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Dealing with Depression: 7 habits of highly corrective people.

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP May 8, 2010

written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I have had depression (off and on) for as long as I can remember but have recently started treatment for it (three years now). The treatment is really helping and I know I am making progress because of it. My depression has manifested itself as fatigue, low-motivation, low self-esteem and a disinterest in things outside the house. I may also be a perfectionist, but I haven’t really looked at that one yet. I have an undergraduate degree and graduated with honors. I just feel as thought my connection to all things work-related is simply missing. I know that this is due to my depression. And while I feel myself coming out of my depression, I also feel frustrated that my interest in things has not followed. I know I need to take baby steps in order to “get back into the world” but do you have any suggestions as to what this looks like? I have considered speaking with a career counselor but I am a bit nervous that it will leave me feeling totally overwhelmed and ready to retreat back into my shell again. (The last time I met with a career counselor I ended up crying uncontrollably in her office). I feel sad for the time I have wasted with this affliction, disgruntled about how depression has stripped me of my ability to “tackle” the work world and unsure of how to proceed in this new tentative period of healing. Thank You.

“If I had not been already been meditating, I would certainly have had to start. I’ve treated my own depression for many years with exercise and meditation, and I’ve found that to be a tremendous help. ” –Judy Collins

I am sorry your depression is so weighty, but admire the strength and resilience you are showing by combating it in therapy. Depression that has a centrifugal nature to it needs to be addressed at many levels. The fact that you are in individual therapy is excellent. Here are 7 other features you may want to consider:

When a depression is so pervasive we need an equally robust offense on the thought process. What I am recommending is a daily dose of strategies from positive psychology specifically designed to shift your thoughts and feelings toward a more positive framework. This isn’t a simplistic “think-happy-thoughts” approach, but rather a focused effort at cognitive restructuring of your thought process. Here is a link to a series of articles looking at the direct application of techniques from the sub-field of positive psychology.
Think of it as an ongoing process as we do with physical hygiene. You may have taken a terrific shower on Monday, but by Wednesday you will need another. It is the same with positive mental hygiene. We need to generate a critical mass of positive thoughts on a regular basis. One of these articles will highlight the fact that it takes three positive thoughts to overcome every negative one, thus the need for daily strategies.
I did not read that you are taking an antidepressant. I would definitely consider this if you haven’t as the research demonstrates quite clearly that the strongest combination is that of therapy and an antidepressant in the approach to coping with depression. With the new medicines being introduced there may be one that suits you.
If you do not want to take an antidepressant there are several homeopathic or herbal alternatives that may be helpful. For these you will want to consult a registered dietitian. Many of the better health food stores have either access to a RD or make available such information. There is some interesting research by the federal Department of Health and Human Services on a supplement known as SAM-E. But please be sure to consult someone knowledgeable in these matters. There may be contraindications if you are taking antidepressants already (or other kinds of medicine) or have certain medical conditions.
You may want to consider group therapy as a means of supplementing your individual therapy. Group therapy is different in that there is an interactive feature that can’t be duplicated in individual therapy, and it often provides a vehicle for support as you begin to make changes in your life. Your therapist may know someone he or she can refer you to in your area.
Meditate. Learning how to self-soothe your emotional turmoil is perhaps the most important skill you can learn. There are dozens of meditation practices and you may have to experiment with several before you find one that you like. Here is a link on meditation to give you a starting point.
Aerobic exercise. The value of exercise in combating depression is very well documented and this is particularly true for any exercise involving aerobic displacement. If you are okay to do this medically, exercise in any form will help.
Review your diet. No one gets depressed, puts the back of their hand to their head and says: “ I am so depressed, I need to have a piece of lettuce.” Our emotional life often changes our craving for various foods, which may not have the best impact on our biochemistry. Again, I would check in with a registered dietitian to be certain your diet is supporting your mental well-being.

Even if you can’t implement all of these things, pick one that isn’t part of your approach right now and begin there. Depression is a formidable foe, but developing these habits for dealing with the symptoms can make the difference.

Wishing you patience and peace,
Dr. Dan

May 8, 2010 0 comments

How Do I Show My Boyfriend He Has Paranoid Personality Disorder?

by Kristina Randle, Ph.D., LCSW June 22, 2009

written by Kristina Randle, Ph.D., LCSW

So, after trying to figure out what has been up with my boyfriend in the last couple of years I think I may have found an answer; he may have PPD – Paranoid Personality Disorder. Problem is, how do I show him this without getting blown up at or called crazy? (The blame usually gets turned around to me because it’s never their fault). We have known each other for 11 years and met online that long ago. He has never told me his last name, or the schools he went to or his parents names or the majority of his friends names (I only know a couple whom he doesn’t talk to anymore), I only found out last year what city he lives in and have only ever received one picture of him two years ago. He also ‘does not feel ready’ to come out and see me. I found a page on this disorder and it’s him in a nutshell. Even though I am emotionally exhausted and getting to the end of my rope with him, I at least want to point out an issue that will probably mess up his other encounters too if not treated. He also wants to go as in leave me, yet does not go and complains about the relationship a bunch. Here is a list off a site of some symptoms;

“People with PPD are always on guard, believing that others are constantly trying to demean, harm, or threaten them. These generally unfounded beliefs, as well as their habits of blame and distrust, might interfere with their ability to form close relationships. People with this disorder:

* Doubt the commitment, loyalty, or trustworthiness of others, believing others are using or deceiving them
* Are reluctant to confide in others or reveal personal information due to a fear that the information will be used against them
* Are unforgiving and hold grudges
* Are hypersensitive and take criticism poorly
* Read hidden meanings in the innocent remarks or casual looks of others
* Perceive attacks on their character that are not apparent to others; they generally react with anger and are quick to retaliate
* Have recurrent suspicions, without reason, that their spouses or lovers are being unfaithful
* Are generally cold and distant in their relationships with others, and might become controlling and jealous
* Cannot see their role in problems or conflicts, believing they are always right
* Have difficulty relaxing
* Are hostile, stubborn, and argumentative

His family has also been split up for over a year now, his dad having cheated on mom 3 times. The thing is, is that even when we were young and that was happening in his household, he never behaved like this to me. Could the rush of testosterone during puberty do it? It has been shown to promote anti social behavior and lack of empathy towards others. Who knows…

Unfortunately, there is no feasible way to know if your boyfriend has paranoid personality disorder (PDD). You’ve included a list of the symptoms as well as a description of the disorder but nothing you’ve written leads me to believe that he has PDD. This is not to say that he does not have it but I can’t tell if he does from your letter.

I also want to add that I find your relationship to be somewhat unusual. You wrote that you’ve known each other for 11 years but you don’t know his last name, the schools he attended, and other basic personal information. You practically know nothing about him. Additionally, it’s not clear in your letter but it seems as though you’ve never met in person. I’m not sure I understand how you could carry on this relationship for so long with a virtual stranger.

I would caution anyone from dating an individual who would withhold basic information about themselves. When it comes to the Internet, I can understand not sharing personal information in the first few days of interacting online. You’d want to get to know someone a little better before you’d share personal information with them. That I understand and I think it’s smart. According to your letter, however, you’ve known this individual for 11 years and you know very little about him. It’s odd that he has not provided you basic personal information but what’s even more peculiar is that you’ve stayed in this relationship for 11 years with a person you barely know and have never met.

I’d suggest before you continue this relationship you find out who this person is. What is his last name? Why will he not share basic information about himself with you after 11 years? It also would have been interesting to know how often you and he communicated or if the two of you have ever spoken on the phone. Do you know where he lives? Perhaps you’re dating a convicted felon who is contacting you from prison. Perhaps not but it is a possibility, unless you have evidence otherwise.

If he’s not willing to reveal basic information about himself at this point then it’s reasonable to conclude he never will. If that’s the case I think you need to reevaluate your relationship with this person and make it a point to only involve yourself with individuals willing to share more than just their first name.

June 22, 2009 0 comments

Did I marry the wrong person?

by Dr. Marie Hartwell-Walker June 14, 2009

written by Dr. Marie Hartwell-Walker

My wife and I have known each other for 4 1/2 years now, and have been married for 1 year. I would like to know if you feel that I am in a healthy marriage with the right person. If not, I would like any suggestions in order to rectify the situation.

When single, I (as anyone does) always had the image/persona of the type of woman that I wanted to marry. My biggest criterion was that she had to be chaste and carry herself like a “lady”. It may seem judgmental, but I always had the idea that I would separate how I treated a “fun” woman and one to be taken seriously, even though I was promiscuous myself at the time. Well, during our dating period, we started off really strong and enjoyed each other’s company exceedingly. Furthermore, she had the appearance and conversation of a chaste woman, so I sort of assumed that she was. I pretty much cut off all ties to the woman that I was dating at the time (the other woman and I were at the end of a non-committal relationship) to concentrate on the woman who would become my wife. However, during the time that we were dating, a series of events occurred that has me thinking to this day if I am with the right person. The first was that we started sleeping together after knowing each other for about 2 months (a little too soon for a woman that I usually consider “serious” material) and not even being in a committed relationship at the time (I had a double standard at the time). The second occurrence was when I found out (she initiated the confession) 8 months after we met (and 4 after we started dating) that she actually was in a relationship when we met. This means that she was cheating on her then-boyfriend when we slept together. To top it off, she was having a physical (but not sexual) relationship with another guy at the same time. Third was when I found out (by this time I started snooping due to my mistrust of her) that she lied to me about conversing with a friend. To explain, she had a married male friend that tried to take things further with her, but she denied him and told me that she cut off all contact with him. Well, he came back and apologized to her. They resumed contact, but she acted to me as if they were still not talking. Fourth was when I saw a flirty email (again, through snooping) that she replied to a guy on a social networking site. This was right after we got engaged and 3 years after we began dating! I considered this an act of infidelity, but she did not. I feel that it’s more understandable (but still unacceptable) to practice infidelity when first becoming committed to someone, but not after 3 years.

In spite of all of these caution flags, I went on with the engagement and marriage. In hindsight, I feel that the fact that she became pregnant when we were dating played a larger role than it should in me wanting to marry her. I just could not imagine one of her boyfriends doing something to my child, like I see so many times in the news. I haven’t found anything incriminating in 19 months, so I feel that she just may have changed. But I also feel that any day now I will come home and find another man in our house. I know that I have a past just like her, but the fact that much of this stuff has occurred while we supposedly committed really rubs me the wrong way. I just sometimes have the feeling that I could have done better if I had been more patient in choosing my partner. I don’t really think that she understands why I don’t trust her. I don’t feel that our values are in line, and I feel that I will need to have a large hand in instilling those chaste and honesty principles in our daughters. Like I’ve said, it been 19 months since the latest known occurrence, but I don’t trust her or respect her like a husband should with his wife. It’s almost like sleeping with an open eye all the time, and that’s how I’ve sort of treated my heart with her.
Thanks for reading.

I don’t know that you married the wrong person but your wife probably did. In spite of the fact that you both have a similar history, in spite of the fact that she didn’t get pregnant on her own, in spite of the fact that she has given you nothing to complain about for almost two years, you continue to snoop and accuse. If she has any self-esteem left, I wouldn’t be at all surprised if she gave up on you.

At your age, you are unlikely to find a woman who will meet your exacting specifications and who will tolerate your double standard. I think you must know that. So I have to wonder if you want to be married at all. Better that you should own that about yourself than to subject a woman who loves you to constant criticism and testing.

Of course, complicating things considerably is that you brought a child into the world. Although I sympathize with your concern about possible harm by someone in relationship with her mother, the current situation isn’t healthy for her either. The relationship you have with her mother isn’t a positive role model for marriage.

Because a child is involved, I do think it important for you to at least give counseling a try. I hope you will give your wife the respect she deserves and give your marriage a chance. With some serious self-examination, you may be able to deal with your issues of trust and commitment.

I wish you well.
Dr. Marie

June 14, 2009 0 comments

Why can’t she stop lying?

by Dr. Marie Hartwell-Walker May 5, 2009

written by Dr. Marie Hartwell-Walker

Hello,

I really, truly believe that I have a problem, but I have no one to talk to about it.

I lie; much more than I should. I am a 16 year old girl, and though I’d like to consider myself mature for my age, I make up these stupid lies, to the point where I have basically created a whole identity that isn’t even me anymore. I have always sort of charmed my way out of things with white lies, but I have NEVER lied about anything to this degree before now.

It started getting bad about a year ago. I was feeling pretty bad about myself, and I had grown distant from my friends. My parents were away, so I planned an elaborate trip to another city which is over 50 miles away– and I planned to go by myself. However, I ended up not going and chickening out, but I told my friends that I went anyways.

I proceeded to tell them that I had gotten hopelessly lost and didn’t have enough money for a taxi, when a stranger helped find me a ride to the station. This stranger was handsome (of course), but I described him in a way that made it sound realistic to them. I told them that he went to the art school there, and that although I was distrustful at first, that he seemed like a very genuine guy. His name was Andrew, and he was 20. This was all a lie of course.

As weeks went on, I would avoid my friends on weekends, and then when monday would come around, I would tell them that I was gone visiting this fictitious guy. All of my friends believed me, and I got used to weaving this fantasy person in my life. He wasn’t perfect, he had flaws too and we had problems. I told them we fought a lot because he thought I had a thing for his friend, random things like that. Every lie I told, although it sounds ridiculous written down, was very believable. I feel very bad about it afterwards, but I was very good at manipulating them to believe me even though they never actually met this person. Lying was becoming very natural. Most liars lose track of the lies they have told, but I never have.

Then I REALLY started to lie too much. I obtained a wrist injury, purely by accident– but I told my closest friend that “the guy I was seeing” grabbed me too hard. Now I am lying about physical abuse… What is wrong with me?! My lies are becoming dangerous, and I KNOW that, but I can’t seem to stop it.

Lying is an automatic response now, as if I truly believe in my lies– but I don’t! Basically, I really feel that this is all spiraling out of control. I don’t even know why I did this to begin with. It’s actually gotten to the point where it’s almost like he DOES exist to me. I automatically integrate this fictitious person in my life. I KNOW it’s not real, but it’s like I am starting to actually convince myself that he is. It’s getting out of proportion, and I can’t stop! It just… happens somehow. I feel like a horrible person, but I’ve been totally programmed to just LIE about it– but only about this double life.

I’m so frustrated with myself. I have taken AP psychology before, I’ve tried analyzing myself. I don’t feel like I have a lying disorder– it’s more like I have identity issues? I live in my dream fantasy world quite often, and now I’m starting to incorporate it too much into the real world in the form of lies.

I don’t know how to stop– I WANT to stop, but I don’t want to come clean about everything, because all that would do is make my friends think I’m insane. Maybe I am? I don’t know what to do!

I guess what I really need advice on, is the reason why I have created this double life? I feel like no one knows the real me anymore. This huge lie has become too much of my identity to other people.

Thank you for reading all of this.

And thank you for writing. It takes courage to face up to a situation like this. You answered your own question. You created this alternative life initially because you felt bad about yourself and you didn’t think your real life was very interesting. Being creative and intelligent, you made up an alternative life that seemed much, much more exciting. For awhile, it was also kind of exciting to see how much lying you could get away with. The energy that comes from playing with “danger” gave a little zing to your life.

The problem is that these things begin to take on a life of their own. What began as a way to help yourself has now turned into an even bigger problem. That’s where you find yourself now. If you tell your friends the truth, you risk losing them. If you don’t stop lying, you will feel worse and worse about yourself. So you avoid the issue as much as you can. But there’s a cost to putting off the truth. Yes, you don’t risk the friendships. But you also do feel worse and your self-esteem sinks even lower. Your system isn’t working any more.

Writing your email was your first step in making the situation better. It took courage to put all that information in one place. It took courage to be that honest. Writing was a small step but an important one because it shows that a part of you has the strength to make change.

The next step is to get some support for yourself. You’re probably going to need someone to be a sounding board as you figure out how to make things right. A counselor can offer you non-judgmental support and perhaps some practical advice. She or he can also help you remember all the positive parts of you that you may have forgotten because you are so distressed. Getting in touch with the positive will help rebuild your self-esteem and will give you the strength you need to get things back to normal.

Please take that next step. You’re worth it.

I wish you well.
Dr. Marie

May 5, 2009 0 comments

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