What to Do When You Are Worried or Sad

What to do if you are sad, worried or scared

• If you feel like this is urgent or an emergency, call 911 or go to your closest Emergency Room.
• If you feel so sad or worried that you cannot keep yourself safe, call 911 or go to your closest Emergency Room.
• If you don’t think this is an emergency or you are not sure, call your therapist or psychiatrist. If you don’t have one, call the Pediatric IBD Team at 617-724-5142 and ask for the social worker on call. We can help you decide if you should go to the emergency room.

When you are in doubt, call 911. Go to your closest emergency room right away. Call the Pediatric IBD team after you go home.

I don't feel like this is an emergency. What can I do?

Only use these tips if you feel you are safe and can cope with your sad or worried feelings. If you feel like there is an emergency or like you cannot cope, call 911 or go to your closest Emergency Room.

• Talk with an adult you trust. This can be your family, your doctor, guidance counselor at school or another trusted adult.
• Use a free mindfulness app. Here are some we suggest: o Stop, Breathe and Think®. A free app that lets you check in with how you feel and guides you through meditation lessons. o Calm.com®. A meditation website and app to bring peace to your mind. The 7-day program is free. Other programs are low-cost. o MindShift®. A free app to teach you positive ways of coping with anxiety, stress and feelings of being overwhelmed. o Headspace®. A free app that guides you through 10-minute meditation lessons.
• Make a playlist of songs you know will help you feel calm or less stressed.
• Use So Far, So Good breathing. This is also called cardiac breathing.
• Use left-right tapping. This is also called bilateral stimulation.

So Far, So Good breathing

This is also called cardiac breathing. This breathing exercise helps you focus on your breath to feel calmer and more in control. With practice, you can learn to use it with success.

1. Touch your tongue to the roof of your mouth. Take a deep breath in, release your tongue, and breathe out normally.
2. Breathe in, quietly saying So.
3. Breathe out, quietly saying Far with emphasis on the “F”.
4. Breathe in, quietly saying So.
5. Breathe out, quietly saying Good with emphasis on the “G”.
6. Repeat breathing in and out while saying So Far, So Good with each breath.

Left-right tapping

This is also called bilateral stimulation tapping. It helps you focus and gives you space to think without being overwhelmed by feelings.

1. Sit with your feet flat on the ground. Put your hands palms-down just above your knees.
2. Switch between tapping your left and right hands on your knees in a steady beat.
3. Keep tapping while you think or talk about whatever is upsetting you. If you feel more stressed or worried, focus on how the tapping feels before thinking about whatever is upsetting you again.
4. You can tap with your fingers or walk in a left-right pattern if that works better for you. The rhythm must be even and steady

A note for your family

When we are stressed as parents, our children can also feel stressed. Here are some ways to help you feel less stressed.

• Take 20 sips of water. Breathe out slowly and deeply when you take the cup away from your mouth.
• Get outside. Fresh air can help clear your mind. It can also help you feel well.
• Look at what is around you. Look up, left, right and down. Breathe in through your nose and out through your mouth as you notice what is around you.
• Gently lift your shoulders. Close your eyes. Breathe in and pull your shoulders up to your ears. Breathe out and bring your shoulders down. Do this 8 times.

If you are worried or have questions, call the Pediatric IBD team at 811-PEDI-IBD (733-4423).

MGH and MGfC do not endorse any of the brands on this handout. This document is intended to provide health related information so that you may be better informed. It is not a substitute for a doctor's medical advice and should not be relied upon for treatment for specific medical conditions.