Shaded Bough Counseling

Tag: mental health

  • What are the Effects of Financial Stress?

    What are the Effects of Financial Stress?

    Last week I talked about what financial stress is. Today we’ll explore the effects on financial stress on families, relationships and mental health. It can happen to people of any income, old or young, even the smartest of us. But no matter your situation, know that you’re not alone.

    Poverty can be traumatic.

    Poverty is unpredictable, exhausting, and frequently treated as shameful. It’s a “chronic stressor,” so even when you aren’t being harassed by bill collectors and you do have food on the table, you never really feel secure. Poverty increases a person’s risk of physical and mental illness, and makes it harder to get healthcare.

    Many of my clients who grew up in poverty report that they still worry about money, even if they’re now financially secure. Others feel guilty about spending money, even on things that make them happy or healthier. It’s difficult to talk about, especially if most of your friends or family haven’t been there, so this kind of trauma can be very isolating.

    The effects of financial stress are generational.

    Most of us learn how to think about money by watching our parents. If your parents worried about how they’d pay the bills, you may worry the same way. Children who notice their parents’ financial stress often avoid asking for things because they don’t want to be a burden on their parents.

    This problem gets bigger if your family has low “financial literacy.” That’s the ability to understand and use money to achieve your goals. Low financial literacy doesn’t mean someone’s unintelligent. It just means they haven’t had the chance to learn these skills. You may have a harder time with money if your family wasn’t able to teach it to you. But just like other learned habits, this is something you can improve.

    Financial anxiety

    Although financial stress hits low-income people the hardest, it can affect people of all social classes. In particular, anxiety often manifests through how we handle our money. Money represents different things to different people: freedom, security, hope, despair, social acceptance, guilt, self-worth, and more.

    Think about what money represents to you. Is it something to save up in case of emergency? Is it a little bit of breathing room, a relief? What do you feel okay about purchasing, and what makes you feel guilty or irritated? How much time do you want to spend thinking about money, and how will you know when you have enough? What will you do if you have enough?

    These questions get complicated quickly. My clients find that discussing it in therapy helps them figure out their core values, and to overcome their deeper fears. It’s hard work, but rewarding.

    Relationship tension

    Another form of financial stress happens when two people in a family have different ideas of how money should be used. Perhaps one spouse thinks they should be more careful with what they spend. But their partner thinks they both need a better quality of life. Maybe a parent wants an adult child to start paying rent while at home – or a child is tired of bailing their parent out of debt.

    With “money” as one of the top reasons couples split up, it’s worth talking to your partner early on about how they view money, and what kind of lifestyle they want. Explore what money represents for each of you. Often, disagreements over money stem from deeper worries or needs.

    Effects of financial stress on mental illness

    One of the toughest effects of financial stress is that it makes every other problem in your life harder. It’s harder to afford doctor visits, medication or therapy if money is tight. Even if you logically know you have “enough,” money can become another reason for your brain to worry excessively. It may also exacerbate feelings of shame, guilt, low self-worth, or feeling “unproductive.” People with addictions often struggle with financial stress, too – and the financial stress can make addiction worse.

    If you need therapy but money is tight, check out FindHelp.org or Open Path Collective. It’s better to start looking early than to wait until you’re overwhelmed, because many low-cost providers have waitlists. I also counsel clients for financial stress, and have a limited number of sliding-scale appointments for people in need. Contact me if you’re interested, or check out my next article on ways to manage your financial stress!

  • What is Financial Stress?

    What is Financial Stress?

    With rising interest rates, inflation, and fears of a recession just around the corner, most Americans are dealing with a lot more financial stress. The best defense is to be prepared. Learn what financial stress is, how it affects you, and what you can do about it.

    Stressing about money – and so much more

    Financial stress occurs any time you find yourself worrying about money, the ability to pay for things, to reach your financial goals or maintain your lifestyle. It can mean worrying about whether you’ll be able to retire, raise children, get out of debt, pay for college, or more.

    Financial stress is not the same as being greedy or materialistic. Most clients I work with face financial stress because they want security, not wealth or high status. They just want to be able to enjoy their life without fearing it will be snatched away from them by bills and debt. In one of the richest countries in the world, that’s not an unreasonable ask!

    What is financial stress from a situation?

    I find it useful to distinguish whether financial stress comes from within yourself, or from the situation you’re in. This helps you identify what you need to do to address it.

    Your situation might give you financial distress if you are in poverty, live paycheck to paycheck, have irregular income throughout the year, lose your job, have a lot of debt, or encounter a disaster or sudden massive bill. The underlying question here is: How will I afford the things I need? The solution to this kind of stress has to address the situation: organizations like FindHelp.org to reduce your bills and get social support, unemployment benefits if you’re laid off, and SNAP and Medicaid to get food and medical assistance.

    However, assistance programs in the USA still have many gaps, and it’s extremely difficult for many people to get out of poverty or debt. We need institutional reform such as a single-payer healthcare system to ensure that people at all income levels can survive. But that’s another topic – let’s focus on what you can do, as an individual.

    What is financial stress from within?

    The other kind of financial stress can happen even if there is no obvious problem to cause it. You may be able to pay your bills, and see no reason why that would change, but you still worry. You might feel privileged, and like you shouldn’t complain because others have it harder, but you still feel guilty about spending money on “unnecessary” things or wonder if you need more.

    This kind of financial stress is less dramatic, but still a real fear many people struggle with. You might have grown up without much money, and worry about going back to that state. Maybe nobody taught you how to manage money effectively. Or perhaps you struggle to gauge how much you have and how much you need. If you suffer from anxiety, or general worries about your future, those often manifest as financial stress, too.

    What you can do

    My specialty is mental health, so that’s what I’ll be focusing on. For more assistance with external money issues, I recommend FindHelp.org – it’s a great directory for free and low-cost services ranging from elder care to groceries to job training, and more. They have a section for low-cost mental healthcare, too!

    I’ll be writing two more posts in this series, one on the effects of financial stress, and another for how to cope with it. For now, the most important things to know are that you are not alone, and you have a right to feel this way. Just because someone else might “have it worse” doesn’t make your stress or anxiety less real. You are not being silly or selfish by wanting to take care of yourself financially, or by not giving money to everyone in need of help.

    The most helpful thing, for me, was not trying to figure everything out alone. I had to reach out to relatives who understood money better than I did, and who were willing to teach me. Look for a friend, relative, or local class that can help you, too. (The library is a great place to ask!) Most people will not look down on you for trying to get to a better place. And if you want more intensive support – especially for handling stress, relationship, or anxiety issues at the same time – don’t hesitate to reach out for therapy.

  • Do I Need a Therapist or Psychiatrist: How to Decide

    Do I Need a Therapist or Psychiatrist: How to Decide

    Mental health services are more widely available than ever, but with that comes the question of figuring out what service is right for you. Who prescribes medication? Who can teach you coping skills? So here’s a simple explanation to help you find the right therapist or psychiatrist for you.

    What’s the difference between seeing a therapist or psychiatrist?

    Psychotherapy or counseling usually means “talk therapy.” You sit in a room with the therapist, talk about your problems, and come up with solutions together. There are variations like art therapy, play therapy, group therapy and even adventure therapy. Therapists help you build a stronger relationship with yourself and other people in your life.

    You can think of “therapist” as an umbrella term with several types:

    • Professional counselors are pretty much what most people think of as “talk therapy.” This is what I am, hello!
    • Marriage and family therapists specialize in working with couples and families.
    • Clinical psychologists have doctoral-level knowledge and sometimes work as therapists, sometimes work in institutions or community agencies.
    • Social workers may also do counseling work, may be case managers or involved in other social services.
    • Depending on where you live, there may be a lot of overlap in what these professions do. In Texas, where I work, all of these professions can diagnose and treat mental illnesses. It’s also common for one person to hold multiple licenses.

    Psychiatry is a special case! Psychiatrists are physicians (MD) who can prescribe medication for mental health. Most professionals in the previous group are not trained to prescribe medication. Appointments with psychiatrists are often shorter, more focused on symptoms and medication management, and may feel more like doctor appointments. Because, well, they are doctors. Psychiatrists can also prescribe behavioral treatments like exercise, journaling and coping skills if they choose.

    These are generalizations. Some psychiatrists are also psychologists or therapists. Psychologists with PsyD degrees can prescribe medication in certain states. When in doubt, ask the provider what working with them would look like.

    Many people get best results from working with a therapist and psychiatrist, to ensure all sides of their recovery are addressed.

    Try reaching out to a therapist if:

    • You want to get support weekly or biweekly.
    • You want plenty of time per session to explore your problems.
    • You are more interested in talk therapy, changing your behaviors, or developing coping skills than in medication.
    • You want to try couples therapy, group therapy, or another treatment psychiatrists usually don’t cover.

    Key words to look for: clinical psychologist (PhD, PsyD), LPC, LCSW, LMFT, LMHC, LCDC.

    Try a psychiatrist if:

    • You want to try psychiatric medication.
    • You want to better understand what’s going on with your brain chemistry.
    • You’re already on medication, and want an expert to help you manage it.
    • Your symptoms don’t get better from talk therapy or behavioral treatments alone.
    • You have an illness that usually needs medication for best results.
    • The therapist you want to see also happens to be a psychiatrist. They are out there!

    Key words to look for: Psychiatrist.

    If you can’t decide between a therapist or psychiatrist, try interviewing them.

    When in doubt, ask. I love it when my clients ask me what kind of work I do. It helps make sure that we’re a good fit before we start working together! And if we aren’t, I’m happy to refer them to a psychiatrist, or marriage and family therapist, or whoever is best qualified to treat them.

    Some useful questions to ask a therapist or psychiatrist are:

    • What license do you hold?
    • What do you specialize in?
    • How long are your sessions and how often would we meet?
    • Do you do talk therapy, medication, or other treatments?
    • If there’s a particular treatment I want (CBT, EMDR, art therapy…) can you provide it?
    • If not, can you refer me to someone who does?
    • How would we know if I’m getting better?

    I hope this helped you get a better idea of what to look for when seeking help. Don’t hesitate to contact me if you have questions, or if you’re interested in starting therapy for yourself.

  • How to Make Friends as an Introvert with Social Anxiety

    How to Make Friends as an Introvert with Social Anxiety

    Making friends is tough if you’re not naturally extroverted, or if your brain freezes up when you try to hold a conversation. As an introvert myself, I struggled for a long time. But becoming a therapist has helped me put the strategies that worked for me into words, and I bet they could help you, too. So here are my top tips for how to make friends as an introvert with social anxiety!

    1. Prepare go-to topics.

    Have a fallback for when you’re not sure what to say. This is especially helpful for small talk, and getting through those first few conversations. My favorites:

    • Make an observation about something you both have in common. If you’re working together, you might say, “How long have you been here? What’s it like?” Or if you’re meeting for a hobby group: “So what got you interested in this?”
    • Compliment them on something they chose. “I like your shoes, where did you get them?” “That’s a sweet cell phone case.” Picking something they chose is also less likely to sound intrusive than commenting on their body.
    • Ask if they have a pet! Everyone who has a pet will love talking about it. If they don’t have a pet, shift to “What would you want if you did have one?” You can also show them pictures of your own pets.

    2. Find predictable ways to connect.

    Structured activities like board games, sports, or trivia nights are great for this. It gives you something to focus on and talk about with others. Plus, team games help people bond quickly. And you won’t have to figure out what’s coming next, so it’s less awkward.

    You can also try finding meetup groups or clubs centered on an interest or hobby. Meetup.com is great for this. You can also go to stores that cater to that interest and ask the staff if they know of groups or events you could join. For instance, if you love fantasy novels, ask the library about local book clubs. If you want to get into Dungeons and Dragons, ask the staff at your local game shop for groups.

    3. When in doubt, focus on the other person.

    Social anxiety makes us look inward, and over-analyze everything we say and do. So I recommend getting out of your own head by consciously listening to what the other person says, does and feels.

    My go-to strategy here is reflection. Try rephrasing or summarizing what the other person says back to them:

    • “I moved to this town just a few months ago.”
    • Reflection: “So you arrived here pretty recently.”

    You can also reflect the emotions that you observe from the other person:

    • “Ugh, I can’t believe my boss dumped this project on me at the last minute!”
    • Reflection: “It sounds like you’re really frustrated about that.”

    The great thing about reflection is that it makes people feel good to be around you, because you’re listening and treating their thoughts as important. It also encourages people to open up more, which keeps the conversation flowing without putting too much responsibility on you to say the right thing.

    4. Let awkwardness happen.

    Inevitably, you will have moments where you’re not sure what to say. This is normal, even for the most confident extroverts. But just because you feel awkward doesn’t mean you’re messing up.

    Instead of paying attention to your inner feelings – which are biased toward anxiety – look at how other people are behaving. Are they giving you “negative signals” like turning away, glaring, responding with one-word answers or not at all? Or do they look upbeat, neutral, or maybe a little awkward themselves? Unless you’re getting clear signals from other people that they’re upset at you, you probably did nothing wrong.

    It’s okay for there to be lulls in the conversation. Just wait, and the conversation will return on its own time. No one ever got hurt by a little awkwardness.

    5. The most important tool to make friends as an introvert with social anxiety…is practice!

    It’s hard and scary, especially at first. You will spend a lot of time worrying about whether you did it right – I know I did. This is a skill that nobody’s born knowing how to do, and it needs to be repeated over and over. Many of my clients are introverts who struggled with social anxiety, but through our work they built the confidence to reach out and make wonderful friends. You can do it, too!

    If your social anxiety is particularly severe, it’s helpful to get support from other people. Your existing friends or family can give you encouragement, feedback, and help you find the courage to reach out. If you need more focused support, therapy can help you overcome your anxiety and build stronger social skills. Let me know if you’re interested in giving it a shot.

  • Four Self-Care Tips for Students

    Four Self-Care Tips for Students

    If you’re in high school, you’ve probably heard stories about how difficult it can be to adjust to college life. If you’re in college or graduate school, you already know! Standard advice like “get eight hours of sleep every night” and “eat healthy” may be easier said than done when you’re moving to a new town or living in a dorm. So, set yourself up for success with some self-care tips for students, based on what’s helped my clients the most in their college years.

    1. Limit your work load.

    Don’t take more classes than you feel ready for. And don’t take harder classes than you have to. This goes double for your first semester, when you’re still figuring out how much you can handle.

    You should also take into account jobs, social obligations, and time commitments from Greek houses if you’re a member. Depending on finances, you may have to work or take a certain number of classes. Ask your program advisor for suggestions about which courses are easier or harder, and how to balance them with your situation.

    If you have ADHD or other mental health conditions, I highly recommend ADDitude’s College Success Strategies for ADHD Teens. They also mention self-care tips for students of their own!

    2. Look for friends who share your values.

    Whether you’re aiming for a 4.0 or are just here for a good time, it helps to have buddies get what’s important to you. Explore the student clubs around campus, look at fliers for upcoming events, and try attending even if you feel nervous the first few times. It’s okay to feel awkward. If you don’t click with one group of people, there will always be others.

    Some prime places to meet people might be:

    • Classrooms and libraries are a great place to meet other people who share your academic interests, or to get a study group together.
    • Dorms and other student housing often have welcome parties and group hang-outs.
    • Churches, synagogues and other spiritual centers often have groups for students. These can be good places to start if your beliefs are important to you or you want to get involved in charity work.
    • Greek houses vary in how much membership costs, how much of a time commitment they require, and how much they focus on academics, social life, and community service. Ask existing members what their daily life is like and how happy they are with the group.

    3. Break down school work into chunks.

    The most common challenge my clients encounter in college is figuring out how to tackle big tests and projects. You might have to study most of a textbook, or put a massive presentation together. But the good news is that these tasks can always be shrunk into something more manageable.

    This is my go-to strategy:

    • Figure out what the assignment is asking for. Or the material you need to review, if you’re preparing for a test.
    • Ask the teacher questions for anything where you’re not completely sure about what they want. Write the answers down.
    • Spend a half-hour just listing the tasks you have to complete to get the whole thing done. It’s like making a to-do list just for this project.
    • Break down each to-do item into smaller chunks. Be as specific as possible. So instead of “Research for a presentation,” the smaller chunks might be, “Find an article about the topic. Read an article. Find a line in it you can cite. Write out the citation for it.”
    • If you’re feeling stuck, or aren’t sure what to do next, try explaining the problem to another person. This will often get it un-stuck.

    If you’re neurodivergent, or just need better study habits, ADDitude has an excellent article on developing your organization and study skills.

    4. Check out your campus’ support resources.

    Self-care tips for students may not be enough on their own. But all colleges in the USA have a disability office you can ask about accommodations, and most have counseling centers. You may be able to score free therapy, career advice, and study skills coaching! Plus access to the gym, recreation center, and other student amenities. Go to the school’s website or student resource center and try to find everything they’re offering. Grab everything your tuition entitles you to!

    The main limitation of college counseling centers is that they often have long waitlists, and you don’t get to choose your counselor. So some students choose to get counseling independently anyway. If you’re in Texas, I’m one such therapist who often works with students, and helps other students find the right therapist for them. Drop me a line if you are interested or want more articles about mental health in college!

  • How to Help Someone with Low Self-esteem

    How to Help Someone with Low Self-esteem

    You probably know people with low self-esteem. It can be frustrating and sad to see someone you care about struggle in how they see themselves, and you might wish you could fix their self-esteem for them. But you can be a voice of support that helps them keep going. So, here are five ways you can help someone with low self-esteem!

    1. Treat them like they matter.

    As children, we learn that we are important, and that our feelings are important, based on how adults react to us. If our feelings or needs are ignored, we may start to think they don’t matter, that we don’t matter. Even as adults we still need that validation from others sometimes.

    So, one way you can help someone with low self-esteem is by acting like they’re important to you. Make time for them. Show interest in their life. Celebrate what makes them happy and listen if they need to vent. It sounds simple, but it can have a profound effect.

    2. Point out their strengths.

    People with low self-esteem tend to have brains that are very good at noticing their flaws, but not so good at noticing their strengths. Over time, this adds up to a lot of negative information that becomes a poor self-image. You can help counter this by reminding them of things they have done right, things they are good at, and other traits that you appreciate about them.

    3. Don’t encourage self-deprecation.

    Many people with low self-esteem make disparaging comments about themselves. Sometimes it’s presented as a joke: “Ha ha, I’m such an idiot.” Not all self-deprecation is bad, but if you think your friend has low self-esteem and they make a lot of these comments, self-deprecation might make their negative feelings worse.

    So, you can help someone with low self-esteem by disagreeing: “No, you’re not an idiot. Anyone could make that mistake.” Or you could tell them those comments make you concerned: “Hey, when you say stuff like that, do you really mean it? Because it seems like a mean thing to say about yourself.”

    Thank them for taking care of themselves.

    When a person with low self-esteem does treat themselves well, ask for what they want, or set a boundary, praise them for it. Taking care of yourself helps you believe you’re a person who’s worth taking care of, and positive feedback encourages that. This can feel odd at first, so here are some examples:

    “Thanks for telling me you weren’t comfortable doing that activity. I’m glad I didn’t put you in a bad situation.”

    “It’s awesome you finally took a day off. You deserve some chill time.”

    “Nice job speaking up back there – it’s good to hear what you wanted, too.”

    And the final way to help someone with low self-esteem is…trust in them.

    One of the trickiest, but most important things you can do is to stop helping, and trust that they can handle challenges themselves. More precisely, stop doing things for them that the person could do for themselves. This goes double if they’re an adult who should be able to express what they want and solve problems on their own.

    This can be hard! You may want to step in and take their problems away, and they may struggle for a while. But people build confidence through the experience of doing things for themselves. They learn that they can get through the struggle without getting crushed by it.

    Think of it like ordering food at a restaurant. Instead of ordering for the person, you tell them, “You can do it!” and high-five them when they order for themselves. You aren’t abandoning them, you’re building them up so they can do it on their own.

    Helping someone with low self-esteem can take a long time, and they may need more help than you can give them on your own. If you think your loved one would benefit from professional support, encourage them to reach out to a therapist. Psychology Today and Good Therapy are great places to start, and I see clients virtually as well.

  • 5 Easy Self-Care Habits You Can Start Today

    5 Easy Self-Care Habits You Can Start Today

    One of the best ways you can improve your mental health is by improving your self-care habits. In the same way that “maintenance” keeps your car running, self-care keeps your brain and body in good shape. Here are five simple, practical self-care habits to get you started.

    1. Prepare with snacks

    Food can affect your mood, energy, and stress level. When you feel irritable, stressed or nervous, check if you’re also feeling hungry. If so, taking a snack break will usually help you feel better. You can also use snacks as a back-up plan for when you’re too busy or tired to cook, which helps prevent you from getting exhausted.

    I recommend keeping “neutral” snacks on hand. A neutral food is good enough to eat, but you don’t have strong feelings about it, positive or negative. If you worry about the calories, don’t like the taste, or get cravings for it, it’s probably not a neutral food. Bonus points if it’s portable.

    2. Take breaks to stretch

    Stretching is another self-care habit that helps physically and mentally. Many people carry tension in their body. This can lead to headaches, muscle cramps, digestion problems and more. Our brains then interpret the body’s tension as a sign that we need to feel stressed or anxious. Stretching helps our bodies relax, and this tells our brains to relax, too.

    If you sit or stand for long periods, do stretches at least once every thirty minutes. You can stretch however you feel like, or you may follow examples like this stretching guide from Very Well Fit. Pay attention to what feels good for your body and do more of it.

    3. Connect with someone

    One of the best ways to feel better is to spend time with someone you care about. Friends can cheer you up, listen when you need to vent, and give you things to look forward to. Think of someone you usually feel better with after talking to them, and send them a call, message or hang out together.

    If you’re not sure how to start, try asking them how their day was, or what they’ve been up to. Or show them a funny picture, or talk about something you’re interested in or looking forward to. If you have had a rough day and aren’t sure whether you should talk about that, ask them whether they’re up for hearing some venting, and they will let you know.

    4. Give yourself credit

    Some of our habits are purely mental. One of these habits is how often we see positive or negative traits in ourselves. If you don’t like yourself very much, your brain has probably had lots of practice at looking for negative traits.

    So, do the opposite! Once a day, think of something good you can say about yourself. It might feel weird, but that just means you’re strengthening a new neural pathway in your brain. It will get easier over time.

    Here are some prompts to get you started:

    • Did you manage to get something done? (Even small things count.)
    • Maybe you did something good for someone else, or made them smile?
    • What are you good at doing? Again, even “unimportant” things count!
    • Do you like something about your appearance, clothes or sense of style?
    • Sometimes just getting out of bed when you’re feeling awful is an accomplishment!

    5. Wind down at bedtime

    Falling asleep on time is one of the most common challenges I see in therapy. Many people stay up later than they want to, or lie awake in bed feeling frustrated. If this is you, you need a way to switch your brain into “bedtime mode.”

    Pick a relaxing activity that gets you out of your own head, but isn’t too absorbing, like coloring, drinking non-caffeinated tea, or rereading a book. Start doing this 20-40 minutes before you intend to sleep. If you feel sleepy earlier than the scheduled time, go to bed right then. This will help your brain associate the activity with sleep time.

    Try to do the same activity, in the same location, at the same time every night. The more familiar it feels, the better your brain will get at going to sleep afterward.

    Self-care habits take time

    It’s okay if you can’t start doing all of these at once, or if you start off strong but miss doing them later. Any new habit will take practice before it becomes automatic, even simple ones. If you need more motivation for developing your self-care habits, consider partnering with a friend to hold each other accountable, or reach out for therapy to get expert support.