Doris Bersing, PhD
Blog

Depression: You Can Break Free From it

Sadness and depression

Copyright: kmiragaya

More than just a bout of the blues, depression is not a permanent personality trait or a character issue or a weakness, nor is it something that you can simply “snap out” of.

Clinicians at the Mayo Clinic state that “…Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depression, major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and depression may make you feel as if life isn’t worth living…depression may require long-term treatment. But don’t get discouraged. Most people with depression feel better with medication, psychological counseling or both…”

Struggling with depression requires action, but taking action when you’re depressed is hard. Even f you know you could do something to feel better, the fact of just thinking about the things you should do to feel better, requires a level of energy, often, you do not have. It’s the paradoxical side of fighting depression: The things that help us the most are the things that are the most difficult to do and overcoming depression is not something you do in the blink of an eye, it is difficult stuff but there’s a difference between something that’s difficult and something that’s impossible.

A recent article on WebMD states that “…many people think of depression as an intolerable sadness or a deep gloom that just won’t go away. Yet depression can also be sneaky, disguised in symptoms that can be hard to identify. If you’ve had unexplained aches or pains, often feel irritable or angry for no reason, or cry at the drop of a hat — you could be depressed.

Fortunately, you can be proactive with depression. Learn how these less obvious symptoms can reveal themselves and when you should seek out depression treatment…” Read More


Resilience: The Client as an Active Agent of Change

Copyright : johan2011

Copyright : johan2011

Accepting we clinicians are not as mighty power as we , sometimes, want to believe, and as much of a blow to our egos, it can be, there is a fact we need to recognize as such: human resilience and people’s self-healing powers count for positive outcomes after traumas and strenuous circumstances, equally effectively or more than proven therapeutic approaches.

A very respected and renowned colleague of mine, Dr. Arthur Bohart always reminded me and anybody who wanted to listen to his revolutionary opinions in regards to the effectiveness of some therapeutic approaches or the best personality traits for a successful clinician, that human beings are more resilient that what we want to account for and that the theory of some approaches being more effective than others are more of a myth than a fact since for Dr. Bohart” the “client acts as a self-healer” and human resilience counts for more of the positive outcomes in therapy. So, what is the clinician’s role? In a way, we therapists are a catalyst or better said a witness to the self-healing process. A guide to educate and share the process with the client. In an article published in the Journal of Psychotherapy Integration, Vol. 10, No. 2, 2000, he describes the dominant “medical” or “treatment” model of psychotherapy and how it puts the client in the position of a “dependent variable” who is operated on by supposedly potent therapeutic techniques. Next I argue that the data do not fit with this model. An alternative model is that the client is the most important common factor and that it is clients’ self-healing capacities which make therapy work…” Read his article

The same concept works with the forgotten population, the older adults and elders. Resilience and aging: it’s a favorite theme of gero-psychiatrist Helen Lavretsy, MD, MS. It’s the subject of her new book, Resilience and Aging: Research and Practice and the theme of a symposium at the APA Annual Meeting in New York City. In a recent podcast, she talks briefly about interventions that can help bolster resilience and help older people recover quickly from adversity. Listen to her podcast

 

Resilience and aging: it’s a favorite theme of geropsychiatrist Helen Lavretsy, MD, MS. It’s the subject of her new book, Resilience and Aging: Research and Practice and the theme of a symposium at the APA Annual Meeting in New York City.Here, she talks briefly about interventions that can help bolster resilience and help older people recover quickly from adversity. – See more at: http://www.psychiatrictimes.com/apa2014/strategies-bolstering-resilience-older-adults#sthash.LuOVSHfT.dpuf
Resilience and aging: it’s a favorite theme of geropsychiatrist Helen Lavretsy, MD, MS. It’s the subject of her new book, Resilience and Aging: Research and Practice and the theme of a symposium at the APA Annual Meeting in New York City.Here, she talks briefly about interventions that can help bolster resilience and help older people recover quickly from adversity. – See more at: http://www.psychiatrictimes.com/apa2014/strategies-bolstering-resilience-older-adults#sthash.IleQ1IGr.dpuf


Depression: A Terrible Truth and a Tale of Courage

Copyright : iqoncept

Copyright : iqoncept

When you read the statistics on the mental health phenomena, they will tell you that mental health is extremely prevalent in the adult population. An estimated 44.3 million American adults experience a diagnosable mental disorder each year. Approximately 18.8 million adults have a depressive disorder and over 19 million adults suffer from anxiety disorders. Millions of other people are dealing with bipolar disorder, schizophrenia, eating disorders, substance abuse and other mental health problems. Mental illnesses can cause a person to have major difficulty functioning at their job, as a parent and in all areas of their lives. It is imperative for adults to be aware of their mental health and the mental health of their loved ones.

From these numbers, it seems like having a mental illness is an issue that everybody portraits, a norm, thus if it is so common, what that really means? perhaps that the abnormal is becoming normal? That the system is screwing us all? or that the paradigm should shift from diagnosing to preventing, re-vamping? Healing? Is it as the allergies in California,  something you develop sooner or later once you have landed here? Is it, really, that prevalent or we are misusing and/or abusing diagnoses?

When abusing or misusing diagnoses we are increasing the stigma that is already linked to mental illness. There is the sense of general stigma  from being different, weaker, suffering from depression, being a loser, having low self-esteem, ADD, not completing tasks, having anxiety or panic attacks, or to that matter any mental disorder found in the voluminous DSM V.

Once diagnosed or complaining about having a mental “issue”, well intentioned people would look at you and say things, like: I too have been sad but if you work hard, you’ll get out of it…well sometimes, you do not; or they will suggest you just try to lead a healthy and balance life, find your purpose, your meaning in life, follow your passion…Really? Some people cannot even get up and go, none the less find a passion to keep going. The stigma and the paralysis to act hits you really hard.

Having mental illness depicted in a negative side and represented in the media inaccurately and giving hurtful representations of its causes and consequences increase the stigma and discourage people suffering to seek help. NAMI StigmaBusters  is a network of dedicated advocates across the country and around the world that seek to fight misleading representations of mental illness. Whether these images are found in TV, film, print, or other media, StigmaBusters speak out and challenge stereotypes. They seek to educate society about the reality of mental illness and the courageous struggles faced by consumers and families every day. Their goal is to break down the barriers of ignorance, prejudice, or unfair discrimination by promoting education, understanding, and respect.Each month, close to 20,000 advocates receive a NAMI StigmaBusters Alert, and it is read by countless others around the world online.

In a candid tale of her own depression, Dr. Elizabeth J. Griffin, MD, a pediatrician tells of her 40-year battle with severe depression, and the stigmatization she fell under. She says “Depression is overwhelming and overpowering, and it crushes its prey…’ Severely depressed persons grow convinced beyond any doubt whatsoever that our families would be better off if we were dead. We believe that only by suicide can we help them salvage whatever remnants of their lives we have not already destroyed, even if we actually have done nothing that would hurt them or anyone else….’ I believed that everyone felt and thought this way to some extent. I once explained some of this to one friend, a compassionate and extremely intelligent physician. He looked at me in amazement and said, “You do know, don’t you, how completely foreign everything you just said is to me?” In fact, learning just that was a real eye-opener for me, “a light-bulb moment.” Read her story  Dr. Griffin has very interesting points to guide people in the process of “how to talk about depression:

  • “…People with depression need someone to speak up when we cannot, especially to explain our illness to our loved ones. Most of us are too frightened and ashamed to talk about it. Unless we learn how to be open about depression, the stigma will remain, and people who need treatment will continue to avoid seeking it.
  • If you have depression, tell someone you can trust and seek professional help. It is available—and it can help. Depression does not have to last forever; you really can get better with time and treatment…’
  • If someone you care about is depressed, tell him you do care, that you love him, and that you want to understand and help. Tell her how important she is to you and what you admire about her. Tell him you want him and need him in your life, and that things will get better. Ask her to hang on until they do. Beg him to promise that he won’t do anything to hurt himself, that he will not commit suicide…’
  • You may save the life of someone you love….”

As mental health providers, we are supposed to be the catalysts of personal growth, soul search, and redemption, we should never give up, labeling, or cast out people who are going through the dark night of the soul, redeeming one person is redeeming the world. Actually, this represents the traditional Jewish principle of Tikkun Olam that is the precept of the Jewish ethical principle that every person is worth saving. The Jewish path of walking through life, is a path of healing. Tikkun olam, the repair of the world, is a macrocosm of the tikkun atzmi, the inner process of healing. Healing, by definition, is the attempt to bring balance to both the inner and external healing processes and that, instead of labeling and pathologizing our clients, should be the role of the clinician. But more about Tikkun Olam in my next post. For now, let’s be a container for those who suffer from depression without judgement or biases, but with the right intervention,  a listening ear, and a compassionate heart.

How to talk about depression
o People with depression need someone to speak up when we cannot, especially to explain our illness to our loved ones. Most of us are too frightened and ashamed to talk about it. Unless we learn how to be open about depression, the stigma will remain, and people who need treatment will continue to avoid seeking it.

o If you have depression, tell someone you can trust and seek professional help. It is available—and it can help. Depression does not have to last forever; you really can get better with time and treatment.

o If someone you care about is depressed, tell him you do care, that you love him, and that you want to understand and help. Tell her how important she is to you and what you admire about her. Tell him you want him and need him in your life, and that things will get better. Ask her to hang on until they do. Beg him to promise that he won’t do anything to hurt himself, that he will not commit suicide.

You may save the life of someone you love.

– See more at: http://www.psychiatrictimes.com/suicide/what-depression-does-our-minds-when-it-attacks/page/0/2?GUID=&rememberme=1&ts=22072014#sthash.buAhOPkF.dpuf


Alternative Therapies for Mental Illness

Copyright : chachar

Copyright : chachar

Searching for more information about how much or how little the public look for alternative therapies when suffering from mental illness and distress, I found an article titled Surprising Alternative Treatments for Mental Disorders. The article claims what I suspected “…The use of alternative treatments for mental illness is growing in popularity due to concern over the side effects of some medications and a general mistrust for pharmaceutical companies. Let’s look at some of the natural ways people are treating disorders like depression, anxiety and schizophrenia.

9.6 million Adults (18+) in the U.S. with a serious mental illness; 52.6% of those with a serious mental illness who used prescription pills to treat their condition in the past year; 36.2 million of Americans who paid for mental health care services in the span of a year.

While a combination of medicine and therapy can help many individuals suffering from a mental illness, some people are seeking other methods of treatment. What options are out there? This article explains how the so called alternative therapies “medicine douce” like Acupuncture, Hypnosis, Ayurveda, Homeopathy, Bio-feedback, Reflexology, Yoga, nutrition and nutritional supplements can help. Actually $34 billion are spent per year in the U.S. on alternative medicine for general use.

Read More


Chemical Imbalance and Mental Issues: An Oversimplification?

17800976_sIn Psychology and Psychiatry, there are theories of brain malfunctioning and chemical imbalance to explain the presence of symptoms or alterations we would call mental illness, too easily.  Nonetheless, beware, neurochemistry, neurophysiology, chemical imbalances, neurotransmitters have being all explanations that had tried to become the panacea that would help us understand what is inextricable and simplify the grasp of it. The most fatal blow to this “brain disease” model has been dealt by the inability of the research to validate the brain disease hypothesis. The most severe mental disorders such as schizophrenia, bipolar disorder, and major depression have been the primary targets of attempts to validate the medical model of mental suffering. Billions of dollars and thousands of research studies have gone into exactly this quest, and yet, according to a large number of highly experienced researchers, scholars and clinicians none of it is substantial. Many claim, in fact, that because the disease model continues to be unsupported in spite of the enormous amount of research that has been conducted in an attempt to validate it, the implications point strongly in the opposite direction—that these types of mental disorders are not caused by a disease of the brain.

Moreover, some doctors believe that they will help the patient feel less blameworthy by telling them,  Dr. Ronald Pies, MD wrote “You have a chemical imbalance causing your problem.” It’s easy to think you are doing the patient a favor by providing this kind of “explanation”, but often, this isn’t the case. Most of the time, the doctor knows that the “chemical balance” business is a vast oversimplification…(Read Dr. Pies’ article)

Could we say, what was first? the chemical imbalance, the symptoms, the wounds, the disease? Cd not this be a minimization of a bigger reality. What’s next? It seems that the only way to deal with this tragic dilemma is to ironically create genuine brain disease (through brain-damaging drugs, electroshock therapy, and/or other similarly harmful means) in an attempt to “deaden” you to your unbearable suffering. What came first? The egg or the chicken?


Time To Heal: What Psychotherapy to Use?

Psychotherpay: Finding Nemo!

Copyright Teerayut Yukuntapornpong

Many patients or clients often ask what is the difference between different approaches of psychotherapy and although much has been written about, there’s no simple answer. Just as people respond differently to different drugs, you might do better with one type of therapy than with another. Many people find that a blended approach — one that draws on elements of different schools of psychotherapy — suits them best. There are many forms of psychotherapy, but some of the most popular forms are psycho-dynamic therapy, cognitive behavioral therapy, humanistic, and couples therapy, which in reality can be based on any other theoretical approach but emphasizing systems oriented therapy.

Although embracing a particular approach of psychotherapy, as a clinician, has to do with your philosophical values and your concepts of health and human potential, knowledge of what can work better or not with your clients is needed. Remember it is not about what you want or like but what could be more efficient and meaningful to your clients.

Cognitive-behavioral therapy (CBT)

CBT helps you identify self-defeating thoughts and start to develop behaviors that are more constructive. And unlike, psycho-dynamic approaches you do not need to explore into issues of the past. CBT is about what happens in your mind, now and how it affects your behavior.

Psychodynamic therapy

In contrast to CBT, which focuses on conscious thoughts, psycho-dynamic therapy emphasizes feelings that are often beneath the surface yet still influence your behavior. The goal: to help you recognize how old, unresolved problems shape the way you operate today. The therapist will guide you to recognize the links between past and present so you can become more self-aware to avoid same patterns or connections. For a comparison between psycho-dynaminc and behavioral therapy click here The Huffingon Post gave it a try as well (Read more)  And my colleague Peter Strisik, Ph.D from Alaska did a more extensive job (Read his take on it). In my own practice, I called myself a humanistic-existential psychotherapist, practicing frequently the tenants of Gestalt Therapy. Of course, at this point, they seem confused and ready to run away from something so esoteric and unpractical. Yes indeed, perhaps the big difference is we do not focus on the past but on what happens in the here and now.

Humanistic therapy

This approach establishes you as the main tool in therapy, your own healer with the potential to achieve your ultimate goals. Human resilience and self-healing are at the core of this approach. The process helps unfold your self-healing potential, stimulates creativity, and promotes personal growth.

A very simplistic way to explain it is that the existential approach in psychotherapy is organized around life on earth itself and the social, cultural and spiritual ramifications of it, that is, the “human condition.” People’s existential issues are related to their mortality and impermanence, their experience of freedom of choice (or lack of it), their sense of worthiness, and their sense of separation/connection with others. We review the contributions of Kierkegaard, Nietzsche, Heidegger, Sartre, Bugental, Binswanger, Fromm, Laing, Sullivan, May, Frankl, and Yalom. We identify five themes that pervade existentialism:

  1. Meaning in life is found in the living of each moment;
  2. Passionate commitment to a way of life, to one’s purpose and one’s relationships, is the highest form of expression of one’s humanity;
  3. All human beings have freedom of choice and responsibility for our choices
  4. Openness to experience allows for the greatest possible expansion of personal expression; and
  5. In the ever-present face of death itself, we find the deepest commitment to life itself.

We also address the relationship between experiential psychotherapy, the existential approach, and Heart-Centered therapies. Needless to say that there is not a system that can really explain the complexity to f the human phenomena and of course, there is not a system that alone can give you a quick fix or a cure. The solution is in the phenomenological understanding of the situation and of the human being involved, the comprehensive analysis of the situational elements, and of the comprehensive concept of care -versus cure- that we clinicians take into account to provide the bio-psycho-social-spiritual dimensions of care.

Nonetheless, there is enough research about the patient/client being the best agent of change and the personality of the therapist being more important than the “approach” itself. Interesting, isn’t.

You can always try to do some research when trying to find the right therapist for you but let’s say that is you are ready and the therapist has enough empathy and active listening, compassion, and of course knowledge, you will be safe independently of the “approach” she/he uses.

Good Luck and do it, it is worth it… Go find Nemo!


Top