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What am I experiencing?
Stress and anxiety: What’s the difference?
Not all stress is created equal. Occasional stress can be useful, like when you need to focus on an exam, compete athletically, or react quickly to avoid a sudden threat. But consistent stress can be harmful to your health in a wide variety of ways, such as disturbing mood and sleep, zapping your energy, and impairing your immune system.
When the brain’s stress response never stops, stress chemicals (cortisol, adrenaline) remain elevated and “feel good” chemicals (serotonin, dopamine) are blocked. This can lead to anxiety. Panic attacks are one example, in which you find yourself totally freaking out in a very real way about less than life-threatening situations, like an exam in history class.
Anxiety shouldn’t be part of everyday life. If you are feeling an overwhelming sense of worry or restlessness every day, there are many options to keep it in check, such as lifestyle changes, targeted therapies such as Cognitive Behavioral Therapy, wellness practices, and medications. Check in with our team or answer a few questions to learn more about what’s going on and explore options for feeling better.
What is depression? How do I know if I have it?
Depression is a common experience that affects how you feel, think, and handle daily activities. It’s different from feeling intermittent sadness or grief. The symptoms stick around for at least two weeks without ever really letting up.
Signs of depression can include feeling sad, nervous, empty, hopeless, helpless, worthless, or flat-out exhausted — not just once in a while, but for most of the day, every day, over an extended period of time. Many people who experience depression express complete loss of energy to conduct regular daily activities.
There are other signs too: Maybe you’ve lost interest in your friends or hobbies. Or maybe you’re having trouble sleeping at night, waking up in the morning, or oversleeping. Or maybe you can’t seem to bring yourself to eat anything or, on the flip side, to stop eating all the things. Or maybe you’re suffering through ongoing stomachaches, headaches, or other pain that just won’t go away, no matter what you try.
Sound familiar? If you’re feeling some of these things regularly, take our self-check-in quiz to better understand what you’re experiencing. And, if you ever feel like hurting yourself — even once — please text HELLO to 741-741 to talk with a crisis counselor. Your life matters.
What is psychosis? How do I know if I have it?
“Psychosis” is a term that describes changes in functioning that make it hard to tell what’s real and what’s not. Common signs of psychosis include seeing or hearing things that others do not, having unusual or disorganized thoughts or behaviors, and/or becoming fearful or suspicious of others. These experiences vary from person to person.
Psychosis can be a short-term effect of extreme stress, substance use, or trauma — or a symptom of a mental health condition like schizophrenia or bipolar disorder. Psychosis can change your perceptions, thoughts, and behaviors. It also can cause you to withdraw socially, feel paranoid, or have difficulty doing everyday activities, such as going to school or work.
Psychosis is fairly common, and it most often starts in teen or young adult years. Three out of every 100 people in the U.S. experience it at some point in their lives.
If you think you may be hearing or seeing things or having troubling thoughts and want to talk about it with someone who has been there, peer mentor, Danny, is standing by. We know these experiences can be confusing and scary at times. Our team is here to listen and identify helpful resources that meet your specific needs.
How soon should I seek help? Will this get better on its own?
Just like any other kind of health issue, the sooner you seek help for emotional and mental health concerns, the better. Early professional support from peers and therapists — and also from your loved ones — can make a big difference in getting back to feeling like yourself again quickly.
Mental health issues rarely go away on their own. Teens and young adults who seek help early tend to recover faster, have fewer setbacks, and stay in school or keep their jobs more often than people who don’t.
Is it common to hear voices?
Not everyone hears voices or sounds, but it’s not an uncommon experience. The types of things people hear vary greatly, from distressing to comforting. Sometimes the voices or sounds go away quickly, and sometimes they linger over time.
Hearing voices does not automatically mean you are experiencing a mental health condition like psychosis. Roughly 5 out of every 100 people hear voices at some point in their lives. But, because changes to how we process sounds are very common with psychosis, it’s a good idea to check in with a professional. Our mental health quiz or free online licensed therapist are good places to start.
Finding help
What should I do if I think I need help?
Reach out. We know that confiding in someone requires strength and courage. (You can do it!) Here are a couple of tips to get started:
Talk to someone you trust. This can be a parent, a friend — anyone who you trust. You might start the conversation by saying, “I haven’t been feeling like myself lately, and it scares me. I’d like some help figuring it all out.”
Talk to a therapist. Check in with Nicole Germano, a licensed counselor who specializes in helping teens and young adults sort out mental health concerns. Nicole will give you her expert advice and connect you with options for getting mental health care, if you need it, as well as other supportive resources. Our online support is a free, confidential resource offered through a nonprofit partnership with Northwell Health and OnTrackNY.
Where can I find help in New York?
Strong 365 offers a safe, confidential way to find accurate information, connect with peer support, and find wellness resources, both online and in your community.
Our free support program, enabled by grant support from the National Institutes of Health, can be your guide to navigating New York’s mental health care system. We’ve partnered with experts at Northwell Health, a nonprofit health care provider, and OnTrackNY, an innovative youth-focused wellness program with locations across the state, to make getting help as easy as possible.
Get started now by talking with our licensed therapist.
(Not in New York state? Visit our Find Help page for national and international resource directories.)
What if I don't have insurance?
Strong 365's online platform and services are completely free for you to use. If our Care Navigation team refers you to a mental health provider, your insurance copay or deductible may apply.
If you don’t have health insurance, or if your policy doesn’t cover everything you need, don’t worry. Check to see if you qualify for any free, sliding-scale, or subsidized programs.
Here are a few options:
You can take advantage of grant or publicly funded treatment programs. Our team partners with youth mental wellness programs across New York state that are available to everyone, regardless of insurance coverage or ability to pay, thanks to nonprofit grant-funded financial support. We may also be able to refer you to other free or reduced-cost support, depending on your needs. Get started now by chatting online with our team, or schedule a time that is convenient for you.
Federal programs like Social Security Disability Insurance, Supplemental Security Income, and Medicaid are available for children, adolescents, and young adults coping with a diagnosed mental health disorder. The requirements differ for each program.
The state of New York offers low-cost health coverage for residents under the age of 19 through a program called Child Health Plus. It’s available to families that earn too little to pay for private insurance but too much to qualify for Medicaid.
Community health centers, programs, and organizations also provide financial assistance or free or discounted services to families with low incomes or youth with special circumstances (such as artists, military, living with HIV/AIDS) who’ve been diagnosed with a mental health condition.
How can I help my child, friend, or loved one?
Here are four things you can do right now to support someone in your life:
1. Take the Mental Health Quiz.
Answer these questions to help determine whether someone you care about could be struggling with stress, or something more.
2. Talk to a therapist.
Check in with Nicole Germano, a licensed social worker who specializes in helping people identify and overcome mental health challenges. She offers guidance to parents and loved ones who are looking to help someone. In addition to connecting you with options for effective care, she can also provide a roadmap of next steps.
3. Try to understand what it’s like to face a mental health challenge.
A little empathy goes a long way. Learn as much as you can about mental health so that common misperceptions don’t get in the way of being positive and supportive. Ask questions and really listen to the answers, with a readiness to learn more about what your friend or loved one is experiencing. To start the conversation, you might say things like: - “You don’t seem like yourself lately, and I’m concerned because I care about you. - “How can I help?” - “How are you feeling today?" - "How can I support you?"
4. Find ways to connect.
Spending quality time together — whether you’re walking the dog, going for a bike ride, playing games or making music online, or collaborating on a craft or other project — can help ward off feelings of loneliness and isolation.
How can Strong 365 help?
Strong 365 is a nonprofit group that provides free emotional wellness resources to teens and young adults. We offer safe, confidential ways for you to find accurate information, connect with peers facing similar challenges, and personalized guidance via a licensed therapist.
Our community, created by people with personal experiences alongside medical experts, supports people ages 13 to 30 who are coping with mental health challenges. We understand how hard it can be to overcome fear, stereotypes, and stigmas. Mental health challenges aren’t shameful, and they can be treated before they disrupt your life. We’re here to support you.
Feeling better & staying strong
Is it possible to feel better? How long does it take?
Yes! Getting back to feeling yourself usually takes time, and often involves some combination of changing daily routines, family/friend support, engaging with peer support networks, working with a therapist, and/or working with a doctor on medication needs.
Sometimes in the depths of a struggle, when we’re feeling most vulnerable, it can be hard to remember all of the skills and inner wisdom we already possess to care of our emotional health, and the amazing people in our lives who are standing beside us to cheer us on. If you are reading this, please take a moment to appreciate both of these things, and know that our team is also here to listen and help you map out a few next steps to feeling better.
Everybody’s path is a little bit different, and that’s normal. There is no one-size-fits-all approach or time schedule for moving through a mental health challenge. But with patience, courage, and determination, it gets better.
How does therapy work, and what are my options?
“Suck it up” is a common refrain that we think or hear from others when unwanted emotions such as sadness, hurt, or anger bubble to the surface. The reality is, as much as we may try, we cannot simply command our emotions away. That’s because feelings are linked to how we perceive ourselves, others, and the world around us. But, if we can alter our perspective and thinking patterns about a given situation (ideally seeing it in a more accurate way), then it becomes possible for our emotional response to it to change.
Cognitive Behavioral Therapy — called CBT or talk therapy for short — helps you change your thoughts or actions by discussing your feelings and perceptions with a counselor. The goal of talk therapy is to interrupt unhelpful thought patterns so that our relationship to a troubling experience or challenging relationship can be shifted.
Mental health care often works best when you consider all the things that could be causing you to feel bad. Some pretty basic approaches to treatment include:
One-on-one sessions talking with a therapist
Group and/or family counseling
Peer support
Assistance with school or work
Help managing medication, if needed
Substance use treatment, if needed
Do I need medication?
Medication can play a role in treating mental health conditions, but not always. In some cases, talking to a therapist and making lifestyle changes may be enough to help you feel better. In other cases, you may find that taking medication eases or gets rid of your most troubling experiences.
Choosing the right approach should be based on your unique situation, with support from your doctor. Chat with our licensed therapist or peer support specialist about how you’re feeling right now and your options for getting help.
Why is getting help early so important?
If you are concerned about your mental health, seeking help right away gives you the best chance of getting back to feeling yourself again as quickly as possible. The goal of getting support early is to get back to living the life you want sooner and minimize life disruptions that can make things worse, such as trouble at school, work or maintaining important relationships.
What questions should I ask my doctor or therapist at my first appointment?
We’ve all been there: It can feel intimidating to talk to doctors or therapists for the first time about an issue — especially one that we barely understand. But, remember this: the most important person involved in your treatment and recovery is you.
Your needs and well-being matter more than anything else. If you have questions — or if you feel uneasy or confused — speak up, or ask a parent or trusted ally to speak for you.
It’s best to bring a list of questions to a first appointment to make sure you get your questions answered. What are your doubts and concerns? Don’t hold back!
Not sure what to ask? Here are some questions you may want to consider:
What do you think I’m experiencing and why? Where can I get more information about it?
What changes can I make in my daily routine to improve my mental health? What are good goals for me to work toward?
When it comes to therapy, what are my options?
How long does treatment last? What are the benefits and drawbacks? Why are you recommending it? What are my options?
How soon (realistically) can I expect to start to feel better?
What types of therapy or community support groups are available for people my age? Where can I find them nearby?
When it comes to medication, what are my options?
What makes this medication the best option for me? How does it work to help my brain? What are the short- and long-term side effects? How long does it take to work? What happens if I miss a dose?
How much does the medication cost? Does the manufacturer have a subsidy or reimbursement program? Is other financial assistance available? How do I apply?
What should I do if I start to feel worse or need help immediately?
What to expect if I seek support?
What happens in a session with a counselor or peer mentor?
First and foremost, this meeting is for you, so what happens is up to you.
We recommend thinking about what you would like to learn about yourself, your experiences, or about emotional health in general. Or if you're looking to learn skills for managing particular experiences or situations, you can ask that question too.
The more you’re able to share with our team about what’s happening in your life and how it’s affecting you emotionally, the more we will be able to help you explore what's going on.
Some people find it useful to go through the quiz together as a starting point. Others prefer to share a bit about what has been different or bothering them, and then we can listen and ask questions that might offer a better understanding or a new perspective.
You might also want to think of a few questions that you want to ask. Those could be specific to you, or something more general, like how counseling works, or how you might go about solving a specific issue, or how to open up to someone about something. Then, we might offer some next steps based on your needs and interests. That could be a range of things, like self-care ideas, coping skills, links to more information or resources, helpful apps, or a referral to specialized support.
Can I get a diagnosis?
It’s natural to wonder about a diagnosis. This isn't something that we are able to offer, since our support is online and temporary. We can help provide you with a referral to a provider who can help make a diagnosis.
It is also worth noting that some people find a diagnosis clarifying, while others find a term for their experiences less useful. Each of these viewpoints, and the spectrum in between, are valid. The most important thing is that you are able to find the right mix of things to support your well-being.
Can I come back for follow up sessions?
Sometimes, we can't get all the answers we need or tackle all issues in a single conversation, so follow ups can be useful.
However, our support service is intentionally temporary so that we can help as many people as possible. Consider us a bridge to appropriate care options, including providers and specialists in your community or online, peer mentors, or self-care tools. We can help you determine what's right for you and connect you to the right support based on your needs.
Is the help you provide confidential? Is it free?
Yes. All of the support options we offer are 100% confidential and free, offered in partnership with Northwell Health.
Our team has worked with teens and young adults on a very wide range of issues and concerns, and understands how important confidentiality is. Our goal is to ensure that people have a safe space to open up and learn more about stressors and emotional health concerns.
Do you collect or share personal information?
We do not share your information with anyone (unless you ask us to do so). Please review our Privacy Policy for more information.
Do I need to be on camera to chat with someone?
No. You can choose to turn your camera on or off while in our chat room.
You can also text or call the team at (516) 388-8567, or email us at strong365@northwell.edu.
Caregiver tips and tools
How can I seek mental health support on behalf of my loved one?
You’ve noticed changes in your loved one’s behavior that concern you. You suspect they need mental health care, but you aren’t sure how to support them. We've designed a 4-step Caregiver Guide to help you figure out how best to take care of them, yourself, and your family.
1. Assess the situation:
Determine whether they’re in immediate danger. Do their recent actions seem completely out of character? Did they tell you that they want to hurt themself or others? If so, seek medical attention right away. (Call 911 in an emergency.) The next thing to do is look for signs of a mental health concern:
Withdrawing
Problems with sleep
Difficulty with school or work
Changes in mood
Troubling beliefs
Perception problems
Disorganized thinking
2. Ask for help.
Seeking mental health care, from coping with emotions to navigating systems, can be a difficult process. You can make things easier for your loved one by being a strong ally. When they’re ready, research and discuss the options available to them. Some options might include:
Healthcare system (doctors, therapists, and other practitioners)
Peer support groups
Local, community-based services
School resources
Family and friends
3. Understand your health insurance benefits and alternatives.
Health insurance often can be used for annual check-ups, specialist visits, medications, and, if needed, emergency care and hospital stays. Your insurer is required to supply you with an easy-to-understand summary of benefits, including mental health coverage.
4. Put together a wellness toolkit for you and your loved one.
Supporting a loved one presents as many challenges as it does rewards. It's essential to take care of yourself first. Staying well--physically, emotionally, and mentally -- and making sure your own needs are met will enable you to show up for your loved one when they need it most.
How can I support my child when they don't think they need it?
Keeping an open, productive dialogue with a young person who is struggling with their mental health but can't see it can be challenging. Here are 3 tips for how to offer support:
1. Find a shared goal
A shared goal refers to something that you and your loved one can agree on. For example, maybe you both want them to feel like themselves again, or maybe you both agree that getting back to school is a priority.
You may not agree on the best way to get to that shared goal, but starting the conversation there is a great place to start. Continue to talk through the different routes for reaching this goal while also trying to understand their perspective. It's important to listen intently without judgement or expectation and realize that it's okay to disagree.
2. Normalize and (try to) relate
It's important to remember that mental health exists on a spectrum with a wide range of severity and resulting distress associated with ill-mental health. For example, young people in the early stages of a mental health condition may have a hard time sleeping or paying attention -- something many of us can relate to, particularly when we're stressed. Try drawing on these experiences to relate to more severe symptoms, such as an inability to get out of bed or a debilitating panic attack.
3. Inquire curiously, and make a plan for a next step together
Build trust and mutual respect with your loved one by asking questions with genuine curiosity. Sometimes, asking for permission to ask questions to help you better understand their experiences and viewpoints and help disarm them and grow their willingness to share with you. It's also okay not to have an answer, or solution, or response to everything they say. Sometimes, just acknowledging that you heard them is enough.
Once you're ready to make a plan, remind them that you're a team with a shared goal. For example, you might ask "What can I do to support you so that you can [work toward our shared goal]?" Sometimes an in-between step prior to speaking to a professional might be speaking or even texting with another trusted ally, such as a school counselor, a teacher, another family member, or a friend.
How do I explain that professional support can be helpful to my teen or young adult?
Though it's getting better, there is still stigma still associated with seeking mental health support and therapy today. This can make it tough to convince some young people to speak with a therapist, psychiatrist, or counselor. But there are a few ways you can explain mental health support that may change their mind.
Therapy used to be something that people didn’t talk about as much, but today it’s becoming better understood as something that anyone can benefit from - it’s not just for people who are in the depths of a personal struggle or mental health condition. It can be a great tool to learn more about yourself, uncover your vision for your life, learn lifelong tools that will serve you in relationships and work, and help you be the best version of yourself.
A common misconception is that therapists and psychiatrists are just going to tell you what to do, or that they'll share information with your parents. This is not the case. Rather, you can think about therapists and psychiatrists as navigation tools, sort of like Google Maps. They'll listen as a young person shares where they want to go, and then help them figure out how best to get there.
Another way to think about it is in terms of sports psychology. Often, when athletes hit a roadblock in their career, they'll reach out to sports psychologists for help overcoming whatever happens to be challenging them at the time. It could be a previous injury, a tough coach, or stress over performance.
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