The Silent Struggles of Depression: Be Proud of Yourself for Surviving

In this post I am going to offer advice to those of us living with depression, anxiety, or other mental illnesses. It is advice that can be beneficial to anyone, but I want to stress how important this is for those of us living with mental illness.  While I offer this advice, I recognize that it is not easy to follow. I struggle with this advice myself because of what depression and anxiety say to me. Still, this is important advice. It is simply: Be proud of yourself for surviving all the silent struggles you do not speak about. Let that sit for a minute. 

Whether we recognize it or not, we all have silent struggles. For some of us those struggles are magnified. These are the painful struggles. The ones that reverberate in our minds. But we are here. That is another statement we need to sit with for a moment. Depression has not taken us. It may not have been easy. We have battled silently, but that does not lessen all it has taken for us to still be here.

Depression, anxiety, and other mental illnesses are difficult to live with. These illnesses affect more than our mood. They affect every aspect of our lives. Depression and the other mental illnesses can get in the way of our work life. Often, we need to put on a front a work. We wear a façade that says, “I am okay.” We do not let our colleagues or supervisors know about our struggles. Instinctively, we know they would not understand. Some days it is difficult to work when our minds are full of the negativity of depression. I remember days when I was pushing through at work, keeping to myself as depression was telling me that my life was not worth living. That is an example of a silent struggle that we do not speak about. 

As I follow the advice I offered above, I need to be proud of myself for getting through those times. I stared suicidal thoughts in the face and kept working. I say that not for praise, but for my own realization that I should be proud of myself for the hard times I have made it through. I never told my colleagues. Some of them are good friends and maybe I could tell them now, but sometimes our struggles are very private. Our struggles are also painful. Can you imagine the pain that accompanies feeling like life is not worth living while going through the motions at work or in social situations? If you have never been in that moment, I can tell you that it hurts. It is painful. I need to remind myself that as painful as those moments were, I made it through them. There are people reading this post who can see themselves in what I have described. My message to you is to be proud of yourself for getting through the moments you do not talk about. 

Maybe it is in a different environment. Maybe we have sat through a family gathering while depression has told us we do not belong. Or anxiety has told us we are not good enough or that we have not lived up to the successes of other family members. For me anxiety berates me for being the only one without children and for just being a teacher. I find myself trying to push anxiety down. Then when I go home depression decides to pop in and tell me I am not good enough and that everyone in my family is better. It is a silent struggle. No one knows. Well, you know now. What I am getting at is that as safe as family gatherings should be, they can be a source of depression and anxiety for many of us. We need to be proud of ourselves for making it through those gatherings. It takes a strength that others do not see or understand. We silently make our way through situations that others find easy. 

Depression, anxiety, and other mental illnesses can impact any area of our lives. They can make getting through the day-to-day aspects of our lives difficult. Others do not always see what we are struggling with because we have learned that it is not safe to let others see our struggle. We may be embarrassed by how mental illness affects us. We need to let go of that embarrassment. Believe me, I know that is easier said than done. I still struggle with this, but I know it is important for us to believe that we are not our depression, anxiety, or other mental illness. Our silent struggles are real, but we have a strength within us that carries us through the tough times. We are still here. Mental illness has not won. For that we can be proud.  So, remember, be proud of yourself for surviving all the silent struggles you do not speak about.

 

How to Support Someone with Depression: The Power of Listening Without Judgment

         I recently read a sentence on social media (Fred’s Fighters) that I feel gets right to the heart of what it means to support someone with mental illness. 

One of the greatest gifts we can give another person is our presence.

                  Let that sit for a moment. To help someone who is struggling with depression, anxiety, or other mental illness, we can support them by simply being present. The “being there” matters more than what you say or even do. How do we do this? How do we allow ourselves to just be present for someone else? 

First, we need to recognize that we do not and cannot fix everything for the person who is struggling. This may look like just sitting next to the person and listening without interrupting. With that in mind, we need to listen to the person without trying to fix them. As a person living with depression and anxiety, there are times when I would like someone to just listen to me. In these moments I am not looking for answers or a fix to the depression and anxiety. I just want to be heard. I want what I am experiencing to be recognized. Sometimes just knowing a friend or family member is with me is enough to build that feeling of safety that I need to work through the depression and anxiety.

I see this modeled by my mental health providers when they listen without interrupting. They allow me to express what I am feeling or thinking before they speak. They allow moments of silence. These can be important because it allows processing time. When there can be silence and we still know we are not alone, it means the other person is really present for us. Of course, mental health professional needs to interrupt the silence and offer support and intervention, but they model being truly present. We can learn from this.

Being present for another person means believing the person without questioning. This is where we remove judgement. If a person says something like “life doesn’t seem worth living”, do not judge them. This is a real feeling, a real experience. Instead, being present means listening to what the person has to say. We need to give the person our full attention. We can reflect on what they are saying. We might say something like, “It sounds like you are carrying a lot.” This lets the person know that are hearing that they are struggling or that things are difficult for them. Avoid phrasing it like a question. Someone who is really listening reflects on what the other person is saying without questioning or judging..

When we are being present, we also want to validate the other person’s words and feelings. As we listen, we might say, “That sounds very difficult” or “I can see why you feel that way.” We can validate without judging. It is important to let the person know we believe their thoughts and feelings are real. Being present means hearing what the other person is saying and then letting them know you are really hearing them and not judging them. This requires us to sit and just listen first. Give the person the time they need to express what they are experiencing. That is being present. As we validate someone’s thoughts or feelings, it is important that we do not minimize those thoughts. The feelings and thoughts are real. They feel heavy to the person. That heaviness should be respected, not minimized.

What about support? How do we support the person as we are being present?  First, we should offer support without taking over. We can do this by saying something like, “How can I support you right now?” or “What would be most helpful from me right now?” It is important to let the person have control over the support they are given. This means respecting that they know what type of support they need in the moment.

What if the person seems hopeless or is expressing a desire to hurt themselves or take their life? This is where being present means ensuring the person is connected to mental health professionals. One way to do this is to ask the person if there is away for them to contact their mental health professionals. Encourage them to reach out to trusted mental health professionals. If the person is in danger or if you think they are going to follow through on thoughts of self-harm or suicide, help them contact emergency services. This might be the 988 lifeline or 911. Always stay present with this person if they are in danger of harming themselves. Maintain the aspects of being present discussed above and keep the person safe until they can receive support from mental health or emergency professionals. 

When we are being present for a person with depression, anxiety, or other mental illness, it is important to remember that we do not need to have all the answers. We want to allow the person to feel heard, respected, and accepted while they are experiencing depression, anxiety, or other manifestations of mental illness. Being present for another person is a gift. On the surface it may sound like a difficult thing to do, but it really comes down to being kind. It is treating another person the way we would want to be treated. We can be present for each other if we let go of preconceived notions and accept the other person for who they are. This means letting go of judgement and replacing it with openness. None of us are going to be perfect at this, but the more we try, the better we will be at being present for others. Think about what a gift it is to simply be present with another. 

 

 

Mental Health Disparities: Why National Minority Mental Health Month Still Matters

July is recognized as National Minority Mental Health Month. In some areas it is referred to as BIPOC Mental Health Month. For the purposes of this post, I will use National Minority Mental Health Month because that is the name it was established as. It is also the name NAMI (National Alliance on Mental Health) uses. NAMI includes Bebe Moore Campbell in the name. More on her later. National Minority Mental Health Month is intended to recognize the unique mental health experiences, challenges, and strengths of people from racial and ethnic minority communities. At the same time this month encourages equitable access to mental health care. 

                  July was formally recognized by the U.S. Congress as National Minority Mental Health Month in 2008. The month also recognizes Bebe Moore Campbell. She was a writer and advocate who worked to reduce stigma and improve access to culturally responsive mental health services. As a result of Bebe Moore Campbell’s work, conversations about race, family, and mental health entered the mainstream. She worked in Black communities to reduce stigma surrounding mental illness. Her work included several books. Bebe Moore Campbell worked to make mental health care compassionate, accessible, and responsive to diverse communities.

                  Before I discuss ways that we can get involved to help reduce stigma and make mental health care accessible and culturally responsive for diverse communities I want to share some personal experiences. As a white woman I have privilege that others may not have. Mental health care has always been accessible to me as an adult. I did not have access to mental health care as a teenager, but that was more a reflection of the time and ignorance of the adults in the school system at the time. My point is that I do not need to worry about receiving the care I need. I have the insurance to cover the costs of my care and treatment. I have the financial means to pay for what insurance doesn’t cover. I am fortunate. That fact is not lost on me. It is part of why I am so grateful to my mental health care providers. Of course, my providers are amazing as well. Is that part of my privilege? I do not need to rely on care from government funded providers. I have the best of the best. That being said, I cannot overlook the struggles of others. As someone who has access to the mental health care I need, I feel I should make efforts to help others. 

                  I have witnessed stigma and the lack of access to culturally relevant mental health care or any mental health care. As a teacher in the inner city for almost 30 years, I have seen students from diverse backgrounds struggle with their mental health. I have seen them face a lack of mental health care. Often, the only mental health support they receive is from a school counselor, who is overworked and responsible for more than the mental health of students.

                  I remember going with a school counselor to a government funded office to try to get services for a five-year old with childhood schizophrenia. I remember waiting in a long line only to fail to get the services in place. This little boy needed help so badly. Yet the support he was given laid mostly in my hands as a special education teacher and a school counselor. His parents were young, from a minority group, and had no resources. They had no way to fight for better services for their child.

                  Countless times I have had to reach out to school personnel when a student expressed suicidal ideation or made direct statements about taking their lives. Often, an administrator who had less training than me would take the student to their office. Sometimes the student would be taken on a psychiatric hold, but often the parents would be called and told to follow up with care. The thing is the parents were given no direction, no contacts for support. They had no access to resources. Other times the student would simply return to class. The administrator deeming there was no crisis.

                  One last story from my teaching experience. I had a student who was of Hispanic background. He was in the class for students with emotional disturbance that I taught. He was 18. He was diagnosed with schizophrenia but was not receiving care. His parents knew he was struggling but they feared asking for support. They were not citizens, and they feared that if they tried to push for services for their son, who was a citizen, they would be detained or sent back to the country they left. I remember the father would come every day to talk to me. We did what we could. We tried to help their son. There was a specialized counselor who came once a week to talk to my students. It did not help. He and my other students would make fun of the young, white counselor who did not “get” them. I remember them referring to her as a dead fish. The counseling lacked cultural relevance and awareness. 

                  Then I started noticing my student’s symptoms worsening. He was laughing inappropriately at odd times. I could actually see him experiencing visual and auditory hallucinations. Several times I reached out to the school’s psychiatric social worker, who would call the district’s emergency psychiatric unit. Each time she was told they would not come to the school because my student was “not in crisis”. I was helpless as I watched his hallucinations worsen. I was left wondering if my student lived in one of the more affluent, less diverse areas of the district, help would come to the school without waiting for him to be in crisis.

                  One morning he came into the classroom in crisis. He was suicidal and suffering from the symptoms of his schizophrenia. This time the psychiatric unit said they would come but we would need to wait for them to get there. That wait was about three hours. A student in crisis was left alone with me and assistant for hours before mental health care providers came to take him to a psychiatric unit. Again, I wondered if he hadn’t been a minority in a low socio-economic area, if things never would have reached this point. 

                  My point in sharing these experiences is to show how being a minority can affect the mental health care a person receives. I have witnessed it firsthand. The disparity is real. The disparity is unfair. The disparity is wrong. I am sure my examples are just a couple of countless incidents that minorities face when in need of mental health care.

                  What I have shared is part of the reason we need this month and why we need to work to improve access to mental health care in minority communities. It shows how racial discrimination, racism, and other social factors can affect access to care. It also demonstrates how financial, geographic, and insurance-related issues can affect mental health care in areas where people from ethnic minority groups live. 

                  My students experienced delays in receiving care. Often, they did not receive high quality care. That is not intended as a criticism of professionals I worked with. They were often not trained as much as was needed. They also had caseloads that were overflowing what any individual should be expected to carry.

What Can We Do?

                  I think one of the most important things we can do to improve access to culturally responsive mental health care is talk about it. We need to use our voices to raise awareness. The more we talk about mental health, the more we improve care. This cannot be done in isolation. We need to reach out into all communities. We can ask questions about how discrimination, language barriers, cultural stigma, and unequal access affect different communities.  We can work with groups such as NAMI to bring resources to diverse and disadvantaged communities. We can bring mental health information into these communities. This might include organizing events such as talks, mental health and wellness fairs, webinars, and community discussions into these communities. NAMI has programs for different communities held in different languages. Encouraging people to attend these events and programs is crucial. It takes more than a sign or post on social media. We need to get out into communities and talk to people.

Representation Matters

                  It is important that people from minority groups who have received mental health care share their experiences. In some groups, there is a stigma attached to mental health and mental illness. If people from these groups who have had positive experiences receiving mental health care can share these experiences, it helps to break down the stigma. It is important that we amplify the voices of mental health professionals, advocates and people with lived experience from underrepresented communities. It makes a difference to hear from people who are like oneself. 

                  Holding mental health fairs in these communities with people from different minority groups participating as leaders can make a difference. Again, NAMI gets out in the community and has diverse participants, leaders, and programs. 

                  We can also promote mental health careers in schools with underrepresented populations. A career fair at a high school is a great place to encourage students to go into mental health careers. 

Check-In on Others

                  One of the most important things we can do is to check in on others. This includes checking in on people from diverse backgrounds. Ask others how they are doing. Go deeper than the “okay” that is the response most of us give. Ask what okay means. Then have a discussion. If someone is struggling offer support. Maybe it is just being a listening ear for someone else. We need to normalize talking about mental health in all communities.

Current Times

                  Right now, we are experiencing increased racism in the United States. This makes it even more important that we check in on the mental health of people from racial minority groups. Experiencing racism can seriously impact one’s mental health. All of us should be checking in on others and helping others. This may mean being a listening ear. It may also mean helping someone find accessible, culturally responsive mental health care. The 988 Lifeline would be a good starting place. NAMI (National Alliance on Mental Illness) is another resource.        

Not Just July

                  It is important to support the mental health of people from underrepresented minority groups throughout the year. July is an opportunity to increase our efforts, but this work should never be limited to one month. Every person deserves accessible, high-quality, culturally responsive mental health care. We need to keep working until that becomes the norm.

I know there is more that I can do in this area. Can you? Awareness is where change begins, but action is what makes equitable, compassionate mental health care a reality for everyone.

Depression Recovery: Why Small Victories Matter More Than You Think

Depression is difficult to live with. Depression affects our motivation, our energy levels, our concentration, our decision-making skills, our self-care abilities, and our feelings of accomplishment. With any or all these things being affected by depression, it can be difficult to experience success in the way society tends to view it. For many of us with depression, it is important that we adjust how we define success.

Healing, or recovery, can be difficult to define because they can look different for each person. Healing can even look different for the same person at different times in their life. One thing we need to avoid when we discuss healing is absolutes. Healing does not mean the depressive symptoms are completely gone. Healing is a process. Since it is a process, we need to recognize the small victories in the healing process. 

Why Small Wins Matter in Depression Recovery

                  Small victories are the little things we notice as depression is lifting. A victory might be getting out of bed in the morning. It might be going 24 hours without a suicidal thought. It might be engaging with a friend. Small victories are the steps that show depression is lifting. One way I know I am coming out of a depressive episode is that I see more color in the world around me. Another way I know I am healing is I isolate less. These are small things on their own, but when look at them through the lens of the healing process, they are important. 

                  There have been times when even the small things have seemed impossible for me. When depression is at its worse, I struggle to function. Simple self-care activities are difficult. Keeping my house clean becomes difficult. I set something down and don’t have the willpower to put it where it belongs. Making a meal for myself can be difficult. There have been times when just washing a couple dishes or washing a load of laundry is an accomplishment. It may seem silly to think of one of these activities as a victory, but it shows how difficult depression can make our lives. 

                  I have been lucky that despite depression ravaging my life, I have been able to work most of that time. Many people are not as lucky. There have been days when just walking in the door at work has been a success for me. Unfortunately, I cannot say that depression has not impacted me at work. The days, even the moments when I have been able to function enough to work effectively are successes.

A Simple Exercise to Recognize Your Progress

                  If you are reading this and you live with depression, I want you to try something. Look at your life. Write down five small things that are difficult for you because of depression. There may be more, but let’s start with five. You can add more later. Next to each one, write what it looks like when you accomplish it. Then I want you to write an equal sign (=) after each description. After each description write the word “victory”. Keep this paper where you can easily access it to remind that you can achieve victories. It does not need to be all five at once. Maybe it is just one today and a different one tomorrow. The important thing is recognizing the small victories over depression. 

                  If you are reading this and you do not live with depression, I want you to go back and read that last paragraph. Now, make a list of small things you do without thinking about it. These are your small victories. The difference is these do not require the same effort from you. What if you could not do these things? What if something as seemingly simple as taking a shower was difficult for you? What if returning a text message took effort from you? This is what life with depression is like. 

Small Victories Add Up

                  Small victories add up. They add up at different paces for each of us. We may have setbacks. We made do more on one day than another. We may have days when depression knocks us completely out and we do not do anything. All this is okay. It is part of the healing process. 

I think one of the important parts of healing is recognizing that it is a process. It is actually a lifelong process because depression is an illness. For most of us it is more than just passing episode. I try to remember that there are going to be times when I am doing well and there are going to be times when I struggle. To do this I need to remain focused on the small victories. For example, having a conversation with the techs when I receive TMS (transcranial magnetic stimulation) or esketamine, is one way I measure my small victories. If I can have a conversation, I know I am improving. I know I am less depressed. 

Depression makes life tough. Those of us who live with it must be tough. We may not recognize how tough we are. That is because depression screams the opposite it in our heads. The truth is we work hard to do the small things. We deserve to recognize these accomplishments. We also need to know that small victories add up. As we do the small things, we increase our ability to do harder things. By focusing on the small things, we can fight our way back into life. We can fight depression and be well. This does not mean we will not fall back into the darkness of depression at times, but if we focus on the small victories, we can keep ourselves on the healing journey. 

 

 

 

 

 

 

 

 

 

A Thank You to My Mental Health Team: A Poem About Hope and Healing

Some of my last posts have been heavy. Others have been long. So, today I thought I would share a poem. It is a poem that recognizes the presence of psychologists, psychiatrists, psychiatric nurse practitioners, therapists, and counselors on the journeys so many of us struggle through as we navigate life with mental illness. As I share this poem, I say thank you to my mental health care team. Every one of you makes a difference in my life. I could not get through life without you. I am grateful beyond words. Hopefully, this poem shares that. 

For all the other mental health care professionals reading this, thank you. Your work makes a difference.

 

I Turn to You

 

When life is turned upside down

And everything is in disarray,

I turn to you.

Needing someone to make sense of the madness.

Searching for a reason I feel so much pain.

You quietly reassure me,

Remind me I am not alone.

Just a few words are all it takes.

Your words healing me,

Soothing my aches.

Quieting my mind.

I turn to you,

Know you are there.

I take comfort in your words,

And live to fight another day.

 

 

Why Structure Is Essential for Managing Depression: How routines can help you stay grounded, reduce anxiety, and protect your mental health during vacations, holidays, and other periods of downtime.

        Vacation! Sounds like just what we need. Whether it is a week off in the middle of the year, time off for a holiday, or the summer off for students and teachers, a break seems like just what we need, especially when we live with mental illness. Time off can be a relief. It can be time to get away from the stressors in our lives. Unfortunately, for many with mental illness, a break can take us away from the routines that ground us and provide a sense of security despite the stress they cause. 

I am a teacher. Many of my friends are teachers. We all look forward to winter break and are even more excited for the longer summer break. Many people look forward to a long weekend. The reality is that as much as we look forward to these breaks, they can disrupt the routines that we come to rely on. There is structure in getting up to an alarm at the same time every day. Our work routines allow us to shift into autopilot. For me this autopilot often prevents me from thinking. The thoughts depression fills my mind with can be ignored because I am focusing on the requirements of my job. We know our day will be filled with work until a certain time. Then it will be time to handle all the home chores that need to get done. 

This raises the question, how does structure help people with mental illness? Let’s look at some of the ways. First, I think it is important to note that while structure is important for many of us, that structure works best when it is flexible rather than rigid. Structure helps us manage symptoms and maintain healthy lifestyles and behaviors. It also provides a better sense of stability. 

There are several ways that structure can help us. Here are a few:

·      Reduces stress and uncertainty - When we know what to expect during the day, our anxiety levels are often lower. Stress is also reduced by having fewer decisions to make during the day. As an example, if a person knows which tasks they need to complete and at what time they need to complete them, it is often easier to be prepared to complete the task. 

·      Supports healthy habits – We can improve our mental health or keep it stable when we have a structure that allows us to maintain healthy habits. When we have a schedule to follow, we can insert meal breaks, time for hydration, and we can include time to destress. That time to destress might be after the workday, but when we are working, we know when that time will be. An example of being healthy when we are working is having to meal plan and prep to make sure we eat healthy. I tend to eat more regularly when I am working. 

·      Builds a sense of accomplishment – When we are working or going to school, we often accomplish things that are noticeable. This can increase confidence, which can improve our mood. We can do this in our downtime, but even then, it requires establishing a routine. 

·      Encourages social connection – When we are working or going to school, being around people is necessary. It is harder to isolate, which those of us with depression tend to do. I know I am alone a lot more when I am not working. Being around people can boost our mood. 

·      Supports treatment adherence – It is often easier to stick to a treatment plan when we have structure in our lives. We might set an alarm for medication or schedule appointments right after work. These things become routine when we are working or going to school. When we are not, taking medication can be easily forgotten. Remembering when our appointments are might become harder because they are at different times. 

 

These ways that structure help us can be achieved when we are not working or in school, but the structure of regular routine is beneficial. When we are not working or in school, it is often best if we set up some type of routine. Each of us is unique in our needs. Some people with mental illness require more structure than others. I know when the depression and anxiety I face are more intense, I need more structure. If I don’t have that structure, I am likely to retreat into nothingness, which worsens my symptoms. 

It is easy to see how being away from a work or school environment can lead to less structure. When we are in a good place with our mental health, we may be able to do well in the freedom of time off. There are those of us who may not be able to do well. One way I have approached this is discussing what I will do with my time off with my mental healthcare providers. I think having a plan is good for anyone with a mental health disorder who is looking at time off. This doesn’t mean we won’t have some freedom. I have a plan, but within that plan I am free to decide what time I get out of bed or when I will make plans with a friend. What is important is that we decide how much structure we need and what that structure looks like for us. We build a plan from there. I am a big proponent of including our mental health providers in this. They can provide feedback and advice. They can also help us be accountable. 

I know I struggle with time off. My mood will drop if I just sit around my house with no plan. One way I keep things structured is by adding activities to the calendar on my phone. I check the next day’s activities the night before. This allows me to plan. It also provides me with the ability to look forward to things. I try to do more in the morning and early afternoon because I know if I get my day started in a positive way, I am more likely to find ways to be positive the rest of the day. This is a little trick that works for me. 

If you are looking at time off and wondering how you will manage it or you have found yourself with downtime and feel like you are struggling, I encourage you to look for ways you can put some structure in your day. While structure will look different for each one of us, we can start by breaking the day into parts. Decide one thing you will do in the morning and one thing you will do in the afternoon. Put it on your calendar. Share what you are doing with someone. This can be a friend, family member, or our mental health care provider. If we do these things, we have provided ourselves with structure, we have given ourselves things to look forward to or expect, and we have provided for some accountability. 

Dealing with downtime can be difficult when we live with mental illness, but we can learn to make the best of our time. We can learn to alleviate the stress downtime can bring. We can keep ourselves from being absent from life. The key is creating our own structure. It is important to remember that we are not going to figure this out overnight. We will make mistakes. We will struggle. So, we need to remember that each day is a new day to figure things out. If with ease structure into our lives, we will find that we can cope with our mental illness in a healthier way. 

Self-Care Myths That Can Make Depression Worse (And What Actually Helps)

                  Self-care is something that is frequently talked in relation to mental health. While it is important to engage in self-care, there are some self-care myths that can actually harm our mental health. This is something I had not really given much thought. However, as I have the summer off from work. I am a teacher. So, I get the summers off. I have been hoping to engage in self-care. I am trying to figure out what that looks like. In that search I have discovered that there are self-care myths that we can get trapped in.

                  Usually, self-care is seen in a positive light. What could be bad about putting ourselves first and taking care of ourselves? Focusing on self-care can unintentionally lead to stress or guilt. We can put pressure on ourselves to engage in self-care. We might fear that we are doing it wrong. These are some of the myths. Let’s talk about a few more. 

                  Often, people think of self-care as being relaxing. Think bubble baths and candles. There is more to self-care. It is not always a relaxing activity. Sometimes self-care is taking care of things we need to get done. An example might be scheduling a therapy appointment. Therapy is an important part of healing. The appointments don’t schedule themselves. So, self-care might include taking care of scheduling that appointment. This is not relaxing, but it is part of self-care.

                  Self-care can also include doing the hard things that we need to get done to feel better about ourselves. This might include having a difficult conversation or setting a boundary. Self-care might include doing something that is hard to do because of depression or anxiety. While these do not sound like self-care, they are supporting our long-term well-being. In doing the hard stuff, we allow ourselves to feel better in the long-term. That is self-care. It is not always easy.

                  This leads to another self-care myth. Self-care does not always mean we will feel better immediately. An example is that it might take time to learn how to meditate and feel relief from it. So, while initial attempts at meditation might not make us feel good, with practice we can develop the ability to gain benefits from meditation. The same is true for other common self-care practices. Taking our medication or receiving a treatment is a form of self-care because we are doing what we need to heal. However, medications and treatments can take time to work. Remember just because an activity takes time to work, doesn’t mean it is not working. Self-care is not always a quick fix.

                  Even self-care practices that we normally find relief from can require time to work or may work one day and not the next. An example from my life is that usually writing is a form of self-care for me. There are times, however, when writing overwhelms me. I understand that sometimes I need to step away from a self-care practice for a bit. Maybe I put my pen down for a few hours and try something else. I need to remember that self-care practices do not always work as we expect. It is okay to try different things. Self-care can be about exploration. We can explore different means of self-care and build a bag of self-care activities. Just because something is labeled as self-care that does not ensure that it will always provide relief or be a quick fix.

                  A myth that sometimes pops up is that self-care looks the same for everyone. This simply is not true. What works for one person may not work for someone else. We can try different things. There are a lot of factors that go into choosing the right self-care activity. Factors can be affected by interests, cultural values, personality, finances, health, and many other things. We can all build our own self-care practice using what works for us. We are all unique individuals. As such, we can each define what self-care looks like for us.

                  Another myth is that if a self-care activity isn’t working, we are doing it wrong. Sometimes our mental illness can impact how certain activities work for us. We also need to remember that we need mental health treatment in addition to the self-care activities. Self-care activities are not intended to replace or be instead of mental healthcare treatment. Self-care should be an add-on to treatment. 

                  Along with this, we need to remember that self-care is more than positive thinking. How many of us have been told to “just think positive”? I hate that. Positive thinking can be helpful as we battle mental illness, but it is not enough. Positive thinking does not make mental illness magically disappear. So, it is a myth that positive thinking Is a self-care practice that can alleviate depression or other mental illnesses.

            Self-care is about making choices that benefit our well-being. It is about engaging in practices that make us feel better even if there is a delayed effect. Self-care is truly personal. What works for one person may not work for someone else. We need to find what works for us. We do not need to believe what others tell us about self-care or aspire to have the same experience someone else has with a type of self-care. Bubble baths and candles might work for the social media influencer, but that does not mean we need to enjoy a candlelit bubble bath. 

Our goal with self-care is to be able to care for ourselves on the good days and the bad ones. Our self-care is going to be unique to each of us. Don’t believe the myths or the hype surrounding self-care. We each can find what works for us. We must accept that this can take time and work. Talk to your mental healthcare provider about what self-care might look like for you. Ask for ideas. They know you and can make suggestions. They can also help you process your ideas for self-care. At the end of the day, self-care is what we make of it. Self-care is unique to us, and we need to be patient enough to give our chosen activities time to have an effect.

 

 

 

 

 

 

 

How to Show Up When You Have Depression (Even When You Don't Feel Like It)

When you live with depression it can be hard to show up in the ways we might want to show up. It is not that we do not want to be fully present or participate some moments. There are times when we just cannot. Depression, anxiety, and other mental illnesses can overtake our desire to be a part of moments or to do things. 

                  Let me explain a little. There are times when depression can make us feel drained or even dead inside. We might be holding pain that we fear will pour out of us if we engage with others. Anxiety can put us on an edge and make us feel like we are going to dive right off it. These feelings are hard to cope with when we are just sitting in our homes. Can you imagine trying to engage with others at these times? 

                  There are times when we do it. Times when can put our mental illness on the backburner, so to speak. It is by no means easy. Nothing is when you live with mental illness. So, how do we do it? How do we show up when we do not have it in us to show up? 

                  Let’s look at some ways to make showing up a bit more doable. First, we should focus on making our involvement smaller. We can be present in less demanding ways. We can prepare ourselves for the involvement. 

                  Here are some things we can try:

·      Redefine what involvement means: We do not need to be fully involved in everything. Maybe instead of being at an event or commitment for the full time, we set a goal of saying for a quarter of the time or half the time depending on what we can do. If it is something we are trying to do for ourselves like clean our house, maybe we commit to washing three dishes or vacuuming one room. If it is going out with friends, maybe we commit to only an hour or two rather than the whole evening.

·      Choose one priority: If we have more than one commitment, choose one to make a priority. Let others know what we are committing to do and be sure to make it known that we will only do what we can.

·      Let others help: If there is someone we can trust involved, we can let them know what we think we handle. Ask them to help us stick to that. We can say something like, “I am having a hard time today. I may need a little help with X or Y?” 

·      Check In Support: If we are going to be out somewhere and think we might have difficulty getting away, we can ask someone ahead of time to give us a call to check in and give us an out. We can also ask someone who is with us to suggest leaving at a set time to help us be able to leave before we become overwhelmed.

·      Prepare in advance: If we know we have something to show up for we can take a few steps to prepare that will make showing up easier. This can range from laying out our clothes the night before to checking out a location in advance. There are many ways we can prepare for things in advance. These are as varied as the activities we show up for. 

     It is important to remember that part of showing up is taking care of ourselves. We cannot show up if we are not taking care of ourselves. This is why being in tune with our mental health is important. To be in tune with our mental health we need to keep appointments with mental health providers. We need to take our medications and receive our treatments. We need to practice our coping skills. We need to ensure we are getting rest and exercise. Basically, we need to take responsibility for our mental health. This is tricky because doing this involves showing up. So, to show up we need to show up. Does that make sense? What I am trying to say is showing up takes making an effort to care for ourselves. We may not always feel like doing this, but if we can just put a little effort into it, only as much as we can give, we can show up.

The thing about showing up is that we are allowed to define what showing up means for us. No one else gets to define it for us. This may sound easier than it is. I know I struggle with showing up and often need reminders. Sometimes I can remind myself. Sometimes I need reminders from my mental healthcare team or others who are close to me. Perhaps, that is the key. We need to have conversations with those who support us. They need to know what we feel we can show up for and how we are able to show up. Of course, our ability to show up is going to vary based on how we are doing. Building a support system is crucial to being able to show up however we can.

Remember mental illness does not need to prevent us from showing up. We need to define what showing up means and then take the steps that will help us show up in our own way.

Checking In: Why Men's Mental Health Matters

Yesterday I realized that I have neglected to post about Men’s Mental Health Month. June became has grown into Men’s Mental Health Month after Congress established and President Bill Clinton signed into law Men’s Mental Health Week in 1994. That’s a long time ago. I am not sure we have made the progress we should have by now.

                  I realized that I had missed posting about this month when I felt like I was adding stress to my brother’s plate. He does not have a mental illness, but he has stressors right now, including my mother’s health and care. Men often deal with stressors that can affect their mental health without any support. Men’s Mental Health Month works to change that as well support men who live with mental illnesses. There is an effort to raise awareness of the mental health challenges men face and to encourage access to support, treatment, and community.

Reducing Stigma

                  I could start this discussion in many ways, but I think reducing stigma can be encompassing of a lot of the issues surrounding men’s mental health. Traditionally, men are seen as the strong ones, the providers. Men are expected to be tough. Often, it is assumed that men can take care of things. This perception can lay a heavy burden on any man, but especially on a man who may have a mental illness. We need to change this perception. Men do struggle emotionally. Men need support. They cannot do everything alone. 

                  As we look to reduce stigma, we need to recognize that it may be difficult for men to talk about emotional struggles. This is just not something that has been a part of the traditional norm in many countries. What if we can provide spaces for men to discuss what they are feeling openly and with the knowledge that it is safe to do so? That seems doable. If not, it should be. 

Along with this we need to normalize men seeking to go to therapy. This is crucial. Therapy is an important part of treating mental illness. Access to therapy is for the most part there, although it could be improved. One of the remaining issues is reducing the stigma. There is this false idea that it is sign of weakness to go to therapy. There is also the misconception that men can just “suck it up” and deal with emotional issues or mental health issues. This is why awareness efforts are important. We can share information about what therapy or counseling really is and how it can help men. 

Discussing Symptoms

                  Mental illnesses have symptoms that are identified as typical of each illness. However, at times symptoms can look different in men. We need to be willing to discuss this and, again, raise awareness. For example, men with depression and/or anxiety might exhibit anger or irritability, risk-taking behaviors, substance abuse, social withdrawal, or excessive work or avoidance. If we can have open discussions about these symptoms, it can lead to men getting the help they need. It goes back to awareness. Friends and loved ones need to be able to recognize these symptoms so that they can offer support or encourage their loved one to seek help. 

Acknowledging the High Suicide Rate Among Men

                  As we are raising awareness about men’s mental health, we need to remember that there is a high rate of suicide among men. Awareness efforts should recognize the suicide rates. Efforts should also be centered on prevention. This includes providing easy access to mental health services. Recognizing warning signs can help with this. 

Direct Suicide Warning Signs

• Talking about wanting to die or kill oneself
• Expressing feelings of hopelessness or having no reason to live
• Saying they feel trapped or that things will never get better
• Talking about being a burden to others
• Looking for ways to die, such as researching suicide methods or obtaining means

    There can also be emotional or behavioral changes including withdrawing from family, friends, and activities they previously enjoyed, loss of interest in work, activities, or hobbies, being noticeably depressed, anxious, or emotionally numb, increased irritability, anger, or aggression, dramatic mood swings, and risk-taking behaviors.

Support Systems That Can Help

                  Providing systems to support men with their mental health is crucial. We cannot leave this to just Men’s Mental Health Month.  It is important to work to provide access to therapy and counseling year-round. Encouraging the creation of more peer support groups for men is important. We also need to encourage men to join these groups. Doing this requires normalizing participation in these groups. Employee assistance programs can be an important support system. 

                  We have more crisis support systems than we have had in the past. It is important that we continue to advocate for funding of crisis support systems. Normalization is needed here as well. Men need to know that it is okay to reach out for help. They need to know that if they are in crisis they can call 911 or 988. They need to know that they can ask a family member or friend to help connect them to crisis support. 

                  Another important part of developing support systems involves education. We need to reach families with education about mental health. It is important to get education and resources in schools and workplaces. This goes back to one of the keys of mental health awareness. We need to make it okay to talk about mental health. We need to let men know that it is okay to talk about mental health.

Final Thoughts

                  Going back to the situation I opened this post with. I am realizing that I have failed at supporting my brother. I spend so much time talking about mental health. Maybe once in a while I need to ask my brother if he is okay. I cannot just talk about mental health without putting what I talk about into practice. I am not saying my brother has a mental illness. I just think maybe he might appreciate being checked in on. I ask you to do the same. Check in on the men in your life.

 

 

 

 

 

 

How to Cope with Depression and Anxiety: 5 Practical Strategies That Help Me Every Day

                  The third anniversary of this blog just passed on June 16. I missed it. Let’s look forward, though. With depression we absolutely need to look forward. I have shared different ideas for dealing with depression. We need to remember that there are always things we can try to ease our depression. Today, I am going to share a few things I am trying to help with my depression and anxiety. Often, both depression and anxiety hit me at the same time. So, some of my strategies help me with both. 

Interrupting the Depression Loop with a Playlist

                  Listening to music can help break the negative loop depression goes on. Many of us with depression experience negative thoughts or ideas running through our minds. It may seem like these thoughts are on a loop because they happen so frequently. I find that if I focus on lyrics when listening to music, I can interrupt the depression loop or anxiety spiral.  What the lyrics are saying is not as important as just syncing into those lyrics, although there are some great lyrics out there to connect to. I try to learn the lyrics of songs I like. Even if it is only for the brief moments the song is playing, I can distract myself with the lyrics. 

                  I have several playlists on my phone. They are for different moods and meet different needs. Creating the playlists is another way of disrupting the depression loop or stopping the anxiety spiral. Deciding on music that meets certain needs or helps certain moods can help us find hope in addition to the distraction. Let me give you an example of a mood lifting playlist. A few years ago, I worked at a school where the environment was contributing heavily to my depression and anxiety. I created a “Morning Work Drive” playlist. The songs played long enough to fill my commute. The lyrics of these songs spoke to me, and they were all by some of my favorite musicians. This playlist gave my mood a boost before I arrived at work, which helped with my mood once I was there. In all honesty, I still had to leave that position at the end of the school year, but the playlist helped me reach the end.

                  If music is something you find comforting or soothing, try making playlists and tuning into the lyrics of your favorite songs. Those lyrics might be able to replace that depression loop or anxiety spiral.

 

Walking and Noticing

                  Walking is known to help improve mood. There is a lot of research out there about this. Rather than go through the research I will just share my experience. 

Walking is the exercise I lean into. I used to walk by myself. I would often combine listening to music with my walks. Being alone and just walking without purpose helped me. Somehow it cleared my head. Some days it worked better than others. That is something to remember with anything you try to ease depression and/or anxiety. Some days they work better than others. 

                  Now, I walk with my dog. Getting a dog and having to walk her has given me a way to escape from my thoughts. I try to follow what my dog is doing. Like all dogs she stops to sniff. I try to follow her lead. No, I do not sniff, but I do stop and notice my surroundings. I try to notice what I see, smell, and hear. As I am noticing my surroundings, I am taking my mind away from the depression loop or the anxiety spiral. I try to name what I am noticing. That gets my mind using words other than what depression and anxiety want me to hear. It is an interruption. That interruption is important. When there is an interruption in the depression loop or anxiety spiral, it keeps them from pulling us in. 

                  I find that if I walk at a good pace in between the stops to notice (and for my dog to sniff), I get my heart rate up. This makes me feel better physically. Depression causes a feeling of being physically drained and heavy. Noticing as I walk makes me feel a little lighter. When I feel better physically, I can let my mind relax. That sounds easier than it is. One walk is not going to change things. It is the practice of committing to walking that makes the difference. You do not need a dog. Just get out there and take a few steps. Maybe the first walk is only five minutes or just to the corner. That is okay. Just get out there and walk. 

 

Journaling

                  I share a lot about how writing helps me heal. It is a major part of how I cope with depression and anxiety that barrels down on me. Journaling is only one form of writing I use. With journaling I tend to write whatever I am feeling or thinking in the moment I have my pen poised over my journal. I use journaling to brain dump. Is that a legitimate term? I do not know, but I am going to use it because it aptly describes what I am doing. I am letting everything flow out of me. I journal to free my mind. I journal to process the thoughts and feelings in my head. My journal gives me a space to store everything. Once my words are stored in my journals, I can choose if or when I go back and reread them. Rereading can be a form of processing. It can also allow us to see where we have come from. 

                  Other times when I use prompts that I find online or in books. Prompts can help guide our writing, which can prevent us from getting stuck on a specific idea. This can be important if we have been journaling about something painful and need a break. Trust your gut as to whether you should be writing whatever you need to get out of your head or whether you need the distraction of a prompt. 

 

Meditative Drawing

                  Again, I am using a term that I made up for something I am doing. I did not look up whether this is a real thing or if this term is already in use. For me meditative drawing started from two conversations with mental health professionals. First, my psychologist mentioned I could try drawing when I did not want to deal with words. It was an alternative to journaling. I quickly bought a sketchbook, drawing pencils, and ink pens. The problem was I knew I was not good at drawing. So, the sketchbook and drawing implements sat untouched even though I meant to give it a try and kept telling myself I would.

                  Then the psychiatric nurse practitioner who leads my TMS (transcranial magnetic stimulation) treatment suggested I try creating a pattern that I drew repeatedly when I was struggling with depression or anxiety. She suggested using circles. Somehow that made drawing seem easier. I pulled out the sketchbook and have been drawing simple designs, mostly variations of the same one. I use different colors to express different emotions or feelings. I always title the drawing at the bottom. The title reflects whatever I was thinking or the purpose the drawing was meant to serve. 

                  Drawing circles helps me. It slows my anxious thoughts, and it quiets my depressive thoughts. I do not know how this is working. I can just tell you that it is working. I am benefiting from drawing. 

 

Breathing

                  Breathing practice is something I struggle with, but I wanted to include here because I am trying it. I know it benefits many people. I am confident that if I keep it simple, I will improve at using breathing practices. 

                  Breathing practice helps us relax when we are agitated or anxious. This happens when the breathing practice slows our heart rate down. Breathing practices can help us bring our focus to something when we are struggling with depression. It does this by shifting our focus within in our brain by decreasing activity in certain areas of the brain and increasing it in others.

                  There are many ways to focus on our breathing. I think the simplest way might be inhaling for a count of four and then exhaling for a count of eight. 

Let’s take a quick look at a few breathing practices:

·      Box Breathing (also known as the 4-4-4-4 Technique)

o   Inhale for 4 seconds, hold for 4 seconds, exhale for 4 seconds, hold for 4 seconds

This can help calm acute panic, lower immediate stress, and sharpen focus.

 

·      Diaphragmatic Breathing 

o   Focus on deeply breathing into the stomach instead of the chest. 

This type of breathing can reduce physical tension and stabilize our baseline mood.

 

·      4-7-8 Breathing

o   Inhale for 4 seconds, hold for 7 seconds, exhale forcefully for 8 seconds

This can help manage anxiety, stop racing thoughts, and can help us fall asleep faster.

 

·      Physiological Sigh

o   Two quick inhales through the nose followed by one long exhale through the mouth

This can stop stress. It also lowers heart rate.

 

·      Alternate Nostril Breathing (also known as Nadi Shodhana)

o   When breathing alternate blocking one nostril at a time during inhalations and exhalations. 

This can help balance the nervous system. It also reduces mental clutter and eases mild depression.

 

Final Thoughts

                  Living with depression, anxiety, or other mental illness is not easy. In addition to the work we do with our mental health care professional, medication, therapy, and treatment, we need to find ways that we can manage our mental health. We need to engage in practices that help us live with our illness. We cannot leave all our healing up to our mental health care professionals. They are important in treating us and supporting us, but we share in the work to bring healing. In this post I have shared some ways we can improve our mental health. The practices are meant to bring some relief. They are meant provide support. They are not meant to cure us or replace our treatment. These practices help us become active in our own healing. I caution that there will be ups and downs. Still, I encourage you to try whatever strikes you as something you would be able to do or would like to do. 

                  When we live with mental illness, we need to be willing to work on our mental health. We need to be willing to give things a try. We need to be active in trying to heal.