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

Part 1      Part 2      Part 3

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

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

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!

 

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!

 

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!

 

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. ❤

 

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

 

 

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.

 

Methodist Church Votes to Maintain Opposition to LGBTQ

In St. Louis this week, 53% of Methodist delegates voted to continue the “traditional model,” which opposes same-sex marriage and LGBT clergy, leaving some LGBTQ members and clergy excluded and heartbroken.

WaPo coverage at Twitter link below, and here: UMC Vote.

If you would like to make an appointment for pastoral counseling with our newest colleague, LGBT-supportive Methodist pastoral counselor, Rev. Dr. John G. Smith, please contact us by email or phone.

 

 

Happy Valentine’s Day! Practice Loving Kindness for Mental Health

 

Be loving to yourself and to others: Mental illness deserves as much care as any other illness or injury. It’s not “laziness” or being “weak” or flawed in character. Practice acceptance and support instead of criticism.

Mental illness is usually unlike the movies. Cultivate loving kindness to yourself instead of judgment and criticism. [Try Loving Kindness meditation by Tara Brach to spread love to self and others.]

Remember that mental illness often affects every aspect of a person’s life and health.

Acceptance: Making People into Trees

Ram Dass (Dr. Richard Alpert) expresses acceptance of self and others with a beautiful metaphor:

 

“…when you go out into the woods and you look at trees, you see all these different trees. And some of them are bent, and some of them are straight, and some of them are evergreens, and some of them are whatever. And you look at the tree and you allow it. You appreciate it. You see why it is the way it is. You sort of understand that it didn’t get enough light, and so it turned that way. And you don’t get all emotional about it. You just allow it. You appreciate the tree.

The minute you get near humans, you lose all that. And you are constantly saying “You’re too this, or I’m too this.” That judging mind comes in. And so I practice turning people into trees. Which means appreciating them just the way they are.”

Remember, emotional and cognitive skills take practice just as physical skills do. Many of us have years or decades of practice in thinking destructively and judgmentally! So practice a little self-acceptance today, and then again tomorrow, and the next day…