Category: Family

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

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

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

Prepping for COVID Winter and an Unusual Holiday Season

Now that election season is almost over, it’s time to prep for COVID winter. Anticipating and preparing for the mental health (and life) challenges of a COVID winter is a must – especially if you’re worried about stress, Seasonal Affective Disorder, depression, anxiety, or increased isolation. Being proactive about mental health isn’t always at the top of our list (especially when the to-do list is LOOOOONG) but our efforts NOW can pay off in important ways.

The Mayo Clinic has this helpful list of suggestions for prepping for COVID winter. One recommendation that stands out is that we should EXPECT that our winter holidays are going to be different. Let’s wrap our heads around that now: our winter holidays will not be the same as usual. We’ll have to adapt traditions that typically involve family and friends or let them go altogether, at least for now. We may not get to have big Hanukah or Christmas parties, Kwanzaa celebrations, Christmas caroling, or New Year’s extravaganzas.

You don’t have to be happy about these traditions going on pause. In fact, give yourself some time to feel grouchy about these losses. (They ARE losses!) It’s hard to move forward if we don’t first mourn our losses. So, here’s a tip: allow yourself a day or even a week to feel all the feelings, whether it’s annoyance, frustration, sadness, anger, or depression. These losses of tradition are worth feeling bad about. (And for those of you saying “But I can’t! Other people have it SO MUCH WORSE” — I appreciate your consideration of others, but stop with the Privilege Syndrome. You trying to convince yourself you have too much to feel so bad doesn’t help anything… and actually gets in the way of letting emotions move through you in healthy ways.)

After that day or week of allowing all the feelings, THEN it’s time to look forward.

First: when it comes to the holidays, allow your imagination some room to roam. If you’re not doing the usual things during this holiday season, what might you be able to do? What might you want to do? What new traditions might you want to create? In other words: what opportunities can you find in the space that COVID has created?

Finally, when it comes to the possibility of anxiety and depression emerging or getting worse, you can be proactive here as well. What extra care do you need that’s realistic? Care can take a lot of forms: checking in with your doctor, taking vitamins, using light therapy, hosting Netflix parties or virtual game nights, and so on and so forth. Make a list and ask friends or family members for their ideas as well. And then put that list somewhere you can regularly see it (like a bathroom wall or on the refrigerator) so when (or if) the winter doldrums hit you don’t have to use energy to think – but can instead just act on the ideas you’ve already brainstormed.

I hope these tips are useful for you! And please reach out if we can be useful to you in other ways.

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.

Family Therapy Works!

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

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.

Surviving Grief During the Holidays

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.