Category: Depression

What the Media Gets Wrong about Depression and Anxiety

What the Media Gets Wrong about Depression and Anxiety

Posted on by Dana Goldman

Here are your instructions:

Go stand on the Beltline. Hang out across the street from my therapy office at Ponce City Market. Go anywhere in Atlanta. Go to Decatur or Midtown or wherever. Look around and do this: Spot the person who’s struggling with depression, anxiety or grief. 

Trick question? You betcha. I was grateful to read this story from Slate called Stock Photos are Terrible at Depicting Illness, Mental or Physical. In a nutshell, it’s looking at the feeble attempts made by photographers — and newspapers, and websites, and bloggers (including me), and everyone else — to depict anxiety, depression and other mood disorders. If you want to see for yourself, do a web search for “depression” and see what comes up. Same with “anxiety” and “grief” and “stress.”

The reality is that most people who are struggling are experts at looking like everything is fine. My clients work hard not to show how rough things have been. My clients don’t walk around with their head in their hands all day, double face-palming with tears streaming down their cheeks. They don’t crouch in a corner photogenically. They are working or going to school, being social, acting like everything is normal (even when everything feels terribly abnormal).

In counseling, we work so that acting “normal” comes from a place of feeling “normal.” Just because you can pretend you’re okay doesn’t mean you should have to. After all, you have better things to do with your life than spend copious amounts of energy trying to look like nothing’s wrong.

 

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.

 

A Way Out of Loneliness — And It’s Link to Depression, Anxiety and Other Ailments

A Way Out of Loneliness — And It’s Link to Depression, Anxiety and Other Ailments

Posted on by Dana Goldman

The research is out, and loneliness is a public health epidemic. I was struck by this story on NPR earlier this week about not just its connections to depression and anxiety, but also its link to stress and resulting physiological problems. Of particular note: about 40 percent of people experience loneliness. That means there’s a lot of people feeling lonely… meaning we’re simultaneously alone in it, and also not alone with the experience.

The story comes from reporting from — who knew? — the Harvard Business Review about the impact of loneliness on workers.

I see teen and adult clients every day who you wouldn’t expect to be lonely. Lots of people have busy lives that may look fulfilling from the outside. Lots of us have relationships with people that have substance and depth. And yet – it may be that when we’re alone with ourselves, loneliness creeps in. Or we’ll be at a party, or at work, or with our families, and feel separate, like we’re pretending to feel something we don’t actually feel or pretending to be someone we’re not. Sometimes when we feel isolated, we stop going out — and then, as a result, feel even more isolated. Or we get busier and busier to avoid the feeling altogether.

There is a way out of loneliness that doesn’t require becoming busy beyond belief. I work with people every day on loneliness in a few different ways. First, we work so that relationships can become more authentic – so you have to hide less of yourself. This can mean dropping the need to look perfect, to yourself and others, which isn’t an easy task for many of us. We work on figuring out what you want for your life, so that you spend less time on things that feel fake or meaningless to you. We also work on your relationship with yourself. How can you spend time with yourself in a way that’s comfortable, and grow to have a relationship with yourself that’s companionable? Loneliness loses its steam when we grow comfortable with ourselves, and with being ourselves.

A Counselor’s Thoughts on Anti-Depressants and Other Meds

Posted on by Dana Goldman

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

Blog Hodgepodge: ACE Scores, Bias, Lived Experiences, and A Radio Interview

Blog Hodgepodge: ACE Scores, Bias, Lived Experiences, and A Radio Interview

Posted on by Dana Goldman

I got to talk on the radio recently about depression, suicide, and teenagers. I’m glad to continue to spread the message about adolescent mental health concerns, even though it’s always sobering to consider how mental and physical health issues can be created or exacerbated by so many preventable factors.

I’m a big fan of the Adverse Childhood Experiences (ACE) Scale as a quick way to look at what sorts of factors may have been present – or absent – in my clients’ lives that may impact them to this day. None of us exist in a bubble. There’s good research on how trauma, neglect, race, class, immigration status, gender and gender identity, and so much else plays into how others treat us, brain function, and how we end up feeling about ourselves. (Here’s a recent reminder of racial bias affecting views toward young black girls.)

In my work as a therapist, I continue to be committed to seeing my clients as individuals whose own stories and experiences are a part of a larger social and cultural framework.

Some helpful stats about the importance of ACEs.

 

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 Science of Social Media and FOMO

The Science of Social Media and FOMO

Posted on by Dana Goldman

Next time you want to go on social media, do a simple experiment. Check in with yourself beforehand for a second. How do you feel about your life, your relationships, your job, your home? After hanging out on social media for a bit, check in with yourself again. Do you feel better or worse?

The science implies you’ll likely feel a bit worse. Some colleagues put me onto this episode of the podcast The Hidden Brain. It’s all about social media, FOMO (fear of missing out), and comparison. Listen here:

http://www.stitcher.com/podcast/national-public-radio/hidden-brain/e/ep-68-schadenfacebook-49872935

We all know our social media versions of ourselves leave out lots of aspects our reality (usually the ugly, the messy, the complicated). The science shows there are consequences to this, and to the comparison that inevitably happens when we spend a chunk of time on social media. It may be that I should be asking all my therapy clients about how time they spend on social media. Counseling helps alleviate depression and anxiety, and it may be that one simple step we can all take is to monitor how much time we spend online – and what we notice as a result.

When the Political Gets Especially Personal

Posted on by Dana Goldman

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

Posted on by Dana Goldman

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

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.