Be wary of self help blogs (even this one!)

Encouraging critical thought and autonomous decision making (should be) part of any mental health provider’s core objective for clients. My assertion is that this applies to not only health care providers, but also the information that flows across your screen. People sharing their experience, and more specifically their personal successes in overcoming life obstacles is a wonderful aspect of mass media, and should be celebrated. Most of us would like to assume that we are resilient and insightful enough to distinguish plausible and useful self-help articles from ill-conceived and amateurish messages parading as fact.

And this very well may be the case for you.

The concern is that even the on-line messages that we do recognize as somehow ‘off’ or skewed can nonetheless impact us. If you find yourself engaged in some form of social media or online presence; you may have noticed the ubiquity of self improvement posts/blogs/editorials/websites/ted-talks, etc. There tends to be a full spectrum of professionalism around these blogs ranging from disguised advertisements and charlatans to journal entries to actual new information based on scientific data to support a hypothesis. In this era of so-called ‘fake news’, I have often wondered about the notion of ‘fake expertise’ in terms of espousing opinions lacking research based credibility and/or information emanating from an individual lacking any kind of training or professional accountability.

So the question becomes: why would someone want to critically assess a self help article that ‘rings true’ or aligns with one’s values and/or goals?

Simply put: because often times our ‘default thought process’ (i.e.how we emotionally respond to something in the moment) may actually NOT have our best interest in mind. An example is a self help blog that taps into a person’s internalized shame via covert messages that ultimately translate to ‘you are not good enough’, ‘you are responsible for others people’s feelings/behaviors’, you are an inadequate spouse/parent/lover/etc’.

Every time a blog, ted talk, or pod cast lists out the ways you SHOULD be doing or thinking about something; please keep in mind there is a not-so-obvious implication that you yourself are not good enough.

This actually is a rather successful marketing strategy that has been used for decades. I remember in the early days of social media; I would take the time to consider if a particular article/message was in some way a commercial in disguise. More recently I have noticed that I stopped really caring one way or the other. . . that can’t be a good thing. The problem arises when marketing, shaming, and self-help become blurred into easily digestible messages leaving us satisfied in the moment; but unsatisfied over time (rather sounds akin to fast food, no?).

Another way in which one can critically examine a self help message is to look for the ‘grey’. That is, does the author address the plurality of ways to achieve a desired goal as opposed to doing something the ‘healthy way’ (i.e. the author's way) or the wrong way (essentially anything else). No matter how much you may agree with a blog’s message, ask yourself if the author is stumbling into a black or white thinking error. If only real and healthy change was as easy as finding the right way to raise your children, or cure addiction, or vanquish depression, or nullify anxiety. It is definitely NOT my intention to vilify the attempts of people to share motivational messages and strategies to navigate through life.

Again, our lives are a shared experience and are deserving of a shared narrative that other can benefit from. The only way to sift out the helpful messages from the rest is via critical thinking and avoiding the trap of seeking out messages that act to simply confirm what we already believe. Because, more often that we might hope or think, that which we ‘already know’ may be emanating from unhealthy parts of ourselves (i.e. addiction, shame, fear, anger, jealousy, etc.). So don’t turn off your screens (or do, but that is for a different blog), simply remember to use you critical thinking skills on even the self help messages that resinate the most. . . yes, yes - this one too.

Understanding and Protecting Your Family from Dark Web Opioid Purchases

The number of people who have died from heroin and opioids in the United States has more than quadrupled since 1999, according to numbers from the CDC. Drug overdose is now a greater cause of death than car accidents.

Although many people unfortunately develop an opioid addiction through the use of prescription pain relievers, prescription abuse is no longer the easiest way to gain access to these drugs. The Internet has become a major player in the opioid industry, with purchases made on the so-called “dark web”—the part of the Internet that exists on encrypted networks and requires special software to access. Since traffic on the dark web is difficult to trace, it is a prime venue for illicit commerce.

Exacerbating this problem is a particular synthetic opioid—fentanyl—which is extremely potent. Because only a tiny amount is enough to get an adult high and only a few flakes of it are enough to cause an overdose, large quantities of it can be transported in a standard first-class envelope. Dealers in China have been known to deliver the drug through the US Mail by routing it through Hong Kong. The dark web is making it easier than ever for dangerous opioids to reach the streets in the United States.

The opioid epidemic is a major public health problem that will require the best efforts of law enforcement, legislators, and local communities to solve. Parents and families may not be able to immediately stop illegal drugs from reaching the streets, but they can teach common sense practices to their children to help protect them. Although the dangers are different, the solutions are largely the same—the chief of which is clear communication between parents and children.

Communicate with your children about the dangers of drug use. And remember that communication is a two-way street: be willing to listen to your children’s experiences of peer pressure, and provide a safe space for them to share their experiences with you—without fear of punishment. Having a strong relationship with your child and encouraging strong and healthy relationships with responsible peers is one of the best ways to prevent high-risk behaviors like experimenting with illicit drugs.

Communicate, too, about the risks of the Internet. In our digital age, it is not unheard of for a curious teenager to explore the dark web and the “deep web”—the part of the Internet not indexed by standard search engines, which houses the dark web. Help your child understand the legal and ethical implications of Internet use, and instill in them a healthy fear of products and services that they may find on the web. Be sure you know what your child is doing on the Internet, and find a positive outlet for their interests—like a coding class.

What Anxiety Feels Like

Q: What is Anxiety?
A: The American Psychological Association defines anxiety as “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.” Anxiety is a normal emotion that most people experience at some point in their life. It is common before significant events—like an important exam or a job interview. But some people experience anxiety with enough intensity and frequency that it interferes with their normal life. In that case, they are experiencing what is called an anxiety disorder.

Q: What does anxiety feel like?
A: Someone who is anxious is nervous and restless. Anxiety focuses the mind on a subject—an exam, or a job interview, for example—and causes a person to think about the potential dangers. They will likely also experience physical symptoms, such as increased heart rate, more rapid breathing, sweating, and trembling. Sometimes physical manifestations can be more serious—insomnia, gastro-intestinal irritation, or fatigue.

People experience extreme anxiety in different ways. General anxiety disorder is often characterized by excessive and persistent worrying about normal activities. Panic disorders involve episodic, rapidly onsetting anxiety that peaks in a state of mental and emotional overload and cause physical symptoms like chest pain and shortness of breath. People with Obsessive Compulsive Disorder have intrusive thoughts that disturb them and motivate them to engage in repetitive acts. Phobias will cause a person to be anxious about a very specific thing or situation. These are just a few examples of serious anxiety disorders.

Q: How do I know whether my anxiety is normal or serious?
A: When a person finds it difficult or impossible to control anxiety and calm themselves, when anxiety begins to interfere with their everyday activities, or when anxiety causes them to avoid places and activities that they might not otherwise, then their experience of anxiety is problematic. Some critical warning signs are depression, self-medication through alcohol or drug use, and the serious physical manifestations mentioned above—insomnia, gastrointestinal irritation, and fatigue. If any of these warning signs are present, it is important to see a doctor about potential treatment, which may or may not include medication.

Q: What if I’m thinking of harming myself.
A: Call the National Suicide Prevention Lifeline right away: 1-800-273-8255; or use the online crisis chat: http://chat.suicidepreventionlifeline.org/GetHelp/LifelineChat.aspx. You’ll be connected to a grief counselor and your conversation will be confidential. Anxiety is not a permanent problem, and there are real and effective solutions.

Q: What can I do to reduce my anxiety?
A: It is most important to know yourself and your symptoms, recognize when you need help, and be willing to seek help when you need it. A mental health professional can provide you with the tools to learn about and keep track of your disorder and can direct you to relevant resources and support groups.

There are also a number ways to self-manage anxiety symptoms that are safe and effective in conjunction with medical advice. Staying physically active is a proven way to reduce stress and overall health and well-being. Developing good sleeping and eating habits can also improve mental acuity. On the other hand, it is best to avoid substances that can increase anxiety, including caffeine and nicotine as well as drugs and alcohol.

Relaxation techniques such as mindfulness meditation are often helpful for reducing anxiety. If you are unfamiliar with mindfulness meditation or other relaxation techniques, a mental health professional can recommend local resources to help you learn about them.

How to Suggest Therapy for a Friend

Therapy can be a difficult subject to broach. For all its benefits, many still consider the need for therapy and other forms of mental health care to be shameful. For someone who is already feeling the burden of anxiety, depression, or another mental illness, careless advice—even if it's good advice—can be harmful.

Nevertheless, there may be a time when it is important to offer such advice to someone. As a friend and loved one, you often have insight into the lives a people around you that they don’t have themselves. Reflecting on Aristotle’s views of friendship, philosophy professor Massimo Pigliucci writes, “Friends hold a mirror up to each other; through that mirror they can see each other in ways that would not otherwise be accessible to them, and it is this (reciprocal)  mirroring that helps them improve themselves as persons.”

The first step is to know what you are talking about. Be aware of the symptoms of depression and mental illness, and be aware of the real benefits of psychotherapy. Depending on pop psychology and attempting to diagnose a friend or loved one can lead to offense, and misconceptions about therapy can create false promises. If you are concerned about someone, make yourself aware of the symptoms and treatments before you say anything. Be careful not to call simple differences in personality mental illness. Rather, be on the lookout for unusual changes in behavior and erratic moods. Be aware of factors in someone’s life that might be contributing to those changes.

Next, consider carefully how you communicate your concerns. Treatment for mental health problems often involves serious and potentially embarrassing topics. Approach the conversation seriously and privately. Both of these factors avoid shaming your friend by demonstrating that you take them and their well-being seriously. By not going behind their back to other friends and family members, you show them that you respect them and trust them to make sound and independent decisions about their life. A group intervention is never the first step.

It’s also important to be aware of your friend or loved one’s mood and receptivity. In their moment of frustration, anger, or stress, their need for therapy might be the first thing on your mind, but it’s likely not an opportune time to communicate it. Avoid raising the topic in the heat of the moment. Let your friend know that you have something serious and important that you would like to talk about, and set aside a specific time to talk about it.

How you frame the conversation is important. Emotional health is a personal matter, and someone who is experiencing a hard time may take any conversation about it as a personal attack. Be careful to use “I” statements rather than “you” statements: “I’m concerned about you”; not “There’s something going on with you.” Focus on the specific words or behaviors that have raised your concern rather than a general sense about your friend: “I’m concerned about the fact that you’ve been doing this thing that’s out of character. Is there anything going on? I think you might benefit from some talk therapy.”

Be honest and empathetic. Trust your friend to make the best choice, and offer your advice as simply that: advice. Not everyone will take it, but it is important to respect their decisions nonetheless.

Summer Self-Care Strategies

“Self-care” is the word of the moment in pop-psychology. Although it gets a bit of pushback in some circles (is avocado toast part of your self-care plan?), self-care can be beneficial if it really is self-care and not simply self-indulgence. Genuine self-care is all about establishing healthy habits that improve your overall well-being, whether at work or at home. Summer, with the many changes it brings to people’s schedules, is a great time to consider starting new habits to improve your life.

1. Develop a Routine
If you don’t have a regular routine yet—or if you have one that you’re unhappy with—establish a good one now! There is no better way provide structure to your day, increase your efficiency, and build your momentum. If you find it hard to motivate yourself to do important work, a regular time every day to do it can help you avoid a daily battle with procrastination. And getting important work done early and regularly will keep it from hanging over your head and allow you to enjoy the rest of your day.

Start simple and begin doing a few things daily and strictly to develop the habit. Don’t expect to become perfectly disciplined overnight. A simple daily planner is a great resource when you are first developing a new routine. Write down reasonable daily goals and check them off as you complete them to avoid the constant feeling that something needs to be done. A routine also allows you to schedule some of the mainstays of self-care—mindfulness exercises, self-reflection, and creative outlets.

2. Sleep Well
One of the best places to start a new habit is in how you sleep. In an era of abundant coffee and Internet access, it’s tempting to trade sleep for a little extra work or the easy stimulation of a Netflix binge. But regular and adequate sleep is a key component to physical and mental well-being. Besides the proven benefits to physical health and performance, sleep improves memory, attention, and mood. Setting a strict and consistent bedtime and giving yourself time to decompress and brush your teeth beforehand are important first steps in developing a healthy routine.

3. Take a Break from Technology
Set limits for yourself when it comes to technology. This is one of the places where the difference between self-care and self-indulgence is most clear. Cell phone use and checking email are quick and easy sources of dopamine. You can get a small rush from them that motivates habitual behavior. But unscheduled screentime has a number of drawbacks. It hurts sleep, lowering melatonin levels and shortening REM cycles. It also interferes with your productivity, interrupting important activities and taking your mind off track. An outright fast can have enormous benefits and provide you with some perspective, but, whether you can go cold turkey or not, it’s important to set reasonable limits. Scheduling regular times for email and social media and avoiding screens before bedtime are great places to start.

4. Go outside.
Being indoors and subject to electric lighting constantly disrupts the body’s internal clock and makes it difficult to keep a healthy sleep schedule. Natural light is important to both physical and mental well-being, and walking outdoors for at least twenty minutes a day—preferably in green spaces, whether a local park or a nearby hiking trail—is a great source of exercise that has been shown to improve mood and a sense of vitality. If the summer heat is a concern, schedule time to be outdoors in the cool of the morning or evening. And don’t underestimate the value of a vacation.

5. Make Time for Friends
Real, face-to-face social connection is the key. Being physically and mentally present with other people has been shown to reduce the risk of depression and promote empathy. That’s not to mention that most people find time with friends to be a worthy end in itself. Combine this with other self-care goals by enjoying outdoor recreation with like-minded peers. Ask everyone to leave their cell phone at home and enjoy the sunlight.

When Empathy Hurts You – Part 2: Minnesota Nice

Having been born and raised in Minnesota, I am very familiar with “Minnesota nice” and the expectations that go along with it.  I have heard that he or she is “so nice” and knew from a young age that being “nice” was something important and valued in our culture.

We all likely know someone who presents as nice all the time – they are pleasing, agreeable, delightful. These individuals often have many friends and their kindness and selflessness is praised. Giving of oneself – often to the point of having nothing left to give – is seen as a virtue.
 
But what if we have this all wrong?

What if anger, dissatisfaction or other forms of unpleasant feelings are just part of the normal range of emotions and not giving them a voice or allowing them to be expressed can cause you harm?
 
Gabor Mate in this youtube video, speaking about his book “When the Body Says No: The Cost of Hidden Stress” highlights the importance learning how to express our anger in a healthy way arguing that unhealthy emotional expression (particularly anger) can have disastrous effects on not only our emotional health but our physical health as well.

Mate describes that each individual has two vital tasks in life: to attach to others and to be authentic. Babies are able to pick up on the stress of their caregivers and if they determine that the caregiver is too stressed out to care for their needs they will shut down and suppress their feelings thus compromising authenticity for the sake of the attachment.

The problem is that as adults we continue this pattern. He argues that there are three ways to deal with anger:

1.      Repress – which can come out as being nice
2.     Giving in – which can be displayed by acting it out
3.     Healthy processing of our anger – setting boundaries, talking about it and funneling the energy into healthy expressions

Mate outlines that our emotional systems mirror our immune system and when we do not take care of ourselves by setting boundaries and being authentic to our feelings it will show up in physical illness – autoimmune diseases and if you tend to repress, and heart attacks and stroke if you tend to give in. The risk of the healthy processing of anger, particularly in setting boundaries and saying “no” is that others may choose to not stick around but the costs may be even more disastrous.

It can be a helpful mental switch to view setting boundaries as an act of kindness since you are showing others that you value, respect and care for yourself. It seems time that “Minnesota Nice” applies to ourselves as well!

You deserve better than to be cushioned.

Technology has changed the way in which a lot of us work, socialize, and date. While there are benefits to this technology, there’s are also plenty of challenges, like the prevalence of an well known behavior that now has a new term: “cushioning.”

What is cushioning?
At worst, cushioning can be outright cheating on an exclusive partner or it can be flirtatious texting back and forth with new eligible singles. The people you're flirting with, aka the “cushion”, soften a fall should you break up with your significant other.  

While the idea of “cushioning” a relationship has been around since dating began, the speed with which we make decisions and access new potential partners has seemed to compound this problem, making cushioning part of a “Netflix and Chill” lifestyle.

Protect yourself from cushioning.
You deserve better than to be cushioned. Here are some red flags:

1.    Secretive about who they’re talking to via text or social media.

2.   Hot and cold behavior - one moment you’re the center of the world, the next they’re too busy.

3.   Evasive about giving you their physical whereabouts.

4.   Tendency to cancel plans last minute, often with vague and sometimes dramatic excuses (“my grandma’s in the hospital”).

5.  Won’t call when they say they will.

6.  Won’t introduce you to friends or family.

Trust your gut. Your intuition is trying to help you. When you feel blown off and manipulated, you probably are.

Please remind yourself you can do better than this.  A person who is truly interested in you will invest in time and energy in you, and follow up on plans.

Everyone has a Love Triangle

A love triangle is something we all have, and, no,  it’s not the kind of triangle you might be envisioning. 

For couples in a relationship, love can be broken down into three concepts that represent corners of a triangle as described in Robert Sternberg’s “Triangle Theory of Love.”  

These corners are Passion, Intimacy, and Commitment. Through these three simplified concepts, we can comprehend, navigate, and even grow our loving relationships.

Passion
It can be thought of as emotional reactivity, physical arousal, excitement.  We experience the feelings associated with passion as visceral and deep-rooted.  Passion can be strong sexual or romantic feelings, strong feeling such as anger or fear, or an enthusiastic zeal.  

Intimacy
This can be understood as a general interconnectedness we feel with someone, the level of closeness/comfort we feel with another.  There are many types of intimacy including physical (both sexual and non-sexual), emotional (feeling of closeness), intellectual (shared ideas), professional (work related), spiritual (involves similar existential and/or religious view), recreational (involves doing pleasurable things together), artistic (shared sense of beauty), etc.  

Commitment
This component is more cognitive or “cold," but often the necessary foundation of a relationship without which passion and intimacy are lost.  A couple makes certain culturally and value based agreed upon promises to each other regarding exclusivity.  Exclusivity may manifest in may ways including sexual fidelity, engagement / marriage / commitment ceremonies, intimacy and emotional fidelity, etc.   Prioritizing and protecting the couple relationship on a daily basis is a manifestation of commitment.  

An Unequal Triangle
If these three corners are given equal attention and energy from each person in the couple, the relationship is healthy, but if one side or two sides are dismissed, it creates relationship problems. 

1. Only Passion = infatuated love (e.g. an affair)
2. Only Commitment = empty love (e.g. lost spark and business-like)
3. Only Intimacy = liking (‘friend-zone’)
4. Commitment + Intimacy = compassionate love (innate/visceral attraction gone)
5. Commitment + Passion = fatuous love (simple, shallow)
6. Intimacy + Passion = romantic love (‘don juan-ism’, often infidelity manifests)

Whether we are in a new relationship or celebrating our 25th anniversary, it’s important to take review the corners of your relationship triangle.  By identifying which component needs enhancement, a couple can actively make changes to significantly strengthen the relationship.

Wally, the Pig - Animal Inspiration

Recently, there was a story about a pig named Wally.

He was a pig being taken to a slaughterhouse on a truck. But, instead of ending up as bacon, he made a decision to escape. And, he took action.

Pigs are pretty intelligent animals, but Wally didn’t sit and think about all the potential variables before making a decision. Wally simply chose to act. Turns out, his decision to act not only saved his life, but made him the happy pig he is now.

We can all learn something from Wally’s story: that we need to act boldly, fall forward. Far too often we get stuck in a cycle of endless “what if” deliberations.  We try to solve problems we’ll likely never face, and so choose to stay stagnant because it feels safer than the unknown. As smart as we are, we will never be able to predict or control all of the variables in our lives.  What we can do is work out any issues that immediately concern us now, then act and move forward.  

Don’t be like the other pigs on the slaughterhouse truck. Be like Wally.  Consider what step you can take right at this moment to get out of the situation that keeps you stuck. Then, with courage and all the integrity you can muster, take action. Trust that, whatever the outcome, it’ll be better than staying on the truck.

Seeking Help for Opioid Addictions

Opioid addiction and deaths are on the rise. In 2016, 20,101 died from opioid overdoses.  Movies like “Trainspotting” and now “Trainspotting 2” have brought some of the realities and problems of opioid use to the public eye, but perhaps glorify it unintentionally. 

For whatever reasons are causing this trend, opioid overdoses on drugs like heroin continue to be one the rise. But, how does a doctor or a friend help someone with these addictions or even in the throws of an overdose? 

A Safe and Tested Solution
A medication called Naloxone has been used since 1961 by paramedics and first responders in 28 states to reverse the effects ofdrug overdoses. Naloxone is administered either through the nose (intranasal), as an intramuscular injection, or intravenously.

In the United States, naloxone is classified as a prescription medication, but is not a controlled substance. While it is legal to prescribe naloxone in every state, dispensing the drug by medical professionals (including physicians or other licensed prescribers) at the point of service is subject to rules that vary by jurisdiction. 

Obtaining Naxolone
In most states, you can purchase naloxone from a pharmacist directly without getting a prescription from a doctor. In Australia, as of February 1, 2016, naloxone is now available over-the-counter (OTC) in pharmacies without a prescription. It comes in single use filled syringe similar to law enforcement kits. In Canada, naloxone single-use syringe kits are distributed and available at various clinics and emergency rooms.

Avoiding Long-Term Complications
The sooner an opioid overdose is treated, the better, because it’s not just death that is the worry, but permanent brain damage and other injuries related to overdose. Even if you are not sure if someone is suffering an opioid overdose, Naloxone has been found to be safe and would have no effect on anyone without opioids in their system. The benefits of increasing availability of naloxone outweigh the risks. 

If you or someone you know has an opioid problem, get help as soon as possible in order to save their life. 

Are You in a Relationship with a Gaslighter?

What is Gaslighting? 
The term “gaslighting” is derived from the movie Gaslight (1944), in which a husband manipulates his wife until she thinks she’s losing her mind.   

This manipulation tactic is used in all kinds of relationships because, sadly, it’s effective. No matter who you are, you are susceptible. 

Why does it work? 
Gaslighters know confusion weakens us because we need a personal sense of reality. Their goal is to consistently make you question what you saw, heard or noticed. Over time, you may doubt your own perceptions.  Ultimately, you may give up and defer to the manipulator as the source of your truth and power.

How do you know when someone is gaslighting you? Ask yourself these questions: 

Do they deny their words or actions even in the face of verifiable proof? 
People who gaslight you tell blatant lies. You know they took the car keys. You saw it five minutes ago. Yet, they still deny they have them. This is a method to make you question your own reality.

Do they attack what’s most important to you? 
Kids are important to you. But they constantly tell you you shouldn’t have them. You’d be an unfit parent. 

Do they project their negative traits onto you? 
They lie. Constantly. When you confront them, they say that you are not smart enough to understand them.  They may suggest that you are the liar, not them. You end up having to defend yourself instead of discussing the problem. 

Do they tell others that you are crazy?
They isolate you by inviting people who support you to question your sanity. This is usually cloaked in grave concern for your welfare. 

Do they say that everyone is a liar? 
By telling you that everyone but them is a liar, it makes you question reality. The goal is to give them the position of power as the only source for the "correct" information.

Do you feel like you have no one to turn to?
People who gaslight you are usually charming.  They manage to get people close to you on their side, so you feel isolated. 

Are they randomly awesome, supportive, appreciative of you?
Gaslighters throw occasional niceties into their long string of interactions that are aimed at devaluing you. This is what hooks you, because after they succeeded in having you feel terrible for so long, a break feels incredibly welcoming.  You’ll want to believe they changed, and that everything will be different now.  You’ll believe this even if, or especially when, you’ve been around this cycle multiple times.  You look so nice today.  I’m lucky to have you.  I made your favorite meal, just for you.  You look tired, why don’t you take a break?  Let’s go out to your favorite restaurant tonight, it’ll help you feel better. It’s always short-lived, and it’s part of the gaslighting process.  It makes you feel they care, that you had really just misunderstood them, that, deep down, they have a good heart.  This will make you stay longer.

Are you starting to question your own grasp on reality despite data points not adding up?
Please remember: when stories consistently don’t add up, it means that they really don’t.  They are filled with lies, half-truths and intended omissions.  Trust your instincts. 

Have you decided it’s just easier to not say anything, even when you feel something’s very wrong?  
A person who gaslights wins by attrition, by wearing you down over time until you question yourself and avoid bringing up what concerns you.  

If you think you may be in a relationship with a person who gaslights you, it’s time to find someone who can help. Contact a family member or friend outside the manipulator's circle of loyalty, or contact a therapist to help you get out of this toxic relationship

The Connection Between Facebook and Depression

We live in a world of social media addiction and a virtual world that isn’t real. We’re online constantly: at home, work, the bus, school, and simply whenever we have down time. We’re barraged by what people choose to share — the best of themselves, and what they want you to believe about their lives. 

No doubt about it, there are psychological effects of this new digital age that are only just being uncovered. 

Depression and Social Media
Recently, researchers at the University of Pittsburgh School of Medicine conducted a study about the effects of social media habits on the moods of users. 

This research found that the more time young adults use social media, the more likely they feel  depressed.

According to their study, participants used social media 61 minutes per day and visited various social media accounts 30 times per week on average and more than a quarter of them were classified as having “high” indicators of depression.

How could Social Media cause Depression?
What we present on social media isn’t necessarily the truth of our lives. Rather, most are aware it's a thin veneer of a highly edited, idealized and exaggerated version of who we'd like to be. Still, it tends to bring out feelings of envy, a sense that others are happier than we are or living a more successful life.

Despite recognizing the shallowness of social media content, many still feel stuck in constant participation, then end up feeling empty, lost in meaningless exchanges that feel like a waste of time.

Spending significant time online exposes social media participants to cyber-bullying, invites gossip and judgment from others. While many who struggle with depression may use social media to fill a void, exposure also can strengthen depression, and so create a vicious cycle.

What can I do? 
Set limits on how often you are on social media. Seek out offline interactions with friends and family. If you can, stop using a smart phone — the tendency to check updates and alerts is ever-present, and often they are not important. 

If you find that you are unable to control your online behavior, seek professional help to break the compulsive cycle.

When Empathy Hurts You

We’re told often that we should empathize with others. 

As empathy puts yourself in the shoes of another person in an effort to not only understand, but to feel their experience, it’s invaluable in building good relationships and helping others. 

While it’s an essential skill for therapists, healers, and other caregivers, there are times when empathy works against us — and can even hurt us.

Laura van Dernoot Lipsky outlines some of the dangers.

Too much empathy can lead to putting another’s needs in front of your own creating an imbalance in our lives. That imbalance can create secondary (or vicarious) trauma, compassion fatigue, and burnout. 

Secondary trauma may present itself through — but is not limited to — these feelings, actions, or physical symptoms:

• Avoidance
• Cynicism (sometimes cynical humor)
• Anger
• Rage
• Self-righteousness
• Sleep disruptions
• Physical tension and illness
• Hopelessness, helplessness, excessive guilt
• Numbing
• Apathy

Feeding the Problem
When experiencing these traumas, some may numb themselves with drugs, alcohol, sugar, social media, or just plain shutting down. This numbness feeds the problem and we continue to lose our ability to gauge if we are doing harm to ourselves or achieving self care. 

How to Heal
The first step towards good self care is being aware of the situation, then taking the responsibility for your self care. There are many ways to achieve it, but it should include connecting with others, addressing your physical health, and taking time for rest.

How to Avoid
A main reason could be a disruption in setting and maintaining boundaries. We’ll unpack that in part 2 in a continuing discussion about too much empathy and its affects on caregivers.  

In Relationships, We are Both Beauty & the Beast

Beauty & the Beast is a tale we continue to tell because the message to not judge a book by its cover is timeless.  We all hope to have a partner that, like the Beauty, can ultimately look past the emotional reactivity of our “inner beast.” 

Not surprisingly, many people report figuratively experiencing both characters; sometimes from one relationship to another and often within the same relationship. 

We all have within us a beast that can and does emerge when strong emotions enter into a relationship, that we too have an inner conflict between the often competing impulses of fight/flight and healthy communication. 

But while looking past a rough exterior to find the beauty, Belle also shows us she had the insight to look past a polished exterior and recognize inner darkness of someone truly unsafe like Gaston. 

In each of us, we can find both Beauty & Beast, and so do our partners. Seeing past our loved one’s rough exterior, over time and particularly during difficult life transitions, can be increasingly hard without support.  

Couple Therapy can assist in clarifying our values and self compassion as a protective factor helping distinguish between sporadic emotional reactivity versus pernicious emotional abuse.   

We can help couples channel Beauty’s inner strength and resiliency when in a loving relationship either our partner’s Beast emerges, or we recognize our own Beast coming to the forefront. 

Therapy provides couples and individuals tools and skills to navigate the often murky waters of relationships to safe harbor.   

In the end, just like this tale as old as time, we can learnt to see past worldly distractions to see each other with a new and loving clarity.

Thank you Mary Brainerd for Supporting Mental Health

Recently, the Star Tribune Editorial Board wrote an Opinion article about Mary Brainerd, the outgoing CEO of Health Partners. 

Hearing about her contributions to helping expand mental health care from the state-of-the art HealthPartners’ Regions Hospital campus in St. Paul to the “Make it OK” campaign to spread awareness aimed at ending stigma makes Birch Counseling proud to be in Minnesota. 

Her establishment of a mental health urgent care center was groundbreaking, and her dedication to working with law enforcement as well as health care leaders truly provided results for those who were falling through the cracks. 

It’s great to have strong women leaders who not only run a good business, but advocate for those in the shadows and stigmatized from years of bad information, or simply no information at all. 

We wish her all the best in her retirement, and look forward to a successor that will continue the great work she’s done to help expand the awareness around mental health and the essential mental health services Minnesotans need. 

An estimated 600,000 US Women Experience this Depression...

On International Women’s Day, we’ll take a look at a mental health issue affects a large number of women: postpartum depression (PPD), or a depression that occurs after childbirth.

Counter to what you might think, PPD is fairly common.  According to the CDC, 11 to 25 percent of mothers experience postpartum depression.

Sadly, more than half of those affected by it (15 percent) do not seek any professional help.

There are multiple issues that keep women from seeking help for this disorder, most notably guilt and shame. It’s difficult for new mothers to come to terms with “the baby blues” – after all, isn’t having a new baby supposed to be the happiest moment in our lives?

Postpartum depression can be serious. Symptoms may include:

• Depressed mood or severe mood swings
• Excessive crying
• Difficulty bonding with your baby
• Withdrawing from family and friends
• Loss of appetite or eating much more than usual
• Inability to sleep (insomnia) or sleeping too much
• Overwhelming fatigue or loss of energy
• Reduced interest and pleasure in activities you used to enjoy
• Intense irritability and anger
• Fear that you're not a good mother
• Feelings of worthlessness, shame, guilt or inadequacy
• Diminished ability to think clearly, concentrate or make decisions
• Severe anxiety and panic attacks
• Thoughts of harming yourself or your baby
• Recurrent thoughts of death or suicide

Hormonal changes and the stress from sleep deprivation that comes with caring for a newborn are thought to be causes of PPD.

Left unaddressed PPD can lead to chronic problems with depression and anxiety. Mothers with PPD often have difficulty bonding with their children, which impacts their development and so can affect their own mental health down the road.  For your sake, as well as the sake of your child, it is important to seek help. 

Postpartum depression can lead to suicidal thoughts.  
Should you have thoughts of harming yourself or your baby, it is critical to seek help right away.  Please ask for help from those who support you and your baby.  You may also contact:

• Your mental health care provider
• The National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).
• The Crisis Connection, at 612-379-6363, or 1-866-379-6363.
• Your primary care doctor, minister or spiritual leader
• 911
• The mobile crisis team in your county:
  • Anoka: 763-755-3801
  • Carver/Scott: 952-442-7601
  • Dakota: 952-891-7171
  • Hennepin: adults - 612-596-1223, children - 612-348-2233
  • Ramsey: adults - 651-266-7900, children - 651-774-7000
  • Washington: 651-777-5222

Please remember: PPD is not your fault. 

Your body has just undergone significant hormonal changes, and you’re adjusting to a very stressful new reality.  You are not alone.  In the United States alone, an estimated 600,000 women struggle with this disorder. Help is available. 

For your own sake, and the sake of your baby, please reach out.

You are NOT your problems.

It takes a lot of courage to ask for help. And, it usually takes a lot of time to muster up that courage. 

But, by the time you ask, you’ve most likely internalized your problems. 

Internalizing problems over a long period of time can lead to ‘absorbing’ the problems into our identity, meaning you begin to define yourself by the problems. This not only exacerbates your problems, but it also becomes a malicious adversary in our lives. 

When you realize this, it’s time to begin to view problems as being ‘other’ and therefore able to be influenced, challenged, changed, even eradicated.

Therapy can help challenge any preexisting internalization of the problem. That is to say, therapy can be understood, in part, as a process by which the individual can begin to be separated from his/her problematic symptoms. 

No matter how educated we may be and intellectually or emotionally sophisticated; in the quiet moments when our problem presents as overwhelming how long until some version of the internal message ‘what is wrong with me?’ enters into our consciousness.

We live in a society that relentlessly facilitates the internalization of our problems; intertwined into the habitual fabric of our lives. Some of us grow up in homes where shameful messages were ever present. ‘Something is wrong’ so often became ‘something is wrong with me’. If our problematic symptoms are indivisible from ourselves then we are condemned to being ‘less than’, ‘broken’, being ‘apart from’. 

But this is not true.

• You are NOT your symptoms. 
  • You are NOT your problems. 
    • You are NOT your thoughts.

Through Narrative Therapy, we can help you externalize the problems and affirm that you are not the problem, rather the problem is the problem. 

We are here to help.

You can Beat Winter Blues

The holidays are a time spent with family and friends. We enjoy good food, lots of laughs, and excitement of what the New Year might bring. Along with the holidays comes the stress of preparing meals, picking out gifts, and spending time with that one family member who pushes all our buttons.

During the winter months, we can begin to struggle with motivation to do things we once enjoyed. It becomes darker much earlier and let’s not forget the stress of the holidays. When we experience these symptoms, we feel trapped and can’t wait for future summer days.

Seasonal Affective Disorder (SAD) may be behind those unwanted feelings. Common symptoms of SAD include: difficulty sleeping, weight gain/loss, heightened anxiety/stress, sadness, and lack of motivation. Additionally, it may seem like winter will drag on with no end in sight. However, this does not have to be the case.

There are many ways to manage SAD and get back to feeling like yourself for the holidays. Self-care is an important way to manage these symptoms. Some ideas include exercising for 30 minutes several times a week, eating a healthy balanced diet, and/or daily meditation. Another important way to manage symptoms is getting outside. Yes, you heard me: being outside can improve your mood! If symptoms continue to worsen, therapy and medication are always an option.

This holiday season, surround yourself with friends and family and enjoy these cold months. Find one thing each day that makes you happy. And, remember we are always here to help you!

Wind Telephone

I was listening to an episode of This American Life entitled “One Last Thing Before I Go.” It was talking about how people in Japan have coped with the loss of loved ones following the tsunami of 2011, specifically in the town of Otsuchi as it had one of the highest death tolls. Following the desire to stay connected to his deceased cousin, Itaru Sasaki decided to buy an old phone booth which he placed in his garden complete with a disconnected rotary phone as a respite where he (and eventually others) could call their deceased loved ones and stay connected. Since a regular telephone is not able to call the dead, this phone has been called a “wind telephone” as the conversations were “carried in the wind.”

As listeners, we got to overhear some of the conversations. There were a variety of reactions from a recap of day to day occurrences, uncomfortable laughter, long pauses, gasping tears, and reassurances that they were doing just fine. One family was finally able to speak about the loss of their father as a family since the wind telephone had opened up their lines of communication.

This got me thinking of the various ways we can honor our loved ones who have passed on. We can write a letter or a tribute, light a candle, create a memorial, plant a tree, install a bench, create works of art, cook their favorite meal, compose a piece of music, listen to a song they enjoyed, tend to the grave site, release their ashes in nature, or find a unique way to honor the individual in a way that is authentic to who they were. The theme I noticed involves tapping in to different senses to bring them back to life, if you will.

Another idea is to make amends with someone or to choose to live your life differently such as fulfilling your own destiny. The podcast ended with a story of two brothers who were in their eighties who had been feuding for most of their lives and the son of one of the men who had made it his mission to have them reach reconciliation. I believe This American Life coupled these stories together for a reason. Death has a way of helping us see the bigger picture and focus on what really matters in life. While you are able to do things that can help you grieve and honor the ones who have passed, it can be more fruitful and rewarding to be intentional to connect and reconcile with those who are still alive.

Is there anyone you need to call today, either on the wind phone or your cell phone?