A Letter From A Therapist...

This is a time like no other. We are all facing uncharted territory and trying to stay afloat amidst a chaotic sea of doubt, fear, worry, panic and isolation. We are told to refrain from connection (person-to-person contact), which is so life-giving to so many. We can no longer walk trails or beaches, which provides an outlet for nature lovers and reprieve from the constant day-to-day stressors. We are not allowed to gather with family, friends, our churches. Many have lost their jobs. Kids are not allowed to go to school. There are shortages everywhere. The medical community continues to cry out for us to stay home, and many of them feel as though they are sinking.

We have never seen this before. We have never known this particular struggle. Many of us were completely blindsided; not because others knew this was coming, but because most of us never thought something like this would. As I sit here and write this, I am still trying to reconcile all that is going on.

Virus— Pandemic— No Cure— Shortages— Isolation— Loss— Grief

As a therapist I can tell you that no two days are alike for me either. That’s what grief does to you. Some days you have reached acceptance, and others you face denial or bargaining; others still, you are angry or depressed. Some days I can go about, and it almost appears as though nothing is out of sorts, nothing from the outside world can penetrate the bubble of safety I have created in my home. Other days I grieve deeply. For the loss of human life, the loss of financial security, the loss of physical/emotional safety, the loss of consistent meals for so many, families being separated, the loss of large events like graduations and weddings, the loss of plans, the loss of aspirations and dreams, the loss of freedoms we so often took for granted. I grieve for these losses so deeply and my heart aches as I pray for a cure; I pray for total healing and restoration. As I navigate through this with my clients, I can’t help but feel that things are different right now. Many of my sessions, like most others I assume, are about what we are experiencing. There is a loss for words, and silence has become more normal in sessions. But even in that silence I hold hope.

You see, the only thing bigger than fear is faith. And I have faith that we will pull through this. Not unscathed. Not unchanged. Not without exponential loss. Not without grief.

But we will pull through.

I am not only holding hope for my clients anymore, I am also holding it for myself, my family, my friends, my faith community, other clinicians… I feel like I often hold hope for everyone and anyone that needs me to. But I want you to know something, I am hurting too. I see you. I see the deep grievances you face, and it hurts me. I see the uncertainty as we meet through video sessions, and it pains me. I see the fear in your words through our correspondences and I worry for you.

I worry that I was not trained for this. I was not trained to walk you through a pandemic. I was not trained to know what to say, what to do, what to give you in this moment. And if I said I was, I would be lying. This is new to me too. Every day I am learning. Every day I am relying on my intuition and my knowledge to help me piece things together. Every day I remember why you might be feeling this way, why emotions might be magnified. And I ache for you. My heart breaks that you are facing triggers you haven’t in a long time. My heart breaks that anxiety is heightened and depression is magnified. My heart breaks that you have to face yet another tragedy, that you are walking through more trauma.

Please know, my heart breaks for you.

But I want to turn this around now, I want you to see all the things that I am seeing too. I want you to know my heart in this, because if we can’t be vulnerable now, I don’t know when we ever will be.

·         While I was not trained for this, I am here for you.

·         We are experiencing this trauma together, so like I always tell you, everyone’s trauma threshold and response is different. You can lean on me.

·         I will always hold hope for you.

·         You will once again find hope for yourself.

·         This will not last forever.

·         We will get through this.

·         I know you feel stuck, and that your emotions are heightened right now, but you do have amazing new coping skills that you can utilize.

·         Feelings are not facts, and you know how to remind yourself of truths.

·         Your progress is not derailed.

·         Regression is a normal state of progress. Read that again.

 When we face uncertainties, we can often become disoriented; feeling as though we are not truly certain of anything but our fear. But fear is a liar. We are not held captive by fear unless we allow it to hold us captive. We can choose to see things differently. It is not always an easy choice to make, but you do have the power to do it.

I want to remind you (or equip you) of some coping skills you can use. I think its great for all of us to have these in our toolboxes.

Deep Breathing:

Find a quiet place, sit comfortably, close your eyes. Take a deep breath in through your nose for 5, hold for 6, and exhale through your mouth for 7. Repeat 3xs.

Grounding:

5 things you can see

4 things you can touch

3 things you can hear

2 things you can smell

1 thing you can taste

Mindfulness:

I want you to find a safe and comfortable space and either sit or lay down (it can either be in a quiet room or with your favorite music playing softly in the background). I want you to visualize a place of complete serenity. I want you to picture all the different colors you see, the landscape or place you are in, what does it look like? What can you touch? What can you hear? Is anyone with you or are you alone? What can you smell? What can you taste? I want you to visualize yourself in this space. I want you to feel yourself completely free of worries, fears and doubts. I want you to take some deep breaths and tell yourself you are safe. You can stay in this place for however long you would like. When you are ready you can open your eyes.

Follow up activity: find a picture or create a picture that reminds you of this place and hang it somewhere you will see it often and be reminded that you can utilize mindfulness to reset and feel safe again.

Other effective coping skills:

·         Healthy sleep and eating

·         Journaling

·         Being creative

·         Connecting (phone/video/email/text) with people you love

·         Exercise (wear a mask outdoors or find fun stuff to do inside, dance parties are awesome!)

·         Read a good book/listen to music/watch your favorite movie/tv show

·         Practice self-care (a warm shower/bath, spa day at home, a cup of coffee with the fireplace on…this can be anything that is healthy for you and makes you feel good).

Above all what I hope this message conveyed to you, is that you are not alone. We are all in this together, and that there will always be people who care and want to hold hope for you. I would be lying if I said this was easy, and I wanted to share my heart today and let you know I am worried too. But what I also know is that worry is like a rocking chair, we go back and forth but we never get anywhere. Its okay to sit in the chair sometimes, because sometimes we just need to acknowledge our worries. But worrying can not add anything to your life, it just takes all the good things away. I needed you to know that I have been spending time in this chair too, and that it is normal. I do not want you to judge yourself right now (or ever really). I want you to acknowledge your feelings. To be present. To be mindful. I want you to practice your coping skills and self-care. I want you to reach out. But more than anything, I want you to be well. I want you to be safe. I want you to be thriving.

There is so much pain and heartache right now, but there is also so much hope and healing taking place. I see it all around me too. I see people connecting in ways they haven’t before, faith becoming stronger, communities pulling together while distanced. I see people doing the hard thing and staying home, staying away from those they love BECAUSE they love them. I see all the “essential” workers and that they continue to show up and be present for us all. While we might be distanced physically, I am not sure we have ever been closer emotionally.

To whomever needs to hear this right now, I want you to know you are loved, valued, treasured and cherished. Your life matters. You have a purpose greater than you know, and there are people who deeply care about you and your well-being.

Its okay to be tired. Its okay not to have a schedule. Its okay to eat ice cream for dinner (maybe not all the time 😉). Its okay to do nothing. Its okay to stay busy. Its okay to talk on the phone. Its okay to ignore a phone call. Right now, in this moment, I want you to give yourself permission to do a self-check-in and to write down everything you have been holding inside. Then drop your shoulders, breathe deeply and release the tension.

Remember this, it is always one day at a time, but sometimes we have to take it moment by moment too.

This is new. This is scary. But I see you. I hear you. I feel you. And we are in this together.

Lovingly,

Melani Samples

A Day in the Life of Anxiety: My Personal Experience, part 2.

I am fine.

Walking through the weeks as though they are days, I find myself battling to keep up. The time goes by without any remembrance of what has come or what has gone, and I pass through life as though it were a time-lapse video, the scenery changes but I remain the same.

Discouraged to the point that I feel as though nothing will ever change, this new me, the one I so despise, this is the real me; it has been all along. The smiles and the laughs continue, no one even notices or bothers to ask. I hide my pain so well, and then blame those around me for not taking the time to help me pick up the shattered remnants of what I once was.

You look at me and simply see a woman; one who appears so very well put together. You see the accomplishments and the triumphs…you see the friends that surround me and the ability to carry myself in a manner that would make others want to be like me based on the vibrancy I put out into the world.

Inside I am dying.

My heart is racing, my mind is pacing-it never slows down. My thoughts overwhelm me, and I wonder if I will drown In my sea of doubts, fears and distortions.

Insomnia ridden, sleep eludes me.

But I push on. I tell myself that I have made it this far, so I push harder. If no one has noticed yet, they never will. I continue through the winding road called life, knowing that there will be turns and bumps that will knock me down. But, I don’t focus on that. My motions appear robotic to me, but at least I keep moving. If I acknowledge this turmoil it becomes real, and real is not something I can handle.

I am the woman you see every day, never questioning my emotional state or mental process, you just assume that I am fine (after all, its what I have led you to believe). Those three words, they often lead to death. When I tell you, “I am fine,” I am anything but fine. I am to the point that death; physical, mental, emotional…they all seem more appealing than this hell that I am living.

People say, “Just pray harder…” “take a cold shower…” “its all in your mind.” Do you think, just for a moment, that if there would be a way to change the way I am feeling in this moment, that I would have done it already?

I am a prisoner of my own mind. The coherent me is held captive by these destructive thoughts that wash over me like a raging river with no intention of keeping me above the water. I am struggling to find a way out, but the shore is not in sight and the current is too strong. I have tried grasping the branches, I have tried swimming to the side, the only thing left to do is wait it out and pray for calmer waters ahead. Nothing could ever prepare you to deal with this, unless you have gone through it already. It feels like there is no way out when you are in the midst of it, so you just have to let it be.

I do not need you to save me, if you attempted to rescue me, you would just get pulled into chaos that you cannot understand. What I need is someone to be there, for someone to say, “this is just a nightmare and it will be over soon” Please do not tell me what to do, or what to try, or, “I know how hard this is for you.” Do you really? Have you gone through hell and back? Have you thought, every single day for as long as you can remember that TODAY is the day you will die? Not wanting to celebrate the good because something bad will inevitably happen. Paying attention to every hospital just in case…

Have you wished you were dead, and at the same time feared you were dying?

The next time you tell someone, “its all in your head,” remember this, one day it could be in yours too. Mental illness does not discriminate. It is not picky and it can choose you. The next time you say to someone, “you are not depressed, you are just sad. Stop focusing on the negative all the time,” or, “you just freak yourself out, you think too much. It isn’t that bad. Maybe you just need to stop being so stressed, that’s what is causing all of your anxiety.” I want you to go look in the mirror and I want you to say to yourself, “thank you Lord that I do not struggle with these silent killers. Thank you for my health; physical, mental and emotional. And please Lord, help me to keep my mouth shut when I do not know what I am talking about.”

When you struggle with mental illness, every SINGLE DAY can be a battle. Anxiety, Panic Disorder, OCD, Depression… did you know they often occur together? Imagine THAT, not just one, but all coming to get you at the same time. Engulfed by despair and hopelessness that nothing will ever change, panic ridden over intrusive thoughts that are not conducive to life, and filled with anxiety for fear of the future, you battle hard just to keep your head above the water.

You keep saying, “I am fine, I am fine, I am fine…” but really, you are slowly drowning in a sea of people that keep telling you useless things to “snap you out of it.” You are shouting in your head, “It won’t work… I have tried that before… it only makes it worse…” But they keep saying the same things over and over again. THIS is mental illness, this is something you cannot fully understand unless you have walked a day in these shoes.

So the next time I say, “I am fine,” please think about what that could really mean, not just for me, but for the response you may have toward me. The only stigma that exists is the one we allow to circulate, I am not in need of saving, just understanding. And even if you don’t understand, it is nice to have someone to sit with through the storm.

I am battling hard, I struggle every day. Please do not judge a book by its cover, a smile hides SO many things. But smiling is so much easier than admitting the truth.

If you have gone through this, talk to someone. There are others who have gone through it too. Reach out, do not let one more day pass where you are engulfed. For what its worth, you can keep treading water. You can keep your head up, even if barely above the surface, and while you don’t need to be saved, there are people who have life preservers to throw to you; lifelines that will allow you to get back in the boat and find new ways to cope. Your life matters, your story matters and there are people who will understand.

I know I do.

*special note:

Everyone experiences mental illness differently. When I was in the pit of despair I wrote this way often, writing helped get it out of my head and I found calm. I also talked to someone. I went to therapy and I processed what was going on. I learned about my triggers, and I learned about how certain things are connected. I learned tools and techniques to manage my anxiety. There are days that are still hard, things that happen and my natural response is panic. But in those moments I have learned that I AM in control. I have learned how to take my life back, and I believe that you can too.

Suicide: what we all need to know.

If you need to talk to someone right now, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to speak with someone that can help, or text HELLO to 741741.

Suicide is a difficult topic to discuss. It brings up all types of feelings. Those who struggle with suicidal thoughts and ideation often feel like the world would be a better place without them. They report feeling like a burden to others and that they have no value. Many report feeling guilty that they continue to feel the way they feel, and worry about bothering others. They feel like they have no value, like their life doesn’t matter and that nothing will ever get better. This is especially true for those struggling with long-term mental illness. The people who love those with these thoughts often struggle to understand why “they can’t just get better,” or believe that, “thinking about suicide is selfish…”

Those who struggle with thoughts of suicide or suicidal behaviors/attempts often feel self-loathing, they are plagued by negative thoughts and often truly feel like they have no purpose. The pain becomes unbearable. Death becomes and option when it is more enticing than living through the constant hell inside their minds.

It is important to remind them they are NOT a burden, they are NOT unloved, and they are NOT unworthy. That we will be there for them, no conditions.

We still have a long way to go, especially within the church and mental health, but it all begins with one person having an honest conversation. Mental illness is real, and there are situations (suicide included) that people are in need of specific types of care; Mental health professionals that are trained to help and connect people with the proper resources. It is time we open a conversation and learn the facts, saving lives starts with understanding.

Suicide is the 2nd leading cause of death among the youth (ages 10-34) in our nation. The United States ranks number 27 out of all the countries for completed suicides; This includes those countries where they must report assisted suicide in their numbers. It is currently the 10th leading cause of death in the US, and there are more than two times the amount of suicides (47,173) than homicides (19,510) recorded in the span of a year.  

Suicide does not discriminate. These thoughts can creep up on anyone, and no one is exempt. There are some common risk factors, that include, but are not limited to:

·         Previous suicide attempts

·         History of substance abuse

·         Physical disability or illness

·         Losing someone close to you by suicide

·         Exposure to bullying (including cyber-bullying)

·         Having a mental health condition/illness

·         Recent death of a family member or friend

·         Access to harmful means

·         Relationship problems

·          

It is important for us to pay attention, not only to those we love, but to all those around us. People who are suicidal often do not appear suicidal to others. Suicide doesn’t have a “face.” It can be all of us. There are some “typical” warning signs which can include the following:

·         Negative view of self

·         Hopelessness and helplessness

·         Isolation

·         Aggressiveness and irritability

·         Possessing lethal means

·         Feeling like a burden

·         Drastic mood change or change in behavior

·         Frequently talking about death

·         Self-harm

·         Engaging in “risky behaviors”

·         Making funeral arrangements

·         Substance abuse

·         Making suicide threats.

If you or someone you know is struggling, please know that there is hope and there is help. You are cared for, loved, valued and cherished. The world needs you. You are important. I know that right now, in the darkness, it is difficult to see the light, but I can promise that there will be someone to walk alongside you as you look to see it again.

If you need to talk to someone right now, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to speak with someone that can help, or text HELLO to 741741.

We can all help. We have to know the signs for suicide, we can reach out and stay involved with friends that we know struggle or suddenly withdraw, we need to be willing to have a conversation about it, we can be direct and ask the hard questions, and if you think someone is suicidal stay with them, listen to them and take them seriously. You can help them get help by connecting them with the crisis line, or if they are in imminent danger you can call 911. It is important to remember that you are not alone, your friend or loved one (or stranger that you are trying to help) is not alone. We all want the world to be different, we just have to be willing to be the change. It starts with us. Every life matters because we all have a purpose. You are needed. You are loved. You are important.

Statistics taken from:

https://www.nimh.nih.gov/health/statistics/suicide.shtml

Back to school: Child and Youth Mental Health

Back to school can be an extremely stressful time for all children, even more so for those who struggle with mental health. It can create and complicate anxiety, depression, phobias, and  more. Childhood mental health is crucial, and while we have made progress, we are far from “having it right.” So many of our youth today hear things like, “what do you have to be stressed about?” “Just suck it up and stop whining…” “its all in your head.” Reaching out for help isn’t even an option for many, because when they have made attempts, they have been immediately shut down. School counselors are over-crowded, often with hundreds of students to one counselor. Teachers are not properly trained, and parents are often ill-equipped; they don’t know where to turn for help or they think their child should have perfect days.

Our kids are faced with so many pressures. Social roles, grades, extra-curricular activities, home lives, siblings, friendships, and more. Yet they are often expected to never be tired (or act as if they are), to never have bad moods (because, I mean let’s face it, bad moods are unacceptable), and to always do their best. But what if their best is simply making it through the day? What if their genuine best was having that meltdown instead of retreating internally and feeling like they just want to die?

1 in 5 children/youth will or currently have a serious mental health diagnosis. Most lifetime cases begin by the age of 14. The sad part is, they typically go an average of 8 to 10 years without intervention or treatment.

We must do better.

Statistically speaking, 20% of our youth live with a mental health condition, 11% have mood disorders (like depression), 10% have a behavioral disorder, and 8% have anxiety disorders. In our youth, aged 10-24, suicide is the THIRD (3rd) leading cause of death, and 90% of those who died by suicide had an underlying mental illness.

We MUST do better.

Of course, there are warning signs or symptoms, including but not limited to:

Feeling sad or withdrawn (2 weeks+)

Sudden and overwhelming fear

Intense worry that gets in the way of daily activities

Drastic changes in behavior

Difficulty concentrating or staying still

Severe mood swings

If you notice any of these, or even a change in your child that is not normal for them or their character, talk to them. Even if you don’t know what to say, just being present and supportive is crucial to them. You can say things like:

I am here to listen.

Do you want to share with me?

What can I do to help right now?

You are not alone.

You can talk to their pediatrician or primary care provider who can give you referrals. You can seek help from a mental health professional/therapist. You can work with their school and you can look to connect with other families.

Childhood mental health is important and our kids and youth face more than many of us could ever understand. Many of them carry the burdens of their home, schools, peers and more on their shoulders. They are going through major life transitions and they do not know where to turn, or that there is help. Mental illness is treatable. Suicide is preventable. We can do better for our kids and teach them that emotions are normal, that its okay to struggle but its not okay to get stuck. We can teach them that they have a voice and they are important. That their struggles are real and matter. We can show them that we are there for them and help them through the darkness. Our kids and youth deserve to be heard and loved, regardless of what they might have going on emotionally. They deserve to have people in their corners who are supportive and understanding and will help them help themselves. They deserve to know that, even the darkness doesn’t last forever, because just as the sun sets every evening, it also rises every morning.

Child/Youth Anxiety scale:

https://depts.washington.edu/dbpeds/Screening%20Tools/ScaredChild-final.pdf

Child/Youth Depression Scale:

https://depts.washington.edu/dbpeds/Screening%20Tools/PHQ9.pdf

https://cesd-r.com/

*Statistics taken from:

https://www.nami.org/NAMI/media/NAMI-Media/Infographics/Children-MH-Facts-NAMI.pdf

Depression

I am fatigued; it appears as though I will be eternally drained of any substantial amount of energy. I feel like a shell of myself; either angry or sad, no true peace exists. It is almost as though there is a part of me looking at this person, the one that exists now, grieving the person that used to be. Waves of emotion hit me and wash over me leaving me debilitated. I yearn for connection but do not have the power to reach out. Others look at me with pity, they believe this is something I can just “snap out of,” if only they knew how draining this was. There are days I wish I didn’t exist at all; days I wish I were dead; it would be easier for everyone. No one would have to feel compelled to check on me, or to see if I am okay; no one would have to feel obligated. But I don’t even have the energy to follow through with that. When I do force myself to go out or socialize, I am immediately overwhelmed. I plaster a fake smile on my face, I mutter “fine” to just about everything, and all I can think about is how awful and broken I feel. I am no longer me, but this is what I have been reduced to. All hope is gone, I ache everywhere; I have no appetite and no desire to even follow through with my basic care and needs. I am drowning in a pool of my emotions and no one can save me.

Depression is one of the most common mental health disorders and effects 17.3 million adults in the U.S, as well as 2.3 million adolescents (www.nimh.nih.gov ). It typically involves depressed mood, appetite disturbance, sleep disturbance, loss of interest in typical activities, low energy, difficulty concentrating and questioning self-worth. Depression is also often linked to suicidal ideation and attempts. Not everyone experiences depression at the same magnitude and there are variations in diagnoses. The important thing to remember is that depression isolates you, and isolation leads to more severe symptoms. It is difficult to fight against it, to find the energy to do the things your brain is telling you and convincing you not to do. But reaching out, connecting, letting someone know you are not okay is the way to help, hope and healing. Everyone experiences sadness or depressed mood; grief and loss can often be at the root of depression. For women factors such as, hormones, recent pregnancy or birth and history of depression all play a key role in getting the type of help you need. Depression has a genetic component and there are several ways to receive help. If you feel that you are struggling with mild to moderate depression reach out to someone who can help. Contact a qualified therapist to give you the tools you need to take back your life. If you are struggling with severe symptoms and have thoughts of suicide with intent to follow through, please go to your nearest emergency room hospital or call 911. Please do not find a permanent solution to a temporary problem. While it may feel as though all hope is lost and there will never be help, you can find relief from your symptoms. There are people who truly care about you and want to help you write a story you will love. It might take some time, but you can get there.

If you feel that you might be struggling with depression, feel free to take the assessment below:

Adults:

https://screening.mentalhealthamerica.net/screening-tools/depression

Adolescents:

https://www.psycom.net/depression-test/

 Children:

https://www.mentalhealthamerica.net/conditions/childrens-depression-checklist

Always remember, there is hope and there is help. You can write a story you will love.