Low Grade Depression

Photo Credit: NPR

Recently, Michelle Obama launched her own podcast, which is already successful with many people tuning in each week. The most recent episode has her discussing her “low grade depression.”

Actually, the statistics suggest that 1 in 3 Americans are suffering from a similar low mood, given all the stress we are under in our personal lives and the collective society. If you are having a consistent low mood these days, know that you are not alone.

For Obama, she noticed that she is slower in what she is doing, going to bed late, waking up in the middle of the night, not always working out — and trying to go easy on herself and accept how she is feeling in the moment without feeling guilt or shame about not getting to everything as she used to.

She notes she combats her low grade depression with exercise, routine, rituals such as eating dinner together, and finding ways to connect with her family on a regular basis. These are all sound steps to finding a rhythm that honors the current mood, but also allows one to be in the low mood without pressure to have to get out.

Americans are taught on some fundamental level that mental illness, like depression, is not real. Rather, we control our capacity to not feel depressed. If we are feeling this, there is something wrong with us. We are not positive enough, we are suffering from a condition that is not real, and more. So many of us have to pretend that we are not depressed in order to meet society’s expectations otherwise we are judged and dismissed.

I am grateful to Obama for naming her low grade depression to help name something that many, many people experience, especially during a pandemic where our lives have been significantly curtailed. I appreciate her normalizing that a low mood is something common and to be present to it rather than push it away. Naming it, being present to it, and taking action to help one’s self ease the depression are all keys to feeling better.

So, if you too are experiencing a low mood, make space for it. Create rituals and routines that will care for yourself. No need to push it away, but recognizing it and being honest that your are in a low grade depression is essential. Yes, engage with people. Yes, take a news diet. Yes, engage in activities that promote your mental health well-being. The list goes on and on, but do not deny or run from it.

If your low mood continues to persist or it worsens, seek out therapy to treat your depression. Sometimes working with a counselor can help alleviate your symptoms as well.

Be well!

Doomscrolling

Doomscrolling. What a clever word for something many people are doing today.

Most of us were attached to our phones before the pandemic and political craziness of 2020 had taken hold. Yet, now something different is happening when we reach for our phones. It’s like the Temple of Doom.

We turn it on, head to our favorite social media sites, and go down the doom tunnel. A horrific article about the politics of the day to the ever-widening death toll from the pandemic to the economic havoc and mayhem — and that’s just the start. Another critical part of the doom scroll is reading all of the comments. I often think the comments grab us into doom more than the news itself.

All of a sudden, we are reading, scrolling, getting amped up, becoming anxious and depressed all at once — and it just keeps going. Compulsively we continue the doomscroll barely able to take a breath away from all we are reading. Someone told me he finally stops when there is no new doom to read. Seven hours in he takes leave of his phone!

This article in the Washington Post lays out what doomscrolling is and how to reign it in so you aren’t relying on the doom all day long. Some ideas in the article include changing your screen color to gray, spending limited amounts of time on-line in these ways, finding places on the Internet that offer the exact opposite of doom – like cute pictures of animals.

A few more ideas – actually purchase a real newspaper and read it. So old fashioned I know. Here though you can enjoy all of the news of the day without reading the comments of doom. Further, it provides space for your own good thinking about the article. Also, you are deciding what you will read in depth, skim, and skip altogether. Online reading is much more difficult to discern which is which for you on any given article as you may not be so interested, but you do want to hear what others think about it. Taking a more solo path can keep the doom at bay.

Also, choose your time of day for a good doomscroll. One where you are awake, active, and alert and not seeking rest and relaxation. Align yourself with the most energy you have to take it in and then leave plenty of time afterwards to let it all go. At night, keep your phone outside of your bedroom. Do not mindlessly reach for it, but keep in mind and value your sleep and rest over the doomscroll. Don’t worry all of the doom will be there waiting for you tomorrow.

We are wired to latch on to the bad and then worry to the nth degree about it all. We also our communal beings — we are drawn to know what someone else is thinking and then perhaps try that stance on and see if we feel the same way or not. However, this muddies the waters of knowing our own minds and trusting how we are thinking for ourselves. Reading without adopting how others are thinking about something is creating space for your own independent thinking. More important than ever these days.

Finally, doomscrolling is a time suck. It sucks you right down into the temple of doom and doesn’t let you go to actually live your life. There is less time for you. Sometimes I read the comments on news and its just on and on fighting and fighting and I think to myself do people really have so much time to fill arguing with strangers? Everyone is always saying how busy they are — is this what people are busy with? Or is doomscrolling a way to escape life that feels miserable? Sometimes I feel like attracts like. We feel our personal lives are doomed and so we seek out external doomscrolling to match this internal feeling.

Take a break and take stock. Life is lived in reality. Put the phone down, pick up a real paper, after a little bit of time, put the paper down, and go out and embrace your life. May it be full of Joy Living — hopefully steps — even miles — away form the doom.

Book Review: The Blue Day Book

The Blue Day Book

Do you have blue days? Those days where it’s difficult to get out of bed, where it’s hard to rally a smile, or to even see anything as positive in your life.

We all have these days — I don’t think we would be human if we didn’t feel blue. And that’s why I love this little book from the 1990s that is called The Blue Day Book. It’s a quick read with lots of pictures of animals with a few words meant to cheer you. What I love is it takes less than five minutes to read and just gives a jolt of something funny and fun to lift one’s spirits on blue days.

I keep this little book on my bedside just so I can reach for it for a laugh or a positive message that cheers me up with some lighthearted humor and animals that make me smile. Often a bad day can just turn on something as simple as a Blue Day Book. We often forget to reach for simple things like this thinking it cannot help.

However, being able to do this simple act – like reading this book – can actually open you up and out of singing the blues and into a more positive frame of mind. Laughter can also do this and this book invokes laughter. Sometimes when we are feeling depressed though it is beyond difficult to reach for a book or a laugh. That is why it is no easy step to take.

However, I do recommend having a few fun and funny books within easy reach on any given day to lift your spirits in case you need them. It may not completely cure your blues, but it may take your mind away from them and allow something new to come in to feel during the day.

All these old books I am reaching for this summer learning that these oldies still offer a lot of wisdom for today’s pressures and feelings. Some days and things do not change.

Keeping Good Humor

Family Keeping Good Humor

A friend sent me an article about laughter during a pandemic. I think my friend knew I needed a lift and sent it along to me as a reminder to keep good humor during this uncertain time. Of course, I enthusiastically asked her to send me this article as I desperately needed to read it as I sometimes feel it is not OK to laugh or be light and funny during this time. Yet, it’s actually exactly what I need — i.e. to not take the whole thing so seriously and not get caught up in the abyss of the future that is more unknown than ever.

Are you keeping good humor these days? Are you the one sending around funny memes? Are you engaging in a deep belly laugh every now and again? Are you able to see the light side of the situation and make a joke? Or are you the person scouring when others engage in these ways? Whichever your reaction, my guess is that is says something about your mental state.

To be able to laugh is mentally healthy. Yes, even during a pandemic, it is important to give in to the lighter side of life and see that we can still hold on to this part of ourselves that is resilient, courageous, and has the ability to persevere in times of crisis and/or facing the unknown. Giving ourselves permission to give in and enjoy life during this time with good humor is really very important.

Have you noticed if nothing feels fun or funny or that people are annoying you who are embracing this these days? It may be an indicator of being very stressed, anxious, or depressed or a combination of all three states. One cannot embrace good humor – either our own or that of others – if we stay stuck in a serious, dire, anxious frame of mind. Living too far into the future or just looking around at reality in despair can truly lead to bad humor which can lead to low moods, physical ailments, or a general feeling of despair and inertia.

I want to encourage you to maintain some level of good humor during this time, especially if you feel anything but. Moving out of your comfort zone of being in misery, sadness, anxiousness, or hard-heartedness will not be easy, but I want you to open up and give it a try. See if some good humor can make it any better. And don’t do it for any great reason besides lifting your own spirits. Sometimes we feel guilty for putting ourselves above the collective situation and taking care of ourselves through something like laughter.

Good humor, laughter, optimism are all important components to being mentally healthy and resilient during this pandemic. Keep this in mind and laugh away!

Mental Health Crisis in America

Mental Health Crisis in America
Mental Health Crisis Brews in America

I read an interesting article the other day in the Washington Post regarding how the current COVID-19 pandemic is pushing America to the brink of a mental health crisis. I cannot even believe it has taken a severe public health crisis like this one for the media to begin to pick up on how difficult it is for Americans to find and receive quality mental health care today.

Sitting from the vantage point of a therapist, I know this to be true for many reasons. While most articles, like the one in the Post above, focus on access to mental health care, there is something else one has to first realize. Access to mental health care starts with clinicians who are in training to work in the field and serve people in need of mental health services.

It is an unfortunate truth and one not often discussed in the media that to do the work of a therapist, or, as the traditional license is called, a Licensed Mental Health Counselor, is a costly and time-consuming journey. One cannot clinically practice one-on-one therapy with individuals without holding a Master’s Degree in counseling, social work, or marriage and family work. This type of degree takes 3-5 years to complete with significant amounts of debt taken on to complete the degree, upwards and over $100,000.

Along this journey, graduate students in training are called to do an internship with a significant number of clinical hours and supervision time spent in order to earn one’s degree. Although a person may have at least 2-3 years of training experience in school, one’s internship is unpaid. People must find paid jobs as they juggle their internship demands.

This is where it strikes me that the mental health system is failing at its core. Community Mental Health Agencies that serve the poor and mentally unwell, a segment of the population that would have very little access to mental health services, are staffed with interns from graduate schools who are seeing these people for free. The core of the mental health services offered to thousands of Americans is valued at an intern level who earn nothing.

From there, graduate students leave school and are permitted their first license. Where I live it is an Associate’s license, which means you have the ability to see patients, but you must be supervised for a set amount of hours as you work toward full licensure, which is additional hours. Often Associate Mental Health Counselors use this period of time to take clinician positions in mental health agencies. Now they are no longer serving for free, but for $17 to $23 per hour. The average case load for a new Clinician is upwards to 100 clients. Then add in the math of $100,000 of student loan debt.

It is from this vantage point that I see our mental health system failing in America. From the start, when people seek to train to become a mental health clinician, no value is given to the skills that they are learning and employing to help people with their mental health needs. From weighting people down with student loan debt, to not providing any value to the intern seeing clients, and then providing a very low income to the new clinician with a caseload that no one can keep up with — not only are the clinicians burned out, but the system is overwrought with little to no support for people who need tremendous care.

What happens after one has completed her Associate’s license requirements and you are now a fully licensed therapist? Unfortunately, most clinicians leave Community Mental Health and set up their own private practice. Even if the clinician charges a reduced fee, it is often three times the amount one was earning at the mental health agencies. It is unfortunate that the very poor and mentally unwell people in America are left to be churned through by clinicians who are in some training phase of their career burning out without proper care, support, or caseload numbers.

Insurance also plays a roll in the inequity of the Mental Health system in America. Are you in network and, if you are, your patients may benefit, but the Clinician will likely make very little money for their services when all is said and done. If you are out of network, then the Clinician works with the patient to determine the fee. A patient may submit a receipt to their insurance company which may provide them with a portion of the fee they have paid. In this way, the patient has to decide what can they afford given the insurance company will only be reimbursing some of the full fee and that is often after deductibles are met.

All of this to say that when we look at the mental health crisis in America, we need to critically think about how we value our clinicians in training as well as how we value the services provided to the mentally unwell, especially those accessing care through the community mental health agencies. It begins with both parties being valued and supported in terms of money and care.

Until this happens, the system is on crumbling crutches which is going to further lead to the black hole of inadequate care, funding, and a lack of people to serve during crisis such as the one we are in currently.

Do You Have that Forgotten Feeling?

Feeling forgotten like wilted flowers

Do you have a feeling of being forgotten these days?

During this extraordinary time, all of us are spending our days at home. If you are single or living alone for another reason, it is easy to not only feel lonely, but there may also be a sharp edge to this feeling — one that is laced with feeling you are forgotten by others. It is one thing to be lonely, quite another to have a felt sense of being forgotten by your family and friends.

This felt sense of being forgotten by those you care for can land one into a depression thinking that no one remembers you exist and are curious enough to reach out, check in, and hear how you are doing. There is never an excuse for people to not remember, but in the fast-paced world that we normally move in we are left with little space to touch base with those we are thinking of on a regular basis. We become too caught up in our own selves.

But what is happening when all we have is time on our hands? Still, no calls come in to you with people checking in on you. I believe this situation is extraordinary in and of itself and has thrown people off kilter. I am not sure they are forgetting you, but rather are caught up with their own whirlwind of emotions as they face this crisis that they fine there is no extra room for others.

What if you are noticing you are the one always reaching out and thinking of others and checking in? Yet, the same is not returned to you in kind. This may also lead to a felt sense of feeling forgotten by others. Unless you are reaching and doing, nothing is happening. How empty!

How can you move out of the feeling of being alone that is laced with feeling forgotten and into feeling connected and remembered by others? Here are some ideas:

  1. Set up a standing check in time with others and take turns reaching out to one another.
  2. Use your voice and let people know how you are feeling so that people can move in toward you rather than you moving away from them.
  3. In your family, set up a chart of Birthdays and anniversaries and other important dates and share it. Make a commitment to remembering one another.
  4. Reach out and ask a friend to call you
  5. Observe who is making gestures to share time with you. Perhaps there are people doing this, but you are not tuned in to these people as you are focused on someone else remembering you. Keep track of who is present and available to you and show up to this person and be present.

It is a terrible feeling to feel lonely and it is even more complex when there is an element of feeling forgotten. Recognize the feeling and move toward caring for yourself, especially during these extraordinary times. When a friend recently confided how alone and lonely they felt, I made the effort to text this person and sent some real mail. Her sharing her very real feelings with me allowed me to directly remember her and hold her up.

Be open to surprise! Others may do the same for you.

Do You Feel Alone or Lonely?

Woman alone or lonely
Are you alone or lonely?

Do you feel alone or lonely these days?

Well, for many people we are going either into Day 1, Week 1, Week 4 or more under a “Shelter in Place” order by our Governors across the United States and for many abroad where the entire countries in Europe and beyond are also indoors — staying put to slow down a virus and save lives. For now, we are all in this together — but on our own. Meaning, you are basically with who you live with — no more, no less.

This may mean a houseful of people, a couple and a child, a couple, or one person on her own. Regardless of who you are at home with these days, it can be difficult. Even if you are an introvert, it may be easier to be home in isolation with yourself or others, but when it is not a choice it can be difficult for you as well.

Thus begs the question in these days whether we feel alone or lonely. Sometimes we can feel both.

To be alone is not necessarily a bad state to be in. How often do we yearn for time to be alone with our thoughts or to spend time exactly as we want to spend it without concern for others. Being alone opens a gateway to engaging with one’s self without any distractions. To be alone can be wonderful.

To be lonely is an entirely different matter. Loneliness can make one feel empty and unwanted and may also lead to depression. Being alone is not a time to recharge, but rather time to move into a low place of feeling about one’s self. In these times of “sheltering in place” many people are not only alone, but are also feeling lonely. And even if you are not alone as you are living with your family, you can feel utterly lonely.

Normally one of the antidotes to loneliness is to reach out and be with others. However, in our current circumstances that is near impossible. So, how do we combat loneliness during these extraordinary times?

  1. Pose the question to yourself — are you alone, lonely or both?
  2. If you are alone, but not feeling lonely, relish this time. Follow your bliss at home and enjoy the time to recharge alone and/or with your family.
  3. If you are feeling lonely, whether alone or living with others, this is a natural feeling when so much of life has changed and there is forced time to be at home. Ask yourself if you are feeling empty and unwanted? What is this time bringing up for you? Use the feeling of loneliness to learn more about yourself.
  4. From there, think about what you can do to bring yourself out of your lonely state. Although we are in our homes, we are encouraged to go outside and take walks in nature which may help you place yourself in the larger world. Indulge in taking care of yourself at a very high level indulging in things that make you feel good, perhaps a salt bath or a vigorous workout, a favorite show or book to tune into, or a favorite song that will move you to dance.
  5. Of course, connection is key as we are humans and desire to connect with one another. If you are feeling lonely, even as you are living with your family, make time to connect with them in meaningful ways. If you are alone, make video call dates with family and friends. I have also heard of on-line classes taking place where people are making things together or working out together. You may want to look into activities that can be done together on-line. Make sure to keep connecting each day.

To be alone is not synonymous with feeling lonely. During this time of “shelter in place” check in with yourself often to see how you are feeling and make sure to move to take care of yourself during this time. You may be alone or feel alone, but you can combat the feeling of loneliness if you continue to check in and ask yourself what you need in the here and now moment.

My hope is each of us will use this time to nurture ourselves — learning about how we react to such times internally and what we move to do externally to care well for ourselves.

Social Distancing

Woman chats with someone via technology for social distance connection

According to ThoughtCo, Social Distance refers to “a measure of social separation between groups caused by perceived or real differences between groups of people as defined by well-known social categories.” This sounds very academic and, if you were to go on to read the rest of the article you would read about the different types of social distancing – mainly phenomena around separation of groups of people based on race, class, and more.

What? Social Distance actually has a theoretical frame and it doesn’t seem to be anything to do with our current pandemic where the idea of “social distancing” is being used to keep individuals apart to control spread of a virus in our communities. For this meaning, we have periodicals like the Atlantic Monthly giving you the “dos and don’ts” of social contact during this strange time.

I hear some people are taking it seriously and not leaving their homes and then others who are going out for some things, but have cut other things out (if it hasn’t already been out out for you, like school and work), and then others who are going about their life as normally as possible. Where I live in Seattle, WA, the guideline is to socially distant, but there has been no legal enforcement. Instead, people are given agency over their decision to distance from their friends and community.

It’s at times like these that we realize how much we need people or, at least, being out and about within our communities. I hear this is an introvert’s dream, but even introverts get out to do errands, work, drop their kids at school or go to school, work out, and more. To take away social interaction with others exerts a pressure for us to be alone for the good of the other. A bit of an oxymoron, right?

Some of the ramifications I see from this social distancing recommendation are the following:

  • Loneliness
  • Loss of connection
  • Stress on close relationships
  • Boredom
  • Lack of productivity
  • Inertia

One of the best ways to combat any and all of these feelings is to use technology to remain connected to our friends and family. We don’t normally think in this way to see our local friends, but it can really help stave off loneliness and isolation, to FaceTime our friends in lieu of meeting up for coffee, dinner, or drinks. You just have to think of it as a viable option and reach out and set a date. I have tried it a few times during the past few days, and it truly brightened my spirits and helped me to feel less isolated. Ah! My friends are out there experiencing all that I am. Sharing this with the other is critical.

So, what to do? Think about your friends, family, and others in your community. Now, reach out and ask if they would like to set a FaceTime date with you? Put it on your calendar, as you would any other event, and show up. Spend the time on-line connecting. Afterwards, check in with yourself and see how you feel. My guess is a lot less isolated and lonely. For me, a real sense of being in it together was felt in both my mind and body.

Even during these days of social distance, we can stay connected given the tech times we are living in – make sure to connect and encourage your partner, kids, and anyone else you know to do that same.