Category: Crisis

What’s “Normal” In the Slow Fade of a Pandemic?

What’s “Normal” In the Slow Fade of a Pandemic?

Posted on by Dana Goldman

Even as the pandemic begins a slow fade, the mental health crisis that the pandemic ignited in kids, teens grownups, and caregivers for elders is sticking around. In my therapy office of late, I’ve heard clients name rumination, depression, grief, more alcohol and marijuana, new existential questions about meaning and purpose, relationship challenges, parenting stress, exhaustion, preoccupation about weight, intrusive thoughts, and lots and lots and lots of anxiety (social anxiety, health anxiety, traveling anxiety, etc.) In fact, we now have a name for all the inner debris that the pandemic has left in us: Post Pandemic Stress Disorder. This is on top of all the stress, anxiety, depression, and relationship stuff many of us carry around even in non-pandemic days.

So here are a few points I wish we could all keep track of:

1: Sometimes my clients think that if an event is over, they should be over it. But our brains, nervous systems, and bodies don’t work like light switches. Rather our nervous systems are like cars — needing time to rev up and time to slow down. So it’s normal to not feel normal right now. It’s normal to be experiencing residual exhaustion, more sensitivity to stressors, and to generally feel on edge and like you don’t quite have your social sea legs. Does this mean it’s fun? No. But is having a disrupted nervous system normal given the completely abnormal last 16 months? Yes. Absolutely, yes.

2: During the last year plus, we’ve all been taking stock of our lives: what we like, what we don’t like, what we want more of, and what we want less of in our lives. If you are still looking around trying to figure out what you want your new normal to include and exclude, you are doing something important – and normal. Many of us have had a break from friends, commutes, social obligations, work travel, etc. and now, to some extent, we have some choices in front of us. Do we want to socialize more, less, or differently than before the pandemic? Do we want to advocate for different hours or different amounts of times at our jobs? Do we want to set different boundaries with our families or around our time? These questions are normal. And it’s normal to re-evaluate our priorities following a big, terrible event.

3: If you have gained weight during the last 16 months, congrats on being normal. As far as coping strategies go, eating a bit more than we need is not the worst thing ever. We’ve been going through an ongoing trauma, and our bodies naturally crave sugar and salt when we’re stressed. I hope you can give yourself a break over the weight gain. And maybe even learn about the Health At Every Size movement. Or if you can’t be kind to yourself about your body, please come see me and and let me give you a break.

4: Finally, if you’re feeling bad for feeling bad (as in “I have so much privilege, I don’t deserve to be having a hard time”) then congrats – also normal. Think of this like survivor’s guilt. There’s a guilty feeling that’s hard to shake. But guess what – this too is normal. And while I know it’s hard to stop guilt once it’s ramped up, your guilt does not help anyone.

So – what to do? Consider self-compassion. Surround yourself with people who will be supportive and not make you feel like a weirdo (unless you’re a weirdo in all the good ways). Remind yourself that your experience can be normal AND still be really, really hard. And help your nervous system know it’s now safe to calm down: through regular sleep, nourishing food and relationships, movement, time outside, and – the hardest for many of us – not pushing yourself too hard. Does all that sound impossible? If so, no worries… that’s normal too (and why we therapists are here).

Courtesy of Rahul Jail on Unsplash.com

“COVID is (Almost) Over: Why Don’t I feel OK?”

Posted on by Dana Goldman

This past 15-plus months of pandemic life has been a crash course in tolerating uncertainty. Remember when we weren’t sure how COVID spread? Remember when we weren’t sure if we should be wiping down our newly-purchased cereal boxes and bananas? Remember when we weren’t sure what school was going to look like in the months ahead? (Oh, wait… I think that last one about school is STILL true. Yikes.)

Living with the uncertainty brought on by COVID has been no joke. And the stress is still impacting our bodies even as life returns to some semblance of pre-COVID normalcy. Every week I see clients describing difficulties with concentration and focus and irritability and motivation and – last but not least – exhaustion. Is it possible that these clients are anxious or depressed or have ADHD? Yes, of course. But it’s also true that we’re still reeling from a catastrophe most of us couldn’t have imagined two years ago. We all just experienced – and are still experiencing – an ongoing trauma. Our lives were just turned upside down – and stayed that way for more than a year. Of course we’re not going to feel great. Of course we’re going to be struggling.

This relates to an insidious kind of suffering that I see a lot (and that I’m not immune to myself). It happens when we have an unpleasant experience (like “ugh, I’m exhausted”) and then judge ourselves for that experience (like “I shouldn’t be exhausted”). It has variations: I’m grieving a death or break up, but I should be over it by now. Or: I just had a promotion fall through, and something’s wrong with me because I can’t let it go yet. Or: I am struggling but I have so much, so therefore I am wrong to be struggling. (See: privilege syndrome.)

I find that it’s always useful to help clients set realistic expectations for the time and effort it can take to recover from a difficult experience or a trauma. And just because COVID is almost over, that doesn’t mean your body has gotten the message. Our stress is not, unfortunately, a switch that we can just turn on and off. That’s why – if you go on vacation – you don’t automatically feel relaxed. Your body and mind can be in stress-mode even if you’re wearing a swimsuit drinking a mojito.

Think about it like this: your nervous system has likely been on overdrive for more than a year straight at this point, with many more “fight and flight” moments (complete with the release of stress hormones like cortisol and adrenaline) and many fewer “rest and digest” moments. At this point, your body has developed a stressed-out baseline rather than a baseline that’s neutral or even relaxed. So it can take some intentional effort to reset and to re-teach our bodies that we are safe with no imminent threat to ourselves or the people we love.

BUT YOU ARE NOT A LOST CAUSE. YOU DON’T HAVE TO LIVE LIKE THIS FOREVER. There are some things we need to learn to accept in life (the need for sleep; the reality of pollen; the deliciousness of pizza). But feeling agitated, panicky, and anxious ALL THE TIME is NOT something we need to accept.

The brain is beautiful, and complicated, and capable of changing. So is your body. So are you, as a person who has survived long enough to be able to find and read this blog post. You deserve to feel okay, no matter your privilege or lack of privilege. You deserve to feel okay, no matter who you are.

It doesn’t have to be like this. Photo by Aarón Blanco Tejedor on Unsplash.
We Are STILL In A Pandemic

We Are STILL In A Pandemic

Posted on by Dana Goldman

We Are STILL In A Pandemic

I say these words multiple times a day, multiple times a week: We are STILL in a pandemic. I say these words when a client with depression can’t figure out why they aren’t feeling better, despite their best efforts: We are still in a pandemic. I say these words when a client with anxiety can’t figure out why therapy and exercise aren’t making them feel zen: We are still in a pandemic. I say these to people suffering from loneliness and grief as well as from chronic professional and financial and relationship uncertainty. We are still in a pandemic.

I say these words because it’s easy to dismiss the effort it takes to act normal – and perform normally – in hugely abnormal times. We think, Oh, it’s been a year, so I should have acclimated. This should be easier. But we are still in a pandemic. We believe, Well, I still have my job/home/health/privilege, so I shouldn’t be struggling. To you I say: We are still in a pandemic.

It doesn’t matter how much privilege we have and how much we have been spared. Chronic stress is real, and we are still existing within an extended period of trauma. This trauma affects not just those who have been sick with COVID, but also those of us (and it’s most of us) who have watched the slow-moving epic disaster of COVID wreak havoc on our communities, neighbors, families, economy, schools, the U.S., and the world.

When we beat ourselves up for feeling stress, loneliness, sadness, or worry, we make ourselves feel worse. When people with financial security wallow in guilt about what we have – when so many others live in scarcity – this does not help. Our self-flagellation serves no one and gets in the way of harnessing the energy to figure out how we can be useful to those around us.

So, in the words of the great Bob Newhart in the skit below: STOP IT. (And sheesh – if only it was that easy!)

Managing the Chronic Stress of Parenting during COVID

Managing the Chronic Stress of Parenting during COVID

Posted on by Dana Goldman
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.

Family Therapy Works!

Posted on by Dana Goldman

There’s a lot that I’m not intimidated by. While I’m naturally a bit introverted, I’ve worked hard to talk in front of groups fairly comfortably. I’m not scared of Atlanta’s parking garages, elevators, or boats (unlike certain family members). I don’t enjoy shopping, but I can hit up an Ikea and come out alive and well. In my therapy practice, I can comfortably help clients tackle sticky issues like challenging relationships, infertility, abortion, depression, grief, and trauma. But what puts fear in my heart?

The idea of being in counseling with my parents.

And I’m not the only one. Quite often when I’m working with a kid or teen, I mention that a few family counseling sessions might help with improving communication or clarifying expectations or figuring out how to respectfully disagree with one another. And then I watch those teens as their faces go from open and interested and curious (because after all, teens are awesome if you’re not their parents) to shut-down, please-Dana-don’t-make-me-you-must-be-crazy-if-you-think-I’ll-do-that.

And I get it. Family therapy can be intimidating. Kids worry they’re going to get teamed up on or lectured. Often they hate their parents seeing them emotional and would really rather not cry in front of their parents. Teens already recognize there’s a lot they don’t control in their lives, and family counseling can appear—at first—to be another place where they won’t have control or a voice.

And yet. And yet. Family counseling can be powerful: healing, reinforcing and strengthening relationships, shifting communication patterns to be more healthy and constructive, and building trust and mutual respect. Kids and teens find they have a voice and relax as they see their parents listening to them; parents find that their kids can hear them differently through family therapy. Together, we make strides to strengthen the family. Because at the end of the day, none of us lives in a vacuum. We’re all connected. So let’s work on being connected in healthy, happy ways… even if it’s intimidating at first.

Let’s have more moments like these, okay?

Abortions: When the Political Is Personal

Posted on by Dana Goldman

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.

We Need to Talk – and DO – More about Suicide

Posted on by Dana Goldman

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.

Teens and the Anxiety Epidemic

Teens and the Anxiety Epidemic

Posted on by Dana Goldman

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.

 

Separating Suicide Facts from Myths

Posted on by Dana Goldman

My heart has been hurting these past few weeks as I’ve been following a terrible story unfolding in the news. A teen was suicidal; his girlfriend urged him, via text messages, to actually kill himself. He did. She’s now been found guilty of involuntary manslaughter.

Everything about this story is awful, and this tragedy likely could have been avoided. Many people experience thoughts of “I just want this to end” at some point in their lives, and we know that most people who survive suicide attempts and live to recover from depression end up incredibly glad that they are alive.

Based on my professional experience, I want to mention a few specific points that are important for us all to know:

  1. If you think a loved one may be depressed or suicidal, it’s always, always, always worth getting them evaluated by a therapist or at a hospital. Here’s a good resource on identifying warning signs. There is no reason to wait. 
  2. No matter our age, depression and anxiety almost always cloud our judgment. For teens, add in a still-evolving sense of self, lack of control (here’s a great YouTube video my teen clients often like on the subject) and a still-developing brain and it’s a recipe for potential trouble. 
  3. You don’t need to tiptoe around the topic of suicide. It’s okay to say “have you been having suicidal thoughts?” This will not plant the idea of suicide in anyone’s mind and it may be a relief to have someone ask directly.
  4. The suicide case that I started this post with is the exception, not the rule. Many of the teens I’ve counseled over the years have risked important friendships by telling a parent or teacher when a friend has been depressed or suicidal. On the whole, teens, like adults, typically do the right thing — even when it has the potential for major social consequences.

The “Hilarious” World of Depression

Posted on by Dana Goldman

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.