Input: What can I do about my depression and anxiety after trying so many things?

Instruction: I have terrible anxiety and depression. I've tried various therapists and pills, but nothing's helped.

Output: I'm sorry you've had a difficult time finding what you need.  Sounds like you have been trying super hard!It's common for people to go through a few therapists before they find a fit.  I agree with the prior post that relationship is the most important factor in counseling, otherwise techniques don't really work.  It can be the case that you are connecting with your counselor but not able to implement what you are learning for whatever reason.  That's pretty typical in depression when lethargy is high and motivation is low.  Have you discussed your medication with your prescribing provider?  It seems like you have advocated for yourself in the past and have put some effort into trying new things.  That's actually really tough to do, depression or not!  When I have clients that seem to make no progress despite many sessions and different medications, I recommend trying a service called GeneSight.  Here's the link: https://genesight.com/.This service allows you find medications that fit best with your genetic makeup.  I don't have any affiliation to this service, but I've seen some success for people that have followed through since it is very personalized.  I believe some insurance companies cover the full cost and it's easy to use.Let me also point out that your motivation is spectacular.  You have been through multiple therapists and meds, yet you still reach out on this forum filled with counselors!  That shows some dedication to yourself and hope that you can find help to change.  That's not easy with depression or anxiety.


Input: What can I do about my depression and anxiety after trying so many things?

Instruction: I have terrible anxiety and depression. I've tried various therapists and pills, but nothing's helped.

Output: I'm sorry that you have tried several different things and not had much relief.I will say that there are several different types of medications that may help and each therapist is different, so it is quite possible that a different combination of things you've already tried may be helpful.I would encourage you to continue trying different therapists. I would say to give each one at least six sessions before you decide that the approach that they are using is not working for you. Also, most places have a certain sort of structured initial session that must be done, but after that, the decisions are largely up to what you and the clinician feel is helping. If something is or is not working, communicate this with your therapist. This is a big deal. Most therapists I know actually welcome this feedback.There is a fair amount of research into the idea that the therapeutic alliance (the relationship that you have in the context of working through the reasons that brought you into therapy) is very important. Also, sometimes anxiety and depression can make it difficult to go to therapy on a regular basis. If that is something with which you are struggling, I would encourage you to talk about that as well.In addition to a solid relationship with a therapist who you connect with, you may consider trying something like yoga or meditation. Mindfulness is sometimes helpful as well.Here's a link to questions for finding suitable therapists: http://www.pharmatherapist.com/12-tips-for-finding-a-suitable-therapist


Input: How can I help my husband after a suicide attempt?

Instruction: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Output: Hello, and thank you for your question. This is a very serious time. I don't mean to frighten you, but you are right to be concerned. The time right after people leave the hospital after receiving psychiatric services is a time of high risk for suicide. It is very important, after hospitalization, to get follow-up care with a professional as soon as possible. If your husband has an established therapist, this is the time to call. It is also a good time to alert your support system of friends, family, clergy or others to let them know he is still struggling. This is good support for him AND you.It is important to think about means and opportunity to make another attempt. Means really do matter.  So, if you have a firearm in the home, it is really important to remove it. You can't remove all things that a person may hurt themselves with, but some things are more lethal than others. Firearms are very lethal. I am not sure what means he used last time, but try to reduce the opportunity for him to access it again. This is where your support system can help out. People can take turns hanging out with him until you are sure the crisis is over.If you believe that an attempt is going to occur, talk to your husband about going back to the hospital. If he refuses, you will want to find out what your options are to have him go even if he doesn't want to. I know the thought of that really hurts, but it can save his life. Calling 9-1-1 is always a good option if you are not sure. Usually a suicide crisis, meaning they want to harm themselves right now, lasts a few minutes, hours or days. Sometimes when you get them through the crisis stage, they no longer want to commit suicide. But, as you are indicating, that feeling of wanting to commit suicide can come back again. So, it is always good to have a plan. If you want more information, call the National Suicide Prevention Lifeline. They will always answer: 1-800-273-8255. They can help you create a specific safety plan. I do hope things work out alright. Be well. Robin J. Landwehr, DBH, LPCC, NCC


Input: How can I help my husband after a suicide attempt?

Instruction: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Output: This is actually more common then we often realize, and actually understandable, as he has gone through a trauma, an unresolved existential crisis.  He was taken care of by others and now is again left alone with his own internal, and rather horrific inner struggle.In my work with CCT, or Contextual Conceptual Therapy, (see www.suicidetherapy.com) I have learned how trapped suicidal people are in their own isolation, also called a "mysterious isolation," a form of self protection which cuts the off from their Self, or spirit.  And unless they address this message from their soul, accompany a guide on a journey to discover their own missing information, that is to recognize how their own uncomforted emotional pain has resulted in a coping stategy which has effectively cut themselves off from their own beauty, their Self, and their ability to receive love from themselves and others. Their attempt to kill themselves is a cry from their soul or spirit that they cannot live the life they are living any longer.  They take this literally and try to end their life, when in fact what their soul or spirit is saying is they need to begin to live the life they came here to live.


Input: How can I help my husband after a suicide attempt?

Instruction: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Output: I'm thankful to read your husband found care and that his suicide attempt wasn't successful.   While he was hospitalized, and prior to his release, your husband would've been provided in writing a self-care action plan. This typically includes things like committing to a contract 'not to harm' and what to do if he felt overwhelmed by his anger, depression, and hopelessness (e.g. call 911, call therapist, go to nearest hospital emergency department). Additionally, his protocol would've provided instructions for his taking medication(s) as directed, having a follow-up appointment(s) with his psychiatrist/psychologist/clinical social worker, and participating in some form of small group support.  If your husband's struggling as you describe, and you are feeling overwhelmed or frightened for his (your) safety, I'd encourage you to seek immediate assistance.


Input: How can I help my husband after a suicide attempt?

Instruction: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Output: This must be so difficult for both of you.  Watching someone you love suffer so profoundly can bring up lots of difficult feelings.  Without knowing what you are already doing, I have a few thoughts to share with you. First and foremost, know that you cannot fix this for him, and get support for yourself.As much as you are able, make space in your relationship for him to talk about what he is experiencing.  He might not want to talk, and that is ok.If he wants to talk, try to listen without judgement and without trying to talk him out of his feelings.  Focus on validating his feelings and just sitting with him in his pain.Let him know how you feel...that you love him, that you care, that you are concerned, that this is scary for you too, that you are here.I hope that this is helpful.  On my website (www.sarahmcintyrelpc.com), I've written a series of blog posts about coping with distress.  The techniques I've written about there may be supportive for you and your husband.  Sending warm wishes your way.  -Sarah


Input: How can I help my husband after a suicide attempt?

Instruction: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Output: I appreciate that you are concerned about your husband's emotions and want to support him as best you can right now. I imagine that you must be going through your own difficult time too. You've had a complicated shock and trauma in your life and in your marriage; it's normal for both of your emotions to move from hope to despair to fear, anger, gratitude... there is no wrong way to feel and there is no particular pattern your emotions or his will follow. Try not to assume what he is feeling but ask him instead. "How are you doing today?" is something that can be asked over and over again and your love and compassion for him will come through. If he has a hard time talking, you can share your observations. "I notice you're more withdrawn. This worries me." Certainly it will help you if you know what he's thinking and feeling because he hid his intentions to hurt himself. It's normal that you want to know. If there is depression and hopelessness, this likely was part of what led to his initial despair. There is help out there. Depression is treatable, and seeking that treatment is important right now at this vulnerable time. This is the kind of complex situation that can be assisted by a therapist who is qualified to help you both understand and manage your emotions. Whether your husband seeks help or not, I hope that you do.


Input: How can I help my husband after a suicide attempt?

Instruction: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Output: A failed suicide attempt is commonly thought of as a “cry for help,” however it can also be a serious attempt to find a permanent solution to depression, hopelessness or other feelings a person feels are unbearable. It’s wonderful that you want to support your husband, but If your husband is feeling depressed and hopeless, you can best help him by getting him to a mental health professional. Feelings of hopelessness and depression, and previous attempts at suicide are all risk factors for future suicide attempts. With a mental health professional, or in the emergency room of a hospital, your husband should be evaluated for suicidal thoughts, intent and plan, and if he is a danger to himself he should probably be hospitalized again until he is stable. Without knowing the particulars, your husband may suffer from Major Depressive Disorder or some other illness on the depressive spectrum. In that case medication could help him immensely, at which point you can offer your support and encouragement him to practice gentle self-care. And do not forget to practice it for yourself.  Remember: a suicide attempt not only affects the person, but it is an immense stressor for his or her loved ones as well. As they say, “put your oxygen mask on first.” Then you will be better able to provide your husband with calm and loving care and attention.Kayla Schwartz, LMSW[email protected]


Input: How can I help my husband after a suicide attempt?

Instruction: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Output: The fact that you're reaching out for help here is really helpful.The first thing I would suggest is that you consider seeing a local mental health professional yourself to be able to talk about the details, how this is affecting you, and how you can hold onto you are while also being supportive to you husband.From the way that you describe this, I wonder what has changed since coming home from the hospital. Perhaps you can have a conversation with your husband this and mention that you are asking him questions to learn more about his experience and you can discuss how you notice that things were going much better when he came home from the hospital, and now things are not as good. Perhaps he can tell you about what is different so that you may know him would be most helpful to him.I also hope that you husband is still continuing with his own treatment.There may also be a local peer support telephone number for the county that you live in that they be able to help you determine whether your husband needs more immediate treatment if he is feeling hopeless again. There are national crisis telephone numbers listed below as well.


Input: How can I help my husband after a suicide attempt?

Instruction: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Output: Before I answer your question I want to cover some basics given that attempted suicide is very  serious. I don't mean to scare you but I do want to be realistic with you. If a person attempts suicide once it is more likely they will try again. Men also succeed more often than women because they typically use a means that is more fatal. Here are some signs you can watch for:Threatening to hurt or kill himself, or talking of wanting to hurt or kill himself; and or,Looking for ways to kill himself by seeking access to firearms, available pills, or other means; and/or,Talking or writing about death, dying or suicide, when these actions are out of the ordinary. Some other signs are:Increased substance (alcohol or drug) useNo reason for living; no sense of purpose in lifeAnxiety, agitation, unable to sleep or sleeping all of the timeFeeling trapped – like there’s no way outHopelessnessWithdrawal from friends, family and societyRage, uncontrolled anger, seeking revengeActing reckless or engaging in risky activities, seemingly without thinkingDramatic mood changesGiving away prized possessions or seeking long-term care for petsNow, in terms of ways you can help: 1. Ask if your husband is okay or if he is having thoughts of suicide2. Express your concern about what you are observing in his behavior3. Listen attentively and non-judgmentally4. Reflect what he shares and let him know that his is heard5. Tell him he is not alone6. Discuss treatments available that can help7. Guide them to additional professional help: National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).A mental health professionalA hospital emergency departmentIf you are interested, I have more information on my website under "Resources/Information" and "Suicide". www.bbcounseling.net I wish you both the best!


Input: How can I help my husband after a suicide attempt?

Instruction: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Output: Since as husband and wife your lives are closely joined, how your husband feels greatly influences the way you feel.Give yourself some time to concentrate on how you've been affected by your husband's suicide attempt.   Even if you decide against immediately telling him how you're feeling, knowing this about yourself will guide how and the topics you bring up with him.Is your husband talking easily with you?Do you have some ideas as to what is creating his feeling of hopelessness?The ideal approach would be if the two of you are able to discuss what bothers him and what bothers you.Depending on how far away you each are from such a position, you may benefit from speaking with a licensed professional therapist who can guide you and or you and your husband on opening up for discussion what feels stressful enough to merit taking one's own life.


Input: How can I help my husband after a suicide attempt?

Instruction: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Output: It seems like you are very receptive of your husband’s emotions and want to support him trough this time.  But it is also important of being aware of your emotions.  How are you feeling after the suicide attempt?  It is common to experience negative feelings while you try to make sense of the incident.  Feelings like anger, shame, guilt and fear are frequent; while, wanting to avoid, minimize and become distant from the person are parts of the defense mechanism to attempt a quick resolution.  Once you understand and overcome those feelings you may be in a better position to help your husband; who may be experiencing some negative feelings as well.First, it is important to have a safety plan in place, which includes removing harming objects from the home, knowing who to call if there’s a new attempt (either 9-1-1, or nearby treatment center), have a professional expert who monitors you and your husband’s progress, either a Counselor or mental health provider could help you manage negative feelings and identify ways to handle triggering situations.Once the safety plan is in place,  make him feel supported and not judged, saying open ended statements, like: “I am glad that you are here, please let me know what I can do to help you through this process”.  Making small changes toward a healthier living may help as well.  Exercising, eating healthier and practicing new leisure activities may be good ways to start.  Also, explore your spirituality and your husbands, looking for ways to encourage each other by joining a support group or finding people who share your spiritual beliefs.If you have more questions or concerns I offer teletherapy in the State of Texas, and traditional Counseling in Puerto Rico, call 787-466-5478. ¿Cómo puedo ayudar a mi esposo después de un intento de suicidio?Después de que el llego a casa del hospital estaba enojado, luego por un tiempo maravilloso.  Ahora está deprimido y sin ánimos.Parece que estas muy atenta a los sentimientos de tu esposo, y que lo deseas ayudar durante este momento de su vida.  Pero también es importante estar consciente de tus propias emociones.  ¿Cómo te has sentido luego de este intento de suicidio?   Es común que experimentes emociones negativas mientras los recientes sucesos hacen sentido.   Sentimientos como coraje, vergüenza, culpa y miedo son comunes, y el querer evitar, minimizar o distanciarte son mecanismos de defensa igualmente comunes.  Ya que comprendas y superes estos sentimientos,  estarás en una mejor posición para ofrecerle ayuda, recuerda que tu esposo también debe de estar experimentando sentimientos negativos. Es muy importante tener un plan de seguridad, esto incluye remover todos los objetos que pueden ser dañinos o facilitar un futuro atentado, saber a quién llamar en caso de una emergencia (9-1-1 o una clínica de emergencias cercana),  tener un experto que monitoree tu progreso y el de tu esposo, puede ser un Consejero u otro experto de salud mental que te ayude a manejar los sentimientos negativos y situaciones retantes.Ya que el plan de seguridad sea activado, crea un ambiente donde tu esposo se sienta apoyado y no juzgado.  Utiliza frases abiertas para comunicarte, dile que estas feliz de que este contigo, y quieres saber cómo puedes ayudarlo durante esta etapa.   También haz cambios pequeños para mejorar su calidad de vida como pareja.  Hacer ejercicios, comer más saludable y compartir actividades puede ser un buen comienzo. Explorar tu espiritualidad y la de tu esposo también puede ser de ayuda, y encontrar personas o grupos que compartan esos mismos intereses puede ser una manera de mantenerse motivados.Si tienes más preguntas o preocupaciones sobre el tema, ofrezco teleterapia en Texas y Consejería Tradicional en Puerto Rico, llama al 787-466-5478 para más información.


Input: How do I get back on my feet while going through a bad divorce?

Instruction: I am going through a divorce. He is extremely angry. He refuses to physically assist me with our teenager daughter. I have no extended family support. Often times, I feel overwhelmed, tired, and joyless. I feel out of control, sad and depressed on a daily basis. I am just going through the motions of life every day. I am in my mid-50s. I have almost 29 years on my job. How can I handle this?

Output: Going through a divorce is often a very low point for the people involved.Are you surprised that your soon to be ex doesn't help with your teenage daughter?Usually patterns and dynamics in parenting are not  sudden developments.Is it possible that what you're feeling now is more intensity to the stress of parenting by yourself, not that this is a sudden problem?This is relevant because you may be more familiar and more capable than you're giving yourself credit.  The lack of emotional support is definitely stressful.Your parenting skills may still be at the level at which they were prior to the divorce.Take your emotional weariness seriously and reflect on the various ways of stress relief which are available and interest you.Give yourself extra time to rest, nurture yourself and be flexible in finding what feels right for stabilizing yourself.Since you talk about your daughter and help in physical ways, if it is a matter of strength that you need, talk with your attorney so that the child custody agreement includes whatever is physically necessary in the way of strength, in taking care of your daughter.The Courts are very good at making effort that the custody agreement offers proper care to the kids.


Input: How do I get back on my feet while going through a bad divorce?

Instruction: I am going through a divorce. He is extremely angry. He refuses to physically assist me with our teenager daughter. I have no extended family support. Often times, I feel overwhelmed, tired, and joyless. I feel out of control, sad and depressed on a daily basis. I am just going through the motions of life every day. I am in my mid-50s. I have almost 29 years on my job. How can I handle this?

Output: You are in the midst of a really hard time and it sounds like you have no help at all.  Search out a local support group through community counseling type centers.  If you can't find a group, at least get in to see a therapist who can help you manage stress and upset better.  Your sadness, depression and out-of-control feelings don't mean there is something wrong with you - they just mean that your circumstances are too big for your current resources to handle, so get some help. Take care of YOU and you'll be able to get through this.


Input: I think my friend might have depression

Instruction:
She has trouble falling and staying asleep and she's always either extremely hungry or not hungry at all. She also gets angry and feels like crying really easily for no reason. She says she is always "kind of down."
   Is this depression? What can I do to help her?

Output: Do you feel heavy with despair, struggling each day to keep your head just above the darkness and dread? Does it take every ounce of energy to stay afloat? Or are you feeling overwhelmed by feelings of helplessness and hopelessness? If this sounds familiar, we want you to know that you are not alone and therapy for depression could help.While it may seem difficult to find your way back to hope and happiness, therapists have  been helping clients to personally do just that for years. To experience the joy of warm sunshine on their face, to reconnect with estranged loved ones, and to re-engage with a meaningful life.Just like other chronic illnesses, depression is not your fault, it’s nothing you’ve caused. And also like many other illnesses, effective treatments exist to help ease and eliminate the struggles you face.If you’ve said or thought these things a lot recently: “I’m too tired to try.”“I don’t want to leave home.”“I don’t care anymore.”“Why am I always crying?”“I don’t even know who I am any more.” Or even, “I wish I wasn’t here.” Then there are proven steps and therapies that can help you get remarkable relief. Therapy for depression can bring you hope, help and a way forward. Visit denvermhc.com to read more.


Input: I think my friend might have depression

Instruction:
She has trouble falling and staying asleep and she's always either extremely hungry or not hungry at all. She also gets angry and feels like crying really easily for no reason. She says she is always "kind of down."
   Is this depression? What can I do to help her?

Output: Sounds like signs of someone who is depressed.Since the person in question is your friend, offer your friendship to listen to any situations or feelings she has about herself and the way her life is going.Depressed people are often lonely people and feel as though no one around them cares or notices them.  Your willingness to be available to her may lift her spirits.  Feeling loved goes a long way to dissolving depressed feelings.Also, if in the beginning when you offer to talk, there is a high chance she'll be defensive and turn down your offer.Try again on another day and then another day.When people feel depressed they usually shut down.  So you may need a few or several tries before your friend accepts your offer to show her you care about how she is doing.Also, watch for signs within yourself that your friends' depression is not sinking your emotions.  Depressed people are draining to be around because they often see and talk about only the negatives and drawbacks of situations.


Input: Why am I upset or down every day even when nothing is going on?

Instruction: How can I get to a place where I can be content from day to day?

Output: Your question is a fascinating one!As humans we have the ability to reflect on situations in our lives.Even if nothing currently goes on in a particular moment, it’s possible you’re reflecting on a serious or upsetting matter.And, our emotions linger within us.Just because a particular moment feels calm, inside your feelings may be the sense of a strong unsettled emotion from the recent past.Good for you to be aware of your own sensitivity to living with awareness of your moods and thoughts.


Input: Why am I upset or down every day even when nothing is going on?

Instruction: How can I get to a place where I can be content from day to day?

Output: One thing that comes to mind is making a list of some things that happen each day. It could be that there are things that are affecting how upset you are, but because so many other things are going on, you may not notice.Another idea to try is to keep a list for a month of one good thing that happened each day. This way, when you're having a rough day, you have a list to think of and take a look at.Are you eating and sleeping in ways that are typical for you (typically at least two meals per day and roughly 8 hours of sleep that night (may be different depending on your age)? These two ideas are closely related to changes in your mood.From where do you have support? Friends or family?Can you take 5 or 10 minutes per day to do something that you enjoy?If you think back to the last time that you felt "content," what was contributing to that?Another possibility is to try to be mindful of things that you do every day. For example, rather than eating a turkey sandwich as fast as possible on your lunch break, consider actually tasting it and enjoying it. Also consider giving yourself praise for doing something well. For example, when you finish your paperwork, take a moment to notice that and maybe reward yourself by checking your e-mail, reading five pages of a book, or something else that can be done quickly before you get back to your next task.


Input: Why am I upset or down every day even when nothing is going on?

Instruction: How can I get to a place where I can be content from day to day?

Output: It's important to take a look inside and see what's going on with you to cause you to have these feelings.  Please contact us in whatever way is most comfortable for you and we can get you set up with someone who will help you figure out this space in your life.


Input: How can I deal with depression stemming from chronic pain?

Instruction: I have a severe back problem. I've had 3 major and several minor operations, but I'm still in constant pain. How can I deal with the depression from this chronic pain?

Output: Chronic pain at the back likely results from a few areas:L4-L5 kidney zone, most likely (lower back);Bone spurs, fused discs, and slipped discs, caused by connective tissue weakness, and calcium deposits used to neutralize highly acidic areas...The 'depression' will evaporate when the chronic pain is drained out, through natural means;Pharmaceutical means will simply extend the pain and cause it to deepen over time, not solving the problem;Remember, medical doctors suppress, natural doctors cure...


Input: How can I deal with depression stemming from chronic pain?

Instruction: I have a severe back problem. I've had 3 major and several minor operations, but I'm still in constant pain. How can I deal with the depression from this chronic pain?

Output: Maybe if you started to address questions of an inner nature of what changed in your life as a result of the back problem.To know your limitations and the areas of your life which they affect, will greatly contribute to stronger self-knowledge within you.Greater awareness and sense of direction very often decreases depression.


Input: Why does it feel as if self-harm is an addiction?

Instruction: I self-harm, and I stop for awhile. Then when I see something sad or depressing, I automatically want to self-harm.

Output: In a way, self-harm can present somewhat like an addiction.  According to new research within the field of neuroscience there is a valid explanation for this.  When a person cuts or uses other forms of self harm, the body produces endorphins to help make a person feel better.  If a person was dealing with depression or high anxiety, that might be misinterpreted by the brain as a way to help oneself feel better and a new neural network or map might form (addiction) that would utilize this new behavior.  Another way to look at it would be thru a behavioral lens, a positive reward for a behavior, even though the behavior has other long term negative consequences.  Consider working with someone who can both have you work on and address those items that trigger your behavior and the root causes, in this case sadness or depression, and second find someone who can help give you alternatives that take into account the neurological requirement by replacing the behavior with another behavior (such as snapping a rubber band on the wrist) and working to extinguish the unwanted behavior.   Someone who is trained in Dialectic Behavior Therapy and/or Interpersonal Neurobiology would most likely have the skills and means available to address this with you.


Input: Why does it feel as if self-harm is an addiction?

Instruction: I self-harm, and I stop for awhile. Then when I see something sad or depressing, I automatically want to self-harm.

Output: Self-harm has a way of becoming a go-to method of coping. When we get stuck using self-harm as a way to deal and manage emotions, when something serious happens it totally makes sense that that will be one the first things to go through the mind. It is its own kind of addiction. There is a therapy, DBT or, Dialectical Behavior Therapy, which focusing on giving you new tools to get through hard times, understand and manage your emotions, to stay present and to deal with relationships. This one of the most effective interventions there is for self-harm. If you are interested in DBT, reach a local therapist in your area and ask if they do DBT or can recommend you to a DBT program. This can help immensely. Self-harm recovery is totally possible, but it is definitely hard work!


Input: Why do I crave depression?

Instruction: It's not entirely true to say I enjoy being sad, but I always find a way to feel that way. I listen to sad music, read tragic stories, and, in a twisted way, like how bad it makes me feel. I focus on negative aspects of my life even if they aren't legitimate or I just make it seem negative.

Output: It sounds like you are noticing that you are drawn towards sad and negative content and it's hard to understand why. This may sound counter-intuitive, but sometimes we do things that on the surface may look problematic (or even cause us some real problems) because it serves us in some unseen way. A simple example would be somebody who is addicted to a substance; their addiction may be causing serious problems in their life, and they may even know it, but the addiction serves them by helping them to avoid painful feelings that they anticipate having if they quit using. Now I am not saying that what you describe is an addiction, it is just a really illustrative example of the unseen benefit.One thing I would be wondering about is what is the unseen benefit of seeking out sad and negative content? I'd also be wondering what your relationship is to other feelings. These are things you may benefit from exploring with a competent therapist.


Input: Why do I crave depression?

Instruction: It's not entirely true to say I enjoy being sad, but I always find a way to feel that way. I listen to sad music, read tragic stories, and, in a twisted way, like how bad it makes me feel. I focus on negative aspects of my life even if they aren't legitimate or I just make it seem negative.

Output: I applaud your courage in asking this question to gain some deeper insight into what is happening in your life. This is one of the most common things that I personally have seen in the population of individuals who suffer from depression. It is often that I notice clients focusing on the negative to the complete dismissal of the positive when they are dealing with depression. It is inspiring that you have noticed this in yourself because many clients are not aware that this is a pattern for them, or are not yet willing to face that depression has become a pattern they cling to. Depression, if dealt with for extended periods of time, can become a way of life, an identity of sorts, that is very difficult to part from. While you desperately desire happiness, who would you be without the depression? Sometimes it is scarier to journey into the unknown (in this case, happiness), than it is to stay in the known, and the often times comfortable space of your depression. Human beings, for the most part, fear and stray away from change in general, especially a change that is so impactful. Allowing yourself to confront the possibility of change as positive with the support of a professional counselor is often extremely helpful.


Input: How can I find myself again?

Instruction: I just don't know what I want in life anymore. I'm can't figure out what it is that is keeping me distracted and unfocused. I can't put things into perspective at all. I'm just stuck, and I'm disappointed with my lack of accomplishments.

Output: If you are a people-pleaser type or a natural caretaker, you can slowly "lose yourself" over time if you are always tending to the needs of others and neglecting yourself.  If this sounds like a familiar pattern for you, this may have happened without you even realizing it if you were raised in a family where you had to pick up the slack alot.  Maybe your parents were addicts or they might have even just worked all the time and you learned to "take care of everything" because that is what you had to do to help the family run smoothly. Over time, a person who grows up in this type of environment learns that you put the needs of others before your own.  You might also be stuck in these types of patterns in intimate relationships as well; if you completely give yourself over to your significant other and you don't create a life for yourself with your own interests and supportive friends, you are at risk of losing what is unique and amazing about you.  If you grew up in a family where you learned this role out of survival or because it was needed to take care of your family, it's easy to re-create this in adult relationships.In both scenarios, if there is no awareness that this "self sacrifice at the expense of others" is going on, your identity is shaped around being a caretaker/enabler/people-pleaser and down the road it can lead to depression, low self esteem, and a confused sense of self.  Basically, you spend so much time helping other people that you don't make time for yourself or create a life of fulfillment.  Before you realize it, you have been living a life for others instead of yourself and you have no idea who YOU are.  Supporting loved ones and friends is important and certainly admirable, but if you are always that person that rescues, those that rely on you begin to take advantage of you and they will suck you dry if you let them.  In conclusion, learning to set boundaries with those in your life that are too needy becomes a really important part of the process when you begin to recognize that you are unhappy and unfulfilled in life.  It sounds like you may be at that crossroads right now.  Take one small step at at a time.  Identify the worst offenders in your life that suck time and energy, and limit your contact and/or set some strong boundaries with those people so you can refocus and do some soul-searching.  Meanwhile, engage in pleasurable activities with people you enjoy being with, get yourself outside in the fresh air, get some good sleep, and eat some nourishing food!


Input: How can I find myself again?

Instruction: I just don't know what I want in life anymore. I'm can't figure out what it is that is keeping me distracted and unfocused. I can't put things into perspective at all. I'm just stuck, and I'm disappointed with my lack of accomplishments.

Output: Give yourself credit for what you already know.For instance, you do know that you're unsure about your life direction. Take off any pressure on yourself to decide an answer in a certain amount of time.  Inner reflection work takes time and has its own course.   Trust that answers will show once you've done the work to understand yourself and circumstance, and the relationships in your life.From what you describe, your interest is in a broad scope life change. One direction is to start with only one specific part of your life you would like to change.  By examining one area in detail you will gain self-trust and confidence in handling your life.   And, you will have clarity as to which area to change first.


Input: How can I find myself again?

Instruction: I just don't know what I want in life anymore. I'm can't figure out what it is that is keeping me distracted and unfocused. I can't put things into perspective at all. I'm just stuck, and I'm disappointed with my lack of accomplishments.

Output: Thank you for sharing! It can be very disorienting not to know what you want and where you are headed. Sometimes we are so focused on something we haven't achieved yet or on comparing ourselves to others that we lose touch with what we actually want and need. At times like this, it's important to go back to basics. Try out this simple exercise, take a few minutes to write down all your present responsibilities. For example: make meals, complete homework...etc.  Then in the column next to it, write down the things that you do for yourself to recharge yourself and to enjoy your time. Is your list of responsibilities way longer than your list of stuff you do for yourself? It is easy to get lost in the sea of responsibilities and disconnect from what you want and need. To fix that, write another list of things that you enjoyed doing in the past for yourself and start incorporating them into your schedule on a regular basis. This will help you re-connect with yourself, and bring focus and clarity to your life.


Input: How can I find myself again?

Instruction: I just don't know what I want in life anymore. I'm can't figure out what it is that is keeping me distracted and unfocused. I can't put things into perspective at all. I'm just stuck, and I'm disappointed with my lack of accomplishments.

Output: Check this blog out:  Four-ways-add-self-esteem-friends-listHope you find a few nuggets of helpfulness in this.


Input: How can I find myself again?

Instruction: I just don't know what I want in life anymore. I'm can't figure out what it is that is keeping me distracted and unfocused. I can't put things into perspective at all. I'm just stuck, and I'm disappointed with my lack of accomplishments.

Output: It sounds as if you would benefit from talking with a local mental health professionals so you can discuss some details.Having said that, I wonder if you could consider how you would define yourself to someone who doesn't know you. For example, honest, adaptable, fun-loving, dependable, compassionate, open-minded, dedicated, etc. If you're looking for a list of adjectives, try these: https://www.englishclub.com/vocabulary/adjectives-personality-positive.htm . There is a list of negative ones here too. If you're going to use those, try to use three positive ones for each of the negative ones. You could also try asking yourself what you love about yourself and/or what others love about you. Sometimes it's easier to consider what others see as our positive points and if this is difficult for you, try asking someone who you trust to help you with the list.The idea here is to look at your relationship with yourself. I don't mean this in a way that you would be talking to yourself and receiving answers, but rather looking at yourself in a way that you deserve the same kind of loving and compassion that you give to others or want others to have.I'm also curious as to whether you are eating and sleeping okay, as these things can really affect your focus and many other changes, such as differences in your emotions. Also, you saying that you are struggling to put things into perspective leads me to believe that you are going through some things right now that are not typical for you, if so, consider from whom you have support and the ability to talk about what you are going through.Consider Metta meditation here to help give yourself loving kindness: http://www.mettainstitute.org/mettameditation.html


Input: Is wishing I wasn't born a sign of something deeper?

Instruction: I'm not suicidal and wouldn't take my own life, but sometimes, I've wished for an accident to occur and take it. I feel like I just shouldn't be here and wish I wouldn't have been born so I didn't have to go through life. For me, it's a chore, but I don't know if that's normal or a sign of something.

Output: Sounds like a sign of great unhappiness, or sadness, or insecurity.The real way you'll find out what this feeling is about is to ask yourself your own question.  Inside you are the only one who will feel when you discover the true answer to your question.Everyone feels some amount of discontent in their lives once in a while. Its normal to not feel entirely happy all the time.Try to accept your unhappiness as motivation to learn more about who you are, what you like, whom you like.Study yourself bc this way you increase the chance to find a road which feels right and happy.


Input: Is it normal to take a parent role and feel so hurt and broken as a teenager?

Instruction: I'm a teenager. My dad has been jail for the last five years. It's tough, but my mom really tries to give a normal life to my two sisters, my brother, and I. I feel like I took upon a parent role when I'm the second youngest, and I'm not stable. My mother and sisters say I'm overdramatic. I’m just so hurt, and I keep breaking down.

Output: Each person handles themselves differently in any situation.Since you are willing to speak about how you feel, keep looking for blogs and forums on whatever topics you feel most describe your current circumstance.Your mother and sister, even though they are family seem to prefer the opposite method to yours.Find your own path of supportive other people and possibly a therapist.This way you’ll have understanding and validation which your mom and sister don’t want to give you right now.


Input: Is it normal to take a parent role and feel so hurt and broken as a teenager?

Instruction: I'm a teenager. My dad has been jail for the last five years. It's tough, but my mom really tries to give a normal life to my two sisters, my brother, and I. I feel like I took upon a parent role when I'm the second youngest, and I'm not stable. My mother and sisters say I'm overdramatic. I’m just so hurt, and I keep breaking down.

Output: It sounds like you have a lot of weight on your shoulders.I'm not sure what you mean when you say you're not stable and you are breaking down. If you are crying because you're sad, that is okay. If you are crying a lot or having trouble eating or sleeping, that's different than just crying sometimes because you are sad. It may be helpful to talk with a local mental health professional in your area. They can help you to figure out what you could do differently to have the role in your family that you would like while also supporting yourself and what you want.


Input: Is there anything I can do about my depression and anxiety?

Instruction: I have been dealing with depression and anxiety for a number of years. I have been on medication, but lately my depression has felt worse. Can counseling help?

Output: Thank you for asking this important question. I find that there are three steps to getting ready for treatment. Step one is expressing interest in wanting to receiving treatment for the outcome of positive behavioral change. Congratulations you did the first step! You are showing your readiness to start counseling by asking this question. Now the second step is to find a counselor who specializes in treating clients with Anxiety and Depression. The therapeutic orientations I have found to be helpful in treating clients with  Anxiety and Depression are a combination of Cognitive Behavioral Therapy with Mindfulness, and Solution Focused Brief Therapy. Receiving meditation for your symptoms if part of the treatment, and the other part is receiving counseling to increase your resilience for future events. Research has found that medication and psychotherapy treatments together shows the most effective outcome for Depression.  The third step is to increase your positive self-talk to motivate yourself to attend treatment. As counselors, we are aware of the anxieties and fears that are associated with talking to a new professional for the first time. However, remind yourself that you are doing this to improve your well being. I hope this was helpful, and good luck with your treatment journey.


Input: Is there anything I can do about my depression and anxiety?

Instruction: I have been dealing with depression and anxiety for a number of years. I have been on medication, but lately my depression has felt worse. Can counseling help?

Output:
Certainly counselling can help. however, there is a caveat, namely, you will need the right counsellor with the right approach. This leads to two questions: 1) What are the identifiers for the right counsellor, and 2) What is the right approach?1) What are the identifiers for the right counsellor? The right counsellor will almost certainly have a lot of experience. He or she will have done a lot personal work and have an ongoing practice of inner work both on their own and with the support of an experienced therapist. This person will be viewing you as a human being with challenges, not as a diagnostic category. He or she will be willing to work with you over an extended period of time and have experience doing such work. Further they will be well versed in approaches that are responsive to you in the moment and overall. The in-depth work will be collaborativel designed in an ongoing way that is responsive to you, the moment, your overall life experience, and their in-the-moment experience. It goes without saying that you will subjectively evaluate the felt sense of connection with this person and the feeling that they are invested in their work with you, value you as a human being, and value the connection. As well, it is crucial that you feel this connection and that your therapist 'gets you.' 2) What is the right approach?  As Carl Jung stated, "When the doctor sits down with the patient he (or
she) must drop all theories and learn the theory of this person." The approach must include a bond between you and your therapist that is in a continuous process of development, attention to pre-verbal imprinting, development of awareness ability, ongoing development of the ability to attend to and stay with inner experience, development of a process orientation, attention to egoic structures that were seeded from the earliest days in the service of perceptions of threats to needs being met, identification of current egoic states and work with these inner selves and their relationship with each other to facilitate movement from developmental points of arrest, increased ability to access and contain non-ordinary states of consciousness, attending to what is, and working with this in the service of moving towards optimal human development.depression is generally experienced as the system shutting down. anxiety is a signal that something is wrong. anxiety is not the problem. it is a sign that there is a problem. the core of these issues is a lack of inner security that is the outcome of insufficient bonding. the work of psychotherapy is to establish an environment and relationship that will facilitate work with the bonding ruptures and re-initiation of the developmental process that stopped at an early stage.


Input: Is there anything I can do about my depression and anxiety?

Instruction: I have been dealing with depression and anxiety for a number of years. I have been on medication, but lately my depression has felt worse. Can counseling help?

Output: My initial response:  consider a more comprehensive MH assessment to determine other factors. A medical evaluation is warranted to rule out poor health issues. Blood work is helpful. Review what hadn't helped.


Input: Is there anything I can do about my depression and anxiety?

Instruction: I have been dealing with depression and anxiety for a number of years. I have been on medication, but lately my depression has felt worse. Can counseling help?

Output: From whom do you get anti-depressants?This person should be talking with you to know whether the pills are helping or not.Trust your own instinct that the pills aren't helping you.Pills work differently for everyone and not all people feel better from them.It is also possible the particular pills have lost their effectiveness because after around six to eight months, this usually happens.Try to understand what is depressing you.  This is slow work since you may have many theories.Just by addressing your own emotional needs and life structure in a caring and respectful way, may improve your mood so that you'll feel less depressed.


Input: Does my friend have depression?

Instruction: I am really worried about one of my friends because I think he has major depression. He disagrees with me on that. He is shut off when it comes to talking to people and telling them how he really feels. He told me he feels empty inside and the only emotions he feels are anger and sadness. I suggested to him to get help and talk to his mom about it but he refuses.

Output: First of all, I can tell that you really care about your friend and I think it's great that you are reaching out with your concern. It's hard to determine whether your friend would meet the criteria for an official diagnosis of depression without working with him, however, whether he does or not, therapy may be beneficial for him in working through these difficult feelings and relational challenges. Unfortunately, you can't make your friend get help. He will ultimately need to make that decision for himself, however, you can talk to him about your concerns and your hopes that he will reach out for help.


Input: I completely lost myself—how can I find myself again?

Instruction: I've become so jaded that I can't control my thoughts. I cannot focus on anything and been having anxiety attacks.

Output: Maybe your thoughts require your attention and the best course would be to pay attention and follow them!If you're in an especially stressful or uncertain time in your life, then the best way through is to understand the tension you feel.It keeps trying to get you to know whats going on deep within you.Anxiety is a sign of stress and weariness.  Your thoughts are a chance to simply rest and know what they would like you to know.Then, when that process is finished your anxiety will no longer be necessary and will most likely leave you alone.


Input: I completely lost myself—how can I find myself again?

Instruction: I've become so jaded that I can't control my thoughts. I cannot focus on anything and been having anxiety attacks.

Output: I imagine that it's pretty disconcerting to feel as though you lost yourself.When you said that you are jaded, I'm not sure whether you mean that you are jaded toward someone, something, life in general, or some combination thereof.One of the difficult things about anxiety is that anxiety can lead to more anxiety because of being concerned about having another panic attack. Consider remembering that panic attacks usually only last a few minutes and the reason they don't go away right away is because of the way your brain releases chemicals because some part of your brain is reacting as if you are in danger in some way.As far as finding yourself, you may consider looking at what parts of each day you can control as a way to stay centered. You could also focus on something that makes you feel happy and/or comfortable.You may also consider the list of values here to give yourself an idea of what is most important to you, what it is that you are living by now, and what values you would prefer to live by. http://www.therapistaid.com/therapy-worksheet/values-clarificationIf this proves to be difficult, consider seeing a local therapist.


Input: I've been feeling sadness

Instruction: When I get around a particular person or when I go home, I'm just sad or irritated. The feeling comes and goes all day every day. I don't know what wrong. I'm not sure if I'm just making up symptoms and problems in my head or if there is something actually wrong.

Output:
Feelings are real, is very unlikely that you are making them up since they are a response to the thoughts in your mind and your daily experiences and interactions. Often we assume that feeling sadness is bad and that we should only feel happiness and joy; but all feelings have a purpose: joy, sadness, anger, frustration, excitement, anxiety, among others.   Is not healthy to experience the same feeling for a long time, so we should learn to identify what causes them and how to process them so you can navigate through life experiences with more ease. I am a Licensed Professional Counselor in Texas, currently providing services in West Houston.  You may reach me at 787-466-5478 to schedule an appointment.   ------------------------------------------------------------------------------------------------------------------------------------------Me he estado sintiendo tristeCuando salgo con una persona en particular o cuando llego a casa, estoy triste o irritado.  El sentimiento viene y va todo el día. No sé qué está mal.  No estoy seguro si estoy inventando los síntomas y problemas en mi cabeza o si algo realmente está mal. Los sentimientos son muy reales, y es muy poco probable que los estés inventando, por que los sentimientos son una respuesta tanto a los pensamientos que hay en nuestra cabeza, y, a las situaciones que nos ocurren día a día.  Muchas veces pensamos que sentirnos triste está mal, y que solo debemos sentirnos alegres, pero todas las emociones tienen un propósito y razón de ser, tanto la alegría, como la tristeza, el coraje, la frustración, la excitación o el desespero, entre otros.  No es bueno quedarnos estancados una emoción.  Así que es importante aprender a identificar que causa nuestros sentimientos, como procesarlos para poder superar nuestras emociones y movernos de una experiencia a otra con más tranquilidad.
Soy Consejera Profesional Licenciada en Texas y Puerto Rico, veo clientes en el este de Houston y proveo servicios de tele terapia.  Para una cita puedes llamar al 787-466-5478.


Input: How do I talk about my feelings of depression, and to who do I talk to?

Instruction: I am a teenager. I have been experiencing major episodes of depression (if that's even what it is) for several years. It’s always getting worse. I have been having panic attacks, feeling like I can't control my fears, and I can't even bring myself to care if I live or die anymore. The problem is that I don't know who to ask for help. When I try to talk to my parents, I freeze completely and can't do anything but make a joke because never once in my life have we talked about our feelings.

Output:
I understand that talking about our feelings can be awkward and using jokes is a way to relieve that awkwardness, but there is a right or wrong way to talk about your feelings. The important part is to recognize that you need help addressing those feelings and reaching out, which you are doing already.  Having small conversations with your family is helpful, you can explain to them that you have been experiencing emotional discomfort and would like to talk to them about it.   Since you been experiencing anxiety, panic attacks, and have thought about dying,  It is VERY important that you ask them to help you make an appointment with a mental health professional.  Those symptoms indicate that your body is having a hard time managing intense feelings and it will be helpful if you understand why they occur and how to cope with them. You may contact your school counselor or you may schedule an appointment with a local therapist.  You may contact the Texas Crisis Hotline 800-989-6884 where you can talk or chat with mental health professionals or schedule a teletherapy session.   The National Crisis Hotline is also available for calling and texting 1-800-273-8255.I am a Licensed Professional Counselor in Texas, currently providing services in West Houston.  You may reach me at 787-466-5478 to schedule an appointment.   ------------------------------------------------------------------------------------------------------------------------------------------¿Cómo hablo de mis sentimientos de depresión y con quién hablo?Soy un adolecente.  He estado experimentando episodios de depresión severa (si es lo que creo) por muchos años.  Siempre se pone peor.  He estado teniendo ataques de pánico, sintiendo que no puedo controlar mis miedos y sintiendo que ya no importa si quiero vivir o morir.  El problema es que ya no sé a quién pedirle ayuda.  Cuando intento hablar con mis padres, Me congelo y solo puedo hacer bromas porque nunca en mi vida hemos hablado de nuestros sentimientos. Entiendo que hablar de tus emociones puede hacernos sentir inadecuados, y bromear es una manera de manejar ese sentimiento incómodo, pero no hay forma correcta o incorrecta de hablar sobre tus sentimientos.  Lo importante es reconocer que necesitas ayuda para manejarlos, y ya tu estas en ese proceso.  Tener pequeñas conversaciones con tu familia te ayudara a explicarles los sentimientos que estas experimentando.  Es importante que les pidas hacer una cita con un profesional de la salud mental, ya que has estado experimentando síntomas que indican que tu cuerpo ya no puede manejar tus sentimientos y necesita nuevas herramientas.  Puedes contactar a tu consejero escolar, o a un proveedor de salud mental cerca de ti o por teléfono.  Mientras tanto, puedes llamar a la línea de crisis de Texas 800-989-6884 para hablar con un profesional de salud mental.  La línea nacional de crisis también esta disponible en todos los Estados Unidos y proveen servicios en español 1-800-273-8255
Yo soy una Consejera Profesional Licenciada en Texas y Puerto Rico, veo clientes en el este de Houston y proveo servicios de tele terapia.  Para una cita puedes llamar al 787-466-5478.


Input: I have long spurts of depression, anxiety, and need change constantly—why?

Instruction: I'm depressed often, and my mind goes a million miles a minute. Every once in a while, things are okay for a few days. After a bit, I start noticing that I am picking at my skin profusely. After roughly a week, the anxiety is back and still picking. Sometimes I find myself causing fights to have change.

Output: One way to know yourself a little better and why the dynamics you describe take place, is to understand the particular dynamics of your life context.Look at your major areas of where you spend your time, whether you are happy with the people with whom you socialize, how you feel toward family members and how they seem to feel toward you.If you examine your relationships and life this way then you may start to notice areas where you have some control or at least a say in how your life is going.If you are socializing among people whom you don't like, have a job you don't like and your family mistreats you and you mistreats them, for example, then anxiety and depression are an understandable natural result.If you make improvements in your life and relationships, even tiny improvements and even the effort and intention to improve, you may find your anxiety and depression dissipating.People usually feel their worst when they feel lack of control in their life.Look for ways you can regain and/or strengthen yours.


Input: I have long spurts of depression, anxiety, and need change constantly—why?

Instruction: I'm depressed often, and my mind goes a million miles a minute. Every once in a while, things are okay for a few days. After a bit, I start noticing that I am picking at my skin profusely. After roughly a week, the anxiety is back and still picking. Sometimes I find myself causing fights to have change.

Output: Hello, and thank you for your question. I am very sorry that you are struggling. I have a few thoughts and perhaps some of my colleagues will add something else. Depression and anxiety can both be chronic conditions, as you have experienced. This means that they may always require treatment in order to have some kind of relief from them. Treatment could mean medication or some kind of counseling. Some people may take medication for the rest of their lives. Some people may go to counseling at times when the depression and anxiety worsens. As you mentioned, sometimes the symptoms improve for a little while, but they can also come back. When they do, it is important to talk to your medical provider if you are getting medication, and/or to go back to your counselor and talk to them about the symptoms that have returned. Skin picking and some other behaviors are not uncommon for people who are experiencing something like anxiety. Many people report that they do this when they feel anxious, and some say it calms them down. It is not really a surprise that you are constantly trying to change things and even starting fights to do so. These are ways to try to avoid, escape and distract yourself from the feelings of anxiety and depression. That is a very normal thing to do. Nobody likes these feelings, and so distraction is something we naturally try in order to get rid of them. The problem is that things like distraction and escape do not work as a long-term solution. In fact, they usually make things worse for many different reasons. Depression and anxiety can  be treated, but it is likely something you will need some help with. I would recommend finding a counselor who has experience with anxiety and depression. Medication can be helpful, but I still recommend counseling. The reason for this is that the medication can help with symptoms, while the counseling can address the symptoms and provide you with very helpful skills. Be well,Robin J. Landwehr, DBH, LPCC, NCC


Input: How would I know if I was depressed?

Instruction: I'm constantly in a bad mood and I have no energy. Is that depression?

Output: Depression has many different signs and symptoms and looks different for every person.  Often times people think depression is more about feeling "sad," but depression can, in fact, express itself through irritability (or bad mood as you say) and lack of energy.  According to the DSM-V (Diagnostic and Statistical Manual of Mental Disorders), depression includes the following symptoms:-Depressed mood-Irritable mood-Decreased interest or pleasure in activities you usually participate in or enjoy-Significant weight change or change in appetite-Change in sleep (insomnia or hypersomnia)-Psychomotor aggitation or retardation-Fatigue or loss in energy -Feelings of worthlessness or excessive guilt-Diminished ability to concentrate or indecisiveness-Thoughts of suicide or plan The great news is that there are many ways to improve depressive symptoms.  If you are up for it, perhaps the best place to start is by seeing a physician or a therapist who can help determine how severe the depression is and can suggest methods of addressing the depression that fit your lifestyle, values, and capabilities.  Good luck!


Input: Is my moodiness just a phase or do I need help?

Instruction:
I'm a teenager and I I go through periods of moodiness. I have extreme feelings (but I bury them), and then I feel nothing - just empty and emotionless.
   I have trust issues, low self esteem,ban extreme fear of abandonment, and I constantly reevaluate my relationships. I also don't know who I am as a person. I'm not happy overall, but I'm not suicidal. Can I just feel happy?

Output: Sometimes the way to feel happy is to address all the questions you just described.Teenage years are the first time any of us starts to feel and recognize our uniqueness.  The fact that you recognize your great range of feelings, as uncomfortable as they may sometimes be, is healthy.Also healthy is that you are asking for opinions of therapists who would be familiar with when a range of feelings shows an out of the ordinary problem.One path to take is to reflect on the topics you wrote here and especially to ask yourself your reasons for how the problem started and what it would take for it to resolve.Do you have trust issues because someone broke your trust? You're entitled to a repair of your trust by the other person.   Even if the person never offers this to you, to know you deserve to be restored to whole, may help you feel more secure.The same is true with the other topics, abandonment and relationships generally.The more you continue to value your unique understanding, expectations, and standards, the more likely you'll create relationships which do not have these qualities, and you will restore your sense of hope that other people may treat you in a fair and kind way.


Input: How can I deal with my depression?

Instruction: I know I need to deal with my depression. But I don't know how and I don't want to tell anyone.    How can I deal with depression without telling anyone?

Output: Love yourself more and treat yourself kindly, with empathy and compassion.Usually when people feel depressed they also feel lonely and isolated.  Since at this time you wouldn't want to tell anyone about the way you feel, which includes the possibility that a few of the ones whom you tell would offer you emotional support, give this to yourself.Also consider to make a goal of eventually telling someone whom you are reasonably sure would understand and empathize, about your depression.This will help alleviate the sense of shame, unworthiness and pervasive guilt which often comes along with depression.Sending you good luck!


Input: How can I deal with my depression?

Instruction: I know I need to deal with my depression. But I don't know how and I don't want to tell anyone.    How can I deal with depression without telling anyone?

Output: It can be really tough to tell someone - anyone - that you're feeling depressed. But finding that supportive person that you can share with is a big part of the battle with depression. Depression thrives on being secret, it seems to grow the more we isolate ourselves and hide it away so I'm with Laura Cassidy, when she suggests finding that professional support person so you can start fighting back against your depression. If that feels like too big a step right now, maybe check out a book or two... I'm a big fan of a book called 'Feeling Good' by Dr. David Burns if you want some practical thoughts on tackling depression and on 'Radical Acceptance' by Tara Brach if you prefer something a little more spiritual.


Input: How can I deal with my depression?

Instruction: I know I need to deal with my depression. But I don't know how and I don't want to tell anyone.    How can I deal with depression without telling anyone?

Output: Hello,It is completely understandable that you would not want people to know about your depression. I would first like commend you for realizing that you need to help with your depression by reaching out here. That is a great start, and you've taken the very first courageous step. Depression can feel debilitating and overwhelming. Depression is also a very personal thing and no one has know but you and the therapist. The best way to begin learningand dealing is to pick up the phone and call a therapist or email a therapist and schedule a session. The great news is that with professional help you can feel better and you will learn how deal with and manage the depression. There are many ways to help with depression that a therapist can teach you and help guide. You do not have do this alone. Asking for help and going to therapy is a strength! This can be done in a private and confidential setting.Depression should be treated by a therapist, in a safe, confidential office setting. The therapist can then discuss your depression with you in more detail to figure out the underlying cause, how long you've been feeling this way and identify what brings on these feelings. There is hope and depression can be treated with great success, you CAN feel good again. Depression can be managed appropriately by seeing a licensed therapist. Often times therapy will offer relief because you would have someone there simply to listen to you, validate your feelings and listen to your story. The therapist will be able to offer professional insight and perspective on the situation and help you think outside the box. The therapist can do many things with you, provide insight and offer many ideas to help you learn new coping skills and ideas of things you enjoy, encouraging you to re engage in hobbies you once enjoyed or even discover new things you may enjoy. There are creative ways to learn to cope too!Your therapist will also be there to support you, without judgement, at your pace, through the entire process. But the first step is finding a therapist and beginning to identify the cause your depression. Healing is possible and getting your happiness back is also possible.Feel free contact me for additional help or informationLaura Cassity, LMSW, LMAC


Input: How do I make myself happy without someone who made me happy?

Instruction: How do I make myself happy without the people who made me happy? Now that they’re gone, I feel sad. It’s been two months now but I seem to be unable to stay okay and independent.

Output: Hello. So, someone made you happy but is no longer around? I am sure that feels devastating. As a counselor I usually have to ponder this kind of thought because it lends itself to suggesting that happiness comes from the external, rather than the internal side of a person's life. Happiness is formed within ourselves. All the external trappings of happiness are usually quite fleeting, and temporary. Even relationships fo not last forever. If we get to a place where we are reliant and dependent on those around us to create happiness in our lives, then we lose the opportunities for us to do it ourselves. We are entirely capable of finding ways to be happy. Sometimes this entails working out issues that are holding us back from reaching a place of peace, or resolution to a specific problem.What I would offer to you, is to find ways in which you can develop happiness for yourself. What do you like about your life as it is right now? What can you do to create change in your life to increase your happiness? These kinds of questions can be valuable to you as you seek out ways to make happiness an internal rather than an external event. Mourning the loss of a social connection (in whatever way that occurred), is part of the grieving process, but it is not permanent. It is a path to healing and moving forward. From this, you can seek out new sources of happiness. I encourage you to remember that happiness is independent of the external experience you have in the world. Happiness is an expression of the internal feelings, so that will be the source or the font of positive emotion from which you really draw. If you are lacking in happiness, then it becomes important to examine why that is, and what you can do about it to promote self-care. Seeking out a professional counselor can also be a good option as you move through the grief/loss process and examine the reasons happiness is not in greater supply.I wish you happiness for every day of your life.Best wishes.


Input: How do I make myself happy without someone who made me happy?

Instruction: How do I make myself happy without the people who made me happy? Now that they’re gone, I feel sad. It’s been two months now but I seem to be unable to stay okay and independent.

Output: It sounds like you have been feeling pretty down, since the loss of a relationship, and you're wondering how to be happy by yourself. Intimacy is a very natural human desire and at the same time learning to enjoy ourselves, even when we are alone, can strengthen our ability to lead a satisfying life in and out of relationship. Working with a therapist, you may be able to gain insight into how you show up in your relationships with yourself and others and discover more fulfilling ways to do so.


Input: Is this depression?

Instruction: I feel like I am internally screaming all the time. Externally, I am calm, but I have this intense, unidentifiable emotion constantly. I don't feel sad. I don't cry a lot. I feel rather emotionally distant other than the internal screaming. It kind of feels like I'm a caged animal.

Output: It is hard to make a definite diagnosis however I would say  that it could be and or a combination of depression, stress, PTSD, etc.  More background information would have to be needed.  One thing I would say is that you really need to seek guidance from a professional to work through these symptoms.  If what you described as a caged animal is released, all the crying, sadness, and controllable emotions will come out.  That would not be good when they do.  Get help before they do..


Input: Is this depression?

Instruction: I feel like I am internally screaming all the time. Externally, I am calm, but I have this intense, unidentifiable emotion constantly. I don't feel sad. I don't cry a lot. I feel rather emotionally distant other than the internal screaming. It kind of feels like I'm a caged animal.

Output: As far as the formal diagnosis of depression goes, it would be hard to determine without more information. It sounds like you are noticing that there is a significant difference between how you are feeling on the inside and how you express yourself outwardly. Part of you is quite distressed and yet it remains invisible to the outside world, almost as if it is trapped inside of your body. Many people who are depressed experience such things as intrusive thoughts, emotional numbness, difficulty expressing themselves, and bodily tension (caged animal?). In working with a competent therapist, you may be able to get more insight into what you are going through, the nature of the disconnect between you inner feelings and outer expression, and eventually gain relief from the distress as well as a greater sense of connection with yourself and personal freedom.


Input: Is this depression?

Instruction: I feel like I am internally screaming all the time. Externally, I am calm, but I have this intense, unidentifiable emotion constantly. I don't feel sad. I don't cry a lot. I feel rather emotionally distant other than the internal screaming. It kind of feels like I'm a caged animal.

Output: It sounds like you are trying to find a label to help you to understand why you are feeling the way you are feeling.  Sometimes there are no labels for how we feel.  Sometimes there is no name for the emotions that we are experiencing. Regardless, you do not have to continue to feel this way, no matter what you call it.  If you are seeking to experience an internal calmness such as your external calmness, you may want to try some mindfulness practices or meditation.  However, being able to get at the root cause of what you are feeling may be what you need to help you release this feeling for the long term.  I recommend seeking support for this to allow this internal screaming to get some air and begin to breathe.


Input: How do I deal with parental figures who have hurt me?

Instruction: People who are parental figures in my life have, in the past, hurt me, and some continue to do so. It makes me feel like I'm not good enough for my husband or the life he provides me. I have had jobs, but I am going through a lot of my past garbage and trying to figure out when it all went wrong. Any time I bring these things up, I am expected to be over the issue. These are people that you can't just cut out, but I have never received apologies for so much of my pain. I don't know what to do any more. I don't know who I am anymore.

Output: It sounds like you have been thinking about how past hurts have influenced you, and when you try to talk about these hurts with people in your life, you are feeling invalidated. It also sounds like current conflicts are continuing to leave you feeling hurt and devalued. In working with a therapist, you may be able to get some clarity about your past, who you are, and what kinds of boundaries you want in your relationships, so that you can lead a life that is more satisfying to you.


Input: How do I deal with parental figures who have hurt me?

Instruction: People who are parental figures in my life have, in the past, hurt me, and some continue to do so. It makes me feel like I'm not good enough for my husband or the life he provides me. I have had jobs, but I am going through a lot of my past garbage and trying to figure out when it all went wrong. Any time I bring these things up, I am expected to be over the issue. These are people that you can't just cut out, but I have never received apologies for so much of my pain. I don't know what to do any more. I don't know who I am anymore.

Output: Hello. Adults who come from abusive home histories (physical, emotional, or even psychological), may take a long time to heal from that abuse. We carry our past with us everywhere we go, and it is up to us to find resolutions to past hurts. This is often easier said than done, but it is possible. From the perspective of those with whom you have shared your concerns, it might be assumed that based on where you are in life and who you are now, that you have already worked through any issues from your younger years. Some of our deepest scars in life are indeed invisible and suppressed. We have to get to the place where we can take care of the inner child that is still hurting, by recognizing that those who hurt us - however they did, might have had their own challenges which prevented them from functioning and behaving in ways we might have deeply needed. Those who have directly hurt you, may not be capable of acknowledging and understanding how you were affected by their actions - even in the worst of cases. They themselves may be doing what they can, either out of shame or heartbreak for their own actions, to work on forgetting how they behaved toward you all those years before. How are they behaving toward you now? Can you find it in your heart to forgive those who have hurt you? Forgiveness is the gift we give ourselves, and isn't dependent on an apology from an offender. By forgiving (even in the absence of any apology), we are releasing the weight of the burden we are carrying that reflects the offense we feel was committed against us. Sometimes therapy can be helpful in this process. Talking with someone who can be non-judgmental and reflects an empathetic position toward you might be what you need right now. Seeking out a therapist to help you work through these negatives feelings and thoughts is much easier, than trying to go it alone. I would encourage you to reach out and find someone who resonates with you on that journey, so that you can begin a path toward healing.Warm regards,Shawn Berthel, M.S., LMHC


Input: My parents are getting a divorce and I feel depressed

Instruction: I am going through a very hard time and I'm so depressed. My parents are getting a divorce and a lot of bad things are happening. I want to lull myself.

Output: It sounds like a tough time and it's normal to feel down when your family is going through a divorce or other hardship. There's a difference between feelings like sadness, discouragement, grief, loneliness and depression, though. Sadness is sadness and sometimes we have to go through a grieving or other process, that is a normal reaction to events in our lives. Depression, on the other hand, is more about being stuck. Lulling yourself with self-care sounds like a healthy response and a way to give yourself support. So as to the uncomfortable but healthy part of your feelings, do the best you can to put names to it and share with a trusted other person. You will find comfort. The part of your situation that's depression -- feeling stuck, not able to get out of bad, concentrate, changes in sleeping and eating, loss of enjoyment in living, poor hygiene, feelings of hopelessness, that's different. First step, identify your own symptoms of depression. If you have any thoughts of hurting yourself, tell someone. If you're not sure, you can try 800-lifenet or other support line to get feedback. First aid for depression includes: daily care and feeding, good sleeping and eating, lots of exercise--even when you don't feel like it-- healthy socializing, and focusing on talking to yourself in a positive way. If you aren't able to move yourself out of your depression,  work with a professional to make short-term goals and get some support. You may also talk to your doctor or psychiatrist about trying an anti-depressant to give you a little lift while you go through a rough patch.Best wishes,Karen


Input: My parents are getting a divorce and I feel depressed

Instruction: I am going through a very hard time and I'm so depressed. My parents are getting a divorce and a lot of bad things are happening. I want to lull myself.

Output: Consider yourself quite normal for feeling overwhelmed and depressed about your parents divorce.   This is the most natural way to feel at this time.Depending on how old you are, and whether you live under their roof,  are dependent on their support, and are either part of the decision or not, of with whom and where you will live, start considering these points.How did you find out about the upcoming divorce?Are either of your parents reluctant to answer your questions or is it clear that neither of them want to talk about anything with you?Whatever your fears and questions about your own future, these are all real.  It is necessary for you to know about your basic future.If you are living on your own and the main problem is your inner adjustment that your family structure is completely changing, then probably a good therapist would be a great help to you now, to clarify these tensions.Sending lots of good wishes for an easy resolution to your new path!


Input: I need help coping with depression as a result of stress

Instruction: My depression has been reoccurring for a long time. It all started when I was being bullied in high school. In ninth grade, my principal told me I needed to stay home for a couple days to protect myself while she spoke to my classmates. I needed professional help for my stress because I was having crying spells from the stress of going to school and confronting my classmates. After that, I was fine for a couple of years. I entered my first year of college in a really tough program with high demands of expected work. I believe my depression re-booted from there with the stress. I began to cut myself because a friend of mine at the time told me how she used to do the same and it used to feel good for her. Obviously, that wasn't the right choice. I regret ever doing that, seeing as even though I'm not self-harming anymore, I always look back at that time whenever I feel very stressed. I have a big problem with handling problems in life. Whenever a problem arises, I get stressed and I feel hopeless, as if it's not going to get better. I get way too stressed from my problems, which leads to overreacting a lot (especially when talking to others), which then leads to depression. I have a hard time coping with stress because I know that if I could handle it easily then I wouldn't be sad all the time, and I would say and do the right thing instead of overreacting to my loved ones.

Output: I couldn't help but notice that you did not specify your age, so I am unable to set the total chronological order and length that you have suffered in this way, but I want to start by commending you on seeking out additional coping techniques on your own.  Unfortunately, it sounds like you were offered some that were more dangerous than helpful, but be proud that you were able to curb those before they caused too much harm. From what you have written, stress has always been a difficult thing for you to manage.  Often, when I am working with those who offer the same concern, there is a degree of people pleasing that comes with that stress.  When we are trying to make others happy, especially when we are unable to distinguish the proper "rules for success", it can make even the simplest of tasks overwhelming. Stress management is just that, management; of our own anxieties about the needs of others, about our skills and the ability to complete a task and having multiple requests at any given time. Each of these aspects requires a separate sets of "tools" to manage them accordingly. For example, assertiveness communication training could aid in communicating with your colleagues to manage their expectations of your deadlines and abilities, but it will not assist you with managing your own anxieties. Try to separate the different areas of the problem, in order to help yourself to find a solution and work on them in their own time. Perhaps keeping a journal will help you to better understand why you are so easily overwhelmed by stress and help you track some of your less-helpful responses to stress. For example, does a certain person's style of communication always make you feel undervalued and therefore push you to finish their requests first? Is there a certain time of the day where you start to fall off in productivity?  Is that the time fo the day where you also tend to pile up your requirements?Try to ask yourself some of these harder questions and see where they lead you.


Input: I feel like my existence is meaningless

Instruction: I've been depressed for quite a while. I've been trying to work through it, and my boyfriend has been my rock. He is honestly the only person I trust enough to talk to about anything, but he decided to break up with me because of my depression. I cannot afford to see a therapist or anything, so he saw no hope in staying with me. My insurance has a $5000 deductible, so I’m screwed. I've had everything from suicidal thoughts to trying to quit my job. I have no one. My family doesn't care about me; they kicked me out when I turned 18 a few years ago. I had friends, but they have all moved on with their lives and have no time for me. My ex-boyfriend is trying to help but is making things worse because every time I see or hear him, I break down into tears. I found out that I will never be promoted now because of my depression.

Output: It sounds like you have been struggling with this for quite some time, using many of the same coping techniques that feel tried and true to no avail. Often, we fall back on coping techniques that would be helpful in other problems (stress, social anxieties, etc.) for our depression, but the truth is that depression requires it's own little tool kit. Depression is all-encompassing, and, based on what you've written, the symptoms are already affecting work and your personal life in myriad ways.  The best route forward would be to seek out counselling, admittedly, but if your insurance deductible is too high, that can be very expensive. I would recommend contacting your Employee Assistance Program (EAP) if offered by your employer. If not, you can look into community centres for counselling options, check if your doctor will give you a referral or your local religious organization. If, however, you are motivated to get your depression under control, there are some great workbooks out there that you can use on your own or with your therapist (as long as your therapist is trained in Cognitive Behavioural Therapy, or CBT), such as "Mind Over Mood".


Input: Why do I feel worthless and tired?

Instruction: I always feel like I'm doing something wrong. Everything I do is crappy. I want to cry all the time. I can't eat or sleep.

Output: You are describing some of the most common symptoms of depression: low self esteem, difficulty sleeping, changes in appetite, sad mood, feelings of hopeless and feelings of worthlessness. A full assessment/evaluation with a mental health professional is warranted to understand if indeed you meet criteria for a Major Depressive Disorder i.e.., are delressed. One thing I often tell patients is that "Do you think you are depressed?" People often answer yes or no, but many individuals respond with a question: How would I know? To that I often explain that if I stopped watching movies or better, stopped enjoying watching movies that would be a clear indication for me that I am delressed. It would be a sign that I have lost pleasure or interest in the activity that I typically enjoy most . I'll ask you to think of one activity which you really really enjoy.  It could be anything from reading, to being with friends, to skiing to watching tv.  I would like to now ask you if you have stopped enjoying that activity or can't find the motivation to engage in it? This is another symptom of depression: loss in pleasurable activities. The good news is that there are many effective, available treatment if you are indeed in a depression or simply, you want to modify/decrease your depressive symptoms i.e., you want to stop feeling so tired and so worthless. Treatment includes one or more of the following: psychotherapy, medication, exercise. Any one or combination of both of these can help to improve your mood. The even better news is that feeling that you are doing something wrong can diminish with appropriate treatment over time.  I hope you find this information helpful. The most important next step is to get evaluated by a mental health professional typically a psychologist or psychiatrist, and for both you and the professional to better understand your symptoms and your mood in the context of what is going on in your life.


Input: How can you get back to my old self?

Instruction: I no longer carry expressions on my face, and my emotions are decreasing the more I have fights with my fiancée.

Output: Sometimes repressing anger can lead to depression and block all kinds of other emotions too.  I would wonder about your experience with anger and if you've ever been discouraged from expressing anger.  I would also wonder if you feel like you have space to express yourself in your relationship or if you feel like you really aren't being heard.  It's hard to feel cared for and connected to someone else when you don't feel accepted by them.


Input: How can you get back to my old self?

Instruction: I no longer carry expressions on my face, and my emotions are decreasing the more I have fights with my fiancée.

Output: Sometimes when we fight a lot with our partner, it becomes more uncomfortable to share emotions because it feels like it will lead to another flight or disagreement.You could try having a conversation when you're not fighting and starting it out by saying that you would like to discuss something important to you and see if your fiancée is open to that.Something else is that you could have an agreement that if one of you is having a really strong emotions in a difficult conversation and would like to break from the conversation, you could agree (ahead of time) that you'll say that you would like a "timeout" and will come back to discuss the issue in a certain amount of time (usually about an hour) and then try to resume the discussion. The reason this can work is it can give you a chance to calm down and then still go back to the discussion rather than not talking about it again. This only works if both of you agree to that before something starts, though.


Input: How do I tell my parents that I'm depressed and need help?

Instruction: I'm depressed. I have been for years. I hide it from everyone because I'm scared of the reactions I'll get. Last time I tried telling my parents, it was a huge argument about me being too young to be depressed (I’m a legal adult), calling me ungrateful, and telling me that if I can't handle things now, it's only going to get worse in the future (which is turning out to be true). It's exhausting pretending to be okay, and I don't know how much longer I can try. I'm just really tired, and sadly, I can't afford the help I need on my own.

Output: Hi Georgia, There's a really good lesson here. People tell us things, and we tend to think that's the truth...but it's not! I'll do some translating for you..."You're so ungrateful" means "I need you to be successful and happy in order for me to feel I'm a good parent"."You're too young to be depressed" means "I don't want to deal with your mental health issues right now. I'll pretend it's not happening so I don't have to face my fear and shame"."It's only going to get worse" just means "I don't know how to support you beyond scaring you into wanting to at least fake happiness for my sake".Your parents are being unsupportive, not because you're not suffering, but because this is all they're capable of right now. They are not where you will find the support you need, so keep looking for it in other places. It's out there. If might be an aunt or a friend, or a friend's aunt. It might be a therapist or a bus driver or your family doctor. Keep looking for someone who will hear you. I hope you don't ever give up. :)


Input: How do I tell my parents that I'm depressed and need help?

Instruction: I'm depressed. I have been for years. I hide it from everyone because I'm scared of the reactions I'll get. Last time I tried telling my parents, it was a huge argument about me being too young to be depressed (I’m a legal adult), calling me ungrateful, and telling me that if I can't handle things now, it's only going to get worse in the future (which is turning out to be true). It's exhausting pretending to be okay, and I don't know how much longer I can try. I'm just really tired, and sadly, I can't afford the help I need on my own.

Output: Don't think that you can't afford the help you need on your own.  There are several counselors that see people on a sliding scale that can be as low as $5 (based on your income).  Find a center that is non-profit, they have great counselors as well. It sounds like you know what you are experiencing and know that you need someone to talk to, someone that is willing to listen.  Your parents may not understand what your are feeling right now and that is not totally abnormal.I would encourage you to seek help immediately so you can live the best live you can...which is not being depressed.


Input: My husband wants a divorce after I was diagnosed with severe depression

Instruction: He said he would try and he never did. It's been nine months, and this is making me worse. Today, he said I have to respect whatever decision he makes. Is that true? Am I supposed to respect the decision to leave because he can't handle what I'm going through and leaves me here crying and worried every night? He's constantly changing his mind on if he wants to work it out.

Output: Wow that is tough. There is nothing worse than fearing abandonment when you are already struggling with depression. It sounds like you are still wanting to work through whatever challenges you and your husband are having but your husband may not be on the same page. I would encourage you and your husband to seek professional support if you haven't already. While depression can put real strains on a relationship, relationship problems can lead to or contribute to depression and there may be some real benefits to both of you in doing some couple therapy. With that being said - if your husband is not willing to do therapy or is clear that he wants the relationship to end, then I can't see what choice you have but to "respect his decision" as you mentioned. This doesn't mean that you have to feel okay with the decision - as I'm sure you wouldn't - but ultimately loving one another and staying in committed relationships is a choice that we each have to make. If he is wanting to leave - this could make things a lot tougher for you. I would encourage you to seek professional support for yourself and reach out to lots of friends and family. You do not need to face depression alone - nor should you have to. We all need support at tough times like these.