The Benefits of Naming Your Feelings

In my last blog, I discussed the benefits of knowing your depression cues. Specifically, the benefit of identifying them and naming them out loud, or through journaling. But why does this matter?

In his book Uncovering Happiness: Overcoming Depression with Mindfulness and Self-compassion, Dr. Elisha Goldstein highlights research done by the UCLA Social Cognitive Neuroscience Laboratory. Using functional magnetic resonance imaging (fMRI), scientists were able to see that when they scanned the brains of people while they labeled their feelings, a specific brain region in the prefrontal cortex, which is less active in depressed people, was activated. They also saw that activity in the amygdala, the part of the brain that senses fear and prepares us for fight or flight, was reduced. This part of the brain is typically overactive in people experiencing depression. 

The concept of effectively identifying, naming and acknowledging our feelings is called affect labeling. Scientists theorize that it works because when a depression cue is triggered, we begin to experience fear, which activates the amygdala. When our amygdala is activated, we begin to feel those physiological experiences that are often associated with feeling panicky or stressed, such as increased blood pressure or shallow breathing. By using affect labeling, we are able to calm down the activity of the amygdala, bringing the brain back into balance. As we practice this skill over the course of time, we are able to re-wire our brains, resulting in naturally antidepressant brain chemistry.

So, the clique about therapists asking “And how does that make you feel?”...there is science behind it!

If you think you may be experiencing symptoms of depression, make an appointment with me today. 

The Value of Knowing your Depression Cues

Depression can be so draining and overwhelming. In addition to feeling sad, fatigued and unmotivated, among other things, it can also leave us feeling very hopeless. The good news is that that it’s treatable, and there are many things that you can do on your own to learn to manage it. In his book Uncovering Happiness: Overcoming Depression with Mindfulness and Self-Compassion, Dr. Elisha Goldstein notes that one very important strategy for managing depression is identifying and acknowledging your depression cues. 

One of the cornerstones of Cognitive Behavioral Therapy (CBT) is the concept that thoughts, emotions, sensations and behavior are all factors that are connected to one another to impact mood. They can all also signal cues that a period of depression is beginning. Goldstein notes that “depression often starts with a cue, or trigger: an initial sense of unease that can be brought on by a subconscious thought, memory, physical feeling, emotion or some external life event”. 

The cue is typically followed by:

Thoughts- Rehashing negative events, future planning, anticipating possible negative scenarios. This thought process creates more stress.

Emotions- The more your negative thoughts loop around, the more anxious and depressed you become.

Sensations- You may begin to experience fatigue, changes in sleep, appetite or concentration. 

Behavior- The combination of these factors may prevent you from feeling motivated or able to make healthy choices, such as exercising or spending time doing something that makes you feel good. 

By recognizing your typical depression cues, you will be more prepared to notice and interrupt a period of oncoming depression. Think back to times in the past that you have experienced depression and see if you can identify some of the first warning signs. These are the cues to be on the lookout for. 

For more information on how noticing your depression cues can benefit you, stay tuned for my next blog, where we will dive in to the research behind the benefits of acknowledging your feelings directly. 

If you think you may be experiencing symptoms of depression, make an appointment with me today.

5 Steps for Mindful Eating

Almost everyone eats too much occasionally. I love food, and I’m particularly likely to eat way more than necessary if I’m enjoying one of my favorite foods, like pizza or nachos. But I can also turn to food to feel better when I’m in a bad mood, to celebrate when I’m in a good mood, or to pass the time if I’m bored. Occasional overeating isn’t the end of the world, but overdoing it regularly isn’t good for your health, either emotional or physical. 

Mindfulness has become a popular buzzword recently, and for good reason. Approaching various areas of your life mindfully can have all kinds of positive benefits. When it comes to mindful eating, what it really means is to be intentional with the way you eat, rather than sitting in front of the TV and surprising yourself when you realize you’ve accidentally finished the bag of Cheetos (I’ve been known to do this).

Check out these 5 tips for mindful eating:

1. Check in with yourself

How do you feel emotionally? Are you using food to manage boredom, sadness, or anxiety? If so, consider if there is something else you could try first.

What do you notice in your body? Are you actually hungry? 

2. Observe your food

Before you dive in, take a moment to visually observe your food. Take note of whether it looks appealing, which may help with enjoyment and satisfaction. Notice your portion size. Is this enough food to fill you up? That should help determine whether you need a second round. If it’s way too much food for one sitting, make sure you take note of that and adjust accordingly.

3. Taste your food

If you’re in a rush or just mindlessly eating, it’s easy to wolf down an entire meal without actually tasting it, let alone enjoying it. Taking time to eat more slowly and taste every bite will lead to feeling more satisfied, which can help reduce overeating. 

4. Check in with yourself- again!

Pay attention to how you’re feeling as you eat. It can take up to 20 minutes before your brain registers that your stomach is full, so pay attention as you eat. What do you notice in your body? Taking time to eat slowly and check in with yourself after every few bites can help alert you when it’s time to stop. 

5. Recognize when you are using food to manage emotions

Unlike other addictions, we can’t go without food, so abstinence isn’t an option. Food is one of the easiest ways to get immediate gratification, self-soothe and experience pleasure, which is why so many of us overeat. However, chronic overeating or bingeing can be a sign of an underlying emotional issue, and can lead to serious health problems. 

If you think you may need help managing binge eating or if you want some extra support learning to eat mindfully, make an appointment with me today!

The 5 Most Common Misconceptions About Antidepressants

Over the 8 years that I have been in private practice, I have treated hundreds of clients. Many of them have presented with depression and anxiety, and of those, many of them have decided to include medication as part of their treatment, in conjunction with therapy. Medication isn’t necessary for everyone, but when symptoms of anxiety and/or depression are persistent, severe and disruptive enough, it can make a world of difference. 

When I approach clients about the option of considering medication, many of them express immediate skepticism. They have heard negative feedback from a friend or family member who once took medication, or they’ve done some internet research and felt intimidated by what they read. 

Anyone can find an endless amount of information online. I’m writing this blog to share my anecdotal experiences as a therapist, I have supported many through the transition to first time medication use. 

Here are the 5 most common misconceptions that I hear about medication use:

1. I will experience negative side effects. While it’s true that some may experience side effects from medication, a severe negative reaction is extremely uncommon. During my time working as a therapist, I have seen maybe a handful of people experience some type of side effect that they experienced to be disruptive enough that they discontinued medication use immediately as a result. Most commonly, my clients have experienced some difficulty staying asleep over the first few weeks of medication use while their bodies become accustomed to it. After this time period, this issue typically subsides and sleep improves quite drastically. Decreased sexual interest and pleasure is also common in both men and women, though this is temporary and reversible. 

2. It will blunt my emotions and I won’t be able to feel anything. This is not the case. In fact, depression is very likely to cause decreased interest and pleasure, as well as a negative change in thought patterns. Medication works by reducing the symptoms of depression, allowing users to experience their actual feelings more accurately, rather than their symptoms. The protocol for prescribers is start off with the lowest dose and increase from there if needed. You should never feel blunted or “zombielike”. 

3. It will change my personality. Medication can’t change your personality. The visual I always have is that antidepressant medication reaches in to your brain, grabs hold of the depression or anxiety, and removes it. What you’re left with is the opportunity to return to your authentic self, without the haze of depression hanging over you. 

4. I’ll become dependent on it. While some medication can be habit-forming, this is not the type of medication that would be prescribed to treat depression or generalized anxiety. These types of medications are in a class called Benzodiazepines, and would be used to treat panic attacks. The medication that is prescribed to treat depression and generalized anxiety is typically in a different class of medication, called SSRIs (Selective Serotonin Reuptake Inhibitors) or SNRIs (Selective Norepinephrine Reuptake Inhibitors), and these medications are not habit forming. Although it is necessary to follow your doctor’s plan to assist with titrating your dosage down before completely discontinuing one of these medications, this can be done within a month or so, and you can decide to discontinue medication use at any time. 

How you feel emotionally when you discontinue medication use will depend entirely on your own life circumstances and physiology. Some will feel just fine after discontinuing medication use, while others may realize that the reason they were feeling better is because the medication was working, as their symptoms have returned. The only circumstance in which you would come to “depend” on a medication is if the symptoms of your depression or anxiety are so severe that it’s difficult to function without it. 

5. I’ll have to take it forever. Starting a trial of antidepressant medication does not mean a life sentence of medication use. You are free to discontinue and revisit medication use at any time, and many people do. Again, your individual experience will determine whether you choose to use medication long-term, or only temporarily. You are entirely in charge of your own health decisions. 

Medication isn’t right for everyone, but for many, it can be a game changer. I have seen so many people feel significantly better as a result of medication use. At the very least, it’s important that people are aware of the facts, rather than making assumptions based off of misinformation, so that everyone can make an informed decision about their own health. 

If you are experiencing anxiety and/or depression, make an appointment with me today.

5 Lifestyle Changes to Boost your Mood

We all feel a little down sometimes. Serious changes in mood and functioning may require treatment, such as therapy and/or medication. Whether you are experiencing symptoms of depression or just going through a little slump, there are several lifestyle changes you can try on your own that are proven to have a positive influence on mood. 

Try these tips:

1. Exercise. Exercise releases feel-good endorphins and other natural brain chemicals that can enhance your mood. Intense aerobic exercise is not necessary to gain the benefits of exercising. Regular walking and yoga, or anything that gets your body moving, can be just as helpful. 

2. Meditate. Those who practice regular meditation may experience decreased depression and anxiety. Research also indicates that in addition to the mental health benefits of meditation, regular practice may lead to changes in the brain that help to manage stress and improve compassion and self-awareness. 

• There are tons of free meditation apps that will guide you through led meditations so that you don’t have to go it alone. Spend some time looking for the one that works best for you.

• Integrating meditation into your daily practice does not have to be time-consuming. Most led meditations are 7- 10 minutes long. 

• Meditation can be used in the morning to get your day off to a good start, in the middle of the day to decompress from work stress, as part of your bedtime routine to start winding down, or anywhere in between!

3. Maintain a proper sleep routine. The average adult requires 7-9 hours of sleep every night in order to get the rest that their brain and body needs. Many people with anxiety and/or depression struggle with falling asleep and staying asleep. A regular sleep routine is essential to maintaining health and routinely not getting enough sleep leads to lowered mood and poor cognition. 

• Create a regular bedtime routine for yourself. This will signal to your brain that you are starting to wind down for the day. This can include drinking some Sleepy Time tea, taking a bath or shower, reading in bed and meditation.

• Limit screen time at night. Looking at your phone or TV screen stimulates cognitions and the light that your screens emit send signals to your brain that it’s still daytime. 

• Even if you are having a hard time sleeping, stay in bed. Do not distract yourself by getting up and changing your environment, reading or watching TV. Even if you are not asleep, your body is benefitting from much-needed rest. 

4. Practice Gratitude. Take time each day to recognize the good in your life. Research shows that people who practice daily gratitude have improved mood and decreased depression. Whether you keep a journal or just take a moment to recognize these thoughts to yourself, try to be aware of all that you have rather than taking it for granted.

5.  Prioritize proper nutrition. We all know that proper nutrition is good for our physical health, but many of us underestimate the importance that it plays in our brain health. Proper nutrition is one of the easiest ways to boost your mood, and it has the bonus of providing many other health advantages as well.

• Avoid highly processed foods that are high in sugar, fat and sodium

• Follow nutritional recommendations and prioritize fruits and vegetables, lean protein and healthy fats 

• Brightly colored fruits and vegetables provide the most nutrients.

If you feel that your change in mood may require more than a few lifestyle adjustments, therapy may be recommended. A therapist can help determine whether you may be experiencing depression and assist with identifying a treatment plan that will work for you. For help managing your mood, make an appointment with me today. 

Is all Suffering the Same?

Many of the people I see in therapy are experiencing depression and/or anxiety. They feel down, unmotivated and apathetic about life. They may be experiencing a lot of worry and feeling very negatively. People regularly express a sense of shame that they aren’t more grateful, acknowledging that others have it worse. They ask themselves how they can feel so badly all the time when they have a nice home, a loving family, a good job, and good health. People out in the world are starving and the news gets sadder every day. They wonder why they can’t  just be happy with what they have.

I am often in the position of reassuring my clients that their feelings are valid. Yes, others may be experiencing life circumstances that would traditionally be considered “worse”, but anxiety and depression are real, and they don’t discriminate. It doesn’t matter how good your life may be on paper. If depression has seeped through the cracks, it can take over. 

In her book Rising Strong, Dr. Brene Brown references this common feeling. She calls it comparative suffering. She notes that the refugee in Syria does not benefit if you conserve your compassion by withholding it from your neighbor who is going through a divorce, or from yourself. There is enough compassion and empathy to go around, and all are deserving. Brown notes “Yes, perspective is critical. But I’m a firm believer that complaining is okay as long as we piss and moan with a little perspective. Hurt is hurt, and everytime we honor our own struggle and the struggles of others by responding with empathy and compassion, the healing that results affects all of us.”

I couldn’t agree more. All pain is valid and worthy of acknowledgement. Perspective is necessary in all situations. So drop your shame and guilt about not feeling happy and seek some support in your process of reclaiming your life. 

For assistance in managing anxiety or depression, make an appointment with me today.

Helping Kids Cope with Tragedy

Blog written by Emily Eichmeier, LCSW, high school social worker and therapist specializing in treating children, adolescents and young adults.

As the news of the El Paso and Dayton (or Parkland..or Las Vegas...or countless others) came out, I prepared myself to have conversations with the children, teens and families I work with about how this horrific event impacts them.  Unfortunately, stories of shootings in schools, public spaces, or communities are no longer uncommon. As a parent, you may be wondering the best way to talk to your children about this type of violence. You may even question whether or not you should talk about it at all.  Below are some tips to guide these difficult conversations. 

Consider Their Age

Where your child is at developmentally can impact how you choose to talk to them about violence.  Their age, maturity and understanding of the impact the event has had can determine how much detail you go into.  The American Psychiatric Association recommends a child be at least 8 years old before your discuss these topics unless they directly impact your family. For elementary age children, be prepared to answer questions.  It may also be helpful to focus on the positive, such as talking about the great impact first responders have. For pre-teens and teens, let them share how they’re feeling and follow up with how they can help. This may be through making a donation as a family to the victims or discussing positive ways to give back to your own community.  It is also important to be factual when having these conversations. Be sure to refute any rumors or unconfirmed details about these events.  

Help Them Cope

Let your child show emotion and teach your children healthy ways to cope with these difficult emotions.  Encourage them to express themselves through activities such as art, music, writing and especially through talking to you or other trusted adults such as teachers or school counselors.  Validate how their feeling by letting them know it is very normal for them to be scared, sad or nervous after hearing about the event. One thing you may want to monitor is their exposure to the event.  Constant exposure or repeated images of a violent act can be distressing. Try to jump back to your normal household routine rather than letting the media coverage alter your normal family activities.

Help Them Feel Safe

Reassuring your child that they’re safe is one of your biggest roles as a parent.  Children often wonder if it could happen to them when they hear about a tragedy. Talk to them about all the ways in which you, your child’s school and the community are working to keep them safe on a daily basis.  An extra hug, special trip to the park, or one more story at bedtime are just a few small ways in which to show your child some extra love on difficult days like this.  

Written by: Emily Eichmeier, LCSW

How to Do a Mid-Year Check-In

Well, July has arrived and we are officially (a little more than) half-way through 2019. I was introduced to the suggestion of a personal mid-year check-in while I was listening to the Rise Podcast with Rachel Hollis (if you don’t know her, check her out for some high energy business and personal motivation!). The idea of taking time to check in with yourself is something that I talk about with clients all the time; how are you feeling, what are you thinking, etc. I love the idea of checking in with yourself regularly about how you’re doing with reaching your goals, as many of our New Year’s resolutions are often long-forgotten by the time summer rolls around. 

Doing a mid-year check-in is a great way to review your goals, evaluate your progress, and prioritize how you want to move forward. 

So how do you do a mid-year check-in?

1. Review your goals for the year. If you don’t already have them, set them. No better time to start than the present!

2. Reassess. If you are on-track to be where you wanted to be, congratulations! Keep up the good work! If you have fallen behind, reassess. Don’t just quit. What would be a more realistic, manageable goal for the rest of the year? Keep working towards that!

3. Be honest with yourself. Do an honest inventory of what it would really take to reach your goals. What would need to change? Is it realistic? 

4. Audit your calendar. Check in to see if you are using your time well. I did this recently. I felt like time was just slipping through my fingers and I wasn’t able to get nearly as much done as I wanted to. I did a calendar audit and realized that I need to wake up earlier (NOT happy about that one!) and spend less time on social media. Making a few tweeks has helped me to maximize my time and get closer to accomplishing my goals.

5. Double down. Identify areas where you will see the most impact if you double down on your efforts- then get down to business!

6. Block out time for fun and rest. Create designated time and stick to it. Maximizing your time and getting the most return for your effort only works if you allow yourself time to have fun and ample time to rest. These are often two of the first things to go when we are working hard towards a goal. We often view them as a distraction or a waste of time, causing feelings of guilt if we aren’t working hard every moment. In reality, fun and rest are crucial to have a full life and creating all of the emotional fuel that is needed for your hard work. 

Best of luck in reaching your goals!

For help identifying, setting and sticking to your goals, make an appointment with me today.

5 Ways That Personality Traits Can Enable an Emotional Blackmailer

In the first four blogs of this series, I reviewed the warning signs and behaviors of emotional blackmailers, based on Susan Forward’s book Emotional Blackmail: When People in Your Life Use Fear, Obligation and Guilt to Manipulate You . In this post, we’ll take a look at the role of the target’s personality traits that help to enable and bolster the blackmailer’s game. This is not to suggest that the target is in any way responsible for the blackmailer’s abuse, but rather to clarify how our own vulnerabilities may make us an easier target for a skilled manipulator.

Traits that make us vulnerable to blackmail:

1. The approval junkie- Seeking approval and enjoying the feeling is normal and healthy in moderation. For some, receiving outside validation is the only way to feel secure. When a blackmailer picks up on this trait, it gives them a road map for how to best manipulate us. If they withhold their approval when they don’t get what they want, they can create enough insecurity and discomfort that their target will voluntarily change course to meet their requests in order to feel better about themselves.

2. The anger avoider/ peacemaker-Most of us don’t enjoy engaging in conflict, but for some, the idea of causing anger and conflict is truly terrifying. They will do anything to avoid it, which means that they don’t speak up about their own needs and don’t challenge others when they feel that they are being taken advantage of. If a blackmailer knows that you will do anything to avoid conflict, it gives them license to behave however they want, because they know that they won’t be challenged.

3. The blame-taker- Taking responsibility for ourselves is positive and something I certainly encourage. However, it can become problematic when we begin accepting blame for everything, including things that are not our fault. This personality trait fits perfectly into the blackmailer’s plan, because they are already operating from the perspective that if you are unhappy with something that they have done, it’s your problem, not theirs.

4. The bleeding heart- As Forward notes, empathy and compassion are positive qualities. For some, their sense of pity for others can overpower their sense of what’s reasonable, causing them to be put-out and taken advantage of as they try to support someone else. Blackmailers have a keen eye for someone who will be drawn to someone else’s neediness and support them without question, often playing up their vulnerabilities in order to garner more sympathy from their targets.

5. The self-doubter- While questioning our own thoughts and keeping an open mind to others’ perspectives can be a strength, it can also become problematic when we are unable to stand firm in our knowledge and beliefs. Since blackmailers are master manipulators, they are often very skilled at revising history in a way that makes us questions ourselves. People who have been gaslighted in abusive relationships are particularly susceptible to this. If a blackmailer can get us to question our own memories and experiences, they can easily re-frame any situation to meet their own needs.

As Forward says, “everyday of our lives, we teach people how to treat us by showing them what we will and won’t accept, what we refuse to confront, what we’ll let slide.” In this way, we are either setting healthy boundaries or inadvertently giving the blackmailer a tutorial on how to best control us. You can set expectations early in a relationship by standing up for yourself, setting limits, confronting the blackmailer’s bad behavior and letting them know that it’s unacceptable.

For more on this topic, I recommend picking up a copy of Emotional Blackmail: When People in Your Life Use Fear, Obligation and Guilt to Manipulate You by Susan Forward, Ph.D. (1998).

If you think you may be experiencing emotional blackmail or may benefit from assistance setting healthy boundaries in your relationships, set up an appointment with me today. I can help.

Emotional Blackmail: Tricks of the Trade

In her book Emotional Blackmail: When People in Your Life Use Fear, Obligation and Guilt to Manipulate You, Susan Forward explains the concept of emotional blackmail. In the first three blogs of this series, I outlined the signs that you may be a target of this type of manipulation, the styles of emotional blackmail, and how blackmailers play on your emotions by engaging you in an emotional FOG. In this post, I will outline Forward’s explanation of strategies that blackmailers use to get their way. The tools of the trade, so to speak.

Strategies that blackmailers use to manipulate:

1. The spin- Blackmailers are skilled at manipulating their targets by spinning the story. In the simplest terms, the blackmailer and the compliant target are the “good guy”, but if their target offers any resistance, they’re labeled the “bad guy”. They reinforce these roles by ascribing positive labels to themselves and their ideas and use negative labels to describe their targets. They often do this by challenging the character, motives and worth of their targets.

2. Pathologizing- Pathology is the science of determining the root causes of a disease. To pathologize someone means to label them as sick. Blackmailers will often engage in this behavior by suggesting, either directly or indirectly, that the reason you aren’t going along with their requests is because there is something wrong with you. For targets of blackmailers, this can be particularly hurtful because they will often use vulnerable information that you have shared with them (such as a history with depression, areas of personal insecurity or perceived weaknesses) to skew the facts and reinforce their position. If this persists, this type of accusation can often make us question our own judgment and sanity.

3. Enlisting allies- When blackmailers feel that they aren’t able to successfully get their way on their own, they may call on others to support their argument. As master manipulators, they are often able to convince others to see their perspective, and may enlist friends and family members to support their case and create additional pressure on their target. This tactic can become increasingly effective when blackmailers take it a step further to gather support from authority figures or a higher power, such as a therapist, a religious figure or a religious script.

4. Negative comparisons- Blackmailers will often play in to our feelings of self-doubt by comparing their targets to someone else, making statements like “why can’t you be more like…?”. They will identify an ideal model for behavior and then point out all of the ways that their target doesn’t measure up to this person. This type of manipulation causes us to feel deficient and creates pressure to adjust our values and behavior to be more like someone else who the blackmailers has deemed to be more desirable.

In the next edition in this blog series, I’ll explore the traits that make us most vulnerable to blackmailers.

For more on this topic, I recommend picking up a copy of Emotional Blackmail: When People in Your Life Use Fear, Obligation and Guilt to Manipulate You by Susan Forward, Ph.D. (1998).

If you think you may be experiencing emotional blackmail or may benefit from assistance setting healthy boundaries in your relationships, set up an appointment with me today. I can help.