depression – Healing Heart

Posted on January 30, 2018January 30, 2018 by Tanya Ruckstuhl LICSW · 2 Comments

SAD to Glad: Surviving Seasonal Affective Disorder

Tanya Ruckstuhl LICSW

In the gloom of a Seattle January, it’s vital to keep our inner sun ignited. Seasonal Affective Disorder, with its attendant low levels of energy and flattening of enthusiasm, affects many to some degree.

Do you find yourself hitting the snooze button and rolling over? Do you look out the window and scowl?

People in Seattle, we need a whole battalion plan of fun to battle the winter meh’s. What is fun? I’m talking about tiny bits of delight, not the roller coaster of joy. Fun is subjective, subtle and easily attainable.

Visualize Picturing the golden sun in a clear blue sky is uplifting. Imagine a garden in the late spring; recall the delightful riot of blooming peonies and lily-scented hyacinths. Visualization is not just for woo-woos. I know a clinical social worker working with professional athletes in Chicago. He has injured players picture themselves practicing and playing the game while in their hospital beds. Just by visualizing, these players are able to retain muscle tone and skill level. Think of visualization as the opposite of catastrophic thinking. Instead of using your imagination to freak yourself out, visualization is using your imagination to improve your reality. Conscious use of visualization is effective, free and has no unwanted side effects!

Progress The therapeutic value of a feeling of progress cannot be overstated. Sure we are all aging and the mortality rate is a solid hundred percent, but here you are, alive and able, so do something to make your life even a tiny bit better/prettier/healthier/more interesting. Each winter I repaint bits of the ceiling and walls that are marred. This weekend my boyfriend and I spent half a day making a week’s worth of healthy breakfasts and lunches from scratch to save time and money during the work week. Learning anything is a slam dunk for creating a sense of progress. With the internet, learning has never been so abundantly available. As an example, the DuoLingo app offers free daily language lessons that take just five minutes and allow you to choose from all the major world languages. I’m currently working on my Spanish and will learn French next. And you don’t need Wi-Fi to learn: Find someone who knows something you don’t and ask them questions.

Travel Depending on destination and level of luxury, travel costs vary from modest to major. If you can afford it, go to the sun midwinter for a blue sky break. Stay somewhere you can walk outside every day for an hour and get your vitamin D recharged. If that’s too much for your budget, take a weekend getaway with your partner or friends and go somewhere to connect with loved ones and shake up the routine. If you don’t want to commit to a whole weekend, get outside of the city and go east to the mountains for a day of snowshoeing or sledding or skiing. Take in the beauty of snow blanketing the landscape and feel the refreshing chill of high altitude winter air.

Experience Novelty Anything new and different wakes your brain up and makes you feel alive, which happens to be exactly the opposite of how Seasonal Affective Disorder makes you feel. Think of novelty as the umami flavoring that makes life delicious. Again, we’re talking little bits of newness here, not enter the witness protection program and move across the country. Discover a new show on Netflix or Amazon that makes you laugh, cry or think. Throw a party for a truly ridiculous reason (The Winter Olympics watch party! National Pie Day!). Spend an evening listening to a new album, or internet-stalk your favorite musician and listen to their side bands. Make a paper-mache mask. Take a class that you would have loved as a child. I’ve taken classes on hip hop dancing, ceramics building, jewelry-making, mosaics, writing, interior decorating, cooking, and painting. Remember adults take recreational classes for fun, not to create an amazingly impressive product, so dump your perfectionism before you go.

Get Physical Attend to the mammalian needs of your body. The basic three are: sleep, exercise and food. It’s easy to have not enough of the first two and then try to make up for feeling lousy with way too much of the third. Make a plan to get to sleep earlier. Block out time on your schedule to get regular, healthy movement. Do a little prep each weekend by making or buying readymade meals for the work week so you can have food that sustains you without inflating you. Drink more water and less everything else liquid. Have sex. Really! Schedule it if need be. Sexual activity increases both self esteem and dopamine.

Finally, consider this general philosophy: Nibble on as many different sources of self care as you can dream up. Consider emotional nutrition akin to dietary needs for variety and enjoyment.

Posted on February 27, 2013 by Tanya Ruckstuhl LICSW

Cynicism and Vulnerability

by Tanya Ruckstuhl-Valenti LICSW, MSW

Why do we equate vacancy with appeal?

Americans worship cool people. Dark sunglasses, blank facial expressions, stony silences, we perceive as toughness, and we all long to be tougher than we really are. Think Sylvester Stallone in Rocky and Arnold Schwarzenegger in the Terminator series.

Hedy Lamarr, (an actress and mathematician from the 1940’s who invented spread spectrum communications and frequency hopping which are used in wireless communications to this day) once said “it’s easy to look glamorous; all I have to do is stand there and look as empty-headed as possible.”

A friend of mine said something the other day that perfectly captured the way children can inspire us to become better humans. “Now that I’m a parent, I can’t afford to be cynical anymore. I don’t want my children to be cynics.”What he wants for his children is openness to the magic and joy of life.

Cynicism is a defensive mental habit of pushing away the very real and painful experiences of life with a dismissive, jokey “I expected that.” It lowers our individual experiences of disappointment by creating global expectations of disappointment. It’s a bit like lighting a candle with a blow torch. In the same way that depression hits a global emotional mute button, cynicism is a removal from the immediacy of our experience.

We do it out of a superstitious attempt to push away our vulnerability/ fear of loss or of exposure by hiding it under an attitude of “I’m too cool to care.” The problem with this approach is manifold:

It doesn’t work
It turns other people off and therefore isolates us
It is no fun! A cynic can enjoy being clever and right, but they can’t trust enjoyment itself, can’t lean on it and feel its durability and cyclical nature.

I propose a revolution. Or at least, an inversion.

What if we collectively decided that pretending to be invulnerable is as appealing as turning into a granite slab? That what so-called cool people lack is the very quality we all actually crave, which is warmth and that we cannot convey warmth without also being vulnerable to rejection?

Imagine attending a dinner party. Would you rather sit next to someone with enthusiasm or someone who acts disengaged? Who is easier to connect with? Who is more inspiring? I would take goofy over glossy any day.

Cool in my book is passion, enthusiasm, and excitement. It’s silly and experimental and risk-taking and fun. It’s bold and geeky and snorting with laughter with a big ol’ wad of spinach between your teeth.

Try this:

If you find yourself thinking or speaking in a cynical manner, gently refocus. A great question to ask is “How can I trust that no matter how this experience turns out I will be okay so that I don’t need to prematurely destroy it?”

Posted on February 11, 2013 by Tanya Ruckstuhl LICSW

Lazy/Greedy

by Tanya Ruckstuhl-Valenti LICSW, MSW

Most of the time, I write a pretty positive blog here at the old WordPress site. I try not to cast aspersions on anyone’s character or promote theories of reality that increase our collective cortisol levels.

But once in a while, the urge to snark strikes and even a doggedly cheerful gal like me needs to vent.

I’m talking today about an evil symmetry that exists between the general public and the multinational corporations known as the pharmaceutical industry. Now big pharma should be a friend of mine. They pay me well to take provider surveys. They have both improved and even saved the lives of some of my clients who needed medication in order to get better. And you sure can’t beat an antibiotic when needed.

The problem is that for many people in our society, psychotropic medications plays to their basest fantasy of swallowing a pill to solve a complex condition. And guess what? The pharmaceutical industry actively promotes that fantasy, advertising before and after that look like depression turned to active engagement with life.

We human beings are multi-cellular creatures, and like all cells we seek to expend as little energy as possible to get the job done. In other words we are all just a bit lazy.

Corporations are like multi-cellular creatures without skin: there is no limit to their expansion. In medical terms we would consider the behavior of corporations to be quite like a cancerous tumor. They are insatiable, greedy creatures beholden to profits rather than social/environmental impact.

So what happens when you put lazy together with greedy? There is a cycle of consumption that feeds the corporate interest of expansion and the human tendency towards passivity.

Psychotropic medications work as stand-alone treatments in 20% of cases, but you will not find that statistic in the disclosure forms on your medication packs.

If you are suffering from any mental health condition, review your basic self care. Are you sleeping? Eating vegetables? Do you get exercise (walking totally counts) at least every other day? Do you have friends? Are you hugged daily? Are you living a life of honesty and integrity? Do you feel you are making some contribution to the world at large? If the answers to any of these questions are no, you must make some lifestyle changes if you want to feel well.

Medication may very well be a part of your recovery, but it will not save you.

Posted on December 9, 2010December 13, 2010 by Tanya Ruckstuhl LICSW

What to do When a Friend Is Suffering

By Tanya Ruckstuhl-Valenti LICSW, MSW

It is difficult for friends and family members to know how to respond to a loved one experiencing a mental illness. All too often the default family-and-friends response is initial panicky attention followed by frustrated withdrawal.

Clients in therapy frequently need two tiers of treatment: one to address their depression and anxiety and another one to address their feelings of rejection by loved ones during those dark times.

It is natural to want to withdraw when we do not know what to do, or when what we do seems to be ineffective. I’m speaking here both about the self-isolating behavior of the depressed person as well as their freaked-out friends who dump or cease contact with them. Our desire to feel capable can get in the way of our duty to be decent.

If you have a friend or family member experiencing depression you must check your own expectations out. If you think you can help by providing time and compassionate attention, that’s great. But if you think you can change them by telling them what to do or why they shouldn’t be feeling the way they do, that’s a problem.

Depression and anxiety do not respond to dismissal, arguing or declarations of how easy it would be if only the other person would X (fill in the blank).

A depressed person is not going to jump up off the couch and proclaim, “Wow! I never saw it that way before. Thanks for the reality check!” And then dash off to do socially significant volunteer work while teaching themselves French cooking.

Mental illness responds s-l-o-w-l-y to therapy, medication and time. The symptoms can be temporarily alleviated by consistent, loving contact in the same way that arthritis temporarily subsides with the ingestion of anti-inflammatory drugs like Tylenol. (Or for locals who prefer a more Bastyr-flavored approach, Boswellia, an Ayurvedic herb for arthritis).

If you have a friend or family member who is depressed or anxious, consider what you can emotionally “afford” to offer. Using your own emotional wellbeing as your guide, you can provide support as long as it does not cause feelings of resentment or burden. Perhaps a weekly walk or a monthly lunch or an occasional cultural event or a daily email or phone calls to check in. But. Not. All. Of. These.

Don’t worry if you don’t know what to say. They don’t either! But if you really want a direction you can start with, “I know this is a tough time for you” and then you can stop speaking. You don’t need to say more than that. You don’t need to take the pain away any more than you need to make the sun come out in December. You can’t.

(I want to recommend “The Secret Life of Words” about a Yugaslavian genocide survivor. Incredibly sensitive depiction of survivor’s guilt in the aftermath of catastrophic trauma. I highly recommend.)

Depression Traps: Social Withdrawal, Rumination, and More (webmd.com)
Some Of The Common Symptoms Of Depression (healthlifestyleforever.com)
Insight into the Physical Symptoms of Depression (brighthub.com)
Is Cognitive Behavioral Therapy for Psychotic Depression an Appropriate Treatment? (brighthub.com)
What to Expect from Family Counseling for Depressed Teens (brighthub.com)
Teen Depression & Suicide: Is Your Child At Risk? (brighthub.com)

Posted on May 18, 2009 by Tanya Ruckstuhl LICSW · 3 Comments

Trauma Turtles: What to do when someone you love is depressed

I was walking around Green Lake Friday morning when I came to one of my favorite sites: the turtle log. Adult and baby turtles loll together in a bumpy chain on a fallen tree in the lake, catching the sun. I counted twenty one of them.

Turtles are amazing creatures, both because they are prehistoric and because they come with housing installed. When a threat comes along, they pull their head, feet, and tail inside the shell where very little can get to them.

People experiencing depression do this as well. And yet, unlike our full time RV-lifestyle friends the turtles, we homo-sapiens are the result of fifty thousand years of evolution and when we respond to perceived emotional threats by withdrawing from our family, friends, and environment, it is at the peril of our mental and ultimately physical health.

Withdrawal is a symptom of depression that becomes self-reinforcing: it feels safer to stay inside a small and predictable life experience. In the same way an angst-y teenager wants to paint their bedroom walls black and leave the curtains shut, a depressed adult (or child) develops a preference for the very things that drive depression; Staying in bed, watching TV, not eating, avoiding friends, staying indoors, not exercising, not sleeping all contribute to depression.

When a depressed person is told, “You need to get out more! Enjoy your life more! Do something fun!” even though this advice is true, they respond by withdrawing even more. Why? Not to drive you nuts but because it feels too raw, too painful to risk coming out of their shell.

What can you do? Offer to take them to a therapist. If finances are tight, look up reduced fee therapy online or call your local community mental health center. Offer to book the first appointment for them and provide transportation.

Take them for a walk. Gentle movement and undemanding companionship are wonderful sources of comfort during an emotional emergency.

Get them a massage or to an energy healer such as a Reiki practitioner. Healing touch is now being taught to nursing students (a main stream medical population) for one simple reason: it works.

If you have ANY concerns about suicide, TALK ABOUT IT! Bring it up! Ask, “Are you thinking about hurting or killing yourself?” Asking about suicidal ideation will not push a non-suicidal person into becoming suicidal anymore than having a fire extinguisher in your kitchen makes you engage in arson.

If your friend or family member says, “yes,” or “I’m not sure” or anything other than “no” then you say, “I love you and I need to make sure you are safe.” Call your local crisis hotline (in Seattle its 206 461-3222) for support. You will then be guided by trained volunteers about how to help keep your friend or family member as safe as possible.

Ultimately we must leave shells to the experts: turtles. We humans are thin skinned because we need contact with each other to survive.

It is difficult for friends and family members to know how to respond to a loved one experiencing a mental illness. All too often the default family-and-friends response is initial panicky attention followed by frustrated withdrawal.

Clients in therapy frequently need two tiers of treatment: one to address their depression and anxiety and another one to address their feelings of rejection by loved ones during those dark times.

Depression and anxiety do not respond to dismissal, arguing or declarations of how easy it would be if only the other person would X (fill in the blank).

A depressed person is not going to jump up off the couch and proclaim, “Wow! I never saw it that way before. Thanks for the reality check!” And then dash off to do socially significant volunteer work while teaching themselves French cooking.

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