by Andrew Neufeld | May 3, 2018 | Anxiety, Depression, Mental Health Disorder
Anxiety and Depression account for the majority of mental health diagnoses in Canada. At any given time, at least 11.6% of Canadians aged 18 and over are dealing with a mood or anxiety disorder based on a survey in 2013. My experience suggests that this number is low, both because the statistics are now 5 years old, and because it’s based on self-report and we know that many people don’t report their struggles even when asked on anonymous surveys. One of the common questions we get here at Alongside You is how to support a friend or family member who is struggling with depression. In fact, we were asked again yesterday and that’s what instigated this article.
If you run a Google search on the subject, there are many articles on this topic, such as this one from the Mayo Clinic, or this one from HereToHelp. There are many great resources out there with many suggestions around educating yourself on depression, helping friends get exercise and eat healthy food, and similar tactics. These are all great suggestions and ideas and I encourage you to spend some time looking through the articles that are available.
In this piece, I want to take a slightly different road and look at how we can help a friend, family member, or other loved one who is struggling with depression in terms of how we need to be with them. This might sound a little strange because many of us (myself included) are practical, hands-on types who like practical strategies. The thing is, being who we need to be with people is a practical strategy, and it is very effective.
The Importance of Not Knowing
When we’re struggling with something, and certainly when that something is depression, we often feel misunderstood. We say things like, “They just don’t get it,” or, “Nobody understands how I feel,” and quite frankly, it’s usually true. Even for those of us who have struggled with depression in our lifetime, the experience of someone else may be very different. How it felt for us and how we responded may not line up with this person’s experience. If we assume we know how the other person is feeling, we run the risk of alienating them and making them feel even less understood than they already do.
So, our first job then is to listen and to listen to understand versus listening to respond. Often, especially when we’re under stress, we do the latter; we listen and feel the need to respond in the hope that it will help someone feel better or feel connected. Often, we’ll respond with something along the lines of, “Oh yeah, I totally know how you feel, I went through the exact same thing!” No, we didn’t. We may have been depressed, we even may have been through similar circumstances and reacted similarly, but we don’t know how they are feeling unless we ask and listen, and we most certainly didn’t go through the exact same thing. If we want to be helpful and fight against the alienation and isolation our loved one is likely experiencing, we need to listen to understand.
The Importance of Empathy
One of the greatest challenges we face in trying to support a loved one with depression is the fact that we don’t understand. In fact, this very thing often places a great deal of stress on us because we want to understand, we feel we need to understand. The fact of the matter is, we don’t need to understand to be helpful. If we build on this stance of not knowing, we can work toward understanding on a deeper level, understanding the emotional level, and by strengthening the connection between us. This, in a nutshell, is empathy.
Empathy is not our naturally occurring, number one go to strategy – our go-to natural strategy is usually sympathy. If you haven’t seen it already, I would encourage you to watch this short video of Brené Brown talking about the difference. When people are depressed, one of the most significant things that help is the connection with others. This is why empathy is so important – we can show empathy without understanding yet. It can be as simple as saying, “Wow, I don’t even know what to say right now but I’m glad you told me, and I’m here.” And yes, I totally stole that line from Brené Brown. I stole it because it’s that good. See, if we can admit our limitations and be vulnerable with our loved one that is struggling, not only do we encourage connection, but we model the vulnerability that they need in order to connect with us. If they can do this in return, it will directly combat those voices in their heads telling them that nobody cares, nobody listens, nobody understands, and they are not good enough.
Seeking Help
If we can do the two things above, we stand a greater chance of success in this third thing I’m going to talk about: getting help. Most of us are proud people – we think we can do it all on our own and further, we think we should. I remember when I was dealing with major depression I thought it was because I was doing something wrong, that I just wasn’t working hard enough, and that I was a failure. Part of the reason that I believed this is because to my knowledge at the time, nobody I knew, and none of my family had ever struggled with depression, and certainly not the suicidal thoughts that were commonplace for me. This is where vulnerability and even some self-disclosure on our part can be helpful, particularly if we’ve struggled with depression ourselves. Some careful self-disclosure can normalize the struggle, and fight against the negative self-beliefs.
If we can listen to understand, and show empathy, we send the message to the one struggling that it’s ok that they’re struggling, it’s ok that they don’t have it all figured out, and it’s okay to ask for help. Now, when I say it’s ok I don’t mean it’s pleasant, or that we should like being depressed, or anything along these lines. What I mean is that it’s not because of some inherent flaw in who they are that they are struggling, and it certainly isn’t because they’re not worth it.
See, by spending time listening and understanding, spending time in empathy and connection, we are sending a strong message. That message is, “You’re worth it.” In my opinion, this is the single most important message for anyone to receive when they are dealing with depression because if their belief about themselves is that they aren’t worth it, then why would they tell anyone how they feel? Why would they open up to someone? Finally, why would they bother asking for help, because they don’t deserve it?
If we can help our loved ones come to a place of even beginning to understand that they are worth it, they are loved, and they are valuable then we stand a much better chance of succeeding at getting them the help they need. This is where we can again show vulnerability and explain that we love them, but we don’t possess the skills necessary to help them recover fully, the skills that a mental health professional does. This is also where we can reinforce that we’d like to help them get the help they need and that we will be there alongside them as they go through this. In fact, we can emphasize that we will go through this together with them.
How We Are With People Is Most Important
The reality is that helping a loved one who is struggling with depression is usually a start and stop, back and forth, messy process. Most of the time, emphasizing the practical strategies doesn’t work very well. Why is this? Because we don’t have the connection needed where the person will believe they are worth it, that they are loveable, and that recovery is possible. If we can be with the person on a deeper, empathic level, we give them the best chance possible to buy into the recovery process and we show them that they’re not alone.
If you’re reading this because you have a loved one struggling, or because you are that loved one struggling, I encourage you to take the first step toward recovery. If we can be of help to you, please don’t hesitate to ask. This is why Alongside You exists – because we believe that everyone is worth it. Feel free to contact us!
by Share Forde | Apr 26, 2018 | Anxiety, Depression, Dialectical Behaviour Therapy, Mindfulness Meditation, Therapeutic Yoga
“You are richer than you think.” This is the current slogan being used by Scotiabank. When I hear this slogan, I think of the clients who are participating in the various DBT groups here at Alongside You. DBT is the short form of Dialectical Behavioural Therapy, created by Dr. Marsha Linehan, who is a psychologist working at the University of Washington in Seattle. This treatment is the gold standard for clients struggling with unstable identity, risky behaviours, chaotic relationships and an inability to regulate emotions and urges. The DBT skills taught in our groups focus on Distress Tolerance and Crisis Management, Interpersonal Effectiveness, Emotion Regulation and Mindfulness. There has been much research supporting this form of therapy that it is now also designated as the gold standard for Borderline Personality Disorder. The skills are also very helpful for clients trying to manage depression, anxiety and substance misuse.
In addition to skill building, learning and participating in a group format has many other benefits. I have facilitated groups of various kinds for 40 years and have been witness to so much growth in so many clients that I can say with confidence that a group experience is a very rich one. Dr. Irwin Yalom describes in his book, The Theory and Practice of Group Psychotherapy that the following factors occur when participating in group therapy:
- Instillation of Hope
- Universality
- Imparting of Information
- Altruism
- Corrective recapitulation of the primary family group.
- Development of socializing techniques
- Imitative behaviour
- Interpersonal learning
- Group cohesiveness
- Catharsis
- Existential factors
Dr. Roy Mackenzie in his book, Time-Managed Group Psychotherapy, identifies learning factors such as
- Modelling
- Vicarious learning
- Guidance
- Education
- Support
- Self-revelation and Insight
As the late famous American poet Maya Angelou says, “we are more alike than we are different.” Why then do we sometimes we feel that we are left behind while others live their life without strife? This is certainly how it may appear on the various social media sites. More and more I see young clients who spend hours daily checking up on friends on the various social media platforms on the internet. It seems to me that it would be much more healthy to call a friend and plan to do an activity together. If we parallel play as young adults we are not growing psychologically. Attending a group is a good start to get back in the game of communicating both verbally and nonverbally with other people. People need people as we are social beings by nature. A group is a microcosm of society in general. When clients feel supported in a genuine way they are likely to experience some or all of the healing factors mentioned above.
Another factor involved in a group setting is the undercurrent explained by the psychoanalyst, Wilfred Bion, in his book Experiences in Groups. Bion says that there are three basic assumptions working alongside any working group. These are mostly unconscious but are helpful for facilitators to consider if a group they are running is starting to struggle. The first basic assumption is the dependency and this happens when leaders are dialectically idealized and devalued. The second basic assumption is pairing in which two group members bond in an attempt to overthrow the leader. The third basic assumption is fight or flight, which happens when the group has a common enemy. It can be a taxing job to be teaching skills as well as observing the group process and the underlying basic assumptions all at the same time. Extra training on group skills is highly recommended when moving from individual therapist role to a group therapist role. I believe that this is one of the reasons our groups are so effective here at Alongside You. We work diligently to create the best atmosphere for people to learn and to grow.
Groups are a dynamic force and when change happens to the individual group members this impacts and creates a vibration which results in changes to the whole group. Systems theory suggests that groups over time tend to develop a self-organizing nature which works to maintain stability and minimize threats. Through this, clients can experience a safe space to explore their challenges and their successes, and learn from, and encourage each other.
My goal when I co-facilitate our Dialectical Behavioural Therapy group is to have clients leave after 24 weeks being even richer than they think they are, as they carry their new tools to help them achieve a “Life Worth Living.” Feel free to contact us to learn more about Dialectical Behavioural Therapy.
by Andrew Neufeld | Mar 15, 2018 | Anxiety, Neurofeedback
Anxiety is one of the most common mental health difficulties in Canada, and across the world. No doubt you’ve seen numerous articles on the subject, describing what anxiety is, why we suffer from it, and what to do about it. One of the questions I get asked quite frequently is whether neurofeedback can fix anxiety. It’s a great question, and here’s my answer!
Why Neurofeedback?
The premise of neurofeedback is that if we are stressed out, anxious, depressed, or are suffering from others negative symptoms, our brain is likely to be operating less than optimally. Neurofeedback is a tool that helps train the brain to adjust how it is operating so that it can function more optimally and efficiently. You might think of it as gym training for the brain. The fact that it is training is an important distinction – it is not a treatment for a specific symptom, it is a training that helps your brain optimize itself over time and learn how to do so for the long term.
What is Neurofeedback?
You may never have heard of neurofeedback before, so here’s a quick primer on dynamical neurofeedback, which is the main type of neurofeedback we do here at Alongside You. Dynamical neurofeedback uses EEG equipment and software to monitor your brain activity, and feed information back to the brain about what it is doing. A crude analogy is to equate the neurofeedback system with a giant mirror being held up for the brain so that it can see its own processes and gain the information it needs.
Why does the brain need this information you may wonder? See, the wonderful thing about our brains is that they are self-regulating. If given the necessary information, our brains can change themselves to function more optimally, back within the parameters they were designed to operate within. The brain doesn’t need us to push it, or pull it in any particular direction if we can provide the brain with the information it needs. This is what dynamical neurofeedback helps the brain with. Our primary system monitors the brain, and feeds back information 256 times per second, allowing the brain to see what it is doing and adjust accordingly.
Can Neurofeedback Fix Anxiety?
There are numerous theories as to why people get anxious. There are personality factors, biochemical factors, life factors, brain function factors, and many more. The trouble with trying to fix anxiety by any means, is there are no guarantees. This is true of counselling, psychiatric medications, and every other form of therapy or treatment out there. I’ve been in this field long enough to know that none of the treatments or therapies we employ can be guaranteed to fix what ails us. This is, however, different than asking whether something can be helpful with anxiety, and if we ask this question, the answer with regard to neurofeedback is a resounding yes in my experience. I’d like to share three ways I see neurofeedback being helpful for anxiety.
3 Ways Neurofeedback Can Help Your Anxiety
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- If you have been on medication, maybe some have worked really well or some have not. Often there are side effects to medications and in some cases, the side effects are worse than the symptom you’re trying to treat. Another concern can be when medications work for a time and then stop working. Sometimes people just simply don’t want to take medications for various reasons. This is where neurofeedback can be helpful and this is because neurofeedback is another way of working with the brain biology without the use of medications.
- If our brains are not functioning optimally when we’re anxious, neurofeedback can train our brain to function better. What’s important about this is that we’re not simply treating, or masking undesirably symptoms, we’re helping the brain function better and learn how to do this long term. Again, the analogy of going to the gym is helpful. If you get injured playing sports, you can simply take some medication to mask the pain. More effective, however, is going to the gym, under the guidance of a physiotherapist or other rehab professional, and working on the muscles, joints, and other areas to rehabilitate the injury and hopefully prevent a new one. This is what neurofeedback does for your brain.
- One of the main triggers for anxiety is the activation of the central nervous system (CNS) and interaction with the autonomic nervous system (ANS). In fact, some of the most exciting research coming out right now around anxiety, depression, and trauma has to do with the CNS and ANS, and particularly, the vagus nerve (but that’s a whole topic on its own). Check out this article if you want to geek out on this information. One of the most exciting things for me in working with my clients with anxiety is that neurofeedback can directly influence the CNS and ANS and induce the relaxation response, lowering the triggers for anxiety. This is especially exciting for those suffering from generalized anxiety because it is one of the most difficult forms to treat by other modalities. I can tell you that in my experience with clients, as well as my own personal experience with a generalized anxiety disorder, neurofeedback has been one of the most helpful things I’ve ever seen or experienced, both personally and professionally.
If I’m Interested in Neurofeedback What Should I Do?
If you’re interested in neurofeedback for your anxiety, please give us a call. It’s not necessarily a fast treatment (in our experience and the data for the system we mainly use, 12-20 sessions is the average), but it’s an effective tool that has long-lasting effects and trains your brain to function better for the long term. It can be used in conjunction with medications, and it actually has the potential to reduce the need for medication and enable a lowering of doses in some cases. Neurofeedback is an exciting tool in our toolbox, and another way to we can bring holistic, integrated approaches to care for our clients. As you can probably tell by now, I’m pretty excited about this.
Please contact us or give us a call if you have any questions or if you want to explore whether neurofeedback might be right for you. We’d love to chat!
by John Bablitz | Jan 17, 2018 | Anxiety, Mindfulness Meditation
My Love-Hate Relationship With Mindfulness… and why you should really, really consider practicing it
Mindfulness has been a buzzword in the health community of late. I’m hoping that after reading this, you’ll have a basic idea of what it is and why it helps.
Western culture is full of busy-ness – depression and anxiety are more common than they’ve ever been. Typically, I like to simplify depression and anxiety somewhat, down to past and future. Anxiety is the uneasiness and even fear of some future threat – generally, one that isn’t exactly easy to define. We might be really anxious about an upcoming presentation, but have a harder time nailing down where that comes from – perhaps it might come from baggage that we carry around from some intense public shame that we’ve felt in the past, and the risk of putting ourselves out there again heightens us to a degree that feels like it doesn’t even make sense (our bodies remember shame a lot more acutely than our minds do). Anxiety is often designed to warn us and protect us against the threat of more hurt like this.
Depression, often, is oriented in the reverse direction – maybe our past experiences have coloured our world in a way that joy is difficult to experience, and it’s hard to believe that we will experience anything different going forward. Depression tends to affect the innate and beautiful sense of curiosity and wonder that comes with being a human being (think of a young child you know interacting with the world around them).
Please understand that these are simplistic definitions, designed to give a basic idea of where mindfulness comes in. Often, depression and anxiety can keep our thoughts in the future or past, which is exhausting. Constant worry or feeling down can lead us to do a number of things that are very adaptive and reasonable in the moment (such as distracting ourselves from a painful experience), but they are exhausting in the long run. Mindfulness brings us to the present. It gives our brain a short break from the constant worry and just brings us into right…now. Young children (for example) are generally really good at being present in the moment.
Being mindful can help ease stress
Mindful meditation might involve focusing on our breath, the food we’re eating, the physical sensations in our bodies, or the sounds outside. It is inviting ourselves to experience the present moment for what it is – without judgment. I have a lot of tension on my shoulders, for example. I carry it with me everywhere, and I really hate having it around. But when I’m mindful, I’m not focusing on how much I wish it weren’t there. I’m just noticing it and training myself to be OK with it, just for a minute. Or, I’m noticing the sounds of the traffic outside, and I’m not thinking any thoughts at all – just experiencing the present for whatever it is. This is really hard – especially at first, and even more so when we are experiencing physical or emotional discomfort.
If you’d like to know the why behind things, I’d like to tell you about the work of two people I admire (who are just like you and me, and also happen to have a long list of impressive credentials that I won’t outline here) named Jon Kabat-Zinn and Dan Siegel. They’ve spent a lot of time researching and exploring mindfulness, and their work is very impressive.
Benefits of mindfulness
One of the main things mindfulness does is increase left forebrain function. This increased brain activity fosters that beautiful curiosity I was talking about. If we can notice and be curious when we’re stressed, we’ve already won. We start seeing ourselves from an outside perspective, with more grace and compassion (have you ever wished you could see yourself the way you see somebody you care about?). We can learn to calmly respond to things that otherwise would have sent us into a frenzy.
I could talk forever about this, but I’ll just give you a quick list of the amazing benefits you can find in mindfulness:
- Direct help with physical symptoms such as chronic inflammation and pain
- Reduced anxiety, stress, and depression
- Improved immune system function and mood
- Healthier coping – an increased ability to bounce back after one of the hard experiences that are so common in life
Sounds too good to be true, right? It is sort of. It’s not a pill – it takes the effort to be mindful. I hate it, actually. In many ways being regularly mindful is a primary component of my job, and I still suck at it. But, I’m getting slowly better – then worse – then better again. But even a little bit helps – if you can manage even 20 seconds a day, you will notice a difference.
If you want to read more about this, the works of Jon Kabat-Zinn and Dan Siegel are a great place to start. Jon Kabat-Zinn has a website and a variety of videos on YouTube that are really interesting. I’ve provided a few links below to get you started.
If you want to get started with a mindfulness practice of your own, there are quite literally endless free resources online in both video and audio format, but I recommend the Headspace app. It teaches you the basics and gives you easy, situation-specific guided meditations.
If you want more information on how to actually do the thing, here’s a Harvard blog that covers the basics pretty well:
https://www.helpguide.org/harvard/benefits-of-mindfulness.htm
Here’s Jon Kabat-Zinn on making what you already do in the morning into a mindful practice (this way, you don’t even need to learn to do anything new!):
https://www.mindful.org/jon-kabat-zinn-how-to-make-your-morning-routine-into-a-meditation-practice-video/
Lastly, if you want to fact check my claims, I have a resource list of academic papers I’d be happy to share with you. Here’s one I really like (you may need access to an academic database to read it):
Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., . . . Sheridan, J. F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65(4), 564-570.
I hope this has been helpful for you. Sometimes we love what helps, sometimes it’s aggravating; one thing is for sure – mindfulness helps us keep calm, be present, and cope. If I, or anyone else on the team at Alongside You can be helpful in working through this with you, please contact us and give us a call.
by Juliana Fruhling | Jan 25, 2017 | Anxiety
These days anxiety is on the rise, thanks in large part to the increase of using numbing out, or disconnecting, to deal with strong emotions. It’s become somewhat of an epidemic, perhaps due to the now widespread use of screens and smartphones, for people to disconnect from their emotions and numb them out instead of soothing them or working through them. Disconnecting in and of itself is not a negative thing – it’s crucial to be able to disconnect from our emotions if we need to get things done, or if we’re not in a safe place. However, the temptation to stay disconnected is huge with so much to distract us, and this can prevent us from attending to and resolving our feelings, or even taking some time to self-soothe.
By being more intentional about connecting to our bodies and learning self-soothing mechanisms we can help decrease anxiety when it begins to rise in us and feel safer in general when navigating our day-to-day lives.
Here are three simple ways to help soothe and reconnect when anxiety arises.
- The 1-2 breath – During times of higher anxiety, our bodies switch into a kind of a survival mode, where our sympathetic nervous system activates and causes us to breathe more rapidly, seeking to increase the oxygen in our bodies and make us “ready for anything,” so to speak. This is an exhausting state to remain in, and can leave us tired and irritable by the end of the day. In this state, often unbeknownst to us, our breathing patterns become more rapid and shallow, and the focus is on the oxygen-inducing inhale, rather than the carbon dioxide-releasing exhale. By paying attention to one’s breathing and focusing on establishing a pattern of shorter, expansive inhales, and longer, slower exhales, the body is invited into a state of relaxation and safety, and it naturally calms and regulates. This can be achieved by breathing into a count of “one Mississippi”, and out to a count of “one Mississippi, two Mississippi”. This is best done in a quiet, calm environment, and placing one hand over the heart and one hand on the stomach during this breath can help facilitate the connection, and help the body focus on slowing down and calming.
- Grounding/Rooting down – When anxiety is quickly rising in our bodies it can be quite an intense experience, one that can even feel like an out-of-body experience, which is a very helpless feeling. Anxiety intensity is usually dominant in the upper parts of the body – churning stomach, pounding heart, racing head, sweaty palms, etc. In order to soothe this, it can be helpful to focus yourself on rooting down, moving yourself to a safe space if possible and focus on the lower, calmer parts of the body, the feet, the legs, the bottom or lower back – any place that is connected to something still and stable, like the floor or a chair. Breathing and getting heavy and focusing on those safe connecting points, even imagining one’s feet as tree trunks, rooting strongly into the ground, can help the body quickly cool down from the rapidly rising anxiety and help it to feel safer, more connected and stable.
- Sensory tools – another thing that can help ground the body during rising anxiety is to have available a few sensory items that are relaxing and soothing. For those who find tactile items and the sense of touch soothing, keeping a piece of soft blanket or cotton balls, or even sandpaper handy can help – something to hold and focus on in the midst of rising anxiety. For those who find scent soothing – like something reminiscent of a mother’s perfume or a favourite baked item, they can keep a bottle of lotion, perfume, or essential oils handy for calming.
Likewise for those who find music soothing, having a certain song or meditation ready to play to help them breathe and cool down can be helpful. Even taste can help with soothing – having a piece of gum or a jelly bean of a certain flavour. Creatively seeking out things that help soothe the body and having them at the ready in a little, pocket sized “anxiety survival kit” can be a huge help when anxiety unexpectedly arises.
I hope this has been helpful for you and gives you some tips to help manage your emotions and anxieties. Often it helps to go through these with a professional, and sometimes our emotions and anxieties are beyond what we can manage on our own. If you’d like some help, please let us know, that’s what we’re here for!
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If you’d like some help manage your emotions and anxieties, we’d love to help. Please give us a call at 604-283-7827, send us an email through our website, or book an appointment online and one of our counsellors would love to help you out!
