Category: Anxiety

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.

 

 

 

Prepping for COVID Winter and an Unusual Holiday Season

Now that election season is almost over, it’s time to prep for COVID winter. Anticipating and preparing for the mental health (and life) challenges of a COVID winter is a must – especially if you’re worried about stress, Seasonal Affective Disorder, depression, anxiety, or increased isolation. Being proactive about mental health isn’t always at the top of our list (especially when the to-do list is LOOOOONG) but our efforts NOW can pay off in important ways.

The Mayo Clinic has this helpful list of suggestions for prepping for COVID winter. One recommendation that stands out is that we should EXPECT that our winter holidays are going to be different. Let’s wrap our heads around that now: our winter holidays will not be the same as usual. We’ll have to adapt traditions that typically involve family and friends or let them go altogether, at least for now. We may not get to have big Hanukah or Christmas parties, Kwanzaa celebrations, Christmas caroling, or New Year’s extravaganzas.

You don’t have to be happy about these traditions going on pause. In fact, give yourself some time to feel grouchy about these losses. (They ARE losses!) It’s hard to move forward if we don’t first mourn our losses. So, here’s a tip: allow yourself a day or even a week to feel all the feelings, whether it’s annoyance, frustration, sadness, anger, or depression. These losses of tradition are worth feeling bad about. (And for those of you saying “But I can’t! Other people have it SO MUCH WORSE” — I appreciate your consideration of others, but stop with the Privilege Syndrome. You trying to convince yourself you have too much to feel so bad doesn’t help anything… and actually gets in the way of letting emotions move through you in healthy ways.)

After that day or week of allowing all the feelings, THEN it’s time to look forward.

First: when it comes to the holidays, allow your imagination some room to roam. If you’re not doing the usual things during this holiday season, what might you be able to do? What might you want to do? What new traditions might you want to create? In other words: what opportunities can you find in the space that COVID has created?

Finally, when it comes to the possibility of anxiety and depression emerging or getting worse, you can be proactive here as well. What extra care do you need that’s realistic? Care can take a lot of forms: checking in with your doctor, taking vitamins, using light therapy, hosting Netflix parties or virtual game nights, and so on and so forth. Make a list and ask friends or family members for their ideas as well. And then put that list somewhere you can regularly see it (like a bathroom wall or on the refrigerator) so when (or if) the winter doldrums hit you don’t have to use energy to think – but can instead just act on the ideas you’ve already brainstormed.

I hope these tips are useful for you! And please reach out if we can be useful to you in other ways.

Tips for Election Anxiety

Hi y’all. It’s Dana here, your friendly local therapist with some unsolicited thoughts about getting through this upcoming election in one piece. 

Probably by now you’ve received a hundred texts, phone calls, emails,and  social media notifications letting you know about the election on November 3 and asking you in increasingly desperate pleas to PLEASE PLEASE VOTE. Lots is being written about making a plan for voting: requesting absentee ballots and returning them and confirming they’ve been received by your local election office OR voting in person and preparing for long lines, tech snafus and possible voter suppression. 

But there’s another sort of election planning that needs to happen that we also can’t neglect. This planning is more personal, and in some ways more challenging. After all, how do you brace yourself for the uncertainty of a hugely important election, especially given that results will likely not be known for days if not weeks? 

Y’all, it’s time to prepare yourself internally and internally for what’s to come. I’m hearing from friends, family members and clients about spikes in anxiety, a heightened awareness of uncertainty, and a general sense of being out of control. 

So, in hopes that this can be useful, here are some tips and strategies for the coming weeks: 

  1. Do what you can to remember the big picture – the scope of history and space. Even though this moment feels big and impossible it is, in the grand scheme of things, this is just a moment. This may be a good time to watch a documentary about space or nature. It may be useful to print out a photo of the world’s oldest living tree or Stonehenge as a reminder that now is not forever.
  2. It’s time to create a bit more structure and ritual in your day. A friend of mine is now spending 20 minutes first thing in the morning outside walking, followed by 5 minutes of stretching and 5 minutes of guided meditation. I’ve been trying to end each day with a hot bath and an unrealistic mystery novel. For other people, useful ritual might mean a daily habit of morning pages, a daily text check-in with a good friend, or having a mini mid-day dance party. 
  3. Get on a regular sleep schedule if possible. “Sleep hygiene” is the ultimate unsexy phrase. But there’s something to it. The more regular structure we create in the hour or two before sleep – and the more consistent we are about what time we get in bed – the better chance we’ll have of a good night’s sleep. (Pre-bed ideas: reading, letter writing, stretching, listening to music, connecting with a friend, hot bath or shower, or a small snack. Not so helpful for sleep: social media or news.)
  4. Replace doom scrolling with something less crazy-making (such as stretching, audiobooks, online games, etc.) The negative consequences of compulsively scrolling the news or social media have been well documented. In Jenny Odell’s book, How to Do Nothing, she names that this can be quite challenging – especially at first, and especially when so much is happening around us. She writes, “To pay attention to one thing is to resist paying attention to other things; it means constantly denying and thwarting provocations outside the sphere of one’s attention.” It’s time to consider unplugging, at least a little bit.
  5. Figure out what’s within your control and what’s not. Focus on what’s in your control.  What can give you a sense of purpose? If you’re anxious, how do you want to use that nervous energy? It’s unlikely that more information won’t make you feel any more settled. Instead, focus on what’s before you. If the election is important to you, can you write letters, make donations, call friends, post information in your community, or volunteer in another way? Other things that are in your control: how much attention you give the daily media rollercoaster, what you do to relax and unwind (and unplug!), and how you match your actions to your values. Research shows people feel better when helping others, so it may be time to do something for others. Bake brownies for a neighbor. Write and send love notes to your friends. You get the idea.
  6. Allow yourself some comfort. With heightened anxiety comes an understandable need for heightened comfort and soothing. Now is the time to start thinking about what provides you comfort and what might be soothing in the days leading up to the election. Some ideas: comfort foods, cans of soup or frozen pot pies, aromatherapy, nightly hot showers or baths, journaling, movies or TV or books that are soothing and easy. Time outside weeding or walking. Time with pets. Time with hobbies. 
  7. Connect with your people. Social isolation makes everything harder, and being connected to one another usually makes everything easier. If you’ve been out of touch with important friends or family members, it’s time reach out or set up a phone date.
  8. Work to have realistic expectations of ourselves and others during this wild time. Anxiety does not make us do our best work (or best parenting) and we are going to be distracted in relationships and work. Please, give yourself a break. If you give yourself a break it will be easier to give others around you a break as well.
  9. Finally, make a plan for how you want to spend election day and plan something to look forward to after November 3rd. If there’s a chance that anxiety will spike on election day itself, how can you prepare to meet that anxiety? Would it be helpful to keep busy, or to plan to have a quiet day? Is there a meal or a phone call that you could look forward to? Is it possible to plan for a hike or special outing the weekend after? If so, do it!

Managing the Chronic Stress of Parenting during COVID

Managing the Chronic Stress of Parenting during COVID

Photo by Raychan on Unsplash. Parenting can be so isolating, especially right now. Hang in there, folks.

My friend Suzanne, juggling two kids at home and a full-time job, found relief recently when she heard pandemic parenting advice from psychiatrist Dr. Matthew Biel on a podcast (last six minutes or so). “We’re not trying to get it right, get it perfect,” he said. “We’re just trying to do something that feels reasonably responsible.

I’ve been thinking about that advice – to aim for reasonably responsible parenting – ever since Suzanne shared that quote with me. The advice stood out because it goes counter to the belief that many of my counseling clients have that they should be rocking parenting out of the park – even during this COVID catastrophe and the depression, anxiety, stress, and isolation that has come with it. So many parents right now are struggling with a gap between their expectations of themselves as parents and the reality. For instance: Many parents have the expectation that they should always be able to be calm and patient with their kiddos. Next to perfect, really. But the reality is that most parents are struggling to do an impossible juggling act right now, and even under ideal situations it’s impossible to always be our best selves with our children.

I want to say that last bit again: It’s impossible to always be our best selves with our children. It’s not realistic. It sets us up for failure and the belief that we’re “bad parents” the minute we scream or stomp our feet or create an irrational or extreme consequence.

And the truth is that good parents scream and stomp our feet and do things we regret. Especially right now. And for good reasons. For the most part, we have more responsibilities right now and fewer resources (such as childcare, money, community, etc.). More responsibilities+fewer resources=stress. Big stress.

Parents, we need to lower our expectations of ourselves right now. This is not the time to aim for excelling. This is the time to aim simply for being reasonably responsible – making sure our kiddos are alive, safe, eating, drinking and sleeping, and aware most of the time that we love them even when we’re not acting like it. Is it ideal for kids to exist mostly on cheese and bread and cereal? Nope. But these are not ideal times, and they’ll still grow. Good enough. Is it ideal that most kids are spending tons of time on screens right now? Nope. But these are not ideal times, and this screen-gorging will not last forever. Is it ideal that parents are stretched beyond belief? Nope. But these are not ideal times, and our kids will survive our divided attention. If we give ourselves a break and aim simply for “reasonably responsible” so will we.

Are the holidays tough? If so, you’re not the only one.

There’s no way around it: the season of Thanksgiving and the holidays that follow suck for so many of us. As I’ve written here before, grief can be extra lonely and difficult when everyone around you is wishing you a merry Christmas or Happy Hanukah or meaningful Kwanzaa. All of us with complicated families struggle as we perhaps spend more time with family members than usual – or notice their conspicuous absences. Sure, spontaneous gratitude and good cheer may arise. But also there’s the potential for surges of sadness, sorrow, disappointment, anxiety, and pain.

Here’s what I want you to know:

The cultural myth that you “should” be happy at this time of year is not based in reality. If difficult things are happening or have happened to you, especially in November or December, it would be weird if you were suddenly all cheery. Same too if you have seasonal depression. Your low mood likely makes sense given the situation. And, when you beat yourself up for feeling bad instead of good, you’re adding to your pain.

Also, I want you to know that you are not the only one struggling right now. I have the privilege of sitting with lovely, kind, intelligent people every day who are grappling with how to navigate the holiday season without feeling crazy or eating all the cookies you didn’t actually like in the first place. I wish there was a secret handshake or cool badge people could wear to say you’re part of the club of people who’d rather just skip to January, so you could all know and enjoy each other, but alas… I don’t know of anything like that yet.

So, take good care. I MEAN IT. The only way to get to January is to get through November and December. And as stupid as it sounds, drink water! Sleep regular-ish hours! Take walks! Pet animals! And know you’re not alone. Really.

If I got a dollar every time…

Say I got a dollar every time I heard the following words:

  • “But other people have it worse.”
  • “Yeah I’m depressed and anxious, but I have privilege so I shouldn’t feel this way.”
  • “I’m not sure I deserve to be in counseling.”
  • “I’m worried I’m taking your time away from people who need help more than me.”

How much $$$ would I have at the end of a year if I faithfully put a dollar in a jar each time I heard a variation of these words?

Enough to go out to a great dinner. A really great dinner.

We often wish we could decrease stress and depression and anxiety by reminding ourselves of the hard stuff that other people face. But that’s not how it works.

I’ve written on this blog before about what I call “privilege syndrome” — the belief that if we have privilege in some way, it can be easy to feel guilty or judgmental about the ways in which we struggle. And this is common.

I wish that privilege could buffer us from anxiety. I wish that knowing about climate change or homelessness would mean that people with secure housing and middle class incomes could be immune or invisible from stress or depression or trauma.

But the brain and body don’t work like that. While those of us with stable housing or relationships may be less likely to experience trauma or stress, our nervous systems aren’t designed to tease out nuances of privilege. The body just experiences a flood of stress hormones like cortisol or adrenaline. The body just knows we’re depressed or anxious. The body knows we don’t feel okay, even if we try to use our intellect to convince ourselves we should feel differently.

And the research shows that judging ourselves for our responses and reactions don’t actually do much help.

Instead, I try to help clients cultivate neutrality or even self-compassion for our experience. It’s only by accepting what’s here – the pain, the suffering, the fear, the sadness – that we can begin to move through these difficult feelings. It’s only by acknowledging what’s true for us – whether we like the truth or not – that we can begin to move forward.

I see you, perfectionists.

Perfectionists, I have a heart for you. I get it. You don’t think of yourself as a perfectionist, you just think I don’t like to make mistakes. You know intellectually that your spouse/friend/employer would probably not dump you if you made a mistake… but why risk it? After all, making a mistake feels beyond terrible to perfectionists, like our lives and relationships and careers are on the line and the whole world could implode or explode at any moment.

So no wonder you live with a constant tension, a constant pressure, a constant anxiety, checking and double-checking to make sure nobody can find fault with you (except for you of course). And then of course if you’re critical of yourself—if you let Self Doubt or The Inner Critic be in charge—then maybe it won’t hurt as much if someone finds a flaw in you.

It’s not easy to live as a perfectionist. You might look like you have everything together on the outside—you might be organized, you might show up everywhere on time, your clothes are rarely wrinkled—but the inner reality can be so, so different and so, so difficult. It’s hard to live in fear of mistakes, to believe that mistakes will define us and make us less lovable (if lovable at all). It’s hard living with the belief that we’re one mistake away from unworthiness or that our worth in general stems from our ability to be flawless rather than our humanness. It’s hard to constantly compare ourselves to a version of ourselves we can’t live up to. And of course it’s hard as a perfectionist to open up to others, to admit what’s true: life is hard. Things aren’t easy. (Blog post continues after photo.)

Perfection isn’t all it’s cracked up to be.

Usually when perfectionists come to counseling, they’re coming to therapy for issues that they see as distinctly separate from perfectionism. But feeling out of control, experiencing anxiety about personal and the political, and feeling alienated and isolated, can all link back to difficulty allowing ourselves to be human and make mistakes.

There’s sometimes a mistaken belief that perfectionists have that anxiety and perfectionism is helpful, that without that pressure and tension and Inner Critic they may not be as effective. If I don’t beat myself up, how will I do my best?

But research shows that we learn and perform much better when we’re open and curious and allow our humanness to shine (including the messy parts). Shame and self-judgment, it turns out, bite us in the ass more than we think. It is possible to create a different relationship with ourselves, the Inner Critic, Self Doubt, and our lives.

Here’s a perfectionism test if you’re curious to learn more… and you’re always welcome to talk through concerns in our Kirkwood therapy office.

Abortions: When the Political Is Personal

It’s hard to turn on the news in Atlanta right now without hearing about the new anti-abortion bill that’s been passed in Georgia or anti-abortion legislation in other states like Alabama. This legislation fires up people of all beliefs and backgrounds. But it can also be triggering—if not outright re-traumatizing—to women who have made the difficult choice to have an abortion.

And most of the women who find themselves stirred up by all the talk about abortion will likely stay silent. Talking about abortion is still taboo even though an estimated one in four women will have an abortion during their lifetime. For many women, a past abortion is a secret they don’t share out of fear of judgment or because of judgment they impose on themselves. As a result, there can be tremendous shame, guilt, and unresolved grief—often leading to isolation, depression, and increased anxiety.

Grief? Yes grief. It’s totally normal for women who have abortions to need to grieve. Unfortunately it’s also perfectly normal for women to believe they “shouldn’t” need to grieve. But abortion is complicated for many women, a difficult choice at a difficult moment in their lives. Grief is normal and natural.

We know that the antidote to shame and unresolved grief is speaking our truths—the messy, complicated truths—to safe people in safe places. As abortion continues to be a political issue, I sincerely hope that all who have actually experienced an abortion are surrounded by comfort, love, and support. You are not alone.

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.

Hi, I’m Dana – She/Hers/Her (Gender, Gender, Gender!)

I led a workshop yesterday on mental health for parents of high school seniors. Introducing myself, I said, “I’m Dana, and my pronouns are she/her/hers.” Those same pronouns are at the bottom of my email signature. Were the workshop attendees confused by my sharing of pronouns? I couldn’t tell. But for lots of reasons, saying my pronouns is something I’m trying to do more often.

For many cisgender people (cisgender: people who’s gender identity matches what they were assigned at birth) the movement toward saying pronouns has been a bit baffling. Isn’t it obvious when someone’s male or female, man or woman? Not always. I was excited to go to a great workshop recently all about gender with multilingual Atlanta therapist Irene Celcer (her website’s in Spanish), hosted by the Georgia Society for Clinical Social Work. We talked about the difference between sex and gender (“sex is biology; gender is society”; “sexuality is who you go to bed with; gender is who you go to bed as”), gender incongruence (often known as gender dysphoria) and best practices for therapists working with LGBTQIA+ clients.

Especially given Atlanta’s big-big-big population of gender-nonconforming queer people, and the continuing discrimination and abuse they face – and often resulting trauma – it’s important to me that I and other cisgender therapists and counselors do our best to be respectful and helpful to these clients.

For lots of us who are no longer young adults, it’s a bit jarring to re-think our old ideas of gender, ideas we took for granted as reality. But one of the things I love about being a therapist is that I get to rethink old ideas and learn new ways of seeing and being. I am so grateful for this work.

I love the creativity of all the different affirming bathroom signs popping up around Atlanta.