Support & Treatment

Considering Behavioral Health Supports and Treatment

It’s estimated that around 25% of the people in the U.S. will experience some type of mental health disorder in their life. Many of us have experiences with depression, anxiety disorders, substance use disorders, sleep disorders, and many other psychological or psychiatric difficulties. Similarly, children can experience a wide array of mental health problems including various forms of anxiety disorders, mood disorders, school-related difficulties, and attention deficit disorders.

The goals of this module include:

  • 1. Help you carefully review how you are doing and make adaptive decisions to promote positive mental health.
  • 2. Provide information that can help you to determine whether or not reaching out to a mental health professional could be useful.
  • 3. Provide you with information about the easiest ways to get mental health assistance, by identifying resources in your community and the potential value of the use of telehealth or telemedicine services in mental health treatment.

Video about mental health, how to spot the signs that your mental health may be affected, and when to seek help.

Click here for video

What you Need to Know

Support & Treatment

Understanding the Impact of Stressful Events on your Mental Health

The impact of stressful events youron mental health can vary from person to person and may change over time. Some people might notice very little effect on their mental health. They might be fortunate to be quite resilient. Others may notice short-term periods of depression or anxiety which is concerning, but basically resolves with time as the stress subsides. Other people might notice a more enduring pattern of psychological difficulty that persists beyond the initial stress of an event.

For many people, psychological symptoms may not develop until after the stress has at least partially resolved. Notably, some people already have significant psychiatric or psychological difficulties and may notice that the stress of an event has changed or complicated their disorder.

I already have a diagnosis of a psychiatric disorder, how might a crisis or disaster affect me and what should I do?

If you’ve been diagnosed with a mental health condition, it’s important to know that the stress associated with a crisis might cause your symptoms to worsen. We encourage you to take the following steps to look after your emotional health.

  • If you are currently receiving treatment, be sure to continue with that treatment. If you are not able to receive in-person care, develop a plan for telehealth sessions with your provider(s).
  • Make sure that you’re taking your medications as prescribed and have a plan for maintaining access to those medications.
  • If you are not currently receiving treatment, make sure to monitor your symptoms closely and reach out to your mental health care provider(s) if those symptoms begin to worsen or impact your daily life.
  • Think back to the strategies and coping skills that were helpful to you in the past and put them back into action now.
  • Find additional mental health supports.
I am worried about my mental health but have never had significant mental health problems. Am I at risk of developing a mental health disorder because of stress from a disaster?

Disasters can be very stressful for individuals and communities, particularly for those who suffer significant losses, or are directly impacted by the event. Many will experience symptoms related to mental illness, such as anxiety, depression, stress, etc… but for most, they are short lived. A smaller group of individuals will meet criteria for a diagnosis of a mental illness. While not a guarantee against more serious concerns, individuals and communities can practice and build their resilience. The acronym FACTS can be a helpful reminder:

The FACTS

And, unfortunately, there are more frequent natural and human-caused disasters (large scale events disrupting community functioning) occurring. As such, there is year-round crisis-counseling available through the following resource:

Disaster Distress Helpline

Learn more about each of these common behavioral health concerns, and review a list of common symptoms.

Support & Treatment

Depression: Signs and Symptoms

  • Not feeling interested in things or activities that you used to enjoy
  • Tearfulness and crying
  • Angry outbursts
  • Sleeping too much or not sleeping enough
  • Eating too much or not eating enough
  • Thinking and moving more slowly (or more quickly) than normal
  • Having trouble concentrating, even on simple tasks
  • Thinking about death and suicide

Feelings of Sadness or Depression?

Many of us feel sad about the ways in which crises can impact our lives. We grieve for the loss of normalcy and social connection. So, it is normal for us to experience some moments of sadness or depressed mood during time of stress.

When these experiences last for long periods of time and impact your ability to meet your daily responsibilities to work or family, this can be a sign of a more serious mood disorder (e.g. depression).


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Support & Treatment

Anxiety: Signs and Symptoms

  • Feeling nervous or tense
  • Having trouble concentrating
  • Having trouble sleeping
  • Feeling weak or tired
  • Avoiding people, places, or things that make you feel nervous, even when you know you shouldn’t avoid those things
  • Experiencing intense physical symptoms out of the blue (including fast heartbeat and breathing, sweating, and trembling) that can’t be explained by a physical health condition

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Support & Treatment

Substance Use Disorder: Signs and Symptoms

Look for the following issues, which might indicate a more serious substance use disorder:

  • Drinking more alcohol or using more drugs than normal, or more than you originally intended
  • Needing to drink more alcohol or take more drugs to get the effect you want
  • Having strong cravings or urges to use alcohol or drugs
  • Feeling like you need alcohol or drugs in order to wake up in the morning or get through daily activities
  • Spending lots of money on alcohol and drugs, even when you can’t afford it
  • Continuing to drink alcohol or use drugs when you know that it is harmful to your physical or mental health, or when other people have told you to stop
  • Spending lots of time getting alcohol or drugs
  • Failing at attempts to stop using alcohol or drugs
  • Driving or doing other risky behaviors after using alcohol or drugs
  • Experiencing severe withdrawal symptoms such as excessive sweating, shakiness, agitation, or mental confusion

Normal Substance Use or a Use Disorder?

People commonly drink alcohol to relax, or to help reduce unpleasant feelings like stress, anxiety, sadness, or boredom.

Although light or occasional alcohol use may not pose a problem for many people, it is important to keep in mind that alcohol is an addictive substance that can cause serious problems for a lot of people. Similarly, other substances like marijuana, might be used to relax, but could also cause significant problems.


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Support & Treatment

Post-Traumatic Stress Disorder (PTSD): Signs and Symptoms

  • Having frequent memories about the event that make you upset
  • Feeling as if you are reliving the event all over again
  • Feeling intense fear or distress when something reminds you of the event
  • Avoiding people, places, or things that remind you of the event
  • Feeling hopeless about the future
  • Feeling negative about yourself, other people, and the world
  • Having a hard time staying close to family and friends
  • Feeling numb
  • Being easily startled
  • Feeling that you are always on guard and needing to protect yourself from danger
  • Trouble sleeping
  • Trouble concentrating
  • Feeling guilt or shame because of the event

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Support & Treatment

Suicidal Thoughts

When life hurts, our minds sometimes turn to thinking about suicide and death. If you are having suicidal thoughts, we want you to know that you are not alone. Your life is valuable and there are healthy ways to cope. Below, you will find some tips for soothing your pain, finding reasons to be hopeful, and keeping yourself safe from harm.


Soothe your emotional pain

  • With self-compassion. When life is hard, it is extra-important to be friendly toward yourself.
  • With fun/pleasant activities. For example, step outside, stretch, listen to a funny podcast, watch comedy, play a game, listen to music, create art, take a hot shower, nap, or read. Even if you don’t enjoy these activities as much as you would under other circumstances, they can still help to reduce the intensity of emotional pain by creating more opportunities for joy.
  • Relaxation exercises. If you’re feeling stuck and don’t know how to soothe yourself, try these free relaxation exercises.

Look for hope

  • Reduce focus on the negative. Many people are working on solutions to help financially, medically, and to provide support within communities. Our mind naturally pays more attention to signs of danger and despair, but with effort, we can increase attention toward realistic sources of hope too.
  • Find what makes you feel hope. Find pictures, quotes, music, and other things that give you a sense of hope and spend time looking and listening to them whenever you are feeling down.

Connect with people

  • Prioritize connection. Prioritize making time for video chats/phone calls with friends, family, co-workers, etc.
  • Quality time. Spend time with the people that you live with and focus on talking and interacting rather than just sharing space.
  • Reach out. Ask people how they are doing, listen without judgment, and ask how you can support them. Find more tips for how to help here.

Contribute and find meaning

  • Check-in. Check on people who live alone to see how they are doing
  • Send an encouraging message. This can have a powerful impact during a stressful time.
  • Help others. Help people out in ways that you can, and give yourself credit for that. Do not minimize your contribution because it is less than you could do under other circumstances or because it is not as much as other people can contribute right now.
  • Find spiritual meaning. If there are spiritual scriptures or other inspirational quotes that fill you with a sense of meaning, focus on those during tough times.

Increase safety

  • Means reduction: Store lethal means safely (e.g., store guns separate from ammunition, locked in a safe; store medications safely and do not stockpile them). Read more about “means reduction” strategies from Harvard School of Public Health.
  • Reach out. Connect with loved ones and let them know you are struggling. Ask them for extra support. It is okay to ask for help – we all struggle at times.
  • Save resources and supports. Program emergency numbers into your phone – e.g., Crisis Text Line (text HOME to 741741), 1-800-273-TALK. People are available to talk to you in your time of need.
  • Get immediate help.
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Support & Treatment

How you can Gain Access to Mental Health Supports

While most of us are experiencing some challenges to our emotional well-being, two of the biggest clues that your emotional (e.g., sadness, anxiety) and behavioral (e.g., substance use) responses to the pandemic might have turned into a more serious disorder are:

  • If your problematic emotions or behaviors last for long periods of time, or
  • If those emotions/behaviors prevent you from meeting your daily responsibilities

If you think you might be experiencing a mental health disorder, then we recommend accessing mental health supports. This might mean using self-help tools, or working with a mental healthcare professional who can provide support and guidance.

Self-help

Self-help mental health resources vary considerably. Some resources have very little basis in science, while others have been shown to be quite effective for managing mental health concerns for a number of people. Good self-help resources may help you to manage mild symptoms of a mental health disorder. In addition, if you’re having difficulty connecting with a mental health professional, following a self-help manual can be a great way to bridge the gap until you are able to secure a provider.

Self-help resources:

Finding a mental health provider

Working with a professional mental healthcare provider can be an excellent way to increase your level of support and get personalized guidance for how to move forward. Identifying a provider can sometimes be time-consuming and may take some persistence. So, while you pursue this important source of support, consider using the self-help resources listed above. Take the following steps to find a provider that will work well for you:

  • Contact your health insurance company. They can explain how your plan works and supply a list of covered providers in your area.
  • Connect with your Primary Care Provider (PCP). Your PCP may provide an initial mental health screening and/or offer a list of mental health providers.
  • Check out your company’s Employee Assistance Program (EAP). Your Human Resource Department can provide information about your company’s EAP and/or provide a referral.
Identifying providers in your region

There are a variety of options for mental health services in our region that include private practices, large multi-specialty clinics, state-run human service centers, and a variety of nonprofit facilities and agencies. If you are not aware of the opportunities available to you, trying the Services Locator managed by the Substance Abuse and Mental Health Services Administration.

Get immediate help

If you are having extreme distress or feel like you want to harm yourself or someone else, please seek help now by calling 911, 988, or contacting FirstLink. FirstLink is a free confidential service available to anyone at any time of day or day of the year for listening and emotional support or referrals to resources for assistance, and crisis intervention.

For simple support, you can dial 211 or text your zip code to 898-211 from anywhere in North Dakota or northwest Minnesota.

911, 211, 988 information

From the 988 web page: https://988lifeline.org/

988 information

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Support & Treatment

What you Need to Know About “Teletherapy” for Mental Health

Using telehealth means that you can receive mental healthcare services without having to leave your home. It also means that individuals living in rural areas can have better access to mental healthcare.

What you need to know about teletherapy
If you are interested in receiving mental health treatment using telehealth:

  • Speak to your current provider(s) about telehealth options for continuing your care.
  • Reach out to your insurance company to ask about coverage for telehealth services and a list of covered providers.

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Modules describing signs and symptoms of behavioral health conditions are not diagnostic. If you have questions or concerns about your mental well-being, contact My Sanford Nurse at 701.234.5000, 1.800.821.5167, or click here to find a Sanford Health care professional. If you are having thoughts of self-harm, call the suicide prevention LIFELINE anytime at 1-800-273-TALK (8255). If this is an emergency, please call 911.

Provider Locator