Category: Anti-Depressants

Happy New Year! Your WEIGHT is NOT your WORTH.

Contemplating a new year’s diet? If so, please first consider these words by Anne Lamott:

We need — I need — to have the same little talk we have every year at this time: I know you might be starting a New Year’s diet. I used to start diets, too. I hated to mention this to my then-therapist. She would say cheerfully, “Oh, that’s great, honey. How much weight are you hoping to gain?”

I got rid of her. No one talks to me that way.

Well, okay, maybe it was 10 years later, after she had helped lead me back home, to myself, to radical self-care, to friendship with my own heart, to a glade that had always existed deep inside me, to mostly healthy eating, but that I’d avoided all those years by achieving, dieting, binging, people-pleasing and so on.

Lamott goes on to say:

It’s really okay, though, to have (or pray for) an awakening around your body. It’s okay to stop hitting the snooze button, and to pay attention to what makes you feel great about yourself, one meal at a time. Unfortunately, it’s yet another inside job. If you are not okay with yourself at 185 pounds, you will not be okay at 150, or even 135. The self-respect and peace of mind you long for is not out there. It’s within. I hate that. I resent that more than I can say. But it’s true.

Sometimes people seek out counseling because of the pesky problem of a diet that just won’t work. Or in the middle of talking about depression or anxiety, a client will also mention a weight gain that’s simply intolerable. If weight’s not in the foreground, it’s always hovering in the background.

And there are good reasons why. In general, here’s the message that our culture gives us:

Weight is something that can and should be controlled: the more tightly the better. Weight – and appearance – matter more than health and happiness. Fat=bad, and too much if any fat makes us undesirable (to self or others). If we don’t fit the current white ideal of beauty, we should feel ashamed and make a massive effort (often using lots of hard-earned money) to “fix” what’s seen as a problem.  If we’re unhappy and dissatisfied, the messaging goes, losing weight will make us happy and satisfied, fixing all our issues with relationships and self-love and self-worth and self-confidence.

Sometimes these messages are so convincing, so embedded in the fabric of white American culture, that we don’t realize these messages are beliefs, not facts. And when we examine them for their truthfulness, it turns out that these beliefs range from complete bull to containing a bit of truthiness to being only partially true if placed appropriately within a larger context.

But here’s what I know.

*Weight can only be controlled to a certain extent.

*While “dieting” acts like it’s on the outs with certain crowds, it’s merely gone underground. It goes by code words now like eating “clean” and eating for “health.”

*The connection between weight and health isn’t as well established as we’ve been led to believe. The Health at Every Size movement and Lizzo (yay!) are challenging those of us who were raised to believe that being healthy means being skinny.

*When people lose weight, it usually doesn’t change how happy they feel.

*The energy that so many women spend trying to control their weight could be used for SO MANY OTHER IMPORTANT THINGS including: self-care, friendships, walks, exploring interests, toppling outdating systems of oppression, etc.

*We need to look at WHY we feel such a desperate need to control, WHY we can’t imagine being happy without being a certain (different size), WHY our self-love is tied up with weight.

I am so excited to be supporting clients to explore weight, body image, self-worth, and to begin to disentangle weight – and the overall need to control – from happiness. Best of luck to you this year as you experiment with different ways of being in – and thinking about – your body.

 

 

 

Talking Drugs with your Teens: Good Luck!

Every time I do a presentation for parents of teens, two questions just about always come up:

  1. Will my kid be a functional, productive adult, even if right now they’re (fill in the blank):
  • not doing enough homework?
  • not doing anything but homework?
  • not taking school seriously enough?
  • taking school too seriously?
  • going out too much?
  • not going out enough?

AND…

2. What is the “right” thing to say to teens about drugs and alcohol?

The first question has an easy-ish answer: Despite (or because of) your kid’s idiosyncrasies, they will most likely make it through adolescence relatively unscathed and learn enough adulting skills to have a pretty reasonable life, even if their life, values, and priorities are different from yours. Most of us get through adolescence. If you’re reading this, I’m guessing you did.

But the second question is trickier. What is the “right” thing to say to teens about drugs and alcohol?

For starters, I’m pretty sure there is no one right thing. Teens (and the rest of us) are getting insane mixed messages about drugs, especially marijuana, right now. Some parents buy marijuana for their kids; some pull out a frying pan and an egg to give a 1980s-esque demonstration showing this is your brain on drugs. Some places it’s legal; some it’s not. Some people swear marijuana helps with anxiety, depression, creativity, and sleep; some people argue it interferes with all of the above as well as with brain development, makes ADHD and motivation worse, decreases efforts to build alternative coping strategies, and lowers the effectiveness of anti-depressants.  It’s especially tricky when we consider how common marijuana use is among white people as well as people of color, and yet marijuana laws are so selectively enforced, with huge disparities in enforcement based on race. A black teen getting caught smoking marijuana may face drastically different legal consequences than a white teen doing the exact same thing. So how do you create rules or express family values when there are so many shifting cultural messages, and no coherent community principles or agreed-upon research to support, reinforce, or guide you? Not so easily.

But I think there’s an even more important question that’s even harder to answer. How do parents build a strong enough relationship with their teens to be able to talk about drugs and have the best chance of a positive impact? That’s the gazillion dollar question. And it has no simple answers… except maybe family counseling (which is of course my bias).

I loved this article and this follow up  for their thoughtful discussions of these topics. Pro tip? Print the article and send it to your kid and ask them what they think about it. Sometimes introducing a topic through an article is a way to open up a conversation without defensiveness.

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