World of Psychology » Erika Krull, MS, LMHP http://psychcentral.com/blog Dr. John Grohol's daily update on all things in psychology and mental health. Since 1999. Wed, 22 May 2013 10:32:13 +0000 en-US hourly 1 Self Honesty – Knowing Is Better Than Not Knowing http://psychcentral.com/blog/archives/2009/06/04/self-honesty-knowing-is-better-than-not-knowing/ http://psychcentral.com/blog/archives/2009/06/04/self-honesty-knowing-is-better-than-not-knowing/#comments Thu, 04 Jun 2009 14:52:44 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=4642

The truth hurts sometimes, but trying to keep an obvious truth hidden inside yourself can hurt even more. Making excuses doesn’t help, rationalizing doesn’t help, yelling doesn’t help. Bringing yourself to a painful but honest realization will actually do you more good.

When some of my clients have been avoiding a problem and struggling with reality, I have often said something like this, “You can think that way about your problem if you like, pretend it isn’t there. Or you can face the truth and acknowledge its existence. Either way, the reality of your problem will still be there. You just have more power to make your situation better if you face it.”

This has usually gotten a knowing look from the people I’ve worked with. By that point, they have usually been struggling with some key issues for long enough that the whole reason they are in counseling is because they can’t manage it the same way anymore. The old excuses and rationalizations aren’t enough to keep the emotional pain in check. Reality is trying come to the surface anyway, and yet they keep trying to stuff it down.

Take a person with an alcohol addiction. The truth is, they cannot drink alcohol for the rest of their life. The risk for relapse is high given their history. If they continue to associate good times and stress management with having a drink, they will struggle to accept this reality. Even when they relapse and start thinking addiction thoughts, they keep fighting to ignore the truth.

They can try to pretend their addiction really “isn’t that bad” or that they know how to control their drinking now, but the addiction is still there. Period. Trying to justify alcohol use will cause the same problems they came to counseling with. The only way to be free of this bondage is to face the reality of the addiction and make different choices.

A very useful activity when you have an ongoing struggle like this is to check your expectations. Are they realistic? Do I have evidence that this situation will likely keep turning out the same each time? Is much of the solution out of my hands? Do I really want to create this much misery for myself trying to pretend or make this problem be something it can’t be? Am I harming a relationship because my expectations have been inflexible or unreasonable?

The person with alcoholism may have expectations that they can get over the worst of their problem and then resume some occasional drinking. In all likelihood, this will result in relapse and more life problems. Their expectation is unrealistic and they probably have much evidence to support the most likely outcome of resumed drinking. The solution is in their hands – sobriety – but they will need to be honest with themselves to have the best quality of life. They may very well be creating misery for themselves and important relationships by trying to shove reality under the rug. All of this comes down to accepting the ugly but ever-present truth.

Usually, facing the truth of a difficult situation is a shorter-term pain than most people anticipate. It can hurt like a sucker punch, but then the best part comes. You get the chance to move forward with your life, leaving behind a clunky, dirty piece of baggage that you’ve been dragging around behind you. As long as you keep trying to dress up that piece of baggage and keep it with you, it’s going to keep weighing you down. Call it out for what it is, dump it, and get on to the best part of life: Living with honesty.

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If Only – Keeping You Stuck and Frustrated http://psychcentral.com/blog/archives/2009/05/03/if-only-keeping-you-stuck-and-frustrated/ http://psychcentral.com/blog/archives/2009/05/03/if-only-keeping-you-stuck-and-frustrated/#comments Sun, 03 May 2009 16:44:08 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=4058

Two words. Six letters. So much potential for destruction. You say it to yourself and so do I, sometimes without even realizing it. Do you even realize how powerful it is?

If only I had more time, I would exercise. If only my parents weren’t so annoying, I’d be less stressed. If only I had a bigger house, then I’d be more organized. If only, if only, if only…You know, it isn’t just the “if only” part that is so damaging. By itself, it just a harmless wish or fantasy. It’s saying “then”, as if you only have permission to have this better outcome when the first part happens.

Let’s break this down once, shall we? Take the example about having a bigger house and being more organized. I threw this one in for me. We still live in the starter home my husband and I bought before we had kids. It seemed huge back then. It’s now quite small for all five of us and I find
myself frustrated on a regular basis.

So my desired outcome is being more organized. There’s always some truth to the if only-then combination, so let’s find it and make peace with it. What are some advantages of a bigger house regarding organization? Bigger closets, more floor space for furniture, more rooms for everything to have a place, storage for seasonal things. OK, those are all true and would make sense.

Here’s the kicker – watch for the black-and-white extreme language. Does being in my current smaller house completely forbid me from being more organized than I am right now? Well, NO. I actually have plenty of choices. I could give away some things, I could throw away some things, I could replace
larger things with smaller things, we could work better with our budget to save money for a larger house, and I could just be thankful I even have a house in today’s bad economy.

I’m doing pretty much all of those things, and they do help. Would it still be simpler and easier to have more elbow room? Yes. Is it likely that we’ll get a bigger house in the not-so-distant future when we have made our situation favorable? Yes. Is it still possible for me to keep things better organized than I do right now? Oh yes, there’s always potential for that. I’m simply frustrated that this problem isn’t going to be solved tomorrow.

Oh, and don’t forget this – I could still be disorganized even in a bigger house. That’s the real disillusion. Just because my wish might come true doesn’t mean I’ve actually solved my problem. I would have a better opportunity for organization with more space, but I still have to put the work into it. Let’s take the other examples for a moment here. Your parents could suddenly become less annoying and you might still have plenty of stress. You might find yourself out of work – with plenty of time on your hands – and you may still not exercise one minute.

It’s deciding to make the choice for your desired outcome, regardless of whatever the “if only” excuse is in front of it. Want to be more organized? Watch the “Clean Sweep” show on TV and take some notes. Want to be less stressed? Take a yoga class. Want to exercise? Find ways to be active in short periods of time without fancy equipment, like a short walk over lunchtime. No need to wait around for the “if only” part to happen.

Just watch yourself one day, today, and see how many times you say “if only” to yourself. What are your “if onlys”? Are you really trapped by the “if only” part, or could you make it happen anyway with a little creativity?

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Worrying About The Swine Flu? Some Pesky Questions http://psychcentral.com/blog/archives/2009/04/29/worrying-about-the-swine-flu-some-pesky-questions/ http://psychcentral.com/blog/archives/2009/04/29/worrying-about-the-swine-flu-some-pesky-questions/#comments Thu, 30 Apr 2009 04:06:04 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=3988

Another blogger here wrote a great piece on reducing your anxiety about the swine flu outbreak. My post is going to be a little different, a little less on the practical side. No global truths or silver bullet theories, just honest human wonderings about worrying and this swine flu thing. I’m about to be the pesky six year old in your family who bombards you with questions at holidays.

1- Is all worry a bad thing? Well, excessive worry is definitely a bad thing. It causes people to build their lifestyle around their anxiety. It causes them to not do things they value because of the potential to make them anxious.

2- But couldn’t worrying be OK in some situations? I mean, a moderate amount of worry can get us off our rear ends and into planning mode or action when needed. For instance, I told my girls to wash their hands more at school for a while. I just told them there’s another germ going around; didn’t mention the worldwide outbreak part.

Getting panicked and taking them out of school would not be reasonable right now, but my worry has prompted me to do at least something by instructing them on their hygiene. If or when the threat gets closer, I imagine my worry and action buttons will buzz louder. To NOT worry, at least a little, might put us in harm’s way at some point.

3 – But don’t some people have a right to worry about the swine flu more than others? People close to those who are infected might certainly have the right, but it ultimately matters how far they take that worry. If it is something that makes them run down, bothers their infected loved one, and keeps them from actually being helpful, then they may have a bigger anxiety problem.

But then again, they are closer to the direct impact and probably have more frightening questions on their mind. They have more plans to make, more direct need for preventing transmission, more reason to be aware of any symptoms, and so on. Maybe, in that situation, some worry is actually a normal and expected state of being.

4 – Do you think the CNN correspondent guy is worried about getting the swine flu? I just came up from the family room where my husband was watching a CNN news brief. They had a guy with a mask standing next to the wing of the hospital in Mexico City where they are treating anyone with symptoms of swine flu. He was mere feet away from potential virus transfer, yet there he was.

He could have quit his reporting job when they asked him to go to the heart of the outbreak. But he went anyway and reported the news to us. Doesn’t mean he isn’t worried – his chances of getting sick are certainly higher as he’s doing his job. Not something a lot of people would do. Makes me wonder how he does it.

5 – How long will the world population worry about the swine flu? Will there be a point when everyone will worry about their neighbor, the school, their office? Or will it fade off soon, and only those who tend really to worry a lot will keep vigil? Yep, this is me worrying. I’m not locking down my house like Ft. Knox, but I’m not brushing off the news reports either. I’m somewhere in the middle – wondering and worrying, but not really, really worrying.

Are you worried about the swine flu? If you are, how are you handling it? Are you close to a more threatened area where it’s affecting your activities and daily lives more? Whatever’s going on for you, feel free to just share here. Maybe a little “coffee shop” chatter here will calm everyone’s nerves.

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Depression: Becoming Invisible To Yourself http://psychcentral.com/blog/archives/2009/04/23/depression-becoming-invisible-to-yourself/ http://psychcentral.com/blog/archives/2009/04/23/depression-becoming-invisible-to-yourself/#comments Fri, 24 Apr 2009 01:24:27 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=3883 One thing that strikes me about depression recovery is how people can become invisible to themselves. They don’t matter, they don’t “count,” and they take themselves out of the picture before anything ever happens.

I know this both professionally and personally. For myself, I know I just gave all I had to my daughters when I was depressed. I gave what I could as a wife and friend, but I put on my best for the girls. Not only did I think of them first, I just didn’t think about me hardly at all. I thought about my state of being and my misery, but I didn’t really think about ME as a whole significant human being.

Granted, it can be tough with a small baby who needs stuff around the clock. The joke about new moms not getting a shower until the afternoon is really no joke. Been there! But it was more than just that for me. Even when I got showered, dressed, “ready” in whatever way, I still didn’t really care for myself like I could have. I couldn’t – I could hardly get past the basics and I was overwhelmed with everything else. I’ve said it before, but it all just felt so hard.

After a while of living like this, I just kind of forgot about myself. I did what I needed to so I could be dressed appropriately for work, for bed, for getting out of the house to get groceries, and so on. I was pseudo-functional, as I stated in a post I wrote yesterday. But being functional and taking care of myself were completely different things.

When you are depressed, a lot of your thoughts tell you that you are so wrong in so many ways. Eventually, you might conclude that it would just be easier if you dropped into a hole somewhere and you didn’t need anything. If there is no way to make up for all your “wrongness,” then at least get out of the way. Don’t make any more fuss than you already are just by existing and breathing air.

You get into a bad mental habit of thinking like this after weeks, months, even years. Finally, when you are fortunate to find help in one form or another, you start to come out of the fog. As you come out of the fog, you discover a great deal about yourself that has changed since you’d been depressed. I forgot how to make myself important to myself and to others. I didn’t say anything if I thought things were touchy or there was conflict. I didn’t take the initiative to do something out of the blue that I enjoyed. Or if I did, I sometimes felt bad about it later. Then I forgot to keep it up. It’s like I felt bad for feeling good.

Depression thinking is the culprit here. Rampant negativism and a flood of shaming thoughts overrides the mind’s ability to fight back. After a while, it’s just easier to let it wash over for a while. When you are in depression recovery, it is important to remember that the flood is under better control.

It is indeed right and salutary that you should enjoy yourself and be significant in the world! The shame talk is not reality, that is the depression. Do not forget yourself, and make sure no one else does either.

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Nurturing My Soul: Stadium Therapy http://psychcentral.com/blog/archives/2009/04/21/nurturing-my-soul-stadium-therapy/ http://psychcentral.com/blog/archives/2009/04/21/nurturing-my-soul-stadium-therapy/#comments Tue, 21 Apr 2009 15:37:08 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=3775

Everyone has a few places on this earth they consider special. People get a certain feeling when they are there, like putting on a pair of old comfortable shoes or being plugged into a charge of energy. Memories, emotions, physical sensations – these places stir them all up, creating a divine craving to return often. For me, it’s an old football stadium.

This past weekend I went to the football stadium of my alma mater. It’s just a spring scrimmage, but it’s a Huge Deal every year. This thing is more than just a sporting event. It’s an excuse to “be there”, to bask in the aura and the atmosphere, to get lost inside the experience.

I went to college there, so did my husband, my dad, and so many other people in my family. I was in the marching band, and I feel a certain attachment to the field. My husband was also in the marching band. The football team has a tremendous tradition and connection with the state’s culture. One of my top favorite foods in the universe is served right there in the stands. My daughters have now all been to the stadium and I’m passing down the tradition. I’m telling you, this place is “it” for me.

It’s like therapy when I go. It’s such a huge structure, so much potential for me to be part of something so big. Of course, there aren’t many opportunities to get the full experience during the year. Only six or seven football games and the Spring Game. I don’t care if it’s snowing, raining, foggy, icy, windy, or perfectly clear – it’s no ordinary day when I go to the stadium.

I can scream at the top of my lungs and no one will care. I can complain about a bad call with thousands of others and no one will care. I have experienced a wide range of emotions including tears of joy and tears of sorrow. I have my own unique experiences as a fan, but I am part of a rocking crowd on an emotional roller coaster. And yes, it is likely that I will cry sometime during the day, usually when the band warms up.

When the day is done, I’m tired, overwhelmed with emotion, and I’ve seen many people I know. I find myself aching to be there when my schedule doesn’t work out for me to go. It’s not just following the team or watching the game on TV, it’s being “there” that fills my soul. There is no substitute and I know I will never tire of it.

You don’t have to be a big football fan to see how the experience of being in the stadium fills so many needs for me. Free expression of emotion, connection with others, memories, attachment to past experiences, being a part of something bigger than me, a full distraction from any other stress I may have. There are other places that I cherish and that fill my needs in different ways. The Tetons in Wyoming and Glacier National Park in Montana are peaceful and fill me with awe. Florida is about freewheeling fun and family traditions.

I really need these places in my life, as much as air and water. I know I need to feed my soul like that to feel fully human. These places make me feel alive, charge up my batteries, and make me more hungry for life. Fortunately, I can make it to a few games each year more often than Florida or Montana. This Spring Game was an oasis in the desert of my calendar. Only five more months to go before kickoff of the season opener, the chance to return to my idea of “heaven on earth”.

So what places do it for you? Where do you feel your most open, free, alive, happy in your own skin?

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Susan Boyle: A Lesson In Expectations and Emotion http://psychcentral.com/blog/archives/2009/04/17/susan-boyle-a-lesson-in-expectations-and-emotion/ http://psychcentral.com/blog/archives/2009/04/17/susan-boyle-a-lesson-in-expectations-and-emotion/#comments Fri, 17 Apr 2009 16:00:13 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=3678
In a mere six days, Susan Boyle from Scotland has become a multi-million-view sensation on YouTube. Her rendition of “I Dreamed A Dream” from Les Miserables has been a phenomenon, growing steadily by the minute as more and more people see the video.

Clearly, Susan has an amazing voice. She owned this song, and the audience before too long. In my opinion, “I Dreamed a Dream” is one of the most gorgeous songs ever written, and it’s difficult to sing well. It has a musical range much like the “Star Spangled Banner” (ever have to sing that one by yourself in front of people?). To really pull it off, you need to have some good singing chops. Boy, does she.

But here’s the thing, the real secret to why this woman is getting so much attention and so many cheers. She is not what you expect when she isn’t singing. Susan sang this song on a British talent TV show in front of a large studio audience and and even larger audience watching at home. Though she was just using her voice, so much of a show like that is a visual experience.

She had a lovely dress on, but she wasn’t particularly pretty. Her hair wasn’t anything special, she’d never been married, and she didn’t look like she had a chance. She looked like someone you should feel sorry for, giving it her darnedest but a certain failure about to unfold on stage. As she was being introduced, you could hear sarcastic catcalls and see expressions of disbelief that this woman could ever succeed. A woman like that? Yeah…. right. Looks of confusion, giggling, pity. Expectations of what they thought was about to unfold.

And that’s when the magic happened. At one singular moment about 3 seconds into her singing performance, the entire audience saw how wrong they had been and dropped their expectations straight to the floor. One half second later, they embraced this unbelievable reality of a plain looking unknown woman singing like a Broadway legend. So wrong one second, so emotionally overwhelmed the next.

The crowd eagerly went on the emotional ride with Susan. She hushed them with the sincerity of the lyrics in quieter parts, then shot them through the roof during the climax near the end. Just her voice alone was enough to be thoroughly enjoyable. If this were only an audio clip with no video, the impact would not be as strong. You needed to see her appearance, make your own prejudiced judgment, then go on the ride yourself. To understand how the audience transformed in less than 2 seconds is to understand the miracle of being open to change.

Two of the judges had great courage to speak aloud what the audience had been thinking before Susan’s performance. They were honest to admit that they themselves had been surprised, one saying they were all somewhat “cynical” before she started. The entire audience traveled such a great distance between their initial expectation and the emotional reality, and they did it in a snap. What a rush! That made everyone a bit more humble, and made their satisfaction even deeper. The floor of that performance hall had to be wet with tears.

I even knew there was supposedly something amazing about this video and it still blew me away. Yeah, but how good is she really? Everyone thinks they’re good on these shows. Because of those thoughts, I didn’t watch it until last night even though I’d seen other people commenting on the clips since Monday. Certainly opened my eyes. Go ahead and watch the video, even if you’ve watched it 50 times already. Can’t hurt to do it again.

Here’s the takeaway — who are you misjudging that could blow you away if you gave them the chance? Who is a hidden gem in your life? Who do you minimize in your mind because of your own skewed expectations?

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Postpartum Depression Advocacy http://psychcentral.com/blog/archives/2009/04/16/postpartum-depression-advocacy/ http://psychcentral.com/blog/archives/2009/04/16/postpartum-depression-advocacy/#comments Thu, 16 Apr 2009 21:26:36 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=3667 I’ve spent a good deal of the day writing advocacy for postpartum depression. I’ve been in communication with the wonderful and passionate Katherine Stone, author of the blog “Postpartum Progress” and postpartum depression advocate. It’s been a great way to learn and stand up for women with pregnancy-related depression disorders.

The MOTHERS act is currently going through congress. It is a bill that supports research for the causes of postpartum depression as well as education and helping families with appropriate services. There is a great deal of controversy about this act. Those who support are hopeful it will provide better support and services for women who need it. Those who oppose fear that postpartum depression will be overdiagnosed, leading to a greater dispersion of antidepressant medication. They have concerns for the moms being put at greater risk and the babies being exposed to medication before birth and during breastfeeding.

There is plenty, and I mean plenty, of controversy about this. While I appreciate the concerns of those not wanting to unnecessarily medicate women and their babies, I personally see a greater risk in denying the progress of comprehensive support for researching and treating PPD. The bill has fairly clear wording about education and research, mentioning nothing about specific treatments. Even though I had a positive experience with medication, I would love to see what research can find about effective alternative treatments. So many depressed women would just be happy to do something effective.

I see the huge risk of what happens when many many women continue to go undiagnosed and untreated. I was that way for three and a half years. While I hope that my children have suffered few or no lasting effects from my depression, I know for certain that I continue to have “depression leftovers.” Anyone who has followed some of my posting the last two months on Psych Central has read about them. And honestly, my kids do have a greater risk for depression in their life because they have at least one parent with confirmed depression for a number of years.

I don’t know all there is to know about how depression and families are connected. But it’s certainly possible they could inherit certain sensitivities from me. That’s also why I need to keep fighting for women who will experience PMDD and postpartum depression in the future. I want my girls and every female their age to have doctors, nurses, and a society that understands postpartum depression better than when I had them.

Ideally, you wouldn’t have to legislate to make that happen. However, we still have a huge stigma about mental illnesses of all kinds. Creating the opportunity for more research and better preventative practices will make some important strides. I can’t change the fact that I experienced postpartum depression, but if I can help more women get information and support at the moment they need it, I didn’t suffer in vain.

Here is the text of the act – please let me know if this link doesn’t work for you.

http://http://www.healthfreedomusa.org/?p=527

One final thought – you do not have to agree with me here. I have seen many people with differing opinions after my posts, which is fine. It can make for stimulating conversation. I may have some of the same unanswered questions you do about PPD, even if we have different opinions on this act. I have to be true to myself and support what I believe in. At the very least, consider your own viewpoint on postpartum depression, anyone you’ve known with PPD in your life, etc.

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Depression Leftovers Making a Catastrophe in My Mind http://psychcentral.com/blog/archives/2009/04/14/depression-leftovers-making-a-catastrophe-in-my-mind/ http://psychcentral.com/blog/archives/2009/04/14/depression-leftovers-making-a-catastrophe-in-my-mind/#comments Wed, 15 Apr 2009 03:21:26 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=3632 I continue to find many annoying leftovers from my days of depression, and I know that black and white thinking is responsible for much of it. Something I find particularly exhausting and annoying is how I can make emotional mountains out of molehills. This is called catastrophizing. Inside my head, I let my imagination go wild and create the worst possible outcome for problems that have yet to occur.

I know I do better to prevent it, yet I still continue to do it. I know better, and that’s what frustrates me. I can even say to myself, “Hey, this probably won’t be THAT bad.” But sometimes, the temptation is irresistible. I get sucked into the drama of playing out a worst-case-scenario in my mind.

It takes me through a whole range of emotions, which is an exhausting journey. Take a look at my Mood Swings Are Exhausting post from a few months ago to read more about that. Plus, I get full color images and emotionally charged dialogue to go with it. To make matters worse, I usually develop a few assumptions as the story progresses.

Those darned assumptions, they are a pretty tricky side effect. I must be careful that my emotional joyride doesn’t leap over the border into my real life. I might be in a real mood when my husband comes home because I took way too much meaning into a side comment. I could get teary and overly wrapped up in future events like my daughter’s surgery months before anything even happens.

I’m not advocating this, making a horror movie in your head about your biggest worries. It’s no fun and it rarely accomplishes anything helpful. And catastrophizing is a fairly common activity – it’s just worrying with an extra gear. But when it really gets rolling, I believe the depression thinking makes the extra push. Those old depression connections in my mind really know how to create a catastrophe out of not much. Even a semi-harmless worry can stimulate those nerve paths in my mind that used to run hot with worry and rumination for years.

I’m being honest here – I need to work harder to nip these in the bud. Some days the reminders of my worries seem to be all around me, but I know I’m primed to look for them, too. I think there’s a finer skill to be honed – capturing information, keeping what’s useful, and discarding anything that could run wild in my head.

I would do myself a favor by improving my ability to cut off any worrisome scenario before it got a head of steam. Finding emotional and thought triggers would be a good place to start. Acknowledge the fear, state what I know and what I need to learn, and then tell myself that my fear doesn’t necessarily dictate or match reality. It’s a challenge to adjust bad thinking patterns, but a simple approach can help.

I can’t change the fact that I had depression. I probably can’t change the reality that I’m more susceptible to these leftovers like worry and catastrophizing. But I’ll do my darnedest to use these opportunities to learn about myself. And stopping catastophes before they start? Well, I guess I’ll take that over depression any day.

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Is It Depression Or Just A Bad Mood? http://psychcentral.com/blog/archives/2009/04/13/is-it-depression-or-just-a-bad-mood/ http://psychcentral.com/blog/archives/2009/04/13/is-it-depression-or-just-a-bad-mood/#comments Mon, 13 Apr 2009 13:00:01 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=3434 Depression is a common problem for people across the world. About 10 percent of the U.S. population over 18 has depression. Women report depression twice as often as men, though it’s not clear if this really shows how many men and women really have depression. And if you have already had depression once, you are at a higher risk of relapsing. It’s a good thing to consider whether you are dipping into clinical depression or just have a low moment.

Here are some things to check for if you think you might be headed toward a depressive episode:

Thoughts

Being aware of your thinking patterns can really help. If you are thinking more negatively than usual, you may just be having a rough day. But also take a look at how those thoughts are affecting your decisions, your outlook on things beyond that day. Are you more frustrated with things, or are you really beating yourself up?

Having trouble concentrating is another symptom of depression. Negative thoughts can lead to trouble making decisions, confusion or forgetfulness. Just a day or two of this doesn’t mean you necessarily have depression. But if your thoughts turn suicidal, seek help right away.

Emotions

You can feel sad or down without having depression. But you do need to take note of how down you really get. Are you feeling mildly sad or let down, or are you feeling hopeless and helpless? Also, with depression you many feel a sense of being overwhelmed with emotion and have a negative or sad mood that others can sense.

Again, if someone notices you are down or crying, that doesn’t automatically mean you have depression. But if they notice this for several weeks, they may also have noticed other symptoms of an impending episode.

Physical Behaviors

Sleep disruption and appetite changes are hallmarks of depression. A night or two of disrupted sleep or eating isn’t necessarily a big deal. But if this continues and makes life even more difficult than it already is, you may need to talk to someone about what’s going on.

Try Something To Shake the Depressive Feeling

Do something about your mood to change it. Go for a walk, talk to a friend, make a decision to think differently for the rest of the day, watch a funny show. Do something that you think would likely help you break the monotony of your mood and thinking patterns. Sometimes, just getting distracted and out of your own head can change the course of your day. Sometimes just getting a good night of sleep can help clear the negative thoughts and give you fresh start.

All of these are things you have probably done at one time or another to give yourself a lift. If these work, chances are you have just had a down day or two. You are capable of bouncing back from a mildly low mood and going on with your life.

If, however, you find that these things don’t work and you continue to feel these symptoms for two weeks or longer, you may be heading into a depressive episode. You may need to take a wait-and-see approach before you can really know where it’s going.

Get Help Now If Things Seem Really Bad

But even if it only lasts for less than a day, if you have thoughts or feelings that truly disturb you, or you seem uncontrollably weepy, call a doctor or mental health counselor. If it is disrupting your daily life or you feel like you might hurt yourself, don’t wait for two weeks — get help now. Supportive friends and family also can help you through these low times. Whether you have a bout with depression or just a low day, a warm support network can help you snap back to your old self.

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Unexpected Crying: How Do You Handle It? http://psychcentral.com/blog/archives/2009/04/10/unexpected-crying-how-do-you-handle-it/ http://psychcentral.com/blog/archives/2009/04/10/unexpected-crying-how-do-you-handle-it/#comments Fri, 10 Apr 2009 17:39:09 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=3534 Unexpected Crying: How Do You Handle It?Today I got a surprise. I was at a day-long training with a variety of activities, and one of them was watching a short video about older people in the hospital. It depicted them being in their own thoughts, remembering times when they were younger, and how they looked at different stages of their life. It was intended to give us a better appreciation of the people who come for physical and mental care.

The room was dark, and I could feel the emotion coming in the last 30 seconds or so. I was happy there was a tissue box nearby because the tears were practically squirting out of my eyes by then. I could not do a thing about it except to soak them up on the tissue. I was over the edge from the undeniable emotion that swelled inside, and I wouldn’t be coming back for a little while.

I know that if I’d tried to stifle that, I’d probably have gotten a headache. And I may have cried later anyway. Thankfully, this was a fairly safe group of about a dozen people. The facilitators had planned the video just before a break. Each time they’ve done the training, someone has needed to take a private moment before joining the group because they cried. The timing helped to make it less embarrassing or noticeable if someone was missing for a few moments.

While I was definitely caught off guard, I’m so glad I had the chance to express myself and recover with a bit of privacy. It gave me a chance to connect with some work associates I hadn’t gotten to know very well yet. And truthfully, ever since I was pregnant with my first child, touching family stuff like this video has made me much more prone to crying.

I can also expect to cry at least a few times every time I’m at Disney World. I have gone with my kids and parents the last couple of years, and I also went as a child many times with my sister and parents. When I’m watching the parade, seeing Cinderella’s castle for the first time, watching the performers in front of the castle, all of it. It floods my senses and nearly always overflows my emotional channels. So technically, that isn’t unexpected. But it is in public and I have no control over it.

I used to be more self-conscious of this, and in a less comfortable circumstance, I’m still more wary of letting it go. However, I’ve simply decided that in those kinds of situations, I’m more willing to be authentic than to appear in control. The tears say to me that the experience is meaningful. It stirs past fond memories, makes me think of important people, connects generations together, or impresses other deep things on my heart.

If I can’t control the flow of tears or emotion anyway, what good does it do to deny myself the expression? Some of these are tears leftover from grieving a death, some of these are tears of joy for passing on traditions, some of these are tears of nostalgia for happy experiences that shaped my life.

That’s just how I have learned to deal with these expressions. I also spent some years crying in private shame from depression that no one really understood or knew about. Perhaps because of that, I’m both more easily triggered and more ready to be open about it.

Anyway, I’m interested to learn more about how you have handled unexpected emotion that has caused you to cry or almost cry in public. Did it feel OK, or did you feel uncomfortable and fight it? What were the circumstances?

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How Depression Is Like The X Files http://psychcentral.com/blog/archives/2009/04/08/how-depression-is-like-the-x-files/ http://psychcentral.com/blog/archives/2009/04/08/how-depression-is-like-the-x-files/#comments Wed, 08 Apr 2009 14:24:43 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=3439 Huh?? That’s probably what you thought when you clicked on this blog post. Depression….. The X Files….. Right. I’ll admit, I’m a scifi fan, and the X Files is one of my all-time favorite shows. I’m old enough to have enjoyed it the first time around in the ’90s, and now I’m watching the entire series again on DVD. Yes, I’m a big nerd, but I digress.

A couple of nights ago, I watched one of the many alien conspiracy episodes involving Agents Scully and Mulder, Assistant Director Skinner, Alex Krycek, and a host of other folks mixed up in a thick plot. This is somewhere in the last of nine seasons, so alien conspiracy and high drama are not new to the regular viewer by this time.

I had a few thought collisions today, leading me to compare depression with the X Files. I was briefly distracted from my normal writing tasks when I recalled what I was thinking during the episode I watched recently: “Geeze, it always seems like nobody believes these people, even when there’s clearly a huge problem.”

They can’t tell anybody, they don’t know who to trust, and whoever they do tell surely will think they are crazy. Really, who would ever believe that the informant who is trying to feed the agents helpful information really has the scar from a metal chip in his neck because he’s an alien hybrid? Even though all the viewers and the key cast members know all about this threat, the agents never seem to know who they can trust. They live in a world of worry, peril, secrecy, and confusion.

Ta-da. There’s my connection. I have often said to myself that my depression felt like an alien had taken over my brain, though the takeover wasn’t complete because I still knew that I was me. I was just disabled enough to have little control but aware enough to realize I wasn’t able to get the alien out by myself.

I needed help. This wasn’t normal; I knew something was different. But what? And how do I describe this? Would anyone believe me? And would I wish I would have kept my mouth shut once I said something? How will this affect my job, my kids, my marriage? I can’t keep going on like this, but I don’t know if I can tell anyone either. Which is more dangerous?

And all Mulder, Scully, and Skinner have is each other. They’ve witnessed and been through difficult things that would be hard to believe unless you’d been there. Depression often is that unbelievable, too. Unless you have felt the takeover of your mind, seen the lost look on your own face in the mirror, and begun to doubt everything you’ve known, it can be hard to understand from the outside.

Fortunately, there is much more support and help available for people with depression than there ever seemed to be for Scully, Mulder, and Skinner. Those aliens just kept coming at them and they kept fighting them tooth and nail. Suddenly, I’m feeling a fond kinship with these X Files heroes – alien fighters to the end.

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Negative Anticipation Set Up For Worry http://psychcentral.com/blog/archives/2009/04/06/negative-anticipation-set-up-for-worry/ http://psychcentral.com/blog/archives/2009/04/06/negative-anticipation-set-up-for-worry/#comments Mon, 06 Apr 2009 13:55:00 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=3428 Last night I was worried about a work thing that I felt less than ideally prepared for. Some parts were fine, but others worked against my weaknesses. In short, I was pretty worried. When I went in to work, it all went better than I expected. Some bumps in the road, but it was a great learning experience with good support. I knew this in my head going in, but I was still worried. And I was still somewhat worried about doing it the next time. So if my logic tells me it’s likely to be OK, why did I still get so worried?

Worrying is feeling anxious about something that could or will happen in the future. The emotion usually includes fear of either something specific or of the unknown. Your heart beats faster, you might feel sweaty, and you often feel a sense of physical tension in your muscles. All of this goes on plus a whole lot of “what if” kinds of questions.

And here’s the kicker. All of this is based on your negative anticipation about the upcoming possible situation. Your beliefs about your abilities to handle things often create negative anticipation. If it is something you have strong confidence about, you don’t get worried because you have a positive expectation of your performance.

This could come from some past difficult experiences or it could be because you have no experience and you think you will flop. For example, if you have tried to get your driver’s license three times and keep flunking the driving test, you might start to really get worried about that. If you get caught up in that past difficulty and project it into negative anticipation, you are likely to dread every moment until you get the results of the test. And you might even worry about your eventual disappointment at failing yet again.

If you were going to try out for a play but had never done it before, your worry might stem from not having any idea what could happen up there. Will you freeze? Could you start sweating profusely? Will you embarrass yourself so much you’ll want to hide? If you have had other experiments like this that have ended in disappointment, you might begin to worry here, too.

A person who enjoys the challenge of trying new things would probably know they could mess up, but would feel more excitement than anything else. And really, fear and excitement are different sides of the same coin. Much of your interpretation depends on your personality, collection of experiences, and attitude.

So there I was, feeling worry that I’d have the opportunity to mess up, and in the end I think I really did pretty well. Although it might not have felt like it then, I know this will add to my collection of positive experiences about this work situation. I have a few strategies to help me with the parts I’m not comfortable with, which should take some of the negative anticipation out of the way.

I could just hate it every time and see if I could get away with quitting this job. But you know, I’m starting to see the adventure in this scenario. Maybe instead of worrying, I’ll be saying to myself, “Wow, I can’t wait until the next time I get to go.” Hmmm, I don’t know, but it’s gotta be better than worrying all night.

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Fear Is a Hungry Monster http://psychcentral.com/blog/archives/2009/03/27/fear-is-a-hungry-monster/ http://psychcentral.com/blog/archives/2009/03/27/fear-is-a-hungry-monster/#comments Fri, 27 Mar 2009 19:51:12 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=3276 What did President Roosevelt mean when he famously said, “We have nothing to fear but fear itself”? Actually, Roosevelt’s been referenced a lot lately regarding the bad economy. What would he have known about how fear interacts with itself?

The current global economy and the Great Depression have more in common than just bad stock markets. They also had a healthy dose of daily fear. I do not profess to be any sort of economist or historian. But I can see how this works judging from my personal perspective on this calamity.

Investing money takes confidence; confidence that your money will generally do well if you choose wisely. Those willing to be especially bold might opt for investments with higher risks but higher potential payoffs. Others might rather keep their money growing slowly and steadily until they need it way down the road.

When people see the property values tumbling, jobs being lost in their neighborhood, and their 401k’s shrinking, they become afraid. They don’t go out to eat as often, they put off building that new house, they don’t drive out of town as often.

Here’s an example of how the slow-down in the housing market can affect a community across the country. Fear and shaky finances hold back people interested in building new homes. Fewer construction projects are started. Fewer heavy duty trucks deliver building supplies, and therefore require fewer oil filters. Orders for filters drop at a filter manufacturing plant. Plant workers get laid off to match slowed demand. The community gets a job-cut shock, and more fear and financial problems abound.

Of course, it’s always wise to live within your means and save money for the future. But when people dramatically change their spending habits all at once because of an emotional reaction, it can act like a chain reaction that grows strong over time. A person cuts way back on spending because they fear what could happen to their job. Other dominoes fall in the economy, and more problems occur. These problems further reinforce and justify the person’s fear. As a result, they cut their spending to the bare minimum. Fear begets more fear, which then feeds the fear even more. The bigger the monster grows, the hungrier it gets.

When people get locked into this kind of fear, it can make getting out of the situation fairly difficult. People need some kind of confidence to spend their money. Trust is slow to build and easy to lose. And right now, I sense a hefty skepticism in how soon things will improve. People are still waiting for the other shoe to drop with job layoffs. They are holding their breath when they hear about the stock market. They are building a stack of unopened investment reports in their file cabinets.

Really, I am no economist and don’t know exactly what financial mechanics it will take to make things improve. But many people are waiting for better news to start releasing the tension in their shoulders. They are waiting to feel some twinge of optimism from reading the newspaper. They want to see more job openings than layoffs in their community. When those things happen, the collective emotion of the country may start to shift. The fear monster can eventually go back into the
shadows for a while.

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Sick Days, Working Parents and the Bad Economy http://psychcentral.com/blog/archives/2009/03/17/sick-days-working-parents-and-the-bad-economy/ http://psychcentral.com/blog/archives/2009/03/17/sick-days-working-parents-and-the-bad-economy/#comments Wed, 18 Mar 2009 02:15:00 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=3149

It’s an epic battle that surfaces every year in about October, and usually dies down in the spring. Microscopic invaders keep thousands of kids home from school every day during the fall, winter, and early spring months. Parents do their best, but we often feel powerless to prevent sick days. In light of the current national job situation, a working parent today may have more on their mind than just their child’s health.

I work part time and am able to stay home with my kids most of the time. Nevertheless, I have had my share of trouble with “kid germs” interfering with my work schedule. I’ve missed more than one “really important meeting,” rescheduled training days, and reworked my writing projects around nebulizer treatments and doctor’s appointments. We’ve hit the jackpot of bad germ luck this year – someone in our family has been at home from work or school for eight consecutive weeks. Yes, eight weeks. And we might be working on a ninth by the looks of things today.

So I have contemplated many times – what in the world would parents employed full-time have done with my situation? Many corporations have policies about use of sick days for yourself and family. If you use too many, you might be at risk for violating attendance policies and not being fully available to do your job. Having anything resembling a red flag at work is about the last thing anyone wants now.

I’m not saying lots more people are getting fired now because they have taken a few extra sick days. But working parents are already anxious about so many things right now. College savings are shrinking, retirement accounts are dwindling, nearly everyone knows at least one person who’s been laid off or had reduced time at work because of the economy. Just read the newspapers – it’s like waiting for the other shoe to drop with job cuts, maybe in your workplace. And now you have to deal with opportunistic microorganisms?

Yes, this is a reality for many working parents. Some communities have sick-child day cares. Other people have friends or family with flexible schedules to help out. And some parents load up on disinfectant and pray. Do you send them to school knowing they are sporting a fever, or do you risk a verbal warning from your vice president because of yet one more sick day? It’s making my stomach queasy just thinking about it.

I don’t have any really good answers here. Of course, the best defense is to wash hands, use sanitizers, and avoid touching things in really public places. Not too realistic with schools and day care centers, but it’s just about all we have to work with. I know that if I’m worried about it, other parents are, too. Everyone wants to just close their eyes and coast through this next year, hoping to wake up to a brighter, less job-threatening economy.

It’s likely to be several more months until it really looks a lot better, according to all the economy pros. Probably not the only wintery germ season we’ll go through with nervous parents hoping to keep their jobs off the chopping block. Until then, I can say this. Thank the heavens above that spring is right around the corner.

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Emotional Payoffs Finally Revealed http://psychcentral.com/blog/archives/2009/03/12/emotional-payoffs-finally-revealed/ http://psychcentral.com/blog/archives/2009/03/12/emotional-payoffs-finally-revealed/#comments Thu, 12 Mar 2009 18:18:49 +0000 Erika Krull, MS, LMHP http://psychcentral.com/blog/?p=3094 Alright, so I teased you a bit on the first post of this topic. You probably thought you were going to hear all about these so-called “emotional payoffs” I keep talking about. Well, here I will get to the “rest of the story.”

Just a caveat, this whole self-awareness thing can be kind of dicey. Be careful what you ask because you might get answers that make you uncomfortable. If you see yourself in these descriptions, try not to soak it up too strongly all at once. Just make a note of it and read on through the end. Keep in mind that the first post referred to your special someone becoming disinterested in a night out with you. We will now look at the emotional possibilities with this conflict.

Angry and vocal – This brings the confrontation to a head quickly. The payoff could be good if something has been brewing and needs to be discussed. If the emotion can stay in control and a good conversation can begin, the evening may be better for it. Or, you might be feeling powerless and this is a way to make your special someone know you have power in this relationship, too. Payoff – This direct confrontation can make you feel in control, though you might lose the evening if you push it too far.

Slow and simmering anger – Being passive-aggressive like this is also about feeling powerless. You are rubbing it in their face somehow, most likely talking in a sarcastic but smooth tone, bringing up old hurts when the opportunity arises, taking jabs that you know will sting. Or, if your special someone does make a positive advance at you that evening, you might reject them simply because they had rejected you first (even though it’s what you had wanted earlier). Payoff – You may end up feeling in control, but you may also do damage to your relationship.

Retreating inside despair – It’s all your fault, you screwed up just like usual, and it’s no wonder they hate you. What?? That’s kind of extreme, but it becomes a pity party for you. You pout, sit off in the corner with a hurt look on your face, but you won’t really talk about anything unless it’s about how awful everything has become. You are essentially the martyr, making your special someone the bad guy. You jerk around your special someone’s emotions to make them react in a sympathetic way. Payoff – They try to smooth things over with you, which brings them close to you again. You may believe that your intense reaction was justified, but your see-saw emotions will feel manipulative and draining to your special someone.

Shaking it off – You are somewhat stunned and yes, disappointed. But you also remembered that they hadn’t felt well during the week. They also had a difficult day at work, and they were looking forward to hanging out at home. Although they didn’t want to go out, they are ready to watch a movie and just be casual. They have offered to go out the next weekend instead.

While this isn’t your first preference, you would rather spend the evening having some fun rather than being a big pain about it. After a little quiet time to collect your thoughts and emotions, you come back with some suggestions about which movie to watch and what to cook for supper.

You may be saying, “Wait a minute, I can’t control how I react.” And to some extent, it may feel like it is all automatic and happens in a snap. However, many reactions are out of habit and established emotional patterns. Do you typically lash out when you are upset? Do you find yourself always doing a “poor me” type of thing?

Everyone has patterns and no one is perfect, even when you are honestly trying to make good choices. Even responses that would seem destructive are often chosen for their particular benefit. It also depends on what behaviors the person is comfortable with. Whatever your reaction of choice, it’s helpful to see what your ultimate payoff is.

How much do you want to have emotional control over the situation rather than finding a way to spend time with your special someone? A tough question, but a useful one. I’ve learned about my own habits over the years, especially those born of my depression years (and less mature years). I must always be cautious of becoming the martyr or being sullen and sarcastic. I’m sure you didn’t notice that at ALL.

Whatever the payoff is, be aware of whether your choice is destructive or positive. It can make all the difference.

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