NAMI Mercer County

Families Meeting the Challenge of Mental Illness

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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

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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! 

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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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