The difficult truth is there are a huge number of factors we cannot control in life. This has been even more apparent than ever as our daily lives changed in ways we never thought possible in response to the COVID-19 pandemic.
Stressing out about things you can't change isn't limited to coronavirus and global emergencies though - it's one of the main symptoms of anxiety. Most people feel anxious from time to time, but it tends to be a problem if:
- the worry is out of proportion to the stressful situation
- persists when the stress is over
- occurs when there isn't an obviously stressful situation
Anxiety often means worrying about things that are out of our control. The mind has the ability to catastrophize regardless of what's going on.
Why do I always imagine the worst?
If your mind always jumps to the worst-case scenario, you’re not alone. Anxiety would have been an advantageous trait when humans first emerged. Our ancestors needed to be primed for danger in order to survive and reproduce. We call this response 'fight or flight' - where a hormone called adrenaline is produced by the body.
It was useful back then, in case you needed to run away from a saber-toothed tiger, but it's of less benefit in modern life where the threat isn't usually quite so obvious. Too much adrenaline can also cause physical symptoms such as a pounding heart, sweating, breathlessness, and panic attacks. Not the best symptoms to have if you’re in a meeting at work, or simply at home by yourself.
Look for evidence
There will always be periods of life that are more challenging than others. We don't have control of that, but we can choose to respond to a difficult situation in a more helpful way. Focusing on what might go wrong and the worst possible scenario can trap us in the negative thought loop, leading to feelings of hopelessness and fear.
Cognitive behavioral therapy (CBT) can be really helpful for those who find themselves struggling with spiraling negative thoughts. It aims to break problems down into more manageable chunks to stop you from getting overwhelmed.
CBT is about checking to see what's real. Ask yourself: do I have the evidence that this thought, this feeling, or this scenario is actually going to happen?
Focus on what you can control
While there's a lot we can't change in life, there are some things that we can influence. For instance, while we can't control the actions of others, we do have control over how we behave in response to them.
You may not know how you're perceived by someone, but you can choose to show kindness towards them. Similarly, we may not know what's around the corner, but we can make sure we're looking after ourselves and following a healthy lifestyle so we're in the best position to help others if a challenging situation does occur.
When people feel overwhelmed by the lack of control, they have a choice in how they behave. You can either go towards the anxiety and the fear and get completely caught up in it, or you can choose to be more mindful about your reactions to things.
Stay away from social media
If you know certain things tend to trigger negative thoughts and anxiety spirals, it's best to take some time away from them. Constantly reading the news or checking social media may feel like a productive action because you convince yourself you're gaining useful information to help you prepare for disaster, but it may just be making you feel worse. Plus, a lot of misinformation circulates online. Try to limit yourself to checking trusted sources of news only one time per day for no more than 20 minutes if you're feeling overwhelmed.
If you're constantly fed negative messages and you have anxiety, that's terrifying because you will believe what you're seeing. You need to be able in some ways to remove yourself from that.
Bring it back to the present
We don't know what's going to happen in the future, so trying to focus on the present moment can really help with anxiety. Mindfulness is based on this principle. Paying moment-by-moment attention to what's happening in the now, rather than the past or future, can be incredibly therapeutic.
You haven't got the next moment and you haven't got the past, you've just got this moment. It's about asking: Am I safe right now? And if that's true for you at that moment, it's the truth.
Anyone can practice mindfulness. There are many good guides on YouTube or apps such as Headspace to introduce you to the basic techniques. But even a simple breathing exercise can help.
This is a simple exercise to slow the mind down and engage the senses:
If your worries are affecting your daily life, you don't have to just put up with them. If you live in Georgia or Indiana, I would be happy to have a consultation with you as a start to assist you with living your best life. Contact me today!
The past doesn’t always stay where it should.
If you experienced childhood trauma, the mental, emotional, and even physical issues you faced when you were little can still be present when you’re an adult.
Childhood trauma can leak into your adult life and affect personal and business relationships, but most of all - your happiness!
Sometimes it sneaks up on you and it can turn your life upside down. You ask yourself, “Why now?”
“Why now?” probably seems like the sixty-million dollar question. You’ve done your best to move on. Even successfully blocked it out most of the time.
But lately, you’ve started to feel anxious again. Sometimes on the verge of panic. Depressed feelings are beginning to take over. Maybe you even feel like withdrawing into a shell.
After all of these years, how can your childhood trauma still be unresolved?
What is unresolved trauma?
When you’ve been traumatized as a child, it lives deep inside of you. You could even say it settles in your bones.
The memories, even if pushed away and not conscious, are etched into your symptoms, in your relationship struggles, and into your negative self-esteem.
Many traumatized children feel they’ve always been on their own and do the best they can to work things out for themselves.
The problem is, there’s only so much you can do all by yourself. That’s why the deepest effects of childhood trauma often go “unresolved.”
You might ask: “Even if I’ve had therapy?”
Not all therapists are the same, so it is important to work with one that has the tools to help you heal from childhood trauma.
There is no “one-fits-all” template for working out unresolved childhood trauma. Each person has their own experiences and these have affected you in your own particular way.
The roots of your childhood trauma perpetuate symptoms that might go underground for a while, but not disappear entirely. Stress that causes an emotional upheaval, or an event that serves as too close a reminder of your earlier trauma, can put you back into the original experiences which quickly bring the symptoms back to the surface.
Why “the past” isn’t always the past.
Although your trauma is technically “in the past,” traumatizing experiences in childhood can’t be laid to rest until the ways they live on in your current experiences, symptoms, and relationships are deeply understood.
Freud said we have a “compulsion to repeat,” even if we try not to. That’s why you might find yourself in relationships that remind you of those that traumatized you in the past.
There are many different forms your symptoms or behaviors might take. Again, these are very individual to you. The important thing is: The past is never “just” the past.
Until you’ve had help working out exactly how the roots of your past are alive in the present, your childhood trauma can remain “unresolved.”
What causes trauma in childhood?
Sometimes — as in physical or sexual abuse — trauma is quite obvious. But there are many kinds of childhood trauma that you might not identify as trauma at all.
Neglect is also traumatic, and so is the loss of a parent, a serious childhood illness, a learning disability that left you doubting yourself, too many siblings, a detached, emotionally unavailable, or anxious parent, even your parent’s own childhood trauma.
Maybe you experienced a combination of these.
Childhood neglect means that your emotional or physical needs were not attended to. This may be because your parents were overwhelmed and preoccupied.
Or because of the mental illness of one or both — making them expect you to be the “parent,” take care of the other kids, or do many more household chores than any child should.
Whatever was the cause, your needs for nurturing and care went unseen, were pushed aside, or were greatly resented. A child should never be exploited because of a parent’s needs.
A child’s emotional and physical needs should come first. If yours did not, you experienced neglect.
Losing a parent to death or abandonment early in your life is a trauma. No matter how nurtured you were by other relatives or your remaining parent, this kind of loss runs deep.
If your sadness wasn’t seen, heard, or allowed, then that loss lives on even more significantly inside you. You needed (or may still need) a chance to mourn.
You learned much too early that a needed loved one can suddenly go away or be taken away. You typically then grow up afraid of loss.
Even if you lost your parent in your early 20s, this is a vulnerable time. You may fear closeness because closeness and need signify possible loss.
Most unresolved childhood trauma affects self-esteem and creates anxiety.
Did you suffer a serious childhood illness? If so, you were likely isolated at home or hospitalized.
This meant being removed from normal social activities and you probably felt lonely, maybe even worried about being different.
Maybe now you feel less socially confident because of it and find yourself not sure where you fit in.
Hospitalization also means separation from parents, often traumatizing medical procedures, and fear. This can leave you with anxiety that persists.
If your attachments to your parents were secure and they were available and supportive, that helps. If not, you may now feel insecure in important relationships.
If you struggled to learn, had dyslexia, or ADHD, or any other learning problem, you likely felt different or compared yourself unfavorably to the other kids.
Learning problems are particularly difficult to live with if they went undiagnosed and you didn’t get sufficient help. Even very intelligent children end up thinking they aren’t smart at all.
This has a negative impact on your self-image. You might have tried very hard to do better, struggling against challenges you couldn’t control. Or maybe you gave in and gave up.
Either you are still too perfectionistic, trying always to please, but never feeling good enough, or you feel always behind and can’t get ahead.
Effects of learning problems can live with you, even if you think they’re all worked out.
Are you one in a family of many kids? Did it feel like there was never enough to go around? That’s often the case in families with a lot of children.
Resources are limited, especially if you were all born close together. Especially if your mother was tired, beleaguered, and preoccupied with the siblings that seemed to always need more.
Or, if you were the oldest — expected to care for the younger ones.
As loving as you might be convinced your family was (or maybe you didn’t feel that way at all), being a child among many siblings can be traumatic.
You might have felt lost among the many. Not seen or heard. Pushed aside, left out, and very much alone. This sibling situation can leave a child emotionally neglected and feeling unloved.
You might even feel you have to push your needs aside or be the giver in order to be loved. And you may live with deep hunger for the love you feel you can and never will find.
The effects of too many siblings are even more pronounced with a detached or unavailable mom.
An unreachable parent is traumatic. Children need to be seen, heard, held, emotionally embraced, and valued. The effects of waiting, watching, and longing to have your feelings heard can last a lifetime.
Maybe you’re wary of your needs and uncertain of being loved. And maybe you learned to stay distant yourself, not expecting much.
Perhaps you had an anxious parent. One that was afraid, expected catastrophe, hid away from people, and perhaps didn’t trust anyone or anything.
A parent’s anxiety can seep into a child’s pores and leave you traumatized, constantly worried, and living with the same kinds of anxieties your parent had, without even knowing it happened.
An emotionally detached or anxious parent was probably traumatized too.
There is definitely such a thing as transgenerational trauma.
If your mom or dad had a traumatic childhood and that trauma was also unresolved, it is passed down from parent to child, from unconscious mind to unconscious mind.
Children are vulnerable. You picked it up. You were affected too.
Parents that were traumatized live out their trauma. They often can’t be fully there for you or become identified with the abuser who abused them.
In instances where your mom or dad survived a horrific event, such as the Holocaust, the terror and unbearable losses can live like ghosts haunting both them and you.
All these various sources of trauma live on if they are unresolved and all can affect you long into your adulthood — in their many ways and many forms.
How does it affect you as an adult?
Childhood trauma can sometimes leak into your adult life because no matter how hard you’ve tried to go on, there is still a traumatized child living inside you.
If you haven’t had sufficient help or the right kind of therapy to work out your trauma, this child part of you still carries your trauma and suffering.
Maybe you don’t always feel it or know it’s there, but symptoms of your childhood trauma spill out when you’re stressed. Or when something in your life serves as a subtle or not-so-subtle reminder of what happened to you as a child.
Your childhood trauma lives in your symptoms. Depression. Panic attacks. An eating disorder. Obsessional worries, catastrophic anxieties, and relationship fears.
You might have difficulties trusting, low self-esteem, fears of being judged, constant attempts to please, outbursts of frustration, or social anxiety symptoms that won’t let up.
Can childhood trauma be healed?
Yes, unresolved childhood trauma can be healed.
You don’t have to live with the upsurge of symptoms that leak out under stress or unpleasant reminders. When you have this kind of therapy and can give yourself the time you need, you will heal from unresolved childhood trauma.
If you are a resident of Georgia or Indiana, please contact me to learn more about my process and how together we can heal your childhood trauma.
What Is Fear?
Fear is a natural, powerful, and primitive human emotion. It involves a universal biochemical response as well as a high individual emotional response. Fear alerts us to the presence of danger or the threat of harm, whether that danger is physical or psychological.
Sometimes fear stems from real threats, but it can also originate from imagined dangers. Fear can also be a symptom of some mental health conditions including panic disorder, social anxiety disorder, phobias, and post-traumatic stress disorder (PTSD).
Fear is composed of two primary reactions to some type of perceived threat: biochemical and emotional.
Fear is a natural emotion and a survival mechanism. When we confront a perceived threat, our bodies respond in specific ways. Physical reactions to fear include sweating, increased heart rate, and high adrenaline levels that make us extremely alert.
This physical response is also known as the “fight or flight” response, with which your body prepares itself to either enter combat or run away. This biochemical reaction is likely an evolutionary development. It's an automatic response that is crucial to our survival.
The emotional response to fear, on the other hand, is highly personalized. Because fear involves some of the same chemical reactions in our brains that positive emotions like happiness and excitement do, feeling fear under certain circumstances can be seen as fun, like when you watch scary movies.
Some people are adrenaline seekers, thriving on extreme sports and other fear-inducing thrill situations. Others have a negative reaction to the feeling of fear, avoiding fear-inducing situations at all costs.
Although the physical reaction is the same, the experience of fear may be perceived as either positive or negative, depending on the person.
Fear often involves both physical and emotional symptoms. Each person may experience fear differently, but some of the common signs and symptoms include:
Shortness of breath
In addition to the physical symptoms of fear, people may experience psychological symptoms of being overwhelmed, upset, feeling out of control, or a sense of impending death.
Talk to your doctor if you are experiencing persistent and excessive feelings of fear. Your doctor may conduct a physical exam and perform lab tests to ensure that your fear and anxiety are not linked to an underlying medical condition.
Your doctor will also ask questions about your symptoms including how long you've been having them, their intensity, and situations that tend to trigger them. Depending on your symptoms, your doctor may diagnose you with a type of anxiety disorder, such as a phobia.
One aspect of anxiety disorders can be a tendency to develop a fear of fear. Where most people tend to experience fear only during a situation that is perceived as scary or threatening, those who live with anxiety disorders may become afraid that they will experience a fear response. They perceive their fear responses as negative and go out of their way to avoid those responses.
A phobia is a twisting of the normal fear response. The fear is directed toward an object or situation that does not present a real danger. Though you recognize that the fear is unreasonable, you can't help the reaction. Over time, the fear tends to worsen as the fear of fear response takes hold.
How to Tell the Difference Between a Fear and a Phobia
Fear is incredibly complex. Some fears may be a result of experiences or trauma, while others may represent a fear of something else entirely, such as a loss of control. Still, other fears may occur because they cause physical symptoms, such as being afraid of heights because they make you feel dizzy and sick to your stomach.
Some common fear triggers include:
Certain specific objects or situations (spiders, snakes, heights, flying, etc)
Real environmental dangers
Certain fears tend to be innate and may be evolutionarily influenced because they aid in survival. Others are learned and are connected to associations or traumatic experiences.
Some of the different types of anxiety disorders that are characterized by fear include:
Generalized anxiety disorder
Post-traumatic stress disorder (PTSD)
Separation anxiety disorder
Social anxiety disorder
Social anxiety disorder
Misconceptions and Facts About Phobias
Repeated exposure to similar situations leads to familiarity, which can dramatically reduce both the fear response. This approach forms the basis of some phobia treatments, which depend on slowly minimizing the fear response by making it feel familiar.
Phobia treatments that are based on the psychology of fear tend to focus on techniques like systematic desensitization and flooding. Both techniques work with your body’s physiological and psychological responses to reduce fear.
With systematic desensitization, you're gradually led through a series of exposure situations. For example, if you have a fear of snakes, you may spend the first session with your therapist talking about snakes. Slowly, over subsequent sessions, your therapist would lead you through looking at pictures of snakes, playing with toy snakes, and eventually handling a live snake. This is usually accompanied by learning and applying new coping techniques to manage the fear response.
This is a type of exposure technique that can be quite successful. Flooding based on the premise that your phobia is a learned behavior and you need to unlearn it. With flooding, you are exposed to a vast quantity of the feared object or exposed to a feared situation for a prolonged amount of time in a safe, controlled environment until the fear diminishes. For instance, if you're afraid of planes, you'd go on up in one anyway.
The point is to get you past the overwhelming anxiety and potential panic to a place where you have to confront your fear and eventually realize that you're OK. This can help reinforce a positive reaction (you're not in danger) with a feared event (being in the sky on a plane), ultimately getting you past the fear.
While these treatments can be highly effective, it's important that such confrontational approaches be undertaken only with the guidance of a trained mental health professional.
There are also steps that you can take to help cope with fear in day-to-day life. Such strategies focus on managing the physical, emotional, and behavioral effects of fear. Some things you can do include:
Get social support. Having supportive people in your life can help you manage your feelings of fear.
Practice mindfulness. While you cannot always prevent certain emotions, being mindful can help you manage them and replace negative thoughts with more helpful ones.
Use stress management techniques such as deep breathing, progressive muscle relaxation, and visualization.
Take care of your health. Eat well, get regular exercise, and get adequate sleep each night.
Fear is an important human emotion that can help protect you from danger and prepare you to take action, but it can also lead to longer-lasting feelings of anxiety. Findings ways to control your fear can help you better cope with these feelings and prevent anxiety from taking hold.
I’m here to help. Please contact me to schedule an appointment.
If you or a loved one are struggling with fears, phobias, or anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, refer to the National Helpline Database.
You might be alone on Christmas for different reasons, such as the death of a loved one, living far from relatives, or because of social isolation due to the pandemic. If you have social anxiety disorder (SAD) and don't have close relationships with family or friends, loneliness at Christmas could be particularly hard.
In general, there are three ways to cope with being alone at Christmas. First, you can address your mental state and how it is contributing to your loneliness. Second, you can find things to do at Christmas that make you feel less alone. And third, you can plan ahead so that you are not alone this time next year if you don't want to be.
Addressing Your Mental State
Christmas is the perfect day to take the time to appreciate what you have in life, be it good health, a place to live, or food on the table. Having gratitude will also help you to move past anxiety, as you learn to live in the present moment and be mindful of your surroundings. One way to practice gratitude is to write down three things you are grateful for on this day.
What if you're plagued by negative thoughts? If you feel like you don't know how to cope with being alone, ask yourself, "What would I do if I did know how to cope?" You have more power over your thoughts and how they make you feel than you think.
You can choose to feel lonely because you are alone, or you can choose to feel grateful for the positive things in your life. Reframing your negative thoughts is the basis of cognitive behavioral therapy (CBT), an effective treatment for social anxiety disorder.
Tips for Coping With Loneliness at Christmas
One way to cope with being alone on Christmas is to actually go out and do something productive. Rather than spend the day at home alone, find something that you can do that fits with your mindset and mental state for the day.
For example, if you feel full of energy, and the weather is decent, go for a long run. If you feel social, consider attending a church service to be in the presence of others. Below are some other ideas to keep you from focusing on the fact that you are alone this holiday.
Perhaps you are alone this year because you turned down invitations. Know that it's OK to call those people back and say "yes." This is often a problem for those with social anxiety—you turn down invitations only to regret it and feel lonely afterward.
However, you're likely not the only one turning down invitations this year. As the COVID-19 pandemic continues, health experts are urging Americans to stay at home and celebrate with only those in their household.
Take Time to Volunteer
One way to gain a better appreciation for the good things in your life is to get involved in volunteering. During the holidays, volunteering is a way to connect with others, boost your self-esteem, and bring joy to people who are less fortunate. Consider offering to help serve dinner at a soup kitchen, bring gifts to a children's hospital, or visit lonely residents at a nursing home.
During the coronavirus (COVID-19) pandemic, volunteering opportunities may look a bit different. For example, you might consider doing a grocery run for someone with a compromised immune system or a neighbor who is over age 65. Be sure to take expert-recommended precautions including wearing a mask and practicing social distancing.
If you feel nervous about doing these social activities, all the better; it's a chance to test your boundaries and expand your social skills. In fact, research shows that practicing kindness may reduce your tendency to avoid social situations.
Host an Orphan Christmas
You are not the only one alone during the holidays, especially this year as large gatherings and travel are not recommended due to the coronavirus pandemic.
Plan an "Orphan Christmas" for those who have no one to spend the holiday with or join a group of people in similar circumstances. If you feel anxious about reaching out—consider that other people who are alone on Christmas may feel isolated, lonely, and nervous to call on you, too.
If you do decide to gather (instead of having a Zoom get together on video chat) with other "orphans" this year, just be mindful of the recommendations by the Centers for Disease and Control Prevention (CDC) for holiday celebrations and small gatherings:
+ Follow state, local, territorial, or tribal health and safety laws, rules, and regulations.
+ Keep in mind that misusing alcohol or drugs may alter your judgment and make it less likely you'll follow safety guidelines (and exacerbate your symptoms if you've been diagnosed with SAD).
+ Practice social distancing (stay 6 feet, or two arm lengths, apart from others not in your household).
+ Prioritize outdoor over indoor gatherings.
+ Wash your hands.
+ Wear face coverings.
Get to Work
If you enjoy your work, and you have the option to work on Christmas, spend the day being productive. This is a smart choice if your job involves interacting with co-workers or customers; being at work may help you to feel less lonely.
If you don't have the option to work on Christmas, spend the day working around your home or on a project that you've put off for too long.
Do you have online friends? Do you have long-distance relatives? Host an online Christmas by setting up a Skype chatroom or Facebook group. People can drop in and out as they please, and you don't have to cook, clean, or even get off the sofa.
As an added bonus, you'll have a chance to practice your social skills as you welcome new people to the group and catch up with old friends. You'll also be keeping yourself and your loved ones safe as you socialize virtually.
If being alone on Christmas is unavoidable, plan a day for yourself. Buy something online to treat yourself, cook your favorite foods, or plan a movie marathon.
Or, cut through the clichés and do something offbeat like learning a new language or starting work on the novel that's always been in your head.
Christmas is a day to indulge in whatever makes you happy.
How to Plan Ahead for Next Christmas
Plan for a better future. If social anxiety has left you alone and lonely on Christmas, vow to visit your doctor in the new year and get a handle on your anxiety. If you haven't been diagnosed, make a plan to share your concerns—you can even hand a typewritten letter to your doctor if that helps.
Social anxiety tends to be overlooked or mistaken for other problems, particularly because people with the disorder are not good at sharing how they feel. Use whatever means necessary to impress upon your doctor the severity of your symptoms.
If You're Having Difficulty Coping
If you are feeling really down about being alone on Christmas and can't pull yourself out of it, reach out for help. Call a friend, family member, or a helpline.
Regardless of whether you are physically separated from people on Christmas, you should never feel like you are lacking support. There are people who would love to hear from you and trained volunteers waiting to support and counsel you.
If you or a loved one are struggling with social anxiety disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, visit the National Helpline Database.
While feeling socially isolated around the holidays may be common, finding yourself crippled by social anxiety more days out of the year than not may be a sign of a disorder.
If you've not already consulted your doctor about your social anxiety, be sure to make an appointment to discuss the possibility of a diagnosis and referral for treatment. You can always reach out to me to schedule an appointment at Pathways to Change.
How many times have we wondered if a certain behavior or trait was due to our genetic makeup, or whether it was due to how our environment shaped us? You may be surprised to learn which is nature vs. nurture.
The nature vs. nurture theory is the scientific, cultural, and philosophical debate about whether human culture, behavior, and personality are caused primarily by nature or nurture.
What exactly is nature vs. nurture?
In the context of the nature vs. nurture debate, “nature” refers to biological/genetic predispositions’ impact on human traits, and nurture describes the influence of learning and other influences from one’s environment, culture, and experience.
The debate over whether the strengths and weaknesses of people are the results of nature or nurture has, and somewhat continues to rage on. This debate has had significant social implications, particularly concerning what is thought to determine people’s ability to learn/intelligence.
Studies to determine nature vs. nurture
While certain physical traits, like skin and eye color and diseases like sickle cell anemia and Huntington’s chorea, are the result of direct genetic inheritance, virtually any pattern of thinking or behavior can be understood from the perspective of a combination of nature and nurture.
In the animal kingdom, domestication of many species is understood to be the result of encouraging domesticated behaviors (nurture), then having animals that most successfully adopt those behaviors breed with each other so it becomes part of their nature.
Several studies done on twins separated shortly after birth reveal that genetics do play a significant role in the development of certain personality characteristics, sexual orientation, and religiosity. The bond between identical twins was also suggested to be genetic by these studies, as 80% of identical twins reported that they felt closer to their twin than they did to their closest friends, despite having just met their twin.
One study also suggested that genetics play a significant role in the development of personality: Environment had little effect on personality when twins were raised together, though it did have an effect when they were raised apart.
How does nature vs. nurture affect our mental and physical health?
It is understood that certain physical traits, as well as the susceptibility to most physical and mental health disorders, tend to run in families. Specifically, whatever illnesses your parents, grandparents, siblings, and other biological family members have does not guarantee you will inherit them, but it does increase the likelihood that you may develop them.
On the other hand, it is understood that environmental factors often have a significant effect on whether or not you develop the health problems that run in your family. (You can change your gene expressions).
A couple of examples of how the environment (nurture) can provide a benefit, and possibly decrease your risk of getting an illness from your family are:
Nature, or genetics and disposition, have been proven to be an important factor in the development of some mental health conditions, such as schizophrenia, bipolar, and major depression. Bipolar, for example, is four to six times more likely to develop when there is a family history of the condition. However, although the importance of genetic factors cannot be denied, the development of mental illness is not entirely genetic. For example, identical twins share their genes, yet if one twin develops schizophrenia, research shows the other twin only has a 50% chance of also developing the condition. This indicates that nature, while it plays an important part, is not the only contributing factor.
Another area where researchers may place more emphasis on nature than on nurture is that of addictions. Research indicates that alcohol addiction, for example, can recur in families and that certain genes may influence how alcohol tastes and the way it affects the body.
How nurture affects mental health
Certain genetic factors may create a predisposition for a particular illness, but the probability that a person develops that illness depends in part on environment (nurture). When a genetic variant indicates the possibility of developing a mental illness, this information can be used to direct positive (nurturing) behavior in such a way that the condition may not develop or may develop with less severity.
James Fallon, a neuroscientist who discovered that he had the brain of a psychopath, has stated that he believes growing up in a nurturing and loving environment helped him become a successful adult and may have been effective at preventing him from fully developing traits of psychopathy. Similarly, the basis for addiction is not thought to be entirely genetic by most researchers. Environmental aspects, such as the habits of parents, friends, or a partner, might also be significant factors contributing to the development of an addiction. A genetic predisposition to alcohol addiction may be far more significant if one is routinely exposed to binge drinking or other forms of alcohol abuse and comes to view this as normal alcohol use.
Researchers at the University of Liverpool recently found that while a family history of mental health conditions was the second strongest predictor of mental illness, the strongest predictor was in fact life events and experiences, such as childhood bullying, abuse, or other trauma. This supports the idea that nurture plays significant role in the development of mental health issues.
Is our intelligence based on nature or nurture?
As with most human traits, intelligence is now understood to be the result of some combination of both nature and nurture. While genes have a great influence on the size and biochemistry of the brain, its full development does not usually occur until after the first 20 years of life. Also, the heredity of intelligence tends to vary between different aspects of cognition.
Intelligence and subsequent learning also are viewed as being largely molded by the environment the person grows up in, both before and after birth.
If you are pregnant, don't drink alcohol or use other illegal drugs. Check with your doctor or pharmacist to make sure that any current drugs or supplements you are taking will not harm your baby.
It is imperative to have safe communities and schools that nurture learning and confidence for all children so that the quest can continue to promote high cognitive development in each child.
Nature vs. Nurture in Therapy
In the mental health field, some therapeutic treatments and approaches may be nature-based or nurture-based, depending on which paradigm to which they adhere. For example, an extremely nature-based approach might seek to address mental health on a biological or genetic level, while a nurture-based approach could be more likely to address a person’s learned beliefs and behaviors. Most approaches borrow from both nature and nurture-based philosophies, and many seek to address the interaction between nature and nurture.
For example, using medication to treat a mental health issue may be a primarily nature-based approach, while behavioral therapy, which stems from behaviorist psychology, addresses a person’s upbringing and conditioning and takes a nurture-based point of view. Meanwhile, therapies based on cognitive psychology may be more likely to address the effects of both nature and nurture.
During our sessions, I consider multiple factors, including how nature and nurture work together. Please contact me today to set up an appointment.
While everyone has experienced sadness, not everyone has experienced depression. In fact, if you’ve never been depressed, chances are that you don’t have a real grasp on what living with this complex mental illness is like.
Depression is insidious. It affects not only your mood, but also your ability to feel, think, and function. It blunts sensations of pleasure, closes off connectedness, stifles creativity, and, at its worst, shuts down hope. It also often causes deep emotional pain not only to the person experiencing it, but to that person’s close family and friends.
Depression Statistics: Disturbing Trends, Helpful Treatment
Unfortunately, there are plenty of people who know exactly what it means to be depressed. An estimated 17.3 million, or 7 percent, of adults in the United States had at least one major depressive episode in the past year, according to the National Institute of Mental Health, making it one of the most common mental illnesses in the United States.(1)
What’s more, a recent report from Mental Health America, a nonprofit founded in 1909, offers startling statistics pertaining to one of depression's most disturbing symptoms: thoughts of suicide.
According to its 2020 State of Mental Health in America report, suicidal ideation among adults increased from 3.77 percent in 2012 to 4.19 percent in 2017, the most recent year for which statistics are available.(2) That means more than 10.3 million adults in the United States are affected by negative thoughts or emotions.
There is a bright side. Although there is no one-size-fits-all cure for depression, there are many effective treatment options, one of which is bound to help you heal if you’re struggling with the illness. This cannot be emphasized enough, given that roughly two-thirds of people living with depression do not receive the care they need, according to a report in the journal Neuropsychiatric Disease and Treatment, published online February 22, 2019.(3)
Signs and Symptoms: How to Identify Depression
If sadness alone isn’t a good gauge of depression, what is? According to the American Psychiatric Association’s current Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the diagnostic guide used by most mental health professionals, if you’ve experienced at least five of the following symptoms most of the day, nearly every day, for at least two weeks, you may be diagnosed with major depressive disorder (MDD), also known as clinical depression.(4)
To be diagnosed with MDD, one of your symptoms must be a persistent low mood or a loss of interest or pleasure, the DSM-5 states. Your symptoms must also not be due to substance abuse or a medical condition, such as thyroid problems, a brain tumor, or a vitamin deficiency.
Of course, it’s normal to have any or all of these symptoms temporarily (for hours or even days) from time to time. The difference with depression is that the symptoms persist and make it difficult to function normally.
Important: If you suspect you have depression, or if you’re feeling troubled by your symptoms, have suicidal thoughts, just need to talk, want some advice, or need a referral for treatment, call the National Suicide Prevention Lifeline at 800-273-8255 or the National Substance Abuse and Mental Health Services Administration Helpline at 800-662-4357. Both are free and available 24/7, 365 days a year.
What Are the Different Types of Depression?
In addition to MDD there are several other kinds of depression, including:
One reason depression can be hard to identify is that its signs can vary widely from person to person and sometimes be masked by atypical symptoms. For example, some people who are depressed may show it by acting disgruntled, resentful, or irritable. In fact, aggression — including outright acts of violence — can be indicative of “hidden” depression, according to a February 28, 2017, report in Psychiatric Times.(11) Depression masquerading as anger may seem surprising at first, but not when you consider that several underlying factors, including alcohol or substance abuse and childhood trauma, have been linked to both.
Similarly, although it’s not clear why, a person who experiences anxiety is at high risk for developing depression, and vice versa. The National Alliance on Mental Illness reports that as many as 60 percent of people with anxiety will also have symptoms of depression; the same goes for people with depression having symptoms of anxiety.(12) Some researchers even suspect that depression and anxiety are, in fact, inexorably intertwined expressions of the same underlying psychological disorder.(13)
Depression may also manifest psychosomatically, meaning that instead of presenting first and foremost as a mood disorder, the dominant symptom may be things like vague aches, dizziness, headaches, digestive problems, or back pain, according to the Journal of Clinical Psychiatry.(14) Complicating matters is that it’s often hard to know whether depression is causing the physical symptoms, or if the physical symptoms are causing depression.
What Causes Depression?
No one knows for sure why some people become depressed and others do not. As with other brain diseases, such as Alzheimer’s, the precise cause remains elusive. Depression can occur spontaneously, without any obvious cause. And it’s well documented that once you’ve had one depressive episode your risk of having another later in life increases. For example, a study in Psychological Medicine found that more than 13 percent of people who recover from their first episode of major depression go on to have another episode within five years; 23 percent within 10 years; and 42 percent within 20 years.(15)
Psychiatrists today generally look at depression in “bio-psycho-social” terms, meaning that they see it as a complex disorder most likely triggered by overlapping biological, psychological, and social (also referred to as environmental) factors.(16)
Among the potential contributors to depression are:
Depression and Gender: Is It Different in Men and Women?
When it comes to depression, there is a distinct gender gap. Depression is nearly twice as common in women as in men, according to data from the National Center for Health Statistics.(24) Hormonal and other biological factors play a role in this disparity. After all, only women can have premenstrual or postpartum depression. The same is true of antenatal (or prenatal) depression — depression during pregnancy — which the American College of Obstetricians and Gynecologists estimates affect anywhere from 14 to 23 percent of pregnant women.(25)
But women also have higher rates of seasonal affective disorder, depressive symptoms in bipolar disorder, and persistent depressive disorder, note Harvard Health experts.(26) The reasons for this are cause for speculation. Some researchers believe that environmental factors, such as the different stressors and expectations that society places on women, are an important factor. Others theorize that men and women actually have depression at similar rates, but that women are more likely to talk about their feelings and seek help.
Depression Treatment: Lifestyle Changes, Talk Therapy, Antidepressants
If you suspect that depression is interfering with your life, talking about what you’re experiencing and discussing treatment options with a medical professional is essential. As actress Taraji P. Henson, who describes her depression as “suffocating” darkness, recently explained in an interview with Self magazine, “When you’re quiet, things aren’t fixed. It gets worse.”(27)
The good news is that there’s abundant evidence that people with depression who seek treatment will find significant relief from lifestyle changes, talk therapy (psychotherapy), medication, or a combination of all efforts, according to the Anxiety and Depression Association of America.(28)
Lifestyle Changes for Depression
Lifestyle changes, such as making art, journaling, exercising more, and practicing yoga or mindfulness, can also alleviate depression and the stress that can heighten it. Alternative treatments like massage, acupuncture, and light therapy may also help.
Diet changes, too, can uplift your mood by reducing inflammation and helping to ensure your brain gets the nutrients it needs to function at its best.
One randomized controlled study, published October 9, 2019, in the journal PLoS One, found that self-reported symptoms of depression dropped significantly in just three weeks in young adults who changed from a highly processed, high-carbohydrate diet to a Mediterranean diet focused on vegetables, whole grains, lean proteins, unsweetened dairy, nuts and seeds, olive oil, and the spices turmeric and cinnamon. In contrast, the depression scores didn’t budge in a control group of people who didn’t change their diet.(29)
Which Types of Talk Therapy Work Best for Depression?
The Society of Clinical Psychology rates several types of psychotherapy as highly effective treatments for depression:(30)
What’s the Difference Between Grief and Depression?
Given that the primary symptom associated with depression is sadness, it can be easy to think of grief or bereavement as depression. But grief is a natural response to specific experiences, such as the end of a relationship or the death of a loved one. While you might feel regret or remorse, and you might withdraw from usual activities if you are experiencing grief, you’re unlikely to feel the overwhelming sense of worthlessness, thoughts of self-harm or suicide, and other symptoms of depression. Another important difference is that in grief, painful feelings usually come in waves and are often mixed with positive memories.
In some cases, however, grief and depression do coexist, or grief can trigger depression, according to experts writing in the journal American Family Physician.(31) Having a mental health professional help you distinguish between them can ensure you get the support you need.
If you are experiencing depression and sadness, please email me or call (770) 203-9060 to set up an appointment. Together we will work to fashion an active program of change which lefts you out of the distress you are experiencing and places you on the pathway where you want to be.
1. Major Depression. National Institute of Mental Health. February 2019.
2. Reinert M, Nguyen T, Fritze D. The State of Mental Health in America 2020. Mental Health America. 2020.
3. Bailey RK, Mokonogho, J, Kumar A. Racial and Ethnic Differences in Depression: Current Perspectives. Neuropsychiatric Disease and Treatment. February 22, 2019.
4. What Is Depression? American Psychiatric Association. January 2017.
5. Persistent Depressive Disorder. Cleveland Clinic. March 3, 2015.
6. What Are Bipolar Disorders? American Psychiatric Association. January 2017.
7. Bipolar Disorder. National Institute of Mental Health. November 2017.
8. Seasonal Affective Disorder (SAD). Mayo Clinic. October 25, 2017.
9. Premenstrual Dysphoric Disorder (PMDD). U.S. Department of Health and Human Services Office of Women’s Health. March 16, 2018.
10. Postpartum Depression. American College of Obstetricians and Gynecologists. November 2019.
11. Krakowski M, Nolan K. Depressive Symptoms Associated With Aggression. Psychiatric Times. February 28, 2017.
12. Salcedo B. The Comorbidity of Anxiety and Depression. National Alliance on Mental Illness. January 19, 2018.
13. Hari J. Lost Connections: Uncovering the Real Causes of Depression — and the Unexpected Solutions.Bloomsbury. November 2018.
14. Trivedi M. The Link Between Depression and Physical Symptoms. Primary Care Companion to the Journal of Clinical Psychiatry. February 2004.
15. Hardeveld F, Spijker J, De Graaf R, et al. Recurrence of Major Depressive Disorder and Its Predictors in the General Population: Results From the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Psychological Medicine. January 2013.
16. Pies RW. Debunking the Two Chemical Imbalance Myths, Again. Psychiatric Times. August 2, 2019.
17. Howard D, Adams M, McIntosh A, et al. Genome-Wide Meta-Analysis of Depression Identifies 102 Independent Variants and Highlights the Importance of the Prefrontal Brain Regions. Nature Neuroscience. February 2019.
18. What Causes Depression. Harvard Health. June 24, 2019.
19. Pariante CM. Why Are Depressed Patients Inflamed? A New Path to Personalized Treatment in Psychiatry. Psychiatric Times. May 31, 2018.
20. Social Determinants of Mental Health. World Health Organization. 2014.
21. Williams LM, Debattista C, Duchemin A-M, et al. Childhood Trauma Predicts Antidepressant Response in Adults With Major Depression: Data From the Randomized International Study to Predict Optimized Treatment for Depression. Translational Psychiatry. May 3, 2016.
22. TBI-Related Emergency Department Visits, Hospitalizations, and Deaths. Centers for Disease Control and Prevention. March 29, 2019.
23. Singh R, Mason S, Lecky F, Dawson J. Prevalence of Depression After TBI in a Prospective Cohort: The SHEFBIT Study. Brain Injury. November 30, 2017.
24. Francis HM, Stevenson RJ, Chambers JR, et al. A Brief Diet Intervention Can Reduce Symptoms of Depression in Young Adults — A Randomised Controlled Trial. PLoS One. October 9, 2019.
25. Brody DJ, Pratt LA, Hughes JP. Prevalence of Depression Among Adults Aged 20 and Over: United States, 2013–2016. Centers for Disease Control and Prevention. February 13, 2018.
26. Depression and Postpartum Depression: Resource Overview. American College of Obstetricians and Gynecologists.
27. Women and Depression. Harvard Mental Health Letter. May 2011.
28. Taraji P. Henson on Living With Depression and Anxiety. Self.com. December 3, 2019.
29. Salcedo B. Depression Treatment — It Works. Anxiety and Depression Association of America.
30. Francis H, Stevenson R, Chambers J, et al. A Brief Diet Intervention can Reduce Symptoms of Depression in Young Adults — A Randomized Controlled Trial. PLoS One. October 9, 2019.
31. Kavan MG, Barone EJ. Grief and Major Depression — Controversy Over Changes in DSM-5 Diagnostic Criteria. American Family Physician. November 15, 2014.
There are 4 typical misconceptions about family therapy:
1. Family therapy takes a long time. Medicating children or teens for their problems is much quicker.
2. Family therapists blame parents for their children's problems.
3. Family therapy means that the whole family will have to be present at every session.
4. Family therapy is ineffective.
Here are facts that will set these misconceptions straight.
Many people, when they hear the word "therapy," get a mental image of a Woody Allen-type character spending countless years on a therapist's couch with little or no improvement in his original problem.
When parents hear "family therapy," they think it will take years to complete. This is the first misconception about family therapy.
From its very beginnings, family therapy has typically been "brief therapy." This is what attracts many therapists to work with families in the first place.
Master family therapist Jay Haley says, “the average number of sessions required to resolve a child's problem is seven.” Family therapy is not traditional individual therapy, which can take a longer amount of time.
Many parents believe that a family therapist is going to blame them for their child's problem. Why else would the therapist want to include parents in their child's therapy? Parents already feel terrible because their child is unhappy or struggling at school. They don't want to feel even worse by having a therapist point the finger at them or label them "dysfunctional." No wonder parents want to head for the hills when they think about calling a family therapist. This is the second misconception about family therapy.
One of the most basic notions in family therapy is the concept of joining. "Joining" means that the therapist respects and listens carefully to each and every member of the family. The therapist may ask parents to change certain aspects of their parenting, such as being consistent about rules and consequences.
We may recommend that parents alter particular aspects of their communication with one another, such as not arguing or yelling in front of their child. We may recommend that they give their child more choices about food, clothing, etc. or limit their child's time on electronic screens. But family therapists are very aware that we must have a good relationship not only with the child in treatment but with the child's parents in order to be effective.
Family therapists work collaboratively with parents as a team.
Most people think that family therapy means having the entire family in the room for every session. The very thought of this would present most parents with a scheduling nightmare. In today's world, it's difficult enough to get the whole family to sit down at the dinner table once a week much less get them all in a therapist's office at the same time. This is the third misconception about family therapy.
Although some early family therapists, like Virginia Satir and Mara Selvini Palazzoli, typically preferred to have the entire family in family therapy sessions, not all therapists usually work that way.
Typically, therapists start out by seeing both parents together with their child in the first session and work with the parents alone after that. Sometimes they work only with the parents and never see the child at all. In the case of a teenager, they might see a mother and daughter, or a father and son, or a teenager with a sibling. When an older child or teenager has a particular kind of struggle such as anxiety, panic attacks, or difficulties with friends, I might see the teen alone for a few sessions.
Family therapists are flexible and work in whatever way makes sense with each individual family to solve the problem quickly and effectively.
Some parents have found in their own experience that therapy is ineffective. Years of talking about their feelings in a therapist's office did not help their depression or their anxiety or panic attacks. They finally started to feel better only after taking anti-depressants or anti-anxiety medication. Since therapy was not effective with their own problems, why would therapy help their child more than medication? This is the fourth misconception about family therapy.
Family therapy is quite different from individual talk therapy. The family therapist works with the awareness that each human being is not merely an individual, but is also a part of many social groups or social systems. A child's behavior is influenced by the people in his social groups: most importantly, his parents and siblings. Other important people in the child's social environment are teachers and friends.
Family therapists do not, of course, deny the importance of a child's temperament. Some kids are more energetic than others from the time they are born. Others are more shy and sensitive. It is just a question of where in the system we focus in order to achieve the fastest change.
Rather than looking for the sources of a problem within the child's individual psyche or in the chemistry of the child's brain (unless there is a true neurological disorder such as epilepsy), the family therapist looks at the child's social context.
A child can be worried and distracted because her father has been laid off from his job. A boy can hit and kick other children because he overhears his parents having loud arguments and he fears that his parents are going to divorce. A girl can be failing at school because her brother is failing in life. To most people, these events may seem disconnected. But to a family therapist, they are interwoven with invisible threads. By making carefully targeted changes in the child's social context, the family therapist can be very effective at resolving a child's troubled feelings or behavior.
Family therapy is effective because it harnesses the power of the family to heal itself.
Is family therapy for you? Contact me today to discuss your options.
One thing that typically comes up when you feel like you have hit the point of no return is the option of marriage counseling. When it comes to keeping your marriage together and you have tried everything else marriage counseling is usually the last step for struggling couples. Getting through a tough time in a relationship can be extremely hard and painful. Marriage counseling can be the one thing that saves your marriage.
If you both are not 100% committed to fixing your problems, you are unlikely to get the results you are looking for. Whether a marriage can be saved or not relies on several factors that the two partners bring to counseling. If you have both motivation and commitment, you can expect the desired results. Unfortunately, most couples have lost one or both, and it can be difficult to find motivation and commitment again.
It is not an easy process. There will be painful things that you will have to hear. One of the most important parts, outside of both of you being motivated and committed, is having the right counselor. It is vital to have a counselor that allows you both to speak and be heard. One that does not take sides but listens equally to both and provides helpful tools for you to work on together. It is an amazing feeling when you can re-connect to your spouse once again and re-ignite the love you once shared that you feared was gone forever.
Factors That Make A Difference
One of the biggest issues that can hinder the desired result from counseling is that couples tend to leave this option until it is the absolute last resort. Quite often there has been a great deal of damage done to a relationship by the time they decide to get professional help. The key to success rates in marriage counseling is approaching the issues as early as possible. This does not mean that it is too late to heal if you seek therapy late. It just means that it may take longer at that point.
Communication breakdown is one of the leading causes for the need of marriage counseling. Sometimes couples have been holding a grudge about previous issues for years. Failing to tell someone how you are feeling about a subject or issue will eventually result in either a massive buildup that turns into a blow-up, or it builds so much that the couple can’t even stand the sight of each other anymore. This sort of lack of communication is one of the main causes of marital affairs and can often simply end in divorce before any of the issues are fixed. Silence is a killer in relationships. Especially if your communication skills are not great, marriage counseling could be the one thing that saves your marriage.
Blow Up Event
It can often take a massive episode that will force the couple into counseling. Unfortunately for some to take relationship problems seriously often takes a serious announcement, like an affair or the threat of separation or divorce. It is usually the last bit of effort before making a marriage counseling appointment. The best advice is to seek counseling when you start having issues from daily bickering to feeling emotionally distant. The sooner you begin, the easier it is to mend.
How Marriage Counseling Helps
Marriage counseling achieves the best results when issues are tended to early. Teaching communication skills is a great way to make a relationship in the early stages of disaster better, but it is not going to be the only solution if you seek help when it already feels too late. It takes both parties in the relationship to want to change. If you are not both in it for a solution, then it may already be too late. The role of a counselor is not to fix the issues of your marriage, it is to bring attention to what your issues are and offer solutions and tools to empower you both to repair the damage. The key factor here though is that you both must be 100% willing to listen, self-reflect, and be dedicated to fixing the issues.
What is involved?
The first step to marriage counseling is to put out any current fires that are burning out of control in the relationship. These immediate issues need to be stabilized to move forward. Then, you can work out the underlying causes of the problems.
Some things the counselor may immediately bring up to assess the situation include whether you and your partner are willing to learn new things about yourself, communication, and relationships. They will need to know if you are able and willing to let go of the need to be right and accept responsibility for the areas where you fall short in the relationship and pass on the blame.
Marriage therapy takes motivation and commitment.
If you and your spouse are ready to revive your marriage and heal from past pain, contact me to schedule an appointment. When it feels like it is too late, do not miss out on your last chance for reconciliation. It is possible.
If you’ve been exploring your options for therapy but prefer the comfort of your home, telecounseling is your best option.
The Basics Of Telecounseling – How It Works
A lot of independent therapists offer telecounseling through Skype and other online video chat platforms. At Pathways to Change, we use a HIPAA compliant video service called Thera-Link to ensure your privacy and confidentiality.
Telecounseling works in the same basic way that therapy works.
You’ll connect with a therapist, and have regular sessions over video chat to discuss your mental health, the struggles you’re experiencing, and anything else you would talk about with a therapist in person.
Is Telecounseling As Helpful As In-Person Therapy? Studying The Benefits
So, is telecounseling as helpful as in-person therapy?
One study showed that cognitive-behavioral therapy (CBT) for bulimia nervosa that was done over video chat was just as effective as CBT that was delivered in person.
Another study in 2014 showed that, in teens with Obsessive-Compulsive Disorder (OCD), counseling over the phone was just as effective as in-person counseling. However, the sample size for this study was quite small.
Further, a study done in South Carolina found that veterans suffering from PTSD who received treatment via videoconferencing had similar positive outcomes, compared to those who got treatment in person.
For now, the results seem to indicate that telecounseling can be just as effective as in-person therapy. However, this depends on your mental health, your personal situation, and your preferences for care.
Also, telecounseling is a very good option for anyone who is already seeing a therapist in-person, but cannot make every appointment in-person.
What Should I Think About Before I Choose Telecounseling?
If you are thinking about telecounseling or teletherapy, there are a few things you should keep in mind before you make your decision.
Find a licensed therapist – First and foremost, you will need to make sure that your therapist is fully licensed in your state. Just because you’ll be getting therapy online doesn’t mean that you should settle for anything less than a fully-certified, licensed professional therapist. Consider the qualifications of your therapist while you’re thinking about telecounseling. I provide telecounseling for both Georgia and Indiana.
Consider your health insurance – In-person therapy is almost always covered by health insurance for mental health disorders, substance abuse, and other such mental health conditions. Your insurance will typically pay for most or all of your treatment. In contrast, telecounseling and teletherapy may or may not be covered by insurance companies. You may have to pay the full cost yourself. Where I am a provider, insurance companies are now accepting claims from those who have had online counseling. Double-check with your insurance company to see if they cover telecounseling with your therapist. If not, it could actually be cheaper to see a therapist in-person.
Think about your personal preferences – Do you feel more comfortable opening up and discussing your emotions and your life with a counselor via video chat from the comfort of your home? If so, telecounseling is definitely right for you. But for some, it’s easier to truly open up in person. It may be worth trying both telecounseling and in-person therapy to see which one will be a better fit for your needs.
Just like in-person therapy, it’s very important to choose a therapist who can work with you to address your specific mental health issues and who understands your lived experience. So do your research, and make sure you work with a qualified professional.
Telecounseling Can Work – But It Might Not Be Right For Everyone!
Telecounseling does seem to hold a lot of promise, particularly for patients who have trouble making the time to see a therapist in person. In the future, it’s highly likely that this industry will quickly grow, along with other areas of telemedicine, especially during COVID-19 stay at home orders.
At Pathways to Change, I am ready to provide you with the counseling and therapy you need. Contact me today to schedule a telecounseling or in-office appointment.
Before I get into strategies to quell anxiety surrounding the Coronavirus, let’s first talk about what is happening in the brain and body as you notice anxiety levels rising. Having this information will help you understand how to use the benefits of feeling a little bit anxious and how to help yourself when you feel taken over by anxiety.
Some Anxiety is Normal
First of all, being anxious is normal during periods of the unknown. Right now, we have concerns around the physical health and wellbeing of ourselves, our families, and our communities. With uncertainty, comes some anxiety. Give yourself and your anxious loved ones some grace here.
What’s Happening in the Brain and Body?
In the most basic terms, our amygdala, located in the center of our brain, is responsible for detecting threats and danger. The amygdala is working 24 hours a day, even when we are sleeping, making sure we are safe and monitoring for any signs of danger. Information comes in through the five senses and if the amygdala detects danger, it will immediately (outside of our awareness), send a signal to rest of the brain and body that there is a potential threat.
The autonomic nervous system responds to the amygdala’s perception of danger by sending the brain and the body toward the fight, flight, or freeze response. The body responds by orienting toward the danger, narrowing our focus, releasing mobilizing stress hormones, altering digestion, increasing heart rate, and a myriad of other somatic affects.
All of these effects are imperative for sustaining life when we are under a threat of danger, so we owe much gratitude to our amygdala.
The Benefits of Some Anxiety
As you might imagine, some anxiety is helpful in our current situation. Anxiety mobilizes us to take precautionary measures toward keeping us and our loved ones physically safe. A little extra energy in the nervous system makes sense so we are more alert, more cautious, and have a bit more focus to deal with the new unfolding situation and can take appropriate action to ensure the best possible outcome.
When to Relax
It’s time to relax after you have implemented the necessary health precautions and made the appropriate modifications to your daily schedule. After that, it is time to un-enroll the amygdala and let it go back to its job of being the silent watchdog.
How do I Relax?
As mentioned above, the amygdala is scanning 24 hours a day outside of our conscious awareness to ensure our safety. When it detects danger, it deploys the “big dogs” to prepare the body to protect itself. If there is not an immediate threat, we don’t need the amygdala to tell the rest of the body to prepare for danger.
It’s also important to note that the amygdala is a bit primitive in that it doesn’t know the difference between an internal/external or real/perceived threat of danger. Why is this important to know? Because the amygdala responds to your thoughts and your conversations. If you’re spending a lot of time thinking and talking about the worst case scenario of the Coronavirus, your amygdala won’t get the message that it is safe to chill in this moment of time.
If you’re stuck in anxiety or panic, your amygdala may need a little help and encouragement to “stand down,” if you will. It needs you to focus on something else besides danger so that it can get the message that you are actually safe right now, in this moment.
A rested amygdala is actually better prepared to take appropriate action when it’s under immediate threat.
With intentional and focused attention (also known as mindfulness), your amygdala is pretty darn obedient. With mindfulness or observing awareness, we engage our prefrontal cortex (PFC), which releases calming peptides to settle the amygdala, all of which sends the signal to the brain and the body, that we are safe. With focused attention, orienting your attention away from danger and toward something that is neutral or positive, it will help to calm your system.
Without further ado, I present strategies to cope with COVID-19 anxiety.
10 Tips to Settle Coronavirus Anxiety
1. Limit Exposure to Media
Being informed is important. It allows you to make important decisions to keep you and your family safe. Pick two reliable sources of information and check them no more than once per day. Make appropriate adjustments to your daily schedule and then leave it alone. As mentioned above, it is not helpful to your nervous system to stay plugged into the media about the Coronavirus all day; everyday.
2. Be Intentional with Thoughts and Words
After you’ve gotten the update for the day, made decisions accordingly, and taken appropriate action, be intentional about how much time you spend thinking about the virus and talking about it with others. As mentioned, your amygdala is responding to what you think and talk about.
3. Engage the Five Senses
If your amygdala is driving the bus, you will need to recruit the help of your prefrontal cortex through focused attention. One sure fire way to do this is to bring awareness to your five senses. Notice what is happening in your immediate environment. Notice colors, sights, sounds, scents, and temperature.
4. Be Here Now
If you’re stuck in a negative feedback loop of anxious thoughts, emotions, and body sensations, you’re likely experiencing a little amygdala hijacking. The tendency from this place is to ruminate about the worst case scenario. With focused attention on the present moment and grounding, you can orient your brain back to the safety that is to be had in this moment. You can ask yourself reframing questions such as, “What is safe right now?” or “What is ok right now?”
5. Distract yourself
There are many ways to distract yourself. As mentioned above, your amygdala responds to what you are focused on. Watch a movie that elicits positive feeling states, like a comedy, or a hallmark movie; read a feel good book, pet the dog, or call a friend (and talk about something other than the virus).
6. Thank the Amygdala
We can all appreciate the intention behind the amygdala’s hyper-vigilance. It’s just trying to keep you and everyone else safe. If you notice the amygdala has taken you on a runaway train, put one hand on your heart and say, “I’ve already taken necessary precautions today. Thank you for having my best interest at heart. I am going to focus on something else now.”
7. Be Kind to Yourself
Your first reaction to your struggle is your own internal reaction. If that is one of kindness and compassion, it just makes everything else easier. If you judge yourself or your anxiety, it adds another layer of suffering. If you find that you’ve spun up and feel anxious, say something kind, “This is tough. It’s difficult to worry about all of this.” Commit to continued self-kindness through this situation.
8. Be Kind to Others
If you know someone that is quarantined, reach out to them and extend emotional support. Call, FaceTime, email, or text them. Let them know that you are thinking of them. Continue to stay connected and nurture your support system.
There is another benefit to being kind to others. When you think of other people, it actually engages a part of your brain that calms the amygdala. When you call someone and say, “What is going on with you?” your nervous system stops orienting to danger and starts being connected to and concerned for others.
9. Excavate for your Resilience
What emotional, mental, or physical mountains have you climbed in the past? What have you been faced with and then made it through? If you’ve made it this far in your life, you’ve had to overcome some obstacles to get here today. Know that the same grit and strength that got you through that will get you through this.
One of the silver-linings of a community-wide adversity is the experience of unity and support that got us through it.
10. Seek Help from a Professional
If you’ve noticed that your anxiety has skyrocketed, and you just can’t seem to bring it down, seek the support of a trusted professional to help you get settled. If you’re concerned about leaving your home, request a video session. Most mental health professionals, myself included, are offering telehealth options during this time.
Contact me to schedule an appointment for anxiety. Let's bring peace back into your life.