People do what makes sense to them

People do what makes sense to them

I can’t prove it, but I firmly believe that people usually do what makes sense to them. While that statement may sound cliché, it holds powerful meanings that can clarify who we want to be and how we get there.

How do harmful actions make sense?

An obvious objection is that people behave in all kinds of harmful, self-destructive ways. If you are like me, you can easily remember actions that were against your values or with hindsight didn’t make sense. How do such actions compute? Let me be clear that people don’t think through each action and consciously say ‘ah yes, what a great, logical action to do.” Some of our most upsetting or harmful actions occur when we feel unable to take other paths.

To understand harmful actions, let’s do a thought experiment. Envision a family member who is making an unwise decision that will hurt them and you. Now imagine that with Star Trek-like technology, I *completely* switch you into their brain and body. ‘You’ (I use that term loosely) have shed every aspect of your own person; instead, you take on the family’s member’s experiences, genetics, learning, memories, relationships, current thinking and emotions, etc – in short, every atom of the person and their experiences.

Would the modified ‘you’ would end up making the same decision as them? I hope you agree that there is a high chance. Sure, unpredictable external and internal forces might have unexpected influences; nonetheless, on average you would likely head down the same path.

What can you take from the thought experiment? Let’s dig into the implications with the next pair of topics: understanding and acceptance.

Understanding and acceptance

One lesson from the thought experiment is that your behaviors may seem foreign at times, but they aren’t arising from nowhere. The more you understand your personal context, the more you can shed light on the black box that led you to the action.

Having a greater understanding of your actions can unlock a number of paths to change: turned inwardly, understanding helps you to identify 1) problems, 2) how your desired destinations are different than the present, and 3) what internal and external factors are contributing to problems. With the knowledge of 1-3, you can better take steps toward actual change. When oriented toward others, making sense of people’s “senseless behavior” often leads to greater mental peace and improved behavior. Imagine that your best friend has been ignoring your texts. With building irritation, you finally reach them, ready to give an earful. It turns out they’ve had a work emergency! Their boss resigned, and they are shouldering the extra load. Now how do you feel toward them? How would your behavior change? Again, understanding the causes of behavior is powerful.

Importantly, understanding ≠ excusing. We all make missteps and do ‘wrong’ according to our respective moral codes. Guilt, regret, sadness, and other emotions can motivate you to seek change and repair, as long as they don’t become excessive. As a result, understanding negative emotions about your behaviors can be a useful tool for taking appropriate responsibility. Negative emotions can help us move from doing what made sense in the moment to doing something better.

Several threads I’ve mentioned are prominent in Dialectical Behavior Therapy (DBT). DBT integrates the notion of dialectics, or contradictory ideas that each seem to hold truth. One central dialectic is between acceptance and change. DBT contends that to change, you first have to accept the reality of the present and allow it to exist without seeking to resist it (i.e., radical acceptance). While radical acceptance is an ongoing process, heightening your radical acceptance can paradoxically move you toward future change. Here I can’t help but insert a similar Maya Angelou quotation: “Do the best you can until you know better. Then when you know better, do better.” Rephrased inelegantly into the current context, one might say: ‘accept that what you are doing what makes sense to you; when you learn behaviors that make more sense, do them.” I’m clearly not a poet, but the point remains: from a stance of current, active acceptance, we can free ourselves to learn, try anew, and do better.

Making sense with other perspectives

Embedded in Maya Angelou’s words is a major question: how the heck do we begin to know better? I’ve already discussed how understanding and radically accepting your behaviors can be a start. However, you have plenty of other resources at your disposal to start to know better. For some folks it is conversations with friends and family; for others it may be therapy. For still others, it may be seeking out new cultural experiences, new structured learning, trying out new behaviors directly, or all of the above. The overarching goal is to uncover perspectives that allow new behaviors to “make more sense.”

Feel like you already ‘know better’ but still are doing the same old behaviors? You aren’t alone. Still quibbling with what it means for a behavior to make sense, or to be understood? I’m in the same boat, continually. Perhaps I will tackle these topics another day – for today, I’m present in my happiness that you and I are thinking meaningfully about understanding, acceptance, and change.

The Back to School Blues

The Back to School Blues

For many people, August and September mean the beginning of the school year. Whether you or a loved one is the student, the fall can bring on the “back to school blues” as you adjust. It’s important to attend to your needs and take proactive steps to cope with school adjustments.

Life transitions tend to sap resources

Keep in mind that any major life transition frequently activates the bodily systems that underlie stress. Stress during life transitions isn’t necessarily bad; our bodily systems are amping up for a challenge appropriately! It is only when stress is chronic or results in experiences like panic attacks that it raises a red flag. Nonetheless, stress is draining. Do you end the day feeling like you’ve run a marathon? Exhaustion may be a sign that your body and mind have been on ‘high alert’ all day.

How else besides stress can the start of school trigger the “school blues?” The answer is that school can aggravate areas we already struggle with.

School transitions can trigger ‘vulnerable’ areas

Think about what the start of school often involves for students and loved ones:

  • New people (academically and socially)
  • Adjustments to existing relationships – emotional, time, and otherwise
  • New schedules
  • New sources of evaluation (e.g., exams)
  • Heightened work and planning
  • Decreased free time
  • Unpredictable disruptions (e.g., COVID)

Any element by itself could result in symptoms of depression, anxiety, or sleep disruption for some. Combined? The risks multiply. Importantly, if you possess an area of your self that is already vulnerable, transition stress within that area can leave you uncertain and doubting yourself. For instance, what if you are someone who often worries that others are judging your appearance negatively? Coming across a variety of new classmates and instructors in dazzling new outfits may present plenty of opportunities to criticize yourself. Unfortunately, stress may also drain some of the very coping resources you would typically use to combat these insecurities.

While I’ve painted a rather dire picture of risks for school blues, let’s turn to the glass half-full side.

Use your strengths to battle the school blues

First, many back to school elements don’t need to be negative. Look at the list above again, but with an eye toward reframing them. You may find that some can be viewed as novel opportunities or challenges that you enjoy seeking out.

Second, this isn’t the time to forget your tried and true self-care methods. What has worked for you in the past? The momentary newness may cause you to forget about or hesitate to use effective coping strategies.

Third, just like you may have vulnerable areas of yourself, chances are that you have relevant self-areas you perceive as strengths. Are you excellent at organizing new schedules? Do you get energized about meeting other students, or about learning a new topic? Think of these self areas as buffers you can lean upon to maintain your confidence and mood. Research suggests for people with existing vulnerabilities, developing a longer list of areas you value about yourself may be beneficial. By reflecting upon your genuine strengths and vulnerabilities, you may protect yourself from the mental downsides.

If you would like help with this reflection or have other questions about the back to school blues, please feel free contact me for a free consultation. We can discuss whether counseling would be a good fit at this time.

Little-Known Symptoms of Depression

Little-Known Symptoms of Depression

You probably have at least a vague sense of what depression is. If I forced someone in the grocery store to tell me a symptom of depression, I’m guessing they might say depression involves feeling extremely sad (after they decided against chucking a few apples at me). Prompted by the setting, *maybe* they might also say that depression symptoms can include changes in appetite. Perhaps a bagger might chime in about energy loss, and so on. Indeed, these guesses would be on target: current diagnostic criteria for depression incorporate these three as well as five other relatively well-known symptoms (lessened enjoyment, change in weight, feelings of worthlessness or guilt, lessened concentration, and suicide-related thoughts or behavior). However, our understanding of depression goes much deeper than this simple picture.

Depression looks different for each person

Certainly, many depressed people experience the most well-known symptoms mentioned above. Even so, symptoms of depression often look different from this stereotypical picture – and in fact, from many other people’s. Cutting-edge research suggests that unique combinations of symptoms may be closer to the rule than the exception.

One reason is that the diagnostic criteria don’t capture all key symptoms. For instance, one scientific paper described all the ways professionals have measured depression. The author identified 52 different symptoms that professionals have suggested might be part of depression! Part of the variation is likely due to poor measurement. However, symptoms like irritability, anger, pessimism, and crying can be parts of depression that aren’t adequately described by the standard 8-item list. Like the better-known eight symptoms, any possible symptoms of depression could always be part of another mental struggle, medical issue, or other separate cause. Thus, figuring out what symptoms are and aren’t part of your depression is an important puzzle.

A second way you may be unique concerns how troubling you find various symptoms. If you’ve ever experienced depression, you know that not all symptoms are equally bothersome. For someone who is a restaurant critic, a lack of appetite may impair their ability to work effectively. For a sales associate, their lack of concentration may be causing them to lose potential clients. In addition to experiencing the symptom itself, each person may find a symptom uniquely upsetting or impairing.

A final complexity stems from the mathematics of how symptoms combine. Even if you only use the standard eight symptoms, “depression” could still present in numerous ways. For example, current criteria suggest a person must have five out of eight symptoms for a diagnosis. It turns out there are 93 different ways a person could be experiencing ≥ five out of the eight symptoms!

Teamwork Can Figure Your Symptoms Out

Above all, the lesson to take about symptoms of depression is that each person needs to be carefully understood as an individual. The good news is that you are well-positioned to seek such an understanding and handle whatever struggles your symptoms may be causing. At Wellness Path Therapy, I consider you to be the expert on your own experiences. You are the only person who has been there minute-by-minute, experiencing what it is like to be you your entire life! By combining your expertise with professional support in understanding symptoms, you can get to the bottom of what is happening. If you are considering professional help to address your symptoms of depression, I encourage you to reach out to me or other therapists to begin your therapy journey.

Overwhelmed? You might be suffering from chronic stress.

Overwhelmed? You might be suffering from chronic stress.

Stress has an unfair reputation. Sure, few of us enjoy feeling stressed. Yet picture a world without stress. Amidst an argument with a partner, you would feel entirely unperturbed. When an important work deadline nears, you would feel…nothing. As you scrambled to pay next month’s rent, your mind and body would be completely unbothered. At first glance, you might think this lack of stress would be nice. But think again; an important role of stress is how it activates our mental and bodily systems to respond effectively to challenges. In other words, normal stress plays helpful functions. It activates your sympathetic nervous system, which coordinates additional bodily resources toward a challenge. Without stress, it would be much harder to effectively handle the difficult situations that arise in everyday life. Knowing about this helpful side of typical stress allows us to distinguish it from chronic stress.

While typical stress is experienced by everyone from time to time, chronic stress reflects ongoing exposure to stressors. Your body’s built-in system for responding to stress activates beyond what is healthy, putting you at risk for longer-term illnesses. Further, your body does not fully activate its typical recovery and relaxation systems following stress. To distinguish between ‘everyday’ and chronic stress, let’s use a silly example.

Paul and the ‘stressful snacks’

Paul, a former chef, dislikes snacks that leave remnants of the snack on a person (think of cheese puffs). He has good reasons for his dislike, and becomes quite stressed whenever he encounters such a snack. Several times a month he encounters coworkers’ lunches that leave him feeling stressed out. When this happens, he typically experiences unpleasant emotions and his thinks negatively about ‘stressful snacks’ for a few hours. However, he is generally able to address the situation and bounce back quickly.

Unfortunately, Paul is now moving due to his partner’s change in jobs. When they move into the new company housing, he is horrified to find that his unit is surrounded by several snack factories. When he looks closely, he notices that the ground has a coating of snack ‘dust’ – he is literally living amidst stressful snack residue! What’s more, his partner is now provided with ‘stressful snacks’ for free and has taken a liking to them, often eating them at home. Now nearly every time he steps foot near his house, he feels stressed. He doesn’t feel like he can relax or get away from thinking about the snacks.

What are symptoms of chronic stress?

You don’t need to feel stressed about cheese puffs (I hope this is rare!) or be experiencing an extreme situation like Paul’s to have chronic stress. The key is the repeated, ongoing nature of stressors. The exact symptoms of chronic stress take forms as varied as the individual. One way of considering the symptoms of chronic stress is to separate them into physical, emotional, and thinking components. Common physical symptoms include aches, tension, fatigue, and stomach difficulties. On the emotional and thinking side, people may feel highly irritable, anxious, sad, and worried. They may have a difficult time distracting their thoughts from stressful topics, and may feel exhausted or hopeless when thinking about the stressors. Overall, the experience of chronic stress often feels overwhelming.

Effective treatments are available for chronic stress

According to research, a number of treatment methods can be helpful for chronic stress. Therapists may help you to learn relaxation techniques, new ways of thinking about stress, or consider how to modify the stressful situations. With counseling, you may learn how to better lean upon the social support you need or engage in practical problem-solving focused on solutions. Across methods, you can learn to feel more in control of stressful situations and better able to cope with stressors.

When should you seek help?

If your level of stress is distressing or is impairing your functioning, it may be time to consult a professional. Listen to your friends and family – they may notice the outsized impact of stress before you do! A therapist can help you to evaluate your stress and provide support for getting back on track.

Panic Attacks

Panic Attacks

To grasp what panic attacks are like, picture the following: as you are walking upstairs, you suddenly notice weird sensations in your body. Your heart begins racing and a dread fills your stomach. Your chest is rapidly tightening up. Breaths of air don’t seem to come quickly enough as a horrible fear takes over your brain: are you having a heart attack? Your feeling of panic becomes almost unbearable as you lay on the floor and try to keep it together. What is happening?

Minutes or hours later, the panic lessens again. But what had been a happy, normal day is now wrecked by your exhausting experience. At Wellness Path Therapy, this is the type of experience that many clients have reported before beginning therapy.

What is a panic attack?

You may not have needed that description to imagine a panic attack. Panic attacks are quite common, with over 1 out of 10 Americans experiencing one each year and even more panicking during their lifetime. Panic attacks look different from one person to the next. For some people, they may feel highly concerned about situations like driving, crowds, public transportation, or exercise. Others may focus on avoiding situations that they fear could trigger panic.

Panic attacks themselves involve the activation of our nervous systems, which include both physical sensations and scary thoughts. Common physical sensations may include racing heart, sweating, dizziness, tingling or numbness, nausea, and shortness of breath. However, you may not know that frightening thoughts are also part of our nervous system’s reaction to perceived danger. These scary thoughts often focus on physical sensations. For example, “what if this dizziness means I am having a stroke?” or “I’m going crazy, I know it!” Our bodies generally react to such scary thoughts with even more panic.

Panic attacks are different than panic disorder

Experiencing even a single attack can be overwhelming. So how do you know when panic is becoming a problem? The simplest answer is that if your panic is bothering you, you can talk with a professional to figure out what is happening. Our job is to help you with exactly these types of questions.

To better understand the impact panic attacks may be having on you, professionals distinguish between panic attacks and panic disorder. Among other differences, panic disorder occurs when your panic attacks keep recurring unexpectedly. You may find yourself worried about future panic attacks or changing your behavior to try to avoid them.

It is also important to rule out other medical, medication, or substance-related causes for panic attacks. For instance, someone may be experiencing panic attacks due to steroid medication, marijuana use, or as part of an emerging condition like diabetes. In these examples, your health professional can do a thorough assessment of the possible causes for your panic attacks and help you determine what types of support are most appropriate.

Panic can be treated

There is good news about panic: it is treatable! Research shows that not only do many people benefit from panic treatment, it is one of the mental health areas we are best at addressing. The leading treatment for panic is cognitive-behavioral therapy, which teaches you new skills for thinking about physical sensations. The treatment also helps you to ‘face your fears’ through exercises that intend to bring on sensations of panic attacks. It may seem counterintuitive, but we want you to approach rather than avoid panic. This process reteaches your brain that the physical sensations during panic aren’t truly dangerous. In other words, experience (through practice) is truly the best teacher! I am in awe of the way my clients bravely engage with this treatment despite how (literally) scary it is; it is wonderful to see their hard work paying off as they find relief and happiness.

I hope this post is useful for learning some basics about panic attacks and treatment. If you are interested in pursuing online therapy for panic, there is research suggesting it is effective. Please contact me for a free consultation and we can discuss whether counseling would be a good fit at this time.

Avoidance in Panic Disorder

Avoidance in Panic Disorder

Have you heard of the fight or flight response? In a nutshell, when your mind perceives danger, a variety of systems across your mind and body leap into action. These systems prepare your entire self in incredible ways to ‘fight’ or ‘flee’ the danger (or lesser discussed possibilities like ‘freezing’). The fight or flight response exists for a useful reason: quickly orienting and responding to dangers has kept us safe (and alive!) throughout human history. However, panic can co-opt the typical process. By encouraging you to ‘flee’ safe experiences, a behavior called avoidance in panic disorder can start a vicious cycle of escalating anxiety.

What is avoidance?

In psychology, avoidance means staying away from particular experiences, situations, people, feelings, etc. Avoidance within the context of mental health problems is often contributing to those problems in key ways. Avoidance is particularly relevant to panic attacks and panic disorder. When you experience a panic attack, by definition you are feeling an intense surge of anxiety and distress. For most people, it feels natural to want to reduce that anxiety in any way possible. As a result, they begin to avoid possible triggers of their panic attacks: public transportation, driving, activities that make their heart race. Besides my examples, there are probably thousands of possible triggers for unique people.

Avoidance worsens panic over time

Avoidance in panic disorder teaches your brain a harmful lesson. In the short term, avoidance feels great. By not riding that bus, you may avoid not only worrying about panic, but actual panic attacks! Sounds great, right? Unfortunately, in the longer-term, think about what your brain may be learning. What may have been mild hesitations (“Riding the bus make me feel uneasy”) turn into stronger, harmful beliefs (“If I ride the bus, I might have a heart attack…I will definitely panic…there is no way I can ride the bus!”). Over time, avoidance creates higher levels of panic. And those high levels of panic? They feel like they can only be solved by – you guessed it – further avoidance. The bottom line: avoidance teaches you that situations are dangerous and must be avoided, reinforcing itself. The diagram at the top of the page illustrates this vicious cycle of panic and avoidance.

Avoidance may be “avoiding” your awareness

A tricky aspect of avoidance in panic disorder is how routine avoidance behaviors become. You can become so used to avoidance that you barely realize you are doing it! Think about when you first learned to ride a bike (sorry to non-bike riders!). Many initial rides were marked by an intense awareness of your hands and legs, your precise feelings of balance, and repeated scanning all over your body. The more you learned, the less you probably thought about these aspects. As an experienced bike-rider, you probably now focus your attention on the route, sights, and sounds. Avoidance behaviors work the same way – experienced ‘avoiders’ often need to take a step back to see the avoidance behaviors that they no longer notice. An important part of therapy is identifying these relatively automatic behaviors.

Treatment”short-circuits” avoidance in panic disorder

For a more information about general panic treatment, please read my blog entry on panic attacks. In terms of avoidance, a key component of many panic treatments involves reengaging with avoided areas. Just as avoidance teaches your brain that experiences are dangerous and to be avoided, practice teaches a powerful alternative lesson: you can approach those same experiences safely. Practice allows you to reverse the vicious cycle to your advantage. By willingly engaging with greater short-term panic, you are reducing panic in the longer-term. While scary, this repeated practice works: exposing yourself to your fears with professional support is an effective treatment.

I hope this post is useful for learning about how avoidance figures into panic disorder and its treatment. If you are interested in online therapy for panic, research suggests it is effective. Contact me for a free consultation and we can discuss whether counseling would be a good fit at this time.

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