Category: Depression

young woman experiencing negative emotions

Treating Depression with Behavior Therapy

Depression can be a daily struggle. It can make even the simplest tasks seem monumental. With depression, it can be difficult to get out of bed, even with all of the opportunities that await us. We may not enjoy things that we normally would, and we may feel as though we have no energy to spend time with those who would otherwise make us smile. Symptoms such as these are why depression is being recognized as the leading cause of disability in the world, according to a new report by the World Health Organization.

This report, which was reviewed in April 2016, reveals that “Depression is a common mental disorder. Globally, an estimated 350 million people of all ages suffer from depression.” Additionally, they confirm that “depression is the leading cause of disability worldwide, and is a major contributor to the overall global burden of disease.”

Depression is Highly Treatable

Thankfully, however, depression is among those diseases that are highly treatable, particularly with therapeutic intervention. One of the most successful treatments for depression is CBT, or cognitive behavioral therapy. CBT focuses on grounding the patient in the present moment to decrease rumination and reliving unpleasant thoughts and experiences. It can also help patients change their thoughts and behaviors to improve their overall mood. In many cases, therapy alone can be effective against depression, but for some patients, a combination of therapy and prescription medication is recommended. The most commonly prescribed medications are selective serotonin reuptake inhibitors, or SSRIs.

Medication can be a good way to reduce symptoms of depression but they don’t get to the root of the problem. This is where therapy is particularly beneficial. Therapy can help us understand what we’re feeling and lead us to possible reasons why. Through this, we can learn strategies to help better manage our emotions in a healthy and constructive way, rather than allowing them to consume us. However, there are a few things that we can personally do to help facilitate this process. Although depression can feel as though it has taken control of our lives, there are ways in which we can remind ourselves that we are in control: over our minds, our lives, and ultimately our happiness.

What is Behavioral Activation for Depression?

Known as Behavioral Activation, this treatment method involves focusing on altering certain behaviors to reduce depression. Behavioral Activation is a relatively low-cost and straightforward approach to combatting depression. To practice it, we must find activities in our lives which we enjoy, and which provide a sense of competence and importance. These feeling provide a sense of security, which depression is known for taking away. By using Behavioral Activation, we can identify which activities cause us to feel joy and fulfill us in the ways we need most. Below are a few strategies through which we can make the most of our Behavioral Activation. In this way, we can come closer to overcoming our depression.

3 Things to Try to Brighten Your Mood

1. Plan Activities You Enjoy

 Perhaps the most important step to the Behavioral Activation treatment method is to plan activities that are enjoyable and/or significant to us. Depression can make it hard for us to feel motivated to do the things we value, so it’s important that we learn to make time for ourselves so that we can establish a sense of purpose and fulfillment. It’s best to plan activities which produce some sort of reward which we enjoy. For example, planting seeds to grow a garden.

2. Take it Step by Step

When planning these activities it’s important to break them into manageable increments. If we try to take on too much at once we can become easily overwhelmed. For instance, we might decide to clean the house, but thinking of cleaning every room can be daunting. So instead, we may start by organizing some books, or doing the dishes. Starting with activities that are easier or more manageable allows us to enjoy ourselves more, rather than worrying about what we did or didn’t get done.

3. Be Accountable

When planning these activities we must make sure that we set aside an adequate amount of time for them, without cheating ourselves of the opportunity to engage in something we will enjoy. While struggling with depression it may be easy to forget sometimes the enjoyment derived from certain activities, but we can’t let the negative mindset of depression get in the way of our Behavioral Activation. Being accountable doesn’t necessarily mean being monotonous, nor does it mean being overly regimented. It just means that if we promise ourselves to do something we like, or something that is important to us, we hold to that commitment, and make time for us to do so. Basically, we are making a promise to ourselves to do something that will make us feel good. This commitment to our own happiness and well-being is a necessary step in overcoming depression,

In using Behavioral Activation, we are telling ourselves that activities we value are important. As such we are committing ourselves to making time to do things that we enjoy. We are reminding ourselves that we are important, thus our interests, passions, and ambitions are important to. Depression, though it may hinder our motivation, does not take away from our significance.

If you want to know more about seeing Dr. Mike or one of our therapists for treating depression in Boca Raton, give our office a call at 800-378-9354.
hands up to sky, holding the sun

How Light Therapy Can Combat Seasonal Depression

It’s not uncommon to feel “down” or “blue” from time to time. After all, life comes with it’s fair share of ups and downs and, as humans, we’re all along for the ride. Some seasons, however, might make us more prone to feeling blue than others. Known as seasonal depression, seasonal affective disorder (SAD), or “winter blues,” something about the cooler months seems to make many of us more likely to feel depressed than during any other part of the year. While scientists have yet to come up with a definitive reason as to why this might be the case, the most popular theory is that it has to do with the amount of daylight we receive (or lack thereof) during this part of the year when compared to all other seasons.

Understanding Seasonal Depression

Marlynn Wei is a board-certified Harvard and Yale-trained psychiatrist and therapist. Dr. Wei is also a certified yoga instructor and author who frequently writes about the healing powers of yoga, meditation, exercise, and healthy nutrition. According to Dr. Wei, seasonal depression is about more than just being sluggish due to colder weather. She explains that: “Shorter days from early fall through winter can cause even your serotonin to hibernate in your neurons.” In other words, this shorter amount of sunlight exposure can actually affect us on a biochemical level, causing us to feel more tired and less motivated. This decrease in physical activity and increase in desire to sleep can contribute to the depressive symptoms commonly associated with Seasonal Affective Disorder.

Dr. Wei’s research has shown that “You’re more at risk for the winter blues if you’re a woman, younger, live further from the equator, or have family members who have depression or a mood disorder.” Furthermore, she adds that “People with seasonal depression have been found to 5% higher levels of a transporter protein(link is external) that whisks serotonin away from the space in between neurons and moves serotonin back into the presynaptic neuron, which can lead to depression.”

Typically, sunlight during the summer months prevents this from happening, but during winter there is less sunlight which can lead to more serotonin hibernating in the neurons. This, many believe, is what truly causes seasonal depression. However, people with Seasonal Affective Disorder may be more prone to over-producing melatonin during the winter. This hormone is released in response to darkness and is what causes us to feel sleepy.

Benefits of Light Therapy

Phototherapy is a common and fairly effective treatment for individuals struggling with SAD or seasonal depression. Alternatively known as Bright Light Therapy, this form of therapy is usually employed in conjunction with antidepressants, Vitamin D, and traditional psychotherapy for maximum success in afflicted patients. That being said, light therapy is more than just simply standing in front of a box of light or sitting in an illuminated room. In order for the treatment to work, individuals and their practitioners must take care to avoid common mistakes which may cause the treatment to be less effective. Below are a few of them:

1. The Light Box must be 10,000 lux.

According to Dr. Wei, it’s important that the lightboxes employed during this form of therapy closely mimic the full spectrum of sunlight. As such, regular, ordinary lamps are fairly ineffective for this purpose. There are light boxes specially made for Bright Light Therapy or phototherapy that are designed to emit at least 10,000 lux. This is 20 times the strength of your typical indoor lighting. Lamps with fewer lux units would need to be used for longer periods of time to achieve the same benefit.

2. The Light Box Must Provide the Full Spectrum of Bright White Light (Minus the UV Rays)

One of the benefits of using a light box is that you can actually avoid exposure to harmful UV-rays, which is a risk that can come with overexposure to the sun. The light box one uses during phototherapy should filter out 99% of ultraviolet rays which could otherwise cause bodily harm.

3. The Box Should Be at Eye Level or Higher and 2 Feet from the Eyes, at an Angle.

Because the purpose of the light box is to mimic the sunlight it’s important that it’s kept at least eye level or higher. According to Dr. Wei, the ideal distance is also approximately 2 feet away from the eyes. Although, if the light box is weaker than the recommended 10,000 lux then one should seat themselves closer depending on strength to achieve the same effectiveness. Another important tip is to keep the box angled 45 degrees either to the left or right. Dr. Wei advises against putting the box directly in front of the eyes.

4. Use the Light Box Every Morning for 20-60 Minutes Between Fall and Winter.

When using phototherapy, consistency is key in order to see results. Dr. Wei recommends starting out at 20-30 minutes every morning to see if it causes a boost in mood and energy. If this period of time doesn’t seem to make a difference, then she recommends going up to maximum of 60 minutes. Light therapy time can also be used to multitask and go about one’s usual routine. Perhaps have a cup of coffee or check email, if it suits you and doesn’t seem to distract from the desired effects. Using light therapy every morning from early fall to winter can help maximize effectiveness whereas only using it a few times a week for a shorter period of time can make the treatment less effective overall.

Don’t Use if You’re Taking Medications Which Make You Photosensitive

This one might seem obvious but it can be surprisingly easy to overlook. Certain medications can make one photosensitive, meaning that the skin will become more sensitive to light. This can lead to sunburns or rashes with overexposure. Such medications typically include lithium, melatonin, certain antibiotics, and certain acne medications like isotretinoin, more commonly known as Accutane.

6. Monitor Your Mood and Combine With Other Treatments if Necessary

Improved mood and energy should be noticeable within 1 to 2 weeks with regular treatment, however, many people notice a more immediate response. That being said, it’s very important to talk with one’s doctor first to find out if phototherapy is right for you. Otherwise, there is the potential for a negative reaction such as developing excess energy (hypomania) and lacking in sleep as a result. There are worksheets available to track one’s mood during treatment so that it can be easier to keep track of changes. However, if light therapy isn’t enough, this treatment can be combined with other forms of therapy, like cognitive behavioral therapy (CBT), mindfulness, meditation, and exercise.

a woman who appears to be sad sitting on a bench

The Power of Positivity During the End of the Year

It’s no secret that the end of the year can be stressful. This time of year always brings with it a myriad of emotions ranging from joy and excitement to depression. But why? Well as the end of the year draws nearer we often find ourselves faced with surmounting responsibilities. After all, it can be difficult to find time to cook, decorate, gift shop, and entertain, even though we might feel compelled to do so because it is expected of us. It can be even more difficult to afford all of these things, as the holiday season brings with it increased expenditure in the name of giving and receiving. That being said, the holidays can also be extremely rewarding. The emphasis on togetherness and giving brings with it a sense of comfort and closeness not only amongst our families and loved ones but within our communities as well. Holiday traditions such as tree decorating, lighting candles, or baking cookies can put a smile on anyone’s face and help us remember sweet memories of holidays past. In essence, despite all of the stresses brought upon by this time of year, there is, to use the old adage, a silver lining – tinsel, perhaps. Or is there?

What it Means to Truly be Happy

So what makes “holiday cheer” so important? Why must we be cheerful? How does this benefit us? Well firstly, it’s worth noting that there’s a difference between being genuinely happy for the holidays and feeling as though we should be happy. A major distinction between the two is whether or not we genuinely feel good or whether we feel compelled to feign holiday spirit because we believe it’s expected of us. The latter can magnify negative feelings because it removes our happiness from ourselves and turns it into an obligation rather than actual enjoyment. We’ve discussed previously how keeping our true feelings bottled up and hidden can be unhealthy and this time of year is no exception. Numerous studies have detailed how our attitudes can profoundly affect our health and well-being. Dr. Diane Dreher, best-selling author and associate director of the Spiritual and Health Institute, explains: “We pay a price for being too nice. A phony smile may fool others, but cannot fool our bodies…Real positive emotions, on the other hand, help us become healthier, happier, and more successful.”

The Dangers of Faking Happiness

Pretending to be happy when we’re not can actually put us under excessive stress, whereas genuinely allowing feelings of positivity and joy into our lives can enable us to be healthier and even more successful. Psychologist Barbara Frederickson found in her research that “the emotions of joy, elevation, gratitude, and love strengthen our immune systems, making us physically healthier, while broadening our vision and building our resources. Positive emotions help us see more clearly, discover new possibilities, build connections with other people, who support us in our lives and work.” In fact, in order for us to flourish, we need a 3 to 1 ratio of positive emotional experiences to negative ones each day.

Positivity  – A Powerful Tool

In other words, genuine positivity can be a powerful influence on our day-to-day lives, and particularly during the holidays when we need it most. Luckily, there are a number of ways we can increase our positivity by consciously building more positive experiences into our lives. A good way to start is by taking time every now and then to pause and ground ourselves in the present moment. Perhaps you’ve heard the saying, “stop and smell the roses?” There is more truth to this than we might initially realize. These moments of pause and reflection can enable us to see the beauty around us which can benefit our mood and overall wellbeing. Taking time for ourselves is essential to the preservation of our own happiness. To accomplish this, we might take some extra time to meditate to help restore our peace of mind during this hectic time of year and maintain a sense of balance. We might also, however, take time to do something we love, be it creating something, reading a book, or finding something that makes us laugh or smile.

The key is to find something, anything, that we enjoy and remember to treat ourselves as we worry about treating others. While giving is important, we ourselves deserve health and happiness, and it’s important to remember that protecting these things does not make us selfish. After all, the end of the year is a time for celebration, and positivity is something to be nourished and fostered, not simply manifested. Positivity can not only help us survive the end of the year depression that many of us feel, but can also ensure that we enjoy it as well. This year, we must remember to enjoy what makes us happy and take time for ourselves, and, in doing so, feel joyous, instead of simply pretending to be.

a woman looking stressed out with her hand on her head

Staying Mindful to Prevent End of Year Sadness

The holiday season can be one of the most stressful times of the year. In between all the holiday shopping, family planning, and decorating, many of us seldom find the time to stop and enjoy the cooler air or the smell of pine and baked goods. But those moments can be essential to maintaining our overall sense of happiness and wellbeing during the otherwise trying time. Commenting on the chaos of the holidays, Dr. Diana Raab, specialist in transpersonal psychology, states: “Being in the moment helps us gain a better understanding of ourselves.” She quotes the following sentence from Be Here Now, by Ram Dass, which focuses on yoga principles and reconnecting man with their spiritual self, that: “The journey across the great ocean of existence is a journey inward . . . ever in deeper and deeper and the deeper you get in the more you meet the truth.” According to Dr. Raab, one way to meet this truth is by practicing mindfulness. After all, mindfulness can help us recognize the already existing happiness in our own lives. In other words, it can remind us to be thankful for what we have, as well as make us more aware of what we have to be thankful for.

Staying Mindful During the Holidays

There are a number of ways to increase our mindfulness, especially over the holidays. Perhaps one of the most overlooked practices associated with heightening awareness is mindful breathing. What does this mean? Take the time to focus on the sensation of inhaling and exhaling. As we breathe in, let’s be aware of that intake of air, and as we breathe out, let’s be aware of it rushing past our nose and lips. At first glance, it might not be immediately apparent what this simple activity can do, but in essence it is to remind us that we’re alive. This is something that is easily taken for granted, but this practice can help us remember the fact that we are living, breathing human beings, and that alone is something to be thankful for.

Another helpful practice is becoming aware of our bodies and minds. In addition to focusing on how we breathe and the sensation of breathing, we should learn how to expand that awareness to encompass our entire bodies. Live in each action in each moment. Paying attention to the little things can help ground us in the present which can keep us from stressing or worrying about things that are outside of our control. In fact, much of the stress surrounding the holidays comes from a lack of attention that is placed on the here and now. Instead, we worry about the “what if’s”: what if we get the wrong gift? What if we can’t afford what we initially wanted? What if the recipient doesn’t love the gift? As these thoughts flood our conscious mind we begin to spiral into self-doubt and distress. Instead, by grounding ourselves through an enhanced awareness of our physical being, we can then begin to address our holiday responsibilities with a new, calmer demeanor. This can allow us to make wiser choices rather than allowing stress to overwhelm our decision-making. It can also keep us from over-thinking what we want by reminding us to be thankful for what we already have.

This heightened awareness of ourselves can help relieve the tension that tends to build up in our bodies and minds, particularly at this time of year. As we exhale, we might imagine ourselves physically releasing our tension with each breath. Although we might be constantly on-the-go in order to complete the number of errands that seem to accumulate as the holidays draw nearer, we can still find time to meditate. Movement doesn’t make meditation impossible, in fact, Dr. Raab advocates what she calls walking meditation. She explains: “If you have difficulty sitting still or are limited for time,  a walking meditation is a great alternative to a seated meditation. Pay attention to your body as you do a ‘royal stroll,’ feeling and being aware the ground with each step you take. Think of each step as a miracle.” Time spent shopping or moving about can be useful for becoming more in-touch with our inner selves. By practicing walking meditation we are not only grounding ourselves but also cultivating a sense of inner peace and balance which can be otherwise difficult to find with all of the hustle and bustle surrounding us.

Benefits of Self-Awareness

Addressing the effectiveness of these techniques, Dr. Raab states that: “All these techniques lead to increased self-awareness, which is about having a clear perception of who you are—your personality, strengths, weaknesses, thoughts, beliefs, idiosyncrasies, motivations, and how in touch you are with your emotional well-being.” After all, increased self-awareness can make us better capable of understanding ourselves as well as others, which can also make us more resilient and comfortable in our own skin.

Remember the Here and Now

Among many other things, increased mindfulness and self-awareness reminds us to be here, now. And in doing so, we remember that each day is precious, so why worry about a few days out of the year? After all, every day is special. In essence, let’s be thankful for each moment remember to appreciate the simple things. The holidays aren’t just about wish lists.

a young man in therapy to learn about coping skills.

8 Things You Learn in Therapy About Coping Methods

We will all encounter stressful situations at some point in our lives, whether it be related to work, school, or our personal relationships – any therapist will tell you that. That being said, we all cope with stress differently, and the ways in which we learn to deal with these stressful situations can be the key to whether or not we remain stressed or can move beyond whatever our circumstances are and find peace. As such, it’s important for us to learn good coping methods to carry with us in our day to day lives.

What is Coping?

First and foremost, let us look at what exactly “coping” is. In essence, coping describes how we consciously deal with stress. In other words, it refers to the strategies we employ to deal with whatever is causing us stress or discomfort: do we face the problem head on? Do we brush it away and hope it disappears? And so on. Our coping methods can determine a lot of things about how we manage ourselves under duress, with some of us being more prone to seeking external relief sources such as drugs and alcohol. Unfortunately, while these substances may provide short-term relief they do nothing to solve the actual causes of the stress, nor do they help us develop our own resilience, hence why we might become dependent on them for escape. Additionally, drugs and alcohol are incredibly risky to our health and wellbeing, making them maladaptive coping mechanisms.

However, we must also keep in mind that how we cope may vary depending on the types of stress we are experiencing. For example, it’s not uncommon for those who suffer from extreme anxiety triggered by specific circumstances or PTSD to avoid the things that may cause them severe stress. In such cases, these behaviors may be advised so long as they aren’t interfering the with individual’s overall quality of life or happiness.

8 Popular Coping Methods and What They Mean

1. Distancing

Distancing is a popular coping mechanism which involves the individual removing themselves from the situation and thereby trying to minimize its significance. After this, the individual can choose to either avoid the situation completely or use the reduced feelings of stress allowed by the distancing to better assess the situation and come up with a solution.

2. Confrontation

The opposite of distancing, confrontive coping involves, as the name implies, the individual aggressively confronting and making efforts to change the stress-inducing situation. However, some methods of confrontation can become excessive and the individual might find themselves behaving riskily or in a manner that is antagonistic as a result.

3. Seeking Support

For some individuals who encounter stressful situations, seeking support from friends and loved ones may be their go-to method of coping. The support of others can make otherwise seemingly insurmountable tasks become less daunting and thus can allow us to feel more capable when it comes to facing our stress and dealing with it.

4. Self-Controlling

On the other hand, some individuals may find it easier to cope with stress by assuming control over their own feelings and responses. Feelings of control can sometimes act as a psychological substitute for a lack of external stability, as is often observed in situations that induce stress. Although these feelings seldom actually address the situation itself, they may make us feel more equipped to do so through establishing a sense of internal resilience. Unfortunately, taken in a wrong direction, an excessive need to feel in control of a stressful situation may lead to self-blame. This is because in their efforts to seek control, the individual might declare themselves solely responsible for their negative experiences.

5. Accepting Responsibility

There is a difference between accepting responsibility in a stressful situation and blaming oneself. The latter implies that we are taking responsibility for things that are even outside of our control. However, accepting responsibility in order to cope with stress actually entails understanding and accepting our roles insofar as we are involved with contributing to the stress and seeking to improve. In doing this, we are not taking responsibility for the actions of others, only our own, which we have control over. Individuals who use this coping mechanism do so in order to lessen the stress of a given situation by being mindful of the influence of their own actions and words.

6. Problem Solving

This coping method involves analyzing the stressful situation and planning to find a way to resolve it. Through this individuals can treat stress as something that can be solved rather than something that is unable to fixed or that will remain a permanent stressor.

7. Positive Reappraisal

It’s not uncommon to find this coping method advocated in many religious teachings although it is not solely practiced by individuals who are religiously affiliated. Here, those who practice this kind of coping take the experience of dealing with stress and turn it into an opportunity for growth.

8. Escape/Avoidance

This coping method is pretty self-explanatory. Those who practice escape or avoidance as a means of coping with a stressful situation are avoiding dealing with the problem. This coping mechanism can be problematic because it means that the individual is essentially avoiding addressing the problem which is causing them stress. This means that the primary stressor remains and can continue to cause them discomfort because nothing has been done to actually remedy this.

Healthy vs. Unhealthy Coping Methods

Discussing the ways in which we cope, Dr. Jennifer Golbeck, director of the Human-Computer interaction lab at the University of Maryland explains that “Some of these strategies, like Escape-Avoidance, are maladaptive since they don’t help to deal with the stress longer term. Others, like Planful Problem Solving, are useful for heading off future stressors and therefore are more proactive coping styles.” In other words, when developing a method of coping with stressful situations it’s better to act proactively than avoidantly. After all, avoiding a problem will only make it worse in the long run.

When facing circumstances which cause us stress, we must take a moment to assess our situations and what can be done about them. It is through this that we can hope to resolve the underlying problems that induce the feelings of stress rather than allowing them to continue undeterred.

woman smiling with eyes closed, laying in green grass

Five Common Myths about Emotional Health

Often disregarded because they’re assumed to be irrational and thus not worthy of attention, many of us may find ourselves withholding and even denying our emotional selves. There are many reasons why this happens, but at least some of it can be attributed to either a reluctance or a fear of truly getting to know who we are emotionally. The famous philosopher Frederick Nietzsche believed that people were often clueless about things that were closest to us.

There are several common misunderstandings that we tend to have about emotions:

1. Emotions Can’t Be Expressed Verbally

Many of us may struggle when it comes to being able to express our feelings through language. It’s true that many languages are not necessarily built for acutely describing our “inner experiences”, including the nuances of our emotional states. However, this doesn’t render our emotions completely indescribable with words. Emotions are connected to our sense of judgment, therefore they can be both described and analyzed in detail. Learning how to express ourselves verbally is not only good for learning how to communicate to others how we feel, but is also incredibly important to establishing a sense of self-control. By learning how to process feeling into language, we are transposing our more irrational senses into a rational, understandable format, allowing us to diminish overreactions and process our feelings more constructively rather than destructively, as the case may be.

2. Emotions Are Just Feelings

Although I used the words emotion and feeling seemingly interchangeably above, as many of us do, emotions are much more than feelings. The relationship between the two denotes a link between our psychological and physical responses, which is why many of us tend to think that emotions and feelings are one and the same. However, this is not the case. To feel, which is a bodily sensation, we must first have some element of awareness of our conscious state. What does this mean? Think of what it means to feel sad. For many of us, we experience the emotion of sadness, which is psychological and triggers the subsequent feeling of being sad. This may include bodily responses such as potentially feeling as though our heart hurts or perhaps as though we’re heavy with the weight of our emotion. Thus, while feeling and emotion do indeed have a connection, one does not necessarily define the other.

3. We Can’t Control How We Feel

As mentioned before, emotions are essentially judgments. They are psychological responses to a given thought, situation, or stimuli, which then trigger the physical response we come to call “feeling”. Dr. Shahram Heshmat, an associate professor emeritus of the University of Illinois in Springfield, describes the experience thusly: “A person’s emotional experience typically results from a subjective interpretation (appraisal) of an event rather than the event itself, even though the appraisal (beliefs) involved may not be accurate. Different individuals can interpret the same event differently.” Think about jokes, for example. In order for an individual to find a certain joke funny, the subject of the joke, the delivery, and all other variables must be such that the individual perceives it to be so. Everyone has a different sense of humor, therefore we each find different things funny. Thus, even emotions have a sense of rationality. The basis of cognitive therapy is that much of the emotional pain we experience is simply caused by distorted or “irrational” thinking. But this doesn’t render our psychological judgments inherently irrational as a whole.

4. Emotions are Stupid

Because of the common misbelief that emotions are irrational and therefore not to be taken seriously, it follows that many of us may develop the belief that emotions are somehow “stupid”. Dr. Heshmat explains that “Emotion and reason are not competing forces but complementary processes that interact and influence each other.” As an aspect of judgment, emotion is part of our mechanisms for reasoning. Lacking emotion can be very detrimental to decision making. In this instance, consider those who are described as “emotionless”; has this ever been used in a positive context, particularly with acts of alleged reason? Emotional reactions act as summaries for our past experiences with certain situations. We “feel” this summary when we experience what is commonly referred to as “gut” feelings, or intuition. Sometimes in the absence of fully knowing what should be done, going by feeling or instinct can help fill in any blanks to make our decision-making process more efficient.

5. Emotions “Happen” To Us

The notion that emotions are things that simply happen to us implies that emotions are beyond our control. However, this isn’t really true. Emotions are seldom unprovoked or random, rather they are patterns of behavior that are chosen and practiced over time. We cultivate our emotions based on our life experiences by observing what impact our expressions have on ourselves and others. For example, if a person knows that their anger can be used to intimidate others, then perhaps they might learn to become angry at the slightest provocation. In this case, anger becomes cultivated based on an experience. There are many examples like this, but in essence, our emotional selves are developed based on experience, not random happenstance.

Try to Remain Aware of Emotional Misconceptions

Dispelling these myths surrounding emotions can not only lead to a better understanding of our emotional selves but can enable us to develop a better overall sense of mental and physical wellbeing. So don’t be afraid of emotions, they are a natural and healthy part of human expression and experience.

silhouette of woman practicing mindfulness therapy on beach

The Sustainability of Mindfulness Therapy

In previous articles we’ve discussed the benefits of mindfulness therapy with regards to treating depressive disorders and addictive behaviors. For many years, this form of therapy has been the go-to for many patients to seek to overcome what is ultimately a psychological impasse by teaching them to take control of their own thoughts and feelings. However, surprisingly little focus has been placed on whether or not mindfulness therapy can actually assist us in the long-term by making us more resilient. Dr. Michael Ungar is an executive board member of the American Family Therapy Academy and he questions whether or not mindfulness therapy and its related practices are actually sustainable.

Is Mindfulness Therapy Sustainable?

Addressing the various studies which point to the success of mindfulness therapy and meditation on the human mind, Dr. Ungar states that “At the core of all these experiments are emotional regulation (e.g., the ability to not eat a marshmallow when it is delectably place in front of us) and focused attention on what really matters (rather than being distracted by our fears and obsessions).” He admits that  “Both strategies can improve our lives.” But he questions the undisputed nature of many of these large claims. While there is nothing inherently wrong in this pattern of thinking, which essentially follows the same thought path as “mind over matter”, he raises concerns that “None of those studies have told us much about whether mindfulness practices are sustainable and improve mental health outcomes for people who are actually struggling with severe mental illness or chronically toxic environments.”

The Mythology of Infallibility

A favorite subject of motivational speakers, mindfulness therapy has become surrounded by a sort of mythology of infallibility. In other words, often times when mindfulness practices are discussed, they are talked about in such a way as they provide a more or less permanent solution to an ongoing problem. For many people, depression is not a one-time occurrence, and for others struggling with addiction, the desire to use is not singular and non-recurring. For those who step up on platforms to discuss their seemingly permanent success with these treatments, Dr. Ungar notes that: “you’ll notice a curious thing is missing. Context. They never mention that all their wonderfully illustrative examples come from motivated people who got the very best support available and that the changes they made were seldom sustained.”

Dr. Ungar is not necessarily attempting to discredit the practice of mindfulness therapy as a whole, but rather is trying to extract the truth about the treatment’s sustainability for those who may not have the same access to the same privileges that may have been enjoyed by someone who is able to travel and discuss their success story with others. However, the reality of resilience, Dr. Ungar explains, is that: “it is not something we build alone in the dark. It is a facilitated process of engagement with an environment that makes it possible for us to fully realize our capacity.” As such, he believes: “Mindfulness is a shallow description of a much larger process that makes us resilient when bad things happen.”

Environment Makes a Difference

In essence, Dr. Ungar encourages us to adopt a more realistic perspective on the effectiveness of mindfulness and related therapies, seeing them not necessarily as an answer to all one’s problems, but rather a helpful tool that assist how we perceive things, but not necessarily powerful enough to change the reality of our situations. According to him, “we are so enamoured thinking about how mindfulness changes our susceptibility and make us better able to exploit our environments, that we forget at our peril that environments are more important than the brains themselves.” Consider, for example, a person living in an abusive environment. While therapy can potentially train that person to better deal with the effects of the abuse psychologically, it is not until that person is removed from that environment that they can be truly freed from the abuse. Dr. Ungar points to a more extreme example of the Syrian refugees, arguing that “Positive thinking may help keep them moving forward, and being able to regulate one’s emotions may help an individual refugee tolerate the endless lines to cross borders, but all the hope in the world will not keep someone alive when a barrel bomb is dropped on them by their government.”

While that example may seem harsh, it carries with it an important truth, that a person’s surroundings can be just as influential to their safety and health as their perspective, if not more so. To ensure the resilience of treatments such as mindfulness therapy, we must consider the influence of extraneous variables within a person’s life which may inhibit their healing. Dr. Ungar asks us to question the role of privilege and accessibility in the mainstream purported success of mindfulness treatments and meditation, raising awareness that taking the time to engage in these practices, to some, may be more of a luxury than a reality. He explains: “The originators of mindfulness practices, Tibetan monks and Christian aesthetics, understood that their contemplative practices required near complete devotion and the benevolence of a community to clothe, feed and house them while they ascended the spiritual ladder. In other words, even in their bare bones world the founders of mindfulness knew that their path to brain plasticity was facilitated by the privileges of their status as their community’s spiritual guides.”

The True Potential for Mindfulness Therapy

So is mindfulness therapy useless as a practice? Not exactly. Dr. Ungar believes that mindfulness therapy and related practices can potentially be liberating and help in making us better people. After all, mindfulness therapy can help us appreciate life and control minor stresses in our day-to-day lives. Furthermore, it can help us maintain focus but in order to accomplish all of this mindfulness therapy requires that we sustain the practice daily.

To this, Dr. Ungar responds: “But it does all this much better when we have a job and a place to come home to. First things first, I say. To be resilient we must experience security, social justice, a powerful identity, personal power, and positive relationships. Psychological enlightenment is a luxury enjoyed by those whose basic needs have already been met.” In saying this, he hopes to raise awareness about the influence of privilege in certain therapeutic practices which thrive on an individual having the free time to regularly sustain them.

Anxiety and Depression in Children On The Rise

A recent report by Psychology Today reveals that “Rates of depression and anxiety among young people in America have been increasing steadily for the past fifty to seventy years.” According to some estimates, at least 5 to 8 times more high school and college students meet the diagnostic criteria for depression and anxiety disorders than was true almost half a century or more ago. Initially, one might assume that this increased psychopathology could be due to a change in diagnostic criteria, however, it holds even when the measures and criteria used are constant.

Anxiety and Depression on the Rise for Young People

The most recent evidence of this rise in depression and anxiety for young people comes from a recently released study from Jean Twenge at San Diego State University. Twenge and her colleagues utilized information from the Minnesota Multiphasic Personality Inventory, or MMPI, which has been administered to large samples of college students since 1938, and the MMPI-A, which provided data from younger adolescents of high school age since 1951, to determine changes in the reported mental health of these populations over time. Her results are consistent with other studies which reveal dramatic increases in anxiety and depression, in both children and young adults, over the last 5 or so decades.

Dr. Peter Gray, research professor at Boston College, writes: “We would like to think of history as progress, but if progress is measured in the mental health and happiness of young people, then we have been going backward at least since the early 1950s.” But why? Interestingly, this increased psychopathology seems to have little correlation with more realistic dangers like changes in economic cycles, wars, or any other world changing events. In fact, rates of anxiety and depression in younger populations were much lower during the Great Depression, World War II, the Cold War, and the politically turbulent 1960’s and 70’s. What does this show? That perhaps feelings of anxiety and depression are more connected to how these young people view the world than the state of the world itself.

Anxiety as a Response to Self Control

In fact, these feels of anxiety and depression seem to strongly correlate with the individual’s own feelings of control or lack thereof over their own lives. As Dr. Gray explains: “People who believe that they are in charge of their own fate are less likely to become anxious or depressed than are those who believe that they are victims of circumstances beyond their control.” One might think that sense of personal control has increased over the past few decades. However, while progress has occurred in our ability to prevent and treat diseases, reduce the old prejudices which once limited citizens on the basis of race, gender, and sexuality, and increase wealth, feelings of control over their own lives has actually declined significantly within the past decade.

Measure of sense of self-control is measured through a questionnaire which was created in the late 1950s by Julien Rotter, called the Internal-External Locus of Control Scale. The questionnaire consists of 23 pairs of statements. One statement in each of the pairs represents belief in the internal locus of control, or control by the person, while the other represents belief in the external locus of control, or control of circumstances outside the person. The individual taking the questionnaire must determine which of the statements they feel to be more true. Dr. Gray provides the following example: “(a) I have found that what is going to happen will happen. (b) Trusting to fate has never turned out as well for me as making a decision to take a definite course of action. In this case, choice (a) represents an External locus of control and (b) represents an Internal locus of control.”

The Importance of Play

Studies have shown that a rise in externality and decrease in internality leads to anxiety and depression. After all, if we feel as though less things are in our control it may lead to feelings of distress. When feelings of anxiety and helplessness become too great it can lead to the development of depression. But why are children experiencing decreased internality? Signs point to a correlation between decreased play time. Playtime allows children time to explore and act independently from adult direction, but unfortunately, the amount of playtime children are allotted has decreased significantly within recent decades. Dr. Gray describes this essential time as being “ the means by which children learn to solve their own problems, control their own lives, develop their own interests, and become competent in pursuit of their own interests.” Thus a decline in this developmental time for children has lead to a deprivation in allowing children the opportunity to learn how to take control of their own lives. Even with the best intentions, Dr. Gray believes that while  “we may think we are protecting them, but in fact we are diminishing their joy, diminishing their sense of self-control, preventing them from discovering and exploring the endeavors they would most love, and increasing the chance that they will suffer from anxiety, depression, and various other mental disorders.”

Even in schools, less time is allotted for play than for more regimented curricular and extracurricular activities. Through this, children learn that what they want is insignificant when compared to what adults what for them. They are directed, organized, and ranked according to the expectations set by adults, thus, their sense of self is largely defined by others. In fact, Dr. Gray describes modern schools as being “a place where children have little choice about with whom they can associate. They are herded into spaces filled with other children that they did not choose, and they must spend a good portion of each school day in those spaces. In free play, children who feel harassed or bullied can leave the situation and find another group that is more compatible; but in school they cannot. Whether the bullies are other students or teachers (which is all too common), the child usually has no choice but to face those persons day after day.” The results of which, he notes, are disasterous.

That’s not to say that schooling and education aren’t important, however, and beneficial to the intellectual development of children and young adults. Rather, allowing kids the freedom to play and develop as individuals can enhance their education by instilling a willingness and motivation to be educated rather than depriving them of any choice. Perhaps by reinstating playtime and emphasizing its importance in the development of our children, we can collectively reverse the rising rates of anxiety and depression by allowing them the self-control they need to be both happy and healthy.

USPSTF Says Most Adults Should be Screened for Depression

It is estimated that around 1 in 10 Americans experience depression at some point in their lifetimes with Major Depression affecting approximately 7% of the total U.S. Population. With statistics like these, it’s not surprising then that according to a recent draft recommendation issued by the U.S. Preventative Service Task Force, all adults should be screened for depression including “pregnant and postpartum women”.

Survey of Participants Screened for Depression

In a previous 2009 recommendation, the USPSTF stated that adults should be screened “when staff-assisted depression care supports are in place, and selective screening based on professional judgment and patient preferences when such support is not available.” However, they have since amended this recommendation and they now suggest that doctors should screen all patients 18 and older for depression using the Patient Health Questionnaire, or PHQ. The PHQ is currently the most commonly used tool for screening patients for depression. The survey includes 9 questions which are meant to assess the individual’s overall mental health. For example, the PHQ may ask “Over the last 2 weeks have you been feeling tired or having very little energy?” or “Over the last 2 weeks have you had little interest or pleasure in doing things?” Patients are supposed to mark their answer on a 0-3 scale ranging from “not at all” to “nearly every day”. The scores are then added up to diagnose whether or not the patient is suffering from mild to severe depression. Such diagnosis will then help their doctor determine what treatment may be best for them.

Why Recommend Depression Screening?

But why the change in recommendation? According to the USPSTF, “In recognition that such support is now much more widely available and accepted as part of mental health care, the current recommendation statement has omitted the recommendation regarding selective screening, as it is no longer representative of current clinical practice.” In other words, the wide acceptance and increased availability of mental health care has effectively reduced some of the stigma regarding mental health screenings and diagnoses. The USPSTF also reports that “Depression is among the leading causes of disability in persons age 15 years or older. It affects individuals, families, businesses, and society. It is common in primary care patients. Depression is also common in postpartum and pregnant women and affects not only the woman but her child as well.” These facts and statistics have effectively contributed to the USPSTF’s stance on depression screenings and now they advise that general screening can potentially help with early detection and treatment of depression and depressive symptoms.

And according to the USPSTF, early detection and treatment can be highly beneficial. The USPSTF states that they have found “ adequate evidence that programs combining depression screening with adequate support systems in place improve clinical outcomes (i.e., reduction or remission of depression symptoms) in adults, including pregnant and postpartum women…that treatment of adults and older adults with depression identified through screening in primary care settings with antidepressants, psychotherapy, or both decreases clinical morbidity…[and] that treatment with cognitive behavioral therapy (CBT) improves clinical outcomes in pregnant and postpartum women with depression.” But what about the consequences of early detection and treatment? According to the USPSTF there are little to  none. Of course, women who are pregnant will likely need to be more careful about what medications they are taking while pregnant, but other treatments like CBT can be used alternatively or in conjunction with medication to treat depression.

The USPSTF insists that all adults be screened regardless of risk factors as such screenings are beneficial to the general adult population.Dr. Kristen Bibbins-Domingo, vice-chair of the USPSTF, explains that “Depression is not only common, it is one of the leading causes of disability in the United States. The Task Force’s recommendation for all adults to be screened by their primary care physician will help to identify depression and connect patients with the treatment and support they need.”

Official Announcement to be Made in Late August

Medical News Today reports that the “The USPSTF is taking public comment on the recommendation until August 24th. The expert panel will review all comments before making their final recommendation.” However, the USPSTF has made it clear that when it comes to depression, it’s important to screen early for maximum treatment benefit. With the lessened stigma surrounding mental health care, perhaps this new recommendation can be what’s needed to raise awareness about depression and provide necessary treatment to those who may not have previously had access.

New Research Provides Fresh Insight into Treating Depression

It is estimated that over 350 million people worldwide struggle with depression. The World Health Organization claims that depression is the leading cause of disability and is a major contributor to the overall global burden of diseases. Statistically speaking, women are about twice as likely to suffer from depression than men. Futher, according to the Depression and Bipolar Support Alliance, “as many as one in 33 children and one in eight adolescents have clinical depression.” But new studies may change the way we see, and subsequently treat depression.

Common Depression Treatment and Side Effects

Currently, the most prevalent treatment option for those with depression is psychotherapy, which provides counseling for those struggling. Psychotherapy is usually combined with antidepressant medication to combat certain depressive symptoms like fatigue, low appetite, slow cognition and movement, and overall feelings of low self-esteem or self-worth.

While many believe strongly in the psychotherapy portion of depression treatment and the benefits of receiving proper counseling, antidepressant medications have been the subject of more debate due to their various side-effects which can sometimes have negative physical and/or psychological impact – ie: weird dreams, diarrhea, decreased libido, etc.

Researching Negative Side Effects

These side-effects have been a drawback for many individuals struggling with depression has lead some scientists like Dr. Greg Siegle to seek alternative options which treat depression as more of a physical ailment than a mental one. Dr. Siegle’s research focuses primarily on the dorsolateral prefrontal cortex which controls executive function, cognitive flexibility, and working memory.

Why this part of the brain? Research shows that people with depression have a more difficult time using their dorsolateral prefrontal cortex when compared to their non-depressed counterparts. According to a study published by the National Center for Biotechnology Information, lack of activity in the dorsolateral prefrontal cortex when combined with an  active ventromedial prefrontal cortex leads to increased chances of depression. This is because the ventromedial prefrontal cortex is primarily responsible for emotion, threat detection, and fear conditioning. While in a non-depressed brain these two cortices balance each other out in terms of neurotransmissions, depression could result from an imbalance in which the dorsolateral prefrontal cortex is inactive or less active than it should be.

Cognitive Control Therapy

By examining depression as a physical ailment the key for treatment then lies in toning up the brain as a muscle. Dr. Siegle and his colleague’s work aims to strengthen this portion of the brain using what Dr. Siegle calls “cognitive control therapy”. What this entails is a doctor administering a gentle electrical current into the patient’s brain, over the scalp. In a study published in the Journal of Affective Disorders, “Both [Cognitive Control Therapy] alone and combined with [transcranial direct current stimulation] ameliorated depressive symptoms after the acute treatment period and at follow-up, with a response rate of approximately 25%. Older patients and those who presented better performance in the task throughout the trial (possibly indicating greater engagement and activation of the [dorsolateral prefrontal cortex]) had greater depression improvement in the combined treatment group.” And in Dr. Siegle’s own studies, cognitive control therapy, or CCT, has been shown to be successful in trial cases.

New Treatment Aimed At Ailing Symptoms of Depression

Dr. Siegle’s treatment does not aim to target depression as a whole, but rather to alleviate some of its most prevalent and persistent symptoms. According to Dr. Siegle: “Many depressed people think about things they don’t want to think about over and over again…Medications don’t help decrease rumination much. This suggests that even if you’re taking them, it might be helpful to get the rumination under control. In our research we set out to use these exercises to improve executive control and working memory.” In other words, CCT aims to help patients suffering from depression control their thoughts and memories so as to not contribute to or strengthen their depression from unwanted ruminations.

That being said, Dr. Siegle emphasizes that his treatment is not to replace traditional health care and therapy for those with depression. He argues that “I am not recommending that people stop seeing their therapist or stop taking their medication to take this program” Currently, the program is actively undergoing clinical trials but Dr. Siegle is hopeful that this treatment can alleviate some of the symptoms of depression, helping the overall recovery process of the patient. We can only wait and see where this goes, but one thing is for certain: Dr. Siegle’s studies have shown that depression is both a physical as well as mental illness. Therefore, the future of treatment for depression might just seek to address the physical as well as psychological aspects, offering a more encompassing approach to treating depression as a whole.

A male and female interlocking hands in what appears to be a strong, happy relationship.

Building Communication with Relationship Therapy

Most couples will argue from time to time. For the most part, this is normal behavior, because loving someone doesn’t necessarily …

Man sitting on couch holding hands over his face as his partner walks away angrily.

The Five Stages of Ending a Long-Term Relationship

Sometimes relationships just aren’t meant to be. Love has plenty of ups and downs, but increasing negativity can be a sign …

Vintage photo of a peaceful, beautiful nature scene with river and trees.

Smell The Roses: The Benefits of Nature Therapy

With the hustle and bustle of our daily lives and responsibilities, it can be hard to remember to take time to “stop and …