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How to Become a Mental Health Therapist

Here is a little video I made detailing the process of becoming a mental health therapist. This was fun to make and hopefully left you all with more information on how to join in on the fight toward mental health awareness and recovery! The Wellness Warrior was designed to use as a platform where we can all start a dialog about health and wellness. That being said, I LOVE engaging with you all, reading your comments, and taking in your feedback. Thank you for tuning in, for visiting The Wellness Warrior and for wanting to be a part of this journey with me! Much love <3

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A Day in the Life of a Mental Health Therapist

Hi there, Wellness Warriors!!

I hope you are all doing well. Here is a little video I made to highlight some ins and outs of therapist life. It includes what a typical day looks like (specifically a day during a pandemic), what a therapy session consists of, and tips for choosing the right therapist. Enjoy!

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What No One Tells You About Being a Therapist

A therapist’s office is intended to be a safe, warm space that allows for others to express and process patterns of thoughts, feelings, and behaviors. It’s a place where people go to feel better. As a helping professional, I have the privilege of being part of the personal development and growth of my clients. I am deeply passionate about what I do, and I’ll be the first one to admit that I still get goosebumps whenever a client experiences an “Aha” moment. That being said, the mental health profession is not one without challenges.

According to the Philadelphia’s Department of Behavioral Health and Intellectual disAbility Services (DBHIDS), it’s estimated that about 22% of adults in the city are diagnosed with Depressive Disorder, 16% of adult Philadelphians experience frequent mental stress, and 13.8% of teens experience suicidal ideation.

To paint a clearer picture, these statistics mean that in Philadelphia 1 in 5 adults are diagnosed with depressive disorder, and 1 in 7 high school students have reported seriously considering suicide. These startling numbers are not counting the undiagnosed or unreported cases. These rates have remained consistent within recent years, with the exception of a wild increase of opioid-related deaths and ER visits for drug overdoses. With the growing severity of the opioid epidemic in the United States, an already overwhelmed system seemingly only has so much wiggle room before it breaks.

Community Behavioral Health (CBH) is a non-profit corporation contracted by the City of Philadelphia to provide mental health and substance use services to Medicaid recipients in Philadelphia County. There are about 144 Community Behavioral Health organizations in Philadelphia, and I have worked for and with many of them. Although I love the work that I do with clients, working in community agencies has created an entirely new perspective on how therapists and participants are treated among the Community Behavioral Health system….. and I think we all deserve better.

I remember learning about proper ethics and counseling techniques in my graduate program, bright eyed as I geared myself up for a future as a helper. Looking back, it seems so naive for me to have thought that it would be easy. Admittedly, I often wish I could go back to school and pay closer attention to discussions on how to avoid burnout, but sometimes it seems that in the community behavioral health field, burnout is inevitable. Although it would not have changed my choice of profession, I wish I had been more prepared for the community mental health world.

Here’s what I wish I had known:

  1. There are not enough mental health therapists in the community behavioral health system. It seems as though a major theme within the therapist community is the feeling of being overwhelmed by a bogged down system. Community Behavioral Health has an incredible amount of participants in need of mental health care and not enough wo/manpower to provide the quality of care necessary to treat severe mental health symptoms. This means that the large number of participants receiving services are divided among the limited mental health professionals that exist, meaning higher burnout rates for therapists.
  2. There is a major focus on productivity. Full time therapists are given a certain number of clinical hours that they must provide per month, typically called productivity. For example, in my organization, the month of October held 160.63 available treatment hours. I need to achieve 66% of that, meaning I needed to provide at least 106 hours of therapy to meet productivity expectations. If I don’t, I risk being written up. So when we get into the nitty-gritty of things, my work performance is not determined by the quality of therapy I provide, but by the quantity of services I provide. Where I try to validate myself, it is sometimes hard to focus on my successes with clients when I am consistently reminded of “my numbers.” It also makes it more difficult to be understanding when clients cancel, which is often framed as one less hour toward productivity.
  3. Many organizations are turning to fee-for-service. Fee-for-service is pretty self-explanatory. In fee-for-service positions, therapists only get paid for the sessions they complete. This means that if a client does not show up, the therapist will either not get paid, or will get paid a small percentage of what they would have received. Oh, and fee-for-service therapists don’t get paid for the paperwork or outreach they do…. and let me tell you, in this field there is always a lot of paperwork and outreach to do.
  4. Community behavioral health is behind. Think about all of the ethical guidelines, evidence-based practices, and sensitivity training we learned about in school. Now, try to imagine trying to implement those practices in an organization that always seems 20 years behind the present status quo. This isn’t necessarily community behavioral health’s fault. It simply takes time to roll out new methods given the amount of education and training they require.
  5. Sometimes people don’t listen. I feel like I can talk about ethical treatment and appropriate care until I’m blue in the face, and it still doesn’t feel like I am heard. I often find myself thinking of therapists as the nurses of the mental health field– we have an incredible amount of knowledge, have spent years studying the subject, and care deeply about making sure our clients are receiving proper care… and it still feels like we are spinning our wheels just to be heard and respected.

And finally, none of this would matter if we didn’t care. Professionals typically don’t join the mental health field if they don’t care about the well being of others. This makes it even more frustrating when we can see that the overall focus is not on the quality of care we provide, but instead, on the success of the business. Although I can recognize that the business aspect is important, it just does not feel right to put the needs of the business before the needs of people. Helpers feel passionately about the injustices within social systems, because we care about the outcomes of the people we work with. It can be incredibly frustrating to see the above factors as barriers to doing what we love most– helping people.

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Digging up the Roots of Depression

Anyone can experience sadness, grief, and despair (assuming one has the emotional capacity), but not everyone will experience depression. Depression is characterized by loss of interest, lack of pleasure, changes in appetite or sleep, irritability, low energy, decreased mood, among other symptoms that can have a severe impact on daily life. Try to picture being a slug with no hope and no desire to do anything- that’s depression. It’s like trying to run against the current… while underwater… and someone forgot to give you a scuba tank so you could breathe. Depression is as abundant as the common cold, and it is one of the most common mental disorders in the United States. Although previously believed to stem from chemical imbalance, we now know that root of depression lies among a variety of risk factors, including physiological, environmental, emotional, and situational circumstances.

Physiological factors may include genetics, diet, hormonal imbalances, or chronic illness. Both of my parents were diagnosed with clinical depression at some point in their lives. In my own case, an extensive family history of depression put me more at risk for developing depression myself (I like to call it The Double Whammy). So, while this encouraged me to learn some skills early to manage depression, I didn’t quite understand what it would actually feel like to be- in the words of a client- “cuckoo-nuts,” until it got severe enough that I couldn’t work through it on my own. In some cases, poor diet or hormonal imbalances can relate to decreased energy or mood, influencing depressive symptoms. In my case, this was a chicken-or-the-egg scenario. I’d feel depressed and lose my appetite, have candy or chips or nothing for dinner, and then feel MORE depressed because I was eating like garbage. Often, individuals with chronic illnesses, sleep disorders, or other health concerns experience depressive symptoms, as well, particularly if these conditions cause challenges completing daily tasks and living a fulfilling life.

Depressive symptoms may also be affected by environmental factors. For example, if someone lives in a stressful or chaotic environment, that person may be more likely to experience depression. My own depressive symptoms heightened after moving to the suburbs. Living in a house that I could not afford, working two jobs, and living far from my friends created financial stress, lack of self care, and isolation. I found myself hiding in my room with debilitating anxiety at the thought of coming out of my cave and engaging with my manipulative roommate and her bro-in-denial boyfriend- which often meant navigating my way through stale marijuana smoke and Patron. And don’t get me wrong, I am far from prude, but this wasn’t the lifestyle I wanted or expected when I moved. My inability to cope with feeling stuck in an unhappy and unfulfilling environment was a major factor in my depression spiraling. Additionally, environmental factors may affect those living in a setting with increased violence, domestic disturbance, or crime.

Individuals who experience low self esteem, pessimism, or have a history of physical or emotional trauma may be more susceptible to symptoms of depression. This can be more apparent in people who lack coping skills or positive outlets for emotions. I used to have a saying: “Turn your sadness into anger, and lock it up in a box.” Now, picture me screaming this from the tallest rooftop: THIS WAS NOT HELPFUL. It took a LONG time to realize that feelings are normal and okay, and pretending it does not exist does not mean a feeling goes away. It just means that it’ll eventually come up more bubbly and more aggressive than before, like an exploding pressure cooker, or manifest in symptoms of depression or anxiety. And so, my new saying is: “Listen to yourself.” We experience emotions for a reason, and, whether they are accurate or not, they all deserve to be respected and acknowledged.

Last, but certainly not least, feeling sad is not the same as experiencing depression. Let me say it again: feeling sad is not the same as experiencing depression. However, if you are a human you have probably encountered a situation that has caused you intense grief- and if you haven’t, give me some of those unicorn-and-rainbow sunglasses you’re wearing. Life transitions can be complex. Death of a loved one, issues in work or school, relationship problems, financial issues, moving- these are all situations that can cause one to feel stressed, overwhelmed, distraught. These are some of the situations that I deem the “Big Bad Sad-Makers.” Major life changes can affect daily routine, cause anxiety, and manifest symptoms of depression. If emotions that come from these situations cause disruption in your ability to engage in daily life, it’s something to look at more closely.

While these are common roots of depression, they are surely not the only ones, and many individuals experience more than one of these risk factors for depression. Take me for example- all four of these things joined up to make me a tiny burrito of sadness! From the time I was in college, factors have been coming in and out of my life to cause disruptions in mood, and the one thing that encouraged me most in dealing with my depression was learning about my depression. Everyone has a different experience with mental health, and if I can offer you one piece of advice in tackling your own mental health concern, it is to learn about it. It’s like Voldemort- Harry had to learn about Voldemort’s history, strengths, and weaknesses before he could defeat him. Yes, I just turned Mental Health into a Harry Potter reference… and I think it’s my proudest moment of the day.

Thanks to @depression-patriciajordan.com for inspiring me to write this. It’s not a simple answer, but it’s an answer none-the-less.

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How Live Your True North Began

My History With Depression

In October 2018, my therapist diagnosed me with depression after spending months struggling with chronic unhappiness. Although I seemed content from the outside, I constantly struggled with irritability, sadness, and loneliness. I paid horrible attention to my daily needs, and I spent a great deal of time wrapping myself up like a blanket burrito to hide from the world. For me, depression felt like running underwater against the current. I forgot how to be myself and often ruminated on memories of laughing easily, completing tasks with ease, and surrounding myself with good people. 

I let depression hold me captive as I fantasized about my life instead of actually living it. When I did go out, I fought through intense anxiety and discomfort. Negative thoughts swirled in my brain and told me that I was not good enough. At work, I struggled with motivation to complete tasks, crying spells, and anxiety. To make matters worse, my unhelpful thoughts screamed, “You’re a mental health therapist! You’re not allowed to get depressed!” 

My Breaking Point 

I naively expected to pick myself up from my bootstraps and get better on my own. Realistically I knew that I could not help others if I did not help myself. I struggled to navigate the cognitive dissonance associated with being a therapist who needed therapy. I felt ashamed that I couldn’t manage my depression independently, and I felt like a fraud counseling others. Instead of acknowledging that I needed help, I pretended that I knew exactly what was wrong and exactly how to fix it.

On a Saturday in September, I finally reached my breaking point. That day at work, I ran late for a therapy session with a young client, which triggered the child’s parent to feel frustrated. Naturally, I expressed my apologies and explained the nature of the delay and resumed the therapy session. However, I could not stop ruminating on what happened. Her reaction caught me off guard and triggered intense anxiety about being bad at my job. I cried, trembled, and struggled with thoughts of not wanting to be here. After processing the event and my reaction with a friend, I finally accepted that I needed help.

Finding a Therapist

I first dabbled in therapy in college after experiencing difficulty transitioning to the new environment. My therapist at the time, a lovely woman with short, black hair and a soothing demeanor. However, I didn’t feel a close connection, and I struggled to fully engage with my therapist. I eventually worked through the transition on my own. Now, though, I felt emotions I didn’t understand and didn’t know how to overcome. 

Finding a therapist was relatively easy using both Psychology Today’s “Find a Therapist” tool and the phone number on the back of my insurance card. After finding a clinician who accepted my insurance, I sat with the phone number until I gained the courage to call schedule an appointment. My therapist, Ron, was a former baseball player who changed careers after suffering permanent spinal cord damage. He had a tall and lanky frame, and his wispy gray hair framed his strong facial features. His minimalistic office featured just a few artful pictures, a cluttered desk, and a long futon where I sat week after week.

Doing the Work

It took time, but Ron helped me understand that the only thing preventing me from overcoming depression was myself. Ron described a phenomenon called “Paralysis by Analysis,” where my negative overthinking prevented forward motion and decision making. We explored the onset of symptoms and events in my life that potentially contributed to unhelpful thinking styles. With Ron’s help I realized that simply attending therapy was not enough. If I wanted my life to change, I had to take what I learned in sessions and apply it outside of the office. 

First, I left a toxic roommate situation and moved into my own apartment. Then, I spent more time with family and friends, and I engaged in more overall self care. Even though the healthy habits I created helped, I still fought against the darkness. When I hung out with others, it told me I’d rather be home by myself, doing nothing, feeling hollow. I processed this feeling with Ron, who suggested following up with my primary care doctor.  “If depression is still keeping you from coping, then maybe you should explore medication,” he said.

Finding Relief

My heart initially sank at the thought of being prescribed medication. I worried about side effects, and I worried that medication with either not work or make things worse. I didn’t want to feel more emotionally stunted that I already felt. Nevertheless, I took Ron’s guidance and made an appointment with my doctor, who took the time and care to educate me and ease my concerns. In April 2019, I began taking Prozac once a day. 

After a few weeks, I noticed a lift in mood. The heavy water that I ran through began to evaporate. Prozac helped my brain maintain serotonin, which helped my mood, energy level, and quality of sleep. I actually trained my body to eat normal sized meals again, now that it felt hungry. Better yet, I happily found that my only side effect was mild dry mouth that disappeared after increasing my water intake.  

Maintaining the Progress

I needed to find a way to keep moving forward in my depression recovery. I started by noticing how I felt when I completed certain activities. If I did something that helped me feel better, I wrote it down in a list. By paying attention to the impact of my behaviors, I learned that eating healthy, being active, and engaging in artistic forms of self expression helped me to feel my best. These habits helped me become my happiest self. 

It takes anywhere from 18-240 days to form a habit and another 60 days for that habit to become an automatic behavior. I understood that I needed to focus on making these a bigger part of my lifestyle. I ate on a Paleo diet for several months in an attempt to reset my eating habits, I adhered to an exercise plan, and I made time for activities such as painting, drawing, and journaling. Furthermore, I frequently reminded myself that progress truly is an ongoing process that never ends, and positive self talk allowed me to more easily work through challenges. 

Sharing My Journey

When I created a blog, I intended it to serve as a space to document and record my personal growth. Sharing my story helped me to hold myself accountable and allowed me to change my lifestyle more consistently, and I quickly found that there is an entire community of wellness warriors out there trying to do the same thing. I hope to empower others to ask for help in finding balance and happiness. I recognize that I will never be done growing, and I want this space to grow with me. 

Above all, I learned that no one is immune to struggles with mental health, and we all get by with a little help from our friends. Live Your True North is a safe space for healing and self exploration.

I hope you choose to join me in living well, being myself, and living my True North.

Much Love, 

Kel

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Suicide Prevention: Fact or Fiction

Each year, September brings a slight chill to Pennsylvania, generating anticipation for changing leaves, crisp air, bulky sweaters, and hot apple cider. It also brings a deeper sense of purpose and passion to those acknowledging September as National Suicide Prevention Month. All month, individuals around the world work together to spread suicide prevention awareness.

Suicide is a 10th leading cause of death in the Unite States, and it is the 2nd leading cause of death among people ages 15-24. Although suicide is preventable, it is a serious public health issue. In 2018, 48,344 Americans died by suicide, and there were an estimated 1.4 million suicide attempts.

Talking about suicide can be scary and uncomfortable, but it is also a critical to engage in conversations surrounding suicide prevention awareness in order to save lives. We can prevent suicide by openly discussing mental health and understanding warning signs and risk factors. Knowledge is power. Check out these myths and facts to learn more about suicide

Taking to someone about suicide will make them more suicidal.

MYTH. Research shows that people who are experiencing suicidal ideation feel a sense of relief when someone asks them about it in a caring way. Encouraging others to openly share their thoughts and feelings can actually help them to feel better.

This being said, it is important to recognize that those who talk about suicide are still at risk of experiencing a suicide attempt. It is important to ask if the person has a plan with intent to act and encourage them to seek appropriate counseling assistance.

Suicide rates are highest among adolescents.

MYTH. Elderly males experience the highest suicide rates in the United States. Researchers theorize that this relates to the high frequency of undiagnosed or untreated depression, as depressive symptoms are common toward end of life. Older individuals are more likely to lose their spouse or develop chronic illnesses, which can be incredibly stressful and traumatic. Additionally, elderly adults often experience loneliness due to infrequent socialization, which can exacerbate depressive symptoms. Although suicide rates have actually decreased among this population, it still remains the age group that experiences the highest rate of completed suicide.

Knowing warning signs can help to prevent suicide.

TRUE. Individual, relationship, and environmental factors are some elements that may influence the risk of suicide. Individuals who have suffered through traumatic experiences, such as abuse or exposure to violence, are more at risk of suicide.

Warning signs may include:

  • isolation from others
  • changes in sleep patterns
  • low mood
  • low energy
  • talking about wanting to die
  • increased substance use
  • feeling trapped or like a burden
  • feeling hopeless and/or helpless
  • giving away prized possessions
  • attempting to access lethal means

Males experience higher rates of suicide attempts.

MYTH. Although males complete suicide at a higher rate than women, women actually experience high rates of suicide attempts.

You may be wondering: If women have more suicide attempts, how can men have higher completed suicide rates? Men often choose more lethal, immediate methods of attempting suicide, such as using firearms, whereas women tend to choose methods, such as poisoning or suffocation, that are more likely to respond to medical intervention.

Once someone attempts suicide, they are less likely to attempt again.

MYTH. An individual who attempts suicide is actually more at risk of experiencing a future attempt. Once someone experiences a suicide attempts, it is critical for them to receive immediate mental health support to lower the risk of future attempts and the risk possible completion. Suicidal ideation can be a fatal symptom and should always be taken seriously.

Most suicide victims suffer with depression.

TRUE. Depression is the most common mental health condition. Although most people with depression do not die by suicide, experiencing depression does put someone at greater risk of experiencing suicidal ideation. An estimated 60% of individuals who complete suicide suffer with mood disorders (depression, bipolar disorder, etc.). Many of them experience co-occurring disorders, such as substance use disorders.

Do you have any questions about suicide? Write in and let me know. Let’s all strive to learn how to help ourselves and how to help each other.

Much love,

Kel

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Conquering Your Inner Critic: 7 Ways to Overcome Negative Thinking

I’m not worth it. There’s no use. I can’t do it. I’ll never follow through. People won’t like me. Others are better than I am. I am not enough. I must be perfect. I am a failure. The world is evil. All people are bad.

If these phrases sound similar to your thoughts, you may struggle with unhelpful thinking patterns. Often unhelpful thoughts stem from negative perceptions of ourselves and the world around us. Negative perceptions can directly influence our thoughts, feelings, behaviors, and reactions to life events. It is unrealistic to expect that we can think happy thoughts all the time. However, we can train our brain to adopt a more realistic and healthy mindset. After all, spiraling into unhelpful thought patterns may increase feelings of stress, anxiety, and depression.

For more detailed explanation of unhelpful thought patterns, check out this psychoeducational worksheet that describes commonly used thinking errors.

After learning more about common thinking errors, keep scrolling to check out some useful tips for conquering your inner critic and decreasing negative thinking habits.

Catch Your Thoughts

Our thought patterns can eventually become habitual. This means that we can experience unhelpful thought styles without being aware of it. The first step in gaining control over our thoughts is to notice them. I encourage my Wellness Warriors out there to pay attention to your thoughts and attempt to label them. Learning about your negative thought patterns (triggers, related emotions, etc.) can give you the power to overcome them.

As a therapist, I love teaching clients to utilize an automatic thought record. This simple worksheet begins by allowing one to identify negative thoughts while encouraging further exploration and processing. To take catching your thoughts a step further, you can practice categorizing your thoughts using labels from the commonly used thinking errors worksheet.

Play out the Narrative

Often times, unhelpful thoughts can present in the form of chronic worries and “what if” statements. What if I fail? What if I get sick? What if my partner gets angry with me? Chronic worrying can send us into a negative thought spiral.

To combat this, consider what would happen if your worry came true. Ask yourself what you would do to address the situation. Developing a plan of action can be incredibly useful; if we have a plan, we naturally tend to stress less.

Practice Thought Stopping

If I tell you to think of a pink elephant, what do you think of? Most often, it is, indeed, a pink elephant.

After you catch your unhelpful thought, utilizing thought stopping techniques can help you break the cycle of negative thinking.

Common thought stopping techniques include finding a replacement thought or visual image, such as counting to ten or visualizing a scene from your favorite movie. One can also simply yell or think “Stop!” and find an alternate activity for a distraction.

Check the Evidence

There is no better way to challenge an unhelpful thought than to examine it. Remember, we are not attempting to exclude all negative thoughts. Instead, we are training our brains to think more realistically. We can achieve this by putting our thoughts on trial and exploring the evidence.

I often use this example: Imagine you are about to take a test. Your thought is, “I am going to fail.” Naturally, we may identify this thought as negative and engage in thought challenging and ask, “What evidence do I have that supports the thought that I am going to fail?” List all of the reasons why that thought might come true. Did you prepare for the test? Did you study for an adequate amount of time? Did you pay attention in class? Did you take notes? Did you study in a way that is effective for you? Do you feel focused?

If the evidence we identify supports the negative thought, it may just be that the thought is realistic. If the evidence contradicts our thought, consider that this thought is likely unrealistic and untrue.

Reframe Negative Thoughts

After we identify negative thoughts, we can reframe them to appear more balanced and realistic. Reframing simply means creating alternative, more helpful thoughts. By doing this, we begin to change our perceptions of events, experiences, or emotions.

In the earlier example, we established that the thought, “I am going to fail,” is likely true. It is important to recognize that we can still reframe negative thoughts if they appear to be true. Instead of thinking, “I am going to fail,” we might consider the reframe, “I will do the best I can.”

Take your own advice

It is so much easier to give advice than it is to take our own. Taking our own advice is challenging, but it is a critical step to overcoming unhelpful thinking habits. A helpful practice is pretending you are giving advice to your best friend. Consider the following: Would you try to get more information about what happened? Are you considering other’s perspectives? What are the different ways the situation might unfold? Finally, what advice would you give him or her?

Allowing yourself to step away from the experience and explore it objectively is amazingly simple, yet incredibly effective.

Find Gratitude

Gratitude is strongly associated with greater happiness and contentment. Practicing gratitude increases our ability to see that there is good in the world. Check out this previous post where I practice gratitude after a series of hard events and negative thought spirals.

To incorporate gratitude into our daily routines, we can keep a gratitude journal, write gratitude letters, or use visual reminders (like sticky notes on your mirror).

Practice Mindfulness

Practicing mindfulness can help relieve stress, regulate emotions, and remain nonjudgmental. Mindfulness involves simply observing, not judging, our thoughts. Imagine your thoughts are like cars passing at a busy intersection. When cars arrive at the intersection, sometimes they just pass by and sometimes they stop for a while. If we get stuck on a negative thought, we can simply engage in deep breathing while focusing on the breath, not the thought. In time, just like the cars, our thoughts pass by.

Okay, Warriors, it’s your turn: What negative thoughts have you been struggling with? How have negative thinking patterns impacted your life? What have you done to overcome your inner critic?

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What Is Depression?

Depression is as prevalent as the common cold. The Anxiety and Depression Association of America estimates that 264 million people around the world live with depression. Most people experience sadness, loneliness, or fear. These feelings are a normal part of life. However, depression involves clinical levels of low mood that impacts a persona’s ability to function within their daily lives.

Clinical depression is characterized by the following symptoms: persistent depressed mood, diminished pleasure or interest in activities, decrease or increase of appetite, insomnia or hypersomnia, psychomotor agitation or slowing, fatigue or loss of energy, feelings of worthlessness or guilt, diminished ability to focus or think, indecisiveness, and recurrent thoughts of death or recurrent suicidal ideation. The Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5)’s diagnostic criteria states that 5 or more of the above symptoms must be present within the same 2 week period.

How Is Depression Different From Sadness?

Most people experience intense sadness or grief. These feelings can impact a person’s ability to function, and they can also exist for at least 2 weeks. However, when we experience something difficult, sadness and grief are natural reactions. Sadness and grief share some characteristics with depression, but they are temporary and typically fade with time. Usually, sadness or grief involve moments of relief and have no significant impact in thought processes or behaviors.

Sadness is simply one symptom of depression. The DSM-5 indicates, “Responses to a significant loss (e.g. bereavement, financial ruin, losses from a natural disaster, a serious medical illness or disability) may include the feelings of intense sadness, rumination about the loss, insomnia, poor appetite, and weight loss noted in Criterion A, which may resemble a depressive episode. Although such symptoms may be understandable or considered appropriate to the loss, the presence of a major depressive episode in addition to the normal response to a significant loss should also be carefully considered.”

Who Is At Risk For Depression?

Mental illness does not discriminate. Anyone can experience symptoms of depression at some point in their lives. However, there are some factors that put others at more risk of depression than others. Biochemistry is a well-known factor in determining whether or not someone will experience depression. Individuals with depression often experience a deficit in certain neurotransmitters in the brain. This explains the effectiveness of medications that help to balance chemicals in the brain.

Although it is commonly believed that depression is the result of a chemical imbalance, the condition is much more complex. Genetics can also play a role, meaning that individuals with a family history of depression are more likely to experience depression. Research shows that there is also a connection between personality and depression. Studies show that difficulty coping with stress, limited engagement in community and environment, and limited insight may increase risk of depression. Environmental factors, including exposure to community violence, traumatic experiences, or limited access to resources, can also be predictors of depression.

When Should Someone Get Help?

Sometimes the line between between depression and sadness is clear, but sometimes it is not. For example, you may feel nervous while giving a presentation, but that doesn’t necessarily indicate a mental health disorder. However, becoming so overwhelmed with nervousness that you cannot follow through with the presentation may indicate a need for help.

If symptoms interfere with your ability to function within your daily life, it may be time to seek help. Challenges maintaining relationships, engaging in social settings, or performing in work and school can indicate a mental health disorder. Mental health disorders can also be responsible for changes in personality, energy level, and mood. Typically, symptoms that last 2 weeks or longer should be evaluated by a professional to determine the appropriate care. However, these are not the only situations during which to seek help. Anyone can get help at any time. If you feel the desire for therapeutic support, explore it regardless of how your situation compares to others!

How Is Depression Treated?

There are many types of treatments for depression. Just as depression looks different for everyone, depression treatments may have different effects for each individual. The most effective treatment method for depression is a combination of psychotherapy and medication. Some common forms of psychotherapy that are effective in treating depression include cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), or psychodynamic therapy. One might also seek support groups, group therapies, or community engagement programs for added support.

Research shows that the relationship between the clinician and client is the most effective tool in treating mental health disorders. That being said, it is important to have an open mind and to remember that effective therapy requires the ability to trust the clinician. If you seek support and find limited connection with the clinician, don’t be afraid to explore other options. Read about alternative treatments here!

How Can Someone Find Help?

Especially during times of high need, finding help can unfortunately require time and patience. Psychology Today has a great Find a Therapist tool, where you can limit search based on insurance, areas of practice, or location. Most insurance plans also have a website where you may consult your provider directory. This is a good way to ensure that a clinician accepts your insurance. It is a good idea to look more closely at your insurance plan to determine if your plan limits the amount of sessions you can attend.

To find help, it can be helpful to ask someone your trust. A referral from a friend, colleague, or medical professional is a good way to find a clinician who may be a good fit for you. Additionally, online resources, such as Anxiety and Depression Association of America, are a helpful way to navigate the mental healthcare system. It can also be a good resource to learn more about types of depression treatments to determine the modality that may be most helpful. Make sure you check out this page with information on support groups and additional resources for navigating the mental health system during a pandemic!