Category: Depression

Yes, you can be “successful” and feel like shit

Yes, you can be “successful” and feel like shit

Restauranteur Chef David Chang has it all. At least on the surface. He’s the founder of a gazillion restaurants, is star of the TV show Ugly Delicious, and has won too many awards to count (really). He. Has. It. Made.

Except he doesn’t. In recent interviews publicizing his new memoir, he’s naming what’s been beneath the surface even as he’s been accumulating accolades: depression and bipolar disorder. I was really moved to hear this interview with him, and in particular his naming that professional success is not a protective factor when it comes to mental health. In other words – it’s great if you’re rolling in money, and have an awesome job, and people adore you. But checking off those boxes and looking good on paper, on the surface, doesn’t guarantee ANYTHING about your mental health.

I’m so glad David Chang is speaking up. So many of my clients believe they “shouldn’t” be feeling like shit because their life looks good on paper. (And there are some specific barriers that get in the way of Asian Americans speaking up about mental health challenges.)

I’m grateful for all those famous folks like David Chang who are speaking up about their experiences with depression (including Trevor Noah, Michelle Obama and Lady Gaga, to name a few). Each person who speaks up helps reduce the stigma of mental health challenges. And when we reduce stigma, we bring light to darkness – and it’s THEN that we can get and receive help.

David Chang at one of his massively successful restaurants.

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.

Trevor Noah, Depression, and The Ongoing Gaps in Mental Health Care

I just love Trevor Noah. And he’s just given me one more reason. He’s using The Daily Show to raise the issue of why black people and other people of color have a hard time seeking out therapy and finding useful therapists.

Trevor Noah has been public about his own experience of depression in the past, using his leverage as a celebrity to speak bravely and truthfully about what so often goes unsaid and unspoken. Is it a surprise that this extraordinarily funny and smart man also struggles with depression? It shouldn’t be. Noah reminds us that we can never know from looking at someone what their internal experience is. Never.

I’ve written about mental health access for people of color and crappy differences in therapists’ response before here. But it’s still hard to see these disparities continue. “Disparities continue” makes it sound clinical, impersonal—but what that means is that unless you’re white and middle class, it’s still extremely hard to find a therapist who is likely to get you and understand where you’re coming from. That’s the worst. It’s deeply painful to acknowledge you need help and seek it out just to come up empty or invalidated.

It’s time for therapists, and especially white therapists, to do better. As we prepare to enter 2020, us white therapists need to consider our own limited understanding of the varied experiences of People of Color and do our own work to see how race – including whiteness – affects how we care for our clients.

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.

Revisiting Habits, asking “How’s This Working For Me?”

A month ago I went cold turkey.

No online, paper, or radio news.

No social media.

No falling down the internet rabbit hole.

It wasn’t a particularly well-thought-out, planned-for decision. (Which defies everything we think we know about habit change – right? Conventional wisdom is that habits are easiest to change if we have a plan, have prepared, told significant others, have figured out alternatives, etc.)

But I had no plan. It was an impulsive decision, and I had prepared no one, including myself. I just knew that I felt attached at the hip to the news cycle, and wasn’t sure if it was serving me even though it’s easy to believe that we “should” be paying moment-to-moment attention. Life felt loud, like a bunch of clanging bells always ringing, shaking me out of my own thoughts and efforts. I felt attached at the hip to social media because of FOMO, but didn’t find myself happier or more connected as a result. (The research supports that anxiety and depression and isolation can actually increase because of internet usage!) I’m not morally opposed to the internet, and am grateful for the amazing things that happen on it and because of it. I hold no judgments of other people’s internet habits, but was finding that my own habits weren’t feeling particularly skillful. In other words: was it really worth the time and attention I was giving it?

Now, it’s been almost a month and I find that the impulse to open news and social media websites has mostly faded. Sometimes I find myself staring at my email, wanting there to be something entertaining and new there that somehow I missed, but then I realize – oh, I’m tired – or, oh, I’m not doing anything – and close the computer. Somehow, taking a sabbatical from most of my online world has reduced my stress and quieted the clanging.

I don’t miss the news. I hear from friends or family about what’s happening politically, and am concerned but also don’t miss the roller coaster ride. I’m finding other ways to be involved and engaged – reading more books (like The New Jim Crow and Mindful of Race), getting together more with colleagues, and listening to a series of Tara Brach’s lectures on Mindfulness and Psychotherapy. Somehow it seems like I’m experiencing more spaciousness as well – perhaps because I’m bombarding myself less with stimuli. I certainly don’t feel worse. If anything, I feel a bit healthier – a bit more here, in the present moment, with therapy clients and when I’m with family or alone.

My experience has reminded me that taking a step back to assess a part of our life – even a minute, mostly inconsequential part – can sometimes be useful. In the words of America’s favorite non-therapist therapist, Dr. Phil, “How’s that working for you?” He’s cheesy as hell, but it’s a great question.