Hello Darkness, My Old Friend

Archive for the ‘Depression’ Category

Hello Darkness, My Old Friend

Posted on: January 9th, 2020 by Lindsey Rogers, LCPC

The temperature drops, the sunlight is scarce, and our mood, in turn follows suite. Perhaps for you, the winter is not a time to bust out your snowboard and ice skates and enjoy the falling snow. Maybe December does not make you feel jolly but instead causes you to experience some serious winter blues. Seasonal Affective Disorder (SAD) is a real disorder that is estimated to affect 10 million Americans a year according to NAMI (National Alliance on Mental Illness). Let’s find out more information about SAD and ways to feel gain control of our mood despite the darkness and winter chill.

Gasp. Do I have SAD?
Perhaps you have self-diagnosed yourself with SAD or even just notice that your mood changes throughout the year. The diagnosis of SAD was first acknowledged in the 1980’s and it is not considered a different disorder from depression but instead is characterized as a type of major depression which reoccurs in a pattern based on the seasons. It is possible to experience SAD during the spring and summer but this is less common. SAD is four times as common in women than in men. SAD is also diagnosed more frequently in young people and in those who live farther north or south of the equator. So hello, living here in the Windy City means we may be more susceptible to seasonal fluctuations in mood versus than our friends living in sunny Florida. In order to meet criteria for the diagnosis of SAD, a person has to meet full criteria for major depression during specific seasons for at least two years. So if the holidays have you feeling low for a day this year, it does not mean you have SAD. Criteria for major depression according to the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) includes symptoms such as having low energy, social withdrawal, overeating and weight gain, and increased sleep as well as others. Self-diagnosis (thanks WebMD) is prevalent and part of our culture and there is a lot to be said for awareness and insight, but if you are concerned that you are experiencing symptoms of depression or SAD, best to allow a licensed mental health professional or physician to diagnose and treat you.

But why so SAD?
According to the National Institute of Mental Health (NIMH), we don’t know the exact cause of SAD. However, research findings point to seasonal affective disorder being tied to brain chemistry and hormones. Some research has posited that people who experience seasonal affective disorder have trouble regulating serotonin. Serotonin is the brain chemical that is integral in mood regulation. Other research points to folks with SAD perhaps having an overproduction of melatonin which triggers sleep and makes people feel lethargic. And finally, there is also research that links SAD to a lower production of Vitamin D. Vitamin D has been linked to serotonin activity and therefore, mood symptoms. So, just as psychology is always trying to answer the question of nature versus nurture, there is some science backing up the brain science or nature aspect to this disorder.

It is helpful to know brain chemistry can certainly impact us but it is also possible that our mood lowers due to the limitations of winter. We can certainly succumb to feeling like we need to hibernate and hunker down inside. Don’t get me wrong, there is a lot of great content on Netflix this time of year. We can be less active and find reasons why going outside is not preferable when the weather is as the song says, “frightful.” When we are less physically active, we can often struggle with sleep regulation and mood. And hibernating can also limit our social contact.

How to beat the blues
In a hilarious episode of Broad City, the character Ilana soaks up the light from her light box (“Happy Lamp”) to help combat her seasonal depression. The need for the light grows and grows and she eventually creates a tinfoiled room to allow her more light exposure and in turn, more functionality at work and an improved mood. This is an extreme, yet comical, example of a treatment for SAD. Light therapy is used in treatment of SAD to replace the lack of sunshine during this time of year by providing exposure to a bright light. Typically, light boxes have a filter to keep out UV rays and include florescent light that is, according to NIMH, 20 times greater than regular lighting and requires exposure of up to an hour on a daily basis throughout fall and winter months. Also good to check in with your physician to see if taking a Vitamin D supplement or an antidepressant could also be helpful.

Ideally, anyone experiencing depression seasonally or regardless of the time of year, can benefit from psychotherapy. Exploring thoughts and feelings is always helpful. Perhaps there is some negative self-talk that gets especially loud during the winter and a trained mental health provider can help provide tools to address those intrusive and unhelpful thoughts. Behavioral activation is also an important aspect of treatment. Because winter can fatigue us (see desire to hibernate above), it is helpful to build in ways to stay active. This does not have to necessarily mean becoming an expert in a winter sport but can involve renewing a gym membership, exploring online exercise programs that teach you yoga moves at home, getting bundled up and going for short walks, or even finding a place like a mall that allows for indoor walking. Scheduling time to meet with friends to cook with or starting a book club can be good ways to make socialization part of your winter routine. Even scheduling a weekly phone call with friends or family can push back against feelings of isolation. Being intentional and scheduling allows for more accountability versus waiting to feel like you want to socialize. Finally, if time and means are available to you, it may be time to take that vacation and find some warmer and sunnier locales to enjoy. I mean, there is a reason the geese do it, right?!

Bundle up in hopefulness
The seasons are changing and your mental health can, too. You have to put on a warmer coat and add gloves and a hat when you leave the house now. In the same way, your mental health may need more care and extra layers of help, too. Know that you are not alone and there are ways to feel better. Living underground may sound easier right now but know with some work and effort, it is possible to make the winter feel a lot cozier.

‘Tis the Season of Gratitude

Posted on: November 26th, 2019 by Lindsey Rogers, LCPC

Fall and winter can be a difficult time of year. There is a lot of pressure to feel joyful, and when the cheery décor surrounding our workplaces, homes, and city is a direct mismatch to how we are feeling, it can foster an even deeper sense of sadness. Thoughts like, “It’s the holidays and I still can’t be happy?!” can overwhelm us and trigger feelings of guilt and shame. Finding joy and happiness can feel like an insurmountable task. But a powerful step in the direction of positivity is gratitude. Psychologist Robert Emmons, PhD is an expert in gratitude and defines it as “a sense of wonder, thankfulness, and appreciation for life.” Dr. Emmons divides gratitude into two parts: (1) acknowledging the good in our lives; and (2) acknowledging that the source of that goodness is outside of ourselves. It may sound tough to think about giving when you feel empty, but tapping into feeling grateful or thankful allows us those pinpricks of light to change your otherwise gloomy perspective.

How An Attitude of Gratitude Works
Depression and negative emotions turn us inward. It is hard to consider others or anything outside of ourselves and how bad we feel. Our perspective is skewed to a catastrophizing state of what is terrible and how life is going to get worse. When we feel this way, it is common to think that the curated version on social media is actually true and everyone else is having a great time during the holidays. Feeling bad can make us think, “Look at that! Everyone in Chicago is at the Christkindlmarket enjoying all sorts of holiday fun with their significant others but me!” Yikes, that sounds super gloomy. But those are irrational and definitely unhelpful thoughts. Implementing gratitude can allow us to have a bigger perspective and shift away from negativity. If you are feeling thankful, you are glad something happened or even happy something is over. If you narrowly miss getting sideswiped on your commute, you likely take a beat and think, “Wow, that could have been bad.” Depressive thoughts would keep you stuck. Those thoughts might include, “I am so careless,” or, “Why are bad things always happening to me?” Taking on an attitude of gratitude, however, allows you to zoom out from your own experience to see the bigger picture, like changing the screen resolution on your thoughts. There is that sense of “Whew, I survived that!” That feeling is gratitude. We are able to affirm what is good in our lives or in the moment instead of getting stuck with negativity.

How to Get Started on Thankfulness
This time of year, there are likely plenty of school-aged children tracing their hand and then turning their handprints into turkeys. Joining the ranks with the hand turkey might also be the practice of going around the table at Thanksgiving dinner and saying what you are thankful for. If you have been part of this table scene, how many times have you said pumpkin pie? Or the Bears? Maybe those aren’t profound moments of gratitude for humanity but they’re a great start. A way to expand past the amazing stuffing or the scoreboard on Thanksgiving is to first find some time that you can collect your thoughts. Start by taking out a journal or a blank document on your computer screen. Try to start a list of things for which you are grateful. This can be a feeling or an actual event. It can be a person, place, or thing. You can experience gratitude for something very tiny or something huge. Maybe you structure your thoughts around what you are grateful for at a certain time of day or time of year. Maybe you consider who you are grateful for and think a little more deeply about why. You can write bullet points or a list. You can write a letter to express your thankfulness to someone and you don’t even have to send it. Journaling is a great practice but there is no one-size-fits-all, right-or-wrong way when it comes to gratitude. And these are your own thoughts so be honest. No one gets to tell you that you aren’t actually experiencing gratitude.

How to Expand on Gratefulness
Gratitude is about seeing the good in life, but ironically focusing on your challenges or hard times can also be a good place to start. Remember when we were talking about feeling depressed? Making a leap to feeling thankful during the holidays may be too much. But if you are struggling or have been challenged in the past, examining how you got through it or what you learned from it can be a great way to tap into gratitude. You don’t have to fully jump into joy and reverence. But acknowledging in even a small way how now is slightly better than then or how you have grown and learned since that previous bad time is a great way to change your perspective.

Volunteer work and contributing in a philanthropic way can help foster a sense of gratitude. You can acknowledge how others need your help and you can see how others in need feel grateful. You can see how thankful someone feels when they are in need and you give them something they need. Helping others can trigger you to think about how others have aided you or currently support you. In this way, you are giving back and getting all at once. What a great deal!

How to Manage Roadblocks with Giving Thanks
Sometimes, gratitude is hard to come by, such as when you find that you are getting stuck on journaling or find yourself feeling bored. If you are starting to check out and you find yourself wanting to say something like “blah, blah, blah,” then put down your gratitude journal. Because here’s the thing: Gratitude does not work if you are going through the motions. You may need to change it up. If writing down grateful thoughts does not trigger positive feelings, perhaps you need to say those thoughts aloud to yourself or mediate on those thoughts. Another way to freshen up your practice is to change your expectations—maybe daily gratitude practice feels thankless but taking time to journal once a month works much better for you. Gratitude can be a personal practice but you can also share your feelings with others. You can communicate to friends, family, strangers that you appreciate them. They’d probably appreciate your gratitude, too. And do not worry, you won’t run out of gratitude. This is an emotion that can replenish itself so there is plenty to go around.

An important trap to avoid with gratitude is judgment. If you are journaling and those nasty “shoulds” start appearing, do your best to reset yourself and challenge those unhelpful thoughts. When thoughts like, “Well, I should really be grateful for this nice house but I actually hate it” or anything that makes you feel stuck creep in, put away this exercise and try again another time. Or try to counter that thought with something like, “But I do really feel grateful for my neighbors.” Your feelings are valid and you get to appreciate and value and express gratitude for what matters to you. There are ways to expand or grow. You can work on being more mindful and changing what you notice around you. But gratitude is about you feeling what you feel and you are the expert when it comes to that. No pressure to be grateful for anything. First try to examine what you are grateful for and if you want that to expand, keep asking yourself how you feel until you locate the pieces that trigger gratitude in you.

Gratitude, like cooking a perfect turkey, takes practice and the right conditions. Use this time of year to start thinking about and noticing things you are grateful for and see this as an opportunity to change your perspective and your brain. You will be supporting yourself and the world around you, which is goodness you can get on board with regardless the time of year.

A Holiday Survival Guide

Posted on: December 15th, 2016 by Justin Tobin

Written by: Lindsey Rogers

Before the Halloween candy is even handed out, stores like Target roll out holiday decor signaling that the time is upon us. Before it is time to “fall back,” let alone dig out some winter scarves, we are swiftly inundated with advertisements heralding “the most wonderful time of year!” But all this ever-present messaging of joy and cheer can cause a real disconnect for those of us who aren’t part of a loving, “traditional” family like the ones depicted in those saccharine Hallmark Channel Christmas movies. It can feel like a lot of pressure to engage in joyful gatherings when you feel stressed or depressed. Holidays evoke all sorts of feelings and memories in all of us—the good, the bad, and even the ugly.

Perhaps your family is similar to the ones in those iconic Norman Rockwell paintings in that you feel all warm and fuzzy when you think of the holidays and time with your loved ones. But even if you feel like you are one of the lucky ones who really get along well with your relatives, the holidays can mean pressure to follow through with traditions and rituals from the past. If you have a more challenging relationship with the people you grew up with, being back in your original home environment can trigger feelings of sadness and frustration. With the recent election results, family time can be even more fraught if you and your family members do not share similar viewpoints.

As if the days getting shorter and the weather getting colder were not enough, the holidays and their attendant obligations can bring up substantial anxiety and dread. Maybe it has for you? Well, grab a long pull of that hot cocoa and take a breath. There are ways to manage the ups and downs of holiday time with family. It is important to identify what you are worried about: Is it answering the question of who you voted for and why? Is it being asked about your plans for the future and yeesh, when are you going to settle down already?! Or is it criticism that this stuffing is not nearly as good as Grandma’s? If you are worried about judgment and disapproval, you can work on setting boundaries to decrease the likelihood of those fears being realized. Imagine putting on that suit of armor to protect yourself from emotional attacks. Perhaps this means asking to take all political talk off the table or having a good comeback like: “I don’t have an answer but I am feeling happy about the future” to ward off pressure to talk about yourself.  When all else fails, change the subject toward a more innocuous topic. And recall that, although family systems can make us feel like we are tiny children again, in reality, we are still adults and sometimes adults need to go take a walk. If holiday family time is feeling too stressful, take a break—whether that means going to the store for more ice or just escaping to that peaceful place in your mind for a few moments.

 

The holidays can not only make us feel less than jolly when it comes to our family situations but they can also bring a lot of other imposed celebrations. Work parties, gatherings with friends, and neighborhood get-togethers can create a dynamic in which the overload of forced cheer is impossible to push back against. Why keep up with healthy habits like good sleep hygiene, working out, and eating healthy when you can stay up late, party with your bosses, gorge yourself on holiday confections and drink so much spiked eggnog that it starts to taste good?! Not only can the holidays wreak havoc on things like caloric intake, but they can also do some financial damage. So before you create a debt-filled and out-of-shape new year to deal with, set some goals for yourself. The holidays are about indulgence—but indulge within reason. Build in some time to recharge and relax outside of those social gatherings and try to get back to your normal routine in between parties. That way, once 2017 hits, you won’t feel like you’ll need a scroll to capture all your resolutions.

So, maybe the holidays give you a mixture of feelings and that’s okay. Just know that before you realize it, there will be commercials telling you it is time for spring break and swimsuits…this holiday season will go by quickly. And with anything that is stressful, difficult, or pressure-filled, it is best to have a plan of action, implement ways to stay in control, and just try to keep it all in perspective.

The Boss, The Rock, and Don Draper walk into a therapist’s office…

Posted on: October 5th, 2016 by Justin Tobin

Written by: Justin Tobin

You know how that one goes, right?  Or maybe you don’t.  Because men, ‘real men’ like Bruce Springsteen, Dwayne Johnson, and Jon Hamm wouldn’t need therapy.  They don’t get depressed or anxious.  Or if they did, they certainly wouldn’t talk about it openly.  Or let it be known they have worked with a psychotherapist. But it turns out, that’s not true.  All three of these respected male celebrities have experienced and talked openly about their struggles with their mental health; Bruce Springsteen recently got candid about his lifelong struggle with depression in his new autobiography.  And it is time more men took their cue without fearing it would strip them of their masculinity.

frustrated young business man

Depression is prevalent in our society, and you’ve probably come across the staggering statistics one way or another: 15 million American adults experience depression in a given year; which breaks down to about 5 million men and 10 million women.  I personally think the rates are grossly underreported, especially for men, primarily due to the lingering stigma of depression. Too many men hide their depression from their wives, girlfriends, husbands, and boyfriends for fear of burdening them with their problems.  They hide their depression from their friends and family for fear of being seen as weak and not able to handle their problems or rise to life’s challenges.  Hiding not only echoes the belief that being depressed is not normal or healthy for a man, it also causes unnecessary isolation and crushing loneliness.

It would be unfair to fault the depressed man for not outwardly acknowledging or talking about their depression.  Simply put, they may not be ready to address their depression.  But there are many men who have decided to speak out, be honest, and shed shame.  And because some of these are high profile men like Springsteen, Johnson, and Hamm, it has made it easier to talk about in general because these men have been helping to flip the stigma upside down through their honesty.  We can even look to revered heroes such as Abraham Lincoln and Theodore Roosevelt and successful artists like Mark Twain and F. Scott Fitzgerald – they have all dealt with depression and found a way to reveal their struggles as part of their collective histories we can all learn from with fuller perspectives and appreciation for what it means to be a man working through mental health issues.

More men today need to follow this lead on talking about their depression.  Depression does not need to define who you are.  Like a Springsteen song, you can also be in charge of your own story.

 

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