Category: Depression

I see you, perfectionists.

Posted on by Dana Goldman

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

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.

Talking Drugs with your Teens: Good Luck!

Posted on by Dana Goldman

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!)

Posted on by Dana Goldman

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?”

Posted on by Dana Goldman

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.

 

Surviving Grief During the Holidays

Posted on by Dana Goldman

It’s that season. You know the one – the one where there’s upbeat Christmas music playing in stores, and it seems like everyone’s talking about The Holidays (Christmas, New Years – and, less often, Kwanzaa and Hanukah). It’s a special time of year! we’re told. A time for cheer! And parties! 

And the holidays sometimes really, really suck for people who are living with grief and loss. Those with grief don’t usually get a lot of attention at this time of year, or ask for it. (Who wants to say “oh, I’m decorating the tree thinking about my dear friend who died!” or “Hanukah feels different without my mom”). And yet, there’s a large group of us who are mourning someone who was important to us. And we’re more at risk for depression if we’re grieving and feeling isolated when we’re “supposed” to be feeling cheerful. 

I think it’s worth acknowledging that this particular time of year is chock-full of landmines for those of us grieving. Grieving is different for everyone, but a recipe you love might also be a recipe you associate with someone who’s died. The person you called first thing on New Year’s Day may no longer be around. Or, you might have had a terrible relationship with your cousin, but feel immensely guilty for not missing her. Did I already say this can really, really suck? It can be super stressful, even when we’re trying to be brave or have fun or appreciate what we do have.

Here are some great tips about surviving the holidays while living with grief.

And I want to plug the terrific book It’s OK That You’re Not OK. I don’t get paid to do so; I just sincerely loved this book and found it useful.

Take good care – especially now. Self-care is not a luxury when grieving; it’s a necessity.

 

 

 

 

The Hardest Things To Talk About Are Sometimes the Most Important

Posted on by Dana Goldman

It’s easy to circle around the hard things: Death, shame, our heart’s disappointments. They can feel too intense to name directly: abuse histories, experiences with sexual assault and harassment, death and loss, abortions and miscarriages. They hover at the edge of our consciousness, where we try to push them away and distract ourselves: the ways we’ve messed up or been let down, our regrets and fears, our shame and sense of unworthiness. They hover at the edge of our consciousness, where we try to push them away and distract ourselves. They can be overwhelming. We worry that if we let ourselves feel the feelings, we may get too immersed in them to find our way through.

I’ve been thinking about this a lot with the #metoo movement and #whyIdidn’treport. I’ve been asking the question: How is that I haven’t known until now that some of my beloved friends and family members have been assaulted? How is it that even in intimate relationships, these things go unspoken – and unasked about?

Asking takes courage, though of course it takes more courage to name outloud, to ourselves and others, the hardest things we’ve experienced. That’s why I have so much respect for all who continue to share their stories of surviving trauma, including assault and abuse.

We need these stories to be out in the open. The hardest things to talk about are sometimes the most important. For healing, we need to be able to hold each other with compassion and support – and to hold perpetrators accountable for their actions. For a more just society, we need to call out abuse and abuse of power. We need to address barriers to naming these difficult truths out loud – barriers that are significant to all people, and barriers that are often most profound for women of color.

I am continuing to work to make workspace a safe space, for all stories, for all aspects of self, for all experiences that have led us to this moment. I am working to ask and to listen to your stories, even the ones that are hardest to tell.

 

 

 

 

Taming and Treating “Privilege Syndrome”

Posted on by j_mcdonald

 

At some point, with many clients, comes an earnest variant of the same question: Who am I to have pain – or see a therapist – given that so many other people suffer in visible, heartbreaking ways?

I call this the Privilege Syndrome. The reasoning usually sounds like this:

• If I don’t live in a less-developed country where I only have access to one meal of day, I should be happy. (But I’m not.)
• If I have money, I shouldn’t feel depressed. (But I am.)
• If I have a job, I shouldn’t be annoyed with my work. (But I am.)
• If I don’t have to represent my race on a daily basis, or live in fear of violence, then I shouldn’t complain about the challenges I do have. (But I do.)
• If I have a loving family, I shouldn’t be lonely. (But I am.)
• If others respect me, I shouldn’t live in fear of rejection. (But I do.)
• If I haven’t survived one or more traumas, I shouldn’t be suffering. (But I am.)
• If my life looks good on paper, I should be happy. (But I’m not).

How lovely that so many of us know that other people also struggle! How terrible that we deem ourselves not worthy of struggling and suffering because of our privileges!

From a mindfulness perspective, Privilege Syndrome is all about getting caught in a mindstate of comparison, or what I and many other mindfulness practitioners call Comparison Mind. The good news about Comparison Mind is sometimes it makes us feel superior to others! But the bad news… well, you know all about the bad news of comparison. We end up feeling inferior and unworthy – and then judge ourselves for feeling so bad.

The truth is that we increase our suffering when we can’t acknowledge and accept our own pain and heartache. When we dismiss or minimize our own pain because So-and-So has it worse, we are acting from a faulty belief that suffering is reserved only for others.

The only “cure” for Privilege Syndrome is to learn to accept and honor our own suffering – no matter our privilege – while also acknowledging the suffering of others. When we can work toward the end of our suffering and the suffering of others, we stop comparing ourselves. Instead of landing in Comparison Mind, we access compassion. Instead of being better than or worse than others, we’re simply with ourselves and with others. That is connection. That is healing.

 

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.

What Information Should Families Have If Their College-Age Kid is Depressed?

Posted on by Dana Goldman

I read with sadness but not surprise this article about suicide on college campuses. A big question the article talks about is when and if parents should be informed if their age 18+ kid  is struggling.

I’ve written before about the rise in anxiety and depression in teens and the general public. The news on the subject continues to be disturbing, with a 33% rise in depression diagnoses between 2013-2016.

I’m so glad that depression is continuing to be identified more quickly, and that more and more people are willing to seek help. But these numbers – and the stories behind these numbers – speak to a pretty terrifying moment for young adults and those who love them.

Anytime I work with a new client, we talk openly and honestly about confidentiality. Lots of us have had the terrible experience of having someone betray our trust and confidence, and I’m committed to keeping therapy a private space. It’s impossible to get the most out of counseling if we’re worried about someone out of the psychotherapy office knowing what we’re talking about.

BUT – I tell everyone – if I start getting worried about a client in an immediate life-or-death kind of way – I will tell that client directly, not going behind their back, and we’ll talk about if my concerns are justified or not. If so – if a client agrees they’re in a scary moment – together we’ll figure out a way to pull in someone from their life who cares about them, and loves them, and desperately wants and needs them alive.

I love being a therapist, and I take the responsibility of it incredibly seriously – both in figuring out when and how to support someone to get more help, if needed, and when to uphold and protect confidentiality if more support isn’t needed.