15 Important Ways to Fight Depression at Home
Remember that feeling sad or experiencing grief is normal under unpredictable and potentially dangerous situations. Social distancing and coping with the fallout of a pandemic will cause uncomfortable feelings in most everyone. If you are able to look forward to better times and can find some in each day, your emotional discomfort may very well be within normal limits.
Acknowledge that depression and isolation feed on each other. When people are depressed, they tend to put less effort into connecting to others. When people are isolated, they tend to feel more depressed. It can become a vicious cycle. Those who have been struggling with depression before the social isolation imposed by the COVID-19 crisis, need to be extra vigilant and work at staying ahead of their depression.
Think about a difficult time you have already been through. Remember that you got through it. It did come to an end. And you still have the coping skills and strength you used back then inside you. Write a letter to yourself complimenting yourself for getting through that difficult time. Outline the strengths and courage you used then. Assure yourself that you will ride out this difficult circumstance as well.
Let someone know you are struggling. Tell a good friend, a relative, your doctor, call a warmline or NAMI or a therapist. Don’t suffer alone, reach out, there are many, many people who care and will be there for you. You have to reach out and make the initial self-disclosure and let them know. Even those who love you can’t always read your mind. If someone you’ve told hasn’t reacted in a helpful way, tell someone else. Don’t give up. Keep letting people know.
Put on music that makes you want to dance. Even if you don’t think you will like listening to lively music and it seems like too much effort, try it anyway. Music is one of the fastest ways to change your mood.
Send greetings, digitally or by snail mail. Reach out and encourage others, even if they haven’t reached out to you. Try not to keep score or lower yourself to others’ level of functioning. Send out written notes of encouragement and hope. Let others know you are thinking of them, even if you haven’t heard from them in a long time. Even thinking of lifting others up will help your own feelings of gloom.
Get outdoors for at least 30 minuets a day. With the social distancing mandates stay in areas where there aren’t many people. Watch nature. It always changes. The weather, the seasons, the sky, the tides, the moon, the temperature are always dynamic. Remember that even your sad emotions and your isolation will also change.
Keep a gratitude journal. Gratitude is very powerful. Read the research that supports how gratitude changes many negative states in the human mind. If you can only think of a few things to be grateful for, break each of those into 5 subcategories. For instance, if you are grateful for your pet, also list the playfulness, the companionship, the sense of being needed, the entertainment and exercise your pet brings you.
Explore something you have been curious about. Watch a YouTube video and learn a new skill. Learn how to: draw, organize your garage or closet, paint, build something, play the guitar or piano, do origami, yoga, cook, bake, or make a home repair. When you watch a video on a topic you thought you might be interested in, you may even find that there are other activities you may curious about.
Plant something. Work in your yard or plant a pot on your balcony. Watching something grow that you planted can create a sense of accomplishment and satisfaction. There is even some research to support that micronutrients in soil may help depression. Plant something that brings you joy, flowers or vegetables.
Laugh out loud every day, as many times as you can. Turn off the news for most of the day and watch comedians, Comedy Central, YouTube humorists, a funny movie or TV show. Be willing to find the humor in things. With enough time, pretty much any event will eventually have a humorous side.
Get enough sleep. Seven to nine hours for adults, nine to ten hours a night for children and teens. If you can’t get that much sleep at night, take naps. Sleep deprivation releases fight or flight chemicals and adds to feelings of distress. Meditate, rest, follow guided imagery videos or listen to breathing exercises on Sound Cloud and other internet sites. Give your body a break from the stress and rejuvenate. Sleep is essential.
Eat throughout the day. Don’t go long periods of time without eating. Eat a little something within a half hour of waking and every three hours throughout the day. The healthier and more low-processed the better. Eating a little protein when you do snack can help maintain your blood sugar as well, easing the mood swings that can accompany blood sugar drops.
Exercise. You knew this one was coming. As boring as it may seem, exercise is one of the best ways to address depression. Find something you like (or at least don’t hate) and start slowly. Even ten or twenty minuets a day can start to make a difference. Having an accountability, like an online personal trainer, can help keep you motivated and focused.
If you have been prescribed medication to treat your depression, be consistent in taking it and don’t go off medications without coordinating with your prescribing physician. If getting your prescriptions is more challenging during the pandemic call your physician and pharmacy for suggestions. Some health insurance companies will help by contacting the prescribing health professional, shipping medications or delivering them to your home.
Be kind to yourself. Some emotions change slowly. Give yourself credit if you notice even temporary elevations in your mood. Compliment yourself if you are able to make small changes. Over time even small changes can have a great effect. You will get through this.
Dr. Lois Nightingale PhD
Psychologist PSY9503
714-993-5343
How Do I refer someone for therapy?
Sometimes I am asked how people can recommend therapy to someone they care about who is in emotional pain. It may be uncomfortable to say, “I’m in therapy and finding great results”, or “You really ought to see a psychologist”. It may be easier to say, “I know of a therapist who specializes in treating _______” (anxiety, depression, relationship issues, addictions, etc.). Or, I have heard of a local therapist who has written about _______”. Just letting someone know where he or she can obtain more information about an emotional problem, can provide a step toward getting help.
You might also recommend looking at the increasing resources available on the Internet. On Dr. Nightingale’s website site there are anxiety and depression questionnaires for people wondering about their symptoms. This site also has free articles, including one on how to choose a therapist. Tell him or her that financial arrangements can be made by calling the therapist’s office. Often office staff will explain different payment methods, what the fees are for individual therapists, what if any discounts are available for paying at the time of visit, and may even check on insurance benefits for potential clients.
Therapy is about personal growth, exploration and finding coping skills to enjoy life again. Therapy is not a place of coercion, confrontation or where only seriously mentally ill people seek treatment. Therapy is more like having a coach for the most important sport you can play…your life.
Good results in therapy are best attained when a person has a good rapport with the therapist, is highly motivated to change painful aspects of life, and has specific treatment goals he or she wishes to attain.
© Lois V. Nightingale, Ph.D., 2018 Clinical Psychologist, (lic. #PSY9503), Marriage, Family and Child Therapist (lic # MA21027), director of the Nightingale Center, author, national speaker and mother 714-993-5343
How Do I Know My child Needs Therapy?
Many adults now acknowledge the benefit of a supportive professional as they face the challenges a divorce inevitably brings. But many parents are unsure at what point their child may be exhibiting signs that indicate a need for professional counseling.
Many of these signs are similar to the symptoms adults experience when undergoing severe stress.
Sleep disturbances
Some children wake with nightmares or have great difficulty going to sleep, saying they are afraid (of monsters, burglars, ghosts, etc.). Other children may regress to earlier sleeping patterns, such as sleeping with a favorite object, wetting the bed, or sleeping in a parent’s room. Children may also withdraw and hide in sleeping, which is more likely in teenagers and sleep longer hours than usual.
Eating changes
Some children under severe stress have difficulty with appetite. They may find their stomach hurts or feels upset and they may appear more picky than usual or refuse to eat at certain meals. Other children may find solace in food and try to nurture themselves by eating sweets and high fat foods. Both are signs that a child is not addressing directly their feelings of stress, anxiety or possible depression.
School problems
Teachers can often tell when there are problems at home just by observing a child’s behavior at school. A child who was once very social may isolate or even push peers away. Children can become aggressive, exhibiting the interaction styles they have witnessed between their parents.
Withdrawal
Some children withdraw and isolate when they are afraid or upset. When isolating children may be doing things that help them feel better, such as writing, drawing or listening to music. But a child may be feeling alone, left out, frightened and obsessing about how out of control their life feels.
Outbursts of anger or destructive behavior
Children who have been holding in how they feel will let it out at some point. If outbursts of anger (verbal or physical) are modeled by either of the parents, children are more likely to let this anger out in similar ways. Children’s anger and frustration need to be heard, not “fixed” or reasoned away.
Trying hard to get parents to reconcile
It is very normal for children to want their parents back together, but if a child becomes fixated on this activity it can be a sign of severe stress and fear. Some children try to get their parents back together by being exceptionally good so parents won’t fight about them, others will act out to try to get parents to focus on them rather than the separation.
Becoming the “perfect” child or confidant
Some children cope with the stress of a divorce by trying to take the place of the absent parent. They may try to make life easier for a parent, and in return deny their own natural needs as a child. This robs a child of having a healthy childhood and can cause serious problems later on in life.
Coping with a difficult custody battle.
Custody battles can take a grave toll on children. Often they are pulled this way and that and may even be asked by the court with which parent they wish to live. A child entangled in a complicated custody battle can almost always use some outside help and counseling.
While some of these signs may appear for a short period of time and in mild forms during any divorce, if they are present for a significant period of time (weeks or months) it is important for the child to be evaluated by a professional therapist. Children usually feel comfortable with a therapist who specializes in treating children or has children of their own. A therapist working with children should also have supplies on hand to help children feel comfortable sharing their feelings. Some common therapy tools are, drawing materials, such as crayons, markers, colored pencils, puppets, books, sand tray and toys.
Remember it is always appropriate to ask several therapists questions about how they conduct therapy before choosing one for your child. A therapist with experience in working with children should help your child feel comfortable in their office. Both parents and children need extra support when going through the challenges of divorce.
© 2004 Lois V. Nightingale, Ph.D. psychologist psy9503
Clinical Psychologist, 714-993-5343
Director of Nightingale Center in Yorba Linda, California.
Author of “My Parents Still Love Me Even Though They’re Getting Divorced”
Anxiety Can Get Better
40 million people suffer from some form of anxiety every year in the US. This includes Panic attacks, Obsessive Compulsive Disorder, Agoraphobia, Generalized Anxiety Disorder, Post-traumatic Stress Disorder and Phobias, including test-taking phobias, driving phobias and Separation Anxiety in children. In therapy, clients can learn relaxation skills to address the “fight or flight” reaction and coping strategies to overcoming anxiety.
Anxiety Books
The 10 Best-Ever Anxiety Management Techniques: Understanding How Your Brain Makes You Anxious and What You Can Do…by Wehrenberg
When Panic Attacks: The New, Drug-Free Anxiety Therapy That Can Change Your Life, by Burns
The Anxiety and Phobia Workbook, by Bourne
What to Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety (What to Do Guides for Kids), by Huebner and Matthews
The Mindfulness and Acceptance Workbook for Anxiety: A Guide to Breaking Free from Anxiety, Phobias, and Worry… by. Forsythand, Eifert
The Anxiety Workbook for Teens: Activities to Help You Deal with Anxiety and Worry, by Schab
Freeing Your Child from Anxiety: Powerful, Practical Solutions to Overcome Your Child’s Fears, Worries, and Phobias… by Chansky
Feeling Good: The New Mood Therapy, by Burns
The 10 Best-Ever Anxiety Management Techniques: Understanding How Your Brain Makes You Anxious and What You Can Do..by Wehrenberg
When Panic Attacks: The New, Drug-Free Anxiety Therapy That Can Change Your Life, by Burns
The Anxiety and Phobia Workbook, by Bourne
What to Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety (What to Do Guides for Kids), by Huebner and Matthews
The Mindfulness and Acceptance Workbook for Anxiety: A Guide to Breaking Free from Anxiety, Phobias, and Worry… by. Forsythand, Eifert
The Anxiety Workbook for Teens: Activities to Help You Deal with Anxiety and Worry, by Schab
Freeing Your Child from Anxiety: Powerful, Practical Solutions to Overcome Your Child’s Fears, Worries, and Phobias… by Chansky
Feeling Good: The New Mood Therapy, by Burns
Easy to use stress reduction strategies
Aps for your phone:
Meditation Timer & Tracker
Relax Melodies – Free
Anxiety Free – Free
Breathe2Relax – Free
Qi Gong Meditation Relaxation – Free
Nature Sounds Relanxiety3ax and Sleep-Free
Worry Box—Anxiety Self-Help-Free
Stop Panic & Anxiety Self-Help-Free
Relax & Rest Guided Meditations by Meditation Oasis
Universal Breathing by Saagara-Free
Easy Breathing Techniques:
1. Re-lax: Take 5-10 min. and breathe in slowly, saying silently to yourself “Re” and slowly exhale saying “Lax”.
2. Breathe in through your nose deeply (starting with your abdomen) to the count of 4. Hold your breath for 4 counts and then slowly exhale through your mouth for 4 counts. Repeat 10-20 times.
3. Place your tongue on the roof of your mouth (it stays there throughout this exercise). Breathe in through your nose for the count of 4. Hold for the count of 7. Exhale through your mouth around your tongue (it should make a noise) to the count of 8. Repeat 10 times.
Dr. Lois Nightingale, Psychologist, PSY9503 714-993-5343
8 Important Tips for Choosing a Therapist
In choosing a professional with whom you plan to discuss your most personal issues, one who you trust to give you direction and assistance, it is important to first spend some time considering what results you would like to see if therapy was successful from your own perspective. Remember no one can change someone else. We can only choose to help change ourselves, and a person has to first be uncomfortable with the way their life is going before they are open to alternative ways of doing things. There is, however, a very good chance that if one person changes what they contribute to a situation others around them will not only begin to respond differently but may also be motivated to have a different life for themselves.
After becoming clear about what you would like to obtain from therapy it is then important to consider what are the most important qualities you want in a therapist working with you or those you love. Educational qualifications are important to many people. The following is an outline of the most common types of psychological counselors and the academic and experiential qualifications of each:
Psychiatrist. A Psychiatrist is a Medical Doctor who after completing an M.D. has had 3 years of specialty training in mental disorders. A board-certified psychiatrist has, in addition, practiced for 2 years and passed the written and oral examinations of the American Board of Psychiatry and Neurology. Most Psychiatrists only handle medication prescriptions for patients. Some psychiatrists have taken further training to conduct psychotherapy, and of those, most have been trained in psychoanalysis, which is an analytical and individual process-focused therapy. Medical continuing education is required to maintain their licenses.
Clinical Psychologist. A Clinical Psychologist has a Ph.D. in psychology and has completed a doctoral dissertation, as a contribution to new research and information in the field of psychology. He or she has completed at least two years of working with clients under supervision. They then must pass written and oral examinations. Psychologists are also required to complete continuing education classes to renew their licenses. The license of Clinical Psychologist has the widest scope of practice for psychotherapists, including, prevention and treatment of emotional and mental disorders with individuals, children, adolescents, couples, families and groups with personal, social, emotional or behavioral problems. They are licensed to do assessments, psychological testing and interpretation and hypnosis. They may have hospital admitting privileges, do forensic evaluations and be expert witnesses in a court of law. Psychologists cannot prescribe medications.
Registered Psychological Assistant. A psychological Assistant is training to be a Clinical Psychologist. He or she has a Masters degree, is finishing or has finished their Ph.D. and is in the process of collecting the above mentioned 3000 hours. They are under the direct supervision of a Psychologist who has been licensed for at least two years.
Educational Psychologist. An Educational Psychologist has a Masters degree and an Ed.D., a doctorate in education. They also have completed 3000 hours under the supervision of a licensed supervisor and then passed a written and an oral test. Their training primarily focuses on learning and social problems in school-age children. A School Psychologist is recognized in many states and is a Masters level license.
Licensed Social Worker (LCSW). A Licensed Social Worker has a 2-year Masters Degree in Social Work plus 1,000 hours of clinical placement and 3200 hours of post Masters clinical supervision. They are then required to pass comprehensive written and oral examinations. Their training focuses on social work, such as family intervention and the welfare of children. They provide individual, group, family, child, marital, and adolescent therapy. They generally practice in family service agencies, HMO hospitals, employee assistance programs, mental health clinics, courts, and health center.
Marriage, Family and Child Counselor (MFCC). A Marriage Family and Child Counselor or Therapist, as they are most often referred to, holds a Masters degree in counseling and has completed 3000 hours of supervised counseling. They must also pass a written and an oral examination. Their license allows them to counsel individuals, couples, children, adolescents and groups with relationship problems. They are also required to attend continuing education classes for license renewal.
Registered Intern. An MFCC Intern is working on or has finished a Masters degree in counseling and is working toward licensure by collecting the 3000 hours to be eligible to sit for the licensing exams for Marriage, Family and Child Counselor. They are practicing under the direct supervision of a licensed therapist and treat relationship issues.
Psychiatric Nurse. Psychiatric-mental health nurses are registered professional nurses who have specialized training at the Masters level or above. They conduct individual, family and group consultation and education. A few are in private practice, but most practice in hospitals, community mental health centers and other agencies.
Pastoral Counseling. These are members of the clergy, some have specialized training in psychology, counseling or social work. They provide inexpensive counseling but it is important to evaluate psychological counseling from anyone with little or no training in psychotherapy.
Lay Counselor. A Lay counselor is an unlicensed person who offers counseling through an organization such as a church, temple, nutritional program, self-help group, school, etc., or just on their own. Anyone can call themselves a counselor or therapist, so be sure to ask about training, credentials, certificates, internships, qualifying exams, liability carriers, insurance reimbursement, length of experience and their “scope of practice”. Don’t be afraid to ask what their intended outcome is for treatment and how many people they have treated with your particular concern.
Remember all licensed therapists are ethically required to list their license numbers in advertising. For instance: Licensed Clinical Psychologists’ numbers start with PSY…, licensed Social Workers’ license numbers start with LCS…, and MFCCs’ license numbers start with MFC…
Finding a therapist with whom you feel comfortable is very important. Sometimes this may mean asking a potential therapist about their views on topics of importance to you. Most therapists have been trained to be as objective and accepting as possible, but they are still human. You may want to know how long they have been in practice, do they have any specialties that they write or speak about. You may want to know if a therapist has experience raising children of their own or if they use scientifically based treatments. Just taking the time to have a brief conversation over the phone with a potential therapist can give you a great deal of information about your comfort level in working with him or her.
Knowing the background and specialties of a therapist can help you make your decision. A therapist should be able to provide you with an outline or brief summery of their experience. Look to see how long he or she has been treating people with your specific concern. Look for community service and other indications that he or she is genuinely concerned about people. If you have a preference for a particular type of therapy, look to see if he or she has had personal training and experience in that therapeutic intervention.
A therapist should also be willing to tell you his or her fees up-front. You may be responsible for looking into your own insurance or HMO to see if or how much is covered by your carrier, but the therapist should let you know what his or her customary fee is, and on what terms that fee is expected. Do they bill insurance for you? Are all fees due at time of service? Is there a discount if you bill your own insurance? Can you put the fee on a credit card or pay it off over time? Don’t be afraid to ask the financial questions, you are hiring this professional to help you.
Most therapists are very conscientious when it comes to client confidentiality, but some policies differ from office to office. If you are in a special circumstance such as, a divorced parent or the parent of an adolescent in therapy, you may want to ask the therapist what his or her policy is regarding disclosure to family members in these situations. You may want to know how your records are kept after termination of therapy and for how long. Some therapists must disclose client conversations with case managers if they are reimbursed by an HMO or third party insurance. If you have concerns about your privacy and confidentiality be sure to ask the questions you need answered up-front.
Phone policies differ between therapists. Many times the first contact you will have with a therapist is by phone, and during the course of therapy there are often phone contacts made between therapist and client. An initial call to a therapist’s office should be returned within twenty-four hours during business days or the following business day if placed during a weekend. Ask up-front what the therapist’s policies are regarding phone calls. Does he or she return your calls in a timely manner? Does he or she carry a pager in case of emergency? Are there hours when a live person answers the phone? Does the therapist charge for phone calls during non-business hours or for calls over a certain length of time? Who covers for them when they are on vacation?
Trust your intuition. If you feel uncomfortable with a therapist after a couple sessions don’t keep hoping it will change. Talk about it with the therapist and if you still do not feel rapport and a sense of trust, try another therapist. One of the reasons psychotherapy is successful is the relationship between the therapist and client, if this relationship is not good, therapy has little chance of working.
Therapy can be a life-changing experience or an exercise in frustration. As with any professional service, care must be taken in choosing the professional you trust. Talk to friends about things they found valuable in their therapists. Spend time reading about the kind of therapy you would like to receive. Be an educated consumer. This is your life and you deserve to have a great one!
© 2014, Lois V. Nightingale, Ph.D., Clinical Psychologist, (lic.#PSY9503) director of the Nightingale Center in Yorba Linda. For more information call 714-993-5343