Category: panic attacks

Teens and the Anxiety Epidemic

Teens and the Anxiety Epidemic

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 Counselor’s Thoughts on Anti-Depressants and Other Meds

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

Beyond Upset? 8 Small Things To Do Right Now

  1. First Things FirstFirst: Don’t make major life decisions in the middle of a crisis. If you’re feeling an impulse to make a big change right now, notice that impulse and then do yo
    ur best to sit on it for a few weeks.
  2. Undercommit. During times of challenge, you’re allowed to be a little flaky. I recommend sentences like “I’m a tentative yes for this” or “I’d like to, but I need to think about whether I can do this.”
  3. Limit your exposure to information you may find upsetting. Set a timer to remind you to stop compulsively reading whatever is making you panic. There will be plenty of time to read and learn later on. It’s not selfish to choose to opt out for a while.
  4. Get outside. Once there, move your body. Slowly is fine. Less slowly is also fine.
  5. Eat. At regular intervals. The best you can.
  6. Sleep. At regular intervals. The best you can.
  7. Find comfort. Take comfort. Give comfort. Cookies, TV, books, friends, and food are all good starts.
  8. Figure out a small way to use the power you have in a tangible way. That may mean doing something kind for someone else. That may mean volunteering. That may mean writing a letter to the editor. Be careful not to overextend yourself! Refer back to #2.

Dealing with our worst moments

“Whsecrets lead to depression and anxietyat would happen,” the attorney asked, “if everyone around you judged you for the worst moments of your life?”

The room fell silent. I was with a group at Atlanta’s Southern Center for Human Rights listening to a lawyer speak about his work against the death penalty. And while I haven’t ended up in prison for any of my worst moments, the attorney’s words have stayed with me.

At some point in our lives all of us act in ways that go against our values, principles and beliefs. We lie, or cheat, or cut someone off in traffic when we’re really mad at our boss or child. As kids, and then as teens and adults, we behave in ways we later want to forget because these moments stir up such guilt and embarrassment and shame. We get nervous someone will find out, and this anxiety can pave the way for depression or panic attacks.

So many of my counseling clients worry terribly about what I and others will think of them when one of their worst moments is revealed. They worry they will be judged as harshly as they have judged themselves. They worry that others won’t forgive them, especially since it has been so difficult to find forgiveness in themselves. They worry that others will write them off as bad, since they see themselves as bad.

I know these truths for two reasons: One is because I’ve listened to many of these worst moments in my therapy sessions with clients. Second is because I’m a human with my own worst moments.

Coming to therapy is a brave act. It takes courage to begin to speak about these worst moments and what we fear they say about us. When we speak them out loud, we often fear being judged as harshly as we have judged ourselves.

But there is more to us than our worst moments — much, much more. In counseling, we look at our worst moments and best moments from a place of compassion and curiosity, because we can learn from them both. It’s important to put both in a larger context, trying to make sense of them so we can let go of debilitating shame, depression and anxiety, and truly move on.

So please remember: There is more to all of us than our worst moments. There is more to you than your worst moments.