26 May 2020
Top 25 Ways To Deal With Depression

Many people think depression is an emotion, often confusing it with just being unhappy. However, depression is a clinical condition and is the leading cause of disability among U.S. individuals aged 15 to 44 years. Depression is fairly common, affecting more than 15 million adults in the United States.

Depression is when you feel sadness, hopelessness, and helplessness and just can’t snap out of it. It may be hard to socialize, meet the demands of school and work, and may even lead to thoughts of self-harm. With depression, the activities you once found enjoyable are no longer bringing any pleasure and the feeling of slipping into a dark place looms over you every day for weeks at a time.

Some people have reported to me that when they are feeling depleted from depression, they just can’t seem to get the laundry done, and the ever-looming pile keeps growing and growing. And yet, they will look at it, and just walk by it due to feelings of overwhelm and being totally unmotivated to take care of it. Other clients have reported to me that they just stopped caring about daily grooming. Finding it hard to shower, brush their teeth and put any make-up on. Weight gain and weight loss can both happen during a depression episode.

The persistent feeling of sadness or loss of interest that characterizes depression can lead to a range of behavioral and physical symptoms. These may include changes in sleep, appetite, energy level, concentration, daily behavior, or self-esteem.

Recognizing an on-going pattern is very important as it can become a very dangerous game for some if the confusion about depression continues unchecked. If you feel that you shy away from what you love or what usually gives you energy then it’s time to examine deeper as to why you are feeling that way. Many people can reach out to find some relief by talking to a supportive family member or friend, but when your own support system is not enough, it is probably time to see a professional counselor. The good news is that treatments are available. But many people who have depression do not seek treatment.

The medical community does not fully understand the causes of depression. There are many possible causes, and sometimes, various factors combine to trigger symptoms.

Factors that are likely to play a role include:

  • Genetic Features
  • Changes In The Brain’s Neurotransmitter Levels
  • Changes In Hormonal Levels
  • Environmental Factors
  • Psychological And Social Factors
  • Adverse Childhood Experiences
  • Lack Of A Positive Support System


Types Of Depression

There are several forms of depression. Below are some of the most common types.


Major Depression

A person with major depression experiences a constant state of sadness. They may lose interest in activities that they used to enjoy.
Treatment usually involves medication and psychotherapy.


Persistent Depressive Disorder

Also known as dysthymia, persistent depressive disorder causes symptoms that last for at least 2 years.
A person with this disorder may have episodes of major depression as well as milder symptoms.


Postpartum Depression

After giving birth, many women experience what some people call the “baby blues.” When hormone levels readjust after childbirth, changes in mood can result.
Postpartum depression, or postnatal depression, is more severe.
There is no single cause for this type of depression, and it can persist for months or years. Anyone who experiences ongoing depression after delivery should seek medical attention.


Major Depressive Disorder With Seasonal Pattern

Previously called seasonal affective disorder, or SAD, this type of depression is related to the reduction in daylight during the fall and winter.
It lifts during the rest of the year and in response to light therapy.
People who live in countries with long or severe winters seem to be affected more by this condition.


Depression Treatment

For mild-moderate forms of depression, psychotherapy is usually the first-line treatment. When the symptoms are more severe or chronic, some people respond better to a combination of psychotherapy and medications.

CBT and DBT psychotherapy are two types of psychotherapy successful in treating depression. It is a way to challenge the negative recurring thoughts that bring you down and to reintroduce affirmations and self-care behaviors. It can also uncover old unresolved trauma issues, even as far back as childhood, that may be contributing to the depression cycles in adulthood.

CBT is the best-proven form of psychotherapy. It sometimes works as well as antidepressant drugs for some types of depression. Some research suggests that people who get CBT may be half as likely as those on medication alone to have depression again within a year.

Medication works well to treat depression. If you also get CBT, your treatment might work even better and the benefits might last longer. Most people who get CBT for depression or anxiety continue to keep using the skills they learned in therapy a year later.

Dialectical Behavior Therapy is a very structured form of therapy based on a synthesis of self-acceptance and change. It incorporates techniques geared toward validation and tolerance, as well as techniques that will improve certain behaviors.

A 2002 study published in the American Journal of Geriatric Psychiatry found that 71 percent of study participants who received Dialectical Behavior Therapy for depression reported to be free of their depression symptoms by the end of the study.

Researchers taught the participants new skills to help manage their negative emotions and life problems, especially in times of crisis. These skills can be especially useful when dealing with the negative emotions you typically experience when depressed.



25 Things You Can Do To Fight Depression

  1. Exercise – This has been my sharpest sword. Try to get at least 20 minutes of exercise everyday, even if it’s just a quick walk.
  2. Eating Well – Depression can lead to overeating or under-eating. Eating better makes your body feel better. Consider eating less sugar and processed foods and eating plenty of protein, fruits and vegetables.
  3. Find a Counselor – Find someone to talk to about the way you are feeling and who can help you navigate the hardest parts of your story. Having a confidential person who is on the outside of your life looking in can often see things friends and family cannot.
  4. Journal – Writing down how you are feeling can bring relief and provide a feeling of “control” that depression can often take from us. You may find it helpful to write a Gratitude Journal: jotting down five things or people you are thankful for each day to keep my mind focused on the good.
  5. 7-8 Hours of Sleep – Another symptom of depression is over-sleeping or under-sleeping. If you’re struggling to fall asleep, try moving all of the screens and distractions out of your room. Give yourself an hour to wind down in the quiet with soft music, a journal or a book. Set an alarm and get up at 8 hours.
  6. Stick to a Schedule — – If you’re struggling, make a few appointments throughout the day and stick to them. Could be a workout time at the gym, going to something at church or a park, even just alone time at a coffee shop. Make a plan to get out of the house and around other people.
  7. Don’t Over-Schedule – Make sure you are not hyper-busy and over-extended. Make sure you have time to relax and recharge.
  8. Go for a Walk or Hike – Not only will the exercise improve your mood, being in nature has shown to ease stress.
  9. Medication – There are many medications out there that have been proven to really help. Talk to your doctor and consider giving it a try.
  10. Avoid Drugs and Alcohol – When at your lowest state, alcohol often seems like a quick-fix and a crutch to numb the depths of your sadness. However, chemicals not only numb the low, they numb the good feelings as well. And can lead to addictions and major health problems.
  11. Set New Goals –Goals give life focus and direction. They help remind people what they are working towards and provide satisfaction when they accomplish them. Set small goals to get instant successes. These will build over time.
  12. Get a Massage – Touch therapies have been shown to ease the symptoms of depression by lowering stress and increasing the feel-good oxytocin.
  13. Meditate and Pray – Daily time in meditation encourages a relaxation response that is very beneficial to your mental health. As prayer can be a great way to ground yourself and connect to your spiritual senses.
  14. Watch Something Funny – Medical research has shown that laughing actually provides relief and gets your mind off your struggles.
  15. Get Around People – In the worst moments sometimes it helps to just get around people. Either strangers at a store or loved ones.
  16. Challenge Negative Thoughts –When a negative thought starts swarming, such as, nobody cares about me, immediately challenge that thought and write down a counterargument. Don’t let those thoughts take hold.
  17. List Your Accomplishments – When you are having negative thoughts and life may feel like it isn’t going anywhere and that you haven’t really done much. Writing a list of those things that you have accomplished, no matter how small, helps to get us unstuck.
  18. Try Something New – New experiences can provide a quick jolt of fun and happiness, a reminder that life is meant to be lived to the fullest. Make time to take that class you’ve always wanted to take. Go visit a new park or ice cream shop.
  19. Take More Pictures –Do one thing every single day that makes your life better or makes the world a better place and photographs it. Then anytime you are really struggling, you can look at the photo album and see that life is in fact worth living.
  20. Write Your Life Story – There are some really cool studies out there that show writing your life story is one of the most therapeutic things you can do because it allows you to document what you have lived through and shape it using your own narrative. You definitely don’t have to share it with anyone either.
  21. Forgive Someone –Release yourself from those angry feelings that may be part of what is weighing you down like a sack of rocks and move on. Just because you forgive doesn’t mean that you approve of what they did.
  22. Listen to Upbeat and Positive Music – We have known for thousands of years that music can change our moods. Create a playlist to use when you are having a negative moment or day.
  23. Make a Bucket List (and check something off) – Similar to setting goals. Print off a list of the things you’ve always wanted to do and hang it up somewhere you will look at it regularly.
  24. Do Something You Don’t Feel Like Doing –By getting unstuck from a pattern of neglecting things you are empowering yourself to see that you can handle things, perhaps one at a time.
  25. Never Give Up – If you’re having suicidal thoughts, please ask for help. Talk to someone you love. Call the suicide prevention hotline at 1-800–273-TALK (8255).


06 May 2020
What Is Self-Esteem and Why Is It Important?

What Is Self-Esteem?


The term self-esteem is used to describe a person’s overall sense of self-worth or personal value. In other words, how much you appreciate and like yourself.

  • Self-esteem is often seen as a personality trait, which means that it tends to be stable and enduring over the lifespan.
  • Self-esteem can involve a variety of beliefs about yourself, such as the appraisal of your own appearance, beliefs, emotions, and behaviors.
  • Self-esteem refers to a person’s beliefs about their own worth and value. It also has to do with the feelings people experience that follow from their sense of worthiness or unworthiness. 


Self-esteem is based on who you are and the relationships and experiences you have had at home, in school, with friends, and in the community. You form an image of yourself based on these experiences and relationships, starting with your parent or primary caregiver. Positive experiences and relationships contribute to healthy self-esteem, and negative experiences and relationships contribute to poor self-esteem.


Self-Esteem Is Important


Self-esteem is important because it heavily influences people’s choices and decisions. For instance, some people really like cars. Because cars are important to them, these people take really good care of their cars. They make good decisions about where to park the car, how often to get it serviced, and how they will drive it. They may decorate the car and then show it off to other people with pride. Self-esteem is like that, except it is yourself that you love, care for and feel proud of. When children believe they are valuable and important, they take good care of themselves. They make good decisions about themselves which enhance their value rather than break it down.


Self-esteem is important because it heavily influences people’s choices and decisions. In other words, self-esteem serves a motivational function by making it more or less likely that people will take care of themselves and explore their full potential.


Healthy self-esteem can help you achieve your goals and can contribute to good relationships with others. It can give you self-confidence. Poor self-esteem can make it difficult to get things done, make you question your abilities, and can even contribute to depression.

Signs of Healthy Self-Esteem


You probably have a good sense of who you are if you exhibit the following signs: 


  • Confidence
  • Ability to say no
  • Positive outlook
  • Ability to see overall strengths and weaknesses and accept them
  • Negative experiences don’t impact overall perspective
  • Ability to express your needs

Signs of Poor Self-Esteem


You may need to work on how you perceive yourself if you exhibit any of these signs of poor self-esteem: 

  • Negative outlook
  • Lack of confidence
  • Inability to express your needs
  • Focus on your weaknesses
  • Excessive feelings of shame, depression, or anxiety
  • Belief that others are better than you
  • Trouble accepting positive feedback
  • Intense fear of failure

Rebuilding Self-Esteem


Rebuilding self-esteem takes time, self-compassion, self-acceptance, patience and mindful action. Here are 4 things you can do to rebuild your self-esteem:

  • Be Mindful of Self-Talk

Negative self-talk can really alter our perspective on the world and our role in it. The problem with negative self-talk is that over time, it can become something which happens automatically – we don’t even realize we’re doing it. In order to change that, we need to start being mindful of our thoughts. We need to consider whether the expectations we place on ourselves are realistic and fair. Whether we allow ourselves to make mistakes and learn from them or make mistakes and erode ourselves with belittling and self-loathing. Try reading daily affirmations.

  • Make An Effort To Practice Self-Care

Self-Care really matters and it doesn’t have to be expensive. The negative self-talk we may be indulging in can become dominating, overbearing and destructive. When we take small actions of self-care, we’re taking back some of the power. We’re showing our negative thoughts that we ARE worthy of care and kindness.  It can be very empowering.

  • Spend Time With People That Give You Good Energy

Sometimes we spend time with people we don’t really enjoy, it doesn’t feel like a choice but an obligation or duty. Sometimes we don’t know how to say ‘no’and so we bend backwards to accommodate the needs of others. Try to spend time with those you actually enjoy spending time with. Those who you would absolutely choose to see. Practice saying ‘no’ to those that bring you down. It’s not easy, but it does get easier over time.

  • Compartmentalize

To avoid feeling overwhelmed or not good enough, try breaking things down into smaller chunks. Each time you complete a micro action, your faith in your abilities will grow incrementally over time. Smaller actions tend to be achievable, maintainable and not at all overwhelming. Learn to create small successes.


27 Apr 2020
Creating Structure With Your Children At Home

During the current pandemic most children are at home and will not be returning to school or daycare for many weeks to come.  This can create chaos in the house and make parenting a difficult and sometimes overwhelming experience.  This article is about creating a structure in your home so that its not becoming a never ending free-for-all.  Let’s look at some common behavioral challenges and how structure can help you, as a parent, to reduce some of these problems.


Consistent routines and rules help create order and structure your day. Things go more smoothly when you and your child know what to expect. When things are reliable and predictable it can relieve anxiety and apprehension.


It’s normal for young children to test the limits. That’s how they learn what is right and wrong. But, it can be frustrating and really test our patience as parents! One way to keep control and help children learn is to create structure. Structure is created by consistent routines and rules. Rules teach children what behaviors are okay and not okay. Routines teach children what to expect throughout the day.


Structure helps parents and their kids. Kids feel safe and secure because they know what to expect. Parents feel confident because they know how to respond, and they respond the same way each time. Routines and rules help structure the home and make life more predictable.


Three key ingredients to building structure in the home:

  1. Consistency
  2. Predictability 
  3. Follow-through




Consistency means that you respond to your child’s behavior the same way every time no matter what is going on or how you’re feeling. Misbehaviors are less likely to occur again if you always use the same consequence, like ignoring or time-out. Good behaviors are likely to be repeated if you let your child know you like them. This doesn’t mean that you need to give consistent attention to ALL of your child’s behaviors. Think about something you want your child to do more often. This could be sharing, cleaning up, or following directions. To increase those behaviors, praise them each time you see them occur. Your consistent response will help those behaviors happen more often.




Predictability means your child knows what will happen and how you will respond. When your daily routines are predictable, your child knows what to expect for the day. When your rules are predictable, your child knows how you will react to her behavior.


Follow Through


Following through means that you do what you say you will do in response to your child’s behaviors. This is often called the “say what you mean and mean what you say.” If you tell your child a behavior will be punished, you punish it every time it happens. If you tell your child he will be rewarded for a behavior, you give him the reward after he has done what you asked. To be consistent and predictable, we need to follow through. Follow-through is important for ALL behaviors. This includes behaviors we like and don’t like. Use the Reward Menu and Consequence Chart (below)


Reward Menu


The concept of a reward menu is to have incentives that you can easily use to promote desired behaviors.  Poll the child/children to see what kinds of things they would like and create a list with a variety of their choices that you agree to provide. Some items may be food rewards, video game time, staying up late, getting out of a chore, reading a book with mom, etc.  The menu can offer the five to ten most popular choices. 


Consequence Chart


The concept of a consequence chart is to get your child/children to participate in their own punishment choices for 3 levels of infractions.  This process creates a kind of contract with the kids.  For each level, negotiate up to 4 consequences. By doing this at a time of calmness and cooperation, executing it during a battle becomes a much easier way to enforce the consequences.  Also, you as a parent have a ready made list of choices that are appropriate for the right level of infraction.  It is probably not fair to be on restriction for 3 months for leaving the lights on.


  1. Level 1:  YELLOW ZONE – minor infraction
  2. Level 2:  ORANGE ZONE – moderate infraction
  3. Level 3:  RED ZONE – major infraction


Bedtime Routines


Establishing a bedtime routine is very important. This routine includes what your child does before bed and where your child sleeps at night. It may be helpful for the routine to include things that help your child relax, such as reading a story. Once you decide on the activities for the routine, talk about it with your child. Some parents like to make the routine into a song and sing it with the child. For example, you can sing, “After you take a bath, we’re going to put your PJs on, brush your teeth, get you in your bed, read a story, and then it’s time for sleep!” Your child may try to push the limits and get a “few more minutes” of awake time before sleeping, but do not allow this. At the end of the routine, leave your child to sleep. By creating a bedtime routine and sticking with it consistently, your child knows exactly when and where she should be sleeping.


Troubles With Transitions


Having trouble getting your child to go from one activity to another during the day? Daily schedules can help because they take the surprise out of what will happen next.


A structure that helps your child learn to behave has routines and rules that are consistent, predictable, and have follow through. There is a basic routine you follow and rules you live by on most days of the week. You set appropriate expectations and limits for your child’s behaviors. Your child learns how you are going to respond to behaviors that are okay or not okay.


Daily schedule


  • Wake up at 9:00 a.m. 
  • Cartoons until breakfast at 9:30 a.m.
  • Get dressed for the day
  • Snack at 11:00 a.m.
  • Art or Science activity until lunch
  • Lunch at 1:00 followed by nap/quiet time at 1:30 p.m.
  • Outdoor play following nap or quiet time around 2:00 pm
  • 3:00 pm Snack and Video games/TV/reading
  • 4:00 pm chores (older kids)
  • Prepare dinner around 5:00 p.m., eat around 6:00 p.m.
  • Bath time around 7:30 p.m.
  • Read or do something together, like a game or art project, around 8:00 p.m.
  • Pajamas, brush teeth and then to bed by 8:00 p.m. (younger kids)
  • Read story and quiet/asleep by 9:30 p.m. (older kids)




  • Instead of looking at large time blocks, make the day into short, manageable chunks (think 30-minute blocks).
  • Be flexible! Don’t stick to the time listed in the schedule, it’s more about flow. If the kids are playing nice – don’t stop them because the schedule says it’s snack time. Let it be.
  • Adjust this to fit your child – you know your kid(s) and what they need. You know how long they can tolerate certain activities. Adjust for them.
  • Don’t rely on screen time to save the day: use screens as your tool and reserve it for when it’s crucial.
  • It’s important to give some of your time to engage in activities with the kids, but also encourage some independent play for kids so you can get some time to yourself also.


26 Feb 2020
New Things In Counseling: NEUROPLASTICITY

This is a new day for psychotherapy and the understanding of how counseling works. It is much more than just talking to vent our frustrations, or get validation from a professional person. The challenge is to create new neuropathways to establish and sustain positive change.

I really love YouTube as it often has short videos on key concepts so that we can all understand some of these complex issues. I will be posting links to some of my favorite things so that you can benefit from these little gems.


05 Jan 2020
Understanding Play Therapy

I have met many therapists that see play therapy as a way to build a rapport with children but can not articulate beyond that. Play Therapy is a very special kind of treatment, if done properly, to create a verbal and non-verbal expressive clinical environment to work with children that are suffering from a variety of mental health issues. The play therapy rooms at my offices are set up with 5 standard kinds of toys found in a well-designed setting. All of our therapists get the play therapy training needed to ensure a relevant and effective treatment experience for you and your child. Good treatment is far more than just playing board games with a counselor.

15 Dec 2019
Seasonal Depression

The Holidays can be a time of friends and family. It can be a time of giving and sharing joy. But for many it is a time of depression and like the weather, it feels kind of gloomy. For some people it may be a reminder of a lost loved one; all the festivities can re-activate grief and loss. You may be experiencing Seasonal Affective Disorder or Seasonal Depression. Over 10 million Americans get this every winter.


It hits young women the most, as they are 4 times as likely to feel depressed and hopeless during the holidays. You do not have to go through this alone. Our Therapists are here to help you by providing validation, support and using a variety of techniques to assert yourself into new patterns of more positive thinking, feeling, and being. Light therapy is often recommended as there is a correlation between depressed mood and lack of sunlight. We focus on DBT and CBT therapy and use a version of these techniques in an integrated play therapy for kids.

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