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We Need to Talk – and DO – More about Suicide

I’m not into fashion (obviously, my clients would say) but the suicide of designer Kate Spade was big enough news to enter my orbit last week. I was still reeling from

the news, as I do with any news of a suicide, wrestling with the same questions as everyone else – namely, how can someone look so successful and yet feel so terrible as to take their life? – when chef Anthony Bourdain killed himself.

It’s so easy to believe that loads of money or fame or professional recognition should or would inoculate any of us from isolation and despair. But these tragic deaths are reminders that depression and suicidal thoughts don’t just hit those of us down on our luck. Financial wealth is not a guarantee of happiness or ease. Fame is not a guarantee of happiness or ease. Depression is real, and needs real treatment. There are myths about depression that are widespread, but it’s important to know the facts. 

The writer Andrew Solomon’s book about depression, The Noonday Demon: An Atlas of Depression, chronicles his experiences with depression and those of others – as well as looking at various treatments and interventions. For clients, the stories Solomon tells are a reminder that depression – as terrible as it can be – doesn’t have to stay a stagnant part of life. Things can get better.

What Information Should Families Have If Their College-Age Kid is Depressed?

I read with sadness but not surprise this article about suicide on college campuses. A big question the article talks about is when and if parents should be informed if their age 18+ kid  is struggling.

I’ve written before about the rise in anxiety and depression in teens and the general public. The news on the subject continues to be disturbing, with a 33% rise in depression diagnoses between 2013-2016.

I’m so glad that depression is continuing to be identified more quickly, and that more and more people are willing to seek help. But these numbers – and the stories behind these numbers – speak to a pretty terrifying moment for young adults and those who love them.

Anytime I work with a new client, we talk openly and honestly about confidentiality. Lots of us have had the terrible experience of having someone betray our trust and confidence, and I’m committed to keeping therapy a private space. It’s impossible to get the most out of counseling if we’re worried about someone out of the psychotherapy office knowing what we’re talking about.

BUT – I tell everyone – if I start getting worried about a client in an immediate life-or-death kind of way – I will tell that client directly, not going behind their back, and we’ll talk about if my concerns are justified or not. If so – if a client agrees they’re in a scary moment – together we’ll figure out a way to pull in someone from their life who cares about them, and loves them, and desperately wants and needs them alive.

I love being a therapist, and I take the responsibility of it incredibly seriously – both in figuring out when and how to support someone to get more help, if needed, and when to uphold and protect confidentiality if more support isn’t needed.

 

TV Families and What They Have to Do With Us

TV Families and What They Have to Do With Us

I haven’t seen the new reboot of Roseanne but grew up on the original series (along with so many other shows… I was permanently indented into my family’s couch for a few years there.) It’s been interesting to follow different reviews of the new version, including critiques of its social or political messaging and diversity as well as positive reviews (sometimes both from the same source).

But what’s been most interesting to me is what the show has already spurred – lists of other shows that may be worth watching for their depictions of “real” America and real families. I read this list with tons of interest: it includes shows I’ve heard of like Black-ish and Fresh off the Boat, and then others that my pop-culture-oblivious self had no idea about (like The Good Place and Speechless).

So why does this matter so much I’m posting about this? Because there’s often a link between what we watch and how we feel about ourselves and the world. When we consistently don’t see people who look like us on TV (as is the experience of most people of color), we get the message we don’t matter, and that our experience isn’t important. We begin to believe the lie that a “normal” exists and that we’re different in a bad way. Racism on TV shows can make us more racist too

There’s also lots of research, of course, that shows that when we only see stick-thin actors with perfect skin, we compare ourselves negatively to those images. In these and other moments, these TV images can make us feel worse and more isolated instead of what good TV can do: make us feel more connected and empathetic, and even boost our emotional IQ.

So I’m putting Black-ish on my list, along with a handful of other shows. Maybe you will too.

What I’m Reading: Grief, Loss, And Life After

What I’m Reading: Grief, Loss, And Life After

Grief and loss are the worst. And really it doesn’t matter whether it’s anticipatory grief (waiting for a death that you know is coming sooner rather than later), grief after an unexpected or expected loss, a collective grief (like after a school shooting) or grief involving trauma. What does matter is that grief can change our internal landscape and lived experience in an instance, sending us lurching into an existence we didn’t want and don’t know how to maneuver through. Probably I don’t have to tell you this, though. You know this from personal experience. If we live long enough, we end up carrying the losses of loved ones who’s died. It’s inevitable. And often very, very lonely.

When I heard Megan Devine talking  about her book “Its OK That You’re Not OK: Meeting Grief and Loss in a Culture That Doesn’t Understand” it was immediately clear that she gets grief in all it’s pain and complexity. She gets how terrible grief is and doesn’t try to sugarcoat it. And instead of trying to “fix” grief, she suggests tending to our own grief in a new, tender way.

Needless to say, I immediately went out and bought the book (from my favorite bookstore, Charis Books, how’s that for a plug?) Even though it’s been a number of years since my own latest grief, reading this book is like breathing a sigh of relief: finally someone who gets it!

A Quick Judgment Reality Check: 2 Questions & 3 Fast Facts

A Quick Judgment Reality Check: 2 Questions & 3 Fast Facts

Let’s do a quick reality check in the form of two questions:

  1. Mentally jot down one aspect of your life that you’re worried others judging you about. (Physical appearance? Certain unwanted habits? Your status with work?)
  2. Now ask yourself this: In the last month/6 months/12 months, how many times has someone BESIDES YOURSELF explicitly judged you specifically for those particular things? 

I ask these questions today with curiosity and sincerity. Judgment’s been on my mind since a local magazine writer contacted me to ask about parent shaming for an article she’s writing. (I’ll post a link when the article comes out!)

So often, articles about shame, guilt, and judgment focus on people besides ourselves giving us a hard time. And this does happen. In unhealthy families and friendships and in abusive relationships, we can get torn down and made to feel unworthy for who we are and our choices. And when we go against cultural norms because of values, beliefs, or life circumstances, it can feel like we’re swimming upstream and alone.

But most of the time WE are our worst enemies when it comes to judgment and guilt. Here’s how:

  • We compare ourselves to the curated versions of other people that they showcase online – without accounting for the fact that social media profiles reflect only a very partial reality.
  • We compare ourselves to an ideal version of ourselves – and usually our benchmarks for that ideal self keep moving, meaning we never feel okay just as we are. We “should” be doing more. Right?
  • We have unrealistic expectations of ourselves. We cannot do everything. We cannot be everything to everyone.
  • We spend time around people (and websites or blogs) that add to our already-existing worry about not being enough. 
  • We believe our worst moments mean something big and absolute about us. 

It’s natural to compare ourselves to others, and sometimes it’s useful. But if you find that your mind is full of anxiety, guilt and fear of judgment, it may be worth checking yourself to see where the judgment is actually coming from. You don’t need to beat yourself up. But you can see clearly – and seeing clearly is the first step to knowing what you may want to do differently. 

 

 

Instead of Resolutions, Try Reflections: 12 Questions to Reorient for the Coming Year

Instead of Resolutions, Try Reflections: 12 Questions to Reorient for the Coming Year

I managed to carve out two hours last week to reflect on the year that’s almost past. It can be hard for me to think about goals or even intentions for the future without such reflection. And the truth is we learn best when we can think about what’s happened and what we might do differently next time. When I sat down and thought and wrote about these questions, I was able to clarify to myself how I got in my own way during 2017 (mostly by overcommitting) and imagine what I want more in the future. I’m sharing my reflection questions in case they may be useful prompts for you as well.

-What in my life would I happily get rid of if I could? 

-What in my life would I be happy to have more of?

-What external factors are holding me back?

-What internal factors are holding me back?

-Where do I feel most insecure professionally and personally?

-Where do I feel most confident professionally and personally?

-What were the big areas of learning and growth for me this year in terms of my personal life and work? 

-When I was fatigued, why?

-When I was energized, why?

-What goals were easiest and hardest to meet this past year – and why? 

-If I gave myself permission to dream big, what would I want for this next year or in general?

-What big areas of learning and growth do I want in the coming year, both personally and professionally? 

 

 

 

What the Media Gets Wrong about Depression and Anxiety

What the Media Gets Wrong about Depression and Anxiety

Here are your instructions:

Go stand on the Beltline. Hang out across the street from my therapy office at Ponce City Market. Go anywhere in Atlanta. Go to Decatur or Midtown or wherever. Look around and do this: Spot the person who’s struggling with depression, anxiety or grief. 

Trick question? You betcha. I was grateful to read this story from Slate called Stock Photos are Terrible at Depicting Illness, Mental or Physical. In a nutshell, it’s looking at the feeble attempts made by photographers — and newspapers, and websites, and bloggers (including me), and everyone else — to depict anxiety, depression and other mood disorders. If you want to see for yourself, do a web search for “depression” and see what comes up. Same with “anxiety” and “grief” and “stress.”

The reality is that most people who are struggling are experts at looking like everything is fine. My clients work hard not to show how rough things have been. My clients don’t walk around with their head in their hands all day, double face-palming with tears streaming down their cheeks. They don’t crouch in a corner photogenically. They are working or going to school, being social, acting like everything is normal (even when everything feels terribly abnormal).

In counseling, we work so that acting “normal” comes from a place of feeling “normal.” Just because you can pretend you’re okay doesn’t mean you should have to. After all, you have better things to do with your life than spend copious amounts of energy trying to look like nothing’s wrong.

 

Teens and the Anxiety Epidemic

Teens and the Anxiety Epidemic

The New York Times Magazine cover story this past week was about teens and anxiety. Yay!

And it’s not that I’m a sicko who takes pleasure from other people’s suffering.

Rather, it’s nice to see attention focused on what’s been obvious in my office: that many teens — delightful, smart, precocious, thoughtful teens — are really struggling in profound ways. Self-harm is one way that this struggle shows up. A struggle to get to school is another big way this shows up. And it puts parents in a huge bind over what to do.

Here’s what I want you to know. Anxiety is terrible, and the impulse is to avoid anxiety by avoiding what makes us anxious. But as this article mentions, avoidance generally makes things worse. What helps? Looking at and re-writing thoughts, coping skills for calming the body and mind, and practice showing up for things that feel scary — like school.

 

A Way Out of Loneliness — And It’s Link to Depression, Anxiety and Other Ailments

A Way Out of Loneliness — And It’s Link to Depression, Anxiety and Other Ailments

The research is out, and loneliness is a public health epidemic. I was struck by this story on NPR earlier this week about not just its connections to depression and anxiety, but also its link to stress and resulting physiological problems. Of particular note: about 40 percent of people experience loneliness. That means there’s a lot of people feeling lonely… meaning we’re simultaneously alone in it, and also not alone with the experience.

The story comes from reporting from — who knew? — the Harvard Business Review about the impact of loneliness on workers.

I see teen and adult clients every day who you wouldn’t expect to be lonely. Lots of people have busy lives that may look fulfilling from the outside. Lots of us have relationships with people that have substance and depth. And yet – it may be that when we’re alone with ourselves, loneliness creeps in. Or we’ll be at a party, or at work, or with our families, and feel separate, like we’re pretending to feel something we don’t actually feel or pretending to be someone we’re not. Sometimes when we feel isolated, we stop going out — and then, as a result, feel even more isolated. Or we get busier and busier to avoid the feeling altogether.

There is a way out of loneliness that doesn’t require becoming busy beyond belief. I work with people every day on loneliness in a few different ways. First, we work so that relationships can become more authentic – so you have to hide less of yourself. This can mean dropping the need to look perfect, to yourself and others, which isn’t an easy task for many of us. We work on figuring out what you want for your life, so that you spend less time on things that feel fake or meaningless to you. We also work on your relationship with yourself. How can you spend time with yourself in a way that’s comfortable, and grow to have a relationship with yourself that’s companionable? Loneliness loses its steam when we grow comfortable with ourselves, and with being ourselves.

A Counselor’s Thoughts on Anti-Depressants and Other Meds

Happy? Antidepressants?New therapy clients often wonder where I stand about anti-depressants. Will I be pushing them? Completely against them? Chances are, your own thoughts about anti-depressants put you in one of three categories:

a. You see anti-depressants as similar to other meds that you might take for medical conditions like high blood pressure, migraines, or a bad cold. If this is you: You may have friends and family who have been open about struggling with depression, panic attacks, and anxiety. You may know people who’ve benefited from meds.

b. You want to avoid anti-depressants at all costs. If this is you: You believe you should be able to handle how you’re feeling without drugs; you may think it will mean something negative about you if you decide to try meds for awhile. You may also have known someone who’s had a negative experience on an anti-depressant (or perhaps you have had a negative experience in the past). You may worry that you’d be on a med for life, and you definitely don’t want that.

c. You’re wary, but open to anti-depressants if needed. “If needed” may mean that things would need to get unbearable for you to consider meds. If this is you: You may know people who’ve gotten some use out of meds, but others who may not have. You may have had some bad experiences of your own. You may have lots of mixed feelings and see the possible benefits but may have significant concern about possible side effects.

So where do I stand when it comes to anti-depressants and their psychopharmacology siblings? I’m pretty cautious about meds, but I don’t think they’re evil. I see medications as a tool that should be used thoughtfully and under close supervision. Here are some facts for you to know:

  1. Every person is different. Most people can benefit from counseling, and, sometimes, medications can help people get more out of counseling and make progress more quickly (especially in the case of severe depression).
  2. I always, always want to rule out a medical condition that may be causing anxiety or depression. Funkiness with the thyroid can often lead to depression and anxiety symptoms. I often ask that new clients go have a physical to rule out medical conditions as a cause for low or anxious moods. 
  3. If you’re struggling with basic daily tasks like going to work or school — and counseling hasn’t helped you with these tasks after a chunk of time, then a medication consult may be appropriate. 
  4. There are lots of alternatives to medications. Exercise, meditation, social time, meaningful activities, consistently getting good sleep, the much-derided self care, and some supplements can often be as helpful as medication.
  5. Most people who take medications for anxiety and depression don’t stay on them forever. You always, always get to decide whether to stay on a med or not. (That said, going off cold-turkey is never a good idea!)
  6. I always want any client trying a new medication to have a good psychiatrist or physician and to be in close contact during the first weeks of taking it. Most people do quite well on meds but we never want to take that for granted.

I’m always happy to talk with you about therapy and medication. Feel free to call or email  if you want help figuring out what’s going to be most supportive for you at this time.

Warmly,

Dana