Category Archives: Mental Health

How to Help Your Depressed Son or Daughter

Mood Disorders, Depression, children, Adolescent, risk  The family is the basic fundamental unit of our society, and depression of one family member always affects the rest of the family.   A child struggling with temporary feelings of depression can be difficult to understand and deal with.   He or she may bring feelings of guilt, frustration or helplessness to parents.   It is important that treating depression be a priority. It is also important to recognize whether the feelings of depression are a short term concern or should be treated as a long term condition.

Without intending to, you can make your son or child feel rejected or misunderstood when you are confronted with their depressive behaviors.  All of the family members, including parents, brothers and sisters, and extended family, should have a basic understanding of depression so that the affected child is not shamed or misunderstood.   Your child deserves to have good support and understanding.  Your family deserves to feel safe and happy.

There are a number of steps that you can take to help your son or daughter who has depression.

1)      Understand that depression is very treatable.   Also understand that there may be reasons for the child’s low moods.   Gather information.   Encourage your child to talk to you.  Talk to the school, friends, and family to see if they have noticed a change in mood or behavior.  Take the child to his or her pediatrician to insure that there are no physical causes of the feelings of fatigue, aches and pains, and low moods.

2)      Provide love and understanding.  Learn about depression, so that you can recognize situations which may lead your child to feel rejected or misunderstood.  Make sure you know and they know that you love them unconditionally.  Help your child realize that his or her feelings are normal: “Everyone gets down sometimes.”  Your son or daughter needs to know that depression is not a sign of weakness, nor is seeking treatment.

3)      Don’t pressure your child to talk if they are not ready to.  Just be ready and available when they are.

4)      Keep kids busy.   Insist that they continue to interact with the family, that they get up, make their bed, do the dishes, do their homework.   Don’t let them avoid their responsibilities.  Of course, don’t yell at them, but coach them.  Gently confront their inactivity and isolation.  You don’t want your children to think that because they are depressed that they don’t have to follow the rules.   It is not an excuse.

5)      Encourage your child to exercise daily, or at least 3 times a week.  There is a lot of research to support the idea that exercise increases one’s confidence and positive feelings.  In addition, make sure that your child gets consistent regular sleep and eats regular healthy meals.

6)      Encourage your child to keep a journal.  Encourage him or her to write, draw, or doodle in it.  This often helps children to identify and express their feelings.

7)      Encourage your child to identify a few support people such as peers, teachers, or family members with whom he or she is comfortable sharing his or her feelings with.  Have these people regularly contact your child, and have your child regularly contact them.

8)      If your son or daughter continues to experience feelings of depression or shows any of the following symptoms, seek professional treatment from a Clinical Social Worker or professional counselor: making suicidal statements, is preoccupied with death in conversation, writing or drawing, gives away belongings, withdrawals from family and friends, or has aggressive behavior.

Gateway Counseling

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Letter Requesting a Letter of Love or Support…

Love Letter or Letter of Support from a Wellness JournalIn past posts, I have talked about requesting “love letters” or letters of support from family, friends, and sweethearts.  These letters should be added to a wellness journal, to be reviewed when you are struggling with feelings of depression, anxiety and loneliness.   I have included an example of a letter to give to your support person.   Keep in mind that sometimes you may not get your letter back for quite some time.  If you provide your loved ones with the paper and a stamped envelope, you may have better luck in getting it back.

Dear [sweetheart, family member or friend],

I have been working on creating a “Wellness Journal” to help me in treating my depression.    A Wellness Journal is a compilation of self-affirmations, positive memories, goals, tools, and letters from people who love and care about me.   I would like to ask you to assist me on my path to wellness and happiness.

One of the key components of a wellness journal is letters of love and support from people like you, people who love and care about me.   To this end, I would like to ask if you would be willing to write an honest, truthful letter outlining the positive things that you like and appreciate about me.

I will be reading the letter when I am struggling with feelings of depression and loneliness.  Memories and examples are often a terrific addition to the letter.   The letter does not need to be long, but it does need to be heartfelt.   Also please handwrite the letter, instead of typing it; there is something powerful about a hand written letter.

Once again, thank you for helping me to treat my depression and to navigate my path to wellness.

Love,  [your name]

Hopefully this example will help you in requesting letters of love and support from your family, friends and sweethearts.

Keep in mind that this only one part of the Wellness Journal, and is only one step on the road to mental wellness.

Your comments are appreciated

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The Whole is Greater Than Its Parts

Treating depression using wellness journals

Doodle Page from a Wellness Journal

The phrase, “The whole is greater than its parts,” is especially applicable when talking about a wellness journal for treating depression or other mood disorders.   Depending on the individual, a good wellness journal contains about  twenty or more sections or parts.   Each one of these parts by itself is a too. However, each one of these tools has limited use.

You will begin by adding the small “parts” of the journal to create a greater whole. It is only when you combine the parts together that the journal can help you the most.   Each of the separate parts is simple, and on its own, it is easy to discount its value.   It is only when you combine your positive affirmations, your spiritual affirmations, your loved one’s affirmations, your goals and dreams, and your memories that the journal truly becomes something that can make a difference in your life.

By combining all of these positive affirmations in one place, you may begin to recognize patterns of truth in those affirmations. It becomes harder to discount the words of one friend because you have many friends or family members making similar statements.

The next step is to add the wellness journal “part” of your treatment to the rest of your treatment tools in order to create the greater whole of your treatment plan. Depression, bipolar disorders, and borderline personality disorders are not simple problems.   Therefore, the treatments of mood disorders are not simple fixes. Wellness journals alone cannot fix complicated problems. Once you have created a wellness journal, you can start adding this powerful tool to other powerful tools, including medication, spirituality, counseling, exercise, support of sweethearts, and education, among other tools.

As you create your wellness journal, don’t get over concerned about the level of effectiveness of any one part.   Focus on the understanding that it is only one part of the whole, just as creating a wellness journal is but one part in your path to wellness.

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I love organized religion

Las Lajas Cathedral (Image Credit: Jungle_Boy [Flickr])As a therapist, I love organized religion.  It is my experience that more often than not the local Catholic, Baptist, Jewish, or even Mormon churches, to name just a few, are often very beneficial in increasing the well-being of my clients, especially those of my clients who suffer from mood disorders.  Of course, organized religion is not the same thing as spirituality. There are different benefits to be had from a life of spirituality. In this article, I only intend to address the benefits of participating in organized religion.

I do recognize that there are times when individuals have had bad experiences with organized religion.   However, if they have had positive experiences in the past, and if it has been a source of support in the past, I encourage the people I work with to regularly attend a church of their choice.   I see a number of positive benefits to both membership in a church and regular church attendance.

First, individuals who regularly attend church, including non-Sabbath activities such as a women’s group or scripture study, are regularly fed positive messages of hope.   Most churches that I work with tell their members that there is a God that loves and cares about them, and who wants them to succeed and be happy.   Most ecclesiastical leaders have been taught that depression is not a weakness of character or a result of sin and these leaders are increasingly encouraging their members to seek help from appropriate sources.

Secondly, people who regularly attend church benefit from the social support of individuals with like values and beliefs.  Congregations encourage fellowship; attendance becomes a source of friendship and camaraderie.   Belonging to this supportive group helps people who suffer from mental illness to feel buoyed up and less isolated.

Thirdly, when individuals who regularly attend church stop attending because of personal challenges, people notice.   Ecclesiastical leaders and members reach out to these individuals, asking what is wrong and how they can help.   Members do not have to face loss or depression alone.

I would never push religion on anyone, but when I find that someone has found support in organized religion in the past, or who is currently attending, I encourage it.  In my experience practicing a religion can be a valuable tool towards seeking better mental well-being.

I welcome your comments, but please do not post any disparaging remarks about any specific religion.

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What is a Wellness Journal, and why should I create one.

Wellness Journal for treating Depression

Wellness Journal

A Wellness Journal is a simple tool which contains coping strategy used by individuals who suffer from depression, bipolar, or other mood disorders to help keep themselves healthy.   It contains about twenty different sections that are created when you are in a good mood so that you can use it to prevent or get out of depression.   It is a tool that does not replace medication or counseling, but augments existing treatments.

A good Wellness Journal is like creating a savings account.  When you are feeling well you contribute to your journal.  Then when you are down, or are seeing warning signs that you may be entering a down you make a withdrawal from your journal.  However unlike a financial savings account, a withdrawal from this account does not reduce your savings.  One entry can be withdrawn hundreds of times.

A Wellness Journal is powerful and proactive yet it is simple enough that anyone can do it.   Even people without depression can create and benefit from Wellness Journals and most people can see how they are beneficial.    Some of the individual parts of the Journal have been well researched to yield positive results, others I have learned about through speaking to other therapists, or through firsthand experience.   A wellness Journal is a constantly evolving tool, which is unique to the individual, and addresses his or her personal challenges.

I encourage my clients to create wellness journals because I want to encourage self-reliance.    I want people to have the tools necessary to succeed without me.   I don’t want them to need me when they are in a crisis.  I don’t want to be their therapist forever.  I want to give individuals tools that help them move on with their life.

Wellness journals are not time consuming, and can be integrated into your daily life with ease.   If working on it by yourself, you can spend as little as five minutes a day writing in it.   If working with a counselor you can spend part of your session each week working on it, in addition to the time spent on your own.   Poor reading or writing skills, penmanship, concentration, or finances are not barriers to creating an effective and valued wellness journal.

When loved ones see your consistent dedication to working on your wellness journal they often recognize your efforts and become reinvigorated in supporting you in your journey towards wellness.  Therefore I recommend that people don’t keep the journal hidden from their loved ones.  It is not something that needs to be hidden from prying eyes, as it contains only positive things.   If someone were to happen upon it they would find nothing that would embarrass you.  My children regularly read my Wellness Journal and comment when I am not following through with things, such as my Wellness Plan.

It is so simple, but so powerful.  In my journey towards wellness my Journal has been an integral part of keeping myself healthy.

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Having depression is like having a pet Zombie … it eats your brain.

Wellness PlanHaving depression is like having a pet Zombie … it eats your brain.

Of course there are a lot of clinical explanations to what depression is, and its symptoms.  It is hard for people who have not experienced depression to understand how depression steels your ability to think.   Depression is like having a pet Zombie. . .  Sometimes it gets out and eats your brain.

When you are depressed it feels like you are thinking in slow motion.    Doing anything requires effort even things that used to be easy.  Talking to people, deciding what you want to do, anything requiring mental ability is just hard.   Crazy thing is that you can still follow instructions, but it makes you angry when you do.   Your sweetheart can tell you to get out of bed, and you can do it.  You can follow instructions but you just can’t think for yourself and you can’t make any decisions.   All options seem bad.   Performance at work and at school plummets often because you can’t decide what to do next, or can’t concentrate on what you are doing.

Sometimes you even physically feel tired or have pain.   It doesn’t make any sense.  You know that you have slept for 9 hours, but you are still tired.  You know there is no reason for the pain, but it is still there.   Over time you get sick and tired of being sick and tired.   You just want to be happy, to be normal like everyone else.   You secretly hate the bubbly woman in the cubical next; talking about everything she did over the weekend.  You could have done all that stuff if you weren’t so tired and depressed, and dang it does she really have to be so annoying.

This is why you need an artificial brain.   You need to have made decisions for yourself when you still felt normal.  You need a Wellness Plan, or a plan of what you are going to do every day to keep yourself working even when you can’t think.  It is a list of everything that you should do on a daily basis, a weekly basis, and a monthly basis to keep working.   It lists things like taking your meds, going to church, calling your sister, seeing your therapist, exercising, everything that you have committed to do to keep yourself working even when depression has stolen your brain.

When you are depressed you simply forget to do the things that you know you should.  The more things that you forget to do, the more depressed you become and the more the situation starts feeling hopeless.  You begin to feel helpless to do anything to get out of your slump and abandon yourself to be ravaged by depression.   A wellness plan is absolutely critical in keeping yourself whole.  So get that Zombie back in it’s cage, and make yourself a wellness plan.

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Creating a Blue List

Wellness JournalsDepression feels like someone came and shoved out your brains.   You can’t think; instead you sit in a stupor, head in your hands, shoulders slumped forward.  All of the energy has somehow been drained out of your body; your arms are heavy and your chest is heavy.   All you can do is sit there and think about how depressed you are.  Sick and tired of being sick and tired.   Despite being hypomanic the week before last you can’t remember the last time you felt happy.  Worst of all, you recall distinctly telling yourself last time this happened that it would never happen again.  You would take your meds, exercise, eat right, and use your coping strategies.   This wasn’t supposed to happen.

You try to think of your coping strategies, the things that you had discussed with your therapist, but you can’t.  You’re too tired to call anyone.  You’re too tired to get out of bed; instead you sit and criticize yourself for how terrible you are, what a loser you are.

This is one of the problems with depression; it robs us of our ability to think, to make rational decision.  It robs us of our motivation and makes us feel hopeless and helpless.  This is a difficult concept for many people who have never experienced depression to understand.

However, there is a strategy that works for many of us.   This strategy makes up part of what I call a Wellness Journal.  In short, we make decisions ahead of time and write these decisions in a positive journal, so that we can use it as our “brain” when our brain is being sabotaged by the illness called depression.

The strategy that I’m referring to is a Blue List.   A Blue List is a list of things to do when we are feeling blue or depressed.   It’s very simple.   When you aren’t depressed, remember you can’t think well when you are depressed, you make a list of positive activities that you enjoy, and write them in your journal.

My Blue List contains the following:

  • Bake Rolls
  • Walk to the convenience store and buy a soda
  • Play on Pinterest
  • Read a book
  • Tinker in the garage
  • Doodle
  • Read my Patriarchal Blessing
  • Go running

Last time my family was out of town, I started seeing my warning signs of problems.  I found myself slipping into depression.   I pulled out my Wellness Journal, turned to the Blue list, and started doing those things that I had written on my list.   I’ve learned from this and previous occasions that you can’t always do everything on your Blue List, so it needs to be diverse enough to help you in lots of different situations, but I have also learned that it can be a life saver.  Each time I used one of those strategies, I was able to make it through another few hours and eventually days, until the hold of depression loosened its grip.

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Are you embarrassed to be mentally ill?

Quit it! Just quit being embarrassed about your mental illness! There was a time when I was embarrassed. Now, I have come to realize that accepting one’s mental illness is one of the first steps in recovery. Mental illness is no different than any other kind of illness; diabetes, arthritis, asthma… The list is endless. All of them are biological conditions which YOU DID NOT CHOOSE. No one ever woke up one morning and thought “I think I would like to have depression.” Yet many of us are embarrassed by our mental illnesses.

Well, of course, part of the reason that we are embarrassed is obvious. In spite of continuing education and progress in diagnosing and treating mental illness, significant social stigma surrounding mental illness still persists. The trick is knowing who to tell and who not to tell about your mental illness. It is important to surround yourself by individuals who understand that mental illness is not a result of a poor character, laziness, or a lack of determination.

The second part is more challenging; convincing yourself that the mental illness isn’t a result of something that you are doing or not doing. Unfortunately, many of us feel that we can fix ourselves if we just had enough fortitude, belief, or determination. We cycle, going off our medications, quitting therapy, telling ourselves that this time we have the determination to stay healthy without the “crutch” of a counselor, medication, or doctor. This is our illness lying to us.

Our embarrassment of our illness sometimes leads to premature termination of services. Yes, there is a time and place for quitting medication or counseling, but it is not because we feel that we are sick of being mentally ill, and we are going to be stronger this time. The decision to reduce medication or counseling should be made in cooperation with our therapist or psychiatrist. Reduction and elimination should only occur when we have developed the coping strategies necessary to handle the vicissitudes of everyday life without high risk of relapse. This cannot be achieved without the approval of your therapist. When we have successfully developed these skills, and only when we have developed them, is it time for measured reduction in our therapy or medication.

Premature termination of treatment of mental illness due to our embarrassment can cause the destruction of families, the loss of jobs, loss of friendships, hospitalization, worsening symptoms, and further embarrassment. This leads to the erroneous confirmation in our mind that we are somehow defective, and that we are ill because of poor character. It becomes a maelstrom sucking us into a life of despair and hopelessness.

Most people I work with know I am mentally ill. They know that I have suffered with the embarrassment of my mental illness. Hopefully they know that I have come to an acceptance that I am mentally ill. I cried the day my psychiatrist told me that I would never be off medication. My wife cries every time I hint at the possibility of quitting them.

I welcome your comments.

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Red List: What to do if I feel like self-injuring

When I ask my clients to create a Wellness Journal to help treat their mood disorder, I often ask them to include a “Red List.”  The red list is different dependent upon the client.   For individuals who have anger issues, the red list is things to do when they are angry.  Likewise for anxiety.   However for many of my client’s the red list is what to do when they feel urges for self-inflicted violence, most commonly cutting.

I worked in the Emergency Department of a local hospital for five years during which time I learned that many professionals do not understand the urge for self-injury.   The advice they give is frequently horrendous.   Often well-meaning medical staff treat “cutters” with cruelty.   They can be cold and distant when treating self-inflicted cuts.   I unfortunately have seen physicians staple or stitch up cuts before the numbing shots fully are in effect.  Worse than the physical pain they cause is the emotional pain, making the individual who has inflicted self-violence to feel belittled.  I have also been fortunate to see that with a little education these same professionals can be kind and understanding to “cutters.”

My experience in working with individuals with urges for self-inflicted violence or cutting is that more than anything they need love and understanding.   The first step is to plan in advance.   I encourage the creation of a red list, or a list of what kinds of coping strategies can they implement when they feel overwhelmed and want to self-injure.   I remind them that cutting is a coping strategy…. not one that I encourage, but indeed a coping strategy.   Instead of putting down their coping strategy I want them to find better ones.

Many times the urge for self-inflicted violence is paired with depression and anxiety.   Unfortunately depression seems to cause memory loss and we completely forget our coping strategies.   This is why a red list is so valuable.   In the list we have written down advance instructions for ourselves.   Unfortunately there is no “one size fits all” list.  Each person must create their own list.   Also unfortunately we usually discover what strategies work and what strategies do not work through trial and error.  This is why it is so imperative that when someone we work with, love or care about does self injure, that we do not put them down.   They did not fail, but just found another coping strategy that didn’t work, and now it is time to work on finding some new, better ones.

So…  What is on your red list?

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Gratitude List: an integral part of a Wellness Journal in Treating Mood Disorders.

Wellness JournalsCreating a gratitude list is a key component in Wellness Journals. Creating a gratitude list forces the individual to start looking for and seeing the positive. Journaling gratitude creates a paradigm shift for the individual. When creating a gratitude list, there is only one real rule… it must be positive. I also suggest that people avoid repeat things, but this can be very difficult. On numerous occasions I have read back in my gratitude list, and found repeated entries.

There are impressive benefits to writing down things that you are grateful for including greater physical wellbeing, mental wellbeing, less depression, reduced anxiety, and a more positive relationship with family and loved ones. I recommend to my clients that they come up with at least three unique things each night that they are grateful for.

In my experience it is easier to do this if you add the activity to an already established habit. I have had good results in suggesting that individuals with spiritual beliefs write in their gratitude list each night before saying their evening prayers, including the things that they are grateful for into their prayers. Alternatively I encourage those individuals who regularly mediate to write in their journals before meditating. Look for some activity in which you engage on a daily basis, it will make remembering to write in the journal easier. It does not matter what time of day that you journal what you are grateful for. Whenever is easiest for you.

Remember not to get too picky about spelling, grammar, and how your handwriting looks. It is more important that you do it. Some studies have shown that doing it two or three times a week is as effective as doing it every night, so don’t worry if you forget a night.

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Are all Counselors/Psychologists/Psychiatrists Mentally Ill?

Mental HealthNo, but some of the best ones are…

Many mental health professionals are naturally empathetic people, who have a knack for understanding and guiding people who are struggling. Oft times this is because they have had their own personal struggles that they have overcome.

The key word is overcome, not cured. Many mental health professionals take antidepressants, mood stabilizers, anti-psychotics, etc. Many of them have seen counselors themselves in the past. However they are not currently struggling with instability. I generally prefer to to refer clients to see counselors with personal experience, at the same token, I don’t want to refer to someone who is currently struggling with personal stability. I worked for 5 years in the emergency department of a hospital, during which time I regularly referred individuals in crisis to counselors who I knew had struggled with their own mental health. They generally tended to be better counselors.

The counselor with his or own history ofttimes can step into the client’s world, without judging the client. The counselor is able to fully see the world of the client, and understand his or her personal meaning.

No not all health care professionals are mentally ill, but some of the best ones are.

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