Sunday, June 29, 2014


If it is important to you, you will find a way. If it's not, you'll find an excuse - Svava's blog

Wednesday, June 25, 2014


9 Ways to Take Care of Yourself When You Have Depression

Associate Editor

9 Ways to Take Care of Yourself When You Have DepressionDepression is an illness that requires a good deal of self-care,” writes psychologist Deborah Serani, PsyD, in her excellent book Living with Depression: Why Biology and Biography Matter along the Path to Hope and Healing.
But this might seem easier said than done, because when you have depression, the idea of taking care of anything feels like adding another boulder to your already heavy load. Serani understands firsthand the pain and exhaustion of depression. In addition to helping clients manage their depression, Serani works to manage her own, and shares her experiences in Living with Depression.
If you’re feeling better, you might ditch certain self-care habits, too. Maybe you skip a few therapy sessions, miss your medication or shirk other treatment tools. According to Serani, as some people improve, they get relaxed about their treatment plan, and before they know it are blinded to the warning signs and suffer a relapse.
Because skimping on self-care is a slippery slope to relapse, Serani provides readers with effective tips in her book. As a whole, the best things you can do to stave off relapse are to stick to your treatment plan and create a healthy environment. I’ve summarized her valuable suggestions below.
1. Attend your therapy sessions. As you’re feeling better, you might be tempted to skip a session or two or five. Instead, attend all sessions, and discuss your reluctance with your therapist. If changes are warranted, Serani says, you and your therapist can make the necessary adjustments.
Either way, discussing your reluctance can bring about important insights. As Serani writes:
Personally, the times I skipped sessions with my therapist showed me that I was avoiding profound subjects — or that I was reacting defensively to something in my life. Talking instead of walking showed me how self-defeating patterns were operating and that I needed to address these tendencies.
2. Take your meds as prescribed. Missing a dose can interfere with your medication’s effectiveness, and your symptoms might return. Alcohol and drugs also can mess with your meds. Stopping medication altogether might trigger discontinuation syndrome. If you’d like to stop taking your medication, don’t do it on your own. Talk with your prescribing physician so you can get off your medication slowly and properly.
Serani is diligent about taking her antidepressant medication and talks with her pharmacist frequently to make sure that over-the-counter medicines don’t interfere. With the help of her doctor, Serani was able to stop taking her medication. But her depression eventually returned. She writes:
…At first, it was upsetting to think that my neurobiology required ongoing repair and that I’d be one of the 20 percent of individuals who need medication for the rest of their lives. Over time, I came to view my depression as a chronic condition — one that required me to take medication much like a child with diabetes takes insulin, an adult with epilepsy takes antiseizure medication, or someone with poor eyesight wears glasses…
3. Get enough sleep.  Sleep has a big impact on mood disorders. As Serani explains, too little sleep exacerbates mania and too much sleep worsens depression. So it’s important to keep a consistent sleep and wake cycle along with maintaining healthy sleeping habits.
Sometimes adjusting your medication can help with sleep. Your doctor might prescribe a different dose or have you take your medication at a different time. For instance, when Serani started taking Prozac, one of the side effects was insomnia. Her doctor suggested taking the medication in the morning, and her sleeping problems dissipated.
For Serani, catnaps help with her fatigue. But she caps her naps at 30 minutes. She also doesn’t tackle potentially stressful tasks before bed, such as paying bills or making big decisions.
(If you’re struggling with insomnia, here’s an effective solution, which doesn’t have the side effects of sleep aids.)
4. Get moving. Depression’s debilitating and depleting effects make it difficult to get up and get moving. Serani can relate to these effects. She writes:
The lethargy of depression can make exercise seem like impossibility. I know, I grew roots and collected dust when I was anchored to my depression. I can still recall how getting out of bed was a feat in and of itself. I could barely fight gravity to sit up. My body was so heavy and everything hurt.
But moving helps decrease depression. Instead of feeling overwhelmed, start small with gentle movements like stretching, deep breathing, taking a shower or doing household chores. When you can, add more active activities such as walking, yoga or playing with your kids or whatever it is you enjoy.
It might help to get support, too. For instance, Serani scheduled walking dates with her neighbors. She also prefers to run errands and do household chores every day so she’s moving regularly.
5. Eat well. We know that nourishing our bodies with vitamins and minerals is key to our health. The same is true for depression. Poor nutrition can actually exacerbate exhaustion and impact cognition and mood.
Still, you might be too exhausted to shop for groceries or make meals. Serani suggests checking out online shopping options. Some local markets and stores will offer delivery services. Or you can ask your loved ones to cook a few meals for you. Another option is Meals-on-Wheels, which some religious and community organizations offer.
6. Know your triggers. In order to prevent relapse, it’s important to know what pushes your buttons and worsens your functioning. For instance, Serani is selective with the people she lets into her life, makes sure to keep a balanced calendar, doesn’t watch violent or abuse-laden films (the movie “Sophie’s Choice” sidelined her for weeks) and has a tough time tolerating loud or excessively stimulating environments.
Once you pinpoint your triggers, express them to others so your boundaries are honored.
7. Avoid people who are toxic. Toxic individuals are like emotional vampires, who “suck the life out of you,” according to Serani. They may be envious, judgmental and competitive. If you can’t stop seeing these people in general, limit your exposure and try having healthier individuals around when you’re hanging out with the toxic ones.
8. Stay connected with others. Social isolation, Serani writes, is your worst enemy. She schedules plans with friends, tries to go places she truly enjoys and has resources on hand when she’s somewhere potentially uncomfortable, such as books and crossword puzzles.
If you’re having a difficult time connecting with others, volunteer, join a support group or find like-minded people online on blogs and social media sites, she suggests. You also can ask loved ones to encourage you to socialize when you need it.
Living with Depression9. Create a healthy space. According to Serani, “… research says that creating a nurturing space can help you revitalize your mind, body and soul.” She suggests opening the shades and letting sunlight in. There’s also evidence that scent can minimize stress, improve sleep and boost immunity. Lemon and lavender have been shown to improve depression.
Serani says that you can use everything from essential oils to candles to soap to incense. She prefers lavender, lilac, vanilla and mango. If you’re sensitive to fragrance, she recommends diluting essential oils, buying flowers or even using dried fruit.
You also can listen to music, meditate, use guided imagery, practice yoga and even de-clutter parts of your home a little each time.
Serani’s last point involves empowering yourself and becoming resilient. She writes:
By learning about your biology and biography, following your treatment plan, and creating a healthy environment, you don’t allow anyone to minimize you or your depression. Instead of avoiding struggles, you learn from them. You trust your own instincts and abilities because they are uniquely yours. If you experience a setback, you summon learned skills and seek help from others to get back on-point. If a person’s ignorance on mental illness presents itself in the form of a joke or stigma, you clear the air with your knowledge of neurobiology and psychology.


Friday, June 20, 2014


Justin Krampert
Justin Krampert 12:56pm Jun 20
Hi Joshua, and everyone! I am a Board-Certified Music Therapist (MT-BC) & Adaptive Guitar teacher in the Bergen County area in NJ. I would like to thank you for adding me to the group, and if I may be of any help to you, or you would like to converse with me about Music Therapy, please feel free to write me!

Peace always,
Justin Krampert, MT-BC

Thursday, June 19, 2014

Psychotherapy Treatment for PTSD

By Sara Staggs, LICSW, MSW, MPH
Therapy has been shown to be effective in the treatment of PTSD.  However, since trauma symptoms are very specific, not all types of therapy are appropriate.  SAMHSA has a list of every evidenced based therapeutic program by the National Registry of Programs and Practices, 17 of which list PTSD relief as an outcome.
There are several ways in which these treatments overlap:
  • Many of them help the trauma survivor develop new coping skills related to their symptoms.  These involve things like emotion regulation, cognitive restructuring, relaxation and mindfulness techniques and psychoeducation about symptoms and issues related to the type of trauma the individual experienced.
  • Many of them require an individual to revisit the event in order to heal.  These can involve repeatedly retelling the story, reprocessing in a new way, or allowing the body to discharge any held energy.
  • Most of them can be delivered in individual or group settings.
  • In order to safely and fully explore one’s trauma, an individual needs to have some stability.  Homelessness, uncontrolled addiction, severe emotional distress showing up as recurring panic attacks or suicidal ideation can interfere with someone’s ability to explore trauma.  Life doesn’t have to be perfect, but the therapy should help with an individual see some improvement prior to exploring the trauma.

What Trauma Therapy Looks Like

There is a three phase treatment protocol that is recommended by expert bodies on trauma:
  • Phase 1: Achieving patient safety, reducing symptoms and increasing competencies This is the skills building phase and clinicians can use any evidence based therapy that has outcomes of improving emotion regulation, increasing distress tolerance, mindfulness, interpersonal effectiveness, cognitive restructuring, behavioral changes, and relaxation.  This phase can also help move someone out of crisis to prepare for the next phase.
  • Phase 2: Review and reappraisal of trauma memories There are different techniques for doing this, and they are described below, but the success of this phase hinges on someone’s ability to tolerate the discomfort of reviewing the memories.  People with single incident trauma may be ready to withstand exposure with minimal distress tolerance training, while people with complex trauma may need months of skills building support in order to be ready to process their trauma.
  • Phase 3: Consolidating the gains The therapist is helping the client apply new skills and adaptive understanding of themselves and their trauma experience.  This phase can also include “booster” sessions to reinforce skills, increase professional and informal support systems, and create an ongoing care plan.

Exploring One’s Trauma in Psychotherapy

There are several different ways to explore one’s trauma:
Exposure therapies
The military has used Prolonged Exposure therapy for years to have the individual talk through the traumatic event over and over until the event is no longer activating.  An evidence-based practice for children and adolescents is Trauma-Focused Cognitive Behavioral Therapy, which uses a trauma narrative to expose the individual to their trauma for the same result. Also, Cognitive Processing Trauma can sometimes include a trauma narrative.
  • Exposure can be done all at once, called “flooding,” or gradually to build up tolerance, called “desensitization.”
  • Trauma narratives can be done verbally, or with images or other forms of art.
  • These therapies are most recommended for individuals who have experienced a single incident, or perhaps experienced several incidents but don’t have any other mental health complications.
On SAMHSA’s National Registry of Evidence-Based Programs and Practices, Eye Movement Desensitization and Reprocessing (EMDR) is the only intervention that allows an individual to reprocess memories and events.  Reprocessing means that an individual accesses the relevant memory and uses dual awareness with bilateral stimulation and images, thoughts, emotions and body sensations to move through the traumatic experiences that aren’t resolved. If storing memories is like putting away groceries, a traumatic event was stored by shoving a bunch of stuff in a cabinet and then any time it gets opened all the stuff falls on your head.  EMDR allows you to pull everything out in a controlled manner and then put it away in the organized way that non-traumatic memories are stored.
  • EMDR is highly recommended for individuals who have developmental or complex trauma, but also has evidence-based protocols for single incident trauma.
  • EMDR has 8 phases of treatment, the first three of which don’t involve any bilateral stimulation, and are more about skills-building and resourcing in preparation for the processing phases.
Somatic Therapies
Therapies that use the body to process trauma are cutting edge and so far none of them are considered evidence based due to lack of research.  Probably the most popular is Somatic Experiencing, based on Peter Levine’s observations of animals’ recovery from traumatic events.  Another model is Sensorimotor Psychotherapy, which also uses the body to work through trauma.
While all of the above treatments are designed to be used individually, most of them can be delivered in a group setting as well. Group therapy can be helpful for many people who have experienced trauma, since simply having experienced the type of event that can produce trauma symptoms can be isolating.  Group members can help normalize a lot of the reactions and feelings that someone has.

Choosing a treatment that is right for you:

As with any therapy, finding a therapist that you feel comfortable with and can trust is the most important thing.  They should be clear with you about what your treatment plan is, and address any concerns that you have about your symptoms and your recovery. With the right therapist, you will be able to work with them on your trauma and they should be flexible enough to shift your treatment plan if things aren’t working. Talk with your therapist about the treatment approaches they use for trauma, and seek a referral if you feel like the therapist or the treatment model is not the right fit for you.
For Further Information


Wednesday, June 18, 2014


“We do not need magic to transform our world. We carry all of the power we need inside ourselves already” - J.K. Rowling.

Friday, June 13, 2014


Thirteen Easy Ways To Give Yourself A Break

525200_73544751Have you been working hard on yourself, mind, body, and soul? Therapizing? Talking? Discussing? Meditating? Self-assessing? Introspecting? Exercising? Volunteering? Self-esteeming? Motivating?
Now, give yourself permission to take a break.
By the way, the idea for this post and nine of these ideas on this list were given to me by a client with bipolar disorder. And most of them are low-cost or free.
And just reading the following list doesn’t work, you actually have to do one of them or use one of your ideas.
1. Choose some really catchy, upbeat music, the kind that you’d be too embarrassed to let anyone know you like, and listen to it while you’re doing chores like laundry.
2. Take an eight-year old to a museum. Or a six-year old to a zoo. Borrow a friend’s kid if you have to. (Yes, of course ask permission).
3. Create a treasure hunt. Invite your most fun-loving friends. Or be brave, and invite everyone in your family to participate.
4. Pack a bag of stale bread and go feed some birds or ducks in a nearby park.
5. Leave your phone, pad, tablet, and all devices at home every time you go out. For at least 24 hours.
6. Dance. Barefoot. If possible, on a trampoline.
7. Create your very own comic strip. Post it on social media or your blog.
8. Create your own Powtoon.
8. Make a scrap-book about your friends or family.
9. Plant a terrarium and get a pet frog.
10. Spray paint a boring piece of furniture a non-boring color. Or graffiti it.
11. Do this with a friend: Buy/rent a small helium tank and a package of 40 or so balloon. Fill them and hand them out to people on the street.
12. Write 2 dozen hilarious predictions. Make fortune cookies. Give them out to people you work or go to school with.
13. Memorize 5 jokes. Tell at least one joke to every person you come in contact with at least for one day.

Thursday, June 12, 2014


Monday, June 9, 2014


Wednesday, June 4, 2014


Sunday, June 1, 2014