Category: <span>Trauma</span>

Depression Stress Trauma By Stephanie Insko, Ph. D 0 Comments

Life Phases and Their Impact on Mental Health

Think about the following folks and what they have in common. Hunter is a 27-year old college graduate who has just quit his third job and is thinking of going back to graduate school, citing unhappiness in his career so far. His friends tell him he’s just having a “quarter-life crisis.” Jennifer is a 48-year old working mother of three who recently moved her mother into her home following a dementia diagnosis. Her husband comments, “you bet she’s stressed out, she’s part of the sandwich generation, and she never gets a break.” And Nancy is a 72-year old retiree from the corporate world who, despite being financially secure, states, “I thought I’d be relieved to be out of the rat race, but instead I’m getting more and more depressed.”

In spite of being in different phases of life, each of the people above is experiencing a significant strain on their mental and emotional well-being. And for all of them, it’s actually the stage of life they’re in that’s contributing to it. In my practice, I work with adults across the lifespan. And for many, their current phase of life has a lot to do with the reason they sought therapy. As humans, we are constantly evolving into new life stages. When we were young, these changes were usually exciting and brought new experiences and long-awaited markers of independence. We can all remember the freedom we felt during those firsts: riding our bikes across the neighborhood to a friend’s house or getting the keys to mom’s car for a night out with friends. But what happens when we, like those in the examples above, find ourselves up against a new life stage that doesn’t bring what we expected?

As we struggle to adjust, we often find that we need to quickly develop new habits and routines that will help us navigate the uncharted territory. This is perhaps most common when the life phase comes on suddenly. Take our middle-aged mom, for instance. She might have known that her mother’s cognitive health was declining, but due to the busy-ness of her own life, she wasn’t aware of the urgency of her mother’s need for round-the-clock care. And as she began caring for both her children and her mother, she came to put herself last. She discovered, perhaps too late, that she couldn’t do it all without significant changes to her life. Gathering the practical support needed to care for both her mother and her children was necessary, but took a lot of time and emotional energy. And that took a toll on her well-being. Mental health concerns like anxiety and depression have a way of sneaking in when we’re most stressed and unable to maintain our previous levels of self-care.

But even when we have time to plan for the change, we might still have a hard time adapting. Think about our retiree above, for example. For years, she had anxiously awaited her chance to spend quiet mornings sipping her coffee and reading the news instead of fighting traffic on her 45-minute commute. She had looked forward to traveling for pleasure, as opposed to catching the red-eye for conferences. And she couldn’t wait to trade emails and meetings for school lunches with her grandkids and pickleball with her friends. Why, then, did she grapple with depression? Big life changes, even those that we welcome with open arms, are usually accompanied by some kind of loss. In our example, the retiree had lost the thing that had filled most of her days for the last 50 years. And yes, she hated aspects of her work, but overall, she did find it meaningful. She felt that her contributions to her workplace and, in a larger sense, to her field, had really made a difference. And working to readjust and find new things to not only occupy those 40 hours a week, but also to bring her the same kind of purpose, was difficult.

Similarly, the young college graduate in our examples above was experiencing loss. The transition to the world of work in a new city meant the loss of significant friendships in his immediate surroundings. Moreover, his new workplace was filled with folks in all stages of life, and he just didn’t feel a natural connection to the 45-year old parents or those nearing retirement. Add to that the learning curve of starting a new job and navigating a new city, and our college graduate felt lonely and inadequate as he struggled to find his place in his new world. Yet, he expected himself to adjust to this new phase of life with relative ease. After all, his story followed the natural progression of things for many college graduates. And on paper, his life was playing out as it was “supposed” to. That might have been precisely why he was caught so off-guard by his unhappiness.

I believe that we need to expand the conversation around life transitions. In addition to emphasizing all the good things they bring, we need to include the possibility that it might take time to adjust to any inherent losses. And perhaps more importantly, we need to remember to give ourselves extra grace as we work to become accustomed to all the newness. Simply remaining aware that mental health concerns such as depression or anxiety can creep in during adjustment periods works wonders. But even more importantly, we need to remain intentional around identifying and working to maintain any coping mechanisms that have worked for us in the past. Remaining connected to previous support systems is crucial. So is continued engagement in activities that bring about relaxation, joy, or fun. And sometimes we need others to make sure we’re staying on top of these things. Whether it’s asking friends and family members to reach out more regularly during the transition or seeking the support of a mental health professional, it’s helpful to have a system in place that can act as a bridge while crossing into the new phase of life.

If you’re struggling to adapt to a significant life transition and need some support along the way, the therapists at Brentwood Counseling Associates can help. Read more about each of us here to find out more, and if you’re interested in scheduling an initial session, reach out to our office manager.

surface relationships
Grief & Loss Relationships Trauma By Richard Gorman 0 Comments

Four things to keep in mind when supporting a friend in grief

My father lost his battle with cancer 15 years ago. He was 59. One of the most confusing dynamics of his death were the varied responses and reactions of my friends. Many responses were wonderful. But many were frustrating. Some were even hurtful.

One of the more challenging aspects of grief is how to support a friend or family member who has experienced intimate loss. The good news is that there are skills and approaches that we can learn in order to be more supportive and helpful for friends in grief. Here are a few things to keep in mind as we try to support a friend who has experienced intimate loss:

1. Be in touch with our own anxieties

One of the most important aspects of supporting a friend in grief is to be aware of the ways that their grief triggers our own fears. Many of us simply don’t know what to do with grief. Which makes sense because we live in a society that goes to great lengths to avoid and deny the reality of death. When someone close to us has experienced intimate loss it brings death really close to home: After all, if tragedy can happen to them then it can happen to us, right? This can be a terrifying revelation that upends our illusions of stability, safety, predictability and control. If we don’t get in touch with our anxieties then our attempts to support can degenerate to frantic attempts to make the bereaved feel better, fix the situation or avoid it altogether.

Following my father’s death, random encounters with friends in grocery stores would often result in them awkwardly dancing around the obvious situation–talking about weather, baseball, church–anything except my recent loss. I get it. We do this because we are afraid of “bringing it up” and “making it worse.” But grief can be isolating. Avoiding the issue reinforces the sense of isolation. The antidote is to be seen and known–to have one’s reality named and honored. When supporting friends in grief we need to be aware of and manage our fears. Realistic appraisal of our own mortality is not a fun process, but it can be very healthy and even liberating.

2. Don’t try to make them ‘feel better’

I attended a funeral several years ago. I overheard someone say “if you’re sad right now, you’re really just selfish and making this more about you– because he’s just fine right now!” This and many other damaging and misguided statements are said under the guise of helping the bereaved ‘feel better.’ Some of the more common phrases that fit this criteria are:

  • “You can always have another child,”
  • “They are in a better place now,”
  • “God must have wanted another angel”
  • “At least he died doing something he loved”

Unfortunately this list can go on and on.

These ill-advised statements are often an attempt to manage one’s own fears and discomfort (see point #1). The more helpful–and challenging–thing is to simply be present and say little. Statements like “I have no words” or “I love you and I am so so sorry” tend to be much more helpful–primarily because they are true. These statements give space for the person to feel how they are feeling and not feel blamed for ‘doing it wrong.’

3. There is no ‘getting over it’ or ‘moving on’

When a friend is in pain we naturally want to make it better. The hard truth is that we are forever changed by some of the things that happen to us. When it comes intimate loss there is no “getting over it” or getting “back to normal.”

In her book “It’s ok that you’re not ok: Meeting grief and loss in a culture that doesn’t understand,” grief expert Megan Devine writes: “If we talk about recovery from loss as a process of integration, of living alongside grief instead of overcoming it, then we can begin to talk about what might help you survive.” Eventually we can take steps forward–not in ‘moving past’ the grief, but in moving forward with the grief. The goal, ultimately, is not to ‘get back to normal’ but learning to eventually carry grief as we begin to move forward.

4. Be a “credible witness”

Grief expert, David Kessler, argues that the most important dynamic for grief to be processed well is empathic connection with another person who is willing to accompany the bereaved in their grief. Keller calls these people “credible witnesses” because they are able to be present and bear witness to the searing pain of traumatic loss without trying to fix it or “make it better.” Being with a person in pain is not easy. It forces us to confront our own fears. It is inconvenient. We may feel rejected. The truth is that nothing we do or say will make it better in the short term. A person in grief needs space to feel how they feel and to be seen and known without feeling that they are ‘doing it wrong’ or that they should feel better.

Grief is a complicated process that demands time, patience, understanding and active work for the bereaved as well as supporters. My hope is that more of us will grow in our ability to accompany friends and family through the searing pain of intimate loss. By becoming a ‘credible witness’ our friends will find a softer place to rest and be given the healing gift of empathy and presence.

Additional Resources:

There are many helpful books. Two that I recommend are:

Additionally, there are many good podcasts and Ted talks. I recommend:

  • “The messy truth about grief” – Ted Talk by Nora McInerny
  • The “Grief Out Loud” podcast by the Dougy Center for Grieving Children and Families These interviews include survivors, experts and others who have experienced grief in myriad ways.
mental health and covid-19
Anxiety Depression Grief & Loss PTSD Stress Therapy Trauma By Stephanie Insko, Ph. D 0 Comments

Mental Health and COVID-19: What’s Normal in the New Normal?

The new normal. Mental health and COVID-19. If you’re wondering how to optimize wellness during the current pandemic, you’re not alone. Over the past few weeks, many of us have shifted to working, learning, grocery shopping, exercising, and hair cutting from home. Instead of spending time in person with friends, family, and co-workers, we talk at our phone and computer screens to stay in touch. The days blend into each other now that we have no places to go or people to see, and we do our best to put some sort of structure to them. And in the time of COVID-19, we consider ourselves lucky if those are our biggest concerns. Some have experienced much more devastating changes due to the loss of jobs, health, and even life. They’ve lost everything, and fear for how much worse it will get before it gets better. This would have all seemed unbelievable just a couple of months ago, and yet, it’s where we find ourselves.

It’s safe to say that the COVID-19 pandemic has changed things for all of us, whether it’s simply the loss of our old way of life, or a much more tragic one. And during these times, it can be helpful to understand what we’re going through in the context of grief. When we think of loss in the traditional sense, we think of the death of a loved one or the end of a significant relationship. But our feelings and reactions to this pandemic are much like what we go through when we grieve. We’re grieving the loss of the way things used to be. And just as some people have a harder time working through the grief process, some folks are finding it harder to adapt to the loss of our old way of life. In this article, we’ll explore some of the normal, common reactions to our new reality, and identify some red flags to watch out for. We’ll also offer a few suggestions about how to grieve the loss of the old normal, and shift into the new one, in a healthy way.

Mental Health and COVID-19

Denial, Shock, and Disbelief

Much like a sudden and unexpected death, the drastic changes we had to make during the month of March seemed to happen overnight. We were caught off guard, and a sense of shock and disbelief set in. We were hopeful that schools and sporting events might start back up at best, in a couple of weeks, and at worst, maybe a month. In those first few days, we just couldn’t fathom that we might be in this for the long haul. The idea that this virus would be so contagious that we’d all need to wall ourselves off from the rest of society seemed like something from a blockbuster science fiction film, not from 21st-century America.

But it wasn’t unlike the denial phase of grief, when we find it hard to believe that a loss is real. Imagine the person, for example, who, soon after a breakup, holds out hope for a reconciliation. When a new way of being is too painful for us to bear, it takes some time to absorb the reality of it. And this denial phase of grief seems to have happened to a lot of us during those early days of quarantine.

But denying that things are different keeps us from doing the things we need to do to stay healthy – in the age of COVID-19, physical distancing, or washing your hands, for example. It can also delay our transition to a new normal, and keep us in a holding pattern of sorts that prevents us from developing new routines. Part of good mental health is having the flexibility to create new versions of our old routines when we’re forced to change our daily lives. For example, just because you can’t go to the gym for six weeks doesn’t mean you have to be a couch potato the whole time. Your new exercise routine might not look much like your old one, but the ability to find ways to approximate it is vital to transitioning into your new normal. Taking a flexible approach when shifting each part of your daily routine is one way to make the overall change seem less overwhelming.

Getting Stuck

As we made the initial adjustment to our new routines, many of us found the extra time relaxing. No more drive time meant we could stay in bed a little longer and skip ironing our pants. Some of us even scrapped the professional look altogether and went straight to sweatpants and ball caps – relaxation at its finest! Hours upon hours at home also lends itself to binge watching TV shows or movies, often snacking while doing so. Downtime is a critical piece of optimal mental health, and many of us weren’t getting enough of it until now. There’s something to be said for our newfound comfort with presenting our “real” selves to the world – long, graying, messy hair, and all. Letting go of our old pretenses around image is a sign of vulnerability, which allows us to connect more deeply with others. Because we’re getting a glimpse into the real world of our colleagues, friends, and family members, we may end up feeling closer to them, because we can see that they’re much like us.

But what happens when the media binges go on so long that we miss sleep or meals, or fall down on the job? Or when one day blends into another so much so that we lose track of hygiene and stop showering or brushing our teeth? These patterns are easy to slip into, and are very common during the grief process. When we’ve lost a critical part of our old way of life, it’s not unusual to get stuck “waiting” for things to return to normal. But putting everything on hold is a signal that adaptation to the new normal isn’t going so well.

Having balance and structure to the seemingly endless days is crucial to maintaining good mental health during these times. You don’t have to create a down-to-the-minute schedule and stick to it; remember that the point is to be flexible during this time. But having some general expectations for each day isn’t a bad thing. It may be helpful to think about this, for example, in terms of physical health, work, and relaxation. A goal might be to aspire to include some work, some rest/relaxation, some movement, and adequate sleep and nutrition. This is just a starting place, though. Think about what’s important to you (spirituality is one example that comes to mind), and consider how that might fit into your daily plan around balance.

Going into Overdrive

What about when your problem is not doing too little, but doing too much? With calendars cleared of extracurricular and social activities, hours are suddenly opened up to devote to those long-delayed household projects. Backs of cabinets and closets have been cleaned out. Lawns are immediately immaculate. And pantries and desk drawers have been organized. Many of us have even taken up new hobbies or returned to old ones. It’s felt good that we’ve been able to make the most of these strange, scary new times by being productive. And there’s nothing wrong with that. But for some, along with all this new productivity came the expectation that they should be doing something fruitful with the extra time, all the time.

It’s not uncommon for people who are grieving to go to such an extreme after experiencing a significant loss. We see a lot of folks who throw themselves into work as a way to cope during the grief process. Staying busy is a way to distract ourselves from painful feelings about the loss. It’s also a way to feel like we’re taking back some control over our lives when it seems like everything has spun out of control. But that busy-ness itself can also spiral out of control, to the point that our mental health suffers. We can start using activities to push down our true feelings of sadness about the loss. Or we can start basing our self-worth on our productivity, feeling guilt and shame when we’re not getting enough done.

It’s important during these times to examine our motives for checking off to-do list after to-do list, and to check in on what emotions we might be using those activities to avoid. Such check-ins with ourselves and others about how we’re really doing with all these changes are vital to maintaining good mental health in this new normal. Don’t be afraid to identify and express whatever you’re feeling, whether on your own through journaling, for example, or with another person. If there’s not anyone in your life with whom you would feel comfortable doing this, please consider reaching out to a trusted professional. From counselors to clergy members, there are people ready to help.

Other Suggestions for Finding a Healthier New Normal

In addition to the suggestions given already, consider limiting time spent reading about the pandemic. It’s good to have information and be up-to-date on the latest recommendations. But given the tragic nature of much of the news these days, information overload can leave you feeling helpless, hopeless, and scared.

Not only can placing parameters on the time you spend consuming COVID-19 information help, but so can giving back. It can easily feel like our sense of control has been robbed from us these days. But helping others, and feeling like you’re really making a difference, can bring it back. Making masks, taking part in a quarantine birthday parade, joining in on a big round of applause for our health care providers, and donating money or food to a food bank are just some examples of ways people have been volunteering their time or resources.

And if you already struggle with stress management or mental health concerns such as depression, anxiety, or addiction, or if you’re going through an additional loss during this time, you’ll need to take extra good care of yourself right now. If you need help finding someone to talk to, please don’t hesitate to contact us at Brentwood Counseling Associates. We’d be happy to help you determine who’d be a good fit for your needs and situation. Whether it’s someone in our practice or somewhere else, we just want to be sure you’re getting the support you need during this time.

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