Category: Anxiety

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

8 Tips for Talking with White Kids about Racism, Violence, and Charlottesville

8 Tips for Talking with White Kids about Racism, Violence, and Charlottesville

I have a love/hate relationship with the internet, but I’m all love for the world wide web when I see articles that aim to help adults talk to children about important issues like racism and violence. Unfortunately, this is a conversation that parents of color are used to having with their children. It’s time for white families to catch up.

At the bottom of this post are a few resources. And here are seven tips:

  1. Let your child know that no question is stupid.
  2. Provide age-appropriate answers that support what you want your child to believe about the world. Do you believe there are “good” and “bad” people? Then use that language. In my family, we talk about how when people feel mad or sad, sometimes they act in mean ways.
  3. Remind them what your family believes – and how that guides your family’s actions. For instance, “In our family, we know that everyone’s equal and important and so we treat everyone with kindness and respect. I’m sorry that other people don’t feel the same way.”
  4. Let them know that there’s also lots of good in the world. Brainstorm a list together of different things they’ve seen or experienced in the last day or two that have made them feel happy, loved and loving.
  5. Let them know your job is to help them stay safe.
  6. Limit exposure to upsetting media. Like adults, kids’ anxiety can go up when they have information they don’t have the capacity to fully process.
  7. Consider a realistic family project to help your child feel empowered to act. A few ideas are drawing a sign for your front yard, having a lemonade stand and giving money to a charity you believe in, or sending a thank-you note to an activist or politician you respect.
  8. Despite what many of us grew up believing, we know now that kids confront racism best when race is something they know they can talk about openly. Being “color blind” is a myth, and one that can be offensive to many people of color. Learn more about talking to kids about race here.

This article from the New York Times does a good job compiling book resources. 

Local bookstore Charis has compiled a great list of books. 

This article may be a helpful first-person perspective on talking with white children. 

 

Testing, Testing – Tips for Parents

These last few weeks, I’ve seen kid and teen clients’ stress skyrocket as a result of mandatory statewide testing. It reminds me of my own days as a student in DeKalb County schools taking the Iowa Test of Basic Skills way back in the 1980s. You may have a similar memory of using #2 pencils to bubble in answer sheets or long hours of boredom ctesting, testingoupled with the pressure to do well. As far as I can tell, none of that has changed.

It’s easy to be sympathetic to these clients and their anxiety. Tests can be confusing, and often don’t reflect what my clients have learned throughout the school year. Multiple studies over decades have shown that race and socio-economic class can impact scores, raising significant doubts about validity.  

And yet, even when these smart, savvy kids have this information, they still feel tremendous pressure to do well on these tests. For some, these test results make up a significant portion of their final grades in school. For some, their performance impacts eligibility for talented-and-gifted programs. For many, it’s easy to tie self-worth to scores — which means even more pressure to perform.

In my years counseling teens and kids, many parents have come to me saying, “my kid seems more irritable around testing time.” This is not a surprise. When we’re anxious and don’t feel a lot of control, that can come out as irritability or efforts to control other parts of our lives in constructive or not-so-constructive ways. 

So here’s what I tell parents:

1. Recognize that your child is likely feeling anxiety and pressure. They may not tell you that they’re anxious, but you may be able to tell if your child is acting out more than usual. Any perceived pressure from you may feel like “too much” to them, since they’re already worried and negatively anticipating the test.

2.  Help them prepare in practical ways (getting a good night sleep and eating a good breakfast beforehand). If their school allows books or other materials for in-between testing times, help them select something that will reduce boredom.

3. Reassure your child that you love them and that testing is much less important than other things (their character, perhaps, or their overall effort during the school year).

4. Make plans with your child to do something fun after testing is over. 

And, thankfully, testing will be done soon!

Grief Before They’re Gone

It’s become clear to me that it’s time to say a bit about anticipatory grief, that sort of pain we feel when someone we love is dying. This is different from grief we feel when someone is already gone; rather anticipatory grief is what we experience when we’re fully aware that a loved one is mortal, and dying, and that we’ll likely be here without them after they die.

anticipatory griefAnticipatory grief carries with it all the usual emotions of regular grief — including anger, guilt, anxiety, denial, bargaining, and sadness, to name a few — but is complicated because the person is still here, in some form or another. We can’t have the same relationship as before, and acting like everything’s “normal” can be a huge strain. We can’t imagine living without them, but we know things will not get better or easier. We know that dying leads to death, and the anticipation of this can be terrible – worse, even, than the death itself.

It’s an honor to get to support people who are experiencing grief. These are some of the most difficult, lonely moments that life brings us, and a time for deep reflection about who we are and what’s most important. It’s a privilege to walk with people through the desolate landscape of grief and help them find their way back home to their own precious life.

 

When the Political Gets Especially Personal

Sexual desire or its absence. Religious beliefs or the belief that the here-and-now is all we’ve got. The thoughts or experiences that make us feel weird, or embarrassed, or alone.

One reason I’m such a fan of counseling is that it’s a space to talk freely about aspects of our lives that sometimes go unspoken to even our closest friends or family members. We need places in our lives to talk openly about who we are without fear of being judged, criticized, or excommunicated from our most important relationships.

personalpoliticsIt’s been especially important to me lately that clients of all political persuasions know that politics is something they can talk about openly in sessions. Some are excited and hopeful as a result of this new presidential administration. Other clients are finding their anxiety aggravated and their depression worsening as a result of recent political actions. More than one has been in a fight with a loved one about ideology or the “right” way to act or react.

For many clients, the political situation has been a catapult into de
eper exploration of meaning and purpose. I can relate. In and out of session, so many of us are wrestling with questions of how to better translate personal principles into purposeful actions that go well beyond our own self-interests. We are exploring how to live with difficult emotions without acting out or checking out. We are figuring out how to engage in respectful dialogue that avoids condescension and assumes best intent. And, of course, we continue to discern how to respond to our own limits and needs with self-compassion.

This isn’t selfish navel-gazing; rather it’s trying to figure out how to live and stay connected to ourselves and to one another despite sometimes widely different beliefs about how to make the world a better place.

It is an honor to walk with clients through these questions, holding space for uncertainty, acknowledging fears and courage, and helping them connect to their deepest values.

“Adulting” Self-Care for Depression, Stress, and Anxiety

self-care with Audre LordeSo often we fall into the trap of thinking of self-care as selfish – especially when self-loathing and guilt is also present. I enjoyed this article “What Nobody Tells You About Depression” since it highlights the more practical (and sometimes painful) side of self-care that includes paying bills, making medical appointments, quitting activities that deplete or overwhelm you, and engaging in what may be challenging introspection. Here’s a quote from the article:

“What social workers and other people don’t often tell you is that self-care can be completely terrible. Self-care includes a lot of adult-ing, and activities you want to put off indefinitely. Self-care sometimes means making tough decisions which you fear others will judge. Self-care involves asking for help; it involves vulnerability; it involves being painfully honest with yourself and your loved ones about what you need.” –

I also love this quote to the right by the late activist and writer Audre Lorde. Even though I don’t think of myself as engaging in political warfare, I do know that my own acts of self-preservation help me be calm, present, and useful in the world at large during times of trouble and uncertainty.

 

The “Hilarious” World of Depression

Hilarious World of Depression

I’ve just listened to the first two episodes of The Hilarious World of Depression, a podcast series that interviews comedians about their struggles with depression, anxiety, and related mental health concerns. Weird combo? Yes. Does it work? From what I can tell, it sure does.

But you can judge for yourself. I’d love to hear what you think the podcast gets right — and wrong — about depression.

 

Beyond Upset? 8 Small Things To Do Right Now

  1. First Things FirstFirst: Don’t make major life decisions in the middle of a crisis. If you’re feeling an impulse to make a big change right now, notice that impulse and then do yo
    ur best to sit on it for a few weeks.
  2. Undercommit. During times of challenge, you’re allowed to be a little flaky. I recommend sentences like “I’m a tentative yes for this” or “I’d like to, but I need to think about whether I can do this.”
  3. Limit your exposure to information you may find upsetting. Set a timer to remind you to stop compulsively reading whatever is making you panic. There will be plenty of time to read and learn later on. It’s not selfish to choose to opt out for a while.
  4. Get outside. Once there, move your body. Slowly is fine. Less slowly is also fine.
  5. Eat. At regular intervals. The best you can.
  6. Sleep. At regular intervals. The best you can.
  7. Find comfort. Take comfort. Give comfort. Cookies, TV, books, friends, and food are all good starts.
  8. Figure out a small way to use the power you have in a tangible way. That may mean doing something kind for someone else. That may mean volunteering. That may mean writing a letter to the editor. Be careful not to overextend yourself! Refer back to #2.
Are Technology and Peace At Odds?

Are Technology and Peace At Odds?

My meditation teacher sent me this article I Used To Be A Human Being and I’m passing it along to you today. It’s all about how to live in an age of constant distraction and, fittingly, it took me three days and three sittings to actually finish it because of the distractions that bombard me.

I’m sharing this article because its author, Andrew Sullivan, speaks to the wrestling that so many of us do figuring out how to live with technology in a way that serves us. It speaks to the ways that technology often keeps us hooked into distraction and compulsive online searching rather than the more important (and often more difficult and painful) internal searching to find and explore the core of ourselves and our purpose.

I hope this article is thought-provoking in all the right ways for you today.

Why You Won’t See Me Quoted In A Magazine Next Month

images-2Last week, my email dinged with a message from a magazine writer asking for an interview. Hurrah! I thought. I love talking about therapy! But then I read closely. The writer wanted my expert tips on how parents should design their children’s rooms for optimal development, including the “right” kinds of toys. I felt my heart slowly sink back to it’s normal position in my chest. For while I love talking about counseling and kids, I hate doing anything to perpetuate parents’ anxiety that they’re not doing enough.

I laughed, thinking about my own kid’s room: a few pieces of used furniture; a motley assortment of stuffed animals (a few of whom have lost plastic eyeballs to our otherwise lovely dog), the usual assortment of kid-related clothing, and lots and lots of books. I’m pretty sure that if I had strong opinions about kids’ rooms, my own child’s room wouldn’t measure up. But the idea that kids only thrive in a very particular set of circumstances simply isn’t true.

So I ended up saying a big fat no to that interview request.

What’s in a kid’s room matters much less than who’s with that kid in life. Research supports that what matters most for healthy childhood development is the presence of caring, mostly-consistent adults, not the presence of particular toys in a certain sort of space.

Is this a missed opportunity for me to spread the good news about good therapy? Perhaps. But I’d rather miss out than spread misinformation and fan the flames of anxiety and guilt.