Shaded Bough Counseling

Author: KNassour

  • What is Seasonal Affective Disorder?

    What is Seasonal Affective Disorder?

    Are you one of the many people who feel tired, glum, anxious or unfocused as the days get shorter? Does it feel like depression hits you at the same time every year? You might be dealing with Seasonal Affective Disorder.

    What Seasonal Affective Disorder Means

    Seasonal Affective Disorder, or SAD, is an old name for what is officially called “Major Depressive Disorder with seasonal pattern.” It’s not really a disorder in its own right, just a subtype of depression. But SAD can also happen to some folks who actually have bipolar disorder, so I’m using the old name here.

    If you have SAD, then at certain times of year you’ll consistently get depressed. Depressive symptoms might include sadness, fatigue, low energy, hopelessness, social withdrawal, difficulty focusing, and irritability. You might also feel worthless, guilty, or not be able to enjoy things you used to. Some people may gain or lose a lot of weight, have difficulty sleeping, or even have thoughts of hurting themselves. The symptoms last for at least two weeks, so longer than a mood swing.

    The most common SAD pattern is for depressive symptoms to start in the fall or early winter, and end in the spring. But other patterns are possible. A few people get SAD symptoms in the summer, which end in the fall.

    Why Does Seasonal Affective Disorder Happen?

    Scientists are still trying to figure that out. Our best guess so far is that it’s related to sunlight exposure. Sun exposure produces endorphins in our bodies, while lack of sunlight increases your risk of Vitamin D deficiency, which in turn raises the risk of depression. Low sunlight may also influence your levels of serotonin, melatonin, and other chemicals in your brain. However, this doesn’t explain why some people get SAD in the summer.

    What You Can Do

    Many people with SAD say that light therapy helps their symptoms. You can do this yourself at home. Go outside every day, even if it’s cold and cloudy. Indoors, you can also use a lamp designed for bright light therapy to mimic sunlight, or simulate dawn arriving earlier with a gradual wake up light.

    Most coping skills for other forms of depression are also effective for SAD. Regular exercise, eating nutritious food, and getting eight hours of sleep each night can make your body better at resisting SAD. It’s also very helpful to find a balance between productivity and leisure time. You need to stay active enough to keep your routine going, but without exhausting yourself.

    If your SAD is persistent, or if you think you may be dealing with major depressive disorder or bipolar disorder, you may want more support. A therapist can develop more personalized coping tools and prevention strategies with you. A psychiatrist can prescribe antidepressant medication if needed. If you think one of these options may be right for you, feel free to reach out to me.

  • 5 Strategies to Avoid Fights at Thanksgiving

    5 Strategies to Avoid Fights at Thanksgiving

    For many people, the holiday season isn’t much of a holiday. You might have to visit family you dislike, or be dreading arguments or uncomfortable questions. In fact, Thanksgiving and Christmas sometimes bring up even more anxiety, bad memories and triggers than the rest of the year! So, let’s explore some ways you can avoid fights at Thanksgiving and make your holiday as relaxing as it should be!

    1. Have a safe topic prepared.

    Think of a few neutral conversation ideas that are hard to turn into politics, religion, or other sensitive topics. Hobbies, favorite books or music, and household projects are all good ideas. If you don’t want to share anything personal, try deflecting the conversation to things that your friends, coworkers, or characters in a popular TV show are up to.

    I like to keep a list of conversation starters at hand. It’s easier to refer to a list and pick something fun than to try to invent it myself when I’m feeling stressed.

    2. Resist getting provoked.

    Some people may insist on turning the conversation into an argument, or bringing up stressful topics, even if you play it safe. Do not engage with them when they do this. Do not let yourself get dragged in. Even if they say offensive or ignorant things, your job is to keep yourself sane.

    Depending on the person doing it, you can either:

    1. Keep talking about the neutral topic as if they hadn’t said anything.
    2. Change the subject again. Try catching them off guard with an irrelevant question, like “What do armadillos eat?” or “Have you ever played pickleball?”
    3. Tune the person out or start talking to someone else.
    4. Tell the person you don’t want to talk about the stressful topic.
    5. Walk away.

    Think about the people you know, and which strategy will work best on them.

    3. Avoid fights at Thanksgiving with a shared activity.

    A shared activity can center everyone’s attention on a safe topic. Watching a movie, playing a sport, board games, making art, or putting jigsaw puzzles together can all work. Dogs, kids, and going outside can also be excellent distractions.

    If your difficult relative won’t join in the fun, and insists on making irritating remarks, the shared activity can also give you an excuse to ignore them. “Can this wait? We’re trying to focus on the game now.”

    4. Watch the alcohol.

    Heavy conversations usually go poorly if one or both sides have been drinking. By limiting your intake, you can better anticipate if a conversation is going south. You’ll also be more able to restrain yourself, redirect things, or leave if necessary. If your family drinks a lot of alcohol at this time, try alternating alcohol with water or juice for yourself. A full glass will discourage others from offering you refills.

    Notice when others are intoxicated, too. Drunk people are more likely to say hurtful things, and arguing with them doesn’t work. That may be your best cue to leave.

    5. Get your own space.

    Sometimes, the best way to avoid fights at Thanksgiving is to just get out of there. Take a break on the back porch. Say you have a headache and need to go to bed early. Offer to get a napkin for someone from the kitchen. If your relatives are very persistent, consider renting a hotel room instead of spending the night with them.

    Bonus tip: If you absolutely can’t avoid a fight at Thanksgiving…take time to recover afterward.

    Sometimes, even if you do everything right, you’ll still get hurtful comments, unwanted questions, or lose your temper. Others may get in a fight even if you stay out of it. You may come back carrying a lot of stress or frustration.

    Try to arrange a day right after the trip when you can decompress. Ideally, a day where you don’t have to work, either. If that’s not possible, find a few hours where you can. Allow yourself to feel upset for several days, look for pleasant distractions, and find supportive people to talk to.

    Sometimes visiting family brings up bad memories or painful emotions we thought we’d dealt with before. If these feelings don’t resolve on their own after a few weeks, it may help to talk to a therapist. Feel free to contact me if you’re interested in working through those issues more deeply.

  • How to Manage Stress From Current Events and News

    How to Manage Stress From Current Events and News

    Many of my clients feel anxious, depressed or angry when they watch the news or hear about it on social media. Others feel guilty about not doing enough, or not knowing enough about what’s going on. With the outbreak of the war in Israel and Palestine, the tensions are higher than ever, even here in the USA. So how can you handle the stress you feel from current events – and make a positive difference?

    1. Limit your exposure to the news

    Most news sources focus on negative events, because bad news gets people’s attention and compels us to keep watching. But our brains aren’t built to handle horrible stories every day, especially about big, faraway problems we can’t personally solve. This causes feelings of helplessness and being overwhelmed.

    Instead, I suggest picking a time when you will catch up on the news once or twice a week. Limit it to no more than an hour each time. Reading is usually better than watching video because you can skim the headlines if you’re in a hurry, or if the news is too triggering to read through entirely.

    2. Examine your sources for stress from current events

    Some news sources are better than others, both for accuracy, and for your mental health. Some social media bloggers will share news in a very stressful way, while others are calmer or more uplifting.

    Notice how you feel as you read a person’s blog, or read articles on a website, or watch a news channel. Are you starting to feel angry? Anxious? Exhausted? Some of these feelings are normal when hearing about disasters and danger, but if some of your sources regularly make you upset, you may need a source with a calmer, more level-headed tone. Some good starting points are the BBC, NPR, the Washington Post and the Economist.

    3. Outrage isn’t activism

    Many of my clients who feel stress from current events also feel like they should be feeling upset, or else it means that they don’t care enough about injustice. But feeling upset, on its own, does not help others. Your day being full of anger or worry will not cause politicians to start acting better.

    Release yourself from the obligation to always know what’s going on. Grant yourself permission not to make posts just because you feel pressured to say something. Allow yourself to set the news aside sometimes and enjoy your day, too. You need breaks and happy times so that you don’t get burned out.

    4. Look for a practical way to help

    Anger, worry, and other negative emotions exist to motivate us. So channel that motivation into an action you can do. Many folks like to pick one cause to focus on, like cleaning up pollution, or reproductive rights, or helping people find affordable housing. You might then donate to an organization related to that cause, use social media to spread awareness, or even check out volunteer opportunities in your community.

    The first key word is “sustainable.” If you can sort donations at a food pantry for an hour a week, that’s awesome. If you can only make posts telling people about food drives and where they can find pantries, that’s also helpful! Do what works for your energy level, time, resources, and personal strengths.

    The second key word is “constructive.” You will probably be much happier if you feel like you’re making a difference – and you’ll attract more people to your cause. I personally have a rule that I don’t share posts on social media if all they accomplish is making me feel upset. Instead, I share information about resources, charities, and ways people can help. That helps me feel more hopeful, too.

    5. Identify who you can talk to about stress from current events

    Some people in your life are better for discussing the news with than others. Some of them may have opinions you find offensive or hateful. Others, you might agree with, but their attitudes are hard to deal with. It’s okay to tell these folks, “I’d rather not talk about the news, thanks.” If someone insists on talking about the news after you asked them not to, change the subject or step away from the conversation.

    Look for people whom you can safely talk to about the news, and whom you don’t mind listening to in return. You both may need to vent sometimes. They may be able to give you ideas for what to do, support you with your own struggles, and help you feel like you aren’t going crazy.

    If your stress from current events is still very high, or you think it’s feeding into other problems like anxiety, depression, or tension with your loved ones, it may help to talk to a therapist. Therapy can give you more personalized tools for stress and difficult interactions with people you know. Feel free to contact me if you think that may be useful for you.

  • My Top 5 Skills to Overcome Depression

    My Top 5 Skills to Overcome Depression

    Depression is one of my clients’ most common struggles, and I’ve had to climb out of that pit myself. There are many tools you can use to manage it, but when you’re feeling this low it’s hard to know where to start. Here’s what helped me overcome depression, simplified. Perhaps it will help you, too!

    1. Get Plenty of Sleep

    Poor sleep can cause you to feel tired, sad, more easily stressed out, and unable to concentrate. You are more likely to feel anxious or overwhelmed, too. These issues mirror those of depression, and can make overcoming depression more difficult.

    If you lie awake trying to fall asleep, practice clearing your mind with meditation, progressive muscle relaxation, or with a nightly routine. If your main issue is getting yourself into bed, identify what activities get in the way, and set a limit on how late you’ll let yourself do them. For instance, I don’t start reading new books after 6pm because I know they’ll keep me up.

    Sleep issues can be vague and hard to untangle. Consider consulting a therapist or having a sleep study done if you struggle to solve it on your own.

    2. Get a Check-up

    Physical illnesses, low exercise, and poor nutrition can contribute to depression. Ask your doctor to run a few blood tests to rule out physical causes that might be making you feel down. Low levels of sunlight, Vitamin D, iron and B12 are common deficiencies for my clients with depression.

    Follow your doctor’s recommendation. This may include taking supplements or changing your diet, exercising more, or taking medication. Or your doctor might find no physical causes, in which case I’d suggest exercising and getting outside anyway. It almost always helps.

    3. Overcome Depression By Writing About Your Feelings

    When you’re depressed, a lot of your thoughts will feel stagnant, hopeless, or like they’re going in circles. It’s hard not to get caught up in your own head. Writing these thoughts down fixes them in place and makes it easier to look at them more objectively.

    If you aren’t used to writing, try a few of these prompts:

    • Think back to a time you felt upset. What was the event that caused it? What thoughts went through your mind? How did you feel?
    • Look at a list of emotion words. Which ones apply to you right now?
    • What do you wish other people knew about what you’re experiencing?
    • If your problems were gone when you woke up tomorrow, how would you spend your day?
    • What would you want a compassionate friend to say to you right now?

    Many of my clients find that when they write down their thoughts, they feel a greater sense of control over them, and it’s easier to be compassionate to themselves. The fears and frustrations that seemed overwhelming become manageable problems they can study. This takes time and regular practice, but helps greatly with overcoming depression.

    4. Overcome Depression By Reaching Out For Help

    It’s incredibly difficult to overcome depression on your own. You might have a voice in the back of your head saying, “I don’t want to burden others,” or “My problems aren’t that important.” That voice is wrong. If a person you loved was going through this, and feeling as bad as you do, would you want them to hide it from you? Probably not. Your friends and family will likely want you to tell them about your needs, too.

    If you’re worried about putting too much on other people’s shoulders, ask them whether they’re in a good mental space for it. If they tell you it’s fine, and they can handle it, take them at their word. Trust them to tell you if they need a break.

    You can also work with a therapist or other mental health professional. Therapists are trained not only to support your recovery, but to teach you skills for managing your thoughts and getting things done. We can also help you work on other mental health issues that might influence your depression, such as trauma, anxiety, loneliness or grief. If you’re thinking of ending your life, call or text the National Suicide Prevention Hotline, or find your local warmline if you just need someone to talk to.

    Lastly, if you suspect that your problems are no big deal, or don’t deserve attention because other people have it worse…it’s good to seek support for milder depression, because that’s the best way to prevent it from getting worse! I love it when people come to me with “small” issues because it makes treatment faster and easier. You don’t have to be at rock-bottom for help to be worthwhile.

    5. And Finally…Sometimes You Just Have to Hold On

    The good news is that nearly all of my depressed clients eventually recover. We have a wide variety of tools to try, more than I could ever list in a blog post, and eventually something almost always helps.

    The bad news is that it is not easy, and sometimes it takes a long time. Sometimes it’s an accomplishment just to get out of bed in the morning. I’m here to tell you to keep going, because even if you do everything “right,” and see a therapist, your brain will still need time to uncoil from “depressed mode” and start healing. You might have to practice exercising, writing, socializing when you don’t feel like it, and more, for several weeks or months before you notice a difference. But it can happen, even if you’ve lived with it for years.

    Depression is not permanent. All you have to do is outlast it. And I believe you can.

  • 4 Signs You Might Be Depressed

    4 Signs You Might Be Depressed

    Depression is one of the most common mental issues, and co-occurs with many other illnesses like anxiety, bipolar disorder and substance abuse. But despite its frequency, it can still be hard to tell if you’re dealing with “real” depression, or just having a bad day. So let’s explore some of the symptoms I most commonly see. If these sound real familiar, you might be depressed.

    1. You Feel Tired All the Time

    Think of your energy level as a battery that can charge up and run low. Most people start their day with 100% of their battery full, maybe a little less if they slept badly or feel stressed. Depression causes you to wake up with just 50%, 30% or even less of your battery, and you have to make that small amount last all day.

    This battery can apply to mental or physical energy. You might have a desk job, but depression can still leave you feeling exhausted after sorting through emails or writing a paper. Simple conversations might wear you down. Or you might find it difficult to cook, brush your teeth or do other physical tasks that seem to be easy for most people.

    If you’re sick, it can be hard to distinguish depression-tiredness from regular tiredness. Chronic illness can make ordinary tasks exhausting. But if the following points apply to you, too, you might be depressed.

    2. You Don’t Enjoy the Things You Used To

    Most people think of depression as “sadness but longer.” And for many depressed people, they do feel sad. But if they don’t feel constantly sad, they might think their depression doesn’t “count,” so you should also look at the absence of good days, too.

    Depression casts a dull cloud over things that should be relaxing, fun and uplifting for you. Friends whose company you normally enjoy, might feel overwhelming, loud, or boring when you’re depressed. Hobbies that should make you smile become pointless and dull. If you’re prone to anxiety, you’ll likely feel anxious more often, too.

    3. You Feel Guilty, Worthless or Hopeless

    Most of my clients with depression think badly of themselves. They may ask me if they’re terrible people, apologize when they’ve done nothing wrong, or call themselves “stupid.” Or they might feel like they don’t have the ability to get better. If it’s hard for you to think of good qualities about yourself or believe people like you, you might be depressed.

    Depression lies to you. It shows you all the negatives while hiding the positives. That includes only seeing the negatives about yourself. Even if you don’t have depression, this mental bias lowers your self-esteem and can make you vulnerable to being mistreated by other people.

    4. You Want to Get Away From It All

    With a low battery, low mood and little belief in yourself, you’ll probably start feeling overwhelmed. Depressed people feel stressed out more easily and often want to withdraw from people and responsibilities. You may feel like you want to “take it easy,” or wish you could have more time to yourself to recharge. In extreme cases, you might even think of ending your life just to get away from all the stress and exhaustion you’re under.

    This is a natural response when you have so little energy, but it’s also a trap. The more you withdraw, the harder it is to get back into these habits, and the more likely you are to feel helpless and stuck.

    If You Think You Might Be Depressed, Ask For Help

    It’s impossible to diagnose yourself for sure based off an internet article. Even as a therapist, I can’t diagnose someone who’s not a client. But even if it’s not “official” depression, you still deserve support. It’s much easier to treat depression if you catch it early than wait for it to get severe.

    Reach out to friends and family you trust, or look for a support group. Often, just talking about your problems can help you work out how to solve them, and help you feel less alone. It’s also a good idea to check with your physician for illnesses or nutritional deficiencies. Sometimes depression has a physical cause that you can treat. If you’re thinking of ending your life, call or text the National Suicide Prevention Hotline, or find your local warmline if you just need someone to talk to.

    If you need a formal diagnosis, more focused support, or are worried about “burdening” others, consider getting a therapist. Most of my clients have experienced depression at some point, and I’m happy to report that it’s almost always treatable. In my next post I’ll go over some of the strategies I use for it with clients. See you then!

  • How to Be Assertive Without Being Rude

    How to Be Assertive Without Being Rude

    Do you struggle to say “No” to people? Do you worry about being selfish or entitled when asking for what you want? You’re not alone. If you’re used to going along with what others say, it can be hard to tell the difference between acting assertive and acting like a jerk. So let’s examine how you can be assertive – without being rude.

    Being Assertive (Without Being Rude) is Subjective

    What counts as “rude” or “polite” varies by culture. Different people in your life will also disagree about the right way to make requests and say no to others. You might even know some people who think anyone disagreeing with them is automatically rude. These folks might react badly even if you use the nicest words possible to say no.

    That’s why it’s important to decide what you think is fair, instead of trying to please everyone. Your best guide is treat others as you’d want them to treat you. Try saying a request or refusal out loud, and consider how you’d feel if someone else said it to you. If you wouldn’t feel hurt by someone else saying that, it’s almost always okay to say it to others.

    It’s also helpful to identify people you know who are assertive, and confident, but kind. How do they bring up problems? How do they ask for things and set boundaries? Maybe you can pick up their tricks.

    Keep Your Cool

    If you’re prone to getting angry, exhausted, anxious or overwhelmed, step away from the situation and give your brain time to calm down. Use that time for breathing exercises, a short walk, or other coping skills, then figure out what you want to say.

    It’s okay to interrupt a conversation if your feelings are getting too intense to handle it effectively. Walking away from someone might feel rude, but a person who respects you will understand if you need a break. Some things you could say are:

    • Hold on, I need few minutes.
    • Can we come back to this [in ten minutes/an hour/tomorrow]?
    • This isn’t a good time for me to talk. I’ll return when I can give you my full attention.

    State Your Needs

    In order to get your needs met, you will have to say them out loud sometimes. This may feel strange, especially if your needs were treated as “demands” or “selfishness” in the past. But people who care about you will want to hear what your needs are, because they don’t want you to feel miserable. You will also be making their lives easier because they will know for sure what’s working or not working for you, instead of them feeling confused or worried. Being honest about your needs is a kindness, not rude.

    Try framing your needs and feelings as “I statements.” This helps prevent the statement from feeling accusatory. Here are a few examples, in increasing directness:

    • I feel frustrated when you don’t do the chores we agreed were yours.
    • I’d like for you to wear headphones while playing videogames so I can study quietly.
    • I’d appreciate it if you didn’t talk about my weight.
    • I need you to knock before entering my room so I’m not startled.

    Some cultures will allow more directness than others, so pick what feels fitting for you. But remember that being direct is not the same as being unkind, and you are not hurting anyone or putting them down by making requests. They can say “No” if it doesn’t work for them.

    Say “No” Clearly

    Being assertive (without being rude) is not just about what you want. It’s also about what you don’t want. That means turning down requests and expectations from other people sometimes.

    I recommend practicing an all-purpose statement like “I’m sorry, but that won’t be possible.” Or “I won’t do that.” Or even just “No.” Most people will accept that immediately. People who keep pushing for you to say yes are usually not respecting you. Don’t try to justify, argue, or explain your reasons to them, just keep saying “It won’t be possible,” or “It’s just not happening.”

    Saying “No” does not mean you’re saying “I don’t care about you.” “No” is not an insult or rejection of someone as a person. All it means is that you won’t be doing that specific thing they asked of you. If they interpret your “No” as a personal attack or insult, that is on them, not you.

    Saying “No” is also necessary so that you can be kind to others sustainably. Protecting your own boundaries and energy prevents you from becoming burned out, resentful, and letting problems fester until they explode. People who respect you will understand that you can’t do everything they ask, and they will want you to be happy, not just make them happy.

    Practice Being Assertive Without Being Rude By Using a Friend

    It can be hard to judge what’s “reasonably assertive” and what’s “pushy” or “rude” when you’re still learning. Your internal expectations are probably distorted. But you can correct them more quickly by testing out these skills and getting feedback from friends you trust. Find a friend, relative or colleague who strikes a good balance of assertive and polite, and ask them, “I’m trying to figure out how to word something, could you tell me what you think?”

    Assertiveness skills are one of my favorite subjects to teach my clients. It’s awesome to see their confidence grow and their stress drop as they take more control of their lives. Let me know if you’re interested in professional feedback and support as you practice these techniques.

  • What to Expect From Your First Therapy Session

    What to Expect From Your First Therapy Session

    Have you been considering therapy, but aren’t sure about taking the plunge? Are you worried about what to do, or whether you’d screw it up? Here’s a play-by-play of what a first therapy session looks like, so you can decide what you’re ready for, and what kind of therapist is right for you.

    Getting Comfortable

    Therapy starts with finding a comfortable place to prepare for your session. If you’re seeing a therapist in-person, their office will usually have a waiting area with chairs, a couch, maybe magazines or a water cooler. You might talk to a receptionist if it’s a larger agency, and they’ll hand you paperwork at the first therapy session. You might pay before or after session.

    Therapists don’t really ask for the “lie down and stare at the ceiling while monologuing” anymore. You totally can if you want to, though. There may even be blankets or stuffed animals you can borrow for extra comfyness!

    If you’re seeing an online therapist (like me!) then you have options. Most of my clients do therapy at home, often with a cup of coffee, or a dog in their lap. Some clients will have sessions from their car (while parked) or workplace. This is okay as long as it’s a completely private space that you’ll have for the full 50 minutes. You’ll also need to be in the same state your therapist is licensed in, since our licenses usually don’t cross state lines. Most of us use Zoom or other HIPAA-compliant video platforms, and I find that progress usually comes faster with video. But, phone calls and text-based therapy are also available.

    Many therapists are switching to digital paperwork and billing. For instance, my clients get a secure link where they can do the paperwork, put a credit/debit card on file, and download any receipts or other documents they need. I love this because you can just set and forget it.

    The First Therapy Session Special…Paperwork!

    Your first session will involve reviewing the paperwork, as well as talking about what brings you to therapy. The papers are pretty dry stuff, mostly about scheduling, payment, digital security and privacy policies. But on the bright side, you’ll know exactly what charges to expect, how to handle the internet going out mid-session, accessing your records, and things like that. This also lets you decide if you’re comfortable with your therapist’s style before sharing really personal, heavy stuff with them.

    I tend to meander a bit while talking about the paperwork. Because it’s more fun to hear your thoughts instead of just monologuing. But that’s alright; anything we don’t get to, we’ll have time for in the next session.

    Identifying Your Problems

    You probably had a chance to chat with your therapist over the phone about your concerns. And the paperwork will usually have a space for that, too. But this is where you get to elaborate more and start working together!

    It’s normal to feel some anxiety or awkwardness in the first therapy session. It’s okay if you’re not sure where to start or how to put things into words. We’re trained to help you find the words. If you’ve found the right therapist for you, it’ll feel like they’re listening to you, that they want to get to know you as a person, and that they know what they’re talking about.

    Safety Check-Ins

    At some point your therapist will gauge whether any issues could affect your immediate health or well-being. These issues might involve domestic violence, suicidal thoughts, substance use, eating disorders, or financial hardship. Some therapists will ask you outright, some will have you fill out the answers in the paperwork, and others will play it by ear.

    I like to poke a little fun at myself and flat-out call these the Awkward Questions. Because that’s what they are! Very personal things to tell someone you’ve just met! But you can say “pass,” or tell me as much or as little as you like. Besides safety, I’ll also check with people about whether they have concerns about their physical health, or intersectional issues like race, gender, and orientation. Maybe you do, maybe not, but the topic’s open in case it’s on your mind later.

    Wrapping up the First Therapy Session

    Between the paperwork, the Awkward Questions and identifying the issues, that usually leaves a few minutes to explore your options moving forward. I like to list ideas I have for coping skills, habits, and other techniques that I think could be useful for you. If there are specific diagnoses you’re interested in, we’ll assess for that in the next session to make sure there’s enough time. You’re also welcome to add things you want to get to later, too.

    There’s a lot of ground to cover in the first few sessions. It can be nerve-wracking to reach out, and heavy subjects to talk about. But my clients have told me that they ended the first session feeling relieved and hopeful. Like there was a path open for getting better. If that’s the feeling you get from your therapist, you’ve probably found a good one.

    Did this article help you feel more confident about whether to try therapy or not? Are there questions I didn’t answer? Let me know! I’m always happy to help people find the right healthcare for them.

  • How to Make A New Year’s Resolution Stick

    How to Make A New Year’s Resolution Stick

    A new year is a great time to assess where your life is, and where you want it to go. Committing to a firm goal can motivate you and help you feel progress in your life instead of being stuck or in a rut. But resolutions are also notoriously hard to stick to, so how do you make a New Year’s resolution that works for you?

    Make a New Year’s Resolution That Matters to You

    You need a “why.” What makes this goal meaningful to you? Are you doing it for yourself, for people you care about, or just because you think you’re supposed to? If you aren’t sure that this is what you want, your motivation is likely to falter.

    Let’s take exercise as an example. If your goal is to “Get in shape,” do you want to get strong? Avoid health issues or chronic pain? Feel confident in your appearance, or something else? Any of these can be valid reasons, but you need to know your reason. Then, you can remind yourself of it on days you don’t feel like working out.

    Identify your reservations, too. If you have mixed feelings about “getting fit” because you’re concerned about body-shaming in our culture, you might not work out as much as you intended. However, if your goal is to strengthen your joints, or keep up with your kids, your values will keep you going.

    So, ask yourself: what’s important to you? What would make you feel happier with your life?

    What Can You Control?

    Center your resolution on choices you make, not on external events, other people, or things you can only affect indirectly. Setting expectations for things you can’t control leads to frustration.

    For instance, you can’t control whether you get a better job. If you make that your goal, and you go through five interviews without getting an offer, you will probably feel like a failure. But you can control how many job applications you submit. You can control what your resume looks like, and you can look up common interview questions to rehearse. So if you set your goal as “Revise my resume and submit three applications each week,” you can definitely meet that.

    What physical actions can you take to get closer to your goal?

    Make It Measurable

    Have you ever wondered why computer programs show a progress bar while downloading big files? It’s because we aren’t good at waiting on things without some indication that we’re getting closer to what we want. The progress bar reassures us that things are happening, that we’re on the right track. It helps us keep going instead of giving up.

    Make your own “progress bar” by making a New Year’s resolution that you can measure. Perhaps you want to save money for a new car: how much do you want to save? How much of each paycheck can you set aside for that? If you want to save $5000 this year, and you’re paid monthly, then you could put aside $417 each month into a bank account for that purpose. Then you can see the number slowly rising each time you add to it.

    Or, suppose that you want to improve your drawing skills. How do you measure something like that? Maybe you could do quick sketches of 100 faces. Or maybe you could draw 50 types of animals, or doodle for 15 minutes a day. Look for some number you can count, and a way to record it, so you can give yourself a pat on the back for all your work later!

    Aim For Consistency, Not Intensity

    Most big changes take a long, long time. Longer than your initial burst of motivation will last. You might even have to do them forever, if it’s something like “Eat vegetables every day.” So you need to a way to sustain the work even when you aren’t motivated.

    Start with a small, simple habit you can do regularly. Same time every day, ideally. Make it as easy as possible to do and remember. Consider attaching it to another consistent habit you have – like if you want to floss more, put the floss dispenser on top of your toothbrush and always floss first.

    If your goal is a 30 minute workout three times a week, but you find yourself not doing it, what about a 10 minute workout each morning? Or, if you can’t write 500 words per day, what about 100? (These last two paragraphs are 110 words!)

    Aim for the easiest version of an activity first. You can up the challenge later.

    Make Your New Year’s Resolution With a Buddy

    Personal growth can be a lonely journey. Find someone you can share your struggles and successes with. Friends, relatives, people who share your interests, even social media can all work. It’s even better if they make a New Year’s resolution, too, so you can encourage each other’s progress.

    If your resolution is particularly tough, or you’ve got other problems getting in your way, you might want more specialized support. Therapy can be a good option here, since therapists are trained to turn vague issues like “anxiety” into specific techniques you can try. I love the process of pinning down what, exactly, the problem is, and being able to label it is often a huge relief for my clients even before we start finding solutions. If you think this process could be useful for you, drop me a line!

  • Are You a Narcissist?

    Are You a Narcissist?

    Narcissism has become a “trendy” word in pop culture lately. I’ve seen people use it to mean “selfish,” “egotistical,” “uncaring about others,” and more. But this might make you wonder, are you a narcissist, too? Let’s cut through the stereotypes and see what that actually means.

    What is narcissism?

    Narcissistic personality disorder (NPD) is a mental illness. It involves an inflated sense of self-importance, a strong need for admiration, and lack of empathy for others, even if that causes problems for your life or for other people. This is different from simply “being selfish.” Most of us act selfish at some point, but we can stop doing so with a bit of self-reflection, or around people we care about. Narcissistic personality disorder is consistent across a person’s relationships.

    Narcissism is not:

    • Thinking you’re awesome. You can have a high opinion of yourself and treat others with love and respect.
    • Thinking about yourself a lot. Most humans think about ourselves and how others perceive us often.
    • Wanting attention, status, or to be liked. Most humans feel this way, too.
    • Telling people what you want. That’s not narcissism, that’s a communication skill.
    • Being a jerk to others. Some narcissists can be charming, funny and helpful. And most people who act like jerks aren’t narcissistic.
    • Being a bad person. Narcissists are people with good and bad qualities, too.

    What makes narcissism a disorder is pursuing admiration, exploiting others, or focusing on your own desires to the extent that it damages your relationships with other people.

    Narcissism is a spectrum

    Narcissism has become an insult in many circles, a way to say “bad person.” Most of my clients who worry that they’re narcissists are, deep down, worried that they’re bad people. But humans are complex.

    It’s common to have a few narcissistic tendencies without it being a full-blown disorder. For instance, most toddlers start out self-centered, because they need a lot of attention. Teenagers may feel like their problems are more important than anyone else’s, but develop a broader perspective over time. Learning to balance your own needs with those of other people is part of growing up.

    Some narcissistic traits can be neutral, or even helpful, if balanced with other strengths or used in the right way. Having a high sense of self-importance may make one person act entitled and rude – but it might give someone else the confidence to speak out against injustice. Wanting admiration can make some people put down others – but it could also motivate healthy competition and pushing yourself to grow.

    It’s true that people with severe narcissism can act self-centered, exploitative, and uncaring toward others’ feelings. But their actions are what’s right or wrong; they choose to mistreat others. You, too, can choose what kind of person you wish to be, no matter if you have a diagnosis or not.

    Are you a narcissist…or just anxious?

    Most of my clients who ask “Am I a narcissist?” aren’t on the NPD spectrum at all. They usually have the opposite problem: their self-esteem is too low. They mistake “having positive thoughts about yourself at all” for “being a narcissist,” so they feel afraid to acknowledge their good qualities. Or they think “setting boundaries and asking for what you need” is the same as “being entitled and uncaring toward others,” so they never speak up for themselves.

    If you’re worried that you might be a narcissist, first rule out whether you have anxiety or depression, because those disorders are much more common, and might cause those kinds of thoughts. Or, if someone else told you you’re a narcissist, consult a mental health professional to get a more objective opinion. And remember that diagnosis isn’t destiny: you always have the ability to grow.

    The healthiest mindset is a middle ground: valuing yourself and respecting other people. You can build up yourself and build up others, too. It’s easier said than done, but with good friends and maybe some therapy, you can get there. If you’re interested in professional support to help you find that balance, drop me a line.

  • How to Control Your Anger: 4 Practical Skills

    How to Control Your Anger: 4 Practical Skills

    Last week I wrote about how to tell if your anger is becoming a problem. This time, we’re exploring how to make anger work for you instead of against you. “Cooling down” is easier said than done. Fortunately, you can learn how to control your anger with specific, concrete skills.

    1. Learn what anger looks like for you.

    It’s easier to manage anger when you can catch it as it’s starting. To do that, you need to be able to recognize your anger early on. Think back to situations you have felt angry, and ask which of the following apply to you:

    • Feeling heat or tension in your body
    • Fist clenching
    • Glaring or scowling
    • Heavy or rapid breathing
    • Sweating or shaking
    • Becoming argumentative
    • Shutting down or withdrawing from people
    • Raising your voice
    • Getting in people’s personal space
    • Throwing or breaking things
    • Wanting to hurt yourself or someone else

    You may also think of other “symptoms” of anger unique to you.

    Try pausing a couple of times a day, and ask yourself if any of these signs are popping up for you. It’s also helpful to observe if you’re feeling tired, sick, stressed out, annoyed, hungry, or worried, because sometimes our bodies turn these feelings into anger. See if you can take a break to address these feelings before your anger reaches a boiling point.

    2. Identify your triggers.

    Everyone has a trigger: a person, thing or situation that brings up big unwanted emotions. Getting triggered does not mean you are weak. It means your brain is reacting very strongly to try to protect you, someone else, or something important to you. When you know what triggers your anger, you can decide whether you’re ready deal with that trigger today, and prepare yourself if needed.

    Some triggers are emotional:

    • Feeling disrespected, used, or hurt
    • Feeling helpless or trapped
    • Worrying about someone
    • Feeling overwhelmed or exhausted
    • Being reminded of a bad memory

    Others are situational:

    • Being stuck in a traffic jam
    • Seeing a person who wronged you
    • Being lied to or manipulated
    • Being ignored
    • Getting criticized

    There are many, many possible triggers, so examine the situations in which you felt angry. What events led up to that feeling? What thoughts kept going through your head? Once you know what made you angry, you can plan for how to respond next time.

    3. Control your anger with a safe outlet or distraction.

    Trying to suppress your anger usually makes it worse. Most of my clients who have angry outbursts try to bottle it up or pretend they aren’t angry, until they can’t take it anymore. So you need a way to “let off steam” in a way that works for you.

    My favorite outlet is literally walking away from the trigger. If it’s someone I’m talking to, I’ll say, “I need a few minutes. Back later,” then leave the room. If it’s an email or thing on the internet that upset me, I close the app. Then while I’m away from the trigger I’ll distract myself, write down how I’m feeling, or message someone else who’ll let me vent.

    But walking away isn’t always possible. Maybe you’re stuck in traffic, or have to hear a lecture from your boss. At times like this I find two strategies useful: distraction and expression. By taking your mind off the irritant you can reduce its effect on you. Or, by physically expressing the anger safely, you can take the pressure off.

    Some distractions might include:

    • Doodling
    • Thinking about something you’re looking forward to
    • Taking an object apart and putting it back together
    • Counting the number of objects in a room
    • Picturing your favorite person, places or animals

    Some expressions of anger might include:

    • Scribbling really hard on paper, then crumpling it as tight as it will go
    • Tearing apart cardboard
    • “Taking notes” that are really about how you’re feeling
    • Waiting until you have time alone, then hitting things with a stick
    • Cleaning aggressively until the dirt is terrified out of your house
    • Venting about the problem to a friend
    • Exercise – This one is especially good for getting the pent-up stress out of your system.

    One other note: suppressing anger altogether is usually unhelpful, but putting anger aside temporarily can work well. The key is to acknowledge briefly that you’re feeling angry, and give yourself permission to respond to the anger later. In the meantime, find a distraction or project you can focus on to help you cool down.

    4. Practice expressing your needs in a healthy way.

    Anger has a purpose: it tells you to act, because something is wrong. It often arises because we feel that we’re being mistreated, our boundaries are violated, or the expectations on us are unfair. So it needs to come out. But if we learn how to control our anger constructively, it won’t have to come out in a bad way.

    Communication skills are your friend here. Assertiveness skills will help you make requests from other people and stand up for your needs. Boundary-setting skills enable you to say “No,” and prevent yourself from getting mistreated. Lastly, conflict-resolution skills reframe problems from “you vs. the other person,” to “you and the other person working together against a problem.”

    I’ll elaborate on these in future posts. For now, ask yourself if there are more direct, respectful ways to tell other people what you need. My personal favorites are “I feel [emotion] right now, and I need [request],” for stating your needs, and “I’m sorry, that won’t be possible,” as an all-purpose way to say “No.”

    Bonus tip: Use feedback to learn how to control your anger more effectively.

    It’s hard to gauge how to control your anger better if you’re just guessing how others perceive you. Look for a friend, colleague or family member with whom you can practice having hard conversations. Ask them how your words and body language come across. You can also pick up strategies by watching how they handle frustration, and what words they use when they feel upset.

    A therapist can be helpful if you want in-depth support for understanding what causes your anger, deeper issues it may be masking, and which coping tools work best for you. Anger issues are very treatable, and I find most of my clients who want to get better at it, will. If you’re considering whether therapy might be right for you, drop me a line.