Imagine you wake up one morning to an incessant knocking on your front door. You peel yourself out of bed in a groggy stupor, wondering what kind of surprise awaits you on the other side of the door. As you pull open the door, your heart sinks.
There on the doorstep stands your old friend, Mr. Depression. He came without warning. No letter. No phonecall. No email. Not a single little heads up. Even though you are very familiar with Mr. Depression and knew that he could be deciding to visit you again at any moment, you weren't expecting him. Not today. Not now. Yet, here he is, standing on your doorstep with his suitcase in his hand.
In an instant, everything changes.
Mr. Depression breezes by you and barges into your house, bringing with him a dark, heavy cloud that he places directly above your head. That old familiar feeling of self-loathing, hopelessness and dread starts to fill your mind. A heaviness grows in the pit of your stomach while a tightness creeps across your chest. That negative soundtrack in your mind kicks in and you can feel yourself sinking into a dark area.
In a panic, you start to ramble off a few questions for Mr. Depression:
Mr. Depression stays silent and simply stares back at you. He knows that you already know the answers to your questions. As you reflect back on the weeks leading up to this unexpected visit, you might be able to identify some triggers or warning signs; some clues that Mr. Depression was on his way for a visit. Maybe you were overworked. Maybe there was some additional financial stress in your life. Maybe there were some relationship conflicts. Maybe the weather was lousy. Maybe your nutrition and exercise patterns were off. Or, maybe there were no signs.
Sometimes the reasons for Mr. Depression's visits are rooted in our childhood experiences or are the result of trauma. Sometimes Mr. Depression visits us because of life adjustments and losses. Sometimes Mr. Depression is an old family acquaintance who has been passed from generation to generation. Sometimes Mr. Depression shows up for no reason at all. Yet, there he is, in your life. In your house.
Regardless of his origins, Mr. Depression has visited you many times before today. Sometimes he stays for just a day or so but sometimes his stays can be lengthier. When he arrives, he never tells you how long he is going to stick around. Mr. Depression is a terrible houseguest. He is demanding, consuming and completely attached to your hip. He follows you around everywhere you go: to work, places with your children, out with your friends, to the grocery store, in the car. Everywhere. He saps your energy and leaves you feeling completely empty. The longer he is here, the more effort it takes for you to do previously simple tasks like answering texts, getting out of bed, exercising, eating, even brushing your teeth or putting on a bra. Mr. Depression makes everything significantly more challenging and the whole time he is here, he is whispering awful things into your ear - he thinks you are a terrible person; he thinks you are ugly; he thinks you are a bad parent and an awful friend; he thinks you are a failure. The longer he sticks around, the more you start to believe his words.
Often when Mr. Depression comes to visit, you try your best to keep his visit a secret. You don't want your friends to know about your new house guest. Afterall, they might think you are crazy. They might think you are just looking for attention. They might not understand why you can't just grab Mr. Depression's suitcase, toss it out into your front yard and give Mr. Depression a good shove out the front door. They might ask why you can't simply choose to have a visit from Mr. Happy or Mr. Grateful instead. And while you know that your friends will mean well, their questions and advice will probably only tighten Mr. Depression's grip on your life right now.
So, you settle in and try to do the things that have made Mr. Depression leave in the past. Perhaps you adjust some medications, take some trips back to psychotherapy, focus on increasing your coping strategies, increase your self-care efforts and lean on people who are supportive and won't judge you. Over time, like always, Mr. Depression eventually starts to loosen his grip on your life. He stops following you everywhere and eventually one morning you wake up and find that he has left your house in the middle of the night. Of course, he always leaves things behind; little reminders that he was there and that he could be back at any moment.
But what is this visit from Mr. Depression like for the people on the outside, the people unaware of his arrival? For them, they often witness significant changes in their friend; perhaps overnight or perhaps gradually. Their once cheerful, outgoing friend now appears grumpy, irritable and sometimes non-responsive. Texts and phone calls to the friend go unanswered. They begin declining or canceling plans to get together. On the rare occasion that they do engage in social activities, they are a bit of a drag as they talk badly about themselves and focus on the negative. Even their physical appearance seems different. Their social media account activity changes. Friends might think they are being iced out of relationships, that their friend has suddenly become bitchy and uninterested or that it takes too much energy to be around their friend now. All of this means that by the time Mr. Depression finally leaves, he may have already caused some significant damage to relationships.
So, how can we minimize that chances of Mr. Depression destroying our relationships? One good start is to be honest.
For those of you dealing with the unexpected visits from Mr. Depression, consider being honest with those people closest to you. They will notice the changes in you anyways- help them to see what is at the root of these changes. Educate them about your experiences with depression and teach them about what you need in terms of support. If you are struggling with depression and would like additional support, please review The Depression Toolkit.
For friends of someone who might be struggling, be supportive and resist the urge to pass judgement. Remember that the vast majority of individuals would much rather Mr. Depression not be a part of our lives. It's not a choice they make for attention or sympathy or medication prescriptions; It's just part of them. Holding space and providing support for someone with depression can be emotionally exhausting so remember to take care of yourself during those times as well. For additional resources for family and friends, please visit the University of Michigan Depression Center.
For more articles on mental health, depression and self-care, click on the following links:
Now that I am Getting "Me" Back, I have been much more mindful of the concept of balance in my life. For many years, I have grappled with the age old question "Can we really have it all?" While I tend to believe that we can, in fact, have it all, I don't necessarily think we can have it all in total balance all the time. In other words, sometimes something has to be focused on a little less so that our other needs can be addressed. Recently I was reminded via Timehop of how important tracking my macros used to be to me from a physical standpoint and I realized that macros are a great metaphor to how to balance life.
So, what are macros?
I'm sure there is a scientific explanation for macros but you won't find it here. In my experience, macros are components of nutrition - namely carbs, proteins and fats. They are elements that make up the food we eat. Our body needs carbs, proteins and fats each day to help it function at its best. When I was working out 12+ hours/week, my body always functioned best when my average daily intake of food was 40% carbs, 30% fat and 30% protein. Other people's ideal macros may be different. It took some trial and error and experimentation to determine what was best for me. Was I perfect every day? Hell, no. But, it sure felt good when my pretty little macro pie chart was perfect. There was no denying that everything just clicked when those three elements were balanced in the way that worked for me.
So, how does this relate to life? Easy. What are your life macros? What are the components of your life that each are good in their own way but need to be balanced in order for you to function at your best? In other words, what makes up YOU?
My macros include my various roles in life: psychotherapist, clinical supervisor, professor, mother, wife, friend, healthy woman and pet owner (perhaps pet collector?). Are all of my roles equally balanced each day? Hell, no! Are there areas which need to take more of my attention or fill my life more than others in order for me to feel whole? Absolutely!
Are you ready for a small homework assignment? (Sorry, sometimes my CBT and professor sides start to show). Grab a writing utensil and piece of paper. Or, open up a new document on your computer.
1. Make a list of your life macros. Who are you? What is important to you? What are your various roles? What makes you YOU? Write those down.
2. Assign a percentage to each of your life macros. How much of your attention and focus each week gets directed at each macro? Be honest. This should be how things get distributed on average each week, not how you want them to be distributed. Don't forget about your elementary math skills - these percentages need to add up to 100%
3. Are there things that are missing from your list? Things that make you YOU but you are not giving attention to right now? Add those to your list and write "0%" beside them.
4. Draw a pretty little pie chart of your life macros so that it reflects the assigned percentages.
5. Take some time to reflect on your chart. How does it feel? Is it accurate? Are you proud of it? Do you wish it were different? If your pie chart is perfect and you feel totally balanced, bravo! Store that chart somewhere handy and refer to it regularly to make sure you are keeping your life macros in balance. If not, read on...
6. After you have spent some real time reflecting on your macro distribution and chart, make a new one - one that reflects your ideal life macros. What would your ideal life macros be and how much attention would they receive?
7. Now it's time to create an action plan. What would it take to be able to shift your current life macro chart to your ideal one? What small things can you do today to help get your macros moving in a way that works better for you?
Spend some time evaluating your life macros and seeing how making some adjustments might move your life to a more balanced and satisfying state.
For more blog articles on self-care, click on the links below.
Have you ever felt like you can’t catch your breath, are wound-up or on edge?
Have you ever felt like your mind is racing and you can’t keep up?
Do your thoughts about what you have to do consume you?
Have you ever laid in bed awake and unable to fall asleep because you have so much on your mind? Have you ever realized that your shoulders and neck are so tense that they become painful?
Have you ever felt like there is an elephant sitting on your chest making it difficult to breathe?
Have you ever wanted to lock yourself in a room and hide from all the things that you have to do?
Welcome to anxiety.
There is some good news, though. You are not alone. Over 40 million adults in the US report some level of anxiety. That’s 18% of the population. For over 4% of those individuals, their anxiety is severe (National Institute of Mental Health, 2016).
Think about those numbers and then think about your life. Chances are that nearly 20% of the adults in your life have dealt or are currently dealing with anxiety issues. That’s 1 out of every 5 people you know. Yet, for so many people, anxiety is a shameful secret they struggle to hide.
When your anxiety rears its ugly head, you might find yourself thinking things like “What’s wrong with me?” “Why can’t I just stop worrying?” “Why can’t I just be grateful for all the good things in my life?” You might find that you are starting to turn to some unhealthy coping tools such as cigarettes, alcohol, drugs and food. You might find that your anxiety is causing you to miss work, cancel social activities or even starting to impact your physical health.
It’s time to tell anxiety who is the boss in your life. It’s time to tell anxiety to hit the road. It’s time to take control of your thoughts and your mind. You deserve it. And I have a magical solution.
Wouldn’t that be nice?
Unfortunately, there is no magical solution. It’s entirely possible that your good friend anxiety will stay will you forever. (Wow. This article is turning out to be super motivational and inspiring so far.) The good news is that you CAN learn some ways to manage your anxiety. Anxiety is not something you can beat forever. It is a part of you and is probably part of what makes you, YOU. At some point in your life, your anxiety may have even helped you! However, it does not need to control you or define you. So, let’s look at some ways to manage this beast called anxiety and prevent it from taking over our lives:
1. Let Go of Perfection
Many people with anxiety have a belief that they need to be perfect. The perfect mother. The perfect friend. The perfect neighbor. The perfect employee. To you, a messy house is an indication of failure; a child with hair that is a bit overdue for a haircut means that you are a neglectful parent; leaving your trash barrels out until 6pm means that you are the worst neighbor ever; being 10 pounds overweight means that you are disgusting; asking your friend for help means that you are too needy.
None of that is true.
Your thoughts can become your own worst enemy. Stop trying to prove your worth. Stop trying to live up to people in your life that you think are perfect. Stop trying to be the best. Honestly, stop.
What would happen if you tried to just do the best you can do right now? Maybe your best today is to feed your kids mac and cheese for dinner. Does that mean you are the worst mother? No. Maybe your best today is to throw your dirty clothes in the hamper rather than on the floor. Does that mean you are a lazy slob? No. Maybe tomorrow you can do more. Maybe not. Don’t beat yourself up. Cut “I should” out of your vocabulary. Accept yourself for who you are right now and focus on the good, not the bad.
2. Rethink Social Media
A quick word on all those perfect people on social media: most of them are fake. Their pictures were posed and reposed, edited and re-edited. Their posts have been rewritten and reworded. Their videos have been cut and redone. What you are seeing is the best version of them, not the real version. Resist the temptation to compare yourself. If there are people on your social media accounts who always seem to have it together and you find that their posts somehow leave you feeling worse about yourself, try hiding their posts for a bit. It’s ok to take a break. They don’t even need to know.
3. Make Room for Self Care
In my experience, many of the people who struggle with anxiety are really wonderful caregivers – except when it comes to caring for themselves. They place everyone else’s needs above their own and by the end of the day, there is nothing left for them. That kind of behavior needs to stop if you are ever going to manage your anxiety.
What are some things that make you feel good? Is it 15 minutes drinking coffee by yourself in the morning - no phone, no tv, no other people? Is it a long bath at the end of the day? Is it one night out a week with a friend? Is it some time with a good book at night for 20 minutes? Is it scrapbooking or photography or writing? What is it that fills you up a little bit? Once you figure out what it is, schedule some time, preferably daily, for that self care activity. Even 5 minutes each day would be wonderful! Hold that time sacred. Block it out and schedule things around it. Don’t allow yourself to feel badly about it. Self care is not selfish.
A large part of learning to manage your anxiety is learning how to calm and quiet your thoughts. Many people have found activities such as yoga, meditation and mindfulness training to be effective at increasing their ability to quiet their mind. It’s not easy. You will likely find your first 5 sessions of yoga, meditation or mindfulness work will leave you feeling even more anxious because you will suddenly be extremely aware of just how fast your thoughts are moving. Stick with it. It will become easier and, with practice, you will be able to sit in silence without your mind racing. These are wonderful tools to have in your toolkit.
5. Get Moving
Physical exercise can be extremely beneficial for those with anxiety. Exercise can be something as simple as a 10 minute walk each morning. Go at it with the goal of increasing physical activity and decreasing your anxiety. Resist the urge to set sizeable goals for yourself with regards to weight loss. You want to avoid opportunities for causing more anxiety in your life. Set yourself up for success.
So, what do you do when anxiety hits you full force and you can’t catch your breath? Being able to get control of your breathing again is key. There are two main techniques that I like to recommend to patients:
7. Watch Your Diet
Take a few days and track everything you eat and drink. Also track any times of day where you may be feeling more anxious. Look for patterns. Caffeine can sometimes heighten your symptoms of anxiety. Perhaps it would be worthwhile for you to slowly decrease your caffeine consumption and/or limit your intake of sugar. Small and steady changes can make a big change over time.
8. Find a Counselor
Perhaps I am biased because I am a counselor, but I tend to believe that everyone can benefit from a counselor or psychotherapist. I recently talked to someone who was hesitant to contact a counselor because they didn’t exactly know how to explain their concerns to the therapist. Don’t worry. A good therapist will help you articulate and identify your concerns and needs. They also can help you learn new coping and calming strategies and skills, can assist you with areas of stress in your life and can help you increase your overall quality of life.
Not sure where to find a good therapist? Talk to your friends. They may be able to recommend a great one. You can also check out your health insurance company’s list of approved behavioral health providers. Psychology Today has a great searchable database of clinicians as well.
What if you see a therapist and don’t feel like you connect with them? Find another one! This is about you – not the therapist’s feelings.
9. Be Open to Medication
I am not one to advocate skipping all of the previous steps and going straight to medication. However, panic attacks and chronic severe anxiety can feel terrifying. There are many medication options available today to help manage anxiety. These medications can be taken daily or taken as needed. Some of you may be thinking, “I don’t want to be snowed.” Or “I don’t want a tranquilizer.” Fear not. Medications are much more refined today than they were decades ago. If you feel you may want to explore medications for your anxiety, speak to your primary care physician or schedule a consult with a psychiatrist. (In general, I find that a psychiatrist tends to be a better option over a primary care physician for medications for depression and anxiety – it’s their specialty.)
10. Be Kind to Yourself
This mantra seems to find its way into many of my articles. I cannot stress this concept enough to you. Be kind to yourself. Forgive yourself. Accept that you are not perfect. Accept that you are flawed. Accept that you are human. Surround yourself with people who allow you to be kind to yourself. Better yet, surround yourself with people who encourage you to be kind to yourself.
With anxiety, some days are harder than others. In fact, some days just feel damn near impossible. Know that those days will pass and know that there are resources, supports and tools available to help you manage your anxiety. You don't have to fight this battle alone!
National Institute of Mental Health. Any anxiety disorder among adults. (n.d.) Retrieved December 29, 2016 from https://www.nimh.nih.gov/health/statistics/prevalence/any-anxiety-disorder-among-adults.shtml
For more blog articles on managing anxiety and depression, click the links below:
Before I became a parent, I had some basic parenting expectations for myself. For example, I was quite positive that my children:
Once I became a parent, however, that list quickly got tossed into the garbage. Parenting, it turns out, is something that you can never fully prepare for or predict. I am often making things up as I go along, course correcting and adjusting as I evaluate how I am handling the monumental task of parenting. Most days I feel like a total failure but sometimes, every once in a while, everything falls into place and often, when it does, it's because I listened to that little feeling in my gut - my intuition.
Two nights ago, after a weekend full of sports game, field clean up, work, errands and kitchen painting, my 8 year old laid in his bed and sobbed in my arms about how all he wants is "one day to just do nothing." He was tired of school, tired of sports, tired of running errands, tired of having to clean his room. He was tired. His gas tank was empty.
I talk about this concept a lot with my patients - the notion that we are like cars (crude comparison, I know) and if we don't take care of our cars and fill them with fuel, eventually they will sputter and leave us stranded on the side of the road. My little guy was very quickly running out of fuel and was close to breaking down on the side of the road. With my patients, we brainstorm ways to refuel ourselves. For some of us, it's exercise, for others it's time with friends, for others it's time alone. For my insightful 8 year old, he had identified that what would refuel him was a day to just be a kid.
My initial reaction was to validate his feelings and commit to finding a time to take a day off together but as we talked, I felt that feeling. You know the one: that intuitive, instinctive feeling in our bellies or our chests that is left over from evolution. Usually it tells us what we need to know in critical moments - like when we are in danger. But, if we listen, it can also help guide us in our decision making process and let us know which decision is the "right" one. My gut was telling me that I needed to make time now.
I tucked him in to bed and then set to work rearranging my schedule so I could be home the next day. When he woke in the morning, I invited him to stay home with me and have his day off. He smiled bigger than I had seen in a few weeks, hugged me and ran into the living room. I also invited his older brother, who had been fighting off a virus, to stay home as well. It took him a good 30 minutes to make his decision but he also ultimately decided that he could use a day off too.
You read that right. I let my children miss school and neither of them were physically sick. But, I would argue, both of them were mentally and emotionally running out of fuel and needed some time off. After all, mental health and emotional health are just as important as physical health. In fact, they could be MORE important than physical health as it has often been suggested that when we are emotionally and mentally run down, we are more susceptible to illness.
The rules of the day off were quite simple - there were no rules. Also, there had to be fresh baked banana bread (per my 8 year's old request.) We stayed in our pajamas and sweat pants for the day, ate fresh banana bread and just "were." The boys played games, watched tv, played video games, drew, colored and played outside. It was like a snow day, the blizzard kind, where the roads get closed down and everything pauses. Except there was no snow and no need to shovel.
As dinner time rolled around, I found myself reflecting a lot on the day. My boys were smiling and their fuel tanks were refilled. I also noticed that my fuel tank was much more full. Hearing my children just be children and do the work of children - play - was a beautiful thing. If we, as adults, can take a breath and really evaluate our lives, we probably will find that we could benefit from more snow days, minus the snow, in our lives.
No matter how busy our lives are, I strongly believe we all can find a way to fit some snow days into our schedule. Sometimes the laundry, dishes, phone calls, bills, errands and work can wait. Sometimes it is ok to ask others for help. None of my hospice patients have ever looked at me while approaching their final days on Earth and admitted that they wished they had worked more, kept a cleaner house or spent less time with their loved ones. No. It's the opposite. Almost everyone I have been with at the end of their lives shares the same sentiments - it's the small things that matter in the end - time with children doing nothing, time with friends over coffee, tea or wine, lazy mornings with their partner. It turns out that often the things that refuel us are also the things that we treasure and need the most.
So, my challenge to all of you is to tune everything out for 5 minutes. Really. Do it. Let the dishes pile up. Leave the stack of bills on the counter. Leave the laundry in the baskets. Let those calls you need to return wait a few moments. Look around at your life. What is truly most important? What fills your tank? How can you make room in your schedule this week to fit in some of these activities?
I suspect that for many of you, you are running on fumes now. You are flying down the highway at 90 miles an hour, seeing your gas needle nearing closer and closer to "E." Yet, you are ignoring it, hoping that you can run on fumes, "just" a bit longer. Pull over now and fill that tank. Stop putting you and your own needs last. Make your own snow day!
About Changing perspectives...
I often find myself encouraging people to consider changing their perspective or reframe the way in which they view things. This blog is an extension of that practice and is also an opportunity for me to write from a number of different perspectives including clinician, educator, mother, friend and supervisor. Blog topics are also quite varied and changeable. Topics explored include, but are certainly not limited to, grief, parenting, health and wellness and relationships. Join me and explore a number of changing perspectives!