-THE NAVIGATEUR- 
                     
n. One Who Navigates

Depression: The Unwanted Present During the Holidays

undefinedHave you ever received a gift during the holidays that you’d just love to return? Well, depression during the holidays isn’t a present that would be on anyone’s wish list. Unfortunately however, many people will suffer through a depression during what’s supposed to be the most joyous time of the year.

The holidays are difficult for various reasons even for those who aren’t depressed. Tis the season invites high expectations to feel certain ways and to do certain things and this can be hard, especially for the person with depression. And what’s even worse, loved ones might not understand why you can’t just “snap out of it.” This experience can make someone with depression feel lonely and isolated, leading to an exacerbation of his or her depression. It’s truly a vicious cycle.   

This time of the year comes with a lot of expectations, like decorating the home, shopping and wrapping, cooking and baking, cleaning, and attending holiday parties to name just a few. I bet your to-do list is a mile long. I know mine is! But for the person who’s depressed, facing these long lists of things to do feels like climbing Mt. Everest...it just seems impossible.

While you can’t return the unwanted gift of depression during the holidays, you can counter it by giving yourself something much better: compassion. I like to think of compassion when directed toward oneself as being loving and empathic. This idea of having compassion for oneself also applies for those who don’t suffer from depression because generally, the holidays are typically rated as some of the most stressful and tense times of the year. Finding ways to have compassion for yourself is crucial to surviving the ups-and-downs of the season. So, how do you shop for compassion? Here are few tips you might find helpful:  
  • Make things easier on yourself and shop online or give gift cards when possible. This can cut down on the frustration of driving in congested traffic, parking at malls with limited parking, and being around crowds of people who are rude and unforgiving. And if you’re on a limited budget, give gifts that are made from the heart; you can never go wrong with giving gifts that are homemade (unless it’s an ugly Christmas sweater).  
  • Learn to say no! It’s so easy to over commit yourself during the holidays, and for the person with depression, overcommitting yourself can deepen your depression. If there’s a commitment you just can’t let go, perhaps there’s a different one you can. Be flexible, plan ahead, and be realistic about what you can and can’t do. You will thank yourself later and so will your loved ones.   
  • Remember that you’re in control! You don’t have to be around people you don’t want to be around and you don’t have to stay at a party longer than you wish. The holidays are all about family and friends, and so you’re going to find yourself around people. While at holiday parties, if some of these people like to poke and instigate you, surround yourself with positive people who edify and encourage you and make you feel good.  
  • Reach out for support! If you’re experiencing depression over the holidays, make sure to communicate to your loved ones that you’re struggling to feel the “holiday spirit.” Acknowledge your feelings and reach out to others you believe will understand and provide you with support. If you’re alone, I encourage you to reach out in some way, whether that’s getting in touch with your spiritual side and going to church, attending community events, or volunteering at a soup kitchen or a toy drive. I know I always feel better when I give back to others. If you find yourself without much support, seek out a licensed therapist who can help you navigate this time of the year. Nobody deserves to be alone during the holidays. 
  • If you’re grieving over the holidays because you lost a loved one recently or in the past, remember the loved one(s) you’ve lost in positive ways. Rather than focusing on the loss per se, thinking of your loved one(s) in positive ways can brighten your mood and even make you smile. I really like the idea of celebrating your loved one(s) in some way that lifts your spirit. Creating new family traditions or doing something totally different can really be helpful in grieving the loss of your loved one(s), especially during this time of the year.  Whatever you do, don’t avoid thinking about the loved one you’ve lost, that will only make you feel worse in the long run. 
  •  This is a big one and the most important: take care of yourself. Make sure to eat healthily, sleep often, exercise frequently, take medications as prescribed, and be mindful of your alcohol intake. An imbalance in any one these areas can be a recipe for disaster. Eating healthily can be a real challenge with all the food and sweets available; if you splurge one day, don’t fret, just get back on track the next day. Nowadays, I don’t think we can ever get enough sleep, but during the holidays, getting enough sleep is crucial. Otherwise, your mood will likely take a dip for the worst. Also, try to get some sunshine, preferably in the early morning, given the shorter days and longer nights. Exposing ourselves to the sun can boost our mood—try it and see for yourself! Of course, you know I have to mention libations. Libations during the holidays are usually part of the menu, and my favorite is the Peppermint Martini. However, alcohol can intensify your depression and can also interact with your medications. So if you’re going to consume alcohol, do so in moderation.  
Compassion is going to be what the doctor ordered this holiday season. It’s the gift that should be on everyone’s wish list because it will improve your mood and help you to feel better. The best part is that you don’t have to go to the doctor to get a prescription, pick it up at the pharmacy, or worry about refills. All you need to do is to keep the following in mind: 1. make things easier on yourself, 2. learn to say no, 3. reach out for support, 4. remember that you’re in control, 5. remember the loved one(s) you’ve lost in positive ways, and 6. take care of yourself. 7. Oh, and don’t forget to breathe through it all!    

Cheers to a more peaceful holiday season! 

Robin Williams: Questions About His Death and the Resiliency of the Human Spirit

Impromptu posts are the worst but I wasn’t going to allow time to get away from me on this one. I’m sure many of you have heard about the tragic loss of well-known undefinedcomedian, Robin Williams. It was just like yesterday that I first remembered him on Mork and Mindy. Nonetheless, some may say that he ‘chose’ to take his life and I would like to say that depression and alcoholism took his life from you, me, and the world. Depression is a disease and has to be treated in a similar fashion just like any other disease. I didn’t know Robin Williams personally, although that would’ve been one for the books, but I wonder in what way(s) he reached out to obtain help for his depression and alcoholism. Stories say that he was in and out of treatment a couple of times throughout his life; however, he reported to have struggled with depression and alcoholism from a young age. Some of my patients and people I have spoken to are confused and wondering how someone could be so happy on the outside but is so tortured on the inside. It’s got people talking because the world has recognized how the use of humor is a great way to cover-up, cope, and hide from our problems. Unfortunately, many of us know all too well how to cover-up how we “truly” feel.  How did we learn this? Why would we need to use humor or some other form of denial to cover-up how we truly feel? What’s wrong with having feelings, and more importantly, what’s wrong in expressing our feelings? Are we scared to be vulnerable? Does shame keep us from being vulnerable? Is the shame just so strong that it’s debilitating and life threatening? Are these some of the very things that were obstacles in Robin Williams’s life?

I sometimes think asking for help is like a faux pas, at least in the U.S. There are constant messages that we receive from the world and possibly from our parents and friends that we can do it on our own; that becoming independent is a milestone and it’s one of the signs that we’ve made it in the world. For me, being independent seemed ingrained from an early age; I conquered many of my motor tasks earlier than most children my age. I remember when I began riding a bicycle that I didn’t want anyone’s help; I wanted to do it on my own and that’s just one example of many. As an adult, I'm much better in asking for help when I need it. The problem is that life is like riding a bicycle, which as you know can be pretty messy, especially at the beginning. But, this “life is like riding a bicycle” analogy has gotten me to think about the resiliency of the human spirit. I suppose lucky for me, I never really knew the resiliency of the human spirit until my post-doctoral training at a Level 1 Trauma Center in Florida. It was then that I understood that the human spirit desires to live and will do whatever it takes to accomplish this. During this brief one year experience, I worked with patients and families who endured and witnessed some of the most horrific tragedies that anyone could experience; however, I saw these same patients and families fight for their life, heal, recover, and for them begin a new life. I was amazed to see this unfold. On the other side however, I saw patients and families give up and give up easily. It was as though hope and determination didn’t exist; as though things wouldn’t get better. I ponder what makes some human spirits endure longer than others…why some are more hopeful and determined than others. I wonder at what point Robin Williams lost all hope and determination; why his spirit didn’t want to endure. As someone who has lost a loved one to suicide, I honestly believe that until we’ve been in a place like Robin Williams and countless others, we can never completely understand or fathom what that would be like because our psyche can't handle a place that is so dark, hopeless, and painful. This is the hardest for most people to understand especially for those who have lost a loved one to suicide because we’re never fully able to understand the “Why.” So instead, we are forced to accept and make some sort of meaning out of the death of our loved one.   

As a psychologist, I try to look on the bright side of things usually, go figure right. But honestly, it’s like music to my ears hearing people talk about depression and suicide. Why is it that we have to lose a wonderful and loving person before people start talking? A way to destigmatize mental illness is to talk about it until we’re blue in the face! Well okay, maybe not that far, but I think you get my point. I want to encourage you too, that if you struggle or suffer with a mental illness, find someone you trust and talk about it. Start sharing your story…it could save a life. And I can’t end this post without bringing back the analogy about the “life is like riding a bicycle.” I know it’s a bit cheesy and clichéish, but when you fall down get back up. If you keep falling down, ask for some help, there’s always someone who can pick you up and place you back on your bike. You might suffer some injuries along the way, but the most important thing to know is that you never have to endure them alone.

* Check out the American Foundation for Suicide Prevention website for all sorts of helpful information about suicide, prevention, research, and education.
* Also, check out the Depression and Bipolar Support Alliance support group in Indy.

In remembrance of Robin Williams and the countless others that sadly we’ve lost to suicide but who have taught us so much about life. Thank you!


THERAPY GOAL

undefinedThere's all sorts of different therapies in the realm of counseling and psychotherapy, but I really identified with the following quote that I recently came across on a listserv. Although simply articulated, I believe that this really gets at the crux (i.e. "the goal") of psychodynamic and psychoanalytically informed psychotherapy.

"Finding a solution to a problem is easy, finding the right problem to solve is hard...to discover the real problem(s) is the goal of therapy." Dr. Rune Moelbak, Psychologist/Psychotherapist, Houston, TX.

I often find that the reason someone initiated treatment isn't the "real" reason treatment was initiated. I believe that the "real problems" often lie in our unconscious, which means it's out of awareness. The goal then during psychotherapy is to make the unconscious conscious, for there, the real work begins. Psychotherapy requires a great deal of patience because "discovering the real problem(s)" takes time, energy, persistence, commitment, and a tolerance for ambiguity. Psychotherapy is hard work, but if you desire to get to the "heart of the problem," contact me, and together, we'll begin the process of your new journey!


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