8 Ways To Persevere When Depression Persists

See PsychCentral Article Here
By 

Although I like to cling to the promise that my depression will get better — since it always has in the past — there are long, painful periods when it seems as though I’m going to have to live with these symptoms forever.

In the past, there was a time when I had been struggling with death thoughts for what seemed like forever. One afternoon, I panicked when I surmised that they might always be with me. I embraced the wisdom of Toni Bernhard, who wrote a brilliant handbook for all of us living with chronic illness, How to Be Sick. While reading her words, I mourned the life I once had and made room to live with symptoms of depression indefinitely.

The death thoughts did eventually disappear, but I’m always mindful of my depression. Every decision I make in a 24-hour period, from what I eat for breakfast to what time I go to bed, is driven by an effort to protect my mental health.

When I hit a painful stretch that feels like forever, I return to Bernhard’s insights and to my own strategies that have helped me persevere through rough patches along the way.

Here are some of them:

1. Revisit the Past

When we’re depressed, our perspective of the past is colored by melancholy, and we don’t see things accurately. For example, if I’m in a low mood, I look back on those years when I experienced death thoughts and think that I felt nothing but depression for more than 1,000 days. It’s helpful to peak at my mood journals from that period to see that I did have some good days and good times scattered throughout the painful stretches, which means I will have good hours and days in coming hard periods as well.

I also look at photo albums that bring me back to moments of joy sprinkled in amidst the sadness; these give me hope that even though I’m still struggling, it’s possible to contribute a nice memory to my album.

2. Remember that Pain Isn’t Solid

Going through mood journals is also a good way to remind myself that pain isn’t solid. I may start the morning with excruciating anxiety, but by lunch I might be able to enjoy a nice reprieve. At night I may even be capable of laughing at a movie with the kids.

Bernhard compares the painful symptoms of her illness to the weather. “Weather practice is a powerful reminder of the fleeting nature of experience: how each moment arises and passes as quickly as a weather pattern,” she writes.

I like to think of my panic and depression as labor pains. I breathe through the anguish, trusting that the intensity will eventually fade. Hanging on to the concept of impermanence gives me consolation and relief in the midst of distress — that the emotions and thoughts and feelings I’m experiencing aren’t solid.

3. Maximize Periods of Wellness

Most people who have lived with treatment-resistant depression or another chronic illness have learned how to maximize their good moments. During painful stretches, I consider these moments to be the rest periods I need between contractions. I soak them in as much as humanly possible and let them carry me through the difficult hours ahead.

4. Act As If

Author and artist Vivian Greene has written, “Life isn’t about waiting for the storm to pass … It’s about learning to dance in the rain.”

That sums up living with a chronic illness. There’s a fine line between pushing yourself too hard and not challenging yourself enough, but most of the time, I find that I feel better by “acting as if” I’m feeling okay.

So I sign up for a paddle-boarding club even though I don’t want to; I have lunch with a friend even though I have no appetite; I show up to swim practice with tinted goggles in case I cry. I tell myself “do it anyway” and operate like I’m not depressed.

5. Embrace Uncertainty

Not until I read Bernhard’s book did I realize that much of my suffering comes from my desire for certainty and predictability. I want to know when my anxiety will abate, which medications will work, and when I’ll be able to sleep eight hours again. I’m wrestling for control over the steering wheel, and the fact that I don’t have it is killing me.

The flip side, though, is that if I can inch toward an acceptance of uncertainty and unpredictability, then I can lessen my suffering. Bernhard writes:

Just seeing the suffering in that desire loosens its hold on me, whether it’s wanting so badly to be at a family gathering or clinging to the hope for positive results from a medication or desiring for a doctor not to disappoint me. Once I see the [suffering] in the mind, I can begin to let go a little.

6. Stop Your Inner Meanie and Remember Self-Compassion

Like so many others who battle depression, I talk to myself in ways I wouldn’t even address an enemy. I call myself lazy, stupid, unmotivated, and deserving of suffering. The self-denigrating tapes are so automatic that I often don’t catch how harmful the dialogue is until I’m saying the words out loud to a friend or doctor.

We can relieve some of our suffering by addressing ourselves with the same compassion that we would offer a friend or a daughter. Lately, I’m trying to catch my inner meanie and instead offer myself kindness and gentleness.

7. Attach Yourself to a Purpose

Friedrich Nietzsche said, “He who has a why to live can bear almost any how.”

When my depression gets to be unbearable, I picture my two kids and my husband, and I tell myself that I have to stick around for them. It’s fine if I never wear one of those “Life Is Good” T-shirts. I have a higher purpose that I must complete, like a soldier in a battle. I must see my mission through to the end. Dedicating your life to a cause can keep you alive and give you the much-needed fuel to keep going.

8. Stay in the Present

If we can manage to stay in the present moment and focus only on the thing that is right in front of us, we eliminate much of our angst because it’s almost always rooted in the past and in the future.

When I’m in a painful stretch, one day at a time is too long. I have to break it down into 15-minute periods. I tell myself that for the next 15 minutes, my only job is to do the thing in front of me, whether that’s helping my daughter with homework, doing the dishes, or writing a column. When 15 minutes are up, I commit to another 15 minutes. That way, I patch several days together, and before long, one of those days contains some joy.

 

9 Thoughts That Can Prevent You From Confronting Depression

See Author Article Here
One of the many difficult things about mental illnesses is that an illness can construct a narrative in your head that isn’t necessarily true. With depression, a combination of stigma and difficult-to-pinpoint symptoms may make diagnosis difficult. But the symptoms of depression are well-documented, and the first step is paying attention.

Since depression can alter your thoughts, it can be hard to differentiate when the illness is talking, versus when you are “When we are depressed we are viewing the world through a lens that isn’t congruent with our external reality, but during a depressive episode, our internal reality changes so it seems like things can be hopeless which often leads us to feel helpless,” Travis McNulty, LMHC, GAL, of McNulty Counseling & Wellness, tells Bustle. “ […] Usually depression manifests its form in a cycle of negative thoughts, negative emotions, and negative behaviors that further perpetuate one another.” These negative influences can actually start to convince you that you aren’t dealing with depression.

Some of these self-doubting thoughts may begin to dissipate when you acknowledge that depression is a serious diagnosis, and that you deserve help for the things you’re struggling with. Finding a mental health professional you can trust may help get you there even sooner.

Here are nine thoughts that can mask depression for what it is, according to experts.

1. That It’s Not “That Bad”

Aleksandr and Lidia/Shutterstock

If you’ve been noticing yourself feeling worse and worse for a while, but have a narrative of “I’m fine” running through your head — you may want to examine that thought further.

“One of the biggest lies that depression tells us is that we are OK,” licensed clinical social worker Melissa Ifill, tells Bustle. ” […] Unfortunately, we are often slow to give credibility to [any changes] or are truly unaware of how the depression is impacting us.” So if you find yourself minimizing your feelings, remind yourself that you don’t have to be at absolute rock bottom to deserve help.

2. “I Can Deal With This On My Own”

Ksenia Lucenko/Shutterstock

Depression is a serious illness, not a burden you have to bare alone. Even if you have been through blue spells before, you deserve help this time around.

“One of the major thoughts people often have when experiencing depressive symptoms is that they do not need help,” Ifill says. “They believe that the mood, feelings or thoughts will go away by themselves or if they keep behaving as if things are OK, they will be eventually.” While some wounds may heal with time alone, it’s OK to admit that you may need the support of friends, family, or a professional, for what you’re dealing with.

3. That Everything Is Bad

Prostock-studio/Shutterstock

While it’s harmful to downplay your symptoms, it can also be harmful to catastrophize what you’re feeling as well.

“Black and white thinking is a classic thought pattern for those who are experiencing depressive symptoms,” Ifill says. “[…] Having a good supportive network (which should include a helping professional) can assist you in challenging some of these thought patterns and help you to see the more varied perspectives that life has to offer.” Many people have felt like there’s no way out before, and there are a plethora of resources to help.

4. That It Doesn’t Matter Anyways

Creativa Images/Shutterstock

Another harmful way depression can try to trick you into thinking you’re not depressed is by telling you that it doesn’t matter either way.

“Depression causes helplessness and hopelessness,” Lara Schuster Effland, regional managing director of clinical operations for Eating Recovery Center’s Insight Behavioral Health Center, tells Bustle. “One may believe they are the problem and [that they are the reason] why they feel lonely and lost.” Blaming yourself for causing the consequences of your depression is hurtful. Finding a therapist or psychiatrist may help you break out of this thought pattern.

5. That You “Just Need A Vacation”

Creative Family/Shutterstock

Minimizing your symptoms does not always take the form of self-blame. Even telling yourself that you “just need a vacation” can be a way that the depression can get ahead.

“Feeling overworked, under-rested, and overwhelmed when depressed [is common],” Effland says. If you have a sense that you’re unable to get ahead, reaching out for support on that level is likely more helpful than a few days off could be.

6. That You’re Fine Because You’re In A Relationship

Ashley Batz/Bustle

Depression doesn’t discriminate. Having depression doesn’t make you ungrateful, either. So if you’re equivocating by telling yourself that you’re fine because you’re in a relationship, have a good job, or have great friends, you may actually be minimizing a serious illness.

“People who have the ‘perfect’ situation aren’t immune to depression, and often depression can come when everything is going well, because it often can’t be explained,” LGBT-affirming therapist Katie Leikam, LCSW, LISW-CP, tells Bustle. It’s important not to discredit your need for support just because things seem good on the outside.

7. That You Don’t Cry Much, So It Doesn’t Count

LightField Studios/Shutterstock

While depression can cause symptoms like excessive or easily-triggered crying, that doesn’t mean you should discount all of your other signs of the illness just because you haven’t been experiencing this.

“Depression can present itself in a lot of ways and only one of those ways is tears,” Leikam says. “Depression can also present itself in feeling lonely or numb of emotions and often people who feel numb, aren’t always able to cry.” If you’ve noticed that you’re feeling more apathetic than usual, then it’s a good first step to talk to your doctor.

8. That Excelling At Work Discounts Your Feelings

Andrew Zaeh for Bustle

Depression doesn’t always take away your ability to function. Many people with depression are still able to go about their daily lives. Just because you’re excelling at work doesn’t mean you don’t have depression.

“You can be on top of your game at work and still have clinical depression,” Leikam says. “Successful people can still have depression. Depression can be a chemical imbalance so it doesn’t discriminate against who has it and who doesn’t have it.” You deserve help even if you’ve been noticing symptoms, but are ignoring them because you think being high-functioning disqualifies you from the support you need.

9. That You’re Just Not “Normal”

Aaron Amat/Shutterstock

Mental health stigma can be incredibly powerful, especially if you’ve internalized it to the point that you believe something is wrong with you for feeling this way.

“Without an understanding of mental illness individuals often believe that depression is an indication that they’re not normal anymore, and that they are somehow different,” Dr. Neeraj Gandotra, MD, chief medical officer at Delphi Behavioral Health Group, tells Bustle. Reminding yourself that you’re still you, and that any changes to your health are worth taking care of, may help you get the boost you need to seek help.

Separating yourself from the symptoms of your depression can help you from being tricked by negative self-talk. “I like to help my clients refer to their depressive symptoms as ‘the depression,'” Ifill says. This way, you may be able to externalize the symptoms and emotions associated with depression, potentially making it easier to find a professional to support you.

Five Enlightened Ways To Think About Mental Health

See Psychology Today Article Here
By Hilary Jacobs Hendel 

It’s time to eradicate stigmas.

Life is hard even under the best of circumstances. Without physical and mental health, it’s difficult to enjoy life and to thrive. It makes good sense to take care of ourselves and that includes getting help when we suffer physically or psychologically. When we feel sick we get ourselves to the doctor. And when we feel so bad that we think about hurting ourselves or others, or when we cannot engage positively in work or in relationships, or we cannot accomplish what we want, we should seek help to feel better. That is what all of us deserve.

Mental health shouldn’t be a dirty word. Still damaging stigmas prevail allowing ignorance to end lives. Judging others or ourselves for our suffering is just plain harsh, not to mention counterproductive. When was the last time telling a depressed person to “get over it” worked? Try never! And using shame as a tactic to “encourage” someone to be what you think they should be only adds to a person’s suffering.

Mental health problems should be thought of no differently than physical health problems. In fact, they are completely related: mental health problems affect physical health and physical health problems affect mental health. We need a world where no one feels embarrassed or ashamed about their suffering. We need a world where suffering evokes only kindness, compassion, and a desire to help.

Here are 5 enlightened ways to think about mental health:

1. Everyone suffers.

I have never met anyone who is happy and calm all the time. It’s just not possible, no matter how good someone’s life looks like from the outside. Most people suffer at some point in their life from anxietydepressionaggressionPTSDshamesubstance abusedisorders, and other symptoms. And, if a person is lucky enough to never suffer psychologically, they surely love someone who does suffer in these ways. Instead of living lives of quiet desperation, to paraphrase Henry David Thoreau, let’s encourage honest talk. If someone gets uncomfortable with honest talk, we can talk about that too.

2. Mental health checkups are an important part of wellness.

Do you feel ashamed when you go for a check-up at your internist? Probably not. On the contrary, you’re likely to feel proud that you are taking care of your health. Yet most people are ashamed to call a psychotherapist for a consultation. This makes no logical sense. A mental health checkup is a great idea especially if you are suffering and not able to function the way you want. You should feel very proud for taking care of your mental health.

3. Gym for the brain.

That’s exactly how I describe therapy for my patients who come in feeling bad that they “have to come to therapy.” In our society, we praise people for working out at the gym. We think of them as maintaining their health and taking good care of themselves. Well, that’s no different for a person wanting to enhance their psychological wellbeing. Therapy grows new brain cell networks, calms the mind and body, makes it easier to meet life’s challenges, and helps us thrive as we become the best versions of our self that we can.

4. Education in emotions is a game-changer.

We live in a challenging society because it is not very nurturing. That’s why rates of anxiety, depression, and substance abuse disorder have skyrocketed. According to a new disturbing report from the CDCsuiciderates are steadily increasing. At the very least, our society could provide an accessible and understandable education on emotions. This would help us all understand how our childhood experiences translate to directly affect our adult mental health (for better and for worse). Emotion education debunks myths like “emotions are just for weak people” and we can control our suffering with “mind over matter.” Our schools should be teaching us trauma-informed tools like the Change Triangle. Our educational institutions should be teaching skills for managing relationships and interpersonal conflicts constructively so bullying, for example, would become a thing of the past. Parents should be taught about emotions so they don’t unwittingly create shame and anxiety in their children. Education on emotions and how emotions affect the brain, body, and mind depending on how we work with them, has great power to change society for the better and even reverse the current epidemic in depression, anxiety, and addictions.

5. Question assumptions, judgments, and fears around mental health and mental illness.

Many of us fear difference. When people feel, act or look different than we do, we tend to judge them. Judgment, while a form of misguided emotional protection achieved by distancing ourselves from those we fear or don’t understand, is destructive for all of us. Judgment is the basis of stigma and justifies the horrible way we treat people who suffer mental illnesses and substance abuse disorders. Judgment shames those who suffer, and that is all of us. No wonder shame-based depressions are rampant in our society. Instead of judging others for emotions and suffering, can we instead be curious about our assumptions and question where we learned to judge or fear people who struggle psychologically?

Most suffering can be eased with support, proper treatment, and a variety of resources. Let’s be proud to grow our collective and individual mental health. What a difference it makes to wholeheartedly say to someone seeking help, “Good for you! I could use some help for myself too!” Because we all can.

How Anxiety Impacts The Way We Perceive And Think

See Psychology Today Article Here
By Lobsang Rapgay Ph.D.

How we see, hear, and think about what we experience within and outside ourselves determines who we are and how we relate to the world.  Disorders such as anxiety not only interfere with but also impair these processes, creating a distorted view of our internal and external worlds.

According to many researchers, working memory is the most important of the perceptual and cognitive functions.  Our ability to learn new skills—from driving and golfing to mathematics and meditation—to master attentional skills, meet goals, plan a vital activity, and make decisions and choices all rely heavily on an effective and efficient working memory.

Working memory acts as a sketchpad that enables the performance of the above wide-ranging tasks.  Once the relevant set of information for a task is obtained, that information has to be held in memory, organized, manipulated, and updated so that the task can be performed accordingly.  Take the example of the complex reading span test, which is a test used to measure the size of the working memory space.  Subjects see a set of words depending on how many they can recall correctly.  After each word, a statement is presented for the subject to determine if it is true or false.  The task requires the subject to manipulate, encode, and hold the words in memory while carrying out the competing task of reading the sentence and determining whether it is true or false (Daneman & Carpenter, 1980).

Many complex cognitive processes, such as attention, inhibition of distractors, shifting from one sub-task to another, strategic online monitoring of performance, instant detection of errors and their correction, and the updating of ongoing information are necessary for the effective and efficient completion of working memory tasks.

Increasing evidence shows that anxiety hurts both working memory space and cognitive processes to varying degrees, and adverse effects occur.  Studies have conclusively shown that people with anxiety automatically perceive threats over other stimuli at the expense of crucial ongoing tasks (Bar-Haim et al., 2007).  A person with severe anxiety is also likely to have difficulty separating himself or herself from frightening images and words, preventing him or her from returning to perform the task (Grant et al., 2015).

The instant perceptual bias towards threats in anxiety persists into subsequent cognitive processes.  The bias affects both the amount of verbal and visual-spatial information that working memory can hold, as well as the cognitive processing of the relevant information.  When subjects were tested to determine how many digits they could hold in memory in a complex working memory capacity test, subjects with high anxiety held much fewer digits compared to those with low anxiety (Diamond, 2013).  The capacity to hold verbal information was also a lot less with high anxiety subjects who were made to worry, as compared to those who were not. (Leigh & Hirsch, 2011).  However, numerous studies show that the amount of information held in working memory during the performance of a task determines the degree of impairment caused by anxiety.  When the amount of information held in memory is low to medium, anxiety impairs working memory capacity significantly because the cognitive processes that are not required for carrying out the task are available for processing threat distractors.  However, when the load is high, anxiety impairs the capacity of working memory much less since all of the resources are consumed by processing the high load of information, and little to no working memory is available to attend to the distracting threats (Derakshan, N., et.al., 2009).

Robust evidence shows that anxiety impairs each of the specific cognitive processes responsible for carrying out the multicomponent tasks of working memory.  Studies show that people with elevated anxiety are not able to inhibit threatening distractors as compared to neutral stimuli during a cognitive function.  They fail to disengage from the threat and return to the task (Grant et al., 2015).  Other studies show that people with elevated anxiety fail or take a long time to shift from one cognitive set to another during the performance of a working memory task (Ansari & Derakshan, 2011).  Given that working memory tasks consist of multicomponent sets of a task, the ability to readily move from one to another is critical for the correct and rapid performance of the task.

Impairment of attention, inhibition, and shifting interferes with the functions of monitoring and updating.  Constant updating of sub-tasks during the performance of any learning and goal-oriented task prevents awareness of errors (Folstein & Petten, 2008).  Strategic online monitoring of performance at each of the various sub-stages of a task aims to identify the mistakes early on so they can be corrected instantly.  Undetected errors compromise the performance of the subsequent tasks.  Instant detection and correction of errors help to conserve and distribute the limited cognitive resources and their allocation to subsequent sub-tasks.  Studies show that people with clinical anxiety tend to have elevated error-related negativity (ERN), a specific evoked response potential (ERP)—a method used to aggregate brain activity in a particular region of the brain—that measures error and its correction (Gehring et al., 1993).

Updating is a process of continuously adding new relevant information to existing ones according to the demands of the sub-task or when unforeseen situations occur during the ongoing performance of a task.  During this process, the data undergoes multiple transformations and substitutions.  The ability to update effectively has been shown to be a significant predictor of higher mental skills, such as fluid intelligence.

Based on these findings, researchers have developed two major treatment protocols, namely attentional bias modification (ABM) and cognitive bias modification (CBM) (Amir et al., 2009), (Macleod et al., 2012).  These protocols involve the manipulation of attention away from threatening stimuli to the neutral.  Studies show that both protocols demonstrate small to moderate effects.  However, they also appear to be less effective than existing empirically proven treatments for anxiety.  Moreover, researchers have raised questions about whether training an individual to move away from a threatening stimulus increases avoidance behavior, which has been shown to increase anxiety in the long run.

Researchers have suggested that since attentional bias to threat is sustained for long periods, replacing the brief 500-millisecond presentations, used in ABM and CBM to move attention away from the threat, with more extended periods of presentations is likely to produce more effective results.  However, anxiety disorders are complex and often have roots in stressful and conflictual early childhood environmental and developmental conditions.  Without addressing these factors, it seems unlikely that prolonging the period of presentation and moving attention away from the threat, even though helpful, will resolve the underlying causes of anxiety.

Lobsang Rapgay Ph.D.

How we see, hear, and think about what we experience within and outside ourselves determines who we are and how we relate to the world.  Disorders such as anxiety not only interfere with but also impair these processes, creating a distorted view of our internal and external worlds.

According to many researchers, working memory is the most important of the perceptual and cognitive functions.  Our ability to learn new skills—from driving and golfing to mathematics and meditation—to master attentional skills, meet goals, plan a vital activity, and make decisions and choices all rely heavily on an effective and efficient working memory.

Working memory acts as a sketchpad that enables the performance of the above wide-ranging tasks.  Once the relevant set of information for a task is obtained, that information has to be held in memory, organized, manipulated, and updated so that the task can be performed accordingly.  Take the example of the complex reading span test, which is a test used to measure the size of the working memory space.  Subjects see a set of words depending on how many they can recall correctly.  After each word, a statement is presented for the subject to determine if it is true or false.  The task requires the subject to manipulate, encode, and hold the words in memory while carrying out the competing task of reading the sentence and determining whether it is true or false (Daneman & Carpenter, 1980).

Many complex cognitive processes, such as attention, inhibition of distractors, shifting from one sub-task to another, strategic online monitoring of performance, instant detection of errors and their correction, and the updating of ongoing information are necessary for the effective and efficient completion of working memory tasks.

Increasing evidence shows that anxiety hurts both working memory space and cognitive processes to varying degrees, and adverse effects occur.  Studies have conclusively shown that people with anxiety automatically perceive threats over other stimuli at the expense of crucial ongoing tasks (Bar-Haim et al., 2007).  A person with severe anxiety is also likely to have difficulty separating himself or herself from frightening images and words, preventing him or her from returning to perform the task (Grant et al., 2015).

The instant perceptual bias towards threats in anxiety persists into subsequent cognitive processes.  The bias affects both the amount of verbal and visual-spatial information that working memory can hold, as well as the cognitive processing of the relevant information.  When subjects were tested to determine how many digits they could hold in memory in a complex working memory capacity test, subjects with high anxiety held much fewer digits compared to those with low anxiety (Diamond, 2013).  The capacity to hold verbal information was also a lot less with high anxiety subjects who were made to worry, as compared to those who were not. (Leigh & Hirsch, 2011).  However, numerous studies show that the amount of information held in working memory during the performance of a task determines the degree of impairment caused by anxiety.  When the amount of information held in memory is low to medium, anxiety impairs working memory capacity significantly because the cognitive processes that are not required for carrying out the task are available for processing threat distractors.  However, when the load is high, anxiety impairs the capacity of working memory much less since all of the resources are consumed by processing the high load of information, and little to no working memory is available to attend to the distracting threats (Derakshan, N., et.al., 2009).

Robust evidence shows that anxiety impairs each of the specific cognitive processes responsible for carrying out the multicomponent tasks of working memory.  Studies show that people with elevated anxiety are not able to inhibit threatening distractors as compared to neutral stimuli during a cognitive function.  They fail to disengage from the threat and return to the task (Grant et al., 2015).  Other studies show that people with elevated anxiety fail or take a long time to shift from one cognitive set to another during the performance of a working memory task (Ansari & Derakshan, 2011).  Given that working memory tasks consist of multicomponent sets of a task, the ability to readily move from one to another is critical for the correct and rapid performance of the task.

Impairment of attention, inhibition, and shifting interferes with the functions of monitoring and updating.  Constant updating of sub-tasks during the performance of any learning and goal-oriented task prevents awareness of errors (Folstein & Petten, 2008).  Strategic online monitoring of performance at each of the various sub-stages of a task aims to identify the mistakes early on so they can be corrected instantly.  Undetected errors compromise the performance of the subsequent tasks.  Instant detection and correction of errors help to conserve and distribute the limited cognitive resources and their allocation to subsequent sub-tasks.  Studies show that people with clinical anxiety tend to have elevated error-related negativity (ERN), a specific evoked response potential (ERP)—a method used to aggregate brain activity in a particular region of the brain—that measures error and its correction (Gehring et al., 1993).

Updating is a process of continuously adding new relevant information to existing ones according to the demands of the sub-task or when unforeseen situations occur during the ongoing performance of a task.  During this process, the data undergoes multiple transformations and substitutions.  The ability to update effectively has been shown to be a significant predictor of higher mental skills, such as fluid intelligence.

Based on these findings, researchers have developed two major treatment protocols, namely attentional bias modification (ABM) and cognitive bias modification (CBM) (Amir et al., 2009), (Macleod et al., 2012).  These protocols involve the manipulation of attention away from threatening stimuli to the neutral.  Studies show that both protocols demonstrate small to moderate effects.  However, they also appear to be less effective than existing empirically proven treatments for anxiety.  Moreover, researchers have raised questions about whether training an individual to move away from a threatening stimulus increases avoidance behavior, which has been shown to increase anxiety in the long run.

Researchers have suggested that since attentional bias to threat is sustained for long periods, replacing the brief 500-millisecond presentations, used in ABM and CBM to move attention away from the threat, with more extended periods of presentations is likely to produce more effective results.  However, anxiety disorders are complex and often have roots in stressful and conflictual early childhood environmental and developmental conditions.  Without addressing these factors, it seems unlikely that prolonging the period of presentation and moving attention away from the threat, even though helpful, will resolve the underlying causes of anxiety.

How we see, hear, and think about what we experience within and outside ourselves determines who we are and how we relate to the world.  Disorders such as anxiety not only interfere with but also impair these processes, creating a distorted view of our internal and external worlds.

According to many researchers, working memory is the most important of the perceptual and cognitive functions.  Our ability to learn new skills—from driving and golfing to mathematics and meditation—to master attentional skills, meet goals, plan a vital activity, and make decisions and choices all rely heavily on an effective and efficient working memory.

Working memory acts as a sketchpad that enables the performance of the above wide-ranging tasks.  Once the relevant set of information for a task is obtained, that information has to be held in memory, organized, manipulated, and updated so that the task can be performed accordingly.  Take the example of the complex reading span test, which is a test used to measure the size of the working memory space.  Subjects see a set of words depending on how many they can recall correctly.  After each word, a statement is presented for the subject to determine if it is true or false.  The task requires the subject to manipulate, encode, and hold the words in memory while carrying out the competing task of reading the sentence and determining whether it is true or false (Daneman & Carpenter, 1980).

Many complex cognitive processes, such as attention, inhibition of distractors, shifting from one sub-task to another, strategic online monitoring of performance, instant detection of errors and their correction, and the updating of ongoing information are necessary for the effective and efficient completion of working memory tasks.

Increasing evidence shows that anxiety hurts both working memory space and cognitive processes to varying degrees, and adverse effects occur.  Studies have conclusively shown that people with anxiety automatically perceive threats over other stimuli at the expense of crucial ongoing tasks (Bar-Haim et al., 2007).  A person with severe anxiety is also likely to have difficulty separating himself or herself from frightening images and words, preventing him or her from returning to perform the task (Grant et al., 2015).

The instant perceptual bias towards threats in anxiety persists into subsequent cognitive processes.  The bias affects both the amount of verbal and visual-spatial information that working memory can hold, as well as the cognitive processing of the relevant information.  When subjects were tested to determine how many digits they could hold in memory in a complex working memory capacity test, subjects with high anxiety held much fewer digits compared to those with low anxiety (Diamond, 2013).  The capacity to hold verbal information was also a lot less with high anxiety subjects who were made to worry, as compared to those who were not. (Leigh & Hirsch, 2011).  However, numerous studies show that the amount of information held in working memory during the performance of a task determines the degree of impairment caused by anxiety.  When the amount of information held in memory is low to medium, anxiety impairs working memory capacity significantly because the cognitive processes that are not required for carrying out the task are available for processing threat distractors.  However, when the load is high, anxiety impairs the capacity of working memory much less since all of the resources are consumed by processing the high load of information, and little to no working memory is available to attend to the distracting threats (Derakshan, N., et.al., 2009).

Robust evidence shows that anxiety impairs each of the specific cognitive processes responsible for carrying out the multicomponent tasks of working memory.  Studies show that people with elevated anxiety are not able to inhibit threatening distractors as compared to neutral stimuli during a cognitive function.  They fail to disengage from the threat and return to the task (Grant et al., 2015).  Other studies show that people with elevated anxiety fail or take a long time to shift from one cognitive set to another during the performance of a working memory task (Ansari & Derakshan, 2011).  Given that working memory tasks consist of multicomponent sets of a task, the ability to readily move from one to another is critical for the correct and rapid performance of the task.

Impairment of attention, inhibition, and shifting interferes with the functions of monitoring and updating.  Constant updating of sub-tasks during the performance of any learning and goal-oriented task prevents awareness of errors (Folstein & Petten, 2008).  Strategic online monitoring of performance at each of the various sub-stages of a task aims to identify the mistakes early on so they can be corrected instantly.  Undetected errors compromise the performance of the subsequent tasks.  Instant detection and correction of errors help to conserve and distribute the limited cognitive resources and their allocation to subsequent sub-tasks.  Studies show that people with clinical anxiety tend to have elevated error-related negativity (ERN), a specific evoked response potential (ERP)—a method used to aggregate brain activity in a particular region of the brain—that measures error and its correction (Gehring et al., 1993).

Updating is a process of continuously adding new relevant information to existing ones according to the demands of the sub-task or when unforeseen situations occur during the ongoing performance of a task.  During this process, the data undergoes multiple transformations and substitutions.  The ability to update effectively has been shown to be a significant predictor of higher mental skills, such as fluid intelligence.

Based on these findings, researchers have developed two major treatment protocols, namely attentional bias modification (ABM) and cognitive bias modification (CBM) (Amir et al., 2009), (Macleod et al., 2012).  These protocols involve the manipulation of attention away from threatening stimuli to the neutral.  Studies show that both protocols demonstrate small to moderate effects.  However, they also appear to be less effective than existing empirically proven treatments for anxiety.  Moreover, researchers have raised questions about whether training an individual to move away from a threatening stimulus increases avoidance behavior, which has been shown to increase anxiety in the long run.

Researchers have suggested that since attentional bias to threat is sustained for long periods, replacing the brief 500-millisecond presentations, used in ABM and CBM to move attention away from the threat, with more extended periods of presentations is likely to produce more effective results.  However, anxiety disorders are complex and often have roots in stressful and conflictual early childhood environmental and developmental conditions.  Without addressing these factors, it seems unlikely that prolonging the period of presentation and moving attention away from the threat, even though helpful, will resolve the underlying causes of anxiety.

Who The Hell Am I & Why Bother Reading My Posts?

HEYLO… call me Mina, or Amelia. Here is a picture of a baby alpaca I just got, that is made from REAL F’N BABY ALPACA FUR! (Her name is Bettie Page).

Anyways, I currently am living in Portland, Oregon with my boyfriend & my dog. PROUD DOG MOM ALL DAY. (his name happens to be Fox). 



*this is called a sploot, if you didn’t know. –>

I work on a vineyard as a “Tasting Room Associate.” The irony in this is that we moved all the way to Oregon because I was accepted into a doctorate program with a focus on substance abuse. SoOoOo… a 180 in the whole career thing.

I’m from the East Coast ~ New York & Massachusetts, but Cape Cod is where I grew up. I lived in New Orleans for 5 years for undergrad have a degree in Psychology.

 

I am no pro but I have seen some shit. I have a list of different psychological diagnoses & feel like the poster child for Big Pharma at times. I decided to start a blog after a failed suicide attempt that I swore I’d keep a secret… it is cathartic, but heavy. Really heavy. I never sleep, don’t leave my house without my xanax, and try to avoid small talk like the plague. Buttttt we’re all just getting by & that’s what this is all about. 

I grew up in and around addiction, and have struggled and continue to struggle with an addictive AF personality. I used to hate the saying “one day at a time,” I don’t anymore. I haven’t struggled with any significant substance .issues since 2011, but it’s always there.

Most of the relationships that I stay in turned out to be toxic, with the exception of my boyfriend now. He is the fkn best, and never judges or manipulates. I don’t deserve him.

I am a firm believer of using Cannabis …..for anything, really. So there’s that.

….I don’t really have an answer about why you should read stuff that I share. Maybe because I just want to spread the word about living honestly in the lens of mental illness but still making it through, and make 0 bucks typing these words. Zilch. That’s not the point.

I’ll share more later! It got weird talking about myself so much.

img_8022

*Me as a child. Yes, I’m serious. I also had to wear headgear at night around this time.
& yes, that’s pleather.

Oregon Lawmaker Seeks $2 Million For Mental Health Centers

See Author Article Here
By Elliot Njus

The Oregon Senate’s Housing Committee advanced a bill that would enact a statewide rent control policy and restrict evictions, sending it to the full Senate for a vote.

Lawmakers heard nearly four hours of testimony from renters and landlords as Senate Bill 608 had its first hearing in the Senate’s Housing Committee. It’s poised to cruise through the Legislature, with support from leaders of the Democratic majority in both the House and Senate.

Oregon lawmakers propose unorthodox approach to rent control

Oregon lawmakers propose unorthodox approach to rent control

Their proposal attempts to sidestep longstanding criticism of the polarizing policy, but it’s also drawn some misgivings from rent control supporters.

Two landlord groups, the Rental Housing Alliance Oregon and the Oregon Rental Housing Association, are both remaining neutral, with their leaders saying the bill is palatable, if not appealing.

That’s a relatively friendly position for their constituency – both statewide advocacy groups geared toward small landlords.

“There’s a lot here for landlords to dislike,” said Jim Straub, the legislative director for the Oregon Rental Housing Association. “But I’d also like to recognize it for what it isn’t: an industry killer. As written, I do not believe it will be catastrophic to our livelihood.”

The larger Multifamily NW, whose Portland-area membership includes larger landlords and property management companies, opposes the bill, as did many landlords who testified on their own behalf. They argued it would hurt business and discourage investment, resulting in substandard housing.

They pointed to a large body of academic research that’s found rent control policies in other states have resulted in a reduced housing supply and higher rents.

“At best, Senate Bill 608 will have no effect,” said Deborah Imse, the executive director of Multifamily NW, “but at worst it will make housing less affordable in the long run.”

Renters and tenants’ rights activists largely argued the bill would help protect against eye-popping rent increases that have frequently grabbed headlines across the state.

“It doesn’t solve the entire problem,” said Katrina Holland, the executive director of the Community Alliance of Tenants. “It certainly does take a giant leap forward by giving a measure of predictability for hundreds of thousands of renters in hundreds of cities across the state.”

Senate Republicans on Monday released statements in opposition to the proposal.

The bill would cap annual rent increases to 7 percent plus inflation throughout the state — a rate that’s much higher than most municipal rent control policies in other states. In many California communities with rent control, for example, affected apartments see their rents climb only by the rate of inflation, or a fraction of it, each year. (Annual increases in the Consumer Price Index, a measure of inflation, for western states has ranged from just under 1 percent to 3.6 percent over the past five years.)

The rent increase restrictions would exempt new construction for 15 years, and landlords would be free to raise rent without any cap if a renter left of their own accord. Subsidized rent would also be exempt.

The bill also would require most landlords to cite a cause, such as failure to pay rent or other lease violation, when evicting renters after the first year of tenancy.

Some “landlord-based” for-cause evictions would be allowed, including the landlord moving in or a major renovation. In those cases, landlords would have to provide 90 days’ notice and pay one month’s rent to the tenant, though landlords with four or fewer units would be exempt from the payment.

The bill would not lift the state ban on cities implementing their own, more restrictive rent control policies.

Sen. Fred Girod, R-Stayton, the ranking Republican on the Senate Housing Committee, said Senate Democrats flatly rejected a suite of amendments, including the removal of an emergency clause. With the clause, the bill would take effect when it’s signed by the governor; if passed without it, the bill would take effect next year. Girod abruptly left the hearing after it became clear the amendments would not pass.

Sen. Tim Knopp, R-Bend, the only Republican remaining after Girod left, cast the lone “no” vote.

“We’re making policy that ultimately going to be counterproductive to hat all the people who testified said they actually want,” Knopp said.

Sen. Shemia Fagan, D-Portland, who chairs the housing committee, said she shared concerns from people who testified it doesn’t go far enough.

“I wish this bill would do more, and I would be willing to go further,” she said.

— Elliot Njus

10 Things People Get Wrong About Living With Depression

See Author Article Here

There are many stereotypes surrounding depression, from being unable to get out of bed to crying at all hours of the day. But those living with the condition will tell you that the illness comes in many forms, and often looks far different than what we’ve learned over the years from movies and the media.

Because of these misconceptions, people who haven’t had a personal tryst with depression often don’t fully know the ins and outs of the disorder. For instance, depression is not something that you can “snap out of.” You can recover from it and manage it, yet it still can easily come back. And it’s entirely possible to be depressed but also experience joy in the company of friends.

Curious what other things people frequently get wrong about living with depression? Experts and people who live with the condition break them down below:

You can be depressed and not appear sad.

CAIAIMAGE/PAUL BRADBURY VIA GETTY IMAGES
“It’s a misconception that depression is all about constant sadness. Yes, persistent sadness is a symptom, but it’s just one of a range of emotions, or lack thereof, that someone living with depression can feel,” said Helena Plater-Zyberk, co-founder of Supportiv, an anonymous peer support network for people with struggles like depression. She added that many would be surprised to know that people with depression are also to experience an array of emotions, including joy.

Mike Veny, an author and keynote speaker who often speaks about his own depression, agreed. “People get confused when they learn that someone who is confident and smiling all the time struggles with depression,” he said. He added that just because a person appears positive and upbeat, doesn’t mean that they aren’t struggling to hold it together inside.

You can’t flip a switch to flip to feel better.
“The biggest misconception about being depressed is that you can just ‘snap out of it,’” said Samantha Waranch, a publicist in Los Angeles who lives with the condition, noting that it’s frustrating when people imply that being depressed is “all in your head” and can be warded off by “thinking happy thoughts, being around people or hitting the gym.”

“While things like exercising can help, I think people who have never experienced depression don’t understand that it is an illness, a chemical imbalance that is beyond your control,” she added.

Depression isn’t merely triggered by stressful situations.
“People think depression is because of a trigger or that something bad had to have happened to be depressed,” said Katie Leikam, owner of True You Southeast, who has dealt with depression herself. “Yes, depression can come from things like grief, but sometimes you just wake up one morning depressed and you cannot point to a solid reason.”

Dr. Melissa Pereau, medical director and psychiatrist at the Loma Linda University Behavioral Medicine Center, said that depression can be a highly genetic disease involving chemical neurotransmitters in the brain. Depressive episodes that last weeks or months can also often occur without any cause.

“Asking a person who is living with depression, ‘Why are you depressed?’ is sometimes just as frustrating to them as saying, ‘You should try to be more positive,’” Pereau said.

Isolation isn’t always best.
Dr. Don Mordecai, the national leader for mental health and wellness at Kaiser Permanente, noted that checking in on a loved one who is suffering can go a long way in showing that you care.

“You can say things like, ‘I’m here for you. What can I do to support you?’ or ‘Depression is a real health issue that can be treated. Have you talked to your doctor about this?’” he said, adding that in having these conversations, you may be surprised to learn how much the people that you care about appreciate the opportunity to share how they are really feeling.

It looks different for everyone.
“Depression looks different in people,” said Tameka Brewington, a psychotherapist and owner of Real Talk Counseling. “For instance, some people will want to sleep all the time, while others are not getting enough sleep. Some people will isolate and withdraw while others will engage in a hostile or aggressive manner.”

Since depression manifests itself in different ways, Brewington said it’s important to know that each and every person suffering from the mental illness will have different needs.

Medication takes time to work.
Medications can certainly help to ease the symptoms of depression, but they won’t instantly make everything better. It takes time. “Chronic diseases require chronic treatment,” said Dr. Michael Genovese, a clinical psychiatrist and chief medical officer of Acadia Healthcare.

Even when the medication does help, it’s important to continue on with your prescribed dosages until your doctor gives you the green light to back off. “I’ve seen many patients over the years that will start taking their prescribed antidepressants, and as a result of the medication, they will feel better. This can lead to patients abruptly stopping their medication, which is a mistake,” Genovese added.

He advised patients to work with their physicians on a long-term plan. “Evaluate your options after you have committed significant time to your treatment plan,” he said.

It’s easy to overlook.
In addition to sadness, depression can also manifest itself in physical ways. For instance, people with depression may suffer from sleep and appetite disturbance, low energy, lethargy, difficulty concentrating, poor memory or low libido.

“Often these symptoms are misattributed to other illnesses and people suffer from undiagnosed and therefore untreated depression for years,” said Zainab Delawalla, a licensed clinical psychologist in Atlanta.

Not being properly diagnosed can be frustrating and people who live with the condition may end up bouncing from doctor to doctor before finally getting the proper help they need.

Having depression doesn’t make you weak.
The idea that only “strong” people don’t have a mental health condition is one of the biggest misconceptions about mental illness, said Kelan Kline, who runs the lifestyle blog The Savvy Couple with his wife and lives with depression.

“I consider myself a very strong person ― super happy-go-lucky all the time,” he said, noting that “depression can hit anyone at any time, no matter how strong you are.”

L’Tomay Douglas, a life coach and founder of Brand Me Beautiful Inc., added that people are misinformed when they think that people living with depression are lazy.

“As a person diagnosed with clinical depression since 2003, I often had people saying things to me like, ‘Your problem is you need to get up off the couch and do something,’” Douglas said. “What they didn’t know was I was living, I was still breathing despite the darkness that tried to suffocate me and tell me to end it all.”

Medication is not the only treatment option.

Sydney Williams, who writes about her experiences of recovering from sexual assault on her website, Hiking My Feelings, said there’s more to managing depression than taking medication.

“Not everyone wants to take medications to manage their disease and some folks don’t have access to medications,” said Williams, who stressed the importance of exploring a variety of treatment options. This can include talk therapy, lifestyle changes (for Williams, that meant hiking) and more.

There is no time frame for depression.
“Depression is not a now/later or here/gone thing,” said Lynn R. Zakeri, a licensed clinical social worker based in Illinois. In fact, she added that “people often say that because they experienced it, they feel much more at risk of returning to that and even feel it is a faster route right back down to the bottom since it is now a familiar route.”

Leikam added that clinical depression lasts for at least two weeks at the time, but “you can go through periods where you are fine and then it can come back through circumstances or coming off of medication.”

People With Mental Illness Need More Than Just Talk

See Author Article Here

Philip Moscovitch writes frequently on mental health and mental illness. He is working on a book about life with psychosis – for those experiencing it and those around them.

It’s nearly Bell Let’s Talk Day. You know, the one day of the year when social media is flooded with messages urging us to talk about mental health and to feel good about doing it.

But as the father of a young adult who has experienced mental illness, campaigns like this make me want to scream.

On its Let’s Talk website, Bell boasts about donating money to “mental health” – the words “mental illness” rarely appear – and uses inane slogans such as “Mental health affects us all.” Money from the campaign goes to causes including “fighting the stigma”, a vague-sounding goal that puts the onus on people facing prejudice to end the discrimination against them.

Canada has no shortage of mental-health advocacy and awareness groups. In my province, the Mental Health Foundation of Nova Scotia holds an annual gala fundraiser, complete with local celebrities and politicians. The organization’s key platitude: “#changingthewaypeoplethink.”

And in late November, the Canadian Mental Health Association published a blog post encouraging readers to “keep your mental health top of mind” by putting together a “workplace wellness box including things that help reduce stress and put an accent on feeling well.” What kinds of things? Oh, you know: colouring books, essential oils, fidget spinners, tea. Leading mental-health expert Stan Kutcher, who has since been appointed to the Senate, tweeted in response: “You got to be kidding. Right?… Please tell us that this is not what our mental-health advocacy has become.”

It’s hard to argue with raising awareness and fighting stigma. But those things don’t do much to help people who are living in precarious housing or trying to find a way to pay for anti-psychotic medication, which can cost thousands a year.

There is little evidence that these kinds of campaigns have any significant effect on changing people’s beliefs or behaviour. A study published in the medical journal The Lancet in 2015 said that when it comes to medium- and- long-term effectiveness of anti-stigma campaigns, there is “some evidence of effectiveness in improving knowledge and attitudes, but not for behavioural outcomes.” In other words, people might change the way they think – but not how they behave.

Even worse, the campaigns could be counter-productive. “The more we emphasize how widespread the stigma of mental illness is,” said psychiatrist Ross Norman at a 2013 conference in Montreal on early psychosis treatment, “the more we may be reinforcing people’s stigmatizing responses.”

My son, who has been open about his recovery from psychosis, knows this flipside of fighting stigma and how appearances are inherently built into how people respond to someone else’s mental illness. “Even as a privileged person, you are marginalized when you have a mental illness,” he said at a 2017 talk at a coffee house in Nova Scotia organized by a group advocating for better funding, community support and more creative solutions in mental-health care. “There were nights when people I thought were my friends wouldn’t let me sleep at their place, I thought I was alienated from my family, it was minus-15, and I was just walking down the streets of Halifax with jeans that were frozen to the bone, unable to go anywhere and sleeping in underground parking lots.”

One mental-health professional – who has a diagnosed mental illness and asked to remain anonymous because of potential career repercussions – told me she used to appear at awareness fundraising galas but doesn’t anymore. “You become kind of a dancing monkey.” she said. “I’m there representing people with mental illness because I can put on a dress, look like a middle-class person, speak at a fancy event and not make people uncomfortable … Meanwhile, people who are not being served well by the system would not even be allowed into the room.”

Indeed, despite years of anti-stigma campaigns, most of the people I have interviewed about psychosis don’t want to use their real names, for fear of the personal and professional consequences. Asking people with mental illness to reduce stigma by telling their stories potentially exposes them to more discrimination.

I’m not suggesting groups devoted to raising awareness don’t also fund worthwhile programs and services. They do. But they don’t emphasize the kinds of fundamental change we need.

It does no good to raise awareness if you have an underfunded mobile crisis team that only has the capacity to go out on calls for 12 hours a day, or if patients wait months for assessment, or if you can’t provide stable, supportive housing for those who need it so they can recover and carry on with happy and productive lives.

Let’s talk about that.

On Subramanian Swamy & Priyanka Gandhi: Restigmatizing Mental Illness As A Political Tactic?

HuffPost

Narratives of mental illness don’t always begin or end well. For those who are able to successfully manage their afflictions and live rich, full lives, few things matter more than narrative. As someone who was diagnosed bipolar 12 years ago, I know how important stories can be. I am functional and productive today because I have been allowed to control the telling of my history. My life has been interrupted by mania, yes, but by being the primary narrator of these debilitating events, I’ve been able to salvage some agency. Besides, my few days of mania have not overshadowed my years of lucidity.

Overused in popular mental health discourse, the word ‘stigma’ had recently lost some of its import. Swamy has given it back some of its sting. Even though his byte lasts only a minute, he builds suspense. He drops the word ‘bipolarity’ as if he were speaking in an exotic tongue. His obvious presumption—not many people know what it means—is perhaps on point, but Swamy exploits the foreignness of the word with a sly cunning. Gandhi, he then suggests, is violent because she is bipolar.

“Priyanka Gandhi’s Mental Health Isn’t Subramanian Swamy’s Business”

Dear Subramanian Swamy, your words on Priyanka Gandhi and mental illness are toxic

India Today’s Article