"Finding Emo"--Part Two: Am I Moody?

We all have our ups and downs.

However, for some people mood swings can be a routinely troublesome occurrence.

A person can start the morning as calm as can be only to drop into a very low mood by the end of the day.
Alternately, one could be quite bogged down and sad upon awakening only to find by day's end that one's energy has been turbo-charged!

Anyone with questions about moodiness will find that a competent mental health clinician (psychologist, psychiatrist or social worker) can help clarify your situation.

The clinician should ask you about your emotions, moods and worries in a very detailed way.
An assessment should include
--your medical and "emotional" history as a child, teen and grownup
--your family's medical and "emotional" history
--a review of the ways you handle your moods
--a discussion of your goals and desired outcomes

It is extremely helpful to have a day-by-day diary of your moods and worries for at least two weeks time (while a month-long record is even better!).
Getting information about your moods that is collected in real time (rather than distantly remembered) can show you and your therapist your ups and down in a more accurate way.

Mood charts are available for free from a number of sources.
I recommend the ones that can be downloaded and printed from a PDF form rather than via a mobile phone "app".  Unfortunately, most of the smartphone apps for mood tracking require that you register your personal information such as name and email address. For better or worse, smartphones are hackable and can get lost. Having your mood data away from prying eyes on the Internet is a safer step.

My favorite mood chart comes from Dr. Gary Sachs at Massachusetts General Hospital.
(http://psychres.washington.edu/clinicaltools/moodchart_inst.pdf)
He created this chart for his own research and has generously made it available to the public.
Be sure to read the directions as it allows you to create a very detailed daily picture of your ups and downs, anxiety, and irritability as well as daily events, medication, therapy and usage of drugs and alcohol that may impact your emotions.

Additional mood tracking PDFs are noted below to help you capture the truest pattern of your moods and worries. 

http://www.dbsalliance.org/pdfs/calendaranxforweb.pdf
http://echopen.files.wordpress.com/2011/05/daily-mood-chart-for-mood-tracking_pdf.pdf
http://echopen.files.wordpress.com/2008/06/mood-disorder-managent-chart-jpg.jpg
http://www.cqaimh.org/pdf/tool_edu_moodchart.pdf

Remember--while these charts are available for anyone's use, it is highly advised that these charts be used while seeking professional counseling. 

Getting guidance from an experienced mental health clinician is the surest way to get off an emotional "seesaw"and back on steady ground.

Whatever Makes You Happy?

Welcome to 2013 and best wishes for one and all.  

Lots of folks are making New Year's resolutions for changing behavior and attitudes to arrive at better outcomes.  Before you do, let me suggest an article by Alina Tugend from the June 30. 2012 edition of  The New York Times, "Redefining Success and Celebrating the Unremarkable."  It's essential reading for any of us contemplating  the end goals we "need" to meet to be content.

Until next time, take good care.

Redefining Success and Celebrating the Unremarkable

www.nytimes.com

Many of us define success as being extraordinary, but where does that leave the average child who enjoys a pickup basketball game but is far from Olympic material?

Holiday Health and Healing Humor

News Flash: Better health (and lowered stress) can be found in your funny bone!

We all know that December has short, dark days, colder, wetter weather and a lot of pressure to "be happy" with upcoming holidays, parties and extended time with friends and family. 

 

We also know that we often drink or eat too much during this end-of-year stretch.

Step away from the buffet and bar and take a peek at this Mayo Clinic article on the healing and calming qualities of a good giggle. Enjoy and take good care!

http://www.mayoclinic.com/health/stress-relief/SR00034

Stress relief from laughter? Yes, no joke - MayoClinic.com

www.mayoclinic.com

"It's All Too Much": The ABCs of Managing Traumatic Stress from APA

For most folks along the eastern seaboard,  Hurricane Sandy has stirred up more than wind, water, beach and trees. The American Psychological Association has provided the following article about dealing with the aftermath of traumatic stress and has allowed its members to reprint or repost. It is an excellent summary with sage advice about taking good care. Please be well.

Managing traumatic stress: Tips for recovering from disasters and other traumatic events   (http://www.apa.org/helpcenter/recovering-disasters.aspx)                     

 Disasters are often unexpected, sudden and overwhelming. In some cases, there are no outwardly visible signs of physical injury, but there is nonetheless a serious emotional toll. It is common for people who have experienced traumatic situations to have very strong emotional reactions. Understanding normal responses to these abnormal events can aid you in coping effectively with your feelings, thoughts and behaviors, and help you along the path to recovery.  

What happens to people after a disaster or other traumatic event?                                                                                                                                               Shock and denial are typical responses to traumatic events and disasters, especially shortly after the event. Both shock and denial are normal protective reactions.Shock is a sudden and often intense disturbance of your emotional state that may leave you feeling stunned or dazed. Denial involves not acknowledging that something very stressful has happened, or not experiencing fully the intensity of the event. You may temporarily feel numb or disconnected from life.

As the initial shock subsides, reactions vary from one person to another. The following, however, are normal responses to a traumatic event:

• Feelings become intense and sometimes are unpredictable. You may become more irritable than usual, and your mood may change back and forth dramatically. You might be especially anxious or nervous, or even become depressed.
• Thoughts and behavior patterns are affected by the trauma. You might have repeated and vivid memories of the event. These flashbacks may occur for no apparent reason and may lead to physical reactions such as rapid heartbeat or sweating. You may find it difficult to concentrate or make decisions, or become more easily confused. Sleep and eating patterns also may be disrupted.
• Recurring emotional reactions are common. Anniversaries of the event, such as at one month or one year, can trigger upsetting memories of the traumatic experience. These "triggers" may be accompanied by fears that the stressful event will be repeated.
• Interpersonal relationships often become strained. Greater conflict, such as more frequent arguments with family members and coworkers, is common. On the other hand, you might become withdrawn and isolated and avoid your usual activities.
• Physical symptoms may accompany the extreme stress. For example, headaches, nausea and chest pain may result and may require medical attention. Pre-existing medical conditions may worsen due to the stress.

How do people respond differently over time?                                                                                                                                                        It is important for you to realize that there is not one "standard" pattern of reaction to the extreme stress of traumatic experiences. Some people respond immediately, while others have delayed reactions — sometimes months or even years later. Some have adverse effects for a long period of time, while others recover rather quickly.

And reactions can change over time. Some who have suffered from trauma are energized initially by the event to help them with the challenge of coping, only to later become discouraged or depressed.
A number of factors tend to affect the length of time required for recovery, including:

• The degree of intensity and loss. Events that last longer and pose a greater threat, and where loss of life or substantial loss of property is involved, often take longer to resolve.
• A person's general ability to cope with emotionally challenging situations. Individuals who have handled other difficult, stressful circumstances well may find it easier to cope with the trauma.
• Other stressful events preceding the traumatic experience. Individuals faced with other emotionally challenging situations, such as serious health problems or family-related difficulties, may have more intense reactions to the new stressful event and need more time to recover.

How should I help myself and my family?                                                                                                                                               There are a number of steps you can take to help restore emotional well-being and a sense of control following a disaster or other traumatic experience, including the following:

• Give yourself time to adjust. Anticipate that this will be a difficult time in your life. Allow yourself to mourn the losses you have experienced. Try to be patient with changes in your emotional state.
• Ask for support from people who care about you and who will listen and empathize with your situation. But keep in mind that your typical support system may be weakened if those who are close to you also have experienced or witnessed the trauma.
• Communicate your experience. In whatever ways feel comfortable to you — such as by talking with family or close friends, or keeping a diary.
• Find out about local support groups that often are available. Such as for those who have suffered from natural disasters or other traumatic events. These can be especially helpful for people with limited personal support systems.
• Try to find groups led by appropriately trained and experienced professionals. Group discussion can help people realize that other individuals in the same circumstances often have similar reactions and emotions.
• Engage in healthy behaviors to enhance your ability to cope with excessive stress. Eat well-balanced meals and get plenty of rest. If you experience ongoing difficulties with sleep, you may be able to find some relief through relaxation techniques. Avoid alcohol and drugs.
• Establish or reestablish routines such as eating meals at regular times and following an exercise program. Take some time off from the demands of daily life by pursuing hobbies or other enjoyable activities.
• Avoid major life decisions such as switching careers or jobs if possible.                                  These activities tend to be highly stressful.                                               

  When should I seek professional help?              Some people are able to cope effectively with the emotional and physical demands brought about by traumatic events by using their own support systems. It is not unusual, however, to find that serious problems persist and continue to interfere with daily living. For example, some may feel overwhelming nervousness or lingering sadness that adversely affects job performance and interpersonal relationships.

  Individuals with prolonged reactions that disrupt their daily functioning should consult with a trained and experienced mental health professional. Psychologists and other appropriate mental health providers help educate people about normal responses to extreme stress. These professionals work with individuals affected by trauma to help them find constructive ways of dealing with the emotional impact.
  With children, continual and aggressive emotional outbursts, serious problems at school, preoccupation with the traumatic event, continued and extreme withdrawal, and other signs of intense anxiety or emotional difficulties all point to the need for professional assistance. A qualified mental health professional can help such children and their parents understand and deal with thoughts, feelings and behaviors that result from trauma.
  

(The full text of this article from APA Help Center may be reproduced and distributed for noncommercial purposes with credit given to the American Psychological Association.) Any electronic reproductions must link to the original article on the APA Help Center.

"Do I Have Depression?" 101

Every October is National Depression Screening Month.
Here are the reasons:

The National Institute of Mental Health (the largest U.S.agency dealing with these issues) reports that the chance of becoming depressed at some point in one's life is almost 17%.


Within this year alone, almost 7% of our US population will become depressed and almost of third of them have depression at a "severe" level.

Now, here's an eye-opener: Barely half of those folks are getting ANY treatment at all!!

(http://www.nimh.nih.gov/statistics/1MDD_ADULT.shtml)



The social and economic cost of untreated depression is enormous--one source puts it at 43.7 billion dollars for the US alone.. (Journal of Clinical Psychiatry, 2003, Dec:64(12): pg. 1465).

--At work it includes a greater number of sick days,  lower efficiency and poorer concentration at the job, and loss of income.
--At school it includes twice the likelihood of dropping out of college along with lower educational achievement and performance.
--In general it includes a five times higher likelihood of drug and alcohol abuse, higher medical expenses (depressed folks report much greater incidence of physical pain), seven times greater likelihood of unemployment, and---most traumatically--a thirty times greater incidence of suicide than people who are NOT depressed.


Of course, the costs of emotional and psychological distress, fatigue, agitation, poor sleep and appetite, physical pain, loneliness, sadness,and the greatly diminished ability to enjoy one's life, friends and family are incalculable.

The U.S.health agency, the National Council for Behavioral Health, has a reliable confidential depression screening self-test on its website  (developed by Drs. Spitzer, Williams, Kroenke, 2011--Patient Health Questionnaire-9).
No information about you will be recorded, since the questionnaire can be printed and filled out in the privacy of your home.
There are nine questions to answer with results and a recommendation summary at the end.

http://www.integration.samhsa.gov/images/res/PHQ%20-%20Questions.pdf

It could be a step in the right direction.

Till next time, take good care!

The Paradox of Working to Relax

Clinical studies have routinely backed the benefit of mindfulness meditation exercises for folks dealing with issues as diverse as:

anxiety and panic attacks
http://www.brainresearch.us/meditation.pdf

depression                   

http://www-psych.stanford.edu/~pgoldin/Buddhism/MBCTrelapsedepressionTeasdale2000JCCP.pdf

obsessive-compulsive disorder
http://ukpmc.ac.uk/abstract/MED/18311106/

bipolar disorder    
http://guilfordjournals.com/doi/abs/10.1521/ijct.2009.2.4.373

stress-related paranoia
http://www.ncbi.nlm.nih.gov/pubmed/19545481

borderline personality disorder
http://psycnet.apa.org/psycinfo/1995-98090-000

grief
HumphreyFM.pdf

and eating disorders.
http://psycnet.apa.org/psycinfo/1999-05597-007 

Those of us needing basic stress-relief can use it, too. 
http://newsinhealth.nih.gov/issue/Jan2012/Feature2  

The challenge remains for us to weave mindfulness exercises into our daily schedules, especially in the demanding hustle bustle of New York City life.


Who knew that taking a moment or two to scan one's body for tension and focus on breathing through it was so hard?
Gradually filling ones lungs with air would seem to be easy, except that our mind travels away from the task so quickly.
 "Did I remember to buy milk?
"This is boring!"
 "My foot itches."
"What did my boss mean by that?"

Staying in the "present" rather than reliving the past, obsessing about the future or judging ourselves and others can be an Olympian task.

I like to recommend the free downloads at Zencast.org to help you along the way.

Some favorites are:
Zencast 129: "Radical Acceptance" by psychologist, Tara Brach
Zencast 96: "Forgiveness" by Matt White Band
Zencast 67: "Being in the Moment" by Bodhipaksa
Zencast 254: "Basic Introduction to Meditation" by Gil Fronsdal

Let me know what you think of this valuable resource!

Until next, take very good care.

 

A Moving Story.....Change of Address!

 

Spring is here in full bloom and change is in the air!
 

I will be moving offices for the first time in 15 years. 

From today until May's end I will see clients at my existing office.
 

Effective June 1, 2012 my new office address will be:

303 West 13th Street, Suite 104  New York, NY 10014
 

It's a great space on the first floor of a three-story historic building just recently converted into offices. 

The building is right off 8th Avenue and easily accessible by car or public transportation.  There's good street parking as the location is in between Greenwich Village and the Meatpacking District.  The 7th Avenue and 8th Avenue subway trains run express to 14th Street Station while the L subway gets you across town.
 

My phone number will remain the same (212) 974-0005.

Change may have its challenges, but change is GOOD!