Originally published at PsychCentral.com Research shows there may be a link between COVID-19 and the symptoms of depression. Here’s why it happens. Whether you’ve lost a loved one to COVID-19, experienced financial difficulties, or had a hard time adjusting to all the changes, the pandemic likely impacted you in some way. If you feel like you’re living with depression resulting from all of this, you’re not alone. Between 2020 and 2021, diagnoses of anxiety and depressive disorders jumped from 36% to 41%, according to the Centers for Disease Control and Prevention (CDC). But are these symptoms of depression a result of external factors only, or is depression a residual effect of the disease? So far, the research is pointing toward both.

Mental health symptoms of COVID-19

Scientists are learning more about the new coronavirus every day. But, for now, there’s limited information about the long-term effects of COVID-19. But there’s some indication that there may be a link between the disease and symptoms of depression. One study suggested that the coronavirus indirectly creates blood clots, which can cause brain damage. Another study suggested that our body’s immune system could indirectly be injuring brain cells while fighting the virus. Indeed, increased inflammation in the body is linked to depression. The coronavirus’s effect on the brain increases the risk for mental health challenges. About 1 in 5 people will develop a mental health condition 14 to 90 days after being diagnosed with COVID-19. For 5.8% of patients, it will be their first one. Mental health symptoms that developed as a result of COVID-19 also seem to persist 6 months after recovery. There also appears to be a link between COVID-19 symptoms and common symptoms of depression. For example, the loss of taste and smell were associated with depressive and anxiety symptoms. More recent research is starting to link depression with COVID-induced headaches. For example, a study published this year found that people with COVID-19 were at a higher risk for depressive symptoms when they reported headaches. Depressive symptoms were also more likely among younger adults than older adults. Read the full article

Originally published at PsychCentral.com Many of us hesitate to say no to others. With mindful tips like these, saying no is an emotionally intelligent skill anyone can master — really! It’s just two letters, and yet saying no can feel really hard — even complicated. For many of us, saying no doesn’t just feel awkward. It feels wrong. So, whenever anyone asks you to do almost anything, you might blurt out, “Yes! Sure! Of course! Happy to!” But in reality, you may feel the opposite. Maybe you’d rather be doing about a thousand other things. Or maybe you’re OK with saying yes, but it’s not the best thing for your daily bandwidth or mental health. Here’s the good news: Saying no is a skill you can sharpen. The more you say no, the more natural it’ll feel. Here are several ways to build the skill of saying no in different situations — even if it feels like you’re doing it from the ground up.

Why saying no feels hard

For starters, it’s important to realize that if saying no is challenging for you, you’re not alone. As social psychologist Dr. Vanessa K. Bohns writes in a 2016 research review examining people’s influence over others, “Many people agree to things — even things they would prefer not to do — simply to avoid the considerable discomfort of saying ‘no.’” For example, a series of small studies, published in 2014, found that when asked, many people would acquiesce and commit unethical acts, such as telling a white lie or vandalizing a book — even when they felt these acts were perceived as wrong. As social creatures who want to be part of the herd, we also want to preserve our relationships. So, we might blurt out yes because we don’t want to be seen as difficult, says Dr. Emily Anhalt, a clinical psychologist and co-founder of Coa, an online mental fitness club. Or, we don’t want to disappoint a good friend or hurt someone’s feelings, notes Dr. Nicole Washington, a board-certified psychiatrist and the chief medical officer of Elocin Psychiatric Services. Another reason yes pours out of us? Our past. According to Anhalt, while growing up, you might’ve not learned to advocate for yourself. “It’s also possible that you say yes because you deeply want to help. But you forget that your ability to accommodate others isn’t an endless well,” Anhalt says. In other cases — like a work situation — we might worry that saying no says something about our ability to accomplish a certain task, adds Washington. Put another way, we think declining makes us look incompetent.

Why saying no is a good — no, great — thing

When you struggle with saying no in personal or professional situations, it helps to remember the self-preservation in passing things up. “Saying no is one of the best forms of self-care we can engage in,” Washington says. She notes that saying no supports us in:

• creating space in our schedules to rest and recharge
• engaging in activities that actually align with our current goals
• setting boundaries with loved ones and colleagues

Ultimately, saying no gives us greater navigation over our lives, says Anhalt. This grants us the opportunity to build a fulfilling, meaningful life on our own terms. After all, we can only have power over ourselves — so, let’s exercise that power. Read the full article at PsychCentral.com

Originally published at PsychCentral.com Gaslighting can cause intense self-doubt, no matter who's doing it. How can you respond to this behavior? Gaslighting is a form of manipulation that can cause you to doubt your memory, opinions, and even your sanity. It's a tactic some people use to gain power and control over others. Romantic relationships aren't the only situations where gaslighting can occur. It can also happen:

• in a parent-child relationship
• in the workplace
• between family members

On a larger scale, political and authoritative figures have been known to gaslight entire societies. Research suggests that gaslighting behaviors can be rooted in gender and social inequalities. It tends to be common in intimate relationships where there's a power imbalance. It often happens gradually, as well. So you might not realize you're dealing with gaslighting until you begin to wonder why you're experiencing so much confusion, anxiety, and low self-esteem. If you've been experiencing gaslighting for a while, you might start to feel depressed, helpless, and indecisive as a result of the manipulation. One thing to remember in this cloud of confusion is that gaslighting is a form of psychological abuse — if you've experienced gaslighting, it's not your fault. And you're not the only one. Data from the Centers for Disease Control and Prevention (CDC) Trusted Source suggest that more than 43 million women and 38 million men in the United States have experienced some type of psychological abuse or aggression by an intimate partner. But how can you tell if someone is gaslighting you, and is there a way to confront it?

Read the full article

Article by Rena Goldman and originally posted at PsychCentral.com 

A reminder that you don’t have to put up with toxic behavior, even from your mother.

When your childhood wasn’t exactly ideal, Mother’s Day can bring on some complex emotions. Each year, there’s an endless barrage of ads, gift roundup articles, and sappy social media posts. If, like me, you have a complicated or nonexistent relationship with your mother, seeing representations of how American society views mothers can bring feelings of deep sadness and even rage. You might be left wondering why you drew the short straw when it comes to mothers. I’ve had no contact with my mother for over 15 years now, so there’s been a lot of time to process. Honestly, I don’t think much about Mother’s Day at all because I view it as something that doesn’t pertain to me — sort of like Christmas when you’re raised Jewish. It wasn’t always this way. There were definitely years where the mention of Mother’s Day brought anger, jealousy, shame, and feelings of inadequacy. Reading, processing, talking with other unloved daughters, and practicing different types of self-care have helped me get to where I am today. Here are my tips for tackling Mother’s Day as an unloved daughter. Read the full article

We've all heard the saying that familiarity breeds contempt; it's sure not something we'd like to apply to our marriage and relationships. However, my guess is you've never been in a pandemic with your partner before.  Staying at home, living together, working together, day and night, with most likely tons of fear and uncertainty as the sky has been falling. What do we do when we feel irritated and triggered by our partner as we traverse these unknown times? As my couples will tell you, one of the things I'm big on is getting couples to a place of zero tolerance for expressing irritation with each other.  Read the full article at imagorelationshipswork.com »

Re-posted from an article by Jeannie Ingram, LPC-MHSP Valentine's Day just passed and love is in the air. Not for everyone, unfortunately. As a therapist, I'm often needed when love is no longer in the air. A heart has been broken, and love has turned cruel. Or the pain of loneliness has become unbearable. Only occasionally do people seek therapy when love is blooming like the daffodils. But take heart. Like the words in so many songs, love is indeed the answer; it always has been, and always will be. It's the question that needs examining, that question being, "who do you love"?

Love Yourself First

People often give their love to another before they've ever truly explored what it means to love themselves, and this can be a setup for problems in the relationship. Why? Because until you truly deem yourself worthy of love, you may sabotage the love of another, finding it difficult to trust. It's like building a mansion on quicksand. It may be beautiful at first, but after a short time, it will likely disappear. To experience a sustained, loving relationship with another, you must have a sustained, loving relationship with yourself to receive love with an open and undefended heart. I am not talking about narcissism, which is an ego-inflated sense of self-importance. I'm referring to a healthy and loving understanding of self and truly knowing that your value is at least that of others. All of us have equal value. Believe it or not, many people struggle with this. For some, it's due to leftover childhood shame or negative messages that program us into thinking something is wrong with us or that we're not worthy of love. Again, if we didn't get it as children, it's hard to trust when it tries to come into our adult life.

Love is a Verb

Love is about action. Love is about caring behaviors. Many people believe love is a feeling, and it certainly can be. Still, that feeling is ultimately the result of how we demonstrate our love in both giving and receiving. To expect the feeling of love without actively nurturing it through everyday actions is like expecting fruit from a non-existent tree. If we want to grow the fruit of love, we must first take the action steps of planting and nurturing the tree. Then we can expect the fruit or the feeling of love to blossom.

Tips to Grow the Love Tree

• Find ways to express your love, and don't be confused by advertising messages. 
• Spending money to show your love is unnecessary. 
• Showing love through your language, thoughtful, caring behaviors, and realistic expectations. 
• Replacing demands with requests and appreciations allow the flow of love.
• Refrain from language that criticizes, condemns, disparages, and shames. It will create misery, not love. Instead, reframe into expressions of desire, encouragement, and gratitude.
• Try seeing mistakes as opportunities for redemption and forgiveness rather than punishment.
• Try seeing yourself as a human being who, like everyone else, is searching and worthy. 
• Practice random acts of kindness toward yourself, as well as toward strangers.

This is the way we should all be treated, and no one, not even you — should be an exception. Because, like being in love, it sets you up for inner peace, success, and joy in life. Who doesn't want that?  When you have love and peace toward yourself, you're much more likely to attract and maintain genuine love with another person. So this Valentine's Day, may I suggest that you give yourself the gift of love. Begin by looking in the mirror and seeing the person who most deserves it. And love that person with your whole heart and your actions. Love is, after all, the answer.

Infidelity is a major issue these days. I thought that you might find these statistics interesting.

Re-posted from an article by Deborah Fox, M.S.W. How to manage difficult emotions may seem counterintuitive to many people. We humans don't like to be uncomfortable or in emotional pain. How many times have you been told or tell yourself the following:

• "buck up."
• "don't wallow."
• "move on." 
• "don't feel sorry for yourself."
• "think of how many others have it worse than you."

Plenty, I'm sure. The conventional wisdom of our culture is full of "think positive thoughts." The problem is that this wisdom doesn't chart the path we need to follow to that end. The answer to managing difficult feelings, we have to feel them before moving on and regaining our optimism and good cheer. This isn't easy. What may become common parlance, "oh, it's a total 2020," meaning a downer, things couldn't get much worse, is indicative of what many of you are experiencing. We are still in the middle of an uncontrolled pandemic, climate change, and political conflict. How can you not feel sad, or worry, or despair some days? Maybe your distress isn't about current times. Perhaps you struggle with a host of other uncomfortable feelings such as feeling unimportant, insecure, or anxious on an ongoing basis. For many people, the stress of what's going on in the world now exacerbates those feelings.

Managing Positive and Negative Feelings.

Our emotional system is not designed to feel positive feelings only and remove negative ones. That would be nice, but it just isn't so. To find our joy in simple pleasures and with those we're most connected to, we also have to feel our way through the tough ones. The key is to build your tolerance for feeling these difficult feelings and turn towards each other for connection and support. We are social creatures, and we need each other to go through the middle of turmoil to come out the other side.  Tuning into these difficult feelings will inevitably make you feel more vulnerable simply because you will not push the discomfort away. This is a challenge because feeling more vulnerable is uncomfortable, too. However, it's in that state of vulnerability that you can truly connect with another human being. You'll feel less alone, and you can walk through these uncertain times together, rather than just coping in separate silos.  There are moments--- milliseconds that you can grab before they slip away. These are the moments when you can identify that you're feeling down, worried, or despairing. When you're trying to "move on" or distract yourself, you'll find yourself feeling more and more blah or irritable---the perfect hiding places for vulnerable feelings. If you succeed in identifying that you're feeling sad or anxious at the moment, sit there with it. "Sitting with it" means naming it, feeling it, and not allowing yourself to prematurely make it go away by distracting yourself or starting an argument with a loved one. You will feel uncomfortable and vulnerable--- take a deep breath and stay there in that feeling. This sitting with the uncomfortable feeling allows you to know what affects you that you lose touch with when you shut down on the feelings.

Uncomfortable Feelings Have a Lifespan. 

It might be five minutes or five hours, and it may come and go. It's sitting with the feelings that allow you to build your tolerance for feeling vulnerable. You build it slowly, bit by bit. The more tolerance you have, then you can allow its life span to run its course. If you distract yourself by grabbing your phone or turning on the TV, it'll just go underground and lie in wait to ruin your mood for days on end.  Sitting with the feeling allows you to express, usually in a way your partner, or a close friend, can hear and empathize. Their ears open when they listen to you speak from that place of vulnerability. Feeling this connection is what can most alleviate the intensity of the discomfort. It won't make the pandemic uncertainties or anything else go away, but it can allow you to feel less alone. Feeling less alone goes a long way to walking through any crisis feeling stronger. Shutting down or arguing happens so easily because it's a momentary relief from the discomfort. The energy of arguing or the numbness of withdrawing doesn't feel great either, but it can be preferable to feeling vulnerable.  If you're already angry or withdrawn, ask yourself, "what else am I feeling, or what was I feeling earlier?" Maybe not immediately, but this question will allow you to pinpoint what feelings are hiding just below the surface. You know you're irritated, but you might be able to identify that you were anxious before you got annoyed. Then you can choose to sit with the anxiety.

Difficult Feelings are a Normal Part of Life. 

This is always true, but these uncertain times are causing tremendous turmoil and challenging our usual coping ways. What's critical is not to allow these feelings to overwhelm us. We're outside of our comfort zone, and we need to grow that zone to go forward and be able to grapple with what comes our way. We can't do it alone. Turning towards one another will serve us well and allow us to come out the other side to experience joyful moments amidst uncertainty.

Originally posted by Sharon Martin, LCSW Any long-standing pattern of behavior can be hard to change. We’re creatures of habit and tend to repeat the same behaviors over and over, often without even thinking about them — and sometimes we continue even when these behaviors create problems for us. This is the case with codependent behaviors.

What are codependent behaviors?

When I talk about codependent behaviors, I’m referring to things like enabling, perfectionism, self-sacrificing or martyrdom, obsessing about other people’s problems, trying to fix, change, or rescue others – even if they don’t seem very interested in changing. As codependents, we struggle to ask for help, we don’t prioritize our needs (so we get tired, irritable, resentful, and stressed out).

How do you change codependent behaviors?

Even though these behaviors are second-nature to us, we can change! The challenge, of course, is figuring out how to change. What do we do instead of these codependent behaviors? And how do we stick with the new behaviors long enough to see a difference? The answer is lots of practice and lots of self-compassion. Like any new behavior, we need to do the new behavior many times before we master it and feel comfortable doing it. At first, it will feel awkward, scary, guilt-ridden, and uncomfortable. In short, you’re not going to do it well! That’s where the self-compassion comes in. Give yourself credit for trying. Praise yourself for taking baby steps even if they don’t seem to accomplish much at first. Encourage yourself by saying things like, “You can do this!” Don’t expect perfection and try not to criticize yourself if you slide back into old behavior. This is all part of the process – I promise. So, let’s get started with some ideas for changing codependent behaviors.

People-pleasing

Instead of saying yes to every request, doing things you don’t want to do, or doing things out of obligation, consider what you need and want. Ask yourself:

• Am I interested in doing this?
• Why am I saying yes?
• Do I have time for this?
• Can I afford to do this?
• Does this align with my values and priorities?

Remind yourself that you’re allowed to say no. Some people may be disappointed or upset with you, but that is their problem, not yours. You are not responsible for making everyone happy. Action: This week, practice saying no to one thing that you don’t want to do, that doesn’t fit in your schedule or budget or doesn’t interest you, etc.

Acting like a martyr

A martyr is someone who insists on doing everything themself. You refuse help if it’s offered. But you’re not doing or giving joyfully. You’re resentful that you have to do so much and that people don’t help you or think about what you need. Action: The next time someone offers to help, say yes. Or if no one offers to help in the next week, ask. Simply say, “Can you please help me with _______?” They may refuse, but learning how to ask is still a success.

Lack of boundaries or being passive

Instead of letting others mistreat you (say mean things, borrow money without repaying, leaving a mess and expecting you to clean it up, violating your boundaries), set limits by telling people what’s not okay and what will happen if they continue. Action: When you feel mistreated, communicate how you feel and what you want or need using an I Statement. For example, “I feel hurt and offended when you make sarcastic comments about my weight. I’d like you to stop commenting on my appearance.” And if you think it’s helpful, you can also state what the consequence will be if they continue. It might sound like this: “And if you continue, I’m going to go in the other room and watch TV by myself.” When setting boundaries, remember that you can’t force other people to do what you want, but you can change your own behavior to keep yourself safe.

Enabling and fixating on other people’s problems

Enabling is something you do that allows another person to continue in a dysfunctional pattern. It could be pouring out their alcohol, calling in sick for them, cleaning up after them, giving them money. It can seem loving, but it really just allows them to avoid taking responsibility for themselves and from experiencing the natural consequences of their choices. Instead of enabling and focusing on what others are doing, take care of yourself and find healthier ways to manage your worry and anxiety. Often, we focus on other people not just to be helpful, but also because it gives us a sense of control (which helps us feel safe and quiets our anxiety), a feeling of being needed, or a distraction from looking at what we’re contributing to the problem and changing ourselves. Action: Identify your enabling behaviors. When you feel compelled to act on them, step away from the situation. Notice your feelings (see above) and think of an activity that you can do to comfort yourself, calm your fears, and tolerate the anxiety of letting your loved one experience the consequences of his or her actions. This could be calling a friend or sponsor, writing in a journal, taking a bath, exercising, meditating, praying, going to an Al-Anon or Codependents Anonymous meeting, playing with your dog, etc. Make a list of activities that you might try, so you have it ready when you need it! I hope you’ll try some of these action items this week!

Originally posted at Beacon Lens The holidays are upon us, and the irony they bring is the potential for isolation and loneliness. Holidays’ essential identity is getting together with loved ones, but some people do not feel as connected as they would like or expect. In 2020, add COVID-19 and its quarantining dictates, and the potential for such feelings can strengthen. The holidays, therefore, present an excellent time to discuss how we can reinforce connections during a time that requires us to be apart to protect our physical health, a requirement that paradoxically can have a damaging effect on our mental health. We can, however, take charge of improving our mental health.

Loneliness and isolation and our health

What is the difference between loneliness and isolation? “Loneliness is the feeling of being alone, regardless of the amount of social contact,” according to the Centers for Disease Control and Prevention (CDC). Social isolation, on the other hand, is a lack of social connections. Put differently, one can have many social connections but still feel lonely. The physical and mental health risks of loneliness and isolation are significant. They include but are not limited to:

• Social isolation increases the risk of premature death by 29 percent, rivalling smoking, obesity and physical inactivity.
• Social isolation is associated with increasing the risk for dementia by approximately 50 percent.
• Loneliness is connected to higher rates of depression, anxiety and suicide.

A 2020 report by the National Academies of Science, Engineering and Medicine (NASEM) states that more than one-third of adults 45 and older feel lonely, and approximately one-fourth 65 and older are socially isolated. Add the holidays and COVID-19 to an already preexisting condition, and the time is ripe for all of us to take action to protect our mental health.

Simple steps for better mental health during the holidays

Specific to the season and the times, there are common-sense tips that we all can practice to help manage loneliness. For example:

• Talk to someone about your sense of loneliness and isolation. There’s stigma around loneliness so it can be hard to do. However, you may well find that you’re not alone in those feelings, and sharing them can help lessen their effect.
• Manage your holiday/COVID-19 expectations. The holidays can fall short of expectations, but this year it may be worse. Understand that the pandemic won’t last forever, and that we’re all in this together. Indeed, many people’s holiday gatherings will likely be different this year.
• Remember to take care of yourself, now more than ever. Sleep, exercise and good nutrition — with the proper amount of holiday indulgence — go a long way in addressing mental health.
• Avoid social media, such as Facebook or Instagram, especially during the holidays. It’s easy to negatively compare one’s life to the “perfect” lives posted on social media, forgetting that people mostly post only the positive.

Loneliness and isolation as its own pandemic

The holidays don’t last forever, and we will get through the COVID-19 pandemic. However, loneliness and social isolation may persist, which presents a challenge for behavioral health providers. The recent NASEM report explores interventions that the healthcare system can take to address loneliness as a societal condition, such as engagement in support groups, cognitive behavioral therapy and mindfulness, social determinants of health, social prescribing and more. Social prescribing is arguably one of the more interesting interventions in that it puts a clinical lens on non-clinical solutions. While there is no hard-fast definition of social prescribing, it is generally accepted as a way to connect people to non-clinical sources of support, according to the NASEM. Specifically, it is a “non-medical referral, or linking service, to help people identify their social needs and develop wellbeing action plans to promote, establish or reestablish integration and support in their communities, with the aim of improving personal wellbeing.” Examples of secondary services that improve social concerns affecting health include housing and food insecurity services. While known to varying community-based organizations, social prescribing is not common among practitioners, but it’s a common-sense solution. An analysis of one pilot program from the NASEM report — albeit a small one — found that social prescribing reduced inpatient admissions by as much as 21 percent and emergency room visits by 20 percent. A modern world — without COVID-19 — is more connected than ever due to social media and other technology. However, studies have shown we are more lonely now than in any other time in recent history. It’s time to think out of the box as we realize more and more how non-physiological conditions — such as issues ranging from a public health emergency to social media — can affect our health.