This is PathwaysVoice, our blog of interesting comments, observations, news, and helpful insights into the world we see around us. It is our effort to support, care, guide, and motivate each of us on our individual paths.
Susan Heitler Ph.D.Resolution, Not Conflict Nervousness can feel awful. What are the up and downsides of treatment options? To understand why pills for treatment of anxiety can be problematic, look first to the growing understanding of the downsides of pills for physical pain. Physician Russell Portenoy, a prominent New York pain specialist, twenty years ago spearheaded the movement that encouraged doctors to prescribe more painkiller medications to suffering patients, a movement that helped many but at the same time minimized the dangers of addiction. Now Dr. Portenoy has come full circle. He has become a leader in warning physicians and the general public of the addictive potential of painkillers, particularly when used for on-going long-term problems as opposed to for brief acute pain such as from a surgery. Many doctors similarly have begun to rethink the frequency with which they prescribe drugs to quell physical pain. The Wall Street Journal (12-15-2012) reports that 16,500 people die of overdoses annually from these medications, more than from all illegal drugs combined. What about taking pills for easing anxiety, a particularly common form emotional pain? Many physicians prescribe anti-anxiety medications to decrease feelings of worry, stress, stomach butterflies, and other anxiety manifestations. For patients who are suffering with extreme and chronic anxiety, the medication is a godsend. They can relax and live normal lives. That strategy though, like use of physical painkillers, risks addiction. Many anti-anxiety drugs, like physical pain reducers, are highly addictive substances. So while using them briefly to calm short-term major anxiety may be worthwhile, wariness is appropriate. Benzodiazepine medications, with familiar names such as Halcion, Klonopin, Librium, Resteril, Valium and Xanax, are among the most widely prescribed pharmaceuticals in America, and also the deadliest. Like opioids, benzodiazepine drugs are highly addictive if used for more than a brief period of time and on a regular, as opposed to occasional basis. Instead of risking addiction and potential overdose from benzodiazepines, doctors and nurse practitioners are increasingly prescribing antidepressant drugs for anxiety relief as some of these have sedative (relaxing) side effects. These SSRI medications have another downside however. They make you drug dependent, which is the same as addicted but without feelings of craving. Ceasing the use of these medications once you have been on them for some time can engender sick feelings and/or trigger an intense withdrawal-induced depression. Anxiety Treatment Re-Thinking TV pharmaceutical ads would have us believe that anxiety, an unpleasant sensation for sure, is a chemical phenomenon that needs to be subdued, soothed, or in some other way eliminated. Their recommended route to calm is to take a pill. A similar re-thinking as what has happened with opioids for physical pain may be needed for this widespread prescribing by doctors of drugs to quell the emotional pain of anxiety. Is there any way that is anxiety good for you? The good news is that anxiety, like physical pain, is almost always a valuable signal. It tells you that troubling is brewing. Like a blinking yellow traffic light, anxious feelings signal “Pay Attention. There’s a problem here that merits addressing!” Because anxiety warns you that there is a problem that needs to be solved, a best first response to anxiety is to get to work gathering information about the problem and mapping an effective plan of action for dealing with it. Already then the anxiety is likely to begin to lift. Anxiety in this regard...read more
my MorinWhat Mentally Strong People Don’t Do There’s an unfortunate myth that says mental illness stems from weakness. There’s a pervasive belief that mental illness stems from weakness. It’s not true. Unfortunately, however, this belief is so widely held that some people don’t recognize that they’re attaching a stigma to mental illness. When I wrote a book about mental strength, I received comments from people accusing me of stigmatizing mental illness by talking about mentally strong people. They were assuming that mentally strong people couldn’t have a mental illness, but the truth is, many individuals who have a mental illness are mentally strong. In fact, some of the strongest people I’ve ever met were those who entered my therapy office seeking help for illnesses like PTSD or depression. Those who assume otherwise don’t understand mental strength. And they certainly don’t understand mental illness. Mental Illness Isn’t Treated the Same as Physical Illness When someone develops a physical illness, like cancer, no one ever says, “He wasn’t physically strong, was he?” Instead, we look to things like genetics, the environment, and the person’s immune system. While it’s clear that a nutritious diet, plenty of sleep, and regular exercise can prevent some health issues, other physical conditions aren’t 100 percent preventable. From the common cold to Alzheimer’s, science hasn’t yet given us a blueprint to prevent all illness. Fitness guru Bob Harper is a perfect example: As a personal trainer best known for his role as a coach on The Biggest Loser, Harper appears in a variety of workout videos, and he’s authored many books about diet and fitness. And when Harper experienced a heart attack, no one questioned his commitment to good health. Instead, people used his story as a reminder that you can’t control your genes. Wouldn’t it be nice if we did the same for people with mental illness? Instead of gossiping about someone who is hospitalized for anxiety or blaming someone with depression for being lazy, what if we applauded them for staying strong? A healthy lifestyle can go a long way toward preventing mental illness. But just like you can’t prevent all physical illness, you can’t prevent all mental illness. And people who have a mental illness can be just as strong — even stronger — than those who don’t. Just like someone who has diabetes can still be physically strong, a person with depression could be highly mentally strong. After all, someone with a mental illness has several complicating factors that make it even more difficult to develop mental muscle. We Need to Talk More About Mental Strength Talking about mental strength isn’t about shaming people with a mental illness. Instead, it’s about encouraging a healthy lifestyle that could prevent some mental health problems. Holding more conversations about the habits that develop mental muscle can reduce the stigma associated with mental illness. It can also encourage people to seek help if they experience symptoms or warning signs. And it’s important to note that being mentally strong isn’t the same as acting tough — it’s not about seeing how much suffering you can endure. It’s about taking steps to reach your greatest potential, which often involves asking for help when you need it. Want to learn how to give up the bad habits that rob you of mental strength? Pick up a copy of 13 Things Mentally Strong People Don’t...read more
Raychelle Cassada Lohmann MS, LPCSTeen Angst Addressing the misconceptions of depression. Depression affects an estimated 300 million people of all ages worldwide. It is a common, and serious mood disorder that alters how people think, feel and behave. Unlike being unhappy, depression is an intense feeling of deep sadness and despair that can last for days, weeks and even months. The symptoms of depression can include feelings of hopelessness, rejection, poor concentration, lack of energy, sleepproblems, and sometimes suicidalthoughts. Depression is not a choice, it is an illness. Depression is a serious medical condition that according to the Centers for Disease Control and Prevention, affects approximately 8% of the U.S. population ages 12 and up. Although there are effective treatments, less than 50 percent worldwide seek professional help. People may be reluctant to get help for a variety of reasons, such as they think they can overcome depression on their own, or they believe that no one will understand how they feel. There are a lot of myths surrounding depression and the two most common are: depression is triggered by a negative life event, and people who are depressed should find something that makes them happy and “snap out” of the depression. Both misconceptions are not accurate portrayals of depression, and both feed into the stigmatization of the illness. 5 things to know about depression: It can affect anyone. Depression can affect people of any age, ethnicity, geographic location, or social position. It is common. The World HealthOrganization estimates that depression will be the second highest medical cause of disability by the year 2030, second only to HIV/AIDS. It may not have a cause. The onset of depression may not be triggered by a specific event. Depression can occur at any time and any place. It can’t be fixed quickly. Some who suffer from depression attempt to alleviate their symptoms by self-medicating. Their attempt to find a fast fix can lead to a life of self-destruction. They may turn to alcohol, drugs, sex, or other dangerous behaviors to help them cope with their thoughts and feelings. It responds to treatment. In nearly 80% of the cases, people who receive professional treatment for depression say it helped them feel better. Treatment may include a combination of medication, therapy, or alternative approaches. 5 ways to support someone with depression: Be patient. Depression is an illness that needs to be professionally treated. Healthy coping skills are learned and rehearsed, and that takes time. Listen without judgment. Talk less and listen more. Allowing someone to speak aloud their thoughts and feelings can be extremely beneficial. Focus on the present and take small steps. With depression, looking at the big picture can be overwhelming. That’s why it’s good to live in the present, and take one day at a time. Get involved and do something. Get moving, go to the mall, watch a movie, cook a nice dinner or just go to the park for a walk. When people are depressed they tend to isolate themselves from others. A great way to keep connected is by engaging in a fun or relaxing activity. Learn about depression. Knowledge is power. The more we know, the more we can proactively change the perception of depressi Depression is a real and serious condition. No one chooses to have depression, just like no one chooses to be ill. Odds are most of us know someone, friend or family member, whose...read more
Susan Heitler Ph.D.Resolution, Not Conflict If you feel down on yourself, irritable, and discouraged, try this strategy. Feeling like there is a dark cloud over you? Like you don’t have your usual enthusiasm, and are having trouble motivating yourself to do things? Maybe more self-critical than usual? Isolating at home instead of wanting to go out or do things with others? These signs of depression are important to notice. At the same time, why you are feeling down may remain a mystery. How to feel better may feel equally challenging. In the TEDx talk below, I offer a surprisingly easy three-step route to identifying the cause of your low feelings and then lifting away the dark cloud. [Note that these understandings apply to the depressed feelings of non-physical origin, which are the vast majority depressive episodes that most people deal with. Physical factors such as insufficient sleep, post-operative depression etc. may need additional treatments.] The beginning of the TEDx talk explains that in the face of depressed feelings many, and maybe even most, people either assume there’s nothing they can do that will help them to feel better, or go to a physician to get antidepressant pills. Both of these routes can have significant downsides. Here’s an alternative. At about four minutes into the talk I explain what triggers depression. If you are already aware of the risks of medications, you might want to begin there. I then focus on the three steps that can lead you up and out, back to the realm of well-being. For more information on the causes of depression and how to release yourself from it, see my new book Prescriptions Without Pills: For Relief From Depression, Anger, Anxiety and More. Also, do check out the free videos and downloadable worksheets at prescriptionswithoutpills.com. Help yourself to feel better, soon. Or ask a therapist to guide your use of these techniques. Life is not meant to be an endurance contest. If you or someone you know has been feeling depressed, take action, now. Say good bye to those depressed feelings,...read more
Amy MorinWhat Mentally Strong People Don’t Do While many other quarterbacks might have crumbled under pressure, Tom Brady’s mental strength became most apparent in the second half of the 2017 Super Bowl. As many New England Patriots fans lost hope for a win by halftime, Brady led the team to in one of the most stunning comeback victories in the history of the sport. What’s the secret to Brady’s success? He undoubtedly puts in countless hours of practice on the field, but he also reports relying on brain exercises to sharpen his decision-makingskills. His dedication to training his brain to perform at its peak appears to be one reason he’s secured the title of best quarterback of all time. You might not need to demonstrate mental toughness on the athletic field, but you certainly do need mental strength to be a champion at whatever it is you do in life. Whether you’re an accountant gearing up for tax season, or a stay-at-home parentreadying the family for back-to-school, your brain can be greatest best asset or your worst enemy. These four brain exercises can train your brain to perform at its peak: 1. Play to win. It’s doubtful that Brady entered the second half of the game telling himself, “I just hope we don’t embarrass ourselves.” Judging by his poise, it’s much more likely he was focused on winning. Researchers from the Institute of Sport in England discovered that a simple shift in the way you think about your performance can make a big difference in the outcome. If you walk into a situation thinking, “I hope I don’t lose,” you’ll perform worse than if you think, “I’m here to win.” Take a deep breath and tell yourself, “I’m going to do well.” That slight change in your thought process will increase your chance of success. 2. Practice mindfulness. Studies show that mindfulness changes that way the brain responds to stress. That’s why the military has started teaching mindfulness to soldiers prior to deployment: Gaining better control over their brains helps soldiers respond to difficult situations with less anxiety. Athletes from Kobe Bryant to Derek Jeter have also incorporated meditation into their training routines. Phil Jackson, former coach of the Chicago Bulls and the Los Angeles Lakers, says teaching his players mindfulness helped him claim 11 NBA titles. Clearly, raising your awareness of the present moment gives you a major competitive advantage, especially in today’s distracted world. 3. Visualize success. In an interview with Mindbodygreen, Olympic gold medalist Lindsey Vonn said, “By the time I get to the start gate, I’ve run that race 100 times already in my head, picturing how I’ll take the turns.” Mental imagery has a profound effect on the way your body behaves. Studies consistently show that no matter your skill level, visualizing yourself going through the motions will help you do better. Whether you’re about to ask for a raise or give an important presentation, imagine yourself going through the motions. Thinking about each step in the process can help you perform at your peak. 4. Use positive self-talk. When asked about his decision to leave the Cleveland Cavaliers to play for the Miami Heat, LeBron James told reporters, “I wanted to do what’s best for LeBron James and do what makes LeBron James happy.” Initially, social media buzzed with teasing about James referring to himself in the third person. Although some suspected he was losing touch with reality, the truth is that...read more