October is Domestic Violence Awareness Month. You can wear purple ribbons to educate yourself and others about the horrors of inter-personal violence. But if you know a victim of domestic violence--and they're all around us--do you know how to help them share their story and get help?

Send them to Violence UnSilenced, a relatively new and somewhat unconventional website that gives excruciating voice to the survivors of domestic violence and sexual assault.

It's a simple thing you can do, but sometimes the simple things are the most profound.

Started by a Wisconsin woman, the website is a flood of sad and often brutal stories that oddly inspires as it educates. Tens of thousands of people each month read the stories of violence survived that Maggie Ginsberg-Schutz receives and posts weekly. Even if the authors are not yet able to extricate themselves completely from the violence that surrounds them, the readers are listening to the stories of survivors, not victims. It takes shocking courage and bravery to give voice to previous shame and silence, and it's in that awakening where the power lies.

Help a victim give voice to her anguish, guide her to appropriate help and elevate her to survivor - make it your mission next month. Even if you think you know no one who is affected, look around. I bet you'll find someone.

A good friend of eight years casually informed me over lunch one day how she'd gotten a permanent bump on her elbow: it was courtesy of her father after he'd thrown her into a plate glass window when she was in junior high school. She told me how he regularly threw her into brick walls, and down stairs. He kicked, punched, slapped, humiliated - even stuck safety pins into her and her brother's skin. This, from a father who had always been portrayed as a paragon of virtue and heroism. This, from a simple lunch discussion on a child abuse story in the news and a direct question from me. She eventually started therapy and is healing, even if in spurts and starts.

You see, domestic violence victims - and the larger class of violence and sexual assault victims - are all around you. They're in your workplace, at your church or temple, in your classroom, on your community web boards, on airplanes, next to you at lunch counters and in public restrooms, next door, maybe even in your own house. Victims of violence in all its forms - physical, mental, emotional, sexual, spiritual, inside and outside the home - are everywhere. You just have to open your eyes and ears and look and listen.

You just have to look and ask. It's simple, but it can be profound.

Though we've recently celebrated America's independence, we shouldn't let another year go by before considering the emotional and physical toll incurred by the men and women (as well as their families) who serve our country. BeWell's Dr. Saralyn Mark recently spoke to Congress about the "invisible wounds" of war:

The Invisible Wounds of War

After hearing Dr. Mark's below briefing, the U.S. Senate Armed Services Committee voted unanimously to adopt the Montana model for assessing returning combat vets for post-traumatic stress disorder. Read the story here.

Last Wednesday, I had an opportunity to present to Congress my thoughts on the "invisible wounds" of war. According to a 2008 RAND report, nearly 20% of veterans who have returned from Iraq and Afghanistan suffer from post traumatic stress disorder (PTSD) or major depression. I think that these numbers are actually low, since the report was based on extrapolated data from a survey of less than 2,000 troops. We now know that the number of Army suicides has increased every year since the Iraq War began, and this is the first time since the Vietnam War that the Army suicide rate has surpassed the civilian suicide rate.

Continue reading The Invisible Wounds of War.

Other links to explore:
Military Wives' community board
Dr. Mark on "Shock and AWE"

Saralyn Mark, MD BeWell Expert

Associate Professor of Medicine adjunct
Yale and Georgetown University Schools of Medicine

Affiliate Professor
George Mason University School of Public Policy

Senior Medical Advisor
NASA
*The opinions expressed are the views of the author and not of NASA.

Q: Are there any natural supplements that would be helpful for anxiety and/or mild depression during perimenopause? Is it normal to feel high anxiety during this time? Please tell me it won't last 10 years!
--cl-lisacap21

A: Perimenopause is a normal part of life, and every woman is different in how she feels during this period of time - which can be as long as a decade until periods stop altogether (that's menopause). Many women have physical symptoms, behavioral symptoms, or both. The reasons (and the solutions) are both biological and lifestyle-related. You sound like the mental health issues of anxiety are bothering you the most. Changing hormone status can influence mood and sense of well being, including anxiety.

Also, for many women perimenopause is a time major life-change - "empty nesters" with children grown; aging parents; the recognition that it's the end of the reproductive years (not that you want to have another baby!); changing work ambitions and goals. These can all promote anxiety, even without the hormonal changes. Talk to your gynecologist about this, and determine whether prescription medication for anxiety, or hormonal fluctuations might meet your needs. Try to structure your eating and physical activity to be regular - which can sometimes help.

I'd steer clear of over the counter dietary supplements, since they are not approved by the FDA, and are without any documentation of product safety, efficacy, or dosage. While there might be some useful products, you'll have to review very carefully, and seek information from your local pharmacist. Remember, "natural" doesn't always mean safe - arsenic is natural!!

Also, try to set aside some daily time for yourself, for a walk, or a cup of chamomile tea and a magazine - about 30 minutes a day. Think about the reasons for your anxiety, and determine if you need further help in managing your personal life stressors. Sometimes private or individual therapy can be of help, if friends and relatives are not enough support to meet your needs. Good luck - and let us know how you are managing!

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Madelyn H. Fernstrom, PhD, CNS, is the iVillage Health Editor-at-Large, Diet & Nutrition Editor for the Today Show and the Founder and Director of the University of Pittsburgh Medical Center's Weight Management Center.

Hi, All. I'm Lori Hope, and I'll be on "The Today Show" this Monday, June 8, sharing advice about how to support people with cancer, based on the research I conducted for my book, Help Me Live: 20 Things People with Cancer Want You to Know, the myriad responses of my readers, and my personal experience as a cancer survivor.

Thought I'd share a few tips with you here. For more info, check out my website, blog, or book. And please let me know if you have other tips to share. Thanks!

What NOT to say to your friend with cancer 

1. "You poor thing, I feel so sorry for you." People with cancer need compassion, not pity. Pity implies hierarchy, while compassion puts you on the same level.
2. "What's your prognosis?" Prognosis is a medical term and it makes most people with cancer think about how long they might survive. Even if they're positive thinkers, they may not want to think about how long doctors indicate they're going to live.
3. "Let me know if there's anything I can do to help." This might seem like a helpful statement. But according to my research, that statement is one of the least helpful. When people have cancer they may feel so overwhelmed that they can't focus on what they need. Offer something specific -- run an errand, give a foot rub, weed their garden.
4. "My aunt [or anyone] died of breast cancer." Tell positive stories, never scary stories, about other people who have had cancer. More than anything, people with cancer need hope, and horror stories dash hope.
5. "At least they caught it early [or "at least" anything]." Your friend needs to know you're acknowledging his pain and taking it seriously. If you say, "At least you don't have to go through chemo..." or something similar, you minimize what he's going through. He may discover what's good about his situation himself, but doesn't want to hear it from you.
   

NEXT: 5 Things You SHOULD Say to Your Friend with Cancer

Susan Boyle on May 8 Photo: bauer-griffin

Susan Boyle on June 5 photo: ap images

Less than a week after being hospitalized for "exhaustion" and a reported "nervous breakdown", Susan Boyle has reportedly been released. To understand what she might be going through, and whether she's getting the best care, we spoke with Srinivasan Pillay, M.D., Assistant Clinical Professor of Psychiatry at Harvard Medical School and a clinical associate at McLean Psychiatric Hospital in Belmont, Massachusetts.

"Coming back too soon and too fast can be dangerous, if a person is exposed to a stressful situation without treatment in place," says Dr. Pillay. What is too fast, of course, depends on the individual, he says, "but a reasonable estimate is to try to diminish exposure to high-levels stresses for two to four weeks after the initial event. Afterwards, you can expose yourself to a lower-stress environment, while remaining in contact with your therapist, so before and after the event you can process what's been happening."

"It astonished us," recalls Wanda Jones, Dr.P.H., director of the federal government's Office on Women's Health, now celebrating the 10th anniversary of Women's Health Week, the focus of iVillage's Health is Beautiful campaign.  She is recalling the "electronic brainstorming" sessions that began in 2003 and eventually lead to the report released this morning, May 11, 2009, Action Steps for Improving Women's Mental Health. The core question: What is the most important action for improving the mental health of girls and women?

"Resilience was at the heart of it," says Dr. Jones. Yes, it's true, women are more at risk for mental health conditions such as depression and anxiety disorders compared to men. Yes, they are much more likely to experience trauma, violence and abuse, with potential lifelong damage to mental health. These are real, and the appropriate response isn't to adjust to them, but to prevent them in the first place.

But women also have more emotional strengths than men have, and more ways to support each other. "Resilience is the ability to bounce back when things hit us hard," explains Dr. Jones. "If you are resilient, you can go back to a normal approach to work, to play, to family. The event or issue doesn't dominate your life. It's not quite as if it never happened, of course," she says. "We are changed by these events. Whether it's a natural disaster or being victimized, some people are completely incapacitated. But others can put it in perspective and move on."

Resilience: Reflections on the Burdens and Gifts of Facing Life's Adversities, by Elizabeth Edwards, was published by Broadway Books on Friday, May 8, 2009. It is an honest searching book that explores her own struggles to be resilient in the face of the death of a son, her terminal cancer, and the marital infidelity of her husband, John Edwards. Here are a few quotations:

On Resilience
"Too many times I have had to use my father's strength--or my mother's grace as she stood beside him--as a touchstone. I suspect we each have someone like him, someone whose personal courage in the face of impossible odds inspires us to do something we thought we could not do, who reminds us that what seems like a mountain in front of us can in fact be climbed. My father was an imperfect man in many ways, but maybe it was better than he was imperfect and that I knew he was, for I learned that perfection was not a requirement of resilience. This was Dad, and if he could decide to live, so could I."
p. 9

On Acceptance
"This is the life we have now, and the only way to find peace, the only way to be resilient when these landmines explode beneath your foundation, is first to accept that there is a new reality. The life the army wife knew before her husband went to war, the life of the patient before the word "terminal" was said aloud, the life of the mother who sat reading by her son's bed and not his grave, these lives no longer exist and the more we cling to the hope that these old lives might come back, the more we set ourselves up for unending discontent....My life was and would always be different, and it would be less than I hoped it would be. Each time, there was a new life, a new story."
p. 31

On Finding Support on the Web
"I found a group of people who were as lost and miserable as I was and we helped each other find our footing and find our individual paths. I suspect there are few better examples of barely functional people than those who have just buried their children. We are fortunate just to be dressed, particularly fortunate if it is not exactly what we wore the day before. We barely eat, we don't know where to go, we don't seem to belong anywhere. Yet some of us gravitate to the Internet, and there, with a little searching, we find one another...And there we were all equal, in a fashion. There we were all parents who have done the impossible: We have placed our child in a box and the box in the ground and we do not know what to do next. And yet we were stronger when we were with one another." 
p. 82

On Choosing Happiness
"I cannot pretend that I didn't wish the disease was in my control. All that is in my control is how I live now. I could fill the days with fears--there are plenty of those--or I could fill them with the best joys I can cobble together....There is enough unhappiness and pain to fill my days, but I choose to be happy."
p. 149

My husband comes from a long line of herniated disks. Two of them are painfully present in his own spine, and several others have shown up in the spines of his father and brothers. Breaking free from genetic inevitability, my husband is the only family member to refuse spinal surgery - so far. (In case you're wondering, that's NOT him on the left.)

He prefers a sometimes stubborn approach which involves living with what he feels is an acceptable level of constant pain, spending liberally on osteopathic and athletic therapy, pursuing high-level athletic goals which force him to stay fit, and swallowing a very large daily dose of denial along with his ibuprofen.

"Shock and awe" is a phrase that was introduced and quickly woven into our conversations during March 2003. We knew that it conveyed our military's strength and superiority fighting the enemy in Iraq. We were transfixed by the fireworks illuminating the night's sky over Baghdad. Six years have gone by since "shock and awe" transformed our lexicon and eight years since our troops landed in Afghanistan. Battles have been fought in distant lands to protect our freedom and security.

Now we are finally acknowledging that this war is coming home. On March 18, 2009, in two locations in our nation's capital, the truth about this war reached our shores. For years we knew that this was coming, but it was difficult to face. The casualties are not just our troops"the collateral damage includes their families. At the Pentagon, the secretary of Veterans Affairs and the deputy secretary of defense hosted a screening of the PBS special "Coming Home: Military Families Cope with Change"--a show that highlights families who have faced amputations, traumatic brain injuries and post traumatic stress disorder. While at the same time, there was a hearing of the Senate Armed Services Committee to discuss the rise of suicides among military personnel.

What connects these two events is shock and AWE. It is time for our nation to accept and understand a new version of this concept--one still grounded in military strength but now associated with a benevolent action rather than destruction. Military jargon is filled with acronyms. So to continue that long-standing tradition, AWE can be an acronym for "Adaptation to the War Environment." AWE is a normal process that the body and psyche experiences to adapt to the extreme environment of battle in order for a person to survive. By just changing the nomenclature, we can begin to change a climate filled with stigma, fear and humiliation. Instead of saying post traumatic stress disorder or PTSD to describe the signs and symptoms that our troops experience--which can imply victimization, weakness, disability or disease--we can describe it as AWE, a normal reaction to an abnormal situation.