depression – Page 4 – Licensed Mental Health Counselor

Co-Rumination: Talking Too Much Can Lead To Depression And Anxiety In Adolescent Girls

8 Jul 20148 Jul 2014by Torey C. Richards, LMHC5 Comments

For the most part, adolescent girls talk more than adolescent boys. They just do. Little girls generally start talking sooner than boys and even as children are able to verbalize and express themselves much more efficiently. This ability to communicate has many advantages, especially in helping develop social-perspective taking skills (the understanding of other peoples thoughts, motivations, feelings and intentions).

Females are generally more gifted in the area of social-perspective skills which have great benefits including greater quality of friendships, better ability to get along with others, to show empathy and to be great caretakers. However, there is a downside to having well-developed social-perspective taking skills, including what is called co-rumination.

Co-rumination refers to extensively talking about and revisiting problems, focusing on negative feelings and speculating about problems with peers. While it is usually healthy to talk about problems, co-rumination generally focuses more on the problems themselves (especially negatively) and not on actual resolutions and therefore can be maladaptive.

Adolescent girls with good social-perspective skills are more likely to co-ruminate because they find it easier to talk to and relate to their friends about their problems and to understand their friends negative feelings about the problems. This type of understanding breeds closeness.

A problem with co-rumination is that it exposes the person to their friends problems, worries and negative affect repeatedly which can lead to empathetic distress. Empathetic distress is feeling the perceived pain of another person. Which means not only does the youth have their own problems, they are also taking on the problems of their friends.

When I worked in the high school I would be amazed at how teenage girls would take on each others problems so much so that you would think it were their own. Some would see this as an endearing quality, but much of it was definitely dysfunctional. Sometimes the amount of enmeshment would almost seem pathological. Some teens would find it hard to concentrate because they were so worried about their friends problems even when in all reality, it had no impact on them.

I would listen to them discuss the same problems with each other over and over again offering no real resolutions, but instead harping on and internalizing them in ways that were more detrimental than helpful.

As a counselor, I would encourage problem solving and positive thinking. I would try to help them understand that their friends issue isn’t theirs as well as try to help them understand disclosure. Many teenagers today, in part thanks to social media, share way too much personal information with each other without understanding the impact it may have later. Not understanding personal boundaries and disclosure is a crucial part of co-rumination and both rumination and self-disclosure have been linked to increased anxiety.

Girls in friendships with a lot of co-rumination often view their friendships as high quality because there is a lot of understanding and empathizing, but there is often also a lot of internalizing of problems which leads to negatively and has been shown to increase the risk of anxiety and depression.

Boys on the other hand generally do not socialize and c0-ruminate as much as girls do. The trade off is that while they may be more protected from empathetic distress, they are also less likely to have high quality friendships. There must be a balance.

I also believe that the impact of co-rumination and empathetic distress affects people well into adulthood, especially those in enmeshed friendships or in the helping fields where we in some instances we call it secondary PTSD and burnout.

So what do we do with this information?

It’s hard to curtail co-rumination without discouraging social-perspective taking which also has very high and much needed benefits. One solution is to help the individual understand and balance their concerns for other people with their own needs. Helping an individual learn what is their problem, and what is not their problem also helps to start separating some of the negative affects of co-rumination.

Also, focusing on the positive would help a lot. Many young girls focus on and talk about their problems way too much and internalize them instead of resolving them which only makes them feel worse.

I’m not discouraging talking about problems or young girls talking to their friends about their problems, but there is certainly a healthy and unhealthy way for young girls to discuss, think about and solve their issues without ruminating and falling victim to empathetic distress.

Taking Control of Your LIfe

It’s Not All Your Fault

1 Jun 201416 Jun 2014by Torey C. Richards, LMHCLeave a Comment

Recently I was talking to a 27-year-old female who had been arrested for the first time on various drug charges. Emotionally she was a wreck. I could tell she was really a good person on the inside, but emotionally she obviously wasn’t as stable as she could be and I immediately sensed that her childhood was filled with some type of neglect or abuse.

Why was I able to sense that? Because from my years of working with people, especially teenagers and women who have been abused and/or neglected as children, I’ve noticed that a large majority of them present very similar including being angry, shy, depressed, manic or lacking boundaries coupled with other cues such as body language.

This young lady was at some points crying, then angry, then laughing, and then crying again. Her life was “a mess” as she put it. She had two children, was in an unstable relationship (like all the other relationships she had been in), couldn’t seem to get her life together or in her words, “do anything right” and she had started smoking crack cocaine, a secret she kept from her family until she got arrested.

She couldn’t understand why she couldn’t get her life together. Why every time things would be going good, she would do something to mess it up. She was living almost in constant chaos and was using drugs to escape it. She had never been diagnosed with anything before and blamed herself for not being able to stop herself from making bad choices over and over again.

And then I asked her if she was ever abused before. I already knew the answer, I would have been shocked if I was wrong, I was hoping I was wrong, but I was right. She started crying and told me she had been molested repeatedly from the age of 8. Her childhood from that point on was filled with abuse, neglect and abandonment. No wonder now as an adult her life was “a mess”.

One of the things that happens to children and even adults when we experience abuse, neglect, trauma, abandonment or anything that is so mentally and emotionally painful that we can’t make sense of it, is that it doesn’t get fully processed and it becomes clutter in our minds, thoughts and emotions.

Our emotions and thoughts become fragmented with a lot of unprocessed feelings and those unprocessed feelings are what eventually will cause us to express ourselves in unhealthy ways, especially if we aren’t naturally resilient or have great social-emotional supports. However, even if we are naturally resilient and have great supports, chances are that fragmentation will still affect the way we think, feel and interact with other people.

That is what was going on with this young lady and until I explained to her how the trauma and pain from her past was affecting her future, she had no idea that at least some of what she was going through wasn’t totally her fault. Deep inside she is holding on to feelings of rage, insecurity and hurt from all the abuse, trauma and abandonment. All that unprocessed, raw emotion has to come out somewhere consciously or unconsciously. In a lot of people it comes out in the form of rage towards themselves or others.

They may cut themselves, or do other things that demonstrate a lack of love for themselves such as being promiscuous, abusing drugs or alcohol and getting into abusive or neglectful relationships over and over again just to name a few. Some may even attempt suicide. Drugs, sex, self-mutilation and even suicide may be used as ways to try to control the rage they have inside.

They may turn their rage outwards and inflict hurt on others by being abusive, bitter, and pushing people away sometimes to the point where they wake up one day and realize they are totally alone and will blame other people for abandoning them even when they were the one pushing them away.

On top of that, they become so used to hiding their real feelings and emotions that they have difficulty communicating and expressing themselves in a healthy way. In return, they often end up feeling misunderstood and often blaming others for everything that doesn’t go right. Their psychological defenses will leave them blind to their own role in their interpersonal difficulties.

When someone has all this stuff going on in their conscious and subconscious mind, there’s no wonder their lives are continuously in chaos. Almost nothing they do will fix it if they remain unaware and blind to how their past is influencing their present. If they aren’t willing to try to change and get help, then it’s very unlikely that their lives will ever be all that it could have been.

Change Starts With Insight

Sometimes the toughest part of therapy is insight building, which means getting the person to see things as they really are and how they are truly affecting their lives. Many people like to place blame on others and take absolutely no responsibility for their circumstances. Even this young lady at one point was trying to blame her boyfriend for calling the police when he couldn’t find her. When the police found her and search her, they discovered the drugs so this was all the boyfriends fault according to her.

Once I got this young lady to see that she had to take responsibility for her current incarceration, I pointed out to her that it wasn’t all her fault. Much of her current issues, the relationship instability, the drug use, the emotional instability, all had roots in her past. Once she got this she had an “aha” moment. She had never even put the two together. Even in that moment I could see the light bulb go off as some insight started pouring in.

That was amazing, but now it was time for the real hard work to begin. Now that she had insight, she had even more responsibility to start taking charge of her life and to stop letting the garbage from the past stink up her present and future.

Where To Start Healing

Immediately she said she wasn’t strong enough to do that, that she was too weak and that might be true which is why I told her the first thing she needs to do is to get into rehab. She needs to get clean and then to also find a good psychotherapist. She is going to have to be determined, patient and emotionally open because she will have to face a lot of emotional pain she’s been avoiding and she’ll have to resist the urge and the fear to do what she’s always done which is to get angry, runaway from getting help or to sabotage herself again.

This is not something that is going to be resolved in one session, one month or even one year. This will likely be a life long battle for her, but one that is worth fighting.

She has a long road ahead of her, but if she is willing to do the work, she will have a much better life. Until she does the work and gets the help she needs, nothing in her life will make sense the way it should and she will always be left feeling like a victim. It’s not all her fault, but she now has the responsibility to take control of her life and to at least minimize the hurt from the past.

This one young lady’s experience echos that of hundred of young women I have dealt with over the last several years. Many of them due to their experiences, stressors, and predispositions to certain illness will go on to become drug addicts, alcoholics, diagnosed with bipolar disorder, borderline personality disorder, depression, anxiety, etc. Some of them will be resilient and despite their past live incredible lives as relatively emotionally healthy people.

It may not be all your fault, but it is your job to take responsibility and control over your life.

Popular Psychology

Anti-Depressants May Increase Suicide Risk In Children, Teenagers and Young Adults

4 May 2014by Torey C. Richards, LMHC1 Comment

It’s been known for a long time that when people with depression are treated with antidepressants, their risks of committing suicide can actually increase, at least initially.

It’s thought that one of the causes of this is because highly suicidal people are often so depressed that they don’t have the energy to go through with attempting suicide. However, when they start taking antidepressants, sometimes they will start to feel more energy before they actually start to feel less depressed, therefore they now have both the thought to commit suicide and the energy to do it.

Recently, a study published in JAMA Internal Medicine explored the effects of antidepressants on children and young adults and found that they too have an increased risk of suicide when they first start on antidepressants, perhaps even more so than older people, especially when given selective serotonin reuptake inhibitors (SSRIs).

SSRI antidepressants can increase suicidal thinking and behavior in children, teenagers and young adults which is why the Food and Drug Administration issued a warning about the risk in 2004 after various independent studies showed a higher rate of suicides and suicide attempts among children and teenagers taking SSRI antidepressants .

The risk of suicide was most severe for those young people who started taking antidepressants at higher than average doses. They were twice as likely to attempt suicide when compared to those taking an average dose.

Than why are SSRI antidepressants being used? It’s because many think the benefits of them far outweigh the risk since the medication eventually lessens the risk of anxiety, depression and suicidal thoughts and behaviors. In most cases, SSRI antidepressants work really well and can be life savers, but there are risks that every parent should know about including the risk of increased suicidal thoughts.

People under 25 who were started on a higher than recommended dose of SSRI antidepressants were twice as likely to attempt suicide, especially in the first three months of starting them.

You may be asking, why then do doctors prescribe a higher dose than necessary?

In the study, almost 20 percent of the people had been given an initial prescription for higher than recommended doses. Part of the reason why is often times doctors including psychiatrist, play a guessing game when prescribing medication. They often don’t know what doses will be effective for a person and often don’t follow guidelines. They start people off with a dose that may be too much or too little and count on them to come back and let them know if it’s working or if they are having too many side effects. Then they will decide if they should increase the dose, decrease it or change the medication all together.

I’ve worked in the mental health field long enough to know that psychiatry is often a guessing game and anyone who has been on psych medications before can attest to this. Many patients often tell me they feel like the psychiatrist is using them as a Guinea pig because they keep trying different medications and doses of medications out on them. In all fairness, usually psychiatrist do this to see what works best for the patient, but often time the patient is left feeling an experiment and may even stop seeking help.

I’ve included a great Ted Talk video on psychiatry that talks about the importance of looking at individual brains instead of playing guessing games when it comes to treating people. Not everyone who has depression or anxiety or any other mental illness should be treated in the same way with the same drugs or with the same therapy, but in psychiatry and the mental health field in general, that is often the case.

If you or your child is depressed and thinking about getting on an anti-depressant, make sure you talk to your doctor, read the black box warnings and ask the important questions so that you will be informed and also know what warning signs to look for. antidepressants have worked wonders for many, but for some they have also been tragically bad.

Popular Psychology

Tragic Romeo And Juliet: Teens Kill Officer Then Themselves

26 Mar 201426 Mar 2014by Torey C. Richards, LMHC

In an article I wrote previously Are You In Tune With Your Teenager, I discussed the importance of parents engaging their teenagers in conversation and actually listening to what they have to say. So many parents simply do not listen to their teens and in this one incident in particular, it proved to be deathly.

Last week, in Windermere, Florida, a very small town just outside of Orlando, 18-year-old Brandon Goode and 17-year-old Alexandria Hollinghurst, two troubled teens in love from Davenport, Florida, decided to run away together. They were both suicidal.

Alexandria seemed to have been suffering from depression while Brandon may have suffered from any number of mental issues (in 2012 his mother called the police reporting that her son had painted his face black and was threatening her with an axe).

Their relationship seemed to be as unstable as the typical teenage relationship, but much more so due to both of their emotional and mental health states. Alexandria’s family didn’t seem to like Brandon too much, and three days before they ran away together, Brandon wrote Alexandria a letter apologizing for the trouble he had caused her with her parents and thought it would be better if they broke it off so he wouldn’t continue to cause her pain.

In that letter which was partially made public, and previous letters, it was obvious that the two were in love and had an intense emotional relationship, even declaring themselves to be engaged. They had thoughts of running away to the west coast of Florida together and sailing a boat to Panama where they would get married and live happily every after. A teenage fantasy that they were determined to either make happy, or die trying.

Brandon Goode and Alexandria Hollinghurst

On the day they ran away together, Brandon left a suicide note that said: “Please don’t be sad, this is what I want now, I get to die peacefully with the woman I love, the woman of my dreams, my fiance (Yes we were engaged!).”

Alexandria had written a suicide note a day earlier, stating to her mother: “If I had stayed another minute I would have painted the walls and stained the carpets with my blood, so you could clean it up,” she wrote in another letter to her mother “you turned a conversation about depression and suicide into something all about you.”

Her mom called the police who were there when Alexandria showed back up at her home. She denied being suicidal and the deputy left. The next day she ran away with Brandon. The two were immediately listed as “missing and endangered” and local and surrounding police officers went looking for them, even spotting them once before they drove off recklessly, only to later encounter Windermere police Officer Robert German as they walked along the side of the road.

Officer German immediately called for assistance, but it was too late. The teens shot and killed the officer before killing themselves.

Could the murder of this officer and the suicide of these two teens have been prevented? I’m almost sure it could have, but it may have taken some type of intervention a long time ago. However, I can’t help, but to wonder what if Alexandria’s mother would have really listened to her when she tried to talk to her about depression and suicide? Would she have been able to save her daughter, get her some help and maybe both her daughter and Officer German and maybe even Brandon would be alive today?

We will never really know, but I definitely think this reinforces the fact that parents really need to listen to their teens, make sure they understand what their teen is trying to say and DO NOT turn their conversation into a lecture or something about the parent. That’s not what your teen needs in that moment. They need you to listen, to be in tune with them and definitely to help support and guide them.

There is a lesson to be learned from every tragedy and I hope this one helps us learn to listen, communicate and pay attention to warning signs before it’s too late.

Popular Psychology

Urban Outfitters Pulls “Depression” Shirt

17 Jan 201416 Jan 2014by Torey C. Richards, LMHC1 Comment

Urban Outfitters came under fire after it began selling this shirt that has “depression” written all over it as if depression was something to be advertised. For Urban Outfitters to initially not see anything wrong with this (they have since pulled the shirt after public outcry), shows how much society has not only minimized mental illness, but even romanticized it. Granted, Depression is the name of the clothing company out of Singapore, but Urban Outfitters no doubt knew that they were pushing the envelope when they decided to sale the shirts in their stores.

This isn’t the first time urban Outfitters has come under fire for tasteless shirts. In 2010 they had a shirt that read “Eat Less” which seemed to make light of eating disorders, and another one that read “Syringe Shot Shooters” which addiction organizations protested.

The problem with shirts like this is that they minimize and make light of serious disorders and addictions. They also make it seem “cool” to have these issues.

You don’t know how many young girls I’ve worked with who are “cutters” and while most of them had some mental instability behind their self-mutilating behaviors, at least some of them did it for attention and because it made them seem complexed. The same is true with some of the depressed teens I worked with. Some of them were indeed truly depressed, but some of them carried around the bleakness and darkness like a badge of honor.

It also, in my opinion, takes some of the responsibility away from people who have these issues and then broadcast it with these types of shirts. The type of people who would wear these shirts aren’t saying “I’m depressed and I am fighting it with all my might”, but “I am depressed so excuse my darkness”.

People who truly suffer from these disorders and addictions don’t advertise it. Teens I see who seriously self-mutilate attempt to hide it, cutting in places you wouldn’t even think of and wearing excessive clothing to cover their scars. People I’ve worked with who suffer from eating disorders hate the disorder and the fact that they have to fight it everyday or risk dying or causing other serious medical issues to themselves. How are these people supposed to feel when their condition is being advertised and sold on a t-shirt? How is it supposed to make society take their condition seriously?

While these shirts may seem harmless, they are not. They are sending some hidden and unhidden messages to the public which can be dangerous. Shirts that say “Alcoholic”, “Crack Head” and “Suicidal” may seem harmless and even amusing to some, but for people who actually suffer, know or worse, have lost someone to those conditions, it is not funny.

Watch the documentary The Bridge which is a film about suicides committed by people jumping off the Golden Gate Bridge in San Francisco. You won’t see anyone who jumped to their death wearing a shirt advertising their pain or issues. Mental illness is nothing to glamorise. It is not something that can be fixed by giving someone a little more attention, but instead it takes hard work and dedication by both the person suffering from it and those that love them, including professional help and sometimes medication.

The best thing that I’ve seen come from this situation is the public outcry, for society to say that in the face of all the recent tragedies that have been linked to mental illness, we will not make light of it and forced Urban Outfitters to remove the shirts. Now only if Urban Outfitters and other companies that sale similar shirts would think about humanity more than profitability.

Acceptance

31 Dec 2013by Torey C. Richards, LMHCLeave a Comment

I’ve learned a lot from counseling other people and personal experience that a lot of anxiety and grief comes from refusing to accept reality.

A lot of times our perceptions or what we want things to be are out of line with reality. When we fight against that and refuse to accept to see things the way they are, it can create a lot of anxiety, depression, anger and neurotic behaviors. Ignoring reality keeps us stuck and doesn’t allow us to move on so that we can create and live a better, happier life.

We sometimes get stuck in relationships with partners, friends, and family members that need to be ended or at least changed in the way we deal with those people. Being in a relationship with an alcoholic for example, who refuses to stop drinking, while you hold on to the ideal that one day they will stop, will only disappoint and hurt you over and over again.

You have to see the person for who they are. That doesn’t mean you leave them if you don’t want to or stop trying to offer them help, it means that you align yourself more with reality so that everytime you find that person drunk you don’t take it personal and maybe it means you put more responsibilty on that person to attain sobriety instead of on yourself to do it for them. This will not only take a tremendous burdan from you, but it will also allow you to step back and see the situation more clearly.

The same goes for any relationship, including work.

Sometimes at work we make ourselves miserable, wishing things were different instead of accepting the reality of the way things are. By accepting reality, we can choose to either adjust to it so that we are able to maintain our sanity and a sense of accomplishment or we can decide that this particular job isn’t working for us and we need to move on. That’s what accepting reality does, it allows us to move on in little or big ways from situations that are not working for us.

Most of us don’t like change or for things to end, but often these things are necessary. Sometimes you have to leave one job to find a better one, or change the way you relate to a family member in order to have peace of mind. Beginnings, middles and ends all have their places in our lives and we can’t be afraid of them.

For example, few months ago I was hesitant to enter a new relationship becasue I hate beginnings and endings. I don’t like the feeling of having to “sell myself” or for someone to “sell themselves” to me, and I definitely don’t like the end of relationships. I prefer the middle, where everything is comfortable and stable and all the nuiances of the beginning have already been worked out, but no ending is in sight. However, you can’t get to the middle without the beginning so I had to accept that and I am glad I did as it has allowed me to not only get to know a wonderful person, but to explore myself and the way I am in relationships so that hopefully this relationship will have no ending.

Not accepting things can make us stay in dead relationships and jobs way too long out of fear of the unknown, and sometimes that is okay. Sometimes we are not ready or strong enough to make the change needed and we need some time to build our strength. This is not something to beat yourself up over because change takes preparation and when we are ready, when we feel strong enough, we will make the change necessary. No one can tell us when we are ready, but we’ll know. As long as we are accepting the reality of the situation, we will know when the time is right to make change.

Every real relationship we have, job we have, place we go has lessons for us to learn and once we’ve learned those lessons, it is often time to move on or to change something about ourselves. Making changes takes courage and faith and the ability to let go of fear, something I personally have to work on. We have to know that while change can be difficult and scary, we will be okay.

I personally believe that our lives are carefully and lovingly planned and that all of us are right where we are supposed to be. We aren’t off track or a mistake. We are currently, at this moment, right where we are supposed to be, with the people we are supposed to be with, for one reason or another. Each step is a lesson and change is usually just a progression of lessons. Sometimes people have to learn to love and be loved. To stand up for themselves. To stop wasting time and money on other people or wasting away at dead end jobs. Everything is a lesson and until we learn what the lesson is through acceptance, we’ll continue to be faced with the same challenges.

Once we’ve learned those lessons, we will be presented with new ones. It’s just the way the universe works.

Not all lessons we have to learn are painful, but sometimes we have to go through those painful lessons so that we can get to the lessons that are filled with love and happiness. By accepting reality and where we currently are, even if we don’t like that place, it will help us learn the lessons that situation has to teach us so that we can not only be grateful for them, but also move on.

People who struggle with acceptance usually end up creating a life for themsleves that is full of drama, heart ache, confusion, disappointment and regrets. Acceptance helps us take those lessons and become stronger, smarter and

How Your Teen Gets In Their Own Way And How To Help Them Stop Sabatoging Themselves

11 Nov 2013by Torey C. Richards, LMHC5 Comments

Working with teenagers for as long as I have, I realize that many of them come with various challenges, from emotional and educational challenges to family issues that seem to drag them down. However, in a majority of the cases I’ve worked with, the teens themselves are usually the ones who are getting in their own way of success and happiness.

They often don’t see it that way and will blame their family, their friends, their environment, any and everything, but themselves and it will take many sessions before I am able to help them realize that they themselves are indeed the cause of their problems through self-destructive and self-defeating behaviors and thus are also the answer to their problems.

Most people who have been around adolescence know that many times they get in their own way and do things that are self-defeating or self-destructive. Self-defeating behaviors are behaviors that get in the way of constructive action while self-destructive behavior generally causes some type of harm to the person.

In early adolescence for example, teens often start focusing more on friends, fighting with their parents and other adults as they try to discover their own identity and may end up struggling in school in response to paying more attention to friends than to their grades.

During this time of conflict, (ages 9-13), it is common for certain self-injurious behaviors to start occurring, such as cutting as a way to deal with much of the psychological conflict and pain, especially with teenager girls while teenage boys may do things such as punching walls, getting into fights or destroying property even if it’s their own.

During mid adolescence, ages 13-15, friends are generally ultra important and so is being accepted by your peers. This is the age that teens are going to high school for the first time and can be overwhelmed by the pressure to fit in.

When a teenagers faces feelings of inadequacy about their self-image they may shy away from their peers and develop anxiety issues and/or depression or even self-destructive behaviors such as eating disorders and suicidal thoughts.

During late adolescence, ages 15-18, teenagers may engage in self-defeating behaviors that include more risk taking such as drugs, alcohol, and sex simply for the excitement of it and not considering the dangers that can happen.

This is the age that I worked with the most to either help them stop drinking or using drugs, or to help them with issues surrounding sex including pregnancies, sexually transmitted diseases and even rape.

As someone who has worked with teens for a long time, it can be very frustrating to see a young lady with endless potential, waste it because she wants to be liked by her friends or a boy or she doesn’t like herself. The same rings true for many of the young men I worked with who were more concerned about having a “tough guy” image, than actually doing something positive with their lives.

Parents indeed find this self-defeating and self-destructive behavior frustrating, but what can they do? Often times teenagers are too defensive to actually take and listen to advice from their parents so parents often would bring their children to me and then wonder what it was about me, or what did I say that got through to their teenager that they couldn’t and I would always tell them that they had to practice objective parenting.

They had to work on not telling their teenager what to do and think or what not to do or think, to not judge, but instead simply draw conclusion between their choices and the consequences of their choices in an empathetic and objective way, and then let their teen decide to either continue the behavior or to try something different.

This is often hard for parents to do because they would like to control their teenagers choices, but they can’t. They have to allow their teenager to make their own choices, however, parents can continuously attempt to put healthier and more constructive choices in front of their teenager for them to accept or not to accept.

The more healthy options you place in front of a teen, the more likely they are to accept at least some of them. As a therapist that is what I did. I would know that I wanted a teen to stop doing a particular self-destructive or self-defeating behavior, I would share my observations about what they are doing and what they are getting (or not getting) from their actions and then attempt to continuously give them multiple alternatives in hopes that they would try at least one.

For example, one teenage girl was obsessed with trying to get pregnant simply because she wanted a baby. I tried to help her see how having a baby would hinder many of her plans and goals for the future, but she didn’t really see that. I then gave her many other things she could be doing instead of trying to get pregnant and she finally decided to try one which is playing softball. She tried out for the team, made the team and two years later graduated from high school with a scholarship to play softball and never got pregnant.

While her mother thought I had worked some type of miracle (she was sure her daughter wouldn’t finish high school without getting pregnant) all I did was give her an opportunity to try something new and that ended up being self-affirming and she basically did the rest.

As a therapist, it is easy for me to be non-judgmental, to allow teenagers to continue making mistakes and learning from them while still giving them healthy alternatives until they finally realize that what they are doing isn’t working and are ready to try something different.

For parents, it’s hard for them to have that same amount of patience because the attachment they have with their teen makes it much more painful for them to witness their teenager continuously sabotage themselves by making poor choices. It’s very difficult for them to be as objective as I try to be.

Because this is very difficult for most parents to do, seeking help from a therapist is often the best solution, especially if the behavior is self-destructive such as cutting, suicidal thoughts, eating disorders, etc.

A book I recommend for teenagers who are constantly self-sabotaging themselves is How to Get Out of Your Own Way by Tyrese Gibson.

Popular Psychology

Donald Glover’s Dark Instagram Musings: Celebrity Meldown Or A Cry For Help?

17 Oct 2013by Torey C. Richards, LMHC1 Comment

I know Donald Glover more for his music. He’s a rapper and goes by the name Childish Gambino, but he’s not just any rapper. In my opinion he is a lyrical genius and generally writes lyrics that are controversial and thought-provoking at the same time. His music, for the most part has a sense of depth to it which separates real artists from those who think they are real artists.

Most people however know Donald Glover from his work as a writer on the NBC hit 30 Rock as well as his character Troy on the NBC show Community which he recently left, some say to pursue his rap career. He’s also a talented comedian and only 30 years old.

Recently, Glover set the social world ablaze when he went diary like on his Instagram account on October 14th, revealing some intimate and honest feelings about his inner most fears which include fears over disappointing his fans, his career and his love life.

On a piece of hotel stationery he wrote:

“I feel like I’m letting everyone down,”
“I’m afraid people hate who I really am.”
“I’m afraid I hate who I really am.”
“I’m afraid this is all an accident.”
“I’m scared I won’t know anything ever again.”
“I’m scared I never knew anything.”
“I’m afraid I’ll regret this.”
“I’m afraid this doesn’t matter at all.”
“I don’t wanna rap,” he wrote. “I wanted to be on my own.” (clarifying that he didn’t leave Community to pursue his rap career)
“I’m afraid of the future,”
“I’m afraid my parents won’t live long enough to see my kids”
“I’m afraid people think I hate my race.”
“I’m afraid people think I hate women.”

On one hand, this freeing of emotions, this type of introspection is heroic.

Celebrities, especially Donald Glover, often times come off as shallow, narcissistic, and ego-maniacs. It’s refreshing to hear a celebrity express his fears. It humanizes them and reminds us that we have much more in common with each other than we may realize.

This sort of expression is good for the person too, it’s a catharsis and can help us not only think about what we are doing and where we are going, but also helps us bring balance back into our lives. The release of emotion is generally the mind and body trying to get back to a sense of balance when we feel out of balance.

However, there are times when this type of expression, especially when made as public as Donald Glover’s was, is a cry for help. A sign that someone is dealing with more mental angst, anxiety and/or depression than they may believe they can handle so they are putting it all out there in hopes that if the action alone doesn’t bring about a sense of relief, then hopefully it will gain the attention of people willing to help them get back into a state of balance and peace.

Some of his fans even feared that this could be a type of suicide note for now or in the future, and while I don’t believe it is, I can see where they could get that from. We’ve lost enough young celebrities this year to know that many have no overt signs of suicidal tendencies and the ones they did have were often overlooked or ignored. I would hate for this to be another one.

If I were someone close to Donald Glover, his friend, his family, even his business partner, I would definitely use this as an opportunity to reach out to him to make sure that he is okay. Chances are he is fine. Artist, depression and anxiety often go hand in hand. There’s been many studies and books written on manic depression and creativity and how depression, anxiety and even mania can spark creativity and yet sabotage the artist by overwhelming them.

Look at how many artists, musicians, and actors have killed themselves either purposely or through drugs and alcohol.

While I definitely think it’s freeing and refreshing to see an artist be so open about their fears, I think it’s also a warning sign for those closest to him to make sure that he stays balanced and doesn’t go too far unto the side of negativity and ends up ruining his life or doing something that is irreversible.

I am all about creative expression and introspection, but I also know that celebrities most often do not ask for help directly, usually do to their pride and status, yet they are just like the rest of us when it comes to dealing with our intrapsychic suffering.

Popular Psychology

Mental Health Awareness Week: Miriam Carey And Postpartum Psychosis

6 Oct 2013by Torey C. Richards, LMHC3 Comments

This week is Mental Health Awareness Week which was established by the U.S. congress in 1990 to recognize the National Alliance of Mental Illness’ efforts to raise the awareness of mental illness. It just so happens that last week’s police chase and subsequent shooting and killing of Miriam Carey has brought mental illness and postpartum psychosis into the spotlight.

What Is Postpartum Psychosis?

Many people have heard of postpartum depression, but not many people have heard of it’s evil sister, postpartum psychosis. When I was in graduate school I was so fascinated by postpartum psychosis that I actually did a 20 page research paper on the phenomenon.

It isn’t uncommon for women, after giving birth to feel down, sad or even somewhat depressed. This is what is known as “baby blues” and approximately 70-80% of mothers feel this contradicting negative thoughts and sadness after experiencing the joy of giving birth.

Many women don’t talk about it because they feel guilty or “bad” because of these feelings, but it’s important that they talk about the way they feel so that the “baby blues” don’t progress into something deeper like postpartum depression.

Postpartum depression basically is a much more intense and prolonged feeling of negativity, depression and mood swings when compared to the “baby blues”. This can last weeks, months or even longer.

Postpartum psychosis is the most severe and extreme form of postpartum depression and not only does it typically include the intense sadness, negativity and mood swings of postpartum depression, but it also includes the onset of psychotic symptoms after childbirth.

An example taken from a personal experience I had dealing with a client I diagnosed with postpartum psychosis is that she was extremely depressed at times and then highly erratic and impulsive other times. She was extremely irritable and was having hallucinations which included voices and delusions that her newborn was evil and needed to be killed.

Like a lot of women who deal with the “baby blues”, postpartum depression and postpartum psychosis, she tried to hide the way she was feeling and mask her psychotic symptoms until it got to the point that she was about to drown her child in the bathtub. It was then she went to her family for help and was taken to the psychiatric hospital.

This particular young lady ended up being okay after treatment which included therapy and a brief period of taking lithium. Her child was subsequently raised by the maternal grandparents although legally this young woman still has full custody and spends time with her daughter often.

Postpartum psychosis is extremely rare which is one reason it is not often talked about and another reason many people who suffer from it try to hide it because they are struggling to try to understand exactly what it is they are going through and may feel alone.

Symptoms

Symptoms of postpartum psychosis Include, but are not limited to:

euphoria
overactivity (hyper)
decreased sleep
talkative (loquaciousness/hyperverbal)
flight of ideas
disinhibition
irritability
violence
delusions
grandiose thinking or behavior
religiously preoccupied
delusions
hallucinations
depression
mood swings
mutism

10 Mindfulness Techniques You Can Start Using Today

24 Sep 201324 Sep 2013by Torey C. Richards, LMHCLeave a Comment

Most of us spend a lot of time feeling pain, guilt or regret about our past and anxiety about our future. We can get so wrapped up in this past and future thinking that we don’t even enjoy the present moment we are living in.

Mindfulness is a form of self-awareness that helps brings us back to the present moment. It is taken from mindfulness meditation which is based on Buddhist meditation principles. It the past decade or so it has become very popular, especially as part of dialectical behavior training which has been successful in treating borderline personality disorders.

The basics of mindfulness helps us to pay attention to the present moment and disengage from the mental clutter and chatter that is almost always filling our minds.

How many times have you found yourself at a party, in a meeting, on a date even playing with your kids and yet while you are physically there, mentally you are somewhere else. You are in your head, dwelling on your past, thinking about the future and not living in that very moment. We have so much going on in our lives today that it’s hard to live in the present.

We are with our spouses, but thinking about everything we have to do at work tomorrow so we aren’t really hearing what they are saying or we are doing a task we do regularly, but are just going through the motions and not really paying attention to what we are doing (which is one reason accidents happen).

I have to admit that there have been many times when listening to a client that my mind will wonder. I’ll start thinking about my past, I’ll start thinking about what I have to do later that day and before I realize it, I’ve missed a good portion of what that client was talking about (it’s bad I know, but it happens… therapist are human too). I have to fight with myself sometimes to stay in the present, to not allow the clutter and chatter in my brain to take me anywhere else, but to remain in the here and now which takes practice.

As a matter of fact, during group therapy, being in the present and being mindful are two of my 10 rules. Often times when one group member is talking, some of the others will drift off to their own issues, their own regrets over the past and anxieties about the future to the point that they can’t offer support and encouragement to the group member who was speaking because mentally they weren’t there.

Here I’ve listed 10 ways to help you start being more mindful and to start living in and enjoying the present moment today.

One Minute exercise: sit in front of a clock or look at your watch for exactly one minute and focus all of your attention only on your breathing and nothing else. Sounds simple, but your mind will tend to rebel and try to fill itself with all kinds of past and future thoughts. Resist it, focus simply on your breathing for one minute. Once you have this down pat you can start extending it by another minute up to five minutes or even longer!
Take a shower. Showers can be relaxing and can be a mini vacation away from everything and everyone else. Feel free to use your imagination and picture yourself standing under a tropical waterfall.
Speaking of water, sticking your hand in some warm water and concentrating on the sensation on your skin is not only a great way to bring you back to the present, but it is also helpful for de-stressing because it brings your brain a sense of comfort. If you aren’t near any warm water try rubbing your hands together to get a similar affect.
Listen to music, calming music preferably and music you’re not familiar with is best, but really listen to it, not just the words, but the sounds of the instruments and the rhythm of the beat. Even familiar music can sound new again when you truly are present with it.
Mindful Eating: Most of the time when we eat, we aren’t really paying attention to what we are doing. We are distracted by our mind, the television or anything else. In mindful eating, you sit down with no distractions, paying full attention to every bite you select and put into your mouth being aware of its color, how it smells, how it taste, the different textures, how it feels in your mouth. You may be surprised at how your food actually tastes different once you slow down and focus on it and possibly, how little of it you actually need to fill full. If trying this for an entire meal is too hard, try doing it for the first two bites of each meal.
Mindful Walking: This is similar to mindful eating accept you take a walk and allow yourself to only focus on what is happening right now. How the ground feels beneath your feet, how the wind and/or sun feels on your skin, on how the leaves look and sound on the trees, even observing other people. It’s also good to pay attention to your breathing as you walk to help keep you present and centered.
The acronym R.A.I.N. is used to describe a more advanced technique for when you are feeling unpleasant emotions where “R” stands for recognizing when a strong emotions is present, “A” is to acknowledge the emotion (instead of denying or running from it), “I” is to investigate where the feeling is coming from by checking in with your mind, body and feelings, and “N” is to non-identify with what’s there, meaning to not allow the emotion to define you or control you, but to understand that it is just another passing emotion that doesn’t have to control you. RAIN is about staying with your emotions and then letting them go, not dwelling on them or doing things to try to escape them, but acknowledging them and then allowing them to leave. It can be challenging to stay with your emotions and still let them go which is why this and the next technique are both considered advanced, but once you practice and can use them effectively, they can be life changing.
Most of the time before we know it, our minds are racing, we are thinking about the past, the future, anxious, and just going through the motions of our daily routine. This is when we need to find time to S.T.O.P. which means to Stop what you are doing, if only for a minute, Take a breath and pay attention to your breathing, allowing it to flow in through your nose deeply and out through your mouth fully. You can try imagining breathing in a cloud through your nose and blowing it back out through your mouth. Observe your thoughts, feelings and emotions. Know that you can observe them, but they are just thoughts, feelings and emotions, that doesn’t make them facts they are not permanent. Often times recognizing, observing and letting thoughts, feelings and emotions go will work much faster than any psychotropic medication can in alleviating anxiety and depression. Lasting proceed with something supportive and positive such as talking with a friend or exercising.
Un-tunnel your vision. A lot of times when we are stressed it’s because we are focusing on a single point that eliminates or obscures all other options. Try extending your arms all the way out until you form a “T” and then wiggle your fingers. Slowly bring your arms back in until your fingers are insight and then extend them again. Repeat this. Playing with your peripheral vision can help your brain to remember to expand and to remember that their are other options and possibilities other than that single point it’s currently focusing on that’s causing you stress.
Come up with your own ways to be mindful and in the here and now! There are so many different ways we can practice being in the moment and there is no better way than finding something that works best for you.

A lot of our discomfort comes from worrying about the future and beating ourselves up about the past, but the past is gone and the future has not happened yet. Living happens in the moment we are in right now so taking some time to remember that and appreciate the present will definitely make our entire life experience richer.

Tag: depression

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Mental Health Awareness Week: Miriam Carey And Postpartum Psychosis

What Is Postpartum Psychosis?

Symptoms

Other Famous Examples of Postpartum Psychosis

Melanie Blocker-Stokes

Andrea Yates

Miriam Carey

10 Mindfulness Techniques You Can Start Using Today