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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

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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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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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Yoga Through the Lens of Western Science

Yoga class concept

Our physical, emotional, and cognitive aspects are interconnected and interdependent. This is the case whether we use a psychodynamic approach or a cognitive-behavioral psychological approach. If we are experiencing (noticing) dysfunction in one area, the whole system is actually affected. The good news about this is that by changing things in one aspect, we can affect other aspects as well.

This does not mean that we can simply “think away illness” or that if we can exercise “perfectly” (whatever that would be!) then our thoughts and feelings will just “snap out of it” into rationality and/or bliss. What it does mean, however, is that when we gradually move our habits towards health and balance in one aspect, the other aspects will also move more towards health and balance.

That means when behaviors become healthier, thoughts and feelings become healthier. When thoughts become healthier, feelings and behaviors become healthier. When feelings become healthier, behaviors and thoughts become healthier. A change in any one of them changes all of them!

When we consider the interconnected areas of behavior, cognition, and emotion, the most easily and directly influenced aspect is behavior. We can change what we do, which can help to change what we think and how we feel.

Remember, with any behavior change, the idea is not instant change, but rather successive approximation: doing things a bit more like the goal behavior, and then when that sticks, we do it a bit more like the goal behavior. Attempting drastic changes is less likely to create long-term change than creating and conditioning gradual habit change.

This really interesting clip discusses some ways in which developing–for example–a yoga practice can influence not only thoughts and feelings but also our bodies down to the cellular and chemical level:

 

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Depression and Mood Screening Clinic 2/28-3/1

 

Wondering if you have depression or a mood disorder?

Give us a call or email to set up an appointment with one of our caring mental health professionals for a brief screening during our depression and mood disorders screening clinic.

Depression can be treated–it’s not “laziness” or a character flaw!

Give yourself a chance to be involved in your own life (and enjoy it more)!  ❤

Screening Flyer Dep

 

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Checking In With Yourself

When you’re feeling really depressed, upset, or anxious, it can be hard to come up with ways to understand what is happening with yourself, let alone what to do about it. Even the most basic self-care can be hard to remember when your executive functioning is down.

This is a very helpful list to have handy for those times when you are unable to generate the energy to remember how to support yourself:

 

http://eponis.tumblr.com/post/113798088670/everything-is-awful-and-im-not-okay-questions-to

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Depression Part 3: Nurture Yourself Back to Life

Part 1

Part 2

Part 3: Physical Aspects–Sleep and Nutrition

It can be very hard to take care of yourself even at the best of times, especially if you have a trauma history. And when you’re depressed, it can be even harder to take care of yourself. You might feel too drained, sad, and even unworthy of care. But this is exactly when it is most important to take care of yourself, even if you can only do a little bit.

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

First, stabilize your physical aspect as best you can. The four most crucial mental health needs of your body are sleep, nutrition, exercise, and social interaction. You may also be considering medication.

Sleep: regular sleep is probably the single most important thing your body needs to maintain mental health. If you have been skimping on sleep in order to get things done, you may need to let a lot more tasks go in order to recover. The purpose of sleep is to release toxins from your brain cells. If you are not getting enough sleep, then you are intoxicated, and not in a fun way–your brain is poisoned. Start developing a sleep routine that is as regular as you can make it, close to the same time every night.

If you are struggling with insomnia, the insomnia needs to be addressed so you can get the sleep you need. It’s not uncommon for depression or anxiety to remit simply by getting your sleep stabilized. Don’t use alcohol as a sleep aid: alcohol is not only a depressant, but it also interferes with sleep cycles, so it can worsen sleep problems.

If depression is causing you to sleep too much, it may be most useful to first address other physical aspects of depression before trying to cut down on sleep. Besides, is it actually “too much”? You may need extra sleep for the time being. If it feels like you are convalescing from an illness, that is because you are.

Nutrition: Your body needs fuel in order to operate physically and mentally. Your mood will be worsened by hunger, even if you are not feeling the hunger. At least get a bit of  protein and some complex carbohydrates. If your appetite has dropped and you are having trouble eating, or caring about eating, then try having something like Ensure, or chocolate milk, or kefir on hand – it can be easier to drink something. If you can eat a little something a few times a day, even if not your usual meals, it will help you not to sink further into depression.

When you’re feeling up to it, treat yourself nicely when you eat. It can be comforting. It may be you’re just eating condensed soup sitting on the couch, but see if you can eat it from your favorite bowl. Or try eating something that reminds you of childhood in a pleasant way.

When you have regained enough energy to attend better to your meals, you can get back to what you would normally eat, but for now it’s okay to just eat something.

If you are suddenly eating a lot more than you normally would, try to be gentle with yourself. There is a reason you are doing this–you feel bad!–and it’s not worth harshly criticizing yourself. Indeed, you will make yourself feel worse and it might compound the issue. Remember the important thing is to fuel yourself and restore your balance overall, and do so gently. The goal is not to sternly restrict. That may backfire.

 

Next: Part 4: Crucial Needs–Exercise, Social Interaction, Medication (?) / “Just Do the Little Bit That You Can”

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Depression Part 2: When You’re Depressed

Part 1

Part 2:

Recognize Depression: Depression often creeps up gradually and may affect you for a while before you realize what is happening. What effects do you usually experience? Are your symptoms usually physical, emotional, or cognitive, or a combination? Exhaustion, achiness, overwhelm, lack of motivation, negative thoughts, suicidality? (See Part 1.) If you have a better idea of your own symptom profile, you will be able to catch a depressive episode sooner when it occurs.

It is often a great relief simply to realize why you’ve been feeling bad. Also, it can be encouraging to remember that most depressive episodes remit within two weeks even without intervention!

Accept Depression: Depression can be tricky because we often have a belief that if we recognize what’s going on, we should be able to “snap out of it” by some act of will. While it’s good to try some things you think might help you feel better, the process is healing rather than fixing. You are an organism, not a mechanical device. It may take some time to get through the healing process.

Most people feel impatient about this, because depression interrupts whatever else you’re trying to do with your life. That’s the part most people have a hard time accepting. But depression is a real thing that really affects people on many levels, so work on accepting how your feelings and your functioning are affected. Then you can better decide how to address it.

Beating yourself up for “feeling bad for no reason” or “not getting enough done” will only make things worse! It may be that during some depressive episodes you will  feel bad “for no reason” or that you may not get as much done as you want to. That’s what happens during depression. You can do many things to support your healing, but you can’t just decide to not have depression.

Most people experiencing depression–even severe depression–are mostly functional in some life areas, which can lead to denial or minimization. “They must not be very seriously depressed, I just saw them laughing and joking at a party,” or “I can’t have severe depression since I’m able to work 12-hour shifts on a busy floor.”

Functionality varies from situation to situation and from day to day. You can be functional in one or more life area, or appear “okay” to others. That doesn’t mean the depression isn’t real or isn’t serious.

 

Depression Part 3: Nurturing Yourself Back to Life

 

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Depression Part 1: Depression and Functioning

Because we often think of depression as “lying on the couch crying,” many people don’t recognize what they’re experiencing as depression, especially if they’re high-functioning or have “smiling” depression.

But the most prominent and common symptom of depression I see is a lack of motivation. It can be anything from “I don’t care about anything and I don’t want to do anything” to “I’m too exhausted to do even the smallest thing” to “I want to do this one thing and somehow I just…don’t.” It’s also very common to function well at work, only to “fall apart” off the clock.

While actual proportions vary from person to person, few if any depressed people look like the “just sad” stereotype. A graphic in an article by Anna Borges depicts the discrepancy:

 

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It makes sense if you think of what “depress” means: to push down. Depression pushes down your physical, emotional, and/or cognitive functioning, in any combination.

If your physical functioning is depressed, you may feel exhausted and achey or move and speak more slowly than usual (often without realizing it). You may experience sleep difficulties.

If your emotional functioning is depressed, you may feel low, sad, hopeless, pessimistic, guilty, or even strangely flat, empty, and detached.

If your cognitive functioning is depressed, you may have difficulty concentrating, planning and implementing anything, or trouble with memory. The “planning and implementing” piece is the brain’s executive function. This is where the motivation problems come in, and why a person experiencing depression can’t simply “snap out of it” and “motivate.”

Also in terms of cognitive functioning, you may generate a lot of irrationally negative thoughts (and you may believe them uncritically), or have thoughts of death or suicide. It’s especially important to recognize that suicidal thoughts, while scary, are a symptom of depression and usually diminish when depression improves, so seeking help with depression is important.

 

Next:

Part 2: When You’re Depressed