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Recognize Depression by the Lies it Tells

I wonder if you’ve noticed some negative thoughts about yourself lately. These might be something like:

“Nobody really likes me.”

“I’m not good at anything.”

“I’m not loveable.”

“Nothing I do works.”

“I have nothing to look forward to.”

If these sound familiar, there’s a good chance you’re experiencing some depression. Depression often generates these kind of negative, judgmental thoughts. There are a couple of important things to remember about depressive thoughts.

  1. Thoughts are not facts! We can have thoughts that are true or false. In fact, thoughts generated by depression are often false (or greatly exaggerated). Just because a thought pops into your head does not make it true. Depression is a really good liar! So when you recognize that you’re having a bout of depressive thoughts, remember not to buy into the content.

  2. Depressive thoughts are a useful indicator! When you learn to recognize that these kind of thoughts are generated by depression, it lets you know that you’re experiencing a bout of depression. That will allow you to take care of yourself properly so you can get through the depression, instead of making it worse by ignoring it.

This may sound simplistic, but many times we do not recognize we’re experiencing a depressive episode until it’s been going on for a while. And during that time, we may be buying into the content of depressive thoughts, berating ourselves for not functioning normally, self-medicating or making other bad choices in an effort to cope, wondering why we’re exhausted or down, and generally making the depression worse. This happens surprisingly often, even for people who have known for years that they are susceptible to depression.

So the key is: notice your depressive thoughts. And instead of simply believing them (buying into the content) and spiraling, mentally “step back” from the thoughts. Notice how you’ve been feeling overall. Take the thoughts as an indicator that you may be having a depressive episode that needs to be managed.

It’s never too late to stop believing the lies. ❤️

We offer remote therapy sessions anywhere within Pennsylvania. Most people qualify for a sliding-scale discount; use the calculator to instantly see what your fee would be. Email IntersectionalLife@gmail.com to schedule a session.

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Letting Go of “Unlikeability”

You Have Been Good Enough All Along – by @tlkateart
 
 
You may have recently seen some discussions about a post online stating that trauma survivors are “fundamentally unlikeable.” I hope it has not been too derailing to your healing.
 
If it has been derailing or activating to you, it may help if you can step back mentally and see the statement for what it is: a cognitive distortion arising from PTSD. It is also an expression of internalized ableism.
 
Remember, when you have feelings of depression or anxiety, your feelings are understandable and deserve compassion. AND–you also do not have to buy into the cognitions or judgments that arise from these feelings!
 
In Radical Acceptance, Tara Brach talks about the “trance of unworthiness” that is engendered by trauma. This is also called “SHAME.” This kind of shame is the deep sense that one is fundamentally unworthy of love. (It is different from guilt, which is a pain from hurting someone and a motivator to do better next time.)
 
In my experience as a clinician and also as a trauma survivor, shame is pretty well universal among trauma survivors and it is easy to get sucked into. But you can remember not to buy into it. You do not have to buy into internalized ableism.
 
If someone dislikes you because you have trauma symptoms, that has more to do with who they are than who you are. If you feel unlikeable because of your trauma, that has more to do with trauma symptoms than with your actual likeability.
 
Another important aspect of this is that you do not owe anyone a performance of likeability. You yourself may want or need to be liked, for your own reasons: psychological, social, practical, or safety reasons. But likeability is not something you owe to others. You don’t have to be likeable for the sake of others’ comfort.
 
 
You are not a burden, you are carrying a burden. 
 
You are not a burden, we are lucky to have you
You Are Not a Burden by @tlkateart
 
 
You might also find it useful to listen to the following meditation from Tara Brach*: Healing Shame
 

(Note: Dr. Brach uses “toxic shame” vs. “healthy shame” to refer to what I would call “shame” vs. “guilt.”)

 

You are already fundamentally likeable, just as you are. ❤️

 

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About Those “Pandemic Pounds”

In the past few weeks, I’ve seen an increase in people discussing and writing about having gained weight since the event of the pandemic. Many of us have turned a corner from “acute crisis” to “settling in for the long haul,” and we’re taking stock now. We’ve also recently heard some public figures make critical remarks and references to others’ weight, which has only increased pressure on everyone who already struggles with body image or who experiences criticism about their bodies.

Just so you know, this is not a post about how to lose weight. This is a post about some steps to take if you are thinking about losing weight. This is because the first thing we often jump to when feeling unhappy about our bodies is restricting food intake (“dieting”). But that’s often literally the last thing to do! So please remember to consider these other factors FIRST before jumping to food restriction.

Sleep

Sleep is often one of the biggest factors in weight changes. Have you been struggling with sleep the past few months? Many people have, whether because of anxiety, depression, or change in routine. Sleep deprivation can change hormones: it reduces leptin and increases ghrelin, which can dramatically disrupt both appetite and metabolism. This can mean experiencing intense cravings and processing fuel differently.

Sleep deprivation also interferes with executive function, which means both cognitive and emotional processes are harder to manage. That can mean it’s hard to plan for and prepare the food you’d like to eat. It can also mean increased emotional eating, or in some cases loss of appetite because of anxiety or depression.

So first of all, make sure to prioritize sleeping enough and sleeping regularly before addressing your eating.

Exercise

After getting your sleep on track, next consider how you’ve been exercising (or not!)

Whether you’re an essential worker who’s been stressed and working extra hours, or you’ve been working from home, or you’ve been unemployed and out of your normal routine, your body needs the stress outlet of some kind of movement.

Often when people are worried about weight, they focus on exercise as a method of “burning calories.” There are a lot of good reasons to exercise, but “burning calories” is usually an unhealthy way to approach exercise. It’s often an approach that is self-punishing (“I must do an unpleasant activity because of my size!”) or contains elements of bargaining or paying for eating (“I can eat this food I like if I ‘pay’ for it by exercising!”) You don’t have to “pay” for eating with exercise.

A healthy exercise approach is to focus on improving heart function, improving lung capacity, gaining flexibility, metabolizing cortisol to decrease anxiety and regulate sleep, and attenuating depression. In other words, exercise to improve your physical and mental health. Not as a way to neutralize eating.

Nutrition

If you are not satisfied with the overall nutritional balance of foods you are eating, then you are certainly allowed to modify what you’re eating. But when changing your diet, it is important to remember that the goal is to first ADD components you believe you are not getting enough of. Maybe you feel you’re not getting enough leafy greens, or enough legumes, or protein, or calcium. Search out foods that will help to add those elements to the overall balance of your diet! It is acceptable to still eat other foods for enjoyment.

It can be hard to prioritize “adding in” foods, partly because we are constantly bombarded by puritanical, perfectionistic messages that we should be removing or restricting foods.

Checking in with Your Emotional Side

So you’ve stabilized your sleep, you’ve improved your relationship with exercise, you’re getting a better balance of the nutrients you need, and maybe that’s enough! Maybe you’re back to feeling okay!

–Or, maybe you still feel you’re eating more than you want to, or more than you think you “should.” What then? You’re doing all the “right stuff!” Why are you still eating more! Well, this is the hard part, as the emotional component of any behavior change usually is.

Whenever a behavior is difficult to change, there is usually some part of you that is using the behavior to feel okay. To feel safe, comforted, entertained, loved, awake, valued, to feel pleasure. Eating is such an emotionally layered action. We are not simply input/output mechanisms for fuel and activity.

What emotional need has food been fulfilling for you while you’ve been dealing with stress? Until you can find another satisfactory way to fulfill that emotional need, you will continue to use eating behavior as an emotional tool. No amount of calorie tracking, substitute sweeteners, or rigid meal-planning will sustainably alter that dynamic.

Something to keep in mind is that you can’t fool yourself about your own motives. What I mean by this is, you may be saying to others or to yourself, “I’m doing this for my own good! I need to restrict my food for my health!” but meanwhile there is part of you thinking “I’m going to restrict food because I should be punished [for existing, for taking up space, for using any resources, for having the “wrong” appearance].”  Or maybe there is a part telling you that it’s not okay to be fat, or maybe it’s calling yourself names.

Guess what? Until you can keep that part of you from bullying the part that is using food to feel better, it will only make things worse for all parts of you.

Ironically, the bullying part needs patience and tenderness to change, too. That bully part is usually trying to protect you from the criticism of important others. “If I criticize me first, then I won’t get criticism from others.” Let the bullying part of you know that you truly appreciate the protection, but that it’s not necessary any longer. You don’t need it to call you names or harass you.

When you are able to pacify the bullying part, then you will be able to more clearly hear the part using food as an emotional tool.

If that part of you is using food for comfort or safety, is there something else you can use sometimes to feel comforted or safe? If that part is using food to feel loved or valued, can you find some other ways to remind yourself you are loved and valuable? If that part has been using food to quell boredom, can it tell you some other things that might help you feel interested and alive?

Once you have examined the emotional underpinnings of your eating habits and your body image, then you can find more acceptance for yourself, and you can choose whether you want to change your behaviors. But in the meanwhile, remember that this body has carried you, and helped you survive and overcome everything that you have lived through so far. It deserves gratitude and care from you! And so do you, yourself.  ❤

The article linked below has more discussion about an emotionally balanced approach to eating:

Intersectional Life Counseling and Psychology offers remote video sessions for PA residents, as well as sliding-scale rates from $70. Please EMAIL if you would like to schedule or have any questions!

 

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Depression Part 4: Just do the little bit that you can.

Part 1: Is It Depression?  Part 2: When Depressed   Part 3: Nurture Yourself Back to Life

Part 4:

Exercise: We’ve been told so often that we must exercise, that now we may hear it as a burden. Who can carry any more burdens when severely depressed? Who can go lift weights when it’s a struggle to get the bathroom and brush their teeth? But exercise is not supposed to be horrible. You can’t go wrong if you focus on exercise primarily as a way to make your body feel a bit better. It’s not some kind of punishment for resting, or for eating, or for existing in a body of any shape or size. It does not have to be within a contest. It is not a “cure” for mental illness, though it can help to improve your mood. It is an activity your body can like if done in a pleasant, kind way!

I often suggest to clients that if they are too exhausted to go to the gym or whatever their preferred exercise may be, just walk around the block. If that is still too much for right now, then just go outside and walk around the house and back in! Just do the little bit that you can.

There are very few texts that “get” how to approach exercise when you’re experiencing severe depression, but this excellent article really helps when you need to ramp up from zero: “Depression-Busting Exercise Tips For People Too Depressed To Exercise” (Sarah Kurchak)

Social Interaction: Maintaining social interaction can be a tricky aspect of depression. You need some level of social interaction to help stabilize your emotions and keep you woven into reality. If you are in a marginalized group, it is especially important to have supportive others to validate your experiences and keep you feeling sane, cared for, and safe. However, there is a HUGE difference between how much social interaction you need if you are more extroverted versus the amount you need if you are more introverted.

Extroverts can more easily harness the power of friends and family to help recover from a depressive episode: being around others will energize you and give you a bit of motivation. It’s straightforward. Seek out others to talk to daily and if possible, to see in person. It may be hard to ask for help, but see if you can ask for help with something simple. This could be something like dishes, child care, or taking you to the grocery store. You can also just ask someone to watch a movie with you or go for a walk. Ask several different people to do several different things. Being able to be in supportive company will be very useful in your recovery.

Introverts, however, may have a harder time with this. Since interacting with others can drain you of energy, you may need to be choosy about whom you contact and how you interact with them. It’s still a good goal to speak with another human at least once a day. But it’s okay if this is just talking to a friend on the phone, getting your change from the clerk at the corner store, or even calling a help line. If you have the energy to tolerate having someone in your space, it’s good to ask a friend for a little help. But make sure it’s someone who understands your limits and does not expect you to be entertaining or emotionally fulfilling to them. You can offer that later when you are not in a depressive episode! If it is still very hard to see people or even to just talk on the phone, you can start with just texting or emailing with someone(s) daily. But try not to let a day go by without communicating with others. And keep doing it.

Furthermore, you may also be considering medication.

Medications: There are a lot of non-medical things you can do to manage your depression, and medication is certainly not mandatory. However, medications can be a useful part of managing depression. They will not make you immune to sadness, but if you are especially low or “flat” or suicidal they may pull you up enough to get to your self-management.

Other people in your life may have a lot of strong opinions about medications, but this is your decision, not someone else’s. If someone tells you that you should take medication but you don’t want to, you do not have to. If someone tells you that you should not take medication but you want to try it, you may try it. That decision is between you and your physician, and you need to do what will help YOU to recover.

Most antidepressants and anti-anxiety medications are prescribed by people’s primary care physicians, though often your PCP will require that you are also seeing a therapist if they are to prescribe psychoactive medications. A psychiatrist can address more complex psychoactive medication issues than your primary care physician. A psychiatrist may be necessary if you have resistant depression or other mental health issues, such as hypomania or psychosis. It may take up to three months to get an appointment with a psychiatrist, since they are in short supply everywhere. So if you think you may want a psychiatrist, don’t wait to start looking.

Now you have stabilized yourself as best you can! You have examined the four crucial life aspects influencing mental health (sleep, nutrition, exercise, and social interaction), you have considered whether you’re interested in medication, and you have begun doing what you can to develop a healthy rhythm in those areas.

For today, you are doing the little bit that you can. And you will keep doing it. It’s very hard to manage your mood at all when even one of these aspects is disrupted, so stabilizing them all is the basis of recovery.

Next part: Emotional Aspects: Mood Management

lancaster-CCP5

Just do the little bit that you can. And keep doing it.

 

~You may qualify for our new sliding-scale fee discount.~
~Please contact us for an application.~

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You Are Not Your Trauma

 

An early experience of trauma can have effects that you may not start experiencing until adulthood. It can feel “crazy”! But having PTSD symptoms doesn’t mean that you will always feel that way. It means that you have emotions and reactions that are ready to be processed so that you can begin healing.

While healing from trauma can be a lifelong process, you can often start feeling better in many ways right away! You are still a whole, worthy human being, rich in the capacity to enjoy life in your own ways.

If you are ready to start processing, please review our quick chart to see how you can access our therapeutic services from anywhere in Pennsylvania!

 

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You Are Already Worthy!

 

Calling yourself “lazy” or “unproductive” is usually an internalized message of shame from your formative years. The message is “If you would just ‘will’ yourself to do more, then you would be acceptable and worthy. Otherwise, you must just be a bad, unworthy person.”

The fact is, you are already acceptable and worthy, without doing anything to “earn” that worth. Now, you might feel better or happier if you were doing certain things, and they are certainly worth trying, to see if that is the case.

But feeling terrible about yourself is not a good motivator for anyone! In fact, it is likely to worsen your exhaustion, depression, anxiety, insomnia, and concentration, which will make it even harder to do whatever it is you would like to be doing.

If you are ready to start healing your self-worth, please review our quick chart to see how you can access our therapeutic services from anywhere in Pennsylvania!

 

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A Peaceful Meditation Day to All!

The physical and health benefits of meditation have been noted for years and repeatedly validated by science. You don’t have to switch to an entirely new lifestyle in order to practice meditation! There are many ways to begin practicing, a little at a time.

Many people with anxiety do very well with the structured approach taken by Headspace (Andy Puddicombe). With simple graphics that clearly explain physical, cognitive, and emotional aspects of meditation, you will find the process easy to understand and implement. Even if you do not get a subscription and only use the first sessions that are free, it is well worth a look:

Another meditation tool that many clients report being highly satisfied with is Insight Timer:

And if you’re ready to go a little deeper into the emotional aspects of meditation, I highly recommend anything at all by Tara Brach!

 

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Mental Health: Accepting Healing Over Time

 

Valarie Ward has written a good breakdown of how pop mental health writing is often not only unhelpful, but perpetuates stigma and judgment. Treatment–whether chemical, cognitive, or situational–can support and help to heal mental health, but it’s not a magical instant “cure.”

It’s useful to find the type of treatment or intervention that is most helpful and supportive to YOU. It doesn’t mean you’re “doing it wrong” if you still have symptoms or flare-ups. It means that humans are biological, not mechanical objects that can have new parts swapped in for an instant fix. [See: PTSD as chronic illness]

There is nothing wrong with trying to find things that help you feel better and function better. We encourage you to explore treatment modalities!

But the danger in chasing a “cure” can be the idea that if it’s not “cured,” then we just aren’t trying hard enough. Plenty of people with mental illness and injury hear this message from well-meaning friends, family, and loved ones, though sometimes in different words.

“You’ve been in therapy for weeks/months/years, why isn’t it helping?”: If it’s truly not helping, then of course try something else, or something additional!

But often this really means “I’m upset that you’re not ‘cured’ yet.” Unfortunately, we may also internalize these messages ourselves, which just means that we have found another “should” with which to beat ourselves up; another way to use perfectionistic standards against ourselves.

Instead, notice how far you’ve come since you started working on your healing. Even if it has only been a few days, I bet you already learned some things that help you to comfort yourself or to reframe your thoughts in a healthy way that hurts less!

And if you’ve been working on healing for a while, I bet you are experiencing more days during which you can get out of bed. Or get out of the house. Or days you can do some meaningful work or play. Or days you can spend time with your children. Or fewer days spent in the hospital. Or a better ability to see yourself having a future. Or a few more relationships that are going a little better than they used to. I bet you’ve already done a lot more healing than you think!

So instead of beating up on yourself for not suddenly being “cured” or “fixed,” take stock of how your healing really is progressing, and be proud of yourself. ❤

 

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Healing, Not Fixing, PTSD

 

Post-Traumatic Stress Disorder (PTSD) is often best approached as a chronic condition that may have “flare-ups.” This is true of many other mental illnesses and mental injuries as well.

It can certainly be the case that someone experiences some symptoms of PTSD one time and never again in their life, but for most of us, what it means is that we are vulnerable to experiencing symptoms again during periods of stress (or in the case of activating events).

We are experiencing healing, which means we are able to improve certain things with support and as we learn to attend to ourselves, but we don’t know how much everything will heal nor how long it may take. This is different than “fixing,” which is when we remove a “broken” part and replace it, and then everything is as though nothing ever happened. You are an organism, not a bicycle.

This does not mean “I have PTSD, so now everything is hopeless forever,” it means that we need to learn how to manage our environments, life situations, and our selves in order to reduce the severity of symptoms and the likelihood of recurrence, rather than to assume “I haven’t had any symptoms in a year, this must mean it’s okay to stop attending to myself!”

It means not subjecting ourselves to unreasonable stressors and life-sucking situations, personally and in our work. It means taking our physical and emotional discomfort seriously instead of blowing it off until it blows up. It means not listening to internalized minimizing messages that say “suck it up” when distressed. It means learning to re-parent ourselves where necessary.

It means treating ourselves with support, care, and dignity, and developing boundaries to ensure that others do, too. It means practicing self-care as a habit, not only when unduly stressed. It means recognizing symptoms as symptoms, rather than as some kind of weakness that deserves self-punishment.

It means learning what events, people, and circumstances make your symptoms worse, and modifying those as best you can. It means learning what activities, people, and circumstances help you feel better, and including those more. It means taking yourself to the doctor or the therapist when you need to go. Sounds simple, but it’s not always easy!

Basically, it means learning to take care of ourselves “as though” our well-being actually mattered instead of as an afterthought. Let me repeat: treat yourself like your well-being matters, because it does. ❤

 

“Treating yourself with kindness is a life skill. It doesn’t matter whether you are ”good at” this skill It only matters that you keep going💛” — Jeffrey Marsh

 

 

yaelingh From You

Our First “From You”: “Belonging to Yourself”

 

 

From time to time, our clients bring in articles, books, essays, or other materials that they have found especially helpful in work we are doing. Since one of the most valuable reviews is from someone who has been there, we’d like to share the helpfulness with others who may need it!

Today’s link is an article by Celeste Scott. It features an aspect of self-parenting: learning to belong to yourself instead of waiting for permission or approval from others.

To learn about other aspects of self-parenting (or self-re-parenting) in adulthood, read more on our blog here.