I can't fight this feeling anymore. I've forgotten what I started fighting for.

And if I have to crawl upon the floor, come crashing through your door. Baby, I can't fight this feeling anymore.

Sorry I'm not sorry for getting this song stuck in your head.  But since we learned so much about identifying and owning our feelings last week, today we are going to jump right back in and feel some more emotions. GET EXCITED.

If I could name one mental illness I have learned most about through clinical experiences at the hospital, it would hands down be bipolar disorder. You can only read about bipolar characteristics so much in books, but witnessing a manic or depressive episode and the swings between in person is on an entirely different level. As I started leading groups and realized how chaotic a room full of people experiencing manic episodes can truly be, I decided to educate myself on what to do!

So the overall goal of treatment for bipolar disorder and really for anybody is to maintain a baseline of moods and emotions. This obviously is incredibly difficult for anybody with a diagnosis of bipolar disorder. So what can we realistically do to combat or alleviate these mood swings?

Self awareness, my friends, seems to be the key to everything. After hearing the many stories of my patients with mood regulation issues, each individual with bipolar disorder is unique. Their manic and depressive episodes can look quite different and display unique symptoms. So, if anything is possible during my limited time with my patients, it is to encourage them to develop a better understanding of how their moods change and what that looks like. 

For example, when during the day am I most likely to feel depressed or sad? What am I doing or who am I around when I happen to feel alone or lonely? Am I alert enough in the morning to get out of bed or go to work or take care of my kids? Often times, even I am unaware of my mood changes throughout the day. But understanding what factors may affect our moods can be incredibly helpful in regulating them.

So here is my super cool helpful mood chart. You write down your mood throughout the day, potentially adding in what you were doing, where you were, or what may have caused a mood change, in order to promote greater awareness. And once you fill it out, I would encourage the individual to find commonalities such as, "Oh, I seem to have a tendency to feel depressed in the evening when I am with my significant other," and from there behavioral changes can be made in order to alleviate the negative affects. For example in this situation that mean working in some alone time in the evening in order to let off steam if there are issues in the relationship causing added stress.

So there you have it, mood charting! TA-DAH! I would definitely suggest this for more people than just those with bipolar disorder. As I said, even I am sometimes unaware of my mood changes throughout the day. This could be helpful with a person struggling with a multitude of mental health issues, such as depression, anxiety, PTSD, etc. 

I Just Have a Lot of Feelings...

Ever feel like you just have too many feelings? Like you just wanna curl up in bed and eat 7 bowls of Reese's Puffs?

I know, I know. It happens to the best of us.

So often as humans we let our emotions take hold of us. We sometimes let one small issue get in the way of a good day and sometimes even treat people like crap because of it! But before we tackle how to lessen the negative effects of these feelings, we have to learn how to label them and know why the hell we are so freaked out in the first place!

A common technique used in therapy involves encouraging the client to use "I feel" statements. Instead of the oh so common habit of saying "I feel like....," clients are forced to choose a particular adjective, or feeling word to describe what they are currently experiencing. This is incredibly helpful when attempting to create a greater understanding and awareness of our own emotions and what kinds of experiences cause negative emotional reactions.

And HOORAYYY, this goes back to the super fun and abstract idea of mindfulness. How can we learn to be more aware of the present moment and be accepting of ourselves and our feelings? By accepting them, labeling them, and taking control of them! Using feeling words is usually really difficult to get into the habit of using so in the past I have given copies of the "Feeling Wheel" to my clients who struggle with identifying their feelings.

So DO IT, try to have a hang out session with a friend withOUT saying "I feel like..." and instead try using "I feel" statements. I promise it's a lot harder than it sounds, but over time you will create a greater understanding and acceptance of your own feelings. It's okay to be crazy emotional sometimes. In fact, last night I was frustrated with a friend of mine so I stayed at home by myself, ate peanut butter, and watched a Mary Kate and Ashley Olsen movie. We all have those days, I promise. But a resilient person shows their strengths in their ability to continue persevering despite setbacks and continues maintaining hope for the future.

The Life of a Guilt Stricken Mental Health Counselor

The other day one of my patients at the hospital compared been given a mental health diagnosis to developing a criminal record - it follows you forever.

Do I agree with this? WELL YES, I do. I believe mental illness is real, has physiological effects, and requires appropriate treatment. But it doesn't change the fact that I  am incredibly careful to choose the appropriate condition so as to not mislabel the problem.

Unfortunately because of health insurance, each patient who is admitted to the behavioral health center MUST be given a mental health diagnosis of some sort. So naturally when I open a patient's file and see "OCD, generalized anxiety disorder, major depressive disorder, psychosis NOS, and hoarding disorder," I'm like "yup, just another day at work."

.....But then I'm there, ready to break the computer.

Ok, so that was definitely an exaggeration. I've never seen anyone with that many diagnoses. Don't get me wrong, the majority of these particular patients have serious mental health issues which are rightfully identified, yet I take diagnosis quite seriously. Many patients of mine have expressed frustration regarding how one professional will say they have one condition, and another will diagnose something entirely different. Once again, many people have distinct mental illnesses which demands appropriate treatment. However, mislabeling mental illness can have a multitude of negative effects on the individual, including self fulfilling prophecies!

So in light of all this negativity I've been experiencing, I think it's important to keep in mind why diagnoses are useful and important, despite some of their negative implications.

1) Communication between professionals: A mental health diagnosis is a very short way of explaining a wide variety of symptoms experienced. For this reason, diagnoses are extremely useful when one professional is consulting with a new professional working with the individual. Diagnoses provide a short and sweet way of providing a greater understanding of the client.

2) Ease of access to treatment interventions: Mental health diagnoses often allow individuals to receive a variety of potential treatment strategies though insurance at a discounted price or even free of charge! MO' MONEY, MO' PROBLEMS.

3) Externalizing the issue: Diagnoses also serve as a therapeutic technique in externalizing an individuals struggles. An example would be saying "It's not me, its the bipolar disorder." So often people experiencing mental health issues internalize their condition and may somehow think they are incomplete or screwed up. Diagnosis is useful way to externalize the problem and allow the client to take control over their condition through treatment.

So there you have it! Diagnoses aren't all that bad! I'll agree, it isn't perfect...but for now all I can do is be sure to continue taking diagnoses seriously and keep my clients' best interests in mind.

"I hope you fail."

So today one of my patients at the hospital walked up to me as I was minding my own business, looked me in the eyes and said, "I HOPE YOU FAIL," in regards to the fact that I am a student intern.

It's hard to explain what I was feeling in that moment. Half of me kind of wanted to giggle because it was really random and about 6 confused nurses and techs listened to her public declaration. The other half of me was slightly insulted.

Being a counselor takes tough skin. Hell, being a human being takes tough skin. It's easy to let occurrences like this effect our mood and behaviors for the rest of the day. Sad times. BUT there are ways to lesson the negative consequences of things not going our way, and it involves the way we think and perceive things that happen to us.

This super fun thing called automatic thoughts are essentially all of the thoughts that pop into our minds in reaction to life's daily situations. Some automatic thoughts are more harmful than others and as difficult as it may sound, it is possible to change these thoughts in an attempt to become for positive! Ugh, I know, positivity again. So let's take my failure situation. Here are some of the possible negative automatic thoughts that could've popped into my head in the moment following that charming interaction:

1) My patients don't like me, I must not be relatable or approachable enough.

2) I must have screwed something up to cause her to say that, I AM pretty inexperienced in this field anyway.

3) What a jerk, forget her. She wouldn't know brilliance and beauty if it hit her in the face!

This are pretty drastic and yes, they would be decently harmful for my well being. The goal is when we think this harmful automatic thoughts, we stop ourselves, and try to think about or perceive the situation from a fresh perspective. Try to understand the situation of the other person. Do I really want four words to ruin my day? So here are ways I can "reframe," or think about these particular statements in a new light that is more beneficial to my well being.

1) This patient isn't too crazy about me right now, but it's not my fault. She is upset because her social worker is in a meeting and I happened to be in the wrong place at the wrong time!

2) It's not my fault, she is trapped in a hospital and needs a way to release her frustrations. This is teaching me how to remain more calm in these situations.

3) I'm not gonna let this bother me. I think I'm pretty cool but I can't expect everyone to love me because that's not possible!

Easy peasy lemon squeezy, right? LOL yeah I know, it's not easy to change your thoughts. But take it one step at a time. First try to catch yourself when you are thinking negative and harmful automatic thoughts. Maybe jot it down in a journal, and reflect on how you can think about the situation in a new way. Just like with any new habit, practice makes perfect! 

How to Relate to the Young Folk

Ok, so I know I'm only 23 years old but sometimes I forget what it was like to be young and pubescent.

I doubt I ever said this to my parents (because yes, I was a "goody two shoes" or whatever you want to call it), but I distinctly remember thinking these sort of snotty comments.

I'm lucky that I'm a bit younger than my coworkers at the hospital because somehow that allows the teens to be more open to trust me. I don't really understand this concept because I was that kid who loved hangout out with the adults but once again, I wasn't an entirely "normal" child. Moral of the story - it isn't too difficult for me to connect with the teens, but sometimes I need some extra guidance! Here are some tips I've learned to be better prepared to relate to my adolescent patients:

1) Give Them a Sense of Control - I know this sounds like a recipe for disaster but you don't have to give them ALL the control, just a SENSE of control. Realistically teens don't have much freedom or control over their lives...depending on the parenting style of course. But it's common for adolescents to just want to do whatever they want and they typically struggle with considering potential consequences beforehand. And we all know that leaving these teens to their own devices would be utter chaos. However when I work with my teens, although they are Baker Acted and required to be in the hospital, I do my best to give them some leeway or choices they can make regarding their treatment. For example, I usually bring two different activities to group and give the teens a choice between the two. Between you and me, I realistically don't give them much control but a little goes a long way!

2) Make Sure They are Well Informed - This holds true for any client, minor or adult, however I believe it is particularly important for teens. Providing information is another action that provides them with a sense of control. Many of my teens were brought against their will and weren't even told beforehand what would happen. Make sure your teens know why they are receiving treatment, what sorts of sessions and activities they will have to participate in, what progress may or may not look like, allow them to ask questions, etc. In general, information gathering helps reduce anxiety or fear of the unknown in any patient.

3) Get on Their Level - This one is my all time favorite and not to toot my own horn, but I'm wonderful at it. My key way to get a teen to open up to me is to make connections that make sense to them. If I need to talk about boy bands, super heroes, punk rock music, rap music, young adult novels, or Disney, I will do it! Lucky for me, I have a lot of similar interests of 15 year olds, which gives me a clear advantage. Teens love to talk about things that they like and if you're able to hone in on that, you're golden. Plus they will see you as "cool," which makes me feel pretty good about myself.

4) Establish Authority - Ok fine, this is the one I kind of suck at. I like to be well liked and sometimes that holds me back from laying down the law when necessary. Basically it takes a firm authority who teens see as slightly intimidating but can also be chill and approachable at the appropriate times. I still haven't figured out how to be that person but I'll let you know once I get a clue.

5) Be Real! - This one is the easiest! People can tell when you are being disingenuous. With teens, it's all about maintaining an appropriate level of professionalism while also not taking yourself too seriously. Because if you get too stuffy they will just want to tell you to take a chill pill like Lizzie McGuire.

Here's a super fun prezi I had to create with these tips for class. I had too much fun searching for the perfect pictures so enjoy!

http://prezi.com/gydrqubnzntm/?utm_campaign=share&utm_medium=copy 

This Is For All You Sleepy Puppies Out There

Oh, hello. This is me today.

Ever have one of those days where multiple people just look at you and say, "OH, you look so tired"? Mmmhmm, that was me today. And I'm like, "Thanks for oh so delicately pointing out the obvious." Today I yawned approximately 27 times while I was in my office between seeing patients. And I realize that this is semi normal, but what happens when we get into a cycle of being constantly exhausted, worn out, and run down? If I don't take care of myself, I won't be able to appropriately help others. Whether it be in my clinical experience or in my personal life. So today we are talking abouttttttttt.....you guessed it, COPING SKILLS. There are ways we can work time into day that involves taking care of ourselves and releasing negative energy or whatever will help to refresh your mind and body.

Everybody seems to have different ways to cope that work for them, but here are a couple of my go-to options. These are just some suggestions that can be tweaked to your liking, everyone is different!:

1) Running - Ok before you shoot me down, I understand that not everybody enjoys running. I love running. But it's important to take note that I don't love running because I feel like I'm dying. I love running because I get fresh air, feel the wind hitting my face, block out the world by listening to music, and focus my energy on releasing any negative feelings or emotions. That can be done by almost any form of physical exertion. Simply going outside and taking the time to acknowledge and appreciate the world around me does WONDERS for my well being.

2) Yoga/meditation - Yeah yeah, I know this is another one that is an acquired taste. I once had a patient tell me "I don't do none of that hippy dippy stuff" in response to a comment about yoga and meditation. So I get it, it's not for everyone. But it's worth trying! Meditation and deep breathing has been proven to have a variety of physical and mental health benefits.

3) Spending time with others - This is kind of a no brainer but how easy is it for us to become so wrapped up in school or work that we find ourselves neglecting our relationships! Every now and then I just need to talk to my friends and eat chocolate and vent and have a dance party. And so do you.

4) Writing - Now this one is my go to suggestion for my fellow introverted patients. Writing is an awesome way to expressed your feelings and emotions without feeling rushed and intimidated about saying it out loud and to somebody's face. Who does that anyway. For example, writing a letter to someone who has hurt you...or you have hurt in the past. Except don't actually give it to the person unless it's appropriate because you might end up coming back to beat me up when that doesn't go over well with the other person. Daily journaling is another great option!

5) Music - This one is the big winner. Everyone seems to love the idea of music as a coping mechanism. Music has a way of making us feel understood and not alone. In fact, nothing feels better to me than finding a song that perfectly portrays how I feel about a particular experience or person. Something I learned from the music therapists at the hospital is how to use music for mood changing. If you are feeling depressed, start out by listening to sad song. But then slowly make the progression of songs you choose less and less sad until you are able to lift your spirits even just a little bit. I'm all about making playlists on Spotify so that idea is perfect for me.

So as adorable as those sleepy puppies and kitties are, don't fall into a rut of chronic exhaustion and neglect to take care of yourself! In fact, I suggest you go adopt a sleepy puppy of your own, but that's just me.

WHOS READY TO GET POSITIVE.

WELCOME TO THE POSITIVITY PARTY. <3.

It's okay if you feel like April Ludgate. You're invited to the party as well.

Being negative is fun sometimes, I get it. Misery loves company. Seriously, I'll be first to admit that I LOVE sipping on wine and complaining to my best friends about anything and everything from school, to men, to being a poor graduate student. But I also cannot stress enough the power of positivity in actually achieving successes in our daily lives. If you envision yourself succeeding and believe that you have the necessary skills, often times you will perform better than if you decided you were a failure or mediocre person. So what are some positive psychology interventions that I like to use/hope to use when I'm actually an experienced counselor? SO glad you asked.

DISCLAIMER: Positive psychology interventions aren't going to work on everyone. For example, someone who is dealing with clinical depression may not find it feasible to engage in these positive thinking interventions. It's incredibly important that the client display openness and readiness to engage in interventions that will be most effective considering their contextual background and experiences.

1) Three good things in life - Oh, hey! This is something I actually do in my own life. So believe it, I do practice what I preach. This intervention involves writing down 3 good or positive things that happened each day. Currently, I journal everyday something good that happened each day and something that I am positive about in my future. And my list is attached to my bathroom mirror so I'm forced to look at it when I wash my hands, brush my teeth, etc. And I can honestly say that it makes a difference. This causes me to be intentional in acknowledging the good things that happen in addition to instilling hope and a vision for the future. Be to be real, it was really difficult when I first started doing it. But now? I find myself thinking throughout the day "Oh! I can write this on my positivity list tonight!"

2) Best possible selves - As a self diagnosed over thinker, I have a tendency to spend way too much time thinking about all the bad things that could happen. But what if we focused on what our lives would be like if we succeeded in our endeavors? In this technique, you are encouraged to write or discuss what your life would look like if things happened as favorably as possible. How would you feel? How would you spend your time? Who would you surround yourself with? In short, envisioning success makes it seem more feasible, thus encouraging and motivating the individual to place effort and focus on their vision for the future.

3) Signature strengths - Now this intervention I actively do with my adolescents quite often. I give my teens paper and tell them to write down 5 positive personality traits they have. Some really struggle coming up with 5, others don't. This presents an opportunity to build up the self esteem of the individual by assisting them in coming up with 5 even though there are many more! The teens also end up contributing positive traits for their peers, which promotes group unity and feelings of belonging within the group. This intervention also presents an opportunity to discuss how we get ideas about whether or not we are smart, funny, loyal, outgoing, etc.

POSITIVITY PARTY IS A SUCCESS. Here's your party favor - try making mental note and journaling something positive or good that happens each day. And go back and read them when you are feeling down! If that doesn't help even just a little, maybe you actually ARE April Ludgate....which actually isn't terrible because I love her but you get the point.

http://www.psych-it.com.au/Psychlopedia/article.asp?id=406