Enlarge By Stephen Brashear for USA TODAY Holding it together: Pam Salter sings to son Braddock, 2, in the family's 300-square-foot trailer in Tacoma, Wash. "Always there's this anxiety in the background," she says. "It's like you're constantly in a state of emergency." CUSHIONING THE IMPACT FOR KIDS CUSHIONING THE IMPACT FOR KIDS Children can do well despite a family's financial setbacks, says Jana Martin, a psychologist in Long Beach, Calif. -Parents should explain what is changing and what isn't, she suggests. "We may have to move, but you'll get to keep your bed and your favorite things." Keep as many family routines as possible. If something has to go, try to give options: The family makes pizza together instead of going out. -Invite teenagers to help brainstorm ways to cut costs and contribute. -Notice signs of possible worry, such as changes in sleep, crying or isolation from friends. Ask about their fears. Correct misinformation and comfort them. -Let children know that they can ask questions about changes and that parents will talk about whatever upsets the kids. RESOURCES FOR THOSE IN NEED RESOURCES FOR THOSE IN NEED For referrals to local psychologists, from the American Psychological Association: (800) 964-2000 National Suicide Prevention Helpline: (800) 273-8255 National Domestic Violence Hotline: (800) 799-7233 Resources for those facing foreclosure: (888) 995-HOPE DAILY HEALTH BLOG DAILY HEALTH BLOG Get wellness tips, medical study roundups and news for healthy living here, including info on ... • Fitness and nutrition

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• Watercooler-worthy bits Signs abound that the battered economy is causing serious damage to the mental health and family lives of a growing number of Americans. Requests for therapists have soared, Americans say they're stressed out, and domestic-violence and suicide hotlines are reporting increased calls. "I've never seen this level of anxiety and depression in 22 years of practice," says Nancy Molitor, a psychologist in Wilmette, Ill. "The mental health fallout has been far worse than after 9/11." There has been a sharp rise in mental trauma even among those who still have jobs: The demand for therapists surged 40% from June to December — driven largely by money-related fears — at ComPsych, which runs the nation's largest employee-assistance mental-health program, says ComPsych chairman and CEO Richard Chaifetz. Nearly half of Americans said they were more stressed than a year ago, and about one-third rated their stress level as "extreme" in surveys out in September from the American Psychological Association. That was before the stock-market dive. PERSONALITY: Some 'types' can thrive in economic uncertainty QUIZ: Are you terrified or 'Type T'? BETTER LIFE: More on mental health Meanwhile, financial advisers say they're finding themselves in a new abnormal "normal." John Jones, a financial planner at ComPsych, says he's referring many more workers to counselors. "They start crying. They tell me they're not eating or sleeping. One even said about his family, 'They'd be better off without me,' " Jones says. Many colleagues around the USA are having the same experience, he adds. Joy Browne, a New York psychologist whose WOR-based radio talk show airs in 200 cities and live online, says she hears "a lot of free-floating anxiety." Many callers have been laid off. "But even if they have jobs, they fear they're going to lose them. People are kind of holding their breath." Background anxiety Pam Salter, 40, of Tacoma, Wash., is struggling to keep her head above water, emotionally and financially, as a tidal wave of challenges washes over her family. A college graduate who worked in human resources at a large company, Salter had to quit two years ago when Braddock was born with serious health problems. The family rented a 2,400-square-foot home, and her husband, Ron, had a software-related job. Last February, with money getting tight and her son's health problems resolved, Salter began job-hunting. After she had searched for six fruitless months, the Salters and their two sons moved into a 300-square-foot trailer to keep the family afloat. Pam Salter felt lucky when she latched onto a temporary five-month administrative support job in December. But her husband was laid off the next day. "There aren't any software jobs out there now," she says. Ron Salter, 50, has diabetes and high blood pressure. She says that when she took her husband's blood pressure a couple of weeks ago, it was 200/101. (Normal is 120/80.) His blood pressure medicine had run out three days earlier, and he hadn't told her he was trying to do without to save money. He also has "stretched" his insulin, triggering dangerous blood sugar spikes, she says. They have no health insurance. The couple is bickering more and, Salter says, her temper is shorter with Braddock and 4-year-old Bronson in such a tight living space. "Always there's this anxiety in the background. It's like you're constantly in a state of emergency." Salter's job might be extended in May, and she's trying to keep her spirits up. "But if I'm on unemployment and he doesn't have a job, it just scares the hell out of me," she says. "I don't know how we can take care of our family." The Salters want to stay together, but the economic collapse may be preventing some miserable couples from divorcing because they can't afford an attorney or separate homes and can't sell the house. "These couples are living in separate rooms, unhappily," says Priscilla Marotta, a psychologist in Plantation, Fla., who increasingly sees this scenario. Molitor, the suburban Chicago therapist, says she's noticing physically abused spouses staying in marriages because the economy has shrunk their options. "More people are living in homes that are kind of like tinderboxes now — they blow up every once in a while," says Karen Myatt, a divorce lawyer in Fort Lauderdale whose practice is shifting to domestic violence. Calls to the National Domestic Violence Hotline have shot up during the recession, says spokeswoman Retha Fielding. For example, there were 21% more calls in September than in September 2007. When the stock market plunged in October, there were 18% more calls than in October 2007. "And we hear more and more about money. 'We're about to lose the house, my husband lost his job.' " Domestic violence is about power and control, Fielding says, "so if an abuser loses control of one part of his life, he's going to try harder to get control at home." And concern is rising about possibly higher rates of child abuse, which increases in tough economic times, though national statistics lag a few years behind. Unemployment and financial problems create stress, "and we know they're contributing factors. The more stress factors a family has, the more likely you are to have child abuse and neglect," says Theresa Costello, director of the government-funded National Resource Center for Child Protective Services. Futures threatened On the other hand, many parents who thought they were taking extra-good care of their children by setting up college funds are now shell-shocked because the funds have rapidly shrunk — and their kids still need tuition. Linda Yalen, 52, of Simsbury, Conn., was part of a mass Aetna layoff in December. A legal administrator and single mother, she has two teenage daughters, including a high school senior gifted in math and science who has her heart set on a top college. Her daughter's college fund has deflated, Yalen says. She has scoured the area for legal administrator jobs. "There are no jobs in this area. None," she says. Yalen is looking into other kinds of work and tries to stay positive. "But I'm really worried about how we'll have to struggle now and upset about what will happen with my daughter's education after she worked so hard. I get depressed thinking about it. In the past, I could fix anything. I can't fix this." Maybe there's no quick fix in sight, but Americans have been through bad times before, and some have thrived despite adversity. How they did it is a lesson for us all, says psychologist Salvatore Maddi of University of California-Irvine. He coined the term "hardy personality" after studying more than 400 Illinois Bell Telephone managers who faced layoffs or changes in their jobs amid deregulation of their industry three decades ago. Maddi's 12-year pioneering study found that those who stayed on an even keel emotionally and kept their health shared three key qualities missing from colleagues who developed anxiety disorders or health problems. The hardy people stayed committed to what they were doing; they didn't back off or become alienated. They also sought control, trying to influence what happened to them, looking at every avenue for solutions. They saw stressful changes as inevitable and took them as a challenge, an opportunity to grow. In this frightening economy, "it helps to have a broader perspective," Maddi says. "People have recovered from this kind of thing before. Rather than bemoaning one's plight, it's important to come up with action plans that might make a difference." Pam Salter, who's living in the tiny trailer with her unemployed husband and two boys, takes pride in her own fighting spirit and determination to make it through. In fact, she named her younger son after James J. Braddock, the boxer in Cinderella Man whose comeback allowed him to pay back every dime he got in welfare payments during the Depression. "That moment showed such pride and honor," she says. "I hope to keep our spirits high and hold onto our honor. But it isn't easy." Guidelines: You share in the USA TODAY community, so please keep your comments smart and civil. Don't attack other readers personally, and keep your language decent. Use the "Report Abuse" button to make a difference. You share in the USA TODAY community, so please keep your comments smart and civil. Don't attack other readers personally, and keep your language decent. Use the "Report Abuse" button to make a difference. Read more