Winter Blues: Seasonal Affective Disorder Q and A

“What is it?”

Although the specific diagnosis is complicated, these symptoms may indicate signs of Seasonal Affective Disorder: craving for carbohydrates, excessive sleeping, lack of energy, weight gain, and all of the symptoms of depression that go along with it: excessive guilt, irritability and others.

“Who’s at risk?”

People who live at higher latitudes have a higher risk, as do people already diagnosed with Bipolar II disorder. Younger people are more at risk than older ones. Regardless of these factors, anyone can suffer with symptoms of Seasonal Affective Disorder. ONLY A LICENSED HEALTH PROFESSIONAL can make this diagnosis!

“What makes it worse?”

Having the short days of winter upon us right after the overspending, overeating, and family time of the holidays can contribute to the exhaustion we feel. Less daytime light to feed our vitamin D needs is also a factor, as is less stimulation of the glands that provide serotonin production. Making New Years’ Resolutions can make you feel ineffective and hopeless if you are depressed; postpone until spring.

“What makes it better?”

Getting outside, even 20 minutes a day, without sunglasses. This exposes you to unfiltered light.

Leaving lights on inside the house, and drapes open to outside light.

Light boxes (available online) specifically designed for Seasonal Affective Disorder.

Therapy to offer support and new ways of viewing your world, and to prevent worsening of depression.

Exercise, exercise, exercise: again, 20 minutes a day helps. Exercise can be a ‘magic bullet’ for depression and anxiety relief! If it’s bad weather, walk at a mall or a gym.

“How can a therapist help me?”

A therapist can hold you accountable for putting these helps into place in your life, as well as help you examine how you think when depressed and challenge that faulty thinking. There’s no need to go at life alone, and untreated depression is indeed dangerous. There IS help!

When the Holidays Aren’t So Merry

When the Holidays Aren’t So Merry—Making it Through the Season

“What’s wrong with me?” my patient (fictional) asked, shredding the tissue in her hands as she wept on my couch. “Shouldn’t this be a happy time of year? Why can’t I feel Christmassy and jolly?”

And she is not alone. When you think of all of the people who are grieving and/or going through their first holiday season after divorce, widowhood, or the loss of a loved one, you realize that the memories can make the holidays more painful than happy at this time of year. Add to that the additional stress the season brings in the form of activities, shopping, and school events—well, you can see the problem. It’s like adding that last too-much drop of water to an already overflowing bucket.

What to do? If you are experiencing loss this time of year, your goal is this: to make it through. This is not the time to fill your chore list with handmade gifts (or gifts at all—who’s going to blame you this year?) or high stress dinners. If ever there was a time in your life to put you (and your children, if any) first, this is it. Exercise your “say-no” muscle with a firm and assertive smile and pass on committees, obligations, and entertaining. The people who might judge you—and believe me, there are fewer than you imagine—are simply not worth a second thought.

When the memories and tears come, allow them. What we resist, grows stronger, so don’t fight the feelings that arise. Tears actually expel cortisol, a stress hormone that is damaging to the body and needs to come out in order for you to be healthy.

Ask your friends and family for what you need this year, specifically. Do you need help making decisions on the children’s Christmas list? You probably have at least one friend who would love to help you. Do you need people to just listen to your grief without advising you? Tell them that you really just need an ear, not a response, from them.

These are just a few ideas; you know best what helps you stay strong. Just remember that you WILL make it through. Rest, heal, and wait for better days.

Managing Holiday Stress

By: Elizabeth Scott, MS

Holiday perfectionism is one of the main causes of holiday stress. We want things to be perfect for our loved ones and for ourselves. They (and we) deserve the best, right? We have the best of intentions. But whether it’s due to the impossible standards of holiday bliss sold to us by various marketing campaigns, to the exaggerated memories of holiday greatness that we’re trying to match (or outdo) from our own childhoods, or simply our regular-life perfectionism carried over and applied to the holidays, holiday perfectionism is all too common.

Signs of Holiday Perfectionism

Perfectionists often think they’re merely high achievers, but there are some key differences. With holiday perfectionism, the differences to look for involve happiness and satisfaction. Holiday high-achieving can mean being busy with holiday activities that will create lasting memories. So can holiday perfectionism. But with holiday high-achieving, if everything doesn’t get done, it’s okay—the focus stays on all of the fun activities that were enjoyed. Not so with holiday perfectionism—for the holiday perfectionist, if everything doesn’t get done (and done perfectly!) it’s a stressful, disappointing experience. Also, holiday high-achievers tend to cut corners here and there in order to get everything done. Holiday perfectionism, however, involves going all-out in every area of holiday activity. Holiday perfectionism involves high demands and little enjoyment.

Examples of Holiday Perfectionism

You might be dealing with holiday perfectionism if:

  • Every gift must be hand-made—and you’re not even enjoying the process!
  • The holiday card is two pages, single-spaced, and includes every detail of your year—along with a hand-written note for each person on your 100-address list. (And each address is hand-written on the envelope!)
  • You spend an entire day on the holiday meal, and can’t enjoy it because you worry that your recipes aren’t elaborate enough.
  • You’re procrastinating on major activities because you want to do an amazing job, but don’t have the time to give an activity the attention you feel it deserves. The activity goes undone, and you beat yourself up over it.
  • The kids look exhausted and stressed early in December because it’s all just too much!
  • You’re doing many, many things to celebrate the holidays, and aren’t enjoying most of them because you feel that your efforts aren’t good enough.

Consequences of Holiday Perfectionism

The main consequence of holiday perfectionism is holiday stress. That stress can be felt by you and everyone around you. Instead of enjoying the holiday season as a time of sharing and celebrating, holiday perfectionism causes people to feel inferior, overwhelmed, and unhappy. And these feelings can be felt by those around them. Basically, holiday perfectionism robs people of the very joy and satisfaction that they’re seeking to achieve in the first place. But it doesn’t need to be that way.

Solutions to Holiday Perfectionism

  • Become Aware of Holiday Perfectionism—Now that you know the signs of holiday perfectionism, examine your thinking and behavior patterns a little more closely and notice whether or not you’re a holiday perfectionist. Just being aware can be a significant help.
  • Re-Examine Your Thoughts—Practice a little cognitive restructuring by paying attention to what you tell yourself as you take on an attitude of perfectionism, and challenge those thoughts. Are you afraid that the holidays won’t be fun for your family if you don’t make everything perfect in one specific way or another? Think instead about how your mood (overwhelmed or happy) might affect their happiness.
  • Practice Imperfection—Purposely challenge yourself to do things somewhat imperfectly. Take shortcuts, do things mostly-well. See how it feels, and practice coping in small increments. This will allow you to feel more in control of your situation without having to make it perfect, and can alleviate some of your holiday perfectionist anxiety.
  • Find Support If You Need It—If you find yourself experiencing stress or anxiety due to holiday perfectionism, you might want to talk to a good friend about it. If you’re experiencing stress and anxiety levels that feel unmanageable, you might want to talk to a professional—there’s a lot that can be done to help.

Bottom line—holiday perfectionism can ruin the joy of the season for you and your loved ones. You can free yourself from the stress that comes from it, and simply enjoy the holidays.

Letting Go of Control

controlA Blog by Dr. Amy Johnson

“If we are facing in the right direction, all we have to do is keep on walking.” ~Proverb

I’ve noticed that things go much more smoothly when I give up control—when I allow them to happen instead of making them happen. Unfortunately, I’m terrible at this.

Although I’m much better than I used to be, I’m a bit of a control freak. I often use perfectly good energy trying to plan, predict, and prevent things that I cannot possibly plan, predict, or prevent.

As a recovering control freak, there are three things I know for sure about trying to control things:

1. We try to control things because of what we think will happen if we don’t.

In other words, control is rooted in fear.

2. Control is also a result of being attached to a specific outcome—an outcome we’re sure is best for us, as if we always know what’s best.

When we trust that we’re okay no matter what circumstances come our way, we don’t need to micro-manage the universe. We let go. And we open ourselves to all sorts of wonderful possibilities that aren’t there when we’re attached to one “right” path.

3. The energy of surrender accomplishes much more than the energy of control.

I suspect it’s slightly different for everyone, but here’s what ‘control mode’ looks and feels like for me: My vision gets very narrow and focused, my breath is shallow, adrenaline is pumping and my heart rate increases.

My mind shifts from topic to topic and from past to future very quickly, and I have little concentration, poor memory, and almost no present-moment awareness.

In surrender mode, I’m calm, peaceful. Breathing deeply, present in the moment. I see clearly and my vision extends out around me, allowing me to (literally) see the bigger picture.

So the great irony is that attempting to control things actually feels less in control. When I’m micro-managing and obsessing over details, I know I’m in my own way.

The Art of Surrender

Surrender literally means to stop fighting. Stop fighting with yourself. Stop fighting the universe and the natural flow of things. Stop resisting and pushing against reality.

Surrender = Complete acceptance of what is + Faith that all is well, even without my input.

It’s not about inaction. It’s about taking action from that that place of surrender energy.

If letting go of control and surrendering not only feel better, but actually produce better results, how do we do that?

Sometimes it’s as easy as noticing that you’re in control mode and choosing to let go—consciously and deliberately shifting into surrender energy.

For example, when I become aware that I’m in control mode, I imagine that I’m in a small canoe paddling upstream, against the current. It’s hard. It’s a fight. That’s what control mode feels like to me.

When I choose to let go and surrender, I visualize the boat turning around, me dropping the oars, and floating downstream.

I’m being gently pulled, no effort necessary on my part. Simply breathing and saying, “Let go of the oars” is usually enough to get me there.

Sometimes it’s a little harder to make the shift from control to surrender. Here are a few questions that can help:

1. What am I afraid will happen if I let go of control?

When you pinpoint the fear, question its validity. Ask yourself, Is it true? If you’re afraid the night will be ruined if your boyfriend doesn’t remember to pick up eggplant (and you’ve already reminded him 14 times), question that assumption.

Can you really know the night would be ruined without the eggplant? And if it would be ruined (by your definition, anyway), what’s so bad about that?

2. Find out whose business you’re in.

Your business is the realm of things that you can directly influence. Are you there? Or are you in someone else’s business? When we’re trying to control things outside of our own business, it’s not going to go well.

3. Consider this: Would letting go feel like freedom?

It almost always would. Let that feeling of freedom guide you toward loosening your grip.

A Friendly Universe

Einstein said, “The most important decision we make is whether we believe we live in a friendly or hostile universe.”

I believe in a friendly universe.

Being receptive and allowing things to happen is a skill that can be practiced and improved upon. It helps to believe in a friendly universe—one that is supporting you at every turn so that you don’t have to worry yourself over the details.

We can always choose to do things the easy way or the hard way. We can muscle through, or we can let go of the oars and let the current carry us downstream.

There is a peaceful, yet focused energy that accompanies holding the intention of what I want, but not forcing myself to do it. That energy is magic. I’m still a work in progress, but I’m allowing it to become a habit instead of making it a habit.

Reality Check: How to Test Your Anxious Thoughts

How we see it is how it will be.” (Anonymous)

Anxious ThoughtsWe most often suffer more from what we FEAR than what actually HAPPENS, so it’s important for you to learn how to evaluate what you are thinking. Things always look less fearful when we face them head on vs. running or distracting ourselves into TV, alcohol, food, or work.

Spend some time in your journal with your anxious thoughts, asking yourself these questions:*

  1. What is the situation that I’m stressed or worried about?
  2. What am I THINKING or IMAGINING?
  3. How much do I believe that thought? A little? A lot? Or give a percentage
  4. How does that thought MAKE ME FEEL? (assign a feeling)
  5. How STRONG is that feeling? A little? A lot? Or give a percentage
  6. What makes me think the thought is true?
  7. What makes me think the thought is NOT true or not COMPLETELY true?
  8. What’s another way to look at this situation?
  9. What’s the worst that could happen?
  10. Could I still live through that?
  11. What’s the BEST that could happen?
  12. What will PROBABLY happen?
  13. What WILL happen if I keep telling myself the same thought?
  14. What COULD happen if I changed or challenged my thinking?
  15. What would I tell my friend _________________ if this happened to him/her?
  16. What should I do now?
  17. How much do I believe that negative thought now? A little? A lot? Or give a percentage
  18. How strong is my negative FEELING now? A little? A lot? Or give a percentage.

Remember: you are not alone! I am here for you to evaluate and explore these fears and help you learn new ways of thinking and seeing your life.

 

*from the work of J.S. Beck

Regular Checkups: The Value of Maintenance Care

Regular Checkups“The depression symptoms are just so bad again,” my patient (fictional) sighed as she settled in on my couch after a six month absence. “I’m having the guilt feelings, sadness, no energy, trouble sleeping, and I’m gaining weight because of stress eating. I know you scheduled me to come in once a month for a while after we finished the Plan of Care, but I thought I was cured and didn’t need to. Can we get me back on track?”

As I listened sympathetically to her complaints, I couldn’t help but think how her pain could’ve been avoided with a simple monthly check-in session. Issues such as depression, anxiety, panic attacks, relationship changes, and poor self-esteem don’t develop overnight, and don’t permanently go away that quickly either. But once change has been achieved in counseling, the progress can be maintained with follow up care. Left without this support, issues can return-and often do.

Think about it for a moment. There is no other doctor or dentist that we see once in our lives, and never again, yet we think one round of therapy can permanently keep us mentally healthy? Problems and challenges arise throughout life, just like illnesses and cavities do, to use the medical support mentioned above as an example. Having the skilled insight and support of a therapist to manage these challenges can be the difference between a prolonged struggle or a successful and quick resolution.

I encourage you to use me as a resource throughout your life, much as you do your other healthcare providers. Why struggle alone? I am here for you through your darkest times or just times that the stress feels overwhelming. Let’s maintain the progress and keep you on track!

Signs of Codependency

CodependencyYou Won’t Change, So I Must Be Doing Something Wrong:

A Quick Look at Codependency

Codependency is excessive emotional or psychological reliance on a partner, typically a partner who requires support due to an illness or addiction.

Being in relationship with an alcoholic, addict, or otherwise out of control person often causes behavior traits to emerge that cause great misery for the “helper.” I often see this person in my office, who comes in wanting to know how to change their loved one. Unfortunately, we cannot change another adult, and efforts to do so usually make the addict resist control by going deeper into their addiction.

The Mistaken Beliefs of Codependents:

“If I AM: good enough/nice enough/skinny enough/vigilant enough/accommodating enough/loud enough/upset enough…

“If I say it enough times in enough different ways…

“If I give enough money/withhold enough money, give sex/withhold sex, pout, criticize, get you out of bed in the mornings, do all the irrational things you demand…

THEN YOU WILL BECOME THE PERSON I WANT YOU TO BE.

You will do what I think you need to do to fix your life, our relationship.

You won’t drink/cheat/use drugs/yell/hit/get mad at me.

You will appreciate me.

If I do all of the above and you STILL DON’T become the person I want you to be, then I FEEL LIKE A FAILURE. I FEEL GUILTY.

I keep doing these things because I believe it will make you/others/God pleased with me. You/others/God will admire me for my sacrifice. This is what makes me worthy.

I know exactly what YOU think, feel, and need, and why. I can analyze you endlessly.

I have no idea what I think, feel, or need, or why. And I am uncomfortable when my counselor asks me to be still, listen to myself, journal, dig deeper, try new things that might make me happy, set a boundary with you.

I would much rather figure out what’s wrong with YOU than look at ME.

Tips for Coping with Panic Attacks

Always begin with a visit to your doctor or health care provider to ensure that there is not an underlying medical cause to your symptoms. Don’t self-diagnose.

Panic attack symptoms include:

  • Shortness of breath
  • Tightness in the chest
  • Rapid heartbeat
  • Inability to relax*

*(NOTE): since these can be symptoms of other medical emergencies, DON’T self-diagnose. Seek emergency medical care if this is the first time you’ve experienced this)

What Can I Do To Cope?

  • RATE the panic on a scale of 1 to 10, 1 meaning not bad at all, up to 10 meaning, call an ambulance! Anything we can MEASURE we can start to control.
  • ACCEPT, don’t fight. Fighting increases the bodily symptoms.
  • ASK yourself: what’s the worst that could happen here? How would I handle it?
  • BREATHE normally and naturally. Pay attention to your breath.
  • FOCUS on an object in the room. See it, describe it to yourself. This helps orient you in the present moment reality.
  • TIME the attack (measuring again). Note how little time it actually lasts.
  • NOTICE if the attacks are happening in a certain location or at a certain time (“cued” attacks.) When it passes, get out a piece of paper and write about that place or time. BE A SCIENTIST about your panic—objective, measuring, curious.
  • TAKE your writings to your counselor to further explore the causes of the panic.
  • REMEMBER that overcoming panic is not a matter of willpower. It is a malfunction of brain chemistry which can be helped by cognitive-behavioral therapy and/or medication.  Medication takes away the SYMPTOM but not the CAUSE. Therapy helps get to the root of the problem.

Remember that a panic attack won’t hurt your physically. Although it’s very uncomfortable, your body will continue to breathe and function through it. Relaxing even a small amount and observing what’s happening will give you a much-needed distance and perspective.

Healing The Past: Children of Narcissistic Parents

“Why is getting along with my mother so hard?” said my client, sighing deeply as she wiped away tears in session. “I feel anxious all of the time, I’m depressed, and I can’t even hear her sigh of disapproval on the phone without wanting to run and hide. What am I doing wrong?”

The tendency to feel like everything is your fault, and that YOU are in fact the one “doing something wrong”, is typical of the child of a narcissistic parent. Karyl McBride, PhD* also notes the following symptoms:

  1. feeling “not good enough”
  2. valued by your parent for what you DO, not who you are
  3. feeling unlovable
  4. constantly trying to win your parent’s approval
  5. your parent emphasizes how your behavior LOOKS, or makes them look, over how you FEEL
  6. your parent is jealous of you
  7. your parent doesn’t support your healthy expressions of self, especially when it conflicts with their own needs or threatens them
  8. In your family, it’s always about pleasing that one parent
  9. your parent can’t empathize with you
  10. your parent is critical and judgmental

There is typically a family “scapegoat,” a person on whom the family blames the problems. “If only Jane wouldn’t cross Mother…if only she would call her more often…THEN Mother wouldn’t get so upset.”

The truth of the matter is, a parent who is narcissistic is always going to be looking for ways that the “scapegoat” lets them down. This parent’s attitude is not, “what have you done for me,” but instead “what have you done for me TODAY?” It truly is never enough to get the “scapegoated” child off the hook.

Freedom comes when, with the guidance and encouragement of your therapist, you begin to gently challenge these things in the family and express your own needs.

*Will I Ever Be Good Enough? Healing the Daughters of Narcissistic Mothers

Healthy Self-Talk: Be Your Own Cheerleader

“I just can’t do ANYTHING right,” my client sighed as she settled further into the couch. ‘I should just accept that I am fat, depressed and a failure at relationships. Nothing will help me.”

And as long as she chooses to continue talking to, and about, herself that way, she WILL be overweight, depressed and alone, and most importantly, unable to change, regardless of her therapist’s skills. For the fact is that every cell in our body responds to what we think and say about ourselves.

Although most of us are familiar with the “love our neighbors as ourselves” directive, we miss the meaning of the last part. Most of us wouldn’t dream of calling our neighbor names or criticizing them point-blank to their faces, yet we look in the mirror and do it to ourselves every day. We feel compassion for our friend’s struggles with food, relationships or other issues, yet we are merciless and impatient with our own. Self love is a vital key to health, and self condemnation the thing that most often keeps us from our goals. For instance, if you are having trouble ending an unhealthy relationship, AND you “beat yourself up” for your “weakness,” we now have THREE issues to overcome—the relationship, the self loathing, AND the damage done to your self image by the insult! Self love, forgiveness for our mistakes, and patience with our failures leads to the strength and discipline necessary to move forward into a healthy, balanced life.

To become your own encourager and best friend requires a deep examination of who taught you to be self-critical in the first place. Where did the “I’m not OK” message come from? It is most often from one of two sources—either what was said about you by your parent, or what a parent said about themselves in front of you. If you heard negativity modeled in your growing up years, the pattern was set for you to live that way as well. Children really do learn what they live. But like any learned behavior, this thinking pattern can be changed; sometimes by yourself, and sometimes with the help of a counselor if the pattern is persistent or severe.

To remain vital and healthy in your thinking throughout your lifetime, practice catching yourself when you are saying or thinking self-critical things. Immediately visualize a big red STOP sign to interrupt the pattern. Replace the self-criticism with a positive, encouraging thought, such as “I’m proud of myself for trying to change.”

 If you focus on what you DON”T like about yourself, you will get more of it, but focusing on the successes in your life will lead to more success. Congratulate yourself on victories, whether it’s a ten minute walk when you really just wanted to watch television, or keeping your temper in traffic.

All of us respond to love and encouragement, including when we give it to ourselves. Give yourself the gift of acceptance!