Month: January 2019

Videos

I was meaning to post some more videos to YouTube today, but for some reason YouTube said my first new video was too long. My video was less than 17 minutes, so I do not believe that, but I am also not going to sit around for another hour while it processes and uploads the video only to be told it is “too big”. That being said, if you would like to have all of the video series I have created please let me know, and we will work out a deal. Thanks!

Multisystemic Therapy

Today I want to discuss another type of therapy I had never heard of until about a month ago, like EMDR (obviously, the conference I went to gave me a lot of new information!).  The therapy I will describe today is called multisystemic therapy, also known as MST. 

According to the Wikipedia article (https://en.wikipedia.org/wiki/Multisystemic_therapy), MST is an intensive family focused and community based treatment program for chronically violent youth.  MST was developed by the Family Services Research Center (FSRC) of the Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina.  In 1996, MST Services and MST Institute was formed.  MST Services is for-profit and distributes and supervises MST information.  MST Institute is non-profit and sets quality assurance standards and monitors program implementation.  Although the specifics of the therapy are not detailed here, it is easy to see why it was named “multisystemic” because of its focus on different systems encountered by the youth.

This is a very general overview, and MST still seems a little vague to me.  Actually, when I heard the term “multisystemic therapy” I thought it would be about looking at all of the body systems to see how they work together to create health or disease.  So, I was way off.  And, like EMDR, I have never heard of anyone who has used MST.  However, at the very least, it is good to know it is out there and possibly another option for youth, some of which might be struggling from depression or some other mental illness.  Although I don’t know much about it, I like the idea of looking deeper and looking at systems instead of assuming the youth may be to blame for everything. 

What do you think about MST?  Do you need more information?  Does its focus on systems sound appealing to you?  Hopefully we will see MST become more beneficial as experience with it increases.

Eye Movement Desensitization and Reprocessing

Today I want to talk about a therapy that I had never heard of until about a month ago – eye movement desensitization and reprocessing, or EMDR.  While it may be difficult for me to describe here, the good news is that it has shown promise in helping people with the emotional pain that can result from disturbing life experiences. 

According to the EMDR Institute (www.emdr.com), the therapy shows that people can heal from psychological wounds, just like people can heal from physical wounds.  EMDR has been used for over 25 years, and millions of people have benefitted from the therapy.  EMDR has typically been used in dealing with trauma, but it can also apply to “everyday” memories, such as feelings of powerlessness.  EMDR includes eight phases of treatment.  Eye movements (or some other form of bilateral stimulation) are used during part of the session.  For example, as specific aspects of memories are targeted by the patient, the patient is also instructed to use their eyes to follow the therapist’s hand movements.  Although I am going to skip the specifics as to the idea of why this works, the net effect is that thoughts that bothered people change to thoughts that empower them.  One big difference in EMDR from many other therapies is that this does not involve homework or a lot of speaking in detail with a therapist.

Honestly, I do not know of anyone who has undertaken this type of therapy, but it sounds fascinating.  It seems that EMDR is relatively simple, but yet can do a lot of good.  I think removing the speaking in detail and homework would be appealing to many people, and I also think this might be another option for people affected by depression. 

How about you?  Have you ever heard of EMDR?  Does this seem like a therapy worth considering?

Friends

In my last entry, I mentioned that I had gotten to see some old friends on a road trip.  After seeing these friends I felt recharged in a way, but I also realized how much I missed them.  It is yet another instance where I have been thinking a lot about friendships lately, and I am starting to feel like I have been taking my friendships for granted.

When I look at my life today, I have realized that friendships are pretty low on the list.  Some of it might be understandable when looking at all of our other responsibilities, but I truly believe that friendships are still very important no matter what age you are.  Friendships can provide a lot of positive benefits and meaning to our lives, and it can help protect us against the isolation that so many people experience. 

For people living with depression, friendships can be a vital part of support and the road to recovery.  Friendships connect us with people who care about your health and path to wellness, and friends accept you and understand that you are not your depression.  Sometimes, friends may also be more helpful than family when it comes to facing a depression.

As I think back to my story, I know I want to work harder to maintain the friendships that are important to me.  How am I going to do that?  Well, that is the part I am not really sure about right now.  I envision scheduling check-ins with friends on my calendar, but we will see if I have any other ideas come up.  Regardless of how I do it, I’m excited to realize that this is an area of my life that needs more attention, and I look forward to enriching and improving my life with deeper friendships.

Connecting to the Past

As I write this entry, I have just returned from a long weekend to celebrate Christmas with some of my family.  During the road trip I also got to see a few of my oldest and dearest friends, and it felt so good to see some of my favorite people in the world all in one trip.  And, while it was great to catch up a little bit, it always seems inevitable that seeing old friends and family gets me to thinking about the past.

What could I say about the past that hasn’t already been said?  Of course, my own past is unique to me, and that is honestly mostly what I will touch on today.  What is it about the past that makes me so pensive?  Why does it seem to make me sad sometimes?  Do I ever believe that the past signifies better times in my life?  Is my past better than my present?  Is it better than my future?  I typically like to think that life just keeps getting better, but sometimes I wonder…

However, I think that is where I stop.  I wonder, but I don’t try to relive my past.  What I do try think about are the fun things and the good things that have happened, and I see if I can incorporate some of that into my present life.  For example, I love 80s music, so that is constantly in my life.  I also loved rainbows growing up, and I continue to surround myself with those.

If you are struggling with depression, maybe looking at the past does not help your situation, especially if it might have in some way led to the depression.  However, if this is the case, it might be helpful to think about what you would love to look back on in the future that makes you smile and enjoy some memories.  It may sound simplistic, but connecting with the good things in your past (or your anticipated past) may be a helpful technique for thinking about depression.

Intersectionality

The words in our language can evolve and change over time.  New words also become a part of conversations, and there is a newer word that I want to discuss today.  The word is intersectionality.  What exactly does it mean?  Where did it come from?  And, for this blog, does is apply to depression?

According to Merriam Webster’s webpage (https://www.merriam-webster.com/words-at-play/intersectionality-meaning), which added the word in 2017, intersectionality is “the complex, cumulative manner in which the effects of different forms of discrimination combine, overlap, or intersect”.  The word has been around since 1989, when it was coined by legal scholar Kimberlé Crenshaw in an essay that asserts that antidiscrimination law, feminist theory, and antiracist politics all fail to address the experiences of black women because of how they each focus on only one factor.

Since its beginnings intersectionality has taken on a broader meaning, and can refer to more than just sexism and racism.  It can include other forms of discrimination as well, such as those based on class, sexuality, and ability.  So, intersectionality looks at the person as a whole and sees where they may face one or more categories of discrimination.  For example, intersectionality would imply that a black female lesbian is going to face more discrimination than a straight white female. 

How does intersectionality apply to mental health and depression?  It can possibly affect things such as access to care and the quality of care that is received.  Intersectionality can also affect the stigma some people experience and some groups may not have their depression symptoms taken as seriously as other groups.  Overall, I think intersectionality is something to consider when looking at someone with depression, as it may play in to how they are being treated.  We need to continue to demand that all patients with depression are treated with respect and compassion, regardless of what categories they may belong to.

Dialectical Behavior Therapy

I would like to highlight another type of therapy that may not be familiar to people – dialectical behavior therapy, also known as DBT.

According to a page on the Psychology Today website, (https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy), DBT is a way to provide individuals with new ways to manage painful emotions and decrease conflict in relationships.  DBT focuses on four specific areas: 1. mindfulness to focus on improving an individual’s ability to accept and be present in the moment 2. distress tolerance to help individuals increase their tolerance of negative emotions instead of trying to escape from them 3. emotion regulation strategies to manage and change intense emotions that are causing issues in a person’s life 4. interpersonal effectiveness techniques that allow a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships.

DBT was originally created to help patients with borderline personality disorder.  However, the use of DBT has expanded to include eating disorders, bipolar disorder, post-traumatic stress disorder, substance abuse, and depression.  DBT typically includes both individual sessions and group sessions, both of which are used to help individuals learn and practice the skills used in DBT. 

Although I have heard of DBT a few times in passing, this type of therapy is fairly new to me.  I am glad that its use has expanded to several areas of mental health, including depression, and it appears to be yet another tool that can be used to help those affected with depression.

How about you?  Are you familiar with DBT?  If so, how has it worked for you?  If you are just hearing about DBT for the first time, is this a therapy that you might consider?  To me, the more options available for the treatment of depression can be a beneficial thing, and I encourage people to learn more about DBT.

Adverse Childhood Experiences

One of the hopeful pieces about depression today is the recognition that there are many, many theories about what may lead to it.  And, while in some ways it makes the story more complicated, in other ways it gives us more information as to how we might treat or prevent depression in the future.  One of the theories is that depression can result from trauma, which is another huge topic.  However, today I want to discuss a subset of trauma that is known as adverse childhood experiences, or ACEs.

According to SAMHSA (Substance Abuse and Mental Health Services Administration), adverse childhood experiences, or ACEs, are stressful or traumatic events.  According to their website page, (https://www.samhsa.gov/capt/practicing-effective-prevention/prevention-behavioral-health/adverse-childhood-experiences), ACEs can include a wide array of experiences, including physical, sexual, or emotional abuse, physical or emotional neglect, intimate partner violence or abuse, substance use in the household, mental illness in the household, a household member in jail, and parental separation or divorce.  These events can lead to an increase in depressive episodes and suicide attempts later in life.  In general, ACEs can also lead to an increase in other issues with substance abuse and issues with physical and mental health.  Sadly, ACEs are very common and touch many of our lives.

Despite the unpleasant reality of ACEs, there is hope.  Recognition of ACEs is growing, and more and more people are beginning to understand the possible relationships between ACEs and future health implications.  Work is also being done to figure out how we might better prevent ACEs from occurring in the first place.  Clearly, there is a long way to go, but I am so glad we are starting to look at a bigger picture of what health and wellness truly means for all of us.  Every little piece matters and can make a difference when our overall health is on the line.