Editor: Denise Nelson
As the nights turned cold and the Autumn winds blew dirt and leaves into my pool, I realized that summer is over and the holiday season is upon us. I hope all of you had a great Thanksgiving. We had face time and telephone calls with family to connect and celebrate. 
Many of NAMI Tulare County’s programs have been curtailed because of COVID-19. However, our office has remained open to handle incoming phone calls and inquiries. Our board members continue to give support to individuals and families affected by mental illness via email and phone calls. Regretfully, our annual Holiday Gift Sack Event, for individuals with mental illness in group homes, will not be possible in December. We are hoping, by spring, the health threats will have improved, and we will be able to make visits to the homes.
Wishing all of you a festive holiday season and a safe and healthy new year.
Ralph E Nelson Jr MD
President, NAMI Tulare County
Our next NAMI Family Support Group is this evening, December 3rd, at 5:30pm, at the Porterville Wellness Center. Please bring a mask. The support group is free, and walk-ins are welcomed.
NAMI Basics is a 6-session education program for parents, caregivers, and other family who provide care for youth (ages 22 and younger) who are experiencing mental health symptoms. This program is free to participants and is online through NAMI Basics OnDemand.

The NAMI Basics OnDemand program is guided by parents and family members with lived experience. It is self-paced and available 24/7, which offers the flexibility of participating in the course on your own schedule.

What You Will Gain
By participating in NAMI Basics, you will realize that you are not alone. You will find the support and shared understanding compassion, reinforcement, and empathy from people who truly get your situation. Through this program, you will learn that recovery is a journey, and there is hope.
Technical Assistance
Have you checked out any of the apps that are related to mental health?
Mobile software applications, or apps, are programs to use on mobile devices like smart phones, tablets, and laptops. Apps that address mental health issues have exploded in popularity in the last few years, offering help with diagnosis, symptom assessment, tracking behavior, and well-being exercises.
Whether you want to learn how to do mindful breathing, monitor your mood, or get guidance in reframing negative thought patterns, you can find worthwhile apps that are available for free (as well as other options that require purchase.)
Carefully chosen mental health apps can be helpful in tandem with your psychotherapy --- and they can be enormously valuable for people who cannot find or afford mental health care. 
One caveat: It’s important to remember that use of a mental health app should never take the place of professional mental health care if you’re experiencing significant symptoms of depression or anxiety.
There are a number of factors to weigh when choosing a mental health app. First, it’s a good idea to read reviews and ratings from previous customers. You should also consider the following:
Ease of Use: How simple will this app be to use to your daily life? Can you navigate its directions without too much effort?  Are techniques or tips easy to understand and follow?
Effectiveness: Does the app have measurement tools? If so, what issues are monitored? How well does the app track your symptoms?

Personalization: Does the app address your unique needs? If so, how well can the app be personalized for you?

Feedback: What kind of feedback does the app offer? If so, how well can the app offer? Do you find your interactions with the app helpful?

Validity: What evidence-based research is behind this app? Are there any clinical studies demonstrating its effectiveness?
Security: What kind of data security does this app use? Will your personal information be kept confidential and private? Will the data collected by the app be sold to marketers or other companies?
What about teletherapy?
Telemedicine, telehealth, telepractice, telepsychology, teletherapy…these interchangeable terms can be confusing, but they all refer to the same thing: delivering medical or behavioral health care in a virtual space while practitioner and patient are physically in different places. 
Teletherapy (not to be confused with the radiation cancer treatment of the same name) can be a convenient way to get mental health treatment without having to leave the house-especially of there aren’t many practitioners available where you live. 
However, teletherapy is not recommended for moderate to severe depression, nor is it appropriate for crisis care. A few things to keep in mind:
Location: Treatment guidelines direct that you work with a therapist who lives in the same state as you. This relates to insurance, licensure and malpractice requirements. So, if you live in California, you can’t work with a therapist in New Jersey via teletherapy. It has to be with a therapist in California.
Platforms: Protecting your privacy online is very important. Is the teletherapist using a service that is HIPAA-compliant? Skype and Facetime are not HIPPA-compliant for teletherapy, so your sessions would not be confidential.
Process: Understand that teletherapy will be a different experience than in person psychotherapy. 
Because you’re communicating through a computer screen, your therapist may miss subtle verbal and nonverbal cues that are more easily sensed when face-to-face. Also, the audio or visual feed can fall out of synch, or the connection may disconnect due to WiFi issues, which can be frustrating and impede your progress.”


Deborah Serani, PsyD, Esperanza, Fall, 2017.
Deborah Serani, PsyD, is a licensed psychologist in private practice, a faculty member of Adelphi University, and the author of Living with Depression, Depression and Your Child, and Depression in Later Life: An Essential Guide. She also manages her own depression, which was diagnosed in 1980.
“This (Twitter) thread will teach you a lot about the defense mechanism, of projection, but zero about the real mental illness that is depression.”

           J.K. Rowling, creator of Harry Potter, responding to British kickboxing champion Andrew Tate’s tweet that stated, “Depression isn’t real. You feel sad, you move on.”   
Feeling Sad, Lonely
Short nature intervention can bring out the best in people
Is it any wonder that most happiness idioms are associated with nature? Happy as a pig in muck, happy as a clam, happy camper.
A UBC researcher says there’s truth to the idea that spending time outdoors is a direct line to happiness. In fact, Holli-Anne Passmore says if people simply take time to notice the nature around them, it will increase their general happiness and well-being.
Passmore, a PhD psychology student at UBC’s Okanagan campus, recently published research examining the connection between taking a moment to look at something from the natural environment and personal well-being. A recent study involved a two-week ‘intervention’ where participants were asked to document how nature they encountered in their daily routine made them feel. They took a photo of the item that caught their attention and jotted down a short note about their feelings in response to it.
Other participants tracked their reactions to human-made objects, took a photo and jotted down their feelings, while a third group did neither. Passmore explains that examples of nature could be anything not human-built: a houseplant, a dandelion growing in a crack in a sidewalk, birds, or sun through a window.
“This wasn’t about spending hours outdoors or going for long walks in the wilderness,” Passmore says. “This is about the tree at a bus stop in the middle of a city and the positive effect that one tree can have on people.”

Passmore, who studies wellness, says she was ‘overwhelmed’ not only by the response of her 395 study participants—more than 2,500 photos and descriptions of emotions were submitted—but also by the impact that simply noticing emotional responses to nearby nature had on personal well-being. And their prosocial orientation—a willingness to share resources and the value they placed on community.
There is scientific documentation that people who live in greenspaces generally seem to be happier, and may live longer than those who don’t. Passmore is taking that research further. This study is one of a series by a research team in UBC Okanagan’s psychology department known as the “Happy Team” which is providing evidence that nature can increase happiness.
“The difference in participants’ well-being—their happiness, sense of elevation, and their level of connectedness to other people, not just nature—was significantly higher than participants in the group noticing how human-built objects made them feel and the control group.”
Passmore’s research, recently published in the Journal of Positive Psychology, is supported by the Social Sciences and Humanities Research Council of Canada.


Good Book Newsletter, U.C. Berkley
A Beginner’s Guide to Wellness Rituals
A wide range of practices can be developed into wellness rituals. Finding the right one for you depends on our interest and values, as well as what helps you unwind and feel at peace, says therapist Sheri Van Dijk. Her advice:
Start With Sleep: Getting quality sleep is a cornerstone for maintaining or regaining wellness. First off, set your alarm for the same time every morning — and heck, set one for a regular bedtime, too. Next, think about what would help you transition to a more sleep-ready state of mind.
Some ideas: Lower the lighting, sit in silence and drink a soothing cup of chamomile tea. Take a bath scented with calming essential oils such as lavender or ylang-ylang. Do a series of resting yoga poses or follow a guided meditation.
The last thing you want to do in the hour or so before bed is stare at a computer, tablet or smartphone. Their screens emit a blue light that interferes with the hormones that dictate the body’s natural side toward rest.
Pick and Choose: In the long term, you won’t stick with something if you don’t feel some sense of reward when you do it.

You are a reader by nature? Create a book nook in your home — as simple as a comfortable armchair with a suitable lamp — and gift yourself with regular reading retreats. Does time outdoors recharge you? Approach your outings as abbreviated spiritual retreats. The intention you bring to everyday activities is what transforms them into wellness rituals.

Repeat Yourself: Engaging in a wellness ritual at the same time every day or every week adds value, the same as eating meals and exercising at consistent times. Van Djilas points out that the more regularity you build into your life, the more you help your “body clock” to sync properly — which both research and clinical experience has shown to buffer against mood shifts. “The human mind and body typically functions best with routine and structure.” She says.
So, if you attend religious services, make it a point to stay in the sanctuary afterward for a period of reflection.

If you work from home, set yourself a rock-solid starting time and spend the first few minutes doing breathing exercises before diving in. Even brushing your teeth can become a wellness ritual if you remind yourself to be completely present in the moment while you clean those pearly whites.  

Christine Yum, Bp, Fall, 2018. Christine Yum is a freelance writer covering health, fitness, food, and parenting. She has written for the Washington Post, Runner’s World, and other publications.
Holidays can be Difficult for Caregivers
To be able to care for the people you love, you must first take care of yourself. It is like the advice we’re given on airplanes: put on your own oxygen mask before trying to help someone else with theirs. Taking care of yourself is a valid goal on its own, and it helps you support the people you love.
Caregivers who pay attention to their own physical and emotional health are better able to handle the challenges of supporting someone with mental illness. They adapt to changes, build strong relationships and recover from setbacks. The ups and downs in your family member’s illness can have a
huge impact on you. Improving your relationship with yourself by maintaining your physical and mental health makes you more resilient, helping you weather hard times and enjoy good ones.

Recharge Yourself
When you’re a caregiver of someone with a condition like mental illness, it can be incredibly hard to find time for yourself, and even when you do, you may feel distracted by thinking about what you “should” be doing instead. But learning to make time for yourself without feeling you’re neglecting others — the person with the illness as well as the rest of your family — is critical.
Any amount of time you take for yourself is important. Being out of “caregiver mode” for as little as five minutes in the middle of a day packed with obligations can be a meaningful reminder of who you are in a larger sense. It can help keep you from becoming consumed by your responsibilities. It is impossible to take good care of anyone else if you’re not taking care of yourself first.
Porterville and Visalia Wellness Centers are open.  My Voice Media Center is open by appointment only. These organizations provide supportive, stigma-free environments and peer-led services for individuals living with mental illness who are well on their way to wellness and recovery.  

Visit our Calendars Page for more information about the activities these organizations are offering for December 2020.
This holiday season, your shopping can help our cause. When you shop with AmazonSmile, Amazon will donate 0.5% of of the price of eligible purchases to NAMI Tulare County.

AmazonSmile is also available in the Amazon Shopping app. Learn how to generate donations for NAMI Tulare County here.
Help us improve the lives of people affected by mental illness.
Thank you for your support!
Ralph Nelson, President
Sandra Juarez, Vice President
Mary Mederos, Treasurer
Kathy Farrell, Secretary
Donna Grigsby
Karen Mabry
Bruce Nicotero
Elizabeth Vander Meer
Ivy Jones
Ray Lara
Have questions? Give us a call.
Office Hours: Tuesday-Friday 8:00am-2:30pm
Office Phone: (559) 732-6264
Office Cellphone: (559) 967-6168 (best option)