Blog : depression

Am I depressed?

Am I depressed?

Depression

Common Types & Signs (From National Institute of Mental Health)

  • Major Depression: severe symptoms that interfere with your ability to work, sleep, study, eat, and enjoy life. An episode can occur only once in a person’s lifetime, but more often, a person has several episodes.
  • Persistent depressive disorder—depressed mood that lasts for at least 2 years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for 2 years.
  • Postpartum depression, which is much more serious than the “baby blues” that many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.
  • Seasonal affective disorder (SAD), which is characterized by the onset of depression during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not get better with light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.
  • Bipolar is cycling of mania and depression (highs lows, used to be “manic depressive disorder”

How depression is covered up

  • Seclusion: Common in new moms
  • Video Games: The Washington Postrecently reported that there are more adult woman gamers than teen boy players in the world. “Internet Gaming Disorder” even made its way into the DSM-5, the diagnosis guidebook for psychiatrists and other helping professionals. Video game addiction has the potential to grow into one of the most challenging addictions to treat.
  • TV, alcohol, and sleep issues

 “Normal” teen behavior vs. Depression

  • Teens are moving toward independence
  • Hormones are going crazy, the pleasure center of the brain is magnified while the frontal lobe (decision-making) is muted. It’s any wonder we survived the teen years
  • Normal teens are: moody, challenging, affectionate one day and a jerk the next.
  • KNOW YOUR TEEN’S BASELINE

Red Flags and when to get help

TWO QUESTIONS: Answer PHQ-2

“not at all = 0”

“Several Days = 1”

“More than half the days = 2”

“Nearly Daily = 3”

  1. Past two weeks have you had little interest or pleasure in doing things?
  2. Feeling down, depressed, or hopeless

Did you score above 3? Take the PHQ-9 assessment below

Depression Patient Health Questionnaire 9

PHQ-9

Down load the PHQ-9 Depression Assessment

 

Have questions? Want to start counseling?

 

 

Kids should play more video games…or should they?

Kids should play more video games…or should they?

Watch Jane McGonigal’s TED Talk above to know how this fits into video games.

Hospice Workers Report Top 5 Regrets on Deathbeds

Here’s the link to the article

1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.

2. I wish I hadn’t worked so hard.

3. I wish I’d had the courage to express my feelings.

4. I wish I had stayed in touch with my friends.

5. I wish that I had let myself be happier.

Read More

Nine ways to get better sleep

Nine ways to get better sleep

9 ways to get better sleep

Sleep is when our brains organize what has happened. Most adults need at least 7 hours of sleep. People/kids in school need 8-10 hours to appropriately categorize what they have learned.

Less sleep = More anxiety/depression/academic failure

Don’t have a TV in your bedroom, it stimulates your brain to think it is morning and makes your brain want to be awake in bed

Turn off screens 30 minutes before bed, it’s like looking at the sun and wondering why you are awake

Keep a notepad next to your bed to write down ideas/to-do list, it frees up your brain

Go to bed and wake up around the same time every day

Read More

Joe’s new parenting book

Joe’s new parenting book

Joe’s New Book

Mental Wellness Parenting | A remarkably simple approach to making parenting easier

 

From Mental Wellness Parenting | A remarkably simple approach to making parenting easier:

Control vs. Voice

So how do we use this new information about guiding our kids to help them change their behavior? Ultimately, you have no control over your child. They make decisions every day. They are their own persons.

Webster’s defines “control” as: “To exercise restraining or directing influence over. To have power over. Reduce the incidence or severity of especially to innocuous levels <control an insect population> <control a disease>”

The part of this definition that I like is the “directing influence over”. I would argue that this comes less from control and more from having a voice in your child’s life.

One of Webster’s definitions of “voice” is, “wish, choice, or opinion openly or formally expressed.” So to have a “voice” in your child’s life is for your wishes, choices, and opinions to somehow take root in them.

Think about who has a voice in your life. Who can say to you, “Here is my opinion” and you consider it?

Is it your mom?

Dad?

Best friend?

Wife or husband or significant other?

How did they gain that voice in your life? Did they do something? Did they act a certain way? Is it because you have seen how they live their life and you respect that? Do you aspire to be like them or certain parts of them? What is it that allows them to have that voice, not control, in your life?

I believe that it is trust. They somehow built trust in you. Building a voice comes from trust. For kids, that trust comes from three specific things. To build trust as parents we must demonstrate:

  1. Consistency and love
  2. Set an example
  3. Spur something in our children that brings life

Consistency and Love

In future chapters I will discuss more in-depth what this looks like and ways that you can increase consistency and demonstrate your love. One definition of “consistency” is “agreement or harmony of parts or features to one another or a whole.”

To be a consistent parent, you have to have harmony in what you do. What does this mean? It means that it is better to say nothing at all, rather than a false promise. By false promise I mean not following through on things you say. If you give a warning to a child regarding their behavior, then follow through.

When you start thinking this way, two things will happen inside of you. First, you will slow down the frequency of threats that you make because you know that you need to follow through. Also, you will evaluate the intensity of threats.

One thing about threats: they don’t work.

 

Threats don’t work

Why don’t threats work? Think about it this way. Your boss keeps coming in your office for two weeks reminding you of a date that a report is due. She says, “If it’s not on my desk on November 12th, then I’m writing you up.” November 12 comes and goes, you had some crazy things happen in your family and you just couldn’t get it done.

Then in January she does the same thing for the report due January 29th. Again you miss the mark and it comes and goes, yet no write up. Imagine this happened over 18 years in the company. Sometimes she does write you up sometimes she doesn’t.

Now imagine a different scenario. At a staff meeting she announces that reports need to be timely. To try and help the staff keep it in their mind, if the November 12th report is in on time you will get an overnight at the hotel of your choice and if not, then you will be written up.

No more reminders.

Then she does what she says.

Often parents believe that they have a voice in their child’s life and that is enough, but really a voice is earned through consistency. Your action of giving positive or negative consequences will speak more than anything you could say ahead of time or threaten.

Even when threats do seem to work, it is usually not based on building a long-term voice in your child’s life.

The second part of this is building love. I trust that you love your child deeply; otherwise you would not be reading this book. So it is not how to build your love for your child that is the issue, it is how do children receive love?
Consistency in parenting helps kids feel safe. If you are about to manage a child in a grocery store and help her choose good choices there, then you can definitely take on any monster, bad dream, bully, and tornado. Kids fear all sorts of things.

A psychologist named Maslow created what he called the “Hierarchy of Needs”. His belief was that if basic needs are not met is it is harder or impossible to work toward higher needs. Thus, if safety needs of security aren’t met, it is harder to build feelings of love and belonging.

I had a client recently who had her apartment broken into. She was staying up all night because she was scared someone would break in, then she was sleeping during the day, but her classes were slipping. Her feelings of lack of safety made it harder for her to do more complex thinking like that which is required in school.

The same is true for kids, as they see that you can handle a variety of situations, they will trust that you can protect them…

counselor Traverse City counseling family

 

 

 

 

 

Joseph R. Sanok, MA, LLP, LPC, NCC is a licensed counselor and owner of Mental Wellness Counseling. He is also the author of the books Mental Wellness Parenting | A remarkably simple approach to making parenting easier
and Practice of the Practice | A Start-up Guide to Launching a Counseling Private Practice

Three things anyone can do to prevent suicide

Three things anyone can do to prevent suicide

 

 

counseling Traverse City counselor therapist

Appearing in the Record Eagle on 9-8-12

In 9th grade, the school counselor brought me and several other students into her office. She informed us that a peer had committed suicide. Later, the entire school was informed. It is devastating to get that type of news. Every 15 minutes another family, friend, and school deal with news of a suicide.

This coming week is Suicide Prevention Week. Often people think that the issue of suicide prevention is only for mental health professionals, but sometime in each of our lives we will probably have it touch us. Here are a few things that every person should know to help a friend, family member, or co-worker.

If you are concerned, ask

Asking a person if they are suicidal is the best first step. When a person is dealing with intense emotions, friends often feel uncomfortable asking about suicide. However, a direct question from a friend or family member is shown to reduce the risk of suicide.

Understand more about suicide

For a number of years, San Francisco has employed interviewers to speak with people who have jumped from the Bay Bridge and survived. One thing that an overwhelming majority report is that during their fall, they regretted the decision and hoped to live. These individuals often became advocates for suicide prevention. Further, research continues to support that suicidal feelings often last only hours, but return if help is not sought.

Know resources

Knowing that you can ask about suicide and that it is often a short-term feeling, getting a friend help is a great first step. Third Level Crisis Center (231-922-4800) is a 24/7 resource.  Also, supporting the individual through counseling and being a friend is the best role that you can have.

When we as a community work together to help those that are struggling, when we ask, understand, and refer, it can help reduce suicide. Each one of us can use our relationships and unique roles to be a part of a more healthy community.

 

counseling private practice

Joseph R. Sanok, MA, LLP, LPC, NCC  is owner and a counselor with Mental Wellness Counseling. He is hosting a free Suicide Prevention Wine Party with NMC Student Life and Lake Side Counseling on Sept 12 at 5:00 at Left Foot Charley. Visit www.mentalwellnesscounseling.com/wine for more details.

Photo used with Creative Commons, thank you Robert S. Donovan

Bus Monitor Bullied

Bus Monitor Bullied

Bus Monitor Bullied

counseling traverse city

 

 

 

 

 

 

 

 

About a week ago, my wife was changing my daughter’s diaper. She was parked outside a pharmacy in Traverse City and she was changing the diaper on the front seat of our car. I wasn’t there.

Some teens pulled up and were seated with their windows down. They started making comments about “the crying baby” and “shut that baby up.” Of course, the audacity of the teens caught my wife off guard and in the moment she didn’t think of what to say or do, she just wanted to leave.

The recent viral video about a bus monitor being bullied has touched a nerve. In the video, a bus monitor is called a litany of names and she ends up crying. The video is just plain terrible.

People are asking:

What has happened to our society?

How are kids this terrible?

Where is the respect?

What is going on?

In some ways, kids are just as cruel as in past generations; however, they have more tools for learning and spreading this cruelty. The point for me is not how we got here, but how do we get out?

When I work with families in counseling, at my Traverse City practice, we discuss a number of factors. Here are a few steps that can help with this discussion.

Schools have been limited

In past generations, teachers and principals spanked, paddled, and hit kids. It is essential to strong learning and emotional development for kids to feel safe. Those days are done and I am not advocating for them to return. However, due to the culture of lawsuits and continued restraints on teachers to give detentions, in-school suspensions, and other negative consequences, it has created an environment where youth will dictate their own culture.

Parents are less involved

As parents evaluate their interactions and involvements in their kid’s lives, they need to continue to seek consistency and a culture of both positive and negative consequences. Our society continues to function based on us all seeking that most of our actions have clear consequences. As parents build this social skill in kids, they will collectively gain traction.

Society as a parent

Even though we are more connected, most cultural tools have been de-centralized. As a result, specific parenting and expectations have become less clear. As  a result, we don’t want to “step on toes”. Often people don’t speak up when their “gut” is telling them to speak up.

The answers to these behaviors are not clear cut like many talking heads are saying, but, as we evaluate empowering schools, parents, and individuals, we may see bullying decrease.

 

private practice

Joseph R. Sanok, MA, LLP, LPC, NCC is a licensed counselor and owner at Mental Wellness Counseling in Traverse City, MI. He has worked with bullied, at-risk, angry, and hurt kids since 1998. He also loves sailing.

Mental Wellness: Build time to slow down

traverse city counseling

 

 

 

 

 

 

Originally published at http://record-eagle.com/features/x239062040/Mental-Wellness-Build-time-to-slow-down by Joseph R. Sanok

I can’t slow down. I need this article more than anyone. I have a baby, house, job, private practice ” the list goes on and on. I bet your list is similar. There is always a reason why I can’t slow down.

I went to the U.P. this past weekend. I sat and drank coffee, looked out at the morning water, and read a magazine. Why is it that when we get away from town, we let ourselves relax? These are three things that are starting to work for me (I’m not there yet).

Put it in the schedule

Did you know that 15 minutes is 1 percent of your day? I think we actually have time to relax for 15 minutes, we just don’t make the time. If something is written down, we’re more likely to follow through. Plan to relax.

Get out

When we are in our homes, we see the laundry, cleaning and opportunities to not relax. Planning time out of our house clears our mind and gives us permission to forget about the struggles for a space of time. Get away from your house.

Drag it out

When I do errands, I fight for the closest parking spot, hurry in, hurry out and run back home. There have been times when we have gone to the farmers market and parked a few blocks away. We strolled, looked at the river, and we didn’t hurry home. Drag out the time that you are out and about.

But why should we slow down? Shouldn’t we be more efficient and productive? Yes, this is true. There are times during the week that productivity and efficiency are of value. Yet, if we make it a lifestyle, we increase our stress, which can lead to a lower quality of sleep, which increases anxiety and depression, while lowering our quality of life.

When you step back, why are you in such a hurry and what is it doing to you? Try it for a day and see if makes you feel better.

 

Joseph R. Sanok, MA, LLP, LPC, NCC is a counselor, therapist, psychologist, and overall helper of people in Traverse City, MI. He has professional experience working with Community Mental Health, residential facilities, foster care, and private practice. As well, he is the author of the book “Practice of the Practice: Basics for Launching Your Private Practice” due to be released in June 2012. He is a frequent speaker and writer locally in Traverse City, Michigan, and nationally.

Friends and Crisis: Dos and Don’ts

You never really appreciate a life of normality until crisis hits. Our family has been through a number of things lately: a death, a major medical issue, and close friends having their own crisis. It is amazing how it seems that high profile events bring out people’s true social skills.

I learned through experience what not to say when someone is in crisis. It was several years ago. I heard that a friend of mine’s parents had got divorced. I was close to my friend, but not to his parents. During a large festival in our town, I ran into the mom and said, “I’m so sorry to hear about you and _______.” It seemed to be the right thing to say. She broke down crying in the middle of the festival.

I felt terrible, I didn’t know how to leave, and I regretted saying anything. After that I was fairly gun-shy. When I heard that people had a miscarriage, death, or sickness, I didn’t know what to say. So I just watched from a distance. Now that I am going through my own experiences, I feel that I have an understanding of what has worked and not worked for me.

Food

Do

Make or bring food. It allows the family to focus on one another, rather than shopping, cooking, and cleaning.

Try and make something they can freeze or bring it frozen. If others are bringing food they can pull it out when the time works for them.

If you can, use things you don’t need back like Tupperware, something disposable, or a pan you don’t care about. Tell them, “Don’t worry about getting the pan back to me.”

Don’t

Don’t expect to hang out with the family long.

Don’t just show up, call and ask if there is a convenient time.

Talking

Do

Empathize with the family. Our friends that have said, “That must be hell” “I can’t imagine going through that” and “When will the universe stop shi**ing on the Sanok’s?” have been some of the most helpful comments. It makes us feel less crazy, like our feelings are normal.

Let the family or person do the talking. Saying, “If you don’t feel like talking about it, that’s ok, but how are you doing?” This is helpful because it is nice to be given permission to blow someone off and stay quiet, yet invited to talk.

Don’t

Don’t offer suggestions unless you are asked. If people are dealing with medical issues, they probably are consulting with the doctors. If they are going through a death, their closest friends will probably know what/when to suggest therapy. In general, suggestions make people feel like you want to solve their problems and make them move through their grief, rather than be with them.

Expectations

Do

Expect that your relationship will be different for a while. They may see you more or less. They may want to sit at home and drink beer. Who knows how they will react? They may not want to talk. Realize that people handle crisis very differently and the way they react can differ too. The best thing for you to do is to carry the relationship for the both of you during this time.

Don’t

Don’t get offended when they focus on something other than your relationship. If you do get offended, don’t show it. Months later if it is still bothering you, you can talk with that person. People don’t need to think about the dynamics of your relationship as well as their crisis.

Don’t worry about spending too much or too little time with them. Ask them if it would be helpful to come over. Most people will tell you what works if you ask in a direct way.

Don’t say, “Call us if you need anything.” Say something more specific like, “Would it be helpful if we had you over for dinner? We’d love to have you, but you can totally say ‘no’.” Sometimes what people need is awkward to ask for like a gas card. Rather than ask, “What do you need?” say something like, “Here’s a gas card/meal/hug if it would help.” By giving the person an out and being specific, it helps to give them the power and control, when life seems out of control.

Depending on which side of the crisis you are (going through it or supporting through it) everyone should realize that you are lucky to have one another. As someone going through life issues, I am so thankful for people saying and doing something, even if they fumble through it. Despite the missteps some have taken, we have realized that it is all done out of love and care for us, which is absolutely wonderful to have in our life.

I would much rather have someone awkwardly try and console me, than to remain quiet out of fear…and then go through a crisis alone. Even if you don’t do all the “dos” or you accidentally do some of the “don’ts” it is ok. Just do your best.

Joseph R. Sanok, MA, LLP, LPC, NCC is a counselor, therapist, psychologist, and overall helper of people in Traverse City, MI. He has professional experience working with Community Mental Health, residential facilities, foster care, and private practice. As well, he is the author of the book “Practice of the Practice: Basics for Launching Your Private Practice” due to be released in June 2012. He is a frequent speaker and writer locally in Traverse City, Michigan, and nationally.

 

Blah in our Brains

 

 

 

 

 

 

Ask Joe
Think “Dear Abby” for a new generation. Each newsletter I will select one or more questions to answer. So if you have a parenting or mental wellness question, please send it my way. I’m sure others have the same question and could benefit. sanokcounseling@gmail.com

Dear Joe,
What are some approaches to improving bed time routines for my kids? They are 9, 12, and 13.
-I Need a Break, Kalamazoo, MI

Dear I Need a Break,
First start with their ages and how much time they need to sleep. Depending on their wake-up and bus times most 9 year old should be in bed between 8:00-9:00, however, since you have two old kids you may want to have the 9-year-old have and 8:30, 12-year-old 8:45, and 13-year-old 9:00. Until high school, most kids should go to bed prior to 9:30. Once you determine the times that you want, stick to them. Start the bed time routine at least 15 minutes before, that means no TV for the 15-30 minutes before bed.

One technique that seems to work well is the have weekend bedtimes based on weeknight compliance. For example, “If you go to bed at 8:30 during the week for 3 nights, your weekend bedtime is 8:45, 4 nights 9:00, all 5 nights 9:30.” This provides a clear positive consequence for the desired behavior. Some families create charts to keep track. Also, tying their behavior to the social skill of “building trust” can help. For example, “Thanks for being in bed on time. By doing that, you are showing me that I can trust you to do what you need to do.” Then, when they ask if they can do something, you can say, “You know, you have done a great job building trust at bedtime, sure you can go to the store with your friend.”

Give those strategies a whirl and let me know how it goes.
I hope that helps.

-Joe

Have a question for Joe? Email him and ask, what’s stopping you? Really, you know you want to:
Click here to ASK JOE 

Blah in Our Brains
By Joseph R. Sanok, MA, LLP, LPC, NCC
I hate the time change. I don’t understand why during the darkest part of the year, we make it darker. I would much rather have it stay dark until 10:00 am and have light in the evening. But maybe that’s just me. This time of year triggers in people a sense of fatigue, sadness, depression, and feelings of blah. Whether you deal with clinical depression, seasonal affective disorder, or feelings of blah, there are several things you can do that will help you feel better.

Get More Light
Even when it is light outside, it seems to still be cloudy in Northern Michigan. A window usually is not enough. Regular lights do not capture the full light spectrum. They usually only have the blues and violets. Getting outside and sitting by a window will help, but changing some of your bulbs in your office or home to full-spectrum light bulbs can really help. A number of studies have shown that full-spectrum light can help with depression, sadness, and the feelings of blah (blah is not a clinical term used in research studies). Bulbs usually run $14-$24 dollars, a lot cheaper than therapy.

Get More Exercise
Exercise releases natural endorphins in your body. I was at the University of Michigan Depression Conference last year and one speaker was discussing how some studies are showing that exercise paired with counseling can be more effective than psychiatric medication. Even a short walk or taking the stairs can be helpful.

Get More Veggies
Fruits and vegetables can help with replenishing the body’s nutrients. Loads of colors in your diet are helpful. A diet of reduced processed foods helps to make the brain more receptive to light and exercise during the winter months. WedMD has a number of helpful nutrition suggestions,http://www.webmd.com/depression/guide/diet-recovery

Get More Socialization
When I work with clients dealing with depression they often get into a cycle of alone time. They don’t feel like going out or doing anything which makes them feel like they don’t want to go out and do anything. During winter months we often feel like we want to hunker down and stay home. Socialization and new activities help us free up the blah in our brain.
Once you try these tips, you will hopefully see changes. With that said, you also need to know when to talk with your health care provider about pursuing additional options.
As with any change, it is better to start small and make little changes that you can do. Maybe for you a step would be to change a light bulb, go for a daily walk, eat broccoli again, or plan a potluck with friends or family. The hardest part is taking a step in the right direction, after that you will pick up momentum and have a blah-free winter.

Do you agree?


Resources 
University of Michigan has a great set of resources called The Depression Tool Kit. There are videos, worksheets, and tons of resources. Check it out, it will help you and/or the people you work with! http://www.depressiontoolkit.org/

That’s it for now. Do good to others and keep in touch!

-Joe

Joseph R. Sanok, MA, LLP, LPC, NCC is a counselor, therapist, psychologist, and overall helper of people in Traverse City, MI. He has professional experience working with Community Mental Health, residential facilities, foster care, and private practice. As well, he is the author of the book “Practice of the Practice: Basics for Launching Your Private Practice” due to be released in June 2012. He is a frequent speaker and writer locally in Traverse City, Michigan, and nationally.