Wednesday, 18 September 2013

depression


BE AWARE

such persons write good but may not be good at counseling

Is this Therapist a Well-Trained Professional or Unqualified Hack?

_DSC5947I once met an art therapist who was providing individual therapy for PTSD and had just learned what a flashback was—from the client she was treating. Yet therapist can also mean licensed clinician with years of training and supervision. Meanwhile a good friend of mine just became a coach after years of rigorous coursework and consultation—and this on top of the fact that she’s a licensed professional counselor. (Denver peeps check her out). But there are other life coaches with only a few hours of training. Obviously, “therapist” and “coach” can mean a lot of different things. Here’s your guide to sorting out the highly trained professionals from the unqualified hacks (or to prevent you from accidentally paying money to a hack-creating organization when you’re trying to become a qualified professional!).

Certificates, Accreditations and Licenses, Oh My! What Does This Stuff Mean?

A certificate is a thing that says someone completed a training program, which can be any length and provided by any person or organization. You can present in class and then give your peers a certificate that they trained in the topic of your presentation. Or a certificate can be quite prestigious. I still have mine from the International Committee of the Red Cross, that says I completed the Health Emergencies in Large Populations training at Johns Hopkins.
How to tell? Ask what organization provided it (“national,” “international,” and “American” in the name are good signs) and how many hours of training were required. I’ll say 30 hours is the minimum needed to claim any kind of expertise in something.
Certifications or accreditation are provided by organizations (e.g. my EMDR certification is given to me by EMDRIA, the only organization that can certify someone in EMDR) and are good anywhere in the United States.
Many organizations will only certify people who have, or are eligible, to practice independent clinical work. Play therapists, for example, must be licensed clinicians, so licensed clinical social workers, licensed personal counselors, licensed marriage and family therapists, psychologists, etc. Same with EMDR therapists.
But some are different. In most states art therapists don’t need a license to practice. Once they have received their certification from the American Art Therapy Association, they are qualified to work independently. Fortunately, this is changing and more programs are incorporating coursework related to counseling (and hopefully mental health) into their programs and more art therapists are being trained and licensed as Qualified Mental Health Professionals.
A license is given to clinicians by their state (or district or territory) to practice. Social workers, counselors, psychologists, nurses, doctors all have to get permission to practice where they live. This is challenging in DC, since Virginia, Maryland and DC refuse to acknowledge the other states’ licenses even though they are clustered together in an area smaller than the size of Harris County, where Houston, my hometown, is located. It’s disorienting that on my daily jog, I cross a border from not being qualified to practice, to being qualified, then back. Most states have similar qualifications for the disciplines, but some are more strict than others. Neither Maryland nor Virginia, for example, feel that my clinical social work license from North Carolina is adequate and require several years (3 for VA, 5 for MD) of full-time clinical practice after I was already licensed to practice independently before I can transfer that license to their state.
Requiring a license to practice is a good thing for the profession. If I act unethically, it is quite easy for a client to file a complaint to the DC licensing board. The board will then investigate the claim and decide whether I need to receive some sort of sanction. This is then listed on the website and anyone can see it. The DC licensing board has no incentive to protect the image of social work by hiding how many clinicians have been disciplined or to not discipline me at all, and ideally they will be objective. Also, masters-level clinicians can have a hard time getting respect as knowledgeable professionals, so it helps when we’re all held to same high standards.
Coaching is not title-protected and anyone can call themselves a coach (this means you!). There are a lot of different certificates for coaches, some of which are awarded after a day or a weekend, whereas others are a lot more rigorous. The International Coach Federation will provide accreditation to programs that meet its requirements, so a good question to ask is, “is your training program certified by ICF?”




Ten Tips for Victims of Sociopathic Behavior

Gas Light MovieIt is apparent that something is out of sorts. At first the person who was extremely charming, almost too good to be real has now become intimidating, demanding and even threatening.  The pathological lying over trivial matters, even when caught, can no longer be ignored.  They are unreliable, unrelenting, irresponsible, disruptive, outrageous, traumatizing, insincere, unrepentant, lawless, and shameless. It appears they are sociopathic.
What can be done? Here are ten tips for the victims of sociopathic behavior.
  1. Name the type of abuse. All sociopaths use some form of abuse to manipulate victims. Abuse can be emotional, physical, mental, verbal, financial, sexual and spiritual. Begin by reviewing examples of each to identify the abuse. For instance, gaslighting is a popular form of mental abuse where the abuser, through a series of lies and deceptions, gets the victim to believe they (the victim) are going crazy.
  2. Diagnosis the behavior. Search the web for descriptions on sociopaths and read blogs written by them. Most sociopaths are unashamed of their behavior and willingly admit to harming others emotionally, physically, or financially. Some even justify criminal behavior by blaming the victim for being too naïve. This will further assist in understanding the disorder and its’ impact on victims.
  3. Recognize their patterns. Now is the time to put the first and second tip together. Even sociopaths are creatures of habit. When they find an abusive pattern that works in one environment, they tend to repeat it over and over. Because they tend to be master seducers, they might use sex as a distraction whenever they are caught in a lie. Or they might seduce superiors at work to advance their career.
  4. Think of this as a game of chess. In order to be successful, defensive and offensive maneuvers must be well thought out. Sociopaths love to place a person on the defensive; it is a way to avoid responsibility. Decide in advance that when cornered by a verbal assault, use a non-emotional response such as, “I’m sorry you feel that way.” Plan ahead of time several short responses that can be utilized instead of responding protectively.
  5. Set boundaries. These boundaries are not for the sociopath because they won’t follow them. Rather the boundaries are for the victim. Know in advance the limits of tolerance for each area of abuse mentioned. For instance, aggressive shoving, secret bank accounts, theft, adulterous relationships, or forced sexual contact may all be a boundary. Once this is crossed, it is time to move on.
  6. Have an exit plan. Sociopaths are very cunning and can smell fear. So the exit plan might have to be done in secret. This should not be a momentary decision, rather a well-thought out scheme to escape. Stash money, passport, clothes, keys, and any other important documents aside before departure. Carefully plan the time to leave and have a safe location to go to in advance.
  7. Tell a close friend or relative. Sociopaths isolate their prey from family and friends to create a dependency on them. It might take some effort to re-establish a safe relationship but it is essential for accountability and healing. Having a perspective outside of the relationship helps to see things more clearly.
  8. Move away if possible. Sometimes the best way to get a sociopath out of a victim’s life is to suggest they move away. Sociopaths tend to take the path of least resistance so the effort to follow a person and continue the abusive behavior requires too much work. In addition, the fresh start for the victim can be transforming as they have a chance to shed the trauma.
  9. Be reflective. Once the victim is safe, it is time to be more reflective about the experience. More than likely, they ignored several warning signs and didn’t follow their own instincts. Now having gone through this experience, the instincts have a chance to grow stronger with greater knowledge and understanding.
  10. New relationships need to be checked. Anxiety over future relationships is a common feeling after being with a sociopath. This is very understandable given the past. Have a close friend who knows of the sociopathic behavior check new relationships. This double check provides some security that the same mistake will not be made in the future.
Victims can recover from the abuse of a sociopath and go on to live very full lives.

Christine Hammond is the award winning author of The Exhausted Woman’s Handbook available on Amazon, Barnes & Noble and iBooks.

About Christine Hammond, MS, LMHC

Christine is a Licensed Mental Health Counselor by the State of Florida with over fifteen years of experience in counseling, teaching and ministry.

She works primarily with exhausted women and their families in conflict situations to ensure peaceful resolutions at home and in the workplace. She has blogs, articles, and newsletters designed to assist in meeting your needs. 
As author of the award winning book, The Exhausted Woman’s Handbook, Christine is a guest speaker at churches, women’s organizations, and corporations.  





Young man consoling a sad woman in the living room at home
“Joan” is a middle-aged woman I recently started working with. She suffers from depression and has been a frequent customer of psychotherapy and medication to treat her symptoms. For years she has relied on pills to help balance her moods so when I asked her to try a new strategy completely free of medication, she looked skeptical, but agreed.
After she had practiced my recommendation to work with her highest strengths (called signature strengths) for three weeks, I asked her about her progress:
“How has your strengths practice been going?”
“I discovered I have to take my signature strength pill every day,” Joan replied.
“What do you mean?” I asked.
“When I use my curiosity or kindness or gratitude in a new way, I feel better that day. When I forget to mindfully use a signature strength, I feel worse. My strengths acts like a pill for me.”
“Tell me more about that,” I commented with curiosity.
“It’s like this – when I take a fresh approach with a signature strength, my roof or ceiling opens up and I see the world more clearly. I see the blueness of the sky and the greenness of the trees. I want to connect with people. I feel better. I’m taking action and I’m taking action with my core parts.”
“Sounds a bit like psychological exercise!”
“Exactly, just like running on a treadmill, it keeps me in a healthy place of taking action.”
Joan’s practice with signature strengths is a good example of the science-based exercise – “take the VIA Survey , identify one of your signature strengths, and use it in a new way each day.” In randomized, controlled trials, this intervention consistently leads to increases in happiness and decreases in depression for people, sometimes with effects lasting six months.  This exercise has been further validated by revealing benefits across a number of populations, including youth, older adults, employees, people with traumatic brain injuries, suicidal people, as well as across various cultures such as China, Australia, UK, US, Canada, and Europe.
To be clear, using character strengths is not a cure for depression. It is an important adjunct. In fact, it’s an often forgotten aspect of depression therapies. This is surprising because it couldn’t be easier for people with depression or their therapists to integrate strengths into treatment.
Here are 2 ways to start:
  1. Take the free VIA Survey  online and bring your test results to the next session.
  2. Explore questions relating to personal identity: What are your best qualities? What parts of yourself are most core to who you are? Which personality  aspects of yourself give you the most energy? How would you describe “the real you”? How might you bring these universal, human character traits forth more strongly in your life?
Pilot research on depression has found that therapists (who practice CBT) that focus on their depressed client’s CBT strengths get better outcomes and their clients have less depression relapse (compared to therapists who focus on their depressed client’s CBT weaknesses)! There is something important about helping people to not forget what they are good at.
You might be asking yourself the question: Why is it that using signature strengths is successful for boosting well-being? This is still a new question needing further investigation but there are many initial reasons that science has uncovered. One reason is that when we use our signature strengths we are making progress on our goals. Another reason is our highest strengths are connected with our life passions. Yet another reason is our basic needs get met when we use our strengths – needs for relationship with others, independence, and a sense of control. All of these reasons bode well for people suffering from depression.
But, the benefits of using signature strengths does not stop there. Here are some examples of what other scientists have found:
  • The use of 4 or more signature strengths at work is a cutoff for more positive work experience and work-as-a-calling.
  • The use of signature strengths is connected with work engagement and work satisfaction.
  • In many cases, knowing your strengths is not enough, you must deploy them in your life too.
  • Using signature strengths is especially powerful for people who are less self-aware.
  • Character strengths are linked with a better workplace climate.
  • Character strengths are connected with the various elements of well-being such as engagement, meaning, positive emotions, and positive relationships.
  • Character strengths are linked with improved achievement and performance.
  • Character strengths help to buffer stress and improve coping ability.
For a review of these and over 200 peer-reviewed studies on character strengths, go to www.viacharacter.org
Interested in the latest book on character strengths? Check out Character Strengths Matters , edited by Shannon Polly and Kathryn Britton. They’ve compiled engaging stories, practices, tips, and research on character strengths from several leaders in the field. All of the book’s proceeds go to support the Christopher Peterson Memorial Fellowship. Highly recommended!


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APA Reference
Niemiec, R. (2015). An All-Natural Mood Booster To Beat Depression. Psych Central. Retrieved on July 19, 2015, from http://blogs.psychcentral.com/character-strengths/2015/07/an-all-natural-mood-booster-to-beat-depression/







2/11/2014
Counseler and depression

watched Amir khan show satyamev Jayate,on mental health

We must not ignore mental health and aproach mental health professional

Good counsellers are also need of the hour

Doctor should also understand that a patient of depression is like a baby,he/she must be couselled properly
few counselers do the job for money, have casual aproach to patient

Such counselers ,see facebook talk on phone and write mesages during counseling, i.e. ignore the patient.

In korchoff model of counseling and REBT model also a good counseler is required for curing the patient

Counsellers must have good qualities,and will to cure patient

It is the patient suffering pain,which a counseler must understand

depression


4 Affirmations to Help with Depression

  1. You are valued even when you’re not productive.
  2. You are loved — despite your sadness.
  3. You are not sick because of a lack of effort or a failure at adjusting faulty thoughts.
  4. You are appreciated even when you can’t contribute much.
  5. You are needed — even though you feel worthless.
  6. You are separate from your depression.
  7. You aren’t any less of a person because certain people can’t understand your illness.
  8. You have persevered and persevered and should celebrate your tenacity.
  9. You are strong in your weakness.
  10. You are much more than your opinions of yourself.
  11. Your brain is your friend (despite what you hear).
  12. Your discomfort won’t last forever.
  13. You are resilient. You are a silent warrior.
  14. You are okay where you are right now.
  15. can contact helplines on the topic
  16. you must not punish yourself for the faults of others
  17. although u have friends and relatives, what utility they have? if they do not help?
  18. so do not expect from others
  19. anyone can have depression in the process of adjusting with calous circumstances and friends and enemies and frenemies
  20. can start to discuss the feelings, with someone dearer than apatheic others(Hard to find)
  21. In case fate gives wrong persons, choice can give good friends Make a choice or make books your friends
  22. Have a good day
  23. Is clinical or undetected or hidden depression is pricking You? Select a good counseller, bad counseller will spoil the case
  24. I have completed study course in Carkhoff model of counseling and can understand depression
  25. Take care
  26. 1. Depression isn’t weakness.
    We often believe that people can control their moods, said Hammen, also co-editor of the third edition of the Handbook of Depression. So when someone can’t seem to manage their mood, they may be seen as somehow inadequate or flawed.
    “It is very common for people to believe that feeling down and bad is a weakness of will or lack of effort to just get over it, or even a willful resistance to fighting it,” Hammen said.
    A stressful event or stressful conditions trigger most depression, which makes it seem like people should promptly bounce back. If they don’t, they may be viewed as “weak-willed.” Even people with depression might see themselves as weak if they don’t recover right away.
    Some people don’t even realize they (or someone else) are struggling with depression. “They may think of it as ‘just stressed out’ and expect them to get over it more quickly.” (These people also “are unlikely to seek professional help for being ‘stressed.’”)
    Clinical depression is an illness. It can’t be willed away. The symptoms of depression — such as hopelessness, helplessness, fatigue, and difficulty concentrating — make it harder for people to take the steps to get better, she said.
    Others’ perceptions (e.g., “get over it”) only make them feel worse about themselves and more alone, she added.
    2. Irritability may be a prominent factor.
    People are well aware that persistent sadness is a symptom of depression. But irritability is a key sign as well. In fact, irritability may even indicate a more severe depression, said clinical psychologist Shannon Kolakowski, PsyD. Irritability also is associated with a greater chance of having other mental illness, such as anxiety, she said. (Learn more about the research here.)
    Other emotions tend to underlie irritability, such as sadness, shame and overwhelm, she said. But irritability shows up on the surface. “This happens when people are less aware of their internal states, where there’s trouble recognizing, labeling and processing their emotions.” (Therapy helps with this, she added.)
    3. Depression affects the entire family.
    “People tend to think of depression as an individual condition,” said Kolakowski, also author of the book When Depression Hurts Your RelationshipHowever, it’s a systemic condition that affects couples and families, she explained.
    For instance, depression can affect everything from a couple’s communication and connection to their sex life to how they handle conflict to their ability to empathize with each other and enjoy time together, she said.
    When someone is struggling with depression, it’s hard to foster warm, supportive relationships, Hammen said. This isn’t “because one is a ‘bad’ parent or spouse, but because they cannot will away the irritability, withdrawal, oversensitivity, lack of interest [and] low energy that are needed to sustain healthy relationships.”
    Consequently, when someone has recurrent or chronic depression, their partner and kids may need treatment, as well, she said. (Learn more about how depression damages relationships and tips for rebuilding your bond here.)
    4. Adolescents and young adults are particularly at risk.
    A complex combination of factors causes depression. These factors include the environment, genetics, biology and personality traits. Many risk factors may predispose teens and young adults, who are “particularly at risk for first onset of clinically significant depression,” to the illness, Hammen said. She shared these examples:
    • A mother who has depression or is impaired in another way.
    • Difficult childhood, which, for example, led to attachment insecurities.
    • Anxiety and fearfulness.
    • Unrealistic expectations (for yourself or others).
    • Poor role models for resolving relationship conflict or disappointments.
    • “Brain circuits that reflect dysfunctions in processing and resolving negative emotions.”
    • Poverty, which exposes individuals to stressors from an early age.
    These factors increase the likelihood of recurrent depression, so it’s important to identify and treat teens and young adults who are at risk, she said.
    5. Cultural views perpetuate depression.
    “There are many self-perpetuating aspects of depression, within the person and within families and within cultures [and] communities,” Hammen said.
    For instance, some cultures believe that because life is hard, it’s normal to be miserable, while other cultures regard happiness as a life goal (“the antidote to feeling low is to pursue the things the culture think should make one happy [such as] intimacy, fame, fortune”).
    Some societies also believe that if you have certain things, you shouldn’t be depressed, she said. “If you are [it’s considered] a flaw of character.” (Again, it is not.)
    Depression is a serious illness. “The more people are aware of depression and how debilitating it is, the hope is that they will demand more resources to be devoted to the problem,” Hammen said.
     take care
    (from psychology journal)
    shubha
  27. In his book, Going to Pieces Without Falling Apart, psychiatrist Mark Epstein, M.D. tells the famous Buddhist story of Kisagotami and the mustard seed:
    A young woman named Kisagotami lost her only child to illness around the time of his first birthday. Bereft, she went from house to house in her village, clasping the dead child to her breast and pleading for medicine to revive him. Her neighbors, thinking her mad, were frightened and did their best to avoid her entreaties. However, one man sought to help her by directing her to the Buddha, telling her that he had the medicine she was seeking. Kisagotami went to the Buddha, as we go to our psychotherapists, and begged him for the medicine.
    “I know of some,” he promised, “but I will need a handful of mustard seed from a house where no child, husband, parent, or servant has died.”
    Making her rounds in the village, Kisogotami slowly came to realize that such a house was not to be found. Putting the body of her child down in the forest, she made her way back to where the Buddha was camped.
    “Have you procured the handful of mustard seed?” he asked.
    “I have not,” she replied. “The people of the village told me, ‘The living are few, but the dead are many.’”
    “You thought that you alone had lost a son,” said the Buddha. “The law of death is that among all living creatures there is no permanence.”

    still death hurts me ,It is a great loss when there is death of near and dear ones 
  28. Depression Newsletter

    Some Frank Thoughts on Suicide
    and Depression

    (Mentoring & Recovery) – Last month we were shocked to discover that Robin Williams had taken his own life. For Shannon, the death still causes her to pause and reflect on her own personal struggles with depression, anxiety, and an attempted suicide.

    Warding Off the High School Blues
    (Psych Central News) – Teaching kids about how people change in adolescence may reduce the incidence of depression that often accompanies the transition to high school.

    Are YOU to Blame for Always Being Overlooked?
    (World of Psychology) - Have you wondered why you are so often overlooked when others aren’t? Others tend to treat us the way we treat ourselves. How are you overlooking yourself?

    Group Walks in Nature Can Relieve Stress, Improve Mood
    (Psych Central News) - Researchers have come up with a simple tonic for stress: Fresh air. Walk. Socialize.
    take care: shubh
    25/9/14
    find a therapist

    There’s little research to demonstrate that one degree will produce better patient outcomes than another. A “patient outcome” is you feeling better, faster. Because, after all, time itself does indeed heal most wounds. As long as the mental health professional has a Master’s or better in education, it’s likely they will all be equally just as helpful. There’s no evidence to support the idea that a graduate degree from one psychology program is better than another, or that a Ph.D. is better than a Psy.D.

    for your feeling better, sooner. Find a therapist that you feel comfortable in working with. As long as they are licensed (or registered) and paid for by your health insurance, you’re good to go.

    I had an experience of a comerce graduate counseller,who practices and earns good,but is very harsh ,careless.She is on her phone and typing mesages and ignoring patients
    She may and she can spoil cases,

    shubha

    I learned professional counseling after listening about that bad counsellers case 

    ##
    case  5


    Depression is debilitating. Heartbreaking. Hard to get over. Well, just depressing. For depressed people, the news is not good.
    But wait…It’s not the truth either.
    And there is an entire field of study that shows that the things that often lead to depression — trauma, setbacks, stress, adversity — can have just the opposite effect, meaning they don’t lead to depression. Instead they lead to growth.
    It’s called post-traumatic growth.
    And studies on post-traumatic growth show that after major life traumas more people show post-traumatic growth than PTSD (Morris, Finch, Scott, 2007).
    So just what is post-traumatic growth, you ask?
    Post-traumatic growth can be defined as the positive psychological change that results from the attempt to find new meaning and resolve after a traumatic event (Tedeshi, 2004). This means that events that shake our very foundation can cause us to get stronger in specific and measurable ways.
    According to Richard Tedeshi and Lawrence Calhoun, authors of, The Handbook of Post-Traumatic Growth: Research and Practice, “The struggle to find new meaning in the aftermath of the trauma is crucial to positive psychological growth, as well as the acceptance that personal distress and growth can co-exist, and often do, while these new meanings are crafted” (Tedeshi &Calhoun, 2004).
    The idea is that struggling to find new meaning after trauma leads to growth.
    And what are these events that can lead to post-traumatic growth?
    Well, what constitutes trauma is very unique to the individual, but a basic definition is:
    “anything that either causes a person to fear for his/her life, or the life of anyone else, or anything that causes a person to become emotionally overwhelmed.”
    For example, a divorce might not necessarily cause a person to fear for his/her life, but may result in feeling overwhelmed in such a way that makes it hard to go to work, get up in the morning, keep a routine, etc.
    What happens in situations like this is that individuals tend to show dramatic advances in growth. And it’s not that they simply put on rose colored glasses — this would be what those in the field of post-traumatic growth call “illusory growth.” Illusory growth is characterized by growth that cannot be substantiated — or a person who simply insists that “everything is great” when the reality looks quite a bit different.
    Instead, post-traumatic growth is characterized by five specific domains that all tend to be linked by one common thread.
    The one characteristic feature of post-traumatic growth is what is known as “dialectical thinking.” Dialectical thinking is the ability to see something from multiple perspectives, identifying both positive and negative aspects.
    It’s the ability to say, “Yes I am feeling very depressed, but on the other hand, I am reaching out more, and feeling more supported,” or, “I am feeling really vulnerable, but I also recognize that I have made it through some very tough experiences, and I do feel stronger.”
    What dialectical thinking enables us to do is find the positives in every situation, and to use those positives to push forward. The idea is that when you are able to see that nothing is “all bad” you are also able to find strengths that you might not have noticed before. You are able to identify opportunities you didn’t know existed — or might not have existed previous the trauma. You are able to reach out to others, deepening relationships in a way not possible before the trauma. Perhaps you also feel a deeper spiritual connection as part of getting through what you didn’t think you could. And you might also feel a profound gratitude as you realize that you endured tremendous circumstances, and survived.
    What I have just described are the five domains of post-traumatic growth. These are:

    • A greater appreciation for life
    • An openness to new possibilities
    • A greater sense of personal strength
    • A deepening of relationships
    • A deepening of spirituality.
    Post-traumatic growth, in many ways, defies everything we have been told about trauma — that it’s debilitating, that it is something that you cannot recover from, that you will be made worse by it.
    Instead, what post-traumatic growth shows is that recovering from trauma is not about putting the shattered world back together just as it was. Instead, post-traumatic growth is about rebuilding the shattered world in a way that is better.
    And this is something every depressed person should know.

    take care~ 4 min read

    Depression and SorrowI’m not sure why more psychiatrists don’t first test for nutritional deficiencies before dispensing Zoloft or Prozac, and especially antipsychotics like Seroquel and Zyprexa. The good ones will send you to get lab work done before upping your meds or adjusting anything. Sometimes we do need antidepressants. But other times we need spinach — think of Popeye.
    In addition to seeing a psychiatrist regularly, I now work with an integrative health physician who tests my nutrition levels every year. If you haven’t ever tested your nutrition levels, you might inquire with either your psychiatrist or primary care physician.
    The supplements can be expensive, but you can make it back two- or threefold by not having to see your psychiatrist as often. You should talk to your doctor before taking any supplements, especially if you’re on prescription drugs.
    1. Omega-3 Fatty AcidsI was surprised when my results showed an omega-3 fatty acid deficiency because I eat plenty of salmon and take fish oil supplements every day. That shows you just how much fish — salmon, tuna, halibut — or flaxseeds and walnuts we need to consume to be at an optimal level. These essential minerals reduce inflammation and play a critical role in brain function, especially memory and mood. The body can’t make them, so you need to either eat them or take supplements. Omega-3 fatty acids are just one of the supplements I take every day for depression.
    2. Vitamin D
      According to Mark Hyman, MD, bestselling author of The Ultramind Solution, vitamin D deficiency is a major epidemic that doctors and public health officials are just beginning to recognize. This deficiency has been linked to depression, dementia, and autism. Most of our levels drop off during the fall and winter months, since sunlight is the richest source. Dr. Hyman believes that we should ideally be getting 5,000 to 10,000 IU (international units) a day. However, the National Institutes of Health (NIH) recommends most healthy adults get only about 600 IUs daily.
    3. Magnesium
      Chances are good that you are magnesium-deficient — up to half of Americans are. Our lifestyles decrease our levels: excess alcohol, salt, coffee, sugar, phosphoric acid (in soda), chronic stress, antibiotics, and diuretics (water pills). Magnesium is sometimes referred to as the stress antidote, the “most powerful relaxation mineral that exists,” according to Hyman. It is found in seaweed, greens, and beans. TheNIH recommends a daily intake of about 400 to 420 milligrams (mg) of magnesium for adult men and 310 to 320 mg for adult women.
    4. Vitamin B Complex
      B vitamins like vitamin B-6 and vitamin B-12 can provide some incredible health benefits, including reduced stroke risk and healthy skin and nails. On the other hand, a vitamin B deficiency may affect your mental health. More than a quarter of severely depressed older women were deficient in B-12, according to one 2009 study.The best sources of vitamin B-6 are poultry, seafood, bananas, and leafy green vegetables. For vitamin B-6, the NIH recommends a daily intake of 1.7 mg for adult men, and 1.5 mg for adult women. Vitamin B-12 is found in animal foods (meat, fish, poultry, eggs, and milk) and shellfish, such as clams, mussels, and crab. Most adults should need to consume 2.4 micrograms (mcg) of vitamin B-12 daily, according to the NIH.
    5. Folate
      People with a low folate level have only a seven percent response to treatment with antidepressants. Those with high folate levels have a response of 44 percent, according to Hyman. That is why many psychiatrists are now prescribing a folate called Deplin to treat depression and improve the effectiveness of an antidepressant. I tried it and it didn’t seem to make that much of a difference; however, I have several friends who have had very positive responses to Deplin. You need not try the prescription form of Deplin. You could just start taking a folate supplement and see if you get any results. Your daily recommended folate intake depends on your gender, whether you’re pregnant or breastfeeding, and age. However, most adults need at least 400 mcg daily. You can also get your daily folate requirements by consumingfoods high in folate, including dark leafy greens, beans and legumes, and citrus fruits and juices.
    6. Amino acids
      Amino acids — the building blocks of protein — help your brain properly function. A deficiency in amino acids may cause you to feel sluggish, foggy, unfocused, and depressed. Good sources of amino acids include beef, eggs, fish, beans, seeds, and nuts.
    7. Iron
      Iron deficiency is pretty common in women. About 20 percent of women, and 50 percent of pregnant women, are in the club. Only three percent of men are iron-deficient. The most common form of anemia — an insufficient number of red blood cells — is caused by iron deficiency. Its symptoms are similar to depression: fatigue, irritability, brain fog. Most adults should consume 8 to 18 mg of iron daily, depending on age, gender, and diet, according to the NIHGood sources of iron include red meat, fish, and poultry. If you really want to get more red blood cells, eat liver. Yuck.
    8. Zinc
      Zinc is used by more enzymes (and we have over 300) than any other mineral. It is crucial to many of our systems. It activates our digestive enzymes so that we can break down our food, and works to prevent food allergies (which, in turn, averts depression in some people, since some of our mood disruptions are triggered by food allergies). It also helps our DNA to repair and produce proteins. Finally, zinc helps control inflammation and boosts our immune system. The NIH recommends a daily intake of 11 mg of zinc for adult men and 8 mg for adult women.
    9. Iodine
      Iodine deficiency can be a big problem because iodine is critical for the thyroid to work as it should, and the thyroid affects more than you think: your energy, metabolism, body temperature, growth, immune function, and brain performance (concentration, memory, and more). When it’s not functioning properly, you can feel very depressed, among other things. You can get iodine by using an iodine-enriched salt, or by eating dried seaweed, shrimp, or cod. I take a kelp supplement every morning because I have hypothyroidism. The daily recommend amount of iodine for most adults is about 150 mcg.
    10. Selenium
      Like iodine, selenium is important for good thyroid function. It assists the conversion of inactive thyroid hormone T4 to the active thyroid hormone, T3. It also helps one of our important antioxidants (glutathione peroxidase) keep polyunsaturated acids in our cell membranes from getting oxidized (rancid). Most adults need about 55 mcg of selenium daily. The best food source of selenium is Brazil nuts, which contains about 544 mcg of selenium per ounce.
      suitcase240Here’s a quick checklist to know if you’re addicted to a toxic relationship:
      • You have more bad moments than good but you can’t let go because you’re always chasing another fix of the good.
      • The relationship depletes rather than energizes you.  It takes away from other areas in your life.
      • You lose resources (emotional, financial, interpersonal) but no matter how great the cost, you continue with the relationship.  You can’t seem to make rational calculations.
      • When you try to leave, you can’t seem to follow through; you go through withdrawals.  You cave, and you relapse.
      • You pretend every time you make up, it will be different.  You consistently ignore the fact that the past is the greatest predictor of the future.  You will be back there, in pain, again.   But you have selective memory (i.e. denial.)
      • You’re lying to your friends and family about the way you’re being treated; you’re minimizing the pain so they won’t turn against your partner, or urge you to do what you already know you should do, which is end the relationship.
      • OR you’ve alienated good people in your life who don’t want to stand by idly and watch you suffer anymore.
      Now here’s how you can start extricating yourself, once and for all.1)  Admit to yourself that it is an addiction.
      The act of naming something as bad for you is an important first step.  It begins to pierce the denial.  But you’ll have to name it again and again, like a mantra.
      That’s because as an addict, you are compulsively driven to try to improve a relationship that never improves for any significant period of time.  You are chasing a fantasy, and it is robbing you of vitality in other parts of your life.
      Worst of all, it is sapping the strength you need in order to leave.  You’re so drained that you feel you have no choice but to stay.
      That is not how love works.  It is how addiction works.
      2)  Recognize that you do have a choice.  In fact, you’re making one every second you remain in the relationship.
      Now think what you’re choosing.  Are you choosing sanity?  Happiness?  Safety?  Security?  Self-esteem?
      Or are you choosing the opposite of those things?
      If you’re choosing self-destruction, ask yourself why.  “I love him/her” is not an answer you should accept any longer.
      You might want a therapist to help you with this.  There could be many contributors and if you allow them to go unexplored, then you never leave.  You stay in a painful, no-win situation, and every day you do so, you’re exposing yourself to more damage that you’ll have to correct later.
      3)  Develop an exit strategy.
      That means plan out everything–from what you’re going to tell the other person, to how to marshal the support of friends or family or a professional, to what you’ll do on the lonely nights ahead when you feel weak and want another hit (think of it as relapse prevention), to how to get back on the wagon if you do relapse (i.e. how to end things all over again rather than simply fall back into old routines.)
      Remember that reunions feel so sweet, but getting high for a while won’t change the fundamental underlying problem.
      Love yourself more than you love the addiction.
      I know, easier said than done, but if you never say it, if you never try, then it will certainly never be done.  You’re making a healthy choice just by reading all the way to the end.  You just completed your first step.So you’re doing okay, cruising right along. Suddenly you realize that you’re slipping into a depressive episode. Once that depressive state starts to hover over you like a dark cloud, remind yourself that it’s only temporary. You will get out of it.It’s so much like a rollercoaster ride that it can make you physically ill as well.
      Here are six helpful tips to get you through on not just a daily basis, but an hourly basis. Don’t look too far ahead too often — that can be overwhelming.

      1. Art therapy.
      Put on your favorite upbeat, happy music and dance the day away if you need to. Draw or paint. Sculpt with clay. These can help to give you a physical release of tensions built up inside you.
      2. Pet your pet.
      Give love to a pet that you already have. Just petting your dog or cat or bunny or whatever you have also gives that “release” feeling and takes away feelings of depression and sadness.
      If you don’t have a pet, try to pick yourself up and get yourself to a pet store or an animal shelter. And while you’re petting your animal, talk to him or her. The loyalty of a good pet is irreplaceable.
      3. Light therapy.
      Do you seem to become depressed in the winter? When we have less light, we are cut short of vitamin D, according to MayoClinic.com and WebMD.com. Besides our feel-good brain receptors, vitamin D also aids in bone health, kidney function and osteoporosis.
      If you notice this deficiency, talk to your doctor about a lightbox. This is not a tanning lamp, so there’s no risk of skin cancers. Most of the time, as long as it is prescribed by medical doctor, insurance will pay for it. If not, you can still purchase one from a medical supply store. They run around $200.
      4. Physical activity.
      Get up, throw on some sweats or shorts and go for a walk. The fresh air and the sounds and sights of nature are a natural pick-me-up.
      If this seems difficult when you’re depressed, start a small routine of even one thing when you’re feeling well. Start going for a walk in a specific area at a specific time every day. Once you get into the habit of doing this, you’ll actually start to feel good.
      5. Have a sanity buddy.
      If you have at least one person to turn to when you need and want to, that’s good enough. Let them know that you’re not yourself. Educate them a little on the goings-on of depression and they’ll better understand when you either need space or checking up on, a shoulder to cry on or someone to rip you out of your shell for a short time.
      6. Make a happy list.
      Start small: favorite colors, places you’d love to visit. Pictures of your favorite place in the world can be on your happy list. That’s the whole concept of a happy list: stuff that makes you feel happy, makes you laugh, or just makes you feel good.
      Use all of your senses for this exercise. List as many and as much as your heart desires. I guarantee that by the end of your list, you’ll be either smiling or just all around feeling better if even for a little bit. Do a happy list whenever you wish, add to it, or remake a new one any time.

    3GvynDO4Ma2IT_rAnLmyuAe6k4dLdUfGLvNd52F_gehRUVciaDHV2qM4w5IiU_8NQ3Zz4dtkXHVh-f8dGn9LMLMOprLl3XJd0kiFtNBcBi3r_oI_khJjurDDuciKKUG_7HsYkn3gpv4HlA0gmFCyshgFvfEb0NxI47d4ijQ=s0-d-e1-ft.jpg3GvynDO4Ma2IT_rAnLmyuAe6k4dLdUfGLvNd52F_gehRUVciaDHV2qM4w5IiU_8NQ3Zz4dtkXHVh-f8dGn9LMLMOprLl3XJd0kiFtNBcBi3r_oI_khJjurDDuciKKUG_7HsYkn3gpv4HlA0gmFCyshgFvfEb0NxI47d4ijQ=s0-d-e1-ft.jpghen a person has been resistant to every form of depression treatment, is it possible that their illness stems from a different place? In a recent New York Times article Hillary Jacobs Hendel, a psychotherapist, writes about a patient who experienced what she calls “chronic shame.”
    Hendel’s patient, Brian, had tried every type of treatment but electroconvulsive therapy, which he didn’t want to do. After meeting with him, she learned that he was neglected as a child.

    During our initial sessions I developed a sense of what it was like to grow up in Brian’s home. Based on what he told me, I decided to treat him as a survivor of childhood neglect — a form of trauma. Even when two parents live under the same roof and provide the basics of care like food, shelter and physical safety, as Brian’s parents had, the child can be neglected if the parents do not bond emotionally with him … Brian had few memories of being held, comforted, played with or asked how he was doing.

    Hendel says the “innate” response to this kind of environment is distress. Brian blamed himself for that distress, believing he was the reason why he felt so alone. He felt shame for being abnormal or wrong. “For the child, shaming himself is less terrifying than accepting that his caregivers can’t be counted on for comfort or connection.” This is called attachment trauma. It results from a child seeking safety and closeness from their parent — yet the parent is not close or safe.
    Hendel also is a clinical supervisor with the AEDP Institute. She specializes in a treatment called accelerated experiential dynamic psychotherapy. Because Brian didn’t trust his own emotions, he was unable to use them as a compass for living, she explains. She aimed to use AEDP to bring this emotional life into awareness and allow Brian to experience his thoughts and emotions in an actively supportive environment.
    Unlike traditional talk therapy, the therapist in AEDP is emotionally engaged and actively affirming. Hendel repeatedly grounded Brian into the present moment, as he still fought bouts of “wordless suffering.” When he was more stable they worked on validating his emotions and helping him to feel them fully. “When I noticed tears in his eyes, for example, I would encourage him to inhabit a stance of curiosity and openness to whatever he was feeling.” It sounds a lot like mindfulness — being in the moment and staying observant without judgment.
    Over time Brian learned to express his feelings and practice self-compassion. In a way, he became the kind of parent he never had. Before treatment he had no template, no model for doing this.
    What struck me the most about Brian’s story is how adversely affected we can be simply by having no model — not just having overtly bad ones. I didn’t have the caregiver who was distant, unfeeling, inaccessible, or uninvolved. I had the unsafe kind. My worth was very clearly communicated through physical violence and verbal abuse. But it’s no different. Depression is so inherent in childhood trauma it’s as natural to us as breathing.
    What comes to mind for me is the feeling of being “unlovable,” and that is the seed of shame. The feelings of the parent, whether expressly communicated or intuited by the child, become internalized and automatic. And the state of being alone and powerless is so pervasive we don’t even know how they shape our lives — even our treatment.
    During my years in talk therapy, most of my sessions focused on my trauma history. Practical techniques from cognitive behavioral therapy were more often aimed at controlling my panic attacks and anxiety. Why didn’t we talk about depression? Why did I accept a prescription for anti-anxiety medication but not antidepressants? Because I had denied my depression for so long that I believed I was powerless.
    When I had a panic attack, I knew something was wrong, but depression was different. A therapist wanting to talk about my depression felt like he or she were questioning my very existence. It was as if taking away sadness was pulling the rug out from under me. It was my way of life. When therapists asked how long I had experienced symptoms of depression, I didn’t understand the question. The answer was, “for as long as I can remember.”
    It took a long time to face the fact that sadness wasn’t supposed to be something that lived in my shadow and took hours, weekends, weeks away from me while I sheltered in bed or in the bathtub wishing I could blink and no longer exist.
    Childhood trauma isolates, then depression keeps that person all to itself. If I could give anyone advice, it’s share. Talk to people about how you feel — especially your therapist. Join a Facebook group like Group Beyond Blue or the peer support forums on Psych Central. Don’t keep depression’s secrets.
    Finding the roots of depression is illuminating, but it’s not enough. We’re all just looking for a model that helps us manage our emotions. If you see someone struggling, offer your support.
    References
    Rholes, W.S. & Simpson, J.A. (2004). Adult attachment: Theory, research, and clinical implications. New York: Guilford Press.
    Freyd, J.J. (1996). Betrayal Trauma: The Logic of Forgetting Childhood Abuse. Cambridge, MA: Harvard University Press.
    Bloom, S. L. & Farragher, B. (2010). Destroying Sanctuary: The Crisis in Human Service Delivery. New York: Oxford University Press.




    81

    There Is No Simple Solution for Depression


    P4150038T.S. Eliot wrote, “We shall not cease from exploration, and the end of all our exploring will be to arrive where we started and know the place for the first time.”
    I remembered those words as I strolled around the Holistic Health Fair in Annapolis the other day. Presented by theMaryland University of Integrative Health, it occupied three floors of the Loews Hotel devoted to massage therapists, acupuncture specialists, detox experts, yoga instructors, and professionals from all kinds of local healing and wellness centers.
    Ironically, they were all the same professionals that I met 10 years ago when, at the lowest point of my breakdown, I decided to drop modern science like a boyfriend with bad breath and go the holistic route. I was sure that someone had the one and only solution that would heal me of my inner demons, the magic urn of ancient cat pee that, with only three sniffs of prehistoric urine, could set my psyche back in balance. So I asked everyone I knew: “Where is the path to the magic urn?” And they all pointed me in different directions.
    I followed all the paths. To yoga instructors and acupuncture specialists and massage therapists and recommended naturopaths. I took Chinese herbs and banged magnesium packets against phone books because that’s what the instructions said. I paid psychics to describe the color of my aura, and to tell me what helpful and frightening things it had to say about my inner life. I listened to tapes of mystic healers like Caroline Myss as I knelt in child pose in our bedroom closet with a candle lit.
    I listened to friends and relatives who told me that my medication was toxic, so I weaned off almost all of my drugs. I did not get better. In fact, I got worse, and was hospitalized a second time.
    Like most psychiatrists, mine tried a few combinations of drugs and recommended that I return to psychotherapy. I got a little better, but the remission lasted only two years.
    Ten years later, I know the hard truth: There is no simple answer to depression.
    If someone tells you they have the cure — whether it be Prozac or Chinese herbs or an anti-stress oil for $30 or six amazing sessions of therapy — my guess is that they are more concerned about paying their mortgage than being a companion with you along your health journey.
    No one who has spent less than a year with you can really know what you need to feel better. And if it doesn’t require hard work on your part — like getting up in the morning to exercise, or eliminating sugar, alcohol, and processed foods from your diet, or exploring some type of relaxation and meditation tool you will use daily to de-stress — it won’t last.
    Unfortunately, nothing worth having comes easy, like the Sheffield band said.
    As I walked around the room the other day, I felt older and wiser. The gray hair framing my face and the crows feet around my eyes showed the difference between who I was ten years ago and today. But more so I noticed the newfound confidence I have in my own health philosophies that don’t fit neatly into any category — holistic or traditional. I embrace both of them and more. Yes, the last 10 years have certainly been an exploration like Lewis says: learning what works, what doesn’t, and how to handle the stuff on which I’m mixed. That’s why I attended the fair.
    I knew that some of the services and items being sold at the booths might very well help me manage my illness, but that none of them could possibly claim to be the answer for me as some of their literature suggested because my situation is as unique as everyone else walking around the room. Acupuncture did not help me, but I have friends who have benefited from it; the “detox bars” that can supposedly fix my depression had ingredients that would worsen my mood — however, they might help someone with a sweet tooth who can’t stop eating Hershey bars at work.
    Ten years ago, I would have listened to each person’s sales pitch and believed their every word, adjusting my health vision yet again based on some new information. Now I know that I am the expert on my health, not my psychiatrist, or my integrative doctor, or my therapist, or my friends and relatives who are anti-medication. I know what works because I have been dutifully logging the results of things like diet, exercise, and stress-reduction tools in a journal for the last ten years. I have my own reliable data!
    Psychiatrists offer an important piece of the puzzle but only a piece. I have yet to find one who talks to patients about the substantial effects of diet on mood, or how getting your heart rate into the aerobic zone every day can fend off suicidal thoughts. Most don’t talk much about meditation practices or relaxation techniques either. It’s not totally their fault. If they take insurance, they don’t have time to discuss anything other than medication and recommendations for a psychotherapist.
    Holistic doctors and naturopaths offer another valuable perspective, but, again, only a piece of the puzzle. The herbs and essential oils and relaxation CDs they sell are the easy stuff. What’s hard is living your life in a holistic way — which involves daily exercise, and lots of trips to the grocery store, and taking time to cook. Wanting a bottle of special herbs to bring peace of mind is natural, but it’s not going to bring long-term, substantial results.
    Nope, nothing worth having comes easy.
    And that includes a solution for depression.
    Join Project Beyond Blue, the new depression online community.
    Artwork by the talented Anya Getter.
    Originally posted on Sanity Break at Everyday Health.

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