Month: October 2016

How False Beliefs About One’s Self Can Play into Anxiety and Depression

What makes you, you? According to Brian Little, PhD, author of Me, Myself, and Us: The Science of Personality and the Art of Well-Being, there are five consistent traits humans embody.

“Many personality researchers have concluded that the hundreds of different trait dimensions can be reduced to five major factors that consistently emerge in data collected across different cultures and language groups. The so-called big five dimensions are: open to experience (vs. closed-minded), conscientious (vs. careless), extraverted (vs. introverted), agreeable (vs. disagreeable) and neurotic (vs. stable).”

Are these qualities cast in stone at birth or are they mutable?  It may come down to the question of nature vs. nurture. Those who take the former stance are referred to as ‘nativists’ who view personality traits as immutable, while others who are in the second camp are referred to as ‘empiricists’.  Each makes a valid point and yet, we are an adaptive species with daily opportunities to take a different path an alter our decision making by changing our beliefs about the person in the mirror.

In an article entitled “Identity Formation.” Boundless Sociology. Boundless, 26 May. 2016, “Identity formation is defined as, “development of an individual’s distinct personality by which he or she is recognized or known.”

Identity is delineated in several categories that include:

  • Cultural
  • Ethnic
  • Religious
  • National

Each is part of a puzzle that comprises the ways in which an individual is viewed by the world and even more importantly, by themselves.

Who Are You? Who, Who, Who, Who. I Really Wanna Know

Rock lyrics aside, an exploration of the ways in which we perceive ourselves and our place in the world, is worth attention.

A therapist who has worked with a variety of clients over three decades has observed that the hardiest and most resilient among them have been able to acknowledge their core essence, and cultivated the ability to become chameleon-like when needed. She recalls an older gentleman who grew up in a working class home, situated in a multi-ethnic neighborhood. He and his three siblings were first generation American born of immigrant parents who fled persecution in their homeland. They were told that they needed to assimilate in order to succeed; speaking their native language in the home, but only English outside the home. She witnessed that he was able to maneuver his way through nearly any encounter with people from all walks of life and socio-economic backgrounds. He had developed that ability by imagining ‘walking a mile in their shoes’.  Although he had a clear idea that he fit into each of the aforementioned categories identity based categories: Blue Collar-Russian-Jewish-American, he knew he was far more than that and as a result was highly successful in his relationships. He exhibited the open minded, conscientious, extraverted, agreeable and stable classifications.

Another, who had experienced abuse at the hands of his alcoholic father, developed the belief that he needed to consistently prove himself and that he would never measure up. Although he presented as confident at times, deeply committed to excellence, affectionate and demonstratively loving, there was another aspect of himself that demanded loyalty and agreement with his world view. As a result, he was often at odds with his finer qualities. He saw himself as the reflection of his father’s perspective and it created conflict in relationships that he desired to be harmonious. Episodic depression and anxiety, as well as OCD behaviors infiltrated his home, work and social life. He exemplified close minded, conscientious, extraverted (with occasional introverted tendencies), disagreeable and neurotic traits. His identity was formulated, also as was the first man, Middle-Class-Irish-American-Protestant; although it had less impact on shaping his affect than did the personality traits.

How Do We Change Our Self -Assessment?

  • Ask yourself, “What am I believing about myself or this experience?”
  • Be aware of when you are making broad generalizations about your behaviors labeling you. An example might be, “I made a mistake vs. I AM a mistake.” Or “I have so many flaws, so I am not worth loving.”
  • Challenge those thoughts.
  • Be willing to re-write the narrative you have running through your head.
  • As is encouraged in the recovery community, do a ‘searching and fearless moral inventory,’ as you take an honest look at what you have done, the decisions you have made and how they impact your life.
  • Choose to change what you can.
  • Put down the proverbial whip which you have brandished at yourself.
  • Embrace your strengths.
  • Accept lovingly offered praise and critique.
  • Learn to offer yourself the same quality of love that you give others.

A Cautionary Tale: How Medications Can Increase the Feelings of Depression

Our bodies are miraculous self-regulating creations that when cared for with healthy food, activity, exercise, rest and proper hygiene, can last a long lifetime. There are times, however that they require chemical intervention to maintain function. There are a number of commonly prescribed medications that are saddled with side effects, including depression.

  • Accutane. Used as an acne treatment.
  • Alcohol. Although many report feelings of elation while drinking, it is a central nervous system depressant that anesthetizes emotions and represses inhibitions.
  • Antabuse: This medicine is used to treat alcoholism.
  • Anticonvulsants: These are used to control epileptic seizures.
  • Barbiturates: These are a group of central nervous system depressants that slow down brain function. These medicines have been used to treat anxiety and to prevent epileptic seizures.
  • Benzodiazepines: This group of central nervous system depressants is often used to treat anxiety and to relax muscles.
  • Beta-adrenergic blockers — Also known as beta-blockers, these medicines are used in the treatment of various heart problems, including high blood pressure, heart failure, chest pain caused by angina and certain cardiac arrhythmias. They may also be used to treat migraines.
  • Calcium-channel blockers: This group of medicines slows the heart rate and relaxes blood vessels and to treat high blood pressure, chest pain and congestive heart failure.
  • Estrogens: Female hormones are often used to treat symptoms of menopause and to prevent or treat osteoporosis.
  • Interferon alfa: This drug is designed to treat certain cancers as well as Hepatitis B and C.
  • Norplant: This is used as a contraception.
  • Opioids: This group of narcotics is used to relieve moderate to severe pain. These drugs have a high potential for abuse and addiction.
  • Statins: These medicines are used to lower cholesterol, protect against damage from coronary artery disease and prevent heart attacks; examples
  • Zovirax:  Doctors prescribe this drug to treat shingles and herpes.

Although it seems contradictory, people who experience medications as an antidote to depression sometimes experience a paradoxical effect and find it increasing.

In 1994 Italian psychiatrist Giovanni Fava, M.D, who is the editor of  Psychotherapy and Psychosomatics, encouraged his peers to accept that it might indeed be so. He wrote: “Within the field of psycho-pharmacology, practitioners have been cautious, if not fearful of opening a debate on whether the treatment is more damaging than helpful. I wonder if the time has come for debating and initiating research into the likelihood that psychotropic drugs actually worsen, at least in some cases, the progression of the illness which they are supposed to treat.”

He reported that, the brain is trying restore its “homeostatic equilibrium,” referring to this enigmatic response to a psychiatric drug “oppositional tolerance.”

This was reinforced by the work of researcher, Rif El-Mallakh, M.D.at the University of Louisville School of Medicine. In the June, 2011 issue of Medical Hypotheses, he offers “emerging evidence that, in some individuals, persistent use of antidepressants may be pro-depressant.” He refers to the term as ‘tardive dysphoria’.

Commonly prescribed anti-depressants include:

  • Celexa
  • Cymbalta
  • Desyrel
  • Effexor
  • Elavil
  • Latuda
  • Lamictal
  • Lexapro
  • Pamelor
  • Paxil
  • Prozac
  • Pristiq
  • Remeron
  • Seroquel
  • Viibryd
  • Wellbutrin
  • Zoloft
  • Zyprexa

Do these findings point to encouraging discontinuing use of anti-depressant medications?

If you find yourself noticing and increase in depressive symptoms and before considering any change in medications, speak with your treating physician. Look to complimentary interventions, including psychotherapy, time in nature, a fitness routine, healthy nutritional plan, socializing as able, refraining from isolating, listening to music, interacting with animals, stretching comfort zones by engaging in new activities, volunteering, journaling, light therapy (for Seasonal Affective Disorder), acupuncture, a support group, yoga, meditation, saffron, fish oil supplements, SAMe, as well as St. John’s Wort. Adding these items to your recovery tool kit may ameliorate some of the side effects.

How Does Mindfulness Reduce Troubling Thoughts?

“I’ve got such a mess between my ears, like dishes in the sink. Stuff I don’t believe just tumbles in so I don’t have room to think”- David Wilcox (Empty Out the Inside of My Head)

This common experience is one that leaves in its wake, distress and is a fertile breeding ground for depression. What are some of the troubling thoughts that fill up your symbolic sink?

  • I’m a failure.
  • I’m not smart enough to go to college.
  • No one loves me.
  • I’m too much or not enough to be in a healthy relationship.
  • I don’t matter and have no purpose.
  • I’ll never get it right.
  • Everyone else is happy, except me.
  • I don’t deserve to have what I want.

As a therapist working with clients in an outpatient addiction and recovery practice, I recall a poignant and powerful statement from a single father of three teenagers. He was insistent that they clean up the kitchen after preparing meals, reminding them, “The sink is for washing dishes and not storing dishes.”  How often do we store the dishes that represent the disturbing beliefs we hold so that they, like literal dinnerware accumulate stuck-on stuff? Imagine instead, running soapy water over them and allowing the remains to go down the drain.

Another potent metaphor is that of a glass half filled with water. You can hold it still for only so long and then your arm begins to shake and with it, the liquid within. A few minutes more and the tremors may increase as the water sloshes over the edge, drenching your arm and the floor. It is only when you still your hand and the glass that it remains contained. So it is with our over active brains. That is where mindfulness becomes a helpful tool.

“Focusing on the here and now helps individuals become aware of their negative thoughts, acknowledge them without judgment and realize they’re not accurate reflections of reality,” says William Marchand, M.D., in his informative book entitled Depression and Bipolar Disorder: Your Guide to Recovery. Marchand is a psychiatrist who specializes in mindfulness as a therapeutic tool.

He adds, “When we practice mindfulness, we experience these difficult thoughts and emotions. But we experience them as an observer – rather than being washed away by the never-ending torrent of cognitions and feelings that flood our minds. By becoming moment-to-moment observers of our thought process, we learn to just watch the deluge without getting carried away in the current.”

Still Waters Run Deep

According to Jon Kabat-Zinn, PhD, author of Wherever You Go, There You Are, and the founder of Mindfulness-Based Stress Reduction (MBSR) “The best way to capture moments is to pay attention. This is how we cultivate mindfulness. Mindfulness means being awake. It means knowing what you are doing.”

So, how can we become mindful, instead of mind-filled to overflowing?

  • Remind yourself when pulled into the past which is generally where depressing thoughts are formulated, “I am here and now, not there and then.”
  • As simplistic as that might sound, consider how often throughout the day, particularly when in the midst of stress inducing circumstances, you hold your breath.
  • Observe what is around you. Remember the childhood game, “I spy with my little eye”? You can adapt it to, “I spy with my mindful eye,” and then state what you see around you.
  • Engage in object awareness. Hold a flower, stone or strawberry in your hand and experience it with all of your senses. Attempt to describe it as if to someone who has never seen it before.
  • Full sensory eating. Pick a favorite treat and smell, see, taste, touch and hear it in silence.
  • Wash the dishes or fold clothing with total attention to what you are doing.
  • Take a walk. This too can be meditative as you focus on each step as a distinct movement. A labyrinth can be an effective tool to assist in slowing your movement.

An Attitude of Gratitude Helps Heal Depression

“Gratitude turns what we have into enough, and more. It turns denial into acceptance, chaos into order, confusion into clarity…it makes sense of our past, brings peace for today, and creates a vision for tomorrow.” Melody Beattie

The alarm goes off and you roll over and groan as he sunlight beams brightly through your curtains. You wonder why you even bother to get up, since the voice of depression that chatters incessantly tells you that this is going to be like countless days before. Another day filled with responsibility, tasks to accomplish, traffic to fight and people to encounter who expect you to be on. It’s all you can do to get yourself in an upright position and muscle your way through the day.

Although it seems difficult to do, one remedy for counteracting the effects of depression is gratitude. Keep in mind that anything done with commitment and consistency can have a potent impact. As is so with any practice, the more you engage in it, the greater the benefit.

Robert Emmons, PhD from the University of California conducted a study linking gratitude with wellbeing. He discovered that those who regularly focused on that for which they were grateful, “reported levels of the positive states of alertness, enthusiasm, determination, attentiveness and energy compared to a focus on hassles or a downward social comparison (ways in which participants thought they were better off than others).”

Why Are Grateful People Happier?

  • They tend to be more optimistic; seeing the glass not only half full, but, indeed ‘all full,’ since although it might only be half filled with liquid, the other portion is air.
  • They are generally more relaxed and tend to go with the flow.
  • They see what is right and not just what is wrong with nearly any situation.
  • They have a higher level of resilience and can bounce back from most challenges they face in their lives.
  • They are better able to engage The Relaxation Response; a term that was coined by Herbert Benson, M.D, about which he says, “The relaxation response is a physical state of deep rest that changes the physical and emotional responses to stress… and the opposite of the fight or flight response.“
  • They note a decrease in depressive symptoms such as excessive fatigue and lethargy, a loss of interest in life circumstances, poor appetite and sleep and/or a reduction in both.
  • They experience as sense of accomplishment.

How Do You Begin and Sustain a Gratitude Practice?

  • Begin and end each day with a mental list of what you are thankful for.
  • Keep a gratitude journal.
  • Take a gratitude walk in nature and notice all that your senses take in.
  • Surround yourself with grateful people. Motivational speaker Jim Rohn states that “You are the average of the five people you spend the most time with.”
  • Use positive self- talk, beginning with the words, “I am…” and then complete the sentence from there.
  • Listen to positive music, also known as Posi’. Many of these songs express gratitude.