Dr.Villarreal on Forum with Michael Kransy

Forum with Michael Kransy of KQED, NPR Public Radio welcomed Dr. Christina Villarreal as a guest speaker and mental health expert on the episode Moving On After a Break Up … And Why It’s Too Painful for Some of Us on February 12, 2016.  With host Mina Kim:  A new Stanford study published in the Personality and Social Psychology Bulletin uncovers why some people have more trouble recovering from breakups than others.  Listen to the entire episode here.

 

 

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Dr. Christina Villarreal in The Green Room @ KQED San Francisco

Strategies overachievers can use to find happiness and purpose

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Starting a new year is especially impactful for people described as ‘overachievers’.  I work closely with young influencers in the tech community of San Francisco, their struggles are as unique as their accomplishments.  From completing their own annual ‘Year in Review’ life progress report (yes that really is a thing) to calculating their financial growth trajectory against the top 1% of earners, they are quick to succeed at what they set out to do.  Most are well under 35, have founded and successfully run and/or profitably sold a company, and are already making more money than their parents.  Nothing to frown at, right?  Yet if this describes you, you’re probably thinking ‘meh, so has almost everyone else I know.’  It’s no easy feat to be impressive in the Bay Area.

Overachievers are known for their willingness to tackle new challenges, push themselves beyond their comfort zone in order to get ahead of their peers, and are highly effective at solving problems.  Yet high achieving people also tend to privately wonder “Am I the only one who has a hard time relaxing and enjoying myself?  Why can’t I stop worrying about falling behind in life?”  Overachievers invest much of their time investigating what ‘the right’ choices are, and can struggle with making definitive decisions out of fear of making ‘the wrong’ choice.  Committing to a specific career direction, choosing a spouse, or deciding which city to settle down in can all be paralyzing decisions for overachievers.  The painstaking (not to mention endless) deliberation of an overachiever can lead to chronic feelings of dissatisfaction, loss of authentic purpose, and ultimately, a barrier to enjoying the outcomes they’ve worked so hard to attain.

 

Cognitive Behavioral Therapy (CBT) is especially effective at exposing and disrupting ineffective thinking styles that can paralyze people’s decision making and lead to feelings of chronic anxiety, emptiness and discontent

CBT-based strategies overachievers can use to find happiness and authentic purpose:

Redefine Happiness.  Consider how often you think “I’ll be so happy when…or “I can’t wait until…” Stop placing a conditional clause on happiness, it prevents you from valuing your current circumstances as worthy of genuine satisfaction.  Ironically, this thinking style begins as way to sustain motivation and increase tolerance for challenging periods in life.  “I’ll be so happy when I finish this damn Ph.D.” (guilty as charged)  There’s nothing wrong with expecting to feel great once something difficult is over or a life milestone has been met.

  • The Stumbling Block:  When this ‘imagined future’ gets placed so far up on a pedestal that it diminishes your current circumstances, and prevents you from investing in present-day opportunities for satisfaction and joy.
  • The Faulty Logic: “If I let myself be happy with where I am right now, I’ll lose motivation to work hard, and I’ll stop striving for that next level of achievement.”  FALSE.  Work ethic is not driven by avoiding happiness.  You aren’t doing yourself a favor by adopting an attitude of ‘my current life isn’t good enough, and I shouldn’t indulge in pleasure, lest I become complacent’.  Nor does any particular achievement guarantee happiness.
  • The Solution:  Keep your happiness barometer focused on the here and now.  Allow yourself to experience real pleasure and contentment today, it will be the positive fuel that will restore and strengthen you for all your future endeavors.  What if you aren’t sure what makes you genuinely happy?  Instead of measuring every person, activity or experience as an opportunity to advance your station in life, start by asking yourself “Was that fun?”

“If you’re happy, that’s probably the most important thing. Everyone probably has their own definition of success, for me it’s happiness. Do I enjoy what I’m doing? Do I enjoy the people I’m with? Do I enjoy my life?”  Michael Dell, Entrepreneur and Founder of Dell

Redefine Failure.  Consider how often you label a situation or outcome in your life a ‘failure’. Many overachievers are quick to discount and devalue something that didn’t go exactly according to plan.  Part of how people successfully achieve goals is by creating highly specific plans with measurable outcomes.  However, overachievers are prone to self-punitive rumination when things don’t turn out precisely as planned, which leads to pervasive feelings of self-doubt and inadequacy.

  • The Stumbling Block:  Choosing to view something as a ‘failure’ blinds you to the value it can contribute to your life.  Tying your sense of worth to quantifiable ‘wins’ and ‘failures’ robs you of the chance to be a whole person, whose contributions and very existence is valuable beyond achievement.
  • The Faulty Logic:  “If something didn’t turn out how I wanted, it should be considered a fail.  I wasted valuable time and now I’m behind with my life plan.  This failure tarnishes me, and now I’m not as valuable as other people because of it.”
  • The Solution:  Practice finding (and believing) in silver linings.  In every outcome and life experience there is opportunity to learn and grow in profitable ways.  Finding out what problem solving strategies and solutions don’t work and why, developing newfound courage, building emotional strength, practicing patience, gaining insights about how people and groups think and behave, increasing your ability to offer encouragement and compassion, uncovering resilience, experiencing autonomy and teamwork in new circumstances, the list is endless!  The point is, the most successful, well-rounded people derive their critical personal development from all sorts of experiences and are better for it.  Do not short-change yourself by writing off even your worst outcomes as worthless.  Moreover, the value of your life cannot be quantified by successful achievement alone.

Success does not Guarantee Love.  This is a big one. Huge actually.  Many overachievers learned early in their life they are more likely to receive praise for their successes, which feels good- especially when it comes from influential people like parents or primary caregivers.  Alice Miller wrote about this over 30 years ago in the classic The Drama of the Gifted Child.  Being singled out for winning can make us feel special and desirable, increasing our awareness of social status.  Criticism for not achieving can feel rejecting and painful and can lower our sense of self-worth.  Over time, overachievers learn to associate social approval, love, admiration, inclusion, and even intimacy.as being dependent on one’s success.  It’s not that seeking social connections through common interests, values or achievements is misguided.  But relying on social status to serve as the most critical criteria for building friendships or finding a romantic partner can result in relationships that never feel good enough or genuinely fulfilling.

  • The Stumbling Block:   When we use our own version of ‘social status’ (prestigious academic or career achievements, artistic talent, wealth, power, socially recognized intellectual or physical superiority) as the primary focus for building our social circle or selecting a romantic partner, we can lose sight of the most important factors that make relationships feel good and lead to lasting love, happiness and intimacy.  We run the risk of developing relationships that feel inauthentic and insecure.
  • The Faulty Logic:  “My own relative success has led me win approval and special treatment from others.  I’ve also learned to avoid painful criticism and negative judgment by demonstrating superior abilities compared to others.  If I don’t choose someone whom matches or bolsters my success, I won’t feel genuinely good about myself or them.  I can’t really love someone who doesn’t measure up to my expectations for success. 
  • The Solution:  Building opportunities for growth through relationships is a healthy, if not critical part of one’s personal development.  However, overachievers can place a high degree of pressure on themselves to select their social circle strategically, or risk failure in life.  Many will point out quotes from high achieving leaders that suggest all social opportunities should be leveraged to boost one’s personal success.  Business philosopher Jim Rohn “we are the average of the five people we spend the most time with” or Michael Dell, Founder of Dell “Try never to be the smartest person in the room. And if you are, I suggest you invite smarter people … or find a different room.”  While this advice has merit, it can be misleading if taken out of context.  It’s understandable to admire and be drawn towards people who show potential to uplift and improve us, but friendship and romance can’t survive without tenets like mutual enjoyment of each other’s company, respect, genuine affection and good will for one another, reciprocal generosity, and willingness to compromise in order to overcome challenges or disagreements.

Further, overachievers can sometimes fail to recognize or appreciate opportunities to learn from people whose personality strengths and achievements contrast with their own.  Overachievers tend to want to find a spouse who ‘has it all’ which often ends up sounding like an ‘idealized and improved’ version of themselves.  Instead, consider what personality styles are complimentary to your own.  Keep in mind people can be ‘Type A’ at work, but ‘Type B’ in social and romantic relationships, or vice versa.  Who you work well with at the office or studio may or may not be who you are best suited for romantically.  People are often happier in relationships that provide an opportunity to balance each other in a way that is mutually beneficial.  So allow some flexibility in how you define ‘smart and successful’, you are increasing your chances for developing healthy, happy  and lasting friendships and romantic partnership.

Finding Direction and Purpose Through Self-Acceptance.  One of the biggest challenges for young overachievers is narrowing down what direction to take their career ambitions. One theme I have heard repeatedly among high achieving millennials in my practice is “I don’t want to just be really successful at something, I want whatever I do to have meaningful social impact.  It’s important for me to be a part of something that leads to positive change in the world.”  What brings them into my office is that in spite of graduating with prestigious accolades or achieving early success in the tech/business sector, they struggle with feeling they are ‘doing the right thing with their life’.  It’s not uncommon for overachievers to experience a surge of perfectionistic career-related FOMO that can be paralyzing and lead to anxiety and depression.

  • The Stumbling Block:  The challenge for overachievers is that they excel in so many arenas that they have less cause for ruling out career choices.  They can often feel pulled in many different directions at once, and experience heightened pressure to always “know what they’re doing, and have a plan”.  Further, many high achievers are so conditioned to rank jobs based on external markers of success that they have a difficult time identifying and valuing their own personal enjoyment as a reason for making choices.  The added pressure to “make a positive difference in the world” creates a feeling of constant unease and intimidation.

“These are kids who will perform to the specifications you define, and they will do that without particularly thinking about why they’re doing it. They just know that they will jump the next hoop.  The fact that we’ve created a system where kids are constantly busy, and have no time for solitude or reflection, is going to take its toll.”  William Deresiewicz, who penned the controversial essay “Don’t Send Your Kid to the Ivy League” which reads like a self-help manual for ambitious yet internally adrift overachievers struggling to figure out how to navigate life.

  • The Faulty Logic:  I constantly feel like I don’t have enough concrete evidence to feel like I’m making the right major decisions, but I can’t afford to waste time doing things that aren’t part of a successful future.  If I don’t know exactly what I’m doing with my life all the time, I’m failing.”
  • The Solution:  First accept that NO ONE can know with certainty they’re making ‘the right or best choices’ for their own future.  Even people we believe turned out to be highly successful, happy and impressively socially responsible can’t look back and know they couldn’t have done things differently for ‘even better’ results.  The point is, let yourself live your life and appreciate a wide range of experiences, including the lulls and pitfalls.  Personal intuition and wisdom grow from a life full of twists and turns.  Learn to trust your own gut feelings, they are the ultimate decision-making tools for making choices, and you can’t hone these tools without testing them out on different experiences.  Feeling purposeful is entirely personal.  You can gather all sorts of facts, create decision-making diagrams and consider data taken from public opinion.  Sooner or later there will come a time when you cannot and will not know with any degree of certainty that something is going to pan out well.  What you CAN do is trust your future self to have the strength, courage and wisdom to handle the outcome if the day comes when you need to change course.  You’ll use the resources you have available, which will be invaluable wisdom gained from the experience, self-care strategies (you’ve hopefully been practicing along the way) and trusted social support.  That’s all any of us can really do!

Effective Strategies for Managing Your Mood: A Dailey Method Workshop

This month I’ll be facilitating a workshop for The Dailey Method, Piedmont!

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Effective Strategies for Managing Your Mood: How to Be Your Best Self More Often with Christina Villarreal, Ph.D
The consequences of not effectively managing our worst days means we are less motivated, less productive and more likely to fall short of others’ expectations. Our relationships at work and home suffer, bearing the brunt of our stressed out mood. Most of us do our best to prevent a bad mood from spiraling out of control, but wouldn’t it be great if you could do it more effectively; before too much damage is done?

Sunday, September 27th 1:30-2:30 pm

4409 Piedmont Ave.

Oakland, CA 94611
510.985.1955

Digital mental health tools: how do they work?

Teaching cognitive behavioral tools for mood management has been a large part of my psychotherapy practice since I began over 10 years ago.  Some of the most effective tools are relaxation techniques that work to help people manage a wide range of common mental and physical health symptoms, including anxiety/worry, self destructive thinking habits, panic attacks, insomnia, depression and chronic pain.  During psychotherapy, patients learn how and why these tools work, followed by demonstrations and practice in session, followed by homework for review in between appointments.  Innovative developments in technology have given people helpful tools to support what they are learning in psychotherapy, including the ability to measure and track their body’s physiological functioning with wearable devices. A variety of mental health focused mobile apps can work as supportive guides for relaxation, cognitive restructuring, and mood management. Some apps are built as digital games, based on research findings that suggest “gamifying” a scientifically-supported mental health intervention offers measurable mental and behavioral benefits for people with relatively high levels of anxiety.  Mental health professionals now have a wide range of supplemental digital tools to choose from to support their patient care, as well as individuals aiming for increased mental wellness.  Discuss with your mental health provider which digital tools best match the work you are doing together; if she/he is not familiar with any, aim for those utilizing evidence-based practices developed by health professionals, and steer clear of those making dubious health claims.  While the latest ‘best mental health apps’ lists are a great place to start, ultimately the ‘best app’ is one that is a scientifically supported one that you feel you can use with ease and consistency.

What makes these tools so effective and how do they work?

Relaxation techniques improve the mind and body’s physiological functioning and health.  Panic and other physical symptoms of stress are caused by the body’s  automatic reaction to perceived fear.  “The Stress Response” occurs when chemicals flood your body that prepare you for “fight or flight.” While the stress response is helpful in true emergency situations where you must be alert and ready to act, overall exhaustion can occur when constantly activated.  Relaxation strategies work to elicit “The Relaxation Response”, which rebalances your body’s physiological system by: deepening your breathing, reducing stress hormones, slowing down your heart rate and blood pressure, and relaxing your muscles. In addition to its calming physical effects, research shows that the relaxation response also increases energy/ability to focus, fight diseases, relieves aches and pains, heightens problem-solving abilities, and boosts motivation and productivity.

Cognitive techniques such as thought records and mood trackers reduce anxious, depressive or self-destructive thinking habits.  Worry, panic and fear are all normal and automatic human responses to real or imagined threats to safety. Self-evaluative thoughts play an important role in motivating us to identify errors and take action for improvement.  All of these types of thoughts work as a natural alert system, compelling us to make necessary changes that can remove us from harm’s way, decrease harmful behaviors or increase healthy behaviors. While sometimes these thoughts work in our best interest, they can also be hazardous to our mental and physical state of health if left poorly managed.  Automatic thoughts of worry or self-criticism can become distorted and irrational when left unchecked, and actually prevent us from being able to function optimally in our daily lives. Learning to refute and manage irrational thoughts is an important step in healthy coping when faced with uncontrollable circumstances.

Professional mental health treatment by trained experts remain an essential part of diagnosing and treating mental illness.  There is no substitute for understanding the myriad composition, history and progress of an individual’s mental health symptoms.  A person’s mental health can erode suddenly and sometimes without warning; dangerous progression of symptoms can be avoided with timely and appropriate professional care. 

 

 

Depression and its effect on your sexual relationship

The hallmark of most new romantic relationships is a passionate physical connection.  But when one or both partners suffer from clinical depression, a couple’s sexual chemistry can suffer.  Approximately 35 to 47 percent of people with clinical depression report having sexual problems.  Sexual problems worsen depending on the severity of one’s depression; sixty one percent of people with severe depression report having sexual problems.  In my practice as a clinical psychologist, problematic sexual functioning is a common complaint of people seeking treatment for depression and anxiety.

What leads to the reduction of sexual functioning in those experiencing depression?

The human brain is the body’s most powerful “sex organ.” Sexual desire begins in the brain, shaping our thoughts, feelings and behaviors. Chemicals in the brain called neurotransmitters help brain cells communicate with each other in order to stimulate blood flow to the sex organs. In a depressed person, their neurotransmitters are out of balance, which can lead to diminished sexual desire.  In addition, low levels neurotransmitters can dull a person’s ability to experience pleasure, both physical and emotional.

Are men and women’s sexual functioning affected differently by depression?

Both men and women suffering from depression describe experiencing a host of the following symptoms:

  • intense sadness that inhibits one’s ability to carry out daily activities
  • loss of interest in things that were previously enjoyable
  • changes in appetite, weight, and/or sleep patterns
  • feelings of guilt, irritability and worthlessness
  • loss of energy, feeling slowed down, or ‘keyed up’
  • impaired concentration
  • thoughts of death or suicide.

But some important gender differences may be found in how people experience depression.  Many men fail to identify themselves as clinically depressed because they don’t relate to feeling sadness.  Their depressive symptoms may only include feelings of tiredness, inability to concentrate or sleep well, hopelessness, as well and loss of interest or pleasure- all of which may be associated with loss of libido and erection problems.

For women, depression can commonly be experienced as feelings of sadness, feeling physically slowed down, worthlessness, and/or guilt along with loss of interest or pleasure- all of which can lead to lack of interest in sex and/or difficulty in reaching orgasm.

Helpful tips in coping with a relationship impacted by depression:

  • Seek out professional consultation. Many people are reticent to reach out for professional help because they feel they ought to be able to overcome problems on their own, or worry about the financial or time commitment of psychotherapy.  But an experienced mental health professional will be able to use their expertise to establish what type of support and resources are best suited for you, given your personal, familial and medical history.  A consultation can typically take place in 1-3 visits, after which, you should have a clear picture of what your options are for improvment. Evidence-based treatment such as Cognitive behavioral therapy (CBT) may be suggested for you, a widely accepted form of treatment for clinical depression.
  • Try to avoid saying “I know what you’re going through” to your partner.  You don’t.  Instead, try: ‘I can’t know exactly how you’re feeling, but I am trying very hard to understand and help.’
  • Take care of yourself. Being in a relationship with a depressed person can be incredibly taxing, so make sure you do whatever it is that helps you feel healthy and happy.  See friends, get in touch with your body through enjoyable physical activity, pursue your own interests and goals, and spend some time away from your partner.  Depressed people often want to stay home and/or isolate themselves from the world. If you attempt to join them in this pattern, you’re sure to end up feeling badly too.
  • Try not to take your partner’s lack of sexual interest personally.  This is crucial to staying invested in making the relationship work.  If you come to believe that your partner will not ever regain their sexual interest, you may end up terminating the relationship before determining if treatment can help.

15 common cognitive distortions- how our thoughts influence our mental health

What’s a ‘cognitive distortion’ and why do so many people have them? Cognitive distortions are ways that our thought patterns can convince us that something is true or false. These are typically thoughts that occur automatically, and are usually used to reinforce negative thinking or emotions.  Our automatic thoughts can feel rational and accurate, and most of all, they can feel factual. But with examination, we can often find evidence that our thoughts are NOT factual, but based on a set of negative thought patterns that have developed based on our feelings, rather than factual evidence.

Cognitive distortions are at the core of what many cognitive-behavioral and other kinds of therapists try and help a person learn to change in psychotherapy. By learning to correctly identify distorted thoughts, a person can then respond to the disorted thoughts by balancing them with thoughts that are more balanced, and based on fact/reality rather than negative feelings. By refuting negative thoughts over and over again, they will slowly diminish overtime and be automatically replaced by more rational, balanced thinking.

Aaron Beck first proposed the theory behind cognitive distortions and David Burns was responsible for popularizing it with common names and examples for the distortions.

1. Filtering.

We take the negative details and magnify them while filtering out all positive aspects of a situation. For instance, a person may pick out a single, unpleasant detail and dwell on it exclusively so that their vision of reality becomes darkened or distorted.

2. Polarized Thinking.

Things are either “black-or-white.” We have to be perfect or we’re a failure–there is no middle ground. You place people or situations in “either/or” categories, with no shades of gray or allowing for the complexity of most people and situations. If your performance falls short of perfect, you see yourself as a total failure.

3. Overgeneralization.

We come to a general conclusion based on a single incident or piece of evidence. If something bad happens once, we expect it to happen over and over again. A person may see a single, unpleasant event as a never-ending pattern of defeat.

4. Jumping to Conclusions.

Without individuals saying so, we know what they are feeling and why they act the way they do. In particular, we are able to determine how people are feeling toward us. For example, a person may conclude that someone is reacting negatively toward them and don’t actually bother to find out if they are correct. Another example is a person may anticipate that things will turn out badly, and will feel convinced that their prediction is already an established fact.

5. Catastrophizing.

We expect disaster to strike, no matter what. This is also referred to as “magnifying or minimizing.” We hear about a problem and use what if questions (e.g., “What if tragedy strikes?” “What if it happens to me?”).

For example, a person might exaggerate the importance of insignificant events (such as their mistake, or someone else’s achievement). Or they may inappropriately shrink the magnitude of significant events until they appear tiny (for example, a person’s own desirable qualities or someone else’s imperfections).

6. Personalization.

Thinking that everything people do or say is some kind of reaction to us. We also compare ourselves to others trying to determine who is smarter, better looking, etc. A person sees themselves as the cause of some negative external event that they were in fact, not resposible for. For example, “We were late to the dinner party and caused the hostess to overcook the meal. If I had only pushed my husband to leave on time, this wouldn’t have happened.”

7. Control Fallacies.

If we feel externally controlled, we see ourselves as helpless a victim of fate. For example, “I can’t help it if the quality of the work is poor, my boss demanded I work overtime on it.” The fallacy of internal control has us assuming responsibility for the pain and happiness of everyone around us. For example, “Why aren’t you happy? Is it because of something I did?”

8. Fallacy of Fairness.

We feel resentful because we think we know what is fair, but other people won’t agree with us. We are convinced that “Life is always fair.”  People who go through life applying a measuring ruler against every situation judging its “fairness” will often feel badly and negative because of it.

9. Blaming.

We hold other people responsible for our pain, or take the other track and blame ourselves for every problem. For example, “Stop making me feel bad about myself!” Nobody can “make” us feel any particular way — only we have control over our own emotions and emotional reactions.

10. Shoulds.

We have a list of ironclad rules about how others and we should behave. People who break the rules make us angry, and we feel guilty when we violate these rules. A person may often believe they are trying to motivate themselves with shoulds and shouldn’ts, as if they have to be punished before they can do anything.

For example, “I really should exercise. I shouldn’t be so lazy.” Musts and oughts are also offenders. The emotional consequence is guilt, which does not propel us to change, but only serves to make us feel badly.

11. Emotional Reasoning.

We believe that what we feel must be true automatically. If we feel stupid and boring, then we must be stupid and boring. You assume that your unhealthy emotions reflect the way things really are — “I feel it, therefore it must be true.”

12. Fallacy of Change.

We expect that other people will change to suit us if we just pressure or cajole them enough. We need to change people because our hopes for happiness seem to depend entirely on them.

13. Global Labeling.

We generalize one or two qualities into a negative global judgment. These are extreme forms of generalizing, and are also referred to as “labeling” and “mislabeling.” Instead of describing an error in context of a specific situation, a person will attach an unhealthy label to themselves.

For example, they may say, “I’m a loser” in a situation where they failed at a specific task. When someone else’s behavior rubs a person the wrong way, they may attach an unhealthy label to him, such as “He’s a real jerk.” Mislabeling involves describing an event with language that is highly colored and emotionally loaded. For example, instead of saying someone drops her children off at daycare every day, a person who is mislabeling might say that “she abandons her children to strangers.”

14. Always Being Right.

We are continually on trial to prove that our opinions and actions are correct. Being wrong is unthinkable and we will go to any length to demonstrate our rightness. For example, “I don’t care how badly arguing with me makes you feel, I’m going to win this argument no matter what because I’m right.” Being right often is more important than the feelings of others around a person who engages in this cognitive distortion, even loved ones.

15. Heaven’s Reward Fallacy.

We expect our sacrifice and self-denial to pay off, as if someone is keeping score. We feel bitter when the reward doesn’t come.

References:

Beck, A. T. (1976). Cognitive therapies and emotional disorders. New York: New American Library.

Burns, D. D. (1980). Feeling good: The new mood therapy. New York: New American Library.

Recognizing the Signs and Symptoms of Clinical Depression

Many of us wonder when we are going through a hard time in our lives “Could I be experiencing Clinical Depression? Or is this just a tough time that will soon pass?”  Recognizing the signs and symptoms of Clinical Depression can be confusing for many people.

Symptoms of depression can make work and our home life almost impossible to endure. Depression can skew your view of the world, making everything seem hopeless and no longer enjoyable. Depression can make you feel completely isolated and alone.

However, it’s more common than you think. Major depression affects about 14 million American adults, or about 6.7% of the population 18 or older in any given year. This list can help you recognize some of the key symptoms of clinical depression.

Recognizing the Emotional Symptoms of Clinical Depression

* Feeling sad, empty, hopeless, or numb. These feelings are with you most of the day, every day.
* Loss of interest in things you used to enjoy. The clinical term for this is called “anhedonia”.  You may no longer feel interested in the things that you used to love doing. You might not like being around friends you used to enjoy. You might lose interest in sex.
* Irritability or anxiety. You might be short-tempered and find it hard to relax or stop worrying.
* Trouble making decisions. Depression can make it hard to think clearly or concentrate. Making a simple choice can seem overwhelming.
* Feeling guilty or worthless. These feelings are often exaggerated or inappropriate to the situation. You might feel guilty for things that aren’t your fault or that you have no control over. Or you may feel intense guilt for minor mistakes.
* Thoughts of death and suicide. The types of thoughts vary. Some people wish that they were dead, feeling that the world would be better off without them. Others make very explicit plans to hurt themselves.

Recognizing the Physical Symptoms of Depression

Most of us know about the emotional symptoms of depression. But you may not know that depression can be associated with many physical (bodily) symptoms, as well.

In fact, many people with depression suffer from chronic pain or other physical symptoms. These include:

* Headaches. These are fairly common in people with depression. If you already had migraine headaches, they may seem worse if you’re depressed or feeling “stressed out.”
* Back pain. If you already suffer with back pain, it may worsen if you become depressed.
* Muscle aches and joint pain. Depression can make any kind of chronic pain worse.
* Chest pain. Obviously, it’s very important to get chest pain checked out by an expert right away. It can be a sign of serious heart problems. But depression can contribute to the discomfort associated with chest pain.
* Digestive problems. You might feel queasy or nauseous. You might have diarrhea or become chronically constipated.
* Exhaustion and fatigue. No matter how much you sleep, you may still feel tired or worn out. Getting out of the bed in the morning may seem very hard, even impossible.
* Sleeping problems. Many people with depression can’t sleep well anymore. They wake up too early or can’t fall asleep when they go to bed. Others sleep much more than normal.
* Change in appetite or weight. Some people with depression lose their appetite and lose weight. Others find they crave certain foods — like carbohydrates laden sugar and/or fat — and gain weight.
* Dizziness or lightheadedness.

Because these symptoms occur with many conditions, many depressed people never get help, because they don’t know that their physical symptoms might be caused by depression. A lot of doctors miss the symptoms, too.

These physical symptoms aren’t “all in your head.” Depression can cause real changes in your body. For instance, it can slow down your digestion, which can result in stomach problems.

So now you’re left wondering “I have some of these symptoms, but does that mean I’m suffering from Clinical Depression?”  Talking with a Clinical Psychologist can help you determine if what you’ve been experiencing may be Clinical Depression, based on the number and duration of your symptoms, as well as help you determine what type of treatment is best for you.