Coping 

Ways to try to overcome, minimize, or avoid mental health obstacles. Coping methods can range from healthy to unhealthy.

How we respond to difficult feelings, situations or obstacles in life influences the impact they have on our mental health, as well as the severity and duration of that impact. Coping refers to the ways in which we try to overcome, minimize, tolerate, or avoid that impact.

We all have different ways of coping with adversity. Even when our coping methods aren’t so healthy, they can leave us feeling better for a little while — which makes them easy to return to in the future. For example, some coping methods (like avoidance or substance use) may help us feel better or forget our challenges for a short time, but will actually worsen our mental health overall. Healthier coping methods (like exercise, meditation, journaling, or talking about our feelings) can help us lean into those feelings in order to move past them, learn from them, or accept them. Developing healthy, effective coping skills can protect our mental health and make us more resilient.

Culturally Competent Care

Mental health care that acknowledges and centers an individual’s cultural background and experiences.

Mental health is intertwined with all aspects of our lives — our background, values, beliefs, and communities — so it’s important that mental health professionals understand these dynamics in order to develop appropriate and effective support or treatment plans. This can include speaking a culture or community’s language, and understanding how experiences, specific types of trauma, norms, sexual orientation, or religious beliefs impact a person’s mental health. For example, while some religious ideology can be a barrier to help-seeking, a culturally competent treatment plan should support and work within those religious beliefs instead of competing with them. 

While the field has seen increased focus on culturally competent care over the last decade, many communities and groups are still underserved in the mental health care system. Media representation of people receiving culturally competent care can be a powerful force in encouraging viewers to seek help and normalizing mental healthcare as a profession for people of all backgrounds.  

Help-Seeking 

The act of reaching out to friends, family, or a professional for help with a mental health challenge. 

Help-seeking is the act of reaching out for help from friends, family, or a professional to improve our ability to cope with mental health challenges. People who are struggling with conditions like depression, or for whom talking about mental health is challenging, may have more difficulty speaking up or engaging in help-seeking behaviors, inadvertently depriving themselves of the support they need to feel better.

Higher-Risk Groups 

Groups that are more likely to experience mental health challenges because of unique stressors like discrimination. These groups may also be less likely to seek help because of cultural norms or systemic barriers.

Some groups are at higher risk for mental health challenges, including (but not limited to) LGBTQ+ individuals, cultural groups for whom help-seeking is looked down upon or not a norm, survivors of trauma like violence, abuse, assault, or suicide loss, and individuals with other disabilities. 

It’s important to note that this higher risk is not the result of someone’s sexual orientation, race, or ethnicity, but rather an outcome of the discrimination, prejudice, social stigma, ableism, racism, and barriers to accessing care that certain communities face. Understanding the needs of these groups can help us better represent them in entertainment media and break down barriers that may prevent people from taking action to support and improve their mental health.  

Mental Health 

Everything related to our feelings, thoughts, and behaviors — from serious emotional challenges to self-care practices and well-being. 

The term “mental health” is often used in relation to serious emotional challenges like trauma, depression, bipolar disorder, substance abuse, and suicide. In reality, mental health is a broad term that encompasses everything related to feelings, thoughts and behaviors: from everyday self-care practices and emotional wellness strategies, to how we cope with tough emotions like anxiety, to how we identify and treat conditions like eating disorders, depression and obsessive compulsive disorder (OCD). Mental health is also referred to as emotional health throughout this guide.

Mental Health Challenges 

Any situation, stressor, or condition that interferes with our ability to function or our overall quality of life.

Mental health is a continuum that ranges from the healthiest state (where we are feeling good, coping effectively, and thriving) to situations or conditions that, if left unaddressed, can put us at risk of harm or death. For the purposes of this guide, a mental health challenge refers to any situation, stressor or factor that interferes with our ability to get things done, maintain relationships, and have a good quality of life.  

Mental health challenges can include conditions like depression or anxiety disorders, difficult transitions like a breakup or job loss, or traumatic events like natural disasters or abuse. Sometimes people are able to navigate these challenges through emotional self-care and other coping skills. Other times they may require professional support.

Mental Health Conditions 

Medical conditions that are diagnosed when a person struggles with thoughts, feelings, or behaviors that meet a threshold of severity and duration of symptoms.  

Mental health conditions — sometimes referred to as mental illnesses or mental disorders — are defined by the severity and longevity of the negative feelings and behaviors, and are typically caused by an intersection of biological, social, and psychological factors.

Mental health conditions are covered under the Americans with Disabilities Act (ADA) of 1990, meaning people with these conditions are protected from discrimination under the law.

The important thing to remember, and a critical message to convey in entertainment media, is that mental health conditions are treatable and manageable. More information about specific mental health conditions and factors that increase our risks of experiencing these conditions can be found here.

Mental Health Factors 

The complex range of internal and external influences that impact an individual’s mental health at any given time. 

There are many factors that influence mental health, including genetics, childhood development, cultural perceptions of mental health conditions and help-seeking, access to self-care resources and professional support, exposure to trauma, or other challenging experiences, and risk factors such as substance misuse and sleep patterns. More details about these factors and where entertainment media can have a positive or negative impact can be found here. 

Mental Health Professionals 

Psychologists, psychiatrists, counselors, and other professionals who are trained to help patients improve their mental health and manage or overcome mental health challenges. 

Mental health professionals are trained to help patients improve their mental health, manage mental health conditions, or cope with difficult thoughts, feelings, behaviors, or situations.  

• Psychologists hold a doctoral degree in clinical psychology or a related specialty and can diagnose mental health conditions and provide psychotherapy.
• Psychiatrists hold a doctoral degree in clinical psychology or a related specialty and can diagnose mental health conditions and provide psychotherapy.
• Counselors, clinicians and therapists have master’s degrees and can evaluate a patient’s mental health and use therapeutic techniques to help address issues.
• Clinical social workers are trained to evaluate a person’s mental health and use therapeutic techniques based on specific training programs.
• Psychiatric nurses can provide assessment, diagnosis, and therapy for mental health conditions or substance use disorders, and can prescribe and monitor medications in some states.  

Negative Outcomes 

Harmful actions that can result from severe or unaddressed mental health challenges — including substance misuse, self-injury, and suicide.  

Mental health challenges often create some level of negative impact on people’s lives. These outcomes can include job loss, financial ramifications, and damage to relationships. The most severe negative outcomes of unaddressed emotional struggles or mental illness include substance misuse/overdose, dangerous behaviors, self-injury, and suicide. Depicting these negative outcomes can be triggering for viewers experiencing high levels of mental distress. More details about how to address negative outcomes in storytelling can be found here.  

Resilience 

An individual’s capacity to bounce back from challenging experiences.

Resilience refers to our ability to adapt or recover when faced with difficult situations. It‘s a muscle that people can build and strengthen in response to challenges, through actions like connecting with a support network, developing healthy coping skills, finding purpose, regular physical activity, and being helpful to others. Being resilient does not mean pushing through without acknowledging or dealing with difficult thoughts or feelings. In fact, a core component of resilience is speaking up when we’re struggling and seeking support when needed.

It is important to keep in mind that few of us actually feel resilient when we are living through challenging events or experiences. It is possible to develop resilience in areas that we perceive ourselves as not having resilience — in fact, this is a core part of healthy development and is a protective factor for a variety of negative life outcomes.

Self-Care 

Proactive steps that people take to improve and protect their mental health such as exercise, meditation, and journaling. 

There is a growing body of research that shows that everyday activities and practices such as exercise, meditation, yoga, journaling, maintaining friendships, and mindfulness can have a tremendous impact on our mental health and reduce stress, anxiety, and depression. People experiencing more serious emotional struggles or mental health conditions may also benefit from professional treatment like therapy or medication, but self-care is a recommended part of the treatment and recovery plan for people with mental health challenges at all levels of severity, supplementing professional treatment. It’s important to note that self-care as we talk about it in this guide is distinct from the “self-care industry” where the term is used to market consumer products. Most self-care practices are free and accessible to anyone.

While there is overlap in practices used for self-care and those used for coping, the main difference is that self-care is generally a proactive way to support our mental health, while coping skills usually relate to specific challenges we’re facing. For example, meditating each morning is a type of self-care, while stepping aside to do a short meditation after a difficult conversation at work or home would be considered a coping skill. 

Transitions 

Life changes that can impact mental health, like a breakup, job loss, or the death of a loved one. 

Change of any kind has the potential to be difficult, but some transitions — like a breakup, job loss, the death of a loved one, or a medical condition that impacts our routine and physical abilities — have a greater impact on our mental health than others. While these difficult transitions can impact people’s lives significantly, most of the time we are able to cope, adapt, and move past these challenging times.  

However, if someone living with a mental health condition is already struggling or has a lack of healthy coping strategies, a transition might put them at higher risk for distress or negative outcomes such as substance misuse, self-injury, or suicide. More details about how to address transitions and difficult experiences in storytelling can be found here.  

Trauma 

An intense emotional response to an overwhelming event like assault or natural disaster, or ongoing negative experiences like abuse or neglect.  

Trauma is an emotional response to experiencing or witnessing a terrifying, tragic, or overwhelming event. Trauma can also arise as a result of ongoing experiences, such as abuse or neglect. The signs of trauma don’t always show up immediately and can last for months or years. Examples of trauma include child abuse, domestic violence, rape, assault, natural disasters, violence, and accidents. 70% of Americans will experience a traumatic event at some point in their lives. More details about how to address trauma in storytelling can be found here.  

Treatment 

Methods of helping patients manage or overcome a range of mental health challenges, including psychotherapy, medication, inpatient treatment, and support groups.

The majority of mental health conditions are treatable, and mental health professionals can support people through a range of challenges including stress at school or work, relationship issues, difficult experiences, and trauma. Here are high-level explanations of common treatment approaches:

Psychotherapy is the process of talking to a mental health professional (psychologist, psychiatrist, or counselor therapist) to treat or cope with mental health challenges. These sessions usually focus on moods, feelings, thoughts, and behaviors. There are a few commonly used and referenced therapy approaches:

• Cognitive behavioral therapy (CBT) is a goal-oriented therapy that focuses on the link between our thoughts (cognition) and actions (behavior) to change thought patterns that cause negative thoughts or behaviors.
• Dialectical behavior therapy (DBT) is a form of CBT therapy that is focused on regulating intense emotions, handling stress in an effective manner, and improving interpersonal relationships.
• Exposure therapy is primarily used to treat anxiety, such as phobias or social anxiety, and involves exposing a patient to their anxiety source in a controlled environment to help them overcome the related anxiety or distress. 
• Eye movement desensitization and reprocessing (EMDR) is a structured therapy where a patient focuses on a traumatic memory while following visual cues to reduce the vividness and emotion associated with trauma or anxiety.

Medication is sometimes used to treat mental health conditions like depression, anxiety disorders, and bipolar disorder. Medication generally works best in conjunction with psychotherapy.   

Group support (or group therapy) is the process of speaking about emotional challenges with others who are struggling, under the direction of a mental health professional. It is sometimes used when addressing challenges and conditions like substance use disorder, eating disorders, self-injury, or distress related to experiences like sexual assault, violence, or the death of a loved one.   

Inpatient treatment/hospitalization involves admittance to a medical or mental health facility, which may be helpful for more serious conditions. This includes, as examples, bipolar disorder and schizophrenia, which may require monitoring of medication and treatment in a safe, controlled environment, as well as problems associated with dangerous behaviors like eating disorders and self-injury, substance use disorder, or treatment after a suicide attempt or overdose.

Electroconvulsive therapy (ECT) is a psychiatric treatment in which seizures in the brain are electrically induced in patients to provide relief from mental health conditions.