Category Archives: depression

Counseling At A Distance

Back in May. 2015 I wrote my first blog about telephone counseling. Over the last few months, I concentrated on becoming a Distance Certified Counselor. Many states are recognizing the benefits of working in creative ways to reach clients, who because of geography, chronic disease or disability are unable to receive counseling in the typical face to face method. My new credential looks like this: Distance Certified Counselor, or DCC.

Distance Counseling is nothing new. Sigmund Freud often corresponded with his patients by letter in between regularly scheduled appointments.  Its popularity has increased over the last 20 years as the therapeutic world embraced the digital world. I participate in distance counseling in order to reach a wider range of people in various locations and to reach people who are unable to participate in typical face to face sessions.

Distance Counseling is an approach that takes the best practices of traditional counseling as well as some of its own unique advantages and adapts them for delivery to clients using electronic means.  I prefer using telephone, teleconferencing, and texting when working with my clients. We now know some clients prefer the anonymity of a distance counseling relationship and are more likely to open up and self-disclose than they would be in a traditional counseling setting.

Distance Counseling is accessible.

            Distance Counseling is convenient.

            Distance counseling provides anonymity.

For those individuals who are ambivalent about therapy or who may be uncomfortable with traditional models of therapy, Distance Counseling may be your answer. This is particularly true for individuals who are suffering social phobia, agoraphobia or anxiety disorders.

If Distance Counseling if intriguing to you, please be give me a call.

 

 

Brighten Your Days: Don’t Be SAD

By Marla Chalnick, Ph.D., LPCsad-winter-depression

Winter means different things to different people. Aside from having to deal with ice, I look forward to the crisp temperatures with great anticipation.  Others may see winter as just the inconvenient interlude between summers. For many people, winter can be down right depressing. They may be suffering from seasonal affective disorder (SAD); a condition that is similar to depression, except it appears only in the winter months.

SAD affects roughly 6% of the adult population of the United States. Women are more affected by SAD, but there are cases of men and children who experience it as well.  SAD can begin as early as September and last until April. The most difficult months are December, January and February because SAD is directly related to the amount of light that is absorbed through the eyes.

The symptoms of SAD occur regularly each winter and may include a number of the following: sleep problems (too much or too little), lethargy (feeling fatigued and unable to carry out daily tasks), difficulty concentrating, overeating (craving carbohydrates and sweet foods), depression, anxiety, and withdrawal from friends and family. In children, symptoms include irritability, difficulty getting out of bed and school problems in the fall and winter.

Dr. Norman Rosenthal, clinical professor of psychiatry at Georgetown University, helped discover the disorder and its treatment in the 1980’s. Dr. Rosenthal described his arrival in the United States from South Africa to complete his residency in psychiatry.

“I was born and raised in South Africa where the geographical climate is very, very pleasant, the seasons blend into one another. And then I came to New York City. I arrived in the summer, and the days were wonderfully long and I was full of energy and enthusiasm.

But then as the days got shorter, something began to happen to me, especially after the daylight savings time change occurred. Suddenly, I felt myself slowed down, less able to carry through on all the projects I picked up during the summer, reluctant to get out of bed and get going in the morning. I sort of soldiered on through the winter until the spring, when it all seemed to get better.”

Light therapy has proven to be an effective therapy in up to 85 per cent of cases of SAD. It consists of using a light box with high intensity florescent lights. Treatment consists of daily half hour to two-hour sessions of sitting in front of the light box, where you can read, eat or do other daily activities. While light therapy is generally the first line of defense, antidepressant medication maybe helpful.  Counseling or any other complementary therapy that teaches relaxation, stress management, adaptation and coping skills can also be useful.

And, if you are very fortunate, take a winter vacation to a warm, sunny place. Spending a week or two in the warm sunshine will have lasting benefits when you return to your winter climate. It’s like “recharging” your batteries. I’ve always wanted to go to Bermuda, how about you?

Winter means different things to different people. Aside from having to deal with ice, I look forward to the crisp temperatures with great anticipation.  Others may see winter as just the inconvenient interlude between summers. For many people, winter can be down right depressing. They may be suffering from seasonal affective disorder (SAD); a condition that is similar to depression, except it appears only in the winter months.

SAD affects roughly 6% of the adult population of the United States. Women are more affected by SAD, but there are cases of men and children who experience it as well.  SAD can begin as early as September and last until April. The most difficult months are December, January and February because SAD is directly related to the amount of light that is absorbed through the eyes.

The symptoms of SAD occur regularly each winter and may include a number of the following: sleep problems (too much or too little), lethargy (feeling fatigued and unable to carry out daily tasks), difficulty concentrating, overeating (craving carbohydrates and sweet foods), depression, anxiety, and withdrawal from friends and family. In children, symptoms include irritability, difficulty getting out of bed and school problems in the fall and winter.

Dr. Norman Rosenthal, clinical professor of psychiatry at Georgetown University, helped discover the disorder and its treatment in the 1980’s. Dr. Rosenthal described his arrival in the United States from South Africa to complete his residency in psychiatry.

“I was born and raised in South Africa where the geographical climate is very, very pleasant, the seasons blend into one another. And then I came to New York City. I arrived in the summer, and the days were wonderfully long and I was full of energy and enthusiasm.

But then as the days got shorter, something began to happen to me, especially after the daylight savings time change occurred. Suddenly, I felt myself slowed down, less able to carry through on all the projects I picked up during the summer, reluctant to get out of bed and get going in the morning. I sort of soldiered on through the winter until the spring, when it all seemed to get better.”

Light therapy has proven to be an effective therapy in up to 85 per cent of cases of SAD. It consists of using a light box with high intensity florescent lights. Treatment consists of daily half hour to two-hour sessions of sitting in front of the light box, where you can read, eat or do other daily activities. While light therapy is generally the first line of defense, antidepressant medication maybe helpful.  Counseling or any other complementary therapy that teaches relaxation, stress management, adaptation and coping skills can also be useful.

And, if you are very fortunate, take a winter vacation to a warm, sunny place. Spending a week or two in the warm sunshine will have lasting benefits when you return to your winter climate. It’s like “recharging” your batteries. I’ve always wanted to go to Bermuda, how about you


 

 

Help for worrying about worrying

worrying  In following up on “When to worry about worrying,” there are 3 strategies you might consider to cope with chronic worrying. It is important to understand what worrying is, since the beliefs you hold about worrying play a huge role in triggering worry. You probably feel like worries come from the outside-from people, events that are stressful or situations you’re facing. In fact, worrying is self-perpetuating. The trigger may come from the outside, but your internal dialogue keeps it going! When you’re worrying you are likely obsessing on worst case scenarios and if you are focusing on ‘what ifs’ your worrying is unproductive. If you can give up the idea that your worrying somehow helps you, you can begin to deal with your worry and anxiety.

Many people with anxiety don’t know how to calm down quickly. Some ideas for self care to create calm include:

  • Exercise, a natural and effective anti-anxiety treatment
  • Get enough sleep, limit caffeine, avoid alcohol and nicotine.
  • Start eating healthy

You will also benefit from learning relaxation techniques-deep breathing, progressive muscle relaxation, meditation and yoga. Be aware of what you can do for yourselves and design a self care program that works for you. Be flexible-does this mean you can never have a glass of wine? Absolutely not-everything in moderation!

If you have given self care a good shot and find you can’t seem to shake your worries and fears, you might consider seeking help from a mental health professional. Cognitive Behavioral Therapy (CBT) is one type of therapy that is particularly helpful. CBT examines distortions in our ways of looking at ourselves and the world. It can help you identify automatic negative thoughts that contribute to your anxiety. For example, if you are the type of person who catastrophizes, always think of the worst case scenarios, you might learn to challenge this tendency through asking yourself questions such as: Has this ever happened before? What is the likelihood it will happen now?, What are some more positive outcomes that are more likely to happen? With the help of a mental health professional it is possible to change your mind set and alleviate your worry and anxiety. This might not come easy to you, but with repeated practice you can retrain your thoughts and consequently your feelings.

Finally, with the assistance of a physician it is possible to alleviate your anxiety with the use of medication. Anti-anxiety medications relieve anxiety by slowing down the central nervous system. Their relaxing effects have made them very popular. Common anti-anxiety drugs are Xanax, Klonopin, Buspar, Valium and Ativan. Your physician can advise you about the pros and cons of these and other drugs to treat your anxiety. It’s important to remember that medications alone aren’t the cure. Therapy and lifestyle changes should be incorporated into your treat plan when you’re worrying about worrying!

 

For further information, visit:

www.healthguide.org

www.americanfamilyphysician.org

www.anxeties.com

 

 

An Exhaustive Battle Over Adrenal Fatigue

I borrowed this title from a Chicago Tribune article written written by Julie Deardorff in August of 2010. As I began researching Adrenal Fatigue I had no idea the topic is so controversial. You can guess the war is between tradition medicine and alternative practices. While Adrenal Fatigue seems to be increasingly common, there remains an unwillingness among medical doctors to diagnose it. Those who believe they are experiencing adrenal fatigue or exhaustion are fighting an uphill battle for legitimacy  even as the term gains traction in alternative health circles and among Americans seeking a solution for chronic and unexplained fatigue, depression and malaise. Common symptoms also include difficulty falling asleep, inability to wake up in the morning, cravings for salt and sugar, anxiety and overall exhaustion.

The disorder is not recognized by most conventional medical specialists, major medical associations and even integrative medicine pioneers such as Dr. Andrew Weill, who reject the idea that excessive stress weakens the adrenals and causes health issues. However, according to those who believe in the adrenal fatigue theory, our life is so relentlessly stressful that our adrenals get overworked and peter out. James Wilson, a naturopath and chiropractor based in Arizona, coined the term adrenal fatigue in 1998 and has written what some call a definitive guide for patients. Many espouse lifestyle changes, dietary changes, exercise programs and supplements as the answers to improving the way you feel.

So, is adrenal fatigue real? “Yes and no, says Dr. Brent Bauer, Director of the complimentary and integrative medicine program at the Mayo Clinic.”  I think it depends on who you talk to. Adrenal fatigue symptoms are very real for the people experiencing them. But it is a real medical condition? Medical research has found no definitive way to test for adrenal fatigue. The doctor’s bible of diagnostic codes, the ICD 10 does not recognize it as a medical diagnosis and the insurance companies will not pay.adrenal-fatigue

However, “any doctor worth his/her salt understands that the term “adrenal fatigue” means mild adrenal insufficiency, The Hormone Foundation statement readily admits that adrenal insufficiency IS a real diagnosis. To me, they seem to be denying the possibility that some people may have a mild form of a real diagnosis. That’s short-sighted and excessively arbitrary” Richard Shames, MD

Resources: Hormone Health Resources

STRESS: A Weapon of Mass Destruction

dear-stress-lets-break-upI am a stress junkie, addicted to natural substances my body produces. Adrenaline and Cortisol are my substances of choice.  Living in a flight or fight modes takes its toll. I learned this way of being at my mother’s knee. She is unpredictable, erratic and volatile, and I became a stress junkie!

Most often when I begin a conversation with a client, the first thing my client says is: “I’m so stressed out!” or “I’m so over loaded!” It is almost a universal way of living for most of my clients. Believe me, stress takes its toll! Ever wonder what our body is doing to create the sensations we label stress?

Adrenaline is commonly known as the fight or flight hormone. It is produced by the adrenal glands in response to a message from the brain that a stressful situation has presented itself. It is responsible for immediate reactions and provides a surge of energy and focuses your attention to help you get out of a potentially dangerous situation.

Cortisol, also produced by the adrenal glands, is known as the stress hormone. It takes a bit more time to feel the effects of cortisol, minutes not seconds, in the face of stress. When you stew on a problem, your body is constantly producing elevated levels of cortisol and chronic elevated levels of cortisol can lead to serious issues. Too much cortisol can suppress the immune system, increase blood pressure, decrease libido and disturb sleep patterns resulting in chronic fatigue. These are just a few examples.  Unfortunately, our bodies require our cortisol levels to return to normal following a stressful event to replenish, but in our current high stress culture, the stress response is activated so often that the body doesn’t have time to complete that cycle.

All this is happening inside your body without your awareness while the sensation you identify is STRESS. If you continue to beat up your adrenal glands you maybe headed for a condition known as Adrenal Fatigue. I will be writing more about that in my next blog as well as de-stressing strategies.

Focus on beauty not on fear, dance with stress.

Debahish Mridha

Why Are So Many Baby Boomers Depressed?

While browsing through one of my favorite website, psych central.com, I came across an article on baby boomers and depression. According to Dr. Donald A. Malone of the Cleveland Clinic, baby boomers have a higher prevalence rate than the generation before them. We are the generation that has continually attempted to have it all and now we are adding the diagnosis of depression to our list of gains. At 66 I feel better about my life than ever before, so I wondered why?

While baby boomers continue to gain material rewards and success, their achievements are often the result of a stressful lifestyle. It’s this stressful lifestyle that many experts link to their depression. And while endless fatigue may seem like a fact of life to the boomers, experts warn this too can lead to depression and other physical problems.

Often your family doctor is your first line of defense for a quick fix. Antidepressants  are commonly prescribed, but sometimes even though many different types of antidepressants are tried, they don’t lift your mood. We are all familiar with the lifestyle changes that could help, like exercise, acupuncture, massage, but few of us will find the time or discipline to integrate them into our day to day lives. And often we forget to look at the psychological root of the problem that could be effectively treated through psychotherapy. However, with everyone in such a hurry, the last thing most want to hear is that they should get in their car, drive across town, and to for therapy once a week.  Sounds like a glum situation!! But each of us has to remember that we got ourselves into this situation and we can find our way out. Small lifestyle changes, maybe antidepressants and therapy can help you find the personal root of your depression. While there are no quick fixes you have options that can make your life better.