Christy Hobza, Licensed Psychologist, PC
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Living with a "Minor" Depression

4/24/2020

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Feeling low can be hard on everyone, especially you.  You may not feel like you have “Major Depression” (a diagnosable depression), but you feel bad – at least intermittently and maybe all of the time.  Emotions, particularly ones like sadness, anger, fear, and worry, can come in waves.  It can be like being on a beach where one moment you are fine and dry and the next you are soaked in an emotional wave.  You may find yourself pulling away from people (withdrawing), getting angry more easily, not wanting to do anything because it just doesn’t feel good (anhedonia), eating less or more, and sleeping more or less or perhaps at times that are not convenient to your responsibilities (e.g. going to bed at 2 am when you have work or child demands in the morning).  When really big waves hit, it might even feel like none of this is worth it and being gone wouldn’t be so bad (passive suicidal ideation) – or maybe it feels really bad and you want to die. 

 

If you are considering suicide, please reach out to someone (Call 911 for immediate support or the National Suicide Prevention Lifeline 1-800-273-8255).

 

So, what do you DO?  How can you get out of this often dark feeling place?  Poems are written about this state and the straps on those boots are not pulling you up right now, so self-help is not as effective as it once was.  You might feel like you are a burden to your friends or like you don’t have friends anymore and it can be hard to turn to people.  Below are some steps that may help you climb back out of this place:

1.     Recognize that your thoughts, feelings, and actions are colored by your mood.  If you feel bad, then even good things may not seem as good to you as they would when you were in a good mood and you respond accordingly.

2.     Knowing this, look at your thoughts, are they blaming or overly negative?  There might be a mismatch with reality and what you are seeing as your reality.  In the table below you can see how your thoughts can impact your response to an event.

Event

Thought

Response

You make a mistake at work.

Negative thought:

“I always mess up.  This is it!  I’m no good at this job and I’m probably going to be fired.”

You withdraw or are overly defensive about the mistake.

Balanced Thought:

“Mistakes happen.  I messed up, but I’m going to work through this like I know I can, even though it might be hard.”

You own up to the mistake and actively work to address it. 

You are isolated and text a friend to see if they can talk because you feel lonely and you don’t get a reply.

Negative Thought:

“They know I need support.  They would pick up if they liked me.  I must not be very likeable.”

You don’t text again or keep trying to connect with someone.

Balanced Thought:

“My friend may be busy and or not feeling like talking right now.”

You try connecting again later, possibly with a different medium (e.g. email or phone call).  You also try connecting with another person.

3.     If your thoughts tend towards negative, when you find yourself considering a response to a situation, look for alternative interpretations of the event and see if you could respond differently (an outside perspective, like a therapist can be helpful when this is difficult).

4.     Aim to respond to the balanced thought rather than the negative thought.  When that doesn’t happen, forgive yourself – remember practice leads to improvement. 

5.     Look at the being and doing options here.  These steps can help with the next part, which are some actions aimed to reduce your minor depression symptoms.

6.     Connect with your community, no matter the size. 

 

Once you are armed with these strategies, when those waves of emotion come rolling in, you have a few new tools to help yourself dry off more quickly.  It doesn’t mean that you won’t get wet or feel down.  These strategies are a metaphorical towel for when those waves happen.  If your towel feels like it is frequently overpowered by the waves, consider therapy. 

 

If you are thinking about suicide, please reach out for help.  The National Suicide Prevention Lifeline is a toll-free number that connects you to a certified crisis center near you.  1-800-273-TALK or 1-800-273-8255

 

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Getting from “OK” to “Better than OK”:  Strategies for a more positive experience of your world

4/21/2020

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Maybe you don’t feel so great but are able to put on a “happy face” and get your jobs done.  You perhaps are “OK” but you have a lot of unpleasant feelings (e.g., fear, worry, anger, embarrassment, sadness, depression, etc.).  How can your change that experience to be better – at least better than OK.  Really, it depends on what works best for you today.  Sometimes people need to do (e.g. engage in an activity that has been proven to increase happiness) and other times people need to be (e.g. live in the moment with compassion and acceptance). Below are some different specific tasks and also some big picture ideas to support you.  
 
If you are a person looking for something to do, some techniques from Positive Psychology may be helpful.  There are many “happiness exercises” which are designed to increase your happiness and thus energy.  Here are a few:
  1. Three good things – Every night before bed, take a moment to reflect on your day and identify 3 things that went well.  Write them down and your role in this good thing.  You can add how this made you feel at the time and how you feel later about it (such as now as you are reflecting on it).  You can add why you think this event happened.  You can write this in any style you want.  (For example: My pet snuggled me.  I was lying in bed feeling sleepy and she jumped up and curled up on my chest.  I started scratching her and she kept pushing her head further into my hand.  I felt happy and warm.  As I think back on it, I remember how soft the fur was and warm I felt as well as how happy I was for that moment and I feel love right now.)  Do this every day for at least one week.
  2. Gratitude visit – Take a moment to identify someone who you feel gratitude towards but have not thanked appropriately.  Picture their face as you experience the feelings of gratitude.  Write that person a letter or note.  Deliver it to them (ideally in person, but now, maybe over video).  Spend some time with that person after you have shared your gratitude.
  3. You at your best – Write about a time when you were at your best, a time when you felt productive and/or happy.  What were you doing and who were you with?  Write or record about this time in detail. Review this story every day for a week and reflect on the strength(s) you identified.  
 
There are many more of these exercises on the Internet and there is even an app that has been created by the US Department of Veteran Affairs to help with coping with COVID-19 stress.
 
If you are a person into being, Buddhist Psychology provides other approaches to move towards improving your mood.  Based off the work of Daya (2000), seven core Buddhist principles that you can apply to your life to move towards a more positive experience of the world are:
  1. Flexibility of self – Work to recognize that your actions are often related to states (flexible) rather than traits (inflexible).  For example, a trait attribution is: I am lazy and therefore I want to lay on the couch.  A state attribution is: I am stressed due to COVID-19 and therefore I want to lay on the couch.  
  2. Being in the present – Focus on the moment you are in and only that moment.  What happened a moment ago or what will happen in a moment is not where you are focused.
  3. Experience without evaluation – Rather than rationalizing or trying to mentally understand your experience, focus on how you feel: your emotions, thoughts, senses, body senses, etc. without judgement.  (This takes a lot of practice!)
  4. Compassion – Practice acceptance, humility, and humor towards oneself.  This is not about a pity party, but rather about being okay with where you are right now.  
  5. Openness – Work to let go of the boundaries that hold you in place and limit you.  These can be fears, expectations that things be a certain way, or something else.
  6. Interdependency – Notice how you are connected to your surroundings.  We live interconnected lives and noticing this systematically can increase an understanding of how we need each other. 
  7. Sitting with suffering or dis-ease – Practice acceptance of your suffering: emotions such as fear, anger, anxiety, and sadness.  This can include noticing what you are feeling when you are in the middle of a tantrum and accepting that this is how you feel and that it is okay.  You are not at ease or are experiencing dis-ease, a state that is experienced by all.  
 
One does not need to commit to one path or the other.  It is okay to switch between doing and being.  As you notice more of the positives in your life and feel content with where you are, you may find you have more energy and a more positive experience of your world.  
 
Reference:
Daya, R. (2000). Buddhist psychology, a theory of change processes: Implications for counsellors. International Journal for the
​            Advancement of Counselling, 22
(4), 257-271. doi:http://dx.doi.org.proxy.library.nyu.edu/10.1023/A:1005648127301

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Adult Tantrums

4/14/2020

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During this time of “shelter in place” as an adult you may find that you are having a harder time keeping your emotions under control.  You are not alone in this experience; stress often leads to emotional dysregulation taking the form of a tantrum because one’s coping strategies are being overwhelmed.  Here’s why:

  1. We start to grow our ability to keep big emotions from overwhelming us (emotional regulation) as soon as we are born.
  2. Children have tantrums when their coping abilities are overwhelmed (emotional dysregulation) and time-outs are designed to help children learn how to get those big emotions under control all by themselves (here is more about time-outs)
  3. When you are in a more intense situation (e.g., sheltering in place due to a pandemic) you may be facing more stressors than you typically cope with leading to emotional dysregulation, which can lead to fits of bad temper – otherwise known as tantrums.
 
This is my favorite metaphor for how emotional regulation and coping happens, which I first heard from Stephen Finn, Ph.D.:
 
If you think of your emotional capacity as a teacup and your emotional support people as the saucer, you are born with a thimble sized teacup and (hopefully) have a really big saucer of caregivers to help you as your thimble will get full very fast and spill over into your saucer.  As you grow and learn more coping strategies, your cup size grows, so it spills over into your saucer less often.  
 
Many of us adults are facing stressors due to COVID-19 that are overwhelming our coping strategies leading to our cups spilling over.  Our teacup is not yet big enough for what we are dealing with, so we are growing it.  Recovering from tantrums grows your teacup.
 
If you are experiencing tantrums, you need to:
  1. Find a safe space for your tantrum where you can be upset
  2. Remember to not break anything you will regret later
  3. Let your emotions out
  4. Notice which emotions you are having (anger, sadness, jealousy, guilt, fear, embarrassment, etc.)  A feelings chart may help you name of the feelings (expect more than one)
  5. Let it ride (again, don’t break things you will regret)
  6. Be patient with yourself while you are upset
  7. You will start to calm down.  Praise yourself as your start to calm down (because you have just reregulated your emotions!) and after you are back in control, rejoin a space with others (virtual connection counts)
  8. Expect to feel tired, possibly for days.  You just had a big emotional workout and you are going to need some recovery time just like you would from picking up a new sport or physical training technique.  This was a marathon!
  9. Take care of you.  Drink plenty of water, take a bath, play music you enjoy.  Whatever you might do to care for your body post work-out.  
  10. Thank your saucers for being there for you
 
Your emotional capacity is growing during this time.  Growth can be painful and does not happen quickly.  You may be in a home with a lot of other people who are growing too.  Keep being each other’s saucers!

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April 08th, 2020

4/8/2020

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Everyone is working through this pandemic experience in their own way.  If you or your child are feeling isolated, sad, anxious, or depressed, you are not alone.  Not being able to physically interact with people can bring up all of these feelings.  Therapy can be helpful with this experience. 
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In addition to therapy, below are some ways to combat these feelings:
  • Engage in self-care such as: avoiding isolation, maintaining professional connections, keeping expectations realistic, balancing work and life, engaging in intellectual activities that are outside of your profession, keeping your long range goals in mind
  • Spend time "seeing" people through video chats.  You can arrange a lunch, dinner, or other hang-out time with friends over video.  You can play a game, such as Yahtzee, Scrabble, Battleship, Sorry, Minecraft, or Fortnight.  Some video platforms like Zoom allow for collaborative drawing and tic tac toe on their Whiteboard.
  • Be purposeful in your activities.  Now is a good time to explore a new interest or hobby as a way to learn and give yourself purpose.  YouTube videos or craft kits are places to look for direction.
  • Exercise to increase your positive feelings and energy levels.  This can be anything - including but not limited to: taking a walk, following an exercise video, doing a routine you make up, dancing to some favorite music, breathing deeply for 15 minutes 

Children may need help to feel connected to their peers whom they typically see effortlessly on a daily basis.  You can help children connect through routines:
  • ​Schedule weekly/bi-weekly club meeting(s) (e.g. book club, drawing club, documentary club, baking club. knitting club, Pokemon, Magic: The Gathering, Dungeons & Dragons) where content can be discussed for 30-60 minutes
  • Plan a regular recess or lunch time to be in a video space together to be silly and play (see potential games above)
  • Provide access to meditation games such as Unyte or biofeedback games such as Mightier to give children more tools to cope with stress
  • Schedule video playdates
  • Facilitate projects like those from Camp Gallileo or other inspirational websites
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Christy Hobza, Licensed Psychologist, PC
CA Licensed Psychologist: PSY23548
​510-460-1919
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