by Molly Pierce | Dec 19, 2023 | Confidence, Depression, Life Style, Relationships, Self Image
Depression is a mental health condition that goes beyond mere feelings of sadness. It would be better described as a persistent and overwhelming sense of despair that can linger for weeks, months, and even years. Depression affects millions of people worldwide, oftentimes having a negative impact on personal well-being, relationships, work, school, and overall quality of life.
Contrary to common misconceptions, depression isn’t a sign of weakness, nor is it a mere mood swing that one can easily snap out of. Rather, depression involves a combination of biological, psychological, and/or environmental factors. Physiologically, there can be multiple neurotransmitters involved, making it difficult to regulate mood. Genetic predispositions can also make certain individuals more susceptible to experiencing depressed mood. Additionally, life events such as trauma, loss, or chronic stress can act as triggers, exacerbating the condition.
Being able to recognize the symptoms of depression is essential, not only for those who experience it, but also for those close to them. Detecting depression at its earliest signs is optimal, as it allows for prompt initiation of treatment, which can prevent the condition from worsening. Common symptoms include persistent sadness, loss of interest in previously enjoyable activities, changes in sleep and appetite, fatigue, and difficulty concentrating.
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) outlines the following criterion for depression (otherwise known as major depressive disorder or MDD). In order to meet diagnostic criteria, an individual must exhibit at least five of the following symptoms during the same 2-week period, representing a change from previous functioning. Additionally, at least one of the symptoms must be either (1) depressed mood, or (2) loss of interest or pleasure.
- Depressed mood most of the day
- Significantly decreased interest or pleasure in all (or almost all) activities
- Major change in weight or appetite (not due to dieting)
- Insomnia or hypersomnia
- Excessive restlessness or observable reduction in activity levels
- Fatigue (exhaustion) or loss of energy
- Feelings of worthlessness or excessive/inappropriate guilt
- Diminished ability to think, concentrate, or make decisions
- Frequent thoughts of death or attempt to end one’s life
These symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. It’s important to note that the diagnosis also considers ruling out other medical conditions or substances that could contribute to the symptoms. Diagnosis and treatment should be conducted by qualified mental health professionals.
Seeking professional help, whether through therapy, medication, or a combination of both, is a crucial step for managing depression. It is certainly not a sign of weakness, but a courageous step towards healing. By fostering awareness, understanding, and compassion, we can collectively promote mental health treatment for those in need of support. The best thing we can do for those affected by depression is (1) listen without judgment, (2) validate their experiences and emotions, (3) connect them with a professional, and (4) continue to connect with them throughout their journey toward a brighter future.
by Molly Pierce | Sep 1, 2016 | Anxiety Related, Balance, Counseling Theory, Depression
The goal of Acceptance and Commitment Therapy (ACT) is to create a rich, full, and meaningful life while accepting the pain that inevitably goes with it. This is done by changing one’s relationship to their symptoms in order to live a more value-driven life. Further, the goal is to accept what is outsideof one’s control, and commit to taking action to enrich one’s life. It can be summed up in one basic premise: pain is inevitable, but suffering is optional.
Oftentimes, trying to get rid of symptoms actually results in being more bothered by the symptoms. For example, try to not picture a pink elephant in your mind’s eye. What happened? You saw a pink elephant. This is just what happens when we try NOT to focus on any particular thing!
Being too focused on symptoms impacts our ability to life a value-driven life. We’re too busy and using all our energy on “symptom-reduction” rather than choosing to focus on what is meaningful in our lives, such as family, friends, relationships, advancing career, rest, self-care, and so forth. When we instead focus on our values, our symptoms can drift to the background, rather than take center stage.
ACT asserts that problems are essentially caused by two things: cognitive fusion and experiential avoidance. Cognitive fusion is when we become inseparable from our thoughts, and then our thoughts dominate our behavior. Experiential avoidance happens when we attempt to avoid, get rid of, suppress, or escape unwanted experiences (thoughts, feelings, memories, sensations, etc.).
Trying too hard to control how we feel simply gets in the way of a rich, full life. We can’t do important, value-driven things if we are always trying to get rid of symptoms. Control is the problem, not the solution.
What can we do about this? Practice defusion to get stuck from our thoughts and gain distance from them. Defusion is taking a step back and seeing our thoughts for what they are: nothing more or less than words and pictures. As I like to say, look AT your thoughts, rather than FROM your thoughts.
Here are some ways you can attempt to defuse from your thoughts:
- Say “I’m having the thought that…”
- Use a silly voice to say the thought
- Sing the thought like a song
- Repeat the thought nonstop for 30 seconds until it sounds like gibberish
Another way to defuse from unhelpful thoughts is to practice mindfulness. What is mindfulness? Mindfulness means paying attention with flexibility, openness, and curiosity. It allows you to be aware of your experience in the moment as opposed to being “caught up” in your thoughts. Mindfulness involves an attitude of openness; being curious about your experience rather than fighting with it. This is helpful because often times the more we try to fight the way we feel, the more we end up feeling it.
The goal of ACT is referred to as psychological flexibility, which entails being present, opening up, and doing what matters. An important facet of psychological flexibility is acceptance: allowing thoughts and feelings to be present, regardless of whether they are pleasant or painful.
The fun part of ACT (in my humble opinion) is valued living: doing what we want to be doing with our lives. What’s important to us? What do we want to stand for? How do we want to behave and act on a daily basis? Our values are our compass; they guide our decisions and behavior. A good way to figure out what your values are is to imagine your retirement party or funeral — Who would you want to speak about your life and what would you want to hear them say?
Once you have figured out what your values are, then final step is to take committed action (effective action motivated by your values). One helpful way to do this are to make a public commitment; tell someone about it. This will create some level of accountability for you. Another thing you can do is create an action plan worksheet. Last, but not least, simply take the first, tiniest step. The first step is often the hardest, but if you can manage to get started, the rest will follow.
For more on Acceptance and Commitment Therapy, click here and here!
by Molly Pierce | Mar 16, 2016 | Anxiety Related, Balance, Counseling Theory, Depression, Relationships
Albert Ellis is known as the grandfather of Cognitive Behavior Therapy. He combined humanistic, philosophical, and behavioral therapy to form Rational Emotive Behavior Therapy (REBT) in 1955. A main assumption of REBT is that people contribute to their psychological problems by the way they interpret events. Further, our emotions stem mainly from our beliefs, evaluations, interpretations, and reactions to life situations. REBT assumes that cognitions (thoughts), emotions, and behaviors interact significantly and have a reciprocal cause-and-effect relationship. Additionally, REBT postulates that people are born with a potential for both rational and irrational thinking.
According to Ellis, we have an inborn tendency toward growth and actualization, yet we often sabotage our movement toward growth due to self-defeating patterns we have learned. We originally learn irrational beliefs from significant others during childhood, and we actively reinforce these self-defeating beliefs by repetition, and by behaving as if they are useful. But it is not useful to blame ourselves and others; instead, it is important that we learn how to accept ourselves despite our imperfections. Therefore, a major goal of REBT is to achieve unconditional self-acceptance and unconditional other acceptance; the more one is able to accept him or herself, the more likely he is to accept others.
The therapeutic process involves identifying irrational beliefs, and replacing such beliefs with more rational and effective ways of thinking. Changing one’s thinking results in changing one’s emotional reactions to situations. Ellis succinctly puts it this way, “You mainly feel the way you think.” Some examples of irrational beliefs that lead to self-defeat include: I must have the approval of all the people in my life, or else I am worthless. I must perform all tasks perfectly, or else I am a failure. It is better to avoid life’s difficulties than to try and end up looking foolish.
The A-B-C framework and method of disputing irrational beliefs is central to REBT theory and practice.
A = an event, behavior, or attitude
B = belief about the event
C = emotional & behavioral consequence or reaction (can be healthy or unhealthy)
D = disputing irrational or self-defeating beliefs
E = effective philosophy of replacing unhealthy thoughts with healthy ones
F = a new set of healthy feelings
A (the activating event) does not cause C (the emotional consequence); rather, B (the person’s belief about the event) largely causes C. D is the application of methods to challenge irrational beliefs by detecting, debating, and discriminating irrational (self-defeating) beliefs from rational (self-helping) beliefs. E is the new and effective belief system that consists of replacing unhealthy thoughts with healthy ones. In doing this, F (a new set of healthy feelings) is created.
In summary, Rational Emotive Behavior Therapy entails the following steps: (1) acknowledge that we are largely responsible for our own emotional problems, (2) accept that we have the ability to change these disturbances significantly, (3) recognize that our emotional problems often stem from irrational beliefs, (4) accurately perceive these beliefs, (5) see the value of disputing such self-defeating beliefs, (6) accept that we need to counteract our dysfunctional beliefs/feelings/behaviors, and (7) practice these methods to improve current and future circumstances.
References:
Corey, Gerald. Theory and Practice of Counseling and Psychotherapy. Belmont. Thomas Learning, Inc. 2005.
by Molly Pierce | Aug 30, 2015 | Anxiety Related, Confidence, Counseling Theory, Depression, Self Image
[from The Confidence Gap: A Guide to Overcoming Fear and Self-Doubt, by Russ Harris]
Rule 1: The actions of confidence come first; the feelings of confidence come later.
The concept of confidence is defined as “an act of trust or reliance” (trusting and relying on one’s abilities and competencies), rather than viewing confidence as “having a feeling of absolute certainty or assurance.” This is a better approach, because if you wait for the feelings of confidence to come before taking any sort of action, then there’s a chance you might end up waiting forever. That’s not very effective. Harris offers four steps to follow in order to become more confident in any action: (1) Practice the skills, (2) Apply them effectively, (3) Assess the results, and (4) Modify as needed.
Rule 2: Genuine confidence is not the absence of fear; it is a transformed relationship with fear.
People believe many myths about fear, such as: fear is a sign of weakness; fear is the enemy; fear holds you back; confidence is the absence of fear. But the truth is that when anyone steps out of their comfort zone, takes a risk, or faces a challenge, they will experience fear. That’s not a sign of weakness; it’s the natural human response. Fear doesn’t have to be viewed as an enemy, or something to hold you back, rather, it can be used as a motivating source of energy to be used for your benefit. It is not true that confident people don’t feel anxious or afraid, but perhaps they have figured out how to handle it and channel it effectively.
Rule 3: Negative thoughts are normal. Don’t fight them; defuse them.
Dealing with negative thoughts can be annoying, but the fact that we have them is actually a good thing! It’s a sign that our brains are working: trying to anticipate what could hurt us or harm us, trying to predict what might go wrong, etc. If your mind has negative or anxious thoughts, congratulations – you have a normal brain. Negative thoughts are not inherently problematic, they only become so if we get all caught up in them, give them all our attention, treat them as the gospel truth, allow them to control us, or get into a fight with them. The goal is defusion: separate from your thoughts and realize that they are simply words.
Rule 4: Self-acceptance trumps self-esteem.
Having high self-esteem means evaluating oneself positively. The trouble is that it gets hard to do this when one is not successful, or when one makes mistakes. On the other hand, self-acceptance means accepting oneself in spite of deficiencies. It involves letting go of all self-judgments. It doesn’t mean that we stop paying attention to the way we behave, and the impact of our actions; it simply means that we let go of blanket self-judgments. When we make a mistake, we reflect on it and assess our actions. Harris puts it well when he poses: “If beating ourselves for every mistake we make was productive, wouldn’t we all be perfect by now?”
Rule 5: Hold your values lightly, but pursue them vigorously.
Values are one’s guiding principles of behavior, according to what is important to them in life. Harris likens values to a compass: they give us direction, guide our journey, and help us stay on track. (Goals are what we want to achieve along the way). Examples of values include: adventure, authenticity, connection, contribution, courage, creativity, flexibility, honesty, humor, intimacy, open-mindedness, respect, self-awareness, spirituality, and trust. One reason to hold your values lightly is the tendency for them to turn into inflexible requirements, such as, “I must be adventurous at all times.” Remember, the goal is to live by guiding values, not rigid rules.
Rule 6: True success is living by your values.
This means using one’s values to set goals, and to sustain movement toward set goals. You don’t have to wait until you achieve a goal in order be successful; you can be successful right now through living by your values. Maybe a goal of yours is to become a doctor because you hold the value of helping others. It will take you several years to actually become a doctor, but you can do many things to help people along the way.
Rule 7: Don’t obsess about the outcome; get passionate about the process.
Process is the way you go about doing something, whereas outcome is the result of what you’ve done. The idea here is not to give up on your goal(s), but to shift the emphasis to engaging fully in the process, and embracing it as an opportunity for learning, rather than obsessing about the outcome.
Rule 8: Don’t fight your fear: allow it, befriend it, and channel it.
Russ Harris Speaks of using “The ABC of Fear-Whispering” for dealing with fear (A=allow, B=befriend, C=channel). Trying to fight against or avoid an emotion oftentimes just makes the unpleasant emotion stronger. So, instead of fighting your experience of fear, try simply allowing it to be. Harris encourages befriending one’s fear: building a positive relationship with it. You don’t necessarily have to like it, but haven’t you ever been friendly to a person whom you don’t necessarily like? It’s kind of like that. Also, fear is worth befriending if it helps you live by your values, achieve your goals, perform at your peak, and live a richer, more meaningful life. Fear is kind of like nervous energy, but it can be less scary if you frame it as feeling “excited” or “pumped” instead. Think to yourself, “How can I make good use of this energy? What can I channel it into?” Use your fear to your benefit. And remember, you can have fear and confidence at the same time. If you recall Rule 2: Genuine confidence is not the absence of fear, it is a transformed relationship with fear.
Rule 9: Failure hurts – but if you’re willing to learn, it’s a wonderful teacher.
In the words of John Dewey (American philosopher): “Failure is instructive. The person who really thinks learns quite as much from his failures as from his successes.” Just like fear, failure is a fact of life. It’s also a natural part of learning; we reflect on what didn’t work, and think about what might work better next time. It is productive to acknowledge what went “wrong,” while also appreciating what went well. It provides good feedback from which to learn!
Rule 10: The key to peak performance is total engagement in the task.
Peak performance requires practice, defusing from reasons not to do it, making room for discomfort or fear, and fully engaging in the process. The key to peak performance is having focused attention on the task at hand. This requires mindfulness: defusing from unhelpful thoughts, such as, what you look like, what others are thinking, judging your performance, thinking about past or future events, etc. While you can’t eliminate unhelpful thoughts or feelings, you can make space for them while remaining focused and engaged in what you are doing in the present moment. It is in this state of mindful, focused action that we perform at our best.
by Molly Pierce | Oct 3, 2013 | Anxiety Related
Interview with Kansas City Blogger Local
High school and college students are no strangers to the effects of anxiety and depression. This segment of the population however, faces a unique type of anxiety and depression that the general population rarely comes in contact with. Test anxiety is a major issue for students the Kansas City metro area. We met up with one local counselor to discuss test anxiety and how to deal with it.
Ben: Hello there. This is Ben Hartman from Blogger Local Kansas City. We’re out in Leawood with Molly Pierce, a Kansas licensed professional counselor and owner of True Self Counseling. We’re meeting with her today to discuss some of the upcoming anxiety that is related to the school season being in full swing. There are a lot of tests coming up. We met with Linden at Get Smarter Prep the other day, and she was actually talking about the ACTs coming up on September 21st. Molly, if you can just tell us a little bit about yourself and True Self Counseling, that would be awesome.
Molly: Aright. I started True Self Counseling in 2010. I really have a passion to help people deal with common everyday problems, such as anxiety, depression, and communication/relationship problems.
Ben: Okay, so you deal with individuals, and then you deal with people in relationships, and then some group counseling as well?
Molly: Yes, absolutely.
Ben: You have a test anxiety clinic going on over at Get Smarter Prep. Tell us about it.
Molly: It’s a one hour clinic in the evening to help students prepare to manage their anxiety, to get the best score that they can on their ACT or SAT. With the ACT test coming up, we actually just did a test anxiety clinic last week.
Ben: Is it open to only people that go to Get Smarter Prep already or is it open to the general public?
Molly: This was the first one we did, and it was just Get Smarter Prep students, but I’m sure that outside people would be welcome to come. There’s just a $25 fee.
Ben: Okay, so this is something that you guys are developing and working on, and it seemed successful this time? There was a good turnout?
Molly: It did seem successful. It seemed like the students really benefited from it.
Ben: There’s kind of two sides to being anxious about tests, the side where it’s impending and you’re stressed and you’re trying to learn as much you can before it comes. Then for some people, afterwards there’s the anxiety of not having gotten the goal they strived for and being let down by or disappointed by their performance. Can you maybe talk a little bit about the difference in the problems face on either side of the test?
Molly: Sure. A lot of the students are getting the help they need in learning how to solve the problems on the exams and they feel confident in that aspect, but they really get freaked out about being timed and running out of time, and then there’s just this train of negative thoughts of like, what if I run out of time? What if I fail? Then I’m not going to get into the school I want to get into, and into my preferred profession.
Ben: It’s a compounding cycle?
Molly: Yes, it can go down this compounding hole of anxiety. Same thing for after the test if they don’t get the score they were hoping for. It’s almost like this sense of impending doom that now they can’t pursue the career that they want.
Ben: Yes, that their life is over.
Molly: Their life is over, even though they can really just go retake the test and go on with life.
Ben: Yes. For some people, they feel like it speaks about them and tells people outwardly something they don’t want to convey.
Molly: That is absolutely true. A lot of people equate their self-worth with how well they perform whether it’s on the test, or in sports, or relationships, or jobs, or whatever, so not getting a good score can actually make people feel pretty bad about themselves.
Ben: Yes. There’s that misconception that the test score you get is a reflection of your worth, and those things are really completely exclusive.
Molly: Exactly, and that type of thinking really leads into depression and just feeling bad about yourself.
Ben: For some people that didn’t come to the clinic what could you recommend? What are some tips that people can follow to get in their habitual nature that will help them avoid getting test anxiety or help them in reducing test anxiety?
Molly: Anxiety is really a twofold issue. There are the physical symptoms of anxiety, so when you feel like your breathing is getting short and shallow, and you might feel tingly. You might feel butterflies in your stomach. One thing you can do is deep abdominal breathing, which really calms your body and soothes the physical symptoms of anxiety.
The other aspect of anxiety is the mental part of it. It’s the thoughts, so if you’re thinking, oh my gosh, I’m so nervous. I’m going to do horrible. I’m going to fail. That thinking is not going to be helpful, so you need to identify that negative thinking and change it into more positive and accurate thinking, such as I’ve prepared for this test. I know what I’m doing. It’s going to work out, and so forth.
Ben: Okay. Do you have any recommended reading for people that need some encouragement, that need to help to and reinforce a better positive mental frame of mind before a test?
Molly: Sure. There’s lots of good reading out there on anxiety and changing negative thinking. One book is the Anxiety and Phobia Workbook by Edmund J. Bourne. Another good one is When Panic Attacks, which is written by David Burns, and he really does a lot in the treatment of anxiety and depression. He’s pretty big in that world.
Ben: Okay, so that would be some good recommended reading?
Molly: Absolutely.
Ben: We will check back in with you soon so we can learn about some of the group work you’ve been doing over at the Leawood Church of The Resurrection on the topics of depression and anxiety. Thanks for your time, and we encourage our readers to check out your test anxiety clinic over at Get Smarter Prep as well as many of the services you offer.
Molly: Absolutely, and really, anyone struggling with anxiety, depression, marital issues can feel free to check out True Self Counseling to see if we might have services that are helpful for them.
Ben: Definitely. Thanks for your time, Molly.
Molly: Thank you.
