What Happens When You Stop Depressant or Anxiety Medications?

Anti-depressant and anti-anxiety medications work to alter your brain chemistry and support a more balanced mood state. Since psychotropic medication changes your brain chemistry and may also come with side effects, deciding to take medication should not to be made lightly.  It’s helpful to understand how the medication you are prescribed works and what to expect when discontinuing it before deciding to stop. It’s always advised to be under the supervision of a doctor who can ensure your safety and help minimize any side effects before discontinuing psychotropic meds.

(Please skip to the last section of this article if you would like to consider alternatives to psychotropic medication and discuss your options with your prescribing doctor and other healthcare professionals.)

Psychotropic medications, taking medicines, psychotherapist

Why Take Psychotropic Medications?

If you are struggling with depression or anxiety in a way that is significantly affecting your life, your doctor may recommend anti-depressant or anti-anxiety medications. Medications are also sometimes prescribed to alleviate symptoms, making therapy more helpful and useful. When feeling burdened by emotional overwhelm, at times it can be impossible to participate in your therapy in a way that promotes the change you need or motivate yourself to follow up on homework in-between sessions. When this is the case, your doctor may recommend psychotropic medication to help you engage in therapy in the way that you need to give you some relief from the symptoms you are experiencing.

Current-day research supports the use of both psychotropic medication and Cognitive Behavior Therapy (CBT) to treat diagnoses associated with depression. Medication may help you be fully involved and benefit from therapy. CBT will help you make the chemical changes in your brain for the long-term so that if you decide to taper off your medication at some point, you can maintain the brain changes you have worked to achieve in therapy.

In other cases, psychotropic medications may be prescribed to address chronic forms of depression and anxiety. Some people suffer from depression and/or anxiety for years. Despite trying many approaches, they struggle with symptoms on a daily basis. In these cases, medication may be a helpful option. Some people choose to maintain their medication regimen for a lifetime because when the medication is withdrawn, symptoms quickly return. Sometimes, even when engaging in all the behaviors necessary to support your health, the chemical components of the disorder you suffer from are just too strong, and medication is an essential part of your health routine. Each person is unique, as are the type, dosage and length of time prescribed medication works best.

It is very important to note that psychotropic medications may be contraindicated for some anxiety disorders and interfere with treatment and prognosis. Evidence-based treatments for anxiety require that you are able to experience the anxiety to its fullest extent in therapy in order for the treatment to be effective. If you are taking medication to decrease your experience of anxiety, in some case, this may interfere with your therapy. Talk to your treatment provider so that you can collaborate about the most effective treatment for you.

 

How Do Psychotropic Medications Work?

Different anti-depressant and anti-anxiety medication work in distinctive ways. Some medications stimulate the brain to produce more neurotransmitters (chemicals in the brain that regulate mood and other processes). Some help the brain by blocking the effects of neurotransmitters. Others, affect the brain by encouraging it to hold onto extra neurotransmitters. Because it takes some time for these medications to affect and balance the neurotransmitters in the brain, anti-depressant and anti-anxiety medications need to be taken for a minimum period of time before results are noticed. Your prescribing doctor can advise you the time needed to experience the affects from your medication.

 

Why Stop Taking Psychotropic Medications?

People often decide to stop using their medications once they start to feel better. This can be a mistake. It is important to carefully consider this decision and preferably, discuss your desire to discontinue medication with your healthcare professional. Often, it’s wise to wait a while after feeling better before discontinuing your prescription. When people quit taking their medication too soon, symptoms can return and sometimes the medication does not have the same effect or potency on mood symptoms the next time around. It is often preferable to wait until you have made changes in your health behaviors and maintained them for long enough where they have become habits. Once you have made the changes needed to support your sustained mental health, you’ll want to make sure they are engrained and part of your life so that you will continue to be supported in this way after your medication has stopped. Other times, people may find the medication they are taking no longer works and they may need to stop one type of medication to start another. Additionally, people may need to discontinue using their medication due to some other health concern (possible side effects, drug interactions, or in cases of pregnancy).

 

What Happens When You Stop Anti-Depressant or Anti-Anxiety Medications?

If you are taking an anti-depressant medication and suddenly stop, it can cause unpleasant symptoms including nausea, vomiting, headaches, dizziness, nightmares, and paresthesia (unpleasant sensations in the skin). If you are taking an anti-anxiety medication (or anxiolytic) and suddenly stop, symptoms could include nausea, vomiting, seizures, sweating, weight loss, heart palpitations, migraines, muscle pain, insomnia, and even suicidal thoughts. Specific side effects are unique to the medication and the person who is taking it. In either case, you may experience a rebound of psychological symptoms.

Because suddenly stopping anti-depressant or anxiety medication can cause unpleasant side effects, it is very important to consult with a doctor before you stop taking prescribed medications. A doctor can help to assess whether this is the right choice. They will also help you slowly reduce your dosage so that you are weaned off the medication safely, which helps to prevent uncomfortable side effects.

When you start or stop medications, it can be helpful to also seek the services of a qualified therapist who can help you address thoughts, feelings and emotions that may be affecting your mental health. A Dialectical Behavior Therapist (DBT) can provide specific education and skills to help you naturally cope with life’s ups and downs, without medication in some cases. A frequently used DBT slogan is, “Skills over pills.” This means that with learning and practice of DBT skills, often people can reduce or eliminate medication and lean on the DBT strategies they have learned to help them function effectively. The most important thing is to work together with your doctor and therapist to find the healthiest and most effective treatment solution for you.

 

Alternatives to Psychotropic Medications

Taking any type of prescribed medication is a personal choice. While doctors can advise you and make recommendations, ultimately, the decision whether to take psychotropic medication is up to you. Many times, making lifestyle changes can significantly impact your mood and decrease the need for prescription use. However, making these changes can be difficult and requires work. Only you and your wisdom can decide whether you are in a position and have access to the support needed to make these changes, or if now is not the time and medication is a worthwhile option.

If you are interested in making changes to your health behaviors to support a more balanced and stable mood, consider consulting with a Health Psychologist, such as Dr Bando. Health Psychologists are trained to understand all the factors maintaining the ineffective behaviors you are engaging in and help you directly target and change those behaviors to better support you. A good therapist can take out the guesswork and help you move toward your health goals with ease and precision.

Whatever your choice, please consult your wisdom and be gentle with yourself. In a time of difficulty (like experiencing depression or anxiety), increased self-compassion is needed.

Take action today and start shifting from surviving to THRIVING!


Feeling Over-“stuffed”: 3 of 4

How to Focus on What Matters During the Holidays (and Keep Yourself Feeling Merry).

Part 3 of 4 of the Holiday Stress Survival Guide

 

The holiday season is filled with so much extra stuff – packed schedules, gifts to buy, errands, food (more on that in Part 4), and people! You may feel over-“stuffed” yet still experience loneliness. Feeling sadness or struggling to enjoy the holiday season is a common experience. Many people find the holidays a stressful time of year. As mentioned, sometimes you may feel lonely (even in a room full of people), have a history of disappointing holiday memories, or have experienced a loss associated with the holiday season (such as the death of a loved one). It can feel like everyone around you is enjoying time with loved ones and the warmth of the season while you feel left out in the cold. If you find this a particularly difficult and lonesome time of year, take heart and read on for some ideas for finding comfort.

 

MAKE MEANING

Research shows us that even in the direst situations (being held in a concentration camp, surviving 9/11, or losing a loved one) people who are able to make meaning have a better quality of life and report more happiness overall in the years following that event. I mention these heart-wrenching examples because when you are down in the dumps and someone tells you, “everything happens for a reason” or some other encouragement geared toward making meaning, it can often feel invalidating and infuriating. The skill of making meaning or purpose in the midst of a painful experience can get you through and help you thrive. Research with survivors of tragic historic events shows us this is true.

 

Here’s what meaning-making is not: Making meaning out of pain is not forcing a smile and pretending everything is okay. It is not people-pleasing and making everyone else happy and comfortable while you suffer inside. It is not telling yourself that this situation happened for a reason or you must have deserved it.

 

What making meaning does involve, is finding a way to derive some purpose, something you can gain, out of the suffering you are in. In other words, how can you play the terrible hand of cards you have been dealt in the most beneficial way possible? Here is an example: I know a woman who has struggled with infertility and it is not possible for her to have children. This is very painful for her and every time the holidays come around, she aches to have a family. Every ornament that is hung and tradition experienced reminds her that she will not be passing any of this on to her own children. She feels pain. Although at times, she may be angry and want to scream how unfair this is, what brings her the most peace is finding meaning through her own spiritual and meditative practices, which she believes she would not do if she had not been met with so much sadness about something she cannot fix. She views her situation as driving her closer to practicing her spiritual beliefs and, as a result, extending increased compassion toward others. This does not make the state of affairs or her pain go away. What this meaning-making practice does, is help her focus on her values and find something of worth in the midst of her circumstances. When she feels lonely, sad, hopeless, she turns to her spiritual practices and finds comfort. This is making meaning.

 

Meaning making is a skill taught in the Distress Tolerance module of Dialectical Behavior Therapy (DBT). Distress Tolerance skills are designed for getting you through the moment when you cannot immediately solve the problem or source of your pain. At times, the holidays can be painful and because of the circumstances, we cannot completely change this. We feel pain, sadness, and loneliness. Making meaning can help us get through until, as with everything in life, this pain too shall pass. There will come a day that you smile and laugh and find pleasure. Remind yourself of this. Don’t let holiday loneliness get to you. Here are some tips to cope with Holiday Season sadness.

 

Online therapy. Loneliness, DBT, video therapy, California psychlogist

 

ENJOY JUST A MOMENT

Another DBT skill, this time from the Emotion Regulation module, is to engage in pleasant activities. The reasoning is that if you don’t have pleasant activities in your day, you cannot have a pleasant life. Sometimes, when you are very low, as you may feel during the holiday season, it feels like nothing gives you pleasure or joy. This is where you must get creative.

 

Instead of looking for bliss, try adjusting your expectations and finding one small thing that you can somewhat enjoy for a few seconds. Some examples are your first sip of coffee, those first few moments of getting into bed after a long day, taking a moment to inhale the delicious aroma of the food you are about to eat, or stopping to notice a beautiful flower. When times are rough and we cannot feel sustained happiness, it does not eliminate our need to be nourished with joy. When we start to notice the little things, even for a few seconds, we begin to build our emotional bank account with some pleasant experiences.

 

Think about having an empty bucket of loneliness or sadness. Every time you notice something even a little bit pleasant, like the moment you take off your shoes when arriving home, you are filling the bucket with a drop of pleasure. Of course, one drop does not make a big difference in a large, empty bucket. If you keep it up, drop by drop, over time, the bucket fills. Although it can feel like a slow process, every single time you turn your attention towards something even a little bit pleasant, you are a drop closer to filling that bucket. When you have accumulated many pleasant events, you will build the ability to feel more pleasure and happiness. Don’t force it. Just keep practicing and it will happen.

 

TAKE TIME TO REMEMBER

If your holiday season is a sad time because of loss and grief, you can make remembrance and the celebration of a loved one’s life a part of your holiday tradition. My grandmother used to make pies during the holidays. She would roll out the extra pie crust, spread it with butter, sugar, and cinnamon, and make special cookies for me to nibble while the pies baked. Now, whenever I make a pie, I use my grandmother’s fabulous pie crust recipe and say a little “thank you” to her for creating this memory for me. My husband now sometimes joins in, and instead of feeling sadness and lack, it has become a bonding experience that brings up nostalgia and gratitude. Rather than trying to push your pain aside or focus only on the positive, you may find a more authentic and touching experience when you take a few moments to remember those you have lost and commemorate this, even with a little “thank you.”

 

I hope that these strategies and activities make the holiday season a lot more enjoyable. If, however, your holiday blues are more severe or do not seem to reduce even after taking steps to help, then you may want to consider visiting a therapist. Therapists trained in Cognitive Behavior Therapy (CBT) and Dialectical Behavior Therapy (DBT) can be particularly helpful in dealing with the realities of the holiday season and finding effective coping strategies. Get in contact with a therapist to find out how they can provide that extra support to help you get through the holiday season, and perhaps feel even better about it.

 

Happy Holidays! Please remember, life is too short just to survive. Use these practices to help you THRIVE!

Read the whole series

Feeling Over-”stuffed” Part 1: Holiday Stress

Feeling Over-”stuffed” Part 2: Navigating Relationships

Feeling Over-”stuffed” Part 3: Loneliness

Feeling Over-”stuffed” Part 4: Overeating

If you use any of the practices suggested, please feel free to share your experiences and send your comments to contact@drbando.com. While Dr. Bando will not answer personally, your comments and feedback help inform future posts.

 

 

 

 


Telehealth vs. In Person Therapy: Which is Better?

You may be familiar with the image of counseling taking place in a psychologist’s office, client and therapist sitting opposite each other, or perhaps the client lying down on a couch. While this model is well known, our current-day communication technology makes it possible to access psychological services in the comfort of your own space.

Therapy has changed over the years, as has the consumer. As more information about psychological health has become readily available, those seeking treatment have become savvy customers. You value your time, money and energy and want gold-standard care. In therapy, this translates to more people looking for skills-based treatment delivered efficiently. Replacing the tradition of a therapist asking you to lie on a sofa and talk about your childhood, are therapists who view themselves as expert consultants, able to teach you the techniques and strategies needed to get what you want out of life. Therapy has become solution-focused and results-oriented, making video sessions an ideal platform for counseling.

In today’s busy world, many people find it difficult to schedule an hour plus commute to their therapist’s office on a weekly basis. Others do not want to sit in traffic, add another appointment to their day, or may want to see a specialist who is not located in their neighborhood. Telehealth provides a convenient solution.

Telehealth can provide greater ease and flexibility, and research shows it can be just as effective as traditional therapy. So which option should you choose?

How is Telehealth different from In-Person therapy?

In-person therapy means face-to-face in the same room or office with your therapist. The therapist provides the office space for your therapy session. Telehealth services are provided remotely, meaning that you and your therapist could be miles apart. Your sessions are assisted with HIPAA-secure technology, such as phone, video conferencing, email, online chat platforms, and even texts. In this model, you are responsible for making sure your space is private and confidential, and you feel comfortable enough to speak freely and be able to benefit from the session in the environment you have created.

Telehealth offers the advantage of making therapy services accessible to anyone, anywhere. This makes it easier to access the treatment you need. If the distance to travel to a therapist or the desire to see a specialist who is not in your area has held you back from therapy before, Telehealth might be a viable option to explore. If you want clear, directed, results-oriented therapy this can be easily delivered over Telehealth and help you reach your treatment goals quickly and effectively.

Teletherapy session, Telemedicine therapy, telehealth appointement

Who can benefit from Telehealth?

Anyone who is looking for results-focused treatment, in which the therapist serves as a teacher to help you gain the skills, techniques, and confidence to apply new strategies to your life and see the changes you want, can be a good match for Telehealth. In short, treatments focusing on helping you build skills to effect change are easily delivered via Teletherapy. Treatments such as Cognitive Behavior Therapy (CBT) and Dialectical Behavior Therapy (DBT) can help you with anxiety, depression, emotion dysregulation and interpersonal problems in an online format.

Clients who succeed with Teletherapy have the ability to provide a private, confidential space that allows them the focus needed to gain the benefits from their online sessions. Practical considerations such as having a strong internet connection, making sure your space is soundproofed enough so that you can express yourself freely, and having pen and paper handy, will ensure you get the most from your Telehealth treatment. With an online session, you do not have to lug your notebooks, writing materials, etc., to your therapy appointments. Everything you need is already at your fingertips.

Telehealth also allows you the luxury of sitting in your space, taking notes, and thinking or processing after the session has ended. Many people who have experienced face-to-face counseling know how abrupt it can feel to end a session after exploring vulnerable topics and then head out into the busy world again. With Telehealth, you have the opportunity to slowly absorb what you have learned, perhaps make a plan for optimizing your week ahead, and at your pace, slowly transition back into the outside environment.

Telehealth can also help people utilize counseling when they otherwise could not access services. This is especially true for people that live in rural areas or overseas, where they may not be able to find a therapist in their area with the expertise they need. People who have limited mobility due to health problems, age, or chronic illness can also find Telehealth helpful. Busy professionals and parents who may not have access to childcare can find Teletherapy an ideal choice. The goal is to access help with more convenience.

Does Telehealth really work?

When Telehealth was very new, there was some initial concern that it might not work as well as traditional therapy. However, research has found that remote therapy can be just as helpful as in-person treatment, with equivalent patient satisfaction scores. The benefits of convenience and accessibility make Telehealth the ideal solution in our increasingly busy and technology-driven world.

To find out if Teletherapy could be the right fit for you, speak with a therapist who specializes in Telehealth services and start shifting from surviving to thriving today!


How To Prevent Seasonal Depression This Winter

seasonal depression, seasonal affective disorder, SAD

 

Many people find it hard to get going on a gloomy day. The covers feel extra cozy and that cup of hot coffee or tea, extra warm and inviting. The urge to stay in your pajamas and curl up indoors beckons you.

You may notice the weather can influence your mood. You might feel more tired or even down and blue. It might be hard to motivate yourself to get much done. Feeling subdued is nothing to concern yourself with if it happens for a day or two. Relax and put your feet up (as much as your schedule allows) and give yourself permission to chill out and indulge. The key is to soak up the laziness and enjoy, without shirking your responsibilities or feeling pulled farther and farther into hibernation.

This may be easier said than done. For some, seasonal depression is an experience that lasts all winter long.

What is Seasonal Depression?

Seasonal Depression is sometimes called “the winter blues” and psychologists give it the more formal title of Seasonal Affective Disorder (SAD). It is a set of depressive symptoms that occur with a seasonal pattern, typically emerging in the Fall, when the weather gets colder, and remitting in the Spring, with the more frequent sunshine. Occasionally, people experience the opposite, with symptoms during Spring and Summer.

Typical symptoms include having low energy, feeling tired, sad and sluggish, losing interest in activities, difficulty concentrating, and sleep/appetite changes. Additionally, with seasonal depression, you may experience irritability, agitation, anxiety, hypersensitivity, and conflict in getting along with others. Frequently, symptoms start out mild and can become more severe.

What causes Seasonal Depression?

A major cause of seasonally-based depression is biology. Your biological clock (or circadian rhythm) may be partly to blame.  Changing patterns of sunlight and less daylight affect your biological clock. Reduced sunlight can also cause decreases in serotonin, a neurotransmitter (chemical in the brain) which affects and regulates mood. Finally, the body’s balance of melatonin may be disrupted, which also affects mood and sleep.

Another cause of seasonal depression is vulnerability factors. In Dialectical Behavior Therapy (DBT), vulnerability factors are described as circumstances that make you more vulnerable to experiencing intense, unpleasant emotions. These factors may include environmental stress, a diet that isn’t supporting your needs, sleep irregularities (lack of or too much sleep), lack of exercise (or too much or the wrong kind for you), and physical illness. During Winter, as the weather and winter colds and flu make you feel tired, worn down, and depressed, you may become even more vulnerable, less equipped to handle stressors and feel greater amounts of unpleasant emotions more frequently.  When vulnerability factors are high, intense emotions can follow, making you even more vulnerable.

How to prevent Seasonal Depression?

A gold-standard and evidence-based treatment (research shows it works) for any cause of depression is called Behavioral Activation. In short, this means that as soon as you suspect depression may be on its way (or has arrived), you make a plan to get active. In DBT, this is called Opposite Action.

Specifically, identify all of the depressive behaviors you might want to engage in (e.g., call in sick to work, stay in all weekend without socializing, watch more television). Then, identify their opposites (e.g., show up early to work, make plans ahead of time with friends and keep them, have your shoes and jacket by the door ready to go for a walk after work). Next, get busy doing the opposite behaviors that you feel like doing when you are depressed.

The key is to be clear and specific about what Opposite Action you are going to take (make plans with Joe to see a movie on Sunday afternoon, not vaguely: make plans this weekend), and then throw yourself in all-the-way. Don’t expect it to be easy. Combating depression is exactly that, combat. And, do not be discouraged. It is a battle you can win with persistence and encouragement.

When engaging in Opposite Action, do not suppress how you are feeling or your desire to stay home and put your head under the covers. Instead, allow yourself to feel how you feel AND, at the same time, throw yourself all-the-way into the Opposite Action you have identified and let the skill do the work. (Do not wait until you feel like doing Opposite Action. That day may never come, and it allows Depression to take even more of a hold.) Then, do it again and again until you have gone through your list of Opposite Action tasks and Depression has been sent on his not-so-merry way. If you find it hard to get started, pick one very small step you can take, and take it! Last (and definitely not least), remember to reinforce yourself for taking each step. Reinforcement is a powerful change agent. The more you use it immediately after engaging in desired behaviors, the easier those behaviors will become.

Another way to prevent seasonal depression is by managing your vulnerability factors. Identify what is making you more vulnerable to intense, unpleasant emotions. Although this step may seem obvious, we often do not realize the number of stressors present until we say it out loud to someone else or give it some intentional thought. Once you’ve identified your vulnerability factors (e.g., not sleeping well, feeling under the weather, nutrition has been off the past week), you can brainstorm some ways to attend to them and give yourself really good cold-weather care. For example, if you know that you need extra sleep during the winter and without it, you become quite irritable, see if you can brainstorm some ways to get even just a little bit more sleep each night. Your body and emotions will thank you.

Other treatments for seasonally-based depression address the physical causes. To help combat decreases in natural light, you might use Light Therapy. This works with specially designed light therapy boxes, and research shows it can help. Some people also elect to try vitamins and supplements (in consultation with their health provider) as an alternative to psychotropic medications, such as anti-depressants.

If you have noticed that your mood shifts as the season changes, you may find it helpful to seek out therapeutic support in learning to manage it. Therapists can teach you how to send depression into remission, and then prevent or drastically reduce the likelihood of a relapse. Dialectical Behavior Therapy (DBT) is one helpful approach. DBT offers techniques to help you identify your unique vulnerability factors, engage in self-care to reduce and manage them, and notice earlier when they may be affecting you so that you can take steps to mitigate depression. If you think DBT may help you, contact a qualified therapist and start shifting from surviving to thriving today!

 


Where Does Anxiety Come From?

We’ve all experienced stress, worry, and anxiety from time to time. For some of us, or at certain times in life, it occurs frequently and can feel overwhelming. At its worst, anxiousness can even impair daily functioning. A lot of factors work together to cause the experience that we call anxiety. Let’s take a look at some specific ways that it develops:

From Chronic Stress Conditions 

Most of us equate stress with anxiousness, and oftentimes, these two do go together. However, when we talk about anxiety as opposed to a passing stressor (a stressful life event that comes and goes rather quickly), there is a lot more to it than just feeling stressed. Some people grow up or live in incredibly stressful environments (e.g., low-income households, experiences of neglect and abuse), and these long-term stressful conditions can make people more vulnerable to anxiety, and in some cases, weaken their ability to handle stress. If your system is already taxed by dealing with chronic, daily stress, your ability to manage more stressors thrown your way will very likely be compromised. A buildup of chronic stressful situations that do not go away quickly can lead to an experience of anxiety.

From Reinforcement

Have you ever heard someone say, “You don’t need to worry,” and you want to answer with, “I do need to worry!”? When we are experiencing anxiety, we often believe it’s helpful, because it gets reinforced. When we feel anxious about something and spend time ruminating and worrying, often everything turns out just fine. We can then believe that anxiety helped achieve the desired outcome. There is an old quote by an unknown author that goes, “Worrying works! 90% of the things I worry about never happen.” We continue to feel anxious and sometimes become almost fearful that if we are not anxious, things will not work out. Most of the time, this isn’t even a process we choose. The cycle gets reinforced, and the brain keeps it going without our intent. Reinforcement is brain food; when a behavior is reinforced, it is likely to occur again.

 

Anxiety, anxious, anxiousness, worry

 

From Avoidance

One function of anxiety is that it helps us to avoid other issues. This can be the most puzzling reason for anxiety. Most of us hate the experience of anxiety, and at first glance, it does not make sense that we would use anxiety to avoid anything. Rather, we want to avoid anxiety! Think of it like this: Anxiety gives our mind something to chew on. We may not like it, and it may not feel pleasant, but it occupies us, nonetheless.

Anxiety tells us that something is wrong and we need to fixate on it, wring our hands, figure it out, look up facts, check out others’ opinions, etc., and it keeps us very busy. Sometimes it keeps us so busy that we can’t focus on much else. If we are having an uncomfortable emotional experience or find ourselves in a painful situation that cannot be solved (e.g. a job we cannot quit, the death of a loved one), sometimes we are so overwhelmed that anxiety jumps in to try to give relief. We may prefer (on some level) the experience of spending our time figuring out an unfixable problem than sitting with the feeling of grief or helplessness.

 From Other Emotions

Another function of anxiety is its ability to hide other, more difficult emotions, because it is a secondary emotion. Anxiousness (or any secondary emotion) happens when the primary emotion is not sufficiently experienced and processed. In other words, your anxiety serves as an avoidance (see above for more explanation on this). When we experience it, we don’t feel the underlying emotion. Our way out of anxiety is to feel this primary emotion. When we resolve a primary emotion, the secondary emotion regulates.

 From Itself

One of the most unpleasant aspects of anxiousness is that once we are aware of it, we can start to feel anxious about our anxiousness. The more we work to avoid it, ignore it, fight it, or self-criticize it, the more space it takes up in our mind. We end up feeling anxious about having anxiety and sometimes anxious about the rare times we do not feel anxiety. We may also experience additional concern about others noticing or criticizing our anxiousness.

If you struggle with anxiety, consider seeking therapy. Therapy can help you safely address and resolve unrelenting anxiousness. A therapist who practices Dialectical Behavior Therapy (DBT) is a good choice. DBT can help you build skills to address any vulnerabilities you have, to identify and cope with primary emotions, and to make more effective choices than avoidance. They can also teach the skill of Radical Acceptance, which is learning how to accept things that cannot be changed, rather than adding to your suffering by fighting it or feeling more anxious. If you could benefit from these skills, contact a qualified therapist and start shifting from surviving to thriving today!


6 Most Common Questions About Therapy Answered

Going to therapy for the first time can be daunting when you don’t know what to expect. Sometimes, even if you have been to therapy before and have not received the results you wanted, you may have questions about how to return to therapy and achieve a different outcome. The answers to these frequently asked questions can help you wisely invest your time and money in therapy to achieve the success you want.

  1. Why Should I Go To Therapy?

If you’ve never been to therapy before, you might wonder why you should take the step to get treatment. Every therapy experience is different, so defining your personal goals can help to guide both your motivation to go to therapy, as well as your choice of therapy type and therapist. If you wisely choose a change-oriented therapist, treatment can be fruitful as a growth experience or to help you navigate a stressful life situation or relationship. Many people visit a therapist to discuss a specific issue or diagnosis, but you don’t need to have that all figured out before reaching out to a new therapist. Just knowing that you want help is enough. A skilled therapist can help you define your treatment goals and decide what changes you would like to see in your life for therapy to be deemed successful.

What is DBT, Dialectical Behavior Therapy, online therapy service

  1. How Do I Find A Therapist?

Common ways of finding a therapist are through recommendations from family and friends, online directories, your insurance company, online reviews or often, a web search. Searching the web allows you to define exactly what you are looking for, and get to know prospective therapists through their websites, before deciding who to contact. A benefit of our technological age today is that you can choose TeleHealth, or online therapy sessions, for location independent therapy when and where you need it.

  1. How Do I Choose A Therapist?

Choosing the right therapist involves either identifying a problem you want help with or the type of therapy you want and evaluating whether the therapist is the right match for you. Some therapists have individual specialties or areas of interest that may appeal to you, such as Dialectical Behavior Therapy (DBT) or Cognitive Behavior Therapy (CBT). Ask for a phone consultation with your potential therapist to see if this is someone you feel comfortable opening up to and working with.

  1. How Will I Know If A Therapist Is A Good Match?

You want to find out if your therapist’s goals match your goals. Is this clinician results-oriented so you can focus on moving forward (not just talking about moving forward) and from therapy eventually? Can they identify your main problem areas, as well as an action plan to work on them? Can they develop a treatment plan and treatment goals with you, and help you project how long you will need therapy within the first few sessions? Therapy is a collaborative effort, and it is important to ensure your goals and vision match those of your therapist.

  1. How Do I Monitor The Progress of Therapy?

You probably want to heal, grow and progress through therapy, and it is important to know how to measure that. An experienced, results-oriented therapist will understand how to monitor progress according to the goals you set. Progress monitoring is essential because you want to make sure therapy not just helps you feel better, but also helps you get better. Using psychological measures to track your progress can help you and your therapist know whether treatment is working, how fast it is working, and whether the treatment plan needs to be altered to receive better results more quickly.

  1. I’ve Never Been To Therapy Before, What Do I Need To Know?

While it’s natural to feel nervous before your first therapy session, understand that your therapist is a professional who is trained and experienced in helping you face problem areas in your life, and promote growth, healing, and change. If you have put the time and research into choosing the right therapist, you should feel comfortable and at ease in therapy within the first few sessions. Stay open minded, and if you experience that things are not going as planned or the therapist is not meeting your needs as you had hoped, feel free to discuss this with the clinician, or to try a different therapist.

Therapy can promote profound, impactful change to your life. It is important that you are empowered to get the right help for you. Hopefully, the tips in this article will boost your confidence about starting or revisiting therapy with these frequently asked questions answered. Take a step towards the life you want today, and start shifting from surviving to thriving!


4 Tips for Handling an Argument

Arguments are an inevitable part of life. If you ever have a relationship with anyone, it is very likely that at some point, you will disagree. Disputes are a normal and expected part of intimacy – whether you argue with your spouse or partner, business colleague or boss, or friend or even acquaintance, arguments are part of how humans connect, understand each other, and sometimes even bond. If, however, you find yourself getting into frequent arguments, your arguments get more intense than seems effective, or you struggle to resolve disputes, try these 4 Tips for Handling an Argument, to improve your communication and increase the probability you get the results that you want.

  1. Use “I Feel” Statements

If you are rolling your eyes because you’ve heard about “I” statements in therapy mumbo-jumbo self-help books before, please suspend your judgment and read on. “I” statements are not about being mushy-gushy, “I’m okay, you’re okay,” and only using language to appease the other person. Used correctly, “I” statements function to reduce the other person’s defensiveness and help you to get your point across clearly. Often, arguments are started or sustained by miscommunications and misinterpretations. Making statements such as, “you are a [fill in the blank with your favorite accusation]” or “you make me feel” put the other person on the defensive and make them unable to hear and understand you, let alone meet your needs. These kind of “You” statements can leave the other party feeling confused, criticized or blamed. That is a recipe for that person putting up their dukes and fighting back. Now, both of you are unhappy, and the argument is unresolved. Being mindful of your language and using “I” statements help you to communicate your experience without blaming the other person, greasing the wheels for their willingness and understanding. Start with “I feel” or “I want” or “I don’t like” and then describe the situation without judgment. (See past blogs on my website for more information about what Nonjudgment is and how to use it.)

  1. Lower The Intensity

If you have heard the phrase, “fight fire with fire” you may know it refers to the idea of responding to a fire by lighting another one.  Sometimes in an argument, we instinctively want to “fight fire with fire.”  We want to be the winner that convinces the other party to change their opinion, agree to our demand, or simply say those magic words, “You are right.”  The problem is that as you each raise your intensity to be the winner, it escalates the dispute, the argument can get out of hand, and no one wins. Next time you argue and observe yourself becoming more intense (louder voice, bigger mannerisms, harsher words), STOP. (This is a DBT Skill that encourages you to Stop, Take a step back, Observe, and Proceed Mindfully.) Take a deep breath in the moment, take a break from the discussion if you need to calm down (and use Willing Hands or Half-Smile, some other DBT Skills that come in handy during an argument), and lower your intensity.  Ask the other party to do the same.  E.g., “Let’s both lower our voices. I’d like us to get through this together calmly and respectfully.” Then it can be possible to talk calmly as equals, hear each other, and respond effectively, working to get everyone’s needs met.

handling an argument, therapy, behavior change

  1. Take a Break

There is an old saying, “never go to bed angry.”  Although this statement probably intends to help resolve an argument, it can convey that when we argue, we must keep arguing until we resolve the disagreement.  This is simply not true, and it is not the most effective way to handle an argument.  If you are in an argument, sometimes the very best solution in that moment, is to take a break to calm down.  However, just walking or storming off can make the argument worse.  Instead, as calmly as you can, let the other person know that you need a break from the discussion.  Taking a break can give you each time to reflect, give your nervous system a chance to calm down, and help you to come back more clear-headed.  Negotiate a time to resume the discussion later.

  1. Practice Acceptance

Some arguments happen because we have different points of view.  You can get wrapped up in trying to make another person agree with your outlook.  Perhaps you even want them to adopt your opinions.  However, there are times you must “agree to disagree.” In other words, sometimes no matter how long or skillfully you talk, you will continue to have a different opinion from the other person. In those moments, you can practice the skill of acceptance. (Radical Acceptance is another DBT Skill useful in the midst of an argument.)  You will be accepting that the other person has a different viewpoint and that you may not be able to change it. Acceptance does NOT equal approval.  You do not personally have to approve of or adopt their perspective. Acceptance means that you accept the reality of the situation, even the parts of it that you don’t like. You let go of trying to change things that won’t change.

 

With these 4 Tips, you can practice handling arguments differently. Start with small, low-intensity disagreements and move to more emotional arguments once you’ve mastered some of these skills. If you often get into arguments, struggle to communicate, or feel unhappy in your relationships, you might seek the support of a professional therapist to help improve your communication and get more of your needs met.


Mindfulness Made Simple

As part of my practice as an action-based psychologist, I teach skills for emotional health and well-being. All of these skills start with the foundation of MINDFULNESS – purposeful awareness in the present moment.

My full definition of mindfulness is: The PRACTICE of adopting a curious, nonjudgmental, and gentle stance while cultivating awareness in the present moment by bringing one’s attention to an intended focus in an effective way.

That’s a dense definition. Let’s just concentrate on the PRACTICE part of mindfulness. Mindfulness is a practice. No one, no matter how much they have meditated or read or talked about mindfulness, can ever make the declarative statement, “I am now mindful.” Mindfulness is a practice, and we slip in and out of this state. When practiced on a regular basis, we build the skill of mindfulness, a first and crucial step to peace, happiness and emotional freedom. When we strengthen our mindfulness skills, we can be more aware and awake in our lives and make conscious choices more often.

Intentionally bringing awareness to yourself and your environment is the first step to building your mindfulness muscle. One way to practice is through a simple daily meditation. Meditation does not have to be complicated. Placing your attention on three breaths as you inhale and exhale can reap benefits.

Even when your mind is very busy this practice is effective. You can attempt, as best you can, to notice yourself breathing for three inhalations and exhalations. When your mind wanders, as minds do, gently bring your attention back to your breath. Do this as many times as is needed during those three inhalations and exhalations. When you bring your mind back after it wanders, it is like doing a rep with your mindfulness muscle. Think of your mind wandering as something that is supposed to happen, and the act of bringing your mind back to your breath, even if only for a second, is like lifting a heavy weight with perfect form and building this focused muscle.

The more you practice (even if it is three breaths once a day), you will start to notice more about your experiences sooner and sooner. For example, you may observe that you are somewhat stressed earlier in the day before it turns into being overwhelmed. Knowing and recognizing what is going on is a powerful tool to allow you to begin making changes.  See video below to practice.

As with anything, reading this article will not change your life. What will? TAKING ACTION! Here are two options for something you can do today:

  1.  Pause, right now, in this moment and notice where you feel your breath in your body. You do not have to change or alter your breath, simply become aware of what your breath is doing right now. Attempt to place your attention on feeling your breath in your body for the next 3 breaths, and when your mind wanders, gently bring it back to your breath. Notice the effect this has on you in the moment and the rest of your day.
  2. PRACTICE with my short, guided introduction to mindfulness.

 

LIFE IS TOO SHORT JUST TO SURVIVE. THAT’S WHY I HELP PEOPLE THRIVE!

Thank you,

Amanda Gale-Bando, Ph.D.

Questions or comments? Email them to contact@drbando.com. While Dr. Bando will not answer personally, she may address your question(s) or comment(s) in a future newsletter.


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Dr. Amanda Gale-Bando

Dr. Amanda Gale-Bando