken Heart Syndrome, also known as Takotsubo Cardiomyopathy. This condition is named after the shape of a traditional Japanese octopus trap, owing to the ballooning of the heart’s left ventricle. It typically occurs after intense emotional stress, such as the loss of a loved one, betrayal, or severe anxiety. The symptoms closely resemble those of a heart attack, including chest pain, shortness of breath, and even heart failure. However, there is no blockage in the arteries. Instead, it is the body’s intense emotional response—often triggered by a surge of stress hormones—that causes the heart to temporarily malfunction.This syndrome serves as a powerful reminder that we do not just experience heartbreak in a metaphorical sense; we feel it physically. Our bodies, with all their wisdom and vulnerability, absorb emotional trauma and manifest it through physical crises.

We say we have a “gut feeling,” but anxiety often turns that sensation into a storm. The enteric nervous system, frequently referred to as the body’s “second brain,” lives in our gastrointestinal tract.

It’s why anxiety so often shows up as

  • Nausea
  • Cramping
  • Bloating
  • Irritable bowels


When we’re stressed, the body diverts blood away from the digestive system to prepare for a fight-or-flight response. The stomach tightens, digestion slows or halts, and suddenly, your mental unrest is causing real gastrointestinal distress. Furthermore, chronic anxiety can lead to IBS (Irritable Bowel Syndrome), appetite changes, and long-term nutritional deficiencies. It’s not “all in your head”—it extends into our microbiome, motility, and hormonal balance.

For instance, our gut hosts trillions of microorganisms that play a critical role in digestion and overall health. Stress can alter the composition of these microbiota, further exacerbating digestive issues. Thus, understanding the interplay between our emotions and gastrointestinal health serves as a reminder: caring for our mental well-being can have profound effects on our physical health. This emphasizes the importance of a holistic approach to wellness—one that considers both mind and body. Engaging in practices that reduce anxiety, such as mindfulness, yoga, or making informed dietary choices, can significantly impact our digestive health and overall quality of life. Ultimately, addressing anxiety is not just about feeling better mentally; it is also about fostering a healthy and functioning body.

Depression often feels like a heavy weight pressing down on the chest—something you simply can’t lift. This isn’t just metaphorical language; it’s a common physical symptom of major depressive disorder. People experiencing depression frequently report sensations such as tightness in the chest, shortness of breath, fatigue, and a slowed heart rate. These symptoms can sometimes be mistaken for heart issues, but they often stem from the body internalizing emotional pain. Low levels of serotonin and norepinephrine—key neurotransmitters that influence mood—also impact pain perception and muscle function. Depression can cause real physical pain, not just emotional distress. It slows the body down, leads to inflammation, and amplifies feelings of aches and fatigue. The tightness you feel in your chest when trying to get out of bed isn’t always due to laziness or illness; it can be a manifestation of grief, loneliness, or hopelessness turned into physical sensations.

Mental health struggles don’t stop at the chest or gut. Stress and trauma live in the body in numerous ways:

  • Chronic tension headaches from overactive stress responses.
  • Jaw clenching and TMJ linked to anxiety and suppressed emotions.
  • Skin breakouts or hives, as cortisol and histamines wreak havoc under pressure.
  • Fatigue, fibromyalgia, and body aches, often linked with prolonged trauma and depressive episodes.

Even posture can change—shoulders curve inward, backs hunch, breathing shallows. The body begins to shape itself around emotional pain.

If trauma and mental illness can live in the body, then so must healing. That’s why somatic therapy, yoga, massage, and even deep breathing can offer profound relief—not just to muscles, but to memories. Mental health treatment doesn’t only belong in the therapist’s chair. It belongs in how we treat our bodies—with rest, movement, nourishment, and compassion.

The body remembers the break. But it can also remember how it healed.

Book of the Week: An Apprenticeship or The Book of Pleasures by Clarice Lispector

An Apprenticeship or The Book of Pleasures is a meditative novel by Clarice Lispector that follows a quiet schoolteacher named LĂłri as she navigates the complexities of love, solitude, and self-discovery in her evolving relationship with a philosophy professor named Ulisses. In Lispector’s lyrical prose, LĂłri undergoes a quiet, inward transformation—one that blurs the boundaries between emotional and physical being. Just as this week’s blog post explores how mental wounds manifest somatically—heartache tightening the chest, anxiety churning the stomach—Lispector’s novel traces how love, loneliness, and longing settle into the body like memory. LĂłri’s journey toward self-love and connection is not only psychological but physiological, emphasizing how the act of feeling deeply, even when painful, is a form of embodiment.

Resources
-NAMI Mercer Helpline Phone Number: 609-799-8994 x17
-NAMI Mercer Helpline Email: helpline@namimercer.org

References

  • Michel, Klaus, et al. “How Big Is the Little Brain in the Gut? Neuronal Numbers in the Enteric Nervous System of Mice, Guinea Pig, and Human.” Neurogastroenterology and Motility, vol. 34, no. 12, 5 Aug. 2022, https://doi.org/10.1111/nmo.14440.
  • Marks DM, Shah MJ, Patkar AA, Masand PS, Park GY, Pae CU. Serotonin-norepinephrine reuptake inhibitors for pain control: premise and promise. Curr Neuropharmacol. 2009 Dec;7(4):331-6. doi: 10.2174/157015909790031201. PMID: 20514212; PMCID: PMC2811866.
  • “Neurotransmitters.” Cleveland Clinic, 14 Mar. 2022, my.clevelandclinic.org/health/articles/22513-neurotransmitters.
  • ‌“Jonathan Abramowitz | University of North Carolina | Anxiety Disorders.” Unc.edu, 2024, jonabram.web.unc.edu.

Feeding Frenzies

By

Angelina Villalva, NAMI Intern

In a world run on social media, it’s no surprise that we are all familiar with the issue of unattainable expectations. It’s easy to compare our lives to the bright perfect faces we see on our screens, promoting workout routines, diet plans, a lifestyle coaching class, or a simple tip book on how to live our lives just as amazing as them. 

When we constantly are put in a state of comparison between us and the (seemingly) best of the best, it’s easy to fall into a pit of insecurity and obsession with perfectionism. This can result in a multitude of mental health issues, especially eating disorders (ED). If you aren’t already caught up on what an eating disorder is or the types of eating disorders that exist, you can read up all about it in Bella Santulli’s blog post, Dorian Gray’s Mirror. 

Although eating disorders are, unfortunately, very common amongst adolescents and teenagers, something that is less commonly known is the subclass of eating disorders known as feeding disorders (FD). These are generally less talked about and less known, but are relatively common, with 1 in 4 children reported to have an FD and as many as 8 of every 10 disabled children having an FD. 

So to begin, what exactly is the difference between an eating disorder and a feeding disorder? There is a small difference in the association of age between the two, with EDs commonly linked to teens and adults while FDs are linked to infants and children (although both can occur at any age). However, the main difference between an ED and an FD lies in its psychology. 

To elaborate, eating disorders stem from issues of body dysmorphia. Behaviors such as self-induced vomiting or laxative abuse are in place as a coping mechanism gone wrong for the main issue, which lies in perception. Meanwhile, feeding disorders do not have this same issue. Feeding disorders are the direct result of food preferences and/or perceived intolerances of the actual food itself, not the effects on the body or bodily image. 

Feeding disorders are especially dangerous for children and infants. An FD may result in a child completely avoiding entire food groups, textures, or liquids necessary to develop properly which can lead to an increased risk for compromised physical and cognitive development. 

Some common causes of FDs are: 

  • Medical conditions (e.g., food allergies) 
  • Anatomical or structural abnormalities (e.g., cleft palate, gastrointestinal motility disorder, oral motor dysfunction) 
  • Reinforcement of inappropriate behavior
  • Behavior management disorders
  • Delayed exposure to a variety of foods
  • Parent-child conflict

The two most well-known types of feeding disorders are Pica and Rumination Syndrome. 

Pica disorder is when an individual compulsively eats things that aren’t food (or have any nutritional value) on purpose. This may not always be harmful depending on the substance, but can prove to be dangerous should the ingested thing be toxic or cause further health issues (such as teeth damage). Pica often affects young children under 6, pregnant women, or people with mental health conditions such as ASD or schizophrenia. Some common non-food items eaten include: 

  • Chalk
  • Charcoal
  • Clay, dirt, or soil
  • Eggshells
  • Hair, string, thread
  • Ice
  • Paint chips
  • Paper
  • Pebbles
  • Pet food
  • Soap 

Pica in pregnant women will usually go away on its own. Children will also usually grow out of pica, but it may be harder to do so for children with intellectual disabilities. The main form of treatment for those struggling is therapy, with medications typically focused for health related issues that have occurred from pica. 

Rumination syndrome is when an individual repeatedly regurgitates undigested or partially digested food. That regurgitated food is then chewed again and swallowed or spit out. People with rumination syndrome don’t purposely try to regurgitate their food, it happens without any effort and typically occurs at every meal. Rumination syndrome can lead to malnutrition, worn out teeth, bad breath, and social isolation. Similar to pica, rumination syndrome is most commonly treated by therapy. 

People who suffer from feeding disorders commonly experience feelings of shame and embarrassment. This can cause individuals to feel isolated and prevent them from getting the support that they need. Should you or anyone you know have similar signs and symptoms of feeding disorders, remember to treat it with grace. As always, stay kind, and remember you are loved and will be supported! 

Resources:

Citations: 

Dorian Gray’s Mirror

By

Bella Santulli, NAMI Intern

Beauty is both currency and a curse. In association with society’s strive for vanity and indulging a life of hedonism, our reflections have become a worship for image, and not a person. Collectively, we forget that flesh was never meant to be flawless, but lived in. And in this forgetting, we starve ourselves of freedom and compassion, all in a pursuit of a standard that was never real to begin with. 

This is where eating disorders place their foundations: the fracture between personal identity and societal pressures. Although according to Mayo Clinic there is not a known set of causes, there are several risk factors, including biology/genetics, bullying, trauma/mental health issues, stress, and frequent dieting. Additionally, there is a spectrum of eating disorders– although anorexia nervosa, bulimia nervosa, and binge eating are the most common, there are approximately eight disorders recognized by the DSM-5. 

  1. Anorexia nervosa → Characterized by restriction of food intake leading to low body weight, typically accompanied by intense fear of gaining weight and disturbed perception of body weight and image.
  2. Bulimia nervosa → Binge eating is followed by compensatory behavior to prevent weight gain like forced vomiting, laxatives/diuretics usage, restricted eating, or excessive exercise.
  3. Binge eating disorder → Chronic, compulsive overeating. Eating large quantities of food in a short period, accompanied by loss of control during binge-eating behavior.
  4. Avoidant or restrictive food intake disorder (ARFID)→ A significant limitation in the amount and/or types of food a person is willing or able to eat. This differs from other eating disorders, such as anorexia nervosa or bulimia nervosa, because the food restriction is not driven by concerns about body weight or shape.
  5. Pica → One of the eating disorders in which an individual craves non-food items like soil, chalk, soap, paper, ice, or hair.
  6. Rumination → A new addition to the eating disorder in which an individual regurgitates the previously swallowed food, chews it again, and then swallows or spits.
  7. Other specified feeding and eating disorders:
    1. Purging disorder → Characterized by purging behaviors like vomiting, excessive exercising, using laxatives or diuretics to control weight.
    2. Night eating syndrome → Characterized by overeating, often after awakening from sleep. It has a strong association with sleep disturbance.
    3. Atypical anorexia nervosa → Has similar features to anorexia nervosa except for BMI in the ‘adequate’ range of 20–25 kg/m2 or higher. Management is similar to anorexia nervosa.
    4. Subthreshold bulimia nervosa and binge eating disorder → Do not meet the ideal definition criteria of bulimia nervosa and binge eating disorder. 
    5. Orthorexia → An obsessive focus on healthy eating. Individuals with orthorexia may eliminate entire food groups, fearing they are unhealthy.
  8. Unspecified feeding and eating disorders → Experiences symptoms which are characteristic of a feeding and eating disorder, causing significant distress or impairment in social, occupational or other important areas of functioning.

Generally, Eating Disorders are behavioral conditions marked by disturbances in a person’s relationship to eating, food, and/or their body that affect at least 9% of the population worldwide. These conditions can impact physical, psychological, and social function in varied and severe ways. Among the deadliest of mental illnesses, eating disorders are responsible for over 10,000 deaths each year, but in the vast majority of cases, full remission is completely possible with early intervention. 

In this new age of digital media, we see the monumental impact it has on people, specifically the immense pressure to conform to narrow beauty standards. This pursuit of achieving thinness enhances shame in others everywhere, creating an unsafe space for millions. Although there are benefits to this online presence, hence recovering communities, it is overrun with triggering and deteriorating videos, with many slipping back into the horrors of this mental challenge.

  • Monetized Insecurities: The weight-loss industry, worth billions of dollars, banks on the premise that bodies need to be “fixed.” Countless products—from detox teas to appetite-suppressant lollipops—reinforce the message that weight loss is the ultimate key to health and happiness.
  • Language Around Food: Everyday terms like “clean eating” or “cheat meals” moralize our choices. This mindset can trigger guilt or anxiety when people deviate from rigid “rules.”
  • Underrepresented Body Types: In mainstream media, bodies that deviate from the thin or toned archetype are underrepresented or depicted only in “before” pictures. As a result, many people rarely see images of body diversity in positive, empowering contexts.

Early detection and intervention can mitigate these harmful cycles. Therapies focusing on body acceptance—such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), or body image–specific interventions—are critical for challenging negative thoughts and improving self-worth.

Additionally, the National Alliance for Eating Disorders is a great resource when struggling, as they have helplines, can connect you to therapists, and provide more resources on the road to recovery. For more information, I would recommend reading the toolkit by a fellow NAMI Intern, A Parent’s Guide to Eating Disorders, to help navigate supporting someone with an eating disorder. Furthermore, the National Alliance for Eating Disorders gives helpful advice and steps to take to move towards a healthy body image:

  • Curate Your Social Media Feed: Unfollow accounts that trigger harmful comparisons or promote restrictive behaviors. Instead, seek out body-positive creators or mental health advocates who remind you that all bodies are worthy.
  • Expand Your Media Exposure: Seek body-diverse TV shows, magazines, or campaigns that celebrate diverse body types, ages, and cultural backgrounds. Representation can ease the sense of isolation.
  • Practice Self-Compassion: Tools such as mindfulness, journaling, or guided meditations can help counteract negative self-talk. Feeling guilty about what you ate, or how your body looks, can be met with gentler internal language: “It’s okay to be learning. My body deserves kindness.”
  • Avoid “Diet” Language: If “diet talk” pervades your social circles or family gatherings, politely redirect the conversation. Normalizing a wide range of eating behaviors helps everyone reevaluate harmful norms.
  • Celebrate Function Over Form: Focus on what your body can do—dance, hug loved ones, enjoy nature—instead of how it appears to others. Physical activity can also be reframed as a way to reduce stress or increase energy, not just alter appearance.
  • Seek Professional Guidance: Therapists, dietitians, and support groups can help unravel deep-seated beliefs about body image. Early intervention is proven to reduce risk of severe eating disorder behaviors.

Book of the Week: The Picture of Dorian Gray by Oscar Wilde

Dorian Gray, enthralled by an exquisite painting of himself, soon realizes he will not be young and beautiful forever. His new friend, Lord Henry Lotton, reminds him that there will be a day when he accumulates wrinkles and turns sour. Outraged at this idea, he makes a deal and exchanges his soul for immortal beauty, but there is a price. The painting will become a reflection of his sins and the deterioration of his age. In the eyes of society, he is a beautiful, polite gentleman, but in secret, he indulges in his corrupt desires and in the process, corrupts his soul. 

For I am nothing if not beautiful. 

A Verse in Motion

But with every pulse of my pupil,
I see an agonizing reflection,
a reflection I wish to fully love.

I yearn for a kiss that wakes me,
but am left with the apple’s rotten taste—
clinging to the first sweetness.

Before hunger became obsession.
Before the mirror whispered back—
that beauty is measured in empty spaces.

Somewhere, in the depths of this glass,
a portrait rots where I cannot see it.
Each moment of indulgence is carved into my skin.
Marks that only once will never be satisfactory.

The gods ignored my prayer,
in a victory more agonizing than defeat.

I was given no such bargain to trade my soul for youth—
only a body I cannot return,
a face I must wear,
even when I no longer recognize it.

Resources
-NAMI Mercer Helpline Phone Number: 609-799-8994 x17
-NAMI Mercer Helpline Email: helpline@namimercer.org
-https://www.allianceforeatingdisorders.com/

References

-“12 Different Types of Eating Disorders | DSM-5 & Related.” Withinhealth.com, 2023, withinhealth.com/learn/articles/types-of-eating-disorders#types-of-eating-disorders-in-the-dsm-5. Accessed 18 June 2025.
-Mayo Clinic Staff. “Eating Disorders.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 28 Mar. 2023, www.mayoclinic.org/diseases-conditions/eating-disorders/symptoms-causes/syc-20353603.
-jkandel@allianceforeatingdisorders.com. “Body Image & Society: How External Pressures Fuel Internal Struggles – National Alliance for Eating Disorders.” National Alliance for Eating Disorders, 12 June 2025, www.allianceforeatingdisorders.com/body-image-and-society/. Accessed 18 June 2025.
-Balasundaram, Palanikumar, and Prathipa Santhanam. “Eating Disorders.” National Library of Medicine, StatPearls Publishing, 2023, www.ncbi.nlm.nih.gov/books/NBK567717/.

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

Resources:

Citations: