Stop Labeling Yourself: 3 Steps to Stop Holding Yourself Back

The terms “mental health” and “mental disorder” are extremely common, but research from biological anthropologists are calling into question these definitions in relation to depression, anxiety, post-traumatic stress disorder, and attention deficit hyperactivity disorder.

New research published in the American Journal of Physical Anthropology posed the question, “What if mental disorders like anxiety, depression or post-traumatic stress disorder aren’t mental disorders at all?” A summary of the results indicated that, “With a thorough review of the evidence, they show good reasons to think of depression or PTSD as responses to adversity rather than chemical imbalances. And ADHD could be a way of functioning that evolved in an ancestral environment, but doesn’t match the way we live today.”

So what does this mean for our mental health and treatment for such mental health difficulties?

As evidence has shown, we have a tendency to identify with our “emotional problems” in a way that we don’t identify with “physical problems.” When we contract a virus, we don’t say, “I am flu.” We say, “I have the flu.” But when we struggle with anxiety (or other emotional difficulties), especially if we deal with chronic disorders, we do often say, “I am anxious,” or “I am high strung,” or something similar. It becomes an identity statement. The problem is, when we personally identify with the anxiety we feel, we begin to think of it as a necessary part of who we are.

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For more on this topic, check out Unworried: A Life Without Anxiety
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How do we, then, break free from these labels and finally identify with our healed, healthy, “true” selves?

1. Identify with strengths, not weaknesses—To counter the tendency over-identify with our emotions it is important that we make an intentional effort to focus on our strengths. Write down at least one thing you did well every day. Identify the strengths that you displayed in that situation in order to handle that moment well. Prioritizing this thought process enables us to begin to identify with our healthy, true selves, rather than identifying with the areas where we may be struggling.

2. Stick to a routine, create “healthy habits”—No matter what we deal with in our daily lives, having a routine helps us to stay on track and cultivate healthy habits. Routines, like getting up and getting ready at the same time every day, doing chores at the same times every week, and going to bed at the same time every day, help us create order out of chaos and make us feel like we are on top of things. Make time for the things that help you feel good, such as journaling, prayer, exercise, or your favorite activity/hobby.

3. Be a gift to others—Look for ways to serve others, nothing is too small. Bake cookies for a friend, hold the door open for a stranger, let someone in front of you in line, reach out to someone you love or someone you haven’t checked in on in a while. Use your gifts to in big and small ways to be a gift to others. When we reach out to others in this way, we are able to make a positive impact on their lives AND feel good about what we have to offer at the same time.

For more on breaking free from labels and becoming the person you were created to be, visit us online at CatholicCounselors.com and check out Unworried: A Life Without Anxiety.

Stay-At-Home Moms and Depression: 4 Things You Need To Know

Being a stay-at-home parent is hard, but does it cause depression? A recent discussion at Peanut Butter and Grace raised this important issue. It turns out that there is more to this question than meets the eye.

Survey Says…

A 2012 Gallup poll found that 28% of stay-at-home moms (SAHMs) had been diagnosed with depression compared to 17% of employed moms (defined as mothers who have both a full or part time job and children under 18).

Of course, this alone doesn’t necessarily mean SAHMs are more depressed than employed moms.  For instance, it could be that working moms are just as depressed as SAHMs; but, between work and household responsibilities, they just don’t have time to seek professional help.  In fact, a 2015 Pew Research poll found that the majority of working moms continue to be frustrated by the uneven division of labor at home.   As sociologist, Arlie Hochschild observed, working moms often feel that, at the end of the work day, they have to go home to work their “second shift” as a homemaker.   Many working moms are not only depressed, they also don’t have time to do anything about it.

Bridging the Gap:
The Ideal vs. Reality

Regardless, few people would argue that being a SAHM is easy.  And it’s clear that some SAHMs are happier in their role than others.  Similarly, because research shows that kids do better overall when raised by a contented and attentive SAHM than kids raised by either working moms or unhappy SAHM’s, there are certain women would feel they should be home with their kids, but who genuinely struggle to make it work for them.

Is it possible to know which moms will be more likely to find real joy in being an SAHM?  Or, for that matter, if a mom has chosen to stay home, but is struggling with it, are there things she can do to feel better about her choice besides going back to work outside the home?

Here are a few things research can teach us about the circumstances that allow certain women to enjoy being a SAHM, along with some suggestions for those who value the role of being a SAHM but currently find little joy in it. (*See note below)

1. They Are Securely Attached

Research consistently shows that SAHM’s who were raised in affectionate, affirming homes that were stable, emotionally supportive, and employed consistent, gentle discipline are much more likely to enjoy being SAHM’s than less securely-attached women.  The term “attachment” refers to the degree a child has a gut-level sense that she can count on her parents to provide the temporal and emotional support and guidance she needs to thrive.

By contrast, women raised in less emotionally-affirming families-of-origin tend to exhibit either anxious or avoidant attachment.

Anxiously-attached women tend to be extremely scrupulous about their parenting, constantly worrying that every little misstep will ruin their children.  Their constant fear of failure and hypersensitivity to perceived (or actual) criticism makes it hard to truly enjoy anything about being home with their kids.  These SAHMs tend to experience both an extremely high commitment to being a SAHM with very low satisfaction in their role.  Depression can be a symptom of laboring under the constant weight of feeling that they are always wrong, always, failing, and never good-enough no matter how hard they try.

Likewise, avoidantly-attached women raised in unaffectionate, unemotionally supportive families-of-origin tend to struggle to enjoy relationships in general.  Things like giving affection and being nurturing tends not to come naturally to them—and may even grate on them.  They tend to focus on the tasks of motherhood rather than cultivating rewarding relationships with their children. Although every mom gets tired of cleaning a room just to have to clean it again, avoidantly attached moms tend to primarily and almost solely view motherhood as a never-ending mountain of tasks that can never be completed. They may experience depression as a result of never being able to feel that they have accomplished anything.

WHAT TO DO: If you struggle in this area, the good news is that there is such a thing as “earned secure” attachment.  Anxiously attached women can learn to stop beating up on themselves, and avoidantly attached women can learn to enjoy being human beings rather than human doings. Books like Dr. Tim Clinton’s Attachments: Why You Love Feel and Act the Way You Do or Dr. Amir Levine’s Attached: The New Science of Adult Attachment are good places to start seeking healing. Professional counseling can also offer tremendous assistance in healing attachment wounds.

2. They Chose It

It is difficult to feel good about something that was forced on you.  Research shows that mothers who feel obliged to be SAHM’s primarily because of social pressure, or poor alternative child-care options, or other reasons, are more resentful of their role and more inclined to depression as a result.

 By contrast, mothers who choose to be SAHM’s primarily because they see, not just intellectual or practical value in the role, but also emotional value in nurturing a deep relational connection with their children, creating meaningful family experiences, and maintaining a cozy home are much more likely to experience real joy in their role.

WHAT TO DO:  In psychology, an external control fallacy is the mistaken belief that I am a helpless victim of my circumstances.  This unhealthy thinking pattern makes us passive-aggressively push back against our “fate,” causing us to “phone in” our effort which, in turn, leads to a sense that nothing matters, nothing is enjoyable, and I can do nothing to make my life more meaningful.  Anyone can fall into this trap, but avoidantly-attached moms are particular prone to this tendency.

There may well be compelling, practical reasons for being home with your children, but don’t ever let that stop you from bringing your creativity, your intelligence, and your whole self to the roles you choose to play—whatever they are!  Happy moms don’t always love every part of parenting, but they make sure to put their own stamp on what they do and the way they do it.  Even when they are struggling to find the energy to do it, they treat homemaking and child-rearing as worthwhile professions that they are committed to being accomplished at and taking joy in.    Research on burnout shows that when we feel uninspired by our work and roles, one key to recovery is making ourselves learn new ways to do what we feel are the “same old things.”  Each morning, ask yourself, “How will I create meaning, joy, and connection today?” Make these goals your priority, and resist the urge to simply coast through the day doing as little as possible, and doing it the same old way you always do. Books like Overcoming Passive-Aggression by Dr. Tim Murphy and The Corporal Works of Mommy (and Daddy Too!) by Lisa and Greg Popcak can be a huge help in these areas.  Counseling can also be a great help for reclaiming your sense of competence and creativity.

3.  They have supportive, involved husbands 

(and other supportive relationships).

A recent Today survey found that 46% of moms find their relationship with their husband more stressful than their relationship with their children.  These moms complained of critical, unhelpful, husbands who were poor helpmates around the house, disengaged fathers, and demanding spouses.

Happy SAHMs have husbands who are vocal about their support and praise for the work their SAHM wives do, are active helpers around the house, effective disciplinarians with the children, and engaged dads. Research by the Gottman Relationship Institute also shows that husbands of happy SAHM’s exhibit strong emotional intelligence; that is, they demonstrate both the ability to genuinely value and appreciate her perspective (even when they don’t agree) and an openness to respecting and learning from her expertise (as opposed to just going along to get along).

Happy SAHMs also do what they can to cultivate other supportive friendships, but it is important to note that having supportive friendships does not tend to make up for having an unsupportive spouse in terms of the risk of depression for SAHMs.

WHAT TO DO:  Know that you have a right to the support you need from your husband to be a great mom. If your husband is a greater source of stress than your kids, seek marriage help today.  Go to Retrouvaille.  Seek professional, marriage-friendly counseling.  If you were sick, you wouldn’t ask permission to go to the doctor.  Your husband doesn’t have to agree that you need counseling (in fact, he won’t if the current arrangement is “working” for him).  Talk to him about it, but whether he wants to or not, make the appointment.  Let him know you’re going with him or without him and you’d prefer he be part of the changes that are coming.  Get the help you need to have the husband you deserve and give your kids the father they need.

4. They Can Meet Their Needs.

Happy SAHMs  feel confident in their ability to meet their personal, financial and other needs—both on their own and with the support of the people in their life.  They are confident in their right to say to their husband, “Honey, I need your help with X.” whether that involves getting a shower in the morning, getting help with a discipline issue, getting assistance with household chores, or any other temporal, financial, emotional, relational, or spiritual need they have—and they are confident that such help will be forthcoming.

If their needs are not being met, they see it as a problem that must be solved, not as a trial that must be endured.  Silently.  With much sighing and hand-wringing because they dare to even have needs much less hope that one day they might be met. Depression can result from the accumulation of unmet needs and the hopelessness of ever being seen as anything but a vending machine.  Anyone can fall prey to this habit, but anxiously-attached moms are particularly prone to this tendency.

It is admittedly difficult to find the healthy balance that allows you to attend your children’s needs, your spouse’s needs and your own needs, but happy SAHMs see this as a challenge, not as an impossible dream.  They use their creativity, assertiveness, and intelligence to find ways to achieve balance, gather new tools, and get the support they need to get their needs met.  They work hard to avoid polarized thinking; acting like they have to constantly choose between meeting their needs or anyone else’s.  They recognize the challenges involved in maintaining good self-care, but see it as a task the requires ongoing collaboration and communication with their husband and children.

WHAT TO DO:  Stop assuming that you are supposed to be a super-hero who is not allowed to have or express your needs much less expect that they should be met.  On the days you spontaneously feel even slightly more connected to your “best self” write down the things that happened that made this possible.  Did you get more rest?  Exercise? Time to pray?  Did you do something enjoyable? Pace yourself differently?  Prioritize your relationships over certain tasks?  These are needs.  Prioritize them.  Talk with your husband and (to the degree that it is appropriate) your children, about how you can all work together to make these things happen on a regular basis.  If your spouse or family are either not receptive or hostile to this idea, seek professional help immediately.  This is an unhealthy dynamic that will undermine your mental health and the stability of your marriage and family if it is allowed to continue.

One book that can help you do a better job of identifying your needs and finding the balance that allows you to be a healthy, fulfilled SAHM is Then Comes Baby: The Catholic Guide to Surviving and Thriving in the First Three Years of Parenthood by Dr. Greg and Lisa Popcak.  And, as above, counseling can be a great help to developing these skills.

Bringing it Home

No doubt you can think of many other challenges that make the life of the SAHM a challenge, but chances are, most of these other things fit into one of the above categories.

The more you have the skills and resources associated with the above four categories, the more likely you will naturally be able to find real joy and meaning in your role as a SAHM.  By contrast, the more you oppressed (or depressed) you feel by your role as an SAHM, the more likely it is that you are missing some or all of the above.

No one can force you to be a SAHM.  If you genuinely don’t want to do it, you are certainly free to do something else.  There are many paths. But if there is any part of you that values the idea of being an SAHM, regardless of your personality or circumstances, you can find greater fulfillment if you commit to getting the resources you need to find meaning and joy in your role.  It might take time, and it might take a little more effort than you thought it might, but your happiness and wellbeing–and the happiness and wellbeing of your family—is absolutely worth it.

To discover more resources to help you be a happy, healthy, fulfilled mom, including professional, Catholic tele-counseling services, visit me at CatholicCounselors.com

*NOTE:  Presumably, all of the above information applies to stay-at-home-dads as well. My experience in counseling SAHDs over the years certainly suggests this to be the case. Unfortunately, there is currently not enough research on SAHD’s to be able to draw definitive conclusions.

Teen Suicide: Parents CAN Make a Difference.

Image: Shutterstock

Image: Shutterstock

There is nothing more painful than losing a child to suicide, and many parents feel powerless to do anything to prevent it except hope that it doesn’t happen.  A new study by the University of Cincinnati reveals that parents can play a tremendous role in helping their teens avoid self-harm.

“Parents ask us all the time, ‘What can we do?'” said King, who coordinates UC’s health promotion and education doctoral program and serves as Director of the Center for Prevention Science. “You can tell them you’re proud of them, that they did a good job, get involved with them, and help them with their homework.”

“A key is to ensure that children feel positively connected to their parents and family,” added Vidourek, who serves as Co-Director of the Center for Prevention Science.

The results of the study were startling.  In particular, 12 and 13yo children whose parents rarely or never said, “I’m proud of you” were nearly five times more likely to have suicidal thoughts, nearly seven times more likely to formulate a suicide plan and about seven times more likely to attempt suicide than their peers. Similarly, 12- and 13 year olds with parents who rarely or never told them they did a good job or helped them with their homework were at excessively high risk for suicide.

Likewise,  16- and 17-year-olds whose parents rarely or never told the children they are proud of them are about three times more likely to have suicidal thoughts and almost four times more likely to make a suicide plan and attempt suicide than peers whose parents sometimes or often did.

The key, as with many problems associated with kids and teens, is attachment, attachment, attachment.  The stronger the emotional bond you have with your children–and more specifically, the stronger the emotional bond your kids feel like they have with you–the more likely it is that your children will choose healthy options for dealing with their problems and avoid more dangerous, and deadly, choices.

For more information on how you can strengthen your emotional bond with your children whether they are toddlers or teens, check out Parenting with Grace: The Catholic Parents’ Guide to Raising (almost) Perfect Kids. Or, contact the Pastoral Solutions Institute to learn more about how our Catholic tele-counseling practice can help you transform your marriage, family, and personal life.

 

New Study Shows Talk Therapy Can Change Brain Function of Schizophrenics

Shutterstock

Shutterstock

Talk therapy can be best understood as physical therapy for the brain.  Many previous studies have been shown to have a positive impact on the brain functioning of depressed and anxious patients, changing the way clients’ brains process, feel, and respond to stress.  Exciting new research shows that even patients who suffer from psychosis (e.g., intrusive auditory and visual hallucinations) and schizophrenia can experience significant improvements in brain function as the result of talk therapy.   But how?

Cognitive Behavioral Therapy (CBT) is a school of psychology that focuses on “reframing,” or changing the way an individual thinks about and responds to their thoughts and experiences as well as developing strategies to reduce stress and improve mental health and well-being.

A study conducted by King’s College London shows that CBT strengthens the “connections between key regions of the brain involved in processing social threat accurately.” Furthermore, this study revealed that the techniques of CBT show increased “connectivity between several brain regions — most importantly the amygdala (the brain’s threat centre) and the frontal lobes (which are involved in thinking and reasoning) — are associated with long-term recovery from psychosis.”

In other words, individuals who experience psychotic symptoms such as those common in schizophrenia and other psychiatric disorder, can benefit from CBT by “learning to think differently about unusual experiences, such as distressing beliefs that others are out to get them.”

“The findings, published in the journal Translational Psychiatry, follow the same researchers’ previous work which showed that people with psychosis who received CBT displayed strengthened connections between key regions of the brain involved in processing social threat accurately.

The researchers of this and other studies explained that individual’s struggling with psychosis often turn immediately to medication for relief from their symptoms. However, the results of this study demonstrate that while CBT is effective during the time the individual is receiving counseling, Cognitive Behavioral Therapy also gives the individual the tools necessary to positively impact long-term recovery.

To discover how Cognitive-Behavior Therapy can help your brain deal with stress, depression, anxiety and other emotional problems more effectively, contact the Pastoral Solutions Institute’s Tele-Counseling practice to make an appointment to speak with a counselor.

Physical Exercise May Be Best Treatment for ADHD

Image via Shutterstock

Image via Shutterstock

The Atlantic reports on a new study published this morning in the journal Pediatrics.

…kids who took part in a regular physical activity program showed important enhancement of cognitive performance and brain function. The findings, according to University of Illinois professor Charles Hillman and colleagues, “demonstrate a causal effect of a physical program on executive control, and provide support for physical activity for improving childhood cognition and brain health.”   Physical activity is clearly a high, high-yield investment for all kids, but especially those attentive or hyperactive. 

The improvements in this case came in executive control, which consists of inhibition (resisting distraction, maintaining focus), working memory, and cognitive flexibility (switching between tasks). The images above show the brain activity in the group of kids who did the program as opposed to the group that didn’t. It’s the kind of difference that’s so dramatic it’s a little unsettling. The study only lasted nine months, but when you’re only seven years old, nine months is a long time to be sitting in class with a blue head.

Earlier this month, another study found that a 12-week exercise program improved math and reading test scores in all kids, but especially in those with signs of ADHD. (Executive functioning is impaired in ADHD, and tied to performance in math and reading.) Lead researcher Alan Smith, chair of the department of kinesiology at Michigan State, went out on no limb at all in a press statement at the time, saying, “Early studies suggest that physical activity can have a positive effect on children who suffer from ADHD.” 

Last year a very similar study in the Journal of Attention Disorders found that just 26 minutes of daily physical activity for eight weeks significantly allayed ADHD symptoms in grade-school kids. The modest conclusion of the study was that “physical activity shows promise for addressing ADHD symptoms in young children.” The researchers went on to write that this finding should be “carefully explored with further studies.”  READ THE REST

All of this goes to why author, Richard Louv, coined the term “Nature Deficit Disorder” as an alternative to ADHD.  No, getting out and playing isn’t the cure for ADHD, but increased physical activity should absolutely be a foundational part of any treatment program for ADHD.  ADHD does not have to be a lifelong sentence.  Kids can overcome it with proper, comprehensive treatment.  For more information on raising healthy, focused, well-rounded kids, check out Parenting with Grace: The Catholic Parents’ Guide to Raising (almost) Perfect Kids.

Spiritually-Integrated Psychotherapy as Effective as Meds for Longterm Relief from Depression, Says Lancet

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Researchers in the U.K. have found that mindfulness-based cognitive therapy (MBCT) may offer just as much protection from depression relapse as antidepressants, with no significant difference in cost, according to a new study published in the journal The Lancet

“Depression is a recurrent disorder. Without ongoing treatment, as many as four out of five people with depression relapse at some point,” said Dr. Willem Kuyken, lead author and professor of clinical psychology at the University of Oxford.

What is MBCT?

MBCT teaches people with recurrent depression to recognize and respond constructively to the thoughts and feelings associated with depression relapse, thereby preventing a downward spiral into depression.  It is often considered a more spiritual approach than traditional cognitive therapy because it employs meditation-based practices to teach clients how to step outside of their emotional experiences, observe their circumstances in non-judgmental fashion and, as a result, respond more proactively (rather than reactively) to stressful circumstances.

According to Dr. Richard Byng, from the Plymouth University Peninsula Schools of Medicine and Dentistry, while medication is the most common method of keeping depression at bay, “there are many people who, for a number of different reasons, are unable to keep on a course of medication for depression. Moreover, many people do not wish to remain on medication for indefinite periods, or cannot tolerate its side effects.”

How Effective Is It?

The study involved 424 adults with recurrent major depression who were taking maintenance antidepressant medication. Participants were randomly assigned to come off their antidepressant medication slowly and receive MBCT (212 participants) or to stay on their medication (212 participants).

MBCT participants attended eight 2-¼ hour group sessions and were given daily home practice. They took part in guided mindfulness practices, group discussion and other cognitive behavioral exercises.  After the group, they had the option of attending four follow-up sessions over a 12-month period. Participants in the maintenance antidepressant group kept taking their medication for two years.

Over two years, relapse rates in both groups were similar (44 percent in the MBCT group vs. 47 percent in the maintenance antidepressant medication group).

“As a group intervention, mindfulness-based cognitive therapy was relatively low cost compared to therapies provided on an individual basis and, in terms of the cost of all health and social care services used by participants during the study, we found no significant difference between the two treatments,” said study co-author Dr. Sarah Byford, from the Institute of Psychiatry, Psychology & Neuroscience at King’s College London, U.K.

Christian Concerns Over MBCT

Many Christians approach MBCT with caution or even suspicion because many clinicians use eastern-based approaches to meditation to teach MBCT skills, but MBCT does not necessitate indoctrination in non-Christian spiritualities.  MBCT experts correctly note that every major spiritual tradition has its own meditative practices which can be respectfully and effectively employed to teach MBCT skills. For instance, in my own tele-counseling practice, where I work with a primarily Catholic population,   I employ approaches to meditation developed and taught by St. Ignatius of Loyola.  Because St Ignatius’ work is greatly respected by Christian spiritual directors and is completely orthodox, by using his teachings, I am able to offer my clients the opportunity to benefit from MBCT in a manner that is completely respectful of their own spiritual heritage.  I discuss some of these approaches to treating depression and anxiety in my book, God Help Me,  This Stress is Driving Me Crazy!  as well as in my upcoming book, Broken Gods: Hope Healing, and the Seven Longings of the Human Heart.

The Takeaway

Medication is often a helpful component to depression-recovery but, at best, it treats one dimension of depression–the physical.  Depression, as a syndrome, doesn’t just attack the body.  It attacks the mind, our spirits, and our relationships as well.  Spiritually-integrated approaches to psychotherapy like MBCT enable clients to achieve healing on every level and experience the emotional freedom they deserve.  If you or someone you love is struggling with emotional difficulties, be sure to take advantage of all treatments that can help you build the life you were created to live–physically, emotionally, relationally, and spiritually.

All Shook Up: “Therapy Better than Meds for Overcoming Anxiety.” Says Major Study

About a week-and-a-half ago, I taped a series on Women of Grace with Johnnette Benkovic on anxiety and my book, God Help Me, This Stress Is Driving Me Crazy!  Finding Balance through God’s shutterstock_174459824 Grace.  At the time, I asserted that while most people only receive medication by way of treatment for anxiety disorders, medication is simply less effective than therapy.  On the show, I said that anyone who has an anxiety disorder and is not receiving therapy is not receiving the best standard of care and may be unnecessarily prolonging their suffering.  A new study in the prestigious journal, The Lancet Psychiatry completely endorses the position I took on the program.  According to the new study…

While antidepressants are the most commonly used treatment for social anxiety disorder, new research suggests that cognitive behavioral therapy (CBT) is more effective and, unlike medication, can have lasting effects long after treatment has stopped.

Social anxiety disorder is a psychiatric condition characterized by intense fear and avoidance of social situations and affects up to 13 percent of Americans and Europeans. Most people never receive treatment for the disorder. For those who do, medication is the more accessible treatment because there is a shortage of trained psychotherapists.

The findings of the study, a network meta-analysis that collected and analyzed data from 101 clinical trials comparing multiple types of medication and talk therapy, are published online Sept. 26 in The Lancet Psychiatry.

“Social anxiety is more than just shyness,” says study leader Evan Mayo-Wilson, DPhil, a research scientist in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. “People with this disorder can experience severe impairment, from shunning friendships to turning down promotions at work that would require increased social interaction. The good news from our study is that social anxiety is treatable. Now that we know what works best, we need to improve access to psychotherapy for those who are suffering.”

[The researchers] analyzed data from 13,164 participants in 101 clinical trials. The participants all had severe and longstanding social anxiety. Approximately 9,000 received medication or a placebo pill, and more than 4,000 received a psychological intervention. Few of the trials looked at combining medication with talk therapy, and there was no evidence that combined therapy was better than talk therapy alone.   READ MORE

If you or a loved one is struggling with problems related to anxiety, I encourage you to learn more about the Pastoral Solutions Institute’s Catholic tele-counseling practice.  We can help you apply both the timeless wisdom of our Catholic faith and insights from counseling psychology to overcome the anxiety you’re facing.  Learn more at our website or by calling 740-266-6461 to make an appointment to speak with a counselor.

 

The Serotonin Myth Continued: What You Need To Know About Depression

A few weeks back, I reported on a new study that pounded yet another nail in the coffin of the theory that depression is caused by low serotonin.   You can read that original post here as well as the follow shutterstock_217156765up post wherein I responded to a question from a reader asking if I was trying to say that people who suffered with depression were to blame for their struggles (short answer:  no.)

Over at PsychCentral, one of the most popular psychology news portals on the web, the director, Dr. John Grohol has an excellent piece summarizing the growing case against the low serotonin theory of depression.  He writes….

Back in 2005, Lacasse and Leo pointed out in the journal PLOS Medicine that there was a huge disconnect between what we knew about serotonin’s role in depression from the medical research, and what pharmaceutical advertisements were claiming we knew:

Regarding SSRIs, there is a growing body of medical literature casting doubt on the serotonin hypothesis, and this body is not reflected in the consumer advertisements. In particular, many SSRI advertisements continue to claim that the mechanism of action of SSRIs is that of correcting a chemical imbalance, such as a paroxetine advertisement, which states, “With continued treatment, Paxil can help restore the balance of serotonin…” [22].

Yet […] there is no such thing as a scientifically established correct “balance” of serotonin. The take-home message for consumers viewing SSRI advertisements is probably that SSRIs work by normalizing neurotransmitters that have gone awry. This was a hopeful notion 30 years ago, but is not an accurate reflection of present-day scientific evidence.

New research that we reported on last month confirms the role of serotonin in depression is not well-understood. In that mice study, removing the stuff in the brain that creates serotonin2 did not create a bunch of depressed mice.

Other research confirms it’s not as simple as a serotonin deficit. As Whitaker (2010) noted, the 1976 Asbert study is still relevant. Asbert looked at levels of a metabolized result of serotonin (something called 5-HIAA) in spinal fluid. If low-levels of serotonin cause depression, then all people suffering from depression should have significantly lower levels of 5-HIAA in their spinal fluid than people without depression.

What Asbert found, however, wasn’t a clean result. In fact, it clearly shows how complicated depression as a disease process is. In both groups of people studied — both a depression group and a control group — about 50 percent had “regular” levels of 5-HIAA, about 25 percent had really low levels, and another 25 percent had really high levels.

If serotonin were really an important part of the picture in depression, we’d expect that group to look significantly different than the control group. In this study, at least, the two groups looked largely the same.

As we said back in 2007, serotonin may play some small, not-yet-well-understood role in depression. But if it does, it looks nothing like the simplistic “low levels of serotonin cause depression” hypothesis that was all the rage ten to twenty years ago.  READ MORE.

Of course, none of this means that depression medication can’t be helpful but only, as I reported before, that it should never be the first course of treatment for depression. Research shows that meds are best when they play a supportive role to therapy.   Meds alone do not represent the best standard of care for treating depression.  If you are on medication for depression but not currently in counseling, talk to your doctor about getting a referral to a therapist in your area, or contact the Pastoral Solutions Institute to learn more about you can benefit from our Catholic-integrated, telephone counseling practice.  Let us help you find effective, faithful solutions to the tough emotional challenges you are facing.

Setting the Captive Free! New Research Illustrates our Power to Overcome Depression

In response to my post linking the new study questioning the serotonin-deprivation theory of depression, I received a very thoughtful email from a reader who wrote, shutterstock_212803426

“Dr. Popcak, some of my friends who suffer with depression are saying that in this article you are blaming them for their depression. Can you explain further?”

Blaming the Victim?  A Response

I am grateful for her question because I would never want anyone to think that I was blaming sufferers of depression for being depressed. She was referring, I suspect, to this part of my post where I addressed the notion that depression is caused by a chemical imbalance.  I wrote, “every choice you make, every behavior you exhibit sends a wash of chemicals through your body.  It stands to reason that healthy thoughts, choices, and behaviors would facilitate a healthy chemical balance and unhealthy thoughts, choices, and behaviors would increase the likelihood of an unhealthy chemical imbalance.”

As I assured my correspondent in the comments section of that post, it was not my intention to blame depression sufferers, rather it was (and is) my intention to show depression sufferers that they don’t have to be passive victims of this horrible disease, that there is a lot that they can do to contribute to their healing.

Depression: No One’s Fault.

It is not the depression-sufferers “fault” that they think the way they do, approach problems they way they do, or have some of the unhealthy habits and/or relationship patterns they have.  For the most part these things were taught and modeled and “caught” unconsciously in one’s family-of-origin over the course of tens of thousands of interactions between parents and children and grandparents and siblings and the community and the belief system one is raised in.  No one person could possibly be personally responsible for all that, but it still impacts us mightily.

How Environment Influences Depression Gene Expression

On top of all this, biology certainly is a factory, but it isn’t as straightforward as saying, “depression is caused by genetics and biology.”  In the first place, depression is not so much genetic as it is an epigenetic illness.   Epigenetics studies how environment effects the expression of certain genetic traits and profiles.  Certain genes won’t “turn on” if the environmental conditions aren’t right. Depression has genetic and biological components, yes,  but those components, by and large, won’t come online unless the environment tells them to.  And, curiously enough, once our life experiences activate our genes they can be passed on to the next generation, communicating positive and negative environmental experiences from parents to children through genetic encoding, which is why depression tends to run in families.

Victim No More

The good news is, we don’t have to be passive victims of any of the “bad programming” from these environmental and epigenetic triggers that cause poor thinking habits, unhealthy attitudes, and destructive approaches to life.  Medication can certainly take some of the edge off the worst of it, but counseling can help us make dramatic changes in our thoughts, behaviors, and relationships that not only help us feel better emotionally, but rewire our biological and genetic programming, bringing healing both to us and the next generation.  With God’s grace and consistent effort, we can master the environmental programming–even the environmental programming that triggers certain biological responses–that causes depression and other emotional illnesses.

A Light in the Darkness

To my way of thinking, that is anything but “blaming the victim.”  That is a tremendously liberating and hopeful idea, a light that shines the way out of the terrible darkness that is depressive illness.

If you would like to learn more about faithful and effective treatments for depression and other emotional and relational problems, visit the Pastoral Solutions Institute’s website (or call 740-266-6461) to learn more about how our Catholic telecounseling practice can help you set you free.

 

 

Dealing With Depression: Getting the Right Kind of Help Matters

The news of Robin Williams’ suicide has brought the insidious nature of depression front and center.  
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I know too many Christians who believe that they should be immune from depression because they are Christian.   While research shows that some believers can be more resistant to depression and have a somewhat easier time bouncing back when they do get depression, it is also true that some approaches to religion can be associated with higher rates of depression and emotional problems.  When evaluating the power of belief to protect against emotional problems, the research seems to show that the question isn’t “do you believe?”  but rather what do you believe, how, and why?

The bottom line is that, by and large,  Christians experience depression at rates that are similar to the general population.  Twenty-Six percent of adults in the US have depression.  The World Health Organization estimates that by 2020 depression will be the second leading cause of disability after heart disease.

Does Treatment Work?

The good news is that depression is very treatable.  Sadly, many comments I am reading on the internet seem to suggest that seeking help must be pointless because if Robin Williams, who arguably had every resource in the world available to him, couldn’t get adequate care who can?  First, we don’t know all the details of Robin Williams situations and we never will.  Secondly, what we do know points to a much more complicated clinical picture than what most people experience.  Robin Williams’ history was not with depression but with Bi-Polar Disorder, which can be characterized by dramatic mood swings and is somewhat more difficult to treat than depression.  This, combined with his long struggle with substance abuse and the unique pressure a person in his position faces,  should remind everyone to resist the temptation to draw broader conclusions about the effectiveness of depression treatment based on the tragic outcome of William’s particular story.

What’s the Best Treatment?

As I mentioned, depression is very treatable.  80% of people who seek help report that they experience significant or even total relief from their depressive symptoms.  That’s a tremendous success rate.

What is the best treatment for depression?  Studies of evidenced-based approaches to treatment show that psychotherapy alone should be the primary method of treatment.  This approach has the highest success rate, the longest-term recovery rates,  the lowest negative effects and the lowest drop-out rate.  For patients who need additional support, adding medication to psychotherapy is the best approach.

Interestingly, despite what all the TV commercials tell you, research seems to show that the least effective approach is medication alone because of the relatively lower rate of effectiveness (about 50%), lower rate of symptom relief (about 30%), higher side-effect profile, greater likelihood of post-treatment relapse, and greater treatment drop-out rate.  Bottom line?  If you have been diagnosed with depression and are not in ongoing psychotherapy, you are not undergoing the best course of treatment. Period.

How Do You Know If It’s Time to Seek Help?

Everyone experiences sadness, but its important not to dismiss depression as mere sadness.  If you are experiencing a period of sustained sadness that lasts for at least 2 weeks and is accompanied by any of the following: a change in eating habits (either eating more or less), sleeping habits (either more or less), withdrawing from social engagements, decreased enjoyment of previously enjoyable activities, feelings of worthlessness or guilt, or especially, thoughts of dying, death, or harming oneself, it’s time to seek help.

How Do We Cope?

Our ability to resist depression or recover efficiently from it tends to depend a great deal on the coping strategies we use to deal with stress in general.  In my next post, I’ll look at healthy versus unhealthy coping styles and offer specific suggestions for coping more effectively with all the challenges in your life.  For now, just know that if you or a loved one is struggling with feelings of sadness or despair that you think might be depression,  getting help early is key.  If you aren’t sure if it’s depression, that’s a good enough reason to get an evaluation (i.e., If you have to ask…). Talk to your doctor or contact a licensed psychotherapist who can help you clarify the nature of the problem you are facing and the best means of resolving it.  Getting help early is the best way to increase both the likelihood of a full recovery and your ability to experience the life God has given you as the gift that it is–even when that gift gets complicated.

For more information on faithful approaches to treating depression and other emotional problems, check out the Pastoral Solutions Institute’s Catholic Tele-Counseling Practice by visiting us online or calling 740-266-6461 to make an appointment to speak with a professional Catholic counselor.  Let us help you integrate the wisdom of our faith with contemporary insights from counseling psychology to help you develop the most comprehensive response to the challenges in your life.